The primary objective of the present investigation was to examine adaptive functioning in the families of patients with a wide range of psychiatric disorders. Seven dimensions of family functioning, as measured by the Family Assessment Device (FAD), were compared across families of patients with a schizophrenia spectrum disorder (n = 61), bipolar disorder (n = 60), major depression (n = 111), anxiety disorder (n = 15), eating disorder (n = 26), substance abuse disorder (n = 48), and adjustment disorder (n = 46). Families in each psychiatric group were also compared to a control group of nonclinical families (N = 353). Results indicated that regardless of specific diagnosis, having a family member in an acute phase of a psychiatric illness was a risk factor for poor family functioning compared to the functioning of control families. However, with few exceptions, the type of the patient's psychiatric illness did not predict significant differences in family functioning. Thus, having a family member with a psychiatric illness is a general stressor for families, and family interventions should be considered for most patients who require a psychiatric hospitalization for either the onset of, or an acute exacerbation of, any psychiatric disorder.

No abstract

This study examined the construct validity of depressive personality disorder (DPD: American Psychiatric Association, 1994). Adult psychiatric outpatients (N = 900) underwent comprehensive Axis I and II evaluations and provided data on 4,768 of their 1st-degree relatives. Despite modest overlap, DPD was not redundant with any Axis I or II disorder. Participants with DPD exhibited more Axis I and Axis II comorbidity, and greater psychosocial dysfunction, than participants without DPD. Relatives of participants with DPD had higher rates of mood disorders, alcohol abuse, and antisocial personality. Results are consistent with findings of several other similar investigations. The authors argue that DPD is a valid construct and should be conceptualized as a personality disorder as opposed to a mood disorder.

The majority of patients with a principal diagnosis of unipolar major depressive disorder have a comorbid anxiety disorder. Because antidepressant medications have differential efficacies for anxiety disorders, knowledge of the presence of a comorbid anxiety disorder in a depressed patient may have treatment implications.

We conducted a meta‐analysis of 48 research reports on the efficacy of group therapy for depression. In 15 studies in which treated participants were compared to untreated controls, the average effect size was 1.03, suggesting that the average treated participant was better off than about 85% of the untreated participants. Analyses of clinically significant change suggested that treated participants improved substantially. However, even after treatment, participants still had pronounced depressive symptomatology relative to normative levels of depressive symptoms seen in non‐depressed individuals. We conclude that group therapy is an efficacious treatment for depressed patients. However, numerous questions remain unanswered. For example, little empirical work has investigated what advantages group therapy might have over individual therapy. We conclude by making recommendations for future research in this area.

In this cross-sectional study, the authors attempted to identify correlates of family functioning in 86 couples with a depressed member during the acute phase of the patient's depression. Demographic variables, psychiatric status, and personality traits of both the patient and spouse were investigated as potential predictors of family functioning. Regression analyses indicated that lower levels of personality pathology in the patient, higher levels of patient conscientiousness, and less psychological distress in the spouse were associated with healthier family functioning. Future research implications and clinical importance of these findings are discussed.

No abstract

Three classical conditioning models (the conditioned compensatory response, conditioned withdrawal, and conditioned appetitive motivational models) postulate that drug cues evoke physiological and emotional responses associated with motivational states that prompt drug use. There is accumulating evidence to suggest that factors other than classical conditioning can influence emotional and physiological reactivity to drug stimuli. This study tested whether stage of change affects the nature of reactivity to smoking cues among continuing smokers. Precontemplators (smokers not considering quitting) and contemplators (smokers considering quitting in the near future) watched videotapes containing smoking cues. Emotional and physiological responses to the smoking video were contrasted with responses to a neutral videotape. Precontemplators had lower heart rates than did contemplators in response to the smoking videotape. Both contemplators and precontemplators evinced increased positive affect in response to the smoking cue. A comparison sample of nonsmokers did not show any reactivity to the smoking cue. Implications of these findings for conditioning theories of smoking are discussed.