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Biomedical subjects

D H Olson

Publications and source records attributed to D H Olson.

12 recordsLinked to original sources
PubMed2001

Five types of African-American marriages.

This study developed a marital typology based on a nonrandom, national sample of 415 African-American couples who took the Enriching Relationship Issues, Communication and Happiness (ENRICH) marital assessment inventory. Five types of African-American marriages were identified through cluster analysis using the positive couple agreement (PCA) scores in 10 relationship domains. Relationships between marital satisfaction, marital stability, and the five marital types were then analyzed. The five types (from highest marital satisfaction to lowest) were labeled as vitalized, harmonious, traditional, conflicted, and devitalized. The results were similar to findings in studies of ethnically mixed (predominantly European-American) marital samples including the number and characteristics of marital types.

Adult↗
PubMed1999

A randomized trial of integrated outpatient treatment for medically ill alcoholic men.

BACKGROUND: Medically ill alcoholics often do not respond to conventional alcoholism treatment or decline physician referrals. Integrated outpatient treatment (IOT), a new treatment specifically designed for this population, combines comprehensive medical care with alcoholism interventions. OBJECTIVE: To compare the efficacy of IOT with that of standard treatment approaches. METHODS: One hundred five male veterans with severe medical complications caused by alcoholism and recent drinking were randomly assigned to receive IOT or referral to standard alcoholism and medical treatment and were evaluated over 2 years. Integrated outpatient treatment patients received medical care and alcoholism interventions once or twice monthly. Patients in the control group were referred for alcoholism treatment, but few accepted. However, patients in the control group did engage in outpatient medical care. RESULTS: At baseline, the mean +/- SD age of the control group was 57.2 + 10.0 years, compared with 52.8 +/- 11.5 years in the IOT group (P= .04). The groups were well matched in other respects. The mean +/- SD number of visits over 2 years for the IOT patients was 42.2 +/- 29.1, compared with 17.4 +/- 15.6 for the control patients (P<.001); the frequency of hospital use was similar in both groups. After 2 years, 28 (74%) of 38 surviving IOT patients and 17 (47%) of 36 control patients were abstinent (P=.02). Nearly twice as many control patients (30% [n = 16]) as IOT patients (18% [n= 9]) died, but the results of Cox survival analysis were not significant. There were no differences in symptoms of alcohol dependence, quality of life, or life problems. The incremental cost of IOT was approximately $1100 per patient per year. CONCLUSIONS: Standard medical care alone was surprisingly effective in inducing abstinence in surviving medically ill alcoholics. Integrated outpatient treatment significantly increased both engagement and abstinence for a modest annual cost. Further refinement and testing of IOT is indicated.

Adult↗
PubMed1997

A clinical tool for rating response to civil commitment for substance abuse treatment.

OBJECTIVE: The objectives of this study were to develop a measure to assess patients' response to civil commitment, to test this measure on two groups of dually diagnosed patients (medically ill alcoholics and patients with dual mental and substance use disorders), and to identify patient characteristics associated with a positive response to commitment. METHODS: The outcome of 38 male veterans civilly committed to inpatient substance abuse treatment for an average of six months was rated by their treating clinicians. Raters used the Commitment Response Form (CRF), a scale anchored to behavioral descriptions that was developed for the study and that measures outcome in five areas: patients' attitude toward recovery, substance use, medical condition, engagement in substance abuse treatment, and independence of functioning. Each patient's medical records were reviewed by two clinical staff members who made independent retrospective ratings and a joint rating using the CRF. They also made independent and joint dichotomous ratings of whether the patient was a positive responder or a nonresponder to civil commitment. RESULTS: The CRF showed superior reliability when compared with the dichotomous rating of outcome. The scale demonstrated reasonable psychometric properties. Mean scale scores did not differ significantly by patient group; slightly more than half were rated as having a good to excellent overall response. Better outcome was associated with longer periods of previous abstinence from alcohol and a higher level of education. CONCLUSIONS: Use of a scale anchored to behavioral descriptions improved reliability of outcome determinations by clinical staff. Civil commitment resulted in good to excellent outcome in many but not all committed patients.

Adult↗
PubMed1995

Integrated outpatients treatment for medically ill alcoholic men: results from a quasi-experimental study.

OBJECTIVE: This report documents the findings of a quasi-experimental study of a new approach to treating medically ill alcoholics. The intervention, the Alcohol Related Disorders (ARD) Clinic, consists of concurrent alcohol treatment and medical care delivered by an interdisciplinary team in an outpatient medical clinic at the Minneapolis Veterans Affairs Medical Center (MVAMC). METHOD: We compared 50 ARD patients with 50 patients who met eligibility for the clinic, but had to be referred elsewhere because the clinic was full at the time (referred patients). Referred patients received medical care in other MVAMC clinics or in the community. RESULTS: During the 2-year follow-up period, ARD patients returned for outpatient visits over three times as often as referred patients (p < .001). More referred patients received no follow-up care at MVAMC (p < .01). ARD patients had more frequent (p < .05) but briefer (p < .01) hospitalizations. Almost twice as many referred (32%) as ARD patients (18%) died during the follow-up period. Referred patients ranged from 1.18 times less likely to 5.03 times more likely to die during follow-up than those in the ARD group (p = .11). ARD patients lived for an average of 82 days longer than referred patients, and each ARD clinic visit in the second follow-up year predicted an additional 3.5 days lived (p < .01). CONCLUSIONS: Integrated outpatient treatment for medically ill alcoholics appears to improve outpatients follow-up and alter patterns of hospitalization when compared with standard approaches. Two-year mortality may have been reduced as a result.

Adult↗
PubMed1991

Three-dimensional (3-D) Circumplex Model and revised scoring of FACES III.

FACES III can, however, continue to be a useful scale now that the Circumplex Model has been expanded into a three-dimensional design. Past and future studies would benefit from using FACES III as a linear dimension with high scores representing Balanced types and low scores representing Extreme types. This approach means that many past studies with FACES III need to be re-analyzed and/or re-interpreted in light of this 3-D Model. This revised scoring will significantly increase the number of studies that support the basic hypotheses of the Circumplex model, that Balanced families tend to function in more effective ways. It is clear from more recent work with the Clinical Rating Scale (CRS) that the lack of support for the curvilinear hypotheses of the Circumplex Model is due to the limitations of the FACES instrument and not the underlying theoretical model. The CRS clearly demonstrated the curvilinear pattern that has been hypothesized. It is important that future studies using FACES III analyze data in a linear way that fits with the three-dimensional model. In this way, there is a better match conceptually and methodologically between FACES III and the Circumplex Model. It is also highly recommended that future studies use both the self-report of FACES and the observational approaches to family assessment of the Clinical Rating Scale. This combined approach will help advance the field conceptually, methodologically, and clinically.

Family↗
PubMed1986

Circumplex Model VII: validation studies and FACES III.

This paper reviews some of the recent empirical studies validating the Circumplex Model and describes the newly developed self-report measure, FACES III. Studies testing hypotheses derived from the Circumplex Model regarding the three dimensions of cohesion, change, and communication are reviewed. Case illustrations using FACES III and the Clinical Rating Scale are presented. These two assessment tools can be used for making a diagnosis of family functioning and for assessing changes over the course of treatment. This paper reflects the continuing attempt to develop further the Circumplex Model and to bridge more adequately research, theory, and practice.

Adaptation, Psychological↗
PubMed1983

Circumplex model of marital and family systems: VI. Theoretical update.

This paper updates the theoretical work on the Circumplex Model and provides revised and new hypotheses. Similarities and contrasts to the Beavers Systems Model are made along with comments regarding Beavers and Voeller's critique. FACES II, a newly revised assessment tool, provides both "perceived" and "ideal" family assessment that is useful empirically and clinically.

Adaptation, Psychological↗
PubMed1979

Circumplex model of marital and family system: I. Cohesion and adaptability dimensions, family types, and clinical applications.

The conceptual clustering of numerous concepts from family therapy and other social science fields reveals two significant dimensions of family behavior, cohesion and adaptability. These two dimensions are placed into a circumplex model that is used to identify 16 types of marital and family systems. The model proposes that a balanced level of both cohesion and adaptability is the most functional to marital and family development. It postulates the need for a balance on the cohesion dimension between too much closeness (which leads to enmeshed systems) and too little closeness (which leads to disengaged systems). There also needs to be a balance on the adaptability dimension between too much change (which leads to chaotic systems) and too little change (which leads to rigid systems). The model was developed as a tool for clinical diagnosis and for specifying treatment goals with couples and families.

Adaptation, Psychological↗
PubMed1976

Tools and techniques for diagnosis and evaluation in marital and family therapy.

This is a slightly edited version of a chapter to appear in a forthcoming book. It is a beginning attempt at codification of existing tools and techniques and is therefore nonexhaustive. The authors welcome feedback from readers concerning omissions and information on new techniques, references, and applicability to therapeutic settings.

Adaptation, Psychological↗