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The development of a measure of intimate bonds

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Synopsis This paper discusses the relevance of assessing the nature of intimate relationships and reports on the development of such an instrument. The Intimate Bond Measure (IBM) is a self-report measure assessing two key underlying dimensions, care and control. Its properties are assessed in separate studies, establishing its high test-retest reliability, the homogeneous nature of the isolated dimensions, its insensitivity to broad socio-demographic influences and its minimal sensitivity to depressed mood state. Support for its validity, in terms of both perceived and actual characteristics of care and control, is demonstrated. It provides a simple and efficient measure of central constructs underlying intimate relationships, and is of potential use in studies attempting to assess the relevance of intimate relationships to the onset and course of psychiatric disorders.
... Personality traits which increase the risk of PPD 9-item self-reported (Boyce et al., 2001) Life Event Scales (LES) Stressful events (obstetric) 54-item self-reported (Barnett et al., 1983) Burden of Infertility and Treatment (BIT) Difficulty with conception 7-item self-reported (Hammarberg et al., 2005) Emotional Go/No-Go task (EGNG) Test of emotional processing in healthy adults/patients with affective disorders-operator administered (Gomez et al., 2007) Postnatal Risk Questionnaire (PNRQ) Psychosocial risk factors in the postnatal period −12-item self-reported (Austin et al., 2005) Sleepiness and fatigue Fatigue Assessment Scale (FAS) Long-term fatigue 10-item self-reported (Michielsen et al., 2003) Fatigue Severity Scale (FSS) Fatigue severity 9-item self-reported (Krupp et al., 1989) Karolinska Sleepiness Scale (KSS) Level of sleepiness (during the day) 9-point Likert scale-self-reported (Akerstedt & Gillberg, 1990) Epworth Sleepiness Scale (ESS) Sleepiness during activities 8-item, 4-point scale-self-reported (Johns, 1991) Circadian Energy Scale (CIRENS) Energy levels during the day/night 2-item, 5-point scale-self-reported (Ottoni et al., 2011) Giallo et al. (2011Giallo et al. ( , 2012 similarly reported statistically significantly elevated FAS scores amongst parents when compared to a community sample. Likewise, in three studies provided by Wilson et al. (2018Wilson et al. ( , 2019aWilson et al. ( , 2019b (Buysse et al., 1989) Multivariate Apnoea Prediction Index (MAPI) Sleep apnoea risk 3 breathing-related questions/demographics ➔ probability of having sleep apnoea (Maislin et al., 1995) Insomnia Severity Index (ISI) Nature, severity, and impact of insomnia 7-item self-reported (Bastien et al., 2001) Psychomotor Vigilance Test (PVT) Reduced alertness (from sleep deprivation) 10-min computerbased reaction self-test (Dinges & Powel, 1985) Visual Analogue Fatigue Scale (VAS-F) Fatigue and energy 18-item self-reported (Lee et al., 1991) Relationships and parenting Intimate Bonds Measure (IBM) Care and control in intimate relationships-24 questions, 2 subscales, 4-point scale-self-reported (Wilhelm & Parker, 1988) Parental Bonding Instrument (PBI) Parental styles as perceived by children>16 years 25-item (12 "care"/13 "overprotection")-self-reported (Parker, 1989) Being a Mother and Bonding Scale (BaMB) Experiences of mothering and bonding with her baby 13-item self-reported (Matthey & Speyer, 2008) NCAST Parent-Child Interaction (PCI) Teaching Scale ...
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Aims: The primary aim of the review was to provide an overall assessment of residential parenting services in Australia, by describing the characteristics of infants and parents using residential parenting services, their prior service use and reasons for admission, referral pathways for access and parenting and infant outcomes. The secondary aims were to explore parent and staff perception of the programmes. Design: An integrative literature review. Methods: A systematic and comprehensive search of health and social sciences databases was conducted for studies related to residential parenting services (published between 1st January 1990-31st December 2019). Six hundred and eleven peer-reviewed papers were identified, after which 301 duplicates were removed and an additional 256 papers excluded after titles/abstracts were read. Of the remaining 54 abstracts/papers, a further 14 were omitted as not relevant. Forty papers were independently reviewed by four authors. ENTREQ and MOOSE checklists were applied. Results: Thirty studies were quantitative, nine were qualitative, and one was mixed methods. All studies originated from in Australia. Women and babies admitted to residential parenting services were found more likely to be: older, Australian born, from higher socio-economic groups, and first-time mothers, and having labour and birth interventions and a history of mental health disorders. The babies were more likely to be twins, male and admitted with sleep disorders and dysregulated behaviour. Studies reporting postintervention outcomes demonstrated improvements to maternal mental health, breastfeeding, parenting confidence and sleep quality, and infant sleeping and behaviour.
... Scales evaluating acceptance and rejection in two or more relationship categories are on a quite limited level. In the literature, there are various scales that can be related to the assessment of interpersonal acceptance and rejection, such as Adult Parental Acceptance Rejection Scale (Rohner, 2005a), Parental Attachment Scale (Parker, Tupling & Brown, 1979), Parent and Peer Attachment Inventory (Armsden & Greenberg, 1987), Intimate Bond Scale (Wilhelm & Parker, 1988), Partner Behavior Inventory (Doss & Christensen, 2006), Attachment to Parents and Friends Inventory Short Form (Günaydın et al., 2005) and Teacher Acceptance-Rejection/Control Questionnaire (Rohner, 2005b). The scales in the literature generally focus on a kind of close relationship acceptance and those scales mostly include parental acceptance. ...
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This study aims to adapt the Adult Interpersonal Acceptance Rejection Scale to Turkish culture and examine the validity and reliability of the Turkish version of this scale. 653 university students selected by the convenience sampling method constitute the study sample. The original factor structure of the scale was examined by confirmatory factor analysis. The results revealed that the original factor structure of the Adult Interpersonal Acceptance-Rejection Scale was confirmed in the Turkish sample. The internal consistency of the scale items was associated with the Cronbach's alpha reliability coefficient and was calculated as .908. In addition, Cronbach's alpha values were.915 for the mother acceptance sub-dimension, .909 for best friend acceptance sub-dimension, and .911 for the romantic partner acceptance sub-dimension. Correlation coefficients were calculated between the Adult Interpersonal Acceptance Rejection Scale and the Two-Dimensional Self-Esteem Scale, the Interdependent Happiness Scale, and the Life Satisfaction Scale to prove the validity of the criterion. The results showed that the sub-dimensions of the scales were significantly related. These results show that the Turkish version of the Adult Interpersonal Acceptance Rejection Scale is a valid and reliable measurement tool that can be used for research purposes to determine the levels of interpersonal acceptance and rejection of adult individuals.
... Perceived social support and conflict in close relationships were measured by the 5-item Schuster's Social Support and Conflict Scale [27] (Cronbach α=.71; n=8139). The 12 items on the care dimension of the Intimate Bond Measure [28] were used as an indicator of perceived care from one's partner (Cronbach α=.96; n=8102). ...
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Background Although numerous studies have demonstrated sex differences in the prevalence of suicidal thoughts and behaviors (STB), there is a clear lack of research examining the similarities and differences between men and women in terms of the relationship between STB, transitional life events, and the coping strategies employed after experiencing such events when they are perceived as stressful. Objective This study aims to examine the differences between men’s and women’s experiences of STB, sociodemographic predictors of STB, and how coping responses after experiencing a stressful transitional life event predict STB. MethodsA web-based self-report survey was used to assess the health and well-being of a voluntary community-based sample of men and women aged 16 years and older, living in Australia, Canada, New Zealand, the United Kingdom, and the United States, who were recruited using web-based social media promotion and snowballing. ResultsIn total, 10,765 eligible web-based respondents participated. Compared with men, a significantly greater proportion of women reported STB (P
... Academics highlighted a critical point : intimacy can either refer to feelings, verbal and nonverbal communication processes, behaviors, people's arrangements in space, personality traits, sexual activities, and types of long-term relationships [56]. Indeed, intimacy aroused a particular interest in interpersonal relationships ; numerous authors consequently proposed conceptual models and tended to describe its manifestations during interpersonal interactions [55,56,68,69]. ...
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Interacting with an embodied conversational agent (ECA) in a professional context addresses social considerations to satisfy customer-relationship. This paper presents an experimental study about the perception of virtual intimacy in human-ECA interactions. We explore how an ECA’s multimodal communication affects our perception of virtual intimacy. To this end, we developed a virtual Tourism Information counselor capable of exhibiting verbal and nonverbal intimate behaviors according to several modalities (voice, chatbox, both media), and we built a corpus of videos showing interactions between the agent and a human tourist. We interrogated observers about their perception of the agent’s level of intimacy. Our results confirm the human ability to perceive intimacy in an ECA displaying multimodal behaviors, although the contribution of nonverbal communication remains unclear. Our study suggests that using voice channel increases the perception of virtual intimacy and offers further evidence that human-inspired design of ECAs is needed. Finally, we demonstrate that intimate cues do not disturb the comprehension of task-related information and are valuable for an attentional focus on the agent’s animation. We discuss the concept of virtual intimacy in relation to interpersonal intimacy, and we question its perception in terms of attentional mechanisms.
... -Ten items each scored on a Likert scale from 0 to 3, total score ranges from 0 to 30 -Translated, culturally verified and formally validated in Vietnam, against psychiatrist-administered structured clinical interviews, cut-off score of 3/4 [26] Mental health history -Study-specific question: history of mental health problems Intimate relationships -Intimate Bonds Measure -Vietnam validation (IBM-V) [27] -Perceived aspects of an intimate relationship: care and control (two subscales) -24 items each scored on a Likert scale from 0 to 3, scores from the 12 questions in each subscale added together to produce subscale scores -Translated, culturally verified and formally validated in Vietnam, against local indicators of quality of intimate relationships, reports of emotional and physical intimate partner abuse and indictors of CMDs [28] Experiences of interpersonal violence -Study-specific questions: fear of family members ...
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Background: This study aimed to establish whether changes in the socioeconomic context were associated with changes in population-level antenatal mental health indicators in Vietnam. Methods: Social, economic and public policies introduced in Vietnam (1986-2010) were mapped. Secondary analyses of data from two cross-sectional community-based studies conducted in 2006 (n = 134) and 2010 (n = 419), involving women who were ≥ 28 weeks pregnant were completed. Data for these two studies had been collected in structured individual face-to-face interviews, and included indicators of antenatal mental health (mean Edinburgh Postnatal Depression Scale Vietnam-validation (EPDS-V) score), intimate partner relationships (Intimate Bonds Measure Vietnam-validation) and sociodemographic characteristics. Socioeconomic characteristics and mean EPDS-V scores in the two study years were compared and mediation analyses were used to establish whether indicators of social and economic development mediated differences in EPDS-V scores. Results: Major policy initiatives for poverty reduction, hunger eradication and making domestic violence a crime were implemented between 2006 and 2010. Characteristics and circumstances of pregnant women in Ha Nam improved significantly. Mean EPDS-V score was lower in 2010, indicating better population-level antenatal mental health. Household wealth and intimate partner controlling behaviours mediated the difference in EPDS-V scores between 2006 and 2010. Conclusions: Changes in the socioeconomic and political context, particularly through policies to improve household wealth and reduce domestic violence, appear to influence women's lives and population-level antenatal mental health. Cross-sectoral policies that reduce social risk factors may be a powerful mechanism to improve antenatal mental health at a population level.
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BACKGROUND AND OBJECTIVES Our objective is to identify common family functioning measurement tools and assess their compatibility with family-health development and life-course perspectives. METHODS Data sources include PubMed, ERIC, CINAHL, Families and Societies Worldwide, PsychInfo, Web of Science, PsychNet, and Health and Psychosocial Instruments. Title and abstract screening and full-text review of articles were conducted by multiple reviewers based on prespecified inclusion criteria. Data extraction focused on features of identified measurements tools, including: (1) name (2) domains of family functioning measured, (3) established psychometric properties, and (4) original context of psychometric evaluation (eg, details about the study sample). RESULTS Of the 50 measurement tools identified, 94% measured organizational patterns (eg, flexibility, connectedness, or resources), 46% measured belief systems (eg, making meaning of adversity, or positive outlook), and 54% measured communication processes (eg, open emotional sharing, or collaborative problem-solving). CONCLUSIONS Existing measures of family functioning can aid life-course researchers in understanding family processes as contexts for health and well-being. There also remain opportunities to refine or develop measures of family functioning more compatible with a life-course perspective that assess family processes (1) at various life stages; (2) with various backgrounds, identities, structures, and experiences; and (3) embedded in or impacted by various contexts that may facilitate or hinder family functioning.
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Elmélet: A gyermekek egészséges testi, lelki fejlődésének támogatása a szülői vágyakon túlmutató társadalmi érdek. Az 1950-es évektől kezdve élénk kutatási érdeklődés övezi a szülői nevelői stílusnak a gyermek fejlődésére gyakorolt hatásvizsgálatát, ám a szülői nevelői stílust befolyásoló tényezőkről kevesebb eredmény áll a rendelkezésünkre. A tanul­ mány célja: a Parenting Styles and Dimensions Questionnaire (PSDQ) kérdőív magyar mintán történő kipróbálása, és a szülői nevelői stílus lehetséges szociodemográfiai, párkapcsolati és pszichoszociális összefüggéseinek vizsgálata volt. Módszerek : 711 fős (113 férfi, 598 nő, átlagéletkor 34,8 [SD = 10,91] év) önbeszámolós, keresztmetszeti vizsgálatunkban a PSDQ 32 tételes kérdőív mellett felvettük az Intim Kötődés Mérésére kidolgozott kérdőívet, a Kapcsolati Elégedettség Skálát, a Közvetlen Kapcsolatok Élményei kérdőívet, a STAI Vonásszorongás, a Zung-féle Önértékelő Depresszió Skálát, valamint a MOS Társas Támasz Kérdőívet. Eredmények: a konfirmatív faktorelemzés a PSDQ-HU önmagára és párjára vonatkoztatott változatának megbízható faktorstruktúráját igazolta (Saját – Self: SRMR = 0,065, RMSEA = 0,059, TLI = 0,796, CFI = 0,818; Másik – Other: SRMR = 0,066, RMSEA = 0,063, TLI = 0,890, CFI = 0,902). A Tekintélyelvű és Irányító skálák belső reliabilitása megfelelő (Cronbach- α = 0,73 – 0,95), a nemzetközi tapasztalatokhoz hasonlóan a Megengedő skála Cronbach- α értéke alacsonyabb (0,64). Az alskálák: Testi fenyítés, Verbális ellenségesség, Indokolatlan büntetés, Melegség, Érvelés, Demokratikus részvétel Cronbach- α értéke 0,54 – 0,93 között mozog. A nem, a családi állapot, valamint az, hogy valaki egyedüli gyermekként nő-e fel, szerepet játszhat a szülői nevelői stílu sában. A PSDQ-HU több kérdőívvel mutatott szignifikáns ( p < 0,05) együttjárást. A párkapcso lati intimitás ( r = –0,38 — 0,62), a felnőtt kötődés biztonsága ( r = –0,31 — –0,57), a párkapcsolattal való elégedettség ( r = –0,39 — 0,58) együtt jár azzal, hogy milyen szülőnek észleli valaki a párját. A vonásszorongás és a Zung-féle depresszió kérdőíven elért pontok a pár szülőként való negatívabb észlelésével korrelálnak (r = –0,33 — –0,38). A minél erősebb társas támasz észlelete a párra vonatkoztatott pozitívabb szülői percepcióval jár együtt ( r = 0,36 — 0,46). Az önmagára vonatkoztatott szülői nevelői stílus nem mutat szignifikáns összefüggést egyetlen vizsgált skálaváltozóval sem, csak a nemmel és a testvér nélküli felnövekedéssel. Következtetések: A PSDQ-HU kérdőív az önmagunk szülőként való észlelése mellett alkalmas a párunk szülőként való észlelésének a monitorozására, s bár nem párokat vizsgáltunk, eredményeink felhívják a figyelmet a mentális állapot, a párkapcsolat minőségének percepciója és a pár szülői nevelői stílusának észlelete kö zötti kapcsolatra, amely a pszicho- edukációban és a családokkal, párokkal dolgozó szakemberek számára nyújthat hasznos támpontot. Background: Promoting the healthy physical and mental development of children is a social interest that goes beyond parental desires. Since the 1950s, there has been a strong research interest in assessing the impact of parents’ parenting style on their children’s development, while we have more modest research findings on the factors influencing parental style. Aim : testing the Parenting Styles and Dimensions Questionnaire (PSDQ) developed by Robinson, Mandleco, Olsen and Hart (2001) on a Hungarian sample and examining the possible sociodemographic, relationship, and psychosocial contexts of the Parenting Style. Method: In our 711-person (113 fathers, 598 mothers, mean age 34.8 [SD = 10.91] years) self-report cross-sectional study, we checked the structure and internal reliability of the PSDQ 32-item questionnaire and its subscales correlation with relationship intimacy (IBM-HU), adult attachment (ECR-RS), relationship satisfaction (RAS-H), social support (MOSS SSS), and mental well-being (STAI-T, ZUNG). Results: Due to the confirmatory factor analysis a reliable factor structure of the self- and pair-version of PSDQ-HU was confirmed (Self: SRMR = 0.065, RMSEA = 0.059, TLI = 0.796, CFI = 0.818; Other: SRMR = 0.066, RMSEA = 0.063, TLI = 0.890, CFI = 0.902). The internal reliability of the Authoritarian and Authoritative scales (Cronbach- α = 0.73 – 0.95) is adequate. Similar to international experience, the Cronbach- α value of the Permissive scale is lower (0,635). The Physical Coercion, Verbal Hostility, Non-Reasoning, Warmth, Reasoning and Democratic Participation subscales Cronbach- α is between 0.54 – 0.93 values. Gender, marital status, and whether someone grows up as an only child can influence the parenting style. PSDQ-HU showed significant association with multiple questionnaires ( p <0.05). Relationship intimacy ( r = –0.38 — 0,62), adult attachment security ( r = –0.31 — –0.57), and relationship satisfaction ( r = –0.39 — 0.58) shows correlation with the way parents perceive their partners. The scores obtained on the trait anxiety and Zung depression questionnaires correlates with the perception of the couple as more negative parents ( r = –0.33— –0.38). Perception of stronger social support is associated with more positive parental perception of the couple ( r = 0.36— 0.46). Self-referenced parenting style does not show a significant correlation with any of the scale variables examined. Conclusions: The questionnaire is suitable for monitoring the perception of our couple as a parent, as well perceiving ourselves as a parent. Although we examined single persons, not couples, our results draw attention to the relationship between mental state, perception of the quality of the relationship, and perception of the couple’s parenting style. Our findings can provide a useful reference point for professionals working with families and couples, and in psychoeducation as well.
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Purpose Some partners experience their relationship with a person with brain injury as the continuation of a loving pre-injury relationship (continuity), but others feel that the pre-injury relationship has been lost and replaced with something very different (discontinuity). This study provided a quantitative test of claims arising from qualitative research that certain symptoms of the injury might contribute to the experience of discontinuity – specifically, lack of emotional warmth, reduced social interaction and aggression. Methods Fifty-three partners providing care to someone with brain injury completed questionnaires assessing continuity/discontinuity and a range of symptoms (emotional warmth, conversational ability, aggression, depression, somatic complaints, cognition, communication, aggression, and physical disability). Results Discontinuity was significantly correlated with all symptom variables except physical disability but, in a multiple regression, only the measures of emotional warmth, conversation, aggression, and depression made a significant unique contribution. Conclusions Discontinuity has been linked with relationship dissatisfaction and dysfunction, greater burden and distress, and a less person-centred approach to the provision of care. Identifying which symptoms contribute to discontinuity may enable partners to be more effectively supported in terms of how they make sense of and react to those symptoms, so that a greater sense of continuity may be retained. • Implications for rehabilitation • In a marriage/partnership after brain injury, some people struggle to maintain the loving relationship they shared with the person with the brain injury before the injury. This has an impact on the psychological wellbeing of the couple and on the quality of care provided. • Certain symptoms of the brain injury may make it more difficult to maintain the loving pre-injury relationship. • These include aggression, depression, a lack of emotional warmth within the relationship, and more general difficulties in making conversation. • Caregivers dealing with these symptoms may need extra support in making sense of, and coming to terms with, these changes.
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Les Agents Conversationnels Animés (ACAs) sont de plus en plus présents dans notre quotidien et s’insèrent progressivement dans nos habitudes d’usage. Ces systèmes experts disposent de compétences métier dans des domaines variés (banque, assurances, santé, éducation). Cependant, ces systèmes souffrent encore aujourd’hui d’un défaut d’adoption de la part des utilisateurs, qui, s’ils ne refusent pas catégoriquement de les utiliser, s’en lassent très rapidement. Il se pourrait que les compétences métier seules soient insuffisantes pour satisfaire les utilisateurs et que les compétences sociales des ACAs jouent un rôle important dans la relation-client. A la frontière de la psychologie sociale, de l’informatique affective et de l’ergonomie, cette thèse a ainsi pour enjeu d’explorer l’impact des compétences socioémotionnelles des ACAs sur l’expérience utilisateur (UX) et la relation-client. Pour son rôle central dans les relations humaines, mais également pour sa contribution au sentiment de présence sociale et à la construction de la relation-client, nous avons choisi de nous concentrer sur une compétence sociale particulière : l’intimité. Nous avons développé un modèle théorique d’intimité virtuelle dédié aux ACAs, inspiré de la littérature en psychologie humaine. D’une part, nous avons confirmé la validité de ce modèle dans une série d’études interrogeant la perception d’intimité virtuelle d’observateurs à l’égard d’interactions entre une conseillère touristique virtuelle exprimant des comportements multimodaux intimes et une touriste. Nos résultats montrent que notre agent est capable de susciter autant d’intimité qu’un humain et que la perception d’intimité virtuelle est sensible à différents facteurs de régulation (propriétés de l’interaction, caractéristiques individuelles). D’autre part, nous avons exploré les perceptions, les comportements et l’expérience de vrais touristes en situation réelle d’interaction avec une version autonome de notre conseillère virtuelle intime. Nos résultats désignent l’intimité virtuelle comme un candidat potentiel pour favoriser la dimension sociale de l’interaction humain-agent et tendre vers une meilleure UX. Ils ouvrent de nouvelles perspectives dans le but de permettre aux ACAs de devenir de véritables partenaires sociaux.
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Objective In comparison to its female counterpart, the transition of men to parenthood has been relatively neglected in previous research. The present paper argues that men may have gender-specific risk factors for perinatal psychological distress and may manifest distress in ways different from women. The prime objective of this research was to document changes in psychological, relationship and lifestyle parameters in a cohort of first time fathers from pregnancy to the end of the first postnatal year. The present paper reports on these changes. Method Three hundred and twelve men were assessed at 23 weeks of pregnancy and followed up at 3, 6 and 12 months postnatally, using a battery of self-report questionnaires covering psychological symptom levels, lifestyle variables and relationship/sexual functioning. Two hundred and four men completed all four assessments. Results The men exhibited highest symptom levels in pregnancy with general, through small, improvement at 3 months and little change thereafter. Lifestyle variables showed small changes over the first postnatal year. Sexual functioning appeared to deteriorate markedly from pre-pregnancy levels with only minimal recovery by the end of the first year. The results highlight that the majority of men anticipated return of sexual activity to pre-pregnancy levels; however, this failed to eventuate. Conclusions Pregnancy, rather than the postnatal period, would appear to be the most stressful period for men undergoing the transition to parenthood. The results suggest that the most important changes occur relatively early in pregnancy. Thereafter, lack of change (rather than change) is the most noteworthy feature. These men appeared to be ill-prepared for the impact of parenthood on their lives, especially in terms of the sexual relationship. Further research to determine the timing and trigger of stress in pregnancy is recommended.
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Peer Reviewed: The very close relationships (VCRs) of a sample of married women living in London are described using a new instrument (SESS) measuring self evaluation and social support. Only a third of the women had a `true' relationship (i.e., one characterized by a high level of interaction and intimate confiding) with someone identified as `very close' yet living outside the home. It is argued that recent research has failed to differentiate between those qualities of relationships which are actively supportive and those which simply reflect `a search for attachment' and that this is the source of the failure to find an association between social support and psychiatric state. In the current survey there is an association between- the type of VCR and both the respondents' positive evaluation of themselves and their psychiatric state. Such associations do not emerge when we look at the strength of the respondents' felt attachment. There is some suggestion that early loss of a father is associated with chronic anxiety and an inability to form a true VCR.
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AN extensive literature exists regarding the relationship of life events and depression. The largest group of studies has concerned the descriptive characterization of those events occurring at the onset of depression. There has been particular emphasis on actual or symbolic losses,1-4 including loss of self-esteem.5 Others have been concerned with the general presence or absence of stress at onset and have attempted to define a group of endogenous depressions, occurring in the absence of stress, and showing characteristic clinical features.6-8 Although it has been generally assumed that most depressions are reactions to events, some dissent has been expressed. Hudgens9 and his colleagues found events uncommon in the six months prior to onset of illness in 40 patients hospitalized with affective disorders. Winokur and Pitts10 reported reactive depressions to be infrequent and threw doubt on the validity of
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Eleven couples who had coexisting chronic marital and phobic-obsessive problems were treated conjointly either by exposure aimed at reducing phobias and rituals or by directive marital therapy aimed at reducing marital discord. After 3 month follow-up couples had the alternative treatment. Each treatment phase consisted of 10 weekly 50-minute sessions. Exposure led to significant improvement both in phobic-obsessive and in marital targets, whereas marital therapy improved only marital discord, not phobias and obsessions. At 13 months follow-up improvement in phobic-obsessive and in marital targets was maintained. Where marital discord coexists with phobias or obsessions, exposure treatment is recommended before marital therapy. The effect of combined exposure plus marital therapy remains to be seen. Marital therapy was distinguished from conjoint therapy. Ideas from psychodynamic and from general systems models about the interrelationship between intra- and interpersonal problems and other neurotic difficulties were not supported.
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The difficulties inherent in obtaining consistent and adequate diagnoses for the purposes of research and therapy have been pointed out by a number of authors. Pasamanick12 in a recent article viewed the low interclinician agreement on diagnosis as an indictment of the present state of psychiatry and called for "the development of objective, measurable and verifiable criteria of classification based not on personal or parochial considerations, but on behavioral and other objectively measurable manifestations."Attempts by other investigators to subject clinical observations and judgments to objective measurement have resulted in a wide variety of psychiatric rating scales.4,15 These have been well summarized in a review article by Lorr11 on "Rating Scales and Check Lists for the Evaluation of Psychopathology." In the area of psychological testing, a variety of paper-and-pencil tests have been devised for the purpose of measuring specific
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The Structured and Scaled Interview to Assess Maladjustment (SSIAM) is described, together with its rationale and development. The SSIAM contains questions by which a trained interviewer gathers evidence of maladjustment, and corresponding scales on which to rate this evidence. The interview, which takes about half an hour, has 45 items to assess deviant behavior, friction with others, and subjective distress, within five fields of maladjustment: work, social, family, marriage, and sex. A further 15 items cover the degree of environmental stress, prognostic issues, and aspects of positive mental health.
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