Is there a 'psychosomatogenic' family?*

Abstract

Review of the literature revealed two family theories of psychosomatic illness: the 'enmeshed' family of Minuchin and the family with affect disturbances. We interviewed twelve families, each containing a child with eczema. Most, but not all, of the families do fit in with one or other or both of the proposed interactional patterns, but the theory of a single family type, the 'psychosomatogenic family', is not supported. This complements the studies of individuals where specificity hypotheses have proved oversimplified.

The “Psychosomatic Family” Model: An Empirical and Theoretical Analysis

“…Most of the studies specifically designed to test this model suffer from conceptual and/or methodological flaws and errors in interpretation (see 8, 22, 23 for reviews). Perhaps the most common flaw is an attempt to address the question of causality using a cross‐sectional design (see 21, 40).…”

“…A related problem in group comparisons is theoretical, and stems from the legacy of the specific “psychosomatic” disease notion that regards particular diseases as “psychosomatic.” Apparently, some investigators (21, 40, 58, 62, 63) assume that if a particular family configuration is associated with a disease considered to be psychosomatic, then these family patterns cause or exacerbate or maintain the illness. This is a spurious assumption based on faulty logic.…”

Quantifying the Clinical Assessment of Family Health

“…Although reliability coefficients were mostly satisfactory, the instrument did not prove easy to use or suitable for our clinical research because interaction was not explicitly valued, for example, in terms of its appropriateness or disruptiveness (cf. Loader, Kinston & Stratford, 1978).…”

Glycaemic Control in Adolescents with Type I Diabetes and Parental Expressed Emotion

“…In addition to individual personality or behavioural characteristics, family in fluences are likely to be important, particu larly for adolescents. Family factors reported to be associated with poor glycaemic control among adolescent diabetics include low tol erance of family conflict, poorly defined boundaries between parents and children, parental overprotectiveness or rejection, and poor marital intimacy [3][4][5], However, in vestigation of these factors has yielded con flicting results [3,[6][7][8][9], One reason for this is that much of the available information has been derived from unstructured interviews, which have poor reliability [10]. Reliability can be improved by observing families in a structured 'laboratory' task [11], but results from this setting may have little validity in real life.…”