Family Concepts and Emotional Disturbance in the Families of Disturbed Adolescents with Normal Siblings

Family Concepts and Emotional Disturbance in the Families of Disturbed Adolescents With Normal Siblings Arthur L. Novak University of Kansas Ferdinand van der Veen Institute for Juvenile Research Chicago, Illinois The assumption that family factors may be pathogenic for emotional disturbance has generally failed to be substantiated, It was hypothesized that this relationship depends on the way in which family conditions are subjectively perceived by the family members. Ss were adolescent patients, normal siblings, parents, and a normal control group of adolescents and parents. Perceptions of the family and ideal family were obtained on the Family Concept Q Sort. As predicted, patients were significantly lower than their siblings on perceived family adjustment and satisfaction; normal siblings did not differ significantly from normal controlb; and parents of patients were lower than parents of normal controls. Distinctive differences were found in the primary content factors of the family concepts of each child and parent group. Family Concepts and Emotional Disturbance in the Families of Disturbed Adolescents With Normal Siblings' Arthur L. Novak Ferdinand van der Veen University of Kansas Institute for Juvenile Research Many studies have found that persons with emotional disorders have early family backgrounds filled with emotional difficulties, such as rejection (Vogel, et al., 1964), child-parent conflict (McKeown, 1950; Vogel and Bell, 1960), inter-parental conflict (Fisher, 1959), broken homes XlUdow and Hardy, 1947), absence of one parent (Ingham, 1949), weak father figures (Millar, 1961), "smothering" mothers, (Sperling, 1951; Glauber, 1951) and prolonged sibling conflict (Ingham, 1949). These findings have led many investigators to refer to these early family environments as "pathogenic", and as central causative factors in emotional disorders. Nevertheless, controlled and systematic investigations have rarely found a direct relationship between family background and psychopathology. Stevenson (1957) states that "if the experiences of childhood importantly influence the later personality, we should expect to find some correlation between such experiences and the later occurrance of mental disorder. In fact, no such correlations have ever been shown (p. 153)." Renaud and Estess (1961) report that extensive interviews with 100 military men revealed a great deal of material regarding family background of a supposedly "pathogenic" nature, yet these men were rated high on emotional adjustment. Similarly, after an extensive review of the literature on the etiology of psychopathology, Frank (1965) concludes Novak and van der Veen 2 that there are no evident factors which distinguish the backgrounds of families of schizophrenics, neurotics and behavioral disorders from the families of normal controls, or from each other. In spite of the lack of corroboration, it is still generally accepted that family background strongly influences later emotional adjustment. A related issue is raised by the view that the patient seeking treatment, especially if that patient is a child, is the representative of a wider problem permeating the entire family unit (Ackerman, 1958; Handel, 1967; Bell, 1962). However, it is possible to find clinic patients from supposedly pathogenic families who have non-disturbed siblings (Vogel and Bell, 1960). To the extent that this is true, it casts doubt on the assumed relationship between family factors and emotional disorders. If the family environment is the principal pathology producing agent, the question arises as to why one child's reaction to this environment is pathological while that of another is not? One possible explanation for the lack of evidence for the family environment-emotional health relationship is that the objective presence of a pathogenic family environment may be only as important as the individual's subjective interpretation of that environment or, more simply, as the particular meaning that it has for him (e.g Frank, 1965; Hess and Handel, 1959). One child may perceive his family experience with such severity that it results in psychopathology, while to another it is only mildly disturbing and results in no lasting emotional problems. This possibility allows for the fact that there is no known one-to-one relationship between family factors and psychopathology and that similar objective conditions can exist for both disturbed and Novak and van der Veen 3 non-disturbed children. This view would, however; predict a difference in the way family conditions are perceived, depending on the degree of disturbance shown by the individual. The present study deals with this prediction for the family view of a disturbed adolescent child and a non-disturbed adolescent sibling. For control purposes, comparisons are also made with adolescent children from non-clinic families, and between the parents of the clinic and non-clinic groups. An assumption of the approach taken in the study is that a person's view of his family experience, his "cognitive scheme" of the family, consists of a coherent and potent set of perceived attributes (van der Veen, et al., 1964). This set of attributes has been termed the person's "family concept" and a test (described below) ahs been developed for its assessment. In previous studies (cf. van der Veen, 1965) measures of family adjustment, family satisfaction and the congruence of family concepts have been obtained by means of the test and have been shown to differentiate between the parents of disturbed children and parents of well-adjusted children. The present study is a preliminary investigation of the hypothesis that the degree of disturbance shown by the child is a function of his perception of the family, especially of the degree of family adjustment and satisfaction shown by his view of his family. It was predicted (1) that there is less family adjustment and satisfaction in the family concepts of disturbed children, than in their siblings or normal controls; (2) that the siblings and normal controls do not differ on these variables; (3) that the family concepts of parents of disturbed children show less adjustment and satisfaction than the concepts of Novak and van der Veen 4 parents of non-disturbed children; and (4) that there are distinctive differences in the principal content dimensions of the family concepts of each of these groups. The first two predictions test the hypothesized relationship between perceived family experience and degree of disturbance. The third replicates an hypothesis tested in previous studies: that factors in the parents' family concepts are associated with the child's degree of disturbance. The fourth prediction explores the relationship between the content of family concepts and the lurson's adjustment and family position. Method Two groups of families were tested. The clinic group had applied to an outpatient clinci for help with a problem concerning an adolescent child. The other group was selected from the community, through the ninth grade school enrollment lists. Thirteen families were selected for each group. For the clinic group, only families with at least two children 11 years of age or older were used. One of these children, the identified patient, was professionally diagnosed as emotionally disturbed, with the exclusion of psychotic or organic disorders. Families in which more than one adolescent was known to be disturbed were excluded. Problems included predominantly aggressive, acting-out ones (4 boys and 2 girls), withdrawal and immaturity (2 boys and 2 girls), nervousness and depression (1 boy and 1 girl) and school phobia (1 boy). Several of these cases also involved psychosomatic symptoms. At the time of testing 10 of the families were on a waiting list and the other 3 had had less than 3 interviews. Novak and van der Veen 5 The community families were selected from a larger sample of 25 families on whom data were already available. This group of families was obtained from children in the ninth grade whose names had been placed by a teacher in either the lowest or highest quartile of general school adjustment. They therefore represent a broad range of adjustment in a school setting. An unusually high number of the fathers in the tested group had graduate education (12 out of 25), probably due to the school's proximity to a large university. These families were dropped from the final sample in order to make the social status of the non-clinic families as similar to the clinic ones ai possible (see Table 1). The distribution of adjustment in the final non-clinc sample was nearly equal: 7 better and 6 worse adjusted. 2 Insert Table 1 about here Family characteristics of the two groups are presented in Table 1. the groups are well matched, with the exceptions of somewhat larger families in the clinic group and a higher proportion of females in the non-clinic children. Testing was done in the home on both parents and all children 11 years of age or older in the clinic group, and on both parents and the 9th grade child in the non-clinic group. This resulted in ter* data from 100 persons for the samples we used. Family descriptions were obtained on the Family Concept Q Sort (van der Veen, et al., 1964). The Family Concept Q Sort consists of 80 items that are sorted into nine piles, ranging from "least like" to "most like" the family (or the ideal family), following the usual forced-sort procedure. Examples of the Novak and van der Veen 6 items are "We are an affectionate family," "We have very good times together," "We just cannot tell each other our real feelings," "Accomplishing what we want to do seems to be difficult for us," "We resent each other's friends." As can be seen, each item concerns the entire family unit and not individual relationships within the fully. This mode of item construction reduced the complexity of describing family experience, made the test results from different family mem