The Evaluation of Family Functioning by the Family Assessment Device: A Systematic Review of Studies in Adult Clinical Populations

Abstract

A large body of research, documenting the impact of a family's functioning on health outcomes, highlights the importance of introducing the evaluation of patients' family dynamics into clinical judgment. The Family Assessment Device (FAD) is a self-report questionnaire designed to assess specific dimensions of family functioning. This qualitative systematic review, which follows PRISMA guidelines, aimed to identify the FAD's clinimetric properties and to report the incremental utility of its inclusion in clinical settings. A thorough literature search was performed, using both computerized and manual searches, yielding a total of 148 studies that were included in this review. The FAD has been extensively used in a variety of research contexts. In the majority of studies it was able to discriminate between clinical populations and controls and among groups of patients with different illnesses. The FAD also showed good test-retest and concurrent reliability, and modest sensitivity to change after treatment. FAD-dysfunctional family functioning was related to several patient clinical outcomes, including lower recovery rates and adherence to treatment, longer recovery time, poorer quality of life, and increased risk of relapse and drop-out. The present review demonstrates that the FAD is a suitable instrument for the evaluation of family functioning both in clinical and research settings.

The Family Assessment Device: A Clinimetric Analysis

“…It has 6 subscales and a General Functioning scale, which assesses the overall health/pathology of the family. The FAD has shown an adequate internal consistency [3,4,5] and moderated correlations with other self-report family assessment questionnaires [6]. Its discriminant validity, between families of medical patients and families of controls, has been studied with heterogeneous results [6], while the discriminant validity among families of different groups of psychiatric patients and normal samples is good [6].…”

“…The FAD has shown an adequate internal consistency [3,4,5] and moderated correlations with other self-report family assessment questionnaires [6]. Its discriminant validity, between families of medical patients and families of controls, has been studied with heterogeneous results [6], while the discriminant validity among families of different groups of psychiatric patients and normal samples is good [6]. The test-retest reliability has been evaluated only for the General Functioning scale (correlation coefficient: 0.60 after 12 weeks and 0.76 after 6 months), while the FAD responsiveness in detecting changes in the family functioning subsequent to a therapeutic intervention was found acceptable [6].…”

“…Its discriminant validity, between families of medical patients and families of controls, has been studied with heterogeneous results [6], while the discriminant validity among families of different groups of psychiatric patients and normal samples is good [6]. The test-retest reliability has been evaluated only for the General Functioning scale (correlation coefficient: 0.60 after 12 weeks and 0.76 after 6 months), while the FAD responsiveness in detecting changes in the family functioning subsequent to a therapeutic intervention was found acceptable [6]. The FAD factor structure is debated: some authors found a substantial subscale overlap and suggested using only the General Functioning scale [7], while other authors proposed a factor solution different from the original one (e.g.…”

“…The FAD factor structure is debated: some authors found a substantial subscale overlap and suggested using only the General Functioning scale [7], while other authors proposed a factor solution different from the original one (e.g. 3 factors [6]; 7 factors [3]). …”

Cohesión, adaptabilidad y composición familiar en adolescentes del Callao, Perú

“…La funcionalidad familiar es definida como la efectividad de la familia para conseguir cierto equilibrio, orden y unidad ante las exigencias del ciclo vital (Staccini, Tomba, Grandi, & Keitner, 2015). Respecto a las dimensiones centrales de la funcionalidad familiar, la propuesta de Olson et al (1982), señala la cohesión, adaptabilidad, comunicación y satisfacción familiar (Copez-Lonzoy, Villarreal-Zegarra, & Paz-Jesús, 2016;Olson, 2011).…”