Talia Zaider

Memorial Sloan-Kettering Cancer Center, New York City, New York, United States

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Publications (18)51.92 Total impact

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    ABSTRACT: Poor family functioning affects psychosocial adjustment and the occurrence of morbidity following bereavement in the context of a family's coping with advanced cancer. Family functioning typologies assist with targeted family-centered assessment and intervention to offset these complications in the palliative care setting. Our objective was to identify the number and nature of potential types in an American palliative care patient sample. Data from patients with advanced cancer (N = 1809) screened for eligibility for a larger randomized clinical trial were used. Cluster analyses determined whether patients could be classified into clinically meaningful and coherent groups, based on similarities in their perceptions of family functioning across the cohesiveness, expressiveness, and conflict resolution subscales of the Family Relations Index. Patients' reports of perceived family functioning yielded a model containing five meaningful family types. Cohesiveness, expressiveness, and conflict resolution appear to be useful dimensions by which to classify patient perceptions of family functioning. "At risk" American families may include those we have called hostile, low-communicating, and less-involved. Such families may benefit from adjuvant family-centered psychosocial services, such as family therapy.
    Journal of pain and symptom management 04/2014; · 2.42 Impact Factor
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    ABSTRACT: Introduction.  Erectile dysfunction (ED) is one of the most frequent sources of distress after treatment for prostate cancer (PCa), yet evidence suggests that men do not easily adjust to loss of sexual function over time. A hypothesized determinant of men's adaptation to ED is the degree to which they experience a loss of masculine identity in the aftermath of PCa treatment. Aims.  The aims of this study were (i) to describe the prevalence of concerns related to diminished masculinity among men treated for localized PCa; (ii) to determine whether diminished masculinity is associated with sexual bother, after controlling for sexual functioning status; and (iii) to determine whether men's marital quality moderates the association between diminished masculinity and sexual bother. Methods.  We analyzed cross-sectional data provided by 75 men with localized PCa who were treated at one of two cancer centers. Data for this study were provided at a baseline assessment as part of their enrollment in a pilot trial of a couple-based intervention. Main Outcome Measures.  The sexual bother subscale from the Prostate Health-Related Quality-of-Life Questionnaire and the Masculine Self-Esteem and Marital Affection subscales from Clark et al's PCa-related quality-of-life scale. Results.  Approximately one-third of men felt they had lost a dimension of their masculinity following treatment. Diminished masculinity was the only significant, independent predictor of sexual bother, even after accounting for sexual functioning status. The association between diminished masculinity and sexual bother was strongest for men whose spouses perceived low marital affection. Conclusions.  Diminished masculinity is a prominent, yet understudied concern for PCa survivors. Regardless of functional status, men who perceive a loss of masculinity following treatment may be more likely to be distressed by their ED. Furthermore, its impact on adjustment in survivorship may rely on the quality of their intimate relationships. Zaider T, Manne S, Nelson C, Mulhall J, and Kissane D. Loss of masculine identity, marital affection, and sexual bother in men with localized prostate cancer. J Sex Med **;**:**-**.
    Journal of Sexual Medicine 09/2012; 9(10):2724-32. · 3.51 Impact Factor
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    ABSTRACT: Background: Clinicians meet a variety of ethnicities among patients and families in hospice programs. This article focuses on Latino families. METHODS: Within a controlled trial of family therapy in the context of palliative care, 17 families identified as Hispanic. Five were examined qualitatively herein. RESULTS: A synopsis of each family's narrative is presented here. Patterns of strong family loyalty (Familismo), the gender roles of Machismo and Marianismo, the importance of family tradition, expectations about caregiving, and the place of faith and religion emerged as prominent and able potentially to impact on the therapy. CONCLUSIONS: Family therapists need to be thoughtful about cultural issues as they strive to support families.
    The American journal of hospice & palliative care 06/2012;
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    ABSTRACT: BACKGROUND: Supporting the family-as-a-whole presents challenges in palliative care, although family meetings are increasingly used in routine practice. The Family Focused Grief Therapy (FFGT) Model guides clinicians in using a range of intervention strategies. AIM: To examine the therapists' techniques used in assessing 'at risk' families in palliative care to better illuminate what helps and what remains challenging. METHOD: Recorded sessions 1 and 2 were coded using the FFGT fidelity coding measure, with its glossary of definitions. Inter-rater reliability between three coders was satisfactory at 88%. Frequencies of strategy utilization were computed, with extraction of examples of both successful and problematic approaches. Setting/participants: From within a larger study of family therapy during palliative care at a comprehensive cancer center, the first two sessions (n = 144) delivered to 74 families (299 individuals) by 32 therapists were coded and analyzed. RESULTS: Therapists readily explored the story of illness and families' ways of coping (97%) and assessed communication and cohesiveness in the majority. Exploration of relational patterns occurred in 89% of sessions, use of a genogram in 80%, understanding members' roles in 65% and family values and beliefs in 62%. Less use was made of summaries (39%), family mottos (34%), exploration of family conflict (35%) and the formalization of a comprehensive family treatment plan (20%). CONCLUSIONS: Challenges exist in therapy with difficult families. Therapy in the home brings special issues. Therapists can apply most of the interventions prescribed by the FFGT model.
    Palliative Medicine 11/2011; · 2.61 Impact Factor
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    ABSTRACT: Introduction.  Few couple-focused interventions have been developed to improve distress and relationship outcomes among men diagnosed with localized prostate cancer and their partners.Aims.  We examined the effects of a five-session Intimacy-Enhancing Therapy (IET) vs. Usual Care (UC) on the psychological and relationship functioning of men diagnosed with localized prostate cancer and their partners. Pre-intervention levels of psychological and relationship functioning were evaluated as moderators of intervention effects.Methods.  Seventy-one survivors and their partners completed a baseline survey and were subsequently randomly assigned to receive five sessions of IET or UC (no treatment). Eight weeks after the baseline assessment, a follow-up survey was administered to survivor and partner.Main Outcome Measures.  Distress, well-being, relationship satisfaction, relationship intimacy, and communication were investigated as the main outcomes.Results.  IET effects were largely moderated by pre-intervention psychosocial and relationship factors. Those survivors who had higher levels of cancer concerns at pretreatment had significantly reduced concerns following IET. Similar moderating effects for pre-intervention levels were reported for the effects of IET on self-disclosure, perceived partner disclosure, and perceived partner responsiveness. Among partners beginning the intervention with higher cancer-specific distress, lower marital satisfaction, lower intimacy, and poorer communication, IET improved these outcomes.Conclusions.  IET had a marginally significant main effect upon survivor well-being but was effective among couples with fewer personal and relationship resources. Subsequent research is needed to replicate these findings with a larger sample and a longer follow-up. Manne SL, Nelson CJ, Kissane DW, Mulhall JP, Winkel G, and Zaider T. Intimacy-enhancing psychological intervention for men diagnosed with prostate cancer and their partners: A pilot study. J Sex Med 2011;8:1197–1209.
    Journal of Sexual Medicine 01/2011; 8(4):1197 - 1209. · 3.51 Impact Factor
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    ABSTRACT: Few couple-focused interventions have been developed to improve distress and relationship outcomes among men diagnosed with localized prostate cancer and their partners. We examined the effects of a five-session Intimacy-Enhancing Therapy (IET) vs. Usual Care (UC) on the psychological and relationship functioning of men diagnosed with localized prostate cancer and their partners. Pre-intervention levels of psychological and relationship functioning were evaluated as moderators of intervention effects. Seventy-one survivors and their partners completed a baseline survey and were subsequently randomly assigned to receive five sessions of IET or UC (no treatment). Eight weeks after the baseline assessment, a follow-up survey was administered to survivor and partner. Distress, well-being, relationship satisfaction, relationship intimacy, and communication were investigated as the main outcomes. IET effects were largely moderated by pre-intervention psychosocial and relationship factors. Those survivors who had higher levels of cancer concerns at pretreatment had significantly reduced concerns following IET. Similar moderating effects for pre-intervention levels were reported for the effects of IET on self-disclosure, perceived partner disclosure, and perceived partner responsiveness. Among partners beginning the intervention with higher cancer-specific distress, lower marital satisfaction, lower intimacy, and poorer communication, IET improved these outcomes. IET had a marginally significant main effect upon survivor well-being but was effective among couples with fewer personal and relationship resources. Subsequent research is needed to replicate these findings with a larger sample and a longer follow-up.
    Journal of Sexual Medicine 01/2011; 8(4):1197-209. · 3.51 Impact Factor
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    ABSTRACT: Little attention has been paid to the role of nonspecific therapy processes in the efficacy of psychological interventions for individuals diagnosed with cancer. The goal of the current study was to examine the three constructs from the generic model of psychotherapy (GMP): therapeutic alliance, therapeutic realizations, and therapeutic openness/involvement in the treatment outcome of women with gynecological cancers attending either a 7-session supportive counseling intervention or a coping and communication skills intervention. Two hundred and three women completed measures of alliance, realizations, and openness after Intervention Sessions 2, 3, and 6, as well as measures of depressive symptoms after these sessions and 6 months after the pre-intervention assessment (posttreatment). Consistent with the GMP, in early sessions, therapeutic bond predicted openness in terms of positive affect experienced during sessions, and both aspects of openness (positive and negative affect), in turn, predicted more therapeutic realizations. Therapeutic realizations predicted perceptions of greater session progress, and greater therapeutic bond predicted more therapeutic realizations. When early session GMP variables were used to predict later GMP processes and outcomes and posttreatment outcomes, early therapeutic bond predicted later session therapeutic realizations directly and indirectly via emotional arousal, emotional arousal predicted session progress, session progress predicted lower postsession depressive symptoms, and depressive symptoms as rated after Session 6 predicted depressive symptoms 3 months posttreatment. However, a number of additional associations among GMP processes were found. Our results suggest that therapy processes played a role in predicting both short- and long-term treatment outcomes.
    Journal of Consulting and Clinical Psychology 04/2010; 78(2):236-48. · 4.85 Impact Factor
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    Talia I Zaider, Richard G Heimberg, Masumi Iida
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    ABSTRACT: Although adults with anxiety disorders often report interpersonal distress, the degree to which anxiety is linked to the quality of close relationships remains unclear. The authors examined the relational impact of anxiety by sampling the daily mood and relationship quality of 33 couples in which the wife was diagnosed with an anxiety disorder. Use of a daily process design improved on prior methodologies by capturing relational processes closer to their actual occurrence and in the setting of the diagnosed partner's anxiety. Analyses revealed significant associations between wives' daily anxiety and both partners' perceptions of relationship quality. Associations were moderated by anxiety-specific support. Results also indicated significant concordance between wives' daily anxiety and husbands' distress. Concordance was stronger for husbands who reported frequent accommodation of wives' anxiety symptoms. Findings are discussed in the context of existing evidence on the social costs of anxiety disorders.
    Journal of Abnormal Psychology 02/2010; 119(1):163-73. · 4.86 Impact Factor
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    ABSTRACT: Social anxiety disorder is a prevalent and impairing disorder for which viable cognitive-behavioral therapies exist. However, these treatments have not been easily packaged for dissemination and may be underutilized as a result. The current study reports on the findings of a randomized controlled trial of a manualized and workbook-driven individual cognitive-behavioral treatment for social anxiety disorder (Hope, Heimberg, Juster, & Turk, 2000; Hope, Heimberg, & Turk, 2006). This treatment package was derived from an empirically supported group treatment for social anxiety disorder and intended for broad dissemination, but it has not previously been subjected to empirical examination on its own. As a first step in that examination, 38 clients seeking treatment for social anxiety disorder at either the Adult Anxiety Clinic of Temple University or the Anxiety Disorders Clinic of the University of Nebraska-Lincoln were randomly assigned to receive either immediate treatment with this cognitive-behavioral treatment package or treatment delayed for 20 weeks. Evaluation at the posttreatment/postdelay period revealed substantially greater improvements among immediate treatment clients on interviewer-rated and self-report measures of social anxiety and impairment. Three-month follow-up assessment revealed maintenance of gains. Clinical implications and directions for future research are discussed.
    Behavior therapy 12/2009; 40(4):414-24. · 2.85 Impact Factor
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    ABSTRACT: The present study evaluated intimacy as a mechanism for the effects of relationship-enhancing (self-disclosure, mutual constructive communication) and relationship-compromising communication (holding back, mutual avoidance, and demand-withdraw communication) on couples' psychological distress. Seventy-five men diagnosed with localized prostate cancer in the past year and their partners completed surveys about communication, intimacy, and distress. Multi-level models with the couple as unit of analyses indicated that the association between mutual constructive communication, mutual avoidance, and patient demand-partner withdraw and distress could be accounted for by their influence on relationship intimacy. Intimacy did not mediate associations between self-disclosure, holding back, and partner demand-patient withdraw communication and distress. These findings indicate that the way in which couples talk about cancer-related concerns as well as the degree to which one or both partners avoid talking about cancer-related concerns can either facilitate or reduce relationship intimacy, and that it is largely by this mechanism that these three communication strategies impact psychological distress. Relationship intimacy and how patients and partners communicate to achieve this intimacy is important for the psychological adjustment of early stage prostate cancer survivors and their partners.
    Journal of Cancer Survivorship 12/2009; 4(1):74-85. · 3.57 Impact Factor
  • Talia Zaider, David Kissane
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    ABSTRACT: In the advanced stages of illness, families manage multiple caregiving demands while facing the emotional task of preparing for the loss of their loved one. Palliative care settings are well suited to identifying families at risk for elevated distress, and providing support as they navigate this process. This review summarizes current research in the assessment and management of family distress at the end of life. The recent literature on families of terminally ill cancer patients has provided a more precise description of the relational and cultural factors that contribute to family distress. Studies eliciting the perspectives of family members on what is needed at the end of life affirm the importance of supportive communication and continuity of psychosocial care into bereavement. Other developments include efforts to establish guidelines for conducting family meetings in the palliative care setting, and to train palliative care practitioners in family-centered assessment techniques. Finally, there is a limited but growing evidence base for the utility of delivering family-focused psychosocial interventions during palliative care. The knowledge gained from current research on what is most salient to family members during palliative care is critical for ensuring effective delivery of supportive services and collaborative engagement in those services.
    Current opinion in supportive and palliative care 04/2009; 3(1):67-71.
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    ABSTRACT: Distress reverberates throughout the family during palliative care and bereavement, inviting consideration of a family-centered model of care. Targeting families thought to be "at risk" has merit. The Family Focused Grief Therapy model was tested in a randomized controlled trial of 81 families (353 individuals) and bereavement outcome is reported here for treatment completers compared to controls. There were no significant baseline differences between treatment completers and non-completers. Significant reduction in distress occurred at 13 months post death for the families completing treatment, with further improvements for the 10% of individuals most distressed at baseline. A preventive model of family-centered care applied to those at greatest risk is meritorious and in keeping with the aspirations of Cicely Saunders for improving the quality of hospice care.
    OMEGA--Journal of Death and Dying 01/2007; 56(1):21-32. · 0.44 Impact Factor
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    ABSTRACT: The current study aimed to extend the evaluation of the utility of the Social Performance Rating Scale (SPRS) [Behav. Res. Ther. 36 (1998) 995]. We examined the utility of a modified SPRS for the behavioral assessment of public-speaking anxiety among patients with social phobia (n = 49). The videotaped performance of public-speaking fearful patients in a public-speaking task was rated using four of the five SPRS ratings and was compared to global ratings by patients and observers, as well as to self-report and clinician-administered measures of social anxiety. The pattern of correlations with criterion measures of social anxiety provided evidence for the convergent and divergent validity of this modified SPRS for the behavioral assessment of public-speaking anxiety.
    Behaviour Research and Therapy 12/2003; 41(11):1373-80. · 3.85 Impact Factor
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    ABSTRACT: The clinical Global Impression Scale (CGI) is commonly used as a primary outcome measure in studies evaluating the efficacy of treatments for anxiety disorders. The current study evaluated the psychometric properties and predictors of clinicians' ratings on an adapted version of the CGI among individuals with social anxiety disorders. An independent assessor administered the CGI Severity of Illness and Improvement ratings to 123 patients at baseline and the subset of treated patients again mid- and post-treatment. Improvement ratings were strongly related to both concurrent Severity of Illness and changes in Severity of Illness ratings from baseline. Additionally, both CGI ratings were positively correlated with both self-report and clinician-administered measures of social anxiety, depression, impairment and quality of life. Measures of social anxiety symptoms accounted for a large portion of the variance in Severity of Illness ratings, with significant additional variance accounted for by measures of impairment and depression. Changes in social anxiety symptoms from baseline accounted for significant variance in Improvement ratings, but no significant additional variance was accounted for by changes in impairment and depressive symptoms. Our findings support the utility of the CGI as an index of global severity and symptom-specific improvement among individuals with social anxiety disorder.
    Psychological Medicine 06/2003; 33(4):611-22. · 5.59 Impact Factor
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    T I Zaider, R G Heimberg
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    ABSTRACT: The purpose of this paper is to present a review of research on the efficacy of psychotherapeutic interventions for children, adolescents and adults with social anxiety disorder. Data are presented on the relative efficacy of cognitive-behavioral therapies (CBTs), pharmacotherapy and combination treatments. We also discuss research on specific clinical conditions that are likely to influence treatment success. Relevant studies were identified through literature searches, reference lists and research databases. Non-pharmacologic treatments for social anxiety disorder, particularly CBTs, have gained substantial empirical support over the last two decades. However, questions remain about how to maximize the benefit of available treatments. New directions for future research in this area are discussed.
    Acta psychiatrica Scandinavica. Supplementum 02/2003;
  • T.I. Zaider, J.G. Johnson, S.J. Cockell
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    ABSTRACT: A prospective longitudinal study was conducted to investigate whether anxiety, depressive, personality, or substance use disorders increase risk for onset of bulimia nervosa (BN) or binge eating disorder (BED) during adolescence. Axis I and II psychiatric disorders were assessed in a primary care sample of 201 adolescents. Axis I disorders were reassessed 10 months later. Youths with dysthymic disorder were at elevated risk for the onset or recurrence of BN or BED after preexisting psychiatric disorders were controlled statistically. Problems with depression or anxiety tended to precede the onset of eating problems. In addition, youths with eating disorder symptoms were at elevated risk for the onset or recurrence of depressive disorders. These findings suggest that adolescents with chronic depressive symptoms may be at elevated risk for the development of BN or BED, and that adolescents with eating disorder symptoms may be at elevated risk for the development of depressive disorders.
    Journal of Youth and Adolescence 01/2002; 31(5). · 2.72 Impact Factor
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    ABSTRACT: This study investigates psychiatric comorbidity associated with eating disorder symptomatology among adolescents in the community. Four hundred three adolescents in the community were administered structured clinical interviews to assess mood, anxiety, eating, substance use, and personality disorders. Adolescents with dysthymia, panic and major depressive disorder were significantly more likely than those without these disorders to have an eating disorder. After controlling for the effects of other Axis I disorders and personality disorders, only dysthymia independently predicted the presence of an eating disorder. Several personality disorders were also associated with eating disorder symptoms. However, only obsessive-compulsive personality disorder predicted eating disorder symptoms after controlling for other personality disorders. Although previous research on adults has focused on the association between major depressive disorder and eating disorders, dysthymia may be more strongly associated with eating disorders among adolescents in the community. This association is not accounted for by psychiatric comorbidity.
    International Journal of Eating Disorders 08/2000; 28(1):58-67. · 3.03 Impact Factor
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    ABSTRACT: The increased risk of physical health problems in adult depressed patients has been shown in numerous studies. A recent study of the offspring of depressed parents found similar associations. The purpose of this study is to examine the strength and specificity of the association between depression and physical health problems in children and adolescents whose parents are dependent upon opiates. The sample consisted of offspring ages 6-17 (mean age 11 years) of opiate addicts who had a history of major depressive disorder (MDD; n = 28); other mood disorders (n = 31); no history of mood disorders but other psychiatric disorders (n = 92); or no history of psychiatric disorder (n = 127). Detailed psychiatric assessment and medical history of the offspring by direct interview with the offspring and an informant were obtained blind to parental diagnosis. After controlling for possible confounders, there was an increased risk of dermatological disorders, headache, other neurological/neuromuscular disorders, bronchitis, other respiratory disorders and hospitalizations for nonsurgical procedures in offspring with MDD, as compared to nonpsychiatrically ill controls. The offspring with other mood disorders had a slightly elevated risk. Major depression in children and adolescents whose parents are dependent on opiates is associated with increased risk of physical health problems. This finding is consistent with other reports and the timing of the physical health problems requires further study.
    Depression and Anxiety 02/1999; 9(2):61-9. · 4.61 Impact Factor

Publication Stats

321 Citations
51.92 Total Impact Points

Institutions

  • 2007–2014
    • Memorial Sloan-Kettering Cancer Center
      • Department of Psychiatry & Behavioral Sciences
      New York City, New York, United States
  • 2012
    • American Association of Hospice and Palliative Medicine
      American Fork, Utah, United States
  • 2011
    • Rutgers New Jersey Medical School
      Newark, New Jersey, United States
  • 2002–2010
    • Temple University
      • Department of Psychology
      Philadelphia, PA, United States
  • 2009
    • Fox Chase Cancer Center
      Philadelphia, Pennsylvania, United States
  • 1999–2000
    • New York State Psychiatric Institute
      • Anxiety Disorders Clinic
      New York City, New York, United States