Biomedical subjects

D Vivian

Publications and source records attributed to D Vivian.

9 recordsLinked to original sources

PubMed2003

Patient's therapeutic skill acquisition and response to psychotherapy, alone or in combination with medication.

BACKGROUND: We tested the hypotheses that the addition of medication to psychotherapy enhances participation in the latter by: (1) speeding the acquisition of the psychotherapy's targeted skill; and (2) facilitating higher skill level acquisition. METHOD: Participants were 431 chronically depressed patients who received Cognitive Behavioral Analysis System of Psychotherapy (CBASP), alone (N=214) or in combination with nefazodone (N=217), as part of a randomized chronic depression study (Keller et al. 2000). CBASP, developed specifically to treat chronic depression, uses a specific procedure, 'situational analysis' to help patients engage in more effective goal-oriented interpersonal behaviours. At the end of each session, therapists rated patients on their performance of situational analysis. Outcome on depressive symptoms was assessed with the 24-item Hamilton Rating Scale for Depression. RESULTS: Although reductions in depression were significantly greater in combined treatment compared to CBASP alone, there were no between-group differences in either the rate of skill acquisition or overall skill level at the end of treatment. Proficiency in the use of the main skill taught in psychotherapy at treatment midpoint predicted outcome independently of medication status and of baseline depressive severity. CONCLUSIONS: Effective participation in CBASP, as reflected by proficiency in the compensatory skill taught in psychotherapy, is not enhanced by the addition of medication and does not mediate the between-group difference in depression outcome.

Adolescent↗

PubMed2001

How much observational data is enough? An empirical test using marital interaction coding.

Using three different samples of couples (clinic, nondistressed community, and engaged), we found that 15 minutes was sufficient to witness enough behavior to make reliable (i.e., internally consistent) estimations of most Rapid Marital Interaction Coding System (Heyman & Vivian, 1993) code frequencies. Ten minutes is sufficient for many codes of interest. The ease in which "how much time is necessary" calculations can be made should entice behavioral investigators from a variety of content areas to publish such figures. By empirically investigating a factor that in most fields becomes reified through convention, investigators can conduct observational research that is both maximally efficient and maximally scientifically defensible.

Journal Article↗

PubMed1997

Relationship factors and depressive symptomatology associated with mild and severe husband-to-wife physical aggression.

This study uses a gender-specific approach to investigate the association among relationship factors, depressive symptomatology and husbands' marital violence in 327 couples who attended a marital therapy clinic. Both spouses reports were used to group couples according to husbands' verbal (VA), mild physical (MA), and severe physical (SA) aggression as measured by the Conflict Tactics Scale (Straus, 1979). Frequency of aggression and spouses' perceptions about their partners' communication skills during conflict (i.e., use of hostile, verbally aggressive and avoidant conflict styles) were different for all groups. Reports on marital quality, conflict management style, cognitions about marriage, and individual affective state were more negative for both spouses when husbands were severely physically aggressive. Wives in the SA group were most likely to believe that partners cannot change. Discriminant function analysis provided substantial prediction of group membership when husbands were verbally or severely aggressive, but weaker prediction when husbands engaged in mild physical aggression. The limits of current measures of dyadic processes for marital violence research are discussed.

Adult↗

PubMed1996

Generalized versus spouse-specific anger/hostility and men's violence against intimates.

The present study examined the extent to which generalized versus spouse-specific anger/hostility was associated with partner violence in 263 men seeking conjoint marital therapy. Clinic men were classified as nonviolent (NV), moderately violent (MV), and severely violent (SV). A community comparison group of relationship-satisfied, non-violent men (CO) was also included. All clinic men reported higher levels of generalized and spouse-specific anger, spouse-specific aggression/hostility, depressive symptomatology and lower spouse-specific assertiveness than community men. SV men reported higher levels of spouse-specific anger/hostility, relationship discord, depressive symptomatology, and lower general problem-solving ability than NV men. Regression analyses confirmed that spouse-specific anger/hostility, low problem-solving ability, and relationship discord were significant predictors of men's violence. Overall, generalized anger and hostility were not unique predictors of men's violence against intimates.

Adult↗

PubMed1994

Are bi-directionally violent couples mutually victimized? A gender-sensitive comparison.

Mutual victimization in marriage was studied in a sample of clinic couples (N = 57) where both spouses reported partner aggression on an adapted version of the Conflict Tactics Scale (Straus, 1979). As predicted, wives sustained more injuries and were more negatively affected by their partner's physical aggression than did husbands. Multiple dimensions of aggression were used to identify subgroups of mutually victimized couples (e.g., frequency, severity of aggressive act[s], psychological impact, and severity of injury). The largest subgroup consisted of spouses who reported low levels of victimization on all dimensions. Subgroup 2 included couples in which wives reported higher overall levels of victimization than did their husbands. A third small subgroup was also identified where husbands reported higher levels of victimization than did their wives. Contrary to prediction, both highly victimized wives and highly victimized husbands in the asymmetrical victimization subgroups reported greater levels of relationship and individual distress than did spouses in the mutual/low victimization and nonaggression control groups. However, the marriages of the two highly victimized subgroups did differ in important ways. The findings were interpreted to suggest an integration of feminist and dyadic theories of marital aggression.

Adult↗

PubMed1992

Marital aggression. Impact, injury, and health correlates for husbands and wives.

The overall aim of the current study was to comprehensively evaluate the prevalence, impact, and health correlates of marital aggression in a clinical sample of maritally discordant couples seeking psychological treatment. Participants were 93 consecutively presenting clinic couples and 16 maritally satisfied matched control couples from the community. Overall, 71% of clinic couples reported at least one act of marital aggression during the past year. Although 86% of the aggression reported was reciprocal between husbands and wives, impact and injuries sustained as a function of this aggression differed between husbands and wives. Specifically, wives were more likely than husbands to be negatively affected and to sustain severe injuries (eg, broken bones, broken teeth, or injury to sensory organs). Additionally, wives who experienced marital aggression reported clinical levels of depressive symptomatology. Recommendations are offered and risk markers are identified to improve detection by physicians of patients who may be involved in violent marriages.

Aggression↗

PubMed1990

Longitudinal prediction of marital discord from premarital expressions of affect.

Theoretical and empirical analyses suggest that affective features of dyadic communication bear importantly on relationship satisfaction. A circumplex model that originated in research on the structure of affect was first replicated using data from premarital problem-solving discussions. Negativity, Positivity, and Disengagement emerged as the three primary factors. Multiple regression analyses, controlling for premarital relationship satisfaction, showed affective Disengagement at premarriage to be negatively associated with marital satisfaction at 18 (n = 84) and 30 (n = 72) months after marriage. Negativity of premarital affective expression correlated negatively with premarital satisfaction (n = 88) but not with postmarital satisfaction. Two variables formed by combining affect factors contributed to the prediction of 30-month marital satisfaction. Elements associated with current marital satisfaction appear to differ from those associated with later marital satisfaction.

Adult↗

PubMed1986

Effect of "wet nights" on daytime behavior during concurrent treatment of enuresis and conduct problems.

The case study reported in this paper focuses on the relationship between bedwetting and misconduct after the implementation of behavior therapy for both problems. A 6 1/2-year-old girl was treated for enuresis and subsequently for conduct problems (lying, aggressiveness). After both bedwetting and misconduct displayed substantial and stable improvement, it was found that occasional nightly relapses in bedwetting were strongly associated with the occurrence of misconduct the following day. Implications of this finding are discussed.

Behavior Therapy↗

PubMed1985

Hyperactivity in Italy.

Prevalence rates of hyperactivity in Italy using commonly accepted cutoff scores in the United States were 20% for boys and 3% for girls; the combined prevalence rate was 12%. Italian children exhibited rates of hyperactive behaviors similar to those of children in New Zealand, Spain, and portions of the United States. Nevertheless, rates of hyperactivity are influenced by ethnic and cultural factors, and differences in prevalence rates may be expected in many situations. Factor structures of the Conners' Teacher Rating Scale for boys and girls were different. The need for separate factor analyses for males and females is stressed; hyperactivity and conduct problems, in fact, were separate factors for girls whereas such behaviors were subsumed under one factor for boys. There were also important similarities and differences with the factor structures for boys and girls in Italy and Spain. Methodological issues such as complete specification of the sample and assuring representativeness of samples are discussed.

Attention Deficit Disorder with Hyperactivity↗