Am J Psychiatry 1996; 153:650-658
Copyright © 1996 by American Psychiatric Association
The Melbourne Family Grief Study, I: Perceptions of family functioning in bereavement
DW Kissane, S Bloch, DL Dowe, RD Snyder, P Onghena, DP McKenzie and CS Wallace
Department of Psychological Medicine, Monash Medical Center, Clayton, Victoria, Australia.
OBJECTIVE: The aim of this study was to identify patterns of family
functioning in adult families after the death of a parent. METHOD: One
hundred fifteen families completed measures of family functioning, grief,
psychological state, and social adjustment 6 weeks (time 1), 6 months (time
2), and 13 months (time 3) after the death of a parent (a total of 670
individual responses). Cluster analytic methods were applied to develop a
typology of perceptions of family functioning during bereavement. RESULTS:
Five types of families emerged from dimensions of cohesiveness, conflict,
and expressiveness on the Family Environment Scale. Thirty-six percent of
the families were considered supportive because of their high cohesiveness,
and another 23% resolved conflict effectively. Two types were
dysfunctional: hostile families, distinguished by high conflict, low
cohesiveness, and poor expressiveness, and sullen families, who had more
moderate limitations in these three areas; they declined in frequency from
30% at time 1 to 15% at time 3. The remaining type (26%), termed
intermediate, exhibited midrange cohesiveness, low control, and low
achievement orientation. The typology at time 1 predicted typologies at
time 2 and time 3. There were no age or gender differences among the family
types, but offspring, as compared with spouses, were overrepresented in the
hostile families. CONCLUSIONS: Family types can be identified, allowing
at-risk families to be helped to prevent complications of grief. Screening
with the family relationship index of the Family Environment Scale would
facilitate such a family-centered approach.
