An examination of family functioning utilizing the circumplex model in psychiatrically hospitalized children with depression

doi:10.1016/0165-0327(95)00042-L

Journal of Affective Disorders

Volume 35, Issues 1–2, 9 October 1995, Pages 65-73

https://doi.org/10.1016/0165-0327(95)00042-L Get rights and content

Abstract

The purpose of the current study was to explore the relationship between childhood depression and family functioning. 11 children with depression and 11 children without depression were compared via scores on the adaptability and cohesion dimensions of the FACES-III-K. Children with depression reported significantly less cohesive and more disengaged (displaying emotional separateness and lack of closeness) families than children without depression. Cohesion (the emotional bonding and individual autonomy of family members), but not adaptability, appears to be an important factor in the relationship between family functioning and childhood depression. Clinicians are advised to use treatments designed to help alleviate low family cohesion for children with depression.

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Citation Excerpt :
Understanding the factors that contribute to or maintain problematic parental responses to adolescent depression are important, as this may highlight potentially modifiable areas to target during treatment. Consistent with previous findings, this study found higher levels of critical, overprotective and distressed/withdrawn responses, and lower levels of supportive responses among parents of adolescents with high levels of depressive symptoms (Asarnow et al., 1994; Kashani et al., 1995; McLeod et al., 2007; Pineda et al., 2007; Rapee, 1997; Sheeber et al., 1998; Sheeber and Sorensen, 1998). This was similar in respect to parental depressive symptoms, with more negative (critical, overprotective and distressed) and less supportive parental responses noted among more depressed parents, highlighting the importance of parental mental health.
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Parents (N = 440) of adolescents aged 13–17 years completed an anonymous online questionnaire.
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Differences between the two sample recruitment sites.
There was evidence of more negative parental attitudes and responses among depressed parents and parents of depressed youth. Improving parental depression literacy and reducing depression stigma during treatment of adolescent depression may facilitate parental responsiveness, and in some circumstances, may help buffer against the negative impact of parental depression.
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The present research examined the correlations between types of family relationships and adolescents’ beliefs about their own health. “Healthy” adolescents (N = 765) completed both the Multidimensional Health Locus of Control questionnaire and Olson’s scale assessing family cohesion and adaptability. They were compared to a group of 358 adolescents diagnosed with mental disorders. Cohesion in the family of origin was a significant factor in the adolescents’ feeling of control over their own health as well as in the level of power they attributed to other people. Among these adolescents, adaptability of the family of origin was positively correlated with stronger feelings of control over one’s own health and with lower levels of belief in chance. Family relations were significant in the adolescents’ acquisition of feelings of control over their own health.
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2002, Journal of the American Academy of Child and Adolescent Psychiatry
To determine the independent effects of parental depression and family discord on psychopathology in offspring at high and low risk for major depression.
One hundred eighty-two offspring of depressed or nondepressed parents were followed over 10 years. In direct interviews, parents’ and offspring's psychopathology was evaluated by raters blind to parents’ clinical status. Five dimensions of family discord—poor marital adjustment, parent–child discord, low family cohesion, affectionless control, and parental divorce—were assessed.
Offspring exposed to either parental depression or family discord had higher rates of psychopathology than their counterparts. High-risk offspring had few family discord measures associated with their psychopathology; in low-risk offspring, family discord was associated with all offspring diagnoses. Between the two risk factors, parental depression proved a more important predictor for offspring major depressive disorder (MDD) and anxiety disorder, whereas family discord was a more important predictor for substance use disorder.
Parental depression is a strong and consistent risk factor for offspring MDD and anxiety disorder. Without parental depression, offspring have less exposure to family discord and lower rates of psychopathology. In the presence of family discord, rates of MDD, anxiety disorder and substance use disorder increased. When offspring matured into young adulthood, effects of parental depression and family discord persisted.
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2002, International Perspectives on Child and Adolescent Mental Health
This chapter presents the cross-cultural differences in suicidal ideation between children in Nigeria and Botswana. Observational studies among Nigerians and Batswana reveal that methods contemplated or used for suicide differ from those of their counterparts in developed countries, such as UK and USA. The commonest method of choice are hanging, using pesticides, swallowing caustic soda, jumping across moving trains, into swift rivers, deep wells or soak-away pits, and setting fire to their huts and themselves after bathing in paraffin or petrol. Use of firearms is the most common method of suicide by American youth, younger and older adolescents of all races. The use of firearms is not a familiar method to Nigerian and Batswana children. This is probably because they do not access to guns. The use of firearms is under very strict government control in these two countries. Psychosocial and environmental factors seem to instigate suicidal behavior among the children in Nigeria and Botswana. Individuals who are high-risk candidates for suicidal behavior tend to have a combination of overlapping risk factors, such as: physical or sexual abuse, a family history of or exposure to suicidal behavior, or mental illness. Other related factors are parental or caregiver loss [as in the case of HIV/AIDS orphans], decreased familial or social support, chronic physical or terminal illness, pregnancy in adolescent females or being recently jilted. A humiliating negative life event is frequently the trigger to suicide in many cases.
Comparing family expectancies of "healthy" and "pathological" students
2002, Annales Medico-Psychologiques
Objectifs. Examiner les différences d’idéaux familiaux entre une population « normale » d’étudiants de 10 à 25 ans et une population atteinte de troubles mentaux. Méthode. 814 jeunes « normaux » ont été comparés à une population de 358 jeunes atteints de troubles mentaux. Ils ont tous complété le questionnaire de Olson sur leur famille idéale et d’origine. Résultats. Les étudiants appartenant au groupe « sain » sont issus de familles plus cohésives et adaptables que ceux du groupe « pathologique » et ils « rêvent » d’une famille encore plus cohésive et adaptable. Si le sexe n’a pas d’influence sur la description de la famille d’origine, il est déterminant par rapport à la famille idéale chez les filles du groupe « sain ». L’âge n’a une influence que chez les adolescents « sains ». Il détermine à la fois un abaissement progressif de la cohésion de la famille d’origine et une augmentation de celle-ci dans la famille idéale. Conclusions. Si tous les adolescents attendent de leur future famille qu’elle soit plus cohésive et adaptable, les adolescents « pathologiques » semblent souffrir d’une plus faible capacité de « rêves ». Il est tentant de rapprocher cette « faiblesse » du plus bas niveau de cohésion et d’adaptabilité des familles d’origine.
Object. Studying the ideal family differences between a group of healthy students (from 10 to 25 years old) and a population affected by mental disorders. Method. 814 healthy adolescents are compared to a population of 358 adolescents suffering from mental disorders. All of them have filled-in the Olson questionnaire concerning their native and ideal families. Results. The healthy teenagers belong to distinctly more cohesive and adaptable families than the adolescents from the pathological group. The healthy teenagers also expect a still more cohesive and adaptable family. Gender has no influence on the native family description, but acts as a defining factor in the expectations concerning the ideal family among the girls of the healthy population. In the healthy group, age determines at once a gradual cohesion decline in the native families and a cohesion rise in the ideal family. Conclusion. If “healthy” adolescents expect more cohesion and adaptability from their future family, “pathological” adolescents show a decreased “dream ability”. Such a decrease could be related with the lower cohesion and adaptability levels described into the native family.
Impact of early onset bipolar disorder on family functioning: Adolescents' perceptions of family dynamics, communication, and problems
2001, Journal of Affective Disorders
Objective: This research investigated the impact of adolescent onset bipolar illness on perceived family functioning in stabilized bipolar I (B) and unipolar (U) probands, and normal controls (C). Method: Sample N=119: 44 bipolar 1(17 M, 27 F), 30 unipolar (9 M, 21 F), and 45 controls (19 M, 26 F). Mean ages: 19.9, 18.5 and 18.2 years, respectively. Instruments: Family Adaptability and Cohesion Scale (FACES II), Parent–Adolescent Communication Scales (PACS), Social Adjustment Inventory for Children and Adolescents (SAICA). Results: There were no significant group or sex differences between controls and mood disordered youth – assessed intermorbidly – in ratings of relationship with either parent. Bipolars acknowledged significantly more minor conflicts with parents than either unipolars or controls. Ratings by mood disordered subjects were significantly less positive in terms of shared activities and communication with siblings. Mood disordered youth and controls were not differentiated on the basis of family adaptability, and all family cohesion scores were within population norms. No significant group differences were observed in communication with parents. Limitations: This self-report study was conducted intermorbidly, does not include objective measures of family functioning, nor does it assess the effect of psychiatric illness in other family members on family functioning. Conclusions: Assessed intermorbidly, bipolar adolescents’ perceptions of family dynamics do not seem to diverge significantly from controls. Further research is needed to investigate the impact of adolescent bipolar illness on family life during acute phases of the illness, as well as the effect on family functioning of psychiatric disorders in other family members.

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Research reportAn examination of family functioning utilizing the circumplex model in psychiatrically hospitalized children with depression

Abstract

J. Am. Acad. Child. Adolesc. Psychiatry

Adv. Behav. Res. Ther.

J. Am. Acad. Child Adolesc. Psychiatry

J. Am. Acad. Child Adolesc. Psychiatry

Coping strategies, self-perceptions, hopelessness, and perceived family environments in depressed and suicidal children

J. Consult. Clin. Psychol.

Children of parents with major affective disorder: a review

Am. J. Psychiatry

Cognitive Therapy and the Emotional Disorders

Family variables and disease management in juvenile rheumatoid arthritis

J. Pediatr. Psychol.

Toward a transactional model of childhood depression

Convergent and discriminant validity of FACES-III: family adaptability and cohesion

Fam. Process

Depressive affect and restraint in early adolescents: relationships with family structure, family process and friendship support

J. Early Adolesc.

Family risk factors, parental depression and psychopathology in offspring

Dev. Psychol.

Family conflict and communication in adolescence

Parent-adolescent conflict

Familial risk factors to oppositional defiant disorder and conduct disorder: parental psychopathology and maternal parenting

J. Consult. Clin. Psychol.

Families of adolescent drug abusers are ‘rigid’: are these families either ‘disengaged’ or ‘enmeshed,’' or both?

Fam. Process

Family organization and parent attitudes of children with conduct disorder

J. Clin. Child Psychol.

The perceived competence scale for children

Child. Dev.

Use of the Family Adaptability and Cohesion Scales in child clinical research

J. Abnorm. Child Psychol.

Depressed children of depressed parents

Can. J. Psychiatry

Childhood depression: epidemiology, etiological models, and treatment implications

Integr. Psychiatry

Research report
An examination of family functioning utilizing the circumplex model in psychiatrically hospitalized children with depression