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Research Paper on High Risk Family Assessment and Health Promotion

The problem of violence in families is a very serious challenge to the entire society since it provokes not only serious psychological problems among members of violent families, especially children, but it can also lead to the development of aggressive and antisocial models of behavior. At the same time, views of the violent families and their impact on children and their health varied dramatically. On the one hand, there were supporters of a natural approach, while, on the other hand, there was a social determinist view of this problem.

The adepts of ‘natural theory’ that has become extremely important just recently when the genetics has made a great progress and now scientists know a lot about genes and their influence on a person. It is a well-known fact that genes are responsible for vitally important functions of a human organism, consequently arises a natural presupposition that they may also affect a psychological aspect of a personal development.

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One of the strongest evidences in their hands is the result of twin study, particularly monozygotic or identical twins. Since researches reveal the fact that “identical twins tend to be around 80 percent the same in everything from stature to health to IQ to political views”(Collins 2000, p.221). Such data urge some specialists to the denying of a traditional idea that “violence is part of a historical process and is not natural or born of biological determinism” but, on the contrary, they believe that violence “is part of our design” (Collins 2000, p.230). A great contribution in favor of the natural or genetic trend was made by Thomas Bouchard’s identical twins studies. He researched the development of personality of identical twins that were brought up in different families, i.e. in different environment, and on comparing the fate of about 60 identical twins he found out that despite the fact that they lived separately, in different families, “the behaviors and personalities and social attitudes they displayed in lengthy batteries of tests were often remarkably alike” (Mann 1994, p.267), so, they still had a lot of common traits of character and behavior which Th. Bouchard considered to be inherited. Consequently, according to such research one can make a conclusion that they might inherit negative traits of character and their antisocial behavior could also be explained by their genetic heritage. It was a really strong argument against the idea of the primary role of nurture and a person’s environment because it is really hard to argue when you read about such twins like James Arthur Springer and James Edward Lewis who had been reunited at age of 39 and both “had married and divorced a woman named Linda and remarried a Betty… they smoked and drank the same amount and got headaches at the same time of day” (Mann 1994, p.270).

However, opponents of natural or genetic determinism have their own counterarguments. Traditional or even conservative psychologist estimate that an aggressiveness and antisocial behavior are learned by children from their parents and it has nothing to do with our genes and their role in the formation of a criminal is extremely limited and do not predetermine a violent behavior. The researches concerning this problem, that were held in Europe, revealed the fact that children who were born to violent parents but raised up in a peaceful families were characterized practically by the same behavioral non-violent trends as other children who were born and raised up in a non-violent families. Whereas on the contrary if children born to non-violent parents grew in aggressive, violent familial environment had a tendency to be criminally aggressive. As a result, such researches permit to nurture oriented psychologist make a conclusion that “if twin and adoption studies show little or no heritability for violence then the reason why violence runs in families must be environmental. The huge body of evidence shows that violence breed violence, not genes” (Cadoret 1996, p.581). Moreover, they doubt whether the researches of Th. Bouchard may be scientifically proved or not because they estimate that when they ask to check the result of Th. Bouchard’s work in the Minnesota University they are always refused.

Thus, it is very difficult what is a real cause of antisocial, aggressive, violent, or even criminal behavior. Nevertheless, it is possible to identify the basic objectives that should be achieved by healthcare and social services in the treatment of members of violent families, especially children. To put it more precisely, it is necessary to focus on the socialization of members of violent families and minimize the risk of aggressive behavior. This means that people having experience of violence in their families need a psychological assistance. They have to learn to cope with their problems without the use of violence and, what is more, control their anger and emotions. Also, these people often need to learn communicating with other people, because often violence in families leads to the isolation or exclusion of an individual from society and he or she turns to be unable to get socialized.

As it has already been said at the beginning we should be very careful in conclusions and avoid being categorists. The fact is that not only natural, genetic factors that each person inherits influence our behavior but also our social environment, family, i.e. nurture also play a significant role and the combination of this two factors form a person’s behavior, either aggressive or not, particularly for twins who, having practically identical genes, usually grow in the same environment. Obviously, it is hard to deny both these factors nature and nurture. Nowadays arguments about the role of genes in personal physical and mental development become stronger and now it is known that certain forms of behavior have a genetic component, for instance IQ is considered to be 60-80 percent heritable, and “the body of evidence for over 90 % of causation of sexual orientation being genetic continues to mount up” (Glass 2002, p.156) and for twins the percentage rate will be much more alike than siblings. However, it doesn’t necessarily mean that genes play a key role or that they predetermine person’s aggression or antisocial behavior. We must realize that there is no ‘criminal gene’ that is exclusively responsible for crimes a person commits. The same may be said about the influence of environment on a personality because in spite of the great role of nurture still each person inherit something from his or her parents that may cause certain shift in a person’s behavior which may be even dangerous. For instance we know that some psychological or psychiatric problems are heritable than it wouldn’t be surprising if a person whose parents had such problems will have problems with antisocial behavior, or something like that. And for twins the concordance rate of similar problems will be as follows: “if 20 twin pairs are studied and in 18 of them both had developed schizophrenia, this would produce the concordance rate of 18/20 or 90%, which is very high concordance. Monozygotic (identical) twins have the same genes (100% concordance) whereas dizygotic (non-identical) twins and siblings are genetically 50% similar” (Morris-Yates 1999, p.78).

So, to understand a person’s behavior we must analyze his or her environment, life experience, i.e. nature and, certainly, nurture. One may contradict me and remind the researches of Th. Bouchard but even if there wouldn’t be any doubts about the authenticity of his research and objectivity of its results it is necessary to draw attention to researches of the scientists in Richmond who analyzed the influence and correlation of drugs on twins. It is worthy to note that they analyzed behavior not only identical or monozygotic twins but fraternal or dizygotic twins as well. Initially they supposed that social environment of people is the main cause of drug experimentations. However, the results of their research revealed the fact that “the identical twin of a drug addict is far more likely to be an addict than is the fraternal twin of an addict”(Rutter 1997, p.394). And the cause is not the fact that twins grow in a similar environment the cause may be also found in the domain of genetics because according to the same research “genes play a major role when it comes to the biochemistry of drug dependence. In other words, “environment” may lead you to fool around with drugs, but genes hook you” (Rutter 1997, p.395). By the way, the same reveal neurological studies that prove that addicts’ brains are wired differently. Thus, as the drug addiction is a really serious problem, that influences the behavior of a person and usually results in crimes, violation of law, antisocial behavior or at least in aggressiveness, and identical twins are at a greater risk than fraternal twins or siblings. Consequently, addiction is conditioned both genetically and environmentally.

While working with members of violent families, nurses need to pay a particular attention to the psychological state of patients. In fact, the nursing intervention should primarily focus on the psychological level, while medication may be used to minimize the negative effect of stressors patients suffer from while they are in their violent families. In this respect, the role of the advanced practice nurse is particularly significant since this healthcare professional should manage the treatment of patients in terms of nurses’ duties and responsibilities. Basically, the advanced practice nurse can assist other nurses giving them the major strategies which could be applied in relation to the patient suffering from significant psychological pressure or the domestic violence involving the closest relatives of the patient. In addition, the advanced practice nurse should assess and control actions of other nurses in order to introduce some changes in their work with the patient if necessary. In such a way, such patients need a psychological assistance and rehabilitation above all and nurses are playing a very important role in this regard because they spend a lot of time with patients and can really help them solve their psychological problems.

Ainslie, R, C. et al. “The early development Context of Twinship: Some Limitations of the Equal Environments Hypothesis.” American Journal of Orthopsychiatry, 57, 1997.
Cadoret, R. J. et. al. “The Developmental Interface Between Nature and Nurture: A Mutual Influence of Child Antisocial Behavior and Parent Behavior.” Developmental Psychology vol. 32, no. 4, 1996.
Collins, W.A., et. al. “Contemporary Research on Parenting: The Case for Nature and Nurture.” American Psychologist, 55, 2000.
Glass, J. “Nature vs. Nurture.” Parenting, vol. 13, no 10, Jan. 2002.
Mann, C. “Genes and Behavior.” Science, 264, 1994.
Morris-Yates, A. et al. “Twins: A Test of the Equal Environments Assumption. Acta Psychiatrica Scandinavica, 81, 1999.
Rutter, M.L. “Nature-Nurture integration.” American Psychologist, vol.52, no. 4, Apr. 1997.
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