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.     

Individual and structural factors associated with HIV status disclosure to main partner in Cameroon: ANRS 12-116 EVAL survey, 2006-2007

Encouraging HIV-positive people to disclose their serostatus to their main partner is considered as a key component of secondary prevention. The purpose of this study was to identify individual and structural factors associated with HIV serostatus disclosure to one's steady partner in Cameroon, a country which has implemented a large program for access to antiretroviral therapy. We used data from the cross-sectional, nationally representative survey, ANRS 12-116 EVAL (Evaluation du programme camerounais d'accès aux traitements antirétroviraux--Impact sur la prise en charge et les conditions de vie de la population infectée par le VIH), conducted between 2006 and 2007 among HIV-infected outpatients attending health care facilities. Among the 1673 HIV-positive individuals reporting a steady partner at the time of the survey (61% women), 85.4% (n = 1429) had disclosed their serostatus to them; 77% of the respondents were receiving antiretroviral therapy. Multivariate analysis based on multilevel modeling approaches showed that the following individual factors were associated with disclosure: living with one's steady partner, living with children, reporting systematic condom use or sexual abstinence with one's steady partner, being a woman who is not the head of the household, and finally having HIV-infected people among friends or relatives and not living below the poverty line. Structural factors associated with disclosure were as follows: attending national health facilities in the country's capital cities Yaoundé or Douala and having access to psychosocial or economical support interventions. These results strengthen the argument for the introduction or development of psychosocial interventions at all levels of organization in Cameroonian hospitals as an important component of public health policies for those living with HIV.     

Factors associated with violence against women in a representative sample of the Lebanese population: results of a cross-sectional study

To evaluate the prevalence of violence against women (VAW) and assess factors associated with VAW among a representative sample of the Lebanese population. This cross-sectional study was carried out between September and December 2018. Participants from all Lebanese governorates were enrolled in this study using a proportionate random sample. The percentages of women who were exposed to physical and non-physical abuse were 37.1% and 49.4% respectively. Factors associated with physical abuse were being divorced, having a partner addicted to substances and alcohol, or with a history of threats, violence, assaults, and crimes, higher stressful life experiences, and abuse reported from childhood (physical, sexual, or psychological). Non-physical abuse was associated with abuse reported from childhood (physical, sexual, or psychological), higher stressful life experiences, and the fact that the partner is addicted to substances and alcohol, or has a history of threats. Our results suggest that being divorced, illiterate, and unemployed, having an addicted partner, and having experienced child abuse are all factors that are associated with more violence against women.

     

Partner consent for sperm donation

The current practice of demanding the consent of the spousefor sperm donation is analysed. Three aspects of marriage maybe involved: (i) sexual exclusivity and adultery, (ii) familycomposition and (iii) procreational exclusivity. The differentjustifications for giving the partner the right to participatein the decision-making process are critically scrutinized. Theperspective taken in this article is that the transfer of gametesmust be understood and situated within the moral framework ofthe relationship between donor and partner. Depending on thekind of relationship the donor has with his partner, he maybe morally obliged to consult his procreational partner. Ina close relationship, all decisions concerning the use of one'sreproductive faculties should be joint decisions. However, itis not the task of the clinic or the physician to see that donorshonour their agreements and commitments. The clinic should notseek the partner's consent, although in the counselling sessionsit should be pointed out to the donor that he may have a responsibilityto inform his partner and to confer with her on his donation.     

Intimate partner violence theoretical considerations: moving towards a contextual framework

Several theories have been developed to provide a conceptual understanding of intimate partner violence (IPV) episodes. Although each of these theories has found some degree of empirical support, they are limited in their explanatory power of IPV episodes and their ability to significantly impact the efficacy of IPV prevention and treatment programs. The current paper provides a review and critique of current IPV theories and highlights strategies for improving upon these theories. An alternative theoretical conceptualization is introduced that incorporates existing IPV and functional analytic literature into a contextual framework for conceptualizing IPV episodes. Components of the IPV contextual framework include distal, static and proximal antecedents; motivating factors; behavioral repertoire; discriminative stimuli (i.e. environmental cues/signals); verbal rules; and IPV consequences. The proposed theoretical framework offers two primary advantages over former IPV theories. First, it provides a comprehensive conceptualization of IPV by integrating components of previous IPV theories and their related empirical findings into one, cohesive conceptual framework. Additionally, it allows for a more fine-grained analysis of more proximal variables potentially related to discrete IPV episodes. A discussion of how the proposed theoretical framework may influence future IPV research and clinical practice is provided.     

Partner violence, partner notification, and women's decisions to have an HIV test

OBJECTIVES: Reports of partner violence against HIV-positive women after they have disclosed their serostatus have led some to reassess partner notification strategies and to speculate that fear of partner violence following partner notification may influence women's HIV testing decisions. We studied whether associations exist between women's declining to have an HIV test and history of partner violence, fear of partner violence, previous experience with partner notification, or beliefs about partner notification. METHODS: In this cross-sectional study, we interviewed women seen at Newark and Miami sexually transmitted disease clinics. The women were at least 18 years old, not known to be HIV positive, not tested for HIV in the previous 3 months, and offered HIV testing during the clinic visit. Women who declined testing were compared with women who accepted. RESULTS: Of 490 participants (89% of eligible women), 16% reported partner violence in the past year, and 28% declined HIV testing. Declining the test was not significantly (p >.05) associated with history or fear of partner violence, previous experience with partner notification, or beliefs about partner notification. When specifically asked, only 2 women responded that their declining the test was related to fear that their partner or partners might harm them if the women tested positive. CONCLUSIONS: Among women seen at these clinics, we did not find evidence that declining the HIV test was strongly influenced by partner violence, previous experience with partner notification, or beliefs about partner notification. However, many women reported partner violence. Therefore, providers should assess the potential for partner violence and be prepared to make appropriate referrals.     

HIV seropositive drug users' attitudes towards partner notification (PCRS): results from the SHIELD study in Baltimore, Maryland

OBJECTIVE: To assess the attitudes of HIV seropositive current or former drug users towards HIV partner counseling and referral services (PCRS) and to determine if opinion varies by partner type. METHODS: We used a cross-sectional survey using structured and semi-structured questions to measure attitudes towards PCRS. RESULTS: The majority of the sample was African-American (97%), male (63%) and had been diagnosed with HIV for a mean of 7.9 years. Most agreed that PCRS would help stop the spread of HIV and AIDS (87%). A range of reactions to scenarios of their drug and sex partners being informed were observed and included positive reactions (e.g. PCRS as a means to facilitate testing of their partners and early treatment) to negative (e.g. feelings about guilt, shame and concern about partner responses). CONCLUSION: Data from this study indicate that HIV positive drug users view PCRS as a viable practice for preventing the spread of HIV, though barriers exist to engaging clients to identify partners. PRACTICE IMPLICATIONS: The range of reactions noted in this study underscore the importance of providing flexible options for PCRS based on partner type. Additional training for counselors, time for case-management and meetings with sex and drug partners and fieldwork for locating contacts are important considerations for providers.     

Increased frequency of both total and specific monoclonal antibody producing hybridomas using a fusion partner that constitutively expresses recombinant IL-6.

The addition of auxiliary feeder cells or conditioned medium has been shown to augment the yield of mouse hybridomas obtained following the cell-cell fusion of myeloma and B lymphocytes. The addition of one of these factors, interleukin-6 (IL-6) has been found to increase the proportion of hybridomas secreting monoclonal antibodies of desired specificity. As an alternative genetic approach, we have examined the efficacy of a retroviral infectant of Sp2/0 cells that constitutively expresses recombinant murine IL-6 (Sp2/mIL-6) as fusion partner. The results demonstrated that the yields of both viable Ig-secreting hybridomas, and antigen-specific monoclonal antibodies were increased 3-15-fold and 5-9-fold, respectively, with the Sp2/mIL-6 relative to Sp2/0 or Sp2/neo cells as fusion partner. Sp2/mIL-6 cells generated hybridomas with comparable growth rates, stability, and Ig production. The results of staining nascent hybridoma colonies immunohistochemically for Ig production suggest that Sp2/mIL-6 cells as a fusion partner increased the viability and/or stability of nascent hybrid cells that are producing Ig. Thus the Sp2/mIL-6 cells are an improved myeloma parent for the generation of large numbers of antibody-producing hybridomas against specific antigens.     

Presidential Address

Abstract

Partner support facilitates successful recovery and adjustment following an acute cardiac event (myocardial infarction or coronary revascularisation), but there is limited research examining the partner experience after an acute cardiac event. A computerised literature search was conducted to identify quantitative research investigating the psychosocial impact of an acute cardiac event on the patient's partner. The research base is limited, somewhat methodologically weak and outdated in relation to advances in cardiac care, and little attention has been paid to the experience of non-Caucasian couples, same sex couples or male partners. However, we found that partners are at significant risk of experiencing distress, anxiety and depression that may extend beyond the immediate recovery phase, and may contribute to adverse patient outcomes. Partners contend with significant disruption to their daily functioning and may engage in substantial caregiving responsibilities. Partners describe a lack of social support and information which may contribute to the high levels of distress. Marital and sexual functioning can also be adversely affected. Partner coping strategies and illness perceptions may contribute to adjustment. The findings of this review reveal that partner experience may play an important role in both partner and patient adjustment to an acute cardiac event and there is considerable scope for updating and extending current knowledge of partner experience.     

Emergency contraception use and non‐use in young women: The application of a contextual and dynamic model

There have been many approaches to understanding contraception use including social cognition models which have been criticised for their individualistic approach and their static nature. The present quantitative study developed and refined a contextual and dynamic model of contraception use that was derived using qualitative research. This model conceptualizes the predictors of contraception use in terms of the meaning and importance of a range of social goals, perceptions of vulnerability, and constraints on or facilitators of contraception use each of which changes over time. The present study operationalized this model in relation to emergency contraception and explored differences between users and non‐users and between episodes of use and non‐use. In terms of users and non‐users, the results showed that the users of emergency contraception showed a more positive view of an emergency contraception user, perceived greater support from their partner for emergency contraception use, rated themselves more at risk of pregnancy, and felt more confident about asking for emergency contraception. In terms of use and non‐use, use was related to an increased belief about the risk of pregnancy, increased partner support, increased concern about health care professionals and the side‐effects of the drug, and a more positive identity of an emergency contraception. The study has helped to develop and refine the model and has identified some key factors that are specifically relevant to emergency contraception use in a sample of women in education in and around London.     

Gender differences in sex risk behaviors among Ukraine injection drug users

OBJECTIVE: To assess gender differences in drug and sex risk behaviors and evaluate predictors of HIV-related sex risk behaviors among heterosexual injection drug users (IDUs) in Ukraine. DESIGN: Street-recruited IDUs from Kiev, Odessa, and Makeevka/Donesk, Ukraine. METHODS: From June 2004 through November 2006, outreach workers recruited 1557 IDUs, including 526 from Kiev, 494 from Odessa, and 537 from Makeevka/Donesk. Participants were administered a standardized computer-assisted interview assessing HIV-related drug and sex risk behaviors, self-efficacy for practicing safe sex, and HIV knowledge. RESULTS: Overall, 80% of the participants were sexually active in the 30-day period before their interview. They also engaged in high-risk sex behaviors during this brief 30-day window: 53% reported anal or vaginal sex without a condom, 27% had sex with more than 1 partner, 41% had an IDU sex partner, and 37% had an HIV-positive sex partner or a partner whose HIV status they did not know. Overall, women were at higher risk than men and were more likely to have been told they were HIV-positive. CONCLUSION: The extremely high HIV prevalence rate in Ukraine and in this cohort, combined with their recent high-risk sex behaviors, forecasts not only a continuance of the epidemic in the region but an escalation.     

Contrasting effects of finger and shoulder interpersonal light touch on standing balance

Sway is reduced by light nonsupporting touch between parts of the body and a fixed surface. This effect is assumed to reflect augmentation of sensory cues for sway by point-of-contact reaction forces. It has been shown that movement of the contact surface can increase sway relative to an earth-fixed contact. Light touch contact with another person, for example, holding hands, affords a moving contact due to partner sway. We asked whether interpersonal light touch (IPLT) would increase sway relative to standing alone. We expected effects on sway to vary as a function of the site of contact and the postural stability of each partner. Eight pairs of participants, standing in either normal bipedal or tandem Romberg stance with eyes closed and using IPLT (finger to finger or shoulder to shoulder) or no contact, provided 4 trials of 30-s duration in each of 12 posture-touch combinations. Sway (SD of the rate of change of upper trunk position at C7) was reliably less with IPLT compared with no contact, with two exceptions: in normal stance, shoulder contact with a partner in tandem stance, and in tandem Romberg stance, finger contact with a partner in the same stance, increased sway. Otherwise, the reduction in sway was greater with shoulder than with finger contact. Measures of interpersonal synchronization based on cross-correlations and coherence analysis between the partners' C7 movements suggest different control factors operate to reduce sway in IPLT with the hand or shoulder contact.     

Sex-specific difference in social support--a study in female guinea pigs

In challenging situations, the male guinea pig's hormonal stress responses can be ameliorated by the presence of his female bonding partner. Such social support cannot be provided, however, by a female with whom the male is familiar but has no social ties. In this study, we investigated whether the same phenomenon also accounts for female guinea pigs. First, the spontaneous behaviour of 14 females was recorded in their home colonies to determine their male bonding partners. Then, a so-called challenge test was conducted with 22 females: they were placed into an unknown enclosure for 4 h either alone (n=8), or together with their bonding partner (n=7) or with a familiar male from the same colony, who was not their bonding partner (n=7). Immediately before as well as 1, 2 and 4 h after the beginning of the challenge test, blood samples were taken to determine cortisol levels (CORT). Further on, the behaviour was recorded during the first 2 h of the challenge test. Placing a female guinea pig into an unknown enclosure led to significantly increased CORT independently of whether she was tested alone or with a social partner. However, females that were tested together with their bonding partner showed significantly lower CORT than females tested alone. In females who were tested with a familiar male CORT was in between. The behaviour during the challenge tests reflected the magnitude of the stress response. Thus, also in female guinea pigs social support can be provided by social partners. In contrast to males, however, not only the bonding partner is able to reduce the female's stress responses, but also a familiar conspecific, though in a less effective way.     

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.     

The role of childhood sexual abuse sequelae in the sexual revictimization of women: an empirical review and theoretical reformulation

There is now widespread empirical evidence that child sexual abuse (CSA) survivors are at greater risk for sexual revictimization in adulthood, but less is known of the mechanisms underlying this relationship. Despite the lack of a conceptual framework to guide research, there has been a recent influx of studies examining explanatory variables, with most focusing on the psychological sequelae of CSA: alcohol and drug use, sexual behavior, dissociation, posttraumatic symptomatology, poor risk recognition, and interpersonal difficulties. With the exception of sexual behavior, the studies reviewed here provide limited or mixed support for the role of intrapersonal factors in revictimization. Future research may benefit from a focus on the function of psychological distress that is expressed as psychological vulnerability, as opposed to individual forms of psychopathology or maladaptive behavior. An ecological framework may be useful as a guide to future investigations, as this model focuses on factors outside of the victim, including childhood factors such as family environment, contextual factors including the behavior of the perpetrator, and societal and cultural factors that impact revictimization. Future investigations should focus on the interaction between victim vulnerability and perpetrator behavior. Implications for prevention programming, clinical intervention, and future research are discussed.     

Paternal and maternal depressed mood during the transition to parenthood

BACKGROUND: The course of postnatal depression was examined in first-time mothers and fathers with emphasis on the role of personality and parental relationships as risk factors. METHOD: 157 couples were assessed at four points: antenatally and at 6, 12 and 52 weeks postnatally. Various measures of mood and personality were administered at each of these assessment points. RESULTS: Examination of the factors associated with depressed mood suggested that a woman's relationship with her own mother was important in the early postpartum stage, and also her level of interpersonal sensitivity and neuroticism. For the father, his relationship with either his mother or father and his level of neuroticism were associated with his mood level early on. By the end of the first year couple morbidity increased, with rates of distress being at their highest for both parents, and factors associated with depressed mood being linked to partner relationship variables, at least for mothers. At most time points, antenatal mood and partner relationship were significant predictor variables for the postnatal mood of both mothers and fathers. Limitations: The sample had a relatively high level of education and this should be taken into account when considering the generalisation of findings to less educated populations. At the time of conducting this study, the Edinburgh Postnatal Depression Scale (EPDS) had only been validated for use in the first few months postpartum, and thus we used another scale to measure the mother's mood at the other assessment points (the Beck Depression Inventory). Current research would suggest that the EPDS is valid both antenatally and at other times in the first year postpartum. CONCLUSION: Whilst there was some consistency for mothers and fathers in the variables that predict their postpartum adjustment, these being antenatal mood and partner relationship, there is also evidence that adjustment to parenthood was related to different variables at different times. Early adjustment was related to the couple's relationship with their own parents, as well as their own personality. Later adjustment was related to the couple's functioning and relationship.     

Cannabis: What Makes University Students More or Less Likely to Use It?

University students' motivations for using or not using cannabis were investigated. Students ( n = 189) aged 17 to 29 years completed a survey to assess their intention to use cannabis and their beliefs about (a) advantages and disadvantages of using cannabis; (b) their perceptions of what significant others think they should do in relation to cannabis use; and (c) factors that might encourage them to use or not use cannabis. Two weeks later, they completed a follow-up survey asking about their actual behavior over the previous 2 weeks. Compared to non-users, users believed more strongly that cannabis would help them fit in with their friends, feel relaxed, forget their worries, and enjoy themselves. They also believed that their close friends, partner/spouse, siblings, and workmates would approve of their using cannabis. Users believed that certain factors (e.g., force of habit, wanting to relax, feeling stressed, being around other people using cannabis) would encourage them to use, while non-users rated work and study as strong reasons for not using cannabis. Beliefs that are relevant to users and non-users in education campaigns can be targeted to reduce the negative consequences of use in tertiary settings.