Better family relationships––higher well-being: The connection between relationship quality and health related resources

Abstract

Family relationships form very important social relationships. They provide the social context enabling the development for a healthy personality and fostering social competencies and the capacity for social adjustment. Several constructs constitute a complex sample of health beneficial attributes, such as resilience, sense of coherence, self-compassion and others, that haven't been investigated in connection with perceived quality of family relationships and collective family efficacy. In three studies we investigated, if perceived quality of family relationships – assessed with a relatively new measure: the Evaluation of Social Systems Scale – was associated with these advantageous health-related qualities, additionally confirming EVOS’ construct validity. In study 1 (N = 207) and 2 (N = 305) university students filled out several paper-pencil-questionnaire whereas in study 3 (N = 528) a heterogeneous sample took part in an online-survey. Controlling for participants’ age and sex, better family relationships were associated with reduced psychological distress (r = −.30 to −.37), more satisfaction with life (r = 0.40), stronger resilience (r = 0.37), sense of coherence (r = 0.37), self-compassion (r = 0.33), optimism (r = 0.32), general self-efficacy (r = 0.27), and self-esteem (r = 0.34). Results highlight the importance of the family environment not only for psychological health and quality of life, but also for individual adaptation and well-being. In future research, this should be especially addressed in designing and providing preventative interventions for families.

Introduction

Social relationships are an important predictor of health and well-being. Supportive social relationships assist people to cope with stress and stay well (Berkman, 2000, Landstedt et al., 2015, Uchino, 2006). In longitudinal studies, good social relationships predicted mental health, interpersonal functioning (Paradis et al., 2011), and even longevity (Kern, Della Porta, & Friedman, 2014). Strong social relationships, indicated by good social integration, increase the likelihood for survival by 50% (Holt-Lunstad, Smith, & Layton, 2010). Loneliness and social isolation can be understood as risk factors for poor health outcomes leading to a reduction of longevity, especially for those under 65 years of age (Holt-Lunstad and Smith, 2012, Holt-Lunstad et al., 2015).

Among the most important social ties are family ties (Beavers, 1981, Beavers and Hampson, 2000, Cohen, 2004, Epstein et al., 1978, Epstein et al., 1993, Miller et al., 2000, Ryan and Willits, 2007, Umberson and Karas Montez, 2010). Social bonds between children and their parents can be regarded as social capital – including norms and values – which may be as important as financial and human capital for health and well-being (Parcel & Bixby, 2016). Consequently, family-related aspects such as maternal support or good family functioning have been associated with better psychological health and individual flourishing (Barber and Harmon, 2002, Dunn et al., 2013, Finchham and Beach, 2010). A need to belong to and to be related to other people forms a basic motive in human development. Self-determination theory posits that relatedness to others is a basic psychological need (Ryan & Deci, 2000). Complementing, rather than opposing relatedness, a need for autonomy is considered to be a desire to be a causal agent of one's life and a preference to choose for oneself. In the best possible way, these basic needs can be met in a flourishing and high-quality relationship context (Deci and Ryan, 2000, Lavigne et al., 2011, Ryan and Deci, 2000).

Family is a social system and at the same time provides a context for development (Henry, Sheffield Morris, & Harrist, 2015). It is often thought to shape an individual's life experience through socialization and gene-environment interaction (Harris, 1995, Kim-Cohen and Turkewitz, 2012). Family systems, their members and their relational ties, are reciprocal in nature and are characterized as dynamic and interdependent (Henry et al., 2015, Masten and Monn, 2015). Not only health and adaptation, but personality itself is thought to develop under the influence of family members from early childhood on (Bornstein, 2006, Pomerantz and Thompson, 2008). Personality development takes place in a relational environment, forming an individual's identity on the one hand and building relatedness as well as nourishing relationships on the other hand (Diehl, Elnick, Bourbeau, & Labouvie-Vief, 1998). Family members offer regulative functions. In healthy contexts, parents co-regulate their children by being sensitive, responsive and caring. They structure, validate and stabilize emotion-recognition and expression, and synchronize while interacting.

The developmental-contextual framework emphasizes the influence of experiences within the family during childhood and adolescence on relationships to significant others in later life (Donnellan, Larsen-Rife, & Conger, 2005). Based on a cohesive child-parent relationship, feelings of support and closeness foster greater social competencies and social adjustment (Allen et al., 1998, Smetana et al., 2006), and are associated with higher well-being in adolescence (Jose, Ryan, & Pryor, 2012). Frequent and positive family involvement, emotional self-disclosure, and a loving expression of affection create a positive family atmosphere, which has been related to reduced symptom development (O'Brien et al., 2006). Although family life is characterized by highly fluctuating challenges and tasks – as the developing child has ever-changing needs – social support, collective decision making, and frequent communication and interactions buffer against stress and the development of psychopathology (Ackard et al., 2006, Laursen and Collins, 2004, Phillips-Salimi et al., 2014). Taken together, high family relationship quality and good family functioning have shown numerous health benefits in the past. Family resilience is fostered by a process of flexible, collective adaption. As a system, families contribute to development of health and may constitute both a protective factor as well as a potential vulnerability (Cicchetti, 2013, Masten and Monn, 2015). Still, the connection between a resilient family with flourishing family relations and a well-adapted individual needs further clarification.

Individual characteristics that promote health and well-being are generally described as inner strength and resilience (Patterson, 2002). There is no definite consensus about what exactly contributes to a resilient disposition, yet a number of psychological constructs drawn from diverse theoretical perspectives have been proposed over the years. These are supposed to reflect how some individuals seem to be spared the effects of hardships and critical life events on health. Among the most prominent are resilience itself (Wagnild & Young, 1993), sense of coherence (Antonovsky, 1987), dispositional optimism (Carver, 2014, Carver and Scheier, 2014), general self-efficacy (Schwarzer, 2014), self-esteem (Rosenberg, 1965), and self-compassion (Neff, 2003a, Neff, 2003b).

Resilience was conceived as a disposition moderating the negative effects of stress. It promotes adaptation to stressful situations (Wagnild and Young, 1993, Windle, 2011). Family and individual child resilience are interconnected, and lead to an overall capacity to maintain functionality in the light of adverse life experiences. A number of scales aim to measure resilience. Windle and colleagues reviewed nineteen different scales and concluded that “the conceptual and theoretical adequacy of a number of the scales was questionable” (Windle, Bennett, & Noyes, 2011). One of the most widely used measures is the Resilience Scale by Wagnild and Young (1993). This conception of resilience encompasses five characteristics: Equanimity, a balanced perspective of one's life and experiences; perseverance, the act of persistence despite adversity or discouragement; self-reliance, the trust in oneself and one's capabilities; and meaningfulness, the view that life has purpose and the valuation of one's contributions; and existential aloneness, the realization that each person's life path is unique. Contrasting many other health beneficial constructs, resilience is often thought to stem from successful coping with negative experience (Windle, 2011). Resilience is therefore often connected to the concept of post-traumatic growth (Jayawickreme & Blackie, 2014). Nonetheless, some individuals possess the ability to cope with stress without having endured significant negative experiences. The idea of the “invulnerable children” reflects that some people appear to be able to cope with any stressful event. Fonagy and colleagues argued that resilience is established by early childhood experiences and interactions (Fonagy, Steele, Steele, Higgitt, & Target, 1994). Thus, regardless of traumatizing experiences in later life, the foundation for resilience may already be established for any adult person.

Sense of coherence, coming from Antonovsky's (1987) salutogenic theory, constitutes a multifaceted construct that is understood as an internal resistance resource. Sense of coherence promotes health when people are faced with stressful life events. It encompasses three major facets: Comprehensibility denotes a person's tendency to perceive situations and events as clear and structured. Manageability represents the belief to possess the necessary skills to deal with life challenges. Meaningfulness describes an individual's conviction that the demands and challenges of life are worthy of investment and engagement. Based on Antonovsky's background as a medical sociologist, sense of coherence is thought to stem from a multitude of causes, including an individual's social environment, social support, but also wealth, education, or even intelligence (Antonovsky, 1987). Antonovsky described these as “generalized resistance resources” and sense of coherence denotes a person's ability to use them (Lindström, 2001). In the past, sense of coherence has been found to outperform other health-beneficial constructs when predicting psychological symptoms or substance use (Grevenstein, Aguilar-Raab, & Bluemke, 2019; Grevenstein, Aguilar-Raab, Schweitzer, & Bluemke, 2016; Grevenstein, Bluemke, & Kroeninger-Jungaberle, 2016).

Dispositional optimism represents a generalized positive attitude towards life and its challenges (Scheier & Carver, 1985). Optimists tend to expect positive outcomes and often cope better with failure. As a self-regulatory resource, optimism promotes persistence in the face of challenges and more adaptive and active coping with stress. It is related to motivational processes in engaging in health-promoting behaviors. Current research suggests that dispositional optimism also leads to stronger commitment in social relationship for example in terms of more constructive problem solving (Carver & Scheier, 2014).

Self-compassion is a relatively recent concept based on originally Buddhist teachings. Based on mindfulness, self-compassion includes a non-judgmental and receptive state of mind, which fosters a clear perception of challenging situations and one's own thoughts and emotions, ultimately leading to a better mental state (Keng, Smoski, & Robins, 2011). Beyond that however, self-compassion describes the tendency not only to be open and moved by one's own suffering, but also to confront life challenges positively (Neff, 2003b). Self-compassion should prevent negative self-evaluation and lead to feelings of caring and kindness towards oneself. Additionally, an individual should perceive her own experience in the context of common human experience.

Self-efficacy describes a person's belief to exhibit control and to succeed in a given situation (Schwarzer, 2014). General self-efficacy is a person's generalized self-efficacy across a broad range of challenging situations that require effort and perseverance and thus goes beyond specific situations (Schwarzer & Jerusalem, 1995). It is an important concept for health development in youth. For example, Di Giunta et al. (2018) showed that lower self-efficacy in adolescents was associated with greater internalizing and externalizing problems. Furthermore, current research indicates that the development of self-efficacy is domain-sensitive and that girls more often than boys rely on social sources in this regard (Butz & Usher, 2015).

Self-esteem describes the overall subjective emotional evaluation of one's own worth. Global self-esteem describes a general judgment of oneself and includes positive and negative evaluations of one's competencies, abilities, and other aspects connected to the self (Rosenberg, 1965).

The presented constructs constitute a complex sample of health beneficial attributes. Coming from different theoretical backgrounds, some constructs are broader and some are more narrowly defined. Some are thought to be rather stable and trait-like, whereas others are considered to be improvable by training or intervention. Still, higher standing on each of these characteristics has been found to be associated with better psychological health and well-being. For instance, sense of coherence has been consistently associated with various health outcomes, such as good mental health and health-related behavior (Eriksson & Lindström, 2006), general psychological well-being (Grevenstein and Bluemke, 2015, Nilsson et al., 2010), depression (Haukkala et al., 2013), and anxiety (Moksnes, Espnes, & Haugan, 2013). Likewise, general self-efficacy has been related to health and performance outcomes (Andersson et al., 2014, Luszczynska et al., 2005). Similar to sense of coherence, general self-efficacy covers aspects of self-regulation (Geyer, 1997). Low self-esteem has been found to be a vulnerability factor for the development of depression (Orth et al., 2008, Rieger et al., 2016). Furthermore, resilience has shown negative associations with depression and anxiety, and positive correlations with life satisfaction as well (Ahern, Kiehl, Lou Sole, & Byers, 2006). Also, optimism plays an important role in self-regulation. Optimists not only cope better with failure, but are more persistent in the face of challenges and engage in more adaptive and active coping with stress. Unsurprisingly, dispositional optimism was found to be related to various positive mental as well as physical health outcomes (Carver & Scheier, 2014). Finally, much like the other constructs, self-compassion displayed negative associations with depression and anxiety, and positive correlations with life satisfaction (Neff, Rude, & Kirkpatrick, 2007). High levels of self-compassion were also related to a more supportive and positive interaction style in close relationships (Neff & Beretvas, 2013).

The present research explores the bi-directional relationships between quality of family relations, health beneficial individual differences, psychological distress, and general well-being. We applied a relatively new, short, and psychometrically sound measure to assess most relevant aspects of social functioning: Quality of relationship and collective efficacy. These two aspects represent affective and cognitive facets of social functioning, which are important targets of change processes initiated by interventions focusing on multiple persons. In EVOS, the following dimensions characterize the two aspects: Communication, cohesion, atmosphere, giving and taking as well as collective aims, resources, decisions, solutions findings and adaptability. All of them have been advanced in theories describing and explaining social functioning (Bandura et al., 2011, Beavers, 1981, Epstein et al., 1978, Olson, 1986) – those of which are especially important in family relationships. The domain of collective efficacy encompasses important aspects of how a system works together in order to pursue goals, handle resources, make decisions, find solutions to problems and adapt to new challenges. Bandura (2000) aptly described his conception of collective efficacy: “People's shared beliefs in their collective efficacy influence the types of futures they seek to achieve through collective action, how well they use their resources, how much effort they put into their group endeavor, their staying power when collective efforts fail to produce quick results or meet forcible opposition, and their vulnerability to the discouragement that can beset people taking on tough social problems” (p.76). Going beyond a simple, context specific idea of self-efficacy, collective efficacy captures a key element of systemic thinking, as it describe a system's ability to create unique solutions.

We assumed that satisfying and positive social relationships help to promote high adaptation in individuals, and possibly vice-versa. Our study will shed more light onto the association between quality of family relationships and collective self-efficacy as well as a variety of characteristics promoting health and well-being, which have not yet been investigated together.