Bipolar Disorder and the Family: An Integrative Model

The relationship between major mental illness and the family is complex. This article describes a model that recognizes biological, individual, and familial aspects of illness, and the interaction and reciprocal effects of these different levels. This model is illustrated using the example of bipolar illness, with particular emphasis on the effects of the illness on the family. Many characteristics previously noted in bipolar families can be understood as consequences, rather than causes, of the illness. A framework for integrated treatment is also described.     

A Coming-of-Age for Research on Interpersonal Perception

ABSTRACT Research on accuracy and consensus in interpersonal perception has become a major topic in the social sciences. Key methodological issues in this research are research design, statistical measures of agreement, unit of analysis, and data aggregation. I discuss the twelve articles devoted to these topics in this special issue in terms of moderators of agreement, the weighted average model of consensus and accuracy (Kenny, 1991), and methodological innovations.     

What is a difficult mental health case? An empirical study of relationships among domain variables

A difficult case in psychotherapy can be defined in many ways. This study proposes a model for that definition, in which three domains (patient characteristics, case characteristics, and therapist characteristics) are considered to impact on that definition. A total of 264 professionals received a questionnaire to assess the relative importance of a series of variables within and across these domains. Wilcoxon Matched-Pairs Signed-Ranks tests indicated that patient characteristics were considered more important than therapist or case characteristics in defining a difficult case. Case characteristics were considered more important than therapist characteristics. Pearson correlations, however, suggested that the three domains in the model are related. Correlations (for years of experience) and Kruskal-Wallis one-way ANOVA for ranks (for professions) also indicated that participants were able to identify variables within domains as important in that definition regardless of years of experience or professions. Across domains, the most important variables included the motivation of the client (a patient characteristic), dropout/attrition and multiple diagnoses (case characteristics), and the degree of therapist-client racial similarity (a therapist characteristic).     

Psychotherapy with families of psychosomatic patients

Paradigmatic complexes in family psychotherapy have been indicating a revolutionary change and the creation of new paradigms for the past thirty years. Starting with the application of the general systems theory and the development of those concepts that have been emerging regarding psychosomatic illnesses we discuss the epistemological confusion created, the methodological problems and the dissociation between theory and practice. We suggest a double process of investigation of the family structure using a knowledge of the basic attitudes and the development of a psychotherapy programme within the family of the psychosomatic patient.