By Steven K. Rothschild (auth.), Richard B. Birrer M.D., M.P.H. (eds.)
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In: Walsh F (ed). Normal Family Processes. The Guilford Press, New York, 1982. 19. Feiner JS, Brown DB: Psychiatric care of the urban poor: an ecological systems approach. Einstein Q J Bioi Med 4. Family Dynamics 2:126-135, 1984. 20. Sluzki CE: Process, structure and world views: toward an integrated view of systemic models in family therapy. Fam Proc 22:469-476, 1983. 21. Griffin A, Johnson B, Litin C: Transmission of superego defects in the family, and Vogel EF, Bell NW: The emotionally disturbed child as the family scapegoat: In: Bell NW, Vogel EF (eds).
5 Death of a spouse is now a well-accepted risk factor, with mortality rates increased from 5- to 12-fold in the year following the death. 6 In a prospective study of 10,000 men that assessed the severity of their problems related to family, work, and finances, these psychosocial and family factors proved as strong risk factors as hypertension and cholesterol levels and a stronger risk factor than cigarette smoking in predicting the development of angina pectoris. 7 Many other studies have been reviewed elsewhere.
Boundaries reflect the rules that govern participation in a family or its subsystems. Hierarchy describes the rules by which power and authority are exercised in the family. Subsystems are the subgroups of the family (one individual or more) that carry out the functions of the family, each with its own boundary and internal hierarchy. , disengagement, emotional cutoff, rigid boundaries, enmeshment, symbiosis, undifferentiated family ego mass) give a sense of scale and a sense of the closeness or separation of family members.