William L. Cook

The Actor–Partner Interdependence Model: A model of bidirectional effects in developmental studies

The actor–partner interdependence model (APIM) is a model of dyadic relationships that integrates a conceptual view of interdependence with the appropriate statistical techniques for measuring and testing it. In this article we present the APIM as a general, longitudinal model for measuring bidirectional effects in interpersonal relationships. We also present three different approaches to testing the model. The statistical analysis of the APIM is illustrated using longitudinal data on relationship specific attachment security from 203 mother–adolescent dyads. The results support the view that interpersonal influence on attachment security is bidirectional. Moreover, consistent with a hypothesis from attachment theory, the degree to which a child’s attachment security is influenced by his or her primary caregiver is found to diminish with age.

Demographic Characteristics and Employment Among People with Severe Mental Illness in a Multisite Study

People with psychiatric disabilities experience disproportionately high rates of unemployment. As research evidence is mounting regarding effective vocational programs, interest is growing in identifying subgroup variations. Data from a multisite research and demonstration program were analyzed to identify demographic characteristics associated with employment outcomes, after adjusting for the effects of program, services, and study site. Longitudinal analyses found that people with more recent work history, younger age, and higher education were more likely to achieve competitive employment and to work more hours per month, while race and gender effects varied by employment outcome. Results provide strong evidence of demographic subgroup variation and need.

Neuropsychological Profiles in Individuals at Clinical High Risk for Psychosis: Relationship to Psychosis and Intelligence

BACKGROUND Characterizing neuropsychological (NP) functioning of individuals at clinical high risk (CHR) for psychosis may be useful for prediction of psychosis and understanding functional outcome. The degree to which NP impairments are associated with general cognitive ability and/or later emergence of full psychosis in CHR samples requires study with well-matched controls. METHODS We assessed NP functioning across eight cognitive domains in a sample of 73 CHR youth, 13 of whom developed psychotic-level symptoms after baseline assessment, and 34 healthy comparison (HC) subjects. Groups were matched on age, sex, ethnicity, handedness, subject and parent grade attainment, and median family income, and were comparable on WRAT-3 Reading, an estimate of premorbid IQ. Profile analysis was used to examine group differences and the role of IQ in profile shape. RESULTS The CHR sample demonstrated a significant difference in overall magnitude of NP impairment but only a small and nearly significant difference in profile shape, primarily due to a large impairment in olfactory identification. Individuals who subsequently developed psychotic-level symptoms demonstrated large impairments in verbal IQ, verbal memory and olfactory identification comparable in magnitude to first episode samples. CONCLUSIONS CHR status may be associated with moderate generalized cognitive impairments marked by some degree of selective impairment in olfaction and verbal memory. Impairments were greatest in those who later developed psychotic symptoms. Future study of olfaction in CHR samples may enhance early detection and specification of neurodevelopmental mechanisms of risk.

Analyzing Nonindependent Outcomes in Couple Therapy Using the Actor-Partner Interdependence Model.

The nonindependent components of couple data require data-analytic strategies tailored to the interpersonal processes occurring between relationship partners. This article examines the benefits of a specifically dyadic analytic method, the actor-partner interdependence model (APIM), for evaluating interpartner influence across time. Both conceptual and methodological features of the APIM are exemplified by applying this model to observations of negative and positive affect and global distress in spouses participating in a randomized trial of couple therapy. In addition to elucidating specific advantages of the APIM relative to alternative data-analytic strategies, the current results shed new light on previous findings from a comparative treatment outcome study evaluating behavioral and insight-oriented approaches to couple therapy.

Application of the social relations model to family assessment.

A family assessment serves two primary purposes: the guidance of clinical interventions and the evaluation of clinical outcomes. To support these activities, a family assessment should provide a level of descriptive detail with respect to family functioning that is commensurate with a family systems perspective. Unfortunately, most widely used self-report family assessment instruments do not provide that level of detail. This article presents a descriptive approach to family assessment that is based on the application of the social relations model (SRM; D. A. Kenny & L. La Voie, 1984) to round-robin family data. In contrast to previous presentations of the SRM, this article outlines the procedure for assessing a single family, thus translating SRM analysis from a basic research tool into an applied, clinical assessment tool.

Deeds matter: daily enacted responsiveness and intimacy in couples' daily lives.

Perceived responsiveness is a fundamental ingredient of satisfying romantic relationships, especially insofar as it facilitates the development of intimacy. This study investigates how partners concrete responsive acts-named here enacted responsiveness-affect the perception of responsiveness in the daily life of dating couples. Additionally, the subsequent association of perceived partner responsiveness with intimacy was examined. Data from both partners in 102 young heterosexual couples were gathered simultaneously 4 times a day over one week. Multilevel analysis within the framework of the actor-partner interdependence mediation model showed that perception of responsiveness is predicted by partners enacted responsiveness. However, own enacted responsiveness also predicts own perception of responsiveness in the partner, suggesting a projection process. Perception of responsiveness, in turn, predicts not only own but also partners feelings of intimacy, demonstrating an intimacy enhancing effect of being perceived as a responsive partner. Mediation analysis showed that perception of responsiveness mediates the effects of both own and partners enacted responsiveness on intimacy. It can be concluded that the development of intimacy in the daily life of romantic couples is truly an interactive process that ought to be investigated from a dyadic perspective.

Examining the validity of self-report assessments of family functioning : A question of the level of analysis

Family assessment instruments attempt to measure family functioning at a particular level of the family system: individual, dyad, or family as a whole. This article introduces the concept of level validity, that is, whether an assessment measures family functioning at the level that it was intended to measure. The authors argue that whenever higher-order factors (e.g., dyadic subsystems) are the target of a measure, these factors should explain variance that is independent of their lower-order constituents (e.g., individual-level characteristics). Previously published data targeting dyadic subsystems within the family were reanalyzed using a model that controls for lower-order effects. Dyad-level factors rarely emerged independent of individual-level factors and, when they did, they did not replicate across samples. The results suggest that level validity should be tested and reported along with other aspects of construct validity before accepting such measures as valid assessments of family functioning.

The SRM Approach to Family Assessment

Abstract. In family systems, it is possible for one to put oneself at risk by eliciting aversive, high-risk behaviors from others (Cook, Kenny, & Goldstein, 1991). Consequently, it is desirable that family assessments should clarify the direction of effects when evaluating family dynamics. In this paper a new method of family assessment will be presented that identifies bidirectional influence processes in family relationships. Based on the Social Relations Model (SRM: Kenny & La Voie, 1984), the SRM Family Assessment provides information about the give and take of family dynamics at three levels of analysis: group, individual, and dyad. The method will be briefly illustrated by the assessment of a family from the PIER Program, a randomized clinical trial of an intervention to prevent the onset of psychosis in high-risk young people.

Change in neuropsychological functioning over one year in youth at clinical high risk for psychosis.

Schizophrenia and related psychotic disorders are associated with significant neuropsychological (NP) impairments. Yet the onset and developmental evolution of these impairments remains incompletely characterized. This study examined NP functioning over one year in a sample of youth at clinical high risk (CHR) for psychosis participating in a treatment study. We assessed functioning across six cognitive domains at two time points in a sample of 53 CHR and 32 healthy comparison (HC) subjects. Linear regression of HC one-year scores was used to predict one-year performance for CHR from baseline scores and relevant demographic variables. We used raw scores and MANOVAs of the standardized residuals to test for progressive impairment over time. NP functioning of CHR at one year fell significantly below predicted levels. Effects were largest and most consistent for a failure of normative improvement on tests of executive function. CHR who reached the highest positive symptom rating (6, severe and psychotic) on the Structured Interview of Prodromal Syndromes after the baseline assessment (n = 10/53) demonstrated a particularly large (d = -1.89), although non-significant, discrepancy between observed and predicted one-year verbal memory test performance. Findings suggest that, although much of the cognitive impairment associated with psychosis is present prior to the full expression of the psychotic syndrome, some progressive NP impairments may accompany risk for psychosis and be greatest for those who develop psychotic level symptoms.

Partner interdependence and coping with life-threatening illness: the impact on dyadic adjustment.

General systems theory and Bodenmanns theory of dyadic coping (Bodenmann, 1997) provided the framework for exploring the impact of life-threatening illness on the dyadic relationship. The sample included 193 dyads experiencing the stress of treatment by bone-marrow transplantation (BMT) for cancer which had not responded to first-line therapies. A prospective design over 12 months included four measurements at designated periods in the treatment process. Except for the symptom checklist, which was completed only by the recipient, data were obtained on each measure from both partners at each time point. The primary outcome was dyadic adjustment measured by the Dyadic Adjustment Scale (DAS; Spanier, 1976). A general linear mixed model indicated that dyadic adjustment was stable over time for BMT recipients and family caregivers; however, caregivers had lower mean values on dyadic adjustment than recipients, and higher mean values on negative affect. Bayesian path analysis was used to test actor-partner interdependence models reflecting the theory of dyadic coping. Models exhibited adequate fit to the data and indicated that apart from baseline dyadic adjustment, partner-related coping had the greatest positive impact on dyadic adjustment over the trajectory for both recipients and their caregivers. Limitations in resources for health care occurring on a national level have increased the extent of in-home care for acutely ill family members, including BMT recipients. This has serious implications for the mental health of the caregiver and for the integrity of the family system. Mental health assessment and integration of supportive interventions would be important in the prevention of secondary psychosocial morbidity.