Biomedical subjects
Publications and source records attributed to N S Jacobson.
The purpose of this article is to present a framework that reconciles the goals of advocates for victims of domestic violence with the goals of clinical researchers who study this phenomenon. I will be discussing the tension between those goals, and the way a research model can complement advocacy goals.
To better understand the relationship dynamics of couples experiencing husband-to-wife violence, the interaction patterns of 29 domestically violent (DV), 15 distressed but nonviolent (DNV), and 13 happily married (HM) couples were examined using the Marital Interaction Coding System and lag sequential analyses. DV spouses were generally more often aversive and less often facilitative than nonviolent couples. DV couples were significantly more likely to engage in negative reciprocity than their DNV or their HM counterparts. DV wives were as likely as their husbands to reciprocate negative behavior. Furthermore, no support was found for a negative reinforcement hypothesis that husbands' aversiveness was shaped or maintained by wives' capitulation.
This study hypothesized that power discrepancies in the marital relationship, where the husband is subordinate, serve as risk factors for husband-to-wife violence. The construct of marital power was assessed from 3 power domains operationalized by discrepancies in economic status, decision-making power, communication patterns, and communication skill. Three groups of married couples (N = 95) were compared: domestically violent (DV), maritally distressed/nonviolent (DNV), and maritally happy/nonviolent (HNV). DV couples were more likely than the 2 nonviolent groups to engage in husband demand/wife withdraw interactions. Within the DV group, husbands who had less power were more physically abusive toward their wives. Thus, violence may be compensatory behavior to make up for husbands' lack of power in other arenas of marriage. Difficulties in assessing marital power and future direction for the study of power and violence are discussed.
This article discusses the outcome and process research on couple therapy and integrates the articles special section "Couples and Couple Therapy" into the discussion. All tested couple treatments show statistically significant effects relative to control groups, but there are no reliable differences between different theoretical models. Moreover, all tested approaches leave substantial numbers of couples unimproved or at least still somewhat distressed. A discussion of the strengths and weaknesses of various designs concludes that within-model comparisons have been more productive in producing knowledge than between-model comparisons. Recommendations for future research include developing a technology that would make possible matching studies focusing on Aptitude x Treatment interactions. Also, there needs to be greater emphasis on basic research and prevention.
This study investigated the effects of behavioral couple therapy, cognitive-behavioral therapy, and their combination on female depression 6 and 12 months after therapy ended. We predicted that couples receiving a behavioral couple treatment would be less likely to relapse than those receiving a cognitive-behavioral treatment for the depressed spouse alone. Relapse rates, however, did not discriminate between treatments at any follow-up point. Reductions in husband and wife dysphoria and increases in wife facilitative behavior during therapy predicted recovery. Moreover, high rates of husbands' facilitative behavior at posttest were associated with wife recovery and predicted low levels of depression at the 1-year follow-up.
Manipulation checks should be used in psychotherapy trials to confirm that therapists followed the treatment manuals and performed the therapy competently. This article is a review of some strategies that have been used to document treatment integrity; also, their limitations are discussed here. Recommendations for improving these checks are presented. Specific guidelines are offered regarding when and how to assess both therapist adherence to treatment protocols and competence.
Data regarding the prevalence of violence among subjects recruited for nonviolent control groups in five studies are presented. These studies examined subjects recruited using a variety of methods, including couples seeking marital therapy and couples recruited from newspaper advertisements. Across the studies, it appears that up to one-third of maritally nondistressed couples and one-half of maritally distressed couples report that husband violence has occurred in their relationship. The implications of these data for the recruitment of control groups in future studies of marital violence are discussed, and questions regarding the ease of recruiting nonviolent couples for control groups are raised.
In 1984, Jacobson, Follette, and Revenstorf defined clinically significant change as the extent to which therapy moves someone outside the range of the dysfunctional population or within the range of the functional population. In the present article, ways of operationalizing this definition are described, and examples are used to show how clients can be categorized on the basis of this definition. A reliable change index (RC) is also proposed to determine whether the magnitude of change for a given client is statistically reliable. The inclusion of the RC leads to a twofold criterion for clinically significant change.
The purpose of this study was to compare cognitive-behavioral therapy (CT; n = 20), behavioral marital therapy (BMT; n = 19), and a treatment combining BMT and CT (CO; n = 21) in the alleviation of wives' depression and the enhancement of marital satisfaction. BMT was less effective than CT for depression in maritally nondistressed couples, whereas for maritally distressed couples the two treatments were equally effective. BMT was the only treatment to have a significant positive impact on relationship satisfaction in distressed couples, whereas CO was the only treatment to enhance the marital satisfaction of nondistressed couples. On marital interaction measures CO was the only treatment to significantly reduce both husband and wife aversive behavior and to significantly increase wife facilitative behavior.
Snyder, Wills, and Grady-Fletcher (1991) reported a 4-year follow-up comparing insight-oriented (IOMT) with behavioral marital therapy (BMT). The effects of IOMT were more durable than those of BMT. These comments question the adequacy with which the two treatments were represented. The BMT treatment manual adequately represents behavioral technology as it existed in 1980 but fails to include more recent clinical innovations. The IOMT treatment manual includes many clinical skills that are integral to BMT but not included in the BMT manual. Documentation is provided that therapists in the BMT condition were not using these important techniques. These and other questions regarding the adequacy of training and supervision may have compromised the integrity of BMT. Nevertheless, the findings do suggest that traditional BMT technology alone may be neither necessary nor sufficient for long-term change.
In this article, patterns of marital interaction as a function of depression and marital satisfaction are examined. The purpose of the study was to separate dysfunctional marital interaction patterns that were unique to depression from those that were associated with marital distress. The presence or absence of a depressed wife was crossed with level of marital satisfaction (distressed or nondistressed) to produce four groups of subject couples. Couples in which the wife was depressed exhibited more depressive behavior than did nondepressed couples, but only during discussion of a high conflict (as opposed to neutral) topic. Sex X Depression Level X Marital Satisfaction interactions were found for aggressive behavior: Depressed women in nondistressed relationships exhibited behavior that was characteristic of maritally distressed couples (high rates of aggression). In contrast, the husbands of these women exhibited behavior that one would expect in happily married couples (low rates of aggression). We failed to replicate previous findings that depressive behavior served a coercive function, although distressed couples, regardless of depression status, exhibited all the usual signs of negative dysfunctional interaction. In general, the findings suggested that marital distress rather than depression per se may be responsible for the dysfunctional interaction patterns frequently observed in depressed couples.
The purpose of this study was to compare our structured research-based version of marital therapy from a social learning perspective with a clinically flexible version of the same treatment where treatment plans were individually-based and there was no specific number of treatment sessions. Thirty distressed married couples were randomly assigned to one of these two treatments. Assessment of outcome was based on global marital satisfaction, spouse reports of functioning in specific areas, and direct observational measures of communication. At posttest there were no differences in efficacy between structured and flexible treatments, although both treatments led to significant improvements. At a 6-month follow-up couples treated with the structured format were more likely to have deteriorated and flexibly treated couples were more likely to have maintained their treatment gains.
This article examines the literature on marital therapy and spouse involvement as treatments for major psychopathology. The focus is on three disorders that have attracted a sufficient number of empirical findings: depression, agoraphobia, and alcoholism. For each of these disorders, we first examine the relation between marital dynamics and the disorder and next discuss empirical efforts to evaluate the impact of marital therapy or spouse involvement on the disorder. In addition, we summarize trends and suggest methodological refinements for future research.
This study was conducted to identify therapist and client behaviors associated with a positive response to social learning-based behavioral marital therapy. A sample of 32 couples receiving treatment was examined. Immediately after each therapy session, the therapist, husband, and wife independently completed process rating forms that measured therapist and client behaviors during the session. Composite scales, derived from these ratings, were entered into multiple regression equations to examine their relationship with posttherapy marital satisfaction. After controlling for pretherapy marital satisfaction and the other predictor variables, therapists', husbands', and wives' ratings of positive client behavior (i.e., collaboration, active participation, and homework compliance) were positively associated with therapy outcome. Implications for marital therapy and suggestions for future research are discussed.
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This study examined the extent to which causal attributions were predictive of depressed mood in college students who experienced a negative event. In a replication and extension of a study by Metalsky, Abramson, Seligman, Semmel, and Peterson (1982), we evaluated students' attributional style and their attributions for an examination performance in the college classroom. Additionally, an indirect probe was used to assess unsolicited attributions. Subjects were asked about their plans to prepare for the next examination in order to test for the motivational deficits predicted by the reformulated learned helplessness (RLH) model. Unlike Metalsky et al., attributional style did not predict depressed mood following a disappointing examination performance. Attributions for the particular examination performance were predictive of depressed mood for students who were disappointed in their examination performance. Few subjects, 31%, gave attributions in response to the indirect probe, and there was no support for the prediction that unexpected negative events would lead to subjects' making more attributions. Internal, stable, and global attributions for poor examination performance resulted in students making more plans to study for the next examination, a finding contrary to what is predicted by the RLH model.
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Explore the source record for details and available documents.