The Spanish validation of the Short Health Anxiety Inventory: Psychometric properties and clinical utility

Background/ObjectiveThe Short Health Anxiety Inventory (SHAI) is a widely used self-report instrument to evaluate health anxiety. To assess the SHAI's factor structure, psychometric properties, and accuracy in differentiating Spanish non-clinical individuals from patients with severe health anxiety or hypochondriasis.MethodA total of 342 community participants (61.6% women; M_age = 34.60, SD = 14.91) and 31 hypochondriacal patients (51.6% women; M_age = 32.74, SD = 9.69) completed the SHAI and other self-reports assessing symptoms of hypochondriasis, depression, anxiety sensitivity, worry, and obsessive-compulsive.ResultsThe original two-factor structure was selected as the best structure, based on its parsimony and empirical support (Factor 1: Illness likelihood; Factor 2: Negative consequences of illness). Moreover, the Spanish version of the SHAI demonstrated good construct and concurrent and discriminant validity, and internal consistency. A cutoff of 40.5 (total score) accurately distinguished non-clinical individuals from patients with severe health anxiety or hypochondriasis.ConclusionsThe SHAI is an adequate screening instrument to measure health anxiety in Spanish-speaking community adults.     

Mexican‐Origin Parents’ Stress and Satisfaction: The Role of Emotional Support

Guided by a process model of parenting and the integrative model, this study examined sources of emotional support (i.e., partner, maternal, paternal) as related to stress and satisfaction resulting from the parenting role in a sample of Mexican‐origin young adult parents who participated in the National Longitudinal Study of Adolescent to Adult Health (Add Health) during Wave IV. Participants were male and female parents (26–35 years of age; 59% female; N = 737) who had children and a partner. Results from structural equation modeling revealed support from mothers as salient; high levels of maternal support were associated with high levels of parenting satisfaction. Tests of indirect effects suggested that parenting satisfaction played an intervening role in the link between maternal support and parenting stress. The pattern of results held across levels of linguistic acculturation but varied by gender. Understanding the mechanisms that predict parenting stress and satisfaction within the Mexican‐origin population may help in the identification of culturally sensitive intervention strategies.     

The Dynamic Interplay Between Satisfaction With Intimate Relationship Functioning and Daily Mood in Low‐Income Outpatients

Substantial research supports bidirectional links between intimate relationship discord and individual psychopathology, including depressive symptoms. However, few studies have utilized daily diary methods to capture the micro‐level processes underlying the association between couple discord and depression, particularly among populations that are at elevated risk for both interpersonal and individual dysfunction. To address this gap, we examined whether daily changes in satisfaction with relationship functioning were associated with daily changes in negative affect and positive affect over the span of 2 weeks among mental health outpatients of low socioeconomic status. Participants were 53 low‐income outpatients from community mental health clinics who completed a semi‐structured interview about the quality of their intimate relationships followed by 14 daily reports of positive and negative mood and satisfaction with relationship functioning across several domains. Growth curve analytic techniques revealed the hypothesized bidirectional relations. Decline in satisfaction with relationship functioning predicted escalation in negative affect and deterioration in positive affect over 2 weeks, and deterioration of mood predicted declining satisfaction with relationship functioning. This study extends existing knowledge about couple dysfunction and individual psychopathology by highlighting the immediate nature of this dynamic process as it unfolds over time.     

When the “U” is not Inverted: Trajectories of Expressed Emotional Arousal Predict Relationship Satisfaction

Maladaptive emotional reactivity and dysfunctional communication during couple conflict are both destructive to couple functioning, and observational research has elucidated how conflict escalates. However, much of the evidence is based on measures that combine content (i.e., what was said) and the emotion with which it was said, which are then examined using sequential analyses. Despite the general presumptions about underlying emotional reactivity and escalation in negative emotions as part of relationship distress and deterioration, little empirical data are available that directly examine these continuous shifts in emotions. The current study examined concurrent and longitudinal associations between relationship satisfaction and trajectories of change in vocally expressed emotional arousal during couple conflict in 62 couples who participated in a relationship education program. Contrary to expectations and patterns found in distressed couples, trajectories followed a U‐shape rather than an inverted U‐shape curve, with steeper and more persistent decreases in emotional arousal predicting more stable relationship satisfaction over time. In addition, there were within‐couple effects. These results suggest that early signs for relationship deterioration may be less in the form of overt escalation as would be seen in distressed couples. Instead, couples who subsequently deteriorate more are less effective in calming emotional arousal. They also are less able to remain at lower emotional arousal. It is possible that the more pronounced escalation toward the end of the conversation in more at‐risk couples is a precursor of the greater escalation patterns seen in distressed couples; this should be examined empirically. Limitations and implications are discussed.     

What Does it Mean to be a Common Factors Informed Family Therapist?

The common factors paradigm in couple and family therapy has gained popularity over the past several decades, leading many therapists to refer to themselves as common factors family therapists. Despite this, no consensus exists on what it means to be a common factors family therapist, or if such a designation even makes sense given that the common factors paradigm is not a model. Synthesizing the existing common factors literature, a case is made for the designation “common factors informed family therapist,” and the following six core principles are outlined that characterize this designation: (1) sees overlap among theories; (2) passionate about theory, not a theory; (3) client centered; (4) monitors hope and the therapeutic alliance; (5) views clients as people rather than objects; and (6) prioritizes healing over therapy. Each of the concepts is discussed in depth, and clinical implications are provided.     

From active imagination to active life: at the roots of Jungian social activism

Our traditional Western worldview is often unconsciously based on a polarized, dichotomous perspective. However, many of Jung's ideas hint at a deep interrelation between opposites, such as inside and outside, which are, as the principle of synchronicity shows, rooted in a conceptualization of psyche and matter conceived as intertwined. Another pair of philosophical concepts, traditionally considered as opposites, needs further investigation: that between imagination and reality. If we are lucky in our daily practice as analysts, we can use imagination as a powerful tool to help people discover themselves as individuals and to get in deeper, more lively and responsible touch with reality. This paper explores the difference that Jung outlined between ‘active imagination’ and ‘passive fantasies’, and the transformative power of taking an active part in what imaginatively happens – he called it ‘active participation’ – rather than being passively overwhelmed by invasive fantasies. It is argued that it makes a great difference whether we become the actors and not just the spectators of our lives, and this is linked with the core of the individuation process in which, if individuals discover their particular place and meaning in the universe, they can live an ‘active life’, playing a heartfelt and responsible role in the collective world to which they belong. These ideas are at the heart of Jung's work, and they represent one of the roots of Jungian social activism.     

Inventing the enemy

The following article elaborates on the need for the Other in order to delineate the self and one's identity, and the eternal psychological process of turning the Other into an enemy. A parallel process, which can be observed nowadays, leads to a disregard for the otherness of the Other that results in the blurring of identity and an internal loss of the differentiation of intrapsychic structures. Both psychological processes share a dehumanizing approach which leads to neurosis and alienation. In order to withstand these tendencies, a revision of analytical psychology's view of the psyche and of the practice of Jungian analysis is warranted: an alternative to the ‘Fear of the Feminine’ described by Erich Neumann in 1959. It is suggested that consciousness and unconsciousness intertwine but from a position of equality and reciprocity. Such an attitude does not inspire fear. Rather, it recognizes the need of one for the Other and the inevitability of this situation. Moreover, this need and interdependence on equal grounds nourish the wish to know the Other, to be aware of the differences, and yet, at the same time, to acknowledge how close the Other really is. Analytical psychological therapy based on this model stresses the power of the ego while also strengthening its capacity for introspection.     

A dynamic systems approach to the feeling toned complex

A review of Jung’s writing on the ‘feeling‐toned complex’ shows that he considered it to comprise independent, split‐off, psychic elements. Modern advances in scientific thinking and technology, namely Dynamic Systems Theory and neuro‐imaging, allow us to better define and explore this psychic phenomenon. Considering the constellation of the complex as a hierarchy of dynamic systems allows for a prediction of the timing of brain activity. This has been confirmed by two independent studies using fMRI and QEEG while administering the Word Association Experiment, the tool Jung used to investigate brain/psychic functioning over a century ago. Using as a framework the stages of the constellation of a complex viewed as a hierarchy of dynamic systems, I review the neuro‐imaging studies reported by Petchkovsky et al. (2013, 2017) and Escamilla et al. (2018), concluding that quantitative theoretical predictions and experimental results are in agreement within an order of magnitude. The change in attention caused by the constellation of the complex can also be conceived as the switching from a default neuro‐network, a startle response activating executive functioning in the frontal cortex of either the ego‐complex or an autonomous complex.     

Couple therapy,family therapy and systemic interventions for adult‐focused problems: the current evidence base

This paper updates previous similar reviews published in JFT in 2000, 2009 and 2014. It presents evidence from meta‐analyses, systematic literature reviews and controlled trials for the effectiveness of couple therapy, family therapy, and systemic interventions for adults with a range or relationship and mental health problems. The evidence supports the effectiveness of systemic interventions, either alone or as part of multimodal programmes, for relationship distress, psychosexual problems, intimate partner violence, anxiety disorders, mood disorders, alcohol problems, psychosis and adjustment to chronic physical illness.