To validate a French version of the Family Assessment Device (FAD), a well-known self-report questionnaire assessing family functioning in clinical and research settings.
Methods:
A French adaptation of the FAD was administered to 3 groups of subjects: a nonclinical group (n = 115), relatives of psychiatric patients (n = 102), and medical patients and their relatives (n = 106). Temporal stability was assessed by test–retest intraclass correlations. Internal consistency was measured by Cronbach alpha reliability coefficients. Discriminant validity was explored, comparing the scores of the 3 groups, using a covariance analysis (ANCOVA). The dimensional structure of the instrument was explored using a principal component analysis, with promax oblique rotation, on the entire sample.
Results:
The French FAD showed good temporal stability and good discriminant validity across groups. Internal consistency was satisfactory only for the General Functioning (GF) subscale. Factor analysis yielded a 3-factor model. The GF subscale was highly correlated with all of the other subscales.
Conclusions:
The French version of the FAD provides a valuable tool for assessing family functioning. However, our study failed to identify the theoretical structure of the FAD and suggests that the GF subscale could be used as a better overall indicator of family functioning.
HalvorsenJG. Self-report family assessment instruments: An evaluative review. Fam Pract Res J. 1991;11(1):21–55.
2.
BeckerHKornerPStofflerA.Psychodynamics and therapeutic aspects of anorexia nervosa. A study of family dynamics and prognosis. Psychother Psychosom. 1981;36(1):8–16.
GavinLAWamboldtMZSorokinN, Treatment alliance and its association with family functioning, adherence, and medical outcome in adolescents with severe, chronic asthma. J Pediatr Psychol. 1999;24(4):355–365.
5.
CohenDMLumleyMANaar-KingS, Child behavior problems and family functioning as predictors of adherence and glycemic control in economically disadvantaged children with type 1 diabetes: A prospective study. J Pediatr Psychol. 2004;29(3):171–184.
6.
ComptonMTChienVHLeinerAS, Mode of onset of psychosis and family involvement in help-seeking as determinants of duration of untreated psychosis. Soc Psychiatry Psychiatr Epidemiol. 2008;43(12):975–982.
7.
IeragoLMalsolCSingeoT, Adoption, family relations and psychotic symptoms among Palauan adolescents who are genetically at risk for developing schizophrenia. Soc Psychiatry Psychiatr Epidemiol. 2010;45(12):1105–1114.
8.
RonningJAHaavistoANikolakarosG, Factors associated with reported childhood depressive symptoms at age 8 and later self-reported depressive symptoms among boys at age 18. Soc Psychiatry Psychiatr Epidemiol. 2010;46(3):207–218.
9.
RydellAM. Family factors and children's disruptive behaviour: An investigation of links between demographic characteristics, negative life events and symptoms of ODD and ADHD. Soc Psychiatry Psychiatr Epidemiol. 2010;45(2):233–244.
10.
JosephsonAM. Practice parameter for the assessment of the family. J Am Acad Child Adolesc Psychiatry. 2007;46(7):922–937.
11.
EpsteinNBBaldwinLMBishopDS. The McMaster Family Assessment Device. J Marital Farn Ther. 1983;9:171–180.
12.
MillerIWKabacoffRIEpsteinNB, The development of a clinical rating scale for the McMaster model of family functioning. Fam Process. 1994;33(1):53–69.
13.
RyanCEEpsteinNBKeitnerGI. Evaluating and treating families: The McMaster approach. New York (NY): Routledge; 2007.
14.
KeitnerGIMillerIWEpsteinNB, Family functioning and the course of major depression. Compr Psychiatry. 1987;28(1):54–64.
15.
MillerIWKeitnerGIWhismanMA, Depressed patients with dysfunctional families: Description and course of illness. J Abnorm Psychol. 1992;101(4):637–647.
16.
KeitnerGIRyanCEMillerIW, Role of the family in recovery and major depression. Am J Psychiatry. 1995;152(7): 1002–1008.
17.
FriedmannMSMcDermutWHSolomonDA, Family functioning and mental illness: A comparison of psychiatric and nonclinical families. Fam Process. 1997;36(4):357–367.
18.
KoyamaAAkiyamaTMiyakeY, Family functioning perceived by patients and their family members in three Diagnostic and Statistical Manual-IV diagnostic groups. Psychiatry Clin Neurosci. 2004;58(5):495–500.
19.
SawantNSJethwaniKS. Understanding family functioning and social support in unremitting schizophrenia: A study in India. Indian J Psychiatry. 2010;52(2):145–149.
20.
Du Rocher SchudlichTDYoungstromEACalabreseJR, The role of family functioning in bipolar disorder in families. J Abnorm Child Psychol. 2008;36(6):849–863.
21.
LiebRWittchenHUHollerM, Parental psychopathology, parenting styles, and the risk of social phobia in offspring: A prospective-longitudinal community study. Arch Gen Psychiatry. 2000;57(9):859–866.
22.
NorthCGowersSByramV.Family functioning in adolescent anorexia nervosa. Br J Psychiatry. 1995;167(5):673–678.
23.
LiepmanMRNirenbergTDDoolittleRH, Family functioning of male alcoholics and their female partners during periods of drinking and abstinence. Fam Process. 1989;28(2):239–249.
24.
MurphyPNBentallRP. Opiate withdrawal outcome: The predictive ability of admission measures from the family assessment device (FAD). Subst Use Misuse. 1999;34(2):307–316.
25.
GowersSGJonesJCKianaS, Family functioning: A correlate of diabetic control?J Child Psychol Psychiatry. 1995;36(6):993–1001.
26.
ArpinKFitchMBrowneGB, Prevalence and correlates of family dysfunction and poor adjustment to chronic illness in specialty clinics. J Clin Epidemiol. 1990;43(4):373–383.
27.
BenderBMilgromHRandC, Psychological factors associated with medication nonadherence in asthmatic children. J Asthma. 1998;35(4):347–353.
28.
ChenJLKennedyC.Factors associated with obesity in Chinese-American children. Pediatr Nurs. 2005;31(2):110–115.
29.
MillerIWBishopDSHermanDS, Relationship quality among HIV patients and their caregivers. AIDS Care. 2007;(19):203–211.
30.
SchmittFPihaJHeleniusH, Multinational study of cancer patients and their children: Factors associated with family functioning. J Clin Oncol. 2008;26(36):5877–5883.
31.
VangelSJJrRapportLJHanksRA. Effects of family and caregiver psychosocial functioning on outcomes in persons with traumatic brain injury. J Head Trauma Rehabil. 2011;26(1):20–29.
32.
KrawetzPFleisherWPillayN, Family functioning in subjects with pseudoseizures and epilepsy. J Nerv Ment Dis. 2001;189(1):38–43.
33.
DiaremeSTsiantisJKolaitisG, Emotional and behavioural difficulties in children of parents with multiple sclerosis: A controlled study in Greece. Eur Child Adolesc Psychiatry. 2006;15(6):309–318.
34.
ChenJYClarkMJ. Family function in families of children with Duchenne muscular dystrophy. Fam Community Health. 2007;30(4):296–304.
35.
MillerIWEpsteinNBBishopDS, The McMaster Family Assessment Device: Reliability and validity. J Marital Fam Ther. 1985;1:345–356.
36.
KabacoffRIMillerIWBishopDS, Apsychometric study of the McMaster Family Assessment Device in psychiatric, medical, and nonclinical samples. J Fam Psychol. 1990;(3):431–439.
37.
BarroilhetSCano-ProusACervera-EnguixS, A Spanish version of the Family Assessment Device. Soc Psychiatry Psychiatr Epidemiol. 2009;44(12):1051–1065.
38.
RonconeRRossiLMuiereE, The Italian version of the Family Assessment Device. Soc Psychiatry Psychiatr Epidemiol. 1998;33(9):451–461.
39.
Al-KrenawiAGrahamJRAl GharaibehF.A comparison study of psychological, family function marital and life satisfactions of polygamous and monogamous women in Jordan. Community Ment Health J. 2011;47(5):594–602.
40.
KazarianSS. Cultural appropriateness of the Family Assessment Device (FAD) in the case of ethnic Armenian adolescents in Lebanon. Int J Soc Psychiatry. 2010;56(3):230–238.
41.
KazarianSS. Family functioning, cultural orientation, and psychological well-being among university students in Lebanon. J Soc Psychol. 2005;145(2):141–152.
42.
ReadJKinaliMMuntoniF, Psychosocial adjustment in siblings of young people with Duchenne muscular dystrophy. Eur J Paediatr Neurol. 2010;14(4):340–348.
43.
RidenourTADaleyJGReichW.Factor analyses of the family assessment device. Fam Process. 1999;38(4):497–510.
44.
ShekDT. The General Functioning Scale of the Family Assessment Device: Does it work with Chinese adolescents?J Clin Psychol. 2001;57(12):1503–1516.
45.
ShekDT. Family functioning and psychological well-being, school adjustment, and problem behavior in Chinese adolescents with and without economic disadvantage. J Genet Psychol. 2002;163(4):497–502.
46.
WennigerWFMdBHagemanWJArrindellWA. Cross-national validity of dimensions of family functioning: First experiences with the Dutch version of the McMaster Family Assessment Device (FAD). Pers Individ Dif. 1993;(14):769–781.
47.
BolducNSt-LouisD.Validation d'une version française du Family assessment device. Présentation au 5e International Nursing Research Symposium on Clinical of Child and Family;Montreal (QC); 1993 Mar 25–26.
48.
FalissardB.Mesurer la subjectivité en santé: Perspective méthodologique et statistique. Paris (FR): Masson; 2001.
49.
WildDGroveAMartinM, Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: Report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005;8(2):94–104.
50.
World Health Organization (WHO)International classification of disease. Chapter 5. Mental and behavioural disorders. Diagnostic criteria for research. Geneva (CH): WHO; 1993.
51.
CronbachLJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334.
52.
VelicerWFEatonCAFavaJL. Construct explication through factor or component analysis: A review and evaluation of alternative procedures for determining the number of factors or components. In: GoffinRDHelmsE, editors. Problems and solutions in human assessment: Honoring Douglas N Jackson at seventy. New York (NY): Guilford; 2002. p 41–71.
53.
HornJL. A rationale and test for the number of factors in factor analysis. Psychometrika. 1965;30:179–185.
54.
FalissardB.Focused principal component analysis: Looking at a correlation matrix with a particular interest in a given variable. J Comput Graph Stat. 1998;8:906–912.
55.
FalissardBCorrubleEMalletL, Focused principal component analysis: A promising approach for confirming findings of exploratory analysis?Int J Meth Psychiatr Res. 2001;10:191–195.
