Differentiation of self: A scoping review of Bowen Family Systems Theory's core construct

Latent Profiles of Fear of Cancer Recurrence in Breast Cancer Patients of Reproductive Age and Associations With Reproductive Concerns

AIM

To identify distinct profiles of fear of cancer recurrence (FCR) among breast cancer patients of reproductive age, investigate the relationship between these profiles and reproductive concerns and explore potential risk factors encompassing sociodemographic, clinical and reproductive characteristics.

DESIGN

A cross-sectional study was conducted from January 2022 to September 2022.

METHODS

A convenience sample of 210 reproductive-aged breast cancer patients completed a questionnaire that included a general information section, the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and the Reproductive Concerns After Cancer Scale (RCAC). Latent profile analysis was conducted using the scores of the 12 items from the FoP-Q-SF as explicit variables, while univariate and multiple logistic regression analyses were employed for statistical analysis.

RESULTS

Three latent variables were identified: low FCR-stable group (27.6%), moderate FCR-uneasy group (17.2%) and high FCR-intense group (55.2%). This study found that FCR was predicted by age, education level, cancer stage, chemotherapy and fertility intention. Furthermore, patients with heightened reproductive concerns exhibited a higher likelihood of belonging to the high FCR-intense group.

CONCLUSION

These findings indicate that FCR varies among breast cancer patients of reproductive age and demonstrates individual differences.

IMPLICATION

Early identification of FCR patterns in patients is crucial for medical professionals, with particular attention given to those in the high-intensity FCR group. Tailored prevention and care strategies should be implemented based on the unique characteristics and influencing factors associated with different potential categories of FCR among patients of childbearing age with breast cancer.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Losing a Family Member in Earthquake: The Mediating Role of Fear of Intimacy Between Family Cohesion and Mental Well-Being

Earthquakes are unpredictable disasters that have catastrophic consequences and caused many people to lose their family members. In this study, the relationships between family cohesion, fear of intimacy and mental well-being were examined in individuals who lost a family member after the 6 February 2023 Kahramanmaraş earthquakes. The study included 385 participants (Mean = 20.56; SD = 2.43) and structural equation modelling used. According to findings, family cohesion positively affected mental well-being and fear of intimacy negatively affected mental well-being. In addition, fear of intimacy partially mediated the relationship between family cohesion and mental well-being. These results emphasize the importance of family dynamics in post-disaster mental health. Strengthening family cohesion after traumatic events may increase both relationship skills and mental well-being. Based on a family systems approach, this study suggests that post-disaster interventions should focus on strengthening family cohesion to improve both relational and mental health outcomes for individuals.

Balancing care and well-being: A study on the quality of life of primary caregivers parents of children with central nervous system congenital anomalies

BACKGROUND

Congenital anomalies of the central nervous system (CNS) pose significant challenges for affected children and their families. Despite extensive research on children with such disorders, studies addressing the quality of life of their primary caregivers remain limited. This study aims to fill this gap by focusing on assessing the quality of life of parents who are primary caregivers of children with CNS congenital anomalies under neurosurgical care.

METHODS

This descriptive, cross-sectional study assessed the quality of life of 44 parents primary caring for children with CNS congenital anomalies under neurosurgical care at a university hospital. Data were collected via the Parent Introduction Information Form and the WHO Quality of Life Questionnaire-Short Form (WHOQOL-SF). The data were assessed via SPSS.

RESULTS

Primary caregivers parents reported the lowest quality of life scores in the social domain and the highest in the environmental domain. The child's gender significantly affects the social quality of life, whereas the type of diagnosis significantly affects the physical quality of life. Economic status affects the environmental quality of life, and low-income families face greater challenges.

CONCLUSION

Caring for children with CNS abnormalities profoundly impacts parents' quality of life. The findings highlight the need for targeted interventions, including economic and social support, to improve caregiver well-being.

Longitudinal Serial Mediation Relationship of Intolerance of Uncertainty, Irrational Happiness Beliefs and Mistake Rumination with Family Communication

The family systems approach suggests that individuals' psychological processes are shaped within the framework of family interactions. Accordingly, the current study examines the long-term effects of intolerance of uncertainty, irrational happiness beliefs and mistake rumination on family communication within the scope of a semi-longitudinal model. The study analyzed the predictive power of intolerance of uncertainty on irrational happiness beliefs and mistake rumination and whether these variables play a mediating role in family communication. The study, which was conducted in two phases at five-month intervals, included 325 adult participants aged 18-51. Longitudinal serial mediation analysis revealed that intolerance of uncertainty increases irrational happiness beliefs and mistake rumination over time, and these processes negatively affect family communication. The findings suggest that individuals' low tolerance for uncertainty may shape long-term psychological and relational dynamics through family interactions. The study emphasizes the importance of holistic interventions to support the functionality of family systems. In particular, it is suggested that short-term systemic family therapy and emotion-focused individual interventions may be effective in strengthening family communication and increasing the psychological resilience of individuals.

The Line of Emotion Dysregulation and Need Frustration from Parents to Adolescents: The Role of Parental Psychological Control

Accumulating evidence, as outlined by Self-Determination Theory (SDT), highlights the crucial role of emotion dysregulation and basic psychological needs in shaping various psychological outcomes. Parental psychological control may play a key role in understanding how these processes develop within the family context. This study aims to examine the intergenerational transmission of basic psychological needs and emotion dysregulation from parents to adolescents, focusing on the indirect association of parental psychological control within this relationship. 210 Italian families living in the same household, consisting of biological parents and one adolescent (55% female) aged between 13 and 18 years old (M = 15.71, SD = 1.76) participated in the study. The results showed that both mothers' and fathers' higher emotion dysregulation were related to their own higher levels of psychological control, while higher maternal need frustration was related to higher perceptions of parental psychological control in adolescents. In turn, higher perceptions of parental psychological control in adolescents were related to adolescents' higher need frustration and emotion dysregulation. Furthermore, higher maternal emotion dysregulation was linked to higher adolescent emotion dysregulation, and higher paternal need frustration was linked to higher adolescent need frustration. These findings are explored in the context of SDT and highlight the significance of both emotion regulation ability and needs in shaping adolescent adjustment.

Parenting Style, Differentiation of Self, and Pornography Use Among Adolescents: Exploring the Links

Parenting style and differentiation of self (DoS), understood as an ability associated with emotional regulation, are two factors that may be linked with pornography use in adolescents. The main aim was to explore the association between parenting style (specifically warmth and demandingness), DoS (specifically emotional cutoff and emotional reactivity) and pornography use in a sample of 7161 hispanic adolescents aged 12 to 17. Frequency of pornography use, parenting style (using the shortened version of the Family Education Scale), DoS (through the Spanish Differentiation of Self for Adolescence) and different sociodemographic variables were evaluated. Higher levels of parental warmth were significantly linked to less pornography use (with a larger effect size in female adolescents). Conversely, higher levels of parental demandingness were significantly associated with less pornography use in male adolescents and in younger adolescents. In relation to DoS, greater differentiation in the Emotional Reactivity dimension was associated with less pornography use. Emotional Cutoff was not associated with pornography use. Adolescents who showed more difficulty regulating their own emotions and who perceived parents as less warm and demanding reported a higher frequency of pornography use. Pornography use may be used as a maladaptive strategy for emotional regulation. The causal relationship between these variables warrants direct examination.

Reported Intergenerational Transmission of Parent Weight Talk and Links with Child Health and Wellbeing

OBJECTIVES

To examine if intergenerational transmission of parent weight talk occurs, the contextual factors prompting weight talk, and whether parent weight talk is associated with child weight, dietary intake, psychosocial outcomes, and food parenting practices.

STUDY DESIGN

Children aged 5-9 years and their families (n = 1307) from 6 racial and ethnic groups (African-American, Hispanic, Hmong, Native American, Somali/Ethiopian, White) were recruited for a longitudinal cohort study through primary care clinics in Minneapolis/St. Paul, Minnesota from 2016 through 2019. Parents filled out surveys at 2 time points, 18 months apart. Adjusted regression models examined associations of interest.

RESULTS

Intergenerational transmission of parent weight talk was observed. In addition, significant associations were found between parent engagement in weight talk and higher weight status and poorer psychosocial outcomes in children 18 months later. Parent engagement in weight talk was also associated with more restrictive food parenting practices 18 months later.

CONCLUSIONS

Parents' exposure to weight talk as children increased the likelihood of engaging in weight talk with their own children and had harmful associations over time with parent restrictive feeding practices, child weight, and psychosocial wellbeing in children. Health care providers may want to consider both modeling positive health-focused conversations and educating parents about the potential harmful and long-lasting consequences of engaging in weight talk with their children.

Examining the association of family environment and children emotional/behavioral difficulties in the relationship between parental anxiety and internet addiction in youth

Introduction

Associations between parental anxiety and adolescent internet addiction have been documented in the literature; however, few studies have analyzed the role of the family environment in this relationship. This study aims to explore the relationship between parental anxiety and adolescent internet addiction while also investigating the indirect relationships involving multiple dimensions of the family environment and child emotional behavior issues.

Methods

Surveys were conducted among 6,296 parent-child pairs. We administered SDQ, CIAS-R, and FES-CV to assess adolescents' issues and internet addiction, and evaluate family environment. Additionally, parents completed GAD-7 to assess parental anxiety levels.Results: Correlation analysis revealed that the family environment and adolescent emotional behavior issues played an indirect relationship in the link between parental anxiety and internet addiction.

Discussion

The findings emphasize the importance of addressing parental anxiety and fostering a positive family environment as effective measures to alleviate adolescent emotional behavior problems and reduce the risk of internet addiction.

Exploring the personality and relationship factors that mediate the connection between differentiation of self and phubbing

One of the family patterns crucial for mental and physical well-being is differentiation of self. In this study, our aim was to investigate its impact on the phenomenon of phubbing-where individuals prioritize smartphones over in-person interactions. The prevalence of phubbing behavior has risen substantially in tandem with the increased adoption of smartphones. The study investigated familial, interpersonal, and personal factors that could potentially contribute to the escalation of phubbing behaviors. It was hypothesized that differentiation of self would be associated with phubbing through the mediation of fear of missing out, romantic relationship satisfaction, and loneliness in intimate relationships. We also expected gender differences in the study variables. A sample of 431 young adults, with an average age of 29 (M = 29.05, SD = 9.14), completed the DSI-R, Phubbing, FoMO, ENRICH, and LIRS questionnaires online. Results indicated that fear of missing out mediated the relationship between three dimensions of differentiation of self-emotional reactivity, emotional cutoff, and fusion with others-and phubbing behavior. However, the expected mediation by romantic relationship satisfaction and loneliness in intimate relationships did not reach significance, although these variables were found to be associated with differentiation of self. Women reported higher levels of phubbing behavior, emotional reactivity, and fusion with others, whereas men reported higher levels of I-position. We conclude that fear of missing out may serve as a catalyst, triggering anxiety in individuals, which in turn drives them to adopt phubbing as a coping mechanism. Moreover, individuals with lower levels of differentiation of self appear to be at increased risk of engaging in phubbing behaviors through the mediation of fear of missing out.

Problem-Solving Skills Training for Parents of Children With Chronic Health Conditions: A Systematic Review and Meta-Analysis

IMPORTANCE

Problem-solving skills training (PSST) has a demonstrated potential to improve psychosocial well-being for parents of children with chronic health conditions (CHCs), but such evidence has not been fully systematically synthesized.

OBJECTIVE

To evaluate the associations of PSST with parental, pediatric, and family psychosocial outcomes.

DATA SOURCES

Six English-language databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Cochrane Library), 3 Chinese-language databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang), gray literature, and references were searched from inception to April 30, 2023.

STUDY SELECTION

Randomized clinical trials (RCTs) that performed PSST for parents of children with CHCs and reported at least 1 parental, pediatric, or family psychosocial outcome were included.

DATA EXTRACTION AND SYNTHESIS

Study selection, data extraction, and quality assessment were conducted independently by 2 reviewers. Data were pooled for meta-analysis using the standardized mean difference (SMD) by the inverse variance method or a random-effects model. Subgroup analyses of children- and intervention-level characteristics were conducted.

MAIN OUTCOMES AND MEASURES

The psychosocial outcomes of the parents, their children, and their families, such as problem-solving skills, negative affectivity, quality of life (QOL), and family adaptation.

RESULTS

The systematic review included 23 RCTs involving 3141 parents, and 21 of these trials were eligible for meta-analysis. There was a significant association between PSST and improvements in parental outcomes, including problem-solving skills (SMD, 0.43; 95% CI, 0.27-0.58), depression (SMD, -0.45; 95% CI, -0.66 to -0.23), distress (SMD, -0.61; 95% CI, -0.81 to -0.40), posttraumatic stress (SMD -0.39; 95% CI, -0.48 to -0.31), parenting stress (SMD, -0.62; 95% CI, -1.05 to -0.19), and QOL (SMD, 0.45; 95% CI, 0.15-0.74). For children, PSST was associated with better QOL (SMD, 0.76; 95% CI, 0.04-1.47) and fewer mental problems (SMD, -0.51; 95% CI, -0.68 to -0.34), as well as with less parent-child conflict (SMD, -0.38; 95% CI, -0.60 to -0.16). Subgroup analysis showed that PSST was more efficient for parents of children aged 10 years or younger or who were newly diagnosed with a CHC. Significant improvements in most outcomes were associated with PSST delivered online.

CONCLUSIONS AND RELEVANCE

These findings suggest that PSST for parents of children with CHCs may improve the psychosocial well-being of the parents, their children, and their families. Further high-quality RCTs with longer follow-up times and that explore physical and clinical outcomes are encouraged to generate adequate evidence.

Effects of parenting style on depressive symptoms, anxiety symptoms, and their comorbidity during the COVID-19 pandemic lockdown among 3117 Chinese junior high school students

INTRODUCTION

Depressive symptoms, anxiety symptoms, and comorbidity increased in junior high school students due to the outbreak of COVID-19. The objective of this study was to measure the impacts of parenting style on depressive symptoms, anxiety symptoms, and their comorbidity in Chinese junior high school students during the COVID-19 pandemic lockdown period.

METHODS

An online survey was conducted in June 2020 among 3117 junior high school students from Shandong Province, China. The Egna Minnen av Barndoms Uppfostran scale was used to measure parenting styles. The 9-item Patient Health Questionnaire scale and the 7-item Generalized Anxiety Disorder scale were used to measure depressive symptoms and anxiety symptoms, respectively. Multinomial logistic regression was conducted with SPSS 25.0 Version.

RESULTS

3117 junior school students enrolled in this study. The prevalence of depressive symptoms only, anxiety symptoms only, and comorbidity among junior high school students was 11.55 %, 5.29 %, and 22.97 %. Paternal over-protection was a risk factor not only for depressive symptoms only (OR = 1.075, 95 % CI = 1.020-1.134) but for anxiety symptoms only (OR = 1.090, 95 % CI = 1.016-1.170) and comorbidity (OR = 1.098, 95 % CI = 1.050-1.148). Paternal over-interference was a protective factor for depressive symptoms only (OR = 0.947, 95 % CI = 0.908-0.987) and comorbidity (OR = 0.953, 95 % CI = 0.921-0.986). However, maternal over-interference and over-protection were risk factors for depressive symptoms only (OR = 1.039, 95 % CI = 1.011-1.068).

LIMITATIONS

This was a cross-sectional study and the causal inferences could not be conducted.

CONCLUSIONS

Junior high school students with poorer family environmental factors were more likely to suffer from the comorbidity of anxiety symptoms and depressive symptoms during the COVID-19 pandemic lockdown. Decision-makers from the government, educational, and healthcare institutions should pay more attention to junior high school students at higher risk of mental disorders due to poor parenting styles. We should discuss family interventions in the future to prevent mental disorders in junior high school students.

Grief is a family affair: examining longitudinal associations between prolonged grief in parents and their adult children using four-wave cross-lagged panel models

BACKGROUND

Losing a parent or spouse in adulthood may result in prolonged grief disorder (PGD) symptoms. PGD levels in parents may affect PGD levels in their adult offspring and the other way around. However, research on transmission of PGD in parent-child dyads is lacking. Consequently, we aimed to examine temporal associations between PGD levels in parent and adult children.

METHODS

In doing so, we analyzed longitudinal self-report data on PGD levels (using the PG-13) assessed at 2, 11, 18, and 26 months after loss in 257 adult parent-child dyads from Denmark. Cross-lagged panel modeling was used for data-analyses.

RESULTS

Changes in PGD levels in parents significantly predicted PGD levels in adult children, but not vice versa. Small through moderate cross-lagged effects (β = 0.05 through 0.07) were found for PGD levels in parents predicting PGD levels in adult children at a subsequent time-point. These cross-lagged effects were found while taking into account the association between PGD levels in parents and adult children at the same time-point as well as the associations between the same construct over time and relevant covariates.

CONCLUSIONS

Pending replication of these findings in clinical samples and younger families, our findings offer tentative support for expanding our focus in research and treatment of PGD from the individual to the family level.

Growing up with a sibling with depression: A qualitative study in Israel

Depression has major consequences for the entire family, among them emotional distress, disrupted daily routine and social damage caused by negative stigmas. The aim of this study was to explore the retrospective experiences of young adults who lived with a sibling with depression while they were adolescents. The present study adopted a qualitative-phenomenological approach. The research participants were recruited via purposive sampling on social networks across Israel from May to September 2022. Semi-structured interviews were conducted with 21 participants aged 18-29 who lived with a sibling with depression during their adolescence. Data collection continued until saturation of concepts was reached. The results underwent thematic analysis. Three themes emerged from the qualitative analyses: 1) "I felt like I was living in a minefield": Adolescence while living with a sibling with depression; 2) "One step forward and two steps back": Siblings' coping strategies; 3) "My parents were not there for me when I needed them": Participants' experiences with their parents during their adolescence. The research findings indicate that adolescents who grew up with a sibling affected by depression had to cope with an acute family crisis, whose serious ramifications required emotional and social support. Mental health professionals and counselors working within educational institutions and the broader community should provide support and intervention for adolescents who have siblings struggling with depression. This intervention may take the form of individual or group therapy that aims to foster a sense of belonging and help affected individuals. Creating a supportive environment that meets the needs of the affected siblings is also crucial in addressing this issue effectively.

Exploring the Relationship Between Intolerance of Uncertainty and Trust in Physicians from Spousal and Parent-Child Perspectives

OBJECTIVE

The present study aimed to probe the intergenerational transmission of intolerance of uncertainty (IU) and trust in physicians. Besides, through the actor-partner interdependence model (APIM), the predictive effect of parents' IU on their own and their spouses' trust in physicians was examined. A mediation model was further constructed to probe the mechanisms by which parents' IU affects children's trust in physicians.

METHODS

The Intolerance of Uncertainty Scale-12 (IUS-12) and the Wake Forest Physician Trust Scale (WFPTS) were employed to conduct the questionnaire survey among 384 families (each family with a father, mother, and one child).

RESULTS

IU and trust in physicians were found to be intergenerationally transmitted. The results of the APIM analyses showed that fathers' total IUS-12 scores negatively predicted their own (β = -0.419, p < 0.01) and mothers' (β = -0.235, p < 0.01) total WFPTS scores. Mothers' total IUS-12 scores negatively predicted their own (β = -0.353, p < 0.01) and fathers' (β = -0.138, p = 0.017) total WFPTS scores. The results of mediation analyses indicated that parents' total WFPTS scores and children's total IUS-12 scores mediated the effect of parents' total IUS-12 scores on children's total WFPTS scores.

CONCLUSION

The public's IU is a crucial influencing factor of their trust in physicians. Besides, the IU between couples and between parents and children could be mutually affected. On the one hand, husbands' IU could affect their own and their wives' trust in physicians, and vice versa. On the other hand, parents' IU and trust in physicians could affect their children's IU and trust in physicians, respectively.

Starting University at the Time of COVID-19: Psychoemotional Adjustment of a Group of Italian Students

The transition from school to university typically occurs during emerging adulthood; this coming together of multiple challenging development tasks at the same time may be stressful for some students. The coronavirus disease 2019 (COVID-19) pandemic, and above all the health measures implemented to deal with it, may have been an additional factor contributing to the difficult adaptation of first-year students to academic life. This study evaluated the role played by emotional processing and differentiation of self for psychological well-being in a sample of 218 Italian students (78.4% women) who began their 1st year of college during the pandemic. The results showed that higher levels of differentiation of self, combined with fewer signs of unprocessed emotions, predicted lower psychological distress. The data support the importance of these variables as protective factors in promoting psychological well-being along with the transition to adulthood and adaptation to new life challenges. These findings draw attention to the relevance of support services aimed at university students and of emerging adults in general in considering and promoting the role of self-differentiation and the style of emotional processing for addressing well-being and mental health during the transition to adult life.