Videotape and verbal feedback in behavioral couple therapy: a review

Reviewed the experimental evidence for the efficacy of videotape and verbal feedback in behavioral couple therapy; it is concluded that research to date does not permit definitive conclusions concerning the efficacy of either procedure. Studies on behavioral differences between happy and distressed couples also were summarized. The evidence indicates that it is, as yet, difficult to ascertain just how the communication behaviors of happy and distressed couples differ.     

Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples

A randomized clinical trial compared the effects of traditional behavioral couple therapy (TBCT) and integrative behavioral couple therapy (IBCT) on 134 seriously and chronically distressed married couples, stratified into moderately and severely distressed groups. Couples in IBCT made steady improvements in satisfaction throughout the course of treatment, whereas TBCT couples improved more quickly than IBCT couples early in treatment but then, in contrast to the IBCT group, plateaued later in treatment. Both treatments produced similar levels of clinically significant improvement by the end of treatment (71% of IBCT couples and 59% of TBCT couples were reliably improved or recovered on the Dyadic Adjustment Scale; G. B. Spanier, 1976). Measures of communication also showed improvement for both groups. Measures of individual functioning improved as marital satisfaction improved.     

Behavioral and psychological consequences of unemployment in blue-collar couples

The behavioral and psychological consequences of involuntary unemployment in blue-collar couples were investigated using Scanzoni's (1972) dynamic model of marital exchange. Thirty-one couples in which the husband had been laid off for at least 3 months were compared with 32 couples in which the husband was employed full time, in terms of exchange behaviors, psychological well-being, and marital satisfaction. As predicted, unemployed husbands reported lower psychological well-being and marital satisfaction, while their wives reported lower marital satisfaction. Unemployed husbands had not significantly altered their exchange behaviors, perhaps due in part to their traditional attitudes toward marital roles which continue to render the contemporary marital exchange relatively inflexible. Level of expressive behavior was by far the most powerful predictor of marital satisfaction for husbands and wives alike. Incongruity in attitudes toward marital roles between traditional husbands and modern wives may constitute both a preexisting source of dissatisfaction and a risk factor following unemployment. These results partially support Scanzoni's model but suggest that the negative consequences of unemployment in blue-collar couples appear first in the psychological as opposed to the behavioral domain.     

Marital therapy as a treatment for depression

The purpose of this study was to compare cognitive-behavioral therapy (CT; n = 20), behavioral marital therapy (BMT; n = 19), and a treatment combining BMT and CT (CO; n = 21) in the alleviation of wives' depression and the enhancement of marital satisfaction. BMT was less effective than CT for depression in maritally nondistressed couples, whereas for maritally distressed couples the two treatments were equally effective. BMT was the only treatment to have a significant positive impact on relationship satisfaction in distressed couples, whereas CO was the only treatment to enhance the marital satisfaction of nondistressed couples. On marital interaction measures CO was the only treatment to significantly reduce both husband and wife aversive behavior and to significantly increase wife facilitative behavior.     

Development of a multi-dimensional measure of resilience in adolescents: the Adolescent Resilience Questionnaire

Background

There is a growing ethical imperative to feedback research results to participants but there remains a striking lack of empirical research on how people respond to individualised feedback. We sought to explore longitudinal study participants' response to receiving individual written feedback of weight-related and blood results, and to consider the balance of harms against benefits.

Methods

A qualitative study with face-to-face and telephone interviews conducted with 50 men and women who had participated in the fifth and most recent wave of the cohort study 'West of Scotland Twenty-07' and received a feedback letter containing body mass index (BMI), body fat percentage, cholesterol and glycated haemoglobin A_1c (HbA_{1 c}) results.

Results

Expectations of, and response to, the feedback of their individual results varied. Whilst half of the participants were on the whole 'pleased' with their results or held neutral views, half reported negative responses such as 'shock' or 'concern', particularly in relation to the weight-related results. Participants who were overweight and obese used the most negative language about their results, with some being quite distressed and reporting feelings of powerlessness, low self-image and anxiety over future health. Nevertheless, some people reported having implemented lifestyle changes in direct response to the feedback, resulting in significant weight-loss and/or dietary improvements. Others reported being motivated to change their behaviour. Age and gender differences were apparent in these narratives of behaviour change.

Conclusions

The potential harm caused to some participants may be balanced against the benefit to others. More evaluation of the impact of the format, content and means of individualised feedback of research findings in non-trial studies is required given the growing ethical imperative to offer participants a choice of receiving their results, and the likelihood that a high percentage will choose to receive them.     

Responses to viewing symptomatic behaviors and labeling of prior mental illness

An experiment was conducted to determine whether a psychiatric label or symptomatic behaviors would be more likely to generate prejudicial attitudes towards a person viewed on videotape. Subjects watched three sequences: one anxious, one depressed, and one normal. One of these sequences was described as an ex-mental patient. The order of presentation, labeling, and actors on the videotape were all counterbalanced. The symptomatic behaviors produced negative ratings on a social distance scale, while labeling did not. Actors showing symptomatic behaviors were also rated as more dangerous, irresponsible, and unpredictable, while the labeled actors were only rated less predictable. Labeling did not interact with symptomatic behavior. There was no evidence that labeling elicited rejection by the observers. Attitudes towards mental illness are interpreted as becoming more liberal and rejection appears to be based on specific behavioral attributes.     

Supplementing behavioral marital therapy with cognitive restructuring and emotional expressiveness training: an outcome investigation

The current study investigated whether the effectiveness of behavioral marital therapy (BMT) would be increased by the addition of cognitive restructuring (CR) and/or emotional expressiveness training (EET) for maritally distressed couples. Sixty such couples were randomly assigned to 1 of 3 therapists and 1 of 5 treatment conditions (BMT Alone, CR + BMT, BMT + EET, CR + BMT + EET, or waiting list) for 12 weeks of conjoint marital therapy. Within each treatment condition, couples typically improved on the variables focused on in treatment. However, comparisons among active treatment conditions showed few significant differences among treatments; the treatments were equally effective in increasing marital adjustment. Thus, the addition of CR and EET did not appear to increase the overall effectiveness of treatment. Possible reasons for the current findings are provided, and suggestions for future marital outcome investigations are outlined.     

The effects of videotape feedback on self-concept,role-playing ability,and growth in a leaderless therapy group

Thirty-two male and female college students participated in six 90-minute leaderless encounter groups in which they received videotape feedback, leader-facilitated videotape feedback, or verbal feedback. Statistical anlysis indicated that feedback through a visual medium had no effect on self-concept, role-playing ability, or group coherence. Groups within the experimental conditions were intially different in their ratings on the dependent measures. These differences were maintained throughout the experiment.     

Patterns of RSA and observed distress during the still‐face paradigm predict later attachment,compliance and behavior problems: A person‐centered approach

This study examined profiles of infant observed distress and physiological regulation indexed by respiratory sinus arrhythmia (RSA) levels during the still‐face paradigm at 6 months using a person‐centered approach. Mothers and infants (N = 206) participated in the study when infants were 6 months, 1 year, and 2 years old. Attachment was assessed at 1 year via the Strange Situation. Children's compliance behaviors were assessed at 2 years during a toy clean‐up task. Mothers reported children's behavior problems at 4.5 years. Latent profile analysis yielded four profiles: highly distressed, but regulating; over‐regulated; resilient to distress; and under‐regulated. Infants in the “resilient to distress” profile characterized by high RSA levels and low negative affect exhibited the most adaptive outcomes such as lower attachment avoidance, higher compliance, and lower behavior problems. Therefore, this study highlights the importance of considering patterns of behavioral and physiological indicators of infant emotionality together for understanding adaptive functioning.     

Event‐related potentials in response to cheating and cooperation in a social dilemma game

A sequential prisoner's dilemma game was combined with psychophysiological measures to examine the cognitive underpinnings of reciprocal exchange. Participants played four rounds of the game with partners who either cooperated or cheated. In a control condition, the partners’ faces were shown, but no interaction took place. The partners’ behaviors were consistent in the first three rounds of the game, but in the last round some of the partners unexpectedly changed strategies. In the first round of the game, the feedback about a partner's decision elicited a feedback P300, which was more pronounced for cooperation and cheating in comparison to the control condition, but did not vary as a function of feedback valence. In the last round, both the feedback negativity and the feedback P300 were sensitive to expectancy violations. There was no consistent evidence for a negativity bias, that is, enhanced allocation of attention to feedback about another person's cheating in comparison to feedback about another person's cooperation. Instead, participants focused on both positive and negative information, and flexibly adjusted their processing biases to the diagnosticity of the information. This conclusion was corroborated by the ERP correlates of memory retrieval. Successful retrieval of a partner's reputation was associated with an anterior positivity between 400 and 600 ms after face onset. This anterior positivity was more pronounced for both cooperator and cheater faces in comparison to control faces. The results suggest that it is not the negativity of social information, but rather its motivational and behavioral relevance that determines its processing.     

Infidelity and behavioral couple therapy: optimism in the face of betrayal

Infidelity is a common issue with which distressed couples and their therapists grapple. However, there are no data on the efficacy of commonly used therapies to treat couples in which there has been an affair. In the present exploratory study, the authors examined the therapy outcomes of a sample of infidelity couples (n=19) who had participated in a randomized clinical trial of marital therapy (N=134). Results show that infidelity couples began treatment more distressed than noninfidelity couples; however, evidence suggests that couples who had an affair and who revealed this affair prior to or during therapy showed greater improvement in satisfaction than noninfidelity couples. Implications for therapy with infidelity couples are discussed.     

Reduced Hedonic Capacity/Approach Motivation Relates to Blunted Responsivity to Gain and Loss Feedback in Children

Adolescents and adults with major depressive disorder or elevated depressive symptoms show reduced reward responses and tend to show enhanced responses to negative stimuli. However, reward-related behaviors and adaptive responses to negative feedback undergo dramatic changes across puberty. Thus, key questions remain regarding how altered incentive processing relates to depressive and anhedonic symptoms in prepubertal child populations. Twenty-four nonclinical prepubertal children 7–10 years of age (15 male; 16 Caucasian) completed two signal detection tasks that assessed behavioral responsivity to candy gain and loss feedback, respectively. These tasks were based on Pizzagalli's probabilistic reward task where asymmetric feedback leads to greater bias toward the more frequently rewarded response in more hedonic or nondepressed adults. We further modified the task to create a version where incorrect responses could result in losses from an original allotment of candy. Children and parents/guardians also completed individual difference questionnaires to assess the child's depressive symptoms, general affect, and hedonic capacity/approach motivation. Regressions indicated a relation between hedonic capacity/approach motivation (child self-report) and response bias in both gain and loss tasks. No significant relations were observed between depressive (child self-report), internalizing (parent report), or externalizing symptoms (parent report) and bias in either the gain or loss task in this small sample. These results suggest that reduced hedonic capacity/approach motivation is associated with blunted responses to both gain and loss feedback in prepubertal children.     

A functional analysis of verbal interactions of drug-exposed children and their mothers: The utility of sequential analysis

Sequential analysis was used to conduct a functional analysis of positive and negative behaviors of five prenatally drug-exposed preschoolers while interacting with their mothers and with an unrelated adult on separate occasions. Videotaped interactions were coded for positive and negative verbal and nonverbal behaviors. Functional relations between child's target behaviors and adults' antecedent and consequent behaviors were identified and resulted in positive-compliant and negative-coercive classes of behavior. All dyads demonstrated positive-compliant patterns. Two mother-child dyads engaged in extended sequences of negative-coercive interactions whereas the unrelated adult terminated negative exchanges quickly. These sequential data suggest the need for developing specific behavioral training programs for mothers of drug-exposed children and other significant adults. © 1996 John Wiley & Sons, Inc.     

Aversive noise effects on performance and thalamocortical responsiveness in cats

The effects of noise bursts (115dBA) on runway performance, emotional behaviors, and visual thalamocortical responsiveness were examined in five cats. Aversion thresholds for noise were subsequently determined in a shuttle box preference test. For three animals the noise was aversive, produced a disruption of runway performance and escape behaviors, and significantly attenuated the intracortical evoked potential (EP) components produced by stimulation of the optic tract. Examination of videotapes taken during noise stimulation indicated that the EP returned to preaversion amplitudes simultaneously with behavioral habituation. The EP intracortical components remained within control levels for animals for whom the noise was not aversive. The aversion effects were concluded to be produced by high arousal activating cortical inhibition. The subsequent behavioral and electrophysiological habituation may involve negative feedback modulation of reticular activity, whereupon cortical functioning returns to preaversion levels.     

Prediction of response to treatment in a randomized clinical trial of marital therapy

This study investigated demographic, intrapersonal, and interpersonal predictors of treatment response in a randomized clinical trial of 134 distressed married couples, which examined traditional (N. S. Jacobson & G. Margolin, 1979) and integrative (N. S. Jacobson & A. Christensen, 1996) behavioral couple therapy. Results based on hierarchical linear modeling revealed that interpersonal variables were the strongest predictors, but their effects were largely limited to predicting initial marital dissatisfaction; greater individual mental health was also associated with less distress initially. Couples who were married longer demonstrated stronger treatment gains, and exploratory analyses suggested that sexually dissatisfied couples showed slower initial, but overall more consistent, gains in the integrative versus the traditional approach. Findings are considered in light of the previous literature on predicting response to marital therapy.     

Decomposing developmental differences in probabilistic feedback learning: A combined performance and heart-rate analysis

Learning on the basis of outcome feedback shows pronounced developmental changes, however, much is still unknown about its underlying processes. In the current study, we aimed at decomposing how value updating, feedback monitoring and executing behavioral control contribute to children's probabilistic feedback learning. Children (ages 8–9), young adolescents (ages 11–13) and young adults (ages 18–24), performed two probabilistic feedback tasks: one required building a value representation on the basis of feedback (noninformed task), while in the other value representations were explicitly presented (informed task). Heart-rate was recorded to augment performance measures of feedback processing. We observed substantial developmental differences in heart-rate responses toward feedback in the noninformed task. Adult's heart-rate slowed more to negative compared to positive feedback relative to the children and young adolescents. In contrast, in the informed task all age groups showed larger heart-rate slowing toward negative compared to positive feedback. These results indicate that children are not impaired in monitoring probabilistic feedback per se, but have a specific deficit in building a task-appropriate value representation on the basis of probabilistic feedback.     

The Barnum effect in couples: effects of intimacy, involvement, and sex on acceptance of generalized personality feedback

The study assessed the impact of test feedback about one partner on both members of male-female couples. Twenty-four males and 24 females ("participants") took an inkblot test and received a standard personality interpretation-purportedly derived from the test-in the presence of a partner (the "observer"). Half the pairs were strangers; the other half defined themselves as intimate friends. Intimate couples rated the feedback as more accurate, remembered more of the feedback, reported more faith in psychological tests, and rated experimenter skill higher than did strangers. Male participants rated the feedback as more accurate than did male observers. Males may be more receptive of feedback in couples when they themselves have taken the test.     

Counselor-trainees' blame-assignment and commitment to change as a function of locus of control and success and failure feedback

Examined the role of locus of control on the counselor-trainees' blame-assignment, expectancy level, and commitment to change. Twenty-four trainees with internal and 24 with external I-E orientation conducted a brief-interview with a client and received feedback on the success or failure of their interview. The results were: (a) Regardless of the success or failure feedback, I-E orientation seemed to have no significant influence on the trainees' blame assignment tendency, expectancy, commitment to change, and their receptivity to feedback. (b) There was dominant effect for the type of feedback delivered. Those who received failure feedback (less than the trainees' expectancy) about their interview blamed themselves and environmental factors more than those who received success feedback. Those who received success feedback showed a significant increase in their level of expectancy for their own performance, a greater willingness to improve their interviewing skills, and a greater receptivity to the feedback offered.     

Long-Term Follow-Up of Families with Young Conduct Problem Children: From Preschool to Grade School

Conducted a long-term follow-up of 83 mothers and 51 fathers who had received one of three parent training programs 3 years earlier for their preschoolers' conduct problems. Follow-up results indicated overall improvements in parent reports of the children's behaviors compared to baseline reports. However, only treatment that combined videotape modeling with therapist-led group discussion achieved stable improvements. Evaluation of the "clinical significance" of the treatment programs indicated that, after 3 years, 25% to 46% of parents and 26% of teachers reported significant child behavior problems. The families whose children were maladjusted were characterized by single-parent status, increased maternal depression, lower social class status, and family history of alcoholism and drug abuse.     

Behavioral couples therapy for female substance-abusing patients: effects on substance use and relationship adjustment

Married or cohabiting female drug-abusing patients (N = 75) were randomly assigned to either a behavioral couples therapy condition (BCT; n = 37), which consisted of group, individual, and behavioral couples therapy sessions, or to an equally intensive individual-based treatment condition (IBT; n = 38), which consisted of group and individual counseling. During most of the 1-year follow-up, compared with participants who received IBT, those who received BCT reported (a) fewer days of substance use, (b) longer periods of continuous abstinence, (c) lower levels of alcohol, drug, and family problems, and (d) higher relationship satisfaction. However, differences in relationship satisfaction and number of days of substance use dissipated over the course of the posttreatment follow-up period and were not significantly different by the end of 1 year.