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To bridge the science-practice gap, the APA Presidential Task Force endorsed the publication of evidence-based case studies, but to date, there have been few such investigations of conjoint family therapy. To fill this gap, we studied a successful case of treatment-as-usual in a community agency. Owing to the complexity of the working alliance in conjoint therapy, we examined how an experienced family therapist managed to develop and sustain multiple alliances over time with an estranged couple in crisis. The outcome data showed clinically meaningful changes as well as high satisfaction levels and notable declines in the target complaint discomfort levels of all family members. Alliance indicators showed that the therapist worked diligently over time to connect emotionally with each family member and to foster and maintain safety. Session impact scores showed consistently deep sessions but more variability in smoothness. By working toward the only shared treatment goal-to repair each parent's individual relationship with their very angry daughter-the therapist was able to reduce the effect of the marital estrangement on the child. At the end of the 10 contracted family sessions, the parents agreed to begin working on their relationship in couples therapy, which led shortly thereafter to a reconciliation.
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PMID:Negotiating therapeutic alliances with a family at impasse. 2405 31

The organizational justice literature has examined the effects of supervisor-focused interpersonal justice climate, or a team's shared perception of the dignity and respect it receives from its supervisor, on a number of important outcomes directed at organizational authorities. Considerably less is known about the potential influence of these shared perceptions on coworker-directed outcomes. In 2 experiments, we predict that a low (unfair) supervisor-focused interpersonal justice climate generates greater team cohesiveness than a high (fair) supervisor-focused interpersonal justice climate. We further examine the process through which this effect occurs. Drawing from cognitive dissonance theory, we predict that low (vs. high) supervisor-focused interpersonal justice climate generates greater team dissonance, or shared psychological discomfort, for team members and that this dissonance serves as an underlying mechanism through which supervisor-focused interpersonal justice climate influences a team's cohesiveness. Our results demonstrate support for these predictions in that low supervisor-focused interpersonal justice climate led to higher levels of both team dissonance and team cohesiveness than did high supervisor-focused interpersonal justice climate, and team dissonance mediated this relationship. Implications and areas for future research are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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PMID:Misery loves company: team dissonance and the influence of supervisor-focused interpersonal justice climate on team cohesiveness. 2524 94

Over 300,000 individuals enter treatment for cannabis-use disorders (CUDs) in the United States annually. Cannabis withdrawal is associated with poor CUD-treatment outcomes, but no prior studies have examined sex differences in withdrawal among treatment-seeking cannabis users. Treatment-seeking cannabis users (45 women and 91 men) completed a Marijuana Withdrawal Checklist (Budney, Novy, & Hughes, 1999, Budney, Moore, Vandrey, & Hughes, 2003) at treatment intake to retrospectively characterize withdrawal symptoms experienced during their most recent quit attempt. Scores from the 14-item Composite Withdrawal Discomfort Scale (WDS), a subset of the Marijuana Withdrawal Checklist that corresponds to valid cannabis withdrawal symptoms described in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; APA, 2013) were calculated. Demographic and substance-use characteristics, overall WDS scores, and scores on individual WDS symptoms were compared between women and men. Women had higher overall WDS scores than men, and women had higher scores than men on 6 individual symptoms in 2 domains, mood symptoms (i.e., irritability, restlessness, increased anger, violent outbursts), and gastrointestinal symptoms (i.e., nausea, stomach pain). Follow-up analyses isolating the incidence and severity of WDS symptoms demonstrated that women generally reported a higher number of individual withdrawal symptoms than men, and that they reported experiencing some symptoms as more severe. This is the first report to demonstrate that women seeking treatment for CUDs may experience more withdrawal then men during quit attempts. Prospective studies of sex differences in cannabis withdrawal are warranted.
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PMID:Sex differences in cannabis withdrawal symptoms among treatment-seeking cannabis users. 2646 Nov 68

Low engagement in posttraumatic stress disorder (PTSD) psychotherapy is a common problem in the U.S. Department of Veteran Affairs (VA), with up to half of veterans who are referred to an evidence-based psychotherapy failing to engage in that treatment. Prior research has focused on identifying general barriers to mental health treatment rather than barriers specific to evidence-based treatments for PTSD. The purpose of the current study was to identify barriers for veterans who referred specifically for evidence-based psychotherapy (i.e., cognitive processing therapy or prolonged exposure) but who did not attend any sessions of those psychotherapies. Qualitative interviews (N = 24) were used to gain a better understanding of the experiences and attitudes of these veterans. Most veterans reported multiple barriers to treatment engagement (M = 4.2 barriers), suggesting that an accumulation of barriers contributes to poor engagement. Barriers fell into 5 categories: practical, knowledge, emotional, therapy-related, and VA-system-related. The most-endorsed category, mentioned by two thirds of the sample, was VA-system-related barriers, including inefficiencies and delays, negative experiences with VA staff and providers, discomfort with the VA environment, and difficulty navigating the VA system. Veterans' experienced barriers to beginning PE and CPT were diverse but, overall, highlighted the need to transform the VA to a more patient-centered model of care. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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PMID:Failure to engage: A qualitative study of veterans who decline evidence-based psychotherapies for PTSD. 2926 43

Distress tolerance, or the ability to withstand uncomfortable states, is thought to be a transdiagnostic risk factor for psychopathology. Distress tolerance is typically measured using self-report questionnaires or behavioral tasks, both of which construe distress tolerance as a trait and downplay the potential variability in distress tolerance across time and situation. The aim of the current study was to provide a method for assessing momentary distress tolerance using ecological momentary assessment to capture both within- and between-individual information. Participants (n = 86) responded to random prompts on their cell phones seven times per day for one week, which included 10 momentary distress tolerance items as well as momentary emotion. After examining item distributions and interclass correlations, we conducted a multilevel exploratory factor analysis using both within-individual and between-individual data to arrive at a brief, 3-item measure we call the Momentary Distress Intolerance Scale. Model fit and reliability indices were good for both within- and between-individual approaches. We found that distress tolerance varied significantly over time, and that average momentary distress intolerance and instability in momentary distress intolerance were associated with trait distress tolerance, emotion dysregulation and tendencies to use experiential avoidance. Neither average momentary distress intolerance nor instability in momentary distress intolerance correlated with behavioral distress tolerance tasks. We discuss the importance of construing distress tolerance from a dynamic perspective and provide recommendations toward future research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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PMID:The dynamics of persisting through distress: Development of a Momentary Distress Intolerance Scale using ecological momentary assessment. 2988 46

Parents of children with oppositional defiant disorder (ODD) experience considerable stress and challenges in parenting. Based on a 2-year, 3-wave longitudinal study of children with ODD (N = 243, mean age = 9.47 years, SD = 1.53; 72.8% boys) and their parents in Mainland China, our study examined the relation between 3 dimensions of parenting stress (i.e., Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child) and their children's ODD symptoms. Using cross-lagged panel models, we tested the bidirectional relation between parenting stress and children's ODD symptoms. We found evidence for both parent-driven and child-driven effects. Specifically, Parent-Child Dysfunctional Interaction (PCDI) at T2 positively predicted children's ODD symptoms at T3. Moreover, children's ODD symptoms at T1 positively predicted parental perceptions of Difficult Child and PCDI at T2. Further, children's ODD symptoms at T2 positively predicted all 3 dimensions of parenting stress at T3. Further, multiple-group path analysis by child's gender suggested that PCDI had a significant negative relation with girls' (but not boys') ODD symptoms from T1 to T2 and had a significant positive relation with boys' (but not girls) ODD symptoms from T2 to T3. These findings provided support for the dynamic relations among parenting stress, parent-child interaction, and children's ODD symptoms and highlighted the different effects of child gender in the parent-child interaction process. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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PMID:Longitudinal linkages between parenting stress and oppositional defiant disorder (ODD) symptoms among Chinese children with ODD. 3032 Oct 15

Individuals with autism spectrum disorder (ASD) exhibit a reduced duration of eye contact compared with typically developing (TD) individuals. This reduced eye contact has been theorized to be a strategy to relieve discomfort elicited by direct eye contact (Tanaka & Sung, 2016). Looking at threatening facial expressions may elicit more discomfort and consequently more eye avoidance in ASD individuals than looking at nonthreatening expressions. We explored whether eye avoidance in children with ASD is modulated by the social threat level of emotional expressions. In this study, 2- to 5-year-old children with and without ASD viewed faces with happy, angry, sad, and neutral expressions, while their eye movements were recorded. We observed the following: (a) when confronted with angry faces, the children with ASD fixated less on the eyes than did TD children, persistently across time; (b) the group differences in the overall eye-looking time were rarely found for happy, neutral, and sad faces; (c) the ASD group showed eye avoidance for neutral faces between 1,000 ms and 2,900 ms after the stimulus onset. Additionally, both groups spent more time looking at the angry faces than the faces showing other emotions. Considering that the children with ASD spent less time looking at the eyes of the angry faces than other emotional faces, the results suggest a combination of vigilance to threatening faces and an avoidance of the eyes in children with ASD. Our study not only extends the gaze aversion hypothesis but also has implications for the treatment and screening of ASD. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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PMID:Eye avoidance in young children with autism spectrum disorder is modulated by emotional facial expressions. 3033 41

Low relationship satisfaction is associated with mental health disorders in service members/veterans (SM/Vs), yet eating disordered behavior (EDB) and sexual function and satisfaction in SM/Vs are understudied. Those with EDB may experience bodily discomfort that may be associated with low relationship satisfaction because of avoidance of physical contact and intimacy, suggesting that sexual satisfaction and function may modify the association of EDB and relationship satisfaction. As the majority of female SM/Vs are partnered, it is imperative to study the association of sexual function and satisfaction with EDB and relationship satisfaction. Partnered female SM/Vs (N = 479) completed an online survey assessing demographic characteristics (e.g., relationship duration, deployment history), EDB, sexual satisfaction and function, and relationship satisfaction measures. Thirty-three percent, 20%, and 58% of the sample reported scores consistent with relational distress, probable eating disorder, and sexual dysfunction, respectively. After adjusting for covariates, EBD was negatively associated with relationship satisfaction with a small-to-medium effect size. Sexual satisfaction and function had a significant indirect effect on the association of EDB and relationship satisfaction, suggesting that sexual satisfaction and function accounted for some of the variance between these 2 variables. Screening for EDB, sexual satisfaction, and sexual function among partnered female SM/Vs may provide critical insight into mechanisms of relational distress. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:The association of disordered eating and sexual health with relationship satisfaction in female service members/veterans. 3070 7

Four studies examined whether pain offset reduces rumination in response to anger or sadness. Past research has demonstrated that, following the offset of pain, individuals show a distinct state of relief involving both reduction in negative affect and an increase in positive affect. This response may help to explain why people sometimes seek out pain and discomfort (e.g., vigorous exercise, self-harm) to regulate negative emotion and suggests that following pain people should recover better from negative emotional states. To test this, we examined ruminative responses to anger and sadness. These negative, approach-related emotions often produce rumination; a response that is generally considered maladaptive. In Study 1, pain was manipulated through a cold pressor task, and participants were induced to experience anger through autobiographical recall. In Study 2, pain was also manipulated pain via a cold pressor task, and anger and sadness were induced through social exclusion using the Cyberball paradigm. In Study 3, pain was manipulated by squeezing exercise handgrips, and sadness was induced with imagery from a sad video. Study 4 replicated the methods of Study 3 and added measures of relief and distraction to examine whether these moderated the effect. A minimeta-analysis showed that, across all studies, individuals engaged in less rumination in the pain conditions as measured by a thought-listing task and a self-reported rumination questionnaire. These results suggest that the regulation of anger and sadness are improved following pain offset. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Pain offset reduces rumination in response to evoked anger and sadness. 3084 24

Positive emotions have been shown to shape individuals' reactions to intergroup conflicts, but the exact mechanism remains unknown. The current research hypothesizes that the impact of positive emotions would be moderated by dialectical thinking: beliefs about accepting contradiction and change. Experiencing positive emotions in an intergroup conflict may be perceived as unacceptable and evokes discomfort among nondialectical individuals, amplifying the negative reactions toward outgroup members. In contrast, because dialectical thinkers accept contradictory emotions, positive emotions may buffer against the adverse consequences of intergroup provocations. Study 1 confirmed this hypothesis by examining Chinese emotions in a real-life and a lab-induced intergroup conflict. Study 2 recruited Western participants and demonstrated that the moderating effect of dialectical thinking was evident only under a conflict-related context. Study 3 confirmed the causality by manipulating dialectical thinking in a historically enduring conflict. These findings suggest that enhancing dialectical thinking maximized the buffering effect of positive emotion against intergroup conflict. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Is positive emotion an amplifier or a buffer? It depends: Dialectical thinking moderates the impact of positive emotion on intergroup conflicts. 3086 36


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