Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “family functioning”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed2006

The implementation and the cultural adjustment of functional family therapy in a Dutch psychiatric day-treatment center.

Because of the increasing severity of adolescent problem behavior, evidence-based practices are becoming of interest as an alternative to traditional treatment with the behavior problems of adolescents in juvenile justice settings. Despite interest in evidence-based practices, questions exist regarding whether or not evidence-based intervention models can be successfully transported to cultures other than those in which they were developed. This article describes the transportation process of an American evidence-based family therapy (Functional Family Therapy [FFT]) into the service delivery system of a psychiatric day treatment center for juvenile delinquents in Amsterdam. The characteristics of FFT that make it cross-culturally sensitive are discussed. Results from the changes in service delivery suggest FFT can be successfully implemented in international settings with adjustments to make the model fit the culture(s) of The Netherlands without changing the model of FFT itself.

Adolescent↗
PubMed1998

Predictors of family functioning after traumatic brain injury in children and adolescents.

OBJECTIVE: To assess factors predictive of family outcome in the first 2 years after traumatic brain injury (TBI) in children and adolescents. METHOD: Subjects were children aged 6 to 14 at the time they were hospitalized after TBI. The study used a prospective follow-up design. Assessments of preinjury factors (psychiatric family functioning, and family life events), injury factors (severity of injury), and postinjury factors (coping and development of a psychiatric disorder, never before present, i.e., "novel") were conducted using standard clinical scales. The outcome measure was family function as assessed with standardized family functioning interviews (at 12 and 24 months after TBI) and primary caretaker self-report questionnaires (at 3 and 6 months after TBI). RESULTS: Fifty subjects enrolled, and the analyses focused on 37, 41, 43, and 42 subjects assessed at the 3-, 6-, 12-, and 24-month follow-up evaluations, respectively. The strongest influences on family functioning after childhood TBI are preinjury family functioning, the development of a "novel" psychiatric disorder in the child, and preinjury family life events or stressors. CONCLUSIONS: These data suggest that there are families, identifiable through clinical assessment, at increased risk for family dysfunction after a child's TBI. Early identification and treatment of the child's psychopathology and family dysfunction may attenuate the associated morbidity.

Adaptation, Psychological↗
PubMed1989

Self-reports of differentiation of self and marital compatibility as related to family functioning in the third and fourth stages of the family life cycle.

Using Bowen's, Olson's, and general systems frameworks, this investigator tested relationships among individual, marital, and family functioning in the stressed childrearing stages of the family life cycle. Sixty volunteer married couples completed the Level of Differentiation of Self Scale (LDSS), Locke-Wallace Marital Adjustment Test (MAT), and Family Adaptability and Cohesion Evaluation Scales (FACES) III. A significant canonical correlation was found among differentiation of self and marital compatibility as they both relate to family functioning. Subsequent canonical correlations were significant for wives but not for husbands, indicating gender differences in relationships among perceived individual, marital, and family phenomena. The concept of adaptability as proposed by Olson's Circumplex Model of Marital and Family Functioning was not supported. A revised model is proposed.

Adaptation, Psychological↗
PubMedDate not supplied

Family functioning of perinatal substance abusers in treatment.

This prospective study examined family characteristics of perinatal substance abusers enrolled in an intensive outpatient treatment program both during and after treatment. Data is provided on family functioning in three areas: current family, family of origin, and love/partner relationship, and at six time points up to 24 months postdischarge. Standard family assessment measures, including the Self-Report Family Inventory (SFI) and Family-of-Origin Scale (FOS) were utilized to measure current family functioning and family of origin health, respectively. A new instrument, the Relationship Assessment Form (RAF), was used to measure the level of unhealthy, codependent behaviors in the subject's love/partner relationship. A mixed models repeated measures ANOVA was used to determine if subjects' family functioning changed over time. Multivariate and univariate methods examined differences between the subjects in the current study and previously reported means for the SFI and FOS. Results were that perinatal substance abusers' perception of the overall health of their families of origin remained stable over time. Subjects rated their families of origin as more pathological than community adults, but similarly to adults presenting for psychotherapy. Although current family functioning was relatively stable, SFI scores that changed worsened over time after treatment. Perinatal substance abusers scored more pathologically at intake than normal, nonclinic families, but were similar to families presenting for family therapy on the SFI. In contrast, enduring changes of greater magnitude occurred in the subjects' self-reported codependent behavior over time. All RAF scores that changed moved in the direction of healthier, more autonomous functioning. Change and stability in aspects of family functioning may be due to specific factors of the treatment program, which are discussed. Standard family measures may need further refinement for use in this population. Recommendations for clinical programs and future research are provided.

Adolescent↗
PubMed1999

Difficulties in family functioning and adolescent anorexia nervosa.

BACKGROUND: Difficulties in family functioning are often evident when an adolescent has anorexia nervosa, and the possible causative or contributory role of such difficulties in the illness is unclear. AIMS: To elucidate the relationship between severity of anorexia nervosa and difficulties in family functioning and whether clinical improvement results in diminution of self-rated family difficulties. METHOD: Thirty-five adolescents with anorexia nervosa and their mothers completed the Family Assessment Device (FAD) while clinicians administered the McMaster's Structured Interview of Family Functioning (McSIFF). Severity of anorexia nervosa was rated at baseline and at one year follow-up using the Morgan-Russell Schedule. RESULTS: Clinicians and patients were more critical of the families' functioning than parents. There was an inverse association between the extent of family difficulties and severity of anorexia nervosa. Over time subjects improved clinically but this was not matched by improvement in family functioning. CONCLUSIONS: Difficulties in family functioning do not appear to be directly associated with severity of anorexia nervosa nor do these difficulties reduce with clinical improvement, in the short term.

Adolescent↗
PubMed1993

Response to the presence of a child with disabilities: parental stress and family functioning over time.

Parental stress and family functioning over time in families of children with disabilities was investigated. Comparisons were made between two time periods and with families of children who did not have disabilities; predictors of parental stress were identified. Results showed a high level of stability in parental stress and a modest degree of consistency over time in family functioning in families of children with disabilities. In these aspects, families of children with disabilities were not different from comparison families. There was also stability in the best predictors of parental stress (presence or absence of disabilities and the quality of family relationship). Of significant concern, families of children with disabilities were distinguished by the exceedingly greater amount of stress at both periods of study. Implications for family services and research were drawn.

Adaptation, Psychological↗
PubMedDate not supplied

Do daughters with eating disorders agree with their parents' perception of family functioning?

OBJECTIVE: The current study compared the perceptions of family functioning between daughters with eating disorders (EDs) and their parents. This investigation was an expansion of the Fornari et al (Compr Psychiatry 1999;40:434-441) study, which investigated the relationship between the perceived family functioning and depressive symptoms in individuals with ED patients receiving outpatient services. METHOD: One hundred twenty-six female subjects, ranging in age from 13 to 34 years (mean 18.3 years) completed the Beck Depression Inventory (BDI) (Arch Gen Psychiatry 1961;4:561-571) and the Family Assessment Device (FAD) (J Marital Fam Ther 1983;9:171-180) on admission to an outpatient ED program. The patient's parent(s) (118 mothers and 96 fathers) also completed the FAD. Eating disorder subgroup diagnosis and major depressive disorder diagnosis were established according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition , criteria, using the Schedule for Affective Disorders and Schizophrenia-Lifetime (Arch Gen Psychiatry 1987;35:837-844). Repeated measures analysis of covariance was performed comparing family members on each of the 7 subscales of the FAD with BDI entered as the covariate. RESULTS: Statistically significant differences were found between patient and parental perceptions of overall family functioning. Mothers rated family functioning as significantly healthier and less chaotic than their daughters did. There were fewer significant differences between maternal and paternal perceptions of family functioning, and no significant differences between fathers' and daughters' perceptions of the family. Eating disorder diagnosis did not contribute to these differences in perception of family functioning. In addition, high self-reported depressive symptoms of the daughters were related to the perception of high family dysfunction for all 3 informants; depressive symptoms did not, however, alter the differences in perception between family members. DISCUSSION: Differences in viewpoints between parents and daughters regarding the family environment may contribute to the continuation of a dysfunctional family pattern and maintenance of the ED and/or impact negatively on the course of treatment. Possible implications for treatment are discussed, particularly because of the differences of the mothers' views. The results of this study strongly support the importance of including the patient's family in the initial evaluation, regardless of the patient's age.

Adolescent↗
PubMed2003

Psychosocial morbidity associated with patterns of family functioning in palliative care: baseline data from the Family Focused Grief Therapy controlled trial.

Family Focused Grief Therapy (FFGT) is a new model of brief intervention, which is commenced during palliative care for those families shown to be at high risk of poor adaptation, and continued preventively into bereavement with the aim of improving family functioning and reducing the morbid consequences of grief. In this paper, baseline data on 81 families (363 individuals) selected by screening from a palliative care population are explored to confirm our previously reported observation that high levels of psychosocial morbidity are positively associated with worsening family dysfunction. The Family Relationships Index (FRI) was used for screening and the Family Assessment Device (FAD) as an independent family outcome measure. The Beck Depression Inventory (BDI), Brief Symptom Inventory (BSI) and Social Adjustment Scale (SAS) were the psychosocial measures. Families were classified according to their functioning based on the FRI. To allow for correlated family data, statistical analyses employed the generalized estimating equation (GEE) method, controlling for gender and depression (BDI). Screening of 257 families (701 individuals) revealed 74 (29%) well-functioning families and 183 (71%) at some risk of morbid outcome. Of the latter, 81 (44%) gave informed consent to enter a randomized controlled trial of FFGT. Patients had a mean age of 57 years, 51% were male and they suffered from cancer, with a median length of illness from diagnosis to death of 25 months. In accordance with the FFGT model, their family types were identified as Intermediate 51%, Sullen 26% and Hostile 23%. These were significantly associated with steadily increasing levels of distress (BSI) and poor social adjustment (SAS). The FAD confirmed the concurrent accuracy of the FRI. As significantly greater levels of psychosocial morbidity were present in families whose functioning as a group was poorer, support was generated for a clinical approach that screens for families rather than individuals at high risk. The predictive validity of the FRI as a screening measure was confirmed. Overall, these baseline data point to the importance of a family-centred model of care.

Adaptation, Psychological↗
PubMed1992

The relationship of pretreatment family functioning to drinking behavior during follow-up by alcoholic patients.

The relationship of alcoholics' perceptions of the pretreatment functioning of their families to drinking outcomes during an 18-month follow-up was examined. Family functioning was hypothesized to be predictive of drinking behavior, particularly in subjects with low assertion of autonomy scores. These individuals report greater dependency and attachment, and therefore might be more affected by the state of important relationships. The results indicated that with low autonomy male alcoholics, greater family dysfunction predicted significantly fewer days abstinent during Months 1-6 and 13-18 and more severe drinking episodes during the first year of the follow-up. In the high autonomy males, family dysfunction was unrelated to subsequent drinking behavior. In women, on the other hand, greater family dysfunction predicted more days abstinent in those high in autonomy and was unrelated to the drinking behavior of those low in autonomy. Implications for patient-treatment matching, differences between male and female alcoholics, and the need for additional studies of family functioning and drinking behavior in women are discussed.

Adult↗
PubMed2001

Observational assessment of family functioning at mealtime in preschool children with cystic fibrosis.

OBJECTIVE: To examine functioning during a dinner meal in families of a child with a chronic illness that requires dietary treatment recommendations, as compared to families of a child without a chronic illness. METHODS: Ratings of seven dimensions of family functioning on the McMaster Mealtime Family Interaction Coding System (MICS) were obtained on 29 families of children with CF and 29 families of children with no chronic illness, ages 2 to 6 years, during a videotaped dinner meal at home. RESULTS: Ratings of families with a child with CF were significantly lower than those for families of children without a chronic illness on Overall Family Functioning and five of the six MICS dimensions: Communication, Interpersonal Involvement, Affect Management, Behavior Control, and Role Allocation and approached significance on the Task Accomplishment dimension. The ratings of families of a child with CF were in the "clinically significant" range on all subcales, including Task ACCOMPLISHMENT. CONCLUSIONS: This study suggests that family functioning at mealtimes may be different in families of children with CF in which explicit dietary guidelines exist than in families of children with no illness or dietary guidelines. These results are discussed in terms of global family functioning and treatment approaches to dietary treatment recommendations.

Child, Preschool↗
PubMedDate not supplied

Predicting family functioning after TBI: impact of neurobehavioral factors.

OBJECTIVE: To identify risk factors for poor family functioning and neurobehavioral problems after traumatic brain injury (TBI) or orthopedic injuries (OI). DESIGN: Longitudinal analyses of data from an inception cohort. PARTICIPANTS: Seventy-five patients with moderate/severe TBI, 47 patients with mild TBI, and 44 patients with OI at discharge; and 49 patients with moderate/severe TBI, 24 patients with mild TBI, and 33 patients with OI at 1-year follow-up. OUTCOME MEASURES: Measures of family functioning (Family Assessment Device) and Neurobehavioral Functioning Index at hospital discharge and 1-year follow-up. RESULTS: At discharge, patients with moderate/severe TBI had more symptoms of depression, memory/attention problems, and motor impairments than patients with OI and greater communication difficulties than patients with OI or mild TBI. At follow-up, patients with moderate/severe TBI continued to have more problems in memory/attention, depression, and communication. Approximately one third of each group had unhealthy family functioning at each assessment period. Few patients reported both impaired family functioning and clinical depression. Distressed family functioning correlated strongly with increased rates of neurobehavioral symptoms. Family dysfunction at follow-up was best predicted by family dysfunction at discharge and depression or memory/attention deficits at follow-up. CONCLUSIONS: After TBI, patients at the greatest risk for distress at follow-up were those with family dysfunction at discharge and continued neurobehavioral problems. High-risk families need to be identified so that necessary referrals and/or treatment can be offered.

Adult↗
PubMed1998

School-age and adolescent children's perceptions of family functioning in neglectful and non-neglectful families.

OBJECTIVE: Examined the question, do neglected children's perceptions of their own family's functioning acknowledge the differences that exist between neglectful and non-neglectful families? METHOD: An inter-rater consistency design was used; child and caseworker reports of family functioning in neglectful (n = 33) and non-neglectful families (n = 34) were compared. RESULTS: After establishing significant differences between the socioemotional and physical environment provided by neglectful and non-neglectful families, the results indicated that children from neglectful families perceived a higher level of quality in family functioning that was not reported by caseworkers or supported by other measures. CONCLUSIONS: Implications for designing effective interventions for school-age and adolescent children from neglectful families are discussed.

Adolescent↗
PubMedDate not supplied

Adolescent mothers: caregiving, approval, and family functioning.

OBJECTIVE: This study tested the Adolescent Family Assessment Model, which describes the relationships between caregiving behaviors, caregiving knowledge, peer and family approval, and family functioning. DESIGN: A descriptive correlational design was used along with causal modeling procedures to test the model. SETTING: Subjects were recruited from teen parent programs and an obstetrician's office. SUBJECTS: A convenience sample of 134 adolescent mothers participated in the study. Each subject had not completed her high school education and was living in the same household as her child. MAIN OUTCOME MEASURES: Subjects completed a demographic questionnaire, the Infant Caregiving Inventory (caregiving knowledge), the Peer and Family Approval Instruments (social approval), and Smilkstein's Family APGAR (family functioning). Instruments were completed twice by each subject, with a 2-week period between administration. RESULTS: Fifteen percent of the variance of caregiving behaviors was explained by ethnicity (beta = -.30) and age of the first child (beta = -.26). Ten percent of the variance of family functioning was explained by age of the first child (beta = -.24) and ethnicity (beta = -.20). CONCLUSIONS: It appears that family functioning declines for the first 2 years after the birth of the adolescent's child.

Adolescent↗
PubMed2002

Family functioning in the context of chronic illness in women: a Korean study.

The aims of this study were to clarify the concept of family functioning in the context of a female family member's chronic illness, and to describe the processes by which the housewife copes with the situation. The study applied the hybrid model of concept development, which consists of three phases: theoretical, empirical, and analytic. In the theoretical phase, a working definition of family functioning was established and the dimensions of family functioning and subconcepts were identified through an extensive review of the literature. In the empirical phase, in-depth interviews with members of six normal families and seven families in which the housewife had a long-term diagnosis of rheumatoid arthritis were carried out in order to gain descriptions of family functioning in both contexts, and to assess how the housewife coped with her illness in relation to family functioning. The final analytic phase identified the differences and similarities in family functioning between the normal family and family with a chronically ill housewife. A refined definition of family functioning emerged that identified the concept in terms of a complex set of functional dimensions comprising affective, structural, control, cognitive, and external relationships. The data revealed that family functioning is dynamically changed when the housewife becomes ill with a chronic disease. Three types of adaptation process were identified by which the housewives adapted to family functioning in the context of their chronic illnesses: negotiated, self-accommodating, and separated-enduring. The implications of these findings for research and nursing practice are discussed.

Adaptation, Psychological↗
PubMed1990

[Analysis of factors affecting family function].

The purpose of this study was to identify the degree of family function and to determine factors influencing family function. The subjects for this study were 451 adults and high school students among the general population from J city. Data were collected by questionnaire from Sept. 1 to Nov. 30, 1989. The measurement tool was the Family Function Questionnaire (APGAR) developed by Smilkstein. Data were analysed by statistical methods including Mean, S.D, t-test and ANOVA. The following results were obtained: 1. The mean Family APGAR score was 5.70 +/- 0.11, in a range from 0-10. 2. Scores from 0 to 6, which fall into the dysfunctional family range, were recorded for 266 families (59.6%). 3. Significant variables among general characteristics influencing family function were age, sex, marital status, educational levels, monthly income and occupation (p less than .001). 4. Significant variables among family characteristics influencing family function were family life cycle (p less than .01), utilization of family resources (p less than .01) and family atmosphere (p less than .001).

Family↗
PubMed2006

Observation of family functioning at mealtime: a comparison between families of children with and without overweight.

OBJECTIVE: To examine differences between families of children with and without overweight on parental control and support. METHODS: Twenty-eight families with an overweight child and a control group of 28 families with a normal weight child (age range 7-13 years) participated in the study. Observations and self-reports of mealtime family functioning were administered and analyzed. RESULTS: Parents of children with overweight reported to exert more control on their children's feeding behavior and an equal amount of parental support in comparison with parents of children without overweight. However, observations at mealtime indicated that in families with an overweight child, maladaptive control strategies were twice as prevalent, and less parental support was displayed. CONCLUSIONS: Self-reports and observations provide complementary information on how parents interact with their overweight children. Family-based treatment programs should include discussions on the adequate amount of parental control and support.

Adolescent↗
PubMed1995

Moderating effects of family functioning on the social adjustment of children with liver disease.

In this study, we examined the moderating effects of family functioning on parent- and child-reported indices of social functioning in 30 children with liver disease. Consistent with previous research, children with liver disease exhibited significantly lower levels of social functioning compared to normative data. Hierarchical multiple-regression analyses were conducted to examine the relative influence of cognitive functioning, disease severity, and family functioning (i.e., family cohesion and adaptability, parenting stress, and parenting esteem) on children's social functioning. Family functioning accounted for an additional 23% of the variance in parent-reported social functioning and only 4% of the variance in child-reported social competence after controlling for cognitive functioning and disease severity. These preliminary results underscore the importance of considering family factors in designing interventions to enhance the social functioning of children with liver disease.

Child↗
PubMed1997

Family functioning and life events in the outcome of adolescent anorexia nervosa.

BACKGROUND: This study investigates the outcome of anorexia nervosa in adolescents in relation to precipitating life events and changes in family functioning over time. METHOD: Thirty-five adolescents with anorexia nervosa and their mothers were administered measures of life events and family functioning at initial assessment and 1 and 2 year follow-up, when outcome was also assessed. RESULTS: Fifty-five per cent of patients had a good outcome. Patients from initially well-functioning families or those with precipitating life events improved more in the first year, than those with dysfunctional families or without events. Subjects perceived a deterioration in family functioning at 1 year follow-up but an improvement at 2 years. Mothers reported no changes. CONCLUSIONS: Approximately half of a series of early onset cases of anorexia nervosa can be expected to recover by 2 years. Healthy family functioning and presence of a precipitating life event predict good short-term outcome. The relationships between subjects' perceptions of family functioning and their recovery from anorexia nervosa is discussed.

Adolescent↗