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PubMedDate not supplied

Families at risk of child maltreatment: entry-level characteristics and growth in family functioning during treatment.

Research suggests that perinatal screening and early intervention may reduce the incidence of maltreatment and improve the parenting in at-risk families. The question of whether families with different sets of entry-level characteristics differ in the way that they respond to intervention is asked in this paper. We investigated whether entry-level family functioning and family problems had an impact on length of time in treatment and the improvement or deterioration of family functioning over time. In our analyses, we used entry-level characteristics to classify families into five homogeneous groups--situationally stressed, chronically stressed, emotionally stressed, multirisk, and violent multirisk--and we found that treatment duration and rate of change in family functioning over time differed in clinically important ways across these groups. Our findings suggest that treatment is likely to be successful in stabilizing and slowly improving the family functioning of the majority of families at risk of child maltreatment.

Adolescent↗
PubMed1999

An efficient tool for screening for maladaptive family functioning in adolescent drug abusers: the Problem Oriented Screening Instrument for Teenagers.

The assessment of maladaptive family functioning among adolescent drug abusers is particularly important because maladaptive family functioning has been linked to adolescent drug abuse/delinquent behaviors, and there are now highly effective family interventions available for treating these family dysfunctions. The purpose of the study reported in this article was to investigate the degree to which the Problem Oriented Screening Instrument for Teenagers screen for the family domain provides useful information regarding family functioning when used with clinic-referred youths with behavior problems. Participants in this study were 135 Hispanic and African-American youth referred for the treatment of severe behavior problems, including drug use. Our findings provide support for the usefulness of the 11-item POSIT family functioning screen. Data supporting the criterion validity of the POSIT Family screen, its ability to classify families correctly in terms of their family functioning, and its significant loading on the latent variable resulting from a confirmatory factor analysis all lend support to the usefulness of this screen of family functioning. In addition, analyses designed to explore the relationships between gender and race/ethnicity and the POSIT Family subscale showed that differences in scores by gender and race/ethnicity are not unique to the POSIT, but rather reflect similar differences in family functioning reported by the adolescent on more extensive family measures.

Adolescent↗
PubMed1994

Cardiac patients and spouses: family functioning and emotions.

This study examined the relationships among satisfaction with family function and emotional states of a nonprobability sample of sixty-six myocardial infarction (MI) patients and their spouses who were recruited from hospitals in the Delaware Valley. Patients and spouses completed the Family APGAR and the Affects Balance Scale. It was found that both patients and spouses experienced substantial emotional distress when compared with the norms for nonclinical subjects. They were highly correlated on both measures, particularly for positive emotion and satisfaction with family function (p < .0001). Satisfaction with family function was significantly correlated with positive affect for spouses (p < .05). These results suggest the importance of assessment of satisfaction with family function and emotional status of both MI patient and spouse, with spouses with lower satisfaction with family function being at greater risk for emotional distress.

Adaptation, Psychological↗
PubMed2000

Family functioning of recovered alcohol-addicted patients: a comparative study.

Regaining the communication, concentration on role conflicts and strengthening of emotional ties are the central issues of socio-therapeutic approach to alcoholism. The aim of the present cross-sectional study was to compare family functioning between two groups of recovered alcohol-addicted patients. They were all participants of treatment program where complex therapeutic interventions were used, and were abstaining for at least 1 year. A total of 30 patients with a spouse or partner participating in the treatment were compared to 20 patients without spouse or partner participation. In order to show a different perspective on family strengths and weaknesses, we used a multidimensional questionnaire of family functioning, Family Assessment Measure (FAM). A significant difference in family functioning between both groups was found. Family functioning difficulties in two dimensions: control and affective involvement, were found in families without spouse or partner participation in the treatment. Even after years of abstinence, family functioning was not satisfactory in these families.

Adult↗
PubMed2003

Chronic posttraumatic stress disorder and family functioning of Vietnam veterans and their partners.

OBJECTIVE: This study examines the association between posttraumatic stress disorder (PTSD), in terms of the three main symptom clusters (intrusion, avoidance and arousal), and the self-report of family functioning of Vietnam veterans and the self-report of family functioning of their partners. A second objective was to determine if depression, anger and alcohol abuse mediated between PTSD symptoms and family functioning. METHOD: Vietnam veterans and their partners completed a series of questionnaires as part of their participation in the inpatient and outpatient PTSD treatment program, in the Veterans Psychiatry Unit, at the Austin and Repatriation Hospital. RESULTS: Data from 270 veterans and partners were used in the final analyses. The PTSD subscales were initially correlated with family functioning for veterans and family functioning for partners. Then two path diagrams were constructed and analyzed using the statistical program AMOS to test for mediating effects between PTSD symptoms and family functioning. For veterans there were significant initial correlations with all three subscales of the PTSD measure. In the path analysis when the mediating variables were included only the avoidance subscale of the PTSD measure remained directly associated with family functioning. The arousal PTSD subscale was mediated by anger. The measures of depression and anger were significantly associated with poor family functioning and the anger and the avoidance subscales were significantly associated with depression. In the second set of analyses conducted on data from partners, the PTSD symptoms of avoidance and arousal were initially correlated with family functioning. When the test for mediation was conducted none of the PTSD subscales remained associated with partners' self-report of family functioning. Posttraumatic stress disorder arousal and alcohol abuse were mediated by anger for partners' self-report of family functioning. CONCLUSIONS: Posttraumatic stress disorder symptoms of avoidance for veterans, and comorbid symptoms of anger and depression for veterans, and anger on its own for partners appear to be important in the self-report of family functioning. These findings suggest that veterans and their partners have similar difficulties as couples with distressed relationships in the community.

Ambulatory Care↗
PubMedDate not supplied

Differences between alcoholics and spouses in their perceptions of family functioning.

The present study is an investigation of differences between alcoholics and significant others in their perceptions of the functioning of their families or households. A sample of 80 pairs of alcoholic patients (PTs) and their spouses or spouse equivalents (SOs) who were living together in the same household evaluated family functioning by completing the Family Assessment Device (FAD). Agreement between PTs and SOs was moderate on the Affective Responsiveness, Communication, Problem Solving, Roles, and General Functioning scales. However, there was little or no agreement on the Behavior Control and Affective Involvement scales. These results indicate that although PTs and SOs tended to agree about how well family members work together and share thoughts and feelings, they disagreed about how well boundary issues were dealt with in their families. Implications for treating alcoholic families are discussed.

Adult↗
PubMed2006

Examining the validity of self-report assessments of family functioning: a question of the level of analysis.

Family assessment instruments attempt to measure family functioning at a particular level of the family system: individual, dyad, or family as a whole. This article introduces the concept of level validity, that is, whether an assessment measures family functioning at the level that it was intended to measure. The authors argue that whenever higher-order factors (e.g., dyadic subsystems) are the target of a measure, these factors should explain variance that is independent of their lower-order constituents (e.g., individual-level characteristics). Previously published data targeting dyadic subsystems within the family were reanalyzed using a model that controls for lower-order effects. Dyad-level factors rarely emerged independent of individual-level factors and, when they did, they did not replicate across samples. The results suggest that level validity should be tested and reported along with other aspects of construct validity before accepting such measures as valid assessments of family functioning.

Adolescent↗
PubMed2006

Grandmothers, caregiving, and family functioning.

OBJECTIVES: We used McCubbin's Resiliency Model of Family Stress, Adjustment and Adaptation ( McCubbin, Thompson, & McCubbin, 2001) to examine how demographic factors, family stress, grandmother resourcefulness, support, and role reward affect perceptions of family functioning for grandmothers raising grandchildren, grandmothers living in multigenerational households, and grandmothers not caregiving for grandchildren. METHODS: A sample of 486 grandmothers completed a mailed questionnaire. We used structural equation modeling to (a) test the effects of demographic factors (i.e., grandmother's age, race, marital status, and employment), family stressful life events and strain, grandmother's resourcefulness, subjective and instrumental support, and role reward on perceptions of family functioning for each grandmother group; (b) evaluate differences in the measurement and structural models between the grandmother groups using multisample analysis; and (c) test the model on the full sample, coding for caregiver status. RESULTS: The models did not differ significantly by grandmother group; therefore we assessed the composite model using a multisample analysis. We found general support for the resiliency model and equivalence of the models across grandmother groups. Less support, resourcefulness, and reward, and more intrafamily strain and stressful family life events contributed to perceptions of worse family functioning. DISCUSSION: Findings demonstrate the importance of the quality of family functioning for grandmothers in all types of families.

Adult↗
PubMed1985

A factor analysis of self-report measures of family functioning.

Four well-known, self-report measures of family functioning were serially examined in order to identify a limited set of reliable concepts for describing families. Following the completion of four separate data collection procedures, a 75-item scale comprising 15 dimensions of family functioning was constructed. The dimensions appear reasonably independent of each other and have satisfactory psychometric properties. An initial effort to validate the scales was undertaken by contrasting scale scores obtained from descriptions of intact families with those obtained from descriptions of families that subsequently were disrupted by separation and divorce. Significant differences in scale scores were obtained on 12 of the 15 dimensions of family functioning. The 15 dimensions of family functioning could be subsumed under the three general headings suggested by Moos, Insel, and Humphrey (14)--relationship dimensions, personal growth or value dimensions, and system maintenance dimensions.

Adolescent↗
PubMed2002

Characteristics of family functioning in patients with endogenous monopolar depression.

The purpose of the study was to investigate dysfunctions in families with a member suffering from endogenous monopolar depression during the acute phase by means of a case-control study, and to consider the possibilities of psychiatric intervention for families with a patient in the course of monopolar depression. Twenty patients with monopolar depression during the acute phase and family members living in the same household (Depressive families) were compared with twenty-seven non-clinical college students and their family members (Control families) with regard to family functioning assessed by the Family Assessment Device (FAD). Depressive families reported significantly worse family functioning than Control families, especially in three areas: Problem Solving, Communication, and General Functioning. Members of Depressive families also perceived their family functioning to be significantly poorer than that of Control families, in the areas of Problem Solving, Communication, Roles, Affective Responsiveness, Affective Involvement and General Functioning, which yielded the same result as a comparison between depressive couples and control couples. The pattern of family dysfunction that was found in the present study, especially in the three areas of family functioning, Problem Solving, Communication, and General Functioning, emphasizes the importance of appropriate family intervention to improve the family's competence in problem solving and to promote better communication in the family during the acute phase of endogenous monopolar depression. Additionally such family dysfunction has been similarly observed in North American studies, indicating that diverse problems emerge beyond differences in the cultural background of families containing a patient with endogenous monopolar depression.

Adult↗
PubMed1995

Family functioning in adolescent anorexia nervosa.

BACKGROUND: Difficulties in family functioning have been noted since early descriptions of anorexia nervosa and may be of importance aetiologically. Previous studies have a number of methodological problems. METHOD: Thirty-five anorexic adolescents were age/sex matched with psychiatric and community controls. A diagnostic interview and a questionnaire, the Family Assessment Device (FAD) were administered to control subjects and their mothers. Anorexic families only received the McMaster Structured Interview of Family Functioning. RESULTS: Multivariate analyses of FAD scores showed pathological ratings for psychiatric control but not anorexic families, compared with community controls. By contrast objective ratings revealed marked dysfunction in anorexic families (greater in the purging subgroup). CONCLUSION: Family functioning in anorexic families is normal by self-report but not by an objective measure. Anorexic families in the purging subgroup appear most dysfunctional.

Adolescent↗
PubMed2006

Unique contribution of family functioning in caregivers of patients with mild to moderate dementia.

The relationship between family functioning and dementia caregiving is complex. The present study examined the interrelationships between family functioning, caregiver burden, and patient characteristics. Participants were 72 live-in, family caregivers of patients with mild (n = 47) or moderate dementia (n = 25). Caregivers completed measures of burden, family functioning, depression, and anxiety. Ratings of patients' memory/behavior problems and patients' activities of daily living were also collected. Results indicated that higher levels of caregiver burden were significantly associated with increased caregiver depression and anxiety, greater frequency of memory and behavior problems in the dementia patient, worse activities of daily living, and poorer family functioning. Even after controlling for caregiver depression, caregiver anxiety, and frequency of memory/behavior problems in dementia patients, poorer family functioning continued to be associated with higher levels of caregiver burden. Caregivers with high levels of burden reported greater family dysfunction in communication and roles, regardless of their relationship to the patient (i.e., spouse or child). These findings suggest that including a family systems component in caregiver interventions may be beneficial in reducing burden in these very distressed individuals.

Activities of Daily Living↗
PubMedDate not supplied

Effect of stress on family functioning during pregnancy.

A theoretical model hypothesized to predict family functioning was tested in four groups of expectant parents, followed by exploratory model building. The groups studied during the 24th to 34th weeks of pregnancy included 153 high-risk hospitalized women, 75 of their partners, 218 low-risk women from the general obstetric clinic, and 147 of their partners. Both partners in the high-risk situation reported greater discrepancy in family functioning than partners in the low-risk situation. The hypothesized models proved to have low explanatory power, accounting for 13% to 15% of the variance. The final empirical models developed explained 33% of the variance in family functioning among high-risk women and 48% among their partners, 23% among low-risk women, and 32% among their partners. The empirical models differed from the hypothesized models in that variables postulated to have only indirect effects were shown to have direct effects on family function and inter-generational variables significantly expanded the theoretical model.

Adolescent↗
PubMed2006

Child comorbidity, maternal mood disorder, and perceptions of family functioning among bipolar youth.

OBJECTIVE: To examine the association between youth comorbid psychiatric disorders, maternal mood disorder, and perceptions of family cohesion and conflict among youth diagnosed with pediatric bipolar disorder (PBD). METHOD: Three hundred eighty-nine bipolar youths and their parents completed a diagnostic interview and instruments assessing family psychiatric history and functioning. Family functioning was assessed with the Family Adaptability and Cohesion Scales-II and the Conflict Behavior Questionnaire. RESULTS: The presence of a maternal mood disorder was associated with lower family cohesion. The presence of a youth externalizing disorder with or without a co-occurring anxiety disorder was also associated with lower family cohesion as well as higher family conflict. Furthermore, the negative relationship between maternal mood disorder and family functioning was stronger in the presence of a youth externalizing disorder. CONCLUSIONS: Youth comorbidity and maternal mood disorders appear to be associated with worse family functioning among bipolar youths. Family-based treatments with bipolar youths may need to integrate treatment of youth comorbidity and address maternal mood disorder for optimal results.

Adolescent↗
PubMed1991

The effects of family functioning on infant birthweight.

A prospective cohort study was undertaken to evaluate the relationship of family functioning to infant birthweight adjusted for length of gestation. The mother's perception of family functioning was assessed at the initial prenatal visit using the Family Adaptability and Cohesion Evaluation Scales (FACES II). All obstetric patients at four family medicine clinics from April 1984 through April 1987 whose initial prenatal visits occurred by the 28th week of gestation were invited to participate; 95% chose to do so. Information was obtained on 833 mother-infant pairs. Listwise deletion on any one variable reduced the sample to 772 with no apparent bias in the dependent or predetermined variables. Twelve percent of the families were considered to be dysfunctional by scoring on the extremes of both the cohesion and adaptability continua of the self-report FACES II questionnaire. Infant birthweight was regressed on length of gestation and other known biomedical, anthropometric, risk-behavior, and sociodemographic determinants, as well as family functioning. Women who perceived their families as dysfunctional were delivered of infants who weighed on the average 126.4 g (95% CI 37.4, 215.4) less than infants born to women from functional families (P = .0055), after adjusting for other known determinants. Family functioning also was found to modify the effects of prepregnancy weight and infant sex on infant birthweight.

Birth Weight↗
PubMed1997

Family functioning and mental illness: a comparison of psychiatric and nonclinical families.

The primary objective of the present investigation was to examine adaptive functioning in the families of patients with a wide range of psychiatric disorders. Seven dimensions of family functioning, as measured by the Family Assessment Device (FAD), were compared across families of patients with a schizophrenia spectrum disorder (n = 61), bipolar disorder (n = 60), major depression (n = 111), anxiety disorder (n = 15), eating disorder (n = 26), substance abuse disorder (n = 48), and adjustment disorder (n = 46). Families in each psychiatric group were also compared to a control group of nonclinical families (N = 353). Results indicated that regardless of specific diagnosis, having a family member in an acute phase of a psychiatric illness was a risk factor for poor family functioning compared to the functioning of control families. However, with few exceptions, the type of the patient's psychiatric illness did not predict significant differences in family functioning. Thus, having a family member with a psychiatric illness is a general stressor for families, and family interventions should be considered for most patients who require a psychiatric hospitalization for either the onset of, or an acute exacerbation of, any psychiatric disorder.

Adaptation, Psychological↗
PubMed1987

Family functioning and functional independence in spinal cord injury adjustment.

The relationships among functional independence, perceived family functioning and duration of disability were studied in 41 non-institutionalised post-traumatic spinal cord injury (SCI) families. Correlational analyses revealed that SCI subjects with greater self initiation of activities, increased social involvement and higher overall level of independence perceived their family environment as affectively responsive, open in communication and clear in delineation of role responsibilities. The 'significant other's' (A 'significant other' is designated by the SCI subject as 'the one most involved with you'. The 'significant other' had to be living with or within 25 miles of the SCI subject and in contact at least 3 times a week.) view of the family was unrelated to SCI function. Conversely, for the significant other but not the SCI subject, greater duration of disability predicted more concern for the family's ability to problem solve, delineate roles and maintain standards of behaviour control. Of the functional areas measured, only participation in outside activities increased significantly over time. The results are discussed in terms of the importance of considering the long-term and separate rehabilitation needs of the individual with a SCI and his or her family.

Activities of Daily Living↗
PubMed1998

Adolescent abortion and parental notification: evidence for the importance of family functioning on the perceived quality of parental involvement in U.S. families.

This study was an investigation of the relationship between family variables and the perceived quality of parental involvement following parental notification of an adolescent's decision to have an abortion. Demographics, family religiosity, and family functioning variables were examined. Pregnant adolescent clients from seven abortion clinics in three states completed a survey assessing their perception of the quality of parental involvement and the family variables. Only family functioning variables were significantly related to the perceived quality of parental involvement. Family adaptability (the family's ability to change its power structure, role relationships, and relationship rules in response to situational and developmental stress) was the most predictive. Adolescents from adaptable families had a more positive experience with parental involvement than adolescents from less adaptable families.

Abortion, Legal↗