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PubMed2002

Age specific and attributable risks of familial prostate carcinoma from the family-cancer database.

BACKGROUND: Familial risks by proband status and age are useful for clinical counseling, and they can be used to calculate population-attributable fractions (PAFs), which show the proportion of disease that could be prevented if the cause could be removed. METHODS: The authors used the nationwide Swedish Family-Cancer Database on 10.2 million individuals and 182,104 fathers and 3710 sons with medically verified prostate carcinoma to calculate age specific familial standardized incidence ratios (SIRs) with 95% confidence intervals (95%CI) and familial PAFs for prostate carcinoma in sons ages 0-66 years. RESULTS: The incidence of prostate carcinoma was doubled between the years 1961 and 1998. The familial SIRs for prostate carcinoma were 2.38 (95%CI, 2.18-2.59) for men with prostate carcinoma in the father only, 3.75 (95%CI, 2.73-4.95) for men with prostate carcinoma in a brother only, and 9.44 (95%CI, 5.76-14.03) for men with prostate carcinoma in both a father and a brother. The corresponding familial PAFs were 8.86%, 1.78%, and 0.99%, respectively, yielding a total PAF of 11.63%. Age specific risks were shown for the same proband histories. The SIR was 8.05 for prostate carcinoma before age 55 if a brother had been diagnosed before that age. If, in addition, a father was diagnosed at any age, then the SIR was 33.09. CONCLUSIONS: The authors recommend that having a brother who is diagnosed with prostate carcinoma before age 55 years or having a brother and father who are diagnosed at any age are indications to screen for prostate carcinoma. The familial PAF of prostate carcinoma among a population of sons ages 0-66 years was 11.63%.

Age Factors↗
PubMed2002

What are patients and their families told about the diagnosis of dementia? Results of a family survey.

BACKGROUND: Controversy exists as to whether dementia patients should be told their diagnosis and prognosis. OBJECTIVE: This study examined the experience of patients and families when a diagnosis of dementia is given. METHOD: Fifty-seven family members from community dementia support groups answered a questionnaire regarding the diagnosis of dementia in a family member. RESULTS: Family members were significantly more likely to have been told the diagnosis and symptoms to expect in dementia than patients themselves. Half of the families felt they were not given enough information regarding dementia. Interestingly, the majority of family members believed patients should be told their diagnosis and prognosis yet about half had reported that informed patients had reacted poorly to being told their diagnosis and only about a third felt it was helpful to the patient. CONCLUSION: The results suggest physicians should better involve patients and their families in disclosing diagnoses and information regarding dementia. The results also suggest the current AMA guidelines to inform patients their diagnosis of dementia are inadequate to address the clinical complexities of this issue.

Adaptation, Psychological↗
PubMed2001

Familial colorectal adenocarcinoma from the Swedish Family-Cancer Database.

Familial risks for colorectal (CRC) adenocarcinoma were characterized from the Swedish Family-Cancer Database covering 9.6 million individuals, whose family relationships and cancers were obtained from registered sources, not sensitive to reporting or ascertainment bias. Cancer cases were retrieved from the Swedish Cancer Registry from years 1958-96. Standardized incidence ratios (SIRs) were calculated based on gender-, age-, period- and tumor type specific rates. A total of 4,794 and 67,925 CRCs were recorded in offspring and parents, respectively. For colon and rectal adenocarcinoma, the SIRs in offspring were 2.28 and 1.68 by parental CRC adenocarcinoma, giving attributable proportions of 6.45 and 3.31%, respectively. The SIR of CRC was over 10 when both offspring and parents were diagnosed at a young age. The risk for parental CRC adenocarcinoma was over 100 when 2 or more children were affected. The risk in siblings was also very high when a parent was affected. The familial cancer sites that associated with CRC were those typical of hereditary nonpolyposis colorectal cancer (HNPCC). This is the largest study published on familial CRC and the only one reporting specifically on adenocarcinoma. The data suggest that HNPCC is the largest single disease entity among CRCs, probably accounting for less than 50% of familial CRC. Other familial components appear heterogeneous, characterized by incomplete penetrance, recessive mode of inheritance and few associated tumor sites.

Adenocarcinoma↗
PubMedDate not supplied

Caring and expressions of stability by urban family caregivers of persons with stroke within African American family systems.

Expressions of stability by urban family caregivers are the focus of this study. Data presented here were collected as part of a larger ethnographic descriptive study that examined caregivers' (N = 24) experience and the meaning of caring as it influences their ability to care for persons with stroke within their African American family systems. For family caregivers, unmet needs and problems with caregiving may occur as depleted resources are compounded by urban decay in many communities. This study was completed within the Framework of Systemic Organization described by Friedemann, in which families, as open systems, strive for well-being. Stability in the family, a component of well-being, addresses traditions and common behavior patterns rooted in basic values and cultural beliefs. Through data analysis, four themes concerning expressions of stability were identified for all caregivers. Caring expressions of stability are defined as (a) emotional burden; (b) evasion of conflicts; (c) motivation from love and a sense of duty between caregivers, the care recipients, and their families; and (d) a filial, ethereal value. Rehabilitation nurses can incorporate these expressions of stability into their assessment, intervention, and evaluation processes, and thereby increase the potential to strengthen successful caring and stability within the caregivers' family systems.

Adult↗
PubMed1988

The autistic child and family functioning: a developmental-family systems perspective.

Autism is a severe, long-term developmental disorder that potentially has substantial influence on different aspects of the family system. Principles from family-systems theory are considered as they relate to the autistic child within the family. A selective and critical review is presented of research findings on the influence of the autistic child on the functioning and interactions of family members, including parents, siblings, and the family as a whole. Research findings are also reviewed on resources associated with successful family adaptation to the autistic child. Suggestions are offered for improved research to assess the relationship between certain child variables and measures of family functioning.

Adaptation, Psychological↗
PubMed1996

Strong evolutionary conservation of broadly expressed protein isoforms in the troponin I gene family and other vertebrate gene families.

It is well established that different protein classes undergo molecular evolution at different rates, presumably reflecting differing functional constraints. However, it is also the case that different isoforms of the "same" protein, encoded by a multigene family, may evolve at different rates. Here I report a relationship within gene families between isoform evolutionary rate and gene expression profile: Broadly expressed isoforms show stronger sequence conservation than do narrowly expressed isoforms. This observation emerged initially from cDNA cloning and sequencing studies, described here, of a vertebrate gene family encoding three differentially expressed isoforms of the muscle protein troponin I. However, the expression breadth/sequence conservation relationship applies to vertebrate gene families in general. In a broad and arbitrary survey sampling of sequence data on well-characterized vertebrate gene families, I found that in 14/15 families the most strongly conserved isoform was the most broadly expressed isoform, or one of several similarly broadly expressed isoforms. Broadly expressed isoforms are presumably subjected to greater negative selection pressure because they must function in a more diverse biochemical environment than do narrowly expressed isoforms. The expression breadth/evolutionary rate relationship has several interesting implications regarding the overall process of gene family evolution by duplication/divergence from ancestral genes.

Amino Acid Sequence↗
PubMed2005

Youth depression in the family context: familial risk factors and models of treatment.

Research on parent risk factors, family environment, and familial involvement in the treatment of depression in children and adolescents is integrated, providing an update to prior reviews on the topic. First, the psychosocial parent and family factors associated with youth depression are examined. The literature indicates that a broad array of parent and family factors is associated with youth risk for depression, ranging from parental pathology to parental cognitive style to family emotional climate. Next, treatment approaches for youth depression that have been empirically tested are described and then summarized in terms of their level of parent inclusion, including cognitive-behavioral therapy, interpersonal therapy, and family systems approaches. Families have mostly not been incorporated into clinical treatment research with depressed adolescents, with only 32% of treatments including parents in treatment in any capacity. Nonetheless, the overall effectiveness of treatments that involve children and adolescents exclusively is very similar to that of treatments that include parents as agents or facilitators of change. The article concludes with a discussion of the implications of these findings and directions for further research.

Adolescent↗
PubMed1987

Family medicine and psychosocial knowledge: how many hats can the family doctor wear?

The paper examines the impact of teaching family physicians psychosocial skills and knowledge during their residency training in family medicine. The idea put forth by the family practice profession that family physicians are trained to treat their patients' biological, as well as psychosocial problems, is important to the social work profession since social workers have had primary responsibility in treating patients' psychosocial problems in the health care arena in the United States from 1904 until now. In order to learn about the effect of adding psychosocial knowledge to the family practitioner's training curricula, the author conducted an exploratory and comparative study to see if family practitioners had any more psychosocial knowledge than other primary care physicians. No significant differences were found. Implications of the study for family medicine and social work, primary health care, and social/health policy are discussed.

Adult↗
PubMed1995

ApoE genotype and familial Alzheimer's disease: a possible influence on age of onset in APP717 Val-->Ile mutated families.

Recent studies have shown a genetic association of the apolipoprotein E (ApoE) epsilon 4 allele with late onset familial and sporadic Alzheimer's disease (AD). In this study we analysed the possible association of the genetic polymorphism of the ApoE gene with age of onset in Italian familial Alzheimer's disease (FAD) families including two early onset familial Alzheimer's (EOFAD) families with the APP717 Val-->Ile mutation in the amyloid precursor protein (APP) gene on chromosome 21. In none of the FAD families analysed was there a significant effect of the ApoE genotype on the age of onset with the exception of one of the two mutated EOFAD families in which the epsilon 2 allele delayed the age of onset.

Age Factors↗
PubMed2006

Familial resemblance for executive functions in families of schizophrenic and bipolar patients.

Executive dysfunctions are considered to be putative markers of familial/genetic vulnerability to both schizophrenia and bipolar disorder. However, familial resemblance must be demonstrated before executive functions are used as a potential endophenotype. The aim of this study was to investigate familial resemblance for executive functions in families of schizophrenic and bipolar subjects. We assessed executive functions by means of two tests - the Wisconsin Card Sorting Test (WCST) and the Trail Making Test (TMT) - in 351 subjects from five populations: schizophrenic patients, bipolar patients, a group of relatives for each patient group and controls. For both tests, cognitive assessment results were consistent with previous studies: schizophrenic patients showed the greatest impairment, followed by bipolar patients and then the two groups of relatives. In families of bipolar patients we observed familial resemblance for the WCST and part A and part B of the TMT. However, by contrast with the classical point of view, considering executive measures to be markers of genetic vulnerability to schizophrenia, we did not demonstrate familial resemblance for either of the two executive tests in families of schizophrenic patients. Thus, executive measures, as assessed by the WCST or the TMT, should not be used as endophenotypes in genetic studies of schizophrenia unless confounders are identified and their effects eliminated.

Adult↗
PubMed1997

Families of homeless and runaway adolescents: a comparison of parent/caretaker and adolescent perspectives on parenting, family violence, and adolescent conduct.

OBJECTIVE: Almost all of what is known about the families of runaways and homeless adolescents is based on adolescent self-reports. The validity of such research is currently being questioned by policy makers. The purpose of this study was to compare runaway and homeless adolescent reports and parent/caretaker reports on measures of parenting, family violence, and adolescent conduct. METHOD: Reports of 120 runaway adolescents and their parents/caretakers from four Midwestern states were compared on measures of parental monitoring, parental warmth and supportiveness, parental rejection, physical and sexual abuse, and adolescent conduct. Comparison groups of nonrunaway adolescents and their mothers in two-parent and single-parent families from the same geographical area were also used for parenting and adolescent conduct measures. RESULTS: The findings indicated that although there were significant differences in means between adults and adolescents regardless of runaway status, adults and adolescent reports were in the same direction and present similar portraits of families of runaway and homeless young people. Both the parents/caretakers and their runaway adolescents reported lower levels of parental monitoring and warmth and supportiveness and higher levels of parental rejection than comparison groups of nonrunaway families. Parents/caretakers and runaway adolescents reported high levels of family violence and sexual abuse. Similarly, they concur regarding conduct problems for the adolescents. CONCLUSIONS: The findings suggest that runaway and homeless adolescents accurately depict the troubled family situations that they choose to leave. The policy implications for recent debates involving criminalization and mandatory return to parental custody of homeless and runaway youth are discussed.

Adolescent↗
PubMed2002

Effects of childhood exposure to familial alcoholism and family violence on adolescent substance use, conduct problems, and self-esteem.

Exposure to familial alcoholism has been associated with many behavioral and emotional difficulties among offspring. However, few studies have examined environmental risks that often coexist with familial alcoholism, and which may influence the development of offspring psychosocial problems. This study examined potential additive and interactive effects of childhood exposure to family violence and childhood exposure to familial alcoholism on adolescent functioning. Three domains of adolescent functioning were examined in a high-risk community sample of 109 families: lifetime levels of substance use, conduct disorder behaviors, and self-esteem. Results indicated that both childhood exposure to familial alcoholism and childhood exposure to family violence were associated with psychosocial functioning of offspring during adolescence, although the relations differ according to domain of functioning and gender.

Adolescent↗
PubMed2002

Family-responsive psychoeducation groups for families with an adult member with mental illness: pilot results.

This paper documents recent pilot efforts of the Psychoeducation Responsive to Family (PERF) model, a yearlong group for families with an adult member coping with mental illness. PERF advances state-of-the-art in its: (a) application in community settings; (b) utility for families coping with all types of mental illness; (c) use of a standardized model, yet retaining a flexible curriculum responsive to family group membership concerns; and (d) recruitment from one-day family workshops of participants eager to further explore their issues. This report examines changes in these families' knowledge and mastery in a small random assignment study comparing the PERF model (n = 9) with a "usual services" (n = 10) condition. Study participants completed surveys measuring perceived mastery and knowledge at baseline and at 3, 6, and 12 months for both conditions. Families in the active PERF intervention demonstrated significant post-intervention improvements in four of five variables analyzed. For one of these items, PERF demonstrated significantly greater improvement than the usual care condition. Achievement of significant changes in these measures was examined in relation to timing of presentation of curriculum topics in the groups. Gains in perceived crisis effectiveness temporally correlated with coverage of that topic in the PERF groups, while gains in other items were instead steadily cumulative across the entire year. The encouraging results of this second pilot effort serve to substantiate the initial efforts in developing the PERF group model.

Adaptation, Psychological↗
PubMed1997

Heterogeneity in the families of sons of alcoholics: the impact of familial vulnerability type on offspring characteristics.

In 2 samples of sons of alcoholics (family history positive for alcoholism; FHP: N = 74 & N = 72), cluster analyses identified 3 subtypes of familial vulnerability: 1 with low levels of familial psychopathology (FHP-LP) and moderate levels of familial alcoholism; a 2nd with high levels of familial antisocial personality (FHP-ASP), violence, and alcoholism; and a 3rd with high levels of familial depression (FHP-DEP), mania, anxiety disorder, and alcoholism. Compared with family history negative (FHN) participants (N = 106), FHP offspring had higher levels of alcohol problems. FHP-ASP offspring had elevated levels of antisocial traits and negative affect. Compared with FHN participants, FHP-DEP offspring elevated levels of antisocial traits, hypomania, and experience seeking. FHP-LP offspring had moderate levels of antisocial traits.

Adult↗
PubMed2001

Cultural perspective on work and family: dual-earner Israeli-Jewish and Arab families at the transition to parenthood.

Parents' functioning in the work and family roles was examined in traditional and modern societies at the transition to parenthood. Participants were 162 dual-earner Israeli-Jewish and Arab families, who were interviewed and observed in dyadic and triadic interactions. Arab parents reported better adaptation to work following the first childbirth, and the triadic family process in Jewish families was more cohesive. Child care arrangements, part-time employment, easier infant temperament, and lower separation anxiety predicted maternal readaptation to work. Traditional sex-role attitudes, career centrality, full-time employment, and marital satisfaction predicted fathers' work adaptation. Parents' family focus, marital satisfaction, and responsive parenting correlated with a cohesive triadic process. Discussion considered the impact of nuclear- and extended-family living arrangements on the emerging work and family roles in young couples.

Adult↗
PubMed2001

Families and family psychology at the millennium. Intersecting crossroads.

This introduction to the International Perspectives section presents a global overview of various issues and trends that families and family psychologists confront at the beginning of the 21st century. These are presented in broad strokes so that a kaleidoscopic intermingling of pieces emerges. Some predictions are included about new and expanding directions the field of family psychology is likely to take in coming decades. The need for additional research to field test criteria sets for emerging relational diagnosis and to evaluate which are the most efficacious therapeutic interventions is highlighted (F. W. Kaslow, 1987, 1995b). This section also includes 3 other articles on various aspects of family psychology by leading psychologists from 3 diverse countries and continents--the Virgin Islands (R. Dudley-Grant, 2001), Israel (E. Halpern, 2001), and Japan (K. Kameguchi, 2001). Each is representative of the larger region in which each author teaches and practices. These articles are intended to present a collage of some of the problems families are experiencing, future trends, and a call to action for psychologists to intervene to prevent and ameliorate family distress. Each author describes the history and current status of family psychology in his or her country and relates key dilemmas to what is happening on the world scene.

Family↗
PubMed2006

The roles of familial alcoholism and adolescent family harmony in young adults' substance dependence disorders: mediated and moderated relations.

This study examined the prospective relations among family history density of alcoholism (FHD), adolescent family harmony, and young adults' alcohol and drug dependence. Family harmony was rated by mothers and fathers in adolescence, and young adults' substance dependence diagnoses were obtained through structured interviews. Higher FHD predicted lower adolescent family harmony, which in turn increased young adults' odds of being diagnosed with drug dependence (with and without alcohol dependence) compared to no diagnoses or to alcohol dependence only. Family harmony also interacted with FHD such that the protective effect of family harmony on young adults' drug dependence with or without alcohol dependence decreased as FHD rose, and was nonsignificant at high levels of FHD. The findings suggest the importance of distinguishing among alcohol and drug dependence disorders and examining their differential etiological pathways, and also suggest that the protective effects of harmonious family environments on substance dependence may be limited at high levels of FHD.

Adolescent↗
PubMed2002

Familial resemblance of body mass index and familial risk of high and low body mass index. A study of young men in Sweden.

OBJECTIVE: Male familial correlations in body mass index (BMI) were studied using a large nationwide dataset of Swedish military conscripts examined at age 18-19 y. DESIGN: Record linkage was performed between Sweden's Military Service Conscription Register and the Multiple-Generation Register, enabling the identification of 92 869 families containing at least two brothers. Data on BMI at conscription was available for 196 743 sons and for 19 972 fathers. Pairs of relatives were used to estimate Pearson correlation coefficients for BMI, and to examine whether there are BMI intervals that show particularly strong familial resemblance. RESULTS: All biological family relations showed highly significant correlations for BMI: 0.28 (95% CI 0.27-0.29) for father-son pairs; 0.36 (0.35-0.37) for full-brothers, 0.21 (0.18-0.24) for maternal half-brothers, and 0.11 (0.08-0.14) for paternal half-brothers. Also, a significant correlation, of 0.06 (0.01-0.11), was found for non-biological quasi father-son relations. Full-brothers were more similar with respect to BMI at age 18 than father-son pairs, and maternal half-brothers were more similar than paternal half-brothers. The familial risk of having BMI values above or below various cut-offs was found to be equally strong for low BMI as for high BMI values. CONCLUSION: The almost twice as strong BMI correlation between maternal half-brothers as between paternal half-brothers illustrates the importance of factors of non-additive genetic origin, to the familial aggregation of BMI. The significant BMI association found between biologically unrelated individuals from the same family emphasizes that assortative mating (and regional clustering) should be taken into account when the heritability of BMI is estimated.

Adolescent↗