Steven L. Sayers

Supplementing Behavioral Marital Therapy with Cognitive Restructuring and Emotional Expressiveness Training: An Outcome Investigation.

The current study investigated whether the effectiveness of behavioral marital therapy (BMT) would be increased by the addition of cognitive restructuring (CR) and/or emotional expressiveness training (EET) for maritally distressed couples. Sixty such couples were randomly assigned to 1 of 3 therapists and 1 of 5 treatment conditions (BMT Alone, CR + BMT, BMT + EET, CR + BMT + EET, or waiting list) for 12 weeks of conjoint marital therapy. Within each treatment condition, couples typically improved on the variables focused on in treatment. However, comparisons among active treatment conditions showed few significant differences among treatments; the treatments were equally effective in increasing marital adjustment. Thus, the addition of CR and EET did not appear to increase the overall effectiveness of treatment. Possible reasons for the current findings are provided, and suggestions for future marital outcome investigations are outlined.

Personality and smokeless tobacco use

Smokeless tobacco use and personality factors associated with smokeless tobacco use were examined in a broad, representative sample of 8th and 10th graders from central and south-central Florida (n = 1413). Current, occasional, or ex-users of smokeless tobacco accounted for 51% of the males and 9% of the females. Smokeless tobacco users, as compared to non-users, had significantly higher Trait Anger, and Angry Temperament and Angry Reaction subscale scores on the State-Trait Personality Inventory, suggesting a possible role in the initiation of smokeless tobacco use. There were no differences in Trait Anger, Anxiety, or Curiosity scores between the three user groups, suggesting that trait personality does not play a role in the maintenance of smokeless tobacco use.

Impact of Message Valence, Focus, Expressive Style, and Gender on Communication Patterns Among Maritally Distressed Couples

This study explored the sequential communication patterns of maritally distressed couples. The findings confirmed the presence of negative and nonnegative (positive and neutral combined) reciprocity. The results indicated that partners tend to respond negatively if their spouses have just spoken about the partners or the relationship and that wives are more likely to respond negatively than husbands, regardless of how positive or negative the communication was. Analyses demonstrated that the speakers gender, the positive/negative nature of the message, the focus, and the delivery skill of the message did not affect the empathic nature of the partners subsequent response.

A Conceptual Framework of Comorbidity for Investigation in the Context of Psychiatric Disturbance

Comorbidity among people with psychiatric conditions is common and is associated with complicated course, poorer treatment outcomes, higher rates of treatment utilization, and higher risk of mortality. However, research on comorbidity continues to be under-represented in the field. This paper presents the Integrated Framework of Comorbidity to promote and improve research and clinical development in the treatment of comorbidity. The Framework has five domains: I) comorbidity influences, II) comorbid disorders or conditions, III) health care interactions of those with comorbidity, IV) comorbidity outcomes, and V) comorbidity associations. Using the Framework should lead investigators to do the following: 1) examine additional outcomes relevant to their area, 2) consider real-world barriers to the implementation of effective treatments of comorbid conditions, and 3) consider etiological mechanisms carefully when testing the effectiveness of treatments of comorbid conditions. The Framework is meant as a general research and clinical heuristic. Implications of the Framework for research and the development of clinical approaches are also discussed.

The ability of schizophrenics to perceive and cope with negative affect

Thirty-four schizophrenic patients in an acute in-patient hospital were compared with 24 in-patients with major affective disorder and 19 non-patient controls on a role-play test of social skills and a test of affect perception. The role-play test consisted of 12 simulated conversations in which the subject was confronted by parents and friends expressing high-EE criticism or non-critical dissatisfaction. Schizophrenic patients lacked assertiveness and social skills in all conditions, but they did not show any differential impairment when presented with high EE. They consistently lied and denied errors rather than responding assertively or apologizing, whether confronted with high-EE or benign criticisms. On the affect perception test, schizophrenic patients consistently underestimated the intensity or negativeness of negative emotions, but they were not deficient in perception of positive emotional displays. The data do not support the hypothesis that schizophrenic patients are poor at dealing with high-EE behaviours, but do indicate that their ability to cope with even mild negative affect is impaired. Possible explanations for this impairment include limited attentional capacity, a neurologically based perceptual deficit, and a self-protective mechanism to reduce or avoid stress.