The concept of codependency has been advanced in recent years in an effort to explain certain psychological and behavioral traits purported to be characteristic of spouses and adult children of alcoholics. The core symptoms which have been considered to define codependency are: low self-esteem, dependency, depression, and excessive sensitivity to interpersonal opprobrium. Secondary features are: defensiveness, anger, marital discord, lower self-perceived psychological health in ones family of origin, and excess alcohol use. To test the validity of this hypothesized syndrome, 97 female subjects married to either an alcoholic (SA) (n = 31), a psychiatric patient (SP) (n = 35), or a dentistry patient (SD) (n = 31) were studied. These subjects were further dichotomized based on whether they had a positive family history (FH+) for alcoholism. Following the obtaining of informed consent, all subjects were administered a battery of psychological tests consisting of the MMPI-168, SCL-90, TSCS, DPE, DAS, and FOS. The results of 2-way MANOVA revealed a significant main effect for both husbands' diagnosis and family history for alcoholism for both the primary and secondary features of codependency. No interaction was present between the grouping factors. Relative to the SD subjects, the SA subjects significantly differed in the expected direction on measures of dependency, depression, interpersonal sensitivity, anger, dyadic adjustment, and prevalence of excess alcohol use. The SA subjects significantly differed from the SP subjects on all of the above measures with the exception of depression. FH+ subjects, compared to FH- subjects, significantly differed in the expected direction on measures of self-esteem, interpersonal sensitivity, anger, degree of psychological health in the family of origin, and prevalence of excess alcohol use. Contrary to expectation, the FH- group scored higher on the administered measure of defensiveness. With the exception of lower levels of psychological health in the family of origin, the SA/FH+ subjects did not statistically differ from the SA/FH- subjects. In addition, the SA and FH+ subjects also evidenced significantly higher scores on many other measures of psychologic symptomatology not purported to be characteristic of codependency. It was therefore concluded these data suggest that two dissociable subtypes of codependency may be identifiable: one subtype associated with parental alcoholism and one associated with spousal alcoholism.

Although the rate of negative outcome in psychotherapy is around 10%, there are virtually no studies that examine the phenomenon empirically using objective data. This study attempted to identify patients who would drop out of or remain in therapy using pretreatment subjective distress variables and pretreatment interpersonal functioning. Of those who remained, this study then distinguished among positive responders, negative responders, and nonresponders. Subjective distress was linearly related to outcome such that patients with higher levels of subjective distress improved while patients with lower levels deteriorated. Interpersonal functioning was curvilinearly related to outcome such that higher levels of difficulty were associated with positive and negative responders while lower levels were associated with non-responders. There was also an interaction between coping style and type of treatment such that more directive treatments were more effective with patients exhibiting externalizing coping styles than with patients exhibiting internalizing coping styles. The reverse was true for non-directive therapies.

Marital research has demonstrated that one of the most important factors related to marital satisfaction is spouses' response to marital conflict. Three types of conflict behavior have been previously identified: problem solving, coercion, and avoidance. Problem solving has been linked to marital satisfaction, whereas coercion and avoidance have been linked to marital dissatisfaction. Previous marital researchers have studied couples' response to marital conflict as though spouses' typical response to conflict consists of only one of these types. In addition, marital researchers have only recently begun examining the role of emotion and cognitive processes in marital conflict. The present study is descriptive in nature and addresses three goals. First, subgroups of spouses and couples are identified based on the pattern of conflict behaviors they endorse. Second, relationships among perception of partner conflict behavior, specific emotions, and perception of self conflict behavior are explored. Third, sex differences found with regard to the first two goals are examined. Subjects consisted of two samples, a clinical sample and a research sample, resulting in a heterogeneous total sample of 117 couples. Cluster analysis identified four subgroups of husbands and five subgroups of wives. Differences in husband and wife clusters were consistent with previous marital conflict research. Although the valence of emotion was found to differentiate among the various subgroups of spouses, the type of emotion (e.g. sadness versus anger) was not found to differentiate these groups. However, regression analyses identified more complex relationships which varied with group identity and gender. In these relationships, the type of emotion was important. Limitations of the present study, clinical implications, and implications for future research are discussed.

Outcome research on marital therapy has consistently demonstrated various treatment techniques to be effective. While therapies developed along affective, behavioral, or cognitive lines all have their proponents, there is no evidence to suggest that any one technique, or combination of techniques, is significantly better than any other. As a possible explanation, it was suggested that this finding of equal outcome among various marital therapy techniques might actually be an artifact of the way in which the research is conducted. Unlike in the marketplace, where couples may select a particular therapist with a particular orientation, couples taking part in a research project are randomly assigned to a particular treatment condition. If couples who are mismatched dropout of the project, results of equal outcome would be based only on data from those couples for whom the therapy they received was appropriate for their needs. This would suggest not that various marital therapy interventions are equal in the general population, but, rather, that different techniques are appropriate for different couples. In order to test this idea, 68 married couples were recruited and randomly assigned to a wait list control group, or one of two different marital treatment interventions. It was expected that, after an eight week intervention, the couples in the two intervention conditions would demonstrate significantly higher marital satisfaction ratings than those in the wait list control, but would not significantly differ from each other. This hypothesis was confirmed. Closer inspection, however, using Discriminant Function Analysis on pretest measures of affective, behavioral, and cognitive factors, suggested that different factors predicted which couples remained in each of the interventions, which differentially emphasized these factors. This was discussed as evidence that all marital therapy techniques are not created equal, but are differentially appropriate for different couples.

Symptom overlap between the Hyperventilation Syndrome (HVS) and Panic Disorder (PD) has been noted by many investigators; however, the reasons for this association are unclear. By following 50 college subjects (36 female and 14 male) who displayed extremely high rates of hyperventilation symptoms over four-week to nine-month intervals, symptom stability patterns as well as the relationship to panic attacks were examined. Rates of overlap between hyperventilation symptoms and panic attacks was 66% in the current sample. Furthermore, 4 of 50 (8%) of panic-free subjects developed panic attacks during the course of the investigation. Although the frequency of hyperventilation symptoms decreased over time for most subjects, many individuals continued to be symptomatic over time. One potential mechanism of association between hyperventilation and panic (i.e., focus on either somatic or somatic plus cognitive symptoms of hyperventilation) was not supported, and several personality variables (repression and anxiety sensitivity) were not found to influence the relationship between hyperventilation and panic. Finally, measurement issues related to a hyperventilation symptom questionnaire were addressed. The two-week test-retest reliability was .79. Evaluation of the validity of the HVQ by assessing end-tidal CO₂ levels of 30 subjects resulted in no significant differences between high and low scorers. Implications of the present findings are discussed in light of current theoretical models of the relationship between HVS and PD.

This study investigated the effects of being perceived as responsible or not for a psychological problem, being responsible or not for solving that problem, as well as type of disorder (substance abuse or depression), on perceptions of clients. It was predicted that clients perceived as more responsible for causing their problem and/or solving it would elicit greater negative reactions than clients perceived as not responsible for their problem and/or its solution. It was also predicted that substance abusers would be derogated more than depressed clients. These hypotheses were tested by having college students (N = 336) read therapists' case descriptions in which the key independent variables were manipulated and then subjects responded to questions measuring perceived client responsibility for the problem and its solution, treatment effectiveness, client competency, feelings toward the client, and social acceptance of the client. A series of hierarchial regressions was performed to create a path analysis. Clients presented as responsible for their problem were perceived to be more responsible and were viewed as less competent, elicited more negative feelings, and were less socially accepted than clients perceived as not responsible for their problems. Although clients presented as responsible or not responsible for the solution to their problems were perceived as such, those perceptions had no impact on other perceptions of clients. Instead, clients presented as responsible for their own treatment were perceived as receiving a less effective treatment than those presented as not responsible for the solution. Perceptions of low treatment effectiveness, in turn, lead to lower ratings of client competency, more negative feelings, and less social acceptance of the client. In addition, substance abusing clients were seen as more responsible for their problem and its solution, were viewed as less competent, elicited more negative feelings, and were less socially accepted than depressed clients. This research has many clinical implications and may help alleviate the discomfort caused when certain attributions are made in regard to clients in treatment for psychological problems.

Closed head injury (CHI) typically results in diffuse damage to the brain with particular damage to the frontal and temporal regions. Individuals who have suffered a CHI often exhibit impaired verbal learning and memory. It has been noted that CHI individuals do not use semantic organizational encoding strategies to the same degree as non-CHI individuals. This failure is presumed to contribute to the observed verbal learning and memory impairment and is likely associated with frontal region damage and related frontal system dysfunction. The purposes of this study were to (a) investigate the effect of providing CHI subjects with guided semantic encoding and (b) describe the nature of the relationship between frontal system functioning and ability to benefit from guided semantic encoding. Twenty-four closed head injured subjects and 24 demographically matched control subjects participated in this study. Verbal learning and memory was measured using the California Verbal Learning Test (CVLT; Delis, Kramer, Kaplan, & Ober, 1987). The CVLT involves learning a sixteen word list containing four words from four categories. The CVLT was administered in both standard and non-standard, guided semantic encoding formats. Frontal system functioning was measured with the Wisconsin Card Sorting Test (Grant & Berg, 1948) and FAS Generative Naming (Borkowski, Benton & Spreen, 1967). Results from this study indicate that verbal learning and memory performance improves following guided semantic encoding. CHI subjects benefit to relatively the same degree as control subjects. This suggests that, with external guidance, CHI subjects have the ability to benefit from organizational cuing in a qualitatively similar manner to control subjects. However, performance of CHI subjects did not reach that of controls, even with guided semantic encoding, indicating additional processing deficits. Guided semantic encoding facilitates performance for both low and high frontal system functioning subjects on free and cued recall tests. Guided semantic encoding particularly helps low frontal system functioning CHI subjects in long delay recall and recognition discriminability. The finding that CHI subjects take advantage of semantic encoding strategies, when encouraged to do so, is similar to that reported for Korsakoff's syndrome and focal frontal lesion patients.

The purpose of this study was to examine the relationships among hardiness, social support, depression, and behavioral repertoire. One-hundred-sixty-five college students participated in the study. The hypothesis that hardiness and social support influence severity of depression and behavioral repertoire, and that depression is also causally related to behavioral repertoire was not supported. Instead, a parsimonious version of the initial hypothesized model was found to be a good representation of the data. The preferred model suggests that the personality characteristic, hardiness, is causally related to severity of depression, and furthermore, that social support directly influences behavioral repertoire. The findings are discussed in light of how they augment previous research and suggest new avenues for future research and practice.

The purpose of this study was to increase our understanding of the mechanisms for socialization influences upon eating disorder tendencies in Japanese adolescent girls. A total of 867 female students in grades 7, 8, 9, 10, and 11 from single-sex and mixed-sex high schools completed questionnaires assessing eating attitudes and behavior, interactions with the mother and peers in the eating/dieting domain, perceived warmth and control of the relationship with the mother and peers, and sensitivity to social evaluation. The mothers completed questionnaires including their eating attitudes and behavior, interaction with daughters in the eating/dieting domain, sex role attitudes, and concern for personal appearance. Girls attending single-sex schools showed a greater prevalence of weight preoccupation and dieting behavior, compared to girls attending mixed-sex schools. The impact of mutual monitoring and perceived control by the peers in the domain of eating and dieting seemed to increase with age, especially in the single-sex environment. The pubertal transition was found to be a particular risk period, both in terms of the girl's individual adjustment to the physical event and in terms of the changes following the menarcheal onset in her interaction with the mother and peers. Structural equation modeling was used to investigate mechanisms among the constructs hypothesized to contribute to greater eating disorder tendencies in this population. As expected, girls who were more sensitive to others' evaluations were more likely to respond to the external pressure to stay thin. Both maternal and peer influences within the eating/dieting domain had direct effects upon the girl's eating disorder tendencies. However, perceived quality of the relationship with the mother had the strongest direct effect. Overall, peers seem to influence the adolescent girl's attitudes and behaviors through their interactions in this specific domain, while the mother seems to influence through the more general climate of the mother-daughter relationship.

The study set out to examine the effect of therapist's orientation on his or her recommendations for individual or family based therapy. Other factors thought to influence the decision reached (i.e. experience, coursework, location of practice, perceived competency) were also explored. Seventy psychologists in the mental health field were presented with six clinical vignettes. The vignettes contained diagnoses or presenting problems that indicated either individual or family therapy, or contained insufficient information to clearly lead to a modality selection. It was found that the case vignette was the only significant variable affecting the modality or goals of the treatment recommendation. Biases in decision making among psychologists, based on orientation and areas of relative competence, were expected but not found. However, orientation did significantly affect the number of sessions recommended, with psychodynamic therapists recommending more therapy sessions than therapists from the other therapeutic orientations.