Jean-Marie Boisvert

Group cognitive-behavioral therapy for generalized anxiety disorder: Treatment outcome and long-term follow-up.

A recently developed cognitive-behavioral treatment for generalized anxiety disorder (GAD) targets intolerance of uncertainty by the reevaluation of positive beliefs about worry, problem-solving training, and cognitive exposure. As previous studies have established the treatments efficacy when delivered individually, the present study tests the treatment in a group format as a way to enhance its cost-benefit ratio. A total of 52 GAD patients received 14 sessions of cognitive-behavioral therapy in small groups of 4 to 6 participants. A wait-list control design was used, and standardized clinician ratings and self-report questionnaires assessed GAD symptoms, intolerance of uncertainty, anxiety, depression, and social adjustment. Results show that the treatment group, relative to the wait-list group, had greater posttest improvement on all dependent variables and that treated participants made further gains over the 2-year follow-up phase of the study.

Specificity of generalized anxiety disorder symptoms and processes

This studys main goal is to test the broad specificity of generalized anxiety disorder (GAD) symptom and process variables. These variables were compared in four groups of participants: (1) 24 patients with primary GAD, (2) 24 patients with secondary GAD, (3) 38 other anxiety disorder patients, and (4) 20 nonclinical control subjects. Each participant received a structured diagnostic interview and a series of standardized questionnaires. The results show that DSM-IV GAD symptoms (worry, GAD physical symptoms, and interference due to worry and anxiety) distinguish GAD patients from those with other anxiety disorders. Two process variables, problem orientation and intolerance of uncertainty, also differentiated GAD patients from other anxiety disorder patients. Overall, these results support the DSM-IV definition of GAD and the broad specificity of problem orientation and intolerance of uncertainty as GAD process variables.

Cognitive-Behavioral Treatment for Adolescent Pathological Gamblers

This study evaluated the effectiveness of a cognitive-behavioral treatment for adolescent pathological gamblers. Perception of control and severity of the problem served as dependent variables. Four adolescent pathological gamblers meeting DSM-III-R criteria were treated in a multiple baseline design across individuals. Results showed clinically significant changes for all subjects; they remained abstinent at 1-, 4-, and 6-month follow-ups. The clinical implications of these results are discussed.

Treatment of pathological gamblers: An experimental study☆

The efficacy of a behavioral treatment for pathological gamblers, including cognitive interventions, problem solving and relapse prevention is examined. Three pathological gamblers meeting DSM-III-R criteria were studied in an experimental multiple baseline design. By the end of treatment the subjects ceased all gambling behaviors, increased their perception of self-control of gambling, and evaluated their problems as less severe. Therapeutic gains were maintained at 6- and 9-month follow-ups. The importance of problem solving and the modification of erroneous perceptions in treatment programs for pathological gambling is discussed.

Psychological and marital adjustment in couples following a traumatic brain injury (TBI): A critical review

The first part of this paper examines current data describing the psychological and marital adjustment of couples following a traumatic brain injury (TBI). Although these findings reveal some discrepancies, they highlight that adjustment following a TBI represents a genuine challenge for those involved in the process. The second part moves toward the examination of factors associated with psychological and marital adjustment in both couple partners. Here again, there exists a large diversity in empirical data and theoretical models informing this emerging area of interest. Nevertheless, cognitive variables such as coping skills are commonly seen as critical variables to explain the adjustment level in people with TBI and their spouse/caregivers. Concurrently with the discussion of the methodological issues and pitfalls encountered in this area of research, the conclusion provides suggestions of further steps to undertake in this endeavour toward a better understanding of the adjustment process following TBI.

Worry themes in primary GAD, secondary GAD, and other anxiety disorders

This study examines worry themes among 87 anxiety disorder patients divided into three groups: (a) 24 primary generalized anxiety disorder (GAD) patients, (b) 25 secondary GAD patients, and (c) 38 other anxiety disorder patients (primarily obsessive-compulsive disorder, social phobia and panic disorder with agoraphobia). Structured and free-recall measures were used to measure five worry themes: relationships, work, finances, physical threat, and the future. Both types of measures revealed that GAD patients worry more about the future than non-GAD patients. Further, post hoc analyses testing for linear relationships indicated that primary GAD patients worry more about the future than secondary GAD patients who in turn worry more about the future than other anxiety disorder patients. The results suggest that although worry about immediate problems may not differentiate GAD patients from other anxiety disorder patients, high levels of worry about future events may be a distinguishing feature of GAD.

Intimate Partner Violence and Psychological Distress among Young Couples: Analysis of the Moderating Effect of Social Support

Young adults are more likely to experience intimate partner violence (IPV) than older adults. Little is known about the effect of confiding to others about sustained violence on the mental health of victims. The objective of this study was to explore the links between IPV, help-seeking behaviors and psychological distress by gender in a sample of 233 young couples.Our results indicate the frequency of sustained psychological violence, but not physical violence, was positively associated to distress. For women, seeking help from a greater number of confidents moderated the association between violence and psychological distress. For men, results showed that frequencies of physical and psychological violence were both positively linked to distress. However, unlike women, social support had no buffering effect on men’s distress. These findings increase our understanding of the effects of social support on young adults’ distress following episodes of IPV.

Psychological adjustment and marital satisfaction following head injury. Which critical personal characteristics should both partners develop

Primary objective and research design: Using a correlational design, this study verifies the relationships between personal characteristics of individuals with TBI and their spouses and their level of psychological and marital adjustment. Methods and procedure: Seventy individuals with TBI and their spouses in the post-acute rehabilitation phase completed self-report questionnaires assessing the predictive variables (coping and social problem-solving strategies; perceived communication skills) and the criteria variables of psychological and marital adjustment. Main outcomes and results: In the target group, the characteristics most strongly related to adjustment variables were an effective attitude towards problems, infrequent use of avoidance coping strategies, and a positive perception of ones spouses communication skills. Individuals with TBI and their spouses report significantly lower scores on some of these personal characteristics, compared to those of a matched control group of 70 couples from the general population. Conclusions: Specific personal characteristics are critical for psychological and marital adjustment following TBI. This knowledge may be of relevance for detecting couples at risk for developing difficulties in the post-acute rehabilitation phase. Rehabilitation interventions targeting the personal characteristics identified as critical for the adjustment process could help to prevent these difficulties.

Perception of marital problems and of their prevention by Quebec young adults

Abstract The perception of marital problems and the interest in different themes that could be addressed in preventive programs for marital conflict were surveyed among Quebec adults aged 18 to 25 years. Results show that communication problems were perceived as particularly frequent and damaging for couples. Furthermore, jealousy seemed to be a particular concern for these young adults. They also showed a level of interest in different premarital counseling topics that was moderately high but less than the interest shown by American college students. Adaptation to the arrival of the first child, parenting skills, and expressing feelings were judged as the most interesting themes by the participants, whereas spiritual development, organizing household tasks, and relationships with in-laws were considered the least interesting.

Assertiveness training and human communication processes

In spite of the wealth of descriptions of assertive behavior, there is no consensus either on a precise definition or on a theoretical model of assertiveness. However, as there is a certain unanimity on the view that assertive behavior should lead to more satisfying, interpersonal relationships for all persons involved, it could be helpful to put the concept of assertiveness in the context of adequate, human communication and its beneficial effects. After a review of the principal controversies concerning the nature of assertive behavior and the content of assertiveness training programs, the authors present the main components of a theoretical model of communication, and consider certain of its implications for the field of assertiveness. The use of a model of communication to define assertiveness would help to develop some hypotheses concerning the function and importance of different aspects of assertive behavior in interpersonal relationships, and give more coherence to the practice of assertiveness training.