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Family dimensions in anxious-depressed school refusers
G A Bernstein1, S L Warren, E D Massie
1University of Minnesota Medical School, Minneapolis, USA.
Journal of Anxiety Disorders
|December 22, 1999
Summary
Adolescents with anxiety and depression reported low family cohesion and adaptability. Extreme family types were linked to higher depression and somatic symptoms, suggesting therapy could improve family dynamics and reduce school refusal.
Area of Science:
- Child and Adolescent Psychiatry
- Family Psychology
- Mental Health Research
Background:
- School refusal is a complex issue often linked to underlying anxiety and depressive disorders in adolescents.
- Family dynamics, including cohesion and adaptability, play a significant role in adolescent mental health and treatment outcomes.
- The Family Adaptability and Cohesion Evaluation Scale II (FACES II) is a validated instrument for assessing these family dimensions.
Purpose of the Study:
- To investigate the perceived family adaptability and cohesion in adolescents with comorbid anxiety and major depressive disorders.
- To explore the relationship between family types (balanced to extreme) and symptom severity in adolescents undergoing treatment for school refusal.
- To identify potential therapeutic targets for improving family functioning and reducing school refusal behaviors.
Main Methods:
- The Family Adaptability and Cohesion Evaluation Scale II (FACES II) was administered to 46 adolescents and their parents.
- Participants were part of a treatment study for school refusal.
- Data analysis compared perceived family functioning and family types with symptom measures.
Main Results:
- Adolescents and parents generally reported low cohesion (disengagement) and low adaptability (rigidity) in their current families.
- Adolescents and parents ideally desired families with higher cohesion and adaptability than their current family environment.
- Adolescents in extreme family types reported significantly higher depression and somatic symptom scores compared to those in balanced families.
Conclusions:
- Low cohesion and adaptability are prevalent in families of adolescents with comorbid anxiety, depression, and school refusal.
- Extreme family types are associated with increased symptom severity, highlighting the impact of family dynamics on adolescent mental health.
- Family therapy targeting cohesion and adaptability, alongside treatments for depression and somatic symptoms, may be crucial for improving outcomes in school refusal.