Using Acceptance and Commitment Therapy to Treat Distressed Couples: A Case Study With Two Couples

Although the field of couple therapy has made significant strides in recent years, there continues to be a need for theoretically sound and empirically supported treatments. The current case study examines whether Acceptance and Commitment Therapy (ACT), an experiential acceptance-based behavior therapy, can be effective in treating distressed couples. Although ACT has demonstrated effectiveness in treating a variety of disorders in individuals, it has not been systemically applied to the treatment of couple distress, and the current study is the first empirical examination of ACT for the treatment of couples. Two married couples participated in the study. A number of core ACT interventions were modified to treat couples in a conjoint format. Cognitive defusion exercises were used to help couples reduce their fusion with and the believability of negative thoughts and feelings related to the relationship. Mindfulness and acceptance techniques were used to help couples increase awareness of their reactions to negative relationship cycles. Finally, value-directed action was used to help partners act in ways consistent with relationship values even in the presence of unwanted thoughts and feelings. The results of this preliminary case study suggest that ACT may be effective in increasing marital adjustment and satisfaction, and in reducing interpersonal and psychological distress in couples. Future studies with larger samples and more controlled designs are needed to build on the results from this single-case study.     

Psychopathology of Adolescent Social Phobia

Sixty-three adolescents with social phobia and 43 with no psychiatric disorders were compared across a number of clinical variables. In addition to clinically impairing social fear, adolescents with social phobia had significantly higher levels of loneliness, dysphoria, general emotional over-responsiveness and more internalizing behaviors than normal controls and 57.1% of socially phobic adolescents had a second, concurrent diagnosis, 75% of which were other anxiety disorders. In addition, adolescents with social phobia were significantly less socially skilled. Though similar in some respects to childhood social phobia, adolescent social phobia has a unique clinical presentation. The importance of developmental differences on the development of age-appropriate interventions is discussed.     

Current and past depression as predictors of family functioning: a comparison of men and women in a community sample.

The association between family functioning and parental depression has primarily been studied in samples of women. In particular, very little research exists that examines how parent gender and past diagnoses of depression are related to family functioning. The family relationships of 469 couples from a community sample were examined using self- and partner report measures of the marital relationship and youth report and interviewer-rated measures of the parent-youth relationship. Both currently and formerly depressed men and women were shown to have poorer family functioning than nondepressed and never depressed individuals, respectively. Interactions of gender and depression status indicated that depression and poorer marital functioning were more strongly related for women than for men, but there were few gender differences in the parent-youth relationship. The results highlight the need for further research on men's family functioning and suggest that targeting current depressive symptoms in treatment may not be sufficient to resolve marital and parent-youth difficulties that endure after depressive episodes remit.     

Free Will in the Block Universe

Carl Hoefer has argued that determinism in block universes does not privilege any particular time slice as the fundamental determiner of other time slices. He concludes from this that our actions are free, insofar as they are pieces of time slices we may legitimately regard as fundamental determiners. However, I argue that Hoefer does not adequately deal with certain remaining problems. For one, there remain pervasive asymmetries in causation and the macroscopic efficacy of our actions. I suggest that what Hoefer may have shown us is that causation, not determinism, was the threat to free will all along. Additionally, Hoefer might avoid the problem of the asymmetry of macroscopic efficacy by noting we have a very small region of space-time completely determined by our choices. However, this move implies our freedom to act is freedom to do very little, given that the region is trivial. I suggest that Hoefer should instead claim that we do have pervasive macroscopic efficacy toward the past, though I am unsure of how well this thesis works. Regardless, there remains a problem that the inside-out perspective requires us to see our choices as brute facts or random occurrences. Attempts to resolve this problem seem to require either a theory of agent causation or a traditional compatibilist argument, making Hoefer’s thesis extraneous, unless he can show us that these require the inside-out perspective. However, Hoefer has not yet shown us this, so there is work to be done.

Explanatory style and Immunoglobulin A (IgA).

The construct of explanatory style has been related to numerous aspects of human psychology, including health. Our research has focused on the effects of various psychological variables on the immune system, in particular Immunoglobulin A (IgA). We had participants fill out the Attributional Style Questionnaire (ASQ), the predominant measure of explanatory style, and assayed saliva samples for secretory IgA. No relationship was observed between overall ASQ score and IgA, or composite optimism score and IgA. However, we observed significant negative correlations between both the composite pessimism score and IgA, as well as the hopelessness score and IgA. Pessimistic explanatory style may therefore be related to immune system deficits and poor health.     

Attachment Styles and Personality Disorders: Their Connections to Each Other and to Parental Divorce, Parental Death, and Perceptions of Parental Caregiving

Attachment theory was explored as a means of understanding the origins of personality disorders. We investigated whether adult attachment styles and personality disorders share a common underlying structure, and how both kinds of variables relate to family background factors, including parental death, parental divorce, and current representations of childhood relationships with parents. A nonclinical group of 1407 individuals, mostly adolescents and young adults, were surveyed about their attachment styles, parental marital status, parental mortality status, perceptions of treatment by parents in childhood, and 13 personality disorders. Results indicated substantial overlap between attachment and personality-disorder measures. Two of the personality-disorder dimensions are related to the two dimensions of the attachment space; that is, there is a two-dimensional space in which both the attachment patterns and most of the personality disorders can be arrayed. The one personality-disorder factor that is unrelated to attachment appears akin to psychopathy. Both personality disorders and attachment styles were associated with family-of-origin variables. Results are discussed in terms of encouraging further research to test the idea that insecure attachment and most of the personality disorders share similar developmental antecedents.     

Does the Demographic Objection to Epistocracy Succeed?

In most, if not all, forms of epistocracy, we can expect (at least in the near future) that the more advantaged demographic groups would have higher rates of representation than less advantaged groups. The Demographic Objection to Epistocracy holds that this means epistocracy is unjust. One version of the Demographic Objection holds that the unequal representation is inherently unfair. I show that this argument fails, as proceduralist concern for fairness does not get us to universal equal suffrage at all. A second version holds that by giving some kinds of people more power than others, epistocracy will tend to help the advantaged and harm the already disadvantaged. In contrast, I argue that certain forms of epistocracy escape this objection altogether. For the others, though, this version of the objection relies on questionable empirical assumptions. In the end, neither version of the Demographic Objection succeeds. The Demographic Objection to epistocracy is much weaker than it seems.     

Pathways maintaining physical health problems from childhood to young adulthood: The role of stress and mood

Objective: Poor physical health in childhood is associated with a variety of negative health-related outcomes in adulthood. Psychosocial pathways contributing to the maintenance of physical health problems from childhood to young adulthood remain largely unexamined, despite evidence that factors such as negative mood and stress impact physical health.

Design: The current study tested the direct and indirect effects of ongoing health, chronic stress, health-related chronic stress, and depressive symptoms at age 20 on the link between health problems in childhood and young adulthood (age 21) in a longitudinal sample (n = 384).

Main Outcome Measures: The hypotheses were tested using a multiple mediation path analysis framework; the primary outcome measure was a composite index of health status markers in young adulthood.

Results: The proposed model provided an adequate fit for the data, with significant total indirect effects of the four mediators and significant specific indirect effects of health-related chronic stress and depressive symptoms in maintaining health problems from childhood into young adulthood.

Conclusions: Health problems are maintained from early childhood into young adulthood in part through psychosocial mechanisms. Depressive symptoms and health-related chronic stress have significant, unique effects on the relationship between health problems in early childhood and young adulthood.     

Moral philosophy's moral risk

Commonsense moral thinking holds that people have doxastic, contemplative, and expressive duties, that is, duties to or not to believe, seriously consider, and express certain ideas. This paper argues that moral and political philosophers face a high risk of violating any such duties, both because of the sensitivity and difficult of the subject matter, and because of various pernicious biases and influences philosophers face. We argue this leads to a dilemma, which we will not try to solve. Either philosophers should reduce their risk by avoiding sensitive issues where they are likely to violate such duties or, for one reason or another, philosophers are to some degree exempt from such duties when doing their work. Either horn of the dilemma, we argue, has unpalatable implications.