Summary
Several studies have highlighted the burden on the families of mentally ill patients and so emphasised the need to investigate the effects of illness on family life and relationships. — A review of the literature showed that many of the published measures of the family lacked satisfactory reliability and validity. — A methodological study of 30 families in all of which there were children of school age or younger and in which one parent had newly attended a psychiatric facility is reported. For each family there was a 2–3 hour interview with the patient, a 3–4 hour interview with the spouse and a third interview of about an hour with the two of them together. At each interview there were two investigators who made independent ratings. There were different investigators for each of the three interviews so that there were 6 investigators and 6 sets of independent ratings for each family. — A basic distinction was made between concrete happenings or activities in the family, on the one hand and, on the other, feelings, emotions or attitudes concerning these events or the individuals participating in them. An interview designed to measure both types of variables is described. By the use of a particular kind of flexible and detailed questioning about recent events an attempt was made to free the measurement of events and activities from attitudinal biases. A different approach was used for the measurement of emotions. By the use of tape recordings and group discussions, interviewers were trained to recognise and rate differences in tone of voice as shown in the speed, pitch and intensity of speech. The third main type of scale consisted of overall summary ratings of relationships. — Each type of scale is illustrated by a number of examples for which detailed results are given. These are ‘warmth’ and ‘number of critical remarks’ as examples of ‘emotional’ scales, ‘participation of husband and wife in household tasks’ and ‘frequency of irritable acts’ as examples of scales of events or happenings, and ‘overall assessment of the marriage’ as a summary scale. Details are also given on the scale measuring ‘parent preferred by the child’ which does not readily fit into any of these 3 main categories. — High inter-rater reliability was demonstrated for the emotional scales. Respondent and rater biases were not found. By comparison of ratings made in different interviews, it was shown that similar feelings were expressed about the spouse in different situations, suggesting that the ratings were valid as well as reliable. A person's report of someone else's emotions, on the other hand, appeared to have a low level of validity in spite of good reliability. — Inter-rater reliability for the measures of activities and for the overall summary ratings was also high and, more important, it was shown that there was good agreement between the accounts of husbands and wives when interviewed separately. — A detailed examination was made of possible factors influencing husband-wife agreement. Slight biases associated with dissatisfaction and patient status were found but these were not sufficient to influence conclusions in most instances. Ways of reducing such bias are discussed.
Résumé
Plusieurs études ont mis en lumière la charge que représente pour les familles un malade mental; elles ont fait ressortir la nécessité d'enquêter sur l'effet de la maladie sur la vie familiale et les relations. Un examen de la littérature a montré que les renseignements fournis par les familles manquaient d'objectivité et de valeur. — Une étude méthodique de 30 familles en tout, parmi lesquelles il y avait des enfants d'âge scolaire ou plus jeunes, et dont un des parents avait été récemment admis en établissement psychiatrique, a été faite. — Chaque famille a fait l'objet de 2–3 heures d'interview avec le patient, de 3–4 heures d'entretien avec le conjoint et d'un troisième entretien avec les deux époux réunis. Lors de chaque entretien il y avait deux enquêteurs qui faisaient chacun un rapport séparé, en sorte qu'il y avait en tout pour chaque famille six enquêteurs et six différentes appréciations. — Une distinction a été faite entre évènements concrets et activités de la famille, d'une part, et, d'autre part, sentiments, émotions et attitude concernant ces évènements ou la participation individuelle. Par un questionnaire souple et détaillé sur les événements récents, on a tâché de dégager l'appréciation des événements et des activités de tout préjugé. Une approche différente a été employée pour apprécier les émotions. Par le moyen de magnétophones et de groupes de discussion, les enquêteurs ont été entraînés à reconnaître et mesurer les différences de ton de voix selon la vitesse, le diapason, l'intensité du langage. Le troisième échelon a consisté en appréciations sommaires des relations. —Chacun des degrés est illustré par des exemples pour lesquels des résultats détaillés sont donnés. Il y a «chaleur» et «nombre de remarques critiques» comme exemples du degré d'affectivité; «participation du mari et de la femme aux tâches ménagères» et «fréquence des actes d'irritation» comme exemples d'évènements; et «conception générale du mariage» comme résumé. On donne également des détails sur le plan «parent que l'enfant, préfère», appréciation qui ne trouve pas facilement sa place dans une des trois catégories. — Quant au plan affectif, la comparaison a démontré une grande justesse des appréciations. On n'a pas noté de parti-pris chez les rapporteurs ni chez les référents. La comparaison des appréciations faites dans différents entretiens a démontré que des sentiments identiques étaient exprimés au sujet du conjoint dans différentes situations, ce qui permet de penser que les appréciations des enquêteurs étaient objectives et valables. Par contre, un rapport fait par une personne sur les émotions d'une autre semble n'avoir guère de valeur, malgré une très bonne foi. — L'enquête a montré qu'on pouvait se fier aux appréciations des enquêteurs sur les activités et les enquêtes en général et, ce qui est très important, elle a montré qu'il y avait concordance entre les récits des maris et des épouses interrogés séparément. — Un examen détaillé a été fait des facteurs pouvant influencer l'accord entre mari et femme. On a trouvé de légers préjugés alliés à une insatisfaction et au status de malade, mais ils n'étaient pas suffisants pour influencer les conclusions dans l'ensemble. Les moyens de réduire ce genre d'inconvénient sont discutés.
Zusammenfassung
Neuerdings betonten viele Untersuchungen die Belastung der Familie durch psychisch Kranke. Eine kritische Literaturübersicht zeigt, daß viele dieser Untersuchungen mit Familien-Kriterien arbeiten, welche nicht genügend gesichert sind. — Hier wird eine methodologische Untersuchung an 30 Familien vorgelegt, in welchen Kinder im Schulalter oder jünger waren und in welchen ein Elternteil erstmals psychiatrische Behandlung in Anspruch genommen hatte. In jeder Familie wurde der Patient in einem Interview von 2–3 Std untersucht; ein zweites Interview von drei bis vier Stunden fand mit dem Ehegatten statt; ein drittes etwa einstündiges Interview mit beiden zusammen. Jedes Interview wurde von zwei Untersuchern getragen, die unabhängig voneinander ihre Feststellungen trafen. Für jedes der genannten Interviews waren wiederum verschiedene Untersucher eingesetzt, so daß insgesamt sechs Untersucher und sechs unabhängige Beurteilungsprotokolle für jede Familie gegeben waren. — Unterschieden wurde zwischen konkreten Ereignissen oder Aktivitäten der Familie auf der einen Seite und Gefühlen und Haltungen zu diesen Ereignissen bei den beteiligten Personen auf der anderen. Es wurde ein Interview erarbeitet, um beide Variablen zu messen. Durch Einführung eines flexiblen und detaillierten Fragebogens über kürzliche Ereignisse suchten wir Fehlerquellen durch Einstellung und Verarbeitung auszuschalten. Anders wurde bei der Messung der emotionellen Seite vorgegangen. Mit Tonbandaufnahmen und Gruppendiskussionen wurden die Untersucher darin geschult, Unterschiede der Stimmführung zu erkennen und einzuordnen. Der dritte verwendete Skalentyp bezog sich auf die zwischenmenschlichen Beziehungen. — Jede Skala wird durch Beispiele und detaillierte Resultate illustriert. Dies gilt etwa für die beobachtete „Wärme“, für die „Anzahl kritischer Bemerkungen“ als Beispiel für die Erfassung der Emotionalität, für „Teilnahme des Ehemannes und der Ehefrau an Haushaltsaufgaben“ und „Häufigkeit gereizter Aktivitäten“ als Beispiel für die Skala konkreter Geschehnisse, für die „generelle Beurteilung der Ehe“ im Rahmen der allgemeinen Beurteilungsskala. — Es ergab sich eine hohe Verläßlichkeit der Einstufungen zwischen verschiedenen Untersuchern im Hinblick auf die emotionelle Skala. Durch den Vergleich der Beurteilungen in verschiedenen Interviews konnte gezeigt werden, daß in unterschiedlichen Situationen ähnliche Gefühle über den Ehepartner geäußert werden. Validität und Verläßlichkeit lagen hier hoch. Auf der anderen Seite zeigte der Bericht über die Emotionalität anderer eine niedrige Validität trotz guter Verläßlichkeit. — Es lag auch die Verläßlichkeit der Beurteilung zwischen verschiedenen Untersuchern bei der Einschätzung der Aktivitäten und des Allgemeineindrucks hoch. Bedeutsam ist, daß zwischen den Berichten der Ehepartner, wenn diese getrennt untersucht wurden, eine gute Obereinstimmung bestand. — Den Faktoren, welche die Übereinstimmung der Aussagen zwischen den Ehepartnern tragen, wurde detailliert nachgegangen. Gewisse Fehlerquellen ergaben sich im Zusammenhang mit dem Status des Patienten, bedeuteten aber keine entscheidende Beeinflussung der Schlußfolgerungen.
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References
Ackerman, N. W.: Towards an integrative therapy of the family. Amer. J. Psychiat.114, 727–733 (1958).
Alpert, M., R. L. Kurtzberg, andA. J. Friedhoff: Transient voice changes associated with emotional stimuli. Arch. gen. Psychiat.8, 362–365 (1963).
Andry, R. G.: Delinquency and parental pathology. London: Methuen 1960.
Baldwin, A. L.: The study of child behaviour and development. InMussen, P. H. (ed.): Handbook of research methods in child development. New York: John Wiley 1960
—, J.Kalhorn, and F. H.Breese: The appraisal of parent behaviour. Psychol. Mon.63, No. 4 (1949).
Bandura, A., andR. H. Walters: Adolescent aggression. New York: Ronald Press 1959.
Baruch, D.: A study of reported tension in interparental relationships as co-existent with behaviour adjustment in young children. J. exp. Educ.6, 187–204 (1937).
Becker, W. C.: The relationship of factors in parental ratings of self and each other to the behaviour of kindergarten children as rated by mothers, fathers, and teachers. J. consult Psychol.24, 507–527 (1960)
— Unpublished supplemental analyses of parent-child data (1961)
—, andR. S. Krug: The parent attitude research instrument—a research review. Child Develop.36, 329–365 (1965).
Bell, J. E.: Recent advances in family group therapy. J. child Psychol. Psychiat.1, 1–15 (1962).
Bell, R. Q.: Retrospective and prospective views of early personality development. Merrill-Palmer Quart.6, 131–144 (1960).
Blood, R. O., andD. M. Wolfe: Husbands and wives: The dynamics of married living. Illinois: Free Press of Glencoe 1960.
Brown, G. W., E. M. Monck, G. M. Carstairs, andJ. K. Wing: Influence of family life on the course of schizophrenic illness. Brit. J. prev. soc. Med.16, 55–68 (1962)
—, M.Bone,Dallison, and J. K.Wing: Schizophrenia and social care: A comparative follow-up study of 339 schizophrenic patients. Maudsley Monograph (in press);
—, and M.Rutter: The measurement of family activities and relationships: a methodological study. Hum. Relat.19 (in press), 1966.
Chapple, E. D.: The standard experimental (stress) interview as used in interaction chronograph investigations. Human Organisation12, 23–32 (1953).
Cheek, F. E.: The father of the schizophrenic. Arch. gen. Psychiat.13, 336–345 (1965).
Clark, A. L., andP. Wallin: The accuracy of husbands' and wives' reports of frequency of marital coitus. Population Studies18, 165–173 (1964).
Clark, A. W., andP. V. Sommers: Contradictory demands in family relations and adjustment to school and home. Hum. Relat.14, 97–111 (1961).
Clausen, J. A.: The marital relationship antecedent to hospitalisation of a spouse for mental illness. Unpublished paper (1959)
—, and M. R.Yarrow: Mental illness and the family. J. soc. Issues11, No. 4 (1955).
Cumming, E., L. R. Dean, andD. S. Hewell: What is ‘morale’? A case history of a validity problem. Human Organisation17, 3–8 (1958).
Dean, J. P., andW. F. Whyte: How do you know if the informant is telling the truth. Human Organisation17, 34–38 (1958).
Ekman, P.: Body position, facial expression and verbal behaviour during interviews. J. abnorm. soc. Psychol.68, 295–301 (1964).
Ellis, A.: Questionnaire versus interview methods in the study of human love relationships. Amer. soc. Rev.12, 541–553 (1947).
Eron, L. D., T. J. Banta, L. O. Walder, andJ. H. Laulight: Comparison of data obtained from mothers and fathers on child-rearing practices and their relation to child aggression. Child Develop.32, 457–472 (1961).
Frumkin, R. M.: The Kirkpatrick scale of family interests as an instrument for the indirect assessment of marital adjustment. Marriage and Family living15, 35–37 (1953).
Garrett, A.: Interviewing: Its principles and methods. New York: Family Service Assoc. Amer. 1942.
Geismar, L. L.: Family functioning as an index of need for welfare services. Family Process3, 99–113 (1964);
—, and B.Ayres: Measuring family functioning. St. Paul, Minn.: Greater St. Paul Community Chest and Councils Inc. 1960.
Goodrich, D. W., andD. S. Boomer: Experimental assessment of modes of conflict resolution. Family Process2, 15–24 (1963).
Grad, J., andP. Sainsbury: Mental illness and the family. Lancet1, 544–547 (1963).
Haggerty, R. J.: Family diagnosis: research methods and reliability of studies of the medico-social unit, the family. Amer. J. publ. Hlth55, 1521–1533 (1965).
Haley, J.: Research on family patterns: an instrument measurement. Family Process3, 41 to 65 (1964).
Hamburg, D. A., M. A. Sabshin, F. A. Board, R. R. Grinker, S. J. Korchin, H. Basowitz, H. Heath, andH. Persky: Classification and rating of emotional experiences. Arch. Neurol. Psychiat.79, 415–426 (1958).
Harris, A., andM. Metcalf: Inappropriate affect. J. Neurol. Neurosurg. Psychiat.19, 308–313 (1956).
Herbst, P. G.: The measurement of family relationships. Hum. Rel.5, 3–30 (1952).
Hoffman, L. W., andR. Lippitt: The measurement of family life variables. InMussen, P. H. (ed.): Handbook of research methods in child development. New York: Wiley 1960
—,S. Rosen, andR. Lippitt: Parental coerciveness, child autonomy, and child's role at school. Sociometry23, 15–21 (1960).
Hoffman, M. L.: Power assertion by the parent and its impact on the child. Child. Develop.31, 129–143 (1960).
Howells, J. G.: Family psychiatry. Edin. & London: Oliver and Boyd 1963.
Johnson, M. L.: Observer error: its bearing on teaching. Lancet2, 422–424 (1955).
Kenkel, W. F., andD. K. Hoffman: Real and conceived roles in family decision making. Marriage and Family Living18, 311–316 (1956).
Kinsey, A. C., W. B. Pomeroy, andC. E. Martin: Sexual behaviour in the human male. Philadelphia: W. B. Saunders 1949.
Kohn, M. L., andE. E. Carroll: Social class and the allocation of parental responsibilities. Sociometry23, 372–392 (1960).
Laing, R. D., andA. Esterson: Sanity, madness, and the family. Volume 1 — Families of schizophrenics. London: Tavistock 1964.
Levinger, G.: Tasks and social behaviour in marriage. Sociometry27, 433–448 (1964).
Marshall, H. R.: Relations between home experiences and children's use of language in play interactions with peers. Psychol. Mon.75, No. 5 (1961).
McCord, J., andW. McCord: Cultural stereotypes and the validity of interviews for research in child development. Child Develop.32, 171–185 (1961).
McCord, W., J. McCord, andP. Nerden: Familial and behavioural cor-relates of dependency in male children. Child Develop.33, 313–326 (1962).
Mishler, E.: Personal communication 1965.
Newson, J., andE. Newson: Infant care in an urban community. London: Alien and Unwin 1963.
Nimkoff, M. F.: Trends in family research. Amer. J. Sociol.53, 477–482 (1948).
Nye, F. I., andA. E. Bayer: Some recent trends in family research. Social Forces41, 290–301 (1963).
O'Rourke, J. F.: Field and laboratory: the decision making behaviour of family groups in two experimental conditions. Sociometry26, 422–435 (1963).
Peterson, D. R., W. C. Becker, D. J. Shoemaker, Z. Luria, andL. A. Hellmer: Child behaviour problems and parental attitudes. Child Develop.32, 151–162 (1961).
Post, F., andJ. Wardle: Family neurosis and family psychosis: a review of the problem. J. ment. Sci.108, 147–158 (1962).
Radke, M. J.: The relation of parental authority to children's behaviour and attitudes. Inst. Child. Welf. Monogr. No. 22 (1946).
Reece, M. M., andR. N. Whitman: Expressive movements, warmth, and verbal reinforcement. J. abnorm. soc. Psychol.64, 234 to 236 (1962).
Richardson, S. A., B. S. Dohrenwend, andD. Klein: Interviewing: Its forms and functions. New York: Basic Books 1965.
Robbins, L. C.: The accuracy of parental recall of aspects of child development and of child rearing practices. J. abnorm. soc. Psychol.66, 261–270 (1963).
Rutter, M.: Children of sick parents: An environmental and psychiatric study. Maudsley Monograph No. 16 (in press) 1966.
Ryder, R. G., and D. W.Goodrich: Married couples responses to disagreement. Unpublished manuscript.
Sainsbury, P., andJ. Grad: An evaluation of treatment and services. In The burden on the community. Epidemiology of mental illness. A symposium. London: Oxford Univ. Press 1962.
Salzinger, K., andS. Pisoni: Reinforcement of verbal affect responses of normal subjects during the interview. J. abnorm. soc. Psychol.60, 127–130 (1960).
Schaefer, E. S., andR. Q. Bell: Development of a parental attitude research instrument. Child. Develop.29, 339–361 (1958).
Sears, R. R., E. E. Maccoby, andH. Levin: Patterns of child rearing. White Plains, N.Y.: Row Peterson & Co. 1957.
Smith, H. T.: A comparison of interview and observation measures of mother behaviour. J. abnorm. soc. Psychol.57, 278–282 (1958).
Starkweather, J. A.: Content free speech as a source of information about the speaker. J. abnorm. soc. Psychol.52, 394–402 (1956).
Strodtbeck, F. L.: Husband-wife interaction over revealed differences. Amer. sociol. Rev.16, 468–473 (1951).
Terman, L. M.: Psychological factors in marital happiness. New York: McGraw Hill 1938.
Tharp, R. G.: Dimensions of marriage roles. Marriage and Family Living25, 389–404 (1963).
Thomas, A., H. G. Birch, S. Chess, M. E. Hertzig, andS. Korn: Behavioural individuality in early childhood. New York: N.Y. Univ. Press 1963.
Tizard, J., andJ. C. Grad: The mentally handicapped and their families. Maudsley Monograph No. 7. London: Oxford Univ. Press 1961.
Vidich, A., andJ. Bensman: The validity of field data. Human Organisation13, 20–27 (1954).
Vidich, A. J.: Methodological problems in the observation of husband-wife interaction. Marriage and Family Living18, 234–239 (1956).
Waskow, I. E.: Counselor attitudes and client behaviour. J. consult. Psychol.27, 405–412 (1963).
Wing, J. K., E. Monck, G. W. Brown, andG. M. Carstairs: Morbidity in the community of schizophrenic patients discharged from London Mental Hospitals in 1959. Brit. J. Psychiat.110, 10–21 (1964).
Winokur, C., andW. R. Gaston: Sex, anger, and anxiety: intrapersonal interaction in married couples. Dis. nerv. Syst.22, 1–5 (1961).
Yamamura, D. S., andM. N. Zald: A note on the usefulness and validity of the Herbst family questionnaire. Hum. Relat.9, 217–221 (1956).
Yarrow, M. R.: Problems of methods in parent-child research. Child Develop.34, 215 to 266 (1963)
—,J. D. Campbell, andR. V. Burton: Reliability of maternal retrospection: a preliminary report. Family Process3, 207–218 (1964).
Yaukey, D., B. J. Roberts, andW. Griffiths: Husbands' vs wives' responses to a fertility survey. Population Studies19, 29–43 (1965).
Young, F. W., andR. C. Young: Key informant reliability in rural Mexican villages. Human Organisation20, 141–148 (1961).
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Rutter, M., Brown, G.W. The reliability and validity of measures of family life and relationships in families containing a psychiatric patient. Soc Psychiatry 1, 38–53 (1966). https://doi.org/10.1007/BF00583828
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DOI: https://doi.org/10.1007/BF00583828