Online-Journal für systemische Entwicklungen

Family Process 2015

Heft 1

Lebow, Jay L. (2015): Editorial: Relational Diagnosis – An Idea Whose Time Has Come. In: Family Process 54 (1): 1-5.

Wamboldt, Marianne, Nadine Kaslow & David Reiss (2015): Description of Relational Processes: Recent Changes in DSM-5 and Proposals for ICD-11. In: Family Process 54 (1): 6-16.

abstract: Epidemiologic, prospective, and retrospective research confirms that family relational variables are significant risk factors for the development of mental and physical health problems in children as well as adults. In addition, relationships also play a moderating role in the maintenance, exacerbation, or amelioration of chronic health problems. Although acknowledgment of the importance of these variables in the pathophysiology of a number of health conditions is reaching more prominence, the integration of assessments of family factors as part of standard health care has made little progress. With the arrival of the Affordable Care Act in the United States, there is a desire for earlier identification of these risk factors, and the ability to implement prevention programs that reduce risk, and enhance protective factors. On a global level, there is increased awareness of the health impact of relational problems, for example, many countries have attempted to implement programs to decrease domestic violence. More reliable and standardized assessments of key relational processes will enhance both of these missions, and allow comparison of a variety of prevention and intervention programs. This article discusses progress over the last decade in constructing more reliable definitions of relationship processes, how these have been integrated into the Diagnostic and Statistical Manual 5th edition (DSM-5), and progress toward implementation into the World Health Organization’s International Classification of Diseases (ICD-11).

Wamboldt, Marianne, Anthony Cordaro & Diana Clarke (2015): Parent-Child Relational Problem: Field Trial Results, Changes in DSM-5, and Proposed Changes for ICD-11. In: Family Process 54 (1): 33-47.

abstract: Caregiving relationships are significant factors in the development, mediation, or moderation of childhood mental health problems. However, epidemiological and clinical research has been limited by lack of reliable, succinct, and standardized methods of assessing parent–child relationship constructs. The Relational Processes Workgroup (ad hoc to the DSM-5 process) proposed more specific criteria to define a parent–child relational problem (PCRP). These criteria were field tested in one of the DSM-5 Field trial sites, utilizing a similar research design as DSM-5. Participants included 133 symptomatic children (5–17 years) in active treatment for a mental health problem and their primary caregiver (86% mothers). Two separate clinicians, each blinded to the assessment of the other clinician as well as the DSM-5 diagnoses, interviewed the dyads within a 2-week period, utilizing the proposed PCRP criteria. Prior to each interview, parents were asked to write about their relationship with their child, and children (over the age of 10 years) filled out the Parental Bonding Instrument, Brief Current, and the Perceived Criticism Measure. Clinicians were able to read the narratives and see results of the child report measures before assessing the dyad. The weighted prevalence of a PCRP in this sample was 34%. The interclass kappa for overall agreement between clinicians was 0.58 (0.40, 0.72), which indicates good interrater reliability. Further, clinicians found the PCRP diagnostic criteria clinically useful and an improvement over the brief description of PCRP that was presented in DSM-IV. Relationships between children and their primary caregiver can be assessed in a reliable manner, based on clinical interview with the child–caregiver dyad and several self-report measures.

Foran, Heather M., Mark A. Whisman & Steven R. H. Beach (2015): Intimate Partner Relationship Distress in the DSM-5. In: Family Process 54 (1): 48-63.

abstract: Over the past 40 years, a large body of literature has documented intimate partner relationship distress as a primary reason for seeking mental health services as well as an integral factor in the prognosis and treatment of a range of mental and physical health conditions. In recognition of its relevance to clinical care, the description of intimate partner relationship distress has been expanded in the DSM-5. Nonetheless, this is irrelevant if the DSM-5 code for intimate partner relationship distress is not reliably used in clinical practice and research settings. Thus, with the goal of dissemination in mind, the purpose of this paper was to provide clinicians and researchers with specific guidelines on how to reliably assess intimate partner relationship distress and how this information can be used to inform treatment planning. In addition to the implications for direct clinical care, we discuss the importance of reliable assessment and documentation of intimate partner relationship distress for future progress in epidemiology, etiology, and public health research.

Heyman, Richard E., Amy M. Smith Slep & Heather M. Foran (2015): Enhanced Definitions of Intimate Partner Violence for DSM-5 and ICD-11 May Promote Improved Screening and Treatment. In: Family Process 54 (1): 64-81.

abstract: Nuanced, multifaceted, and content valid diagnostic criteria for intimate partner violence (IPV) have been created and can be used reliably in the field even by those with little-to-no clinical training/background. The use of such criteria such as these would likely lead to more reliable decision making in the field and more consistency across studies. Further, interrater agreement was higher than that usually reported for individual mental disorders. This paper will provide an overview of (a) IPV’s scope and impact; (b) the reliable and valid diagnostic criteria that have been used and the adaptation of these criteria inserted in the latest Diagnostic and Statistical Manual of Mental Disorders (DSM) and another adaptation proposed for the forthcoming International Statistical Classification of Diseases and Related Health Problems (ICD); (c) suggestions for screening of IPV in primary care settings; (d) interventions for IPV; and (e) suggested steps toward globally accepted programs.

Mansfield, Abigail K., Gabor I. Keitner & Jennifer Dealy (2015): The Family Assessment Device: An Update. In: Family Process 54 (1): 82-93.

abstract: 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.

Staccini, Laura, Elena Tomba, Silvana Grandi & Gabor I. Keitner (2015): The Evaluation of Family Functioning by the Family Assessment Device: A Systematic Review of Studies in Adult Clinical Populations. In: Family Process 54 (1): 94-115.

abstract: 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.

Boterhoven, Katrina L. de Haan, Jennifer Hafekost, David Lawrence, Michael G. Sawyer & Stephen R. Zubrick (2015): Reliability and Validity of a Short Version of the General Functioning Subscale of the McMaster Family Assessment Device. In: Family Process 54 (1): 116-123.

abstract: The General Functioning 12-item subscale (GF12) of The McMaster Family Assessment Device (FAD) has been validated as a single index measure to assess family functioning. This study reports on the reliability and validity of using only the six positive items from the General Functioning subscale (GF6+). Existing data from two Western Australian studies, the Raine Study (RS) and the Western Australian Child Health Survey (WACHS), was used to analyze the psychometric properties of the GF6+ subscale. The results demonstrated that the GF6+ subscale had virtually equivalent psychometric properties and was able to identify almost all of the same families who had healthy or unhealthy levels of functioning as the full GF12 subscale. In consideration of the constraints faced by large-scale population-based surveys, the findings of this study support the use of a GF6+ subscale from the FAD, as a quick and effective tool to assess the overall functioning of families.

Tilsen, Julie & Sheila McNamee (2015): Feedback Informed Treatment: Evidence-Based Practice Meets Social Construction. In: Family Process 54 (1): 124-137.

abstract: This article explores the challenges presented by the mandate for evidence-based practice for family therapists who identify with the philosophical stance of social construction. The history of psychotherapy outcome research is reviewed, as are current findings that provide empirical evidence for an engaged, dialogic practice. The authors suggest that the binary between empiricism and social construction may be unhinged by understanding empiricism as a particular discursive frame (i.e., a particular way of talking, acting, and being in the world), one of many available as a way of understanding and talking about our work. Through a case vignette, the authors introduce the evidence-based practice of Feedback Informed Treatment as an elaboration of social construction, and as an example of bridging the gap between the discursive frames of empiricism and social construction.

Darwiche, Joëlle & Yves de Roten (2015): Couple and Family Treatments: Study Quality and Level of Evidence. In: Family Process 54 (1): 138-159.

abstract: This paper examines the application of the guidelines for evidence-based treatments in family therapy developed by Sexton and collaborators to a set of treatment models. These guidelines classify the models using criteria that take into account the distinctive features of couple and family treatments. A two-step approach was taken: (1) The quality of each of the studies supporting the treatment models was assessed according to a list of ad hoc core criteria; (2) the level of evidence of each treatment model was determined using the guidelines. To reflect the stages of empirical validation present in the literature, nine models were selected: three models each with high, moderate, and low levels of empirical validation, determined by the number of randomized clinical trials (RCTs). The quality ratings highlighted the strengths and limitations of each of the studies that provided evidence backing the treatment models. The classification by level of evidence indicated that four of the models were level III, “evidence-based” treatments; one was a level II, “evidence-informed treatment with promising preliminary evidence-based results”; and four were level I, “evidence-informed” treatments. Using the guidelines helped identify treatments that are solid in terms of not only the number of RCTs but also the quality of the evidence supporting the efficacy of a given treatment. From a research perspective, this analysis highlighted areas to be addressed before some models can move up to a higher level of evidence. From a clinical perspective, the guidelines can help identify the models whose studies have produced clinically relevant results.

Gelin, Zoé, Silvana Fuso, Stephan Hendrick, Solange Cook-Darzens & Yves Simon (2015): The Effects of a Multiple Family Therapy on Adolescents with Eating Disorders: An Outcome Study. In: Family Process 54 (1): 160-172.

abstract: Multiple Family Therapy (MFT) has gained increasing popularity in the treatment of eating disorders and many programs have been developed over the past decade. Still, there is little evidence in the literature on the effectiveness on MFT for treating eating disorders. The present study examines the effects of a particular model of Multiple Family Therapy on eating disorder symptoms, quality of life, and percentage of Expected Body Weight (%EBW) in adolescents with eating disorders (ED). Eighty-two adolescents with ED, aged between 11 and 19 years, were assessed before and after treatment using the Eating Disorders Inventory 2 (EDI-2), the Outcome Questionnaire 45 (OQ-45) and %EBW. Results showed a significant increase in %EBW between the beginning and end of treatment, with a large effect size. 52.4% of patients achieved an EBW above 85%. Symptoms relative to all EDI dimensions (except for bulimia) significantly decreased during treatment. The three dimensions related to quality of life assessment also improved over the course of MFT. At the end of treatment, 70.7% of patients had a total OQ-45 score below clinical significance. This study suggests that Multiple Family Therapy may benefit adolescents with eating disorders, with improvement on several outcome measures (%EBW, ED symptoms, and quality of life). However, the lack of a comparison group entails caution when drawing conclusions.

Slep, Amy M. Smith, Richard E. Heyman & Heather M. Foran (2015): Child Maltreatment in DSM-5 and ICD-11. In: Family Process 54 (1): 17-32.

abstract: Child maltreatment is widespread and has a tremendous impact on child victims and their families. Over the past decade, definitions of child maltreatment have been developed that are operationalized, face valid, and can be reliably applied in clinical settings. These definitions have informed the revised Diagnostic and Statistical Manual (American Psychiatric Association, 2013) and are being considered for the International Classification of Disease–11 (World Health Organization). Now that these definitions are available in major diagnostic systems, primary healthcare providers and clinicians who see children and families are poised to help screen for, identify, prevent, and treat child maltreatment. This article reviews the definitions of maltreatment in these diagnostic systems, along with assessment and screening tools, and empirically supported prevention and intervention approaches.

Knafl, Kathleen, Jennifer Leeman, Nancy Havill, Jamie Crandell & Margarete Sandelowski (2015): Delimiting Family in Syntheses of Research on Childhood Chronic Conditions and Family Life. In: Family Process 54 (1): 173-184.

abstract: Synthesis of family research presents unique challenges to investigators who must delimit what will be included as a family study in the proposed review. In this paper, the authors discuss the conceptual and pragmatic challenges of conducting systematic reviews of the literature on the intersection between family life and childhood chronic conditions. A proposed framework for delimiting the family domain of interest is presented. The framework addresses both topical salience and level of relevance and provides direction to future researchers, with the goal of supporting the overall quality of family research synthesis efforts. For users of synthesis studies, knowledge of how investigators conceptualize the boundaries of family research is important contextual information for understanding the limits and applicability of the results.

Gabb, Jacqui & Reenee Singh (2015): The Uses of Emotion Maps in Research and Clinical Practice with Families and Couples: Methodological Innovation and Critical Inquiry. In: Family Process 54 (1): 185-197.

abstract: We explore how “emotion maps” can be productively used in clinical assessment and clinical practice with families and couples. This graphic participatory method was developed in sociological studies to examine everyday family relationships. Emotion maps enable us to effectively “see” the dynamic experience and emotional repertoires of family life. Through the use of a case example, in this article we illustrate how emotion maps can add to the systemic clinicians’ repertoire of visual methods. For clinicians working with families, couples, and young people, the importance of gaining insight into how lives are lived, at home, cannot be understated. Producing emotion maps can encourage critical personal reflection and expedite change in family practice. Hot spots in the household become visualized, facilitating dialogue on prevailing issues and how these events may be perceived differently by different family members. As emotion maps are not reliant on literacy or language skills they can be equally completed by parents and children alike, enabling children’s perspective to be heard. Emotion maps can be used as assessment tools, to demonstrate the process of change within families. Furthermore, emotion maps can be extended to use through technology and hence are well suited particularly to working with young people. We end the article with a wider discussion of the place of emotions and emotion maps within systemic psychotherapy.


Heft 2


Lebow, Jay L. (2015): Editorial: Conflicts of Interest in Publication about Families and Family Therapy. In: Family Process 54 (2): 199-204.

Updegraff, Kimberly A. & Adriana J. Umaña-Taylor (2015): What Can We Learn from the Study of Mexican-Origin Families in the United States. In: Family Process 54 (2): 205-216.

abstract: Mexican-origin families are a large and rapidly increasing subgroup of the U.S. popula tion, but they remain underrepresented in family scholarship. This paper introduces a special section of four papers on Mexican-origin families designed to contribute to the advancement of research on how cultural, family, and gender socialization processes unfold across key developmental periods and life transitions in this cultural context. Two longitudinal studies of Mexican-origin families provided the data for these four papers: (a) The Juntos Project, an 8-year longitudinal study of mothers, fathers, and adolescent sibling pairs in 246 Mexican-origin families; and (b) The Supporting MAMI Project, a study following 204 adolescent mothers and their mother figures from the third trimester of pregnancy through their young children’s 5th birthdays. In this introductory paper, we highlight four themes, including (a) differential acculturation and reciprocal socialization, (b) interdependence in families, (c) the intersection of culture and gender, and (d) methodological issues. We end with suggestions for future research.

Killoren, Sarah E., Lorey A. Wheeler, Kimberly A. Updegraff, Sue A. Rodríguez de Jésus & Susan M. McHale (2015): Longitudinal Associations among Parental Acceptance, Familism Values, and Sibling Intimacy in Mexican-Origin Families. In: Family Process 54 (2): 217-231.

abstract: Prospective associations among parent-adolescent acceptance and familism values in early and middle adolescence and sibling intimacy in late adolescence and young adult hood were assessed in 246 Mexican-origin families. Older sibling gender and sibling gender constellation were investigated as moderators of these associations. Sibling intimacy was stable over time and younger siblings with older sisters reported higher levels of sibling intimacy than those with older brothers. As predicted, stronger familism values were associated with greater sibling intimacy, but this link was evident only for older sisters and for girl-girl dyads. The links from mother- and father-acceptance to sibling intimacy also depended on the gender constellation of the sibling dyad: Higher levels of maternal warmth were associated with greater sibling intimacy for older sisters and girl-girl sibling pairs but higher levels of paternal warmth were linked to greater sibling intimacy only for older siblings in mixed-gender sibling dyads. Findings are consistent with prior research on the role of gender in family relationships but extend this work to encompass the effects of both parents‘ and siblings‘ gender, as well as the role of sociocultural values in parents‘ socialization influences.

Perez-Brena, Norma J., Kimberly A. Updegraff & Adriana J. Umaña-Taylor (2015): Transmission of Cultural Values among Mexican-Origin Parents and Their Adolescent and Emerging Adult Offspring. In: Family Process 54 (2): 232-246.

abstract: The integration of the U.S. and Mexican culture is an important process associated with Mexican-origin youths‘ adjustment and family dynamics. The current study examined the reciprocal associations in parents‘ and two offspring’s cultural values (i.e., familism and respect) in 246 Mexican-origin families. Overall, mothers‘ values were associated with increases in youths‘ values 5 years later. In contrast, youths familism values were associated with increases in fathers‘ familism values 5 years later. In addition, developmental differences emerged where parent-to-offspring effects were more consistent for youth transitioning from early to late adolescence than for youth transitioning from middle adolescence to emerging adulthood. Finally, moderation by immigrant status revealed a youth-to-parent effect for mother-youth immigrant dyads, but not for dyads where youth were U.S.-raised. Our findings highlight the reciprocal nature of parent-youth value socialization and provide a nuanced understanding of these processes through the consideration of familism and respect values. As Mexican-origin youth represent a large and rapidly growing segment of the U.S. population, research that advances our understanding of how these youth develop values that foster family cohesion and support is crucial.

Toomey, Russell B., Kimberly A. Updegraff, Adriana J. Umaña-Taylor & Laudan B. Jahromi (2015): Gender Role Attitudes across the Transition to Adolescent Motherhood in Mexican-Origin Families. In: Family Process 54 (2): 247-262.

abstract: Using longitudinal data collected at four time points from 191 dyads of Mexican-origin adolescent first-time mothers and their mother figures, we examined changes in and socialization of traditional gender role attitudes across the transition to parenthood using latent growth curve modeling and actor-partner interdependence modeling. Longitudinal growth models indicated that, regardless of nativity status, adolescent mothers‘ and their foreignborn mother figures‘ gender role attitudes became more egalitarian across adolescents transition to parenthood, spanning from the 3rd trimester of pregnancy to 36 months post partum. Furthermore, actor-partner interdependence modeling suggested that adolescents and their mother figures‘ gender role attitudes during adolescents‘ third trimester of pregnancy equally contributed to subsequent increases in one another’s gender role attitudes at 10 months postpartum. Importantly, this reciprocal socialization process was not moderated by adolescent mothers‘ nor by their mother figures‘ nativity status. Findings suggest that it is important to understand the cultural and inter generational family processes that contribute to the development of gender role attitudes during the transition to parenthood for adolescent mothers and their mother figures in Mexican-origin families.

Perez-Brena, Norma J., Kimberly A. Updegraff, Adriana J. Umaña-Taylor, Laudan Jahromi & Amy Guimond (2015): Coparenting Profiles in the Context of Mexican-Origin Teen Pregnancy: Links to Mother–Daughter Relationship Quality and Adjustment. In: Family Process 54 (2): 263-279.

abstract: The current study explored the multifaceted nature of the mother-adolescent coparental relationship with data from 167 Mexican-origin adolescent mothers and their own mothers at 10 months post childbirth. Profiles of mother-adolescent coparenting were created with latent profile analysis using adolescents‘ reports of three dimensions of coparenting (communication, involvement, and conflict). Four profiles were identified: (a) Harmonious Co-parents (equal involvement, high communication, low conflict); (b) Harmonious-Adolescent Primary (adolescent is more involved than mother, high communication, low conflict); (c) Conflictual Coparents (equal involvement, high communication, high conflict); and (d) Conflictual-Adolescent Primary (adolescent is more involved than mother, moderate communication, high conflict). Families characterized by high mother-daughter conflict and psychological control prior to childbirth were more likely to belong in the Conflictual Co-parents profile. In addition, adolescents‘ and mothers‘ depressive symptoms and parenting efficacy after childbirth were linked to profile membership, such that the Harmonious-Adolescent Primary profile reported the most positive adjustment patterns, whereas profiles with high coparental conflict (i,e., Conflictual Coparenting and Conflictual-Adolescent Primary profiles) showed the least positive adjustment patterns. Discussion considers the applied implications of identifying precursors to healthy and problematic mother-daughter coparenting for families of adolescent mothers in the early years of parenting.

Stein, Gabriela L. & Linda E. Guzman (2015): Prevention and Intervention Research With Latino Families: A Translational Approach. In: Family Process 54 (2): 280-292.

abstract: The present paper takes a translational approach in applying the themes of the current special section to prevention and intervention science in Latino families. The paper reviews the current literature on cultural processes in prevention and intervention research with Latino families. Overall, many prevention and intervention programs have either been developed specifically for Latino families or have been modified for Latino families with great attention paid to the socio-cultural needs of these families. Nevertheless, few studies have tested the role of cultural values or acculturation processes on outcomes. We make recommendations based on findings within basic science and in particular this special section on the incorporation of these values and processes into prevention and intervention science with Latino families.

Reynolds, Conroy & Carmen Knudson-Martin (2015): Gender and the Construction of Intimacy among Committed Couples with Children. In: Family Process 54 (2): 293-307.

abstract: This study began with curiosity regarding how long-term couples with children manage their relationships in view of changing societal demands and ideals. Couples interviewed for this study described the intersection of time and intimacy as a core issue. Thus, this analysis focused on how couples construct intimacy in shared time. The diverse sample included 17 heterosexual working and professional class couples in the United States who had been committed for at least 10 years and whose oldest child was aged 6-16. Analysis identified four types of shared time experiences: gender divided, elusive, growing, and emotionally connected. Four factors influenced these types: (a) negotiated gendered differences, (b) intentionality, (c) mutual attending, and (d) dyadic friendship. The most emotionally connected couples reported that time together reinforced satisfaction and pleasure from their relationships. Results help explain different ways couples successfully negotiate changing expectations for heterosexual relationships and why some couples struggle. Findings suggest that therapists help couples intentionally develop habits of friendship and mutual attending.

Ferreira, Luana Cunha, Peter Fraenkel, Isabel Narciso & Rosa Novo (2015): Is Committed Desire Intentional? A Qualitative Exploration of Sexual Desire and Differentiation of Self in Couples. In: Family Process 54 (2): 308-326.

abstract: The question of what heightens or diminishes sexual desire has long been a passionate theme across cultures in literature, arts, media, and medicine. Yet, little research has been conducted to determine what affects level of desire within couples. The degree of differentiation of self has been suggested as an important variable in shaping partners‘ level of desire. Through a qualitative analysis of dyadic couple interviews, this study provides an account of characteristics processes, and trajectories of sexual desire and differentiation in 33 heterosexual couples of varying ages and relationship duration. Factors associated with high desire were change and autonomy, whereas conflict and children were reported to be desire-diminishing factors. Innovation, sharing, autonomy, and effort emerged as desire-promoting strategies, while fostering personal interests, investing in a positive connection, and enhancing personal integrity were identified as couples‘ strategies to promote and pre serve differentiation of self. The results also shed light on couples perceptions of whether and how sexual desire changes over the course of the relationship and challenge common cultural assumptions about desire in committed relationships—namely the myth that the only authentic expression of desire is that which occurs spontaneously and without inten tion and planning. Implications for couple therapy are discussed.

Khaw, Lyndal & Jennifer L. Hardesty (2015): Perceptions of Boundary Ambiguity in the Process of Leaving an Abusive Partner. In: Family Process 54 (2): 327-343.

abstract: The process of leaving an abusive partner has been theorized using the Stages of Change Model Although useful, this model does not account for changes in relational boundaries unique to the process of leaving. Using family stress and feminist perspectives, this study sought to integrate boundary ambiguity into the Stages of Change Model. Boundary ambiguity is defined as a perception of uncertainty as to who is in or out of a family system (Boss & Greenberg, 1984). Twenty-five mothers who had temporarily or permanently left their abusers were interviewed. Data were analyzed using constructivist grounded theory methods. Results identify types, indicators of, and mothers‘ responses to boundary ambiguity throughout the five stages of change. Most mothers and abusers fluctuated between physical and psychological presence and absence over multiple separations. The integration of boundary ambiguity into the Stages of Change Model highlights the process of leaving an abusive partner as systemic, fluid, and nonlinear.

Hunger, Christina, Jan Weinhold, Annette Bornhäuser, Leoni Link & Jochen Schweitzer (2015): Mid- and Long-Term Effects of Family Constellation Seminars in a General Population Sample: 8- and 12-Month Follow-Up. In: Family Process 54 (2): 344-358.

abstract: In a previous randomized controlled trial (RCT), short-term efficacy of family constellation seminars (FCSs) in a general population sample was demonstrated. In this article, we examined mid- and long-term stability of these effects. Participants were 104 adults (M = 47 years; SD = 9; 84% female) who were part of the intervention group in the original RCT (3-day FCS; 64 active participants and 40 observing participants). FCSs were carried out according to manuals. It was predicted that FCSs would improve psychological functioning (Outcome Questionnaire OQ-45.2) at 8- and 12-month follow-up. Additionally, we assessed the effects of FCSs on psychological distress, motivational incongruence, individuals experience in their personal social systems, and overall goal attainment. Participants yielded significant improvement in psychological functioning fd = 0.41 at 8-month follow- up, p =.000; d = 0.40 at 12-month follow-up, p =.000). Results were confirmed for psychological distress, motivational incongruence, the participants‘ experience in their personal social systems, and overall goal attainment. No adverse events were reported. This study provides first evidence for the mid- and long-term efficacy of FCSs in a nonclinical population. The implications of the findings are discussed.

Holtrop, Kendal, Sharde McNeil Smith & Jenna C. Scott (2015): Associations between Positive Parenting Practices and Child Externalizing Behavior in Underserved Latino Immigrant Families. In: Family Process 54 (2): 359-375.

abstract: This study examined whether five specific parenting practices (i.e., monitoring, discipline, skill encouragement, problem solving, and positive involvement) were associated with reduced child externalizing behaviors among a sample of Latino immigrant families. It utilized baseline data from 83 Latino couples with children participating in a larger randomized controlled trial of a culturally adapted parenting intervention. Results reveal that monitoring, discipline, skill encouragement, and problem solving each made independent contributions to the prediction of child externalizing behavior, although not all in the expected direction. Further analyses examining mothers and fathers separately suggest that mother-reported monitoring and father-reported discipline practices uniquely contributed to these findings. These results may have important implications for prevention and clinical intervention efforts with Latino immigrant families, including the cultural adaptation and implementation of parenting interventions with this underserved population.

Wood, Beatrice L., Bruce D. Miller & Heather K. Lehman (2015): Review of Family Relational Stress and Pediatric Asthma: The Value of Biopsychosocial Systemic Models. In: Family Process 54 (2): 376-389.

abstract: Asthma is the most common chronic disease in children. Despite dramatic advances in pharmacological treatments, asthma remains a leading public health problem, especially in socially disadvantaged minority populations. Some experts believe that this health gap is due to the failure to address the impact of stress on the disease. Asthma is a complex disease that is influenced by multilevel factors, but the nature of these factors and their interrelations are not well understood. This paper aims to integrate social, psychological, and biological literatures on relations between family/parental stress and pediatric asthma, and to illustrate the utility of multilevel systemic models for guiding treatment and stimulating future research. We used electronic database searches and conducted an integrated analysis of selected epidemiological, longitudinal, and empirical studies. Evidence is substantial for the effects of family/parental stress on asthma mediated by both disease management and psychobiological stress pathways. However, integrative models containing specific pathways are scarce. We present two multilevel models, with supporting data, as potential prototypes for other such models. We conclude that these multilevel systems models may be of substantial heuristic value in organizing investigations of, and clinical approaches to, the complex social–biological aspects of family stress in pediatric asthma. However, additional systemic models are needed, and the models presented herein could serve as prototypes for model development.

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