Kissane D W, Bloch S, Dowe D L, Snyder R D, Onghena P, McKenzie D P, Wallace C S
Department of Psychological Medicine, Monash Medical Center, Clayton, Victoria, Australia.
Am J Psychiatry. 1996 May;153(5):650-8. doi: 10.1176/ajp.153.5.650.
The aim of this study was to identify patterns of family functioning in adult families after the death of a parent.
One hundred fifteen families completed measures of family functioning, grief, psychological state, and social adjustment 6 weeks (time 1), 6 months (time 2), and 13 months (time 3) after the death of a parent (a total of 670 individual responses). Cluster analytic methods were applied to develop a typology of perceptions of family functioning during bereavement.
Five types of families emerged from dimensions of cohesiveness, conflict, and expressiveness on the Family Environment Scale. Thirty-six percent of the families were considered supportive because of their high cohesiveness, and another 23% resolved conflict effectively. Two types were dysfunctional: hostile families, distinguished by high conflict, low cohesiveness, and poor expressiveness, and sullen families, who had more moderate limitations in these three areas; they declined in frequency from 30% at time 1 to 15% at time 3. The remaining type (26%), termed intermediate, exhibited midrange cohesiveness, low control, and low achievement orientation. The typology at time 1 predicted typologies at time 2 and time 3. There were no age or gender differences among the family types, but offspring, as compared with spouses, were overrepresented in the hostile families.
Family types can be identified, allowing at-risk families to be helped to prevent complications of grief. Screening with the family relationship index of the Family Environment Scale would facilitate such a family-centered approach.
本研究旨在确定父母一方去世后成年家庭的家庭功能模式。
115个家庭在父母一方去世后的6周(时间1)、6个月(时间2)和13个月(时间3)完成了家庭功能、悲伤、心理状态和社会适应方面的测量(共670份个体回复)。应用聚类分析方法来建立丧亲期间家庭功能认知的类型学。
从家庭环境量表的凝聚力、冲突和表达性维度中出现了五种家庭类型。36%的家庭因其高凝聚力而被认为具有支持性,另外23%的家庭能有效解决冲突。有两种类型的家庭功能失调:敌对型家庭,其特点是冲突高、凝聚力低和表达性差;沉闷型家庭,在这三个方面有更适度的局限性;它们的出现频率从时间1的30%下降到时间3的15%。其余类型(26%)称为中间型,表现出中等程度的凝聚力、低控制和低成就取向。时间1的类型学预测了时间2和时间3的类型学。家庭类型之间不存在年龄或性别差异,但与配偶相比,敌对型家庭中子女的比例过高。
可以识别家庭类型,从而帮助有风险的家庭预防悲伤并发症。使用家庭环境量表的家庭关系指数进行筛查将有助于这种以家庭为中心的方法。