The impact of family functioning on health changes in children with cystic fibrosis.

Family stress, family and personal resources, and parental coping were operationalized from self-report questionnaires completed by mothers and fathers in 72 two-parent families who had a child with cystic fibrosis (CF). Three-month and 15-month changes in clinically recorded measures of the CF child's height and weight data and pulmonary functioning were correlated with the family functioning variables. Each of the four criterion indices of CF child health changes were regressed separately on the significant family functioning variables. Twenty-two percent of the variance in 15-month height and weight changes were explained by family stress, family resources, and parental coping. Family functioning variables also explained 17% of the variance in 3-month pulmonary functioning changes and 15% of the variance in 3-month height and weight changes. These findings suggest that the way in which the family functions has indirect effects on critical indices of a CF child's health. These data lend support to an increased focus by physicians and other medical professionals on the health of the total family system as a way to enhance outcomes for children with CF.

Contextualizing family risk factors for alcoholism and alcohol abuse.

OBJECTIVE: Studies of alcohol and the family should represent the full range of family types in the U.S. population. Developments from studies of family systems in other research contexts may be usefully applied to the alcohol field. METHOD: This commentary highlights important methodological and conceptual issues relevant for the design and conduct of family research. RESULTS: Data indicate major changes in the composition of the American family over the past quarter century. Some recent conceptual developments in the field of family research are relevant for studies of alcohol and the family and for intervention development. CONCLUSION: Family-based alcohol research should acknowledge and address the heterogeneity that exists among modern American families. Studies of family risk and resiliency should distinguish between threats to the family's ability to function as a whole, and threats to the well-being of individual members. Additional research is needed on the role of race and ethnicity in family processes.

Adolescent coping style and behaviors: conceptualization and measurement.

The developmental tasks associated with adolescence pose a unique set of stressors and strains. Included in the normative tasks of adolescence are developing and identity, differentiating from the family while still staying connected, and fitting into a peer group. The adolescent's adaptation to these and other, often competing demands is achieved through the process of coping which involves cognitive and behavioral strategies directed at eliminating or reducing demands, redefining demands so as to make them more manageable, increasing resources for dealing with demands, and/or managing the tension which is felt as a result of experiencing demands. In this paper, individual copying theory and family stress theory are reviewed to provide a theoretical foundation for assessing adolescent coping. In addition, the development and testing of an adolescent self-report coping inventory, Adolescent Coping Orientation for Problem Experiences (A-COPE) is presented. Gender differences in coping style are presented and discussed. These coping patterns were validated against criterion indices of adolescents' use of cigarettes, liquor, and marijuana using data from a longitudinal study of 505 families with adolescents. The findings are discussed in terms of coping theory and measurement and in terms of adolescent development and substance use.

A test of nonrespondent bias in a family-based study: a research note.

The increasing use of family samples from "normal" populations (as opposed to clinical samples) in substance abuse research raises concern about the validity of responses from participating families. Nonparticipating families may have greater numbers of substance users who wish to conceal problems, when compared to families which cooperate with researchers. Unobtrusive analyses of institutional records of a health maintenance organization comparing families agreeing to participate in a substance use study (N = 508) with those families unwilling to participate (N = 538) reveal no significant differences in the use of chemical dependency services between the two groups. Surveys of the non-participating families indicate that the major reasons for noncooperation were the lack of time and inconvenience in getting family members together. These findings suggest the feasibility of sampling families from normal populations.

Reliability and validity of adolescent self-reported drug use in a family-based study: a methodological report.

Given the sensitive topic of drug abuse and the private nature of the family, researchers must overcome a number of methodological obstacles when studying drug abuse and the family. The purpose of this study was to determine whether adolescents would provide honest and accurate answers to drug use questions in the context of their homes with their families participating in the same survey. Although there is no direct objective validation of the self-report measures used in this study, evidence from the analysis of the survey data suggests that adolescent self-reports are, in most cases, reliable and valid, and that the setting in which respondents complete questionnaires does not, in general, result in systematic reporting bias.

The corporate executive wife's coping patterns in response to routine husband-father absence.

The routine absence of corporate executive husband/fathers in intact families is a variation of father absence. Though not prolonged, frequent exits and reentries may stress the family system. To determine how nonclinical family members deal with routine father absence, a coping inventory was administered to 66 corporate wives. Factor analysis revealed wives coped with the stress of routine father absence by (a) fitting into the corporate lifestyle; (b) developing self; and (c) establishing independence. Though a pilot study, findings offer empirical support for a premise more traditionally accepted by family therapists than by family sociologists: Individual psychological variables need to be considered along with systems variables in the development of family stress theory.

Interpersonal influences in adolescent drug use--the role of older siblings, parents, and peers.

Drawing data from the first year of a longitudinal study of 508 families with focal adolescents aged 11 to 13 years and their older siblings (14 to 18 years), the investigators examined the influence of older siblings' drug-using attitudes and behaviors, in comparison with parental and peer drug-using attitudes and behaviors, on focal adolescents' nonuse and use of substances. Older siblings are frequently a source of drugs and use substances with their young siblings, though peers remain the primary source and the most frequent coursers. For most substances, frequency of use was predicted by older sibling and peer substance use, each after controlling for the other. Parental drug use was found to be minimal in comparison to older siblings and peers. Findings relative to the potentially important role of older siblings in influencing their younger siblings' drug-using behavior are discussed.

Parental coping in raising children who have spina bifida cystica.

In this study of 40 married couples who are rising a child with spina bifida cystica, the family stress theory was used to assess family regenerative power and vulnerability to stress. The reserach tested for differences between high and low stress families in the family environment, coping strategies, and severity of the child's problem. When compared with the high stress families, the low stress families appeared to be more cohesive, be better organised, have a more active recreation orientation, be lower in family conflict, utilise more family community relationships, and have children who have less severe physical problems. The practical implications of this study include the potentiality for applied usage of family diagnostic tests, the clinical and research application of the findings on family coping strategies for improved patient outcomes, and the need for additional social-medical research to assess accurately family concerns about health care policies.