Much research has explored the cost effectiveness of psychotherapy for schizophrenia. However, to date, no studies have investigated the cost effectiveness of family and individual therapy for schizophrenia in the "real world" of managed care. The purpose of the present study is to compare the cost effectiveness of individual and family therapy for schizophrenia in one leading Health Care Insurer: CIGNA. Six years of outpatient data (2001–2006) and more than 2,100 unique schizophrenic outpatients are included. Research questions in this study concern the total treatment costs, the cost effectiveness, recidivism rates and the dropout rates of individual and family outpatient therapy. The findings show that family therapy is a more cost effective treatment than individual therapy by having lower total treatment costs and recidivism rates. However, family therapy has higher dropout rates than individual therapy.

Traumatic symptoms are common for survivors of childhood sexual abuse (CSA), and such symptoms are often compounded by the presence of shame. While much is known regarding the negative impact of Posttraumatic Stress Disorder (PTSD) on CSA survivors, less is known regarding the relationship between PTSD and shame and little to no research has investigated the impact of PTSD on intimacy mediated by shame for CSA survivors. The current study sought to fill this gap in the literature by exploring this phenomenon. Data was randomly collected from households in the following cities: Chicago, IL; New York City, NY; Salt Lake City, UT; and San Francisco, as well as the Utah State Penitentiary. Those who had completed the Trauma Symptom Checklist-33 (TSC-33), the Personal Assessment of Intimacy in Relationships scale (PAIR), and Internalized Shame Scale (ISS) were included in the dataset. Exclusionary criteria included females under 18, males, those who had not experienced sexual abuse, and those who had not completed the requisite scales. In all, 318 participants met criteria for the current study. The current study hypothesized that: (1) trauma symptoms would be negatively related to intimacy, (2) internalized shame will be negatively related to intimacy, and (3) internalized shame will significantly mediate the relationship between trauma symptoms and intimacy. The hypotheses were analyzed utilizing Structural Equation Modeling (SEM) and the associated AMOS 19 and MPlus software. Results found that trauma symptoms negatively impact intimacy and that shame has a mediating impact on this phenomenon. Further, shame was found to be a full mediator. While results of the current study illustrate the mediating role of shame on trauma symptoms, this mediation is within a relational rather than an individual context. Consequently, the current study fills an important gap in the literature regarding the interplay between shame and trauma for CSA victims within a relational context. Results of the current study give direction regarding the treatment of trauma and point to the importance of addressing shame in survivors of sexual abuse.

In this study, I present grounded-theory analyses of the decision-making process surrounding divorce or reconciliation based on in-depth interviews with 31 individuals thinking about divorce. The overall model of the divorce decision-making process included negative experiences leading to a bad relationship or an unsustainable marriage, the wilderness crossroads, the vast wilderness, and a development of an exit strategy. Repair attempts that were made are what helped the couple move towards a sustainable marriage or closer to divorce. The findings of the present study suggest that the decision-making process to divorce or reconcile can be a chaotic and confusing one—a wilderness—yet the participants sensed that it was necessary for themselves and others to endure this process before leaving the vast wilderness. The study discovered that a bad relationship does not present a straightforward path to divorce because the marriage has its own characteristics and considerations apart from the relationship. Within the vast wilderness there emerged seven key considerations in the decision-making process, namely: (1) the emotional and physical impact (on self); (2) children; (3) friendship and positive memories with spouse; (4) religion, prayer and hope; (5) commitment to marriage; (6) social impact and support of family and friends; and (7) finances. These considerations were focused on the marriage and were conceptually distinct from the romantic relationship of the couple. Marriage considerations were more salient and important than considerations of the spousal relationship, and they were crucial in the decision-making process to stay married or to divorce. I concluded by discussing implications of the study for individuals, clinicians, policy makers, and researchers.

While there has been research published on social withdrawal during childhood, little work has been done on the effects of social withdrawal during emerging adulthood. Since emerging adulthood is a time of transition and initiation to new environments and social contexts, it would be expected to be a time of great anxiety for individuals predisposed to social withdrawal (shyness). Shyer emerging adults are at risk for internalizing behaviors, lowered self-concept, and delayed entry into romantic relationships, therefore, they may also be more challenged when it comes to enacting prosocial behaviors. In addition, the inability to self-regulate emotions may mediate this relationship. This study utilized a sample of 774 college students (538 women, 236 men; 79% Caucasian; M = 20 years old) to test these hypotheses. Results showed that emerging adults who were more socially withdrawn were less likely to exhibit prosocial behaviors toward strangers, friends, and family members. In addition, results showed that the inability to self-regulate emotions, or cope, mediated this relationship in all cases. Implications include the salience of emotional self-regulation as a prerequisite to prosocial behavior directed toward multiple others and the possibly detrimental influence of shyness on relationship and community involvement during emerging adulthood.

This study examined the mediating impact of couples' attachment behaviors on the relationship between poor quality family-of-origin experiences and marital communication quality. The couple data for this study was collected from the Relationship Evaluation (RELATE) database (see www.relate-institute.org). An Actor Partner Interdependence Model using structural equation modeling was used to evaluate 261 marriage relationships. Results indicated that the relationships between family-of-origin experiences and communication quality are significantly related, with more family-of-origin problems associated with poorer positive communication skills. When attachment behaviors (accessibility, responsiveness, and engagement) were added to the model, it significantly mediated the relationship. Implications for clinicians treating couples who present with communication problems are discussed, as are directions for future research.

The scholarly study of materialism is becoming more common in a variety of disciplines. This thesis provides an empirical review of this burgeoning body of literature by conducting a meta-analysis of the relationship between materialism and psychological well-being. A weighted overall effect size from 47 published and unpublished samples indicated that materialism was significantly related to lower psychological well-being. This effect size was modest in strength (r = .159). Materialism scale, psychological scale valance, age of sample, and publication status of the study did not moderate this relationship. Culture did moderate the relationship, with a stronger relationship in individualistic cultures than in collectivist cultures. Implications for individuals, professionals, and organizations are discussed, and critiques of the extant literature, as well as suggestions for future research, are offered.

Recent studies are beginning to show evidence of marital problems for couples that have engaged in early premarital sexual activity compared to those who do not. Adult attachment theory plays an important role in explaining many kinds of distress for couples and helps explain sexual interaction, thus, in this study it is posited that attachment may influence sexual timing patterns. This study focuses on the relationship between insecure attachment styles and early premarital sexual timing. The sample consisted of 256 couples who took the Relationship Evaluation (RELATE) to measure their attachment styles and sexual timing while controlling for length of relationship, religiosity, education and age, which may be related to sexual timing. Models were tested for males and females separately using structural equation modeling (SEM). Results showed a significant, positive relationship between female anxious attachment and early sexual timing. Results also showed a significant negative relationship between female avoidant attachment and early sexual timing. No results showed significant relationships between male insecure attachment and sexual timing. Implications for couples, clinicians and educators are discussed.

While there is substantial evidence that marriage impacts health, no studies have explicitly analyzed the association between attachment behaviors and health practices. This study examines the relationship between couples' attachment behaviors and health practices, as measured by physical activity levels and dietary habits. Couple data was analyzed from the RELATE database (n= 4,957 couples). An Actor Partner Interdependence Model, using a multinomial logistic regression, was used to examine the relationships between attachment behaviors and health practices, as measured by activity level and dietary habits. Results for actor paths indicate that wives' own attachment behaviors significantly influence their own health practices. Husbands' attachment behaviors are not significantly related to their own health practices. Results also show no significant partner paths for either spouse. Clinical implications for treating women who present with health problems are discussed, as are directions for future research.

School-based depression prevention programs are being implemented in schools across the world in efforts to inoculate children and adolescents from depressive symptoms. This meta-analysis examined 56 manuscripts with a total of 82 studies which focused on school-based programs to determine how they affect depression, anxiety, cognitive skills, self-esteem, coping, and internalizing behaviors. For these specific outcomes, effect sizes ranged from .08 to .25. All combined outcomes yielded a significant effect size of .15. Moderator analyses revealed key differences that identified characteristics of the most effective programs. Targeted programs servicing at-risk students yielded an effect size of .31, while universal programs produced a significant but small effect size of .07. However, the program facilitator seemed to impact the effectiveness of all types of programs. Non-school personnel produced a .39 effect size with targeted samples, and .17 with universal samples, while school personnel produced about one half to a third of the effect.

Current research shows that grandparents have made significant contributions to at-risk families. However, few studies have examined the benefits of grandparenting in non-at-risk populations. This study considered whether emotional involvement with a grandparent is associated with prosocial behavior in adolescent grandchildren and examines the mediating role of empathy and perspective taking. A longitudinal sample of 500 participants were taken from waves two thru five of the Flourishing Families Project (FFP) and used to construct a latent growth curve model. Results indicate that emotional involvement with a grandparent was positively linked with initial levels of prosocial behavior in grandchildren. Furthermore, results indicated that empathy and perspective taking partially mediated the connection between grandparent's involvement and the initial levels of prosocial behavior in their grandchildren. Discussion focuses on the distinct contribution grandparents give to families.