ABSTRACT
A better understanding of the effects of family processes on the development and the course of specific diseases is critical if we are to utilize marital and family interventions as effective components of prevention and treatment packages. One practical approach to organizing research on family and health may be in terms of the effect of family relationships on the broad facets of disease processes, rather than on the presence or absence of particular disease states. Likewise, it may be useful to identify common mediators of the effect of family processes on facets of health, rather than to focus only on bivariate relationships between particular family variables and particular health outcomes. In this way, we may subsume and organize a growing body of data within a clear theoretical framework. Accordingly, in the current chapter we begin by discussing the broad facets of disease processes that unite many areas of inquiry in the health area. For each facet we cite illustrative data implicating family processes. Next, we identify three potential mediators that may jointly account for some or all of the effect of family processes on disease. In each case we describe illustrative data documenting that family processes are related to the hypothesizedmediator and that themediator is related to facets of disease. Finally, we discuss recent advances in family treatment, using marital and family interventions for depression as an example. Our goal here is to explore the potential for marital and family interventions to influence health outcomes. Understanding pathways by which family relationships may influence health over time, including allostatic load, depression, and health-compromising behaviors provides clinicians with targets for prevention and intervention efforts aimed at enhancing family functioning and alleviating patient distress.
