Family dimensions in anxious-depressed school refusers

Gail A Bernstein, Susan L. Warren, Elise D. Massie, Paul D. Thuras

Research output: Contribution to journalArticlepeer-review

47 Scopus citations


The Family Adaptability and Cohesion Evaluation Scale II (FACES II) was administered to 46 adolescents with comorbid anxiety and major depressive disorders and to their parents in a treatment study of school refusal. FACES II measures cohesion and adaptability dimensions, as well as family type (balanced to extreme). Generally, adolescents and parents reported low cohesion (i.e., disengagement) and low adaptability (i.e., rigidity) on FACES II. Adolescents and parents described their ideal families as significantly less disengaged and less rigid than their own families. Fifty percent of adolescents, 38% of fathers, and 24% of mothers classified their families as the extreme type. Adolescents in extreme families, when compared with adolescents in more balanced families, reported significantly higher scores on two of three depression instruments and on a measure of somatic symptoms. Family therapy to improve cohesion and adaptability and treatments focused on improving depression and somatic symptoms may improve family functioning and decrease the severity and course of school refusal. Copyright (C) 1999 Elsevier Science Ltd.

Original languageEnglish (US)
Pages (from-to)513-528
Number of pages16
JournalJournal of Anxiety Disorders
Issue number5
StatePublished - Sep 1999

Bibliographical note

Funding Information:
This study was funded by National Insitute of Mental Health grant no. R29 MH46534 to Dr. Bernstein.

Copyright 2007 Elsevier B.V., All rights reserved.


  • Adolescence
  • Anxiety
  • Depression
  • Family
  • School refusal

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