Brian P. Marx

A closer examination of the structured written disclosure procedure

The current study examined psychological and physical health outcomes of the written disclosure paradigm and the hypothesis that the principles of therapeutic exposure account for the beneficial effects of the paradigm. Participants were randomly assigned to either a written disclosure condition or a control condition. Reactivity to the writing sessions was examined using both subjective and physiological measures. Measures of psychological and physical health were completed before and 1 month after the sessions. Participants assigned to the disclosure condition reported fewer psychological and physical symptoms at follow-up compared with control participants, though reductions were clinically significant for only 1 outcome measure. Physiological activation to the 1st disclosure session was associated with reduced psychological symptoms at follow-up for disclosure participants. Subjective reports of emotional responding corresponded with physiological reactivity. Implications of these findings are discussed.

The role of emotion in the psychological functioning of adult survivors of childhood sexual abuse

This study examined the role of two aspects of emotion in the psychological distress of individuals with and without a history of childhood sexual abuse (CSA). It was hypothesized that experiential avoidance and expressivity would mediate the relationship between CSA status and psychological distress. Ninety-nine participants completed measures that assessed for a CSA history, experiential avoidance, emotional expressivity, and psychological functioning. The results indicated that CSA status, experiential avoidance, and emotional expressivity were significantly related to psychological distress. However, only experiential avoidance mediated the relationship between CSA status and distress. These results contribute to the growing body of literature indicating that experiential avoidance has an influential role in the development of psychological symptoms.

Further examination of the exposure model underlying the efficacy of written emotional disclosure

In the current study, the authors examined the effects of systematically varying the writing instructions for the written emotional disclosure procedure. College undergraduates with a trauma history and at least moderate posttraumatic stress symptoms were asked to write about (a) the same traumatic experience, (b) different traumatic experiences, or (c) nontraumatic everyday events across 3 written disclosure sessions. Results show that participants who wrote about the same traumatic experience reported significant reductions in psychological and physical symptoms at follow-up assessments compared with other participants. These findings suggest that written emotional disclosure may be most effective when individuals are instructed to write about the same traumatic or stressful event at each writing session, a finding consistent with exposure-based treatments.

The influence of childhood sexual abuse, physical abuse, family environment, and gender on the psychological adjustment of adolescents

OBJECTIVE The primary aim of the current study was to examine the contributions of sexual abuse, physical abuse, family cohesion, and conflict in predicting the psychological functioning of adolescents. Additional analyses were conducted to determine whether adolescent victims of child sexual abuse and physical abuse perceive their family environments as more conflictual and less cohesive than nonabused adolescents. METHOD Participants were 131 male and female adolescents, ages 16 years to 18 years, receiving services at a residential vocational training program. Participants completed well established psychological assessment tools to assess abuse history, family environment characteristics, and current adjustment. RESULTS Physically abused adolescent females perceived their family environments as more conflictual and less cohesive than females without physical abuse, and sexually abused females perceived their family environments as more conflictual and less cohesive than females without sexual abuse. Physically abused adolescent males reported more conflict than males without physical abuse, but did not differ with regard to cohesion. Adolescent males with and without a sexual abuse history did not differ on the family dimensions. Multiple regression analyses revealed that both conflict and cohesion, in addition to a history of sexual and physical abuse, predicted depression and distress. Separate analyses by gender revealed these variables differentially impact adjustment in male and female adolescents. Results of a power analysis indicated sufficient power to detect these differences. CONCLUSIONS Findings indicate that in addition to child sexual abuse and physical abuse, family conflict and cohesion are risk factors for the development of psychological distress and depression in adolescence. Implications for treatment and directions for future research are discussed.

Sexual assault and alcohol use: exploring the self-medication hypothesis.

Though a link between sexual victimization and alcohol use has been well documented, the mechanisms underlying this relationship remain unclear. The current study used path analysis to examine the role of self-reported levels of psychological distress and the function of alcohol use as indirect pathways between adult sexual assault and alcohol use. Participants were 318 undergraduate female victims and nonvictims of adult sexual assault. Results showed that a history of sexual assault was associated with increased psychological distress, which in turn contributed to alcohol use via negative reinforcement. Taken together, these findings provided support for the hypothesis that women who have been sexually assaulted consume alcohol, in part, to self-medicate. The implications for future research are discussed.

Perceived uncontrollability and unpredictability, self-regulation, and sexual revictimization

This article reviews the descriptive literature on sexual revictimization and the evidence for the theoretical models that have been formulated to explain this phenomenon. Also, a speculative account of sexual revictimization is presented. The proposed model emphasizes individuals’ attempts to influence or control the quality, frequency, intensity, or duration of fear and arousal associated with a history of uncontrollable and unpredictable childhood sexual abuse through the use of antecedent or response-focused emotion regulation processes. The various forms of emotion regulation may produce symptoms or behaviors that may signal vulnerability to sexual predators, result in impairment of the ability to properly process danger cues, and impede successful defensive behavior. Implications of the proposed model and future directions are discussed.

Date Rape: An Analysis of Two Contextual Variables.

This study examined the impact of perceived token resistance and previous sexual contact on mens discrimination of when a female wants her partner to stop his sexual advances. Male college students were randomly assigned to one of four conditions. Before listening to an audiotape of a date rape, subjects were told that the couple had been on five dates. On the previous date, the man had manipulated the womans breasts or genitals. Subjects were also told that the woman did not object to this contact, or that she initially objected to the contact but subsequently stopped resisting the contact. Relative to subjects in the no-resistance condition, subjects in the perceived token resistance conditions took significantly longer to determine that the man should refrain from attempting further sexual contact. The implications of the findings are discussed.

The impact of alcohol and alcohol expectancies on male perception of female sexual arousal in a date rape analog.

The impact of alcohol and alcohol expectancies on mens perception of female sexual arousal and mens ability to discriminate accurately female sexual intentions in a dating situation was examined. In a 2 (alcohol) x 2 (expectancy) balanced placebo design, men were exposed to an audiotape of a date rape and asked to signal when the man should stop making sexual advances. On 4 occasions during the vignette, participants rated how sexually aroused the woman on the tape was at that moment. Relative to controls, participants who consumed alcohol or expected to consume alcohol took significantly longer to identify the inappropriateness of the mans sexual behavior toward his date. Similarly, alcohol participants also rated the womans arousal level significantly higher at the first 2 refusals. Implications of the results are discussed.

FACT: THE UTILITY OF AN INTEGRATION OF FUNCTIONAL ANALYTIC PSYCHOTHERAPY AND ACCEPTANCE AND COMMITMENT THERAPY TO ALLEVIATE HUMAN SUFFERING

Functional analytic psychotherapy(FAP) and acceptance and commitmenttherapy (ACT) are 2 contemporarybehavioral therapies designed toaddress complex clinical problems. The2 therapies are described, and areas ofconvergence and divergence arediscussed. A new psychotherapyintegrating the 2—functional-analyticacceptance and commitment therapy(FACT)—is defined. It is argued thatFACT enhances the utility of FAP orACT alone by expanding the target oftherapy to include both interpersonaland intrapersonal client behaviors. Inaddition, the authors posit that theintervention technologies used in FAPand ACT enhance one another. Theauthors also address the followingtopics: populations for whom FACTwould be most beneficial, supervisionand training issues, current empiricalresearch on FACT, and FACT’sapplicability and generalization.

Interpersonal Rejection Sensitivity in Childhood Sexual Abuse Survivors Mediator of Depressive Symptoms and Anger Suppression

This study investigated whether interpersonal rejection sensitivity serves a mediating role between childhood sexual abuse (CSA) and three long-term psychological correlates of CSA in adult female survivors: depressive symptoms, anger suppression, and attenuated emotional expression. Interpersonal rejection sensitivity has been shown to be a risk factor for the development of depression and is elevated in CSA survivors. Similarly, attenuated emotional expression, particularly anger, has been related to adjustment difficulties in CSA survivors. Participants in this study were 355 female undergraduates, 34 ofwhomreported a history of CSA. Results demonstrated that interpersonal rejection sensitivity mediates the relationship between CSA and later depressive symptoms. Interpersonal rejection sensitivity partially mediated the relationship between CSA and anger suppression; however, it did not mediate the relationship between CSA and attenuated emotional expression. These results are examined within the context of the current literature on adult CSA survivors and their implications are discussed.