Areas Of Family Functioning Research Articles

Behavioral Problems and Family Impact in Congenital Cytomegalovirus Infection.

We examined behavior (Child Behavior Checklist) and family functioning (Family Impact Questionnaire) in 65 children with congenital cytomegalovirus. Behavioral problems were present in 30.8%. Parents of children with moderate/severe outcomes reported strain on all areas of family functioning. Behavioral problems were associated with negative impact on parental feelings and marital/partnership relationship. Our findings inform planning support services.

Family function patterns, and associated socioeconomic variables – a survey study of members of rural Egyptian families attending family medicine centers affiliated to Suez Canal University

Background: Socioeconomic status (SES) is a key factor that impact the family functioning. Results from previous studies demonstrated that low SES status was associated with less satisfaction in several areas of family functioning. Objectives: To describe the family function status patterns and associated socioeconomic status variables in a rural sample of Egyptian families. Subjects and methods: This study was carried out as a cross-sectional survey in a three rural Family Medicine Centres, Ismailia Governorate, Egypt in November 2022. An estimated total sample size of 164 participants was included. Each participant was interviewed to complete an Arabic version of Apgar questionnaire for the family function status assessment and the scale of socioeconomic status for health research in Egypt in sequence. Results: Eighty-two families representing 48.2% were in middle SES grade, 79 families representing 46.5% were in low SES grade, 9 families representing 5.3% were in very low SES grade, and 0 (0%) were in high SES grade. The family function status categories showed 43.5% of families were in highly functional category,49.4% were in moderately dysfunctional category, and 7.1% were in severely dysfunctional category. Mean score SES for the highly functional families was significantly different from the moderately dysfunctional families; 44.35 ± 11.28 (SD) vs 38.68 ± 11.09 (SD), respectively. Total SES score, education, and culture domain of SES scale showed a statistically significant positive moderate correlation with family function status total score (r 0.215, P< 0.005, r 0.225, P < 0.003). Conclusions: More than fifty percent of rural Egyptian families in this study lie in low, and very low SES status. Socioeconomic status score of highly functional families was significantly higher than the score of moderately dysfunctional families. SES score, and education, and culture domain showed a significant positive moderate correlation with the family function status score.

Caring of Old: Carer's Perspective

The burden of aging society and concern towards the shift in young-old population balance is felt throughout the world. The increasing proportions of older persons have been accompanied, in most populations, by steady declines in the proportion of young persons (UN, 2013). Population of over 60 years olds will reach to one billion within the decade estimates report prepared by UNFPA and Help Age International, 2012. In India too, the pressure is mounting with the increased number of 'Older' people (60+ years) by 54.77 percent in the last 15 years. Older People are now living longer with increasing life expectancy and availability of better health facilities but are also requiring more assistance or care to manage their day to day activities. There are many challenges in providing better quality of life to older people especially those requiring high support needs. Older people as a group are also divers and each of them have a distinct need. Carers of older person play a key role in meeting these challenges. Caregivers represent an important source of care for older person and are present in some form in all societies. A caregiver is someone who assumes responsibility for the care of an older person who has some health problems. In Indian context, this role is usually played by family member /members mainly female spouse, daughter in law, son or daughter. The role of caregiver can become increasingly burdensome if the person needs constant care. However, as older persons have many assets, strengths and resources, they can be used, involved in the process of providing care. The aim of this article is to provide an overview of the issues/problems faced by caregivers, level of stress experienced by them in their family relationship and adjustment, burden in different areas of family functioning, social and emotional reactions of caregivers to the responsibility of care giving. The paper is based on the findings of an empirical qualitative in-depth study conducted in the state of Gujarat, India during the year 2012-13. The study concludes that care giving role is a serious and ongoing process. Caregivers often face hardships of various kinds. Daily activities of the care giving coupled with lack of social and familial support causes burden of care, stress and frustration and greatly affect care givers contributing to negative adaptation to the situation thus affecting the their total quality of life. In spite of this carers found lot of satisfaction in the role of carer and carried it out as a sense of their duty to give back.

Impairment in Young Preschool Children with Symptoms of Attention-Deficit/Hyperactivity Disorder and Co-occurring Oppositional Defiant Disorder and Conduct Disorder

Abstract Background: We have limited knowledge of the impact of attention-deficit/hyperactivity disorder (ADHD) symptoms on the daily functioning of young preschool children. Objective: This study investigated the level of impairment related to symptoms of ADHD in different functional domains. It also addressed how impairment caused by ADHD was related to ADHD subtype, symptom load, gender, and the co-occurrence of oppositional defiant disorder, conduct disorder, or both. Method: Participating children (N = 807) who were 3.5 years old were recruited from a population-based sample included in The Norwegian Mother and Child Cohort Study. Children who scored above the 90th percentile for ADHD symptoms were included in the present sample. The assessment of the symptoms and functional impairment described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, text revision, was based on parental ratings and the semi-structured psychiatric interview entitled “The Preschool Age Psychiatric Assessment.” Results: Added burden and discord within family relationships were the areas that were most severely affected. All domain scores were strongly intercorrelated, and they were added to each child’s total score. Children with symptoms of ADHD, inattentive type (mean [M], 3.5; standard deviation [SD], 3.4), or ADHD, hyperactive/impulsive type (M, 2.9; SD, 2.7), were significantly less impaired than children with symptoms of ADHD, combined type (M = 6.4; SD = 3.8; p ` .001). Furthermore, co-occurring oppositional defiant disorder was associated with higher impairment scores (M, 6.1; SD, 4.3) than ADHD alone (M, 3.2; SD, 2.9; p ` .001. About 30% of the variance of impairment score of ADHD was explained by symptoms of ADHD and co-occurring symptoms of oppositional defiant disorder and conduct disorder. Few gender differences were observed. Conclusion: Overall, these non-referred young children with clinical symptoms of ADHD were only modestly impaired. Impairment related to ADHD occurred mainly in the areas of family functioning, and it was associated with ADHD subtype and comorbidity. Still, it is important to assess the impact of ADHD symptoms and coexisting difficulties among preschoolers to identify children and families who are in need of early intervention efforts.

Family Functioning and Income

This study explored the impact of income status (low-income vs. non-low-income) on family functioning, social support, and quality of life in a community sample of 125 families. The sample identified themselves as 17% Black or African American, 7% Latino, 4% Asian, and 66% White. The mean age of participants was 37 years. The study used a self-report measure of perceived family functioning, the Family Assessment Device (FAD). Results demonstrated that low-income status was associated with less satisfaction with several areas of family functioning, and that the effect of having a family member with a psychiatric disorder on family functioning depended on income status, with low-income families with a psychiatric disorder endorsing much greater dissatisfaction with family functioning than non-low-income families with a psychiatric disorder. Low-income families also had significantly lower social support and quality of life scores than non-low-income families. Low-income status appears to put stress on families in general and to compound the effects of having a psychiatric disorder on family functioning. Non-low-income status, by contrast, appears to offer a buffer from the effects of having a psychiatric disorder on family functioning. These findings suggest the importance of providing family-based interventions to low-income families in which one or more members has an identified psychiatric disorder.

Mindful Parenting in Mental Health Care: Effects on Parental and Child Psychopathology, Parental Stress, Parenting, Coparenting, and Marital Functioning

This study evaluated the acceptability and effects of a Mindful Parenting course in mental health care. Parents (n = 86) referred to secondary mental health care because of their children’s and/or their own psychopathology, or parent–child relationship problems, followed a Mindful Parenting course in a group format (10 groups). Assessments took place just before the course (pre-test), immediately after the nine-week course (post-test), and at 8-week follow-up. A waitlist assessment took place only for those parents who had to wait for a course (n = 23). Measures concerned parent report of psychopathology symptoms of their target child, as well as their own psychopathology symptoms, parental stress, parenting behaviors, coparenting, and marital functioning. Only one parent dropped out and parents evaluated the program as valuable and effective in many areas of family functioning. No improvement was reported during waitlist, except for an improvement in parental externalizing symptoms. Improvements after the course occurred in the target child’s internalizing and externalizing psychopathology symptoms, parents’ own internalizing symptoms and further improvement on their externalizing symptoms. Also, improvements occurred on parental stress, parenting, and coparenting, but not on marital functioning. Improvements were generally maintained at follow-up. In conclusion, the very low dropout rate as well as the positive evaluations, suggest that Mindful Parenting is an acceptable and feasible intervention in mental health care. Mindful Parenting appears a promising new intervention for parents in mental health care, as it seems effective on a broad range of child, parent, and family variables. Studies comparing Mindful Parenting to other effective interventions, such as Parent Management training, are needed to gain more knowledge about its relative and differential effectiveness.

Family Functioning Patterns as Predictors of Engagement: Which Families Participate in Services and Which Ones Do Not?

ABSTRACT The present study examines the relationship between specific areas of family functioning and family engagement in prevention services. A sample of 147 families who initiated youth-centered treatment services from a non-profit agency was selected. Statistical analysis was used to test for relationships between family scores on the Family Assessment Measure (version III, General Scale) and family levels of engagement in services. Results of binary logistic regression analysis indicated that individual and family characteristics are associated with family engagement in services. In addition to demographic variables of age and race, family patterns of denial made a significant individual contribution to the evaluated model. Implications for engaging families in prevention services are discussed and suggestions are made for future research.

Client participation and outcomes of intensive family preservation services

This study examined whether and how variations in client participation affect outcomes of intensive family preservation services in child welfare. Two distinct components of participation were identified: collaboration with workers in treatment planning and compliance with program expectations. Controlling for case characteristics and duration of services, results of a simultaneous equations model indicate that greater collaboration is related to better compliance. Compliance, in turn, predicts significant reductions in the likelihood of subsequent reports of child maltreatment and out-of-home placements. Compliance is not predictive of the substantiation of new reports of maltreatment or case closing in the public child welfare agency. Alternative explanations for the findings are considered. Although more active client participation might facilitate change in target problems, compliance itself may affect clinical and judicial decisions that lead to certain outcomes. Key words: child welfare; client participation; compliance; family preservation services; outcomes In the 1980s and 1990s intensive family preservation services (FPS) were widely implemented in child welfare agencies across the United States. This was a response to burgeoning caseloads, a requirement of the Adoption Assistance and Child Welfare Act of 1980 (P.L. 96-272) that states make reasonable to prevent out-of-home placements, and positive early evaluation results (Fraser, Nelson, & Rivard, 1997). In cases of child abuse and neglect, FPS seek to reduce the risk of future harm to children so that they can remain in their own homes safely. The success of FPS may depend in part on the extent to which caseworkers engage parents and other primary caregivers in efforts to improve parenting and family functioning. FPS caseworkers have reported wide variations in caregiver participation (Schuerman, Rzepnicki, & Littell, 1994). Although similar variations have been linked to outcomes in other settings (Blackwell, 1997; Moos & King, 1997; Orlinsky, Grawe, & Parks, 1994), there is little empirical research on caregiver participation in FPS. This study examines effects of variations in caregiver participation in FPS on outcomes in child welfare. Referrals to FPS are usually made by public child welfare agency workers following the investigation and substantiation of reports of child maltreatment. These investigations take place without caregiver consent, establishing the involuntary context of child welfare services. In some cases the courts have ordered caregivers to participate in FPS. Clients usually enter FPS under coercive circumstances including the threat (real or perceived) of child removal as a consequence of nonparticipation. FPS are provided in families' homes and communities over a short period of time, usually between one and four months (National Evaluation of Family Preservation Services, 1995). Caseloads are small (two to 12 families per full-time worker), and workers spend two to 15 hours a week in each family's home (Fraser et al., 1997). Workers are expected to involve family members in treatment planning and help caregivers provide better care for themselves and their children (Kinney, Haapala, & Booth, 1991). FPS workers provide caregivers with information, support, counseling, material aid, and referrals to other community resources. In some jurisdictions, the provision of FPS is viewed by child welfare and family court staff as prima facie evidence that the reasonable standard has been met. LITERATURE REVIEW Recent studies of the effects of FPS have had mixed results (Blythe, Salley, & Jayaratne, 1994; Fraser et al., 1997; Pecora, 1991; Rossi, 1992; Schuerman et al., 1994). FPS have not produced expected reductions in out-of-home placements or in the recurrence of child maltreatment. A few controlled studies linked FPS to modest, short-term improvements in some areas of family functioning (Feldman, 1991; McCroskey & Meezan, 1997; Schuerman et al. …

Evaluating the Effectiveness of Multifamily Group Therapy in Child Abuse and Neglect

This article compares the effectiveness of multifamily group therapy (MFGT) with traditional family therapy in the treatment of abusing and neglectingfamilies. Eighty-one families were ran domly assigned to the MFGT group or a comparison group where they received traditional fam ily therapy. Comparison of group means was conducted at pretest and at the close of service on child abuse potential and numerous measures of family functioning. Within-group changes were also examined between pretest and posttest. At posttest, families receiving MFGT reported sig nificantly lower child abuse potential scores and significantly better social support scores than families in the comparison group. Additionally, within-group comparisons show that the MFGT group significantly improved in a larger number of areas of family functioning than the comparison group. The findings argue for the expanded use of MFGT with maltreating families and its adoption of a greater number of family service agencies dealing with this population.

Psychopathology and family functioning in mothers with epilepsy

In a prospective comparative study of children born to mothers with epilepsy and to healthy controls, maternal psychopathology, family functioning and the effects of maternal psychopathology and family functioning on child mental status were investigated. The instruments used were the Present State Examination (PSE), the Past History Schedule (PHS), a psychiatric interview for preschool children and a structured interview about family functioning. Interviewers were blind to the clinical status of the mother. The group of mothers with epilepsy differed from the control group only regarding a higher prevalence of minor psychopathology and in 1 of 4 areas of family functioning. There was no difference between mothers with epilepsy and the control group regarding major psychopathology, and almost no differences regarding family functioning. The effect of maternal psychopathology on child mental status was mediated by disturbed family functioning only in the epilepsy group.

Changes in family functioning during treatment and drinking outcomes for high and low autonomy alcoholics.

Alcoholics' level of autonomy was hypothesized to have a moderating effect on the relationship between changes in family functioning and subsequent drinking behavior. Functioning of families of patients in outpatient alcoholism treatment was assessed prior to the onset of treatment and again 6 months later. For alcoholics who were low in autonomy, perceptions of improvements in functioning predicted better drinking outcomes during a subsequent 6-month follow-up, while changes in family functioning were unrelated to drinking behavior in high autonomy alcoholics. The areas of family functioning in which change was a significant predictor of later drinking primarily concerned the quality of interactions between family members. Alcoholics' gender, psychiatric comorbidity, and the type of treatment they received did not moderate the relationship between changes in family functioning and drinking outcomes. Implications for the treatment of alcoholic patients and the limitations of the research are discussed.

Family-Guided Assessment for IFSP Development

The assessment of family strengths and needs for Individual Family Service Plan development has engendered considerable anxiety among early intervention practitioners. In the search for appropriate family assessment instruments and models, interventionists are faced with a confusing array of resources, materials, and procedural recommendations. This article expresses concern with prevailing family assessment models that suggest comprehensive assessment across all areas of family functioning. Issues of instrument development and use, the types and nature of early intervention services provided, and the role of interventionists are discussed in light of feedback from practitioners.

A cross-cultural study of family functioning

The Family Assessment Device (FAD) was used to compare patterns of family functioning in two cultural settings, North America and Hungary. The sample size consisted of 95 nonclinical North American families and 58 nonclinical Hungarian families. No cross-cultural differences were found in the families' general functioning nor in their affective involvement or affective responsiveness as measured by the FAD. Hungarian families, however, perceived their functioning as significantly better than the North American families in problem-solving and in communication. North American families rated themselves significantly better than the Hungarians in setting family rules and boundaries and in meeting their family responsibilities. Results from this study suggest that cultural values can affect a family's functioning and that differences in areas of family functioning can be captured using the FAD. A discussion of broad societal values of the two cultures was used to interpret the contrasting patterns of family functioning. Cross-cultural studies serve many purposes. In general they provide knowledge about the different cultures under investigation. As such, they broaden and enrich our perspectives of ourselves and the world around us. More specifically they highlight similarities and differences across cultures, information that can be helpful in further refining our understanding of the impact of diverse and varying socio-political forces. A topic of particular interest to family therapists and researchers is family functioning in different cultural settings. In spite of continuing research in this area, few studies examine cross-cultural patterns of family interactions and even fewer do so with instruments specifically designed to assess family functioning. From a family perspective, particularly looking at pathology in family functioning, cross-cultural comparisons can be used to highlight areas of dysfunction common to families irrespective of the cultural context. From a cross-cultural perspective, family comparisons can be used to point out the cultural effects and emphases given to different dimensions of functioning within a common system (i.e., the family unit). Both conceptual and methodological problems have contributed to shortcomings in previous cross-cultural studies (Fabrega, 1974; Kleinman, 1987; Flaherty et al., 1988; Rogler, 1989). A basic criticism of such studies has been the assumption that meanings and values in one culture are equivalent to those in another. Another issue, which is particularly pertinent to our study, is the use of an instrument which is developed in one culture and administered in another cultural setting. A potential problem this raises is inferring cultural differences between groups when the translated and the original instruments are not actually comparable in meaning. In fact, one objective of the study was to see whether our own self-report measure of family functioning, the Family Assessment Device (FAD, Epstein et al., 1978, 1983), could be successfully used in another cultural setting. The following report is part of a larger research project, conducted in 1986–87, that compared depressed and nonclinical families across two cultures. The findings presented here are comparisons between nonclinical Hungarian and nonclinical North American families. In our earlier study differences in family interactions between clinically depressed and nonclinical families were evident in both cultural settings (Keitner et al., in press). It was not clear, however, if significant cross-cultural differences in family functioning would be found for the “normal” group of families and, if so, how these would differ from their ill counterparts. Inclusion of the normal families thus served two purposes, as controls in the larger study to test within cultural differences and as comparison groups in a separate analysis to test between cultural differences. A specific objective of this study was to contrast patterns of perceived family functioning in nonclinical Hungarian families and North American families. Another objective was to determine if the Family Assessment Device (FAD), a self-report measure of family functioning, could be successfully used in different cultural contexts. Hungary was chosen as an appropriate country of study for several reasons. It is at the crossroads of East and West, sharing enough similarities with western culture to validate comparisons, yet different enough in both its cultural and sociopolitical system that some differences could be expected to emerge. Because it is likely that the Hungarian social system is less familiar to readers than that of North American, the results are discussed with particular reference to Hungary.

Early intervention in the family system: A framework and review

A framework for understanding the effect of early intervention on family structure and functioning is presented. The framework uses five sets of variables to characterize families: Their ecology; and the values, roles, personalities, and interactions of family members. Twenty research studies that met criteria of having comparison/control groups, beginning intervention either prenatally or during the first 3 months of infancy, and directing intervention to family functioning are abstracted and examined in detail. Successful and unsuccessful studies are compared as to population and nature of intervention. Two criteria of success are used: (1) The commonly used criterion of any positive change; (2) a more rigorous criterion of change in at least three areas of family functioning, based on the assumption that more pervasive change will have more lasting influence on child development. Application of the first criterion found that 75% of early family focused intervention studies showed a successful outcome. Application of the latter criterion found that 50% showed a successful outcome. Further, there were no significant differences between successful and unsuccessful studies as to target group or type of intervention. The review suggests that early intervention targeted at family functioning is effective and that a more pervasive and sustained effect is likely if the intervention includes at least 11 or more contacts over at least a 3-month period.

Life change: adjusting to continuous ambulatory peritoneal dialysis.

A period of psychological adjustment occurs when a patient switches from hemodialysis to CAPD. The authors have identified four major categories of obstacles that patients must overcome in adjusting to CAPD and its self-care techniques. Ongoing group treatment is a valuable tool for patients in learning coping skills and alternative behaviors during this adjustment period. Members move through stages in the group, from dependence and a feeling of isolation to a stage of struggle for individuation and a work phase. It is in this work phase that group members show increased mutual concern and understanding, personal responsibility, honesty, individuation, a willingness to share and to be open, and coping skills. The value of this progression within the group is that what members learn there can be carried over to patients' lives outside the group. Group therapy can assist CAPD patients in coping with isolation, perceived abandonment by the medical environment, the resurgence of predialysis conflicts, a possible increase in libido, and new areas of family functioning. The process of individuation that occurs in the group has set patients on a course toward increased independent living, closer self-scrutiny, mutual education, vocational and recreational productivity, and an improved ability to deal with the stresses of end-stage renal disease.