Observed emotional involvement and overinvolvement in families of patients with bipolar disorder

Many studies have examined the construct validity of the criticism component of expressed emotion, but little work has been done on clarifying the emotional overinvolvement (EOI) construct. In a sample of 115 recently episodic patients with bipolar disorder, the authors of the present study examined the construct validity of an observational coding system for both appropriate and inappropriate emotional involvement that permitted separate ratings for relatives' intrusiveness, self-sacrificing behaviors, and distress related to the patient's well-being. Findings support the measure's reliability and convergent validity and are moderately supportive of the measure's discriminant validity. Results also suggest that Camberwell Family Interview (C. E. Vaughn & J. P. Leff, 1976) EOI ratings do not discriminate among the different dimensions of the emotional involvement construct (or their appropriateness or inappropriateness) as revealed in laboratory-based interactions. The findings suggest that clinicians working with such families might consider differentiating among the various ways in which family members are involved with the patient and helping them learn to judge under what circumstances such involvement is appropriate and inappropriate.     

Long-term course of psychoses in continuously hospitalized patients

Thorough reexamination of 70 patients in a long-term psychiatric ward led to partial revision of the diagnoses. Classified on the basis of Leohards's differential diagnostics, the large proportion of schizophrenics has dropped by over a third from 78% to 47%. Half of the 22 psychosis originally considered to be schizophrenia proved to be curable phasic and cycloid psychoses which had previously been overlooked and the other half were mental disturbances caused by brain-organic damage. A third of the chronic mental illnesses were found to be rooted in somatic brain lesions.     

Family interaction and outcome IQ in high-risk boys

This study examined the relationship between measures of family interaction and outcome for 97 boys at risk for psychopathology from having one parent previously hospitalized for psychiatric illness. Measures of communication deviance and of activity, balance and warmth, derived from two family activities, correlated significantly with 3-yr. follow-up adaptive functioning, measured by IQ. Poor family interaction, in previous studies associated with schizophrenic symptomatology, was here correlated with poor cognitive/social/emotional functioning, suggesting that family interaction may be a broad predictor of adequacy of functioning.     

Task effects in family interaction.

The effect of different experimental tasks on emergent patterns of family activity, conflict, and influence was assessed by means of multivariate analysis procedures on a sample of 30 family triads. Although a task effect did emerge for the family activity measure, the overall pattern of findings indicates marked consistency in family interaction across the three experimental tasks. Findings are discussed in terms of methodological and theoretical explanations that could account for obtained results.     

Depressed youth: treatment outcome and changes in family functioning in individual and family therapy

This study explores the role of family functioning in therapeutic change in focused individual psychodynamic psychotherapy (FIPP) and time‐limited systems integrative family therapy (SIFT) for depressed children and adolescents. After a screening process, 72 participants aged 8 to 15 were randomized to either FIPP or time‐limited SIFT. Assessments took place prior to, at the end of, and 6 months after treatment. Families in both SIFT and FIPP showed a small but significant and sustained improvement in family functioning by the end of treatment in both mothers' self‐reports and family therapists' assessments. Better family functioning at baseline in mothers' self‐reports and improved family functioning during SIFT, as assessed by family therapists, predicted a sustained decrease in self‐reported depressive symptoms. Results indicated that time‐limited SIFT may be more effective with younger children and in patients without a diagnosis of double depression than adolescents.     

Simulation in training family therapists: Process and outcome

This article reviews procedures for using simulated families in the training of novice-level family therapists. An evaluation of one training experience is described. The evaluation utilized a repeated measures analysis and found an increase in the student's observational and conceptual skill development.The authors would like to express appreciation to Douglas C. Breunlin, M.S.S.A. for helpful comments in the preparation of this article.     

Marital interaction, family organization, and differences in parenting behavior: explaining variations across family interaction contexts.

Family systems theories remind us that, in two-parent families, children encounter their parents in multiple family configurations, including parent-child dyads and mother-father-child triads, or whole families. There are, however, relatively few empirical investigations of differences in parenting behavior which tend to emerge when a dyad is transformed into a whole family unit. Using a sample of 82 families with a kindergarten-age child, the present study offers support to earlier studies reporting that mothers' and fathers' parenting behavior differs when observed in dyadic and whole family interaction sessions. The present study then turns to examining explanations for these differences in parenting behavior. Limited support was found for the hypothesis that observations of marital interaction are associated with differences in parenting behavior across family interaction contexts. Family level assessment of adaptive organization was found to explain differences in fathers' parenting in the dyad and when the entire family is together, but not differences in mothers' parenting behavior. The clinical and methodological implications of these findings are discussed.     

Caregiver depressive symptoms and observed family interaction in low-income children with persistent asthma

This study examined the relationship between caregiver depressive symptoms and observed parenting behaviors and family processes during interactions among 101 urban, low-income Africtan American families with children with persistent asthma. Caregivers (primarily female) were assessed on four dimensions (i.e., warmth/ involvement, hostility, consistent discipline, relationship quality) in three videotaped interaction tasks (loss, conflict, cohesion). The results indicated that increased depressive symptoms were significantly associated with lower warmth/involvement and synchrony scores and greater hostility scores during the loss and conflict tasks. In the total sample, the highest levels of hostility and the lowest levels of warmth/involvement were found for the conflict task; nevertheless, caregivers with moderate/severe depressive symptoms showed a significantly greater increase in hostility from the loss to the conflict task than caregivers with minimal/mild depressive symptoms. The findings highlight the salience of considering task content in family observational process research to expand our understanding of depressed and nondepressed caregivers abilities to modulate appropriately their behaviors and affect across various family interactions. Implications for improving asthma management for low-income children with persistent asthma are discussed, including the utility of multidisciplinary interventions that combine asthma education with family therapy.     

Family interaction and child outcome in a high-risk sample

This study hypothesized that the quality of family interaction would predict longitudinally children's follow-up functioning. The subjects were 97 boys, functioning on the average within the normal range but considered to be at risk for psychopathology because one parent had previously been hospitalized for psychiatric illness. Family measures of deviant and healthy communication and of activity, balance, and warmth related significantly to children's competent social/emotional/cognitive functioning at a 3-yr. follow-up. The findings suggest the importance of considering multiple predictors of outcome for children and of employing clinical interventions that attend to more than one aspect of family functioning.     

Types of dispute courses in family interaction

The article examines entire dispute courses in family interaction with regard to argumentation. The approach is an interdisciplinary one integrating both linguistic conversation analysis and empirical psychology, and leads to a typology of dispute courses. Research is guided by the presupposition that the presentation of an argument depends on two systems, a cognitive one and a motivational one, and that both systems are reflected in the realization of the interaction.Six types of dispute courses were detected and grouped in the dichotomy of more constructive and more destructive courses where the latter were divided again into courses disturbed in topical progress or disturbed in interpersonal relationships. The types were evaluated through quantitative methods referring to an exhausting coding of the utterances in the material used. Quantitative evaluations yield a synopsis of the different dispute courses concerning the kind of mutual interaction control, the argumentation itself, and the argumentation levels of the participants.This contribution is a revised version of a paper presented at the 3rd International Conference on Dialogue Analysis in Bologna (May 1990). The research was funded by the Deutsche Forschungsgemeinschaft within the SFB 245 Sprache und Situation.     

Ethnic matching and treatment outcome with Hispanic and Anglo substance-abusing adolescents in family therapy.

This study examined treatment outcomes of 86 highly acculturated Hispanic and Anglo substance-abusing adolescents in functional family therapy, testing the hypothesis that ethnic matching of therapist and client is related to better treatment outcomes for clients. Adolescents reported on their substance use pre- and posttreatment on a timeline follow-back interview. Ethnically matched Hispanic adolescents demonstrated greater decreases in their substance use compared with Hispanic adolescents with Anglo therapists. Ethnic match status was not related to treatment outcome for Anglo clients. Thus, the matching hypothesis was supported for Hispanic clients only. The results underscore the importance of greater ethnic diversity among therapists and better cultural competency training for Anglo therapists. More research is needed on individual differences in the effects of ethnic matching.     

Catamnestic surveys on somato-psychosocial development in childhood and adolescence of patients with unipolar depressive and bipolar manic-depressive psychoses

The somatic and psychosocial development of 80 subjects with manifest affective-phasic psychoses is studied retrospectively and compared with that of an identically sized control group consisting of neuropsychiatrically healthy subjects. Statistically significant differences were found particularly in the answers to questions dealing with social situation and social adaptability. Achievement at school and vocational qualifications were lower among the parents of the patients than among those of the healthy subjects. Characteristic features of the patients' childhood and adolescence were transient depression, often for no apparent cause, and maladaption, and vocational wishes were fulfilled less often than among the controls. The patients experienced greater difficulty in settling in to a new group due to their contact difficulties.     

Early interactional change and its relationship to family therapy outcome

In the present study, a tailoring methodology was employed to investigate the detection of early interactional change in the course of family therapy and the possible prognostic value of such change for therapy outcome. The predicted relationship received partial support and suggested a model of change in families, with early interactional change as a mediating factor.