Researchers discover what they already knew about validity: The case of the family-of-Origin Scale

This article is concerned with two recnet studies of the Family-of-Origin Scale (FOS), Gavin and Wamboldt (1992) and Ryan, Kawash, Fine, and Powel (1994). The external validity analyses conducted for the FOS in these studies assumed the scale to be a unidemsional measure. The present discussion centers on methodological decisions and interpretive strategies that may have prevented a more complete understanding of the scale's dimensional structure and theoretical meaning. It is concluded that a unidimensional view of the FOS is an oversimplification that is inconsistent with the available data. A case is made for a more comprehensive and technically adequate evaluation of the FOS. Specific suggestions are offered.     

Family therapy and outcome: Relationships between therapist and family styles

This study examined therapeutic outcome for a group of 175 clinic families divided into levels of family competence and style, and, later, into seven clinical groupings. The division into these groups was based on the level of rated Competence and Style determined by using the Beavers Systems Model. Therapists also rated their level of Openness/Sharing Strategy, Power Differential, and Partnership with the family at the third session. Results indicate that more competent families who fared well in therapy had therapists who formed a partnership, disclosed strategy, and employed a minimal power differential with the family. The most disturbed families, and those with a Centrifugal style, did better with therapists employing a high power differential and lower levels of openness and partnership. The study also presented the distribution of individual diagnoses by family groups. Implications for family therapists, including the value of family assessment, are provided.     

The role of blood pressure, cortisol, and prolactine among soldiers injured in the 1991–1993 war in Croatia

Ninety soldiers with at least three months of combat exposure—60 injured soldiers (30 with permanent disabling and 30 with nondisabling injuries), 30 noninjured soldiers and 30 healthy controls—were interviewed and investigated with physiological (Prolactine, Cortisol, BP, Hb) and psychological tests (MMPI), IES-15 (Impact of Event Scale), PTSS (Post-Traumatic Symptom Scale). Their was related injuries had a different effect on the physiological stress response of the soldiers as reflected in the levels of prolactine, cortisol, hemoglobin and blood pressure. In a report of personality characteristics of the same soldiers, we demonstrated that the experience of posttraumatic stress was not dependent upon physical injury, but rather on the psychological appraisal of the situation. The results of the present article confirm earlier findings that the relationship between physiological and psychological consequences of trauma are complex, and that the perception of an event and the social context within which the traumatized soldier exists is as important as the event itself. The physiological response to the trauma varied greatly among the soldiers regarding the psychosocial impact of the consequence of the injury. So the anticipation of future possible trauma among less severely wounded soldiers (expected to go back to war) was followed by pathological stress responses. Trauma seems to operate somewhat independently from the overt conscious appraisal of the situation and relationship between psychological, psychosocial, and physiological aspects are interrelated in a multifactorial way. An integrative approach is therefore of great importance in assessment as well as in treatment of Posttraumatic Stress Disorder (PTSD). Editorial Note This historical article is being published for the first time. It is based on the Ph.D. thesis of Dr. Harry A. Teitelbaum for which he was awarded a doctorate by the University of Maryland in College Park in 1936. The dissertation was stored prior to publication and was not rediscovered until 1997. Teitelbaum’s work was performed during the early days of the development of knowledge regarding the mechanisms that regulate endocrine function. The understanding of the broad capability of interactions among endocrine glands was evolving. It was a field that Teitelbaum contributed to for several years, many of which were spent in collaboration with Horsley Gantt in his laboratory at Johns Hopkins. Although some of the experimental strategies and some of the wording of the report seem quaint today, the contribution of Teitelbaum’s research was solid and highly relevant to questions being asked at the time.     

The interaction between cohesive systems and dispersive systems: Creating the trigenerational therapeutic context

The author presents a model for research investigation and clinical use that deals with the interaction between cohesive and dispersive family of origin systems as reflected in marital and family interaction in nuclear families.From a paper presented at the tenth annual meeting of the American Family Therapy Association, June, 1988, Montreal, PQ, Canada.     

Commentary on reviews of “outcome” studies of family and marital psychotherapy

Reviews of the outcome literature in family and marital therapy are critically evaluated. The literature is equivocal in regard to the effectiveness of family therapy, particularly in comparison to alternative forms of treatment, so that statements to the effect that family therapy has demonstrated its general efficacy would not appear to be justified. Problems are identified which require solution before the efficacy of family therapy can be demonstrated.Paper presented at the 45th annual conference of the American Association for Marriage and Family Therapy, Chicago, Illinois, October 31, 1987.     

Intuition in family therapy: A short manual on post-modern witchcraft

Intuition is an important part of a mature clinician's work. Yet, it is a component of clinical work which is looked upon with suspicion, due in part to the Middle-Age's association between intuition and the work of witches. This paper describes a tenuous link between intuition, witches, and Carl Whitaker. Patterns for including intuition in family therapy are discussed.     

HIV infection associated post-traumatic stress disorder and post-traumatic growth--a systematic review

The phenomenon of post-traumatic stress has been well documented in the literature as a lasting mental health condition associated with exposure to traumatic life events. The diagnosis and experience of human immunodeficiency virus (HIV) disease may be such a trauma. On the other hand, the phenomenon of post-traumatic growth (PTG) has been described, whereby people show positive mental health growth in the face of such trauma. This systematic review was set out to explore post-traumatic stress disorder (PTSD) and PTG in people with HIV to monitor prevalence, measurement and efficacy of interventions to reduce stress and/or promote growth. Standardised review techniques were used to track reports on both PTSD and PTG. A total of 206 papers were retrieved from the PTSD and HIV searches, and 13 from the PTG and HIV searches. After reviewing the papers for inclusion according to adequacy and relevance criteria and to remove duplicates, 33 PTSD papers and three PTG were available for full coding. Prevalence of PTSD in HIV ranged from 5% to 74%, which were much greater than the 7-10% in the general population. Seven studies showed a relation between trauma and PTSD, while six showed a link between PTSD diagnosis and reduced antiretroviral treatment adherence. Women were more likely to be diagnosed with PTSD. Only three intervention reports were identified that fitted our inclusion criteria. All of these reported on psychological interventions for HIV+?individuals with trauma. The interventions utilised HIV education, training in coping techniques and support groups. Only coping interventions were shown to be effective. PTG was under researched but showed a promising avenue of study. There needs to be harmonised measurement and the evidence base would need strengthening in order to build on the understanding of the impact of PTSD and PTG over the course of HIV disease. There is good evidence to associate HIV diagnosis and experiences during the course of illness as traumatic. PTSD has been shown to be prevalent and there seems to be good evidence to incorporate standardised measures to track the course of the disorder. There is extremely limited evidence that interventions may affect the course of symptom experience. The evidence and insight into PTG show promise but is currently inadequate.