Perceptions Of Family Functioning Research Articles

Analyzing Co-Occurrence of Non-Suicidal Self-Injury With Suicidal Ideation and Related Factors Among Adolescents in Jeju Island.

Non-suicidal self-injury (NSSI) and suicidal behavior, including suicidal ideation (SI) and suicide attempts, are important predictors of suicide in adolescents. This study aimed to investigate the associations between NSSI, SI, NSSI+SI, mental health problems, and family factors in Korean adolescents in Jeju Island, with an emphasis on key findings. A total of 561 adolescents completed self-report questionnaires regarding demographics, NSSI, SI, suicidal behavior, perceived family functioning, and mental health problems, which were assessed using Center for Epidemiological Studies Depression Scale for Children, Screen for Children Anxiety-Related Disorders (SCARED), and Youth Self-Report (YSR). Data were analyzed using descriptive statistics, one-way analysis of variance, chi-square test, post-hoc analyses, and multivariate logistic regression. In this study, 22.3% of adolescents reported either NSSI or SI, with 5.5% reporting NSSI and 20.7% reporting SI. Combined (NSSI+SI) group showed a significantly higher SCARED score, anxiety/depression, thought problems, attention problem, and rule breaking on YSR than did the SI only group. Higher level of depression and anxiety were significantly associated with NSSI and SI. Female sex and perceived family dissatisfaction were significantly associated factors for SI, but not for NSSI in multivariate logistic regression. This study provides insights into the clinical characteristics and associated factors among adolescents with NSSI, SI, and NSSI+SI in Jeju Island. Identifying these results can inform the development of targeted prevention and intervention strategies to mitigate the negative consequences of these behaviors and contribute to a better understanding of the role of family in this context.

The bidirectional connection between family functioning and psychopathology: A network analysis in a large sample of adolescents with anorexia nervosa and their parents.

Family functioning is a risk and maintaining factor for anorexia nervosa (AN). This study aims to identify specific areas of family functioning according to adolescents and parental perspectives associated with eating and general psychological symptoms in people with AN. Four-hundred-forty-five adolescents with AN or atypical AN and their parents were enrolled. Adolescents completed the Eating Disorder Inventory-3, the Youth Self-Report questionnaire, and the Family Assessment Device (FAD). Their parents filled in the FAD. A network analysis was conducted including all subscales. The bridge function analysis was applied to identify the bridge nodes connecting each community constituted of family functioning perception with the communities of adolescents' eating and general psychological symptoms. Family communication was the node most strongly connecting fathers and mothers' perception of family functioning and adolescents' eating symptoms. Problem solving was the node with the highest bridge expected influence between mothers' family functioning and adolescents' general psychopathology. General functioning and problem solving were the bridge nodes between adolescents' view of family functioning and eating and general psychopathology. Maturity fear, interpersonal insecurity, and interpersonal alienation were the bridge nodes between adolescents' eating symptoms and mothers, fathers, and adolescents' family functioning communities respectively. Family members must be involved in the therapeutic process to improve family communication and problem solving diverting their attention toward emotional needs and interpersonal difficulties of adolescents with AN. Developing autonomy and independence from parents and building trustworthy relationships with peers may be favored by improving familiar dynamics and may contribute to prevent the maintenance of AN.

Perceptions of family functioning impact smoking during pregnancy

Background Although socio-environmental factors are known to contribute to the maintenance of smoking behavior, few studies have examined the impact of family functioning on smoking during pregnancy. Objective The current study examined the relationship between perceptions of family functioning and smoking during pregnancy. Methods Pregnant women (N = 345, 59% ethnic/racial minority) completed the Family Assessment Device, a gold-standard assessment examining perceptions of family functioning in seven domains. Multinomial logistic regressions analyzed associations between clinically determined suboptimal levels of family functioning by domain and smoking status during pregnancy (smoking, ≥28 continuous days quit, nonsmoking), with stratified analyses exploring ethnic/racial differences (non-Hispanic/White vs. racial/ethnic minority). Results Participants who reported suboptimal levels of family functioning in domains of Affective Involvement, Affective Responsiveness, Behavioral Control, and Roles were significantly more likely to have been smoking than nonsmoking during pregnancy. Stratified analyses revealed differing effects by ethnic/racial identity, with perceptions of Roles remaining the only significant effect on smoking outcomes for both groups. No significant effects were found regarding the impact of family functioning on whether participants were smoking vs. quit during pregnancy. Conclusions Suboptimal family functioning may contribute to smoking during pregnancy, but effects may differ based on domain of family functioning and by ethnic/racial identity.

Changes in Perceived Family Functioning of Chinese Children: A Cross-Temporal Meta-Analysis

Changes in Perceived Family Functioning of Chinese Children: A Cross-Temporal Meta-Analysis

Perceived Stressful Life Events and Suicide Risk in Adolescence: The Mediating Role of Perceived Family Functioning.

Suicidal behavior is a serious public health problem and a major cause of death among adolescents. Three categories of major risk factors have been identified: psychological factors, stressful life events, and personality traits. Severe and objective stressful life events (SLEs), such as childhood mistreatment or abuse, have been clearly associated with higher rates of suicide risk. However, the relationship between suicide risk and adolescents' perceptions of the SLE impact is not as clear. This paper studies the relationship between SLE impact perception and suicide risk and the possible mediating role of perceived family functioning in this relationship. The need for longer-term or more intense psychological or psychiatric treatment in relation to SLE impact perception is also addressed. One hundred forty-seven adolescents aged 11-17 were consecutively recruited from the Child and Adolescent Mental Health Outpatient Services Department of a general hospital in Madrid, Spain. Self-informed questionnaires were used to assess suicide risk, SLEs, and family functioning. In addition, the clinical records of the participants were consulted to collect information about their treatment histories, including the number of appointments and the duration of follow-up. SLE impact perception correlates significantly with suicide risk, the number of clinical appointments, the duration of treatment, and the perceived level of family functioning. The mediation model of the family functioning perception variable in the relationship between SLE impact perception and suicide risk is significant. The linear regression model of SLE impact perception and family functioning perception on suicide risk is also significant, accounting for 25.7% of the variance. Beyond the clear and proven effect of serious and objective SLEs, the perceived impact of SLEs reported by adolescents is related to an increased risk of suicide and more intense psychological and/or psychiatric follow-up. This relationship is mediated by the perceived level of family functioning. Adolescents' perceptions of their life experiences and perceived family support may be key determinants of suicide risk prevention.

Family functioning of adolescents with restrictive eating disorders with or without nonsuicidal self-injury.

Family influence is a crucial factor in the onset and maintenance of eating disorders. Nonsuicidal self-injury (NSSI) and restrictive eating disorders (REDs) co-occur in a significant percentage of subjects but family functioning of these families remains underexplored. This study examines the family functioning perceptions of 80 families with adolescents experiencing RED, comparing those with and without NSSI, alongside a control group, utilising the FACES-IV assessment. The study also aims to compare the triadic (adolescent-mother-father) perception of family functioning in the three groups. The results reveal distinct family dynamics in adolescents with both RED and NSSI, marked by problematic functioning perceptions from all family members and low parental agreement. A further understanding of the family functioning of adolescents with RED with NSSI can help clinicians in defining the treatment setting.

GRANDMOTHER CAREGIVERS’ RESILIENCE, MINDFULNESS, AND RESOURCEFULNESS AND MCCUBBIN’S MODEL OF FAMILY STRESS

Abstract Grandmothers raising grandchildren face numerous challenges that are reflected in their levels of depressive symptoms and perceived family functioning. Using McCubbin’s Resiliency Model of Family Stress, Adjustment and Adaptation, we examine how demographics, family demands (intra-family strains), mediators of problem-solving/coping (resilience, mindfulness and resourcefulness), resources (support) and situational appraisals (stress and reward) affect a) depressive symptoms and b) family functioning. Our participants were a nationwide sample of 300 American grandmothers raising grandchildren who participated in an online research study. Our regression model for general family functioning had an adjusted R2 of .44. Better self-appraisal of family functioning was significantly associated with younger participant age, identifying as white, higher levels of resourcefulness, fewer reported intra-family strains, more subjective social support and instrumental support. Situational appraisals, the problem solving/coping factors of resilience and mindfulness, employment status, and marital status did not significantly predict family functioning. Depressive symptoms, as measured by the CES-D scale, had an adjusted R2 of .46. Participants who were married, had fewer intra-family strains, higher levels of mindfulness and resilience, higher subjective support, and who appraised greater reward from caregiving to grandchildren had lower levels of depressive symptoms. There was no effect from caregiving stress, resourcefulness, employment status, or race. These analyses show the continued utility of McCubbin’s model, despite different patterns of predictors of family functioning and depressive symptoms. This further develops our prior work showing that resilience, mindfulness, and resourcefulness are correlated but independent theoretical constructs as they interact very differently with our two outcomes.

Associations of youth mentoring with parent emotional well-being and family functioning: Longitudinal findings from a study of Big Brothers Big Sisters of Canada

This study explores the association between child’s participation in a community-based mentoring program and parents' emotional well-being and perceived family functioning. 553 parents and their children were recruited through 20 Big Brothers Big Sisters Canada agencies. Assessments were completed at the time of program referral and 6-, 12-, 18-, 24-, and 30-month post-baseline. Controlling for parent and child demographic characteristics, child’s behavioral difficulties and physical health problems, and baseline scores of parents’ mental health, family functioning, and social support, growth curve modelling was conducted to compare parents with mentored (n = 352) and non-mentored children (n = 201) in their reports of depression, social anxiety, hostility, and family functioning across the six time points. Findings indicated a greater rate of improvement over time in family functioning of parents with mentored children as compared to parents with non-mentored children. Parents with mentored children reported lower levels of depression, social anxiety, and hostility/aggression than parents with non-mentored children, but the group differences were marginally non-significant at p <.10. Effect sizes (Cohen’s d) were small in magnitude. Sensitivity analyses with growth curve models suggested that the findings were robust for family functioning and parental social anxiety. Findings provide preliminary evidence for the potential of one-on-one mentoring relationships between children and community volunteers that are established through formal programs to benefit the parents and families of participating children.

Perceived family functioning within Chinese pregnant women and husband dyads: Levels, consistency, and correlates.

Understanding differences in perceived family functioning between pregnant women and their partners can protect and promote women's health. The purpose of this study was to examine consistency and differences in perceived family functioning within pregnant woman-partner dyads in China and explore correlates of effective family functioning. From 2020 to 2021, 175 pregnant women and husband dyads (100% Han nationality, Mage = 30.3 [4.5] years) were recruited from the women's psychological clinic of Changsha Hospital for Maternal & Child Health Care using convenience sampling. We assessed family functioning and depression and anxiety symptoms. We examined consistency and differences in perceived family functioning between pregnant women and their husbands. Most pregnant women (76.6%) and husbands (71.4%) perceived their family functioning as effective. Pregnant women and their husbands shared poor consistency in family functioning, with an intraclass correlation of 0.25 and most weighted kappa coefficients of individual items < 0.2. Participants reporting effective family functioning had higher education levels and lower depression and anxiety scores. Most pregnant women and their partners perceived effective family functioning, but showed poor consistency. Higher education and milder symptoms of depression and anxiety were associated with effective family functioning both in pregnant women and their partners. For primary healthcare system workers, differences in perceptions of family functioning should be fully taken into account when conducting family based integrated care for pregnant women. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Family Functioning, Illness-Related Self-Regulation Processes, and Clinical Outcomes in Major Depression: A Prospective Study in Greece.

Major depressive disorder (MDD) is a common, seriously impairing, and often recurrent mental disorder. Based on the predictions of the Circumplex Model of Marital and Family Systems and the Common-Sense Self-Regulation Model, the aim of the present prospective study is to examine the predictive value of clinical outcomes of a process model in which associations between perceived family functioning and patient's clinical outcomes (i.e., symptom severity and suicide risk) are mediated by illness representations and coping strategies. A total of 113 patients with a clinical diagnosis of MDD (16.8% males and 83.2% females) aged 47.25 ± 13.98 years and recruited from the outpatient department and the mobile mental health unit of the Psychiatric Clinic of the University Hospital of Heraklion in Crete, Greece, and from a Greek online depression peer-support group participated in the study. Family functioning was assessed in terms of cohesion and flexibility (Family Adaptability and Cohesion Evaluation Scales IV) at baseline. Illness representations (Illness Perception Questionnaire-Mental Health) and coping strategies (Brief Cope Orientation to Problems Experienced) were measured about five months later (5.04 ± 1.16 months). Symptom severity (Beck Depression Inventory) and suicidality (Risk Assessment Suicidality Scale) were measured about 10 months after the baseline assessment (9.56 ± 2.52 months). The results indicated that representations about MDD impact and symptom severity serially mediated the association between family cohesion and suicide risk in MDD. Furthermore, family cohesion was found to be linked with maladaptive coping through MDD impact representations. Family-based psychotherapeutic interventions specifically designed to target unhealthy family functioning, along with negative illness perceptions and dysfunctional coping, could be further developed and explored as adjunctive therapy to standard treatment in MDD.

Family functioning and patients’ depressive symptoms: comparison in perceived family function between patients who had an acute ischaemic stroke and their primary family caregivers – a cross-sectional study

ObjectivesThis study aims to compare perceived family functioning between Chinese patients who had an acute ischaemic stroke (AIS) and family caregivers, and explore the association between family functioning and patients’...

Family functioning and behavioral problems among left-behind adolescent: Self-esteem as a mediator and mother nurturance as a moderator

Behavioral Problems (BPs) in Pakistani Left-behind adolescents (LBA) remain under-investigated. Previous studies exposed that family functioning had a profound effect on LBAs’ behavioral problems, but the mediating and moderating mechanisms that cause this effect are under-studied. In this study, we planned to investigate factors linked with BPs in a large sample of LBAs. This study conferred how left-behind adolescents (LBA) perception of family functioning (FF) influenced their behavioral problems (BPs) through self-esteem (SE). This study also explicated how mother nurturance (MN) affected family functioning direct effects on self-esteem, as well as family functioning indirect effects on BPs via self-esteem. The data for the present research was collected from 400 LBAs in three waves from Rawalpindi and Rawalakot, Pakistan. The results indicates that family functioning had a significant negative predictive impact on BPs. Furthermore, SE acts as a mediator between family functioning and LBAs’ BPs. The outcomes further explicated that mother nurturance has moderating effect on the relationship between family functioning and self-esteem as well as indirect effects on BPs through self-esteem supporting the moderating mediation model. This research offers some innovative implications for practice and research. So, identifying the issues of left-behind adolescents can provide imperative understandings for the development of interventions aiming at the mental health of left-behind adolescents and need to be implemented to improve family functioning in migrant fathers’ family.

Impact of the COVID-19 and psychological risk factors on non-suicidal self-injury behavior among high school students: a one-year follow-up study

ObjectivesNon-suicidal self-injury (NSSI) behavior is a severe public health issue in adolescents. This study investigated the possible impact of the coronavirus disease 2019 (COVID-19) and analyzed psychological risk factors on adolescent NSSI.MethodsA one-year follow-up study was conducted in September 2019 (Time 1) and September 2020 (Time 2) among 3588 high school students. The completed follow-up participants (N = 2527) were classified into no NSSI (negative at both time points), emerging NSSI (negative at Time 1 but positive at Time 2), and sustained NSSI (positive at both time points) subgroups according to their NSSI behaviors before and during the COVID-19 pandemic. Perceived family functioning, perceived school climate, negative life events, personality traits (neuroticism, impulsivity, and self-control) were assessed using self-report scales.ResultsThe data indicated an increase (10.3%) in the incidence of NSSI. Compared to no NSSI subjects, the emerging NSSI and sustained NSSI subgroups had lower perceived family functioning, higher neuroticism, higher impulse-system but lower self-control scores, and more negative life events. Logistic regressions revealed that after controlling for demographics, neuroticism and impulse-system levels at Time 1 positively predicted emerging NSSI behavior, and similarly, higher neuroticism and impulsivity and lower self-control at Time 1 predicted sustained NSSI behavior.ConclusionsThese findings highlighted the aggravated impact of the COVID-19 on NSSI, and suggested that individual neuroticism, impulsivity, and self-control traits might be crucial for the development of NSSI behavior among adolescent students.

Impact of childhood leukemia on siblings: their long-term perception of family functioning and its relationship with their psychosocial characteristics using structural equation modeling.

In the context of pediatric cancer, siblings' adaptation and needs have been previously investigated; however, research on the long-term consequences on siblings, especially on their family environment, is scarce. We aimed to (1) assess the family functioning (FF) perceived by siblings of childhood leukemia survivors long after diagnosis and (2) explore characteristics likely associated and investigate associations with psycho-behavioral and social factors. Childhood leukemia survivors' siblings older than 11years were recruited through the LEA cohort, a French long-term follow-up program, and completed the family assessment device (FAD). Logistic regression analysis was used to determine factors likely associated with unhealthy functioning in families as perceived by siblings. Structural equation modeling (SEM) was used to examine relationships that predict siblings' perception of FF. We included 605 siblings (mean follow-up time from diagnosis 14.1 ± 6.8years), of whom 175 (28.9%) perceived unhealthy functioning. SEM showed that older siblings were more likely to perceive problematic functioning (β = 0.095, p = 0.014). Sex and leukemia burden had indirect effects on FF through mediators. Family financial situation at diagnosis was not associated with the risk of reporting unhealthy functioning. Our study contributed to identifying siblings at risk of facing family issues and reinforced the need to provide more consideration and suitable resources to avoid late consequences. Often considered as the "forgotten children", future research should focus on developing targeted interventions to facilitate family communication and improve siblings' social support. Overall, results regarding FF perceived by siblings are reassuring and provide new enlightening elements that allow for better support to all families.

Non-suicidal self-injury in a college sample: Intrapersonal and family factors

Objective: Adolescents and young adults are at risk for non-suicidal self-injury (NSSI) and suicidal behavior. This study examined intrapersonal (depressive symptoms, self-criticism) and family (perceived family functioning, parenting style, parental attachment) factors associated with reported history of NSSI in a college sample. Method: Participants included 111 undergraduate students (Mage = 20.2) from a private, nonprofit university. Data were collected via online survey. Hierarchical logistic regression analysis was conducted. Results: The final model was statically significant, Nagelkerke R 2 = .40, suggesting a robust association between the predictors and history of NSSI. Self-criticism and unhealthy family functioning were significant predictors of NSSI behaviors after controlling for study variables and demographic characteristics. Reported history of engaging in NSSI was positively correlated with parent alienation, unhealthy family functioning, self-criticizing behaviors, and depressive symptoms. Conclusion: College mental health providers should be familiar with risk factors of NSSI as well as strategies to address self-criticism.

Cancer patient and caregiver communication about economic concerns and the effect on patient and caregiver partners' perceptions of family functioning.

Financial strain and stressful life events can constrain open communication within families. A cancer diagnosis can bring heightened emotional stress and financial strain for most cancer patients and their families. We evaluated how level of comfort and willingness to discuss important but sensitive economic topics affected longitudinal assessments of family relationships, exploring both within-person and between partner effects over 2years after a cancer diagnosis. A case series of hematological cancer patient-caregiver dyads (n = 171) were recruited from oncology clinics in Virginia and Pennsylvania and followed for 2years. Multi-level models were developed to examine the associations between comfort discussing economic aspects of cancer care and family functioning. Broadly, caregivers and patients who were comfortable discussing economic topics reported higher family cohesion and lower family conflict. Dyads' assessments of family functioning were influenced both by their own and their partners level of communication comfort. Overtime, caregiver but not patients perceived a significant decrease in family cohesion. Efforts to address financial toxicity in cancer care should include examination of how patients and families communicate as unaddressed difficulties can have detrimental effects on family functioning in the long term. Future studies should also examine whether the prominence of specific economic topics, such as employment status, varies depending on where the patient is in their cancer journey. In this sample, cancer patients did not perceive the decline in family cohesion that was reported by their family caregiver. This is an important finding for future work that aims to identify the timing and nature to best intervene with caregiver supports to mitigate caregiver burden that may negatively impact long-term patient care and QoL.

Child and parent factors predictive of mothers' and fathers' perceived family functioning.

Understanding family functioning, particularly the risk and protective factors that may contribute to adaptive versus maladaptive family processes, is critical to promote child and family well-being and resilience. Guided by family systems theory and the family stress model, this study longitudinally investigated parents' and toddlers' individual-level challenges and parental internal resources as potential predictors of subsequent perceived family functioning (i.e., general family functioning and family conflict), while accounting for earlier couple functioning. First-time mothers' and fathers' reports of psychological distress, perceived child behavior problems, intrapersonal resources (i.e., coping, emotion regulation, and empathy), and couple functioning (i.e., relationship satisfaction and intimate partner violence victimization) were assessed when their child was 18 months and 4 years of age. Using autoregressive path models, results suggested that greater maternal distress and paternal perceptions of toddler behavior problems predicted later reports of perceived family dysfunction, whereas parental intrapersonal resources predicted more adaptive perceived family functioning. Overall, findings indicate mutual or bidirectional influence within the family, consistent with the family systems principle of reciprocal causality. Clinical implications are discussed, including the need to bolster parents' existing strengths as well as providing prevention and early screening of depressive symptoms among parents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Parental Emotional Availability and Family Functioning in Adolescent Anorexia Nervosa Subtypes.

Emotional availability (EA) is a complex construct describing the emotional bond between parents and child, and it refers to support, sensitivity, warmth and closeness. Few studies have investigated the perception of parental EA and its association with dysfunctional eating pattern. The aim of the study is to explore the perception of mothers' and fathers' EA of adolescents with anorexia nervosa (AN) and any differences between the two subtypes of binge-purge (B/P) or restrictive (R) AN. Furthermore, it investigates the association of parental EA with AN symptomatology and with patients' perception of family functioning, which is identified as a maintenance factor for AN. A total of 60 adolescents between 12 and 18 years and their parents (n = 120) were recruited in two eating disorder (ED) specialized care centers. Patients completed the LEAP and the FACES IV questionnaires evaluating parental EA and family functioning, respectively. Results showed no difference between AN subtypes, but a greater perception of mother when compared to father EA was found. Moreover, the EA construct was found not to be associated with ED symptomatology but with a greater positive family functioning. Our study is the first that explores EA in AN, and results suggest the importance of considering parents' emotional engagement as part of the treatment core, together with the eating symptomatology management.

Perceived Family Functionality among Elderly Patient with Covid-19 Infection: A Perspective from Developing Country

Family is a basic social unit of senior citizen. Relationship among family members considered as source of emotional comfort. Meanwhile, economic, political, and social changes during pandemic has an impact on the family, the support provided can be manifested among vulnerable groups such as the elderly. Prolonged stress due to isolation care of Covid-19 infection increase psychological distress by reducing family support. This study aimed to explore perceived family function among elderly patients after Covid-19 infection. A cross sectional study was conducted among 33 elder patients with history of Covid-19 infection in Saiful Anwar General Hospital, Indonesia. Perceived family functionality was evaluated using APGAR family score. Data was analyzed using descriptive analyses, independent T test, correlation and regression. Mean total APGAR score was 9.610.70 with joint pain had significant association with APGAR score (p 0.021) indicating full family support in elder person with symptoms. Gender female was associated with 'Resolve' (p 0.038) which might correlate with bigger role of elder female in Indonesian family. Length of stay was significantly associated with 'Partnership' (p 0.012) and 'Growth' (0.043) with inverse correlation. It showed how prolonged hospital stay affected family relationship especially in terms of communication. Perceived family supports remained high in elderly during Covid-19 isolation in Indonesia. Specific symptoms such as joint pain, even strengthen the family support for elder member of family. Prolonged stay in the hospital during Covid-19 infection, might become a communication barrier between elder person and the family which affect decision sharing and emotional expression.

Influence of family function on social anxiety among Chinese nursing students: The mediating role of alexithymia.

This study aims to explore the relationship between family function, alexithymia and social anxiety among Chinese nursing students, especially to determine whether alexithymia acts as a mediator between family function and social anxiety among this social group. A cross-sectional study. From January to March 2021, a cross-sectional study was conducted among 204 Chinese nursing students at a nursing school of a medical university in the Northeastern Region of China. The interaction anxiousness scale, APGAR family function scale and Tronto alexithymia scale were used for measurement of social anxiety, perceived family function and alexithymia respectively. The data were subjected to correlation analysis, multiple linear regression and structural equation modelling (SEM). Results indicated that social anxiety score was negatively correlated with perceived family function (r=-.232), but positively with alexithymia (r=.307). After controlling for demographic variables, family function and alexithymia could explain 14.5% of the total variance in social anxiety. The SEM results suggested that the effect of family function on social anxiety was partially mediated by alexithymia with a 36.9% mediating effect. This study reveals that alexithymia might partially mediate the impact of family function and social anxiety in Chinese nursing students. In this sense, improvement of alexithymia is expected to be an effective strategy to ameliorate the severity social anxiety in Chinese nursing students, especially for those with a dysfunctional family context.