Family Adaptability and Cohesion Evaluation Scales IV (FACES IV)

Family relationships health/ well-being, satisfaction, and communication were measured using the Greek version [54] of the FACES IV [28]. The scale reflects the Circumplex Model of Marital and Family Systems [55]. It entails 42 items measuring family functioning in terms of two aspects: a) family cohesion and; b) family flexibility. In the Circumplex Model, cohesion and flexibility are viewed as curvi-linear, and thus very low and very high scores for both these aspects are deemed as maladaptive. In contrast, intermediate scores are considered balanced and adaptive [56]. Corresponding to this, FACES IV has six scales. They include two balanced sub-scales (Balanced Cohesion and Balanced Flexibility), two subs-cales measuring maladaptively low and high cohesion (Disengaged vs Enmeshed), and two sub-scales measuring maladaptively low and high flexibility (Rigid vs Chaotic). For all FACES IV items, responses ranged between 1 = strongly disagree to 5 = strongly agree. Eelevated reported numbers on the two balanced sub-scales are refelective of more adaptive family relationships. Counterintuitively poorer family relationships are reflected by elevated scores in the four maladaptive sub-scales for cohesion and flexibility. For this study, the raw scores from each subscale informed the analyses.

For more robust and holistic evaluation, cohesion ratio, flexibility ratio, and total circumplex ratio scores are recommened to be calculated [28]. These more accurately reflect the relative amount of balance/unbalance for cohesion, flexibility, and the overall (circumplex) family functioning, respectively. Their values fluctuate from 1 to 10, with one indicating equal amount of balanced and unbalanced levels. Higher rates of suggest healthier family functioning [56].

The FACES IV Package also included the Family Communication Scale (FCS, [57]) and the Family Satisfaction Scale (FS, [58]). The FCS and the FSS (10 items each) assess levels of communication and satisfaction within the family, with responses from 1 =“strongly disagree” to 5 = “strongly agree” and higher scores indicating more positive performance across both aspects respectively. The FCS and FSS were additionally completed by the current sample. Like the FACES IV, the FCS and FSS are self-report measures that may be addressed by any family member above 12 years of age. For the current study, these measures were completed by the participants. The internal consistency (Cronbach α) for the 2 adaptive and the 4 maladaptive main FACES IV sub-scales in the current sample fluctuated from .60 to .71, while for the FCS and FSS these equaled 0.91.