Mood disorder in women professionals

The lifetime prevalence of affective disorder in women with M.D.'s and Ph.D.'s was assessed by personal interview. The two groups were matched by age, race, and marital status. Thirty-nine percent of 111 white, women physicians and 30% of 103 white, women Ph.D.'s were found to have primary affective disorder. There was no excess of depression in women psychiatrists or psychologists. Eleven percent of the first degree relatives of the depressed M.D.'s and 7% of similar relatives of depressed Ph.D.'s had affective disorder by family history compared to only 2% of the well M.D.'s and 2% of the well Ph.D.'s relatives.The study confirms that depression is an extremely common problem for professional women. By emphasizing its heritability, it raises the question of the self-selection for professional careers of women with affective disorder.     

Agoraphobia and marital relationship: Theory,treatment, and research

The present paper is a comprehensive review of the literature on the possible interactions between interpersonal, particularly marital factors on the one hand, and agoraphobic behavior on the other. First, some different theoretical formulations are described, followed by a discussion of reports and investigations concerning the agoraphobic's marital relationship. Then, attention is paid to those studies which examine the significance of marital factors in the outcome of exposure-treatment for agoraphobia. The remainder of this paper focuses on practical issues, suggestions, and warnings with respect to the different strategies for treating married agoraphobics. Finally, emphasis is given to methodological aspects of research needs in this area.     

Elevated serum immunoglobulin E in T cell-deficient infants fed cow's milk

Serum IgE levels at various ages during infancy were related to the number of T cells assessed at the age of 1 mo and type of feeding. Cow's milk-fed babies with low T cell counts had higher IgE at the ages of 3 and 6 mo than breast-fed babies with low T cell counts. Of the babies fed cow's milk, those with low T cell counts had higher IgE levels than those with normal T cell counts. Onset of cow's milk feeding before the age of 3 mo in babies with low T cell counts was associated with continuously elevated IgE during the first year of life, as compared with babies with normal T cell counts. However, when cow's milk feeding was instituted after the age of 3 mo such a difference was not noted. It is concluded that in T cell-deficient infants there might exist a critical period during which onset of cow's milk feeding is associated with subsequently increased IgE synthesis.     

A longitudinal analysis of intimacy processes and psychological distress among couples coping with head and neck or lung cancers

Individuals diagnosed with lung and head and neck (HN) cancers and their spouses are at increased risk for distress. This study assessed whether the way couples communicate about cancer and their perceptions of relationship intimacy influenced both partners’ adjustment. One-hundred thirty-nine patients and their spouses [For purposes of clarity, we refer to the patients’ intimate partner as the spouse, regardless of actual marital status and we reserve the term partner to refer to the other person in the couple (i.e., the patient’s partner is the spouse and the spouse’s partner is the patient)] completed measures of spousal communication, intimacy, and distress at three time points over 6 months. Using multilevel modeling, an over-time actor-partner interdependence model was specified that examined whether intimacy mediated associations between one’s own and one’s partner’s reports of communication at baseline and later distress. Patients and spouses who reported greater baseline distress reported more negative baseline communication as well as lower levels of intimacy and greater distress over time. Mediation analyses showed patients’ and spouses’ reports of positive spousal communication were associated with less subsequent distress largely through their effects on intimacy. Clinicians working with head and neck or lung cancer patients should assess communication and intimacy because both impact couples’ distress.     

Expressed emotion: A review of the critical literature

Expressed Emotion (EE) reflects the attitude of a close relative towards a schizophrenic family member. Work carried out over the last decade has provided good evidence that the concept of EE is both valid and reliable. It is, moreover, an accurate predictor of relapse in schizophrenic patients. Since Kuipers's review of the area 6 years ago (Kuipers, 1979), research into EE has progressed rapidly. Not only have there been additional studies replicating, the previously well documented relationship between EE of family members and relapse in schizophrenic patients, but issues relating to the interaction of EE with life events, its psychophysiological correlates, and to intervention procedures have also been explored. In view of these recent developments a reevaluation of the area is necessary. This article will, therefore, review the progress made in the field to date and, in addition, suggest new directions for subsequent research.     

Influence of cortico-striatal afferents on striatal kainic acid neurotoxicity

Decortication, which causes degeneration of the cortico-striatal glutamateric afferents, markedly attentuates the neurotoxic action of kainic acid in the striatum. Injection of 1 μmol of L-glutamate alone in the decorticate striatum does not cause neuronal degeneration whereas the injection of 10 nmol of kainate with 1 μmol of L-glutamate partially restores kainate's neurotoxicity. The results suggest that kainate's neurotoxicity is affected by the synaptic input to vulnerable neurons and may involve a cooperative interaction with synaptically released L-glutamate.     

Marital intimacy and self-disclosure

Examined the relationship between the qualitative aspects of marital intimacy among 20 couples and a quantitative, microalysis of their selfdisclosing behavior. Two interview segments and their combination were scored for the basic parameters of self-disclosure using the Self-Disclosure Coding System (SDCS). The scores served as predictor variables for each of 12 intimacy dimensions derived from the standardized, structured Victoria Hospital Intimacy Interview in stepwise multiple regression analyses. The resulting multiple Rs ranged from 0.357 for Sexuality in segment 1 to 0.853 for Identity in segment II. Analysis of the couples' self-disclosures across segments I and II yielded multiple Rs from 0.446 to 0.850, with the intimacy dimensions of Expressiveness, Compatibility, Behavior, and Identity the highest correlates. These results suggest that although self-disclosure and intimacy are not synonymous, self-disclosing behavior is a major determinant of various aspects of marital intimacy and accounts for more than 50% of the variance in at least four dimensions. Explanations for these findings and their clinical relevance are discussed.     

Marital intimacy,psychosomatic symptoms,and cognitive therapy

The marriages of patients with psychosomatic illness involving chronic physical symptoms of obscure etiology–are often superficially adjusted, but have a significant lack of interpersonal intimacy. Furthermore, the physical symptoms of one partner may be used as an indirect attempt to overcome a frustrating lack of communication. The author describes an approach to family therapy that enables the spouses in such marriages to open up to each other, increasing intimacy in their marriages and im proving chronic psychosomatic symptoms that have been perpetuated by marital maladjustment.     

Self-disclosure and its relationship to marital intimacy

Examined the relationship between marital intimacy and self-disclosure from a multidimensional framework within a sample of 10 clinical and 10 nonclinical married couples. The linear combination of various parameters of self-disclosing behavior was able to account for 71.7% (R = 0.853) of the variance in intimacy ratings derived from a structured interview. Results are discussed in terms of both the role that self-disclosure plays in the development of marital intimacy and its therapeutic benefits and limitations in marital therapy.     

大学生亲密恐惧与父母婚姻冲突知觉的关系

目的:探讨大学生亲密恐惧与父母婚姻冲突的关系。方法:选取255名大学生,采用亲密恐惧问卷(FIS)与儿童感知婚姻冲突量表(CPIC)调查大学生的亲密恐惧与父母婚姻冲突知觉的关系。结果:大学生亲密恐惧总分与冲突频率、冲突强度、冲突是否解决、威胁、应对效能感、儿童自我归因及冲突内容7个因子均呈正相关(r=0.25,0.26,0.30,0.23,0.14,0.20,0.32;P0.001或0.05)。高亲密恐惧组CPIC得分显著高于低亲密恐惧组。结论:大学生亲密恐惧与父母婚姻冲突知觉有密切关系。     

Infertility treatment and marital relationships: a 1-year prospective study among successfully treated ART couples and their controls

BACKGROUND: Evidence about the effects of infertility and assisted reproduction technique (ART) on marital relationships is discrepant. Here, we examined the impact of ART on marital relationships. The roles of life stressors, infertility and treatment characteristics in predicting marital relations were also evaluated. METHODS: Subjects: 367 couples with singleton IVF/ICSI pregnancies. Controls: 379 couples with spontaneous singleton pregnancies. Women and men were assessed when the child was 2 months (T2) and 12 months old (T3). They further reported stressful life events at T2 and depression in pregnancy. RESULTS: No between-group differences were found in marital satisfaction and dyadic cohesion. Dyadic consensus deteriorated from T2 to T3 only among control women. Sexual affection was low among control men at T2 and stressful life events decreased it further. Depression during pregnancy predicted deteriorated marital relations only in control couples. Several unsuccessful treatment attempts were associated with good dyadic consensus and cohesion among ART women. Spontaneous abortions and multiple parity predicted poor marital satisfaction in ART women, whereas long duration of infertility and multiple parity predicted poor marital relations in ART men. CONCLUSIONS: Successful ART does not constitute a risk for marital adjustment. The shared stress of infertility may even stabilize marital relationships.     

Personality,marital and occupational factors associated with quality of life

In three studies that employed community-based samples the relationship between personality, marital, and job-related factors and quality of life was examined. Study I indicated that hardiness and self-esteem were important components of overall quality of life. The marital communication skills of expressiveness and intimacy were identified as major aspects of overall quality of life in the second study. In Study 3, satisfaction with various job characteristics was related to overall quality of life. These studies start to provide definition to the quality of life concept in terms of personality characteristics, skills, and beliefs that have potential for modification.     

How I treat patients with adult onset Still's disease in clinical practice

Adult onset Still's disease (AOSD) is a rare systemic inflammatory disease of unknown etiology characterized by four cardinal signs which are almost always present in patients: high spiking fever, arthralgia (with or without synovitis), maculo-papular salmon-pink evanescent skin rash, striking leukocytosis with neutrophilia. Here, we review the clinical features of AOSD and describe the best practice approaches for its management, reviewing available guidelines and recommendations and providing experts' insights.     

The family of the autistic child: A behavioral-systems view

Parent training is a well documented contribution of behavior therapy to the treatment of autism. There are other less well explored behavioral interventions of potential for the family with an autistic child which need to be examined systematically. This paper adopts a behavioral-systems view to address issues which arise in the family of an autistic child at the time of diagnosis, during early and middle childhood, during adolescence and adulthood, in relation to siblings, and within the extended family and community. Behavioral marital therapy, behavioral family therapy, and individual intervention techniques can help families adapt to the chronic stress of living with a handicapped member. The therapist is cautioned not to overlook the more intensive therapeutic needs of those dysfunctional families for whom the child's handicap is only one factor in an array of predisposing problems.     

Dependent Personality and Interpersonal Dependency: At the Intersection of Developmental,Identity and Interpersonal Aspects

The author examines dependency as a pathological personality feature—one that originates in failures of developmental need fulfilment—and shows how the subsequent identity impairment may influence adult relationships. The author argues that, developmentally, the caregiver's unresolved pathological dependency causes a disruption in the child's need gratification as the child's focus is turned towards the caregiver's pathological needs. Internal object relations become characterized by a dependent internal object and need-fulfilling self-representation, which are supported developmentally by the disavowal of authentic dependency needs. In adult life, the individual's identity and self-esteem, through projections, become dependent on interpersonal relationships, which are used to control internal cohesion at the expense of authentic attachment and intimacy. Pathological dependency is thus intrapsychic rather than merely interpersonal. The author also explores the concept of excessive independence, that is, through identification with independence as an ego ideal, considered a defensive attempt to disidentify from an underlying pathological dependency.     

Individual differences in alpha rhythm responsivity: Inter-task consistency and relationships to cardiovascular and dispositional variables

Individual differences in EEG alpha rhythm responsivity were examined with respect to: (1) consistency of response across cognitive tasks; (2) relationships to cardiovascular responsivity; and (3) relationships to dispositional variables. Inter-task correlations revealed a significant degree of stability in subjects' alpha responses to four ‘sensory rejection’ tasks: mental arithmetic, time estimation and imagining oneself as cold or warm. Individuals evidencing greater suppression of alpha activity during mental arithmetic also displayed greater heart rate increase and greater digital vasoconstriction, as well as obtaining higher scores on the Activity subscale of the EASI-III Temperament Survey and on the ‘Hard Striving’ subscale of the Jenkins Activity Survey for Health Prediction, a measure of the Coronary-Prone Behavior Pattern. Alpha responsivity in the time estimation and warm imagery tasks was also associated with greater heart rate increase. The results suggest that alpha responsivity is related to individual differences affecting one's attentiveness or involvement in experimental tasks.     

Reason,emotion, and cognitive therapy

There are two main assumptions implicit in the theory and practice of cognitive therapy. One assumption is that emotional or psychological disturbances are caused largely by illogical or irrational thinking. The second assumption is that the restructuring of cognitions accessible to awareness represents a therapeutic solution. The present paper examines these assumptions in the context of a general theoretical review of the nature of emotion, cognition, and the relation between emotion and cognition. Also included is a discussion of the potential limitations posed by these assumptions for various cognitive therapeutic approaches, including Ellis's rational-emotive therapy, Beck's cognitive therapy of depression, and attribution therapy. Finally, a neomentalistic research strategy is proposed for the clarification of these issues.     

婚恋培训女性学员的婚姻满意感及相关因素

目的:调查参加婚恋培训女性的婚姻满意感现状并探索其相关因素。方法:采用方便取样,对376名参加婚恋培训的女性学员,用中文版Kansas婚姻满意感量表(C-KMS)、自编婚姻质量问卷和亲密关系问卷进行调查。结果:58.8%被试对婚姻"满意",13.8%"不满意",27.4%"中等"。46.8%的被试亲密关系不安全,最常用的冲突处理模式为回避冲突。回归方程显示有6个因子与婚姻满意感正相关,相关程度最高的因素是冲突处理,其余依次为感受关爱、性生活、宗教信仰/价值观、姻亲关系和金钱管理。有3个因子与冲突处理正相关,相关程度最高的因素为寂寞感,其余依次为战火升高与回避冲突。结论:参加婚恋培训的女性总体婚姻满意感呈中上等水平,学习解决冲突的技巧与增加亲密感的方法可提高婚姻满意感。     

Reasonable expectations of privacy in non-disclosure of familial genetic risk: What is it reasonable to expect?

Where there is conflict between a patient's interests in non-disclosure of their genetic information to relatives and the relative's interest in knowing the information because it indicates their genetic risk, clinicians have customarily been able to protect themselves against legal action by maintaining confidence even if, professionally, they did not consider this to be the right thing to do. In ABC v St Georges Healthcare NHS Trust ([2017] EWCA Civ 336) the healthcare team recorded their concern about the wisdom of the patient's decision to withhold genetic risk information from his relative, but chose to respect what they considered to be an unwise choice. Even though professional guidance considers that clinicians have the discretion to breach confidence where they believe this to be justified, (Royal College of Physicians, Royal College of Pathologists and the British Society of Human Genetics, 2006; GMC, 2017) clinicians find it difficult to exercise this discretion in line with their convictions against the backdrop of the legal prioritisation of the duty to maintain confidence. Thus, the professional discretion is not being freely exercised because of doubts about the legal protection available in the event of disclosure. The reliance on consent as the legal basis for setting aside the duty of confidence often vetoes sharing information with relatives. This paper argues that an objective approach based on privacy, rather than a subjective consent-based approach, would give greater freedom to clinicians to exercise the discretion which their professional guidance affords.