Family Assessment Device Subscales Research Articles

Family Functioning, Growth Initiative and Psychological Wellbeing in Postgraduate Students

A correlational research design was employed to investigate the impact of family functioning and personal growth initiative (PGI) on psychological wellbeing in postgraduate students. The hypotheses of this study were that there is a positive relationship between family functioning, personal growth initiative (PGI) and psychological wellbeing in postgraduate students. It was also hypothesized that family functioning and personal growth initiative (PGI) would predict psychological wellbeing in postgraduate students. Sample comprised of N = 198 postgraduate students (M = 24, SD = 2.74) from Higher Education Comission (HEC) recognized universities.Measures included Family Assessment Device (FAD; Epstein et al., 1983), Personal Growth Initiative Scale-II (PGIS-II; Robitschek et al.,2012) and Ryff’s Psychological Wellbeing Scale (PWB; Ryff, 1989). A positive significant correlation was found among the variables. Also, two subscales of Family Assessment Device (FAD) i.e., Affective Involvement and General Family Functioning along with Readiness for Change scale of Personal Growth Initiative Scale-II (PGIS-II) were found to be strong predictors of psychological wellbeing. Thus, the significance of family functioning along with PGI with regard to psychological wellbeing, has beenhighlighted in this study.

Relationships between family functioning, parenting and peer victimization in adolescent depression: A cross-sectional study.

OBJECTIVE:Major depressive disorder (MDD) in adolescence is a prevalent mental health problem with a complex etiology and a rising incidence. The aim of the study investigated functioning of family, attitudes of parents, and peer victimization in adolescents with MDD and to compare those with healthy adolescents.METHODS:The study was designed as a multi-center, cross-sectional, case–control study. 98 adolescents diagnosed with MDD and 99 healthy controls were recruited for the study. Beck depression inventory, parental attitude research instrument (PARI) tool, family assessment device (FAD), and multidimensional peer victimization scale (MPVS) were applied to all participants. Descriptive, correlational, and bivariate group comparisons were used in analyses.RESULTS:The average ages of adolescents with MDD and control adolescents were 14.7 (S.D.=1.5) and 15.0 (S.D.=1.6) years, respectively. Females formed 74.5% of youth with MDD (vs. 70.3% of controls). The groups were similar in terms of socio-demographic features (all p>0.05). Adolescents with MDD had significantly elevated scores in FAD subscales except problem solving, PARI rejection of homemaking, marital conflict, and authoritarian subscales, and all MPVS subscales. Adolescents with MDD also displayed significant positive correlations between all MPVS subscales and FAD subscales except FAD problem-solving.CONCLUSION:This cross-sectional, multi-center study suggests that family dysfunction and peer victimization may be higher in youth with MDD. Although cross-sectional design precludes evaluation of causality, it may be prudent to evaluate family functions as well as peer victimization of depressed youth.

Evaluation of emotional, behavioral problems and family functioning in adolescents with chronic gastritis.

The aim of the present study was to investigate psychiatric symptoms in adolescents diagnosed as having chronic gastritis, and to evaluate family functioning. The population consisted of adolescents who were diagnosed endoscopically and histopathologically as having chronic gastritis without additional chronic disease. The anxiety levels, depression levels, and emotional and behavioral symptoms of the adolescents were measured using the Screen for Child Anxiety Related Emotional Disorders (SCARED), Beck Depression Inventory (BDI), and Strengths and Difficulties Questionnaire (SDQ). Family functioning was evaluated using the Family Assessment Device (FAD). Fifty eight adolescents were included to study. According to the SDQ subscale results, adolescents with gastritis had more problems in emotional, hyperactivity, and peer relations areas, but the results in conduct problems and prosocial behaviors were normal. Levels of all subscales of Family Assessment Device were higher than 2, showing problems in family functioning. This study suggests that adolescents with chronic gastritis experience more difficulties in peer relations and family functioning, and they express more emotional problems.

Family functioning and 1-year prognosis of first-episode major depressive disorder

This study aims at investigating the characteristics of family functioning in Chinese first-episode major depressive disorder (FE-MDD) patients and its relationship with major depressive episode (MDE) duration. We recruited 63 FE-MDD families and 59 healthy comparison (HC) families from WuHan Mental Health Center and its nearby communities from September 2014 to August 2016. Family functioning was assessed by the Chinese version of Family Assessment Device (FAD). After baseline assessment, MDD patients were followed-up monthly for one year. Independent t test and Pearson correlation analysis were respectively used to compare the family functioning of MDD and HC families and to assess the relationship between family functioning and MDE duration. Our results showed that MDD families exhibited family impairment in all the 7 sub-scales of FAD. MDD patients with “healthy family functioning” showed significantly shorter MDE duration than those with “unhealthy family functioning”. MDE duration was positively correlated with the score of problem solving (PS), communication (CM) and general functioning (GF) subscales. These findings indicate that Chinese MDD families are associated with a wide range of family impairments and family functioning is linked to the MDE duration. Improvement of family functioning may be helpful for the recovery of MDD.

The relationship between internal stigmatization level and marital compliance in married women patients with bipolar disorder

Objective: The aim of this study was to determine the relationship between internalized stigmatization and marital compliance and family processes of married female patients with bipolar disorder. Methods: The patients who were admitted to psychiatry clinic of Kayseri Hospital for Mental and Neurological Disorders with the diagnosis of bipolar disorder according to DSM-5 between January and June 2018. Assessment tools were Internalized Stigma of Mental Illness Scale (ISMI) scale and Marital Adjustment Test (MAT) and Family Assessment Device (FAD). The data were analyzed by SPSS Windows version 24.0 package program using mean, Shaphiro Wilk, Mann Whitney test, Kruskal Wallis test, and Spearman’s correlation coefficient. Results: The mean score of the patients for ISMI was 49.20±16.85. The mean score of the MAT was 23.57±13.42. The total subscales scores of the patients for FAD was over 2. It was found that there was a negative and moderate significant correlation between the total scores of the ISMI and the MAT, and there was a positively weak relationship between the ISMI total score and FAD subscales (p

Family functioning and quality of life among children with anxiety disorder and healthy controls. A cross-sectional study.

Studies have shown that children with anxiety disorders (ADs) present impaired family functioning and quality of life. We aimed to evaluate family functioning and quality of life among children with AD and healthy controls. Cross-sectional study (survey) at two centers in Turkey. The study group comprised 42 children diagnosed with AD and 55 controls. The Screen for Child Anxiety-Related Emotional Disorders (SCARED) questionnaire was filled out by their parents to measure the severity of anxiety symptoms. Family functioning among the children was assessed using the Family Assessment Device (FAD) and Parental Attitude Research Instrument (PARI). The children's quality of life was assessed through the Pediatric Quality of Life Inventory (PedsQL). The children's average age was 10.00 ± 0.21 years in the AD group and 9.98 ± 1.53 years among the controls. There were higher scores on all FAD subscales in the AD group (2.15 ± 0.52; 2.29 ± 0.44; 2.44 ± 0.55; 2.10 ± 0.61; 2.56 ± 0.40; 2.32 ± 0.33; and 2.29 ± 0.47). On PARI subscales, there were significant differences favoring the AD group (p < 0.05), except for democratic attitude. All PedsQL subscales differed significantly between the groups, favoring the AD group. A statistically significant relationship was found between all PedsQL subscales and SCARED scores in the AD group. We found that both family functioning and quality of life among children with AD were negatively affected. However, further studies with larger sample sizes are required to reach stronger conclusions.

The investigation of the relationship between internalizing/externalizing problems and temperament, family functioning, child-rearing attitudes

Objective: This study was aimed to evaluate the relationship between internalizing/ externalizing problems and child temperament characteristics, family functioning and child-rearing attitudes. Methods: One hundred and fifty-seven children with internalizing and externalizing and their parents were included in this study. Internalizing and externalizing problems were evaluated by ‘Children Behavior Checklist’, child temperament was evaluated by ‘School-age Children Temperament Inventory’, family functioning was evaluated by ‘Family Assessment Device’ (FAD) and child-rearing attitudes were evaluated by ‘Parental Attitude Research Instrument’ (PARI). Results: Modelling test has been revealed that affective responsiveness feature subscales of FAD has a mediator effect on the relation found between in which both internalizing and externalizing problems, and marital conflict, rejection of the home making role and equalitarianism and democratic attitudes feature subscales of PARI. Similarly, modelling test has been pointed out that behavior control feature subscales of FAD has a mediator effect on the relation found between externalizing problems and strictness and authoritarianism feature subscales of PARI. Discussion: Our findings showed that family functioning has a mediator effect on the between internalizing/externalizing problems and child-rearing attitudes, these results indicated the importance of parent education in treatment. Long-term follow-up studies are required to determine relationships between internalizing /externalizing problems with child-rearing attitude and family functioning.

Psychometric evaluation of the Greek version of Mc Master Family Assessment Device (FAD)

IntroductionThe Family Assessment Device (FAD) is a self-report questionnaire, developed to assess the six dimensions of the McMaster Model of family functioning. It has been translated to the Greek language but never validated.Aims and objectivesTo evaluate the psychometric properties of the Greek version of FAD in a non-clinical sample.MethodsIn a sample of Greek families, FAD was administered together with the already validated Family Adaptability and Cohesion Evaluation Scale (FACES-III). In a subsample of 96 participants, the scales were administered again after 1 month.ResultsA sample of 453 participants (194 children and 259 parents) had completed both questionnaires (151 families). Mean age of children was 23.62 (SD: 6.35), 68 (35%) were males. Mean age of parents was 51.4 (SD: 8.2), 117 (45.2%) males. All subscales of FAD had significant correlation (concurrent validity) with FACES-III (n = 453, P &lt; 0.001). Test-retest reliability range from 0.58 to 0.82 (n = 96, P &lt; 0.001). Internal consistency (Cronbach's alpha) range from 0.47 to 0.94. A model with the 6 factors had a good statistical fit but not all the items were loading in the same components as from the theory assumed.ConclusionsThe Greek FAD has good psychometric properties, although its factor structure might differ from the original version. Further evaluation of the Greek version of FAD in other settings and in different samples especially clinical remains a task for future research.Disclosure of interestThe authors have not supplied their declaration of competing interest.

COMPARISION OF FAMILY FUNCTIONING, MATERNAL MENTAL HEALTH AND MATERNAL COPING STRATEGIES, BETWEEN THE CASES WHO ARE DIAGNOSED WITH ATTENTION DEFICIT AND HYPERACTIVITY DISORDER AND THE CASES WHO ARE DIAGNOSED WITH INTELLECTUAL DISABILITY

Aim: Comparision of family functioning, maternal mental health and maternal coping strategies, between the cases who are diagnosed with attention deficit and hyperactivity disorder (ADHD) and the cases who are diagnosed with intellectual disability (ID) and controls, was aimed in this study. Method: The study group consisted of 52 cases diagnosed with ADHD and 53 cases diagnosed with ID who are 6-12 years old. The control group (n=101) comprised patients of other clinics at hospital and was similar for gender and age to the ADHD and ID patients.. Sociodemographic form , family assessment device (FAD), general health questionnaire (GHQ), ways of coping inventory (WCI) were used to provide the data of the study. The forms were filled by mothers. Results: The sociodemographic features of cases and controls were similar. There was statistically significant difference in coping strategies and general mental health between groups. Roles, affective involvement, behaviour control subscales of family assessment device were statistically significant different between three groups while the other subscales of family assessment device were similar between groups. Conclusion: The finding, that mothers of children who are diagnosed with ADHD or ID have more difficulties in maternal mental health and maternal coping strategies and family functioning, showed that evaluating family functioning and especially maternal mental health and maternal coping strategies is as important as treating the children.

Family Functioning, Comorbidities, and Behavioral Profiles of Children With ADHD and Disruptive Mood Dysregulation Disorder

Objective: Children with ADHD-combined type (ADHD-C), disruptive mood dysregulation disorder (DMDD), and healthy controls (HC) were compared with respect to the sociodemographic features, psychiatric comorbidities, behavioral patterns, and family functioning. Method: Research groups were identified using the Schedule for Affective Disorders and Schizophrenia for School-Age Children–Present and Lifetime Version (K-SADS-PL). Conners’ Rating Scale–Revised Long Form, Wechsler Intelligence Scale for Children–Revised (WISC-R) test, Sociodemographic Questionnaire, and Family Assessment Device (FAD) were administered to research groups. Results: DMDD group’s rate of psychiatric comorbidity was higher than the ADHD-C group’s rate. In most of the subscales of Conners, DMDD group’s average scores were higher than the other groups’ scores. In “Communication,” “Affective Responsiveness” subscales of FAD, DMDD group’s average scores were higher than the ADHD-C group’s scores. In “Affective Involvement,” “General Functioning” subscales of FAD, DMDD group’s average scores were higher than the other groups’ scores. Conclusion: Children with DMDD were distinguished from children with ADHD-C by their higher comorbidity rate, more impaired behavioral patterns, and family functioning.

The Relationship between Bullying, Family Functions, Perceived Social Support among High School Students

This study aimed to determine the relationship between bullying attitude, family functions and perceived social support. The sample of study is composed of 683 high school students. Data were collected by using Students Relations Attitude Scale, Family Assessment Device and Perceived Social Support Scale. Pearson Moment Correlation Coefficient, ANOVA and Independent Samples t Test were used in data analysing. According to the results of the study, there is a statistically significant relationship between Students Relations Attitude's subscales which is “bully personality” and all of the subscales of Family Assessment Device and Perceived Social Support. Students Relations Attitude's subscales which are self-confidence and “avoidance of bullying” are related to all of the subscales of Family Assessment Device except “affective involvement” and all of the subscales of Perceived Social Support. It was found that, students who stated that they bully others, have high level of bully personality, family dysfunction and low level of avoidance of bullying, family and teacher support. Moreover, students who stated that they are bullied, have high level of bully personality, family dysfunction (except behavior control) and low level of family, teacher and peer support.

Marital Status, Childhood Maltreatment, and Family Dysfunction

Pathological gambling is a prevalent public health problem associated with depression, substance misuse, crime, and suicide. Despite these challenges, little attention has been directed to examining its negative consequences on families and marriages, including divorce rates, childhood maltreatment, and family dysfunction. From February 2005 to June 2010, subjects with DSM-IV-defined pathological gambling and community controls were assessed for marital and family variables and indices of childhood maltreatment. The Family Assessment Device (FAD) was used to evaluate family functioning. Ninety-five subjects with DSM-IV pathological gambling and 91 control subjects without pathological gambling were recruited and assessed. They were similar in age, gender, and employment status. Persons with pathological gambling were more likely than controls to have ≥ 1 divorce (odds ratio [OR] = 2.56; 95% CI, 1.35-4.87; P = .004), to live alone (OR = 4.49; 95% CI, 1.97-10.25; P < .001), and to report any type of childhood maltreatment (OR = 4.02; 95% CI, 2.12-7.64; P < .001). They did not differ on number of siblings or ordinal position among siblings. Pathological gambling subjects reported significantly worse family functioning than control subjects as assessed by all 7 FAD subscales. On the FAD general functioning subscale, 55% of pathological gambling families and 33% of control families were rated "unhealthy" (OR = 2.17; 95% CI, 1.14-4.12; P = .018). Severity of gambling was positively correlated with divorce, childhood maltreatment, and the FAD roles subscale. People with pathological gambling are more likely than controls to have been divorced, to live alone, and to report having experienced childhood maltreatment than controls. They also report greater family dysfunction.

Family function and social support in Iranian self-immolated women

AimThe significance of family function and social support in Iranian self-immolated women was investigated in this study. MethodsIn a prospective design, we selected 53 cases (31 self-immolated women and 22 women with unintentional burn) from Tehran and Shiraz burn centre (Motahari and Ghotbeddin Shirazi, respectively). The average age of the experimental group was 26.19 (S=7.11) with a burn percentage of 46.11 (S=25.52), and the average age of the control group was 29.15 (S=5.12) and their burn percentage was 43 (S=25.98). Along with Demographic Information Questionnaire, participants were administered Family Assessment Device (FAD) and Social Support Scale (SSS). To analyse data, we used chi-square test (χ2), t-test, multivariate analysis of variance (MANOVA) and also logistic regression analysis. ResultsData showed that the difference of Family Function sub-scales between the experimental and control groups was not significant (Wilk's lambda=0.75, F=1.67, df=(8, 51), P<0.05). On the other hand, two independent sample t-tests showed a significant difference of Social Support between the two groups (t=–3.31, df=51, P<0.002). ConclusionsConsistent with previous studies, this research showed that the less Social Support one perceives the more one at risk for self-immolation. Although the mean scores of FAD sub-scales in control group were more than experimental group, there was no significant difference between the two groups.

Effects of teaching problem solving strategies to parents of pre-teens: A study of family relationship

The purpose of the present research was to evaluate the efficacy of problem solving workshops designed for parents of pre-teens. In these workshops topics such as understanding others’ emotions, ideas, and motivations, as well as finding various solutions for a problem, were taught. Participants included 96 mothers of students in private schools. These mothers were instructed in five workshops lasted ten sessions, two hours each. Three subscales of Family Assessment Device (FAD) were used before and after the workshops: communication, affective responsiveness, and affective involvement. Analysis of data indicates that the workshops had positive effects on subjects’ performance in “affective involvement”. © 2011 Published by Elsevier Ltd.

Experienced emotional burden in caregivers: psychometric properties of the Involvement Evaluation Questionnaire in caregivers of brain injured patients

Objective: To examine the psychometric properties (internal consistency, discriminant validity, and responsiveness) of the Involvement Evaluation Questionnaire for Brain Injury measuring emotional burden in caregivers of patients with chronic acquired brain injury. Design: Inception cohort study. Subjects: Caregivers of chronic acquired brain injury patients. Main measures: Besides the Involvement Evaluation Questionnaire for Brain Injury, the Family Assessment Device and the General Health Questionnaire were used. Methods: Ninety-eight caregivers filled out all questionnaires, of which 41 caregivers did this twice, before and after the persons they cared for had started a residential community reintegration programme. Cronbach’s alpha and Intra class Correlation Coefficient were calculated for internal consistency. Pearson correlation coefficients were used for discriminant validity and Intra class Correlation Coefficient and Cohen’s d were calculated to determine responsiveness. Results: The internal consistency of the Involvement Evaluation Questionnaire for Brain Injury was good (α = 0.73—0.84; Intra class Correlation Coefficient = 0.69—0.76). As expected, low correlations were found between the Involvement Evaluation Questionnaire for Brain Injury and either the General Health Questionnaire (r = 0.11—0.40) or the Family Assessment Device subscales (r = —0.29—0.19). Regarding responsiveness of the Involvement Evaluation Questionnaire for Brain Injury, a moderate effect size was found (Cohen’s d = 0.36) while the Intra class Correlation Coefficient was good (0.80). Conclusions: The Involvement Evaluation Questionnaire for Brain Injury measures the experienced emotional burden in caregivers of patients with chronic acquired brain injury and seems to be a promising new instrument with good internal consistency, discriminant validity and responsiveness.

Family functioning and emotional state two and five years after traumatic brain injury

Previous studies have documented poor family functioning, anxiety, and depression in relatives of individuals with traumatic brain injury (TBI). However, few studies have examined family functioning over extended periods after injury. The present study aimed to investigate family functioning and relatives' emotional state 2 and 5 years following TBI, predictive factors, and their interrelationships. Participants were individuals with TBI and their relatives, with 301 seen at 2 years and 266 at 5 years post-injury. Measures included a Structured Outcome Questionnaire, Family Assessment Device (FAD), Hospital Anxiety and Depression Scale, and the Craig Handicap Assessment and Reporting Technique. Results showed that while the group did not differ greatly in family functioning from a normative group, a significant proportion showed unhealthy functioning across most FAD subscales. Both TBI participants and their relatives showed elevated rates of anxiety and depression. There was little difference between family functioning or relatives' anxiety or depression levels at 2 and 5 years post-injury. Path analysis indicated that neurobehavioral changes in the injured individual have an impact on family functioning and distress in relatives even at 5 years post-injury. These findings indicate the need for long-term support of families with a brain-injured member.

The impact of family functioning on anxiety symptoms in African American and European American young adults

The current study aimed to investigate reported family functioning and its impact on anxiety symptoms in a sample of African American and European American young adults. One hundred African American and one hundred twenty one European American young adults completed the Beck Anxiety Inventory (BAI), the State Trait Anxiety Inventory (STAI), and a retrospective version of the McMaster Family Assessment Device (FAD). Results indicated that the African Americans reported significantly less anxiety as measured by the BAI and the STAI Trait subscale. Significant differences did not exist on the FAD subscales. A structural equation model was posed to test measurement model invariance and subsequent prediction of anxiety from a latent factor of family functioning created from the FAD subscales. Results indicated that the family functioning factor loadings were significantly different between African Americans and European Americans. Further analyses revealed that family functioning significantly predicted anxiety symptoms in the European American sample, but not the African American sample. Implications of familial functioning, anxiety, and ethnicity are discussed.

Family functioning and posttraumatic stress disorder in adolescent survivors of childhood cancer.

This study investigated family functioning and relationships between family functioning and posttraumatic stress disorder (PTSD) in adolescent survivors of childhood cancer. To assess family functioning, 144 adolescent cancer survivors 1 to 12 years post-cancer treatment (M = 5.3 years) and their parents completed the Family Assessment Device (FAD). To assess PTSD, adolescents were administered a structured diagnostic interview. Nearly half (47%) of the adolescents, one fourth (25%) of mothers, and one third (30%) of fathers reported poor family functioning, exceeding the clinical cutoff on 4 or more FAD subscales. Families in which the cancer survivor had PTSD (8% of the sample) had poorer functioning than other families in the areas of problem solving, affective responsiveness, and affective involvement. Three fourths of the adolescents with PTSD came from families with categorically poor family functioning. A surprisingly high rate of poor family functioning was reported in these families of adolescent cancer survivors. Adolescents with PTSD were more than 5 times as likely to emerge from a poorly functioning family compared with a well-functioning one. This study provides evidence that family functioning is related to cancer-related posttraumatic reactions in adolescent survivors.

Multinational Study of Cancer Patients and Their Children: Factors Associated With Family Functioning

This study examined factors associated with family functioning in cancer patients' families with dependent children. A sample of 381 families (639 parents and 489 children) was recruited simultaneously in six European countries. Patients and family members completed a background questionnaire, the Family Assessment Device (FAD), the Beck Depression Inventory, and the short form version of the Medical Outcomes Health Survey. Descriptive statistics and a multilevel model that allowed a multi-informant design were used. Analyses were carried out with all participants, and separately with parent-rated and children-rated FAD scores. In descriptive analyses, children reported more impairment in family functioning than parents, but the difference was not significant. Depression prevalence was 35% for ill mothers and 28% for ill fathers. In the multilevel analyses with all participants (ie, adults and children) the ill parent's depression was significantly associated with impaired family functioning on five of seven FAD subscales. In analyses with only children, the perception of impairment of family functioning was not associated with parental depression. Additionally, poorer physical status of the ill parent was significantly associated with impairment on roles and communication. The ill parent's depression was the most significant factor associated with impairment in family functioning. Screening for depression, active diagnostics, and appropriate treatment of cancer patient's and partner's depression may be important to protect their children from mental disorders. Therefore, support systems need to be more family-oriented and child-centered in their approaches to cancer psychosocial care.

Family functioning of patients with an eating disorder compared with that of patients with obsessive compulsive disorder

This study compares the family functioning of patients with anorexia nervosa (AN), bulimia nervosa (BN) and obsessive compulsive disorder (OCD). The study participants, who were all female, consisted of 15 patients with AN, 13 with BN, and 17 with OCD. Family functioning was assessed by using the Family Assessment Device self-rating scale. The study subjects also completed the Eating Attitudes Test. Subjects in the AN and BN groups did not differ statistically either from each other or from the OCD group in all 7 Family Assessment Device subscales. Patients with an eating disorder and OCD rated their family functioning in a similar way. It is difficult to conclude that patients with AN or BN have a specific type of family functioning, which is totally different from the family functioning of patients with OCD. Thus, the study results further support the idea that family interaction in eating disorders is not specific to these disorders, especially when compared with patients with OCD.