Perceived Family Functioning of Adolescents with Affective Disorders: A Multicentric Cross-Sectional Study

Figures & data

Figure 1 The Circumplex Model.

Table 1 Dimensions and Family Types of Family Function of Adolescent with Affective Disorders (N = 235)

	Realistic State Mean ± SD /Frequency (%)	Ideal State Mean ± SD /Frequency (%)
Dimensions
Cohesion	56.31±11.77	69.03±11.41
Flexibility	36.63±10.61	51.71±11.54
Family types
Balanced	28(11.9)	64(27.2)
Mid-range	70(29.8)	78(33.2)
Extreme	137(58.3)	93(39.6)

Table 2 Four Levels of Cohesion and Flexibility of Adolescent Affective Disorders (N = 235)

Cohesion			Flexibility
Levels	Realistic State	Ideal State	Levels	Realistic State	Ideal State
Disengaged	128(54.5)	35(14.9)	Chaotic	184(78.3)	52(22.1)
Separated	50(21.3)	36(15.3)	Flexible	26(11.1)	37(15.7)
Connected	33(14.0)	61(26.0)	Structured	15(6.4)	72(30.6)
Enmeshed	24(10.2)	103(43.8)	Rigid	10(4.3)	74(31.5)

Table 3 General Characteristics of Adolescent Affective Disorders, and the Univariate Analysis of Realistic Family Functioning (N = 235)

Characteristics	Frequency (%) /Mean ± SD	Realistic Cohesion		Realistic Flexibility
		Mean ± SD	T/F/r	Mean ± SD	T/F/r
Gender
Male	48(20.4)	59.94±13.32	2.423^a*	38.77±12.58	1.575^a
Female	187(79.6)	55.38±11.18		36.07±10.00
Ethnic group
Han	222(94.5)	56.45±11.78	0.728^a	36.73±10.68	0.648^a
Minority	13(5.5)	54.00±11.65		34.77±9.49
Educational level
Junior school and below	135(57.4)	55.17±10.77	−1.732^a	35.61±9.53	−1.716^a
High school	100(42.6)	57.85±12.89		38.00±11.83
Residence
Urban	129(54.9)	56.39±12.42	0.123^a	36.87±11.0	0.386^a
Rural	66(28.1)	56.21±10.97		36.33±10.16
Whether one-child family
Yes	102(43.4)	57.31±12.31	1.136^a	37.73±10.86	1.395^a
No	133(56.6)	55.55±11.32		35.78±10.37
Family structure
Nuclear family	80(34.0)	58.43±12.23	7.100^b**	37.33±10.73	5.617^b**
Single-parent family	36(15.3)	52.81±11.35		33.89±9.91
Reconstituted family	37(15.7)	49.97±9.21		31.76±8.82
Stem family	82(34.9)	58.65±11.27		39.34±10.66
Educational level of father
Primary school	49(20.9)	55.69±12.10	2.140^b	35.12±10.83	2.398^b
Junior school	75(31.9)	53.56±10.49		34.45±10.09
High school	58(24.7)	57.71±12.06		38.00±10.47
Junior college	25(10.6)	59.60±13.24		39.00±11.73
College and above	28(11.9)	58.93±11.49		40.11±9.76
Educational level of mother
Primary school	61(26.0)	55.64±11.03	2.735^b*	35.69±9.84	2.662^b*
Junior school	78(33.2)	55.56±11.19		35.71±10.58
High school	47(20.0)	56.64±12.24		34.89±9.66
Junior college	22(9.4)	61.77±13.20		41.14±11.96
College and above	27(11.5)	60.20±11.49		40.74±11.51
Diagnosis
Bipolar disorder	45(19.1)	57.00±11.90	0.435^a	38.02±11.32	0.982^a
Depressive disorder	190(80.9)	56.15±11.76		36.29±12.54
Whether consider NSSI in the past month
Never	11(4.7)	57.45±10.97	2.128^b	36.91±9.03	3.068^b*
At least once	42(17.9)	56.60±11.44		36.48±10.27
Once a week	79(33.6)	58.65±11.71		39.33±11.03
Everyday	103(43.8)	54.28±11.82		34.58±10.24
Whether commit NSSI in the past month
Never	23(9.8)	58.04±11.36	1.603^b	36.91±9.51	0.860^b
At least once	84(35.7)	57.62±10.53		37.19±9.67
Once a week	80(34.1)	56.28±13.10		37.26±11.70
Everyday	48(20.4)	53.26±11.43		34.44±10.81

Notes: *P<0.05, **P<0.01 (two-tailed), ^aIndependent sample t-test, ^bone-way ANOVA.

Table 4 the Univariate Analysis of Dissatisfaction of Cohesion and Flexibility (N = 235)

Characteristics	Cohesion Dissatisfaction		Flexibility Dissatisfaction
	M (QL, QU)	Z/r	M (QL, QU)	Z/r
Gender
Male	9.50(2.00,18.00)	0.481^a	15.00(3.25,24.00)	−0.265^a
Female	12.00(4.00,20.00)		13.00(6.50,23.00)
Ethnic group
Han	11.00(3.82,20.00)	0.632^a	13.00(6.00,23.83)	0.884^a
Minority	15.41(0.77,23.80)		16.00(11.50,24.50)
Educational level
Junior school and below	13.00(4.00,21.00)	−1.238^a	14.00(7.00,24.00)	−0.683^a
High school	10.00(2.00,18.00)		13.00(4.10,18.00)
Residence
Urban	12.11(4.00,21.00)	−0.790^a	14.00(6.00,24.00)	−0.346^a
Rural	11.28(3.00,17.87)		13.00(6.00,23.83)
Whether one-child family
Yes	10.00(3.00,18.00)	1.446^a	13.00(4.89,22.00)	1.712^a
No	13.00(4.00,21.63)		14.78(7.58,24.50)
Family structure
Nuclear family	13.50(6.00,20.90)	5.520^a	18.00(8.25,24.75)	7.210^a
Single-parent family	12.00(5.00,19.89)		14.50(4.50,23.62)
Reconstituted family	14.00(2.20,23.00)		13.00(4.68,25.00)
Stem family	9.00(1.75,16.08)		11.50(4.52,18.00)
Educational level of father
Primary school	12.00(3.5,26.00)	5.512^a	14.00(7.00,26.50)	5.552^a
Junior school	14.00(5.00,22.00)		15.00(8.00,24.00)
High school	8.78(2.00,18.00)		11.50(3.75,22.90)
Junior college	8.00(2.50,18.77)		13.00(1.66,24.00)
College and above	8.00(1.50,17.75)		13.50(4.00,18.75)
Educational level of mother
Primary school	12.00(2.00,20.29)	7.185^a	13.00(7.00,25.50)	4.172^a
Junior school	12.00(4.00,19.66)		13.50(5.84,24.00)
High school	13.00(7.00,24.00)		15.46(8.00,25.60)
Junior college	5.50(0.82,17.00)		9.50(3.75,19.50)
College and above	7.00(1.00,18.00)		13.00(3.00,22.00)
Diagnosis
Bipolar disorder	10.00(3.64,20.29)	−0.118^a	11.00(4.68,23.50)	−0.934^a
Depressive disorder	12.00(3.00,19.66)		14.00(6.88,24.00)
Whether consider NSSI in the past month
Never	17.48(5.00,25.00)	0.881^a	17.00(6.50,25.60)	2.059^a
At least once	10.00(2.75,21.44)		15.73(4.00,24.00)
Once a week	10.00(6.00,20.00)		12.00(6.00,22.00)
Everyday	12.00(3.00,19.00)		15.00(7.16,25.00)
Whether commit NSSI in the past month
Never	15.00(5.00,25.60)	4.736^a	18.00(11.00,25.60)	6.150^a
At least once	9.00(2.00,18.00)		13.00(4.00,20.78)
Once a week	12.00(6.00,20.00)		12.00(6.25,24.00)
Everyday	13.50(2.15,20.50)		18.00(7.65,25.00)

Note: ^arank sum test.

Table 5 Multiple Linear Regression on Realistic Family Function and Dissatisfaction of Adolescent Affective Disorders (N = 235)

Parameters	B	SEE	β	95% CI	P
Realistic cohesion
Constant	49.883	8.056		(34.009~65.757)	<0.001
Age (years)	0.983	0.461	−0.135	(0.075~1.892)	0.034
Gender	−3.450	1.826	−0.118	(−7.048~-0.147)	0.060
Family structure (ref: Nuclear family)
Single-parent family	−5.129	2.246	−0.157	(−9.554~-0.704)	0.023
Reconstituted family	−7.456	2.251	−0.232	(−11.901~-3.029)	0.001
Stem family	0.116	1.755	0.005	(−3.341~3.573)	0.947
Realistic Flexibility
Constant	14.118	6.288		(1.728~26.508)	0.026
Age (years)	1.349	0.411	0.206	(0.539~2.159)	0.001
Educational level of father	1.204	0.523	0.143	(0.174~2.235)	0.022
Family structure (ref: Nuclear family)
Single-parent family	−3.264	2.007	−0.111	(−7.219~0.691)	0.105
Reconstituted family	−4.291	2.014	−0.148	(−8.259~-0.323)	0.034
Stem family	1.678	1.576	0.076	(−1.427~4.782)	0.288
Cohesion dissatisfaction
Constant	13.975	2.321		(9.401~18.548)	<0.001
Number of hospitalizations	2.191	0.839	0.169	(0.538~3.844)	0.010
Educational level of father	−1.188	0.573	−0.133	(−2.318~-0.059)	0.039
Family structure (ref: Nuclear family)
Single-parent family	−1.280	2.223	−0.041	(−5.661~3.101)	0.565
Reconstituted family	−0.301	2.179	−0.010	(−4.595~3.994)	0.890
Stem family	−3.762	1.729	−0.160	(−7.169~-0.355)	0.031
Flexibility dissatisfaction
Constant	20.855	1.908		(17.096~24.614)	<0.001
Educational level of father	−1.404	0.578	−0.157	(−2.543~-0.265)	0.016
Family structure (ref: Nuclear family)
Single-parent family	−1.017	2.222	−0.033	(−5.395~3.361)	0.648
Reconstituted family	−2.801	2.201	−0.091	(−7.139~1.536)	0.205
Stem family	−4.349	1.746	−0.184	(−7.790~-0.908)	0.013