Positive Family Support Research Articles

The Influence of Family on Doctoral Student Success

Aim/Purpose: This qualitative case-study explores how a doctoral student’s family influences the doctoral student’s success from the perspective of doctoral students who were enrolled in an online doctoral program. Background: Previous research has shown that family can significantly influence doctoral student success; however, it is not clear what is meant by family nor what the details of the influence of family look like from the perspective of the doctoral student. Methodology: A qualitative case-study method was used. More than 500 former students enrolled in an online doctoral program were emailed a web-based survey that elicited information about who they considered to be in their family, how they thought their relationship with their family changed while they were a doctoral student, and how much they thought their family understood what it means to be a doctoral student. One hundred thirty-three (24%) former students participated in the study. Qualitative data were analyzed both manually and electronically by three researchers who subsequently triangulated the data to confirm themes. Contribution: This study defines ‘family’ from the doctoral student perspective and provides an in-depth look at how family influences doctoral student success including explanation of family support and lack thereof that previously has been shown to be significant to facilitating or hindering doctoral student success. Findings: Doctoral students mostly considered their immediate and extended family (i.e., spouses, significant others, children, grandchildren, parents, grandparents, grandchildren, nieces, nephews, and parents-in-law) to be family, but some considered friends and coworkers to be part of their family as well. Most doctoral students experienced positive family support, but for those who did not, two major themes emerged as problematic: a reduction in the amount of time spent with family and family not understanding the value of earning a doctoral degree. Recommendations for Practitioners: Institutions of higher education should consider these findings when creating interventions to increase retention of doctoral students. Interventions might include orientation programs to help family members understand the value of earning a doctoral degree, the time commitment necessary to complete a doctoral degree, and ways to support a family member earning a doctoral degree. Recommendation for Researchers: The findings inform future research by surfacing more specific information about what family support and lack thereof looks like for doctoral students and what interventions for improving family support might include. Impact on Society: Improving family support may improve doctoral student success by adding more doctoral-trained leaders, innovators, scholars, and influential educators to society and by supporting the financial investment of students and their families by decreasing attrition. Future Research: Future research should focus on creating quantitative instrumentation to measure the influence of family on doctoral student success. Student populations from different types of doctoral programs (e.g., PhD, MD, DO) might be studied as well. Interventions aimed at improving family support should be designed, implemented, and evaluated for effectiveness.

Initial Validation of an Elementary Version of the Positive Family Support Strengths and Needs Assessment

The purpose of the present study was to conduct an initial validation of the Positive Family Support–Strengths and Needs Assessment (PFS-SaNA) for elementary school children. The PFS-SaNA is designed as a universal screener wherein parents report on common areas their children may need additional support. Parents of children attending one elementary school participated in two consecutive years. A total of 627 parents of elementary school children participated (Year 1 = 368, Year 2 = 259). Exploratory factor analysis was conducted across Years 1 and 2 and a replicability test compared item loadings from Year 1 and Year 2. Finally, evidence of external validity was examined. Results suggested the PFS-SaNA is unidimensional with findings indicating item loadings replicated from Year 1 to Year 2. Finally, evidence of external validity was found. Implications for the PFS-SaNA as a universal parent screener that can be embedded in a multiple gating risk management strategy in elementary school are discussed.

The influence of acculturation level and family relationships on quality of life among U.S. Chinese older adults

ABSTRACTThe present study examined the influence of acculturation level and family relationships (i.e., positive family support and negative family strain) on quality of life (QOL), using the data from the Population Study of ChINese Elderly (PINE) in Chicago (N = 3159). Controlling for sociodemographic variables and health status, it was found that individuals’ acculturation level and positive family support were positively related to QOL, whereas negative family strain was negatively associated with QOL. More importantly, higher acculturation levels were associated with increased protective effects of positive family support and reduced risk effects of negative family strain on QOL among U.S. Chinese older adults.

A Path Analysis of the Effects of Mental Health and Socio-personal Factors on Breastfeeding Problems in Infants Aged Less than Six Months

Background: Despite the large number of studies conducted on breastfeeding, no studies have yet examined the direct and indirect effects of socio-personal factors and mental health on breastfeeding. Aim: This study aimed to analyze of the effects of mental health and socio-personal factors on breastfeeding in infants aged less than six months. Method: This analytical cross-sectional study was conducted on 465 eligible mothers visiting general health centers in a northern city of Iran, in 2015. Data were collected using the researcher-made scale of socio-personal factors of breastfeeding, Spielberger’s State-Trait Anxiety Inventory, Beck’s Depression Inventory, Cohen’s Perceived Stress Scale, the Breastfeeding Difficulties Questionnaire, the Access to Healthcare Questionnaire, and the Poor Health Behaviors Questionnaire. Results: The path analysis of the mental health variables showed that breastfeeding problems are associated through a direct path with depression, through an indirect path with stress, and through both paths with anxiety; a positive correlation was thus observed between these variables and breastfeeding problems. Poor health behaviors also contributed to mothers’ breastfeeding problems through a direct path and indirectly by affecting their level of depression. Income had the highest positive effect (B=0.66), while the number of children had the highest negative effect (B=-3.16) on breastfeeding problems through a direct path. Poor health behaviors had the highest positive effect (B=0.75) and family support had the highest negative effect (B=-0.11) on breastfeeding. Implications for Practice: The early diagnosis of poor postpartum mental health in mothers can help reduce breastfeeding problems.

The Progression of Taiwanese Women’s Roles in Officiating Volleyball

As times have changed, women have attempted through various strategies to redefine their rights to attempt to break down gender stereotypes; this finding is particularly evident in women’s participation in politics and sport. The aim of this study is to investigate the issues that have hindered and those that have aided the advancement of women’s participation in the field of refereeing volleyball in Taiwan. The study takes the form of qualitative research by conducting in-depth interviews of eight participants. The conclusions were divided into two categories: positive factors that aided participation and negative factors that hindered participation. The negative factors that hindered women’s achievement in the field of officiating volleyball were as follows: gender stereotypes from coaches, player/fan inter-dynamics, and females’ family roles and responsibilities. The most predominant positive factors that motivated personal achievement were positive family support and positive interrelationships with referee partners.

Exploring Perceptions about Insulin Dependent Diabetes Mellitus in Adolescent Patients and Peers

ABSTRACTFriends can provide encouragement and support during stressful times. Friends are even more important for children coping with chronic illness such as adolescents managing insulin dependent diabetes mellitus (IDDM). Nurses need to recognize that the knowledge and care of both the children coping with diabetes and friends can be critical. This study explored perceptions of adolescents managing diabetes and their peers. The non-affected peers and adolescents with IDDM ranged in age between 15–18 were studied using an exploratory qualitative method. A sample of 6 subjects, 2 with diabetes and 4 peers, were interviewed. Subjects with IDDM reported manageable stress but frustration with friends’ lack of knowledge. The peers reported different views of managing diabetes than those with IDDM. Adolescents with IDDM also reported positive family support. The study revealed that peers need additional education on the illness. In summary, adolescents coping with diabetes had overall positive perceptions and accurate knowledge, but limited support from peers.

Effectiveness evaluation of the Positive Family Support intervention: A three-tiered public health delivery model for middle schools

This article presents the results of an evaluation of Positive Family Support, an ecological family intervention and treatment approach to parent supports and family management training developed from a history of basic and translational research. This effectiveness trial, with 41 public middle schools randomly assigned to intervention or control, examined student-, teacher-, and parent-reported outcomes, as well as math and reading scores and school attendance. Multilevel analyses suggested that for students at risk for behavior problems, immediate-intervention schools outperformed control schools on parent-reported negative school contacts for students at risk for behavior problems. Implementation, however, was hampered by several challenges, including school funding cuts, lack of staff time to provide parenting supports, and staff turnover. Given that preventive interventions are generally cost effective, it is critical that researchers continue their efforts to refine these interventions and find ways to support schools' implementation of evidence-based programs that can reduce problem behavior. This article is part of a special issue “Parental Engagement in School-Based Interventions”.

Abstract B24: Health related quality of life during cancer treatment: Perspectives of adolescent and young adult cancer patients and caregivers

Abstract BACKGROUND Cancer incidence among adolescent and young adults (AYAs) ages 15-39 has steadily increased over the past 25 years. Moreover, 5-year survival rates for AYAs has not improved in almost 30 years. AYAs with cancer often require an intensive treatment regimen, comprising surgery, chemotherapy, radiotherapy, or a combination. Cancer and its active treatment result in adverse effects, including physical and emotional effects and risk for additional cancers. These have a detrimental impact on health related quality of life (HRQoL) of AYAs with cancer. With a dearth of data to translate into evidence-guided interventions promoting HRQoL, we characterized patients' and caregivers' perspectives regarding cancer and its treatments' impact on HRQoL and strategies to enhance HRQoL. METHODS We conducted qualitative, in-depth semi-structured interviews with AYAs with cancer receiving care at the University of New Mexico (UNM) Pediatrics Hematology/Oncology Clinic and the UNM Comprehensive Cancer Center and caregivers. New Mexico is one of the four “minority-majority” states, with a multiethnic, multicultural, and geographically dispersed population with striking patterns of cancer health disparities. We used community engaged research methods and a purposeful sampling approach, to recruit eligible participants from diverse racial/ethnic and socio-economic backgrounds. We conducted audio-recorded interviews (September through December 2015) focusing on patients' and caregivers' perspectives on the impact of cancer, stressors, coping mechanisms, meaning of life, and strategies to enhance HRQoL. Investigators iteratively reviewed transcripts to create an initial coding structure and transcripts were imported into NVivo 10, a qualitative data analysis program, for final coding. We used the social determinants of health framework to categorize and interpret the data. RESULTS We reached thematic saturation after interviewing 10 AYAs and 10 caregivers, among which there were eight patient-caregiver dyads. AYAs and caregivers expressed acute stress, frustration, anger, and sadness as a result of the cancer diagnosis. AYAs felt a loss of sense of self-worth and self-esteem. Moreover, AYAs and caregivers experienced financial difficulties due to loss of work, reduced work hours, and expenses related to medical care and accommodations; some had to make hard decisions by choosing between basic necessities and medical treatment. AYAs felt stigmatized due to their treatment-related physical appearance and limitation. On a positive note, there were references to inner strength and resolve and discovering the true nature of friendships. When undergoing treatment, a “good day” would be doing “normal” things, spending time with loved ones. There was also the realization that life with cancer meant “live life to the fullest” and “make a difference and help as many people”. Strategies to cope with cancer included maintaining a positive outlook, family support, being engaged, finding distractions, faith, and spirituality. CONCLUSIONS Cancer and its treatment poses a tremendous emotional and financial burden on both patients and caregivers, which they addressed through reframing the meaning of life and positive active coping strategies. Effective interventions to enhance HRQoL among AYAs with cancer and caregivers need to focus on behavioral and lifestyle support coupled with education. Citation Format: Shiraz I. Mishra, Heidi Rishel Brakey, Miria Kano, Andrew Sussman. Health related quality of life during cancer treatment: Perspectives of adolescent and young adult cancer patients and caregivers. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B24.

Exercise in patients with Type 2 diabetes: Facilitators and barriers - A qualitative study.

Introduction:Diabetes is a major noncommunicable disease affecting more than 65 million Indians. Although treatment algorithms suggest lifestyle measures (diet and exercise) along with medications data regarding adherence to exercise as well as facilitators and barriers to the practice of physical activity in such patients are limited. Hence, this qualitative study was conducted.Objectives:The objective of this study is to describe the factors which (1) Facilitated and (2) hindered the practice of regular exercise in patients with Type 2 diabetes.Methodology:The study was conducted on 13 diabetic patients admitted to a tertiary care center in Bengaluru - St. John's Medical College Hospital, to explore factors that acted as facilitators and barriers to physical activity. Data saturation with the coded themes was achieved on interviewing 13 patients, after which, thematic analysis was done, and final themes reported.Results:The age of the study participants (7 males, 6 females) ranged from 40 to 80 years. Among those who did exercise, factors such as awareness regarding the benefits of exercise and complications linked with diabetes, positive family support, and emphasis by nursing staff emerged as facilitators. Lack of time, obligations to others, inability to link exercise with blood sugar control, lack of perception of obesity as a health issue, inadequate emphasis by physicians, social/cultural issues, lack of infrastructure, and physical restriction were the factors that acted as barriers to physical activity. In addition to the above, a clear lack of adherence to standard guidelines, while advising patients by physicians was also noted.Conclusion:A comprehensive approach by both doctors and nurses, based on standard guidelines, could help in implementing adherence to exercise in patients with diabetes.

Diabetes Control and Adherence in Adolescence.

Type 1 diabetes is a chronic disease that can lead to severe complications if poorly controlled. Adolescents are particularly vulnerable to worsening diabetes control due to changes in physiology, family dynamics, and social interactions. Good diabetes control requires following a regimen of frequent blood glucose checks, accurate carbohydrate counts, and compliance with insulin administration. Patients who are challenged in controlling their diabetes do tend to respond to behavioral interventions; however, the effect of the intervention wanes over time. Using technology to provide interventions has shown promise in terms of improving compliance. Positive family support and adequate knowledge of the developmental stages is important to ensure a successful transition from childhood to adolescence. Providers should also incorporate a structured transition from adolescent to adult diabetes care. [Pediatr Ann. 2016;45(9):e327-e331.].

Proactive Parent Engagement in Public Schools: Using a Brief Strengths and Needs Assessment in a Multiple-Gating Risk Management Strategy.

This study examined the viability of a brief, parent-reported strengths and needs assessment as the first step in a multiple-gating approach to proactive positive behavior support for families. The Positive Family Support–Strengths and Needs Assessment (PFS-SaNA) was designed to collaboratively engage parents early in the school year in a home–school coordinated Positive Family Support (PFS) system. In this study, we evaluated the reliability and validity of the PFS-SaNA in the context of public middle schools. Findings suggest that the 14-item, unidimensional PFS-SaNA shows convergent validity with teacher ratings of risk. It can be easily and cost-effectively used by school personnel when parents register their children for school at the beginning of each school year.

"I Told Myself to Stay Positive" Perceptions of Coping Among Latinos With a Cancer Diagnosis Living in the United States.

This study contributes to the sparse body of literature examining perceptions of coping among Latino men and women with a cancer diagnosis living in the United States. There are currently 50 million Latinos in the United States and, by 2050, projected to grow to 128 million. Although some research indicates that Latinos have unique sociocultural beliefs that influence their cancer care, very little is known about their perceptions of coping after being diagnosed with cancer. We examined Latino men and women's perceptions of coping to understand the meaning of their experience with cancer Method: Using criterion sampling technique, 60 immigrant and migrant Latino men and women diagnosed with cancer within the past 5 years were recruited from community-based organizations, clinics, and churches. The study consisted of 60- to 90-minute semistructured interviews asking open-ended questions pertaining to coping. The qualitative design facilitated an understanding of coping within the participants' social and cultural contexts. Median age of the participants was 55 years. Among the women, 80% had breast cancer; 12% had ovarian cancer; and 8% had throat, thyroid, stomach, or skin cancers. Among the men, 94% had prostate cancer and 6% had brain, colorectal, or lung cancers. Emerging themes associated with the development of coping strategies involved positive reframing, family support, religion and spirituality, and support from health care providers. The term "positive reframing" relates to finding meaning and positive emotions that help sustain the coping process, despite having a cancer diagnosis. In addition, when medical and helping professionals provided tangible support, participants engaged in meaning-based coping. This study provides insights regarding the existing coping strategies which Latinos utilize and provides clinician-tangible information pertaining to participant's engagement in meaning-based coping. Family support facilitated coping among the Latino men and women. The role of religion and spirituality in the lives of the participants enabled them to cope with the cancer diagnosis. Future research is necessary to examine coping strategies regarding specific cancers at end of life.

Psychosocial Predictors of Weight Loss among American Indian and Alaska Native Participants in a Diabetes Prevention Translational Project.

The association of psychosocial factors (psychological distress, coping skills, family support, trauma exposure, and spirituality) with initial weight and weight loss among American Indians and Alaska Natives (AI/ANs) in a diabetes prevention translational project was investigated. Participants (n = 3,135) were confirmed as prediabetic and subsequently enrolled in the Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented at 36 Indian health care programs. Measures were obtained at baseline and after completing a 16-session educational curriculum focusing on weight loss through behavioral changes. At baseline, psychological distress and negative family support were linked to greater weight, whereas cultural spirituality was correlated with lower weight. Furthermore, psychological distress and negative family support predicted less weight loss, and positive family support predicted greater weight loss, over the course of the intervention. These bivariate relationships between psychosocial factors and weight remained statistically significant within a multivariate model, after controlling for sociodemographic characteristics. Conversely, coping skills and trauma exposure were not significantly associated with baseline weight or change in weight. These findings demonstrate the influence of psychosocial factors on weight loss in AI/AN communities and have substantial implications for incorporating adjunctive intervention components.

Fibromyalgia: A Critical and Comprehensive Review

Fibromyalgia is a disorder that is part of a spectrum of syndromes that lack precise classification. It is often considered as part of the global overview of functional somatic syndromes that are otherwise medically unexplained or part of a somatization disorder. Patients with fibromyalgia share symptoms with other functional somatic problems, including issues of myalgias, arthralgias, fatigue and sleep disturbances. Indeed, there is often diagnostic and classification overlap for the case definitions of a variety of somatization disorders. Fibromyalgia, however, is a critically important syndrome for physicians and scientists to be aware of. Patients should be taken very seriously and provided optimal care. Although inflammatory, infectious, and autoimmune disorders have all been ascribed to be etiological events in the development of fibromyalgia, there is very little data to support such a thesis. Many of these disorders are associated with depression and anxiety and may even be part of what has been sometimes called affected spectrum disorders. There is no evidence that physical trauma, i.e., automobile accidents, is associated with the development or exacerbation of fibromyalgia. Treatment should be placed on education, patient support, physical therapy, nutrition, and exercise, including the use of drugs that are approved for the treatment of fibromyalgia. Treatment should not include opiates and patients should not become poly pharmacies in which the treatment itself can lead to significant morbidities. Patients with fibromyalgia are living and not dying of this disorder and positive outlooks and family support are key elements in the management of patients.

Perceived Family Support and Antiretroviral Adherence in HIV-Positive Individuals

The purpose of this study was to examine the association between perceived family support, either positive or negative, and adherence to antiretroviral medication regimens among HIV-positive individuals in the Kathmandu Valley, Nepal. We measured past 3-month antiretroviral adherence among 233 HIV-positive individuals, in relation to perceived family support, both positive (in terms of emotional and instrumental support) and negative (in the form of negative interactions), using the 10-item Nepali Family Support and Difficulty Scale. Medium and high levels of perceived emotional support from family were associated with reduced risk of antiretroviral nonadherence, compared with low levels of perceived emotional support (adjusted odds ratio [AOR] = 0.37, 95% confidence interval [CI] [0.16, 0.88], and AOR = 0.23, 95% CI [0.08, 0.64], respectively). Conversely, higher levels of felt emotional distance (AOR = 1.46, 95% CI [1.00, 2.14]) and experienced physical harm (AOR = 2.04, 95% CI [1.07, 3.91]) were associated with increased risk of nonadherence. The results support the recommendation that service providers need to be aware of the significant role of family support in shaping antiretroviral adherence and to consider ways to strengthen positive family support while minimizing negative family interactions to increase adherence rates.

Adolescent attachment, family functioning and depressive symptoms

Background. Adolescence represents a challenging transitional period where changes in biological, emotional, cognitive and social domains can increase the risk of developing internalised problems including subthreshold depression. Adolescent-parent attachment style, perceived support and family functioning may increase risk for depressive symptoms or may reduce such risk. Adolescent-parent attachment, adolescent-perceived support from parents and family functioning were examined as correlates of depressive symptom presentation within this age group. Methods. Participants included a maternal parent and an adolescent (65.5% female) from each family. Adolescents were in Grade 7 ( n =175) or Grade 10 ( n =31). Data were collected through home interviews. The Self-Report of Family Inventory (SFI), Experiences of Close Relationships Scale (ECR), Network of Relationships Inventory (NRI), Children’s Depression Inventory (CDI) and Child Behavior Checklist (CBCL) were used to assess depression, parental support and attachment. Results. Two models were examined: one with adolescent report of depressive symptoms as the outcome and a second with parent report of adolescent internalising symptoms as the outcome. The model predicting adolescent-reported depressive symptoms was significant with older age, higher levels of avoidant attachment, and higher levels of youth-reported dysfunctional family interaction associated with more depressive symptomatology. In the model predicting parent report of adolescent internalising symptoms only higher levels of dysfunctional family interaction, as reported by the parent, were associated with higher levels of internalising symptoms. Conclusion. Positive family communication, cohesion and support predictive of a secure parent-adolescent attachment relationship reduced the risk of a depressive symptom outcome. Secure adolescents were able to regulate their emotions, knowing that they could seek out secure base attachment relations within their family and from friends during times of stress, buffering against the development of depressive symptoms.

Introduction to Working with Military Families

After the 9/11/2001 terrorist attacks in New York, the United States engaged in the global war on terror with two wars, primarily in Iraq and Afghanistan, leading to sustained military operations that lasted for over a decade. Service members deployed to dangerous combat locations, and their families who remained home juggled the numerous demands of daily life. The deployment/s of a service member and subsequent reintegration represents a period of sustained stress for these families and everyone in the system is affected, sometimes negatively, and personal and family change and growth always result from the experience. There has been a large and growing body of literature related to families and military deployment, especially over the last decade. Deployment is an essential and noble component of life in the military. Service members risk their lives and make great sacrifices to defend the freedoms of citizens at home. Yet, deployment and related events represent a crisis for members of families who face many changes and transitions during this time. Post deployment, family members are faced with getting to know each other again, a process made more difficult if the deployment was difficult and family life now includes variables such as poor mental health, financial strain, or recovery from injury. These changes, no matter how big or small, represent losses and additions to daily life and require many skills and qualities including adaptability, communication, patience, understanding, conflict resolution, anxiety management, boundary negotiation, co-parenting, building connection, and acceptance, to name just a few. Effective interventions for military families have the potential to result in changes that have long-lasting consequences across generations. From a military perspective, service members are more content and able to focus more easily on their work when things are going well at home. From a family perspective, children are better off when parents get along, for example, when they are communicating well, agree on family rules and routines, and show positive examples of love. From an individual perspective, life is easier to cope with when things run smoothly on the home front. When relationships are working well, family is the best support system, the finest motivator, and the most prized team. Positive family support makes it easier to face mental health concerns, employment difficulties, and the aftermath of war. Conversely, negative family relationships add to stress, exacerbate mental health problems, and can lead to detrimental outcomes including suicide, interpersonal violence, and other regrettable life-altering decisions. In this special issue focused on military families, twelve articles, authored by a diverse array of scholars, provide insight into the wellbeing of these families, and interventions to strengthen family functioning. Two articles focus on helping children who are dealing with the deployment of a parent in the military. Two articles describe prevention approaches for couples and interventions aimed at educating couples before, during, and after deployment, in a way that addresses problems before they even start. One paper focuses on an intervention for military spouses, a group who have needs for added supports and understanding during a difficult time. Four papers describe different interventions for couples including those dealing with PTSD, intimate partner violence, and sexual trauma. One of these papers includes an innovative description on & Adrian Blow blowa@msu.edu

Adolescent attachment, family functioning and depressive symptoms

<p><span><strong>Background.</strong> Adolescence represents a challenging transitional period where changes in biological, emotional, cognitive and social domains can increase the risk of developing internalised problems including subthreshold depression. Adolescent-parent attachment style, perceived support and family functioning may increase risk for depressive symptoms or may reduce such risk. Adolescent-parent attachment, adolescent-perceived support from parents and family functioning were examined as correlates of depressive symptom presentation within this age group.</span></p><p><strong>Methods.</strong> Participants included a maternal parent and an adolescent (65.5% female) from each family. Adolescents were in Grade 7 (<em>n</em>=175) or Grade 10 (<em>n</em>=31). Data were collected through home interviews. The Self-Report of Family Inventory (SFI), Experiences of Close Relationships Scale (ECR), Network of Relationships Inventory (NRI), Children’s Depression Inventory (CDI) and Child Behavior Checklist (CBCL) were used to assess depression, parental support and attachment. </p><p><strong>Results. </strong>Two models were examined: one with adolescent report of depressive symptoms as the outcome and a second with parent report of adolescent internalising symptoms as the outcome. The model predicting adolescent-reported depressive symptoms was significant with older age, higher levels of avoidant attachment, and higher levels of youth-reported dysfunctional family interaction associated with more depressive symptomatology. In the model predicting parent report of adolescent internalising symptoms only higher levels of dysfunctional family interaction, as reported by the parent, were associated with higher levels of internalising symptoms.</p><p><strong>Conclusion. </strong>Positive family communication, cohesion and support predictive of a secure parent-adolescent attachment relationship reduced the risk of a depressive symptom outcome. Secure adolescents were able to regulate their emotions, knowing that they could seek out secure base attachment relations within their family and from friends during times of stress, buffering against the development of depressive symptoms.</p>

Positive Behavioral Interventions and Family Support for Fetal Alcohol Spectrum Disorders.

Although the scientific community has recognized the effects of prenatal alcohol exposure on development for over 40 years, the empirical study of positive behavioral interventions and family support programs for people with fetal alcohol spectrum disorders (FASD) has only just emerged over the last 10 to 15 years. In this time, dedicated researchers have developed innovative programs that have generally produced large effects and have been acceptable to children with FASD and their families. This body of work demonstrates that children with FASD can benefit from interventions that are appropriately tailored to their neurodevelopmental disabilities. Despite this progress, much work lies ahead to meet the significant needs of people with FASD. This review evaluates available sources of information, including theoretical and Lived Experience models, empirical evidence on existing programs, and best practice guidelines, to guide future research priorities and clinical practice. Three priorities for future intervention research are offered.

In focus: The everyday lives of families of adult individuals with epilepsy.

Epilepsy is a multifaceted chronic neurological disorder with diverse effects on a patient's psychosocial well-being. The impact on quality of life has been well documented, and many studies have addressed the detrimental influences epilepsy has on an individual. However, the emotional impact and the influence of the condition on family members have not been well studied. Furthermore, the majority of the studies on this topic have been confined to childhood epilepsy, and there is only scarce literature that discusses the effects on family members caring for adult patients. The purpose of this literature review was to examine the influence of adult epilepsy on the psychological and social well-being of individual family members. We explored the psychological and physical well-being, satisfaction with social circumstances, and perceived level of support in families of adult patients with intractable epilepsy. The paper also suggests best practices on how to improve the family's quality of life, as well as future directions for research. Superior medical care and a positive family support system are important conditions that can help adult individuals with epilepsy best deal with their condition.