Family's impact on health : a critical review and annotated bibliography / Thomas L. Campbell.

  • Campbell, Thomas L. (Thomas Lothrop)
Date:
1986
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Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Family's impact on health : a critical review and annotated bibliography / Thomas L. Campbell. Source: Wellcome Collection.

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    consistently show an increased mortality rate for all diseases among divorced persons that is higher than that for single, widowed, or married persons. Many of the methodological problems with these cross-sectional studies are similar to those in bereavement studies. In these studies, divorced persons who have remarried are counted as married, and since healthier divorced persons are more likely to remarry, those divorced who remain unmarried may be in poorer health because of this selection bias. In addition, it is known that poor physical health and illness have an adverse effect on marriages (Bruhn 1977; Klein et al. 1968) and can con¬ tribute to their dissolution. This complex relationship between the mari¬ tal relationship and physical health can only be untangled in prospective studies, and no such studies could be found in the literature. One addi¬ tional problem is that marital disruption, the variable of interest, often occurs chronically over years, and the actual divorce may represent an end to the marital conflict and be a positive experience. Despite these difficul¬ ties, there is a need for prospective studies on divorce and health. Family Interaction and Functioning Systems theorists and family therapists are most interested in study¬ ing the interaction of family functioning and the health of individual fam¬ ily members. The most recent studies of family variables and mental health have measured one or more aspects of family functioning. Many of these have used unstructured and impressionistic assessments of the fam¬ ilies. Others have developed elaborate assessment devices that lack standardization or tests of reliability or validity. Some of the better assessment tools consider only the marital subsystem (e.g.. Marital Adjustment Scale [Locke and Wallace 1959]) or one dimension of family life, such as parental communication (e.g.. Family Rorschach [Singer and Wynne 1965]) and expressed emotion (e.g., Camberwell Family Interview [Vaughn and Leff 1976]). Over the past decade, numerous instruments have been developed that attempt to measure the functioning of the entire family, and they are beginning to be used in studies on the family and health. Two ways of categorizing family assessment methods have recently been proposed. Olson (1985й) has described four methodological approaches for studying the family, based on the reporter's frame of ref¬ erence (insider or outsider) and the type of data collected (subjective or objective). Self-report methods use questionnaires or interviews to obtain a family member's (insider) subjective view of his or her family. This is the most frequently used approach in studying families. Behavioral self- reports depend on a family member (insider) reporting objective behaviors of himself or herself or other family members. Observer self- reports depend on an outsider's subjective assessment of the family. Finally, behavioral methods use an outsider to collect objective data about the family. While these methodology characteristics are set up as 13