Psychological Reports, 1976, 38,883-886.
@ Psychological Reports 1976
FAMILIES OF HOSPITALIZED ADOLESCENTS: SEX DIFFERENCES ANTHONY P. JURICH, STEPHAN R. BOLLMAN Kansas State University1
VIRGINIA M. MOXLEY K a n ~ a sState College at Emporitr Summary.-The hospitalized adolescent's family milieu constitutes a large part of his pre-hospital environment. 27 boys and 12 girls in a state mental hospital and their parents were given a structured interview. Although the boys' behavior was more overt, the girls had a home environment marked by stricter rules, more parent-adolescent antagonism, less communication and a greater family stress.
Numerous researchers have reported that there are major differences in problems experienced by adolescent boys and girls. Studies by Adams (1964) and Chabassol and Thomas ( 1969) have demonstrated that teen-age girls were more likely than boys to consider family relationships as a major problem area. Kinlock (1970) found that girls experience more family conflict than boys. Dorwan and Adelson (1966) found that nearly twice as many adolescent boys as girls reported that they were treated democratically by their parents. This finding suggested that adolescent boys might feel less conflict with their parents than girls because they are granted greater autonomy. Therefore, a boy may withdraw from a family conflict by remaining away from home until tensions subside. In contrast, adolescent girls seem socialized toward greater conformity and experienced greater guilt feelings when their behavior led to family conflicts (Sears, et al., 1953). Chafetz ( 1974) found that a conflictful family was particularly distressing to young girls. Considering the important influence the family has upon development, further exploration of such differences is essential to understanding adolescents with problems.
METHOD AND RESULTS Graduate assistants were trained in interviewing techniques by the authors by means of group discussion and role play. An open-ended interview included a series of questions about specific aspects of family interaction. The subject was encouraged to elaborate on any answer he gave. The sequence and content of the questions were the same for each family member. The adolescents were interviewed at the hospital and each parent was interviewed in the family's home. With the permission of the subject, the interviews were recorded on audio tape and transcribed in order to facilitate data analysis. The families of all adolescents at one state hospital lived in rural communities. The adolescents were in the custody of at least one natural parent. In all, 39 adolescents, age 13 to 18 yr., were interviewed-27 boys and 12 girls. All adolescents consented to 'Department of Family and Child Development, Kansas State University, Manhattan, Kansas 66506.
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A. P. JURICH,ET AL.
be interviewed. Parental cooperation was less complete. One or both parents of 26 of the 27 boys was interviewed and at least one parent for 9 of the 12 girls. Three families ( 2 with female and 1 with a male adolescent) refused to be interviewed and one girl's family was out of town at the time interviews were conducted. Because of the remarriage of parents following divorce, 3 parents were interviewed for 2 boys and 1 girl.
Reasons for Hospitalization Two-thirds of the adolescents were diagnosed as having an adjustment reaction to adolescence. Of the girls, 11 had an adjustment reaction and only 1 was classified as schizophrenic. Boys' diagnoses suggested more severe problems. Although 15 had adjustment reactions, 8 were diagnosed as schizophrenic, 2 as mentally retarded, and 2 as having other severe diagnoses. Aside from the fact that more boys than girls were admitted into the hospital, the boys were also admitted at younger ages ( M = 14 yr. vs M = 15 yr.) and had been hospitalized for longer periods ( M = 6 mo. vs M = 4 mo.). Most of the adolescents had been in trouble with the law. Parents indicated a larger proportion of boys than girls had trouble with the police. Of the 9 girls having trouble with the police, 7 were run-aways, 1 was involved in car theft, and 1 wrote bad checks. Of the 22 boys, only 4 were run-aways. Sixteen had committed acts of vandalism or theft or both, 1 wrote bad checks, and 1 threatened to kill his father. Just before coming to the hospital the boys had law violations and the girls had problems with parents. There were also sex differences in the adolescents' use of drugs. Although a large percentage of both sexes drank alcoholic beverages, more boys did this than girls (59% vs 42%). Girls, however, experimented more with other drugs (48% vs 58%). Aside from alcohol, the most commonly used drug by the boys was marijuana. Descriptive data showed that both alcohol and marijuana were ingested as part of a group activity for the boys, while the drugtaking behavior of most of the girls was solitary. The most frequent drug use by girls was the ingestion of vapors (glue, gasoline, etc.) by "sniffing."
Family Composition The median number of children in the boys' families was 4 and in girls' families was 6. The majority ( 6 9 % ) of adolescents of both sexes came from families broken by divorce or death. Almost one in five of the adolescents had experienced the death of a parent or stepparent. Approximately half of the families had a family member who had been in jail and had a parent with a drinking problem. Although the families of both sexes demonstrated problems, the girls' families reported more family disruptions and a greater isolation of the adolescent. While 44.4% of the boys lived with both natural parents, only one girl in the study lived in her natural family. Most of the girls (66.7%) had a stepparent in the family and had mothers who had had two or more marriages. Half of the girls had been placed in foster homes prior to hospitalization. Only
FAMILIES OF HOSPITALIZED ADOLESCENTS
885
11.1% of the boys had been in foster homes. More girls (33.3%) than boys (3.7%) had been in group-care homes for a period of time before hospitalization. Parental Control Parents were reported as exercising more control over girls than over boys. More girls than boys reported that they had to dress like parents wanted (42% vs 7 % ) , parents controlled their friendships (58% vs 33% ) , and decided what they could and could not do (50% vs 19%). Girls felt that their parents nagged them about appearance and friends and indicated that this nagging frequently led to quarrels. Although three-fourths of the girls indicated that their parents' nagging led to a quarrel, only one-fourth of the boys reported similar incidents. The mothers of the adolescents confirmed their adolescents' reports regarding dress and friendships. Besides being more controlled by their families, fewer girls than boys were allowed to assist in making family decisions (33% vs 7 8 % ) . The families exercised a significant double standard which fostered passivity and dependence upon the family by the adolescent girls and independence from the family for the boys. There were also sex differences in the strictness and mode of punishment exercised by the parents. The boys reported more physical punishment than the girls (52% vs 33%). Physical punishment included spanking during childhood and slapping, punching or whipping with an object such as a belt. The parents of the girls more often utilized restriction to the house or yard as a type of punishment ( 8 3 % ) . Only 37% of the boys' parents restricted their adolescent similarly. It is difficult to compare these two different modes of discipline objectively. However, subjectively the adolescent girls more frequently reported that their parents were strict with them (83% vs 33%). The reports of the parents confirm that the parents of the girls were stricter than the patents of the boys (80% vs 31%). Adolescents' Attitudes T o w ~ Thezl d Families Generally, the girls had more negative attitudes toward their families than their male counterparts. Fewer girls than boys reported good treatment from their parents when they were younger (25% vs 6 7 % ) . More girls said that their parents were unfair to them (83% vs 37% ) and commented that parents blamed them for family troubles and treated siblings more favorably (75% vs 3 3 % ) . Over half of the male adolescents (59% ) reported that they had experienced mostly good times in their families, while 50% of the girls had reported that their family life consisted primarily of bad times. More boys than girls said parents would listen to them and understood what they said (52% vs 8 % ) . The parents' reports confirmed that their adolescents, particularly the girls, seldom talked their problems over with their
886
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parents. Although the majority of the parents said that they could usually understand their adolescents when they talked to them, 28.5% of the boys' parents and 42.9% of the girls' parents reported that their adolescents seldom spoke to them about anything. More boys than girls felt close to both parents (74% vs 33%). The boys formed a close relationship with their mothers in over 90% of the families. The girls, however, did not have a close relationship with their mothers in about 60% of the families. They formed a closer relationship with their fathers. The parents' responses verified the adolescents' perceptions. The hospitalized female adolescents reported poorer family relationships and less communication with their parents, especially their mothers, than their male counterparts. Hospitalization
Adolescent boys reported their parents visited them ar the hospital more frequently than girls' parents visited their adolescents (68% vs 18%). This was supported by the parents. More boys than girls wanted to return to their parents' home (89% vs 5 8 % ) . In addition, more boys' than girls' parents wanted the adolescent to come home (89% vs 49% ). Almost 62% of the girls' parents had no idea of their daughter's future following hospitalization. This was true of less than one-fourth of the boys' parents. Fewer girls (25%) than boys (63% ) were dissatisfied with the hospital. The mental health profession often appears to have assumed that, because the adolescent girl's deviance is more covert, she is healthier than the teen-age boy and, therefore, needs less attention. The present study has shown that the families of hospitalized adolescent girls can be less supportive and can contribute to more problems than the families of hospitalized boys. Therefore, treatment of hospitalized adolescents, both male and female, should be done in conjunction with some program to utilize the adolescents' families in the treatment. REFERENCES ADAMS, J. F. Adolescent personal problems as a function of age and sex. Journal o f Genetic Psychology, 1964, 104, 207-214. CHABASSOL, D. J., & THOMAS, D. C. Sex and age differences in problems and interests of adolescents. Journal of Experimental Edacation, 1969, 38, 16-23. CHAFESZ, I. S. Ma~culine/feminineor human? Itasca, 111.: Peacock, 1974. DORWAN, E., & ADELSON, J. The adolescenr experience. New York: Wiley, 1966. KINLOCK,G. L. Parent-youth conflict ac home: an investigation among university freshmen. American Journal of Orthop~ychidry,1970,40,658-664. SEARS, R. R., WHITING,J. W. M.,NOWLIS, V.,& SBARS. P. S. Some child-rearing antecedents of aggression and dependency in young children. Genetic Psychology Monographs, 1953,47, 135-234.
Accepted March 1,1976.
@ Psychological Reports 1976
FAMILIES OF HOSPITALIZED ADOLESCENTS: SEX DIFFERENCES ANTHONY P. JURICH, STEPHAN R. BOLLMAN Kansas State University1
VIRGINIA M. MOXLEY K a n ~ a sState College at Emporitr Summary.-The hospitalized adolescent's family milieu constitutes a large part of his pre-hospital environment. 27 boys and 12 girls in a state mental hospital and their parents were given a structured interview. Although the boys' behavior was more overt, the girls had a home environment marked by stricter rules, more parent-adolescent antagonism, less communication and a greater family stress.
Numerous researchers have reported that there are major differences in problems experienced by adolescent boys and girls. Studies by Adams (1964) and Chabassol and Thomas ( 1969) have demonstrated that teen-age girls were more likely than boys to consider family relationships as a major problem area. Kinlock (1970) found that girls experience more family conflict than boys. Dorwan and Adelson (1966) found that nearly twice as many adolescent boys as girls reported that they were treated democratically by their parents. This finding suggested that adolescent boys might feel less conflict with their parents than girls because they are granted greater autonomy. Therefore, a boy may withdraw from a family conflict by remaining away from home until tensions subside. In contrast, adolescent girls seem socialized toward greater conformity and experienced greater guilt feelings when their behavior led to family conflicts (Sears, et al., 1953). Chafetz ( 1974) found that a conflictful family was particularly distressing to young girls. Considering the important influence the family has upon development, further exploration of such differences is essential to understanding adolescents with problems.
METHOD AND RESULTS Graduate assistants were trained in interviewing techniques by the authors by means of group discussion and role play. An open-ended interview included a series of questions about specific aspects of family interaction. The subject was encouraged to elaborate on any answer he gave. The sequence and content of the questions were the same for each family member. The adolescents were interviewed at the hospital and each parent was interviewed in the family's home. With the permission of the subject, the interviews were recorded on audio tape and transcribed in order to facilitate data analysis. The families of all adolescents at one state hospital lived in rural communities. The adolescents were in the custody of at least one natural parent. In all, 39 adolescents, age 13 to 18 yr., were interviewed-27 boys and 12 girls. All adolescents consented to 'Department of Family and Child Development, Kansas State University, Manhattan, Kansas 66506.
884
A. P. JURICH,ET AL.
be interviewed. Parental cooperation was less complete. One or both parents of 26 of the 27 boys was interviewed and at least one parent for 9 of the 12 girls. Three families ( 2 with female and 1 with a male adolescent) refused to be interviewed and one girl's family was out of town at the time interviews were conducted. Because of the remarriage of parents following divorce, 3 parents were interviewed for 2 boys and 1 girl.
Reasons for Hospitalization Two-thirds of the adolescents were diagnosed as having an adjustment reaction to adolescence. Of the girls, 11 had an adjustment reaction and only 1 was classified as schizophrenic. Boys' diagnoses suggested more severe problems. Although 15 had adjustment reactions, 8 were diagnosed as schizophrenic, 2 as mentally retarded, and 2 as having other severe diagnoses. Aside from the fact that more boys than girls were admitted into the hospital, the boys were also admitted at younger ages ( M = 14 yr. vs M = 15 yr.) and had been hospitalized for longer periods ( M = 6 mo. vs M = 4 mo.). Most of the adolescents had been in trouble with the law. Parents indicated a larger proportion of boys than girls had trouble with the police. Of the 9 girls having trouble with the police, 7 were run-aways, 1 was involved in car theft, and 1 wrote bad checks. Of the 22 boys, only 4 were run-aways. Sixteen had committed acts of vandalism or theft or both, 1 wrote bad checks, and 1 threatened to kill his father. Just before coming to the hospital the boys had law violations and the girls had problems with parents. There were also sex differences in the adolescents' use of drugs. Although a large percentage of both sexes drank alcoholic beverages, more boys did this than girls (59% vs 42%). Girls, however, experimented more with other drugs (48% vs 58%). Aside from alcohol, the most commonly used drug by the boys was marijuana. Descriptive data showed that both alcohol and marijuana were ingested as part of a group activity for the boys, while the drugtaking behavior of most of the girls was solitary. The most frequent drug use by girls was the ingestion of vapors (glue, gasoline, etc.) by "sniffing."
Family Composition The median number of children in the boys' families was 4 and in girls' families was 6. The majority ( 6 9 % ) of adolescents of both sexes came from families broken by divorce or death. Almost one in five of the adolescents had experienced the death of a parent or stepparent. Approximately half of the families had a family member who had been in jail and had a parent with a drinking problem. Although the families of both sexes demonstrated problems, the girls' families reported more family disruptions and a greater isolation of the adolescent. While 44.4% of the boys lived with both natural parents, only one girl in the study lived in her natural family. Most of the girls (66.7%) had a stepparent in the family and had mothers who had had two or more marriages. Half of the girls had been placed in foster homes prior to hospitalization. Only
FAMILIES OF HOSPITALIZED ADOLESCENTS
885
11.1% of the boys had been in foster homes. More girls (33.3%) than boys (3.7%) had been in group-care homes for a period of time before hospitalization. Parental Control Parents were reported as exercising more control over girls than over boys. More girls than boys reported that they had to dress like parents wanted (42% vs 7 % ) , parents controlled their friendships (58% vs 33% ) , and decided what they could and could not do (50% vs 19%). Girls felt that their parents nagged them about appearance and friends and indicated that this nagging frequently led to quarrels. Although three-fourths of the girls indicated that their parents' nagging led to a quarrel, only one-fourth of the boys reported similar incidents. The mothers of the adolescents confirmed their adolescents' reports regarding dress and friendships. Besides being more controlled by their families, fewer girls than boys were allowed to assist in making family decisions (33% vs 7 8 % ) . The families exercised a significant double standard which fostered passivity and dependence upon the family by the adolescent girls and independence from the family for the boys. There were also sex differences in the strictness and mode of punishment exercised by the parents. The boys reported more physical punishment than the girls (52% vs 33%). Physical punishment included spanking during childhood and slapping, punching or whipping with an object such as a belt. The parents of the girls more often utilized restriction to the house or yard as a type of punishment ( 8 3 % ) . Only 37% of the boys' parents restricted their adolescent similarly. It is difficult to compare these two different modes of discipline objectively. However, subjectively the adolescent girls more frequently reported that their parents were strict with them (83% vs 33%). The reports of the parents confirm that the parents of the girls were stricter than the patents of the boys (80% vs 31%). Adolescents' Attitudes T o w ~ Thezl d Families Generally, the girls had more negative attitudes toward their families than their male counterparts. Fewer girls than boys reported good treatment from their parents when they were younger (25% vs 6 7 % ) . More girls said that their parents were unfair to them (83% vs 37% ) and commented that parents blamed them for family troubles and treated siblings more favorably (75% vs 3 3 % ) . Over half of the male adolescents (59% ) reported that they had experienced mostly good times in their families, while 50% of the girls had reported that their family life consisted primarily of bad times. More boys than girls said parents would listen to them and understood what they said (52% vs 8 % ) . The parents' reports confirmed that their adolescents, particularly the girls, seldom talked their problems over with their
886
A. P. JURICH, ET AL.
parents. Although the majority of the parents said that they could usually understand their adolescents when they talked to them, 28.5% of the boys' parents and 42.9% of the girls' parents reported that their adolescents seldom spoke to them about anything. More boys than girls felt close to both parents (74% vs 33%). The boys formed a close relationship with their mothers in over 90% of the families. The girls, however, did not have a close relationship with their mothers in about 60% of the families. They formed a closer relationship with their fathers. The parents' responses verified the adolescents' perceptions. The hospitalized female adolescents reported poorer family relationships and less communication with their parents, especially their mothers, than their male counterparts. Hospitalization
Adolescent boys reported their parents visited them ar the hospital more frequently than girls' parents visited their adolescents (68% vs 18%). This was supported by the parents. More boys than girls wanted to return to their parents' home (89% vs 5 8 % ) . In addition, more boys' than girls' parents wanted the adolescent to come home (89% vs 49% ). Almost 62% of the girls' parents had no idea of their daughter's future following hospitalization. This was true of less than one-fourth of the boys' parents. Fewer girls (25%) than boys (63% ) were dissatisfied with the hospital. The mental health profession often appears to have assumed that, because the adolescent girl's deviance is more covert, she is healthier than the teen-age boy and, therefore, needs less attention. The present study has shown that the families of hospitalized adolescent girls can be less supportive and can contribute to more problems than the families of hospitalized boys. Therefore, treatment of hospitalized adolescents, both male and female, should be done in conjunction with some program to utilize the adolescents' families in the treatment. REFERENCES ADAMS, J. F. Adolescent personal problems as a function of age and sex. Journal o f Genetic Psychology, 1964, 104, 207-214. CHABASSOL, D. J., & THOMAS, D. C. Sex and age differences in problems and interests of adolescents. Journal of Experimental Edacation, 1969, 38, 16-23. CHAFESZ, I. S. Ma~culine/feminineor human? Itasca, 111.: Peacock, 1974. DORWAN, E., & ADELSON, J. The adolescenr experience. New York: Wiley, 1966. KINLOCK,G. L. Parent-youth conflict ac home: an investigation among university freshmen. American Journal of Orthop~ychidry,1970,40,658-664. SEARS, R. R., WHITING,J. W. M.,NOWLIS, V.,& SBARS. P. S. Some child-rearing antecedents of aggression and dependency in young children. Genetic Psychology Monographs, 1953,47, 135-234.
Accepted March 1,1976.
