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  • 1
    Electronic Resource
    Electronic Resource
    Psychological Treatment and Medication for the Mood and Anxiety Disorders: Moderators, Mediators, and Domains of Outcome (2005)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical psychology 12 (2005), S. 0 
    Details
    ISSN: 1468-2850
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: Studies that combine pharmacotherapy with psychological treatment for the mood and anxiety disorders must consider the role of moderators (pretreatment variables that specify the conditions under which treatments are effective) and mediators (change mechanisms in the causal pathways between treatments and outcomes) in explaining the impact of experimental treatments. This article gives examples of the kinds of moderators and mediators—both psychosocial and biological—that are important to examine in combination treatment studies. It conceptualizes outcome as involving multiple domains, including mood and anxiety symptoms, life functioning, and illness costs. Research should also examine the appropriate sequencing of pharmacological and psycho-social interventions and how this sequencing may vary from disorder to disorder.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1093/clipsy.bpi012
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    THE EFFECTIVENESS OF PSYCHOEDUCATIONAL FAMILY THERAPY IN THE TREATMENT OF SCHIZOPHRENIC DISORDERS (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of marital and family therapy 21 (1995), S. 0 
    Details
    ISSN: 1752-0606
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: A review of the literature on family psychoeducational interventions in schizophrenic disorders revealed two generations of studies. The first generation compared the clinical efficacy of psychoeducational family treatments and medication to medication only or routine care. A second generation of studies used more complex experimental designs that often narrowed the differences between the experimental treatment and comparison conditions. The results of the first generation of studies are unequivocal in demonstrating the superiority of family intervention plus medication over medication alone in delaying psychotic relapses. The second-generation studies had more equivocal results; they suggest that the efficacy of family intervention as an adjunct to medication in schizophrenia is in part a function of the type and format of the intervention being delivered, the treatment setting, and other variables.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1752-0606.1995.tb00171.x
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  • 3
    Electronic Resource
    Electronic Resource
    DEVELOPING FAMILY PSYCHOEDUCATIONAL TREATMENTS FOR PATIENTS WITH BIPOLAR AND OTHER SEVERE PSYCHIATRIC DISORDERS (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of marital and family therapy 24 (1998), S. 0 
    Details
    ISSN: 1752-0606
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: Developing family treatments for patients with severe and persistent psychiatric disorder begins at the basic research level, through identifying psychosocial variables that have prognostic significance. Treatment protocols informed by this basic research can then be designed, manualized, and piloted. Next, the efficacy of a new treatment is examined, first in a randomized trial and then, if successful, in a community effectiveness study. We describe this treatment development pathway in a population for whom family attributes have prognostic importance: patients with bipolar affective ddisorder. The methodological complexities of psychosocial treatment studies are many. Moreover, the results of these studies often reflect interactions between treatment, process, and outcome variables.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1752-0606.1998.tb01098.x
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  • 4
    Electronic Resource
    Electronic Resource
    Expressed Emotion and Reciprocal Affective Relationships in Families of Disturbed Adolescents (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Family process 28 (1989), S. 0 
    Details
    ISSN: 1545-5300
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: Relatives expressed emotion (EE) is a known risk factor for relapse among recovering psychiatric patients. Recent research has focused on the behavioral correlates of EE, seeking better understanding of the family processes associated with this important variable. The present study used sequence analysis to explore interactions of high-EE and low-EE parent-child dyads in a sample of disturbed adolescents. High-EE mother-child interactions were characterized by bidirectional influence, and, in contrast to adolescents in low-EE dyads, adolescents in high-EE dyads had an oppositional style of responding. In Low-EE mother-child interactions, the adolescents showed more temporal consistency (stability) of affect than their high-EE counterparts. Overall, the results suggest that high-EE mother-child dyads constitute more tightly joined emotional systems than low-EE dyads. Consequently, interventions designed to reduce this connectedness might also reduce the risk of adolescent psychiatric problems.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1545-5300.1989.00337.x
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  • 5
    Electronic Resource
    Electronic Resource
    Is Expressed Emotion an Index of a Transactional Process? I. Parents' Affective Style (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Family process 28 (1989), S. 0 
    Details
    ISSN: 1545-5300
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: The degree to which expressed emotion (EE) attitudes in key relatives reflect ongoing transactional processes in families is a topic of controversy. The associations between EE attitudes, as measured during an acute hospitalization (using the Camberwell Family Interview) and during the aftercare period (using 5-minute speech samples), and interactional behavior in parents of recent-onset schizophrenics (this article) and in patients themselves (second article), were investigated. In the first study, EE attitudes manifested by parents during the aftercare period were stronger correlates of their interactional behaviors during the aftercare period than were EE attitudes measured during the inpatient period, despite the frequent correspondence between the two EE measures. The pattern of attitudes shown between the inpatient and outpatient periods also predicted transactional styles in parents during the outpatient period, findings not accounted for by clinical attributes of patients. When high-EE attitudes persist during the aftercare period and are reflected in transactional behaviors, the risk for subsequent patient relapse may be enhanced.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1545-5300.1989.00153.x
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  • 6
    Electronic Resource
    Electronic Resource
    Is Expressed Emotion an Index of a Transactional Process? II. Patient's Coping Style (1989)
    Oxford, UK : Blackwell Publishing Ltd
    Family process 28 (1989), S. 0 
    Details
    ISSN: 1545-5300
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: This article examines the extent to which expressed emotion (EE) indexes not only relatives' behavior toward schizophrenic patients but also patients' behavior toward their relatives. The coping styles (CS) of schizophrenic patients were assessed during interactions with their parents and were compared with parental EE attitudes assessed during an acute hospitalization and during the aftercare period. It was found that parental EE attitudes measured during the inpatient period strongly predicted patients' outpatient transactional behavior: patients interacting with low-EE relatives showed significantly fewer critical and more autonomous statements than patients interacting with high-EE relatives. Further, the dominant patient coping style (autonomous, neutral, externalizing, or internalizing) was strongly related to the relatives' interactional affective style (AS) and to their pattern of EE attitudes. Patient coping style was not related to clinical attributes of these patients themselves. This article and its preceding companion (17) together suggest that EE indexes a transactional process so that the quality of both parents' and patients' transactional behaviors may predict subsequent patient functioning.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1545-5300.1989.00169.x
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  • 7
    Electronic Resource
    Electronic Resource
    Global Assessment of Relational Functioning Scale (GARF): II. Reliability and Validity in a Sample of Families of Bipolar Patients (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Family process 35 (1996), S. 0 
    Details
    ISSN: 1545-5300
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: The companion article by the Group for the Advancement of Psychiatry (GAP) Committee on the Family (see p. 155, this issue) describes the development of the Global Assessment of Relational Functioning (GARF) scale. The present study evaluated the reliability and concurrent validity of a manualized version of the GARF in recently episodic bipolar patients (N = 73) participating with family members in laboratory interaction tasks. The GARF was applied with high reliability by raters with little clinical experience. GARF ratings discriminated between families rated high and low in expressed emotion, with families rated as high in emotional overinvolvement showing the lowest relational functioning scores. GARF scores also correlated with affective negativity scores derived from the interactional task-based affective style and coping style coding systems. However, relational ratings were independent of levels of concurrent symptoms or illness chronicity among individual patients. GARF ratings may inform the treatment plans for patients with psychiatric disorders, but the optimal methods of data collection and rater training must be determined.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1545-5300.1996.00175.x
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  • 8
    Electronic Resource
    Electronic Resource
    Clinicians' Fidelity to a Manual-Based Family Treatment as a Predictor of the One-Year Course of Bipolar Disorder (2002)
    Oxford, UK : Blackwell Publishing Ltd
    Family process 41 (2002), S. 0 
    Details
    ISSN: 1545-5300
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: This study assessed whether therapist adherence to the family focused treatment model1 for patients with bipolar disorder and their relatives was associated with patient outcomes at one year after treatment entry. A total of 78 videotaped sessions of FFT consisting of 26 families with a member with bipolar disorder (3 sessions/family) were rated on fidelity using the Therapist Competence/Adherence Scale (TCAS; see Endnote 1, p. 130). Patients' outcomes (relapse status) were assessed using the Brief Psychiatric Rating Scale (BPRS) and selected items from the Schedule of Affective Disorders and the Schizophrenia-Change (SADS-C) scale (measured at 3-month intervals for 12 months). Contrary to expectations, therapist fidelity was not related to overall outcome as assessed by the BPRS and the SADS-C. Among patients who did relapse, higher levels of cooperation among therapists predicted a later date for relapse than did lower levels of cooperation. Surprisingly, and in opposition to the study's hypotheses, patients who were hospitalized because of relapses had therapists who were rated as more competent in their ability to conduct the problem-solving module of FFT. Study implications are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1545-5300.2002.40102000123.x
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  • 9
    Electronic Resource
    Electronic Resource
    Family Transactions and Relapse in Bipolar Disorder (2001)
    Oxford, UK : Blackwell Publishing Ltd
    Family process 40 (2001), S. 0 
    Details
    ISSN: 1545-5300
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: This study examined whether patient symptoms and relatives' affective behavior, when expressed during directly observed family interactions, are associated with the short-term course of bipolar disorder. Twenty-seven bipolar patients and their relatives participated in two 10-minute family interactions when patients were discharged after a manic episode. Results indicated that patients who showed high levels of odd and grandiose thinking during the interactions were more likely to relapse during a 9-month followup period than patients who did not show these symptoms during the family discussions. Relapse was also associated with high rates of harshly critical and directly supportive statements by relatives. Patients' odd thinking and relatives' harsh criticism were significantly more likely to be correlated when patients relapsed (r = .53) than when they did not relapse (r = .12). Results suggest that bipolar patients who show increased signs of residual symptomatology during family transactions during the post-hospital period are at increased relapse risk. The data also suggest that relatives of relapsing patients cope with these symptoms by increasing both positive and negative affective behaviors. Moreover, a bidirectional, interactional relationship between patients' symptoms and relatives' coping style seems to capture best the role of the family in predicting relapse in bipolar disorder.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1545-5300.2001.4010100005.x
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  • 10
    Electronic Resource
    Electronic Resource
    Difficulty in Implementing a Family Intervention for Bipolar Disorder: The Predictive Role of Patient and Family Attributes (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Family process 39 (2000), S. 0 
    Details
    ISSN: 1545-5300
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Psychology
    Notes: Family affect was examined as a predictor of difficulty implementing a 9-month, manual-based, psychoeducational family therapy for recently manic bipolar patients. Prior to therapy, family members were administered measures to assess both their expressed emotion and affective behavior during a family interaction task. Following family treatment, both therapists and independent observers rated the overall difficulty of treating the family, and therapists also rated each participant's problem behaviors during treatment, in the areas of affect, communication, and resistance. Therapists regarded affective problems among relatives and resistance among patients as central in determining the overall difficulty of treating the family. Relatives' critical behavior toward patients during the pretreatment interaction task predicted both independent observers' ratings of overall treatment difficulty and therapists' perceptions of relatives' affective problems during treatment. Moreover, patients' residual symptoms predicted independent observers' ratings of overall difficulty and therapists' perceptions of patients' resistance to the family intervention. Results suggest that difficulties in conducting a manual-based family intervention can be predicted from systematic, pretreatment family and clinical assessment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1545-5300.2000.39110.x
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