Quick, simple measures of family relationships for use in clinical practice and
research. A Systematic Review.
Pritchett, Rachel; Kemp, Jeremy; Wilson, Philip; Minnis, Helen; Bryce,
Graham; Gillberg, Christopher.
ABSTRACT
Background: Family functioning has been implicated in the onset of child and adult psychopathology.
Various measures exist for assessing constructs in the areas of parent-child relationships, parental
practices and discipline, parental beliefs, marital quality, global family functioning and situation
specific measures
Objectives: To identify systematically all questionnaire measures of family functioning appropriate for
use in primary care and research.
Methods: A systematic literature review was conducted, following PRISMA guidelines and searching
14 bibliographic databases using pre-determined filters, to identify family functioning measures
suitable for use in families with children from zero to three years old.
Results: One hundred and seven measures of family functioning were reported and tabulated and the
most commonly used measures were identified.
Conclusions: There are numerous measures available demonstrating characteristics which make them
suitable for continued use. Future research is needed to examine the more holistic measurement of
family functioning using integration of multi-informant data.
Keywords: Systematic Review; Family Functioning; questionnaires
1
INTRODUCTION
Understanding what is going on in the family is a challenge in clinical practice: clinicians in primary
care, paediatrics and psychiatry wish to understand the impact of family functioning on development
and require robust standardised measures that can be administered effectively in busy clinical settings.
The importance of family functioning in the development of child and adult psychopathology is well
established (1;2). Less clearly understood are the specific family processes implicated and the patterns
of cause, correlation and interaction that lead to specific disorders (3). These processes need to be
understood over time and in depth. Cross-sectional research generally fails to disentangle causes from
consequences but longitudinal population-based research offers the potential to elucidate these
pathways (4). This type of research relies on well-validated measures of family functioning that can be
administered on a large-scale, in a cost-efficient manner and be suitable for use with families with
young children. A number of self-report instruments fulfil these criteria and form the focus for this
review.
Previous examination of the literature in this area has focussed on frequently-cited measures without
systematically examining all available measures (5). This present review extends these findings by
commenting on recent validation work carried out on the previously reviewed measures. We have also
widened the literature search to include all the self-report measures of family functioning which have
been developed, producing an up to date, inclusive, systematic review of self report measures of family
functioning.
There are challenges facing those who use self-report family functioning measures(5).
These include
the question of how effective family functioning measures are at examining the family level, rather
than the individual level, and whether averaging individual family members’ scores to gain an overall
score is valid. There is also a broader question of whether people give accurate or simply socially
desirable answers in self report questionnaires. In addition when examining self-report measures for
families with preschool children, it is clear than the measures will be scored solely from the parent’s
point of view. Further issues that have been found to affect self-report measures include gender,
socio-economic status and ethnic background. Tutty (5) discusses these considerations in detail.
2
What do measures of family functioning measure?
No single measure, or group of measures, can hope to capture the complexity of family functioning
completely. Indeed, measures are often developed with a particular purpose in mind, for example to
assess the extent to which a particular familial factor is correlated with a particular disorder, such as
harsh parental discipline with conduct disorder. Other measures have been developed within a clinical
or therapeutic context, as is the case with many of the global measures of family functioning (e.g. the
Family Assessment Device (FAD); (6). Measures of marital quality have been developed for both
clinical and research use. Some measures aim to examine family functioning as a whole, while others
look at specific areas of family functioning. For the purposes of this review measures of family
functioning have been organised into six sections, described below. 1. Parent-child relationships. 2.
Parental practices and discipline. 3. Parental beliefs 4. Marital quality. 5. Global family functioning
and 6. Situation-specific measures.
Family functioning and mental health
In a survey of child mental health in the UK, prevalence of mental disorders was 18% in families with
poor functioning (as measured by the General Functioning Scale of the McMaster Family Assessment
Device – FAD; (6) as opposed to 7% in families with healthy levels of family functioning (7). In the
Ontario study of child mental health, poor scores on the same scale predicted subsequent adjustment
problems and occurrence of suicidal behaviour (8). Families of boys with a mood or anxiety disorder,
boys with ADHD and control boys were compared using the FAD (9). While families of boys with
psychopathology had poorer levels of family functioning there was no difference in profile between the
mood disordered and the ADHD groups. In contrast, Cunningham et al. found no significant difference
in family functioning (FAD) between ADHD and non-ADHD families (10). The evidence linking
family functioning to mental health and development problems emphasises the need fully to understand
different measures of family functioning.
In this systematic review, we present a broad overview of published measures of family functioning.
3
METHOD
A literature search of internet-based bibliographic databases was completed covering the area of
interest, family functioning. Following a preliminary search by one of the authors (JK), a more
comprehensive search was carried out independently by another author (RP) using the guidelines on the
preferred method for reporting items for systematic reviews: the PRISMA statement (11). The search
was conducted using the following databases: 1. PsychLIT/PsychInfo, 2. BNI, 3. CINAHL, 4. Ovid
EBM databases collection, 5. EMBASE, 6. ERIC, 7. Health and Psychosocial Instruments, 8.
MEDLINE, 9. WEB OF SCIENCE, 10. International Bibliography of the Social Service, 11.
PsycARTICLES, 12. Psychology and Behavioural Sciences Collection, 13. socINDEX with Full Text,
14. Health Source: Nursing/Academic Edition. The two searches were cross checked and all the
references identified in the initial search were found in the more comprehensive search. All searches
were limited to references published in English between 1966 and February 2009. Titles and abstracts
were checked by a single reviewer (RP) who sought advice regarding inclusion and exclusion from
other authors in case of doubt. References were then excluded on the basis of the title and abstract if
they did not meet the following criteria: 1. Human study population; 2. Study measures include tools
that a) assess area of interest, b) are self-report measures and thus are potentially suitable for use in a
large scale study c) are suitable for use with members of families with a child at or below the age of
three (can be deemed suitable by author, even if not validated on this age group); 3. Published in a
peer-reviewed journal, book or monograph.
Search terms were modified iteratively to ensure inclusion of key papers identified a priori by experts
in the field., Terms used in the final search were:
1.
exp Family Relations/
2.
Family or families) adj3 (relations* or dynamic* or conflict* or function* or dysfunction*)
3. (parent* or mother* or maternal or father* or paternal) adj3 (disciplin* or permissive* or role*
or influen*)
4. (parental or parenting or child rearing) adj (style* or attitude* or expectation* or skill* or
behavio?r* or role*)
5.
(Sibling* or ((father or paternal or mother or maternal) adj (child))) adj relations*
4
6. self report.mp. [mp=title, original title, abstract, name of substance word, subject heading
word]
7. child, preschool/ or exp infant/
8. (infant* or baby or babies or toddler* or pre-school child* or (child* adj under adj3
three)).mp. [mp=title, original title, abstract, name of substance word, subject heading word]
These eight searches were conducted individually and then combined (1or2or3or4or5) and 6 and (7or8)
(See Figure 1). Additional references were sought where appropriate using a secondary search of the
reference lists from key papers. Experts in the field were consulted to ensure that we had not omitted
any key papers.
Figure 1 here
The papers were then grouped into six themes, based on the aspect of family functioning that they were
each measuring. The sections were created in a way to organise the large number of measures into a
reasonable number of categories to aid ease of finding appropriate measures for future research.
All the measures met basic criteria for reliability and validity, unless otherwise stated. These criteria
required evidence of test-retest or inter-rater reliability and/or basic validation data, including
comparison with existing “gold standard” instruments, factor analytic findings that fit with previously
developed theory or other instruments, or prediction of meaningful correlates or outcomes. The main
references will need to be referred to for individual psychometric properties of the measures.
RESULTS
The tables below display all the identified measures of family functioning. There is one table for each
of the six sections:
1.
2.
3.
4.
5.
6.
Parent-child relationships.
Parental practices and discipline.
Parental beliefs
Marital quality.
Global family functioning and
Situation-specific measures.
The measures are listed in alphabetical order in each table. It should be noted that some measures
could be included in more than one table: where this was the case they were placed in the table deemed
most suitable. We have highlighted the most commonly used measures in each table: these were also
well validated measures, normed in reasonably large populations and generally short and easy to use.
5
One such example is the Parenting Stress Index (PSI) (see below), normed on over 2,500 parents and
its short form contains 36 items tapping into key aspects of parenting stress including parental distress,
difficult child characteristics, and dysfunctional parent-child interaction.
Table 1 displays the parent-child relationship measures. These measures aim to assess patterns of
attachment and other aspects of the parent-child relationship which can be conceptualised by
examining communication, nurturing and a sense of parental pleasure in interaction.
Table1 here
Of the parent-child relationship measures, the most commonly used measures were the Parenting Stress
Index (PSI) and the Child Abuse Potential Inventory (CAPI).
Table 2 displays the parental practices and discipline measures. These measures assess interactional
patterns of behaviours including harsh and inconsistent discipline.
Table 2 here
Of the parental practices and discipline measures, the most commonly used were the Parenting Scale
(PS), the Parenting Daily Hassles Scale (PDH) and the Conflict Tactics Scale (CTSPC).
Table 3 displays the parental belief measures. These measures assess the way in which a person thinks
about being a parent and their beliefs about their particular skills.
Table 3 here
Of the parental belief measures, the most commonly used was the Parenting Sense of Competence
Scale (PSOC).
6
Table 4 displays the marital quality measures. These measures assess marital conflict, quality and
perception of marital problems.
Table 4 here
Of the marital quality measures, the most commonly used was the Dyadic Adjustment Scale (DAS).
Table 5 displays the Global Family Functioning Measures. These measures conceptualise the family as
a system which needs to be examined as a whole.
Table 5 here
Of the global family functioning measures, the most commonly used were the Impact on Family Scale,
the Family Adaptability and Cohesion Scale (FACES), the Family Assessment Device (FAD) and the
Family Assessment Measure (FAM).
Table 6 displays the situation specific measures. These measures assess how a family functions in a
specific situation when a child suffers problems.
Table 6 here
Of the situation specific measures, none had been repeatedly used, and should instead be chosen
depending on the specific situation present.
DISCUSSION
This review demonstrates the vast range of available measures of the family environment, providing an
outline of over 100 measures which can be used to measure different aspects of family functioning.
We extended the findings of Tutty who reviewed 6 commonly used measures of family functioning by
reviewing all self-report family functioning measures. We presented summary evidence on domains
that might be useful in epidemiological research conducted among families with young children as well
as in clinical work with families by non-specialists.
7
For each approach to family functioning, we identified a few key measures which were more
commonly used than others. These commonly used measures have been shown to be short, widely
normed, clinically relevant measures, It is evident that the most commonly used measures have already
shown characteristics which make them strong contenders for their continued use in future research.
Self report measures for assessing six different approaches to family functioning were identified,
however self report measures are more suitable for measuring some aspects of family functioning than
others. Self report measures have proved invaluable in research assessing parental practices and
discipline, with large epidemiological studies using self report measures linking problem parenting
(especially harsh and inconsistent discipline) with disruptive behaviour in children (1;12). Self report
measures are also fundamental in research assessing parental beliefs, as they provide the only means of
tapping into this important area of family functioning. Research into parent child relationships however
have been most commonly examined using observational measures or semi-structured interviews. Self
report measures have not been shown to be as successful at assessing attachment for example, with Lim
et al (in press) concluding that there are no ‘quick and ready’ measures of attachment, and that those
claiming to measure such a construct are “most likely measuring something else” (13). It is clear that
while self report measures offer a valuable way of assessing family functioning, there are some areas
for which they are more suitable, for example beliefs as opposed to behaviours.
Ease of administration and cost-efficiency make self-report instruments attractive for assessing
psychological constructs in large-scale research but reporting bias means the attitudes expressed might
not reflect actual behaviour. Some areas of family functioning appear to have substantially more
measures than others. There may be a degree of publication bias driven by the popularity of specific
areas of research. Greenberg (14) states the importance of acknowledging the effect of such bias,
demonstrating the vast quantity of false information which can be created following distortions.
There are limitations of this review which should be acknowledged. The search criteria used were
potentially restrictive, only including articles with the term self report. Alternative terms, for example,
self completion or pencil and paper, would have broadened the search. The search could have been
further broadened by looking at sources beyond databases and including articles not published in
English. It should also be noted that there is a certain degree of subjectivity involved when assessing
the themes of the instruments.
8
A key area for future research lies in the area of multi-informant data. Many of the measures described
claim to measure how a family functions, while only requiring the input of one member of the family.
Future research should aim to compare and combine self reports from different family members
regarding the functioning of the family as a whole or should ask other important adults, for example, a
child’s carer or teacher, to comment in order to gain multi informant data on family functioning.
Combining information from several informants in order to develop a more holistic measurement has
been done successfully with in other fields. For example, Goodman’s Strengths and Difficulties
questionnaire in which information can be combined from the child, the parent and the teacher in order
to develop the most sensitive and specific screening tool for child psychopathology (15).
Due to the broad span of the study of family functioning, it has not been possible fully to describe each
measure in detail. We intend in subsequent publications to provide more detailed data on the
psychometric properties of the instruments used to assess each of the domains of family functioning we
have described here.
In conclusion, this review has identified over 100 self report measures of family functioning. It has
acknowledged that some of these measures are more commonly used than others, and that these
measures display characteristics which make them acceptable measures for future research in the area.
Some areas of family functioning are better suited to research using self report measures, for example,
parental beliefs, while research into behavioural characteristics may better rely more on observational
measures. The range of measures available in this very comprehensive field should minimise the
necessity for developing new self-report measures of family functioning, except perhaps for specific
areas where family functioning has not previously been explored. Future research should examine the
usefulness of combining information of family functioning from different informants. .
9
Figure 1 – systematic review procedure
Number of records identified
through database searching
Number of additional records
identified through other
sources
1447
1
Number of records after duplicates removed
749
Number of records screened
Number of records excluded
749
238
Number of full-text articles
assessed for eligibility
Number of full-text articles
excluded- not self report
measure
511
404
Number of studies included in qualitative synthesis
107
10
11
Table 1:Questionnaire measures of the Parent-Child Relationship
Measure Name
Main Reference
Measure Description and issues with validity/reliability
Adult Adolescent Parenting
Inventory (AAPI)
(16)
Bavolek, 1984
(18)
Condon, 1993
(20)
Milner, 1986
(22)
Pederson,
Anderson, Cain,
1980
(24)
Wilhelm, Parker,
1988
(26)
Cranley, 1981
(28)
Amankwaa,
Younger, Best,
Pickler, 2002
(30)
Condon,
Corkindale, 1998
(32)
Han, 2002
(34)
Hock, McBride,
Gnezda, 1989
(36)
36 items-parenting attitudes- empathy toward the children’s needs and parental expectations of the child’s development
(17).
Antenatal Attachment
Questionnaire
Child Abuse Potential
Inventory (CAPI)
Father Involvement with
Child
Intimate Bond Measure
(IBM)
Maternal Fetal Attachment
Measure (MFAS)
Maternal Infant
Responsiveness Instrument
(MIRI)
Maternal Postnatal
Attachment Questionnaire
Maternal Sensitivity Scale
Maternal Separation
Anxiety Scale (MSAS)
Montreal Fathers’
Involvement Scale
Two dimensions-mother fetal attachment- how much time the mother spends thinking about the fetus, and degree of
tenderness, affection and protectiveness (19).
77 items-child abuse potential -parental distress, rigidity, unhappiness, problems with child and self, problems with
family, and problems with others (21).
14 items, paternal involvement in child’s life -feeding, dressing and playing with their child (23).
24 items- perceived quality of partner relationship-.affection and consideration, in the care subscale, and criticism and
domination in the control subscale (25).
24 items –maternal attachment to their unborn child- five different domains: differentiation of self from fetus, interaction
with the fetus, attributing characteristics to the fetus, giving of self, and role taking (27).
22 items- how the parent feels about their infant and an appraisal of the infant’s responses- involves rating items, for
example, “I believe I can comfort my baby” on how strongly the parent believes them to be true, (29).
Attachment of the mother to her child after birth- four dimensions: Pleasure in Proximity, Acceptance, Tolerance and
Competence. (31).
36 items- maternal sensitivity- maternal ratings on how likely they are to do something. (33).
Mother’s feelings when she is separated from her infant– examines mother’s level of sadness, guilt and worry (35).
47 items -father’s involvement- six different scales; emotional support, opening to the world, basic care, physical play,
evocations and discipline (36).
12
Myself as a Mother and My
Baby Scale
Parental Responsibility
Scale
Parent/caregiver
Involvement Scale (PCIS)
Parent-Child Relationships
Questionnaire
Parenting Stress Index/Short
Form (PSI-SF)
Postpartum Bonding
Questionnaire (PBQ)
Prenatal Attachment
Inventory (PAI)
Separation-Individuation
Process Inventory (S-IPI)
Paquette, Bolte,
Turcotte, Dubeau,
Bouchard, 2000
(37)
Walker, Crain,
Thompson, 1986
(39)
McBride, Mills,
1993
(41)
Farran, Kasari,
Comfort, Jay,
1986
(43)
Furman,
Giberson, 1995
(45)
Abidin, 1990
(47)
Brockington,
Oates, George,
Turner, Vostanis,
Sullivan, et al,
2001
(49)
Muller, 1993
(51)
Christenson,
Wilson, 1985
Two different dimensions- the mother’s evaluation of how she is developing as a parent, and how the mother evaluates her
infant- 7-point semantic differential scale and adjective pairs, for example, kind-cruel and difficult-easy (38).
14 items- parental responsibility- Parents rate the degree to which they are responsible for tasks such as making babysitting agreements (40).
11 items- parental involvement behaviour- dimensions of quality and appropriateness of the behaviour (42).
40 items- qualities found in the parent child relationship-5 factors; personal relationship-companionship and intimacy,
warmth-nurturance and affection, disciplinary warmth-praise, prosocial behaviours and shared decisions making, Power
assertion- quarrelling and forceful punishment and possessiveness-control and protectiveness (44).
36 items- degree and cause of stress in a parent child relationship- 3 subscales; parental distress, parent child dysfunctional
interaction and difficult child (46).
25 items- Quality of mother-infant interaction- mother’s attachment responses to her infant, for example, rating how often
the baby makes the mother feel anxious (48).
21 items- maternal attachment to a child before it is born-mothers indicate how often they have affectionate thoughts or
behave affectionately towards the fetus (50).
Separation individuation used in mothers while they are pregnant- Mothers rate statements as to how accurate they are in
relation to themselves (35).
13
Table 2: Parental Practices and Discipline Measures
Measurement
Alabama Parenting
Questionnaire
Authoritarianism Measure
Child Rearing Practice Report
(CRPR)
Conflict Tactics Scale
(Parent-child version)
(CTSPC)
Parental Anger Inventory
(PAI)
Parental Authority
Questionnaire (PAQ-R)
Parental Behaviour Checklist
(PBC)
Parental Cognitions and
Conduct Toward the Infant
Scale (PACOTIS)
Parental Control Scale
Parental Locus of Control
Scale (PLOC)
Parental Response to
Main Reference
(52)
Shelton, Frick,
Wootton, 1996.
(54)
Uhde, 1973
(56)
Deković, Janssen,
Gerris, 1991
(58)
Straus, 1995
Measure Description and issues with validity/reliability
Parenting practices-focussing on positive parenting, inconsistent discipline and poor supervision (53).
(60)
Hansen, Sedlar,
1998
(62)
Reitman, Rhode,
Hupp, 2002
(63)
Fox, 1994
(64)
Boivin, Perusse,
Dionne, Saysset,
Zoccolillo,
Tarabulsy, et al,
2005
(66)
Greenberger, 1988
(68)
Campis, Lyman,
Pretice-Dunn, 1986
(70)
A mother’s child abuse potential- anger experienced by a parent in different situations (61).
8 items-Authoritarianism in parenting-2 components; intolerance of ambiguity, and perception of parents as the
primary source of knowledge and power over their children (55).
29 items- authoritative and authoritarian styles of child-rearing- rational guiding of the child and authoritarian control
and supervision of the child (57).
How often a mother acts out different behaviours ranging from non-violent discipline to psychologically and
physically abusive acts and indicators of neglect (59).
30 items- parenting style- 3 scales; authoritarian scale, authoritative scale and permissive scale (62).
100 items- How parents are raising their children- subscales; expectations, discipline and nurturing (63).
28 items- cognitions and behaviours relating to a mother’s interactions with her infant-3 aspects of parenting;
parental self efficacy, perceived parental impact and parental hostile-reactive behaviours (65).
39 items- parental control- disciplinary style, maternal responsiveness, and degree of control over the child (67).
47 items (30 in short form)- locus of control in the relationship between a parent and a child (69).
How parents respond to their children when they misbehave- parents report how often they use each of the 12
14
Misbehaviour Scale
Parent Practices Scale (PPS)
Parenting Alliance Measure
(PAM)
Parenting Styles and
Dimensions Questionnaire
(PSDQ)
Parenting Daily Hassles Scale
(PDH)
Parenting Scale (PS)
Parent Behaviour Inventory
(PBI)
Parent Problem Checklist
(PPC)
Parent Protection Scale (PPS)
Toddler Care Questionnaire
(TCQ)
Holden,
Zambarano, 1992
(72)
Strayhorn,
Weidman 1988
(73)
Konold, Abidin,
2001
(75)
Robinson,
Mandleco, Olsen,
Hart, 2001
(77)
Crnic, Greenberg,
1990
(80)
Arnold, O’Leary,
Wolff, Acker, 1993.
(82)
Lovejoy, Weis,
O’Hare, Rubin,
1999
(83)
Dadds, Powell,
1991
(85)
Thomasgard, Metz,
Edelbrock, 1995.
(86)
Gross, Rocissano,
1988
different disciplinary responses given in an average week (71).
34 items- parents’ patterns of interaction with their preschool children-parent rates how often behaviours occur such
as the child doing something which brings the parent pleasure.
20 items- The strength of the alliance between parents of children aged 1-19 years-parents rate agreement with items
(74).
32 items- parenting behaviour-three different factors; authoritative parenting style, authoritarian parenting style and
permissive parenting style (76).
15 items-parenting stress-parents rate the frequency and intensity of daily events in caring for children (78). The
Parenting Events Questionnaire (PEQ) is an additional measure that has been adapted from the Parenting Daily
Hassles. The PEQ is a 20-item scale that examines daily stress that people experience with parenting (79).
30 items- dysfunctional parenting styles-three subscales; laxness (permissiveness), over-reactivity (authoritarian
parenting, anger, meanness, irritability), and verbosity (use of long reprimands and over reliance on talking) (81).
Parenting behaviour- two broad dimensions of parenting- support/engagement and hostility/coercion-self-report or
observational measure (82).
16 items- conflict between parents over child-rearing practices- parent’s ability to co-operate and work together as
part of a family (84).
25 items- protective parenting- parents rate the degree to which the statement is descriptive of their behaviour with
their child (46).
37 items- parents rate their confidence in their abilities to perform different parenting tasks when looking after their
toddlers (87).
15
Table 3: Parental Belief Measures
Measurement
Battered Fetus Scale (bfs)
Childbearing Attitudes
Questionnaire (CAQ)
Cognitive Appraisal of
Motherhood
Family Satisfaction Scale
(FSS)
Gratification in the Mothering
Role
How I feel About My Baby
Now
Ideas about Parenting Scale
(IAP)
Infant Care Questionnaire
Inventory of Parent
Experience (IPE)
Lang and Goulet Hardiness
Scale (LGHS)
Main Reference
(18)
Condon, 1993
(89)
Ruble, Fleming,
Strangor, BrooksGunn, Fitzmaurice,
Deutsch, 1990
(91)
Folkman, Lazarus,
1985
(93)
Olson, Fournier,
Duickman, 1982
(95)
Russell, 1974
(97)
Leifer, 1977
(99) Cowan,
Cowan, 1992
(101)
Secco, 2002
(103)
Crnic, Greenberg,
Ragozin, Robinson,
Basham, 1983.
(105)
Lang, Goulet,
Amsel, Lang,
Hardiness, 2003
Measure Description and issues with validity/reliability
How often a mother has thoughts of irritation towards the fetus, worries about losing control over one’s temper
and hurting the child, and experiencing urges to harm and punish the fetus (88).
60 items-attitudes towards pregnancy and parenthood- parents rate their agreement with different statements, for
example, on body image, maternal worries, information seeking and negative aspects of caretaking (90).
17 items- how mother’s think about how they cope with different tasks- 3 theoretic factors; threat appraisal,
challenge appraisal, and the appraisal of abilities to deal with a stressful event- Mothers rate how often they
appraise motherhood tasks in the way described (92).
14 items -marital and family systems-2 subscales; family cohesion and family adaptability (94).
What a mother enjoys in her maternal role- Mother’s rate the extent to which they agree to different statements,
for example, “new appreciation for my own parents” (96).
8 items-maternal attachment- Mother’s rate their agreement with items, for example, “I feel drained by my
baby” (98).
46 items- perceived difference in the parenting belief system-Parents rate the extent to which they agree with
different statements about parenting and their perception of their partner’s beliefs-includes areas such as, child
rearing practices, confidence and uncertainty about child rearing. Although this scale demonstrated evidence of
reliability and validity in women, this was not found in men (100).
The mother’s perception of her abilities and competence in providing for her infant (102).
Satisfaction with parenting-Parents rate items on satisfaction, for example, “How do you feel about the chores
that are part of child care?” Also includes questions assessing the quality of social support that the parent
receives (104).
Hardiness in parents who have suffered the death of a fetus/infant-three components; sense of personal control
over the outcome of life events and hardships such as the death of a fetus/infant, an active orientation toward
meeting the challenges brought on by the loss, and a belief in the ability to make sense of one’s own existence
following such a tragedy (105).
16
Maternal Identity Scale
Maternal Self Efficacy Scale
Maternal Self Report
Inventory (MSI)
Modernity Scale
Mother Treatment Scale of
the Parental Image
Differential
Neonatal Perception
Inventory (NPI)
Parenting sense of
competence (PSOC)
Parent Opinion Questionnaire
(POQ)
Paternal Attitude Scale
Parental Attitude Research
Instrument (PARI)
Parental Attitudes Towards
Childbearing (PACR)
(106)
Kho, 1996
(108)
Teti, Gelfand, 1991
(110)
Shea, Tronick,
1988
(111) Schaefer,
Edgerton, 1985
(113)
Ginsburg, McGinn,
Harburg, 1970
(115)
Broussard, Hartber,
1970
(116)
Johnston, Mash,
1989
(117)
Azar, Robinson,
Hekimian,
Twentyman, 1984.
(119)
Boyd, 1981
(120)
Schafer, Bell, 1958
(122)
Easterbrooks,
Goldberg, 1990
17 items-maternal identity- 2 different components of maternal identity; self identity as a mother and
identification with the baby (107).
How mothers perceive themselves as parents- Mothers rate how effective they feel they are on specific tasks
when caring for their infant, for example, feeding and playing (109).
18 items- maternal self-esteem- Mother’s rate how true they feel different items regarding parenting issues are
tapping into the mother’s feeling of competence (79).
30 items- childrearing beliefs-higher scores indicate more child-centred beliefs (112).
15 items-a mother’s perception of her parenting style- 9 items measure maternal concern and the remaining 6
measure maternal restrictiveness (114).
A mother’s expectations of their own infant in comparison to an average infant- domains of feeding, spitting
up/vomiting, sleeping, bowel movements, settling into predictable patterns, entertaining themselves and needing
to be held or carried about (90).
17 items- how confident a parent is in their parental role- measures satisfaction (extent of frustration, anxiety,
motivation) and efficacy (competence, problem solving ability and capability) (81).
80 items- unrealistic developmental expectations that parents hold concerning children-parents have to agree or
disagree on items, for example, “Most of the time a 4-year-old can choose the right clothing for the weather and
then get him or herself off to school” (118).
38 statements- father’s attitudes toward participation in parenting activities- rate statements, for example, “I am
just as capable of giving out baby a bath as my wife” as to how much they agree with them (119).
45 items- parental attitudes of warmth and authoritarianism- parents rate their agreement with statements (121).
52 items- parent’s attitudes towards child rearing- Parents rate their level of agreement with items, for example,
fathers’ warmth and aggravation in relation to the child (23).
17
Parental Efficacy
Questionnaire (PEQ)
Inspired by
Caprara, 1998, see
for details, (123)
van Ijzendoorn et
al, 1999
22 items- parental efficacy-parents’ feelings of competence in child rearing, in particular parents’ ability to
empathise with the child’s feelings and the way they act when under stress (124).
Parental Expectations and
Perception of Parenthood
Adjustment
(125)
Kach, McGhee,
1982
(127)
Pistrang, 1984
(129)
Bugental, Blue,
Cruzcosa, 1989
(131)
Reece, 1992
Open-ended questions and 29 statements- prenatal and postnatal version, administered before and after the
birth of the baby- examining problems, gratifications and feelings about parenthood, which are rated for
agreement (126).
Parental Satisfaction Scale
Parent Attribution Test (PAT)
Parent Expectations Survey
(PES)
Parenting Self Agency
Measure (PSAM)
Perceived Maternal Parenting
Self-Efficacy Tool (PMP-SE)
Personal Expectations about
Parenting (PEP)
Pregnancy Anxiety Scale
(PAS)
Pregnancy Related Anxieties
Questionnaire Revised
(PRAQ-R)
Satisfaction with Parenting
(133)
Dumka,
Stoerzinger,
Jackson, Roosa,
1996
(135)
Barnes, AdamsonMacedo, 2007
(137)
Stiober, Houghton,
1994
(139)
Levin, 1991
(140)
Huizink, 2000
(142)
Parental meaning and satisfaction-Parents rate their agreement with items such as “caring for my baby makes
me feel good about myself” (128).
Perceived balance of the control that the parent thinks there is between themselves and their child-contains a
child control over failure scale and an adult control over failure scale, the difference between the results of the
two scales provides the perceived control over failure scale (130).
25 items- parenting self-efficacy- Mothers rate items on how confident they feel in their ability to conduct
certain tasks, for example, feeding and soothing a new baby as well as how the mother is managing her lifestyle
(132).
The degree to which a parent views themselves as an instrument of their own actions (134).
20 items-A mother’s perception of their ability to parent- four subscales; care taking procedures, evoking
behaviour, reading behaviour or signalling and situational beliefs (136).
30 items- parenting expectations- parents evaluate statements, for example, “Having a baby makes a person
frightened and lonely” and, “A baby protects a mother from feeling lonely” (138).
10 items- anxiety during pregnancy- pregnancy, childbirth and hospitalisation (139).
10 items- pregnancy anxiety- 3 subscales; fear of giving birth, fear of bearing a physically or mentally
handicapped child, and concern about one’s own appearance (141).
12 items- parental satisfaction- 2 subscales; satisfaction in the parenting role (such as measuring time away
18
Scale (SWPS)
Self Efficacy for Parenting
Tasks Index (SEPTI)
Self-Report Co-Parenting
Scale
Subjective Experience of
Parenting Scale (SEPS)
Transition to Maternal Role
Scale (TMRS)
What Being the Parent of a
New Baby is Like (WPL)
Ragozin, Basham,
Crnic, Greenberg,
Robinson, 1982
(144)
Coleman, 1998
(146)
McHale, 1997
(148)
Benjamin,
Benjamin, Rind,
1996
adapted from (149)
Blank’s (1964) and
(150)
Mercer’s (1985) 14
item maternal
behaviour scales.
(152)
Pridham,
Chang, 1985
from the baby and mother’s satisfaction with infant care) and parental pleasure in the baby (such as doubts
about maternal competence and mother’s degree of pleasure in child-care chores) (143).
Parenting self-efficacy- includes examining the constructs of emotional availability, nurturing, discipline and
limit setting (145).
How often a parent does something to promote a sense of family warmth, collaboration and cohesion (147).
128 items-parenting characteristics- parents had to rate how often they engaged in various parenting behaviours,
for example, attachment behaviours, discipline, regulation of anger, and behaviours that promoted the child’s
development (148).
7 items - how a mother adapts to her maternal role-Mother’s rate the level of difficulty experienced on different
items, for example, their enjoyment of motherhood (151).
25 items- parent’s perceptions of themselves as parents- three subscales; success (renamed evaluation in 1989),
Life change (added in 1989) and centrality (153).
19
Table 4: Marital Quality measures
Measurement
Main Reference
Areas of Change
(154)
Questionnaire (A-C)
Weiss, Birchler,
1975
Dyadic Adjustment Scale
(156)
(DAS)
Spanier, 1976
Evaluating and Nurturing
Relationship Issues
Communication and
Happiness Scales (ENRICH)
Four Factor Scale of Intimate
Relations
Marital Adjustment Inventory
(MAT)
Marital Satisfaction Scale
(MSS)
Marital Satisfaction Scale
Marital Status Inventory
(MSI)
Partnership Questionnaire
(PFB)
Positive and Negative Affect
Schedule (PANAS)
Postpartum Partner Support
Scale (PPSS)
Measure Description and issues with validity/reliability
68 items- amount of change that couples seek in their relationship- 34 start with “I want my partner to…” while
the remaining half start with “It would please my partner if I…” (155).
32 items- marital relations- four subscales; consensus on matters of importance to dyadic functioning, dyadic
satisfaction, dyadic cohesion and affectional expression (126).
(93)
Olson, Fournier,
Duickman, 1982
50 items-marital satisfaction- 5 areas of the marital relationship; communication, conflict resolution, children and
marriage, sexual relationship, and egalitarian relations (157).
(158)
Braiker, Kelley,
1979
(160)
Locke, Wallace,
1959
(162)
Roach, Frazier,
Bowden, 1981
(163)
Huston, 1983
(164)
Weiss, Cerreto,
1980
(165)
Hahlweg, 1996
(167)
Watson, Clark,
Tellegen, 1988
(169)
Dennis, Ross,
Marital relationships-four subscales; feelings of love and ambivalence toward the husband, the extent to which
wives feel they have attempted to maintain their marital relationship, and the degree to which conflict
characterizes their interactions with their husbands (159).
15 items - global measure of marital adjustment- differentiates between distressed and nondistressed marital
relationships (161)
How satisfied someone is in his or her marital relationship at any given time indicating greater or lesser
favourability than other points in the relationship (151).
11 items-marital satisfaction- semantic differential measure, with items including boring-interesting and
miserable-encouraging (159).
14 items-dissolution potential in a marital relationship-person answers true or false to statements (155).
30 items- marital satisfaction-3 different aspects of relationships; communication, sensitivity and conflict (166).
20 items, 10 positive and 10 negative- mothers’ subjective emotional experience when they are interacting with
their child-parents rate the degree in which they felt each of the emotions while playing with their child (168).
Perceptions of postpartum support from a partner- examines functional elements of support; appraisal/emotional,
informational and instrumental (169).
20
Quality Marriage Index
(QMI)
Quality of Relationships
Inventory (QRI)
Relationship Dynamics Scale
[RDS)
Relationship Scales
Questionnaire (RSQ)
2006
(170)
Norton, 1983
(172)
Pierce, Sarason,
Sarason, 1991
(173)
Stanley,
Markman, 1997
(175) Griffin,
Bartholomew,
1994
6 items- quality and satisfaction in a relationship- such as stability, strength and happiness (171).
Relationship-specific conflict with a partner one week after their baby has been born-can be adapted and
shortened to as few as 5 items (169).
8 items- relationship problems- partner states how often they feel a certain way in their relationship, for example,
“ I feel lonely in this relationship” (174).
30 items-attachment styles-people rate how well statements describe themselves such as “I find that others are
reluctant to get as close as I would like” (176).
21
Table 5: Global Family Functioning Measures
Measurement
Main Reference
Child and Family Impact
(177)
Measure (CFIM)
Day, Davis, 2006
Family Adaptability and
Cohesion Evaluation Scale
(FACES)
Family Apgar
Family Assessment Device
(FAD)
Family Assessment Measure
(FAM)
Family Coping Strategies
(FCOPES)
Feetham Family
Functioning Survey (FFFS)
Impact on Family Scale
(IFS)
Prenatal Version of Who
Does What
Self Report Family
Inventory (SFI)
(179)
Olson, Portner,
Lavee, 1985
(181)
Smilkstein, 1978
(183)
Epstein, Baldwin,
Bishop, 1982
(184)
Skinner et al, 1983
(186)
McCubbin, Larsen,
Olsen, 1982
(188)
Roberts, Feetham,
1982
(190)
Stein,
Reissman, 1980
(192)
Cowan, Cowan, 1988
(193)
Beavers, Hulgus,
Hampson, 1988
Measure Description and issues with validity/reliability
6 items- impact a child has on a family- 2 scales; impact (including problem severity, child distress and family
distress items) and burden (including interference with child, family and nursery/school activity items) (177).
No evidence of reliability or validity but conceptual base and structure similar to Impact Supplement of the
Strengths and Difficulties Questionnaire (178)
20 items- general family functioning- 2 dimensions of how a family functions; cohesion, the degree of family
connectedness and adaptability, the degree to which the family system is able to change (180).
5 items-Family functioning- family adaptation, partnership, growth, affection and resolve (182).
60 items- family unit functioning- six domains; roles, communication, problems solving, affective interaction,
affective responsiveness, behaviour control and total family functioning (79).
92 items-family functioning- 2 subscales; a general scale and a dyadic relationship scale- general scale
contains 50 items and examines the family as a system-dyadic relationship scale contains 42 items and
measures relationships between specific pairs in the family (185).
Identifies behaviours and problem solving approaches that can benefit a family- Subscales; the mother’s
reframing of family problems and the acquiring of support from family, friends, neighbours and community
resources (187).
An individual’s interpretation of how their family is functioning- the family member’s views on how the
family works in its current environment, the difference between how they expect their family to function and
how it actually functions as well as the relative importance of different family functions (189).
How much a mother perceives their child as impacting on their family-originally developed to assess the
impact of a child with a disability, been adapted for healthy children- subscales; Financial and personal
strains, disruption of family, social and sibling relations, and coping abilities (191).
20 items- parents rate who they anticipate will be responsible for different child care related responsibilities
after the baby is born and who they would ideally like to be responsible for each task- final score results from
the discrepancy between the anticipated and ideal ratings (100).
34 items- internal family functioning-5 dimensions; health/competence, conflict resolution, cohesion,
leadership, and expressiveness (194).
22
Table 6: Situation Specific measures
Measurement
Main Reference
A Screening Questionnaire
(47)
for Mother-Infant Bonding
Brockington, Oats,
Disorders
George, Turner,
Vostanis, Sullivan,
et al, 2001
Family Provider
(195)
Relationships Instrument
Van Riper, 1999.
(FAMPRO)
Maternal Cognitions about
(197)
Infant Sleep Questionnaire
Morrell, 1999
(MCISQ)
Parental Stress Scale: NICU
(199)
(PSS-NICU)
Miles, Funk &
Carlson, 1993
Parent Experience of Child
(201)
Illness (PECI)
Bonner, Hardy,
Guill, McLaughlin,
Schweitzer, Carter,
2006
The Parental Belief Scale for
(202)
Parents of Hospitalised
Melnyk, 1994
Children
Measure Description and issues with validity/reliability
25 items- early indications of disorders in mother-infant relationships- 4 scales; impaired bonding, rejection and
anger, anxiety and incipient abuse (47).
Originally developed for use with parents who had children born with Down syndrome- adapted for use with
parents who had children in an intensive care unit- to assess maternal beliefs, desires, feelings and intentions
concerning family-provider relationships (196).
20 items- how mother’s think about infant sleep- 5 subscales; cognitions about difficulty setting limits on the
infant, anger at the infant’s demands, doubt about parenting competence, worries about feeding during the night
and worries about cot death (198).
Stress of having children hospitalised in intensive care because of low birth weight- 2 dimensions of stress; stress
related to the infant’s behaviour and appearance, and stress related to feeling restricted in their maternal or
caregiver role (200).
25 items- how a parent experiences having to cope with a child who is ill- difficulties with chronic sorrow,
uncertainty, and subjective parenting distress, as well as emotional resources (201).
20 items - beliefs parents have while their children are in hospital- parents rate their agreement with items, for
example, “I am clear about the things that I can do to best help my child” (203).
23
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