Keywords: Double ABCX model, family crisis, adjustment, adaptation .. using the Double ABCX model to examine the relationship that stress, coping and. that face-to face relationships cannot go forward without reconciliation Hill's studies firmly established family crisis as an area of interest and started a modification of the ABCX Model and synthesis of family stress research. Family Stress Theory is a developmental theory borrowed from family science which that families benefit from and contribute to the network of relationships and of the family to respond to and eventually adapt to the situations and crises .
Family Theory as a Framework for Assessment
The pileup of family demands stressors, strains, transitions is related to family adaptation, and this is a negative relationship; Family typologies based on specific strengths of the family system cohesion, adaptability, family hardiness, family time and routines are related to family adaptation, and this is a positive relationship; The family resources are related to family adaptation, and this is a positive relationship; The family's positive appraisal of the situation is related to family adaptation, and this is a positive relationship; and finally The range and depth of the family's repertoire of coping and problem-solving strategies when employed to manage a crisis situation are related to the level of family adaptation, and this is a positive relationship McCubbin,p.
In identifying resilience outcomes, it is necessary to determine the level of the patterns. Are the patterns at the individual level, the family level, or both? While resilience of a child is assessed through responses and behaviors of the child, resilience can be examined through family process, i. Nine aspects of resilient families dealing with a chronic illness situation have been identified. Fine states that," personal perceptions and responses to stressful life events are crucial elements of survival, recovery, and rehabilitation, often transcending the reality of the situation or the interventions of others" p.
Enhanced quality of life, self? Traditional parenting and childrearing: Promoting harmony and beauty for life. Navajo parenting workshop at Northern Arizona Museum. Resilience and human adaptability: Who rises above adversity? The American Journal of Occupational Therapy, 45 6? Quality of life in children and adolescents with cancer. Theory, research, and practice.
Family stress theory and the development of nursing knowledge about family adaptation. Families coping with illness: The resiliency model of family stress, adjustment and adaptation. Perspectives on coping and intervention. Family resilience to the challenge of a child's disability. Pediatric Annals, 20 9Sept, ? Promoting resilience in families experiencing stress. Pediatric Clinics of North America, 42 1Feb, 47? Advance Nursing Science, 19 3 Finally, there follows a discussion of the merits and demerits of the model, which leads to the limitations in the research conducted so far, as well as suggestions for future research.
In the figure below Figure 2post-crisis elements depicted are aA, bB and cC, denoting respectively the pile-up of demands, adaptive resources and perception of the crisis, of the pile- up and of the resources.
In Figure 2, this pile-up is denoted by Factor aA in the post-crisis period, and Table 1 lists the factors associated with each dimension of the model. McCubbin and colleagues point out three main patterns of coping they found crucial from previous research: In order to maintain functional stability, the family attempts to draw meaning Factor cC from the events that precipitate crisis, and even redefine their hardship.
Oftentimes, spiritual beliefs come into play. To them, adaptation is not a process, but the final outcome- a desirable one- of the process of adjustment to stress. An imbalance in any of the factors may lead to maladaptation, instead. In a sample of families of enlisted soldiers that were facing the hardships associated with relocation to the then-called West Germany, the researchers used 15 measures to test the latent variables predicted by the model to be associated with family stress.
They measured relocation strain composed of pre-travel strain and post-travel hardshipslife events, family system resources including family cohesion, family adaptability and supportive communicationsocial support including community support, friendship support and community activitycoherence and meaning including family-army fit, predictability and commitmentand adaptation operationalized by general well being, satisfaction and family distress.
Structural equation modeling was used, as depicted in the figure 3 below. The authors found that a pile-up of stressors does indeed influence general well-being and satisfaction with their lifestyle. Family cohesion, supportive communication, and flexible family systems are more conducive to family adaptation, but do not mitigate the severity of the strain. Social support played only an indirect role and helped the family to perceive the crisis in positive terms.
Finally, some cultural considerations will be discussed. Factor bB was represented by measures of family functioning, material resources, and social support. Factor xX was represented by assessing psychological symptoms and caregiver strain. Structural equation modeling was performed, and resulted in the conclusion that caregiver strain can be distinguished from psychological distress, albeit both concepts are related. Furthermore, caregiver strain was predicted by child symptoms, while life stressors best predicted distress.
Family functioning was found to have no effect on either strain or distress. Social support was a direct influence on distress, and caregiver strain seemed associated with lower material resources.
Using a sample of children and their caregivers, who made use of services, the researchers measured predictor variables including family stressors, resources and caregiver strain.
To investigate service use patterns, they examined combination, sequencing, continuity and amount in cost of services used. Using standard multiple regression and logistic regression, they found that service use patterns were associated with caregiver strain, material resources, life events and family functioning.
The study was limited by its sample consisting predominantly of military families, a relatively high attrition rate and the reliance on the information provided by only one family member Brannan et al, Performing hierarchical regression analysis on variables including stress both in individual life and as pile-up in family lifecoping, social support, and psychosocial adjustment, they concluded that poorer psychosocial adjustment was found to be associated with more stress more in case of pile-up of events, rather than only individual stresspoor coping, poor social support and lesser time since diagnosis.
The study reported some limitations: Another consideration is that social support is not the only resource that the model lists under Factor bB; therefore, more variables may have been studied.
A study was conducted by Lampropoulou and Konstantareas on 42 mothers of deaf children in Greece, examining stress Factor aAavailability of support Factor bBinvolvement with the child, and affective tone of involvement. The researchers concluded that higher maternal involvement was associated with higher maternal stress, and was also found more in case younger and male children.
Negative or neutral affective tone of involvement was associated with higher stress levels, and was found more frequently in Greek mothers than in Canadian ones, despite there being no difference in stress levels of the two sets of mothers. The researchers reported two limitations: A more glaring limitation, however, is that the measurement of the variables did not fit entirely with the model.
Factor cC, which might have shed more light on the variations in the affective tone of involvement, was not directly measured.
In an effort to extend the Double ABCX model to explain specifically the adjustment process of each member of families of children with childhood epilepsy and asthma, Austin examined each factor aA, bB and cC separately for parents and for children.
She also added variables specific to the children with childhood epilepsy or asthma, such as episodes, demographic variables and school status.
The general extended model for both asthma and epilepsy is depicted in Figure 4. Her sample included children with epilepsy and children with asthma. Structural equation modeling was carried out to find two separate models for epilepsy and for asthma.
Family demands aA seemed a strong predictor in the epilepsy model, but was deleted from the asthma model Austin, One such example of a study was conducted by Hall and Graff They first conducted a pilot study, using a focus group interview of 11 primary caregivers of autism-affected individuals.
The focus of the group was on the experiences and challenges of parenting children with autism.
Family Theory as a Framework for Assessment
Conventional content analysis revealed three emergent categories: The children with autism had an age range of 2 to 12 years, which is a wide enough range to bring up a wide range of problems from different stages of the family life-cycle.
Also, a few of the participants were fathers or grandmothers of the child with autism, which could also bring in different perspectives of caregiving. However, one major limitation of this study is that this advantage was not exploited. Using the data from this pilot study, Hall and Graff went on further to design larger studies, using the Double ABCX model to examine the relationship that stress, coping and support have with adaptive and then maladaptive behaviours.
In one of these studies, 75 primary caregivers, most of them Caucasian mothers with some college education, were given questionnaires for coping strategies, family support, parenting stress, and adaptive behavior of the child. Pearson correlation, t-test and multiple regression analysis were done. A major limitation of this study, however, was the application of multiple regression analysis only to find that the coping patterns were associated with each other—something that the authors avoid addressing in their discussion.
Also, no real effort was taken to tie the results in with the Double ABCX model, although they had stated that the methodology was informed by it. They also simply measured parental stress, which is not enough of a measure of the pile-up of stress that the model predicts there should be.
Again, the researchers made no attempt to measure pile-up of stress, and only made a superficial attempt to tie the results of the study with the Double ABCX model. Their racially diverse sample was composed of the primary caregivers of year old children with autism or pervasive developmental disorder. The researchers used a questionnaire or checklist to measure each factor of the Double ABCX model, and analyzed their data using linear regression models.
A Review of the Double ABCX Model and its Applications | Hitha Srivatsan - animesost.info
Results revealed that, although parents experienced high levels of stress, they still reported positive family functioning. Social support and spiritual support as means of coping, which speak to factor bB, seemed to be associated with higher levels of family functioning and lower levels of distress.
Positive reframing, which speaks to factor cC, was also found to affect family functioning and distress. The researchers concluded that their research hypothesis that the Double ABCX model predicts family coping was supported by the data.
However, there were some limitations to the study. In her paper, she presents a case study of a couple of lower-middle socio- economic status, who had no local resources to help them cope with raising their 3-year old son, who was diagnosed with autism. Their therapist systematically broke down their sessions to deal specifically with each factor of the Double ABCX model.
In the first session, she facilitated the couple to talk about their stressors and helped them make preliminary plans to deal with them— for instance, making date nights. The therapist then facilitated a meaning-making discussion about how the couple felt about raising a child with autism.
In this paper, Ramisch then goes on to make specific suggestions for ways in which therapists can design their interventions according to the Double ABCX model. There have been a few studies based on the Double ABCX model that have looked into the process of adjustment in families of children with intellectual disability.
Of these, one study aiming to explain parental stress using this model in a sample of Finnish parents of children with intellectual disability Saloviita et al, The researchers measured a variety of variables apart from parental stress: Factor bB included family adaptive resources, expressive support, instrumental support, informal and formal support, experienced social acceptance of the child, perceived control by parents over life events, and ways of coping.
Stepwise regression analysis was done with parental stress as criterion and other principal variables identified through separate principal component analyses for mothers and fathers, and then rotated by varimax rotation. More importantly, they found that the strongest predictor of stress was negative definition of the stressor, which was associated to behavioural problems by mothers, and to the experienced social acceptance of the child by fathers Saloviita et al, As thorough as this study was, it still yields limited information by its cross-sectional, self-report, and correlational design.
Mothers of elementary school-aged children from one metropolitan area each from either country were recruited. The authors found that Korean mothers reported more traditional values, lower social support, more negative attitude towards the child, and more stress.
This study had several limitations: The researchers recruited only Caucasian mothers to control for effects of ethnicity in the USA sample. The way the instrument measuring traditional values was constructed may not have been applicable to American mothers. Families of Adults with Illnesses or Disabilities The psychosocial adaptation of adults with chronic illnesses or disabilities has also been studied to some extent by researchers using the Double ABCX model as a framework.
One such study examined family functioning of patients after a stroke Clark, Sixty patients diagnosed with stroke were assessed using measures for stroke severity, length of rehabilitational stay, resident medical officer to the probably medical outcome of the patient, functional status, depression, level of activity and abnormal illness behaviours, to represent Factor aA.
Factor bB was measured by initial family functioning and knowledge of stroke. And finally, Factor cC was represented by expectations from the rehabilitation programme, and satisfaction with the progress. As a measure of Factor xX, current family functioning was assessed. Path analysis revealed that the model was reasonably well supported by the data. Using this data, the author suggested modifying the model to include feedback loops between xX and aA, as poor adaptation can be a stressor and between bB and aA, as lack of knowledge—a crucial resource—may be perceived as stressful Clark, Some major limitation of this study is its small sample size, and its cross-sectional design.
Path analysis showed that the double ABCX model was supported, and the models for both groups were similar, with some minor differences in the strength of relationships. However, social support and coping styles were not found to be significant mediators in the models of either group. A major strength of this study is their comparison of the double ABCX model for women with and without disabilities. A sample of 21 Flemish couples, in which the men had been diagnosed with an autism spectrum disorder ASDwho had been married or cohabiting for more than a year, and who had at least one child at home.
Bivariate associations between the factors of the Double ABCX model ASD traits, social support and coping and adaptation was performed for men and women, and then multiple regression analysis was done to find the effect of coping and social support on adaptation in men and women. Informal social support and avoidance coping were found to be associated with adaptation, and formal social support, approach coping and severity of ASD traits were found to be unrelated to adaptation.
The researchers found that severity of ASD traits was unrelated to individual adaptation —although severity of ASD traits did seem to be inversely correlated to marital adaptation for women alone.
Divorce and Remarriage Given that the Double ABCX model is meant to explain chronic stressors, researchers have employed it in explaining the various aspects of the process of adjustment to the crisis of divorce. It has also been used to look into adjustment to remarriages and living in step-families. In a longitudinal study by Tschann, Johnston and Wallersteinthe adjustment of divorcees was examined over a period of two years.
The participants were asked to complete a battery of self-report questionnaires and projective tests at baseline, one year and two years. They also completed a conflict checklist and parental questionnaires, and had a clinician assess clinical ratings for them at baseline.
One year later, parental questionnaires were repeated. At the two year follow up, participants were asked to complete the parental questionnaires, and other clinicians completed clinical ratings of the participants. Factor analysis, principal component analysis with varimax rotation and path analysis were used. The variables analyzed were family stage, SES, pre-separation general functioning, months since separation, decreased income, conflict with ex-spouse, rejecting parent-child relationships, social involvement, supportiveness of new relationship, and positive and negative attachment to ex-spouse.
Post-separation adjustment was measured by effective coping, psychological disturbance and emotional distress. Adjustment is also negatively influenced by conflict leading to negative attachment with ex- spouse, and positively influenced by socialization that leads to lower positive attachment with the ex-spouse.
Some limitations recognized by the authors include limited generalizability and the possible effect of the preventive counseling offered to the participants on the adjustment process Tschann et al, Another limitation is that the authors were vague about the measurements used in the procedure.
Their sample consisted of married adults who had been raised in either an intact or divorced homes. Logistic regression showed that while parental divorce is associated with poorer second-generation marriage outcomes, being raised in an intact home does not prevent second-generation marital dissatisfaction, but does seem associated to self-satisfaction.
Optimism and marital commitment were found to be strong predictors of good marital outcomes, but did not show mediating effects Kahl et al, However, their finding that optimism and commitment could positively influence marital outcomes may merit further study. Using a case example, she explains each factor of the Double ABCX model, and how to use them to assess families going through divorce and remarriage.
Remarriage could be a stressor event Factor Awith several distinct difficulties that come with it, such as new family members to get acquainted to, redistribution of resources, boundary ambiguity between the various subsystems, role ambiguities in step-parents and —children, conflicting stages of the family life-cycle, sexual tension and confusions in loyalty to parents of the same sex.
Factor B, the resources of the family, could include individual and familial resources, as well as those of the community.
Factor C predicts that the families in question will have certain perceptions of the remarriage, and may experience the necessity to change them. Imbalances in these factors cause a crisis factor Xsignified by a variety of resistances and attempts to establish systems and rules.
While trying to cope, the families may experience a pile-up of stressors Factor aAsuch as normative developmental changes in addition to the initial stressor, and consequences of trying to cope with the stress and ambiguity.
Those resources that the families use to meet the crisis are their adaptive resources Factor BB. Adaptation Factor xX can happen if there is a positive spin in the meaning-making process of evaluating the situation Factor cC.
Having explained all this, Crosbie-Burnett goes on to make suggestions for the kind of interventions and policies that can be designed for imbalances in whichever of the factors the model encompasses. A later study by Frame and Shehan examined how families of clergymen responded to the stressors specific to relocation. Their sample consisted of Caucasian married clergymen and their spouses, who had been relocated to their current locations for 4 years or more.
Appraisal of relocation, life events, family problem-solving strategies, and general well-being were measured quantitatively, and responses to two open ended questions about relocation were analyzed qualitatively. Quantitative analyses were done by t-tests and hierarchical regression analysis. Results showed that women reported higher stress, negative perceptions of relocation, lower coping resources and lower well-being than men.