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Toohey BG, Quinlan E, Reece J, Wootton BM, Paparo J. A preliminary study of factors associated with accommodation of obsessive-compulsive symptoms by romantic partners. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2024. [PMID: 39189587 DOI: 10.1111/bjc.12499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 08/05/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVES The accommodation of symptoms of obsessive-compulsive disorder (OCD) by loved ones is highly prevalent and impactful on treatment outcomes; however, little is known about factors that influence accommodation by romantic partners of OCD sufferers. The aim of this preliminary investigation was to explore such correlates. METHODS A community sample of 50 patients self-identifying with OCD (Mage = 29.3; SD = 9.3; 74% female) and 20 individuals self-identifying as the partner of someone with OCD (Mage = 32.1; SD = 12.4; 65% female) participated in this study via an online questionnaire. RESULTS Associations were found between partner accommodation of OCD and a range of obsessions and compulsions across the patient and partner samples, as well as patient-reported symptom severity, functional impairment and negative emotion states. Neuroticism was also positively associated with partner accommodation in the patient sample but did not contribute to its prediction over and above other known correlates of family accommodation. In the partner sample, extraversion was found to be a unique negative correlate of partner accommodation. CONCLUSIONS These findings highlight the vital role both patient and partner factors play in the accommodation of OCD behaviours by romantic partners and the importance of involving loved ones in the treatment of individuals with OCD.
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Affiliation(s)
- Brianna G Toohey
- Psychological Sciences, Australian College of Applied Professions, Sydney, New South Wales, Australia
| | - Elly Quinlan
- Psychological Sciences, Australian College of Applied Professions, Sydney, New South Wales, Australia
- School of Psychological Sciences, University of Tasmania, Launceston, Tasmania, Australia
| | - John Reece
- Psychological Sciences, Australian College of Applied Professions, Sydney, New South Wales, Australia
| | - Bethany M Wootton
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Josephine Paparo
- Psychological Sciences, Australian College of Applied Professions, Sydney, New South Wales, Australia
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
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2
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Pascual-Sánchez A, Jenaro C, Montes JM. Performance of a measure to assess distress in bipolar disorder. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:209-214. [PMID: 32682666 DOI: 10.1016/j.rpsm.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/25/2020] [Accepted: 05/16/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Bipolar disorder is a condition that causes distress even for euthymic patients, having an impact on functional capabilities and quality of life. Personal and social variables are potential sources of distress. Yet, there is a lack of measures to identify specific distress in bipolar disorder. This study describes the development and evaluation of a brief measure for assessing distress in patients with bipolar disorder. We also identify associations with related constructs such as functioning, stigma, and personal beliefs regarding mental illness. MATERIAL AND METHODS We used a sample of 101 euthymic bipolar outpatients. Psychological assessment consisted of the Young Mania Rating Scale (YMRS) and the Hamilton Depression Scale (HAM-D) to establish euthymia. Distress was assessed with Distress on Bipolar Patients-Short (DISBIP-S); associated variables were assessed with the Functioning Assessment Short Scale (FAST), the Internalized Stigma of Mental Illness (ISMI), and the Personal Beliefs about Illness Questionnaire (PBIQ). RESULTS The DISBIP-S has strong internal consistency (Cronbach's alpha=0.90), and medium-high correlation coefficients with the time since last relapse (r=-0.401), predominant polarity (r=0.309), HDRS (r=-0.644), FAST (r=0.453), ISMI (r=0.789), and PBIQ (r=-0.796). Taken together, the scores on the ISMI, and PBIQ and the time since last relapse together explain 69.2% of the variability in distress. CONCLUSIONS The DISBIP-S can be used as a first step to develop interventions aimed at dealing with problematic personal beliefs and interpersonal sources of distress. Reducing distress experienced by bipolar disorder patients could help improve their quality of life and daily functioning.
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Affiliation(s)
| | | | - José Manuel Montes
- Service of Psychiatry, University Hospital Ramón y Cajal, CIBERSAM, IRYCIS, University of Alcala, Madrid, Spain
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Bäckström B, Rask O, Knutsson J. Adolescent and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorders: An Open Trial and Individual Trajectories Study in Routine Psychiatric Care. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01504-1. [PMID: 36849847 DOI: 10.1007/s10578-023-01504-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/04/2023] [Indexed: 03/01/2023]
Abstract
Psychosocial treatments improve outcome in Pediatric bipolar disorder (PBD), but few are developed specifically for adolescents and none has been evaluated in Europe. This study evaluates family-focused cognitive-behavioral therapy for adolescents (ages 13-18) with PBD in routine psychiatric care in Sweden, adapted for teenagers in a European setting from the Child and Family-Focused Cognitive Behavioral Therapy for PBD (ages 8-12) developed in the US. In a repeated-measure open trial, psychosocial functioning, depression, skills and knowledge about PBD, and family climate were assessed at pre-treatment, post-treatment, and after 6 months. Assessments were made by adolescents (n = 45), parents (n = 61) and clinicians. Both group statistics and individual trajectories are reported. Psychosocial function, as rated by parents and clinicians, improved at post-treatment, and parents reported less mania and improved family climate at post-treatment. Both parents and adolescents reported improved skills and knowledge. Most results after treatment showed medium effect sizes. Significant improvements were seen in most individual trajectories, however no change and even deterioration was observed in some. The present trial shows that AFF-CBT is well accepted and associated with improved psychosocial function in adolescents and improved skills and knowledge about PBD in adolescents and their parents. Regarding mood symptoms and family climate the results showed more individual variability, indicating that adjustments in delivery of the treatment according to the unique patient could be of importance. AFF-CBT seems to be a valuable addition to pharmacological treatments in PBD.
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Affiliation(s)
- Beata Bäckström
- Department of Psychosis and Bipolar Disorders, Clinic for Child and Adolescent Psychiatry, Skane University Hospital, Region Skane, Lovisastigen 13, 22185, Lund, Sweden.
| | - Olof Rask
- Child and Adolescent Psychiatry, Department of Clinical Sciences Lund, Lund University, Skane University Hospital, Lund, Sweden
| | - Jens Knutsson
- Department of Psychology, Lund University, Lund, Sweden
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Svendsen ML, Ellegaard T, Jeppesen KA, Riiskjær E, Nielsen BK. Family involvement and patient-experienced improvement and satisfaction with care: a nationwide cross-sectional study in Danish psychiatric hospitals. BMC Psychiatry 2021; 21:190. [PMID: 33849472 PMCID: PMC8042926 DOI: 10.1186/s12888-021-03179-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 03/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Randomised controlled trials suggest that family therapy has a positive effect on the course of depression, schizophrenia and anorexia nervosa. However, it is largely unknown whether a positive link also exists between caregiver involvement and patient outcome in everyday psychiatric hospital care, using information reported directly from patients, i.e. patient-reported experience measures (PREM), and their caregivers. The objective of this study is to examine whether caregiver-reported involvement is associated with PREM regarding patient improvement and overall satisfaction with care. METHODS Using data from the National Survey of Psychiatric Patient Experiences 2018, we conducted a nationwide cross-sectional study in Danish psychiatric hospitals including patients and their caregivers who had been in contact with the hospital (n = 940 patients, n = 1008 caregivers). A unique patient identifier on the two distinct questionnaires for the patient and their caregiver enabled unambiguous linkage of data. In relation to PREM, five aspects of caregiver involvement were analysed using logistic regression with adjustment for patient age, sex and diagnosis. RESULTS We consistently find that high caregiver-reported involvement is statistically significantly associated with high patient-reported improvement and overall satisfaction with care with odds ratios (OR) ranging from 1.69 (95% confidence interval (CI) 0.95-2.99) to 4.09 (95% CI 2.48-6.76). This applies to the following aspects of caregiver-reported involvement: support for the patient-caregiver relationship, caregiver information, consideration for caregiver experiences and the involvement of caregivers in decision making. No statistically significant association is observed regarding whether caregivers talk to the staff about their expectations for the hospital contact. CONCLUSION This nationwide study implies that caregiver involvement focusing on the patient-caregiver relationship is positively associated with patient improvement and overall satisfaction with care in everyday psychiatric hospital care.
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Affiliation(s)
| | - Trine Ellegaard
- Aarhus University Hospital, Psychiatry, Psychosis Research Unit, Palle Juul-Jensens Boulevard 175, 8200, Aarhus, Denmark
- The Research Centre for Patient Involvement, Aarhus University & the Central Denmark Region, Bartholins Allé 2, 8000, Aarhus, Denmark
| | | | - Erik Riiskjær
- DEFACTUM, Central Denmark Region, Olof Palmes Allé 15, 8200, Aarhus, Denmark
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Weintraub MJ, Posta F, Arevian AC, Miklowitz DJ. Using machine learning analyses of speech to classify levels of expressed emotion in parents of youth with mood disorders. J Psychiatr Res 2021; 136:39-46. [PMID: 33549901 PMCID: PMC8009823 DOI: 10.1016/j.jpsychires.2021.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/05/2021] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Expressed emotion (EE), a measure of attitudes among caregivers towards a patient with a psychiatric disorder, is a robust predictor of relapse across mood and psychotic disorders. Because the measurement of EE is time-intensive and costly, its use in clinical settings has been limited. In an effort to automate EE classification, we evaluated whether machine learning (ML) applied to lexical features of speech samples can accurately categorize parents as high or low in EE and in its subtypes (criticism, overinvolvement, and warmth). The sample was 123 parents of youth who had active mood symptoms and a family history of bipolar disorder. Using ML algorithms, we achieved 75.2-81.8% accuracy (sensitivities of ~0.7 and specificities of ~0.8) in classifying parents as high or low in EE and EE subtypes. Additionally, machine-derived EE classifications and observer-rated EE classifications had simiar relationships with youth mood symptoms, parental distress, and family conflict. Of note, criticism related to greater manic severity, parental distress, and family conflict. Study findings indicate that EE classification can be automated through lexical analysis and suggest potential for facilitating larger-scale applications in clinical settings. The results also provide initial indications of the digital phenotypes that underlie EE and its subtypes.
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A qualitative exploration of how people with bipolar disorder consider risk-taking in everyday decisions. Behav Cogn Psychother 2020; 49:314-327. [PMID: 33334387 DOI: 10.1017/s1352465820000946] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Difficulties with decision making and risk taking in individuals with bipolar disorder (BD) have been associated with mood episodes. However, there is limited information about these experiences during euthymia, the mood state where people with BD spent the majority of their time. AIMS To examine how individuals with BD consider risk in everyday decisions during their euthymic phase. METHOD We conducted a qualitative study that used semi-structured audio recorded interviews. Eight euthymic participants with confirmed BD were interviewed, and we used interpretative phenomenological analysis to analyse the data. RESULTS We identified four themes. The first theme, 'Who I really am', involves the relationship between individual identity and risks taken. The second theme, 'Taking back control of my life', explored the relationship between risks taken as participants strove to keep control of their lives. The third theme, 'Fear of the "what ifs"', represents how the fear of negative consequences from taking risks impacts risk decisions. Finally, the fourth theme, 'The role of family and friends', highlights the important role that a supporting network can play in their lives in the context of taking risks. CONCLUSIONS The study highlights aspects that can impact on an individual with BD's consideration of risk during euthymia. Identity, control, fear and support all play a role when a person considers risk in their decision-making process, and they should be taken into consideration when exploring risk with individuals with BD in clinical settings, and inform the design of future interventions.
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Renshaw KD, Allen ES, Fredman SJ, Giff ST, Kern C. Partners' motivations for accommodating posttraumatic stress disorder symptoms in service members: The reasons for accommodation of PTSD scale. J Anxiety Disord 2020; 71:102199. [PMID: 32097730 PMCID: PMC10733866 DOI: 10.1016/j.janxdis.2020.102199] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/27/2019] [Accepted: 02/10/2020] [Indexed: 11/25/2022]
Abstract
Emerging research reinforces the importance of partner accommodation in the interpersonal context of posttraumatic stress disorder (PTSD). A better understanding of partners' motivations for accommodation is needed to help refine or design interventions that target accommodation. To explore partners' motivations, we created the Reasons for Accommodation of PTSD Scale (RAPS) and evaluated it in 263 female partners of male Army soldiers who had returned from a deployment within the past 2 years. Soldiers completed a measure of military-related PTSD, and partners completed a measure of accommodation and the newly created RAPS. Factor analysis of the RAPS yielded a clear, 3-factor solution suggesting the following reasons for accommodating: (1) Relationship & Obligation, or a desire for positive relationship outcomes and a sense of duty or responsibility; (2) Helping Recovery, or a belief that avoidance was helpful for the service member; and (3) Conflict Avoidance/Helplessness, or a desire to avoid conflict or simply not knowing what else to do. Analyses of these factors in relation to soldiers' PTSD clusters indicated that hyperarousal symptoms were uniquely associated with relationship and obligation motivations, re-experiencing symptoms were uniquely associated with helping recovery motivations, and emotional numbing symptoms were uniquely associated with conflict avoidance and helplessness motivations. Furthermore, conflict avoidance and helplessness accounted for the greatest variance in partners' accommodation frequency and distress. Assessment of partners' accommodative behaviors, as well as their motivations for engaging in accommodation, may aid in treatment planning and enhance outcomes for couples in which one individual has PTSD.
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Affiliation(s)
- Keith D Renshaw
- Department of Psychology, George Mason University, United States.
| | - Elizabeth S Allen
- Department of Psychology, University of Colorado Denver, United States
| | - Steffany J Fredman
- Department of Human Development and Family Studies, The Pennsylvania State University, United States
| | - Sarah T Giff
- Department of Psychology, George Mason University, United States
| | - Catherine Kern
- Department of Psychology, University of Colorado Denver, United States
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Abstract
After obtaining a sample of published, peer-reviewed articles from journals with high and low impact factors in social, cognitive, neuro-, developmental, and clinical psychology, we used a priori equations recently derived by Trafimow (Educational and Psychological Measurement, 77, 831-854, 2017; Trafimow & MacDonald in Educational and Psychological Measurement, 77, 204-219, 2017) to compute the articles' median levels of precision. Our findings indicate that developmental research performs best with respect to precision, whereas cognitive research performs the worst; however, none of the psychology subfields excelled. In addition, we found important differences in precision between journals in the upper versus lower echelons with respect to impact factors in cognitive, neuro-, and clinical psychology, whereas the difference was dramatically attenuated for social and developmental psychology. Implications are discussed.
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van den Heuvel SCGH, Goossens PJJ, Terlouw C, Schoonhoven L, van Achterberg T. Self-Management Education for Bipolar Disorders: A Hermeneutic-Phenomenological Study on the Tacit Knowledge of Mental Health Nurses. Issues Ment Health Nurs 2019; 40:942-950. [PMID: 31381457 DOI: 10.1080/01612840.2019.1636166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Self-management of bipolar disorder (BD) education is a complex nursing intervention in which patients and informal caregivers are taught to be actively involved in self-monitoring and self-regulating activities. Some studies question if nurses are sufficiently equipped to deliver these educational tasks. Other studies suggest that nurses have gathered their knowledge implicitly by experience, but to date, this tacit knowledge is not described from the experiences of mental health nurses (MHNs) in ambulant BD care. Objective: To detect the tacit knowledge used by MHNs by interpreting their experiences in delivering self-management education to people with BD and their informal caregivers. Methods: A phenomenological-hermeneutical study amongst MHNs (N = 9) from three ambulant BD care clinics in the Netherlands. Face-to-face, open, in-depth interviews guided by a topic list, were conducted and transcribed verbatim prior to the hermeneutical analysis. Findings: We found five categories resembling the complex character of self-management interventions provided by MHNs: Building a trustful collaboration, Starting a dialogue about needs and responsibilities, Explaining BD, Utilizing mood monitoring instruments, and Conceptualizing self-management of BD. Conclusion: Eventually MHNs use tacit knowledge to cope with situations that demand an outside-the-box approach. Self-management education is partially trained and partially mastered through experience. Practice implications: In order to facilitate long-term self-management of BD, the collaboration of a supporting network is essential.
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Affiliation(s)
- S C G H van den Heuvel
- Expertise Centre for Health, Social Care and Technology, Saxion University of Applied Sciences , Deventer , The Netherlands.,Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare , Nijmegen , The Netherlands.,Dimence Group, Center for Mental Health Care, SCBS Bipolar Disorders , Deventer , The Netherlands.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven , Leuven , Belgium
| | - P J J Goossens
- Dimence Group, Center for Mental Health Care, SCBS Bipolar Disorders , Deventer , The Netherlands.,Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, University Centre for Nursing and Midwifery, Ghent University , Ghent , Belgium
| | - C Terlouw
- Expertise Centre for Educational Innovations, Saxion University of Applied Sciences , Deventer , the Netherlands
| | - L Schoonhoven
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University , Utrecht , the Netherlands.,School of Health Sciences, Faculty of Environmental and Life Sciences, University of Southampton , Southampton , UK
| | - T van Achterberg
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare , Nijmegen , The Netherlands.,Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven , Leuven , Belgium
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Lex C, Hautzinger M, Meyer TD. Symptoms, course of Illness, and comorbidity as predictors of expressed emotion in bipolar disorder. Psychiatry Res 2019; 276:12-17. [PMID: 30981096 DOI: 10.1016/j.psychres.2019.03.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 03/29/2019] [Accepted: 03/30/2019] [Indexed: 11/28/2022]
Abstract
High levels of expressed emotions (EE) reflect the amount of criticism and/or over-involvement in families and has been linked to relapse risk in various psychiatric disorders including bipolar disorder (BD). Less clear is which factors contribute to the development and/or maintenance of EE. Therefore, we tested whether patient characteristics, specifically clinical features and personality disorder traits in BD predicted key aspects of EE as assessed by patients and their relatives. Patients with remitted BD and their relatives were asked to complete the Family Attitude Scale (FAS) and the Perceived Criticism Measure (PCM). Patient characteristics were assessed with a variety of measures including SCID I and II. The FAS and PCM shared 25% of the variance for patients and 14% for relatives, suggesting a conceptual overlap, but they may not assess identical constructs. The number of previous mood episodes, current self-rated manic symptoms, and comorbid symptoms of Cluster C personality disorder predicted patient-rated FAS. Relative-rated FAS was only predicted by comorbid symptoms of Cluster A personality disorder. In BD, specific patient characteristics seem to be linked to key aspects of EE even when in remission. However, it might depend whether the patient, his/her relative, or a neutral observer assessed EE.
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Affiliation(s)
- Claudia Lex
- Department of Psychiatry, Villach General Hospital, Nikolaigasse 43, 9500 Villach, Austria.
| | - Martin Hautzinger
- Department of Psychology, Eberhard Karls University, Schleichstrasse 4, 72076 Tuebingen, Germany
| | - Thomas D Meyer
- McGovern Medical School, Department of Psychiatry and Behavioral Sciences, University of Texas HSC at Houston, 1941 East Road (BBSB 3118), Houston, Texas 77054, USA.
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Nuwara AS, Masa'Deh R, Hamdan-Mansour AM, Qhah IK. Risk of Posttraumatic Stress Disorder and Its Relationship With Perceived Social Support Among Family Caregivers of Individuals With Schizophrenia or Bipolar Disorder. J Psychosoc Nurs Ment Health Serv 2019; 57:37-43. [PMID: 30973614 DOI: 10.3928/02793695-20190405-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 02/27/2019] [Indexed: 12/28/2022]
Abstract
A cross-sectional descriptive correlation study was performed to investigate the risk of posttraumatic stress disorder (PTSD) among 300 family caregivers of individuals with schizophrenia or bipolar disorder and examine the relationship between perceived social support and risk of PTSD. The Arabic version of the PTSD Checklist for DSM-5 (APCL-5) was used to investigate risk of PTSD; the Arabic version of the Multidimensional Scale of Perceived Social Support was used to measure perceived social support. Mean score of the APCL-5 was 46.1, indicating risk of PTSD among family caregivers. A negative moderate correlation was found between risk of PTSD and perceived social support. The caring process is demanding and highly stressful, putting family caregivers at risk for PTSD. Social support is crucial in decreasing this risk. [Journal of Psychosocial Nursing and Mental Health Services, 57(8), 37-43.].
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Haider II, Tiwana F, Zohra N, Rehaman KU. Development and validation of assessment of psycho-education of carers questionnaire: An early experience. Pak J Med Sci 2018; 34:1237-1241. [PMID: 30344583 PMCID: PMC6191818 DOI: 10.12669/pjms.345.15710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Objective Psycho-education is an intervention integrating psychotherapeutic and educational strategies. Whilst carer psycho-education is known to aid in psychiatric disorders, at present there is no known tool to assess the degree to which this is routinely provided by mental health professionals. Our objective was to develop and validate a tool, in English, which assesses psycho-education of carers of psychiatric patients in Pakistan. Methods A questionnaire was generated in English. It was pretested on twenty male and female carers and was refined to attain a more reliable version. Sixty bilingual male and female primary carers, who were fluent in English, and had been in a care-giving role for more than three months were requested to complete the developed Questionnaire for the Assessment of Psycho-Education of Carers (APEC) at Fatima Memorial Hospital Psychiatry Out-patient department within a period of four months from December, 2017 to April, 2018. Carers were identified via patients presenting to a psychiatric OPD. Responses were analyzed for reliability and test retest consistency using Cronbach's alpha analysis, Intraclass correlation coefficients, factor analysis and Paired t-test. Results APEC was found to be easily understandable and capable of adequately assessing aspects of psycho-education. A high degree of internal consistency was demonstrated on cronbach's alpha analysis. Cronbach's α coefficient for various domains was sufficiently high ranging from0.76 to 0.960. Similarly, domains of (APEC) were highly correlated. Test-retest reliability was assessed by computing the correlation between Visits 1 and 2 scores. Conclusion The developed questionnaire can adequately assess psycho-education of primary carers in mental health settings.
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Affiliation(s)
- Imran Ijaz Haider
- Prof. Dr. Imran Ijaz Haider, FRCPsych (London) Department of Psychiatry and Behavioral Sciences, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan
| | - Farah Tiwana
- Ms. Farah Tiwana, MSc Mental Health Studies. Department of Psychiatry and Behavioral Sciences, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan
| | - Noor Zohra
- Ms. Noor Zohra, PhD Scholar. Department of Human Development and Family Studies, Govt. College of Home Economics, Lahore, Pakistan
| | - Khaleeq Ur Rehaman
- Prof. Dr. Khaleeq ur Rehaman, FECSM (European Joint Committee). Department of Urology and Andrology, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan
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van den Heuvel SCGH, Meije D, Regeer EJ, Sinnema H, Riemersma RF, Kupka RW. The user experiences and clinical outcomes of an online personal health record to support self-management of bipolar disorder: A pretest-posttest pilot study. J Affect Disord 2018; 238:261-268. [PMID: 29894931 DOI: 10.1016/j.jad.2018.05.069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/21/2018] [Accepted: 05/28/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND Self-management comprises knowledge, behavior, activities and resources providing people with bipolar disorder (BD) control over fluctuating mood and activity-patterns. The 'Self-management and Dialogue in Bipolar Disorder' project entailed the tailoring of an online personal health record (PHR) originally designed for the chronically ill to monitor condition and share information with their clinician to people with BD (PHR-BD). The aim of this study was to evaluate the feasibility, utility and user-experiences of participants with BD, relatives, and healthcare professionals who worked with the PHR-BD. METHODS Post-test online closed- and open ended questionnaires were used to collect information on utility, and user-experiences with PHR-BD. A pre-posttest design to evaluate clinical effects on quality of life, empowerment, symptom reduction, changes in mood and activity, and illness burden and severity at baseline and at 12-months follow-up. RESULTS Sixty-six participants with BD logged in at baseline. At study endpoint thirty-nine participants with BD, eleven professionals and one family caregiver filled out the evaluations. No significant differences in the clinical outcomes from baseline were found. Qualitative evaluations showed a frequent utility of the mood chart modules, improved communication between clinician and participant with BD and, increased insight in influencing factors of mood fluctuations. LIMITATIONS Small convenience sample, no controls. CONCLUSIONS The option to alternate the interface from a prospective to a retrospective mood chart , and integration with the personal crisis plan was considered to be of added value in self-managing BD. The findings of this study will guide the future implementation of the PHR-BD.
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Affiliation(s)
- Silvio C G H van den Heuvel
- Saxion University of Applied Sciences, Expertise Center for Health, Social Care and Technology, Deventer, The Netherlands; Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands; Dimence Group, Center for Mental Health Care, Deventer, The Netherlands; Catholic University of Leuven, Centre for Health Services and Nursing Research, Leuven, Belgium.
| | - Daniëlle Meije
- Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands.
| | - Eline J Regeer
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands.
| | - Henny Sinnema
- Trimbos Institute, Netherlands Institute for Mental Health and Addiction, Utrecht, The Netherlands.
| | - Rixt F Riemersma
- University Groningen, Department of Psychiatry, University Medical Center, Groningen, The Netherlands; Lentis Institute for Mental Health Care, Groningen, The Netherlands.
| | - Ralph W Kupka
- Altrecht Institute for Mental Health Care, Utrecht, The Netherlands; Vrije Universiteit Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands; GGZ InGeest Institute for Mental Health Care, Amsterdam, The Netherlands.
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14
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van den Heuvel S, Goossens P, Terlouw C, Schoonhoven L, van Achterberg T. Informal Caregivers' Learning Experiences With Self-Management Support of Individuals Living With Bipolar Disorder: A Phenomenological Study. J Am Psychiatr Nurses Assoc 2018; 24:531-541. [PMID: 29313419 DOI: 10.1177/1078390317752864] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND The degree of informal caregiver involvement influences the self-management of individuals living with bipolar disorder (BD). OBJECTIVE This article aims to provide a description of informal caregivers' learning experiences in self-management support of BD in order to guide professionals in tailoring future psychosocial and psychoeducational interventions. DESIGN In-depth open interviews with 10 informal caregivers of patients with BD who followed treatment in the context of specialized outpatient bipolar care were conducted. RESULTS Four learning phases emerged from the phenomenological analysis describing the informal caregivers learning process: (1) understanding BD, (2) overcoming the dilemmas in self-management support for individuals living with BD, (3) dividing tasks and responsibilities, and (4) acquiring a personal definition of self-management support for individuals living with BD. CONCLUSION By grasping the concept of BD, informal caregivers gradually learn how to overcome dilemmas resulting from living with someone with BD, and how to control the expression of emotions. They learn to reflect on the nature of conflicts and how to share the responsibilities of illness management with individuals living with BD and professionals. Mastering these skills eventually allows them to define and delimit their supporting informal caregiver role in the self-management of BD. PRACTICE IMPLICATIONS Our findings provide information regarding the educational needs of informal caregivers to tailor counseling, and psychosocial and psychoeducational interventions in specialized outpatient care for individuals living with BD.
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Affiliation(s)
- Silvio van den Heuvel
- 1 Silvio van den Heuvel, MA, RN, Saxion University of Applied Sciences, Deventer, Netherlands; Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, Netherlands; Dimence Group, Deventer, Netherlands; KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium
| | - Peter Goossens
- 2 Peter Goossens, PhD, MANP, RN, FEANS, Dimence, Institute for Mental Healthcare, Deventer, Netherlands; Radboud Institute for Health Sciences, Nijmegen, Netherlands; Institute for the Education of Clinical Nurse Specialists in Mental Health, Utrecht, Netherlands; Ghent University, University Centre of Nursing and Midwifery, Department of Public Health, Faculty of Medicine and Health Services, Ghent, Belgium
| | - Cees Terlouw
- 3 Cees Terlouw, PhD, Saxion University of Applied Sciences, Deventer, Netherlands
| | - Lisette Schoonhoven
- 4 Lisette Schoonhoven, PhD, RN, FEANS, University of Southampton, Southampton, UK
| | - Theo van Achterberg
- 5 Theo van Achterberg, PhD, RN, FEANS, KU Leuven, Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, Leuven, Belgium; Radboud Institute for Health Sciences, Nijmegen, Netherlands; Uppsala University, Uppsala, Sweden
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15
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McArthur BA, Cherry KM, Braimoh G, Lumley MN. An Exploration of Positive Parenting in Relation to Psychopathology for Youth with a Diagnosis of Bipolar Spectrum Disorder. JOURNAL OF THE CANADIAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY = JOURNAL DE L'ACADEMIE CANADIENNE DE PSYCHIATRIE DE L'ENFANT ET DE L'ADOLESCENT 2017; 26:224-232. [PMID: 29056985 PMCID: PMC5642462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Accepted: 06/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Bipolar Spectrum Disorder (BSD) is a severe psychiatric disorder associated with a host of deleterious sequelae. While researchers have found a robust link between parenting variables and psychopathology for youth with BSD, few have examined positive parenting factors and associated psychopathology for these youth. Furthermore, conclusions from extant literature are hindered by a) exploring a limited range of parenting variables and b) employing retrospective reports of parenting with adult populations. This study addressed these gaps by examining how a range of contemporaneously-measured positive parenting variables were related to psychopathology among youth with a BSD diagnosis. METHODS One hundred fifty families with a youth aged 5-16 years participated in this study and completed screening for a mood disorder through a tertiary care facility. Participants completed measures of depression, mania, behavioural difficulties, and the parent-child relationship. RESULTS Parental characteristics (limit setting, autonomy granting, egalitarian views) were related to lower levels of psychopathology for youth screened for BSD. CONCLUSIONS Taken together, the results from this study contribute to our understanding of the relation between positive parenting characteristics and psychopathology for youth with a diagnosis of BSD.
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Affiliation(s)
| | | | - Gani Braimoh
- Child and Parent Resource Institute, London, Ontario
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16
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Salcedo S, Gold AK, Sheikh S, Marcus PH, Nierenberg AA, Deckersbach T, Sylvia LG. Empirically supported psychosocial interventions for bipolar disorder: Current state of the research. J Affect Disord 2016; 201:203-14. [PMID: 27243619 DOI: 10.1016/j.jad.2016.05.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/29/2016] [Accepted: 05/13/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Bipolar disorder requires psychiatric medications, but even guideline-concordant treatment fails to bring many patients to remission or keep them euthymic. To address this gap, researchers have developed adjunctive psychotherapies. The purpose of this paper is to critically review the evidence for the efficacy of manualized psychosocial interventions for bipolar disorder. METHODS We conducted a search of the literature to examine recent (2007-present), randomized controlled studies of the following psychotherapy interventions for bipolar disorder: psychoeducation (PE), cognitive behavioral therapy (CBT), interpersonal and social rhythm therapy (IPSRT), dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT), and family therapies such as family focused therapy (FFT). RESULTS All of the psychotherapy interventions appear to be effective in reducing depressive symptoms. Psychoeducation and CBT are associated with increased time to mood episode relapse or recurrence. MBCT has demonstrated a particular effectiveness in improving depressive and anxiety symptoms. Online psychotherapy interventions, programs combining one or more psychotherapy interventions, and targeted interventions centering on particular symptoms have been the focus of recent, randomized controlled studies in bipolar disorder. CONCLUSIONS Psychotherapy interventions for the treatment of bipolar disorder have substantial evidence for efficacy. The next challenge will to disseminate these psychotherapies into the community.
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Affiliation(s)
- Stephanie Salcedo
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA.
| | - Alexandra K Gold
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sana Sheikh
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Psychology, Suffolk University, Boston, MA, USA
| | - Peter H Marcus
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Andrew A Nierenberg
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Louisa G Sylvia
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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17
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Fischer MS, Baucom DH, Cohen MJ. Cognitive-Behavioral Couple Therapies: Review of the Evidence for the Treatment of Relationship Distress, Psychopathology, and Chronic Health Conditions. FAMILY PROCESS 2016; 55:423-42. [PMID: 27226429 DOI: 10.1111/famp.12227] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Cognitive-behavioral couple therapy (CBCT) is an approach to assisting couples that has strong empirical support for alleviating relationship distress. This paper provides a review of the empirical status of CBCT along with behavioral couple therapy (BCT), as well as the evidence for recent applications of CBCT principles to couple-based interventions for individual psychopathology and medical conditions. Several meta-analyses and major reviews have confirmed the efficacy of BCT and CBCT across trials in the United States, Europe, and Australia, and there is little evidence to support differential effectiveness of various forms of couple therapy derived from behavioral principles. A much smaller number of effectiveness studies have shown that successful implementation in community settings is possible, although effect sizes tend to be somewhat lower than those evidenced in randomized controlled trials. Adapted for individual problems, cognitive-behavioral couple-based interventions appear to be at least as effective as individual cognitive behavioral therapy (CBT) across a variety of psychological disorders, and often more effective, especially when partners are substantially involved in treatment. In addition, couple-based interventions tend to have the unique added benefit of improving relationship functioning. Findings on couple-based interventions for medical conditions are more varied and more complex to interpret given the greater range of target outcomes (psychological, relational, and medical variables).
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Affiliation(s)
- Melanie S Fischer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Matthew J Cohen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
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18
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Miklowitz DJ, Chung B. Family-Focused Therapy for Bipolar Disorder: Reflections on 30 Years of Research. FAMILY PROCESS 2016; 55:483-99. [PMID: 27471058 PMCID: PMC5922774 DOI: 10.1111/famp.12237] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Family-focused therapy (FFT) is an evidence-based intervention for adults and children with bipolar disorder (BD) and their caregivers, usually given in conjunction with pharmacotherapy after an illness episode. The treatment consists of conjoint sessions of psychoeducation regarding bipolar illness, communication enhancement training, and problem-solving skills training. This paper summarizes over 30 years of research on FFT and family processes in BD. Across eight randomized controlled trials with adults and adolescents with BD, FFT and mood-stabilizing medications have been found to hasten recovery from mood episodes, reduce recurrences, and reduce levels of symptom severity compared to briefer forms of psychoeducation and medications over 1-2 years. Several studies indicate that the effects of FFT on symptom improvement are greater among patients with high-expressed emotion relatives. New research focuses on FFT as an early intervention for youth at risk for BD, neuroimaging as a means of evaluating treatment mechanisms, and progress in implementing FFT in community mental health settings.
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Affiliation(s)
- David J Miklowitz
- Department of Psychiatry and Behavioral Sciences, UCLA School of Medicine, Los Angeles, CA.
| | - Bowen Chung
- Department of Psychiatry and Behavioral Sciences, UCLA School of Medicine, Los Angeles, CA
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19
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Fredman SJ, Pukay-Martin ND, Macdonald A, Wagner AC, Vorstenbosch V, Monson CM. Partner accommodation moderates treatment outcomes for couple therapy for posttraumatic stress disorder. J Consult Clin Psychol 2015; 84:79-87. [PMID: 26501498 DOI: 10.1037/ccp0000061] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Partner accommodation of posttraumatic stress disorder (PTSD) symptoms (i.e., altering one's own behaviors to minimize patient distress and/or relationship conflict due to patients' PTSD symptoms) has been shown to be positively associated with patient and partner psychopathology and negatively associated with patient and partner relationship satisfaction cross-sectionally. However, the prognostic value of partner accommodation in treatment outcomes is unknown. The goals of the present study were to determine if partner accommodation decreases as a function of couple therapy for PTSD and if pretreatment partner accommodation moderates the efficacy of couple therapy for PTSD. METHOD Thirty-nine patients with PTSD and their intimate partners (n = 39) were enrolled in a randomized controlled trial of cognitive-behavioral conjoint therapy (CBCT) for PTSD (Monson & Fredman, 2012) and received CBCT for PTSD immediately or after 3 months of waiting. Blinded assessors determined clinician-rated PTSD symptoms and patient-rated PTSD and depressive symptoms and relationship satisfaction at baseline, midtreatment/4 weeks of waiting, and posttreatment/12 weeks of waiting. RESULTS Contrary to expectation, partner accommodation levels did not change over time for either treatment condition. However, baseline partner accommodation significantly moderated treatment outcomes. Higher levels of partner accommodation were associated with greater improvements in PTSD, depressive symptoms, and relationship satisfaction among patients receiving CBCT for PTSD compared with waiting list. At lower levels of partner accommodation, patients in both groups improved or remained at low levels of these outcomes. CONCLUSIONS Individuals with PTSD who have more accommodating partners may be particularly well-suited for couple therapy for PTSD.
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Affiliation(s)
- Steffany J Fredman
- Department of Human Development and Family Studies, The Pennsylvania State University
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20
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Masland SR, Hooley JM. Perceived criticism: A research update for clinical practitioners. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/cpsp.12110] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Miklowitz DJ, Chambless DL. Perceived criticism: Biased patients or hypercritical relatives? Commentary on “perceived criticism: A research update for clinical practitioners”. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2015. [DOI: 10.1111/cpsp.12108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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22
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Miziou S, Tsitsipa E, Moysidou S, Karavelas V, Dimelis D, Polyzoidou V, Fountoulakis KN. Psychosocial treatment and interventions for bipolar disorder: a systematic review. Ann Gen Psychiatry 2015; 14:19. [PMID: 26155299 PMCID: PMC4493813 DOI: 10.1186/s12991-015-0057-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Accepted: 06/29/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is a chronic disorder with a high relapse rate, significant general disability and burden and with a psychosocial impairment that often persists despite pharmacotherapy. This indicates the need for effective and affordable adjunctive psychosocial interventions, tailored to the individual patient. Several psychotherapeutic techniques have tried to fill this gap, but which intervention is suitable for each patient remains unknown and it depends on the phase of the illness. METHODS The papers were located with searches in PubMed/MEDLINE through May 1st 2015 with a combination of key words. The review followed the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement. RESULTS The search returned 7,332 papers; after the deletion of duplicates, 6,124 remained and eventually 78 were included for the analysis. The literature supports the usefulness only of psychoeducation for the relapse prevention of mood episodes and only in a selected subgroup of patients at an early stage of the disease who have very good, if not complete remission, of the acute episode. Cognitive-behavioural therapy and interpersonal and social rhythms therapy could have some beneficial effect during the acute phase, but more data are needed. Mindfulness interventions could only decrease anxiety, while interventions to improve neurocognition seem to be rather ineffective. Family intervention seems to have benefits mainly for caregivers, but it is uncertain whether they have an effect on patient outcomes. CONCLUSION The current review suggests that the literature supports the usefulness only of specific psychosocial interventions targeting specific aspects of BD in selected subgroups of patients.
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Affiliation(s)
- Stella Miziou
- Aristotle University of Thessaloniki, Thessaloníki, Greece
| | | | | | - Vangelis Karavelas
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Street (1st Parodos, Ampelonon Str.), Pournari Pylaia, 55535 Thessaloníki, Greece
| | - Dimos Dimelis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Street (1st Parodos, Ampelonon Str.), Pournari Pylaia, 55535 Thessaloníki, Greece
| | | | - Konstantinos N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos Street (1st Parodos, Ampelonon Str.), Pournari Pylaia, 55535 Thessaloníki, Greece
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23
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Fredman SJ, Vorstenbosch V, Wagner AC, Macdonald A, Monson CM. Partner accommodation in posttraumatic stress disorder: initial testing of the Significant Others' Responses to Trauma Scale (SORTS). J Anxiety Disord 2014; 28:372-81. [PMID: 24816277 PMCID: PMC4339021 DOI: 10.1016/j.janxdis.2014.04.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 03/28/2014] [Accepted: 04/01/2014] [Indexed: 11/30/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with myriad relationship problems and psychological distress in partners of individuals with PTSD. This study sought to develop a self-report measure of partner accommodation to PTSD (i.e., ways in which partners alter their behavior in response to patient PTSD symptoms), the Significant Others' Responses to Trauma Scale (SORTS), and to investigate its reliability and construct validity in 46 treatment-seeking couples. The SORTS demonstrated strong internal consistency and associations with individual and relationship distress. Accommodation was positively correlated with partners' ratings of patients' PTSD symptoms, patient self-reported depressive and trait anger severity, and partner self-reported depressive and state anger severity. Accommodation was negatively correlated with patient and partner relationship satisfaction and partners' perceived social support received from patients. Findings suggest that accommodation may be an attempt to adapt to living with a partner with PTSD but may have negative implications for patient and partner well-being.
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Affiliation(s)
- Steffany J Fredman
- Department of Human Development and Family Studies, The Pennsylvania State University, 315 Health and Human Development East, University Park, PA 16802, USA.
| | - Valerie Vorstenbosch
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
| | - Anne C Wagner
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
| | - Alexandra Macdonald
- Women's Health Sciences Division, National Center for PTSD, 150 South Huntington Avenue, Jamaica Plain, MA 02130, USA; Department of Psychiatry, Boston University School of Medicine, USA.
| | - Candice M Monson
- Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada.
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