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Eric Taylor - One of the best experts on this subject based on the ideXlab platform.
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Family function and its relationship to injury severity and psychiatric outcome in children with acquired brain injury a systematized review
Developmental Medicine & Child Neurology, 2014Co-Authors: Maria Teresa Lax Pericall, Eric TaylorAbstract:Aim The psychological and psychiatric outcome of children with acquired brain injury is influenced by many variables. A review was undertaken to clarify the contribution of Family function, how it relates to injury severity, and what particular aspects of Family function influence psychological outcome in this group. Method A systematized review of the literature of studies published between 1970 and 2012 from OvidMedline, PsychoInfo, PsycARTICLES, and Cochrane was undertaken focusing on Family function, injury severity, and psychiatric outcome. Results Thirty-six papers met the inclusion criteria. Injury severity was linked to the development of organic personality change. Family function before injury, measured by the Family Assessment Device or the Clinical Rating Scale, had a statistically significant effect on general psychological functioning in six out of eight studies. Family function had a significant effect for oppositional defiant disorder and secondary attention-deficit–hyperactivity disorder. The effects of Family function may differ depending on the age of the child and the severity of the injury. Some styles of parenting moderated recovery. After injury, Family function was related to the child's contemporaneous psychiatric symptoms. The level of evidence for these papers was 3 or 4 (Oxford Centre for Evidence-based Medicine criteria). Interpretation Screening for some aspects of Family functioning before injury and Family function during the rehabilitation phase may identify children at risk of psychiatric disorders.
Melissa A Alderfer - One of the best experts on this subject based on the ideXlab platform.
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introduction to special issue advancing the science of Family Assessment in pediatric psychology
Journal of Pediatric Psychology, 2011Co-Authors: Lamia P Barakat, Melissa A AlderferAbstract:For children with chronic medical conditions, as with typically developing children, Family is of central importance (Kazak, 2008; Schumm, 1982). Consistent with the Burmese proverb, ‘‘In times of test, Family is best’’ (Hla Pe, 1985), numerous studies have demonstrated the role of the Family as a potential protective factor in the adaptation of children with chronic medical conditions and as a key to successful disease management at home (see Alderfer & Stanley, in press, for a brief review). In turn, families are greatly impacted by childhood illness; they experience increased stress, must expand definitions of their roles (e.g., ‘‘parent’’), and learn to communicate and work together to meet medical demands (Kazak, 2001; Radcliffe, Barakat, & Boyd, 2006). Thus, reliable and valid Family Assessments are critical to pediatric psychology: (a) for research that aims to further outline the various aspects of Family functioning that are impacted by medical conditions in childhood and influence child and Family adaptation and quality of life over time, and (b) for clinical practice, to inform the direction of clinical interventions and serve as an evaluation of clinical outcomes (Cook & Kenny, 2004). The call for improved Family Assessment methods is a refrain in the broad Family psychology literature. For example, Cook and Kenny (2004) argued that most Family Assessment tools do not provide a sufficient degree of detail, and Cook (2005) further noted the importance of developing Assessment approaches that take into account reciprocal influences among individuals, dyads, and the Family group. Echoing this call within the realm of pediatric psychology, Palermo and Chambers (2006) argued that Family measures should better specify the pathways by which Family factors play a role in children’s pain and disability. A path to achieving this goal is for Family Assessment to occur at multiple, integrated levels to identify how individual factors work in concert with dyadic and Family factors to impact pain and functional outcomes. Efforts have been made to summarize the current literature regarding the use of Family measures within pediatric psychology and to provide frameworks for categorizing these types of Assessments for use in research and practice. Alderfer and colleagues (2008) reviewed the evidence base of Family measures including self-reports, observer ratings, and interviews and delineated three broad Assessment areas: (a) normative Family processes (i.e., separation and individuation) assessed in families of children with chronic health conditions; (b) impact of childhood chronic health conditions on the Family; and (c) Family and/or parental coping with childhood illness or disability. While most reviewed measures were deemed ‘‘well-established’’ (reliable and valid) or ‘‘approaching well-established’’ (approaching reliability and validity), Alderfer and colleagues (2008) argued that more attention must be given to the psychometric properties of Family measures when used in pediatric populations since many of the measures have been exclusively utilized within the general population. Further, recommendations were made to increase cultural sensitivity of measures so as to capture cultural definitions of Family that extend beyond the traditional nuclear Family dynamic, to use multiple Family informants including fathers and siblings to account for how each Family member perceives the Family situation, and to determine whether Family measures can be used to inform clinical interventions (i.e., are they predictive of treatment outcomes and sensitive to change?). Thus, while some general measures of Family functioning are applicable in the pediatric context (e.g., Family Assessment Device; Epstein, Baldwin, & Bishop, 1983), and other pediatric-specific measures of Family functioning
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Family functioning and posttraumatic stress disorder in adolescent survivors of childhood cancer
Journal of Family Psychology, 2009Co-Authors: Melissa A Alderfer, Neha Navsaria, Anne E KazakAbstract:The purpose of this study was to investigate Family functioning and relationships between Family functioning and posttraumatic stress disorder in adolescent survivors of childhood cancer. To assess Family functioning, 144 adolescent cancer survivors 1 to 12 years post-cancer treatment (M=5.3 years) and their parents completed the Family Assessment Device (FAD). To assess Posttraumatic Stress Disorder (PTSD), adolescents were administered a structured diagnostic interview. Nearly half (47%) of the adolescents, one-fourth (25%) of mothers, and one-third (30%) of fathers reported poor Family functioning, exceeding the clinical cut-off on four or more FAD subscales. Families in which the cancer survivor had PTSD (8% of the sample) had poorer functioning than other families in the areas of problem-solving, affective responsiveness and affective involvement. Three-fourths of the adolescents with PTSD arose from families with categorically poor Family functioning. A surprisingly high rate of poor Family functioning was reported in these families of adolescent cancer survivors. Adolescents with PTSD were over five times as likely to emerge from a poorly functioning Family compared to a well-functioning one. This study provides evidence that Family functioning is related to cancer-related posttraumatic reactions in adolescent survivors.
Gabor I Keitner - One of the best experts on this subject based on the ideXlab platform.
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the Family Assessment device an update
Family Process, 2015Co-Authors: Abigail K Mansfield, Gabor I Keitner, Jennifer DealyAbstract:The current study set out to describe Family functioning scores of a contemporary community sample, using the Family Assessment Device (FAD), and to compare this to a currently help-seeking sample. The community sample consisted of 151 families who completed the FAD. The help-seeking sample consisted of 46 families who completed the FAD at their first Family therapy appointment as part of their standard care at an outpatient Family therapy clinic at an urban hospital. Findings suggest that FAD means from the contemporary community sample indicate satisfaction with Family functioning, while FAD scores from the help-seeking sample indicate dissatisfaction with Family functioning. In addition, the General Functioning scale of the FAD continues to correlate highly with all other FAD scales, except Behavior Control. The cut-off scores for the FAD indicating satisfaction or dissatisfaction by Family members with their Family functioning continue to be relevant and the FAD continues to be a useful tool to assess Family functioning in both clinical and research contexts.
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the evaluation of Family functioning by the Family Assessment device a systematic review of studies in adult clinical populations
Family Process, 2015Co-Authors: Laura Staccini, Elena Tomba, Silvana Grandi, Gabor I KeitnerAbstract:A large body of research, documenting the impact of a Family's functioning on health outcomes, highlights the importance of introducing the evaluation of patients' Family dynamics into clinical judgment. The Family Assessment Device (FAD) is a self-report questionnaire designed to assess specific dimensions of Family functioning. This qualitative systematic review, which follows PRISMA guidelines, aimed to identify the FAD's clinimetric properties and to report the incremental utility of its inclusion in clinical settings. A thorough literature search was performed, using both computerized and manual searches, yielding a total of 148 studies that were included in this review. The FAD has been extensively used in a variety of research contexts. In the majority of studies it was able to discriminate between clinical populations and controls and among groups of patients with different illnesses. The FAD also showed good test-retest and concurrent reliability, and modest sensitivity to change after treatment. FAD-dysfunctional Family functioning was related to several patient clinical outcomes, including lower recovery rates and adherence to treatment, longer recovery time, poorer quality of life, and increased risk of relapse and drop-out. The present review demonstrates that the FAD is a suitable instrument for the evaluation of Family functioning both in clinical and research settings.
Maria Teresa Lax Pericall - One of the best experts on this subject based on the ideXlab platform.
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Family function and its relationship to injury severity and psychiatric outcome in children with acquired brain injury a systematized review
Developmental Medicine & Child Neurology, 2014Co-Authors: Maria Teresa Lax Pericall, Eric TaylorAbstract:Aim The psychological and psychiatric outcome of children with acquired brain injury is influenced by many variables. A review was undertaken to clarify the contribution of Family function, how it relates to injury severity, and what particular aspects of Family function influence psychological outcome in this group. Method A systematized review of the literature of studies published between 1970 and 2012 from OvidMedline, PsychoInfo, PsycARTICLES, and Cochrane was undertaken focusing on Family function, injury severity, and psychiatric outcome. Results Thirty-six papers met the inclusion criteria. Injury severity was linked to the development of organic personality change. Family function before injury, measured by the Family Assessment Device or the Clinical Rating Scale, had a statistically significant effect on general psychological functioning in six out of eight studies. Family function had a significant effect for oppositional defiant disorder and secondary attention-deficit–hyperactivity disorder. The effects of Family function may differ depending on the age of the child and the severity of the injury. Some styles of parenting moderated recovery. After injury, Family function was related to the child's contemporaneous psychiatric symptoms. The level of evidence for these papers was 3 or 4 (Oxford Centre for Evidence-based Medicine criteria). Interpretation Screening for some aspects of Family functioning before injury and Family function during the rehabilitation phase may identify children at risk of psychiatric disorders.
Robin A. Hanks - One of the best experts on this subject based on the ideXlab platform.
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Effects of Family and caregiver psychosocial functioning on outcomes in persons with traumatic brain injury.
The Journal of head trauma rehabilitation, 2011Co-Authors: Stephen J. Vangel, Lisa J. Rapport, Robin A. HanksAbstract:OBJECTIVES To examine the predictive value of caregiver/Family status to well-being of persons with brain injury and to examine whether perceived social support to caregivers moderates their well-being. PARTICIPANTS One hundred nine pairs of adults, a caregiver, and an individual with TBI. MAIN MEASURES Brief Symptom Inventory-18, Satisfaction With Life Scale; Disability Rating Scale; Social Provision Scale, Family Assessment Device, and Disability Rating Scale. RESULTS Canonical correlation indicated the presence of a relationship between well-being in TBI and caregiver participants. Two canonical variates accounted for 47.5% variance. Poor psychological well-being among persons with TBI was associated with poor caregiver perceived social support and poor familial behavioral control. Individuals with high disability also had caregivers with poorer psychological well-being. In post hoc multiple regressions, caregiver/Family psychosocial characteristics added unique prediction of outcome for individuals with TBI. Hierarchical multiple regressions provided evidence that social support of caregivers moderates outcome status for individuals with TBI. CONCLUSIONS Future research efforts should focus on understanding of the specific mechanisms of reciprocal effects, to help design future therapy.
