Family resources and stress: a comparison of families of children with cystic fibrosis, diabetes, and mental retardation.

Assessed patterns of stress in families of children with pediatric conditions that varied on 2 dimensions: (a) fatal vs. nonfatal outcome and (b) presence vs. absence of cognitive impairment. Families of children with cystic fibrosis (n = 23), diabetes (n = 24), and moderate mental retardation (n = 24) were compared to families of well children (n = 24) in 3 age groups. Maternal responses to a multidimensional measure of family stress, the Questionnaire on Resources and Stress--Short Form (QRS-S), indicated that families of children with chronic conditions did not differ from families of well children on scales assessing generic aspects of family stress, such as family conflict. However, diagnostic groups differed on QRS-S scales assessing stressors specific to the child's disability (e.g., families of children with mental retardation were characterized by concerns about caring for the child as an adult). There was no evidence of higher levels of stress for families of older children. Data on the internal consistency of QRS-S scales and their relation to measures of maternal and child adjustment are presented.

The role of maternal employment and depression in the psychological adjustment of chronically ill, mentally retarded, and well children.

Used path analysis to test a conceptual model of the relationship among maternal employment status, maternal depression, and reported child behavior problems. Ss were 95 mothers of children in 4 conditions: cystic fibrosis, diabetes, mental retardation, and well. Regardless of child chronic condition or family SES, mothers not employed outside the home had higher levels of depression than employed mothers. Maternal depression, in turn, was associated with higher levels of reported child behavior problems. Controlling for SES and maternal depression, mental retardation was associated with more child behavior problems, but chronic illness (cystic fibrosis and diabetes) was not associated with more behavior problems. The findings underscore the need to examine the adjustment of children with chronic disorders in the context of their mothers' well-being, particularly when mothers are the principal informants regarding child adjustment.

Facial expressions of mentally retarded and nonretarded children: I. Recognition by mentally retarded and nonretarded adults.

Mentally retarded and nonretarded adults' ability to recognize happiness, anger, sadness, and neutral affect from slides of young mentally retarded and nonretarded children was investigated. Recognizing affects in others is part of social awareness and necessary for successful social interactions. Retarded adults recognized fewer facial expressions than did nonretarded adults. Nonretarded children's expressions were identified more accurately than were those of retarded children. Happiness was recognized best. Retarded adults used the label "happy" most often, whereas nonretarded adults used the label "neutral" most often. Absence of affect (neutral) was recognized least well by retarded adults. Neutral and sad were confounded most often by nonretarded adults, whereas retarded adults confounded angry and sad most often.

Facial expressions of mentally retarded and nonretarded children: II. Recognition by nonretarded adults with varying experience with mental retardation.

The influence of experience with mental retardation on nonretarded adults' ability to recognize facial expressions of emotion by young retarded children was examined. Four emotions were studied: happiness, anger, sadness, and neutrality (absence of affect). Slides of retarded and nonretarded children were presented to three groups: adults without experience in mental retardation, parents of retarded children, and teachers of the retarded stimulus children. Inexperienced adults identified fewer expressions of retarded children than did parents who, in turn, identified fewer expressions than did teachers. Teachers recognized expressions of retarded children best, inexperienced adults recognized expressions of nonretarded children best, and parents recognized expressions equally well in both retarded and nonretarded children. Happiness was recognized best in all children by all participants.

A family development approach to studying factors in the management and control of childhood diabetes.

The study of family factors that relate to diabetes management and metabolic control is crucial because of the family's central role in this management. Four sequential phases of diabetes management are specified in this review: (1) the pre-onset stage; (2) the onset, crisis stage; (3) the accommodation stage; and (4) the stabilization stage. Each stage can be expected to influence the following stage. Thus, each is important to later management of the condition. No theory of family functioning provides a satisfactory framework for understanding the complex relationships between family development and diabetes. The Peabody Family Development Model is introduced as a more complex and systematic way of understanding the stages of management and the long-term view of the individual and family development. Individual and family are acting and reacting, and at the same time, coping with outside influences while moving from one life stage to the other. Historic factors of family and community influence one's view of the world and, consequently, the way regular routines are carried out. Individual characteristics influence individual behavior at any given point in time. The model has at its core a stress-support paradigm, and has an ecologic frame of reference. Behavior is a result of all preceding factors, and information processed is fed back into the system. The Peabody Family Development Model is a way to organize a variety of information on family functioning and to specify how it might relate to the control of diabetes in children.

Policy values in community mental health program planning.

An analysis of values underlying the CMHC program was advanced. Three scenarios were offered to describe how federal policy might be formulated: (1) stop, (2) continue as originally planned, (3) continue based on local demand. Six value questions were posed to indicate which scenario would support that value position. Scenario 3 seemed clearly supportive of four value questions.