The associations between insecure attachment (anxious and avoidant dimensions), maladaptive relational attributions, self-esteem, and psychological aggression were examined in a sample of couples (N ...= 96 couples) across the early years of marriage. Studying these constructs within a single sample is a novel contribution to the literature. Attachment was assessed at marriage, whereas maladaptive attributions, self-esteem, and psychological aggression were evaluated annually over the first 7 years of marriage. For the present study, specific maladaptive relational attributions about the spouse's hypothetical aggressive behavior were investigated. Data from both spouses were examined simultaneously using growth curve analytic and actor-partner interdependence modeling techniques. Results indicated that self locus attributions (i.e., attributing the cause of the spouse's hypothetical aggressive behavior to the self), intentionality attributions (i.e., attributing the spouse's motivation for the hypothetical behavior as intentional), and self-esteem were predicted by insecure attachment and covaried longitudinally with psychological aggression. Husbands' self-esteem and wives' intentionality attributions were particularly consistent in these associations. The results replicate and extend previous research by examining these constructs using a longitudinal dyadic approach. The findings of this study provide specific targets for intervention efforts to reduce psychological aggression and support conceptualizing psychological aggression within a dyadic and dynamic framework.
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Following from an adapted family stress model (FSM), we used two-wave, secondary data from the Building Strong Families project, focusing on 4,424 primarily lower-income, unmarried couples expecting ...their first child together. We used cross-lagged analyses to test the directionality of the associations among financial difficulties, depressive symptoms, destructive interparental conflict, and coparenting alliance for both fathers and mothers when children were 15 and 36 months old. Two of the three hypotheses provided support for the FSM. First, destructive conflict predicted coparenting alliance (but not the reverse). Specifically, higher destructive conflict at 15 months for both fathers and mothers predicted lower coparenting alliance at 36 months for both fathers and mothers. Second, depressive symptoms predicted destructive conflict (but not the reverse). Specifically, fathers' (but not mothers') higher depressive symptoms at 15 months predicted both their own and mothers' higher destructive conflict at 36 months. Contrary to predictions, financial difficulties did not predict depressive symptoms; instead, we found support for the reverse: For mothers only, higher depressive symptoms at 15 months predicted higher financial difficulties at 36 months. Collectively, the results support the use of the FSM to understand the directionality of associations among key risk factors, especially depressive symptoms and destructive conflict, for primarily lower-income, unmarried couples expecting their first child together.
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This conceptual review summarizes two decades of research on conflict management behaviors and their implications for family functioning. We review the accumulated research on the impact of three ...common conflict resolution strategies – destructive interparental conflict, constructive interparental conflict, and intimate partner violence – on parenting and parent–child relationships, including child abuse. Our review is based on published peer‐reviewed articles that include families with minor children of various ethnic and racial compositions and diverse family forms. We also provide a brief overview of the literature covering correlates of specific conflict management behaviors and comment on the effectiveness (or lack thereof) of intervention programs that focus on improving family well‐being. We conclude with suggestions for future research.
Maintaining the resilience of healthcare workers (HCWs) during the protracted COVID-19 pandemic is critical as chronic stress is associated with burnout, inability to provide high-quality care, and ...decreased attentiveness to infection prevention protocols. Between May and July 2020, we implemented the ICARE model of psychological first aid (PFA) in a novel online (i.e., telehealth) format to address the psychological support needs of HCWs during the COVID-19 pandemic. We found that HCWs needed psychological support related to obtaining clear information about pandemic policies and guidelines, navigating new rules and responsibilities, and processing overwhelming and conflicting emotions. The HCWs in our program repeatedly expressed appreciation for the support we provided. Future directions include establishing online discussion forums, increasing opportunities for individual support, and training HCWs to provide peer support using PFA. This program has far-reaching potential benefit to HCWs and to society at large in the context of a pandemic.
Maladaptive repetitive thought (RT) is a transdiagnostic construct associated with several psychopathological disorders, including major depressive disorder and anxiety disorders. However, not all ...forms of RT are maladaptive. Adaptive RT is characterized by primarily positive and concrete thought content, is usually focused on the present rather than the past or future, and frequently from a self-distanced perspective. From a behavioral therapy perspective, interventions that promote adaptive RT may interrupt or decrease engagement in maladaptive RT. In this review, we explore the distinction between adaptive and maladaptive RT and examine the utility of various forms of adaptive RT. Empirical evidence for several examples of adaptive RT (e.g., savoring, reminiscing, compassion, gratitude, mantra-based intervention) are provided, with demonstrated efficacy in the treatment of psychopathology or as components of empirically supported psychotherapies. Using adaptive RT therapeutically may be beneficial for those who are already predisposed to RT, either as an individual difference (e.g., neural default mode connectivity) or in response to a stressful life event. Recommendations for future research into adaptive RT and its potential utility in addressing maladaptive RT in vulnerable populations are discussed.
Piensa de nuevo: el pensamiento repetitivo adaptativo como un transdiagnóstico Tratamiento para individuos predispuestos a estilos de pensamiento repetitivosEl pensamiento repetitivo maladaptativo (PR) es un constructo transdiagnóstico asociado con varios trastornos psicopatológicos, incluyendo trastornos depresivos mayores y trastornos de ansiedad. Sin embargo, no todas las formas de PR son maladaptivas. El PR adaptativo se caracteriza por un contenido de pensamiento principalmente positivo y concreto, generalmente se encentra en el presente más que en el pasado o en el futuro, y con frecuencia desde una perspectiva autodistanciada. Desde la perspectiva de la terapia conductual, las intervenciones que promueven el PR adaptativo pueden interrumpir o disminuir la participación en PR maladaptivo. En esta revisión, exploramos la distincin entre PR adaptativo y no adaptivo y examinamos la utilidad de varias formas de PR adaptativo. Se proporcionan pruebas empricas de varios ejemplos de PR adaptativo (por ejemplo, saborear, recordar, compasión, gratitud, intervención basada en mantras), con eficacia demostrada en el tratamiento de la psicopatología o como componentes de psicoterapias con apoyo empírico. El uso terapéutico de PR adaptivo puede ser beneficioso para aquellos que están predispuestos a PR, ya sea como una diferencia individual (por ejemplo, la conectividad del modo predeterminado neuronal) o en respuesta a un evento estresante en la vida. Se analizan las recomendaciones para la investigación futura sobre el PR adaptativo y su utilidad potencial para abordar el PR desadaptativo en poblaciones vulnerables.
再想想： 适应性重复思维作为个人易患重复思维风格的跨诊断治疗不適應重複性思維（RT）是一種與多種精神病相關的跨診斷結構，包括重症抑鬱症和焦慮症。然而，並非所有形式的RT都是不適應的。自適應RT的主要特點是積極和具體的思想內容，通常側重於現在而不是過去或未來，並經常從自我疏远的角度。從行為治療的角度來看，促進適應性RT的干預措施可能會中斷或減少不適應RT的參與。在本回顾中，我們探討了適應性和不適應RT之間的區別，並考察了各種形式的適應性RT的效用。我们提供了若干种适用性RT（如体味，回忆，怜悯，感恩，基于口诀的干预等）的实证证据，并展示了其对心理病理治疗中的有效性，或作为实证支持的心理治疗的一部分的有效性。使用自適應RT治療可能有利於那些已經傾向於RT的人，無論是作為一個個體的差異（例如，神經默認模式連接）或響應緊張的生活事件。本文討論了今後對適應性RT進行研究的建議及其在解決弱勢群體不適應RT方面的潛在效用。
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There is a discrepancy between the emphasis on relational partners participating in couple relationship education (CRE) programs together (i.e., joint couple attendance; Arnold & Beelmann, 2019; ...Cowan & Cowan, 2019; Johnson, 2012; Markman et al., 2022) and the principles of family systems theory and the spillover hypothesis (Cox & Paley, 1997, 2003; Engfer, 1988; Erel & Burman, 1995). Specifically, the joint couple attendance emphasis of CRE programs implies that individuals participating in CRE without their relational partners may lead to detrimental couple and family functioning outcomes. In contrast, family systems theory and the spillover hypothesis suggest that individual and dyadic participation in CRE programs should have equivalent outcomes due to interactions and spillover between members of the family system. I explored this discrepancy with data from the Building Strong Families (BSF) project. The BSF CRE program provided relationship skills education focused on communication and conflict management, affection and intimacy, and the parent-infant relationship, and served a sample consisting of primarily racial-ethnic minority, lower income, unmarried couples transitioning to parenthood (Hershey et al., 2008). Using data from couples in the intervention condition of the BSF project (N = 2,553 couples) and conducting analyses via structural equation modeling and actor-partner interdependence modeling, I examined the associations between the difference in mothers’ and fathers’ BSF intervention dosage (i.e., an indication of whether and the extent to which individuals participated in the BSF CRE program without their relational partners) and outcomes critical for couple and family functioning.In the first paper (Chapter II), I investigated whether the difference in mothers’ and fathers’ BSF intervention dosage was associated with mothers’ and fathers’ destructive conflict 15 months later. Additionally, given the historical and sociocultural factors that have the potential to uniquely affect relationship and family functioning for Black individuals, I examined mothers’ and fathers’ race – comparing those identifying as Black to all others in the sample – as moderators of these associations. Results indicated that the difference in intervention dosage (i.e., mothers attending more of the intervention than fathers) was associated with greater mothers’ destructive conflict at 15 months. In contrast, the difference in intervention dosage was not associated with fathers’ destructive conflict at 15 months. Lastly, neither mothers’ nor fathers’ race moderated these associations.In the second paper (Chapter III), I evaluated whether the difference in mothers’ and fathers’ BSF intervention dosage was associated with mothers’ and fathers’ coparenting relationship quality 36 months later. Further, I tested mothers’ and fathers’ destructive conflict, which was measured at 15 months, as mediators of these associations (i.e., difference in intervention dosage → destructive conflict → coparenting). Results indicated that mothers attending more of the intervention than fathers was associated with worse coparenting at 36 months as reported by both mothers and fathers. These associations were mediated by mothers’ destructive conflict (i.e., mothers attending more of the intervention than fathers → greater mothers’ destructive conflict → worse coparenting). In contrast, fathers’ destructive conflict was not a significant mediator of the associations between the difference in mothers’ and fathers’ BSF intervention dosage and coparenting.In the third paper (Chapter IV), I assessed the difference in mothers’ and fathers’ BSF intervention dosage, the proportion of BSF intervention hours attended as a couple, and destructive conflict as predictors of mothers’ and fathers’ depressive symptoms at 36 months. Results indicated that the difference in mothers’ and fathers’ BSF intervention dosage was not associated with mothers’ or fathers’ depressive symptoms at 36 months. Similarly, the proportion of BSF intervention hours attended as a couple was not associated with mothers’ or fathers’ depressive symptoms at 36 months. Lastly, greater mothers’ and fathers’ destructive conflict at 15 months was associated with higher levels of their own depressive symptoms at 36 months, but was not associated with their partners’ depressive symptoms at 36 months.The findings across these three papers are mixed. Some results support the joint couple attendance emphasis of CRE programs as the difference in mothers’ and fathers’ BSF intervention dosage was associated with maladaptive outcomes (i.e., greater mothers’ destructive conflict, worse mothers’ coparenting, worse fathers’ coparenting). Conversely, some results align with family systems theory and the spillover hypothesis as the difference in mothers’ and fathers’ BSF intervention was not associated with other outcomes (i.e., fathers’ destructive conflict, mothers’ depressive symptoms, fathers’ depressive symptoms). Future research is needed to continue to elucidate the contexts in which, the participants for whom, and the outcomes for which the difference in relational partners’ CRE dosage matters. Nevertheless, the findings of this dissertation demonstrate the importance of examining outcomes of the process by which CRE is delivered or received (e.g., the difference in relational partners’ CRE program dosage). Moreover, the results provide guidance for future CRE programs designed to improve the couple relationship for unmarried parents, highlight the importance of using dyadic techniques to assess the effects of such programs, and suggest meaningful directions for future research.
Most fibrinogen replacement strategies focus on quantitative deficiencies. A thrombin time (TT) mixing study helped to assess qualitative defects caused by dysfibrinogens. Plasma samples were ...collected from non-anticoagulated subjects (n=6) meeting laboratory criteria for suspected dysfibrinogenaemia (TT > 22 s; fibrinogen activity <180) and from a control group. TT mixing studies were performed on subject plasma with increasing volumes of pooled normal plasma at 1:2, 1:4 and 1:5 dilutions. No subjects with dysfibrinogenaemia demonstrated a complete TT correction at 1:2, but 50% corrected at 1:4 and 100% at 1:5 dilution. Based on these data, a correction factor (CF), defined as the reciprocal dilution yielding complete correction, was incorporated into our clinical practice formula for fibrinogen dosing in patients with dysfibrinogenaemias. Our study incorporates TT mixing studies for assessment of dysfibrinogens. The addition of a mix-derived CF to classical formulae may better approximate dosing in patients with dysfibrinogenaemia.
