In 1984, Jacobson, Follette, and Revenstorf defined clinically significant change as the extent to which therapy moves someone outside the range of the dysfunctional population or within the range of the functional population. In the present article, ways of operationalizing this definition are described, and examples are used to show how clients can be categorized on the basis of this definition. A reliable change index (RC) is also proposed to determine whether the magnitude of change for a given client is statistically reliable. The inclusion of the RC leads to a twofold criterion for clinically significant change.

/pdf/clinical-significance-a-statistical-approach-to-defining-1qbyghhgpi.pdf

Clinical significance: a statistical approach to defining meaningful change in psychotherapy research.

Sexual Behavior in the Human Male

Meta-analyses of studies yielding sex-specific risk of potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) indicated that female participants were more likely than male participants to meet criteria for PTSD, although they were less likely to experience PTEs. Female participants were more likely than male participants to experience sexual assault and child sexual abuse, but less likely to experience accidents, nonsexual assaults, witnessing death or injury, disaster or fire, and combat or war. Among victims of specific PTEs (excluding sexual assault or abuse), female participants exhibited greater PTSD. Thus, sex differences in risk of exposure to particular types of PTE can only partially account for the differential PTSD risk in male and female participants.

/pdf/sex-differences-in-trauma-and-posttraumatic-stress-disorder-2z87gssboo.pdf

Sex differences in trauma and posttraumatic stress disorder: a quantitative review of 25 years of research.

This survey of sexual practices in the United States has been combed by the media for items of interest to the public: monogamous sex is much more widespread in this country than has been thought; infidelity is less frequent than presumed; vaginal intercourse is the defining experience of heterosexual behavior; watching one's partner undress is stimulating to many people; married couples have more sex than single people (unmarried, cohabiting couples have the most sex of all); the majority of couples experience sex twice a week to several times a month; 2.8% of men identify themselves as homosexual and 1.4% of women do so, but a higher percentage of people consider a same-gender experience to have some appeal; 75% of men always experience orgasm compared with 28.6% of women, but more nearly equal numbers of men and women declare themselves satisfied with their sexual experiences. The book is, in fact, a

The Social Organization of Sexuality: Sexual Practices in the United States

Marital problems have been related to numerous indexes of maladjustment in children. Although several parameters of this association have been identified, the process by which exposure to interparental conflict gives rise to adjustment problems in children is largely unexplored. Research on the link between marital conflict and child maladjustment therefore is critically evaluated, and a framework is presented that organizes existing studies and suggests directions for future research on processes that may account for the association. According to the framework, the impact of marital conflict is mediated by children's understanding of the conflict, which is shaped by contextual, cognitive, and developmental factors. The implications of the framework for children's adjustment are discussed. Marital discord has been associated with a number of indexes of maladjustment in children, including aggression, conduct disorders, and anxiety (Emery, 1982, 1988). Research on the effect of divorce on children similarly indicates that the conflict associated with divorce, rather than the breakup of the family, is primarily responsible for many of the problems seen

/pdf/marital-conflict-and-children-s-adjustment-a-cognitive-3xcj9ze6no.pdf

Marital conflict and children's adjustment: a cognitive-contextual framework.

Two studies were conducted involving 150 couples selected at-large and 40 couples in Imlirital therapy. An initial fbcus of the studies was the development of' a 280-item Marital Satisfaction Inventory (MSI) including one validity scale, one global affective scale, and nine additional scales focusing on specific areas qf marital interaction. Correlational analyses confirm that measures qf communication are the best single predictors qf global marital satisfaction. Prqfile analyses demonstrate the ability qf the MSI to discriminate between couples in therapy and a matched control group. Implications for use qf the instrument both as a clinical tool and research instrument are discussed.

https://www.jstor.org/stable/pdfplus/351481.pdf

Multidimensional Assessment of Marital Satisfaction.

This is an edited book that addresses critical theoretical and methodological issues in the rapidly advancing field of emotion regulation. It presents empirical findings linking emotion regulation to individual and relationship functioning across the life span, while providing implications for clinical intervention, public policy, and future research. Contributors - who are nationally and internationally recognized for their expertise in social, developmental, and clinical disciplines - offer diverse perspectives on the role of emotion regulation processes in dysfunction and health. In addition to advancing the latest empirical developments, this volume will also be a prime resource for graduate students and practitioners working with children, couples, and families for whom emotion regulation difficulties are targets of clinical intervention.

Emotion regulation in couples and families : pathways to dysfunction and health

Extramarital involvement (EMI) occurs with high prevalence among couples in clinical and community settings, frequently resulting in considerable distress both to participants and their spouses. The field lacks a synthesized review of this literature. Without such a synthesis, it has been difficult for researchers and clinicians to have an understanding of what is and is not known about EMI. This article reviews the large and scattered EMI literature using a framework that encompasses multiple source domains across the temporal process of engaging in and responding to EMI. In addition, this review delineates conceptual and methodological limitations to previous work in this area and articulates directions for further research.

Intrapersonal, Interpersonal, and Contextual Factors in Engaging in and Responding to Extramarital Involvement

Couple therapy research affirms that various approaches to couple treatment produce statistically and clinically significant improvement for a substantial proportion of couples in reducing overall relationship distress. Recent studies have extended these findings in indicating the effectiveness of couple-based interventions for a broad range of coexisting emotional, behavioral, or physical health problems in one or both partners. In contrast to these encouraging results, research also indicates that a sizeable percentage of couples fail to achieve significant gains from couple therapy or show significant deterioration afterward. Research on processes of change and predictors of treatment outcome in couple therapy provides preliminary evidence regarding factors potentially contributing to variable treatment response. The chapter concludes with 12 recommendations regarding future directions in couple therapy research and clinical training.

http://people.tamu.edu/~d-snyder/Snyder-Castellani-Whisman%202006%20AR%2057,%20317-344.pdf

Current status and future directions in couple therapy.

The discovery or disclosure of an extramarital affair can have a devastating impact on partners, both individually and on the relationships. Research suggests that affairs occur relatively frequently in relationships and are a common presenting problem in couple therapy. However; despite their prevalence, there is little empirical treatment research in this area, and most therapists describe this problem as one of the more difficult to treat. In this study, we used a replicated case-study design to explore the efficacy of an integrative treatment designed to help couples recover from an affair. Six couples entered and completed treatment. The majority of these couples were less emotionally or maritally distressed at the end of treatment, and the injured partners reported greater forgiveness regarding the affair. Details of the intervention, suggested adaptations of the treatment, and areas for future research are discussed.

Douglas K. Snyder

Papers

Multidimensional Assessment of Marital Satisfaction.

Emotion regulation in couples and families : pathways to dysfunction and health

Intrapersonal, Interpersonal, and Contextual Factors in Engaging in and Responding to Extramarital Involvement

Current status and future directions in couple therapy.

An integrative intervention for promoting recovery from extramarital affairs.