Evolving the Biobehavioral Family Model: The Fit of Attachment*

Abstract

The 1993 Biobehavioral Family model (BBFM) posits that family relational patterns and biobehavioral reactivity interact so as to influence the physical and psychological health of the children. The revised 1999 BBFM incorporates parent-child attachment as a pivotal construct. The current study tests the 1999 BBFM by predicting, in asthmatic children, that child perception of parental relationship quality, triangulation of child in marital conflict, and parent-child security of relatedness will be associated with hopelessness and vagal activation (one mechanism of airway compromise in asthma). In this study, 22 children with asthma (11 males/11 females, aged 8 to 16), watched, alone, an emotionally challenging movie, then engaged in family discussion tasks (problem solving, loss, conflict, cohesion) and completed the Children's Perception of Interparental Scale, the Relatedness Questionnaire, The Multidimensional Scale of Anxiety in Children, and the Hopelessness Scale for Children. Heart rate variability, measured at baseline and throughout the movie and family tasks, was used to compute respiratory sinus arrhythmia (RSA)--an inferential measure of vagal activation. The child's perception of parental conflict showed trends of association with triangulation and insecure father-child relatedness. Triangulation and hopelessness also were associated with insecure father-child relatedness, all of which were associated with vagal activation. Insecure mother-child relatedness was correlated only with hopelessness. Anxiety was not related to any variables. These findings lend support to the 1999 BBFM, and suggest a key role for parent-child attachment.

Family processes in pediatric asthma

“…In support of this theory, Miller and Wood [45] found that observing sad versus happy movie scenes in the laboratory produced greater heart rate variability (an index of vagal activation) and instability of oxygen saturation (an index of pulmonary function) in children with asthma. Wood and colleagues [46] subsequently expanded these findings to the family context.…”

The use of effective treatments: The case of an adolescent girl with anorexia nervosa in the context of a conversion disorder

“…Indeed, the intensity with which an individual responds physiologically to stress and the family environment have been shown to have a reciprocal influence on one another (Wood, 1993); a model revision further proposed that it is the quality or security of parent-child attachment that stands to either foster or protect a child against the emergence of illness (Kozlowska, 2007;Wood et al, 2000). Given that the escalation of Claire's symptoms frequently occurred in the context of the absence of a key attachment figure, it was hypothesised that family therapy aimed at addressing attachment insecurity may further support Claire in resolving attachment-related anxiety and managing distress in more helpful ways, less dependent on a physiological expression.…”

Mastering Each New Direction (MEND): A Biopsychosocial Intervention for Pediatric Chronic Illness

“…MEND is grounded in the Biobehavioral Family Model (BBFM; Wood, 1993;Wood, Klebba, & Miller, 2000). The BBFM builds upon the idea of the psychosomatic family from structural family therapy (Minuchin & Fishman, 1981;Minuchin, Rosman, & Baker, 1978), which suggests family patterns and chronic illness interact in a circular, mutually reinforcing manner.…”