Internalizing symptoms and disorders in families of adolescents: A review of family systems literature
Section snippets
The current review
This paper reviews the current literature on internalizing symptoms and disorders in families of adolescents within a family systems framework. While much of the literature emphasizes the effect that parents and families have on the well-being of adolescents, this review aims to highlight the importance of considering possible reciprocal effects between parents, adolescents, and their families.
The majority of research examining associations between family climate and internalizing symptoms and
Family systems theory
Extrapolating from theories frequently applied to biological and social systems, family systems theory conceptualizes the family as an organized whole in which all the elements (i.e., members) are interdependent (Minuchin, 1985). Thus, an individual's behavior is viewed as being strongly influenced and determined by the structure, organization, and transactional patterns of the family system (Miller, Ryan, Keitner, Bishop, & Epstein, 2000). Likewise, the characteristics and behavior of all
Family system
Family functioning refers to the family's ability to deal with everyday life and cope effectively with problems and changes. Researchers and theorists have included various aspects of family life and relationships in their conceptualizations of family functioning which have been assessed via various self-report and observational measures. These aspects include, but are not limited to, communication, conflict, cohesion, affective expression, roles, behavioral control, adaptability, and
Family system
In line with research on parents, research on families of adolescents with internalizing symptoms and disorders has generally reported that family dysfunction is common. However, much of this research has focused solely on depression, with anxiety being once again relatively neglected.
In general, adolescent depressive symptoms and disorders are reported to be related to both overall family dysfunction (McFarlane et al., 1995, Tamplin et al., 1998; see Table 1) and to specific aspects of family
Reciprocal effects in the family system
From the research presented thus far it can generally be concluded that parent and adolescent internalizing symptoms and disorders are associated with poorer family functioning, poorer marital relationships, more negative parenting behaviors, poorer quality of attachment, and higher rates of parent/adolescent psychopathology. However, the main limitation of this research is that the majority of findings are based on correlational designs. While virtually all authors caution that the direction
Limitations
There are a number of limitations in the current literature on the effects of internalizing symptoms and disorders in families. The two main limitations which have already been discussed are the limited interpretation possible from correlational studies and the paucity of studies examining reciprocal effects. However, there are additional limitations. The first relates to the large number of measures and methods that have been utilized to study internalizing symptoms and disorders and various
Summary and conclusions
By presenting the findings from studies of internalizing symptoms and disorders in families of adolescents from a family systems perspective, this review has aimed to highlight the need for future research to more fully consider possible reciprocal effects in families. Despite some important limitations, there is considerable evidence in the current literature to suggest that parent and adolescent internalizing symptoms and disorders are associated with poorer functioning at various levels of
References (116)
- et al.
Effects of parental anxiety disorders in children at high risk for panic disorder: A controlled study
Journal of Affective Disorders
(2006) - et al.
Childhood and adolescent depression: A review of the past 10 years. Part I
Journal of the American Academy of Child and Adolescent Psychiatry
(1996) - et al.
The reciprocal relationship between early adolescent attachment and internalizing and externalizing problem behaviour
Journal of Adolescence
(2004) - et al.
Relationship between youth and parent perceptions of family environment and social anxiety
Journal of Anxiety Disorders
(1999) - et al.
Affective disorder in the parents of a clinic sample of children with anxiety disorders
Journal of Affective Disorders
(2006) - et al.
Frequency, comorbidity, and psychosocial impairment of anxiety disorders in German adolescents
Journal of Anxiety Disorders
(2000) - et al.
Course and outcome of anxiety disorders in adolescents
Journal of Anxiety Disorders
(2002) - et al.
The context of depression in clinic-referred youth: Neglected areas of treatment
Journal of the American Academy of Child and Adolescent Psychiatry
(1999) - et al.
Parent–child interactions and anxiety disorders: An observational study
Behaviour Research and Therapy
(2001) - et al.
Mood disorders in children and adolescents: An epidemiologic perspective
Biological Psychiatry
(2001)
Negative affectivity in children and adolescents: Relations between anxiety and depression
Clinical Psychology Review
The characteristics of asymptomatic female adolescents at high risk for depression: The baseline assessment from a prospective 8-year study
Journal of Affective Disorders
Individual and familial predictors of impairment in childhood anxiety disorders
Journal of the American Academy of Child and Adolescent Psychiatry
Attachment in mothers with anxiety disorders and their children
Journal of the American Academy of Child and Adolescent Psychiatry
Family functioning in families of psychiatric patients
Comprehensive Psychiatry
Perceptions of the family, personality characteristics, and adolescent internalizing symptoms
Journal of the American Academy of Child and Adolescent Psychiatry
Depression and anxiety in parents and children: A direct interview study
Journal of Anxiety Disorders
Self-reported attachment style, attachment quality, and symptoms of anxiety and depression in young adolescents
Personality and Individual Differences
The psychosocial functioning and family environment of depressed adolescents
Journal of the American Academy of Child and Adolescent Psychiatry
Potential role of child rearing practices in the development of anxiety and depression
Clinical Psychology Review
The NIMH diagnostic interview schedule for children version 2.3 (DISC-2.3): Description, acceptability, prevalence rates, and performance in the MECA study
Journal of the American Academy of Child and Adolescent Psychiatry
Family environments of adolescents with lifetime depression: Associations with maternal depression history
Journal of the American Academy of Child and Adolescent Psychiatry
Patterns of attachment: A psychological study of the strange situation
Mothers' interactions with normal and conduct-disordered boys: Who affects whom?
Developmental Psychology
The inventory of parent and peer attachment: Individual differences and their relationship to psychological well-being in adolescence
Journal of Youth and Adolescence
Inventory of parent and peer attachment
Parent and peer attachment in early adolescent depression
Journal of Abnormal Child Psychology
Depression and the social developmental context of adolescence
Journal of Personality and Social Psychology
Attachment styles among young adults: A test of a four-category model
Journal of Personality and Social Psychology
A reinterpretation of the direction of effects in studies of socialization
Psychological Review
Child effects in studies using experimental or brief longitudinal approaches to socialization
Developmental Psychology
Patterns of psychopathology and dysfunction in high-risk children of parents with panic disorder and major depression
American Journal of Psychiatry
Prevalence of anxiety and depression in Australian adolescents: Comparisons with worldwide data
Journal of Genetic Psychology
Comorbidity of anxiety and depression in children and adolescents
Psychological Bulletin
Relations with parents and with peers, temperament, and trajectories of depressed mood during early adolescence
Journal of Abnormal Child Psychology
Mediating links between maternal depression and offspring psychopathology: The importance of independent data
Journal of Child Psychology and Psychiatry
The contribution of parents and siblings to antisocial and depressive behavior in adolescents: A double jeopardy coercion model
Development and Psychopathology
The association between psychopathology in fathers versus mothers and children's internalizing and externalizing behavior problems: A meta-analysis
Psychological Bulletin
Family cohesion, family adaptability, social support, and adolescent depressive symptoms in outpatient clinic families
Journal of Family Psychology
Childhood depression and conduct disorder: II. An analysis of family interaction patterns in the home
Journal of Abnormal Psychology
Interparental conflict and adolescent adjustment: Why does gender moderate early adolescent vulnerability?
Journal of Family Psychology
Informant discrepancies in the assessment of childhood psychopathology: A critical review, theoretical framework, and recommendations for further study
Psychological Bulletin
The relationship between perceived family environment and psychological wellbeing: Mother, father, and adolescent reports
Australian Psychologist
Family structure, family process, and adolescent well-being
Journal of Research on Adolescence
Parenting, marital conflict and adjustment from early- to mid-adolescence: Mediated by adolescent attachment style?
Journal of Youth and Adolescence
Parental dysphoria and children's internalizing symptoms: Marital conflict styles as mediators of risk
Child Development
Depressive symptomatology in childhood and adolescence
Development and Psychopathology
The link between marital conflict and child adjustment: Parent–child conflict and perceived attachments as mediators, potentiators, and mitigators of risk
Development and Psychopathology
Behavioral genetics as a tool for developmental psychology: Anxiety and depression in children and adolescents
Clinical Child and Family Psychology Review
The association between family factors and depressive disorders in adolescents
Journal of Youth and Adolescence
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