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PubMed1999

Preschoolers' characterizations of multiple family relationships during family doll play.

Investigated 4-year-olds' depictions of family relationships during a semistructured doll play task. Examined developmental and family correlates of these depictions, and their relative stability over a 1-month period. Forty-nine children related stories about happy, sad, mad, and worried families using dolls reflecting their own family configuration. For each story, coders recorded (a) proportion of total story time devoted to each family dyad and (b) number of conflictive, aggressive, and affectionate acts per dyad. Children divided their focus during stories evenly between father-child, mother-child, and father-mother relationships with child-sibling interactions occurring regularly among participants with siblings. Depictions of affection and aggression among family figures were relatively commonplace, related to mothers' reports of family climate, and stable across a 1-month period. Results substantiated preschoolers' awareness and discrimination of intrafamily relationship dynamics and provided some guidelines and cautions to practitioners who employ doll family assessments in their clinical work.

Aggression↗
PubMed2003

Family instability and young adolescent maladjustment: the mediating effects of parenting quality and adolescent appraisals of family security.

Examined relations among family instability and adolescent's psychological functioning using family models of children's emotional security in a sample of 220 young adolescents and their primary caregivers. Primary caregiver reports of family instability were associated with multiple informant measures of adolescent internalizing and externalizing symptoms. Findings from structural equation models supported the hypothesis that family instability increases adolescent risk for psychological problems by directly undermining their insecure appraisals of the family. Results also supported a pathway whereby family instability predicted parenting difficulties and parenting difficulties, in turn, indirectly predicted adolescents' internalizing and externalizing symptoms through its association with lower levels of perceived insecurity in the family. Results are discussed in relation to how they advance process-oriented conceptualizations of family instability.

Adaptation, Psychological↗
PubMed2003

Validity of family history data on PD: evidence for a family information bias.

OBJECTIVE: To study the validity of information provided by case and control subjects (or their proxies) about PD among their first-degree relatives. METHODS: Secondary cases of PD were assessed both through a single informant (family history method) and through the study of each relative (family study method). The family study method was considered as the standard for comparison, and the sensitivity and specificity of the family history method were studied. RESULTS: A total of 133 population-based case subjects and their 655 relatives were recruited, and 119 population-based control subjects and their 511 relatives. Sensitivity was 68% (95% CI = 47 to 85) for cases and 45% (95% CI = 17 to 77) for controls. Specificity was 99% (95% CI = 98 to 99) for cases and 100% (95% CI = 99 to 100) for controls. The odds ratio (OR) for family history of PD was 4.34 (95% CI = 1.63 to 11.58, p = 0.003) using the family history method and 1.86 (95% CI = 0.78 to 4.44, p = 0.16) using the family study method. The former significant OR more than doubled the latter not significant OR (relative bias = 133%). Bias was more pronounced for proxy interviews and for women informants, and when the relatives were siblings, were living, and were examined or had medical record documentation. CONCLUSIONS: Case subjects with PD (or their proxies) are more aware of PD among their first-degree relatives than control subjects (or their proxies); however, they overreport PD in relatives who are not affected. This causes a substantial family information bias.

Adult↗
PubMed2000

Effects of family coping and resources on family adjustment and parental stress in the acute phase of the NICU experience.

PURPOSE: To determine the relationship between family coping and resources and family adjustment and parental stress in the acute phase of the NICU experience. DESIGN: Correlational study based on the Resiliency Model of Family Stress, Adjustment, and Adaptation. Main study instruments included the State Anxiety scale of the State-Trait Anxiety Inventory, the Family Inventory of Resources for Management, the Family Crisis Oriented Personal Evaluation Scales, and the General Functioning subscale of the McMaster Family Assessment Device. SAMPLE: Data collected from 124 mother and father pairs within two to four days of their infant's admission to the NICU. MAIN OUTCOME VARIABLES: Family adjustment and parental stress. RESULTS: Adequate resources were more strongly related to positive adjustment and decreased stress than were either coping or being a first-time parent. The relationships among the variables were generally the same for both parents. Mothers utilized more coping strategies than did fathers. PRACTICE RECOMMENDATIONS: Families with limited resources should be identified early to facilitate their adjustment to the NICU.

Acute Disease↗
PubMed1990

Homeless and housed families in Los Angeles: a study comparing demographic, economic, and family function characteristics.

We studied 196 homeless and 194 housed poor families in Los Angeles, California to gain an understanding of events that precipitate family homelessness. Both homeless and housed poor mothers averaged 29 years old and were accompanied by two or three children. Three-fourths of both the homeless and housed families had income below the poverty level, and both groups expended almost two-thirds of their income on housing. Mothers in homeless families more commonly reported spousal abuse (35 vs 16 percent), child abuse (28 vs 10 percent), drug use (43 vs. 30 percent), or mental health problems (14 vs 6 percent) and weaker support networks. Homeless mothers more commonly came from homes where their parents abused drugs or alcohol (49 vs 34 percent) or more commonly lived outside the home or in foster care (35 vs 25 percent). Homelessness was reported as due primarily to economic pressures of housing costs, but personal and family problems frequently played a contributing role, especially for single parent families. Burdens of increasing housing costs and family dysfunction among housed poor families place many at risk for homelessness.

Adult↗
PubMed1998

Family relations and psychosocial risk in families with an obese adolescent.

The aim of the present study is a comparison of family relations in families with an obese adolescent and families with a normal-weight adolescent. Particularly, we studied the parents' and children's perceptions of some crucial areas of their relationship, e.g., communication, support, and some factors of "psychosocial risk" for the adolescents. We compared 30 family triads each with an obese child and 30 family triads each with a normal-weight child. We used a questionnaire aimed to evaluate some crucial variables of family functioning such as communication, family climate, support and satisfaction. A multivariate analysis of variance yielded no difference between obese and nonobese adolescents concerning communication with their mothers and fathers and concerning support given and received from them. In particular, analysis indicated no difference between parents of obese adolescents and parents of normal-weight adolescents regarding openness and problems in communication. As a protective factor against psychosocial risk, in both the samples the relationship with the mother arises as relevant, but, for the nonobese adolescents, both support and communication with this parent were important, whereas for the obese adolescents only support seemed to be really important. The results are discussed with respect to this approach which considered the family as the unit of analysis both from a theoretical and a methodological point of view.

Adaptation, Psychological↗
PubMed2001

Familial psychiatric illness and posttraumatic stress disorder: findings from a family study of substance abuse and anxiety disorders.

BACKGROUND: Aside from the possibility of a direct relationship between individual and familial posttraumatic stress disorder (PTSD), there is accumulating evidence that implicates a family history of psychiatric and substance use disorders as an important risk factor in the development of PTSD and associated symptoms. METHOD: The familial risk of DSM-III-R PTSD was examined within a family study of clinical- and community-ascertained probands (N = 263) and their 1206 adult first-degree relatives. RESULTS: Although PTSD among probands was not found to significantly elevate the risk of PTSD among first-degree relatives, an elevated rate of PTSD was found among the relatives of drug abusing probands compared with the relatives of probands with alcoholism, other anxiety disorders, and normal controls. Additionally, affective disorders were significantly associated with PTSD in relatives (p < .01). When these familial and individual associations were examined according to gender, drug disorders in probands were significantly associated with PTSD only among male relatives (p < .01), while the association between PTSD and comorbid affective disorders was seen primarily among female relatives (p < .01). CONCLUSION: Although probands in the present family study were not selected specifically for PTSD, the data afforded a unique opportunity to examine the profile of familial psychopathology as a part of the complex picture of susceptibility for PTSD. Future family study research will be able to determine the generalizability of the present findings through more complete measurement of diverse forms of trauma.

Adult↗
PubMedDate not supplied

Promoting family-centered care with foster families.

There has been a tremendous increase in the need for foster families since the 1980s largely because of the effects of drug abuse on the child and the biological family. As many as 500,000 children are currently living with foster families. Many children living with foster families were exposed to drugs before birth. Even those not exposed before birth demonstrate the effects of having lived with drug-abusing family members. Family life for these children is very often chaotic and unpredictable. There are increased health care needs for foster children due to drug-exposure and neglect. Yet, research suggests that the health care needs of foster children are often neglected. Foster families report that their concerns and needs are, frequently, neither recognized nor addressed by health professionals. Pediatric nurses can improve health care by increasing their awareness of the special needs of foster families and foster children.

Adult↗
PubMed2002

The relationship of family income, family size, age and circumferences with blood pressure in the female students of the Bahauddin Zakariya University, Multan, Pakistan.

In a randomly selected sample of 600 female students of the Bahauddin Zakariya University, Multan, Pakistan, belonging to different socioeconomic groups, age, family income and family size were recorded and measurements were made of arm, waist, neck and total circumferences, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP). The correlation coefficients between different independent (age, family income, family size, arm, waist, neck and total circumference) and dependent variables (SBP, DBP and MAP) showed that age had a strong association (p < 0.001) with all types of blood pressure, whereas the correlation coefficient of family income and family size was significant with SBP (p < 0.05) and non-significant with DBP and MAP. Moreover, all the circumferences had strong relationship (p 0.05 at least) with blood pressure. The regression coefficients of age were highly significant for SBP, DBP and MAP, whereas these were non-significant (p > 0.05) for family income and family size. The regression coefficients for arm and waist were significant (p < 0.05), whereas these were highly significant (p < 0.01 at least) for neck and total circumferences. The neck had a 0.46 mm Hg/cm with SBP, 0.41 mm Hg/cm for DBP and 0.44 Hg/cm for MAP, and these were highest among the circumferences.

Adolescent↗
PubMedDate not supplied

[Family transmission of positive and negative symptoms in familial and sporadic schizophrenia].

INTRODUCTION: A genetic component is recognized as a cardinal feature in the etiology of schizophrenia that is presently conceived as a complex disease. However, identifying its molecular bases has become a problem, mainly due to the difficulties that the schizophrenic phenotype presents. The aim of this study is to determine whether the positive and negative symptoms are differentiated from each other according to family history in a family study using familial/sporadic strategy. METHODS: 601 subjects were studied (196 schizophrenics, 205 first degree relatives and 200 controls). A SCAN system and the diagnosis criteria of DSM IV were used. For the familial study the FIGS and PANSS scales were applied. Families were grouped into familial or sporadic groups according to family aggregation. Comparisons were made using the ANOVA. RESULTS: The groups of patients and the first degree relatives with familial schizophrenia showed significantly higher scores in the negative sub-scale than did the sporadic schizophrenia subjects. Behavior of the first degree relatives with sporadic schizophrenia was similar to the control group. Positive sub-scale scores and general psychopathology showed no differences in the patients and their relatives according to familiar aggregation. CONCLUSIONS: This study confirms previous results that negative symptoms are more frequent in schizophrenics and their first degree relatives with familial schizophrenia. Therefore, it can be said that negative symptoms are a clinical phenotype more related to the genetic etiology.

Affect↗
PubMed2006

[Clinical and mutational analysis of KCNQ3 gene in a Chinese family with benign familial neonatal convulsions].

OBJECTIVE: To study the clinical and genetic characteristics of a Chinese family with benign familial convulsions (BFNC). METHODS: The clinical data of this family was analyzed. The blood samples were collected from 13 members of this family. By four microsatellite markers which are located in the gene loci of both K+ channel KCNQ2 and KCNQ3, the linkage analysis was performed in the family. With DNA direct sequencing and restriction endonuclease cutting analysis, the mutation analysis of KCNQ3 gene was made for the proband, other 12 family members and 76 unrelated normal individuals. RESULTS: There were 7 patients with BFNC observed in the three generation of family. The BFNC seizures of all patients disappeared during one month and no recurrence of seizures was found. The linkage analysis suggested the disease gene linked to KCNQ3 gene locus in the family. The mutation 988(C to T) of KCNQ3 gene was found in the proband by DNA-direct sequencing. Cosegregation of this mutation with BFNC was confirmed by restriction endonuclease cutting analysis. CONCLUSION: Chinese patients with BFNC can be caused by KCNQ3 gene mutation.

Base Sequence↗
PubMed1982

Meeting the challenge of research in family medicine: report of The Study Group on Family Medicine Research.

The challenge of research in family medicine is addressed in this paper by describing the rationale for research, appropriate content areas, resources available, and needs for the future. Family medicine has the opportunity to study health and disease in humans within their natural habitat over long periods of time, and to examine the multiple aspects of personal and family health care delivery. Resources for research include large primary care study populations, practitioner and faculty researchers, and technical support systems. The basic needs for the future are to increase the quantity and quality of researchers and to attract more funds designed for research. It is recommended that family medicine practitioners and teachers support research and participate more actively; that family medicine academic units provide their learners more research curricular time and their faculties more research activity time, and that they develop Family Medicine Research Centers; that family medicine professional organizations raise funds to support research, promote research opportunities for their members, and communicate to others the research activities, resources, and needs of family medicine; and that the requirements for residency training be modified to include elective research opportunities.

Canada↗
PubMed1996

Family needs of chronic hemodialysis patients: a comparison of perceptions of nurses and families.

OBJECTIVE: The objectives of this study were to (a) determine the psychosocial needs of families of ESRD patients receiving hemodialysis as perceived by nurses and family members; and (b) compare the differences of perception of needs between these two groups. DESIGN: The Norris and Grove Questionnaire (1986) was modified for the hemodialysis population to a 33 statement inventory of psychosocial needs. SAMPLE/SETTING: The sample consisted of 10 family members and nine registered nurses. The setting was a Midwestern Veterans Administration Medical Center hemodialysis unit. METHODS: A telephone survey interview was used for 9 family members; one survey was returned by mail. The RNs returned completed questionnaires to the unit. RESULTS: The findings of this study revealed 6 need statements that were statistically significantly different (p < 0.05) between the two groups. All of these need statements were perceived to be more important by the family members than the nurses. CONCLUSIONS: In this study, family members and nurses differed in what they perceived as important family needs. Families identified at least two psychosocial needs--the need for information and the need for comfort as being very important.

Adult↗
PubMed1985

The family void: treatment and theoretical aspects of the synchronous family paradigm.

The synchronous paradigm is a model of families whose members remain uninvolved and disconnected from each other yet somehow maintain relatively unvarying or even rigid patterns of behavior. In the synchronous paradigm, calm agreement and harmonious unity of action are valued above all. The concept of synchronous operation was first formulated by Constantine to solve certain theoretical problems growing out of the work of Kantor and Lehr. The theory has been elaborated upon through linkages established with other clinical and theoretical models of family dysfunction. Clinical experience in treating synchronous families has now contributed more detailed and practical understanding. Clinically, disabled synchronous families may present as bland, boring, or even death-like. They may have considerable difficulty accommodating to necessary developmental changes or to the demands of life crises, employing a variety of strategies to maintain the appearance of synchrony at the expense of adaptation. Their ability to ignore change and to absorb interventions can tax the abilities of even the most creative and energetic therapist. On the other hand, the quiet efficiency of the family and the social sensitivity of its members can be strong assets. Awareness of their strengths and special vulnerabilities can help the family therapist work more effectively with synchronous families.

Adolescent↗
PubMed1982

The Puerto Rican family: cultural factors and family intervention strategies.

We have presented what are considered to be the salient features characteristic of the Puerto Rican family. The composition of the family, the important role of the extended family, the impact of machismo, the authoritarian pattern of child rearing, and the religious practices of the Puerto Rican family have been documented through the findings reported by other researchers. It was noted that the high rate of back-and-forth migration between Puerto Rico and the Mainland as well as the colonial status of the society, creates a situation of accelerated change and shifting cultural patterns. We have felt it important to point out the normative patterns on the island. Quite often a well-intentioned clinician, when confronted with issues such as exaggerated machismo or certain responses to stress, may tend to dismiss them as purely cultural and not address the real issues leading to dysfunction or utilize the most appropriate treatment modality. Structural family therapy as a particularly useful treatment modality has been discussed at length, and its applicability and the justification for its utilization in families under stress were elaborated. Treatment strategies and their relationship to Puerto Rican family structure have been delineated.

Adult↗
PubMed1979

Guidelines for family interviewing and brief therapy by the family physician.

Psychosomatic and behavioral problems are commonly seen in the practice of family medicine. If these problems are viewed as difficulties with family interaction, rather than as difficulties of an individual family member, intervention may be more successful. Treatment of families with problems involves interviewing the family unit, identifying and altering dysfunctional behavioral patterns within the family which serve to maintain the problem, and making selected referrals to experienced family therapists.

Behavior↗
PubMed2000

Cross-trait familial resemblance for resting blood pressure and body composition and fat distribution: The HERITAGE family study.

Cross-trait familial resemblance between resting blood pressure (BP) and body composition and fat distribution was examined in 98 Caucasian families participating in the HERITAGE Family Study by using a multivariate familial correlation model assessing both intraindividual and interindividual cross-trait correlations. The 520 family members were sedentary at baseline examination, and both resting systolic (SBP) and diastolic (DBP) BP were cross-analyzed with each of the following 10 indications of body composition and fat distribution: percent body fat (%BF), abdominal visceral fat (AVF), body mass index (BMI), fat-free mass (FFM), fat mass (FM), sum of eight skinfolds (SF), total abdominal fat (TAF), ratio of trunk-to-extremity skinfolds (TER), waist circumference (WAIST), ratio of waist-to-hip circumferences (WHR). Five of the variables were also corrected for fat mass (AVFf, TAFf, TERf, WAISTf, WHRf) to index these measures independent of total degree of adiposity. In general, the results suggested strictly intraindividual cross-trait resemblance, with occasional spouse cross-trait resemblance, but few or no sibling or parent-offspring cross-trait correlations. This pattern is largely consistent with nongenetic specific environmental determinants for the BP-body composition and fat distribution covariation, with possibly some common environmental influence between spouses and negligible genetic effects. The only findings suggesting any familial cross-trait resemblance were significant sibling correlations for DBP-FFM and DBP-WHR, although the parent-offspring correlation was not significant. These findings suggest that the observed BP-body composition and fat distribution cross-trait correlations in these sedentary families are probably not due to multifactorial effects such as polygenic and/or common familial environmental effects. Whether or not other factors such as nonadditive effects are involved warrants further investigation using other methods. Am. J. Hum. Biol. 12:32-41, 2000. Copyright 2000 Wiley-Liss, Inc.

Journal Article↗
PubMed1977

Familial immunopathies: report of nine families and survey of literature.

Nineteen individuals are reported who represent nine familial instances of various immunopathies. Multiple myeloma was diagnosed in 10 members of five families, lanthanic (idiopathic) paraproteinemia in five members of two families and either myeloma or lanthanic paraproteinemia in four members of the remaining two families. The parent-child relationship occurred in three instances, siblings were affected in three, and first cousins in three families. Immunochemical studies revealed IgG paraprotein in nine cases; IgA in three; IgMl type in three subjects belonging to the same family; Bence-Jones protein in one case and biclonal paraproteinemia, IgGk plus IgAl in one. Three individual cases of lanthanic paraproteinemia, discovered in a prospective study of 76 relatives of subjects with immunopathies, suggest that there may be a higher frequency of immunopathies among family members than observed in the general population of comparable age. The published reports on familial paraproteinemias are reviewed..

Adult↗