A strategy for prevention: Role flexibility and affective reactivity as factors in family coping.

Abstract

A model of family adaptation to chronic illness is described. The model predicts that, when family rules allow for expression of emotions and when family roles are flexible, the adaptation process will be effective. When family rules prohibit emotional expression or family roles are inflexible, adaptation will be ineffective. Ineffective adaptation is characterized by a pile-up of stressors that are related to the adaptation process and that increase the likelihood of negative mental health outcomes for the patient and family members. The implications of this model for prevention and treatment are described, and suggestions for testing the model discussed.When a family member becomes chronically ill, two questions about the family's adaptation process arise. The first asks whether the family's premorbid adaptation played a role in the etiology of the illness. The second question concerns the family's adaptation following the onset of the illness and the implications of that process for the mental health of the patient and his/her family. Characteristics of the family's premorbid adaptation inevitably reappear in the post-diagnosis adaptation (24). However, the preventive mental health implications of a family's adaptation to a chronic illness may be more easily addressed by focusing on the second question.The development of empirically-based preventive mental health interventions for families following diagnosis of a chronic illness may be viewed as a three-stage endeavor. First, a conceptualization of the family adaptation process following the diagnosis is necessary. The conceptual model must include testable hypotheses related to negative mental health outcomes for family members, as well as clear implications for preventive interventions by health care providers and mental health practitioners.The second stage in prevention research involves testing the hypotheses which

Parental coping following childhood acquired brain injury

“…Snidies have consistently shown chat prohibition of emotional expression has adverse effects on a family's adaptation to chronic illness [51,52]. Thompson et nl [23] and Miller ct ill. [24] both found emotion-focused strategies positively associated with poor adjustment.…”

“…A child with a disability may necessitate many changes in a fainily's lifestyle [52]. If the family does not respond to the need to change, this may become an additional source of stress [65].…”

The California Family Health Project: IV. Family Structure/Organization and Adult Health

“…Examples include family cohesion (for example, Barbarin, Hughes, & Chesler, 1985;Olson, Sprenkle, & Russell, 1979); sex role behavior (Downey, 1984); marital power (Mirowsky, 1985); family privacy (Pittman & Lloyd, 1988); and adaptability or role flexibility (Koch, 1985). Examples include family cohesion (for example, Barbarin, Hughes, & Chesler, 1985;Olson, Sprenkle, & Russell, 1979); sex role behavior (Downey, 1984); marital power (Mirowsky, 1985); family privacy (Pittman & Lloyd, 1988); and adaptability or role flexibility (Koch, 1985).…”

“…Research in family sociology and family health psychology has linked several aspects of family Structure/Organization with the health and functional status of family members. Examples include family cohesion (for example, Barbarin, Hughes, & Chesler, 1985;Olson, Sprenkle, & Russell, 1979); sex role behavior (Downey, 1984); marital power (Mirowsky, 1985); family privacy (Pittman & Lloyd, 1988); and adaptability or role flexibility (Koch, 1985). Also, most family assessment inventories include scales that tap various components of family Structure/Organization, for example, FACES (Olson et al, 1979), Family Environment Scale (Moos & Moos, 1981), and Family Assessment Device (Epstein, Baldwin, & Bishop, 1983), attesting to the importance placed on this domain when considering issues of health and illness.…”

The California Family Health Project: III. Family Emotion Management and Adult Health

“…Family researchers have studied the effects of different styles of expressing and managing emotional experiences on various health‐related problems, although their role in the etiology of disorder is difficult to confirm (Campbell, 1986). Koch (1985) suggested that adaptation to chronic illness is enhanced in families that permit the open expression of emotion. Gottman and Krokoff (1989) showed that, although the overt expression of conflict in couples may be disruptive and problematic, expressiveness is associated with improved levels of marital satisfaction at long‐term followup.…”