Family dimensions in anxious-depressed school

The Family Adaptability and Cohesion Evaluation Scale II (FACES II) was adm inistered to 46 adolescents with comorbid anxiety and major depressive diso rders and to their parents in a treatment study of school refusal. FACES II measures cohesion and adaptability dimensions, as well as family type (bal anced to extreme). Generally, adolescents and parents reported low cohesion (i.e., disengagement) and low adaptability (i.e., rigidity) on FACES II. A dolescents and parents described their ideal families as significantly less disengaged and less rigid than their own families. Fifty percent of adoles cents, 38% of fathers, and 24% of mothers classified their families as the extreme type. Adolescents in extreme families, when compared with adolescen ts in more balanced families, reported significantly higher scores on two o f three depression instruments and on a measure of somatic symptoms. Family therapy to improve cohesion and adaptability and treatments focused on imp roving depression and somatic symptoms may improve family functioning and d ecrease the severity and course of school refusal. (C) 1999 Elsevier Scienc e Ltd. All rights reserved.