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The relationship of hyperkinesis and family stress : a clinical study McKee, Kelly Edward 1981

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THE  RELATIONSHIP  OF A  H Y P E R K I N E S I S AND CLINICAL  FAMILY  STRESS:  STUDY  by  KELLY B.Ed.,  A  THESIS  EDWARD M c K E E  The U n i v e r s i t y  SUBMITTED  THE  IN  REQUIREMENTS  of  Victoria,  1976  PARTIAL  FULFILLMENT  FOR  DEGREE  MASTERS  OF  THE  OF  ARTS  in THE  FACULTY  (Department  We a c c e p t  GRADUATE  Counselling  this the  THE  of  OF  thesis  OF  August  c  Kelly,  Psychology)  as confirming  required  UNIVERSITY  STUDIES  standard  B R I T I S H COLUMBIA 1981  Edward  McKee,  1981  to  OF  3E-6  In p r e s e n t i n g  this thesis i n partial  f u l f i l m e n t o f the  requirements f o r an advanced degree a t the U n i v e r s i t y of B r i t i s h Columbia, I agree t h a t  the L i b r a r y s h a l l make  it  and study.  f r e e l y a v a i l a b l e f o r reference  I further  agree t h a t p e r m i s s i o n f o r e x t e n s i v e copying o f t h i s t h e s i s f o r s c h o l a r l y purposes may be granted by the head o f my department o r by h i s o r her r e p r e s e n t a t i v e s .  It i s  understood t h a t copying o r p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l gain  s h a l l n o t be allowed without my  permission.  Department o f  Counselling  The U n i v e r s i t y o f B r i t i s h 2075 Wesbrook P l a c e Vancouver, Canada V6T 1W5  (2/79)  Psychology  Columbia  written  i i  ABSTRACT The kinesis  purpose and  literature  family is  hyperkinetic resources.  five  and  self-concept,  was  perceive rearing would  a  hypothesized  attitudes,  depletion  number  between  of  the  were  explored.  also  examined. The  lack  strengths. connected  and  of  coping  more  managed  family  the  structured,  democratic life.  as  of  enmeshed  and  suggest  tended as  of  non-structured and  coping  examined  a  coping clinical  resources  included  adaptability  hyperkinetic  and In  questions  themselves  and  efficiency  the and  and  parent  cohesion,  as  in  highly  poor  the  child-  anxiety.  They  structured, to  these  examined.  the  would  autocratic  high  of  and  hypotheses,  SES  and  on  the  family  with  family  sex  was  hyperkinetic  of  internal  themselves  as  being  communication  child-rearing attitudes  and  as  dis-  patterns.  self-concept,  of  coping  area  average  as  Differences  extended  families  perceive  having  children  triangles,  that  having  and  effects  especially in to  more  addition  were  hyperactivity  and  lack  communication  resources,  families  possible  family  alliances  study  the  self-concept,  scores,  of  hyperkinesis  containing  to  resources.  rules,  and  hyper-  anxiety.  low  research  father  perceive  anxiety,  coping  stress  of  families  variables  parents  marital  Evidence  The  did  of  The  relationship  that  measures  coping  parent that  family  due  attitude,  families  family  results  children  Parents  and  the  having  poor  secondary  mother and  as  their  stress  studied.  and  assess the  suggests  standardized  child-rearing  themselves  a  child,  were  to  relevant  Research  observations,  perceive  having  both  was  The  experience  communication  It  study  stress.  child  families  marital  this  reviewed.  Using  interviews of  of  low  successfully  Although population, of  the  the  volunteers  their The  who  instrument  pencil  these  ized  measures.  of  more  trends  number  found  to  this  variable. data  were  this  was  for  level  found  to  of  stress  Finally,  The  specimens  parents of  in  the be a  in  contradicted  by  Areas  of  concentration  problems  and  resource the  sample  due  the  the  of  consisted  SES  family  the  and  children. did  paper The  not  and  results  nonstandard-  generalizability should  deficiency,  impact  to  limitation.  determine  of  sample  r e l i a n c e on  to  areas  the  hyperactive  be done  study.  specific  evident  limitations.  consistently  should  were  abnormal  group  assess the  the  of  be  to  communication  sub-systems.  a  parenting  research  results  determining marital  for  measures  Further the  in  used  measures  had  were  measure  from  of  study  membership  accurately  aforementioned  stress  be  on  causes  of  on  family  the  i v  TABLE  OF  CONTENTS  Page ABSTRACT  i i  LIST  OF  TABLES  LIST  OF  FIGURES  '  v i i vi i i  ACKNOWLEDGEMENTS  ix  CHAPTER I  Introduction  1  Background The  of  Problem:  Statement  Purpose  of  Terms  3  or Questions  of  the  to  be A n s w e r e d  4  the Research Questions  Delineations  A Review  2 3  Hypotheses  Importance  the Study  Problem  of  of  1  of  Definition  Rationale  II  the Study  of  of  8  the Study  10  the Study  Relevant  10  Literature  12  Stress  12  General Family  Stress Stress  Theory  12  Theory  17  Summary  28  Hyperkinesis General The Summary  29 Studies  Effect  of  H y p e r k i n e s i s on t h e F a m i l y  29 .  .  .  32 41  V  Page CHAPTER III  Methodology  42  Population  42  Measuring Clinical  Instruments Interviews  Design Data  and Observations  57  .  57  Collection  Statistical IV  43  58  Analysis  58  Results Data  59 Analysis  59  Summary V  Discussion  80  and Conclusions  Parent  Self-Concept  Child-Rearing  Attitudes  83  Resources  85  Coping  Mechanisms  86  Level  Communication  87  of Anxiety  88  Family  Adaptability  89  Family  Cohesion  90  Secondary  OF  82  Coping  Marital  LIST  82  Research  Questions  Limitations  o f the Study  Conclusions  and I m p l i c a t i o n s  REFERENCES  91 93 for Further  Research  .  95 98  vi  Page APPENDICES A  Letter  of  Initial  B.  Subject  C.  Biographical  D.  Family  Profiles  E.  Sample  Interview  F.  Description of  Consent  Contact  103  Form  Data  105  Questionnaire  107 110  Questions  or  Observations:  Content  121  Sample  123  vi i  LIST  OF  TABLES  Table  Page  1  Descriptive  2.  Mean  3  Characteristics of  and Standard  Deviation  Sel f-Concept  Seale  A Comparison  Between  Standard  t h e Sample  Scores  44  for the  Tennessee 60  Deviations  Fathers'  and M o t h e r s '  on t h e S C , T o t a l  P,  D,  Means a n d Total  V  and T/F 4  Sample  63 Scores  for the Attitude  Toward  Child-Rearing  Seal e 5  Sample  65 Scores,  Inventory 6  Means  and Standard  f o r Resources  for  Family  Management  S u b - s c a l e Sample  and Normative  Deviation  for Family  Scores  Deviations  68  Means  and  Inventory  for  Standard Resources  Management 7  Sample  Scores,  Sub-scales 8  Sample the  9  70  of  Means,  Coping-Health  Raw S c o r e s ,  Marital  Raw S c o r e s  and Standard  Means  Deviations  Inventory  and Standard  Communication and P e r c e n t i l e  for  for  Parents  Deviations  .  .  .  for  Inventory Ranks  73  for State  and  Trait  Scales 10  Sample  77 Scores  Desirability Cohesion 11  72  for the Adaptability, Sub-scales of  Evaluation  The D i s t r i b u t i o n Cohesion  of  Scale  Adaptability  Social and  Scale Scores  Sub-scales of  Evaluation  Family  Cohesion,  78 on t h e A d a p t a b i l i t y  Family  Adaptability  and  and Cohesion 79  vi i i  LIST  OF  FIGURES  Figure  -  1.  Cox's  environmental  2.  Propositions  about  3.  Distribution  of total  Child-Rearing 4.  Distribution Management  5.  6.  normative Inventory  the stress  scores  process  .  .  .  stress  of  for the Attitude  Toward 66  Family  o f mean  of  Inventory  for  Resources  the normative  sample  scores  Communication  sample  c o u p l e mean  15 21  Scale  for the Marital  Distribution  of  f a m i l i e s under  scores around  Distribution mean  concept  Page  c o u p l e mean  mean  around  69  the  normative  Inventory scores  s c o r e on t h e M a r i t a l  around  74 the  Communication 75  ix  ACKNOWLEDGEMENTS I Dr.  would  John  be  thank  insight, given  to  University, Comeau  Minnesota,  pated  express  Dr. Dr.  which  Bill John  Borgen  greatly  s c o r i n g the ATCRS,  for  Hinkle,  Cauble,  their thanks  i n the study.  Family  must Their  I  like  work  with  these  Finally, collaboration,  I  thank  to  this  Polytechnic  Science,  H.  their  the f i v e  Vancouver  Family  his  Thanks  must  t h e CHIP  and Dr.  must  Services  to  time also  State A.E.  of  and FIRM  f a m i l i e s who  health  like  a l l of  University  t h e management  family's  would  McCubbin,  the analysis of  to  for  committee,  Institute  Social  to  I  study.  Dr.  dedication  c h i l d r e n and to to  into  Du-Fay Der.  and to  be g i v e n  hyperkinetic also  Virginia  insight  t o my a d v i s o r y  as c h a i r p e r s o n ,  contributed  for  D.B.  and Dr.  Friesen,  D.E.  special  would  my a p p r e c i a t i o n  Dr.  and Dr.  A  to  Friesen,  especially and  like  data.  partici-  of  their  be  commended.  f o r a l l o w i n g me t o  parents. would without  like  to  which  thank this  my w i f e  study  for a l l  could  not  her patience  have  been  and  completed.  1  CHAPTER  I  Introduction Background The  of  the  subject  controversial the  medical  behavior. the  on  Much work  of  added  has been  brain  treatment research.  Included  as R i t i l a n ,  These attention child school  has been  may h a v e aged  Bechtoldt, 1974).  treatments  to  on h i s / h e r  1976; such  that  O'Malley, a large  research  behavior  investigating  patterns  that  the developmental of  research  medicine.  on t h e d e t e r m i n a t i o n  of  the  i n t h e p o s s i b l e causes were system  abnormalities, cannot  of  has become  stimuli  MBD,  and  y e t agree have  Among  t h e most  and behavior  family.  It  on t h e been  of  in etiology  common  attention  presented  interventions  as are  modification.  which  (Langhorne, 1973;  children  Very  l i t t l e  the hyperactive  i s estimated  and E i s e n b e r g ,  of  are being  child-centered.  the effect  number  the focus  interventions  are primarily  given  towards  and environmental  children are hyperactive  With  standable  diet,  abnormal  of  causes.  A variety  drugs  in labelling  Researchers  hyperactivity  for hyperactivity.  of  very  a n d members  the f i e l d  nervous  Diet  treatments such  portion  h a s become  educators,  i n the f i e l d  primarily  possible  of  the term  and the s p e c i f i c  abnormalities.  of  parents,  place within  hyperactivity.  recent  done  dysfunction,  based  Many  The g r e a t e s t  has taken  to the l i s t The  in  i t .  or hyperkinesis,  misused  hyperactivity.  genetically of  have  research focussed  minimal  causes  years.  hyperactivity  the subject Early  or  hyperactivity,  profession  to define  etiology  of  in recent  causes of  help  Study  that  Loney,  4% t o  and treatment  10% o f a l l  Paternite  and Woodard  affected,  (H.A.)  i t  receives  and  is  and  Brodie,  under-  such  atten-  2  tion. with  However,  the  the stress  parents  that  and s i b l i n g s  i s proportionate  of  to  the H.A.  child  the severity  of  must  cope  hyperactive  behavior. The  Problem:  Purpose  Balkwell of  of  the  and Halverson  Study (1980)  stress  present  i n families with  requiring  a great  investment  over of  the imbalance  t h e community  of  of  have  identified  a number  H.A.  children.  Management  the parents'  attention-giving  are cited  families  can cope w i t h  personal  or  internal,  as major  the stress that  time,  sibling  by t h e p a r e n t s ,  sources.  depends  are available  to  programs  jealousy,  to  (Pearlin  reaction  which  the resources,  them  sources  and t h e  The e x t e n t  upon  of  either  and  Schooler,  1978). The on  purpose  the family  stress  assist  stress  study  research  i s to them  theory  management  of  determine  resources  three  and p s y c h o l o g i c a l  Cauble,  Wilson,  and Warwick,  family  and  problem-solving  c)  social  support  system  Cobb,  and L i n ,  1976;  i . e .  services 1979).  that  i . e .  or personality  social  The f a m i l y  network  must  of  of  to  this  the and  families family  can a i d i n  educa-  1978); and c o h e s i o n ,  1978);  and  friends,  access  the  Patterson,  and Friedman,  have  sources  financial,  and Schooler,  (Burns  of  (McCubbin,  and S c h o o l e r ,  o r groups  present.  in stress  resources  resources,  (Pearlin  hyperactivity  purpose  resources, ; i . e . adaptability  resources,  community  i s  are available  1980; Pearlin  abilities  neighbours,  Another  Research  major  personal  that  of  the i d e n t i f i c a t i o n  what  health,  internal  upon  stress.  the impact  stress  children.  tional,  b)  of  H.A.  has i d e n t i f i e d a)  assess  the level  i n coping with  stress:  i s to  has f o c u s s e d  in families with  assessment to  this  by examining  Previous of  of  to  k i n , 1976;  resources  3  in  all  three  which  these  study  has  stress to  cope  social  of  they  are  can  cope  available  to  effectively. each  family  The  degree  to  participating  in  the  assessed.  Problem  the  of  an  family.  with  this  support,  comparative exists  been  presence  in  before  resources  also  Statement The  areas  The  child  and  coping has  variables  is  present  stressor.  evaluation  common  H.A.  study  Aspects has  been  been  within  thought  of  increase  assesses  the  personal  examined  performed the  to  in  in  families  and  other  level  family's  resources,  families.  to  A  determine  than  that  of  ability  internal  five  order  the  of  if  there  an  H.A.  child. Definition A stress  of  number have  of  pertinent  already  operational 1.  Terms  definitions  Hyperactivity presence motor also  been  for  of  used for  the  and  aggressive,  in  no  agreement  in  this  study.  terms  purpose high  of  have  among  be  researchers  refers  children.  of  the as  to  and  continuing,  to  impulsivity,  self-esteem  a cause  hyperactivity  given:  study,  of  in  on  Before  must  levels  low  research  this  excitability  T h e r e i s . no a t t e m p t . t o s t a t e been  used  these  abnormally  activity, be  terms  and  inattentiveness,  H.A.  children  learning  disorder the  the  as  cause  may  difficulties. there  of  has  hyper-  activity. 2.  Self-concept, or has  3.  view  of  been  in  general,  his/her  used  to  self  part  in  Stress  is  "condition  a  worth.  measure  taking  this  refers  the  to The  level  a  person's  Tennessee of  attitude, Self-Concept  self-concept  of  the  feelings, Scale parents  study. of  tension  within  an  individual  which  occurs  4  as  a response  occurs focal  when unit  Anxiety  one o r more  there  (Croog,  between  1970,  t h e demand  and the response  p.21).  It  placed  capability  of  upon  that  a  unit  1970).  i s the state  presence  stressors"  i s an imbalance  by a s t r e s s o r ,  (McGrath, 4.  to  of  some  of  tension  danger  or  uneasiness  or the a n t i c i p a t i o n  produced  of  some  by  the  danger  (Branch,  1968). 5.  Coping group that  i s the process can prevent  mediates  health  Social  present  family,  individuals  or groups  McGrath  or Questions  family  (1970) stress  stress used  sources  and Cox theory,  of  combat stress  families  cope w i t h present  be  support group  i s the  level  of  be m e a s u r e d  behavior  coping  by  the  which  is accessible  through  contact  Social  with  support  to  an  other does  Answered (1979),  in their  provided  Balkwell with  a foundation  Pearlin  studies  important  or family,  stress.  and Schooler  on s t r e s s  information  tests  (1978),  theory  and  on t h e  effects  and on t h e c o p i n g mechanisms and Halverson  H.A.  on w h i c h  children. to  build  have  the following  this  new h y p o t h e s e s  hypotheses:  that  identified  Together,  hyperactivity.  study  social  mechanism.  in families  provides  The  It  or  Scale.  i n the community.  (1978), have  families will  social  such as McCubbin  research  The  to  on an i n d i v i d u a l to  the s t r e s s o r s .  that  family,  and s t r e s s .  f o r Parents  to  or  as a coping  Researchers  are  refers  individual,  Hypotheses  of  an i n d i v i d u a l ,  anxiety  i n t h e sample Inventory  support  function  of  combat  the impact  Coping-health 6.  or  by w h i c h  o n how  5  Hypothesis  1:  Parents  of  Tennessee Studies  H.A.  children will  Self-Concept  completed  indicate  that  level  self-concept.  of  (1978)  report  personal McKee of  parents  that  resources  (Friesen  H.A.  children.  material  Hypothesis  McCubbin  self-concept required  This  and r e q u i r e s  (1960),  children with  and McKee,  et  1980)  of  H.A.  H.A.  more  Scale.  among  dimension Data  a  and of  on t h e  (1961) lower  Schooler the  c o l l e c t e d by  low self-esteem  This  among  based  on  of  that  democratic  (1979)  less  autocratic  fathers  interview  mean  found  affectionate Becker,  attitudes  to children  i s supported  Low s c o r e s  have  Peterson,  i s related  evidence  the normative  and B a r k l e y  children.  report  1980).  above  dominant,  the fathers  and McKee,  intensity  more  for their  (1961)  problems.  by d a t a  on t h e  that  and Shoemaker,  and l a c k with  c o l l e c t e d by  o n t h e ATCRS  indicate  a  attitudes.  3':  Families  with  the Family  Financial family  structure  concern  Hypothesis  on  c h i l d r e n were  and Hellmer  (Friesen  higher  have  and P e a r l i n  evaluation  score  and Cunningham  McKee  and Wylie  behavior  stress.  children will  (1975)  behavioral  mean  testing.  Campbell  parental  (1980)  indicates  Child-Rearing  Lauria,  al  i s a subjective  further  (1974),  problem  to cope with  Toward  provided  Taub  i s an i m p o r t a n t  Attitude  of  the normative  2:  Parents  mothers  below  Scale.  by B e c k e r of  score  an H.A.  child  Inventory  resources  and the community  of  will  score  Resources  and s o c i a l  the normative  f o r Management  support  are important  below  from  both  and necessary  scale.  the to  mean  extended  effective  of  6  coping child  with  stress.  lack  (Friesen  social  Research  support  and McKee,  1980)  families.  The f a m i l i e s  community,  either  The  Symbolic  social which  with  1979). in  It  sources  The  of  i s thus  of  themselves or  social  used  to  provide  McKee  for  these  from  the  pressure. data  structure,  on  a l l  of  resources.  child  will  Inventory  a family  stress  score  for  member  the normative  of  (Balkwell  research  i l l or  s u c h a member  indicates  will  affect  that  ability  any management  determine  i f  H.A.  ability  there  is  to  cope  on m e d i c a t i o n .  and H a l v e r s o n ,  and the coping  mean  Parents.  who i s  high  to  below  assesses the family's  the presence  families with  of  H.A.  Marital  Marital  of  support  by  increases the 1980;  Mattson,  the level  of  low.  coping-  program  a r e common  The which  is  variables  c h i l d r e n which w i l l  affect  stress  attempted. in  the  any  5:  Parents  sets  social  and f a m i l y  H.A.  undertaken  guilt  i s also  an  given.  Hypothesis  coping  is  important  coping-health  the  of  a family  treatment  Space  of  isolated  parental  Inventory  hyperactivity  the families  health  of  indicates that  of  have  communication,  an H.A.  Coping-health  Research  to  families with  Studies  the lack  of  management  with  the presence  number  Life  the Coping-health  The  1978).  support  seemed  that  4:  Families on  of  marital  are important  Hypothesis  (Arnold,  as a r e s u l t  Drawing  support,  indicates  children will  Communication  communication  ability parents  of of  a family H.A.  score  below  the normative  mean  on  Inventory.  i s an i m p o r t a n t  variable  (Croog,  In  children,  1970). using  which  an e a r l i e r  the Symbolic  affects study  of  D r a w i n g of. L i f e  the 12 Space  7  as  a measure,  and a is  Halverson  poor  level  a source  the marital  communication  was f o u n d  (1980)  indicate  marital  of of  Hypothesis  communication;:concerning  of  an H.A.  State  The  presence  Trait  sources  of  average  family, It  child  Anxiety  of  stress.  experience  These  without  more  will  score  Inventory  hyperkinesis  resulting  the raising of  the H.A.  above  percentile  from  child  the 50th  on  (x-1).  in a family  sources  an H . A .  i s therefore  Hypothesis  creates  a number  have  been  previously  child,  does  n o t have  hypothesized  that  described.  a s many  t h e sample  of The  sources  parents  of  will  anxiety.  7:  Families  with  adaptability Research  an H.A.  by P e t e r s o n  with  behavior  parental  concern".  critical  and d i r e c t i v e will  structure. adaptability Hypothesis  et  will  al  (1961,  p.l)  than  183 on t h e  indicates  had " a u t o c r a t i c of  (Cunningham in a less is  less  family  FACES.  problems  rigidity  score  H.A.  attitudes  c h i l d r e n were  and B a r k l e y ,  flexible,  indicated  that  rigid  by t h e l o w s c o r e s  of  and a l a c k  found  1979).  o r more  fathers  to  Such  be  parental  family on  FACES  8: with  an H.A.  cohesion  Families  with  are either  child  dimension  an H.A.  of  child  concerning  will  score  greater  than  271  on t h e  FACES. find  the H.A.  that child  most  d e c i s i o n s made  or these  outcomes  in the are  of  more  dimension.  Families family  of  The mothers  result  The  child  dimension  children  family  conflict  Balkwell  stress.  the  attitudes  that  be p o o r .  6:  Parents  stress.  also  to  8  affected  by t h e p r e s e n c e  friendships, decisions, a  result,  the  were 1.  reaction  of  of  such  t h e community  and e n t e r t a i n m e n t the family  high  score  In  addition  are a l l  testing  Family  to  t h e above  of  and  educational  by t h e H.A.  structure  dimension  relationships  the family,  influenced  has an enmeshed  on t h e c o h e s i o n to  a child.  which  child.  is indicated  As by  FACES.  hypotheses,  seven  other  questions  investigated: Are  there  any d i f f e r e n c e s  TSCS  and the  2.  Does  socioeconomic  3.  How m u c h  between  mother  and f a t h e r  scores  on t h e  ATCRS? status  interaction  affect  takes  the scores  place  between  on t h e  scales?  the families  and t h e  communi t y ? 4.  M s  there  the  evidence  sample  What  alliances  6.  Does  the family  7.  cope Rationale The is  with  How d o e s  of  research involve  stress  stress  of  i n the extended  rules  to  occur within  and myths  families  of  the H.A.  resulting  child  from  the mother  topics.  fathers'  attitudes  in determining  attitudes  affect  of  their  attempts  at  ability  to  the family's of  the secondary  and incomplete  1975;  an H.A.  child?  of  the studies  Cunningham  are just  personality  research  findings  of  on H . A .  suggests  as s i g n i f i c a n t ,  or behavior  questions  previous  and B a r k l e y ,  and s e l f - c o n c e p t  and behaviors child  cause  the presence  The m a j o r i t y  (Campbell,  on p a r e n t a l  family?  Questions:  the inconsistent  on t h e s e  that  the  fail?  f o r the investigation  Research  so,  have  the Research  need  a result  and t r i a n g l e s  the sex of  with  hyperactivity  families?  5.  coping  of  (Becker,  children  1979).  that i f  the not  more  Peterson,  9  Hellmer, et  Shoemaker  a l , 1961).  attitudes  and Quay,  1959; Becker,  The d i f f e r e n c e s  can a f f e c t  1960; Leton,  in the self-concept  the a b i l i t y  of  the family  to  1958;  Peterson  and c h i l d cope  rearing  with  hyper-  activity. Questions coping  two and t h r e e  resources.  financial  The s o c i o e c o n o m i c  resources,  stress  in the family.  stress  increases.  with  needed  also  for effective  indicates  that  extended  family.  not  important  of  or the a v a i l a b i l i t y  of  i n managing  decreases,  to which  coping  can gain  the level  the level  the family  ability.  of  interacts  Through  the social  of  support  the resources  management.  by O ' M a l l e y  the hyperactivity of  income  their  the family  the a v a i l a b i l i t y  variable  the degree  affects  with  status,  the family  stress  research  i s evidence  only  As  interaction,  Finally,  there  i s an important  Similarly,  t h e community  community  are concerned  syndrome  hyperactivity  Information  and Eisenberg  this  research  and Varga  may be h e r e d i t a r y .  in the father's  regarding  for etiology  (1973)  Often  childhood,  aspect  of  (1979)  or  i n the  hyperactivity  but for research  on  is  stress  management. This and  6 address  family. were  H.A.  examined  themselves  to  to  determine  a n d t h e SDFLS  child  family.  also  aspects  can cause  Does  It  is  i f  they  used  stress  the stress  the strengthening  relationships?  were  of  family  the interpersonal  The a l l i a n c e s a n d t r i a n g l e s  examined  FACES,  or  study  which  dynamics.  Questions  relationships  i n the  occur within  are dysfunctional.  in this  assessment.  i n any r e l a t i o n s h i p  result  o r weakening hypothesized  of  the spouse  that  the H.A.  The  families interviews,  The p r e s e n c e  that  i n the t r i a n g l i n g  the  exists  out of  5  of  an  i n the  the H.A.  child,  a l l i a n c e s , and s i b l i n g child  does  become  10  isolated by  from  Campbell  (1975)  relationship Very  Families, that  govern  of  the rules  of  clinical  The  11  hyperactive  Previous  for  studied and/or  1968).  rates  of  such  as  stress  of  doctor  families  with  were  resulting  effectively.  The  was a c c o m p l i s h e d  myths  mother-father,  i n the family.  and by  and  in  poor  Such  a  family  identification  through  the use  FACES.  H.A.  children.  a l l  The H.A.  previously  and by t h e d i s t r i c t ' s two p a r e n t s  were  children  diagnosed public  included  as  health  i n the  volunteers.  Study on h y p e r a c t i v i t y causes  (O'Malley,  the environment  success  expectations,  family  i n an attempt  involving  rules  The c h i l d r e n were  The b e h a v i o r  Studies  stressful.  relationship  have  and cohesion  families  age.  research  causes  on t h e  is  the  or siblings.  in the interviews  or neurological  those  Werry,  of  Only  the  as one t h a t  done  Research  describes  theorists,  in the family  involves  by t h e i r  of  (1979)  c a n be d y s f u n c t i o n a l ,  with  scapegoat.  Study  The p a r e n t s  Importance  organic  the  years  psychiatrist. sample.  t o cope  techniques  study  5 to  Role  adaptability  of  has been  systems  live.  and myths  Delineations  to  male-female,  n o t be a b l e  child  and the f a t h e r  according  communication,  were  child  the family  and Barkley  and H.A.  however,  how t h e y  wife-husband,  would  mother  research,  an H.A.  and becomes  and Cunningham  between  l i t t l e  between  the family,  to  drug  1973; of  hyperactivity Sandoval,  hyperactive  discover  causes  parents  of  has f o c u s s e d  whether  any change  and the drug  Lambert children  treatment  has been  in the hyperactive  (Whaley-Kahn,  on  and Y a n d e l l ,  the manipulation  a r e few i n number  treatment  primarily  1975;  clinically  of  drugs  behavior.  and are concerned with 1977)  or the c h i l d ' s  the  n  cognitive  development  (Campbell,  relationship  between  stimuli  concentrated  space  have  rather It  is  with  the the  assist  of  stress. the  successfully Research only aid  on  the  H.A.  children's  on  attempts  psychological to  continue  children. of  management  who  of  implementing  additional  development  in for  behavior  and  restructure  it  is  also  families  not  stress  dealing  investigation  have  will  a management  data of  on  do  Research  with  the  environmental the  physical  space.  the  hyperactivity  Families  to  However,  s t r e s s management  provide in  H.A.  effect  in  the  necessary  management igate  than  the  1975).  and  the  have  a  program  of  etiology  important their  for  the  an  family  research,  new m a n a g e m e n t  H.A.  strategies  for  to  time  child's child but H.A.  the  invest-  available  difficult  families with stress  to  ability  resources very  and  cope to in  behavior  will  not  will  also  children.  12  CHAPTER A In  reviewing  hyperkinesis stress main  of  I  and h y p e r k i n e s i s .  categories:  with  Stress,  and  Hyperkinesis,  the  Family.  the Relevant  the l i t e r a t u r e  and s t r e s s ,  categories,  these  Review  have  of  examined  these  General  General  Stress  Studies,  of  this  Literature  concerning  The f o l l o w i n g  each  A summary  II  the relationship  relevant  between  literature  on  both  review  i s divided  into  two  categories  containing  two  sub-  Theory  and Family  and The E f f e c t s  literature  will  of  follow  Stress  Theory;  Hyperkinesis the review  on of  categories.  Stress The  literature  categories, on  family  the  literature  stress  review  of  General The  of  decades.  Although  to  stress,  stress (1970),  theory  Selye changes a  caused  person's  always  stress this i t  h a s become review  description  One  of  Selye's  and Cox  to  of  that  major  to  popular  and  two literature  will  and i t  i n the past  primarily  understand  follow  such  three  on l i t e r a t u r e  the principles as Selye  related  of  (1974),  general McGrath  (1978). stress  i s  o r damage"  stimuli  stress  very  by r e s e a r c h e r s  by f u n c t i o n  damage,  his  theory  t h e two c a t e g o r i e s  focusses  i s helpful  states  reaction  cause  stress  into  Theory  (1968)  (1974)  of  c a n be d i v i d e d  areas.  as provided  Branch  general  A summary  two  Stress  to the topic  concerning  theory.  these  study  family  relevant  " t h e sum o f  (p.151).  in his/her  should  by s a y i n g  contributions  to  Stress  nonspecific is a result  environment.  not always that  a l l  life  It  be a v o i d e d . without  the study  of  does  stress  not  He s u m s  stress  is  is his  of  up  death. concept  13  of  G.A.S.,  nature. shows  or general  Stage  begins  Stage  t o adapt  exhaustion  through In  adaptation resulting which  from  Branch, reaction and  condition  McGrath  (1970)  environmental organism  of  are four  imbalance  to occur:  c)  activity  to  explain  alleviate,  a)  a t the time that  behavior  of  temporal  which  anticipation;  the l a t t e r  factor,  coping,  to  c a n be d e c r e a s e d  time is  the organism  stress-inducing more  to  the  as organism  homeostasis. o f an the  organism's homeostatic  a reaction a state  between  demand  of  and t h e  the  "an array  circumstances"  the An  response that  or  stress;  of  can a c t i v e l y  i f  of  indicates  and coping.  effectively  to  the two.  the overload  duration  and d)  by w h i c h  of  The author  stress;  patterns  anxiety  i s not just  can cause b)  from  exists.  stress  of  or respond  stress  factors  the  to alter  i n terms  (p.17).  returns  results  regain  attempt  environmental  organism"  stressor,  of  process  threats  but the relationship  "between  the focal  that  body  i s the stage  i s the result  stress  the  is  the reactive  describes  to  the organism  He a d d s  has occurred  capability  level  stimuli.  which  describes  or the environment  imbalance  overt  i n which also  attempts  stimuli  three  which  or anticipated  anxiety  body  passes.  The a u t h o r  that  i n which  to describe  stress  the  in  and i t s r e s i s t a n c e  Stage  the anxiety  the organism's  to environmental  secure  there  specific  period,  to a long-term  helps  (1968),  states  stress  is triphasic  this  resistance  exposed  is described.  as d i d S e l y e ,  to  of  experiencing  either  during  i f  concept  by B r a n c h  process  occur  This  During  the stress.  the body,  a person  a study  exposed  t o accommodate  stage.  which  being  The c o n c e p t  reaction.  two i s t h e s t a g e  i n which  the alarm  syndrome.  one i s t h e a l a r m  characteristics of  diminished.  to  adaptation  He g o e s covert  only  and  prevent,  (p.33). one  on  The coping  14  method at  a  is  used.  later Cox  stimuli  stage  (1978)  He  research.  of  this  to  has,  organism,  person,  In  1,  of  the  Cox's  of  will  be  a very  organism to  system,  concept  the  examined  reaction  environmental  added  responds or  much  his  however,  organism  Figure  processes  in  more  detail  review.  produce  Instead  the  coping  consolidated  theory  process.  that  The  the  of  concept  reacting  to  some  the  the  This  control  stress  the  stress  factor  to  stressor, indicates  over  process  environmental  of  significant  stressor.  has  and  the  can  previous Cox  states  that  stress  the  process.  be more  clearly  seen. The  adaptation  stress  is  (1967)  describe  controlled  and  reduce  enhance  attempting  distress,  to  psychological components:  in  the  the  perspective, 1)  the  coping  2)  cost  of  the  the  utilization  of  social  these  success.  worth,  of  networks  are  and  and  are  psychological behaviors  social  use  said  or  to  information  important  From  consist  tasks,  or  In  denial,  new m e m b e r s h i p s . is  networks,  (p.278).  patients  to  Adams  those  functions"  accomplishing  Education  responding  restore  tasks,  behavior in  medical  bodily  formation  effectiveness  and  of  the  in  Hamburg  perspective  personal  complete  and  both  medical  recovery  undergoes  behavior.  from  maintain for  a person  coping  behavior  sucessfully  education,  which  their  Included  "prospects  depression,  the  by  coping  perspectives. which  process  of  two  success;  seeking,  components  the  or  and  coping  behaviors. Lazarus of  the  such  as  effects  (1970),  cognitive anger, of  and  fear,  cognitive  in  his  study  personality and  of  factors.  depression,  processes.  coping,  They  which are  emphasizes  He are  suggests coping  responses  the that  importance emotions  behaviors,  to,  not  are  reactions  to,  ;  Envi ronment  Person or System  Success Coping Effectively Prolonged contact with s t r e s s o r w i l l lead to d i s i n t e g r a t i o n of a b i l i t y to cope e f f e c t i v e l y , thus increasing stress,  Stressor  Response Coping Mechanisms  Hyperkinesis c h i l d ' s behavior  Defence f o r s t r e s s - Behavior responses often include 1) an a n t i c i p a t i o n of the danger and the planning of a c t i o n before . the behavior occurs; 2) i l l n e s s ; 3) aggression; 4) escape; 5) depression or hopelessness; and 6) p a l l i a t i o n which includes such mechanisms as taking drugs; d e n i a l ; and r a t i o n a l i z a t i o n s or i n t e l 1 e c t u a l i s a t i on.  Figure 1.  Cox's environmental  Failure Psychological Stress Physiological Stress F a i l u r e to cope with the s t r e s s often leads to i r r i t a b i l i t y , anger, withdrawal, or i l l n e s s . This does not only occur to the person experiencing the s t r e s s but a l s o to the system to which he belongs. In a family, t h i s w i l l lead to dysfunction i n a l l systems.  concept of the stress process.  16  the  environmental  first  appraise  the  many  the  "specific  The  upon  examine  efficacy. provides  mediation  of  the  for  and  a  The  in  three  to  problems;  manner  ways;  must  that  emotional The  consequences  experienced  stress. most  using in  parenting, household  and  in  least  distribution  in  educated  the  the  controlling problematic  resources;  indicate with  effective and  society  stress  areas  occupation. of  affluent,  the  in  The  effective  made g r e a t e r  and  manageable  examined:  cope both  social  a)  responses;  or  can  work  giving  the  and  of  which  are  more  study coping of  also  people  occupation; d)  emotional  marriage  are' and  impersonal;  indicates  behaviors. the  a  the  stress  and  in  (p.2).  coping mechanisms areas  rise  keeping  bounds"  the  use  and  experience by  economics,  individual  To  condition  character;  coping  from  mechanism  of  the  coping  problematic  meaning  houshold  c)  that  in  the  within  parenting,  the  its  Lazarus,  resources,  coping  then  (p.162).  and  experience.  modifying  problems  dealing  economics  and  of  marriage,  results  effective  its  of  with  protects  as  is  comprehensive.  coping,  that  explain  It  including  situation  regression analysis,  psychological The  function or  very  necessary  the  coping  pattern"  is  of  social  the  define  perceptually  neutralizes  authors,  their  by  (1978)  must  definitions  of  response  behavior  have  "eliminating  form  a person  stressor.  researchers,  problematic  protective by  a  or  a given  dimensions  as  stressor,  each  Schooler  coping  person  to  to  previous  a  appraisals  people  lead  and  p s y c h o l o g i c a l , and must  stressful.  b)  define  to  physiological  the .context  They  effectively,  and  works  of  that  Pearl in  the  respond These  responses  behavioral of  To  situation.  appraisals  study  Building  and  the  different  observable  authors  stimuli.  effective  i . e .  an  unequal  Males,  the  behaviors.  17  In  conclusion,  between such  the  demand  a demand.  The  the  of  of  availability  individual. stress  from  crisis which  Stress  or  War  create  II,  a  affect  family's  hardship; makes by  of  one  of  the  call  for  of  to the  presented  as  having  synthesizes (p.9):  his  of  -  members;  satisfaction;  6)  opportunities  stress  another more  in  for  family; growth  article,  fully.  the  imbalance  of  to  cope  stress  the  are  with a  situation,  resources of  to  and  the  the  In  in  Hill  his  crisis  of  a  or  (p.9).  c)  family  family  3) 5)  the  to  in  his  of  of  usual  for  which  stressor the  are  governed flexibility  stress  coaster -  profile  reorgan-  successful of  family  responsibilities;  communication;  his  generic  or  family  and  environment.  develops the  the  and  recovery  of  situations  the  with  household  intra-familial  (1958)  a)  "roller -  effects  variables  adaptability  interdependence  family  block  a crisis  necessary  sharing  the  study  are  the  definition  relationship  concepts  of  as  resulting  "those  Three  the  family  as  which  described  and  stress  conceptualize  disorganization  recognition  the  are  of  success  1)  flexibility  to  a positive  crisis  ingredients  4)  combat  experiencing  ones"  family;  concepts  role  an  understanding  defined  new  The  2)  the  insecurity  variables.  Six  in  stress  reorganization:  In  He  responses  adjustment"  to  of  capacity  psychological  first  sharpened  reaction  Hill  its  definition  families  family.  of  and  of  The  also  ization.  aid  event.  reduction. of  will  and  result  follows.  the  resources  the  these  were  action  b)  social  study  was  sense  of  a  a  on  patterns  and  implemented or  the  Theory in  stress  is  organism  appraisal  both  which  (1949),  World  of  stress  an  mechanisms  concepts  literature  Hill  that  upon  individual's  These  Family  seems  placed  result the  it  concepts  features  of  of  family families,  18  Hill  developed  interacts family's closer  with  B,  the  of  variables  formation  family's  of  examination  the  the  event,  these  which  relationships,  and m i s c e l l a n e o u s six  factors  resulting  in  the  family's  six  stages  can  affect  attempts  of  to  at  disorganization;  outcome  1)  4)  attempts  Hill  (1964)  of  factors  of  levels.  the  the  2)  a  number  in  crisis,  reorganization;  5)  In  a  reaction  roles,  the  economic goals.  that  passes  of  inter-  family,  states  it  elimination  the  of  unrealized  Hill  C,  inadequate  conflicting and  crisis,  with  family's  inadequacy  the  the  crisis.  include  Finally,  to  denial; at  X,  membership,  feelings  interacts  identifies  diversity,  adjustment  adjustment:  representing  produces  These  class  stress  A,  which  Hill  the  cultural  lead  increased  and  factors,  pressures,  where  resources,  crisis-producing event.  personal  All  A.B.C.X.  definition  important to  his  the  in  through  problem;  escape;  and  6)  3)  final  reorganization. Hansen families The  under  authors  stress They  and  is  approach  seen  state  stress,  as  that  affecting  "when  one  re-equilibrium or  doing,  by a  actively  systems  seeking  realignment  disorganization.  The  behavior  is  patterns  norms,  and  structure,  family  variables,  a  all  and  to  a the by  external  homeostasis. a means  of  When  ability by  personality  including  of  a  to  roles,  those  of  concepts.  view  where  existing  in  internal  stresses,  a quiet  thi;s  quiet  takes  variables, such  as  the  state"  faces  reorganize  variables,  concept  of  family  roles  community  values,  to  regaining  redefinition  affected  and  return  to  point  sub-systems  to  H i l l ' s  dimension  transactual  theory,  family's  examine  systems  from  disturbed  is  react  in  add  stress  family of  held,  but  continue  the  (p.787),  a crisis state.  place, towards  In  they so  causing new  including motivation,  expectations,  family.  values, and  integration  19  and  adaptability,  is  also  seen  as  Hansen to  and m a r i t a l  an  important  (1965)  stress.  He  examines  proposes  family's  positional  refer  to  those  with,  or  function  enhance  the  describing  and  in,  summarizes  presenting  family  will  expectations positional sanctions  are  and  by are  perceived  these  voluntary  are  to  and  are  "support  (p.206).  more: by  or  After  types  of Hansen  of  all  members;  members; action  other  recognized  positional  supported  family  voluntary  desires  actions  the  e x p l i c i t and  in  the  interaction  expectations  two  by  expectations  "strong-strong",  accepted  of  influenced  family's  these  families  proposition:  stress and  of  of  Positional  the  support  stress.  is  individual"  degrees  sanctions  exceeded,  needs  the  Social  vulnerability  Personal  following  resist  with  vulnerability  "weak-weak"  understood  the  coping  influence  of  varying  the  adjustment.  expectations.  which  expectations  expectations the  family  systems  better  in  community.  from  and  differential  personal  families with ranging  A  that  the  expectations,  resource the  expectations  personality  by  stability  such  community  personal  intended  members  as  by  of  by  to  the  the  meet  family;  recipients,  (p.210) Thus  the  must  be  family, aware  and must In to  caused  i.e.  Croog  stress, in  normal  children,  are  to  community  support  by  being by  they  the  the  study  cope w i t h  constantly is  of  have a  if  but a  of  be  variables,  the  (1970), as  state  a of  or  social the  source  its  family of  is  Other  needs  with seen The  stress. that  coping  own  stress.  changes  retirement.  in  network  normative  developmental  marriage,  successful  and  which as  it  not  interacts.  only is  having seen  normative  place  sources  stress, resources,  family  This  take  with  of  in  the  stress  as  stress family; in  the  20  family value the of  result  stress.  study  of  In  family  the  problems  of  reaction,  adaptation  clarification, inter-relationships,  adaptation  the  the family  i t s attempts  may i n c r e a s e  is significant  impact Burr  created  of  of  to  reduce of  powers.  model.  illustrate  how e a c h  stress  Croog  states  become  f o r one of  i t s  f o r another  stress  adjustment,  research  a  that  source  members,  member.  This  had focussed  on  family.  of  Although variable  of  family  family  In doing  new v a r i a b l e s .  positional  or values.  stress  previous  in his analysis model  and  a s t r e s s o r may i t s e l f  the level  on t h e  a conceptual  number  to  in that  crisis  (1973),  regenerative a  from  literature,  vulnerability  s o , he has c r e a t e d  Figure i t  stress  to  stress  a model  affects  a theoretical  the family's  and i t s  which  2 i s an i l l u s t r a t i o n o f  i s only  has  Burr's  model,  ability  includes  i t  to  pro-  does  cope  with  stress. Dohrenwend the  relationship  that  people  stressful related  of  life  to  economic,  change  between  lower  of  distress,  be s i g n i f i c a n t . of  financial  affect  Hill  relation  both  sexual  and Hansen  resources,  the capability  of  (1979)  She  exposure  to  explored  hypothesized  "disproportionately this  exposed stress  were  to  is  applied  to  indicate  that  women,  experience  a higher  rate  of  to exposure status this  to  to  stress  and s o c i a l  study  and Burr  and the c u l t u r a l the family  families,  The r e s u l t s  class  of  of  The two hypotheses  In  The f i n d i n g s  heads  and s t r e s s .  and t h a t  status.  social  124  are  distress.  and sexual  the lower  of  status  status  (p.225),  and i n s t a b i l i t y .  theories  social  social  events"  racial  psychological  of  i n a survey  psychological  and members  to  (1973)  class  were  coincide with  (1973).  or social  cope.  and  The  the  availability  values  Without  found  such  and  norms  support,  21  Amount  Change the family  of  change  in  system  Amount  of  crisis  in  family  system  Legitimacy of conjugal power structure  Change  in  power structure  Family  vulnerability  t  A* Family's definition of the seriousness of the change  Amount o f positional influence  to  stress  t  Externalization of blame for change  Amount  of  personal influence  Level  Amount o f time changes are anticipated  Family  Family  integration  adaptability  of  Amount o f anticipation socialization  Reorganization  V  \ f Regenerative  Length of time of family system experiences disruption  Extended fami1 ism  Figure  2.  Amount o f similarity of sentiment  power  r  T  Relative  Amount  conjugal  wife's  power  Marital adjustment  of  social  activity  Amount of consultation  P r o p o s i t i o n s about f a m i l i e s under s t r e s s . (From Theory c o n s t r u c t i o n and the s o c i o l o g y New Y o r k ! John Wiley & Sons, 1973, p.216.)  of  the  family.  22  the  family  would  Hansen theory,  to  which  they  cohesion,  the  community.  were  also  stressed control  advanced  conditions:  increasing  increasing  claims  -  of  stresses that  time  of  that  stress  proposed  and/or  curement  diminishing claims  impact  It  adaptability the family  control;  of  core  diminishing  that  variables  claims of  familial  challenges  Another  variable  the length  i s positively  are valuable  of  stresses  (p.586).  and  control  diminishing  and 4)  i s proposed  and  inventory  -  they  of  additions  of  related  to  ambiguity  or  to  the  model  (1973). of  family  describes  family  stress  three  stability  family;  and 3)  event  or related  efforts"  t h e community  coping  the community,  through  (p.243).  of  and coping  and i n d i v i d u a l  and extended  stressors  theory  aspects  ships  of  of  predicaments  and Johnson's  from  importance  stresses  is anticipated  support  family  a brief  is  i n which  within  stresses  and c o n t r o l "  social  ive  of  of  familial  and communication  an a n a l y s i s  management  3)  -  -  One  Ambiguity  or expectations, of  stress  theory.  communication,  malaise  binds  family  and t h e manner  the development familial  Hansen  time  (1979)  claims,  or anticipation.  by B u r r  McCubbin  of  of  in stress  the interactions  familial  the stressful  perception,  In  affects  affecting  stress.  perception.  It  control;  reduction.  of  event.  increasing  time  i s that  stress  "1) 2)  variable  to  through  to  analysis  response  The c o n c e p t s  and c l a i m s ;  and/or  is  emphasize  thereby  in their  the core  the stressful  and  vulnerable  (1979),  find  to a family's  perceive  highly  and Johnson  attempt  variable central  remain  the direct both  Central  behavior:  anxiety;  2)  1) the  interpersonal attack  individual  coping.,  upon efforts  to McCubbin's  in effective  behavior,  the  the pro-  relationstressor  and c o l l e c t -  analysis  The c l a r i t y  is of  the  23  community  norms,  influence  the  and  the  degree  vulnerability  of  interpersonal  relationships,  together  the  support  with  groups,  propositions Reiss proposes linked  have  and  that  to  added  Oliveri the  its  responses  to  configuration,  related  to  three  work  Aldous  additional 3)  final  this."  (p.439).  that  concept The  is  that,  a  takes  Still  within  as  exploration  an  response family  to  turn,  or  response,  described with  this  the  the  affects  as  a  the  which  a  responsibility  for  the  how  to  outcomes. This  cope  Coordination dimension  the  definition  and  its  decision-making  the  degree  here-and-now.  of  of  of and the  is  event  can  in  and of  refers  to  the  the  be  from  the  solutions;  and  commitment sense  around  its  the  to of  authors  response"  coping  a (p.440).  coping. can  be  seen  family's  solidarity identity,  family's Closure  of  the  which  organization  can  be  ability  to  cope  definition  of  the  family's  influence  to  the  for  The  the  of  search  family's  family  the  are  adapted and  for  is  (1973).  which  shown  "organized  processes. or  are  above.  third  event,  model  dimensions  been  the  These  family  family's  something  the  the  of  vulnerability,  paradigm  trial  to  strength  collective  Burr's  events  influences  the  openness,  Closure  have  family,  families.  closure  second aspect while  in,  central  stated  family do  of  and  refers  can  the  three  and  aspect  by  to  the  The  of  family  response  they  dimension,  new  which  position  made  power  definition  first  by  family  c a p a c i t i e s of The  initial  family,  organization.  in  2)  influences  dimension  phases  "1)  them  participation  coordination,  definition as  and  stress.  closing  to  also  created  Configuration,  related the  family  or  stress.  to  regenerative  coping  information;  family  adaptive  Argyris:  decisions  mastery, state  central  to  important  intrinsic  and  of,  (1980)  paradigm:  of  which  the  an  adherence  the  development  influences  of  24  event, the  whether  novelty  study  social  general  word  be  of  include of  Stress  to  it  these  review  to  the  determine  if  family is  stress  marital  in  time  status  goals.  The  study  reinforces  community  norms  and  society  which  that  in  the  they  Differing  a couple  similar  goals  forward  by  mentioned  to  cope  or  Burr, in  this  results  marriage  stressor,  relationship  negative. for  the  in  creates  This  related  to  perception  of  expectations.  in  Hansen,  areas  relationships,  studied  that  in  2300  and  is  study  social  social  the  relationThe  couple's  influenced of  the  by  is is  stress  goals  to  In  marriage,  results  H i l l ,  and  stress. they  support other  must  the  authors  the  study  and m a r i t a l  lead  in  differing  behavior.  status,  his  expected  than of  stress.  subjects  a different  stress  coping  family  heterogamy  their  These  three  (1975)  important.result  or  the  normative  actual  on  examine  The  propositions  case,  status  stress  the  and  focussed  to  Pearlin  less  the  this  expectations  review.  are  on m a r i t a l and  indicate  Another  between  McCubbin,  and  has  study.  marriage",  values,  live.  with  stress  stress  the  of  perceptions,  results.  family's  however,  relationships.  at  definition  past  the  theory  of  networks,  status  of  the  stress  of  were  of  that  s p e c i f i c areas  support  His  of  or  capabilities  helpful,  status  ships  related.  adaptive  effects  and  present  evaluation  states  It  marital  inequality  to  capacities.  of  more  social  and  the  a family's  Moreover,  related  "status  order  that  reference  and  development.  importance 1.  in  responses  this  theory  studied  defined  shapes  far,  literature  the  the  responses.  Thus  to  of  is  illustrates  coping its  it  order have  theory  put  previously  25  Burke  and  relationship marital  Weir  acts  partners  and  eighty-nine  job  stress,  as and  marital  efforts,  spouses  who  their  were  s a t i s f i e d with  and  to  one's  demands stress  of  had  more  daily  necessary in  of  were  helping  provides  sense  it  and  security  Marriage  the  coping.  This  Schooler's  their  in  a  spouses  in  spouse  turn,  for  study  who  and  provides  contributes  with  the  a moderator  need  that  preventative  availability  (1978)  show  marriages  dealing as  and  These  helping  which  acts  increases  effective  Pearlin  validation of  (p.129).  A  l i f e  satisfied  those  both  hundred  on  partners.  toward  the  spouse's  least  by  by  One  results  the  their  attitudes  the  The  experienced  efforts  personal  and  experienced  (p.123).  health.  stress  helping  information  s t r e s s management.  because  for  stress  provided  was  positive  and  living"  well-being  stress  in  marital  satisfaction with  greatest  marital  function  the  physical  helping  Thus,  examined  of  between personal  support of  the  is structure  coping. 2.  or  the  self-confidence  and  further  the  "the  well-being"  pairs  and  Less  reassurance,  resources  of  also  therapeutic  wife  satisfaction,  marriages.  general.  "support,  and  that  between  resultant  and mental  with  in  their  experienced  individuals  hypothesized  a moderator  husband  helping  life  (1977)  Social  networks  stress issue  been  studied role  support  stressful  life  integration.  networks.  effective  theorists.  buffering social  for  support  of  Only in  during  detail.  social  influences events The  coping  on  has  the  life  individual  been  for  social  presented  by  support most  years,  however,  and  Lin  (1975)  studied  It  hypothesized  (p.403).  events  was  and moderates Social  responsible  support for  his  the is own  has the  impact not  systems  family  six  family. is  need  past  Dean  support"  the  The  this "stressthat of  social  behavior,  but  26  can  receive  individual A  member  that of  protective birth  Results  the  weight,  support  social  of  emotional  or family  with  which  Ensel,  to  cope  Simeone, physical  are  positively  between  social  support  may h a v e  scale  and a sample  the study  social  support  Finally, ship of  of  between  of  social  particular  support  their  and  that  symptoms"  factors  i f  fail  lives. of  social  consisted  that  "social  support  (p.115),  whereas  stressors  to  show  the  Methodological Further  population  helps  formulate  The sample  indicate  with  provides  illness.  The r e s u l t s  i . e .  medica-  compliance  and p s y c h i a t r i c  the general  the study  of  the effects  the results.  be  t h e amount  event  has  retirement.  examined  and s t r e s s .  these  was t o  the stress  The f i n d i n g s  affected  and  and i n f o r m a t i o n  or reorganize  psychiatric  related.  study  for  to  support  in crisis;  aging,  social  to  he i s a  a n d Kuo ( 1 9 7 9 )  550 C h i n e s e - A m e r i c a n s . related  support,  to define  Such  and f a c i l i t a t e Thus  of  The  the subject  samples  death,  above.  and that  (p.300).  "can reduce  (p.310).  stated  leading  from  alcoholism,  recovery  the s a t i s f a c t i o n  (p.405).  esteemed,  obligations"  support  regimens"  to  the prospects  was c o l l e c t e d  and a c c e l e r a t e  on both  negatively  is  Data  "geared  solidarity"  f o r and l o v e d ,  depression,  medical  of  is  as "information  of mutual  that  that  reinforces  support  qualities.  individual  Lin,  of  a network  an e n v i r o n m e n t  strategies  (1976)  he i s c a r e d  required  both  society  and maintenance  social  indicate  prescribed  from  by Cobb  defines  believe  tion  needs  study  author  low  support  relationship  limitations  refinement should  the relationship  is  have  of  the  been  between  of  the  support  considered  stress  and  delineated. by U n g e r  support  and Powell  and f a m i l y  significance  in that  (1980)  adaptation i t  examines  examines to  the  crisis.  who p r o v i d e s  relation-  The  study  support,  27  the is  types  of  support  utilized.  It  use  informal  and  physicians,  welfare found  or  groups, with  term  emotional  services; however,  which  and  to  cost  understand one  must  their stress  affect  the  use  the  the  determine  etc.,  in  or  term  support, There  the  such  aspects  to  the the  such i t  Kin  groups: goods  a  of  in  number  support  and  conditions,  Cultural  values  support.  coping  family  deal  with  material  of  as was  better  help  support.  system of  can  these  accessibility  support  relation  are  in  to  clergymen  group,  can  by  or  tend  stressors.  contact,  given  support  they  family,  friends  were  of  need  informal  short  groups  availability  in  the  organizations  the  maintain  information.  social  formal  for  support  positional  roles,  Normative  of of  boundary  on  normative changes  states  that  normal  family  as  the  The  crisis  as  stress changes a  a  in  source been the  (p.446)  development. Minuchin,  are The  the  boundaries  explored.  with  To  stress  their  systems  greater  by the  in  In  community, and  Boss  recent  (1980) are  family events  the  that  dysfunctional by  the  stress  years  stress  the  is  a  studied the  rules  process.  ambiguity  accompanied  family  Normative  Boundaries  govern  altered  is  research  stress.  family.  which  more  of  of  producers.  boundaries  family  majority  has  stress  issues"  these  d e s c r i b e d by in  stress.  normative  "space-bounding  change  the  are  which  event.  concept  as  of  use  instrumental  supportor  concentrated  result  b)  of  under  extended  Within  to  Peer  types  as  suited  ability  referral  examine  3. has  c)  would  best  commitments.  the  values,  are  families  such  services.  their  support;  and  they  conditions  when  support,  health  Three  the  that  than  neighbours  heterogeneity. a)  of  more  of  and  found  sources  because  long  was  mental  that  given,  occur  of  the  family.  changes  in  or  Boss in boundaries, Each roles  and  28  expectations. "membership  can  who  performs  the  absent  as  A  which  to  normative  stress  were  explored.  by  level  the  from  in  one  or  From  the  and  b)  their  of  how  stress:  1)  3)  family" all  between the  of  the  or  levels  produced,  of  must  the  and  two  Stress  more level may  have  (1980)  is  coping  examined develop-  literature, level  2)  the  interactions the  which  beliefs,  which  the  is  placed  authors is  interpersonal  persons'  be  just  the  Cognitive  intrapsychic  or  perceive  parent-child  self-esteem;  a)  system.  Sigel  previous  systematic  (p.456).  once  child-rearing.  analysis  regarding  members  Families  and  until  family  stress,  relationship,  expectations,  and  to  stress  reorganized  reorganization  marital  interaction  from  system  Normative  relationship  the  one's  the  tasks  experience  McGillicuddy-Delisi,  in  expectations;  stress  about  levels  affected  and  the  to  crisis-induced stress.  children,  three  continue  (p.449).  Johnson,  of  or  roles  bring  ment  found  as  will  c l a r i f i e d and  member"  Bell,  or  be  'stressful'  resources  family  upon  values  "composite the  family  simultaneously.  Summary Family theory and  of  stress  Hill  McCubbin.  understanding who  to  have  theory the  With of  the  integrated  theorists,  have  complex  each  many o f  created  of  the  family  resources  of  the  family,  become  the  central  developed  from  conceptual  additional  effects  behaviors  have  has  of the  the  frameworks  variable,  stress  on  concepts  the  structure  under  can  as  identified  variables  in  by  the  one  be  of  comes  in  by  Pearl in family  and  stress  Hansen,  closer These  the  which  examined.  simplified  Burr,  family.  developed  a conceptual stress  somewhat  an  theorists,  general  the The  to  stress  coping coping  Schooler theory.  (1978),  29  The nature.  majority  of  Although  theory  research,  more  theories. in  this  Empirical  is either  The source be  from  which  model.  effect the  of  to  analysis data  of  very  which  which  the family coping  to  test  the hypothesis be r e v i e w e d  will In  must  the  the authors  cited  on sample  developed  of  populations  provides  data,  case,  cope.  More  and  section  hyperkinesis  is  in the  or  will  The  i s a  of  stated of  and behaviors  hyperkinesis  must  i s that  A description  theories.  a  data  the hypotheses  provide  this  the stress  i n the next  the  or disprove  c a n be d o n e .  resources  that  of  of  in  vague.  research  on t h e f a m i l y .  theoretical  aspect  support  by many  has been  research which  the family's  will  done  the g e n e r a l i z a b i l i t y  of  c a n be u s e d  to  information  or  has been  i s an i m p o r t a n t  been  cases  empirical  support  with  supports  variable  much  field  a r e needed  have  i n most  hyperkinesis  which  which  studies  framework  One a r e a  stressor  studies  not mentioned  conceptual  collected  the  but  in this  construction  empirical  review,  methods  the research  provide  literature  stress-producing  this  review.  Hyperkinesis The  first  Hoffman  h a s become  be d i v i d e d  the  of  hyperkinesis  1975).  popular.  two m a j o r  and L i t e r a t u r e  Since  was u n d e r t a k e n  that  Literature  categories: concerning  time,  this  relevant  General  by area  to  this  studies  the effects  of  Heinrich of study  concerning  hyperkinesis  family.  General The  very  into  hyperkinesis; on  study  i n 1895 ( C a n t w e l l ,  research can  known  Studies  majority  the  description  the  syndrome.  of In  of  early  research  symptoms a study  by  on h y p e r k i n e s i s  and the determination Laufer,  Denhoff,  of  was c o n c e r n e d the etiology  and R e v e r s i c h  with of  (1957),  i t  30  was  determined  behavioral  that  hyperkinetic  symptoms  including  variability  of  poor  performance.  to  school  be  first  moods,  born  intelligence. result the  of  "distorted children  children  pressures,  children  had  and  were  The The  low  from  described  as  being  conscious  or  "unconscious  children i.e.  (p.466).  brain  Studies support  the of  by  the  authors,  children born  hypothesis also  both  the  child  of  8:1  males  the  and  to  found  use  have  et  of  cause  forceps" may  be  hypothesis. children  impulsive.  to  in  be  Using  parents  the  a  result,  being  They  were  either  organic  long  as  a  first  children  found  medications  such  a  ratio  children was  were  further  supports  hyperactive  as  study,  only  Levy's  restless,  seem  hyperkinetic  finding  nature. 225  and  normal  This  chronically  (1966),  The  and  treatments.  the  which  nature,  medication  Levy  than  of  in  possible  In  labour  in  study  both  children  (p.361)..  a  as  hyperkinetic  sample.  children or  be  and  (1957).  normal  organic In  average  a  as  showing  may  (1968),  al  females  short  tended  of  As  of  and  unhappy  inadequacy.  hyperkinetic  hyperactive  were  conform.  recommended  the  Sykes  95  children  being  mothers  syndrome  between  abnormally  the  this  of  span,  •towards"^  and  and  such  described  of  specific  explosiveness,  as  inflexible,  the  Laufer  sample  "more  the  that  found  inattentive  authors  findings  an  by  supports  also  the  difference  following  complicated  and  a  The  hostility"  Webb,  that  often  of  are  feelings  cause  using  was  and  Minde,  approximately  significant  he  for  have  The  injury,  psychotherapy  to  tense,  which  to  of  attention  children  described  (p.466).  to  that  the  school,  self-concepts  found  of  also  home a n d  number  short  found  majority were  a  i r r i t a b i l i t y ,  authors  unfavourable" also  showed  hyperactivity,  impulsiveness,  males.  The  children  the  research children,  unpredictable, amphetamines,  he  31  was  able  to  bring  children. and  Werry  condition"  (1968),  added  deviations  in h i s study  Among  the other  behavior  traits  (p.586).  concluded suggests often  that  aggravated Douglas  She  argues  hyperactive  group"  the  other  tiveness  are  effect  normal  Many that  that  though  other and  be  "inborn'  behavioral  role.  He  evidence biological,  to  two major and to  found  medication  in  disappear.  However,  disappear.  control the to  the  inatten-  in diagnosing  and f a c t o r  have  symptoms,  She c o n c l u d e s  be c a r e f u l  the behaviors  variables.  seems  t h e two  must  of  a small  attention  correlational many  should  By r e d u c i n g  totally  and parents  may be  analytic  are also  that a  studies  found  in  children.  In  a number  Cantwell Miller  suggest  never  He h a s ,  (p.596).  the deficits  seem t o  agrees  Organic  i s probably  down  sustain of  only  i s unknown  She s t a t e s  symptoms  as h y p e r a c t i v e .  cited which  plays  variable  on t h e symptoms.  educators,  "organic  handling"  the disorder  factors"  to  f o r most  and i m p u l s i v i t y  the  authors.  the l i s t .  parental  t h e symptoms  (p.259).  behavioral  researchers, child  etiological  "inability  can account  greatest  of  Medication  narrowed  impulsivity  the  Treatment  to  but there  are "poor  by e n v i r o n m e n t a l  the  i s an  hyperactivity,  by t h e p r e v i o u s  the the "etiology  (1972)  that  given  the syndrome,  causes  the major  i n 219 o f  the disorder  and aggression  of  in nature.  by s t a t i n g  that  behaviors  on d e v e l o p m e n t a l  symptoms  may be a c a u s e  causes.  these  (p.336).  noncompliance  educational  of  he c o n c l u d e d  the description of  however,  and  a reduction  As a r e s u l t ,  reversible  with  about  (1975),  (1978),  of  other  Langhorne,  results  studies, Loney,  similar  to  O'Malley  and Eisenberg  Paternite those  of  and B e c h t o l d t  the studies  (1973), (1976),  previously  and  32  mentioned  were  producing  a constellation  symptoms and  are  excitability.  etiology tions,  of  Hyperkinesis  poor  motor  environmental  play  a  role  the  syndrome  in  also  environment,  symptoms  varies.  factors, causing  vary.  either  be  defined  are  parenting  psychotherapy,  individually  in  the  aggression  genetic  diet,  mood  devia-  characteristics Treatments  have  combination  The  organic  restructuring  in  central  disabilities.  children.  and  or  five  imbalances,  and  hyperkinesis  The  disorder  self-concept,  learning  Chemical  a  hyperactivity,  low  and  Medication,  as  symptoms.  impulsiveness,  coordination  education,  treatments,  can  behavioral  Secondary  hyperkinesis  all  of  inattentiveness,  variability,  as  found.  of all  with  the  can  for  child's  been  suggested  one  or  more  hyperkinesis,  i t  is  others. After clear on  that  the  area  examining there  core  of  and  overactive, literature be  In  a  by  the  pertaining in  the  general among  of  the  presence  to  studies the  agreement,  management  aggressive,  reviewed The  or  This  treatment  caused  the  agreement  symptoms.  treatment  etiology stress  is  all  a  following  does  family  effects  of  Hyperkinesis  on  study  by  Morrison  Stewart  and  the  (1971),  studied.  Through  total  studied:  50  children  and  50  wanted  to  know  families if  there  of was  researchers  not  spread  confusion to  to  the  over  the  alleviate  who  is  chronically  excitable. on  the  the  The  family  will  Family  c h i l d r e n were were  and  hyperkinesis  hyperkinetic  families  a child  the  section.  of  100  help  inattentive,  Effect  of  The  not  of  of does  interventions.  impulsive, the  majority however,  disorder in  of  evidence  of  of  children. the  families  telephone  families  nonhyperactive any  a  the  of  interview  a  hyperactive The  disorder  authors being  inherited  33  and  whether  the  relatives  disorders results showed  there  was a  of  a group  investigated  show  that  of  of  were  was t h a t  hyperactive  group:  "eight  12% o f  authors  the hyperactive  suggest  psychiatric caused  that  disorders  studies  Cunningham children  with  environmental  their  a n d 31  females,  c o l l e c t e d through  and  standardized  became and  became  child  child  behaviors.  The  and tended during  removed  t h e more  During  this  to  (p.758).  a lack  to  emotionally  severe  of  from  They  hyperactive  "some  of  middle  that of  mothers  affection  the boy. for his  age 0 - 1 0 ,  lives  74  class.  situations,  As and  the  their  consisted of  be d i s a p p r o v i n g from  of  and  drew  age p e r i o d .  the punishment  period,  The  disorders  (1975)  examined  free-play  show  continued  or not the  the interaction of  indicate  parents  the prevalence  Campbell  predominately  results  i n the  examined.  The sample  of  control Another  Twelve  in children's day-to-day  the 0-3 years  the mothers  further  became,  observation  Whether  and Lacey  Study.  who w e r e  tests.  critical  older,  examined  the  as c h i l d r e n .  between  (1972),  of  was f o u n d  two" ( p . 1 9 1 ) .  The  children  disorders.  divorce  was n o t  hyperactivity"  Longitudinal  was  hyperactive  and Lacey  factors  from  of  in  three  and h y s t e r i a .  hyperactive  hyperactive  versa  and b e h a v i o r a l  data  were  or vice  Battle  are associated with  43 m a l e s  were  The  t o one s i x t h  is a relationship  (1979)  that  (p.190).  the three  rate  versus  mothers.  Fel's  Of  and h y p e r a c t i v i t y .  and Barkley  of  compared  common  couples group  by B a t t l e  psychiatric disorders  parents"  the parents  a greater  there  the hyperactivity  The  boys  of  A l c o h o l i s m was t h e most result  specific  alcoholism, sociopathy  the disorders  interesting  or  of  hyperactive  one t h i r d  one o r more  group.  "prevalence  adults, Data  interviews, of  H.A.  toward the  the  child  critical  The o l d e r  the  hyperactive  t h e boys  became  more  34  noncompliant. positive. or  For  While  anti-social, Campbell  learning  also  (1975)  more  more  interaction  likely  "provided  H.A.  remain  positively  to  compliant  that  the behavior  causation  studies  change  cannot  Their social  show  of  boys  i s similar  the observation  mothers  "were  interactions,  (p.217).  They  can only  about were  were  more  less  more  however,  Changes  and to  play  respond  activities,  commands a n d  be u n d e r s t o o d  are quick  "less  The a u t h o r s  i n h i s environment"  conclude  within  the  (p.224).  parent to  of  authors  likely  solitary gave  to that  mother-child  active,  the r e l a t i o n s h i p between  the parents  of  The  and d i s a p p r o v i n g .  child  The a u t h o r s ,  be a s s u m e d .  the behavior  (1979)  more  less  the H.A.  mothers  s u g g e s t i o n s , and  and as having  compliant,  of  hyperactivity.  mature  the  mothers  hyperactive  boys  behavior"  that  These  more  task.  "the s i g n i f i c a n t others  these  They  from  and suggestions  of a given  controlling, critical  of  indicate  of  boys.  consisted of  on t a s k " .  i n a number  (p.55).  offered  and Barkley  were  hyperactive,  The r e s u l t s  the completion  on-task  more  All  also  mothers  structure  mothers  and a g g r e s s i v e ,  acceptable.  between  Checklist  as l e s s  the other  the child's  were  context  mothers  by Cunningham i t  more  immature  (p.53).  Problem  r e l a t i o n s h i p was more  socially  and t h e i r  in the a c t i v i t i e s .  than  during  that  to  boys  and d i s a p p r o v i n g ,  often  i n that  observed  as s o c i a l l y  the interactions  d i d the other  encouraging  study  Campbell  and  boys  than  problems  The  the maternal  a c t i v i t i e s were  studied  p e r c e i v e d by t h e i r  conduct  seen  and t h e B e h a v i o r a l  control"  intervened also  were  the g i r l s '  the hyperactive  impulse  boys  girls,  problem-solving situations"  observations  or  H.A.  d i s a b l e d and normal  "structured  of  hyperactive  behavior  point  out  that  i n the c h i l d r e n ' s behavior can  and v i c e  versa.  There  i s ,  however,  35  a  positive  relationship  Woodard treatment family  between  and Brodie  of  (1974)  hyperkinesis.  c a u s e s many  situation  of  behaviors  associated with  For  many  frustrating  friends  experience.  needs  active  children, a wife  while  the father  child,  The  parents  and  physical  through  often  the  child's  the  negative  family  treatment The and  i n the  child  i n the  describe  who e x h i b i t s  this  often  hears  demanding  inability  to  by them  Unfortunately,  view  when  they  spanking patience,  develop  i s accused of  have  stresses  the  anti-social  dynamo  understand  relatives  and  "What  he'll  child  about  enough  .  .  .  hyper-  problems.  o r be f i r m  spend  control  family  that  and emotional  t o cope  puzzling  their  behave"  and i n f o r m a t i o n  he d o e s n ' t  or  of  comment  marital  i s a  as a s i g n  and then  not being  that  feelings  feelings  o u t more  of  experienced  and a proper  disorder.  faces  The a u t h o r s  behavi  enough  time  with  (p.734)  education  carried  this  on s l e e p ,  Often  his  be  short  the family  a hyperkinetic  a child  interpreted  i s an o l d - f a s h i o n e d  Parents,  to  Their  as p a r e n t s .  reinforce  of  of  parenting  hyperkinesis:  adjusting  hiis;dis.ibtlity i s o f t e n inadequacies  raise  and poor  the role  in the family.  who must  parents,  describe  The a d d i t i o n  changes  parents  hyperactivity  Once  the parents  c a n be a l l e v i a t e d  stresses  and g u i l t .  by t h e p a r e n t s  medical  effectively.  various  self-doubt  Even  c a n be  and p s y c h o l o g i c a l have  this  and s t r a i n s  this  stage,  resulting  diagnosis  the  of  many  treatment  however,  from  emotional  lessened  information,  and t h e c h i l d ' s at  The  can  the various  modalities. study  Brodie's  by L e v i n e ,  (1974)  Kozak  findings.  and Shaiova In  their  (1977)  study  supports  Woodward  on h y p e r a c t i v i t y  of  among  36  white  middle  class  children,  majority  of  not  deal  with  the  children  were  on m e d i c a t i o n ,  "the  l i t t l e  pressures the  of  home  created  of  the  with  their  child  taking with  produce  a  do  children,  states  they  time,  assume  parents, cribes  all  energy, do  guilty,  not  that and  the  handicapped,  they  controlling.  The  not  only  also  accept  feelings of  from  face  the  this  to  the  the  schools  without  of  scheduling,  in  as  and  much  prescription  those  home  could  the  described  Ritalin  and  time  atmosphere  with  the'idea  guilt and  and  and  and  social  in  many  cases  cope.  description  but  a double  they  of  parents  the  they  often  of  hyperactive  ability  of  the  the  to  the  child,  love  disorder,  and  They  inadequate  catch  22"  (p.193).  are  failures If  they  being  distress,  problems  way  child.  "a  as  feel  parents  believe  the  overprotective  leading,  only  special  the  as  Not  other  toward  they  is  a  and  hostile  l a b e l l e d as  result  in  parents.  fault.  misbehaviors. are  for  at  situation then  tax  and  cause  are  stress  emotional,  also  health,  know  normal,  control  parents  financial,  mental  parents' is  is  recommending  These  pose  the  disorder,  believe  the  child  cannot  disorders  often or  his  which  the  they  Often  and'embarrassment.associated  stressful  in  but  parents,  because  children.  parents  child,  the  children  Ritalin,  pressures  how  the  that  that:  present  chronic  the  the  of  The  are  The  fears  know  (1978),  Behavior  Parents  not  the  drugs.  along  parents  levels usually  by  found  neglected  teachers  the  authors  (p.162).  disorder•»  faced  Arnold  the  Often  then  criticism,  energy  p i l l "  community.  self-doubt,  the  high  often  golden  at  knowledge are  whom w o r k e d ,  the  in  many  as  The  a  or  (p.192)  result, as des-  they  believe  because child  they  is over-  cases,  of  parents'  author  If  do  to  37  individual for  the  and/or  ruination  Education (1978). about  reasons  necessary The general  for  as  in  well  psychotherapy on  as  a  cited  be  of  does  obtained  This  diagnosis  that  many  i s .  A  on  the  treatment  intervention diet,  parents  responsible  of  are  failure  statement  on in  hyperactive  the his  and  ful  is  one  the aware  hyperkinesis  stress  for  families, a  family  medical is  is  field  often  of  of the  the  be  do  given  and  diagnosis  of  can  Walker  i s ,  It management  quickly,  and  hyper-  concentrating  can  fails,  thorough  diagnosis  way,  etiology can  from  The feelings primary of may  be more  particular  a  range  Walker's  the  stated  what  result.  the  instigated.  diagnosis,  treatment  child  (1980)  understand  Treatment for  There  be  it  work  is  been  the  if  corrected.  education  The  treatment  this  helping  specific.  caffeine.  In  to  family.  From t h i s  a  in  family.  or  that  help  have  hyperkinesis.  very  can  Arnold  expectations.  mega-vitamins  was  what w i l l  will  point,  the  fault  misbeliefs  and  and  at  to  parent  i s more  not  The  parents  done.  this  be  dispell  intervention  behavior.  use  to  roles  functioning.  suggested.  for  the  or  to  according  Often  a medical  treatment  problem of  to  of  presentation must  up  management  the  part  child  discovered if  to  review  said  children,  goals,  or  hyperactive  medication,  and  functional. of  is  Psychotherapy  that  diagnosis  primarily  help  literature  of  the  answers  the  affect  in  the  parents  more  this  cause  before  can  people  the  concerning  majority  must  in  child  behaviors.  realignment  treatment  disorder the  both  become  are  The  disorder will  child's of  section  the  the  to  nature,  one  For  kinesis  the  the  system  with  the  family.  and  studies  however,  of  of  self-concept  family  deals  breakdown.  Information  improve the  family  the be  success-  child.  '.The  38  tests  and  result. been  histories The  given  parents  along  management  of  been  a  use  such  of  as  behavior. stress  in  use.  parents rated is  then  on  use  of  to  or  The  in  aid  to  Behavior  of  popular  topic  O'Leary  and  in  or  recent  as The  implemented  in  classrooms  The  indicate  in  treating  the  shared  improvement"  parents  must  secured  at  be  the  cases  of  the  of  low  parent efficient  of  drugs  such the  use  the  too  has  four  authors program.  program,  but  and  while  demanding,  the  and  childhood  become In  a  program  stage  a  very  study  by  was children.  alone  successful  can  became  changed  warmth,  the  hyperkinetic  behaviors  and  cause  period.  modification  problems,  can  children  the  of  child's  studied  hyperkinesis.  of  H.A.  effective,  during  modification  a  the  adolescent  homes  The  recommended  self-concept,  modification on  long  s t r i c t ,  home a t m o s p h e r e  to  having  has  hyperactive  the  (p.216).  beginning  and  too  responsibility,  committed  or  child,  i n more  (1977)  children's  suspicion, expectation  continued  in  Loney  The  that  by  use  and  and  characterized  "some  aid  the  this  hyperkinesis  when  have  being  behavior  disorder.  insure  with  coping with  even  and  a behavior  extreme of  in  that  in  to  literature  (1978),  results  have  parents  behavior  Pelham the  can  experts  found  self-concept  therapy  child,  however,  c h i l d r e n were  low  to  Psychotherapy  of  Whaley-Klahn  hostility.  cope  treatment  parents  described themselves  related  the Many  self-concept  in  the  to  help  disorder.  drugs,  family. of  higher  for  will  able  problem.  therapy  medication  diagnosis  better  the  problem  Ritalin  the  the  intervention.  The  relationship drug  the  primary  drugs  with  in  are  information  education,  The  made  be  less  radically  hopelessness and  submit Such  an the  to  from one  expectation warning  a commitment  its. maintenance:is  for  that may  the be  often  39  short-lived  due  Studies showed  of  children  took  general  of  Dubey  and  in  of  should  not,  review  of  in  however,  1)  effective  programs  use  positive  reinforcement  required  to  stimulant beyond these  one  direct  year  studies,  members  is  Another is  membership  groups that to  or  in  often  is  H.A. or  the  an  effective  is  used.  which Six  effective;  programs;  5)  "behavior  used  commitment, maintain which  groups.  groups. experience child's to  and  more  groups  behavior. it.  can  Palkes,  depression  of  long  were the  most and  person  is  and  In  benefits both  other  of family  reinforcement.  formal Stewart  guilt  over  They  often  do  authors  his  studies  term  of  and  The  2)  frequently  and  in  157  trained  of  be  They  punishment  commitment  has The  ;  (p.569).  level  become  .  a  6)  date"  the  severity  modification  a constant  Schaefer,  manage  4)  simultaneously;  assessed to  found,  conclusions .  the  authors  included  .  pro-  "taught  Wolraich,  a mixture  is  the  the  The  man-  hyperkinetic  authors in  the  intervention.  effective 3)  in  In  were  and  sample.  procedures  been  how  of  literature,  also  of  workshops.  The  self.  (1979)  parents  intervention  and  parents  (p.142).  systems";  not  parent  or  similar results.  token  27  hyperactivity,  are  only  be  to  in  child  modification  Teachers,  modification  intervention  their  hyperkinesis  the  can  parental  self-help  parents  manage  have  required  programs  such  medication  are  majority  found  "behavior  programs  the  Wolraich  study,  management"  the  and  behavior  first  Parents  be  of  clinical  modification  subjects,  reached:  the  toward  (1978)  use  reduction  behavior  behavior  3,079  In  six  a  behavior  that  the  behavior  post-testing,  feelings  Kaufman  in  Becker's  skills  conclude  original  results  part  on  problem  with  the  hyperkinesis.  based  after  by  positive  agement  gram,  to  have  implemented counselling (1974)  their  not  know  created  state  inability what a  40  program in  which  improving  which  kinetic  own  self-esteem.  of  hyperkinetic  of  a  addresses  living It  and  to  comes  this  a  should  be  subject  time  by  produced  management  of  the  may  child  spouses.  informal  spouse. of  Dealing  The  attention  embarrassment  The  is  or  also  rewards  caused  upon the  networks;  resentment  siblings  by  the  inability  result  support  and  over  rely'totally  The  cause  or  the  such  effects  oh  of  the  in  family  changes Balkwell  hyper-  and  the  challenge  the  parents  amount to  major  to  and  disorder. life.  Halverson other siblings  behaviors  (p.552) over of  the  time  spent  willing  babysitters  to  for  the  towards stress. behavior, all  may  care  lead  the  parents  friends,  or  child  The  unequal  to  may  hyper-  from  the  and  a .  functioning  quality  relatives,  positive  of the  parents  of  in  of  the  obtain  child's  members  family,  and  a  children,  the  themselves  hostility  of  modifications  all  family's  between  experience  for  its  management  by  from  isolation  i . e .  support  of  management  conflicts within conflicts  and  hyperactive  energy in  the  (p.550):  with  and  modifications  be  child.  child"  for  necessitate  and  active  "consequences  supply  and  families  many  forth  will  requires  to  the  article  puts  children  lack.  creates  The  and  in  behaviors  stresses  parents  role  their  also  hyperkinesis  effective  generate  cause  often  that  Such  as  of  groups  apparent  may  This  the  family.  together  Such  child  stress.  lifestyle.  necessity,  Stress  management  on  family's  hyperactive  hyperactive  and  literature  the  examine  with  family's  the  children  hyperkinetic  changes  researchers  the  in  d e s c r i b e d many c h a r a c t e r i s t i c s o f  children,  these  (1980)  of  their  has  presence  With  parents  conclusion,  family  The  aid  parents In  the  will  formal  community.  or  the  other  division  social stress  for  these  41  children.  The community  Complaints  concerning  management,  such  embarrassment community,  can also  the H.A.  child's  as d i s c i p l i n e  to  the family.  losing  be a s o u r c e  stress  behavior,  for  differing  o r the use o f m e d i c a t i o n , The f a m i l y ,  the support  of  necessary  in turn,  the  opinions  on  can cause  withdraws  for effective  family.  from  the  coping.  Summary The  presence  disruption from  of  which  the  the family  of  social  From study  of  this  the  order  aimed of  to  family's  stated  stress  review  emphasis  i n Chapter at  their  defining  I  determining coping  to  cope  of  resources  stress  upon  i t  affect  are based  on t h e l i t e r a t u r e  resources.  the symptomatology  (Burr,  be u n d e r t a k e n .  cope  The d a t a  with  and e t i o l o g y  of  that  of  in this  will  the  also  of  by  further  be d o n e , the  with  family.  a survey  of  hypotheses review  hyperkinesis  gathered  coping  1973).  must  The  to  family's  the family,  must  can  The degree  the  strategies  resources  how f a m i l i e s  behaviors,  by t h e i r  i s apparent  of  resulting  as d e s c r i b e d  and h y p e r k i n e s i s  efficiency  the  by t h e a v a i l a b i l i t y  powers.  the coping  the coping  those  by t h e f a m i l y .  resources  the l i t e r a t u r e , of  of  i s determined  These  can cause  The changes  i s determined  and r e g e n e r a t i v e  placed  determine coping  experienced  functional  (1978).  the relationship  particular In  to  in a family  environment.  and p s y c h o l o g i c a l  Pearl i n and S c h o o l e r vulnerability  stress  ability  child  and t h e management  can remain  Their  necessary  family  behaviors,  the levels  efficiency.  a hyperkinetic  the normative  the child's  increase  of  and are  and t h e aid in  disorder.  extent  further  42  CHAPTER  III  Methodology The  methoclblogical c o n s i d e r a t i o n s  of  this  study  will  now  be  described. Population Subjects Vancouver  Family  previously conducted  and  by  to  Services.  Family and the  H.A.  sample  doctor  Department families, marriage parents  All  Services.  volunteers,  of  a parent  a consent  the  group Each  form  population  mean  These and  in  was  through  presently  parents  family  data  contacted  parents for  which  of  of  received completed  collection.  was  in  11.5  ranged  of age  mean  7.8  years.  education. mother  fathers  had  had  of  The  a  B.C.  years  with  29  to  from  a  belong  H.A. a by  or  children,  letter  of  each  (See  parent  Appendices  range  H.A.  The  3 per  completed  completed  at  a  with  7.5  7  A  year  of  or  more  diagnosed  by  the  Public  were  of  length  of  The  age  34 y e a r s .  with  a mean  with  a  from  Health  two-parent  years.  completed of  one  the  mean  16  a mean  post-secondary one  to  ranged  mean y e a r s  least  The  years  have  from  families  family,  children  children  parents'  the  of  having  previously  marriage.  c h i l d r e n was the  5 families  been  of  39 y e a r s  2 to  of  psychiatrist  All  initial  the  The  by  have  their  from  years. of  observed  ranged  age  consisted  children  Richmond,  each  children  The  One  to  were  commencement  children.  family  of  study  B) The  of  this  belonged  introduction previous  for  of  range 5 to  an  11  The  2.2  of  3 to  of  education  was  degree  nursing,  in  university.  12.5  the number  children.  years  average  of  11 with  3.7  a  years  years. while  two  43  One least All  mother  25% p a r t - t i m e .  of  five  the fathers  families The  one  total  girl.  given  were  sample  One o f  population  of  Child  of  year.  five  H.A.  Resources  i n Table  Scale  (Croake  full-time  The average  at  homemakers.  income  consisted of  c h a r a c t e r i s t i c s of 1.  Individual  Cauble,  the  family  for  the Marital  1978);  the Symbolic  Drawing  1977);  t h e Genogram  (Hartman,  (Spielberger,  Gorsuch  Evaluation  Biographical  Data  their  be g i v e n Tennessee  Scales  four  for  the  boys  and  sample  profiles  concept  five  response  of  Family 1979);  1976);  are  A  Inventory  Space  reliability  1979);  and  Anxiety  the Family  Nevin,  (Bienvenu,  (Geddes  Medway, Inventory  Adaptability  and P o r t n e r ,  brief  Inventory  McCubbin,  the State-Trait  Bell  Toward  and H a r k i n s ,  (McCubbin,  Life  the  the Family  Comeau,  1970);  (Olson,  collection:  the Attitudes  Communications  Questionnaire.  validity,  1965);  Parents  and L u s h e r e ,  1978);  description of  and a  the  and a p p r o p r i a t e n e s s  and  to  measures, the  study  below. Self  Concept  TSCS i s a 100 i t e m  self  (Fitts,  i t s data  (McCubbin,  Inventory  1979);  in  and H i n k l e ,  f o r Management  and  The  employed  adopted.  u s e 10 m e a s u r e s  Scale  Coping-Health  will  were  D.  Concept  the  including  were  children,  the descriptive  will  Self  Rearing  Cohesion  mothers  full-time.  per  was  Two m o t h e r s  Instruments study  Tennessee  employed  c a n be f o u n d  Measuring  full-time.  remaining  the boys  i n Appendix  The  The  i s $32,500  A summary  of  was e m p l o y e d  and s e l f options,  Scale test  criticism. ranging  (TSCS) which measures The r e s p o n d e n t  from  "completely  a person's is  to  true"  level  choose to  one  of of  "completely  44  Table Descriptive  C h a r a c t e r i s t i c s of  Characteristic Numbers  in  1 the  Sample  Number  Sample  Mothers Fathers Boys Girls (H.A. children)  5 5 7 4  Parents  29 - 39 34 3 - 15 8  -  Children Mean  Family  for  Size  Range Mean - Range Mean H.A. children  (No.  of  (4) (1)  7.8  children)  Range Mean  2 - 3 2.2  Education Parents  -  Children  -  Marital  Range Mean Range Mean  9 - 16 12.5 1 - 9 3.7  Status  (Years Range  of  marriage) 7 - 1 6  Mean  Socioeconomic Mean  11.5  Status $32,500  Adopted  Parents  2  Natural  Parents  8  45  false". and  There  a r e two s c o r i n g  the Clinical  dimensional scale, Self  and Research  facet  Self;  Total  Postive  Distribution Scores  A number Score  Score  measure  response  responses.  indicates The  items  literature  survey  nonpatients seven  upon  (Buros,  response  show  features  The  self  items  items  perfectly  of  are also of  were  agree,  Self;  The  the variety  items  then  of  were  The  Variability  of  group  from  1972). a  patients  examined  vs.  Score  (Buros,  of  and  by a team  the defined  chosen  of  positive  Signs  derived  f i t with  of  The  i s a measure  Deviant  the  derived.  styles.  A  Behavior;  self-esteem.  descriptions  which  for  Personal  on a l l s c o r e s  a pool  written  Self;  the variance  t h e Number o f  from  the items Identity;  Ratio  indicates  Scores  and those  a l l could  measure  persons,  ethnic  Scale  use the l a t t e r .  for the  of  constructs, scale  1972).  The  is standardized  aged  12  with  t h e norms  to 68, representing  and socioeconomic  groups,  and w i t h  a broad  based  on a sample  range  an e q u a l  of  number  of  intellectual, of  both  sexes  1972).  Reliability  and  Test-retest .92  1974).  level  The T r u e - F a l s e  deviant  and from  (Wylie,  which  extremity  of  Form,  i s c a l c u l a t e d f o r each  scores  the overall  selected  psychologists  (Buros,  626  were  of  Physical  major  Fainally,  t h e number  Self;  other  Conflict  will  the self:  of  measures  Net  of  A subscore  reflects  study  the Counselling  in the writing  Self.  The E m p i r i c a l  discrimination.  available,  This  aspects  consistency.  style.  negative  of  Moral-Ethical  and Social  aspects.  Form.  was used  a number  Satisfaction;  these  and  design  involving  Family  systems  Validity reliabilities  on t h e v a r i o u s  sub-scales:  over Self  a 2 week  period  Criticism,  .75;  range Self  from  .75  Concept,  to .92;  46  Total  Self  Regard,  correlates Taylor's The  occur lap  with  Anxiety  Cornell  ranging  a  highly  between  reliable  1979;  Wylie,  measures  correlates  of  -.70  Index  and t h e  .70.  Correlations  .50 to  various  (Burns, other  Scale  Medical  from  with  .92  MMPI  t h e TSCS  scales  and v a l i d  measure  of  in the  Positive  Feelings  show  There  scales  to  is  Score.  correlations  . 5 0 ' s and . 6 0 ' s  1972).  known  self  of  measure  functioning:  the Total  Inventory  well  The  personality  with  (Buros,  and other  1974).  frequently  sufficient  conclude  that  overi t  is  concept.  Criticisms Wylie aspects  (1974)  of  i n her c r i t i q u e  the scale  reliability constructs  and v a l i d i t y . which  reliability  guided  checks,  validity  and  neuropsychiatry  of  high  level  scale. scale  Even and  of  of  Fitts  (1972),  a group  of  the items  out that  to  groups,  regard  scores  criticizes  structure  small  delinquents are given  for  the  questioned.  of  manual  for  t h e s c a l e and f o r  aspects  sample  of  sizes  the data  and Bentler  though  i t  cumbersome.  (Buros,  i s organized  1972)  criticize  on t h e  and p r e d i c t s  and s y s t e m a t i c ,  i t  the scoring c a n become  the  the  high  changes.  Serrin  the  students.  the scales,  the instruction  regarding  using  i s  of  the  In d o i n g  including  validity  of  60 c o l l e g e  No r e l i a b i l i t y e s t i m a t e s  of  the  definitions  consisting of  on o t h e r  on t h e i n t e r n a l  studies  c r i t i c i z e d a number  s e l e c t i o n are not given.  overinterpretation cites  the source  the construct  the self  i n Buros  information  score  used  patients.  In examing  validity  Bentler, lack  the item  r e s e a r c h was done  groups.  construct  from  the TSCS,  She has p o i n t e d  Fitts  The  these  ranging  of  system.  tedious  47  Appropriateness The and  scale  reliable  adults;  c)  rapidly;  i s appropriate  indicator  takes  and e)  The  The  forty  from  tions  items  were  items  and  democratic  were  options  constructed attitudes  validity  reliability  for  test-retest  measure  scale  which  to which  with  measures  coefficients  d)  c a n be  valid  with scored  normative  a parent to  data.  must  "strongly  86 statements were  selected  for  the intensity  respond disagree".  derived  submitted  the population.  to 500  Those  observa-  use i n the of  measure.  authoritarian  parents.  t h e same  obtaining a.Pearson  Towards  Freedom  producing  .54 to  (Fox,  by H i n k l e r  the  construct,  from  t h e ATCRS was d e t e r m i n e d  format,  of  the Attitudes  ranging  is a  c a n be u s e d  "agree"  items  were  a)  (ATCRS)  a pool  by t h e  i t :  providing  Scale  to measure  held  b)  be c o m p l e t e d ;  a cross-section of variable  in that  concept;  The o r i g i n a l  t h e most  Scale,  study  labelled  s e l e c t e d from  ATCRS was c o r r e l a t e d  Children  current  a  were  to  Child-Rearing  literature.  The  The  20 minutes  five  representing which  self  is a Likert-type  one of  Adlerian  people  of  Toward  measure  checking  to  global  this  i s a standardized  Attitudes  by  10  of  for  of  .86 et  con-  1979).  al  (1980),  of  the  The using  0.9084.  Appropriateness The reasons  ATCRS as  understand. provides  i s appropriate  the TSCS. The s c a l e  reliable  Family  It is  of  FIRM was d e v e l o p e d by  McCubbin  et  al  takes  at  scores  Resources as p a r t  this  a short  computer  and v a l i d  Inventory  for  of  the University  study time  scored. of fOr  f o r many to  complete,  It  is also  parent  the Family of  and i s easy  standardized  child-rearing  Management  to and  attitudes.  (FIRM)  Health  Minnesota.  same  Program  The  scale  developed records  the  48  availability  of  resources  the family.  the  of  parents  p s y c h o l o g i c a l , community,  respond  "Minimally";  or  s c o r e were  Correlation the  RS,  FIRM  score  coefficients achieved  coefficients  FWB,  FS  Well".  the use o f  of  .85,  Arnold,  options: is  .85,  respectively,  hand  Croake,  and K e l l e r ,  which  at a l l " ;  scored. the  total  Alphas.  . 6 2 were  and of  to  "Not  Cronbach's  . 8 5 , and  social  scale  the s u b s c a l e s and f o r  through  a n d SS s c a l e s  (Hinkle,  four  The measure  for  and  is a Likert-type  by s e l e c t i n g o n e o f  "Extremely  Reliability FIRM  The measure  financial,  achieved  .89 f o r  the  for  total  1980).  Appropriateness FIRM  i s appropriate  resources  available  the  analysis  of  can  be c o m p l e t e d  to  their  for this  study  the family coping  rapidly;  and p r o v i d e s  ability;  c)  it  in that:  b)  i t  a)  the  i t  information  i s simple  is standardized;  assesses  the  needed  in structure  a n d d)  i t  is  in  and  computer  scored. Coping-Health CHIP  Inventory  i s a 45 i t e m  family  finds  member  i s i l l o r when  read  helpful  the l i s t  of  for  Parents  Likert-type  or  "coping  care  "extremely  helpful"  The  instrument  was d e v e l o p e d  a prior  coping  (McCubbin, The  three  support,  study  McCubbin, patterns  to  include:  1)  "not  and t o  and d e f i n i t i o n  of  measures  family  life  Parents  choose  from  what  when  the  a  are asked  four  to  options  helpful".  using  three  coping  patterns  "the home-illness  Cauble,  Wilson  Support  -  and p s y c h o l o g i c a l w e l l - b e i n g ;  integration  scale  is required.  dealing with  Patterson,  The  i n managing  behaviors"  labelled  in  scale.  not helpful  medical  (CHIP)  stressor;  2)  situation"  and Warwick,  the maintenance Family  and 3)  -  family  Medical  identified  -  1981,  of  p.8).  social  organization, communication  49  and  consultation  the  situation. The  These  with  original  items  method"  medical  scale,  were  et  the final  factors  then  were  rotating  subjected  of  Through Environment  .79  and  correlations Scale,  to  FES,  .71  with  was r e d u c e d  factoring  By a p p l y i n g  determined.  the Varimax  Finally,  .79,  t h e SPSS  were  i n an u n d e r s t a n d i n g  80 items  p.12).  factors  the factors.  correlations  using  a l , 1981,  eigenvalues,  resulting  consisting of  "analyzed  (McCubbin  staff  interactions  a scree  test  to  the  c r i t e r i o n which  consisted  were  achieved. health of  items.  resulting  Cronbach's  the v a l i d i t y  45  The t h r e e  using  child  with  to  of  Alphas,  changes  CHIP was  of  reliability  and the  Family  shown.  Appropri ateness The  CHIP  a)  provides  be  quickly  data  pertaining  completed;  i s a two f o r m  MCI  communication.  7.  consists  The s p o u s e s to  "never"  from  to  three  zero  favourable  The with  with scale  to  for  the family's  Inventory measure  of  are asked f o r each  of  to  response.  The  the higher  score  total  items  data.  i s computer  i t :  b) c a n  scored.  the level  for males,  one o f  being  4 options, are  level  of  scored  associated with  successful  F,  labelled  f o r t h e s c a l e may r a n g e  i n d i c a t i n g more  of  and Form  a readability  The o p t i o n s  c a n be s c o r e d by t h e a d m i n i s t r a t o r  the normative  in that  mechanisms;  assess  with  items.  score  score  to  Form M,  select  the  the higher  and c)  created  46 i d e n t i c a l  coping  study  (MCI)  The two f o r m s ,  with  the present  is standardized;  The  "usually"  144,  c)  Communications  females,  Grade  i s appropriate  Marital  marital for  scale  a from  0  to  communication.  as a s c o r i n g  key i s  provided  50  Validity  and  The of  present  48 items  inventory  46 i t e m s  after  a study  instruments a number  The  data  selected  of  following  pilot  were  square  test,  between  group"  (Bienvenu,  the upper  1978,  p.5)  a discrimination of Murstein  (Buros,  validity  are actually  indicate  that  they  .01  studies of  and lower  points  In  to  quartiles  An  with  that  confidence,  out that  correlate  order  indicate  the upper  for reliability.  would  The  earlier  the literature  the remaining  20% between  1972)  of  consisting  and  refine  the  undertaken.  level  while  scale  was c o m p l e t e d .  a review  collected in the pilot the  an e a r l i e r  communication.  studies  at  from  344 s u b j e c t s  on m a r i t a l  questions"discriminate  show  were of  was c o n s t r u c t e d  existing measure  Reliability  of  using the  2/3 of  Bienvenu's  marital  46  the c h i -  experimental  t h e 96  and lower  inspection  45 o f  questions  quartiles.  claims of  of  the items  does  adjustment.  Appropriateness The rapidly, The  MCI  thereby  measure  success assessed  i s standardized  also  making  the final  provides  in marital  and easy  scores  an o b j e c t i v e  communication.  i n the study  to  the family's  of  the Family  readily  measure  This  of  complete.  It  c a n be  available  of  the couple's  i s one v a r i a b l e  ability  to  for  cope  which  with  the  scored analysis. level must  of  be  stressor,  hyperkinesis. Symbolic The "provide (Geddes  Drawing  SDFLS  i s a non-standardized  information and Medway,  assessment Intervention  Life  technique model".  regarding 1977,  Space  assessment  the structural  p.222).  It  (SDFLS) device  configuration  was developed  for his "Short-term  which can of  by M o s t w i n  Multidimensional  a  family"  as an  Family  51  Through the  quality  and  family  or  of  structure;  In three  of  provide  ships  a)  with this  the SDFLS,  data,  used  and  the other  family's between .1.  to  indicate  life.  Place  closeness 2.  Place  Place and  4.  section  of  items  the diagram.  to  symbols  community  part  of your  Draw  lines  the  good average  family  clubs, show  on  relation-  Various  for  and c)  entertainment.  these  members  and a l l o w  space.  of  symbols  the to  family,  the  consultation  follows: each  family  Use space  ring  friends  member to  with  within  indicate  the  each  other.  indicate  any  who y o u f e e l  are  to  family.  i n the t h i r d activities family's  that  to  relationship  or  life  and s i b l i n g s ;  may be i m p o r t a n t  i n the second  extended  between  communication  of your  family's their  a set space.  a r e as  enmeshment  and f r i e n d s h i p s ;  place(s),  that  congruence,  information  father  communication,  representing  circle(s)  provide  be a s k e d of  of  regarding  and  the  aspects  family  are minimal  or strength  of your  important 3.  circle  a small  member  of  The d i r e c t i o n s  a small  inner  will  the confines  The d i r e c t i o n s  regarding  must  i . e . work  or  triangles,  i . e . mother,  i . e . extended  the q u a l i t y  the parents.  the  family;  places,  or  and s p a t i a l  the parents  people,  data  the family  the community,  symbolically within  are  provide  c a n be a c q u i r e d  intra-familial  a l l i a n c e s , dyads  communicative  nuclear  information  communication,  can a l s o  relationships;  interaction To  both  levels:  i . e .  It  completing  kinship  the SDFLS,  interpersonal  estrangement.  perception  b)  the use o f  circle  that  represent  or r e s p o n s i b i l i t i e s that  work,  you feel  life.  the symbols exists: '  to  indicate  school,  the level  of  are  52  Appropriateness The quality extent  SDFLS of  to  is  interpersonal which  the  family,  either  spatial  aspects,  important, factors  are  The  appropriate  at  kinship  especially with  procedures  Evaluating  has  concerning  closely  the  data  this  study  communication,  family  the  for  the  developed level  the  or  to  at  to  the  are  not  complicated  can  also  be  family  the  completed  outside  the  the  the  parents  The  is  of  the  nuclear  level.  All  of  the  and  members,  child.  ability  for  assesses  structure,  family  H.A.  coping  it  community  of  the  related  that  resources  closeness  regards  in  also  these  family. to  follow.  rapidly.  Genogram The  Genogram,  also  a  relationships,  major  migrations  dispersal,  information p.51-52). dynamics  and  about This  of  family  and  instructions  for  1.  Basic  A  of  the  separations generations.  and  study  losses,  role  communication  "genealogical  assignments,  patterns"  provides  family  data  (Hartman,  pertaining  drawing  complete  family and  a genogram genogram  members;  are  should  dates  of  divorces;  and  it  Occupations  and  health  as  include  birth  should  and  cover  histories  the  Basic  to  at  least  should  Symbols: -  male,  with  -  female,  birth  with  birth  names  death,  Symbols: a)  1979, the  follows:  noted. 2.  and  family.  The  data:  records  occupations,  identification,  alignment  current  drawing,  events,  intergenerational  the  ages  symbolic  date date  and  marriages, 3 also  be  53  O-HD  dead  male,  twin  girls  with  miscarriage  or  dates  abortion  m a r r i a g e , w i t h d a t e s ; husband a t l e f t s i d e , w i f e on r i g h t  father, of  b)  Other  Common  mother  birth  from  & children left  to  in  goes  order  right  Symbols:  -  n  common  law or  dates,  with  living  family  together  names  with  above  s e p a r a t i o n , w i t h d a t e s when s e p a r a t i o n b e g a n a n d when c o u p l e r e u n i t e d , as w e l l a s d a t e when m a r r i e d  9 o~5 The concept: and  b)  STAI a)  trait  consists  of  Inventory  was d e v e l o p e d anxiety  anxiety  Each  direction  of  scale  refers  Form X - l  anxiety"  to the anxiety  for state  items  (Buros,  two components  as anxiety  has 40 i t e m s .  the non-anxiety  or trait  dates, after  children are divorce  (STAI)  t o measure  i s defined  two f o r m s ,  anxiety.  state  Anxiety  state  with  mother  f o s t e r o r adopted c h i l d with b i r t h date above and date o f e n t e r i n g f a m i l y below  0 State-Trait  divorce with  1978,  anxiety,  The  anxiety  experiences; instrument  a n d Form X - 2  keys  a high  p.1094).  the  a person  proneness.  The s c o r i n g so that  of  "reverse  score  trait  the  suggests  The manual  for  high  includes  a  54  short  description  and  normative  and  females,  of  junior  state  data.  school  general  and t r a i t  The norms,  a r e based  high  patients,  of  which  on a t o t a l and c o l l e g e  medical  anxiety,  administrative  are recorded  sample  of  2477.  students,  and s u r g i c a l  male  patients  instructions  separately  for  males  The sample  consisted  neuropsychiatry and p r i s o n e r s .  Reliability Test-retest indicating the  state  that  the scale  scale  predictable,  reliabilities  were  taking  Alpha  reliabilities  trait  scores  i s quite  lower, into of  f o r the X-2 stable.  ranging  from  consideration  .83 to  are reported  scale  range  from  Reliability  .27  to  .33.  the concept  .92 f o r state  f o r the normative  .73  coefficients  These  of  scores  .86 to  scores  state  for  are  anxiety.  and .86 to  .92 f o r  sample.  Validity The  STAI  has been  Anxiety  Scale,  ranging  from  correlated  and A f f e c t  with  Adjective  the  Check  I PAT A n x i e t y List,  Scale,  producing  Manifest  s;cores  .52 to .80.  Criticisms The It  major  i s advised  would  criticisms that  be l i k e l y  either  faking  fault,  t h e STAI  of  the user  to fake  t h e STAI assess  their  bad o r f a k i n g  the degree  responses  good,  i s reported  i s that  to  such  i t  i s open  to which  and decide faking  be o n e o f  the  be.  anxiety  faking. examinee  i n which  would  the best  to  direction,  Even  with  this  measurements.  Appropriateness The  STAI  excellent proneness; which  measure b)  t o base  minutes.  i s appropriate  i t  of  both  for this  the degree  i s a standardized  comparisons;  and c)  study of  anxiety  measure i t  in that:  a)  i t  experienced  providing  c a n be c o m p l e t e d  i s an and  normative within  anxiety  data  15-20  on  55  Family FACES scale  (Olson,  designed  instrument cumplex to  Adaptabi1ity  diagnose  choose  which  scale  c a n be h a n d  for  cohesion  the time".  Subscores  on n i n e  A high  autonomy"  and high  "true  239-294  The  chaotic  indicates  a high  level  organization.  Seven  sub-scale  scores  c a n be computed  items. and  f o r the present  Two p i l o t  the other  with  items  on a n i n e  while  9 indicated each  A  analysis  scale within  item  had t o meet  scale:  high  three  deviations;  point  on t h e d a t a .  criteria: range  and c)  of  one w i t h  indicates et  in the  Items  and  The  high  while  a  family dimension.  rated  204  the  adaptability  students  i n the present  selected f o r the scores  the counsellor  ratings;  b)  scores  p.6).  counsellors,  a n d mode  factor  A  an i n i t i a l  35 f a m i l y  low cohesion  low  a l , 1978,  t h e mean  highest  a)  "extreme  The c o u n s e l l o r s  s c a l e used  scores  for this  from  t h e two d i m e n s i o n s .  the four  was done  students.  indicating  of  rigidity  selected  undertaken;  1  levels  using  the appropriate  possible  were  410 u n i v e r s i t y  point  answered factor  studies  s c a l e were  of  organization,  168-182  items  the  be computed.  of  The  range  (Olson  to'1,  dimensions:  162-234  can also  of  to  so that  indicates  autonomy"  indicates  (1979)  i s asked  f o r three  and a low s c o r e ,  f o r cohesion  f o r the C i r -  i s provided  307-378  The  a l l the time",  and C o h e s i o n .  individual  sub-scales  4,  self-report:,  and R u s s e l l  The r e s p o n d e n t  template  score,  item  scale  Spenkle  a r e computed  Adaptability;  for adaptability,  score  from  (FACES)  and c o h e s i o n .  assessment  systems.  Scores  Scales  i s a n 111  by O l s o n ,  A scoring  i s 162-378.  bonding  1978)  adaptability  ranging  scored.  and l i m i t e d  "emotional  score  options  Desirability;  closeness  low  of  Evaluation  as a d i a g n o s t i c  and f a m i l y  four  none  family  was d e v e l o p e d  marital  one of  and Portner,  to assess  "true  Social  Bell  was c r e a t e d  Model  and Cohesion  on s t u d e n t  study. present  fall  lowest data.  56  The  measure  standardized  adults  and  in  administration  the  201  is  adolescents  (n  with  norms  = 603).  The  based  on  a  normative  sample  data  of  is  402  provided  manual.  Validity The  authors  The  high  level  the  level  of  which  empirical various  report  a  high  degree  of  c o u n s e l l o r agreement  the  clinical  v a l i d i t i e s are  validity  supported  by  clinical  on  item  and  ranking  reported. the  empirical  The  high  is  the  basis  construct  factor  validity. for  and  loadings  on  the  factors.  Appropriateness FACES better and  is  appropriate  measures  scored;  assessing  c)  the  dimensions  of it  cohesion is  family  of  whether  a  chaotic  organization,  by  stress  and  is  how  Biographical The social of  BDQ  members,  as  perceived  physical  concerning  the  type  of  in  is  or  order  the  data  determine  pets the  and  family  with  and e m o t i o n a l H.A.  management  child  to  hobbies,  previous  is  i t  is  rapidly  is or  to  how  examine  the  to  have  family  the  answered In  they  the  of  data.  important if  one  know a  rigid  is  or  affected  (BDQ)  Aspects  as  is  i t .  relating  histories.  i t  normative  It  disengaged, to  b)  a)  important  adaptability.  Questionnaire  primarily  is  very  i t  Data  concerned  tion  system, and  that  adaptability;  cope w i t h  heating,  in  providing  enmeshed  provides  as w e l l  and  study  they  and m e d i c a l  housing,  this  standardized,  cohesion  family  for  family  history,  of  social  the  both  including  history  for  individual  a whole.  The  medical  illnesses  in  conditionoof also  practiced,  the  family  recorded.  and  the  Of  length  include  and  members. primary of  time  type  family  history  family,  both  is the Informa-  importance that  the  57  hyperactivity presence  of  (Appendix Clinical In the  present.  hyperkinesis  Interviews addition  interviews questions  and and  in  upon  The  past  final  item  generations  is  or  concerned  the  with  extended  the  family.  Observations  the  the  measures  children  observations toward  questions  family  identified  and  to  directed  interview  focus  been  C)  parents  The  has  in  in  described,  families  were  secondary  research  in  (see  relation  to  interviews  carried  non-standardized  observations  functioning  this  the  were  the  and  previously  with  the  topics  Appendix the  out.  The  exception  (see F)  of  Appendix  did,  research  with  E).  however,  variables  study.  Design The  study  undertaken  hyperactivity,  as  cope  a  with  parental available level  of  such self  b)  internal  the  The sample H.A.  concept,  down  or  coping  All  into c)  of  the  which  as  collection.  It  was  Parents  also  and  and  and  of  ability  The  variables  the  of  history.  to  were  communication,  coping These  family  studied  marital  of  mechanisms,  variables  can  a)  personal  resources;  support;  d)  coping.  A  level  variables previously  are  presence  the  to  and  of  cohesion  important  illustrated  controlled  important  completed  of  effect  categories:  the  the  The  the  availability  family  four  were  selection concerning  child.  assessment.  assessed.  social  that  ability  variables  was  stress,  was  clinical  stressor,  strength  further  examined  a  child-rearing attitudes,  resources;  family.  family's  stressor,  anxiety  broken  in  primary  resources,  be  variable  a  was  in in  Chapter  primarily  of  previously  a  variables  separately.  adaptability  assessing  were  control  data  and  final  The  the  II.  concerned  with  diagnosed concerning timing  was  data  58  important  in order  discussion Data  of  prevent  scale material  contamination and  of  the data  through  responses.  Collection The  data  interviewed and  to  with  Space  was c o l l e c t e d by  individually.  the exception  and Genogram,  without  consulting  completed  by  both  The measures  of  each  the researcher. were  the Biographical parent  his/her  was a s k e d  spouse.  parents.  The  Each  presented  Data to  to  was  the  parents  Questionnaire,  complete  remaining  Consultation  family  on t h e s e  the  three  Life  measures  measures  measures  were  was  permitted. It 20  i s estimated  days,  hours  o r 4 days  in  ability  on  this  study  t o manage  the basis Data  The  is a clinical stress  approximately  s e s s i o n was a p p r o x i m a t e l y  of  this  two  to  CHIP,  the designer were  comparative comparisons.  of  Data  from  of  of  the  family's  an H.A.  each measure  a r e made  STAI,  standardized  data MCI,  for  each  is  between  child,  described  the  families  the instrument  determined with  for  measures  i s described  in  i t s  measure.  a n d FACES  on m e c h a n i c a l l y  analysis  the presence  and c o n t r a s t s  the  the normative  FIRM,  from  or assessment  data.  c o l l e c t e d from  deviations  analysis  resulting  Comparisons  ATCRS was c o m p l e t e d by  Each  s t a t i s t i c s are used.  analysed.  relation  per family.  spanned  Analysis  descriptive and  the c o l l e c t i o n period  length.  Statistical As  that  were  scoreable  (Hinkle,  scored manually. answer  1976).  the  sample  group  to  t h e norm  groups  as w e l l  sheets  Means  and  be u s e d as  and  in  The scored  standard the  intersample  59  CHAPTER  IV  Results This kinesis  study  set out to  and f a m i l y  population  would  determine  stress.  score  the relationship  The hypotheses  below  state  the normative  mean  between  that  the  on t h e  hyper-  sample  following  variables: 1)  parent  self  concept;  2)  the a v a i l a b i l i t y  of  family  resources  as perceived  of  coping  strategies  by  the  parents; 3)  the a v a i l a b i l i t y  as p e r c e i v e d  by  the  parents  It  4)  marital  5)  the degree  was h y p o t h e s i z e d  the  following  family  that  adaptability  by t h e  parents;  as perceived  the scores would  be g r e a t e r  by t h e  than  parents.  t h e mean  for  variables:  child-rearing attitudes  2)  the level  3)  the degree  of  anxiety  of  family  as p e r c e i v e d  experienced cohesion  by t h e  by t h e  parents;  parents;  as perceived  by t h e  parents.  Analysis Means  and standard  instrument. Tables  2 to  hypothesis Only  deviations  The p e r c e n t i l e 10  instrument.  this  of  as perceived  1)  Data  and  communication  and Figures  The will  3 to  statistical  been  has been  determined  6 summarize  analysis  for  calculated for for  each  the  the s t a t i s t i c s  STAI.  for  the data  gathered  for  measures  are included  each each  follow.  the results  chapter.  rank  have  of  Clinical  observations  the standardized interpretations  are included  i n Chapter  resulting 5.  from  the  in  interviews  60  Hypothesis Parents  of  of.H.A.  the  Tennessee  The  results  the parents,  standard results the  1  positive  Self  score  variability true-false  Concept  c a n be f o u n d  a r e based Of  score  P),  which  the normative  assesses 2.  It  the level provides  the sub-scales  of  nine  of  to this  the distribution  of  score  not to  are the  (SC), the (DST  D),  Tennessee  Scores  Self-Concept  Scale  Mean  f o r the  Scale  Standard  35.111  3.1798  0.876  0.1236  -14.889  5.6001  31.556  5.6593  TOTAL  366.889  18.0793  ROW  1  131.333  3.1623  ROW  2  116.667  12.8062  ROW  3  118.889  8.3283  COL  A  73.778  5.8902  COL B  76.333  4.2720  T/F NET  C  TOT  C  .  total  and t h e  Deviation SC  complete  total  2  Deviation  and  The  (T/F).  and Standard  on  self-esteem  t h e means  chose  analysis  the s e l f - c r i t i c i s m score  (V T o t a l ) ,  mean  t h e TSCS.  as one mother  importance  Table Mean  below  Scale.  of  on a sample  (Total  score  i n Table  f o r each  the greatest  ratio  will  f o r the TSCS,  deviations  form.  children  61  (Table  2  continued)  Scale  Mean  Standard Deviation  COL C  69.000  4.2720  COL  D  73.667  4.8218  COL  E  74.111  6.2339  V  TOT  40.222  8.1972  V  COL  24.333  6.6332  V ROW  15.889  3.5862  DST  D  121.556  18.3515  DST  5  16.667  7.9687  DST  4  22.556  8.2932  DST  3  19.556  5.9395  DST 2  16.778  5.2626  DST  24.444  6.9121  DP  59.889  8.4179  GM  102.556  4.5308  PSY  43.778  5.4032  PD  80.111  5.1099  N  87.778  5.6075  PI  10.778  2.9059  2.889  2.0883  1  NDS The (Fitts, is  Total  score  1965, p . 2 ) .  366.889 with  than  P  The t o t a l  a standard  the normative  deviation  reflects  (30.70).  mean  of  "the overall s a m p l e mean  deviation 345.57,  of  level  score  18.079.  but i s within  of  self-estc  for this This one  dimension  score  i s  standard  greater  62  The  s a m p l e mean  openness  to  criticism  deviation  of  of  which  35.54,  indicate 1965,  a  "healthy  of  is  self.  of  Any  indicates  which  is  is  and  reflects  35.111,  slightly  deviation  subjects'  a  the  6.70.  for  the  with  below  of  capacity  does  fall  a whole  standard  normative  This  score  mean  seems  self-criticism"  the  is  another  This  score  is  with  a  DST  D is  above  standard  percentile  which  the  mean  is  defensiveness T/F  scores  at by  the the  ratio  scores  of  all  mean,  of  the of  to  (Fitts,  the  a definiteness 52nd  do  DST  this  the  is  that  the  sample  of  sample,  self.  It  self.  assesses  The of  which  above  sample 18.352. is  120.44  the  85th  of  self.  perceptions a  scale the  deviation  suggesting  of  for  areas  D score  integrate  score  indicating  standard  not  of  percentile  mean  the  range  perceptions  for  perceived  about  percentile,  possible  self-perception.  a  A  inconsistency,  scale  mean  normative  24.19.  The  their  The  standard  of  first  perceived  mean  for  the  12.42.  with  degree  The  of  sample.  indicates  indicate  normative  a  degree  the  The  subject  of  on  above  121.556,  deviation  indicates  high  and  measure  the  the  with  self-perception.  normative  D score  with  indicates  deviation  integrate  for  low  integration.  below  40.222,  compartmentalize  mean  to  score  The  to  the  is  scoring  tends  mean  sample  tend  standard  certainty  sample  score  Persons  below  healthy  the  subjects'  and  score  sample  The  the  self  a  for This  110.  with  while  standard  mean  in  48.53,  High  score,  score  openness  8.197.  0 to  areas  the  a  SC  defensiveness,  This  has  variability  scores  as  or  3.1798.  V Total  deviation  all  the  p.2). The  or  for  that  indicate  how  the a  the  subject  subject has  concentration  achieves  focussed on w h a t  self-definition.  on w h a t he/she  is  he/she not.  i s , A  63  balance The  between  range  0.876  of  with  t h e two d i r e c t i o n s  possible  a standard  is  1.03, with  is  below  a standard  Table  a balanced 3 gives  and f a t h e r s  results  of  mothers 116.6, are  s e l f - e s t e e m among score  higher  t h e normal from  i t  of 0.29.  i s still  within  of  t h e sub- s c a l e s  indicate, the  on  t h e sample  0.955  range,  or  compared  within plus  mean  a b o v e ,.  the  Between  Deviations  Fathers'  A l l the scores one  standard  3 and Mothers'  on t h e S C , T o t a l  P,  Means a n d  D,  Father  Total  V  T/F Standard  35.2  D  Total  V  T/F Total  n  Mother  35  .  Father  Mother  1.939  3.937  360.6  374.75  1.1.608  19.344  116.6  127.75  13.032  19.804  41.2  39.244  0.812  0.955  5  4  The  compared to  to 0.812. o r minus  The  greater  f a t h e r s ,.  Deviation  DST  score  range,  a slightly  127.75,  Mean  P  group  scores for  mentioned  among  o n t h e DST D s c a l e ,  ratio,  Scale  Total  is  f o r t h e norm  the middle  average,  mothers than  and  SC  scores.  score  t h e mean.  Comparison Standard  mean  Although  of the intrasample  Table A  T h e mean  range  perception.  P scale  and on t h e T/F  deviation  score,  f o r each  the Total  also  within  deviation  by m i d d l e  The sample  of 0.124.  a comparison  mothers  of  i s 0 to 3 . 0 .  deviation  the normative  indicating  degree  scores  is indicated  7.521  8.873  0.068  0.115  64  A  final  population the do  analysis  scored  normative not  score  below  above  range  support  the  the  of  for  the  mean  on  indicates  the  normative  mean  the  remaining  scales.  hypothesis  mean  scores  the  that  on  parents  the  that Total  The  of  H.A.  the  sample  P and  within  results,  therefore,  children  would  normative  mean  TSCS.  Hypothesis'2 Parents  Attitude  The  results the  lower  1980,  0.345  of  the  2.13,  scores  was  3.16,  Figure proving  of  the  the  or  achieved  by  for a  standard  All  sample  of  score  the  and  of  deviation  2.052,  Table of  with  a  The  the  on  scores  parents, (Hinkle  with et  a l ,  standard  deviation  further  breakdown  A  deviations  respectively.  of  1.975,  The  0.293  normative  and  mean  0.41.  total  below  4'.  attitudes"  population.  of  individual fall  in  attitudes  standard  fathers  the  Scale.  democratic  sample and  above  recorded  "more  scores  hypothesis.  are  democratic  means  mothers  distribution  3.  ATCRS  indicating  reveals  score  Child-Rearing  total  with  The  toward  A mean  scores 0.445  children will  autocratic  p.35).  of  is  H.A.  the  indicate the  of  scores  the  can  normative  be  seen  mean,  in thus  dis-  65  Table Sample Attitude  Fami1ies  Toward  Raw (Sum  l.A  *  IB  * *  Scores  4 for  the  Child-Rearing  Score of  Scale  Total  160)  (Raw  73  Score  Score/40)  1.825  111  2.775  2A  88  2.200  2B  76  1.900  3A  84  2.100  3B  87  2.175  4A  59  1.475  4B  74  1.850  5A  91  2.275  5B  78  1.950  Mean  of  A  (Standard Mean  of  79  (11.713)  1.975  (0.293)  Deviation)  85.2  (13.644)  2.13  (0.445)  82.100  (13.796)  2.052  (0.345)  B  (Standard Sample  Deviation)  Mean  *  A  represents  mothers  *  B represents  fathers  66  4.0  2  o <_> oo -£  Normative  3.0  Sample  .2.0  mean  3.16  meanx2.052 x  x x 1.0  1A * * *  A  .  2A  mothers  B represents  fathers  3.  Families on  the  The be the  Strains  2B  3A:  with  an  Family  results  found scores (RS),  in  child  Inventory  of  FIRM,  Table  on  H.A.  the  Social  5.  of  showing The  Sources  of  Desirability  sub-scale  scores.  score  below  Scores  within  4B  the  5A  5B  Attitude  indicates one  a  standard  lack  FIRM  (SD),  Extended  of  one  for  the  of  are  Support  (SFS),  Family  Social  the  mean  Resource (FS),  Support  deviation the  resources,  shown,...accompanied  Strengths  in  mean  scale.  coping  Family  standard  of  normative  Management  scores  resources  deviation  below  availability  Financial  and  group  for  score  the  total  (FWB)  A  will  Resources  Well-Being  the  4A  3  Financial  for  3B  D i s t r i b u t i o n of t o t a l scores Toward C h i l d - R e a r i n g S c a l e  Hypothesis  by  .  represents  Figure  can  IB  of  (SS)  the  particular  indicate  a  mean area.  moderate  67  resource the  level.  mean,  indicate  (McCubbin, by  1978,  totalling  mean  while  mean  the Of  the  The  one  within one  4  relation  one  mean.  A  94.9, is  and  with  92.8,  scores  a  13.9  mean  a  97.0 the  the  deviation  (18)  deviation  deviation analysis  are  below  1.565,  comparison for  the  above of  the  the  of  the  the  from  the  the  with  The  of  the  formed  sample  12.149. of  RS,  The  12.416,  and  consult  of  the  percent mean  mean,  FS,  FWB  deviations  (4.425);  SS,  Table  and  8.8 5.  of  scores  20%  while fall  RS, (2.646).  FIRM  the  SS  are:  sample  (110),  and  scores  the  FS  show  score  below  one  standard  sample  and  normative  s u b - s c a l e s can  is  scores fall  30%  fall  within  mean.  sub-scale  mean,  falling  Fifty  below  FIRM s c o r e  deviation  for  fathers  distribution  standard  be  of  resources"  scores.  standard  37.5  and  mean.  standard  and  FWB,  mothers  The  deviation  11.882.  scores  scores  of  deviation  standard and  standard  supply  sub-scale  standard  (1,565);  between  FWB  with  are  one  Directions).  normative  of  deviations  SS,  above  average  the  Further  deviation  RS,  those  than  Scoring  illustrates  to  standard  sub-scores  better  sample  FS,  variance  Figure  below  is  or  s i g n i f i c a n c e are  (6.512);  For  FS,  fathers'  sub-scales. 35.7  "a  score  equal  scores,  Manual  the  FIRM^score  mothers'  in  High  found  in  of  that  50% o f  13.9,  deviation means  Table  6.  and  the  standard from  the  standard  68  Table Sample  Scores,  Family  Means  Inventory  Families  5  and Standard for  Deviations  Resources  for  Management  Sub-scales  FIRM  SFS  RS  SD  FS  FWB  SS  1A  *  4  25  10  13  40  8  86  IB:  * *  5  27  10  12  40  4  83  2A  7  47  13  14  41  12  114  2B  6  38  8  14  41  10  103  3A  5  33  11  13  27  4  77  3B  5  32  6  12  36  10  90  4A  5  34  8  15  31  10  90  4B  6  40  11  14  37  11  92  5A  5  38  10  15  36  8  97  5B  5  43  11  17  46  5.2  35.4  10.4  14  35  Mean  A  11  117  8.4  92.8  2.653  12.416  9.2  97  2.638  11.882  8.8  94.9  2.646  12.149  Standard Deviation  0.979  Mean  5.4  B  7.178  36  1.625  9.2  0.894  13.8  5.329  40  Standard Deviation  0.529  Sample Mean  5.3  5.769  35.7  1.939  9.8  2.236  13.9  3.521  37.5  Standard Deviation * *  0.787  A represents B represents  6.512  mothers fathers  1.782  1.565  4.425  69  130  Normative 1  mean  Standard  +  Deviation  120  110  Normative  mean  Normative  mean  100  1  Standard  -  Deviation  90  80  70 — i  1A*  1  IB**  1  . 2A  1—  2B  —i—  —r-  —i  3A  3B  4A  -  4B  5A  5B  Subjects * * *  A  represents  mothers  B represents  fathers  Figure  4.  D i s t r i b u t i o n of Family Inventory for s c o r e s around the normative mean.  Resources  Management  70  The sample which  results  seem t o  families. fall  below  Of  i n d i c a t e a moderate  significance,  one s t a n d a r d  indicates  that  2.5  families  depletion  of  resources  on t h e F a m i l y  resources.  deviation  (50%)  Five  however,  and Family  Scales  Sample  Standard Inventory  the normative themselves  (100%)  FIRM  the scores  mean.  This  have  a  indicated a depletion  6  and Normative  Deviation for  to  in  sub-scale.  Table Sub-scale  level  are the f i v e  perceived  families  Strengths  of  resource  Means  Scores  Resources  Mean  for  Management  Standard  Deviation  Sample  Norm  Sample  FS  13.9  34.6  1.565  5.8  RS  35.7  38.7  6.512  9.3  SS  8.8  8.7  2.646  2.2  37.5  28.5  4.425  8.6  SD  9.8  12.3  1.782  3.1  SFS  5.3  4.8  0.787  1.1  FWB  The resources be  results in  supported.  seem t o  t h e sample  indicate a  trend  f a m i l i e s , and  towards  suggest  that  Norm  a depletion Hypothesis  of 3 may  of  71  Hypothesis Families  with  Coping-Health  The  results their  (McCubbin  et  each  Medical score  for  the  t h e CHIP  overall  must  p.8)  means  22 a n d 1 5 ;  s c o r e s a r e above from  i n accordance with  Hypothesis  4  Hypothesis  5  Parents  H.A.  Results  i s , therefore,  the MCI,  higher  data  c a n be b r o k e n  couples.  In  down  shows  that  This  relationship  into  score  8.811.  and mean  T h e mean  a n d 17  with  and  3/300.  sub-scale are: In  a l l three  scales,  one  the sample  i n a s s e s s i n g what  below  The  indicating  seems  to  coping  by  the  below  the results  on  CHIP.  normative  Inventory. of  marital  p o s s i b l e range  of  scores  successful communication.  categories:  t h e s a m p l e means falls  (SUP) sample  and w i t h i n  that  life"  stress.  8.  three  on  analyzingothe  Support  each  assesses the level  i n Table  the sample is  mean  group  mean  parents  family  In  5.881  a n d 8'.  Communication  which  scores  comparing  data  of  for  11  of  The t o t a l  not supported  children will  0  with  and MED,  i n coping with  a r e shown  144,  (FAM),  the mean,"indicating  communication, to  7.  deviation  the normative  on t h e M a r i t a l  for  i n Table  deviations  the normative  are helpful  percentile  i l l u s t r a t e s "how  individually.  a standard  the normative  scale.  t h e management  are found  and standard  SUP,  of  Parents which  below  f o r S U P a n d MED a r e 3 4 w i t h  deviation  behaviors  for  s u b - s c a l e s , Family  FAM i s 3 6 , w i t h  sample  score  to  be e x a m i n e d  deviation  will  scale,  response  the three  32 a n d 2 1 ;  standard be  of  normative  FAM,  of  child  Inventory  a l , 1979,  (MED),  standard The  an H.A.  the  perceived  data,  4  to  the normative  t h e norm  i l l u s t r a t e d i n Figure  mothers;  5.  fathers; means,  i n a l l three The  is The  and the  categories.  s a m p l e mean  for  72  Table Sample for  Scores,  Sub-scales  of  Means,  and  7 Standard  Coping-Health  Deviations  Inventory  for  Parents  Sample  FAM  SUP  1  A*  27  33  19  B**  31  32  12  Couple  29  32  16  A  47  41  21  B  23  18  17  Couple  35  30  19  A  34  39  18  B  27  33  11  Couple  30  36  14  A  31  36  13  B  48  31  16  Couple  40  34  14  A  43  48  21  B  46  38  21  Couple  44  43  21  2  3  4  5  Mean  * * *  A  '  MED  A  36  (  7.483)  39  (5.099)  18  (2.966)  B  35  (10.139)  30  (6.663)  15  (3.633)  Couple  36  (  34  (5.881)  17  (3.300)  represents  mother  B represents  father  (Standard  deviation)  8.811)  73  mothers mean  i s 95.8 with  f o r mothers  s a m p l e mean The  couple  deviation means  is  a standard 103.82,  for fathers scores  of  show  11.49.  and standard  with  deviation  a standard  i s 89.8 with  The n o r m a t i v e of  Sample  Raw S c o r e s ,  Means  Marital  Families  of  of  normative 17.38.  deviation a  of  and couples  and 1 0 1 . 6 7 ,  17.86.  Deviations  for  the  Inventory  Fathers  Couples  1  70  73  71.5  2  99  95  97  3  105  91  98  4  106  105  5  99  85  Range Mean  70  -  106  10.628.  8  and Standard  73  -  105.5 92  105  71.5  -  105.5  95.8  89.8  92.8  13.227  10.628  11.490  Standard Deviation  The  standard  for fathers  18.14  Communication  Mothers  The  deviation  9 2 . 8 , with  scores  99.28,  Table  13.227.  a standard  a s a m p l e mean  deviations  of  show  74  103.82 101.67  Normative  Mean  99.58  Mothers  Fathers  Couples  Sample  Figure  5.  Distribution mean- f o r t h e  o f mean Marital  sample s c o r e s Communication  around the Inventory.  normative  75  Figure around below  the normative the normative  deviation and  6 shows  from  within  the d i s t r i b u t i o n mean mean,  average  which  supports  score  below  with  the mean.  one s t a n d a r d  below  score.  level  of  Eighty  deviation.  the hypothesis  the normative  mean  (20%)  These  parents  of  below  mean  scores  the couples  one  score  results  communication that  couple  percent  20% s c o r i n g  One c o u p l e ' s  of marital  sample  standard  i s above seem t o  H.A.  the  mean  suggest  f o r the sample  of  scored  children  a  group, will  on t h e M C I . +1  120^  Standard  Deviation  (17.86)  115_ w  no  cu  S  Normative  105  Mean  00  £ ioo  Z  95_  1  90  CU  o  X  X  X -1  85  Standard  Deviation  a. £  (TOI.67)  (17.86)  80_ 75_ x  70  1  |  !  1  2  3 Sample  Figure  6.  .  1  1  4  5  Couples  D i s t r i b u t i o n o f s a m p l e c o u p l e mean s c o r e s a r o u n d t h e n o r m a t i v e c o u p l e mean s c o r e o n t h e M a r i t a l Communication Inventory.  76  Hypothesis  6  Parents  an H.A.  the  State-Trait  The  results  present, (T),  of  or state  34.5(T).  47  (S),  A further  percentile  ranks  the  perceive  sample  Percentile categories, support  fall  Families  results  sample  perceptions adaptability  on  anxiety sample  of  the data  means  of  mean  (T).  These  and 22  (S)  sample,  percentile.  i s 32  sample of  means  39 (S)  and 32 ( T ) ,  (S)  with that  of  and f o r the two results  for  and  suggest  low l e v e l s  These  trait  a r e 30 and 35  results  as experiencing  or  score  ranks  31  anxiety  proneness,  shows  percentile  of  anxiety. sub-  do n o t  6.  and H.A.  for  10.  normative  of  of  f o r t h e two s c o r e s  for the total  Evaluation  of  each  assesses the level  with  the 50th  percentile  7  deviation  for  which  have  the 50th  (X-l).  rank  themselves  adaptability  i n Table  above  The t o t a l  (T),  20 (S)  below  with  Cohesion The  9.  scores  ranks  Hypothesis  found  of  Hypothesis  family  Scale  analysis  a n d 37  The f a t h e r s '  score  and the degree  in Table  a r e 33 (S)  (T).  Anxiety  The p e r c e n t i l e  respectively. mothers  will  f o r the STAI,  c a n be f o u n d  and  child  9.471,  child  dimension  the adaptability The sample  mean  and a range  families  of mothers in the  of  score  less  the Family  than  183 on t h e  Adaptabi1ity  and  Scale.  i s 183, with  the five  will  of  score 153 t o  a standard seem  and f a t h e r s  family.  dimension  to  is  173.6,  188.  FACES with  T h e mean  deviation  indicate  as to  of  of  1.5.  c a n be a  standard  for  The  an i n c o n g r u i t y  the degree  of  the  family  scores in the  77  Table Raw  S c o r e s and  P e r c e n t i l e Ranks  Sample 1  2  A*  Raw State  Percentile  55  B**State  25  6  Trait  27  8  A  State  28  17  29  12  State  33  26  Tra i t  26  6  A  State  35  48  46  78  35  32  Trait  36  34  State  33  39  39  55  35  32  39  45  State  30  25  Tra i t  31  State  25  6  30  16  33  39  37  47  31  20  32  22  State  32  30  Trait  34.5  35  State  A  Trait B  State Trait  A  B  Trait  Mean A  State Trait  Mean  B  State Trait  Sample  .**  Scales  39  B  *  Trait  Trait  Trait  5  S t a t e and  62  B  4  Score  for  38  Trait  3  9  A  .  19  Mean  represents  mothers  B represents  fathers  Rank  78  Table Sample  Scores Social  Family  for  10  the Adaptability,  Desirability  Adaptability  Sub-scales  and Cohesion  Cohesion, of  Evaluation  Scale  Sample  Adaptability  Cohesion  Social  1  A*  177  239  27  B**  175  253  37  A  153  219  37  B  188  254  36  A  176  273  37  B  177  236  30  A  182  264  36  B  166  232  39  A  174  258  39  B  163  255  38  2  3  4  5  Desirability  Mean  A  173.4  (10.101)  250.6  (19.335)  35.2  (4.214)  Mean  B  173.8  (  246.0  (  36.0  (3.162)  8.841)  9.900)  Sample Mean  173.6(9.471)  248.3(14.618)  Range  1 5 3 - 1 8 8  219  * * *  A  represents  mothers  B represents  fathers  (Standard  deviation)  -  273  35.6(3.688) 27  -  39  79  The be  seen  with  in  Table  The give  adaptability percent  167.  show to  the  Ninety  below  results support  of  11.  30% f a l l i n g  199. and  distribution  a  One  trend  score  towards  Hypothesis  Distribution  of  Adaptability  the  the  scores  fall  (20%)  lies  above  a  less  adaptive  sample below  can  183,  183'and family  below  structure,  11  Scores  Cohesion Family  for  7.  Table The  of  scores  on  the  Sub-scales  and  Cohesion  Adaptability  Adaptability  and  of Evaluation  Scale  Cohesion Disengaged  Separated  Connected  Enmeshed  160  231  251  271  -  230  (15%)  -  250  (36%)  -  270  (35%)  -  303  (14%)  Chaotic 199  -  236  (14%)  Flexible 183  -  198  2B  (35%) Structured 167  -  1A* 3B Sample Mean  182  IB** 4A 5A  3A  (37%) Rigid 109  2A  -  4B  5B  166  (13%) * * *  A  represents  mothers  B. r e p r e s e n t s  fathers  Olson,  David  H.  St. Paul: Addendum.  Family  adaptability  Family  Social  and  Science,  cohesion University  evaluation of  scale.  Minnesota,  1979,  80  Hypothesis Families family  8  with  Table with the  normative  mean the  mean  percent  of  The  The sample  can  is 250.6,  shows  between  fall  between  of  a standard with  below  271  on t h e  and Cohesion  do i n d i c a t e t h a t  60% o f  t o 49% o f  14.618.  273,  The mean  of  of  19.  The  19.335,  deviation  for  while  of 9 . 9 .  i n t h e 251  Ninety  t o 270  range,  below 230.  and father  scores  there  is  is also  shown  incongruity  and  in  in the  fathers.  the hypothesis  that  on t h e c o h e s i o n d i m e n s i o n o f the scores are greater  the normative  in  to  the cohesion scores.  do n o t s u p p o r t 271  i s 219  deviation  50% f a l l  couples,  are found  deviation  c o h e s i o n by t h e m o t h e r s  FACES  of  a standard  271,  mother  the five  s c o r e above  be compared  with  FACES  sample  a standard  a n d 2 5 0 , a n d 10% f a l l  family  results  would  than  Adaptability  deviation  the distribution of  In each o f of  Family  for the total  with  is 246.0,  231  variance  11.  scores  i s 251,  the scores  perceptions  They  sample  11  of:the  and a standard  for fathers  fall  Table  of  248.3  f o r mothers  Table  30%  of  score greater  f o r the cohesion dimension of  The range  a mean  will  Scale.  results  10.  child  cohesion dimension  Evaluation The  an H.A.  than  the  the  scale.  251.  This  scores.  Summary The the  results  Attitudes  Resources  the data  Toward  Marital  and  the Family  scale,  Communication  show  the Tennessee Scale,  the Family  degree  of  Anxiety  S c a l e were a n a l y z e d support  Scale,  Inventory  Inventory  the State-Trait  and Cohesion some  Self-Concept  the Coping-Health  Inventory,  Adaptability  The r e s u l t s  from  Child-Rearing  f o r Management  the  chapter.  of  for  of Parents,  Scale, in  f o r Hypotheses  this 3,  5  81  and  7,  the  results  the  limitations  will  but  be  do  not  in  found  support  relation  in  of  the  the  to  Hypotheses the  study,  1,  subjects and  concluding  2,  4  and  addressed  implications  chapter  8.  of  this  A  in  for  discussion  each  further  study.  of  hypothesis, research  82  CHAPTER V Discussion The  results  discussed  in  addition,  the  limitations will  be  the order  deviant  positive  fathers  having  between  each of  TSCS the  as  fathers' to  are found  in  in this  the  stated  implications  the  study  are  hypotheses.  In  i n Chapter  for  the  scores of  clinical  further  having  congruity  I,  the  research  suggest  that  indicate  The  situation,  using  the  Both  such  these  person. of  the  descriptors  In  were  to  self-esteem  than  the  were  own f e e l i n g s  The  perceive fathers.  inconsistency  more  the  difference  tend  by t h e  checked  case,  and f a t h e r s .  the  as  subject.  may be a  of  and  loving,  every  target  the The  mothers  the mothers  observations  of  self-  perceptions  s e l f - d e s c r i p t i o n s of  and t h e i r  by  fun, c r e a t i v e ,  degree  The mothers  results  self-concepts.  the mothers  of  a greater  The  supported  there  that  level  clinical  differences.  of  the other  for  behaviorally  interviews.  those  a higher  through  are  matched  suggest  with  average  positively,  self-concept  criticism.  these  parents  describe  sub-scales  above  compassionate,  The  also  parents  low s e l f - c o n c e p t s .  the  spouse  that  have  themselves  scores  obtained  family  of in  spouse  level  on t h e  openness  have  sample  and honest.  themselves  the  and t h e  understanding,  perceptions The  the  obtained  described  confident,  support  addressed  questions,  indicates to  self-concepts  easy-going,  data  tend  that  descriptions  The  they  research  study,  research  children  suggest  scores  topics  Self-Concept  Previous  by  the  the  i n which  secondary  of  to  Conclusions  examined.  Parent  TSCS  pertaining  arid  parents  and and  less the  reseracher open  to  and b e l i e f s  discussion than  were  of  the  83  fathers.  The  described  themselves  These  inconsistent In  previous  variables  must  positive  relieve  associated parent  that  they  parents  each  chosen  of  were  aggressive,  assertive,  withdrawn,  for  and  feelings a  the  by  the  difference  in  level  sample  First,  of  all  greatly  they  in  of  self-doubt,  experiencing that  used  guilt  of  the  financial  of  self-concept,  study,  three  have  which  in  to  hopelessness child.  achieving  families  difficulties.  s a t i s f i e d with  attended  attempted  hyperkinetic  five  passive.  mothers.  and  a s s i s t e d them  also  and  parents  group  deviant,  four  were  this  the  enrichment  Secondly,  easy-going,  supported  behaviorally  group  self.  not  the  and m a r r i a g e  the  stated  their  Each  a  more  indicated  The  individual  progress  in  careers.  Finally, one  as  reasons  having  that  view  themselves  considered.  the  with  described  samples  be  of  stated  positive  as  parenting  many  who  d e s c r i p t i o n s were  determining  between  a  fathers  finds  adjust  that  to  in  the  having  professionals,  examining parents  an  i.e.  H.A.  the have  cited  Chapter  significant  factor  an  of  the  H.A.  average this  of  that  the  have age  assessing parental  child, 4 years  time,  psychiatrists,  self-worth  indicates in  age  During  counsellors,  s e l f - a c c e p t a n c e and II  had  child.  parents' in  mean  in  through  the  child  which  to  help  of  doctors,  The is  years,  the  and m e d i c a l  increased.  of  7.8  the  research  a  self-concept.  C h i 1 d - R e a r i ng A t t i t u d e s It  was  autocratic of  the  a more  hypothesized  parents  child-rearing attitudes  ATCRS,  however,  democratic  children.  that  The  do  attitude  reason  for  not on this  than  support the  of  part  H.A. the  this of  difference  c h i l d r e n would norm  group.  view. the is  The  parents clear  The  scores in  upon  have  more  results indicate  raising  their  consideration  84  that was  the  sample  designed  to  Clinical interviews toward  cratic, that  behavior had  my  upon • t h e problems to  methods  point  of  parent  seems  to  fathers the as not  bed  the  support be  a  than  the  trend for  towards  the  "just refer  own  results  their  that  like to  child,  autocratic  which  the  been  strict,  was  or auto-  parents  explain-  accompanied  of  by  they  parenting.  child,  often  medical  attitudes  a  parent  embarrassment,  their  autocratic  had  Each  The  methods  punishing  parent  my m o t h e r "  the  and  of  attitudes  there  parents.  self-doubt  data.  not  going them  repeatedly  to  mother  research  These  to  the  doctors,  evolved  and  into  results  described  to be  come  Observation tendancy  bed:  The  quiet back  to  can  mother  while the  we  father  scores  et  1961).  autocratic  their  disciplinarian called  This  and  (Petersen  a greater  Fathers  situation.  descriptions.  between  mothers.  the  would  of  their  previous  handle  ask  H.A.  and  and methods.  a s s i s t a n c e of  difference  heavy  and  the  group,  the  children  the  physically  of  such  which their  traditional,  Through  being  which  attitudes.  about  stated  program  more  attitudes.  interview that  of  feelings  included  Finally, seem t o  and  asked  attitudes  statements  of  parenting  parents  previously  parenting  interaction  When  the  their  arrival  support  democratic  as  positive  family  attitudes  the  abuse.  of  of  both  a  democratic  premise.  all  father",  traditional  These  the  in  themselves  resorted  more  this  change  like  completed  observations  child-rearing,  described  ed  has  develop  support  "dramatic"  "just  group  of be  dining  further  roles  in  when  family  our room  There  for  raising the  send  by  the  the  supported  the  child  could support  case  children  by  the  mother  interactions  illustrated  would had  attitude  are  upon  a l ,  does  of  off  to  meeting.  The  children  even  the  mother  when  85  threatened children  them  from  to  were  effective  do s o m e t h i n g  tended  to  results  coping  FS  of  of  score  structure,  indicates  personality  the c l i n i c a l  from  conflicting  certain  to  or  the called  punishment  rooms.  attitudes  The  seem  The  toward  the sample in family roles  a high  parents  responsible  mothers  (90%),  fathers  discipline,  while  difficulties family  financial  supports  to  perceive  to  family  for child  contributed  Yet  high  well-being.  The  a position  f u l f i l l .  between  gave  evidence  The d i v i s i o n  of  In  not a major  had  of  labour  The f a t h e r s  the family,  rearing.  the  E a c h member  functioning. of  family the  management.  support  the  themselves  including  and the c h i l d r e n  d i f f i c u l t i e s were  in child-rearing  of  depletion  a n d t h e FWB s u b - s c a l e s .  and e x p e c t a t i o n s .  the family  responsible  RS,  a general  significance to  strengths,  degree  for the financial  were  Of  tends  i n household  of  indicate  families.  r e s p o n s i b i l i t i e s and d u t i e s i n two a r e a s  to  are the FS,  interviews  participation  not equal  group,  scale  traits,  indicate  results.  family  that  a depletion  data  whereas  this  (80%), the  sample  problem,  disproportionately  to  dysfunction.  The seems  stop  was t h e n  threats  in their  in their  resources  seems  were  His  the children  i n the sample  FWB s c o r e  was  not  The f a t h e r  the c h i l d r e n .  t h e FIRM  coping  experiencing  total  could  expectations.  resources  discussion  as  the meeting.  traditional  and r o l e  The mother  Resources  The  The  with  i n keeping  be more  roles  Coping  of  punishment.  interrupting  upon  sex  with  to  results  RS s c o r e , indicate of  representing that  t h e SDFLS  resource  the families  show  feel  a depletion  strains  felt  a depletion  i n support  by t h e of  family,  resources.  networks,  both  The  within  86  the  extended  family  for  example,  upon  noted, lack  usually  of  Results to  perceive  often  parents  do  of  of  the  the  hard  to  make  because  of  resulting Data support poor  from  the  constitute  coping  the  Coping  results  This  themselves scores  and  the  parents  a  and  are  because  The often  of  the  children  are  often  resentment  tended  community,  situation.  H.A.  siblings  indicated  The the  relatives The  were  friendships.  from  their  feeling  indicates  Preceeding  a pattern  generations  autocratic  family  members.  resources,  lack  find  it  embarrassed  and  anger,  often  the  of  communication  often  showed  signs  child-rearing attitudes All  of  these  variables  depletion  of  which  seems  to  and of and  continue  generation.  show  of  result as  that  family,  health.  These group  CHIP seems  show to  sample  the  families  medical  results which  and  may  scores  indicate  s u c c e s s f u l l y managing  utilized  support  and  or  supportive,  problem.  sister,  genogram  other  present  describe  grandparents  also  views.  withdrawn  being  two  families,  Mechanisms  The mean.  or  communications,  from  as  these  four  behavior.  deficiences.  marital  to  of  families  entertainment  friends,  friends,  each  support,  The  support  family's  brother  withdrawal  into  the  keep  poor  as  being  schools  In  kinship  side.  "isolated"  the  of  their in  as  neighbours,  and  of  such  families  see  understanding  community.  interviews  term  with  the  maternal  interests,  not  frustrated  the  their  using  in  examination  on  social  and  tend  provided  both  their to  social  partly  that  to  the  support  in  from  information  above  families  family  perceive  result  be  the  perceive '  lives.  The  themselves ensuring the on  normative  as  their  effects specific  of  sub-scale having copingthe  aspects  of  87  their  resources The  The  clinical  parents  to  them  The  information  (75%), i n d i c a t e d  f o r t h e two y e a r s  mothers  in  and encouragement  were  often  the child.  Upon  families  utilized  the  through  drugs,  Family  such  solved.  following  told  that  the problem  by a d o c t o r  of  The sample  poor  basis  of  for  resources.  the  was n o t  results.  available  child.  in themselves,  the c h i l d  system  as  whenever  not  hyperkinetic, possible,  help. available.  Both  communication,  internal  marital  and e x t e r n a l  understanding  by t h e e x t e n d e d  families  successfully resolved  have  such  the H.A.  lay  of  support  of  support  the b i r t h  was n o t a l w a y s from  some  the medical  the medical  resulting  as the lack  that  implementation  provides  and p s y c h i a t r i c  support  difficulties  also  diagnosis  diet  for  family,  problems  had t o  many  be  of  these  problems. Finally, mechanisms. of  social  in  (1970)  marital  of  to  have  such  concerning  indicate  information  achieve  communication  to  show  is  poor,  suggest  These poor  the interviews,  their  to  i n the data  seems  the f a m i l i e s  has suggested  t h e MCI  the sample.  tended by  resources  communication  results  on CHIP  The c l i n i c a l that  exists  from  a high  both  too great  a score  on  coping  utility  SDFLS  and the  a deficit  of  CHIP.  Communication  Croog between  score  indicates  support  Marital  when  T h e SUP  support.  interviews social  one c o n t r a d i c t i o n  i n which  communication.  there  and s t r e s s  t h e amount a lower  results  levels  that  of  than  is a positive  reduction.  of  stress  average  will level  are supported  both  communication  between  the parents  This  expressed  relationship implies  increase. of  that The  communication  by t h e S D F L S ,  which  the spouses,  dissatisfaction  and with  88  One be  can  lower  skills  only  if.not  were  surmise  for  taught  the and  experienced  marriage  in  to  the  attempts husbands  The  husbands  were  problems, the  levels The  of  low  restricts be  wives,  roles,  restricts  level  Level  df  Anxiety  The  results  parents.  The  mothers  and  the  would an  and  all  of  parents  interviews,  expression  that  were  of  their  discussions of  spouses  have  counselling  the  wives'  stated In  the  marriage  time  would  communication  50% o f  their  expressive.  marital  communication  coping  many  A  other  support  of  the  In  light  and  STAI  poor  level  family  dissatisfied  personal  suggest data  observations,  and  the  test  did  not  resulting  reactions  of  realistic about  that  some  family  the  as  with  low  extremes  degree  functioning,  of  of  their  the  is  family  the  found  social  as  self-concept.  anxiety the  for  one of  child's  may anxiety.  behavior  neighbours.  would  be  completion  the  clinical  level  and  to  often  scores,  the  H.A.  anxiety  and  of  through  measure  school,  such  levels  gathered  about  families  medical,  resources,  accurately  anxiety  sample  communication  such  very  the  the  Communication of  resources,  of  the  of  efficiency.  expressed  interview  the  all  communication  in which  and/or  At  hand,  often  seem  group,  programs,  expectations,  of  access to  that  marital  Furthermore,  other  resource.  financial  conclude  the  families'  coping  interviews  of  satisfaction with  emotionally  support,  sample  support  communication.  on  and  level  communication.  the  a major  parent  enrichment  improve  not  the  practised.  expressed  emotion.  that  present of  an  It during anxiety  scale. The the  results,  presence  of  although  stress.  they  The  are  low,  research  on  may  also  stress  show,  in  indicates  themselves, that  people  89  who of  are experiencing  stress  sample, lower  may h a v e  level  effective  family  to  enforced The  to  deny  cope.  lower  In  scores,  support  their  tend  themselves  to  et  results such  parents  perceive Such  the  presence  the case  of  or described  own n e e d  style. styles  of  of  the a  for  strict.  of  t h e ATCRS  a description  her  siblings.  seems  A significant incongruity family.  between  Sixty  the family poor  to  of  have more  of  of  that  rules  as  between  some  i s  The  which  firm,  negotiation families  are  fairly  varying  of  difficulty  in this  the mother  of  is  have  of  than  of  similar  family  the present  rules  the  incongruence  expectations  acceptance  FACES  family  both are  children.  area  and f a t h e r  d i d not This  by t h e  seem  with  the e x p l i c i t  dimension.of  pattern.  varying  while  measures  Interviews  not understood  the parents  organizational  or  this  the scores  communication,  capabilities,  is  a r e weak.  the f a m i l i e s .  indicated  result  percent  rather  Discipline  and the n o n - s t a n d a r d i z e d  the i m p l i c i t - r u l e s are often child  that  1978).  and c h i l d r e n  H.A.  a  fluctuate  There  skills  suggest  c a n be c h a r a c t e r i z e d  parenting.  and o v e r l y  FACES  as having  The p a r e n t s  i m p l i c i t and e x p l i c i t  a l ,  of  families  but problem-solving  number  (Olson  support  from  to  dimension  be a u t o c r a t i c  The  of  to  tend  the adaptability  and a u t o c r a t i c  an equal  clear,  in order  assertive  role-sharing,  the  ability  themselves  organization.  a mutually  tending  to  of  families  egalitarian  have  given  anxiety,  results  structured  and  their  stress  coping.  sample  having  of  of  Adaptability  The the  levels  and overemphasize  they  Family  high  do h i s /  apparent the  same  perceptions  may  result  functioning situation.  90  The  degree  variable order  in that  t o manage  family to  with  manage  able  families stress.  the c h i l d ' s  sample  results  a tendency  of  emotional  In  relation  et  al  of  perceive  or  of  adapt  to  an H.A.  stress.  behaviors  coping  new s i t u a t i o n s  child  To  and  by t h e o t h e r  with  a trend  presents  cope w i t h  in  the  stress,  the family  must  and  be  attitudes.  from  having  each  other  few f r i e n d s  few shared  number  of  Family positive  decision  family.  Each  coping  moderate  of  cohesion,  at  i s also  of  cohesion  The sample  coping  and  by  Olson  external  spending  some  private  some  time  space;  friends;  making  a  variable.  and m a r i t a l and f a m i l y  level  families  efficiency.  independence.  as described  and g)  can a f f e c t  the family's  of  c)  coping  and r e c r e a t i o n , factors  level  f)  greater  decisions.  an i m p o r t a n t  between  these  joint  low to moderate  individual  and i n t e r e s t s ; than  These There  internal  having  a n d some  the  c h a r a c t e r i s t i c s c a n be  semi-open  home;  that  i n the study.  degree  d)  efficiency. level  high  a  while  as a c o u p l e  An a s s e s s m e n t  of  have  coalition;  interests of  to  suggest  disconnected.  a weak m a r i t a l  relationship  space.  to  FACES  used  the following  having  decisions  cohesion  making,  dimensions  activities  personal  measures  a moderate  a)  of  as being  families  towards  in the families: b)  dimension  themselves  the other  having  to  to  i s an i m p o r t a n t  and development,  the cohesion  bonding  (1978),  having  their  produce  f o r the sample  to  boundaries;  and  which  behavior  are supported  is  a  be a b l e  The p r e s e n c e  its lifestyle  families  results  apart  must  in a family  Cohesion  The  found  adaptability  situations  to modify  Family  e)  of  boundaries,  cohesion  seem  to  is  coalition,  the coping of  There  ability can  exhibit  time  of  a  indicate a low  91  Secondary In were  Research  addition  proposed.  information research. The father  scores  purpose  question  scored  be t h e more  Socioeconomic  scores.on  of  or  d i d not experience  could  have  high  affected  significant  degree  seems  to  family. able  their the  The to  social  place  The  level  anxiety  which  children  such  as a couple on w o r k ,  employment. children.  When  the  this  more  difference  fathers.  intra-sample  general,  to  the  the only beyond  or couple  in  the  families.  research  is  spending  their  members  who  nuclear  a month.  extended  concentrated their  their social  the  There  and  the  •  turn,  friendships once  sample  the f a m i l i e s  the families  about  the  scales,  be r e l a t e d  of  in  fathers  by t h e f a m i l i e s .  an a v e r a g e  and  indicating  for  previous  as s p o r t s ,  asked  the  by  often  often  of  experienced  between  The mothers  of  mother  the  This,  supports  were  that  stress.  experienced  interaction  primarily  home a n d t h e i r  of  In  financial  had few i n d i v i d u a l  socialize  of  and STAI.  chronic  activities,  parents  focussed  CHIP,  previous  addressed  higher,  in the  however,  of  between  been  reason  attitude  additional  briefly.  on e a c h  A possible  could,  gain  indicate  on t h e ATCRS w e r e  isolation  l i t t l e  results  questions  the results  has a l r e a d y  the mothers  It  finding  social  families.  experienced  fathers  of  be v e r y  extended  only  the  with  was n o t a f a c t o r  FIRM,  was t o  the differences  defensive  the scores.  (80%)  One  than  status  the TSCS,  The  attitudes.  guarded  research  now b e d i s c u s s e d  concerning  Scores  parenting  comparisons  comparisons  will  lower  seven  the questions  the hypotheses.  t h e ATCRS.  autocratic  of  t o make  question  hypotheses,  on t h e TSCS a n d ATCRS  of  consistently  may  the major  in order  first  excepting  to The  Each  discussion  Questions  and  were  The  hours efforts lives,  at on the  92  parents with  often  work  child)". child, the  gave  having  The  resulting  experienced  Strong major  statement  and  community,  The  the to  by  be  concerned  parents  c a u s e d many o f  alliances  and  were  when  the  triangles between  were  the  sibling(s)  and  the  father.  between  the  mother  the  H.A.  child  to  strong  be a  the  mother  liked  to  as  result  as  into  siblings of  much  this  strengthening  from  feelings  they  and  a  H.A.  In  were  child,  each  the  them  family  expectations  the  from new  of  on  Each  found  effectively  family  how  have  a  that  family  rules  and  when  should roles  were  upbringing.  coping  structure  there to  the the  appeared  perceive and  father  marital  affected  many o f  concerning  and  parent,  The  relationship  indicated  that  families.  was  often  discord. father  H.A.  as  a  child.  possibly  resulted  mother. to  own  helpful  mother  home.  mother,  seemed  to  into  sample  strained,  her.  H.A.  relationship  aligned with  the  these  parents'  rules  and  H.A.  the  stay  the  out,  family  the  the  child  child-rearing, of  in  get  the  of  the to  and  leading  greatly  the  choose  often  H.A.  often  seemed  idea  parents  and  from  parent  focussed  in  The  father-sibling  and myths Each  was  between  take  Although  possible with  be more  the  structure.  rooted  as  behavior  child  to  (name o f  observed  understanding  alliance  preconceived  family  prevented  time  isolation  rules  ideas  and were  more  to  of  efficiency.  had  These  of  them.  relationship,  strong  This  coping  the  appeared  the  Family  between  being  spend  triangled The  bond  .  did  to  H.A.  the  .  the  they  parents  impossible  .  from  between  and  almost  about  embarrassment  the  alliances  "It's  with  their the  the  families'  they be  of  got  structured.  family  traditional Upon ideas child  the or and  to  be  formulated  in  members, in  nature  arrival  of  the  rules the  child-rearing attitudes,  had  married  stress. role  order  to  cope  93  effectively. mothers with  This  than  the  by  new  to  have  the  it  was  containing  degree  of  stress that  the  a as  the  the  neighbourhood.  it  may  be  even  to  reactions stress  act  of  In  sampling  proved  to  be  volunteers  the  maximum  sociable,  The  the  the and in of to  abnormal.  family  cope to  by  the  struggle  H.A.  female  H.A.  child  with  stress.  The  the  same  children.  The  parents  problems to  because  child  seems  experience  contrary  friends,  study,  stated  attitude,  at  school  previous of  the  that  research,  social  it  is  not  fostered  by  the  increased  the  and  level  rules  of  family.  it  income  appears  sample, of  that  chosen  the  Gall  (1979),  using  higher They  The  due  the  to  results  that  more  to  be  $32,000.  This  to  less  appears  approval  target  than  authoritarian to  alone  of  warranting  have  education  factor  the  use  more  tend  a mean  The  intelligent,  also  in  accessibility,  tend  social  had  is  volunteers  of  parents  its  population.  need  population  limitation  conclusions  state  class,  major  in  sample  The was  social  of  their  volunteers,  higher "be  in  the  target  generalizability  (p.189).  characteristics.  mean  that,  this  girl's  to  the  behavior  and  sample  tend  same  a  of  male  This  family  abnormal  Borg  sex  does.  an  educated, and  of  The  unconventional.  these  a continuing  seemed  with  with  procedure.  non-volunteers" more  readily  Study  confidence  better  child  stated  she  the  the  ability  the  mother  way  by  affects  population.  be  the  analyzing  had  difficult  extended  of  that  H.A.  They  The  experienced  Limitations  the  more  behavior.  feminine  indicated  families  female  the  her  a c c o m p l i s h e d more  family's  female  in  for  who  observed  affected  family  indicated  fathers,  was  rules.  Finally, not  adaptation  of  makes  to  the and  many  of  12.5  years.  the  sample  94  Another  c h a r a c t e r i s t i c of  generalizabi1ity  of  or  a  are  this  attending  group  they  the  insight  both  family  and  majority  of  target  istic  the  that  of the A  the  third It  anxiety  for  family  to  be  the a  by  the  More  STAI,  although  individual,  did  not  It  level  in  of  stress.  keeping  family with  the  results  the  stress  inventory,  allows  for  of  paper  the  clinical  measures  so,  the  and  Through  parenting  support  for  to  the  that  this  character-  results  than  the  however,  total  that one  the  more as  which  care  be  the  assesses  fact  the  taken  compare  the  proceeding  for  with  and  data  the  hard  be data  given that  family of  found  being  the  observations. in  the  to  the  can  suitable  stress  the  be  measures,  s e l e c t i n g a more  spectrum  was  this  contradicted  standardized  of  of  in  MCI  considered  must  level  total  the  used  s c a l e s were  be  the  in  of  level  interviews  using  state  the  pencil  should  family  assess  instances,  the  of  instrumentation  produce  In  assesses  across  to  structure  to  sample.  more  generalization  so  it  measures  and  from  recommended  population.  of  of  pencil  majority  observations  across  and  type  gathered  doing and  the  data  on  new  measurement  effectively  difficult  in  The  the  therefore  limitation,  In  analyzed  was  paper  interviews  is  the  clinical  future.  it  that  found  can  on  emphasis  the  attended  children.  unavailable  believed on  have  the  volunteers.  reliance  exception.  is  in  the  Finally, study,  impact  H.A.  are  affected  parents  patterns,  groups  a greater  that  hyperkinesis,  found  was  to  parent  the  of  be  stress.  variables  of  communication Such  of  parents  It  limitation  an  for  population  all  population.  had  were  that  knowledge  their  self.  sample  sample  stress.  into  sample  is  group  gained  methods, the  results  support  have  the  and  target  95  Conclusions and Imp!icatibns for Further Research This study set out to examine the relationship between family stress and hyperkinesis.  In assessing the variables affecting the  sample families' coping efficiency, the following characteristics -.were 1  identified: 1.  Parents tended to have above average self-concept as measured by the TSCS.  2.  Parents tended to have democratic child-rearing attitudes as measured by the ATCRS.  3.  The families tended to show a depletion of coping resources, especially in the area of internal family strengths, as measured by FIRM, SDFLS, and clinical interviews and observations.  4.  Parents seem to perceive themselves as being successful in managing family l i f e as measured by CHIP.  5.  Parents seem to perceive the level of marital communication as being below the norm, as measured by the MCI and the clinical interviews.  5.  Parents experienced a low level of anxiety as measured by the STAI.  7.  The family organization seemed to be perceived as being structured as measured by the adaptability dimension of FACES.  8.  Families tended to perceive themselves as being disconnected as measured by the cohesion dimension of FACES.  Although the study has limitations, a number of significant trends were discovered.  Of significance is the fact that the sample, which  96  is  abnormal,  resources  in  than  experiencing  that the  as  resources,  which  social for  the  family be  coping  resource  and  researchers  should  The also  be  strategies of  to  more  to  stress  with  low,  was  Future  observation  format,  in  the  system  family. stress  The and  This  families  should  communication The  results  is  important  communication  perceived The support,  trend  closely  is  the  of  greatest  addition,  the  integrated  into  be more  closely  in  families  such this  to  and  study  determine  its  future  interview-  factor  of  of  in  analysis,  been  necessary  relationship  The  clinical  In  be  extremely  more  have  also  family  research.  ability.  to  resources.  are  multivariable  resources  it  They  stress.  which  coping  themselves  extended  examined  of  effect  assessed. should  support what on  factor(s)  the  family's  stress.  the  present  subsystems.  of  be  or  closely.  level  with  determine  marital  although  be  the  number  coping  resources,  future  coping  However,  this  Finally,  of  poor  findings.  cope  that  to  individual  ability  shown  attempt  the  to  family  structured  factor  which  contribute  is  a  family's  examined  previous  or  in  a  the  trend  of  should of  perceived  structure,  closely  use  a greater  hyperkinesis.  family  to  coping  of  family  internal  the  program  the  result  deficiency  Through  to  have  population,  a depletion  more  observation  degree  to  s u c c e s s f u l l y cope  examined  significance  a  include  to  should  research.  as  having  support,  seem  target  stress  themselves  they  the  level  of  clinical in  the  research, should  hyperkinesis  experienced  observation  spouse, using  assess  strength.of  stress  the  siblings,  a more  the  and  of  should  be  kinship  stress  relationship  the  interviews  structured  level  by  families indicated  and  community  interviewin  each  subsystem  between  this  sub-  determined.  97  In  conclusion,  sample  size  perceive H.A.  and  Each  resentment,  and  many  professionals.  on  the  prevented  only  family  to  Such into  health.  insight  of  assist can  etiology  their  although  families  resulting  feelings  of  their  interventions  and  have  further  subject the be  have  of  help.  gained  hyperkinesis,  in  but  an  problems. consulted This  with has  Professionals and  its  coping with  through  to  having  failed.  hyperkinesis  families  tend  further  into  by  frustration,  for  attempts  affected  from  help  only of  the  stress  seeking  the  study,  that  finding  these  from  into  better  the  in  different  them  this  show  expressed  Many  insight  family  children. not  many  of  experiencing  hopelessness  have  further  as  family  They  gain  tried  findings  characteristic,  themselves  child.  however,  the  its  not, must  effects  their  H.A.  research,  effects  on  98  REFERENCE  LIST  A r n o l d , L. 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Z.  & Hellmer, Child  R e i s m D. & O l i v e r i , M . E. F a m i l y p a r a d i g m and f a m i l y c o p i n g : A proposal f o r l i n k i n g the f a m i l y ' s i n t r i n s i c adaptive c a p a c i t i e s to i t s responses to s t r e s s . F a m i l y R e l a t i o n s , 1 9 8 0 , 29_, 4 3 1 - 4 4 4 . Sandoval, J . , L a m b e r t , N. hyperactive children. 45, 323-334.  M . & Y a n d e l l , W. American Journal  Current medical practice of Orthopsychiatry, 1975,  S c h a e f e r , J . W . , P a l k e s , H. S . & S t e w a r t , M. A. Group c o u n s e l i n g parents of hyperactive c h i l d r e n . C h i l d P s y c h i a t r y a n d Human Development, 1974, 5_, 8 9 - 9 5 . S e l y e , H. Stress without d i s t r e s s . American L i b r a r y , Inc., 1974.  New  York:  Signet  Books,  and  for  New  S p i e l b e r g e r , C. D . , G o r s u c h , R. L . & L u s h e n e , R. Self-Evaluation Questionnaire. Palo A l t o : Consulting Psychologists Press, 1970. T a u b , M. Self-concept of parents J o u r n a l , 1974, 3, 142-145. U n g e r , D. G . of- s o c i a l  & Powell, network.  D. R. Family  Varga, J. The h y p e r a c t i v e American Journal of the Walker, S. Columbia Springs,  and  children.  Supporting Relations,  Home E c o n o m i c s  f a m i l i e s under s t r e s s : 1980, 29, 566-574.  Research  The  role  child: S h o u l d we b e p a y i n g m o r e a t t e n t i o n ? D i s a b l e d C h i l d , 1979, 133, 413-418.  Treatment of h y p e r a c t i v i t y . Paper presented P s y c h o l o g i c a l A s s o c i a t i o n Annual Conference, November, 1980.  Werry, J . S. Developmental hyperactivity. A m e r i c a , 1 9 6 8 , JJ5, 581-597.  Pediatric  at the B r i t i s h Harrison Hot  Clinics  of  North  W h a l e y - K l a h n , M. A. & L o n e y , J . A m u l t i v a r i a t e study of the r e l a t i o n s h i p o f p a r e n t a l management t o s e l f - e s t e e m and i n i t i a l d r u g r e s p o n s e i n hyperkinetic/MBD boys. P s y c h o l o g y i n the S c h o o l s , 1977, 14., 485-492. W o o d a r d , P. B. & B r o d i e , B. C l i n i c s in North America, W y l i e , R. The 1iterature.  The h y p e r a c t i v e c h i l d : 1974, 9_, 7 2 7 - 7 4 5 .  Who  is  he?  Nursing  self-concept: A c r i t i c a l survey of pertinent research Lincoln: U n i v e r s i t y of Nebraska P r e s s , 1961.  103  APPENDIX Letter  of  A  Initial  Contact  104  Letter of Initial Contact  Dear Parents: I am a U.B.C. student in counselling psychology currently working on research for my masters degree. I would like to ask your help in my research which involves the study of families with a hyperkinetic child. To obtain this help, I am sending this letter to you and requesting your cooperation. Enclosed you will find a copy of a consent form. My request is for you to f i l l out the form and return i t to me. All personal information gathered during the course of the research, approximately 6 to 8 hours, will be held in professional confidence. Information will be fathered through the use of a number of questionnaires, scales, observations, and interviews. You will be free to withdraw from the project at any time and may choose not to answer any of the questions. I appreciate your help in this matter. It would be most helpful if you could return the enclosed form as soon as possible. If you return the form, I will understand that you are willing to participate in the project. If you have any questions concerning this study, please do not hesitate to call me at my home at Thank you very much for your help. Kelly McKee, Counselling Psychology, U.B.C. Dr. John Friesen, Faculty Supervisor, Counselling Psychology, U.B.C.  105  APPENDIX Subject  B  Consent  Form  106  Subject  We  (the  Consent  Form  parents)  and  consent to take part i n a research p r o j e c t which assesses the family's a b i l i t y to cope w i t h s t r e s s i n r e l a t i o n to h y p e r k i n e s i s . Such consent i s given w i t h the knowledge t h a t our f a m i l y w i l l agree to take p a r t in t h e f o l l o w i n g t a s k s w h i c h w i l l t a k e a maximum o f 8 h o u r s t o c o m p l e t e : 1.  We w i l l b e a s k e d t o c o m p l e t e a n u m b e r o f q u e s t i o n n a i r e s a n d s c a l e s which examine f a m i l y h i s t o r y , f a m i l y dynamics, coping h e a l t h , and p e r s o n a l i t y c h a r a c t e r i s t i c s .  2.  We w i l l b e i n t e r v i e w e d functioning, including  3.  Our f a m i l y w i l l be o b s e r v e d further insight into family cope with s t r e s s .  All information complete confidence. r e f u s e to answer any  concerning aspects of the family's interpersonal relationships. by t h e r e s e a r c h e r so a s t o g a i n f u n c t i o n i n g and our a b i l i t y to  g a t h e r e d t h r o u g h o u t t h i s p r o j e c t w i l l be k e p t i n I f we w i s h t o w i t h d r a w f r o m t h e p r o j e c t o r q u e s t i o n , we a r e f r e e t o d o s o w i t h o u t prejudice.  Parents'  Signatures:  Researcher's  Date:  Signature:  107  APPENDIX Biographical  Data  C Questionnaire  108  Biographical  Parents:  Years Have If  Data  Questionnaire  Names  of  Age  Marriage:  there  yes:  been  any  previous  marriages?  Dates  Length  (Yes of  or  No)'  Marriage  Children: Name  *  HA  Years  of  Schooling  History:  Previous of  b)  Age  child  Medical a)  Sex  illnesses  illness,  State  and  perceived  members  (Good,  its  (Give  of  person,  illness,  date  duration):  physical Fair,  name  and  Poor):  emotional  condition  of  family  109  c)  When  d i d you  (Give  d)  What  Are  of  perceive  child  and  attempts  (Give  e)  age  f i r s t  both  you  nuclear  medical  aware family  hyperactive?  Socio-economic  have  of  any  and (Give  status:  place  of  made  to  been and  that  your  manage  person  extended name  and  was  hyperactive  residence).  non-medical  other  child  the  HA  child?  interventions.)  in your  family,  that  family, is  or  has  both been  relationship)  Please check  appropriate  annual  5,000  -  10,000  35,000  -  40,000  10,000  -  15,000  40,000  -  45,000  15,000  -  20,000  More  20,000  -  25,000  25,000  -  30,000  30,000  -  35,000  than  45,000  income:  no  APPENDIX Family  D  Profiles  Ill  Family  Identification Parents'  Number:  Age:  Profile  1  _31 32  Years  of  Marriage:  Children:  7.5  Age  Sex  3.5  F  1  F  1  5.5  *  HA  *  Years  of  Schooling  Child  Medical  History:  The m o t h e r a n d f a t h e r p e r c e i v e t h e m s e l v e s t o be i n g o o d p h y s i c a l and mental c o n d i t i o n . N e i t h e r p a r e n t has a h i s t o r y o f s e r i o u s illness. T h e r e i s a h i s t o r y of h e a r t d i s e a s e and c a n c e r i n the m o t h e r ' s extended family; i . e . one u n c l e d i e d o f c a n c e r ; and both g r a n d p a r e n t s have a history of heart problems. T h e HA c h i l d h a s s e r i o u s a l l e r g i e s t o p o l l e n , g r a s s , d u s t , and bed m i t e s . She has had her a d n o i d s r e m o v e d . She was d i a g n o s e d a s h y p e r a c t i v e a t two y e a r s o f a g e , a n d has been t a k i n g R i t a l i n s i n c e the age of 3 y e a r s , a t a r a t e of t h r e e times a day. Other t r e a t m e n t s used have been a change of d i e t , a r e d u c t i o n o f f o o d c o l o u r i n g and a d d i t i v e s , and the m o d i f i c a t i o n o f parenting strategies. P s y c h i a t r i c h e l p f o r t h e mother and a p o s i t i v e parenting p r o g r a m , a t t e n d e d by b o t h p a r e n t s , a r e a l s o p e r c e i v e d by t h e p a r e n t s a s being e f f e c t i v e i n combatting h y p e r a c t i v i t y . The y o u n g e s t g i r l is p e r c e i v e d as b e i n g h e a l t h y , a l t h o u g h she i s a l l e r g i c to d u s t and bed mites. There i s evidence of h y p e r a c t i v i t y i n the f a t h e r ' s extended family. The f a t h e r and h i s s i s t e r a r e d e s c r i b e d o v e r a c t i v e . The mother i s a l s o d e s c r i b e d as s u c h , h a v i n g "an abundance o f energy and has t o be d o i n g s o m e t h i n g a t a l l t i m e s " . SES: Parent  25,000  -  30,000  Occupations: A.-  Homemaker/Dental  B.  Sheet  Metal  Assistant  Worker  112  Test  Scores:  "A TSCS  (Total T  ATCRS  P  Couple  -  Score)  (Total  B  Score)  51 1 .'825  54 2.775  53 .2,3  FIRM  86  83  84.5  MCI  70  73  71.5  62 55  6 8  38 32  177 239  175 253  176 246  27  31 32 12  29 32  STAI  -  State Trait  FACES  -  Adaptability Cohesion  CHIP  -  FAM SUP MED  33 19  16  113  Family  Identification Parents'  Profile  Number:  Age:  39 38  Years  of  Marriage:  Children:  *  HA  16 Age  Sex  Years  of  Schooling  15  F  9  11*  M  5  9  M  3  Child  Medical  History:  Both p a r e n t s p e r c e i v e t h e m s e l v e s as b e i n g i n good p h y s i c a l and emotional health. N e i t h e r p a r e n t has had a h i s t o r y o f c h r o n i c i l l n e s s . The f a t h e r ' s f a t h e r d i e d o f a n e r v o u s s y s t e m d i s e a s e a t t h e age o f 6 5 . The m o t h e r ' s f a t h e r has P a r k i n s o n ' s d i s e a s e and h i g h b l o o d p r e s s u r e . T h e HA c h i l d d o e s s u f f e r f r o m h a y f e v e r . He w a s d i a g n o s e d a s hyperk i n e t i c a t t h e a g e o f s e v e n , a l t h o u g h t h e p a r e n t s s u s p e c t e d t h a t he was a n HA c h i l d w h e n he w a s s t i l l a b a b y . He w a s a l w a y s m o v i n g a n d h a d many t a n t r u m s . T h e s e p r o b l e m s w e r e o r i g i n a l l y t h o u g h t t o be t h e mother's problem; g u i l t r e s u l t i n g from his being adopted. R i t a l i n was used as a t r e a t m e n t from t h e age o f t h r e e to e i g h t y e a r s o f a g e . It was f o u n d t o have l i t t l e e f f e c t . The F e i n g o l d d i e t was u t i l i z e d for s i x w e e k s , a g a i n w i t h no c h a n g e o c c u r r i n g . P r e s e n t l y , the parents are a t t e m p t i n g to r e s t r i c t sugar and f o o d a d d i t i v e s i n t h e f a m i l y diet. The d a u g h t e r i s p e r c e i v e d as b e i n g i n good p h y s i c a l h e a l t h , but as moody o r a s h a v i n g mood v a r i a t i o n s . The p a r e n t s a s s o c i a t e t h i s phenomenon w i t h h e r a g e . The y o u n g e s t boy has mood v a r i a t i o n s a n d i s d e s c r i b e d as tempermental and a g g r e s s i v e . He i s i n g o o d p h y s i c a l h e a l t h . H y p e r a c t i v i t y d o e s seem t o be p r e s e n t i n mother d e s c r i b e s her b r o t h e r , mother and aunt SES:  35,000  Parent A. B.  40,000  Occupations: Homemaker/Library Banker  Clerk  the mother's f a m i l y . as being hyperactive.  The  114  Test Scores:  TSCS (Total P T Score) ATCRS (Total Score) FIRM MCI STAI  -  State Tra i t  FACES  -  Adaptability Cohesion  CHIP  - FAM - SUP '-' MED  A  B  65  52  .2.2  1.9  Couple 58 2.05  114  103  108.5  99  95  97  17 12  26 6  22 9  153 219  188 254  170 236  47 41 21  23 18 17  35 30 19  115  Family Identification Parents'  Number:  Age:  Profile  3  _29 32  Years  of  Marriage:  ChiIdren:  *  HA  10 Age  Sex  Years  of  Schooling  6*  M  1  4  M  1  Child  Medical  History:  The p a r e n t s p e r c e i v e t h e m s e l v e s as b e i n g i n good p h y s i c a l and emotional c o n d i t i o n . The m o t h e r d i d go t h r o u g h p o s t p a r t u m d e p r e s s i o n a f t e r the b i r t h of the second c h i l d . Her f a m i l y has had p r o b l e m s w i t h ear i n f e c t i o n . D i a b e t e s , g l y c o m a , and c a n c e r have been found i n her extended f a m i l y . The f a t h e r ' s f a m i l y has had a h i s t o r y o f hay fever and h i g h b l o o d p r e s s u r e . C a n c e r and h e a r t d i s e a s e has a f f e c t e d h i s g r a n d f a t h e r and u n c l e r e s p e c t i v e l y . T h e HA c h i l d w a s d i a g n o s e d a s hyperactive at 4 years of age. The mother p e r c e i v e d a p r o b l e m f r o m t h e t i m e t h e c h i l d was " o n e day o l d . " Prenatal problems, resulting in a long l a b o u r and t h e use o f f o r c e p s a t b i r t h were a l s o a s s o c i a t e d w i t h the boy. He h a s a h e a r i n g p r o b l e m a n d h a d t o h a v e h i s h i p c o r r e c t e d t o a l t e r t h e movement o f one f o o t . A t t h e age o f one t o two y e a r s , he e x p e r i e n c e d h i g h f e v e r s and ear i n f e c t i o n s r e q u i r i n g t r e a t m e n t with antibiotics. In t r e a t i n g t h e h y p e r a c t i v i t y t h e p a r e n t s have r e s t r i c t e d f o o d a d d i t i v e s and s u g a r i n t h e c h i l d ' s d i e t and have m o d i f i e d t h e i r p a r e n t i n g methods as a r e s u l t o f a t t e n d i n g a parent support group for p a r e n t s o f HA c h i l d r e n . The y o u n g e s t c h i l d i s d e s c r i b e d as b e i n g i n good h e a l t h . He i s a l l e r g i c t o m i l k a n d e x p e r i e n c e s s p o n t a n e o u s nose bleeds. H y p e r a c t i v i t y was d e s c r i b e d a s b e i n g f o u n d i n b o t h extended families. The f a t h e r was v e r y a c t i v e a s a b o y , and p r e s e n t l y b e l i e v e s t h a t h e w a s a n HA c h i l d . The m o t h e r d e s c r i b e d her b r o t h e r as hypera c t i v e and her f a t h e r as v e r y a c t i v e . SES:  15,000  Parent  -  20,000  Occupations:  A.  Homemaker/Day-Care  B.  Service  Station  Mother  Manager  116  Test  Scores: A  TSCS  (Total T  ATCRS  P  Score)  FIRM  FACES  CHIP  56 2.1 77  MCI STAI  Couple  -  Score)  (Total  B  105  2.175  2.138  90  83.5  91  98  -  State  48  32  40  -  Trait  78  34  56  -  Adaptability Cohesion  176 176  273 236  224 206  34 39 18  27 33 11  30 36 14  -  FAM  -  SUP MED  117  Family  Identification Parents'  Number:  Age:  Profile  _4  37 36  Years  of  Marriage:  15  ChiIdren:  *  HA  Age  Sex  9  F  4  6*  M  2  Years  of  Schooling  Child  Medical  History:  The p a r e n t s p e r c e i v e t h e m s e l v e s as b e i n g i n good p h y s i c a l and emotional health. T h e f a t h e r p r a c t i c e s TM t w i c e a d a y . There i s a h i s t o r y of cancer i n the f a t h e r ' s f a m i l y . H i s mother has h i g h b l o o d pressure. The m o t h e r ' s p a r e n t s were d e s c r i b e d a s b e i n g h e a l t h y . Her grandmother d i d have a s t h m a , and t h e r e i s a h i s t o r y o f a l l e r g i e s i n t h e family. Her g r a n d f a t h e r d i e d o f c a n c e r a t 90 y e a r s o f a g e . T h e HA c h i l d was d i a g n o s e d a s h y p e r a c t i v e b e f o r e b i r t h d u e t o h i s e x c e s s i v e movement. He w a l k e d a t 8 . 5 m o n t h s a n d w a s d e s c r i b e d a s b e i n g d i f f i c u l t to handle. A t 2 . 5 y e a r s he w e n t t h r o u g h a p s y c h o l o g i c a l a n d p s y c h i a t r i c a s s e s s m e n t , and t h e h y p e r a c t i v i t y was c o n f i r m e d . To t r e a t t h e d i s o r d e r t h e p a r e n t s have r e s t r i c t e d f o o d a d d i t i v e s and sugar i n h i s d i e t , and h a v e r e s t r u c t u r e d h i s e n v i r o n m e n t by s e t t i n g a c h i e v a b l e a n d f i r m r u l e s for his behavior. The p a r e n t s have a t t e n d e d a p a r e n t s u p p o r t group for p a r e n t s o f HA c h i l d r e n . The d a u g h t e r i s p e r c e i v e d t o be i n v e r y good p h y s i c a l and e m o t i o n a l c o n d i t i o n . T h e p a r e n t s do s u s p e c t t h a t s h e may have an a l l e r g y . No o t h e r c a s e o f h y p e r a c t i v i t y parents' extended f a m i l i e s . SES:  More  Parent  than  is  45,000  Occupations:  A.  Nurse  (R.N.)  B.  Transportation  Company  Manager  known  of  in  either  of  the  118  Test  TSCS  Scores:  (Total T  ATCRS  P  B  Couple  54  48  -  Score)  (Total  A  Score)  FIRM MCI STAI  -  State Trait  FACES  -  Adaptability Cohesion  CHIP  -  FAM SUP MED  1.475  1.850  51 1  90  92  91  106  105  105  39 55  32 45  36 50  182 264  166 232  174 248  31 36 13  48 31 16  40 34 14  119  Family Identification Parents'  Number:  Ages:  Profile  _5  33 37  Years  of  Marriage:  Children:  *  HA  12 Age  Sex  11*  M  5  3  M  1  Years  of  Schooling  Child  Medical  History:  The p a r e n t s p e r c e i v e t h e m s e l v e s as b e i n g i n good p h y s i c a l h e a l t h . The m o t h e r does have a l l e r g i e s , w h i c h she has c o n t r o l l e d . The father's f a m i l y has had r e s p i r a t o r y a n d u l s e r p r o b l e m s , w h i l e t h e m o t h e r ' s f a m i l y has a h i s t o r y o f a l l e r g i e s and d i a b e t e s . T h e HA c h i l d , who w a s d i a g n o s e d a s h y p e r a c t i v e a t two y e a r s o f a g e , has a l l e r g i e s t o dust, m i l k , tuna and t o m a t o e s . He i s d e s c r i b e d a s a c c i d e n t p r o n e a n d a s having a high pain threshold. He a l s o w e a r s g l a s s e s . His hyperactivity was p e r c e i v e d by t h e m o t h e r a l m o s t a t b i r t h . He w a s c o l i c , r e s t l e s s d u r i n g s l e e p , and c r i e d c o n s t a n t l y . He w a s a b l e t o c r a w l o u t o f h i s c r i b at nine months. His behavior resulted i n m a r i t a l dyscord over parenting techniques. This resulted in a marital separation of eight months. M o d i f i c a t i o n of parenting s t r a t e g i e s , the attendance of a p a r e n t s u p p o r t g r o u p f o r p a r e n t s o f HA c h i l d r e n , a n a d d i t i v e - f r e e diet, and R i t i l a n have a l l been implemented as t r e a t m e n t s f o r the c h i l d ' s hyperactivity. The p r e s e n t d o s a g e o f R i t a l i n i s 30 mg. p e r d a y . The y o u n g e s t boy has e x p e r i e n c e d two g r a n d mal s e i s u r e s b e t w e e n t h e a g e s o f one and t h r e e . He i s d e s c r i b e d a s b e i n g i n g o o d p h y s i c a l a n d e m o t i o n a l health. The m o t h e r ' s b r o t h e r was d i a g n o s e d a s b e i n g h y p e r a c t i v e , having t h e f i v e m a j o r symptoms a s w e l l a s l e a r n i n g d i f f i c u l t i e s , mood v a r i a t i o n s and low s e l f - e s t e e m . The f a t h e r ' s f a t h e r was a l s o d e s c r i b e d a s hyperactive. SES:  30,000  Parent  -  35,000  Occupations:  A.  Homemaker/Public  B.  Sales  Manager  Relations  (Airline  Company)  120  Test  TSCS  Scores:  (Total T  ATCRS  P  B  67  59  Cou|  -  Score)  (Total  A  Score)  2.275  1.950  63 2  FIRM  97  MCI  99  85  92  25 19  6 16  16 18  174 258  163 255  168 256  43 48 21  46 38 21  44 43 21  STAI  -  State Trait -  FACES  -  Adaptability Cohesion  CHIP  -  FAM  -  SUP MED  117  107  121  APPENDIX Sample  Interview  E  Questions  or  Content  122  Sample  Interview  What t h i n g s do y o u (each s i b l i n g )  often  How d o y o u have asked  respond him/her  when y o u r c h i l d k e e p s d o i n g s o m e t h i n g to stop o r f i n i s h ? (each s i b l i n g )  How  handle your  tell  child  member,  Content  of  Describe each f a m i l y weaknesses; parents' history)  family  or  Describe the r o l e s sibilities, etc.)  do y o u  each  Questions  your  when  (duties,  child?  he/she  What  is  chores,  does  angry  or  the  child  that  What d o e s  for  or  family  members,  What t y p e o f n e i g h b o u r h o o d do y o u l i v e bours? Do t h e p e o p l e s e e m f r i e n d l y ? How m u c h t i m e  do y o u  What w o u l d  the  Family  time  be  spend  basis  with  for  your  your  do  in?  do y o u  cope  with  How  do y o u  handle  child  rearing  stress?  conflict  between  Do  children?  line.  How  you  member, (habits; personality; strengths; complementarity, communication, relationship  questionnaires, Did they l e a r n  family,  do?  upset?  D i s c u s s i o n of parents' r e a c t i o n s to s c a l e s , projectives. How d i d t h e y f e e l d o i n g t h e m ? new f r o m t h e m ? the  respon-  spouses?  or anything  entertainment? you  know y o u r  (hours/week) processes?  neigh-  123  APPENDIX Description  of  F  Observations:  Sample  124  Description D e s c r i p t i o n of the family housing.  type  Condition  of  the  Condition  of  surrounding  Interpersonal a)  ii)  of  housing;  interior  Sample  i . e . ,  and  single  family  or  multi-  exterior.  structures.  relationships  of  family  members:  communication patterns; i . e . , dominant-submissive, showing emotion, c o m p l i a n c e , e t c . physical  Parents i) ii) i i i )  and  iv) v)  contact  between  parents  type,  frequency  -  what  positive  statements  Is  a  there the are  are  -  difference  hyperkinetic they?  Is there evidence are they? What  empathy,  Children:  discipline  with what  c)  Observations:  Parents: i)  b)  house;  of  the  of  family  support  -  between  the  child  and  triangles rules  encouragement  and  parents'  the and  other  relationship siblings?  alliances?  If  so,  If  so,  what  myths?  Children: i)  What i s t h e r e l a t i o n s h i p the other siblings?  between  the  hyperkinetic  child  and  Community - F a m i l y I n t e r a c t i o n s (observations of interactions between f a m i l y members and f r i e n d s , n e i g h b o u r s , o r o t h e r community groups).  

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