Interfaces: toward a new generation of systemic models in family research and practice

Family functioning and psychological distress in a sample of mental health outpatients: Implications for routine examination and screening

RATIONALE, AIMS, AND OBJECTIVES

Clinical and research evidence suggests that family functioning is an important variable in shaping psychological well-being, despite being often overlooked in the prevailing approaches to mental health. The aim of the present study is to examine the associations between psychological distress and family functioning in a sample of patients accessing a public mental health service.

METHOD

CORE-OM and FACES IV questionnaires were administered to 112 patients, and all the correlations between the scales and subscales were calculated. Descriptive statistics concerning family typologies and satisfaction with family communication or relationships were also evaluated.

RESULTS

The results showed significant associations between family functioning and psychological well-being. Positive aspects of family functioning, such as balanced cohesion and flexibility, were associated with lower distress, while negative aspects such as disengagement were associated with poorer mental health. According to the Circumplex model, most of the families were described as balanced in their functioning; however, the communication and family satisfaction scores revealed that many patients had concerns about their family relationships.

CONCLUSIONS

This study confirms that family functioning is significantly associated with psychological distress, also in the absence of clear and conspicuous signs of structural imbalances within family relationships.

Individual distress and dyadic adjustment over the course of couple therapy and three-year follow-up: A replication study

This replication study examined the change over time and the relationship between depressive symptoms and dyadic adjustment during residential couple therapy and at one- and three-year follow-up. Mixed models were used in the analyses, and a disaggregation procedure was applied to examine the results on a between-person as well as on a within-person level. Overall, the results of the previous study were replicated. Significant improvement (p < .001) occurred on measures assessing relationship satisfaction and depressive symptoms from admission to discharge (effect sizes .47 to.72) and from admission to three-year follow-up (effect sizes .59 to .66). The within-person finding implies that when a person experiences more depressive symptoms than usual for him/her, subsequent dyadic adjustment is poorer than usual. Thus, our previous clinical implication suggestion is reinforced in this study: When treating couples suffering from co-existing relational and symptomatic distress, couple therapy should include the aim of lowering individual depressive symptoms.