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NGC Domain #11: Family history information

Revised April 2012

Question: The Family History Assessment Module (FHAM) was designed to systematically question an informant about the presence of psychiatric illness in relatives. The method involves the following:

  • Draw the pedigree: The structure of the family pedigree is drawn and reviewed with each informant. Pedigree information obtained from prior screenings and proband interviews is not presented to affected or non-affected family members to ensure confidentiality. It is important to have the pedigree drawing be the first assessment item to verify the informant?s relationship to the proband (self, full sibling, biological parent, etc).
  • Ask the screener questions: Psychiatric screening questions are asked about all relatives in the pedigree. Questions span a wide range of problems including substance abuse, mood disorders, schizophrenia, and antisocial personality disorder. There is also an ?unspecified psychiatric disorder? category, which captures individuals with problems that do not fit into any of the other categories. Information on relatives is also obtained regarding psychiatric hospitalizations, counseling, and/or suicide attempts.
  • Administer the Individual Assessment Module (IAM): Based on responses to the screener questions, an IAM is completed for each implicated individual if they are a first degree relative of the proband. The symptom checklists in the IAM are used for DSM-IV diagnoses. The alcohol and drug sections ask for onset and recency of symptoms and also inquire about any known abstinent periods.
  • Administer Tobacco family history assessment module: The tobacco FHAM gives a brief smoking history of each first degree relative of the informant. Information is obtained regarding frequency and quantity of lifetime tobacco use.

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  • FHAM

Secondary Questions:

Question: Have you had a relative suffer from a drug-related disease?

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Question: Have any of your relatives attempted/committed suicide?

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Question: Does your biological mother/father/spouse/twin ever have a drink of alcohol?

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Question: Were you adopted?

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Question: Medical History

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Question: Alcohol
Did drinking ever cause any of the family members on your list to have problems with health, family, job or police, or other problems?

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Question: Alcohol
Did you ever feel that any of the family members on your list was an excessive drinker?

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Question: Alcohol
Because of drinking, did your (RELATIVE) ever have problems such as:

  • Using alcohol in larger amounts over a period than s/he intended?
  • Being unable to stop or cut down on use of alcohol?
  • Spending a lot of time using alcohol or recovering from other effects?
  • Being unable to work, go to school or take care of household responsibilities?
  • Being drunk when s/he could get hurt?
  • Having accidental injuries?
  • Reducing or giving up on important activities?
  • Objections from family or friends, or at work or school?
  • Having a legal problem (DUI arrest)?
  • Having blackouts?
  • Going on binges or benders, drinking 2 or more days without sobering up?
  • Physical health problems (liver disease, pancreatitis)?
  • Emotional or psychological problems (uninterested, depressed, suspicious/paranoid, having strange ideas)?
  • Withdrawal symptoms (shakes, seizures/convulsions, DTs)?
  • Needing to drink a great deal more in order to get an effect, or finding that s/he could no longer get drunk on that amount s/he used to drink?
  • Any kind of treatment or hospitalization?
  • Making rules to control drinking (never drinking alone, never drinking before 5 p.m., drinking before breakfast, or drinking non-beverage alcohol like vanilla extract, cough syrup, or rubbing alcohol)?
  • Trouble at work or school getting into fights while drinking?
  • Losing friends because of his/her drinking, considering him/herself an excessive drinker, or feeling guilty about his/her drinking?

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Question: Other Substances
Did using drugs ever cause any of the family members on your list to have problems with health, family, job or police, or other problems?

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Question: Other Substances
Did you ever feel that any of the family members on your list had a problem with drugs?

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Question: Other Substances
This is a list of some drugs people use. Which of these drugs has your (RELATIVE) had problems with?

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Question: Other Substances
Because of his/her drug use, did your (RELATIVE) ever have problems such as:

  • Using drugs in larger amounts over a longer period than s/he intended?
  • Being able to stop or cut down on use of drugs?
  • Spending a lot of time using drugs or recovering from their effects?
  • Being unable to work, go to school or take care of household responsibilities?
  • Being high from drugs when s/he could get hurt?
  • Having accidental injuries?
  • Reducing or giving up important activities?
  • Problems with family or friends, or at work or school?
  • Having legal problems (arrests for possessing, selling or stealing drugs)?
  • Physical health problems (hepatitis, overdose)?
  • Emotional or psychological problems (uninterested, depressed, suspicious/paranoid, having strange ideas)?
  • Withdrawal symptoms?
  • Needing larger amounts of drugs to get an effect, or finding that s/he could no longer get high on the amount s/he used to use?
  • Any kind of treatment of hospitalization?

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This page was last updated April 2012

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