The Impact of Chronic Health Conditions as an Underlying Challenge on Couple’s Wellbeing

Chronic health conditions affect over 100 million Americans (Cano and Leonard in J Clin Psychol 62(11):1409–1418, 2006). Many clinicians are not integrating chronic physical health symptoms into psychotherapy. There is a complexity of issues that arise within the context of chronic health conditions. Making more need for couple and family therapists, whose primary focus is on a systemic family perspective, to understand how chronic health conditions are impacting family systems when they present for therapy (Canavarro and Dattilio in Contemp Fam Ther 33:87–90, 2011; Poleshuck et al. in Prof Psychol 41(4):312–318, 2010). The correlation of chronic health conditions on marriages and relationships has received limited attention in clinical research. This secondary data analysis examines the differences in overall well-being and psychological distress of individuals and couples seeking therapy who report a presence of chronic health conditions. Original research on the relationship between chronic health conditions and well-being, as measured by comparison of means, will be presented. Few studies investigate how chronic health conditions, when not the primary reason for seeking therapy, influence wellbeing and distress upon entering therapy. This study included 2742 participants from a clinical sample of individuals and couple seeking therapy in a family therapy clinic at a university training clinic. Independent t-tests, as well as ANOVA, were run to compare well-being and psychological distress of individuals and couples in the sample. Results showed significant differences in both overall wellbeing and psychological distress for both individuals who reported chronic illness for themselves, or their partners, than those that reported no chronic illness. There were also significant differences between groups on both well-being and psychological distress [F (2, 2706)?=?47.55, p?=?.00, F (2, 2697)?=?54.59, p?=?.00]. This results showed significant differences in well-being when no member of the couple has chronic health conditions, one member, or both members, with both members decreasing wellbeing significantly. This study demonstrates that chronic health conditions impact both the individual diagnosed, their partners, and is especially impactful if both members of a couple are diagnosed with chronic health conditions. Study limitations and clinical implications are also discussed.     

Sex differences and the effect of instruction on reorientation abilities by humans

This study examined whether differences in the amount of information provided to men and women, in the form of verbal instruction, influenced their encoding during a reorientation task. When a navigator needs to orient, featural (e.g., colour or texture) and geometry (e.g., metric information) are used to determine which direction to begin traveling. The current study used a spatial reorientation task to examine how men and women use featural and geometric cues and whether the content of the task’s instructions influenced how these cues were used. Participants were trained to find a target location in a rectangular room with distinctive objects situated at each corner. Once the participants were accurately locating the target, various tests manipulating the spatial information were conducted. We found both men and women encoded the featural cues, and even though the features provided reliable information, participants generally showed an encoding of geometry. However, when participants were not provided with any information about the spatial aspects of the task in the instructions, they failed to encode geometry. We also found that women used distant featural cues as landmarks when the featural cue closest to the target was removed, whereas men did not. Yet, when the two types of cues were placed in conflict, both sexes weighed featural cues more heavily than geometric cues. The content of the task instructions also influenced how cues were relied upon in this conflict situation. Our results have important implications for our understanding of how spatial cues are used for reorientation.     

Anisotropic tracking: evidence for automatic synergy formation in a bimanual task

Investigation of interlimb synergy has become synonymous with the study of coordination dynamics and is largely confined to periodic movement. Based on a computational approach this paper demonstrates a method of investigating the formation of a novel synergy in the context of stochastic, spatially asymmetric movements. Nine right-handed participants performed a two degrees of freedom (2D) "etch-a-sketch" tracking task where the right hand controlled the horizontal position of the response cursor on the display while the left hand controlled the vertical position. In a pre-practice 2D tracking task, measures of phase lag between the irregularly moving target and the response showed that participants controlled left and right hands independently, performance of the right hand being slightly superior to the left. Participants then undertook 4 h 16 min distributed practice of a one degree of freedom etch-a-sketch task where the target was constrained to move irregularly in only the 45 degrees direction on the display. To track such a target accurately participants had to make in-phase coupled stochastic movements of the hands. In a post-practice 2D task, measures of phase lag showed anisotropic improvement in performance, the amount of improvement depending on the direction of motion on the display. Improvement was greatest in the practised 45 degrees and least in the orthogonal 135 degrees direction. Best and worst performances were no longer in the directions associated with right and left hands independently, but in directions requiring coupled movements of the two hands. These data support the proposal that the nervous system can establish a model of novel coupling between the hands and thereby form a task-dependent bimanual synergy for controlling the stochastic coupled movements as an entity.     

Technology Delivered Interventions for Depression and Anxiety in Children and Adolescents: A Systematic Review and Meta-analysis

Depression and anxiety are common during adolescence. Whilst effective interventions are available treatment services are limited resulting in many adolescents being unable to access effective help. Delivering mental health interventions via technology, such as computers or the internet, offers one potential way to increase access to psychological treatment. The aim of this systematic review and meta-analysis was to update previous work and investigate the current evidence for the effect of technology delivered interventions for children and adolescents (aged up to 18 years) with depression and anxiety. A systematic search of eight electronic databases identified 34 randomized controlled trials involving 3113 children and young people aged 6–18. The trials evaluated computerized and internet cognitive behavior therapy programs (CBT: n = 17), computer-delivered attention bias modification programs (ABM: n = 8) cognitive bias modification programs (CBM: n = 3) and other interventions (n = 6). Our results demonstrated a small effect in favor of technology delivered interventions compared to a waiting list control group: g = 0.45 [95% CI 0.29, 0.60] p < 0.001. CBT interventions yielded a medium effect size (n = 17, g = 0.66 [95% CI 0.42–0.90] p < 0.001). ABM interventions yielded a small effect size (n = 8, g = 0.41 [95%CI 0.08–0.73] p < 0.01). CBM and ‘other’ interventions failed to demonstrate a significant benefit over control groups. Type of control condition, problem severity, therapeutic support, parental support, and continuation of other ongoing treatment significantly influenced effect sizes. Our findings suggest there is a benefit in using CBT based technology delivered interventions where access to traditional psychotherapies is limited or delayed.