Sex and marital status in relation to the treatment and outcome of alcoholic patients

This article focuses on gender and marital status differences in the treatment process, posttreatment experiences, and outcome of 332 alcoholic patients and explores the utility of several sex-role models in explaining the observed findings. Among men patients, being married is related to better treatment outcome, but the marital status difference is negligible among women patients. Participation in group therapy is related to better outcome for men relative to women; exposure to educational materials on alcoholism is associated with better outcome of women relative to men. Men and women patients also differ in the way in which their perceptions of the treatment environment are related to outcome. After discharge, unmarried women and married men are most likely to receive aftercare outpatient treatment, which is also related to better outcome among men patients. The findings underscore the importance of gender and marital status factors and of patient-program congruence effects in the treatment outcome of alcoholic patients.This research was supported in part by NIAAA Grant AAO2863 and by Vetrans Administration Medical Research Funds. The authors wish to thank Ruth Lederman for her valuable assistance with data analyses, and John Finney and Deborah Shields for helpful comments on earlier drafts.     

Student physical symptoms and the social climate of college living groups

Student physical symptoms were related to the social climates of university living groups. A Physical Symptom Risk Scale, a new subscale of the University Residence Environment Scale, which relates consistently to physical symptom complaints for male, female, and coed living groups, was developed. Living groups characterized by high student physical symptoms were perceived by students as low in involvement and support, high in competition, and low in student influence. The results indicate that certain types of social environments may be "high risk" settings in that they support and possibly facilitate complaints of physical symptoms. These settings may be amenable to early "environmental diagnosis," preventive counseling, and change-oriented social systems intervention.     

Spousal similarity in coping and depressive symptoms over 10 years.

Following a baseline sample of 184 married couples over 10 years, the present study develops a broadened conceptualization of linkages in spouses' functioning by examining similarity in coping as well as in depressive symptoms. Consistent with hypotheses, results demonstrated (a) similarity in depressive symptoms within couples across 10 years, (b) similarity in coping within couples over 10 years, and (c) the role of coping similarity in strengthening depressive similarity between spouses. Spousal similarity in coping was evident for a composite measure of percent approach coping as well as for component measures of approach and avoidance coping. The role of coping similarity in strengthening depressive symptom similarity was observed for percent approach coping and for avoidance coping. These findings support social contextual models of psychological adjustment that emphasize the importance of dynamic interdependencies between individuals in close relationships.     

Integrating Anxiety Sensitivity, Distress Tolerance, and Discomfort Intolerance: A Hierarchical Model of Affect Sensitivity and Tolerance

The purpose of the present investigation was to concurrently examine the latent dimensional and hierarchical structure of anxiety sensitivity (AS) and two key theoretically relevant and related affect (in)tolerance and sensitivity constructs: distress tolerance and discomfort intolerance. These constructs were measured using the Anxiety Sensitivity Index (Reiss, Peterson, Gursky, & McNally, 1986), the Distress Tolerance Scale (Simons & Gaher, 2005), and the Discomfort Intolerance Scale (Schmidt, Richey, & Fitzpatrick, 2006). A total of 229 individuals (124 females; M_age = 21.0 years, SD = 7.5) without current Axis I psychopathology participated by completing a battery of self-report questionnaires. A two-stage exploratory factor analysis was conducted to examine the lower- and higher-order latent structural relations among the variables. The factor solution was subsequently evaluated in relation to negative affectivity, anxious arousal, and anhedonic depression. AS and distress tolerance appeared to be related to one another as distinct lower-order facets of a common higher-order affect tolerance and sensitivity factor, whereas discomfort intolerance did not appear to demonstrate similar relations with either AS or distress tolerance at the lower-order or higher-order levels. A unique pattern of association with theoretically-relevant criterion variables was observed between the affect tolerance and sensitivity higher-order factor, the AS and distress tolerance lower-order factors, and the discomfort intolerance factor. Findings are discussed in the context of theoretical and clinical implications and future directions for the study of affect tolerance and sensitivity in relation to emotional vulnerability.     

Life stressors, social resources, coping, and the 4-year course of unipolar depression

Little is known about the effects of psychosocial factors on the long-term course of unipolar depression. This article examines the 4-year stability and change in life stressors, social resources, and coping, and their effect on the course of treated unipolar depression among 352 men and women. Depressed patients were assessed at treatment intake and at 1-year and 4-year follow-ups. Over the 4 years, patients improved in symptom outcomes, the quality of social resources, and coping responses; there were some declines in life stressors. Life stressors, social resources, and coping were related to patient functioning concurrently, after controlling for demographics, initial treatment, and initial dysfunction severity. Preintake medical conditions and family conflict consistently predicted poorer long-term outcomes. The findings imply that medical conditions and family conflict are important risk factors that predict poorer long-term outcome of depression.     

Life stressors, resistance factors, and improved psychological functioning: an extension of the stress resistance paradigm

This study applied a set of factors previously identified as being linked with stress resistance to the prediction of both stable and improved psychological functioning over a 1-year interval with more than 400 community-resident adults. Stable psychological functioning under high stressors is predicted at the beginning of the year by personal and social resources that are linked to functioning through their influence on increased approach coping during the year. In contrast, improved psychological functioning under low stressors is predicted directly by initial resources. As predicted by crisis theory, improved functioning under high stressors is related to an increase in resources during the year. The findings are discussed in the context of an extension of the stress-resistance paradigm beyond illness prevention toward a general, adaptively oriented health framework.     

Psychosocial adaptation in juvenile rheumatic disease: a controlled evaluation

Juvenile rheumatic diseases are serious chronic illnesses potentially capable of disrupting a child's development and functioning. This study examined the psychosocial functioning of 43 children with severe rheumatic disease as compared to that of 52 children with a milder or inactive form of rheumatic disease. Both patient groups also were compared to 93 healthy children from demographically matched families. Data were obtained from parent reports, from physician evaluation, and, for children who were old enough, from self-reports. The severe patient group showed more parent-reported psychological and physical problems than both the mild patient group and the healthy controls. Compared to the mild group, the severe group also missed more days of school due to illness. Older children in the severe group were more likely to miss school due to illness and to participate in fewer social activities with their families and friends than the controls; however, the older children reported comparable mood and functioning in other areas. An expanded model is proposed to examine risk and resistance factors predictive of psychological and social dysfunction among children with severe chronic disease.