Family Breakup Research Articles

Trabajo Social en los juzgados de familia [Social Work in the family courts

Este trabajo es la experiencia de un año y medio de trabajo en los Juzgados de Familia de la Comunidad de Madrid. La elección del tema tiene que ver con la importancia que las disoluciones familiares están adquiriendo desde la promulgación de la Ley 15/2005, de 8 de julio, y el cambio de valores, que hacen que la familia española de este principio del siglo XXI sea una familia con más libertad en su interior, más tolerante y con una mayor democracia e igualdad entre sus miembros. A su vez trata sobre la aportación del Trabajo Social en los Juzgados de Familia y el papel de los y las profesionales del Trabajo Social como peritos en dichos juzgados. Se compone de dos partes: el marco teórico de referencia del Trabajador Social y la investigación realizada, consistente en entrevistas cerradas a Jueces en activo, Trabajadores Sociales y alumnos en prácticas de Trabajo Social.

Farm, family, and myself: farm women dealing with family break-up

Despite the rising divorce rate among farm families in Norway, surprisingly little research has examined these break-ups. Drawing on interviews with farm women whose marital or cohabiting relationships broke down, we explore the contradictions between individualization and the moral responsibility embedded in the patriarchal discourse of the family farm. We ask whether farm family dissolution represents a break with patriarchal ideology and practice, and thus threatens the survival of the family farm. A key finding is the struggle to balance establishing new lives for themselves with meeting their felt obligations to the farm. None of the women exercised their full legal rights if they worried that it might destroy the farm business. By ensuring the survival of the farm and the well-being of their children, the women's handling of divorce conforms to cultural conventions and protects the family farm.

War experiences, general functioning and barriers to care among former child soldiers in Northern Uganda: the WAYS study

Exposure to war is associated with considerable risks for long-term mental health problems (MHP) and poor functioning. Yet little is known about functioning and mental health service (MHS) use among former child soldiers (FCS). We assessed whether different categories of war experiences predict functioning and perceived need for, sources of and barriers to MHS among FCS. Data were drawn from an on-going War-affected Youths (WAYS) cohort study of FCS in Uganda. Participants completed questionnaires about war experiences, functioning and perceived need for, sources of and barriers to MHS. Regression analyses and parametric tests were used to assess between-group differences. Deaths, material losses, threat to loved ones and sexual abuse significantly predicted poor functioning. FCS who received MHS function better than those who did not. Females reported more emotional and behavioural problems and needed MHS more than males. FCS who function poorly indicated more barriers to MHS than those who function well. Stigma, fear of family break-up and lack of health workers were identified as barriers to MHS. Various war experiences affect functioning differently. A significant need for MHS exists amidst barriers to MHS. Nevertheless, FCS are interested in receiving MHS and believe it would benefit them.

Effects of radio-tag characteristics and sample size on estimates of apparent survival

Background: Radio-tracking is increasingly used to assess key characteristics of population dynamics. Since in many species re-encounter rates are frequently below 1.0 and vary with time and/or life-history stages, known-fate approaches to analyses may not apply. Cormack-Jolly-Seber (CJS) models estimate apparent survival on the basis of individual encounter histories. These models allow for complex re-encounter models and constitute an ideal tool to estimate apparent survival where re-encounter rates vary. However, the implications of radio-tag characteristics and sample size on the precision of survival estimates and the potential to determine temporal variation in survival have rarely been investigated. Here we analyze radio-tracking data from juvenile barn swallows (Hirundo rustica )t hat were instrumented with four types of transmitters similar in mass but differing in radiated power (n=560, 132 broods). Results: For all transmitter types re-encounter probabilities varied between 0.2 and 0.75, depending on radiated power and bird age. Higher-power transmitters significantly improved the re-encounter rates and thus, the precision of survival estimates. Apparent survival varied with age, with a minimum around the break-up of families. Later on survival increased again and approached the rate of adults. Analyses of random sub-samples revealed that sample size strongly affected the variance in survival estimates, and thus the power in discerning temporal or between-group variation in survival. Small samples substantially underestimated the survival to independence. In small subsamples the standard errors of estimates were particularly large in later re-encounters. Consequently, model selection results of different survival models on the basis of small random sub-samples were highly inconsistent. Conclusions: Investigating population processes requires modeling of time- and cohort-dependent survival rates, often for short time periods. We show that CJS estimates of apparent survival from small samples revealed rough patterns in barn swallow survival with samples of c. 50 individuals. However, small samples underestimated the number of survivors reaching independence. Inference on underlying mechanistic models based on Akaike’s Information Criterion (AIC) model selection was unreliable with sample sizes below 200 individuals. As samples are often limited for practical reasons, maximizing re-encounter rates by optimal choice of telemetry hardware and field logistics is a way to increase the precision of survival estimates.

Divorce in Odorhei County, during the 19th Century

The scope of our study covers the 19th century and a currently non-existent administrative unit within the borders of Romania, where Odorhei Seat, and after 1876, Odorhei County was found. In 1869, Odorhei County’s population was 105467. The predominantly (98.57%) Hungarian population followed three different religions: Roman Catholic, Calvinist and Unitarian. In the investigated region, until the introduction of civil marriages (1895), the church possessed the right of declaring the break-up of families. As a source of our assessment we use ecclesiastical archival sources, principally divorce files (almost full collections in the Reformed and Unitarian church archives, conserved sporadically in the case of Roman Catholics). Our goal is to examine these sources from different perspectives, both quantitatively and qualitatively, collecting demographic, ethnographic and anthropological data. We are focusing on problems like: the number of divorces, internal and external factors influencing divorce, causes of divorce and their evolution, the evolution of sexual crimes, the meaning and the role of divorce in the traditional society etc. DOI: 10.5901/mjss.2013.v4n11p192

Group-based antenatal birth and parent preparation for improving birth outcomes and parenting resources: Study protocol for a randomised trial

ObjectivesTo examine the efficacy and cost-effectiveness of group based antenatal education for improving childbirth and parenting resources compared to auditorium based education. MethodsParticipants: 2350 Danish pregnant women and their partners ⩾18years old, recruited before 20+0 gestational weeks.Population-based individually randomised superiority trial with two parallel arms: Four sessions of birth and parent preparation in small groups (experimental group); two lectures in an auditorium (control group).Data is collected by (1) questionnaires at baseline (≈18weeks of gestation), 37weeks of gestation, 9weeks-, 6months-, and 1year post-partum, (2) the hospital obstetric database, (3) national registers. Primary outcome: use of epidural analgesia. Secondary outcomes: stress, parenting alliance; explorative outcomes: depressive symptoms, use of health care services, self-efficacy, well-being, family break-ups.Analyses will be intention-to-treat as well as per protocol. Process evaluation will be conducted using questionnaires and qualitative interviews. The incremental societal cost of the intervention will be computed and compared to the measured outcomes in a cost-effectiveness analysis. ConclusionTo the best of our knowledge this is the largest well-designed randomised trial of its kind to date. The trial will bring much-needed evidence for decision makers of the content and form of antenatal education.

Khat Consumption in Masalani Town, Northeastern Kenya

Khat is widely consumed in Kenya. It contains cathinone, a psychoactive alkaloid, whose health effects are similar to those of amphetamine. A descriptive study was done among men in a remote Kenyan town on consumption of khat. We administered semi-structured questionnaires. Of those interviewed, 68% chewed khat, and of those who chewed, half did so on a daily basis. Most prefer to chew it in the company of their friends and age mates, accompanied by soda, sweet tea, and cigarettes. Those employed were three times more likely to chew khat compared to those unemployed (OR = 2.8, 95% CI 1.03–7.6). A plausible reason is that they have regular sources of income to buy khat. Most respondents were knowledgeable about the health effects of khat, with a third reporting mental health problems. The major social consequences of khat chewing reported were negligence of responsibility by men, family break-up, promiscuity, and impotence. The consumption of khat may increase in the near future, given that a high proportion of the males in this district are below 19 years. This cohort will gradually finish school and gain employment. There may be need to put in place health education programs and provide recreational facilities targeting this group and those already chewing khat in this resource-limited setting.

OP43 Explaining High Parenting Stress in the Growing Up in Scotland Study for Mothers with Both High and Low Educational Levels: The Role of Employment and Social Support for Parenting

BackgroundStresses associated with raising a child may lead to less optimal parenting, with consequences for children’s development. Parent’s employment and receipt of social support may impact on stress differently according...

Adverse life events as risk factors for behavioural and emotional problems in a 7-year follow-up of a population-based child cohort

Background and aim: The aim of the study was to identify risk factors for significant changes in emotional and behavioural problem load in a community-based cohort of Danish children aged 9–16 years, the risk factors being seven parental and two child-related adverse life events. Methods: Data on emotional and behavioural problems was obtained from parents filling in the Child Behavior Checklist (CBCL) when the child was 8–9 and again when 15 years old. Data on risk factors was drawn from Danish registers. Analysis used was logistic regression for crude and adjusted change. Results: Parental divorce significantly raised the odds ratio of an increase in emotional and behavioural problems; furthermore, the risk of deterioration in problem behaviour rose significantly with increasing number of adverse life events. By dividing the children into four groups based on the pathway in problem load (increasers, decreasers, high persisters and low persisters), we found that children with a consistently high level of behavioural problems also had the highest number of adverse life events compared with any other group. Conclusions: Family break-up was found to be a significant risk factor. This supports findings in previous studies. The fact that no other risk factor proved to be of significance might be due to lack of power in the study. Children experiencing high levels of adverse life events are at high risk of chronic problem behaviour. Thus these risk factors should be assessed in daily clinical practice.

Precarity, Militancy and Network-Families

Click to increase image sizeClick to decrease image size Notes 1 Sandra Laugier, Pascale Molinier, Patricia Paperman, Qu'est-ce que le care ? souci des autres, sensibilité, responsabilité (Paris: Payot, 2009), p.39. 2 It is based on interviews done for my Phd thesis, ‘Collective practices: creativity and care’, using the future archive method. Unless otherwise stated, all interviewees are female and in their 30s. See also http://futurearchive.org/static/fa-archive-index.html 3 See the Coventry Industrial Relations Research Unit's work on young people and precarious employment, particularly this list of papers < http://www2.warwick.ac.uk/fac/soc/wbs/research/irru/ywesrc/seminar1/sem1papers/> [02/01/2012]. 4 See Rachel Williams, ‘700,000 children acting as carers, survey shows’, Guardian, 16 November 2010 < http://www.guardian.co.uk/society/2010/nov/16/children-carers-survey> [17/11/2010]. 5 See this anonymous article reporting the birth of ‘Toma la familia’ < http://www.diagonalperiodico.net/En-esta-familia-cabe-mas-gente.html>[22/10/2010]. 6 For some background on Spanish neoconservative and catholic family discourses, see: Izaskun Sánchez Aroca, ‘Recetas antieleccion para salir de la crisis’ in Periodico Diagonal (24 May 2012) < http://www.diagonalperiodico.net/Recetas-antieleccion-para-salir-de.html> [29/05/2012]. 7 As the Rajoy government planned to do in Spain in 2012 (August 2012). 8 The UK conservatives have probably put in place the most extreme workfare programme of Europe so far. See the ‘Boycott Workfare’ Campaign < http://www.boycottworkfare.org/> [29/05/2012]. 9 In Spain, the Rajoy government came up with a decree (16.2012) excluding under 26-year olds who haven't paid into social security in the past 2 years, from access to the healthcare system. This excludes a huge host of people who can't or don't do documented work: migrants, housewives, and the unemployed. 10 See < http://madrid.tomalaplaza.net/2012/05/20/la-familia-nuclear-es-radioactiva-2/> [05/06/2012]. 11 See the blog of the Sol Acampada: See < http://madrid.tomalaplaza.net> (01/06/2012) 12 Claudia Fonseca, ‘Review of “La famille en Europe. Parenté et perpetuation familiale”’. In: L'Homme, EHESS, No.144 (1997), p.224. 13 See Shirley L. Zimmerman, ‘The Welfare State and Family Breakup: The Mythical Connection’, Journal of Family Relations, 40: 2 (1991), pp.139–147. 14 Beyond the individual support people in a network get from their own family. 15 See ‘Pflegeregress: So viel muessen die Steirer zahlen’, Kleine Zeitung (29 July 2011) < http://www.kleinezeitung.at/nachrichten/politik/2797421/so-viel-muessen-steirer-zahlen.story> [29/07/2005]. 16 See Jacques Donzelot, The Policing of Families (New York: Random House, 1979 [1977]) 17 Jacques Donzelot, The Policing of Families, p.227 18 Jacques Donzelot, The Policing of Families, pp.228–229 19 Interview with members of Community Health Centre, San Francisco Solano, Buenos Aires Province, Argentina. April 2012. http://futurearchive.org/movies/63 20 Interview with members of Community Health Centre, San Francisco Solano, Buenos Aires Province, Argentina. April 2012. http://futurearchive.org/movies/63 21 Jacques Donzelot, The Policing of Families, p.94–95. 22 Helma Lutz, The new maids: transnational women and the care economy (London: Zed, 2011), p.79. 23 Helma Lutz, The new maids, p.110. 24 Emmanuel Todd, L'origine des systemes familiaux, Volume 1: Eurasia (Paris: Gallimard, 2011) p.18. 25 Helma Lutz, The new maids, p.113. 26 Helma Lutz, The new maids, p.116. 27 Interview with P. London, October 2011. http://futurearchive.org/movies/55 28 Interview with N. Barcelona, November 2011. http://futurearchive.org/movies/57 29 Helma Lutz, The new maids, p.114. 30 Kay Weston, Families We Choose: Lesbians, Gays, Kinship. (New York: Columbia University Press, 1991), p.109. 31 Interview with M, Madrid, October 2011. 32 Dean Spade, For Lovers and Fighters < http://www.makezine.enoughenough.org/newpoly2.html> [30/06/2005]. 33 Maurizio Lazzarato, La Fabrique de L'homme endetté (Paris: Editions Amsterdam, 2011), p.45. 34 In a session of the Nanopolitics group in London, on love, eroticism and activism, participants read the poem ‘no dominion’ by Dylan Thomas to each other several times. This group has been a site for reflecting on some of the questions raised in this article. See www.nanopolitics.noblogs.org 35 Care networks are also spaces for reflecting on what isn't possible, in relating to limits, blockages and borders. Being able to determine and act upon limitations: to give up the silly promise of unlimited potential, so typical of networks, and engage in crises and fragilities with care and love. A space where to begin to trust, to understand and respect each other in ways one might think belongs only to couples or families. 36 Interview with G., London, June 2011. 37 See also ‘Soziologe: Familie zerbröckelt als Unterstützungsnetzwerk’, Der Standard (30 July 2012). < http://derstandard.at/1342948017557/Soziologe-Familie-zerbroeckelt-als-Unterstuetzungsnetzwerk?seite = 4#forumstart> [15/08/2012]. 38 Interview with N., Barcelona, November 2011. http://futurearchive.org/movies/61

A Family and Community Approach to Stealing

Stealing, a common problem of childhood and adolescence, is often regarded as an expression of distress and is associated with parental “distance” and family breakups, especially in older children (Patterson 1982, p. 263). This article tells the story of family therapy work with a New Zealand Indian family whose son’s stealing habit followed the family from India to their new life in New Zealand. It illustrates a family and community approach to stealing developed by David Epston and Fred Seymour (Epston & Seymour, 2008; Seymour & Epston, 1992). Detailed accounts of therapy are relatively rare in the literature on conduct problems (Hawes, 2011, p. 410).

Faith Pinnacle Moments: Stress, Miraculous Experiences, and Life Satisfaction in Young Adulthood

Religious beliefs often persist among unaffiliated young adults, and certain beliefs about God have been shown to support subjective well-being. Yet we know much less about the persistence or psychological impact of religious experiences, specifically miracles from God. I conceive of such experiences as faith pinnacle moments which express and reinvigorate the individual's reciprocal bond with God, frequently occur in response to certain types of stress, and support well-being by solidifying one's sense of that bond. My results show that net of institutional religiosity, young adults who experience stress from traumas are more likely to report miracles. This suggests that these reports often refer to healings or similar interventions. Stress from family breakups, however, is negatively correlated with miracles, presumably since these disruptions damage the bond with God due to the established connection between parental relationships and perceived relationship with God. Finally, miracles are positively correlated with life satisfaction and partially protect against the negative effects of stress on life satisfaction.

American Abolitionism and Slave-Breeding Discourse: A Re-evaluation

Slave-breeding is a topic that has long divided American historians. Since the late nineteenth century, historians have sought out empirical evidence to prove or disprove the idea that some slave owners deliberately bred slaves for sale or to augment their own labour force. As a result, the historiographical treatment of slave-breeding has become bogged down in what Herbert Gutman called ‘the numbers game’. This essay re-examines the question of slave-breeding and challenges us to consider the broader historical meaning of such sensational accusations. It does this by focusing on the rhetoric of black and white abolitionists in the United States between 1830 and 1861. The author argues that slave-breeding discourse provided abolitionists with a narrative focal point with which to attract public attention to their concerns about the westward extension of slavery, the physical and emotional toll slavery wrought on enslaved women, and the trauma associated with the break-up of slave families.

Early life trauma predicts self-reported levels of depressive and anxiety symptoms in nonclinical community adults: Relative contributions of early life stressor types and adult trauma exposure

Exposure to early life trauma is a known risk factor for depression and anxiety disorders in adulthood. This study aimed to evaluate the relative contributions of early life versus adult trauma in predicting levels of depressive and anxiety symptoms in nonclinical community adults. 1209 nonclinical community adults (18–70 years; 45% male) were assessed for mental health status, early life stressors, lifetime trauma exposure, and self-reported levels of depressive and anxiety symptoms. A subset of the full sample subjected to group comparisons (n = 1088) indicated that early life stressor exposure primarily accounted for significantly higher depressive and anxiety symptom scores when compared against adults reporting to be free of childhood stressor or adult trauma exposure. Subsequent hierarchical multiple regression analyses of this subset using five distinct early life stressor types, namely ‘Interpersonal violation’, ‘Family breakup’, ‘Disasters/war’, ‘Familial health trauma/death’ and ‘Personal health trauma’ derived from principal component analysis of a wide range of self-reported early stressor events in the full sample, showed childhood ‘Interpersonal violation’ differentially predicted higher self-reported depressive and anxiety symptom scores in both males and females. Adult trauma exposure did not significantly predict these symptom scores. These findings underline the relative importance of exposure to ‘interpersonal violation’ relative to other types of early life stressors and adult trauma in the risk of depressive and anxiety symptoms in nonclinical community adults.

Legal Strategies to Resolve Problems of Marital Relationships in the Quran

Sometimes either of the spouses might have abomination or marital misconduct towards the other. This deed which leads to problems in marital relationships is called nushuz, or lack of submission, and can be from either the husband or the wife. Nushuz is the mostly observed factor in divorce so its prevention can save the family break-up. The purpose of this article is to describe the possible mechanism available in this area. The holy Quran also offers some solutions to remove the problems of marital misconducts which cause damage to the family foundation by making the husband primarily responsible for reforming the family prima, and has presented conventional practices. To avoid any kind of damage to the family foundation the husband should practice admonishment and banishment. However, it should not cause bruises on her body or lead to a more strained relationship. Moreover, if the wife is nashiza (rebellious), selecting arbiters from among relatives of the spouses can solve any problem which had led to nushuz and lack of submission. We will discuss the process of reforming the family after an instance of nushuz, which is essential in bringing the relationship back to normal.

Commentary: Alcohol, child development and harm to others: a 'hard' problem

In epidemiology and public health, as in any other area of science, not all interesting and potentially important questions are equally easy to address. Some are tough and refractory, resisting repeated attempts to answer them convincingly. The impact of breastfeeding on child growth and development is at the hard end of this spectrum. Observational studies are fraught with difficulties, as breastfeeding in many countries is highly socially patterned and strongly linked to a range of maternal characteristics, all of which could confound any of the observed associations. In addition, the risk of reverse causality is substantial (a sick infant will be fed differently). Nevertheless, there remains considerable scientific, policy and public interest in the potential benefits of breastfeeding on reduced risk of obesity, improved neurocognitive performance and cardiovascular risk profile in childhood and later life, to name but a few outcomes. One of the most important recent contributions to this research area has been the PROBIT trial set up in 1996–97 in Belarus. 1 Taking advantage of the newly found openness resulting from the then recent break-up of the Soviet Union (1991–92), this study used an ingenious and pragmatic clusterrandomized design, in which maternity units were allocated to provide either enhanced breastfeeding support or usual practice. During the past few years, this large trial has provided some of the most convincing evidence to date that extended breastfeeding is associated with increased childhood cognition, 2 but appears not to increase stature or reduce blood pressure or adiposity or obesity in childhood. 3,4 This study is now being exploited to see what it can tell us about the impact of parental behaviours and family circumstances on child development. In this issue of the IJE, Yang and Kramer report the results of their analyses of parental drinking and family break-up on childhood cognition and behaviour at 6.5 years of age. 5 Like the impact of breastfeeding,

Need for mental health care in adolescents and its determinants: The TRAILS Study

Although a great deal of evidence is available on the patterns and determinants of unmet health care needs among adolescents with mental health problems, little is known about the factors that influence the need for care. The aim of this study is to assess the occurrence of need for care for mental problems in adolescents and the determinants of this need. Data were obtained from three assessment waves of TRAILS (TRacking Adolescents' Individual Lives Survey) (N = 1406). Need for care was assessed at age 16/17 (parent report). Determinants concerned previous health care utilization, emotional and behavioral problems (child behavior checklist and youth self-report) and child and family characteristics. Of the 1406 parents, 409 parents (29%) reported that their child needed help for mental problems. Of these adolescents, only 29% received specialized mental health treatment. The determinants of need for mental health care at age 16/17 were family break-up and parental internalizing problems (age 10/11), parent-reported internalizing and externalizing (age 10/11 and 13/14) and receiving specialized help (age 13/14). A substantial proportion of all adolescents need care for their mental problems, according to their parent. There is also a large group of adolescents with mental health problems according to their parents, but for whom no parental reported need for care is expressed. The findings stress the importance of early interventions focusing on raising parental and child awareness of mental health problems.

Adult Children of Gay and Lesbian Parents

Previous scholars have explored various challenges facing children of gay and lesbian individuals, and some have explored the impact of a parent's sexual orientation on the parent-child relationship. However, the impact of religion on the parent-child relationships of adult children with a gay or lesbian parent has been overlooked. In this study, 10 adult children with both a gay or lesbian parent and a heterosexual parent were interviewed and asked to retrospectively explore how religion impacted their parent-child relationships. The following themes emerged from phenomenological analysis of the interviews: (a) family break-up more difficult than the parents' coming out; (b) discovery that parent was gay or lesbian; (c) initial shame over having gay or lesbian parent; (d) positive aspects of having a gay or lesbian parent; (e) redefined relationship with religion; and (f) impact of culture on how gay and lesbian individuals are viewed.

Heart Rate and Antisocial Behavior: Mediation and Moderation by Affiliation With Bullies. The TRAILS Study

Low heart rate (HR) has been linked to antisocial behavior (ASB). However, the effect of low HR may be mediated by affiliation with bullies. We hypothesized that individuals with low HR are more likely to affiliate with bullies and in turn are influenced by these peers. Data come from two waves of a subsample of the TRAILS study (N = 809; 44.0% boys; mean age of 11.0 years at T1 and 13.5 years at T2). ASB was measured using the Antisocial Behavior Questionnaire at both waves. HR was assessed during rest at T1. Affiliation with bullies was assessed via peer nominations at T1. Possible gender differences were taken into account, and all analyses were adjusted for family context (i.e., family breakup and socioeconomic status). Regression analyses showed that lower HR was only associated with ASB in (pre)adolescents who affiliated with bullies. Moreover, the effect of lower HR on boys' ASB was partly mediated by affiliation with bullies. Our findings show that (pre)adolescents, and in particular boys, seem to be in environments that match their biological disposition and in turn are shaped by this environment.

Sibling Support During Post-Divorce Adjustment: An Idiographic Analysis of Support Forms, Functions, and Relationship Types

This research examines social support from siblings following parental divorce, based on retrospective interviews and ratings obtained from adult children of divorced parents. Sibling relationships were diverse in the extent, form, and direction of support, as reflected in seven types of sibling support relationships (separates, pals, allies, opponents, parent, protector, encourager). Availability/companionship with siblings predicted improved adjustment to divorce, whereas multiple dimensions of maternal support predicted adjustment. Qualitative analyses suggested that the company of a sibling provided reassurance and promoted resilience, even in the absence of explicit support messages or tangible assistance. Supportive siblings appeared to buffer children by providing a sense of continuity and shared experience during family reorganization. Sibling support typically served a complementary role to parental support. However, siblings sometimes provided more extensive and direct compensatory support in situations where competent parental support was unavailable. Such assistance helped children to weather especially stressful family breakups but did not mitigate bad feelings about the divorce. The results illustrate the situational and relational nature of effective social support in families.