Beyond the "Self in Self-Efficacy: Spouse Confidence Predicts Patient Survival Following Heart Failure.

Ratings of patient efficacy to manage illness, made by 191 congestive heart failure patients and their spouses, were examined as predictors of patients' survival over the next 4 years. When considered alone, both the patient's self-efficacy and the spouse's confidence ratings predicted survival, but only spouse confidence remained significant when both partners" efficacy ratings were included in the same Cox regression model. The overlapping prognostic significance of spouse confidence and a global, multicomponent measure of marital quality positioned the former as a proxy for the latter, reflecting a fundamentally social protective factor in patient survival. Successful adaptation to heart failure appears to involve more than the patient's personal agency, and psychosocial data from spouses can improve prediction of patient outcomes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirically supported couple and family interventions for marital distress and adult mental health problems.

This article evaluates the efficacy, effectiveness, and clinical significance of empirically supported couple and family interventions for treating marital distress and individual adult disorders, including anxiety disorders, depression, sexual dysfunctions, alcoholism and problem drinking, and schizophrenia. In addition to consideration of different theoretical approaches to treating these disorders, different ways of including a partner or family in treatment are highlighted: (a) partner–family-assisted interventions, (b) disorder-specific partner–family interventions, and (c) more general couple–family therapy. Findings across diagnostic groups and issues involved in applying efficacy criteria to these populations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification of patients at risk for nonresponse and negative outcome in psychotherapy.

This study evaluated the use of pretherapy patient variables as correlates of 3 categorical types of outcome: negative response (negative change of more than 1 normative SEest on depression measure): nonresponse (change within?±?1 SEest on depression measure); and positive response (positive change of more than 1 SEest on depression measure) to psychotherapy among 62 patients with major depressive disorder. By using 4 scales from the Brief Symptom Inventory, the Inventory of Interpersonal Problems, age, and sex, 75.8% of the Ss were correctly classified into the 3 groups. Negative responders were characterized by high levels of interpersonal difficulty and low levels of subjective distress. Nonresponders displayed moderate levels of both interpersonal difficulties and subjective distress. Positive responders displayed high levels of both interpersonal difficulties and subjective distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couples coping with congestive heart failure: Role and gender differences in psychological distress.

Psychological distress and marital quality were assessed with male (n=128) and female (n=49) congestive-heart-failure (CHF) patients and their spouses. Hopkins Symptom Check List-25 scores were in the distressed range for 57% of patients and 40% of spouses. This role difference was greater for men than for women, and a gender difference (more distress in women than men) was greater for spouses than for patients. The patient's distress, but not the spouse's, reflected the severity of the patient's illness, and distress for both partners correlated negatively with ratings of marital quality. Female-patient couples reported better relationship quality than male-patient couples, however, and a mediation analysis indicated that the gender difference in spouse distress could be explained by marital quality. Results highlight the contextual nature of CHF distress and suggest that role differences in distress vary by gender. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Demand–withdraw couple interaction moderates retention in cognitive–behavioral versus family-systems treatments for alcoholism.

Individually focused Attribute?×?Treatment interaction (ATI) research has neglected attributes of couple and family relationships that may moderate response to different treatments. Sixty-three couples with a male alcoholic partner participated in up to 20 sessions of either cognitive–behavioral therapy (CBT) or family-systems therapy (FST). As hypothesized, couples high on pretreatment measures of demand–withdraw interaction (DWI) attended fewer sessions of CBT, whereas DWI made little difference in FST. A specific, alcohol-related wife-demand/husband-withdraw pattern moderated retention more than the opposite husband-demand/wife-withdraw pattern, although the general affective quality of a couple's relationship may have contributed to ATIs as well. Results illustrate the importance of relational moderators in ATI research and suggest possible benefits of matching alcoholics to treatments when the unit of treatment involves more than 1 person. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the evaluation of probability judgments: Calibration, resolution, and monotonicity.

Judgments of probability are commonly evaluated by 2 criteria: (1) calibration, namely, the correspondence between stated confidence and rate of occurrence, and (2) resolution, namely, the ability to distinguish between events that do and do not occur. Two representations of probability judgments are contrasted: the designated form that presupposes a particular coding of outcomes (e.g., rain vs no rain) and the inclusive form that incorporates all events and their complements. It is shown that the indices of calibration and resolution derived from these representations measure different characteristics of judgment. Calibration is distinguished from 2 types of overconfidence: specific and generic. An ordinal measure of performance is proposed and compared to the standard measures in forecasts of recession and in both numerical and verbal assessments of general knowledge. (PsycINFO Database Record (c) 2010 APA, all rights reserved)