Taking an individualized approach to the assessment of self-efficacy and the prediction of alcoholic relapse

The present study reports on a clinical instrument designed for assessing self-efficacy in alcoholics. In contrast to studies that construct general measures, it was proposed that taking an individualized approach to assessment might offer an effective methodology. Thirty-four alcoholics in an outpatient, behaviorally oriented treatment program participated as subjects. During therapy, an Individualized Self-Efficacy Survey (ISS) was developed for each subject. The ISS was developed by (a) administering the Drinking Patterns Questionnaire (DPQ) to identify important problem areas (e.g., work, children, marital) and specific drinking antecedents and (b) constructing a 15-item scale using each drinker's most important cues. The utility of having clients choose their own items was supported by finding a significant relationship between problem areas identified as important on the DPQ and the areas reported as surrounding relapse. ISS ratings were reflective of efficacy changes during treatment, while posttreatment ISS scores were predictive of subsequent relapse. Situation-specific prediction of relapse was not found. The advantages of this methodology for clinical use are discussed, while general directions for future research are suggested.     

Families and family therapy in Germany

The author describes some of the effects of decades of life under a dictatorship for East Germans and the effects on family life and family therapy of changes following the recent reunification of Germany. A case example illustrates some intergenerational family problems associated with the changes. Contrasts are drawn between East and West Germany and family therapy's present stage of development is depicted in both parts of the reunified country. Germany has approximately 10,000 trained family therapists, a minority of whom work in private practice. The largest amount of family and couples therapy is performed in agencies.Portions of this material were first presented in a poster session at the American Association for Marriage and Family Therapy annual conference in Miami Beach, 1992.     

The holocaust of first nation people: Residual effects on parenting and treatment implications

The residential school experience was devastating for many First Nation (Indian) people. The lingering effects of this era have been far reaching and remain painfully evident throughout Native communities. One of the more obvious areas directly affected has been parenting. This paper discusses current parenting difficulties of Native clients who were formerly in residential schools. A connection is made between the abuse experienced by these individuals and their parental struggles. Along with addressing various sociopolitical issues, a number of clinical interventions designed to promote the healing process of these victims and their families are provided and discussed.     

Personality disorder correspondence between the million behavioral health inventory (MBHI) and the minnesota multiphasic personality inventory (MMPI)

The MBHI and MMPI personality disorder scales were analyzed for convergent and discriminant validity. Correlational data demonstrated that six of the eight scales were significantly related, while the remaining two scales approached significance. Further analyses of these data, however, demonstrated that none of the scales correlated significantly better with its convergent scale compared to nonconvergent scales. The MBHI classified significantly more of the sample as personality disordered (93%) compared to the MMPI personality disorder scales (17%). Furthermore, the MBHI tended to describe the sample as falling within the Anxious cluster of personality disorders, whereas the MMPI described them within the Dramatic cluster. Single scale codetype correspondence was found to be 15%, while two-point concordance was 12.5%, indicating very low congruence between personality style codetypes. These two measures do not appear to be measuring the same personality style constructs.     

Influences of character-based coping style on psychological health

This study explores the moderating effects of early adult character style on correlations between social relationships in adolescence and midlife psychological health. Participants were drawn from the ongoing longitudinal studies at the Institute of Human Development. Individuals who beat the odds of an adverse environment and those who failed to capitalize on beneficial environments were identified and compared at age 30 on the California Psychological Inventory, the Meredith-Millsap Component Scores, and the Thematic Apperception Test. Social relatedness and personal independence were characteristics at age 30 of all subjects who went on to develop good psychological health by age 50. Social relatedness was more associated with overcoming a difficult environment, while self-assurance was more associated with capitalizing on a good one.     

Optimism and coping as determinants of psychosocial adjustment to rheumatoid arthritis

Psychosocial adjustment in 66 patients with chronic rheumatoid arthritis, with a mean duration of 12 years with the disease, were evaluated in a prospective design, with 62% of the sample followed up 16 months later. It was predicted that dispositional optimism would predict adjustment over time and that perceived support and perceived control would be related to psychosocial adjustment at the time of concurrent measurement. At Time 1, psychosocial adjustment was associated with greater optimism and perceived support and less disability. Optimism at Time 1 was the only significant predictor of changes in adjustment at Time 2 controlling for Time 1 adjustment and Time 2 disability. It was found that optimism temporally precedes increases in psychosocial adjustment. In terms of coping strategies, wishful thinking was related to poorer social adjustment, whereas problem-focused coping was marginally related to positive adjustment. Neither coping strategy predicted adjustment across time. Optimism at Time 1 did predict problem-focused coping at Time 2. Perceived social support regarding a specific circumstance at a given point in time enables one to persist in solving a task. Interventions to enhance the quality of life of individuals coping with progressive deteriorative disease must look at the influence of their behavior and attitude on those who provide care for them.     

An investigation of the validity of the SPSI and SPSI-R in differentiating high-suicidal from depressed,low-suicidal college students

The present study examined the validity of the Social Problem-Solving Inventory (SPSI) and SPSI—Revised in differentiating 65 high-suicidal from 63 depressed, low-suicidal college students. Results from multivariate analyses indicated overall differences in problem-solving between these two groups as measured by the SPSI but not by the SPSI-R. Further examination of these differences revealed the high-suicidal group was different in problem-solving orientation, rather than problem-solving skills, compared to the depressed, low-suicidal group. However, when depression was statistically controlled in hierarchical regression analyses, none of the problem-solving measures predicted group membership. The superiority of the SPSI to the SPSI-R in differentiating these two groups appears to be accounted for by the elimination of 28 items in the revised version, many of which measure orientation to problem-solving. Also explored was the possibility that objective measures of problem-solving provide a better prediction of adjustment than do self-report measures.     

Depression and coping in candidates for kidney transplantation: Racial and ethnic differences

Subjects were 288 adolescents and adults with end-stage renal disease who were candidates for kidney transplantation, a group identified at risk for noncompliance. The purpose was to examine racial and ethnic variations in coping—variables that may underlie noncompliance and impact upon health outcome. Secondarily, the relationship between depression and particular styles of coping was investigated. Race/Ethnicity was divided into three categories: Black/Non-Hispanic, White/Non-Hispanic, and Hispanic. Coping and depression were assessed using the COPE and Beck Depression Inventory, respectively. Results indicated that Hispanic and Black subjects were more likely to use maladaptive styles of coping and less likely to use adaptive coping than were White subjects and that Black subjects reported more physical symptoms of depression. These findings point to possible mechanisms underlying the occurrence of noncompliance and resulting poorer health outcome for individuals of different racial and ethnic groups.