Affective disorders

Couple and family interventions for depressive and bipolar disorders: Evidence base update (2010-2019)

This article systematically reviews the evidence base for couple and family interventions for depressive and bipolar disorders published from 2010 to 2019. Included in the review were intervention studies on depression for couples (n = 6), depression for families (n = 13), and bipolar for families (n = 5); zero studies on couple interventions for bipolar were located. Well-established interventions include cognitive and/or behavioral couple and family interventions for depression and psychoeducational family interventions for bipolar. Attachment-based couple and family interventions for depression are probably efficacious. Finally, family psychoeducation for depression is possibly efficacious, and integrative couple interventions and family play-based interventions for depression are experimental. Couple and family interventions also improved relationship dynamics, which is noteworthy since poor relationships are associated with non-remission, relapse, and recurrence of depressive and bipolar symptoms. Future research is needed on couple interventions for bipolar disorders and interventions for minoritized populations.

An exploratory investigation of marital functioning and order of spousal onset in couples concordant for psychopathology

Individuals with a psychiatric disorder are significantly more likely to have a spouse with a clinical diagnosis--marital concordance. We used a community sample of 304 couples concordant for either major depressive disorder (MDD) or substance use disorders (SUDs) to examine the relationship between marital functioning and gendered patterns of mental health diagnosis onset. For SUD concordance, couples in which wives onset before husbands--despite typical later onset for men--reported lower levels of marital satisfaction compared with couples in which the husband onset first. For MDD concordance, couples in which husbands onset with depression before wives--despite typical later onset for men--reported lower levels of marital satisfaction. These results suggest that for couples concordant for mental diagnoses, it is most problematic for marital functioning for one partner to have an atypically early onset. Implications for treatment targets in marital therapy are discussed.

Affective disorders

Depression is a heterogeneous disorder with lifetime prevalence of "major depressive disorder" estimated to be 16.2%. Although the disorder is common and impairs functioning, it often goes untreated, with less than adequate response even when treated. We review research indicating the likely value of utilizing currently available, well-validated, couple- and family-based treatments with depressed individuals, and we provide empirically based treatment decision rules to guide effective application of marital and family interventions for depression in clinical practice. We suggest that traditional forms of couple-based intervention may be most appropriate for discordant, depressed couples, whereas nondiscordant, or mildly distressed, depressed couples may respond well to forms of intervention that have become available more recently and which focus on strengthening the dyad as a source of support. We also discuss parent training as an intervention for depression and describe briefly the directions for future research to enhance couple-based treatment for depression.

Family factors are associated with psychological distress and smoking status in chronic obstructive pulmonary disease

OBJECTIVE

The objective of this study was to test three hypotheses in a sample of individuals with chronic obstructive pulmonary disease (COPD): (1) unsupportive family relationships are associated with psychological distress, (2) psychological distress is associated with smoking status and (3) unsupportive family relationships are indirectly associated with smoking status via psychological distress.

METHOD

Cross-sectional data were collected via self-report questionnaires completed by 455 individuals with COPD who had at least a 10-pack-year smoking history. The hypotheses were tested with structural equation modeling.

RESULTS

All three hypotheses were supported. Unsupportive family relationships were associated with psychological distress (β=.67, P<.001), psychological distress was associated with smoking status (β=.40, P<.001), and unsupportive family relationships were indirectly associated with smoking status via psychological distress (β=.27, P<.001).

CONCLUSION

Results of this study suggest that family relationships are an important factor to include in future longitudinal research that attempts to elucidate social and psychological influences on smoking behavior.

The role of family therapists in veterinary medicine: opportunities for clinical services, education, and research

Marriage and family therapists (MFTs) are applying their specific skill set in a variety of arenas. A new area for collaboration is veterinary medicine. The veterinary medical profession is emphasizing the importance of non-biomedical skills such as communication skills, acknowledging that human clientele are likely to view their pets as family members, and discussing veterinarian personal well-being. Each of these trends has clear application for intervention by MFTs. A discussion of how MFTs may be uniquely positioned to assist veterinary medicine is presented. An example of collaboration between MFT and veterinary medicine at Kansas State University is highlighted. Recommendations are made for development of effective educational relationships and possible private sector collaborations.

Panning for gold: a clinician's guide to using research

The gap between research and clinical practice is one of the key challenges facing family therapy. Clinicians often fail to incorporate research findings into their practice because they do not know how to search, evaluate, or apply research to their clinical work. The purpose of this article is to help clinicians become better consumers of research. This article explores the potential value of research to clinicians, as well as negative beliefs that clinicians may have about research. The article also describes how clinicians can use research to inform their clinical work, as well as potential challenges that can be encountered.