From Application to Approach: A Systematic Review of 50 Years of Psychoanalytic Couple Therapy

ABSTRACT

This systematic review of contributions to peer-reviewed journals in the area of couple interventions aims to provide a comprehensive and intensive overview of this evolving field, within psychoanalysis. Using a pan theoretical systematic review methodology, 113 peer-reviewed journal articles were reviewed, dated between 1963 and 2014, addressing the topic of couple therapy and psychoanalysis. This article addresses a number of specific questions including, where authors have published their work, what methodologies they have used, with which couples psychoanalysts have been working, how writers from within different theoretical orientations talk about their work with couples, and how the field has changed over time. It also explores emerging themes of the relationship between couple and individual therapy, sex, and co-therapy. This review of writing over the past 50 years suggests that although Classical contributions have waned over time, couple psychoanalysts from within Object Relations, Self Psychology, Intersubjectivity, and Relational orientations have evolved in their discourse about couple distress, from an application of psychoanalytic concepts to full-bodied, well-articulated, clear, and concise approaches to diagnosis and treatment. The first 50 years of writing in the field of couple psychoanalysis has brought us distinct treatment models, which have opened the door for greater communication and sharing within and between orientations.     

Cognitive reappraisal reduces perceived exertion during endurance exercise

Emotion regulation may influence psychological responses to exercise. We examined whether the emotion regulation strategies, cognitive reappraisal and distraction, influenced psychological state and prefrontal cortex oxygenation during endurance exercise. Twenty-four endurance runners ran for 90 min at 75–85% maximum heart rate in three separate sessions with no instruction or with instructions to use cognitive reappraisal or distraction. Participants rated their emotional arousal, emotional valence, and perceived exertion before, every 30 min during, and after exercise. Functional near-infrared spectroscopy quantified changes in prefrontal cortex oxygenation. Participants felt lower emotional arousal and physical exertion when instructed to utilize cognitive reappraisal than when given no emotion regulation instruction. Such responses to distraction did not differ from the other conditions. Emotion regulation strategies did not influence emotional valence or prefrontal cortex oxygenation. Participants’ analytical interpretation of the cognitive reappraisal instruction could contribute to small effect sizes and limited effects. Further research should determine contexts under which emotion regulation strategies most benefit endurance exercise experience.     

Measuring Anhedonia in Adolescents: A Psychometric Analysis

Anhedonia—the reduced capacity to experience pleasure—is a trait implicated in mental and physical health. Yet, psychometric data on anhedonia measures in adolescents are absent. We conducted an in-depth psychometric analysis of the Snaith–Hamilton Pleasure Scale (SHAPS; Snaith et al., 1995 Snaith, R. P., Hamilton, M., Morley, S., Humayan, A., Hargreaves, D., & Trigwell, P. (1995). A scale for the assessment of hedonic tone: The Snaith–Hamilton Pleasure Scale. British Journal of Psychiatry, 167, 99–103. doi:10.1192/bjp.167.1.99[Crossref], [PubMed], [Web of Science ®] , [Google Scholar])—a self-report measure of anticipated pleasure response to 14 pleasant experiences—in adolescents. Adolescents (N = 585, M age = 14.5) completed the SHAPS and other paper-and-pencil surveys. Item response theory models were used to evaluate the psychometric performance of each SHAPS item. Correlations of the SHAPS with other personality and psychopathology measures were calculated to evaluate construct validity. Results showed that (a) certain items (e.g., reported pleasure from basic experiences like “seeing smiling faces” or “smelling flowers”) provided more information about latent anhedonia than others; and (b) SHAPS scales exhibited construct-consistent convergent and discriminant validity (i.e., stronger correlations with low positive affect constructs, weaker correlations with negative affect). Reporting diminished pleasure from basic pleasant experiences accurately indicates adolescent anhedonia, which is important for future scale development and understanding the phenomenology of anhedonia in teens. These data support using the SHAPS for assessing anhedonia in epidemiological research and school-based universal prevention programming in general adolescent populations.     

Mental Health Utilization Among Diverse Parenting Young Couples

Mental health issues often become apparent as adolescents emerge into young adulthood. The use of mental health services is low among adolescents and young adults, and use is particularly low among minorities. In this study, we examine mental health utilization among diverse young parenting couples. The sample consisted of 296 couples. We used the social–personal framework to examine personal, family, partner relationship, and environmental predictors for using mental health services. We used the Actor–Partner Interdependence Model to assess actor and partner effects on mental health utilization. We also examined moderator effects for gender and internalizing and externalizing behaviors. We found that being female, being White, higher income, more conduct problems, and less anxious romantic attachment predicted mental health utilization. Significant moderator effects included depression × gender, depression × medical insurance, and stress × Latino. Implications for community mental health practice include conducting mental health assessments during medical visits and systematic mental health follow‐up for individuals and couples with identified mental health and support needs. Future research should include married couples and the spouse’s influence on mental health use and examine relevant parenting factors that may also predict mental health utilization among couples.     

Doubling‐down on deprivation: Using latent profile analysis to evaluate an age‐old assumption in relative deprivation theory

Theorists have long argued that two forms of relative deprivation exist: individual‐based relative deprivation (IRD) whereby a person feels deprived relative to other individuals and group‐based relative deprivation (GRD) whereby a person feels his/her ingroup is deprived relative to other groups. Combinations of IRD and GRD are therefore assumed to produce four response profiles: (i) high on IRD and GRD (i.e. ‘doubly deprived’); (ii) high on IRD, low on GRD; (iii) low on IRD, high on GRD; or (iv) low on IRD and GRD. The existence of these profiles, however, has never been assessed. We address this oversight by using latent profile analysis to identify distinct response patterns to measures of IRD and GRD. Across two studies, we found no support for this typology, nor the oft‐assumed doubly deprived profile. Rather, response patterns showed moderate levels of IRD across discrete profiles accompanied by considerable variability in GRD.     

Do Police Officers' Beliefs About Emotional Witnesses Influence the Questions They Ask?

High emotional arousal associated with witnessing a crime promotes memory error. Police are trained to use open‐ended questioning (i.e., Cognitive Interview) to guard against contaminating fragile witness memory, but do they follow this protocol? We investigated whether officers' belief about arousal's impact on crime scene memory influenced their questioning procedures. Officers read crime scenarios describing the witness/victim as either emotionally distraught or calm, and then they chose among open‐ended and close‐ended question options for witness interviews. Results showed that emotionally aroused witnesses were asked more closed questions by officers who believed arousal did not hurt memory, while officers who believed arousal negatively impacted memory accuracy asked more open‐ended questions. This relationship was not influenced by police experience. Results suggest that regardless of training and empirical findings, beliefs about the arousal–memory relationship may guide the questioning technique that officers employ, potentially contaminating already vulnerable witness memory. Copyright © 2015 John Wiley & Sons, Ltd.     

Augmenting Visual Search Performance With Transcranial Direct Current Stimulation (tDCS)

Military personnel endure rigorous and demanding man-hours designated to monitoring and locating targets in tasks such as cyber defense and Unmanned Aerial Vehicle (UAV) operators. These tasks are monotonous and repetitive, which can result in vigilance decrement. The objective of the study was to implement a form of noninvasive brain stimulation known as transcranial DC stimulation (tDCS) over the left frontal eye field (LFEF) region of the scalp to improve cognitive performance. The participants received anodal and cathodal stimulation of 2 mA for 30 min as well as placebo stimulation on 3 separate days while performing the task. The findings suggest that anodal and cathodal stimulation significantly improves detection accuracy. Also, a correlation was detected between percent of eye closure (PERCLOS) and blinking frequency in relation to stimulation condition. Our data suggest that tDCS over the LFEF would be a beneficial countermeasure to mitigate the vigilance decrement and improve visual search performance.     

The lived experiences of individuals with Tourette syndrome or tic disorders: A meta‐synthesis of qualitative studies

There is a growing body of qualitative literature describing the lived experiences of people with tic disorders (TDs). The aim of this paper was to conduct a systematic review of this literature, synthesizing the perspectives of individuals on their experiences. Meta‐synthesis methodology was utilized to review and draw together findings from 10 articles, from which key concepts were extracted, and over‐arching themes generated. Six themes were identified to encompass the experience of TDs, including (1) cultural, semantic issues of the condition; (2) negative experiences in organizations and treatment; (3) the value and negative impact on interpersonal relationships; (4) personal identity in the constant presence of TDs; (5) concerns for the future; and (6) strategies to control and manage the observable presence of tics. Adaptive coping strategies were found to encompass continuous social adaptation, strategies to manage tics and social perceptions, self‐acceptance, advocacy, and support from others. The results highlighted the significant role of social and cultural issues related to understanding and stigma, which underpinned many of the lived experiences. Implications for clinical practice in supporting individuals with TDs were also highlighted.