Cluster C personality disorder and recovery from major depression: 24-month prospective follow-up

We investigated whether Cluster C personality disorder (CPD) is associated with recovery from depression. Changes in symptom scales in 30 patients with MD and CPD were compared with changes in 60 patients with MD alone over a 24-month follow-up period. Recovery of patients with MD and comorbid CPD was inferior to recovery of those with MD alone based on the Hamilton and Beck Depression Inventory (BDI) scales, and the SCL-90 total score. Only 18% of those with MD alone but 47% of those with CPD and MD met the criteria for major depression at the end of the 24-month follow-up. Multiple logistic regression analyses revealed an independent association between the lack of recovery (BDI score > 9 at 24 months) and the presence of CPD (OR 4.9, 95% CI 1.5-16.0). Moreover, the presence of CPD associated with the presence of major depression at 24 months (OR 4.2, 95% CI 1.4-12.2). The presence of CPD hinders the alleviation of depressive symptoms in major depression.     

Femininity and fertility in sisters with twin brothers: prenatal androgenization? Cross-sex socialization?

Are sisters of twin brothers behaviorally or physiologically masculinized? Prenatal exposure to their brothers' androgens and postnatal socialization experiences unique to girls growing up with twin brothers might influence their attitudes, pubertal development, and reproductive histories. To investigate, we studied age- and cohort-matched samples of Finnish sisters from same-sex and opposite-sex twin pairs. Using data from two ongoing longitudinal studies of consecutive birth cohorts of Finnish twins, we assessed pubertal development at ages 11 and 14 and endorsement of attitudes associated with femininity at age 16. We also studied fertility in Finnish women from same- and opposite-sex twin pairs born from 1958 through 1971, obtaining information on their child-bearing histories when they were ages 15 to 28. Results of each comparison were unambiguously negative: There was no evidence of differences between sisters from same- and opposite-sex twin pairs, and thus, no evidence of either androgenization or cross-sex socialization.     

Couple Therapy for Depression Within a Naturalistic Setting in Finland: Factors Related to Change of the Patient and the Spouse

The study examined factors related to change in treatments for depression in couple therapy (CT; N = 29) and treatment-as-usual (TAU; N = 22). Treatments were adapted in accordance with the patient’s need. The patients’ depressive symptoms, general mental health and marital satisfaction were assessed at baseline and at 6 months post-baseline. The Hamilton Depression Rating Scale, the Beck Depression Inventory (BDI), the Symptom Check List-90, and the Dyadic Adjustment Scale (DAS) were used for the patients. The BDI and the DAS were used for the spouses. The couples in CT group assessed their subjective distress (SD) at every session by using the Outcome Rating Scale. The results showed that the spouses’ gender, the spouses’ depressive symptoms at baseline, and the number of therapy sessions were related to differing changes in the CT and TAU groups at the 6-month post-baseline assessment. The spouses in the CT group demonstrated a higher treatment response than those in the TAU group. In the CT group, the spouse’s benefit from the treatment was related to SD at the outset on the part of either the patient or the spouse or both. The change in the patient’s SD predicted the patient’s change in depressive symptoms, general mental health, and was associated with the patient’s change in marital satisfaction. The study emphasizes the importance of the spouse’s involvement in the treatment of depression, the provision of feedback on SD, and discussion of individual well-being and relational issues, in addition to the focus on depression.     

Establishing Therapeutic Dialogue with Refugee Families

The article describes an investigation into dialogues between native Swedish psychotherapists and refugee families. Dialogue is needed to establish the therapeutic alliance, which is ultimately important for healing, whether of individual sickness or family crisis. However the development of dialogue is hindered by cross-cultural and language barriers. We concentrate on one aspect of research originally presented in a Doctoral Thesis by the first author, asking how culture and power differences, together with their resettlement in a strange country, affected meetings with refugee families, and how these problems were overcome; language and the presence of an interpreter are not discussed. A multi-perspective methodology was used in the original research, combining text analysis, review of video-recordings by the participating therapists, and interviews with the families. All these forms of investigation are drawn on here, but particularly text analysis. Significant hindrances to dialogue turn out to be differences in cultural values between refugee and therapist, their different power positions, and the refugee’s weariness and distrust of meetings. Strategies to minimise power differences are an essential aspect of the Finnish open dialogue approach, which turns out to be particularly relevant to such refugee meetings.