Family processes associated with childhood role reversal and related adult outcomes were examined in a community sample 128 adults using a semistructured interview exploring family, friend, and romantic relationships. Women showed stronger role reversal than men, and role reversal was stronger with mothers than with fathers. Role reversal of women with mothers was associated with parental divorce, neglect, and rejection. Only parental divorce was consistently associated with men's role reversal. Role reversal was not associated with current symptoms for either men or women, nor with attachment orientations for women. Three patterns with distinct family dynamics and outcomes -- guardians/protectors, pleasers/compliants, and spousified -- emerged from qualitative analyses of 16 women who experienced high levels of childhood role reversal.