Family Environment as a Predictor of Adjustment to Metastatic Breast Carcinoma

Abstract

The effects of family environment on the psychological adjustment of 54 women with metastatic carcinoma of the breast were studied over a one-year period. Family environment was assessed using the Family Environment Scale (FES) and a descriptive checklist, and adjustment was measured using the Profile of Mood States (POMS). Patients described their families as supportive and relatively free of conflict, and their spouses or other family members agreed moderately with them. Patient mood disturbance during the year was made the dependent variable in a stepwise multiple regression analysis, with FES subscale scores at the beginning of the year and other control variables as predictors. Better adjustment was found to be predicted by more expressiveness and less conflict and moral-religious orientation in the family. These findings are presented as evidence that the family is a crucial factor in patient adjustment, and that 'conspiracies of silence' in the family may be harmful. A clinical illustration is presented.