不同家庭环境对儿童智力和行为的影响

本文对上海三所普通小学8-11岁2109名学生进行智商测验,从中抽取智商大于130和低于90的儿童各50名,及分层随机抽样调查来自离婚、个体户和寄读三类家庭的儿童各50名,作为观察组并抽取来自一般家庭的儿童50名为对照组。采用“家庭环境指数”“艾氏行为问题量表”探讨家庭环境对儿童智力和行为的影响。结果发现父母素质、教育方式、家庭气氛等对儿童智力发展和行为表现都有极其重要的影响。     

Family Coping with Childhood Leukemia: One Year After Diagnosis

Sixty-four families of children diagnosed with leukemia participatedin the Coping Project, a prospective study of family copingwith leukemia. Based on ratings made by physicians, nurses,psychosocial staff, and parents, most families appeared to becoping well at 1 year postdiagnosis. Mothers'; self-ratingswere significantly higher at I year than at diagnosis, but ratingsby professional staff were relatively stable. Variables whichwere found to be related to good coping were age of child, copingwith other family members, occupational status of the father,and lack of sibling problems. Parent personality and dispositiontowards coping were not related to coping, nor was continuedpsychosocial intervention at this time. It was speculated thatsince most of the children were in remission, there were fewercrises and less need for intervention than in the early treatmentphase of the illness.     

Family environment patterns in families with bipolar children

BACKGROUND: We studied the characteristics of family functioning in bipolar children and healthy comparison children. We hypothesized that the family environment of bipolar children would show greater levels of dysfunction as measured by the Family Environment Scale (FES). METHODS: We compared the family functioning of 36 families that included a child with DSM-IV bipolar disorder versus 29 comparison families that included only healthy children. All subjects and their parents were assessed with the K-SADS-PL interview. The parents completed the FES to assess their current family functioning. Multivariate analysis of variance was used to compare the family environment of families with and without offspring with bipolar disorder. RESULTS: Parents of bipolar children reported lower levels of family cohesion (p<0.001), expressiveness (p=0.005), active-recreational orientation (p<0.001), intellectual-cultural orientation (p=0.04) and higher levels of conflict (p<0.001) compared to parents with no bipolar children. Secondary analyses within the bipolar group revealed lower levels of organization (p=0.031) and cohesion (p=0.014) in families where a parent had a history of mood disorders compared to families where parents had no history of mood disorders. Length of illness in the affected child was inversely associated with family cohesion (r=-0.47, p=0.004). LIMITATIONS: Due to the case-control design of the study, we cannot comment on the development of these family problems or attribute their cause specifically to child bipolar disorder. CONCLUSION: Families with bipolar children show dysfunctional patterns related to interpersonal interactions and personal growth. A distressed family environment should be addressed when treating children with bipolar disorder.     

Family‐Based Therapy for Parent–Child Reunification

Children in highly conflicted, divorced families can become triangulated and polarized in their relationships with their parents. In time, this can lead to a child refusing to have a relationship with a parent, refusing for example, to see or talk to him or her. This access refusal can sometimes become extended, lasting months to years. When this occurs, the courts may request professional involvement to help facilitate parent–child reunification. This article outlines a family‐based treatment model for parent–child reunification cases. This family‐based treatment incorporates treatment goals for each family member and each family member is asked to be a part of the solution in resolving the family's problems. I provide a case illustration as well as helpful tips for treating these families.     

Heterogeneity of risk aggregation for alcohol problems between early and middle childhood: nesting structure variations

We examined how family and child risk factors jointly affected stability and change in externalizing behavior over time in a prospective study of eventual alcohol use disorder. Study participants were community-recruited alcoholic and control families, and their initially preschool-aged male and female children (N = 335). Family risk varied as a function of both parental alcoholism (ALC) and antisocial personality disorder (ASPD) and was evaluated for both parents. Child risk was characterized by a set of risky temperament attributes pertaining to high activity, high reactivity, and low attention span. Externalizing behavior was used as the proxy indicator for later alcohol problems. For children in the high family risk group (involving current ALC in both parents or current ALC + ASPD comorbidity or both), child risk when children were 3-5 years old (Wave 1) directly predicted externalizing behavior when children were 6-8 years old (Wave 2), even when Wave 1 child risk was controlled for. In addition, parents' negative interaction with children at Wave 1 mediated the effect of child risky temperament on Wave 2 externalizing behavior. No such pattern was observed in the low family risk group, where only autostability effects were predictive of outcomes at Wave 2. The importance of nesting structure as an ingredient in the epigenesis of risk was discussed. Its particular relevance in understanding the process of risk transmission among offspring from antisocial alcoholic families was emphasized.     

Family Chaos and Child Functioning in Relation to Sleep Problems Among Children at Risk for Obesity

This study evaluated the influence of child and family functioning on child sleep behaviors in low-income minority families who are at risk for obesity. A cross-sectional study was utilized to measure child and family functioning from 2013 to 2014. Participants were recruited from Head Start classrooms while data were collected during home visits. A convenience sample of 72 low-income Hispanic (65%) and African American (32%) families of preschool-aged children were recruited for this study. We assessed the association of child and family functioning with child sleep behaviors using a multivariate multiple linear regression model. Bootstrap mediation analyses examined the effects of family chaos between child functioning and child sleep problems. Poorer child emotional and behavioral functioning related to total sleep behavior problems. Chaos associated with bedtime resistance significantly mediated the relationship between Behavioral and Emotional Screening System (BESS) and Bedtime Resistance. Families at high risk for obesity showed children with poorer emotional and behavioral functioning were at higher risk for problematic sleep behaviors, although we found no link between obesity and child sleep. Family chaos appears to play a significant role in understanding part of these relationships. Future longitudinal studies are necessary to establish causal relationships between child and family functioning and sleep problems to further guide obesity interventions aimed at improving child sleep routines and increasing sleep duration.     

Family functioning, neurocognitive functioning, and behavior problems in children with sickle cell disease

OBJECTIVE: To investigate the independent and combined contributions of neurocognitive and family functioning to mother-reported behavior problems in children with sickle cell disease (SCD) and evaluate the factor structure of the Family Environment Scale (FES) with African American families. METHOD: The study sample included 289 children enrolled in the multisite Cooperative Study of Sickle Cell Disease. The study protocol included neuropsychological evaluation and brain magnetic resonance imaging (MRI) of the children, and mothers completed the Child Behavior Checklist and Family Environment Scale. RESULTS: With child and maternal demographic parameters controlled, conflicted family functioning, but not neurocognitive functioning, accounted for a significant portion of the variance in mother-reported behavior problems. The factor structure of the FES for families of children with SCD was found to be similar to that for other families. CONCLUSIONS: Family functioning may be a salient target for fostering adaptation to chronic childhood illness.     

Genomic tools for health: Secondary findings as findings to be shared

PurposeWhether and how to disclose secondary finding (SF) information to children is ethically debated. Some argue that genetic testing of minors should be limited to preserve the child’s future autonomy. Others suggest that disclosure of SFs can occur if it is in the best interests of the child. However, the ways that parents conceptualize and weigh their child’s future autonomy against the interests of their child and other family members are unknown.MethodsTo explore how parents understand SF disclosure in the context of their child and other family members’ lives, we conducted semistructured interviews with 30 families (40 parents in total). All parents had children who were enrolled in a genetic sequencing protocol that returned results by default.ResultsWe found that parents did not routinely conceptualize SFs as distinctive health information. Rather parents saw this information as part of their child’s overall health. To make decisions about disclosure, parents weighed their child’s ability to understand the SF information and their other family member’s need to know.ConclusionBecause most families desired SF information, we argue that disclosure of SF be reconceptualized to reflect the lived experiences of those who may receive this information.     

Family resources and stress: a comparison of families of children with cystic fibrosis, diabetes, and mental retardation.

Assessed patterns of stress in families of children with pediatric conditions that varied on 2 dimensions: (a) fatal vs. nonfatal outcome and (b) presence vs. absence of cognitive impairment. Families of children with cystic fibrosis (n = 23), diabetes (n = 24), and moderate mental retardation (n = 24) were compared to families of well children (n = 24) in 3 age groups. Maternal responses to a multidimensional measure of family stress, the Questionnaire on Resources and Stress--Short Form (QRS-S), indicated that families of children with chronic conditions did not differ from families of well children on scales assessing generic aspects of family stress, such as family conflict. However, diagnostic groups differed on QRS-S scales assessing stressors specific to the child's disability (e.g., families of children with mental retardation were characterized by concerns about caring for the child as an adult). There was no evidence of higher levels of stress for families of older children. Data on the internal consistency of QRS-S scales and their relation to measures of maternal and child adjustment are presented.     

Observational assessment of family functioning at mealtime in preschool children with cystic fibrosis

OBJECTIVE: To examine functioning during a dinner meal in families of a child with a chronic illness that requires dietary treatment recommendations, as compared to families of a child without a chronic illness. METHODS: Ratings of seven dimensions of family functioning on the McMaster Mealtime Family Interaction Coding System (MICS) were obtained on 29 families of children with CF and 29 families of children with no chronic illness, ages 2 to 6 years, during a videotaped dinner meal at home. RESULTS: Ratings of families with a child with CF were significantly lower than those for families of children without a chronic illness on Overall Family Functioning and five of the six MICS dimensions: Communication, Interpersonal Involvement, Affect Management, Behavior Control, and Role Allocation and approached significance on the Task Accomplishment dimension. The ratings of families of a child with CF were in the "clinically significant" range on all subcales, including Task ACCOMPLISHMENT. CONCLUSIONS: This study suggests that family functioning at mealtimes may be different in families of children with CF in which explicit dietary guidelines exist than in families of children with no illness or dietary guidelines. These results are discussed in terms of global family functioning and treatment approaches to dietary treatment recommendations.     

Families of the Developmentally Disabled (Book)

Mothers and fathers from 52 two-parent families—26 families with a normal child and 26 families with an attention-deficit-disordered/hyperactive (ADDH) child—independently completed questionnaires regarding child behavior; time for individual, couple, and family activities; extended family and community contacts; depression; and family functioning. The communication, problem solving, role allocation, behavioral control, affective responsiveness, affective involvement, and general functioning of normal and ADDH families did not differ significantly. Families of ADDH children reported fewer extended family contacts and described these as less helpful. Mothers of ADDH children reported higher depression scores than their husbands or the mothers of normal children did. Alcohol consumption was higher in families of ADDH children than in those of normal children and was higher in mothers. Mothers' depression ratings were linked both to family functioning and to child behavior, whereas fathers' depression ratings were linked only to family functioning.     

CLINICAL CHILD PSYCHOLOGY NEWS AND NOTES

Assessed children's worries about the behaviors of significant people in the family with a new measure that focused on both the target of the worry and the types of behavior that worry the child. One hundred twenty-one 7- to 12-year-old children in families with and without domestic violence rated, on a 4-point scale ranging from I (not a lot) to 4 (a lot) how much they worried about 20 behaviors concerning five people in the family: mother, father, brother, sister, and self Varimax analyses provided two factors-Vulnerable and Harmful-that indicate worry about the vulnerable and harmful behavior of each family member. The measure has acceptable internal and test-retest reliability, as well as known-groups validity. Children in the domestic violence families were significantly more worried about the vulnerability of their mothers, brothers, and sisters, and they tended to worry more about the harmful behavior of their fathers than did children in the comparison group. Significant associations were found, for the children of battered women, between child adjustment and worry about the harmful behavior of family members.     

Couple power dynamics, systemic family functioning, and child adjustment: a test of a mediational model in a multiethnic sample

Power dynamics in the marital dyad and systemic elements of whole-family functioning (cohesion, subsystem boundary formations) were examined in relation to each other and also in relation to child adjustment in a multiethnic sample of families. Support was found for a mediational model, such that family functioning was found to mediate the relationship between marital power dynamics and children's internalizing and externalizing behavior. Some support also was found for ethnicity as a moderator of the association between systemic family processes and children's adjustment. Disturbances in family cohesion and subsystem boundaries were more strongly related to internalizing symptomatology for children in European American families compared to children in Hispanic American families.     

Child behavior problems and family functioning as predictors of adherence and glycemic control in economically disadvantaged children with type 1 diabetes: a prospective study

OBJECTIVE: This prospective study examined how child behavior problems and family functioning predict adherence behavior and glucose regulation (glycemic control) in a sample of economically disadvantaged children. METHODS: Children with type 1 diabetes (N = 116; 58.6% African American) were assessed for externalizing and internalizing behavior problems and family adaptability and cohesion and followed for a mean of 3.8 years. Glycemic control (glycosylated hemoglobin [HbA1c]) was assessed at baseline and follow-up, and adherence was assessed at follow-up. RESULTS: Analyses controlled for baseline HbA1c and years to follow-up. Multivariate analyses indicated that better adherence was predicted by high family cohesion. Better glycemic control was predicted by high family cohesion, the absence of externalizing behavior problems, and the presence of internalizing behavior problems. In addition, tests of moderation indicated that better follow-up glycemic control occurred among girls from high cohesion families and younger children from low adaptability families. Although better adherence predicted better glycemic control, adherence did not mediate the relationships of behavior problems or family functioning with glycemic control. CONCLUSIONS: A child's behavior problems and family functioning may influence both adherence to the diabetes regimen and glycemic control several years later, suggesting the potential value of interventions that address child behavior and family functioning.     

6例血液肿瘤儿童的结构式家庭治疗

目的：尝试结构式家庭治疗在血液肿瘤儿童临床治疗过程中的应用。方法：对6例儿童血液肿瘤家庭进行结构式家庭治疗干预及效果评价。结果：通过家庭治疗，患儿及家长的心理状况、对疾病的应对方式，以及家庭的内部环境有不同程度的改善。结论：家庭是影响血液肿瘤诊疗、转归的重要因素，应根据家庭的心理特点，积极开展家庭治疗。     

Family adjustment to childhood developmental disability: a measure of parent appraisal of family impacts

OBJECTIVE: To develop the Family Impact of Childhood Disability Scale (FICD) to assess subjective interpretation or "primary appraisal" of parents regarding the impact of a child with developmental disabilities on the family. METHOD: A random sample of 87 families was assessed while children with developmental disabilities were in the preschool years. After 7 years had elapsed, 64 of these families were interviewed again when the children were in the preteen years. A set of standardized self-report measures provided mother and father views of child, parent, and family functioning. RESULTS: The FICD demonstrated adequate internal consistency, with some evidence of discriminant and predictive validity. The FICD total score, based on the discrepancy between positive and negative subscale scores, was found to be a significant predictor of future parenting stress of mothers and of fathers, even when controlling for other important explanatory variables such as marital adjustment and level of disability in a child. CONCLUSIONS: The 15-item FICD offers a brief assessment of both positive and negative parent appraisals, with a total discrepancy score that predicts long-term parenting stress.     

Review: parent-child relationships and child development in donor insemination families

The present article reviews the empirical research regarding the parent-child relationships and the development of children in donor insemination (DI) families. Over the years, follow-up studies have appeared sporadically and, despite the varying quality of the research methods, preliminary findings have emerged. Heterosexual DI parents were psychologically well adjusted and had stable marital relationships. DI parents showed a similar or higher quality of parent-child interaction and a greater emotional involvement with their children compared with naturally conceived families. The majority of studies which investigated several aspects of child development found that, overall, DI children were doing well. Findings with regard to emotional/behavioural development, however, were divergent in that some studies identified an increase of such problems while others did not. A steadily growing group within the DI population is lesbian mother families. More recently, follow-up studies have been carried out among DI children who were raised from birth by two mothers. Despite many concerns about the well-being of these children, no adverse effects of this alternative family structure on child development could be identified. As the DI children in all investigations were still young, our knowledge about the long-term effects of DI remains incomplete.     

Family stability as a protective factor against psychopathology for urban children receiving psychological services.

Family stability, defined as the consistency of family activities and routines, was examined in a sample of urban families (n = 70) with children (ages 7 to 16) receiving psychological services. Parent-reported family stability was associated with lower parent-reported children's internalizing behavior problems. Child-reported family stability significantly attenuated the influence of parental depressive symptoms on parent-reported children's internalizing, externalizing, and total behavior problems, while controlling for the effect of children's age. Parental depressive symptoms were associated with problems in child adjustment only at the low level of family stability.     

The family of the autistic child: A behavioral-systems view

Parent training is a well documented contribution of behavior therapy to the treatment of autism. There are other less well explored behavioral interventions of potential for the family with an autistic child which need to be examined systematically. This paper adopts a behavioral-systems view to address issues which arise in the family of an autistic child at the time of diagnosis, during early and middle childhood, during adolescence and adulthood, in relation to siblings, and within the extended family and community. Behavioral marital therapy, behavioral family therapy, and individual intervention techniques can help families adapt to the chronic stress of living with a handicapped member. The therapist is cautioned not to overlook the more intensive therapeutic needs of those dysfunctional families for whom the child's handicap is only one factor in an array of predisposing problems.     

Family functioning in school-age children with cystic fibrosis: an observational assessment of family interactions in the mealtime environment

OBJECTIVE: To examine, using direct observation methodology, differences in family functioning at mealtime between families of school-age children with cystic fibrosis (CF) and families of school-age children without a chronic illness. METHOD: Family functioning was rated using the McMaster Mealtime Interaction Coding System (MICS) during a videotaped dinner among 28 families of children with CF and 27 families of non-ill, age-matched peers. Families were rated on overall family functioning and on six dimensions of the MICS: task accomplishment, communication, affect management, interpersonal involvement, behavior control, and role allocation. RESULTS: Ratings for families of a child with CF were significantly lower than they were for comparison families on overall family functioning and on four of the six MICS dimensions: communication, affect management, interpersonal involvement, and behavioral control. Moreover, a significantly greater percentage of families of children with CF were rated in the unhealthy range on overall family functioning and on five of six MICS dimensions. There was no relationship between family functioning and child weight status for children with CF. CONCLUSIONS: The current study suggests that for families of school-age children with CF, the family system is negatively affected during mealtime. Dietary interventions need to address family-centered, as well as child-centered, interventions to help families manage challenges presented during the family meal.