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Attachment and family functioning among a sample of Puerto Rican women living in communities with high levels of violence IFP World Congress of Psychotherapy Amsterdam, The Netherlands June 8, 2018 Dra. Aida Jimnez, University of Puerto Rico

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Attachment and family functioning among a sample of Puerto Rican women living in communities with high levels of violence

  • Dra. Aida Jiménez, University of Puerto Rico
  • Dra. Aysha Concepción-Lizardi, Carlos Albizu University, Puerto Rico
  • Dr. José Martínez, Carlos Albizu University, Puerto Rico

IFP World Congress of Psychotherapy Amsterdam, The Netherlands June 8, 2018

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Aims of this presentation

  • Identify the factors

– that contribute to a healthy family functioning among women

  • living in marginalized

communities with

– high level of violence in Puerto Rico. (drugs and weapons)

  • Explore variables that

affect family functioning

– attachment styles – mental health – sociodemographic variables

  • Explore role past

attachment on

– Current attachments – Family functioning

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SLIDE 3

Literature Review (Why study Family Functioning?)

  • Family functioning has been one of the most

frequently investigated correlates of psychological adjustment of children and their parents.

  • Positive family functioning has been linked

with high levels of secure attachment (Harvey & Byrd, 2000; Sheftall et al., 2013).

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SLIDE 4

Factors associated with poor family functioning

  • Risk factors

– environmental

  • unemployment,
  • perceived stress,
  • low education,
  • stressful life, and
  • poverty

(Webster-Stratton, C., &

  • Hooven. C., 1998; Grecas,

1979; Straus & Gelles, 1986)

  • Poor family functioning

has been related in children and adults to

– health and – mental health problems

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Other factors that affect family functioning: Literature review

  • Psychiatric symptomatology and

attachment history

– Ej. Depressed, stressed, or demoralized parents are less likely to provide

– cognitive stimulation, – emotional support, and – social learning necessary to foster a child's positive behavior (Wahler and Sansbury,1990; 1992).

  • Social inequality

and poverty have adverse effects

  • n health and

mental health.

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SLIDE 6

Scale Measures

  • Beck Depression

Inventory -BDI

  • Beck Anxiety Inventory-

BAI

  • Family Functioning

Scale FF-SIL (Louro Bernal, et al.)

  • Experiences in Close

Relationships-Revised (ECR-R)

– Internal and relationship attachment

  • 2 subscales
  • Cartes: Modèles

Individuels de Relation (CAMIR-R).

– Measures history of attachment

  • 7 subscales
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SLIDE 7

Methodology

  • A cross sectional study,

non experimental design

  • Data collection

– Residents living in underserved communities from 4 sectors in Puerto Rico

  • Sample N=122 of Puerto

Rican women ages 21+

  • Survey assessed

– Family functioning – Attachment – Sociodemographic variables – Exposure to violence

  • Community
  • Intra familial

– Risk and protective factors

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Table 1: Demographic results (n=122)

Variables Mean (SD) Mean CI 95% Lower Upper Age 17.8 (13.03) 15.58 20.02 f (%) CI 95% Lower Upper Civil Status Single Married/Cohab Sep/Div/Widow 72 (60.0) 43 (35.8) 5 (4.2) 50.8 68.8 27.1 44.6 0.8 8.1 Educational Level LT HS HS Graduate College 21 (17.6) 65 (54.6) 33 (27.7) 11.1 24.5 45.8 63.6 19.5 35.8 Income – Less than 5K 104 (85.2) 78.7 91.5 Occupational Status Unemployed 78 (63.9) 55.2 72.0

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Table 2: Risk factors results (n=122)

Variables f (%) CI 95% Lower Upper Impairment (child) 68 (52.3) 43.8 61.5 Alcohol abuse Never/Rarely 87 (71.3) 62.8 79.0 Substance abuse Never/Rarely 98 (81.7) 74.4 88.7 Physical/Emotional abuse Never/Rarely 77 (68.8) 60.4 77.2 Exposure to violence Community Family 73 (59.8) 35 (29.2) 51.2 68.6 21.0 37.9 Psych Symptomatology Mean (SD) Mean CI 95% Lower Upper Depression Anxiety 13.96 (12.46) 13.60 (13.65) 11.74 16.28 11.28 16.13

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Table 3: Protective factors results (n=122)

Variables Mean (SD) Mean CI 95% Lower Upper

Resiliency 5.28 (1.51) 5.00 5.54 Social emotional support 5.24 (1.80) 4.88 5.55 Concrete support 4.75 (1.94) 4.39 5.08 Child development and knowledge of parenting 6.13 (0.86) 5.98 6.29 Nurturing and attachment 6.62 (0.59) 6.52 6.73

Measured by the Spanish Protective Factors Survey (to prevent child abuse & maltreatment), FRIENDS National Center for Community-Based Child Abuse Prevention, https://friendsnrc.org/what-we-do

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Table 4: Attachment Measures and their Correlations: CaMir subscales and ECR-R subscales.

ECR-R Adult Attachment Measures (Present) CaMir Adult Attachment Measures (Internal working models) Scale A Sec. Scale B F Preo. Scale C P Interf. Scale D P Autho. Scale E P Perm. Scale F P Rese. Scale G Inf Trau. Anxiety Related

  • .16

.04

  • .10
  • .21*

.07 .16 .09 Avoidance Related

  • .18
  • .10
  • .01
  • .27**

.06 .06 .03 Total Scale

  • .21*
  • .03
  • .07
  • .30**

.08 .14 .07

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Table 5: Standardized Regression Coefficients Predicting Perception of Family Functioning

Variables B SE B β Participant´s age Violence index Beck Anxiety Inventory (BAI) Beck Depression Inventory (BDI) Socio-emotional support scale (SPFS) Concrete support scale (SPFS) Nurturing and attachment scale (SPFS) Child development and knowledge of parenting scale (SPFS) Resiliency scale (SPFS) CaMir Scale A Adjusted R2 F 0.20 .10 .14*

  • 0.73

1.90

  • .03
  • 0.06

.08

  • .07
  • 0.01

.09

  • .01
  • 0.16

.55

  • .03

0.62 .55 .11 2.91 1.39 .15* 2.05 1.03 .16* 3.56 .59 6.06*** 0.14 .14 1.02 .55 15.02

  • Note. *p< .05; ***p<.001.
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Discussion & Take away message

  • Risk factors

– Less associated with family functioning than protective factors.

  • For example:

– Internal attachment models as measured by the CAMIR did not predict family functioning. – Neither psychiatric symptomatology (dep & anxiety).

  • Protective factors

– More predictive of family functioning. – Need to focus on strengths vs. deficits

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“Familism” and family support in PR: Literature Review

  • About the concept

– Despite the severe social adversity and poverty in PR this has not produced higher rates of mental disorders (Canino, 1987). This phenomenon has been explained with the protective factor of family support and “familism”. Therefore, it is important to understand the role

  • f family functioning and the different factors that contribute to a good

family functioning.

  • Latinos places a high value on “familism” and family support.

This has been related with protective factors against the development of psychiatric disorders (Jimenez, 2014).

  • It seems like in order to increase family functioning, we have to

increase those protective factors associated with family cohesiveness and nurturing.

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SLIDE 15
  • Dra. Aida Jiménez

aida.jimenez@upr.edu

  • Dra. Aysha Concepción-Lizardi

aconcepcion@sju.albizu.edu

  • Dr. José Martínez

jmartinez@albizu.edu

Thank you

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SLIDE 16

References

  • Canino, G. J., Bird, H. R., Shrout, P. E., Rubio-Stipec, M., Bravo, M.,

Martinez, R. & Guevara, L. M. (1987). The Prevalence of Specific Psychiatric Disorders in Puerto Rico. Archives of General Psychiatry, 44(8), 727–735. http://doi.org/10.1001/archpsyc.1987.01800200053008

  • Gelles, R. J. (1992). Poverty and Violence Toward Children. American

Behavioral Scientist, 35(3), 258–274. http://doi.org/10.1177/0002764292035003005

  • Harvey, M., & Byrd, M. (2000). Relationships between adolescents’

attachment styles and family functioning. Adolescence, 35(138), 345–356.

  • Jiménez, A. Alegría, M., Camino R., Lazaro J. (2014). Cultural Sensitivity:

What Should We Understand About Latinos? In: Parekh, R. (Ed.), The Massachusetts General Hospital Textbook on Diversity and Cultural Sensitivity in Mental Health (pp.61-87). New York: Springer. ISBN 978-1- 4614-8918-4 (Online), ISBN 978-1-4614-8917-7 (Print)

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SLIDE 17

References

  • Sansbury, L. L., & Wahler, R. G. (1992). Pathways to Maladaptive Parenting

with Mothers and Their Conduct Disordered Children. Behavior Modification, 16(4), 574–592. http://doi.org/10.1177/01454455920164008

  • Sheftall, A. H., Mathias, C. W., Furr, R. M., & Dougherty, D. M. (2013).

Adolescent attachment security, family functioning, and suicide attempts. Attachment and Human Development, 15(4), 368–383. http://doi.org/10.1080/14616734.2013.782649

  • Straus, M. A., & Gelles, R. J. (1986). Societal Change and Change in Family

Violence from 1975 to 1985 as Revealed by Two National Surveys. Journal

  • f Marriage and the Family, 48(3), 465. http://doi.org/10.2307/352033
  • Straus, M. A., & Gelles, R. J. (1990). Physical Violence in American Families:

Risk Factors and Adaptations to Violence. In 8, 145 Families. New Brunswick, NJ: Transaction Publishers, 1990. xxii+622 pp. http://doi.org/10.3109/09687681003647057