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PubMed1988

Clinicians can agree in assessing relationship patterns in psychotherapy. The Core Conflictual Relationship Theme method.

This study examines interjudge agreement on formulations of dynamic themes in psychotherapy, using a session-based method, namely, the Core Conflictual Relationship Theme. Agreement was assessed by two methods: one was based on themes that were tailor-made for each case, while the other was based on coding themes into a standard set of categories. To assess agreement on the tailor-made formulations, a paired-comparisons procedure was used. For a sample of 35 patients, the similarity ratings for matched cases were significantly higher than for purposely mismatched cases. Using the standard set of categories, agreement was also good; weighted kappa values ranged from .61 to .70. The results also demonstrate reliability for the location of the relationship episodes, which form the database for the Core Conflictual Relationship Theme. Our positive results suggest that this guided clinical method can be used reliably as a measure of relationship patterns in psychotherapy; our results provide the first moderate-sized sample demonstration of clinicians' agreement in formulating this complex concept.

Attitude of Health Personnel↗
PubMed2005

ADHD couple and family relationships: enhancing communication and understanding through Imago Relationship Therapy.

This article reviews the relationship deficits experienced by many individuals who have attention deficit hyperactivity disorder (ADHD) and proposes effective strategies, based on Imago Relationship Therapy (IRT), to assist them in communicating more effectively. The neurological underpinnings of the disorder often contribute to the development of poor social and communication skills and can lead to a lifetime of relationship difficulties. IRT, a brain-based approach, is compatible with the neurological challenges of living with ADHD because it slows the communication process, provides structure, reduces reactivity, and helps individuals to be fully present so that their loved one can feel fully heard and understood. The couple's dialogue strengthens relationships by encouraging the development of stronger listening skills, better self-control, and problem solving. Two case examples illustrate the clinical methods used.

Adolescent↗
PubMed1995

Food craving during the menstrual cycle and its relationship to stress, happiness of relationship and depression; a preliminary enquiry.

The associations between retrospective ratings of food craving and depression during the premenstrual, menstrual and postmenstrual phases of the preceding menstrual cycle and ratings of current levels of stress and happiness of relationship were examined in 5,546 women. In each phase examined, the severity of food craving was very strongly related to the reported severity of depression. Overall levels of food craving were inversely related to happiness of relationship and there was some interaction of this effect with on-going stress. However, once the effect of depression was accounted for there was no effect of either current stress or happiness of relationship on the cycle-related pattern of food craving and in general the magnitude of the effect of these psychosocial variables was very small compared with that of depression. Food cravings were also reported in the absence of depression, tending to show a cycle-related pattern, maximal premenstrually, declining during menstruation and further postmenstrually. Whilst this is consistent with a cycle-related biological explanation, it remains unclear whether the striking amplification of food craving ratings in association with co-existing depression, in all three phases examined, is also biologically based or dependent on psychological mechanisms. In view of the retrospective nature of the ratings of mood and craving and the limited assessment of stress and happiness of relationship, these findings should be regarded as preliminary. They are, however, of potential importance and the association between these two common phenomena deserves further study.

Adult↗
PubMed2005

Meta-analysis of therapeutic relationship variables in youth and family therapy: the evidence for different relationship variables in the child and adolescent treatment outcome literature.

This meta-analysis examines associations between therapeutic relationship variables, and the extent to which they account for variability in treatment outcomes, in 49 youth treatment studies. Correlations between therapeutic relationship variables ranged from modest to strong. Among the best predictors of youth outcomes were counselor interpersonal skills, therapist direct influence skills, youth willingness to participate in treatment, parent willingness to participate in treatment, youth participation in treatment, and parent participation in treatment. Adequacy of current approaches to conceptualizing and measuring therapeutic relationship variables, such as the therapeutic alliance, in youth and family therapy is discussed. This paper represents the most comprehensive analysis of therapeutic relationship constructs in the youth treatment literature.

Adolescent↗
PubMed2000

The relationship between quality of interpersonal relationships and major depressive disorder: findings from the National Comorbidity Survey.

BACKGROUND: The current study compared the quality of interpersonal relationships in individuals with major depressive disorder to individuals with dysthymia, comorbid depression, nonaffective disorders, and no psychiatric disorders. METHODS: Using data from the National Comorbidity Study, a series of logistic regressions, controlling for demographic variables, were conducted to examine the strength of the association between a major depressive disorder and interpersonal dysfunction (positive and negative interactions) in contrast to other psychiatric disorders. RESULTS: Respondents with current major depressive disorder reported significantly fewer positive interactions and more negative interactions with their spouse or live-in partner than those with nonaffective disorders, and than those with no psychiatric disorders. There were no significant differences in quality of interpersonal relationships between respondents with major depressive disorder and those with dysthymia. Among those with major depressive disorder, comorbidity or treatment-seeking behavior did not significantly contribute to degree of interpersonal difficulties. The strength of the association between interpersonal dysfunction and depression were, in general, comparable for men and women with major depressive disorder. LIMITATIONS: The cross-sectional design of this report precludes inferences regarding causality between quality of interpersonal relationship and current major depressive disorder. CONCLUSIONS: The results of this study indicate that, relative to psychiatric illness in general, poor intimate relationships are characteristic of a current major depressive disorder.

Adolescent↗
PubMed2003

Adolescent mothers' relationship with their children's biological fathers: social support, social strain, and relationship continuity.

Two-hundred and eighteen low-income, minority, adolescent mothers were interviewed during the perinatal period and 3 years later about their social networks, including their relationships with their children's fathers. Few adolescents were involved with fathers at both time points. Relationships with fathers were, in general, less supportive and less problematic over time. Moreover, although father support was not associated with adolescent mothers' psychological adjustment, father absence and father strain had negative associations with psychological adjustment. Maternal grandmother support buffered the negative effects of strain in the adolescents' relationships with biological fathers. Perceptions of less social support from maternal grandmothers and more social support from fathers during the perinatal period as well as less social support from a new male partner at 3 years postpartum predicted relationship continuity between adolescent mothers and fathers at 3 years postpartum. Implications for intervention and policy are discussed.

Adaptation, Psychological↗
PubMed2005

Assessing how much couples work at their relationship: the behavioral self-regulation for effective relationships scale.

It is widely believed that satisfying couple relationships require work by the partners. The authors equated the concept of work to relationship self-regulation and developed a scale to assess this construct. A factor analysis of the scale in a sample of 187 newlywed couples showed it comprised 2 factors of relationship strategies and effort. The factor structure was replicated in an independent sample of 97 newlywed couples. In both samples the scale had good internal consistency and high convergent validity between self- and partner-report forms. Self-regulation accounted for substantial variance in relationship satisfaction in both newlywed samples and in a 3rd sample of 61 long-married couples. The self-regulation and satisfaction association was independent of mood or self-report common method variance.

Adult↗
PubMed1989

A relationship pattern measure: the core conflictual relationship theme.

Relationship pattern measures are recently developed systems for measuring the main relationship patterns expressed in psychotherapy sessions or in other interviews. They are precise measures of the kind of pattern that dynamic psychotherapists have estimated clinically ever since the start of such therapies. Leading off the comparisons of such measures that are presented in this issue, this paper will (a) describe a relationship pattern measure, (b) illustrate it, and then (c) compare it with one or more other relationship pattern measures. Beyond these purposes our aim is to indicate the values of these new methods for personality and psychotherapy research.

Adult↗
PubMed2026

Relationships among mechanisms in psychosocial treatments for chronic pain: mechanism to mechanism lagged effects and relationships with outcomes.

Results suggest that psychosocial treatments for chronic pain work via several mechanisms, and that they often do so to similar degrees and in similar ways. Extant research, however, has focused on individual and/or independent effects of mechanisms on outcomes. Whether successful outcomes are also partly because of sequential and meaningful relationships among and between mechanisms-mechanism-to-mechanism effects-has not been examined. Secondary analyses were conducted of an RCT that compared cognitive therapy, mindfulness-based stress reduction, and behavior therapy to treatment as usual in a sample (N = 521) of people with chronic low back pain. Results of hierarchical linear modeling revealed that (1) Treatment Condition × Mechanism interactions predicting changes in other mechanisms were nonsignificant; (2) lagged prior session mechanism changes predicted next session changes in another mechanism; (3) lagged relationships between pain catastrophizing and pain self-efficacy were reciprocal, whereas links between lagged pain catastrophizing and mindfulness changes and lagged pain catastrophizing changes and behavioral activation changes were unidirectional; and (4) individual differences in the strengths of mechanism-to-mechanism relationships predicted pre- to post-treatment changes in outcomes. Results reveal heretofore hidden therapeutic processes that cognitive therapy, mindfulness-based stress reduction, and behavior therapy may share. Namely, that mechanism-to-mechanism lagged effects do indeed emerge beyond mechanism-to-outcome effects. Findings show not only that mechanisms may change in definable sequences relative to each other but that individual differences in the strengths of mechanism-to-mechanism relationships may themselves be predictive of outcomes.

Humans↗
PubMed2001

The challenges to intimacy and sexual relationships for gay men in HIV serodiscordant relationships: a pilot study.

Human Immunodeficiency Virus (HIV) infection and disease progression create imbalance in long-term, HIV-serodiscordant, gay male relationships, particularly in sexual relations and issues of physical and emotional intimacy. Stage of disease progression and worldview of the couple both affect the relationship and its survival. To redress imbalance, partners employ a range of coping strategies and techniques. This article explores these issues in the context of HIV serodiscordant gay couples and how they preserve their relationships in the face of these unique challenges. For workers who provide psychotherapeutic and community support for people with HIV and for their partners, the results of this study may be helpful in recognizing stress factors for couples, and tailoring support services to the needs of both partners. Overall, this study provides a basis for further work examining the dynamics of serodiscordant relationships.

Adult↗
PubMed2003

The dynamic structure of relationship perceptions: differential importance as a strategy of relationship maintenance.

How do couples maintain relationship satisfaction despite specific negative perceptions of their relationships? One way to minimize the global implications of negative perceptions is to attribute differential importance to positive and negative features of the relationship. As those features change over time, satisfied intimates may alter their perceived importance, ensuring that positive features are always more closely associated with global satisfaction than negative ones. The current study examined the specific perceptions of 82 newly married couples at five assessments across their first 3 years of marriage. A tendency to view positive perceptions as more important than negative perceptions was associated with higher marital satisfaction. Moreover, a tendency to alter the importance of specific perceptions as those perceptions changed over time was associated with more stable global satisfaction. These findings highlight the interplay between the content and the structure of intimates' perceptions in determining relationship outcomes.

Adult↗
PubMed2004

An exploratory study of child molesters' relationship patterns using the core conflictual relationship theme method.

This study examined the relationship patterns of N = 20 child molesters (CM) using the Core Conflictual Relationship Theme (CCRT) method. The relationship patterns of the CMs were compared with those of a control group of N = 20 subjects from an out patient counseling service. Results showed that CMs had significantly less wish to be controlled, hurt, and not responsible than the control group. No significant difference was found between both groups for the CCRT response of other component (RO). For the response of self (RS) component, results indicated that CMs reported more relationship episodes in which they felt respected and accepted and self-controlled and self-confident. The authors suggest that these interactions could be indicators of the CMs'attempts to attribute blame to others and present themselves as victims. It is also suggested that CMs may have core issues involving autonomy and control.

Adult↗
PubMed2003

Correlates of gay and lesbian couples' relationship satisfaction and relationship dissolution.

A sample of committed gay and lesbian cohabiting couples engaged in two conversations after being apart for at least 8 hours: (a) an events of the day conversation and (b) a conflict resolution conversation. Physiological data were collected during the conversations and a videotape record was made. Couples viewed the videotapes and rated their affect during the interaction. The video records were coded with a system that categorized specific affects displayed. Models derived from physiology, from the perception of interaction, and from specific affective behavior were related to relationship satisfaction, and to the prediction of relationship dissolution over a 12-year period. Results supported previous findings that satisfaction and stability in gay and lesbian relationships are related to similar emotional qualities as in heterosexual relationships.

Adult↗
PubMed2004

Men's sexual coercion in intimate relationships: development and initial validation of the Sexual Coercion in Intimate Relationships scale.

We report the development and initial validation of the Sexual Coercion in Intimate Relationships Scale (SCIRS), a measure designed to assess the prevalence and severity of sexual coercion in committed intimate relationships. We review existing measures of sexual coercion and discuss their limitations, describe the identification of the SCIRS items, perform a principal components analysis and describe the resulting three components, and present evidence for the convergent and discriminative validity of the SCIRS. Because sexual coercion in intimate relationships often takes the form of subtle tactics, the SCIRS items assess communicative tactics such as hinting and subtle manipulations in addition to tactics such as the use of physical force. The SCIRS provides researchers and clinicians with a valid, reliable, and comprehensive measure with which to study the dynamics of sexual coercion in intimate relationships.

Adult↗
PubMed2000

Connectedness and autonomy support in parent-child relationships: links to children's socioemotional orientation and peer relationships.

Connectedness and autonomy support in the parent-child relationship are constructs that emerge from object relations and attachment theories but that overlap with other commonly studied qualities of parent-child relationships to provide a unifying focus for research in this domain. In this study, these constructs were examined in relation to children's relational competence, including socioemotional orientation, friendship, and peer acceptance. Semistructured conversations between mothers and their 5-year-olds (N = 192) were videotaped at home and rated for (a) connectedness between the members of the dyad and (b) the parent' s support for the child's autonomy. Results showed that connectedness was correlated with children's socioemotional orientations, number of mutual friendships, and peer acceptance and that the relation between parent-child connectedness and children's peer relationships was mediated by children's prosocial-empathic orientation. Implications of these findings for theories that link parent-child relationships to the development of relational competence in children are discussed.

Adult↗
PubMed2001

Relationship quality and potentially harmful behaviors by spousal caregivers: how we were then, how we are now. The Family Relationships in Late Life Project.

Structured interview data from 142 caregivers (98 wives, 44 husbands) indicate that more depressed caregivers are more likely to treat their spouses in potentially harmful ways. However, consistent with hypotheses derived from communal relationships theory, when the preillness relationship between caregiver and care recipient was characterized by mutual responsiveness to each other's needs (i.e., was more communal), caregivers were less depressed and less frequently engaged in potentially harmful behaviors. These effects were not attributable to demographic factors, amount of care provided, care recipient dementia status, or length of time in the caregiving role. Rather, multivariate analyses suggest that the extent to which premorbid relationships were communal in nature determines whether caregivers perceive their current relationships as rewarding, which, in turn, predicts caregiver depression and potentially harmful behaviors.

Aged↗
PubMed2004

Reducing attenuation in exposure-response relationships by exposure modeling and grouping: the relationship between wood dust exposure and lung function.

BACKGROUND: In a study of wood dust exposure and lung function, we tested the effect on the exposure-response relationship of six different exposure metrics using the mean measured exposure of each subject versus the mean exposure based on various methods of grouping subjects, including job-based groups and groups based on an empirical model of the determinants of exposure. METHODS: Multiple linear regression was used to examine the association between wood dust concentration and forced expiratory volume in 1s (FEV(1)), adjusting for age, sex, height, race, pediatric asthma, and smoking. RESULTS: Stronger point estimates of the exposure-response relationships were observed when exposures were based on increasing levels of aggregation, allowing the relationships to be found statistically significant in four of the six metrics. The strongest point estimates were found when exposures were based on the determinants of exposure model. CONCLUSIONS: Determinants of exposure modeling offers the potential for improvement in risk estimation equivalent to or beyond that from job-based exposure grouping.

Adolescent↗
PubMedDate not supplied

The degree and type of relationship between psychosocial variables and smoking status for students in grade 8: is there a dose-response relationship?

BACKGROUND: While most research focuses on simply analyzing the differences between smokers and non-smokers, dose-response analyses may be used to find evidence of the nature of the association between psychosocial variables and involvement with smoking in adolescence. METHODS: For the study, 1,614 grade 8 students from Scarborough, Ontario, Canada, completed a self-administered questionnaire that included items on sociodemographic characteristics, experience with smoking, lifestyle, health and weight, work status, and social involvement as well as parental education, occupation, and family and peer smoking. A series of scales measuring self-esteem, stress, coping, social support, mastery, social conformity, and rebelliousness was incorporated. RESULTS: Dose-response relationships were evidenced for all categories of variables and were demonstrated for the total group and, in most cases, for males and females when analyzed separately. CONCLUSIONS: Relationships between variables are not "all or none," but may vary depending on amount or level of other factors. These relationships provide insight into the mechanisms underlying initiation to, maintenance of, and cessation of smoking and should be taken into account in programs to reduce or prevent adolescent tobacco use.

Achievement↗