Family Process最新文献

Anxiety and insomnia are correlated in older adults and their caregivers, yet the moderating role of mental health literacy (MHL) is unclear. This study aimed to explore dyadic effects of anxiety on insomnia among Chinese chronically ill older adults and family caregivers across age groups and whether MHL moderates these effects. Data came from 1033 dyads of older adults and their family caregivers in China through the Guangdong Mental Health Survey. Anxiety was assessed with the Generalized Anxiety Disorder-7, insomnia with the Insomnia Severity Index, and MHL with the Chinese National Mental Health Literacy Scale (consisting of mental health knowledge, attitudes, and capacity). The Actor-Partner Interdependence Moderation Model was applied for analysis. Young caregivers' mental health attitudes, β = −0.558, p = 0.002, mitigated the effect of their anxiety on their insomnia, while older adults' mental health knowledge, β = 0.428, p = 0.019, enhanced this relationship. Older adults' mental health attitudes, β = −0.731, p = 0.004, reduced the impact of middle-aged caregivers' anxiety on the latter's insomnia. Middle-aged caregivers' mental health capacity, β = −0.367, p = 0.004, attenuated the effect of older adults' anxiety on caregivers' insomnia. No significant moderating effects were observed in the dyad group of older adults and older caregivers. Within caregiving dyads, enhancing MHL can potentially reduce the impact of anxiety on insomnia. Interventions aimed at improving the mental health attitudes of older adults and caregivers are more likely to alleviate anxiety and insomnia than mental health knowledge and capacity.

This study examined whether decreases in parents' negative in-session behaviors predicted reductions in LGBTQ+ young adults' perceived parental rejection and increases in their perceived parental acceptance over the course of attachment-based family therapy for sexual and gender minority (ABFT-SGM) young adults and their nonaccepting parents. A total of 126 videotaped sessions from 22 families who participated in an open clinical trial of ABFT-SGM were coded to assess changes in parents' positive and negative in-session behaviors. Young adults' perceived parental rejection and acceptance were measured at baseline, 8 weeks, 16 weeks, 24 weeks, and 36 weeks. In line with findings from the open clinical trial, on average, perceived parental rejection decreased and perceived parental acceptance increased over the course of therapy. For both mothers and fathers, decreases in negative in-session behaviors moderated increases in young adults' perceived parental acceptance but not reductions in perceived parental rejection. Findings underscore the importance of reducing negative parental in-session behaviors, such as criticism and invalidation, during conjoint sessions with their LGBTQ+ young adult.

Becoming a parent is one of life's most significant transitions and can be a challenging period for many couples. One factor that may increase the difficulty couples experience in adjusting to parenthood is having a history of childhood maltreatment. This study explored whether a history of childhood maltreatment in either partner is associated with couples' relationship functioning as they adjust to parenthood. Structural equation modeling was used to examine the association of childhood maltreatment history with relationship and coparenting quality in both partners of 398 heterosexual couples in the United States having their first child. Relationship quality was assessed during pregnancy, and both relationship quality and coparenting quality were assessed twice during the postpartum period at 10–12 months and 2 years after birth. Father's history of childhood maltreatment was negatively associated with mother's reports of relationship quality at both time points after birth (p < 0.05), and father's maltreatment history was negatively associated with mother's reports of coparenting quality 2 years after birth (p = 0.01). Follow-up analyses accounting for the interaction of both partners' maltreatment history revealed that a combination of maltreatment in both partners was associated with poorer relationship quality reported by mothers during pregnancy and 10–12 months after birth and with poorer coparenting quality ratings by mothers 2 years after birth (p < 0.05). Results suggest that a history of maltreatment in both parents can have negative impacts on relationship and coparenting quality during the transition to parenthood, with mothers appearing more sensitive to such effects than fathers. These findings highlight the importance of assessing both parents' histories of childhood maltreatment in postpartum clinical care to better identify families at risk and tailor supports that strengthen relationship and coparenting quality.

Stepfamilies are increasingly prevalent worldwide; however, research on non-Western stepfamilies remains limited. This study examines stepparenting, parenting behaviors, stepcouple relationships, and biological parents' co-parenting quality in Japan, exploring their impact on the psychological adjustment of emerging adults (EAs). The sample included 421 Japanese EAs (aged 20–29) raised in stepfamilies with a resident biological mother and stepfather and a nonresident biological father. Using latent profile analysis, we identified four relationship patterns: Residence-Centered (37.8%) with strong resident mother–stepfather ties, Inclusive (15.9%) with positive bonds across all parental figures, Inter-household Ambivalent Loyalty (22.8%) with an ambivalent nonresident father bond and biological parents' conflictive co-parenting, and High Stepfamily Conflict (23.5%) with frequent residential stepfamily conflict. The latter two profiles were associated with low self-esteem, high depression and anxiety, and increased aggression. Similar patterns in Western studies suggest that the key aspects of stepfamily functioning may be shared across cultural contexts. Our findings suggest that balanced parental involvement and positive stepparent relationships may influence stepfamily adaptation. Providing effective support for stepfamilies requires assessing the entire family system—including nonresidential biological parents—rather than focusing solely on individual relationships. Positive parenting and connections are important; however, we found that differences in adjustment were more strongly linked to negative relational features. Hence, interventions that reduce these negative dynamics may benefit families facing considerable difficulties. Clinicians should attempt to deepen their understanding of what does and does not work in stepfamily settings.

To ensure continuity of care during the Covid-19 pandemic, family therapy sessions were maintained via videoconferencing. Few studies evaluate the effectiveness of this modality. This exploratory qualitative study gathered the experiences of families who underwent videoconferencing family therapy during the first French lockdown and in-person therapy before and after. This study was conducted in France, within a department of adolescent medicine and psychiatry. Ten semi-structured interviews were conducted with eight families and analyzed using Interpretative Phenomenological Analysis. Results show that the absence of travel constraints in videoconferencing limited engagement during sessions. At home, daily life disrupted immersion, close proximity censored conversations, and therapists' virtual presence was perceived as intrusive or alliance-reinforcing. Patients described the sessions as a hiatus in therapy, citing therapists' exclusion from the family system, the paradox of being in therapy without full participation, and weak integration into the family narrative. However, videoconferencing provided crucial support during the crisis, encouraged initiative-taking, enabled participation of typically absent members, and allowed for experimentation with new formats. Some patients proposed alternating between in-person and remote sessions in the future. These challenges highlight the disruption of the therapeutic system during the abrupt transition. Therapists, shifting from active participants to observers, struggled to maintain a cohesive system. Yet, videoconferencing can redistribute control, fostering family initiative and balancing group and individual identities. This tool could complement traditional family therapy. Further research is needed to identify conditions, populations, and stages of therapy where videoconferencing is most effective.