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Clinical Psychology Review Feb 2022Bowen Family Systems Theory's central construct, differentiation of self (DoS), is one of the most recognized constructs to systemic researchers and psychology... (Review)
Review
Bowen Family Systems Theory's central construct, differentiation of self (DoS), is one of the most recognized constructs to systemic researchers and psychology professionals. The present study reviewed the available evidence on DoS from the inception of the construct until July 31, 2020. A scoping review was conducted and a total of 295 primary studies were eligible for inclusion. Literature was categorized according to the hypotheses postulated by Bowen regarding: the associations between DoS and psychological and health outcomes and how DoS stability and similarity in partner levels operate within family systems. Descriptive data regarding studies on the measurement of DoS and in the area of psychotherapy were also compiled. Results revealed that there is ample support for DoS as a predictor of psychological health and marital quality, and that there are positive associations between DoS and better physical health and intergenerational relationships. Results of this review show that there continue to be underexplored hypotheses and a paucity of longitudinal or causal research designs to test the stability of DoS, the intergenerational transmission of DoS, and the efficacy of clinical interventions in modifying DoS to promote optimal well-being. Recommendations and next steps for researchers and practitioners are outlined.
Topics: Humans; Psychotherapy; Systems Theory
PubMed: 34823190
DOI: 10.1016/j.cpr.2021.102101 -
Annual Review of Clinical Psychology May 2021Committed, long-term romantic relationships are ubiquitous among modern society. They are one of the most important contexts for the development, maintenance, and... (Review)
Review
Committed, long-term romantic relationships are ubiquitous among modern society. They are one of the most important contexts for the development, maintenance, and treatment of psychopathology. In this review, I first place psychopathology within the most commonly cited theoretical model of marital satisfaction and stability and then discuss how relationship satisfaction is conceptualized and assessed in this literature. In the second half of the review, I describe the theories regarding how romantic relationships may be connected to psychopathology. Relationship distress is easily incorporated into a diathesis-stress model as an important trigger for psychopathology. Next, I review cross-sectional research, longitudinal research, and treatment efficacy research linking relationship quality and psychopathology. I provide evidence for the robustness of these effects and areas where research must expand. I finish with a summary section that synthesizes what is known about the mechanisms linking relationship distress and psychopathology.
Topics: Humans; Interpersonal Relations; Marital Therapy; Mental Disorders
PubMed: 33626285
DOI: 10.1146/annurev-clinpsy-081219-115420 -
Psychological Medicine Apr 2023Depression during pregnancy and after the birth of a child is highly prevalent and an important public health problem. Psychological interventions are the first-line... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Depression during pregnancy and after the birth of a child is highly prevalent and an important public health problem. Psychological interventions are the first-line treatment and, although a considerable number of randomized trials have been conducted, no recent comprehensive meta-analysis has evaluated treatment effects.
METHODS
We used an existing database of randomized controlled trials of psychotherapies for adult depression and included studies aimed at perinatal depression. Random effects models were used in all analyses. We examined the effects of the interventions in the short and long term, and also examined secondary outcomes.
RESULTS
Forty-three studies with 49 comparisons and 6270 participants between an intervention and control group were included. The overall effect size was = 0.67 [95% confidence interval (CI) 0.45~0.89; numbers needed-to-be-treated = 4.39] with high heterogeneity ( = 80%; 95% CI 75~85). This effect size remained largely unchanged and significant in a series of sensitivity analyses, although some publication bias was found. The effects remained significant at 6-12 months follow-up. Significant effects were also found for social support, anxiety, functional limitations, parental stress and marital stress, although the number of studies for each outcome was low. All results should be considered with caution because of the high levels of heterogeneity in most analyses.
CONCLUSIONS
Psychological interventions are probably effective in the treatment of perinatal depression, with effects that last at least up to 6-12 months and probably also have effects on social support, anxiety, functional impairment, parental stress, and marital stress.
Topics: Adult; Child; Female; Pregnancy; Humans; Depression; Psychotherapy; Depressive Disorder; Anxiety; Anxiety Disorders
PubMed: 37310303
DOI: 10.1017/S0033291721004529 -
Cancer Epidemiology Dec 2023Lung cancer is associated with high mortality, and significant health burden. Marital status has been associated with lung cancer survival. This systematic review and... (Meta-Analysis)
Meta-Analysis Review
Lung cancer is associated with high mortality, and significant health burden. Marital status has been associated with lung cancer survival. This systematic review and meta-analysis set out to investigate the association between marital status and treatment receipt in lung cancer. The search was conducted across three databases: Medline (OVID), Embase and CINAHL, from inception to June 2022. Retrospective or prospective observational studies that quantified treatment receipt by marital status were eligible for inclusion. Study quality was assessed via a modified checklist for retrospective databased-based studies. Meta-analysis using a random effects model was undertaken by chemotherapy, radiotherapy, surgery, and any treatment relative to married or not married. Pooled unadjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated for each type of treatment. 837 papers were screened and 18 met the inclusion criteria with eight being eligible for inclusion in the meta-analysis. Studies were excluded from meta-analysis due to overlap in the data reported in papers; the mean quality score of the 18 included papers was 12/17. Being married was associated with increased odds of overall treatment OR 1.43 (95 % CI 1.14-1.79; I = 82 %; Tau = 0.07; six studies) and also increased receipt of: chemotherapy 1.40 (95 % CI 1.35-1.44; I2 = 82 %; Tau = 0.00); radiotherapy 1.29 (95 % CI 0.96-1.75; I = 100 %; Tau= 0.09; four studies) and surgery (95 % CI 1.31-1.52; I = 86 %; Tau = 0.00; five studies). The results indicate that those who are married are more likely to receive treatment for lung cancer compared to those who are not married. This requires further investigation to better understand the explanations behind this finding and how we can work to combat this inequality.
Topics: Humans; Retrospective Studies; Lung Neoplasms; Marital Status; Cognition; Marriage; Observational Studies as Topic
PubMed: 37992417
DOI: 10.1016/j.canep.2023.102494 -
Journal of the American Psychoanalytic... Aug 2019Projective identification (PI) is a complex process that can bridge the divide between individual psychodynamics and interpersonal systemic process. Consequently, it...
Projective identification (PI) is a complex process that can bridge the divide between individual psychodynamics and interpersonal systemic process. Consequently, it provides a powerful lens through which to examine couple conflict and unhappiness. This paper aims to clarify and demystify the concept and to illustrate its special utility for clinicians practicing individual psychoanalysis or psychotherapy, and for therapists who treat couples conjointly. It deconstructs PI into components of transference (projection), induction, and identification of both inducers and recipients; distinguishes subtypes; and then discusses some important topics surrounding the concept, including what is meant by "identification," the importance of "containment," and how induction is often accomplished by inaction. Clinical examples illustrate how patients use PI to manage grief, shame, past traumas, and current deficits. The utility of PI for understanding partner selection and marital polarities is illustrated, and guidelines for working with PI in psychodynamic couple therapy are provided.
Topics: Female; Humans; Interpersonal Relations; Male; Marriage; Projection; Psychoanalytic Theory; Psychoanalytic Therapy; Spouses
PubMed: 31604387
DOI: 10.1177/0003065119869942 -
Family Process Dec 2022This paper provides a critical analysis and synthesis of the current status and emerging developments in contemporary couple therapy. Its narrative centers on the... (Review)
Review
This paper provides a critical analysis and synthesis of the current status and emerging developments in contemporary couple therapy. Its narrative centers on the evolution of couple therapy into a prominent intervention modality and coherent body of practice. The review begins with the consideration of the field's strong empirical underpinnings derived from research on couple therapy and basic relational science. Couple therapy comprises the widely accepted method for reducing relationship distress and enhancing relationship quality. Moreover, both as a stand-alone intervention and in conjunction with other treatment formats, couple-based interventions have garnered considerable empirical support for their effectiveness in addressing a broad spectrum of specific relational dysfunctions as well as individual emotional and physical health problems. We highlight the convergence of methods through common factors, shared strategies, and remarkably similar arrangements across approaches. Our review also points to key differences among approaches, the importance of recognizing respective strengths and limitations linked to these differences, and building on differences across models when selecting and tailoring interventions for a given couple. The discussion concludes with a consideration of recent trends in the field including the impact of telehealth and related digital technologies, the expansion of specific treatments for specific problems and diverse populations, the interface of couple therapy with relationship education, and enduring challenges as well as new opportunities addressing broader systemic and global dynamics.
Topics: Humans; Couples Therapy
PubMed: 36175119
DOI: 10.1111/famp.12824 -
International Journal of Environmental... Jan 2022Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health...
Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health effect of marriage or divorce is age-dependent and differs between women and men. The study aimed to identify the age and sex-related associations between marital status with PA and TV time. We used data from Vigitel, an annual telephone survey started in 2006 in Brazil. We applied a complex sample logistic regression model to estimate the odds for PA and TV time comparing marital statuses according to age and sex subgroups, independent of obesity, hypertension, diabetes, self-assessed poor health, and smoking. Our sample included 561,837 individuals from 18 to 99 years, with a TV time > 3 h/day (prevalence = 25.2%) and PA > 150 min/week (prevalence = 35%). Later, we divided our sample in seven age groups by marital status and sex. Compared to single individuals, married men and women were less likely to watch TV more than 3 h/day in participants >30 years old. When compared to single, married participants were less likely to do more than 150 min of PA/week at younger age groups. Married women older than 40 years were more likely to do more than 150 min of PA/week than the single ones, while there were no differences among married men by age group. In conclusion, our study suggests that the investments in public policies to encourage the practice of PA and reduction of TV time could be based on the marital status, sex, and age, prioritizing less active groups.
Topics: Adult; Divorce; Exercise; Female; Humans; Male; Marital Status; Marriage; Obesity
PubMed: 35010761
DOI: 10.3390/ijerph19010502 -
Heart Failure Clinics Jan 2023Biological sex and sociocultural gender are emerging as pivotal modifiers of health and diseases. Sex-based differences exist in the development, pathogenesis, and... (Review)
Review
Biological sex and sociocultural gender are emerging as pivotal modifiers of health and diseases. Sex-based differences exist in the development, pathogenesis, and management of individuals with pulmonary arterial hypertension (PAH). The interplay between gender domains (ie, identity, roles, relations, and institutionalized gender) and PAH has been barely investigated. The aim of this narrative review is to describe up-to-date evidence on the integration of sex and gender in PAH research, highlighting areas for future investigation.
Topics: Male; Female; Humans; Hypertension, Pulmonary; Sex Characteristics
PubMed: 36435566
DOI: 10.1016/j.hfc.2022.09.002 -
European Urology Focus Nov 2020Androgen deprivation therapy (ADT) is a common treatment for many men with prostate cancer. Use of ADT can have significant impacts on the mental health of patients with... (Review)
Review
Androgen deprivation therapy (ADT) is a common treatment for many men with prostate cancer. Use of ADT can have significant impacts on the mental health of patients with both localized and advanced disease. Prostate cancer patients receiving ADT have a 41% higher risk of depression and a 47% higher risk of dementia. Risk factors for the development of depression in this group of men include older age, marital status, greater comorbidity, and a previous history of depression, while being retired may offer a protective effect. Optimal treatment strategies for depression for these men are not well established in the literature. PATIENT SUMMARY: We reviewed the association between androgen deprivation therapy (ADT) use by men with prostate cancer and the risk of mental health issues. There appears to be a higher risk of both depression and cognitive impairment for men receiving ADT. Optimal treatments for depression for men on ADT are still not well studied.
Topics: Androgen Antagonists; Cognitive Dysfunction; Depression; Humans; Male; Prostatic Neoplasms
PubMed: 31911085
DOI: 10.1016/j.euf.2019.11.010 -
Supportive Care in Cancer : Official... May 2023Literature on marital self-disclosure interventions for cancer patients lacks consistency in methodology and content. Moreover, the impact of such interventions on... (Review)
Review
PURPOSE
Literature on marital self-disclosure interventions for cancer patients lacks consistency in methodology and content. Moreover, the impact of such interventions on physical and psychological health, marital relationships, and self-disclosure ability is controversial. This review aims to systematically analyze the studies of marital self-disclosure intervention, synthesize the structure and topics of marital self-disclosure, and summarize and evaluate its effects on improving physical and psychological outcomes and marital relationships in cancer patients and their spouses.
METHOD
This systematic review used the preferred reporting items of Systematic Reviews and Meta-Analyses (PRISMA). We conducted a systematic review of randomized controlled and quasi-experimental studies published from the establishment of the database to October 2022. Marital self-disclosure interventions were conducted with both cancer patients and their spouses. Studies published in a language other than English or Chinese, and studies below a quality grade of C were excluded. Data were extracted through a standardized data collection form, and two reviewers independently extracted and evaluated the data. The quality of the included studies was assessed using the Cochrane Handbook of Systematic Reviews of Interventions, and a third reviewer adjudicated in case of disagreement. The data were synthesized by vote counting based on direction of effect according to the Synthesis Without Meta-analysis (SWiM) reporting guideline.
RESULTS
Thirteen studies were included in the review. Based on quality evaluation, three studies were categorized as grade A (good), and ten studies were grade B (moderate). Seven studies reported moderate rates of participant refusal and attrition. The structure and topics of marital self-disclosure varied across different studies. The five studies had various prespecified disclosure topics, such as fear of cancer recurrence, benefit finding, and emotional distress. The overall results suggest that marital self-disclosure interventions can improve physical and psychological health, enhance marital relationships, and increase self-disclosure ability.
CONCLUSION
The limited number of studies, small sample sizes, diverse intervention strategies, and methodological heterogeneity weakened the evidence base for the effectiveness of marital self-disclosure interventions. Therefore, further high-quality randomized controlled trials (RCTs) are recommended to confirm the effectiveness of such interventions. These studies should also evaluate the interventions' long-term impact, analyze optional topics and methods, identify key features, and explore the development of the best intervention program.
Topics: Humans; Disclosure; Marriage; Neoplasms; Mental Health
PubMed: 37249639
DOI: 10.1007/s00520-023-07826-z