Family environments mediating psychological distress in physically ill elderly

The purpose of the present study was to identify specific aspects of the family environment which influence psychological distress in physically ill elderly individuals. Chronically ill community residents were studied (N = 100). Family support was conceptualized in terms of emotional and instrumental support. Emotional support was assessed using two dimensions of the Family Environment Scale: the Relationship Dimension (which measures cohesion, expressiveness, and conflict) and the System Maintenance Dimension (which measures organization, and control). Instrumental assistance consisted of the Family Helping Behaviors scale which assessed tangible aid provided by the family within the last year. Psychological distress was assessed using the Brief Symptom Inventory which measures three global indices of distress and nine symptom dimensions. Correlational procedures were used to assess predictors of psychological distress, and multiple regression analysis identified specific aspects of family support that buffer distress in the presence of a physical illness. The results indicated that emotional support in the form of enhanced family relationships emerged as the dimension which influenced global indices of distress as well as symptoms of Depression, Anxiety, Phobic Anxiety, Obsessive-Compulsive Anxiety, and Somatization. The Systems Maintenance Dimension did not influence indices of global distress, but did buffer the Hostility symptom dimension. Instrumental forms of social support did not buffer indices of distress or specific symptom dimensions. The results are interpreted in terms of the interactive nature of biological, psychological, and social systems. Implications are discussed with suggestions for intervention and optimization of positive life adjustments to age-related illness