The thermosensory system is relevant to both the conceptualization and treatment of depression. There is evidence that depression is associated with changes in thermoregulatory functioning, and that thermosensory pathways can be recruited to influence affect and reduce depressive symptoms. In this study, we investigated the relationship between severity of depressive symptoms and changes to measures of subjective experiences associated with thermoregulatory processes as well as the relationship between severity of depressive symptoms and affective responses to warm stimuli, specifically frequency of warmth-seeking behavior. Participants (N = 529) completed measures of depressive symptoms, subjective experiences associated with thermoregulatory processes (i.e., perceived sweating and preferred ambient temperature) and frequency of warmth-seeking behavior (e.g., long hot baths, saunas, etc.). We demonstrate that, controlling for age and gender, greater severity of depressive symptoms is associated with greater perceived sweating and lower preferred ambient temperature. Furthermore, we demonstrate that greater severity of depressive symptoms is associated with more frequent warmth-seeking behavior, and that something other than thermal preference (i.e., stated preference for warmer temperature) is driving this behavior. These data highlight the importance of incorporating the thermoregulatory system in our conceptualization of the pathophysiology of depression and support the potential to recruit thermosensory pathways to target depressive symptoms.
Depression is the leading cause of disease burden globally. Existing antidepressant treatments that target the central nervous system have limited efficacy and come at the cost of significant side effects. Thus, there is growing interest in novel therapeutic interventions for the prevention and treatment of depression, including interventions that target interoceptive signaling. The thermosensory system may hold particular promise, given evidence that depression is associated with impairments in thermosensory functioning, and that whole-body hyperthermia produces an antidepressant effect in patients with major depressive disorder. In this study, we investigated whether the severity of depressive symptoms in a non-clinical population moderated the effect of local skin warming on subjective and physiological stress responses following exposure to an acute social stressor. Following exposure to the stressor, participants (N = 90) rested their arm on a heat blanket that was either turned on (local skin warming condition) or left off (control condition). We demonstrate that local skin warming increased fingertip temperature, a marker of reduced sympathetic nervous system activity, but only for participants with high levels of depressive symptoms. While local skin warming also inhibited salivary alpha amylase, severity of depressive symptoms did not moderate this effect, and no effect was found for electrodermal activity. These data highlight the importance of incorporating peripheral physiology in our conceptualization of the pathophysiology of depression and show that changes in sympathetic nervous system activity may underpin the antidepressant effect of warm stimuli.
Many assistance dog providers use volunteer raisers to manage each puppy's learning and daily experiences, which partly determines the puppy's behavioural development. Therefore, it is important that raisers engage in recommended practices. Three common recommendations from the literature include frequent socialisation and consistent training for the puppies, and effective training for the raisers. However, what facilitates or hinders raisers' engagement in these practices remains unclear. To understand this, we interviewed eight raisers (three men and five women) every month during their year-long puppy raising program, and pseudo-randomly selected 16 from 48 interviews for data analysis. Thematic analyses revealed several facilitating and/or hindering factors corresponding to each of the three recommended practices. Frequent socialisation was influenced by the raisers' availability, sharing of puppy raising responsibility with others, support from their workplace, and the puppy's behaviours (e.g., soiling indoors, jumping). Consistent training was challenged by the presence of everyday distractors, accessibility to timely advice, perceived judgement from others, and the puppy's undesirable behaviours. Effective learning was facilitated by having information available in raisers' preferred learning modality, opportunities for peer-learning, and willingness to seek help. Future research should examine these factors quantitatively, which will enable more robust evaluation of programs aimed at supporting puppy raisers.
Introduction: Negative feedback seeking and excessive reassurance seeking behaviors in interpersonal relationships have been shown to frequently occur in conjunction with levels of depression. Method: We used meta-analysis to examine 102 studies (134 effects), relating depression with negative feedback seeking (k = 31) and/or excessive reassurance seeking (k = 103). Results: Depression had positive, moderate effect sizes with both negative feedback seeking (r = .26, 95% CI [.21, .32], p < .001, k = 31) and excessive reassurance seeking (r = .33, 95% CI [.31, .36] p < .001, k = 103). Subgroup analysis revealed the effect size for negative feedback seeking was smaller in romantic relationships compared to other relationship types. Effect sizes for excessive reassurance seeking did not differ for romantic and other relationships but were smaller in romantic relationships of a longer duration. Participant gender and symptom severity did not moderate effect sizes. Studies with child and adolescent samples had larger effects for negative feedback seeking and smaller effects for excessive reassurance seeking, relative to adult samples. Discussion: Longer closer relationships may protect against maladaptive interpersonal behaviors in individuals with depression.
Background Post-traumatic stress disorder (PTSD) refers to an anxiety or trauma- and stressor-related disorder that is linked to personal or vicarious exposure to traumatic events. PTSD is associated with a range of adverse individual outcomes (e.g. poor health, suicidality) and significant interpersonal problems which include difficulties in intimate and family relationships. A range of couple- and family-based treatments have been suggested as appropriate interventions for families impacted by PTSD. Objectives The objectives of this review were to: (1) assess the effects of couple and family therapies for adult PTSD, relative to 'no treatment' conditions, 'standard care', and structured or non-specific individual or group psychological therapies; (2) examine the clinical characteristics of studies that influence the relative effects of these therapies; and (3) critically evaluate methodological characteristics of studies that may bias the research findings. Search methods We searched MEDLINE (1950- ), Embase (1980- ) and PsycINFO (1967- ) via the Cochrane Common Mental Disorders Controlled Trials Register (CCMDCTR) to 2014, then directly via Ovid after this date. We also searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Library. We conducted supplementary searches of PTSDPubs (all available years) (this database is formerly known as PILOTS (Published International Literature on Traumatic Stress)). We manually searched the early editions of key journals and screened the reference lists and bibliographies of included studies to identify other relevant research. We also contacted the authors of included trials for unpublished information. Studies have been incorporated from searches to 3 March 2018. Selection criteria Eligible studies were randomised controlled trials (RCTs) of couple or family therapies for PTSD in adult samples. The review considered any type of therapy that was intended to treat intact couples or families where at least one adult family member met criteria for PTSD. It was required that participants were diagnosed with PTSD according to recognised classification systems. Data collection and analysis We used the standard methodological procedures prescribed by Cochrane. Three review authors screened all titles and abstracts and two authors independently extracted data from each study deemed eligible and assessed the risk of bias for each study. We used odds ratios (OR) to summarise the effects of interventions for dichotomous outcomes, and standardised mean differences (SMD) to summarise post-treatment between-group differences on continuous measures. Main results We included four trials in the review. Two studies examined the effects of cognitive behavioural conjoint/couple's therapy (CBCT) relative to a wait list control condition, although one of these studies only reported outcomes in relation to relationship satisfaction. One study examined the effects of structural approach therapy (SAT) relative to a PTSD family education (PFE) programme; and one examined the effects of adjunct behavioural family therapy (BFT) but failed to report any outcome variables in sufficient detail we did not include it in the meta-analysis. One trial with 40 couples (80 participants) showed that CBCT was more effective than wait list control in reducing PTSD severity (SMD -1.12, 95% CI -1.79 to -0.45; low-quality evidence), anxiety (SMD -0.93, 95% CI -1.58 to -0.27; very low-quality evidence) and depression (SMD -0.66, 95% CI -1.30 to -0.02; very low-quality evidence) at post-treatment for the primary patient with PTSD. Data from two studies indicated that treatment and control groups did not differ significantly according to relationship satisfaction (SMD 1.07, 95% CI -0.17 to 2.31; very low-quality evidence); and one study showed no significant differences regarding depression (SMD 0.28, 95% CI -0.35 to 0.90; very low-quality evidence) or anxiety symptoms (SMD 0.15, 95% CI -0.47 to 0.77; very low-quality evidence) for the partner of the patient with PTSD. One trial with 57 couples (114 participants) showed that SAT was more effective than PFE in reducing PTSD severity for the primary patient (SMD -1.32, 95% CI -1.90 to -0.74; low-quality evidence) at post-treatment. There was no evidence of differences on the other outcomes, including relationship satisfaction (SMD 0.01, 95% CI -0.51 to 0.53; very low-quality evidence), depression (SMD 0.21, 95% CI -0.31 to 0.73; very low-quality evidence) and anxiety (SMD -0.16, 95% CI -0.68 to 0.36; very low-quality evidence) for intimate partners; and depression (SMD -0.28, 95% CI -0.81 to 0.24; very low-quality evidence) or anxiety (SMD -0.34, 95% CI -0.87 to 0.18; very low-quality evidence) for the primary patient. Two studies reported on adverse events and dropout rates, and no significant differences between groups were observed. Two studies were classified as having a 'low' or 'unclear' risk of bias in most domains, except for performance bias that was rated high. Two studies had significant amounts of missing information resulting in 'unclear' risk of bias. There were too few studies available to conduct subgroup analyses. Authors' conclusions There are few trials of couple-based therapies for PTSD and evidence is insufficient to determine whether these offer substantive benefits when delivered alone or in addition to psychological interventions. Preliminary RCTs suggest, however, that couple-based therapies for PTSD may be potentially beneficial for reducing PTSD symptoms, and there is a need for additional trials of both adjunctive and stand-alone interventions with couples or families which target reduced PTSD symptoms, mental health problems of family members and dyadic measures of relationship quality.
Numerous studies show that those involved in disaster response may develop posttraumatic stress disorder or experience secondary traumatic stress (STS). There are few reports about the experiences of postdisaster field research interviewers. We report findings from a follow-up study of researchers who conducted postwildfire field research interviews with residents affected by 5 severe wildfire events in Australia over the period 2009-2014. There were 33 postwildfire research interviewers who reported their experiences, and 18 of them (54.5%) described distressing interviews involving deaths, surviving severe threats to life, and destruction of houses. There were 27 (81.6%) who reported having experienced 1 or more STS symptoms on a 20-item measure. Those who conducted interviews following a multifatality wildfire event reported higher levels of STS symptoms compared with researchers whose interviews followed nonfatal wildfires. There were 21 (63.6%) researchers who reported that their interviewing experiences had positive effects on their lives. This indicates that the researcher role of gathering information so that future wildfire risk could be mitigated may have served a protective function.
To better understand how body image operates within the context of intimate relationships, we investigated women's responses to appearance feedback from an intimate partner. Participants (N=192) imagined receiving feedback from their partner that was either consistent with their own appearance self-view (i.e., self-verifying), more positive (i.e., self-enhancing), or less positive (i.e., devaluing), and then provided their affective and cognitive reactions. As expected, women's perceptions of their own appearance moderated their reactions. Women with more negative self-views felt happier with enhancing feedback, but thought that it meant their partner understood them less well. They also felt less happy when they received verifying feedback, but felt more understood by their partners. Thus, women with body image dissatisfaction may find themselves stuck in the “cognitive-affective crossfire” reacting ambivalently whether their partner enhances their appearance or confirms their negative self-views. Further examination of partners’ actual feedback is needed.
Background: A number of theories have proposed possible mechanisms that may explain the high rates of comorbidity between posttraumatic stress disorder (PTSD) and persistent pain; however, there has been limited research investigating these factors.Objective: The present study sought to prospectively examine whether catastrophizing predicted the development of PTSD symptoms and persistent pain following physical injury.Design: Participants (N = 208) completed measures of PTSD symptomatology, pain intensity and catastrophizing during hospitalization following severe injury, and 3 and 12 months postinjury. Cross-lagged path analysis explored the longitudinal relationship between these variables.Results: Acute catastrophizing significantly predicted PTSD symptoms but not pain intensity 3 months postinjury. In turn, 3-month catastrophizing predicted pain intensity, but not PTSD symptoms 12 months postinjury. Indirect relations were also found between acute catastrophizing and 12-month PTSD symptoms and pain intensity. Relations were mediated via 3-month PTSD symptoms and 3-month catastrophizing, respectively. Acute symptoms did not predict 3-month catastrophizing and catastrophizing did not fully account for the relationship between PTSD symptoms and pain intensity.Conclusions: Findings partially support theories that propose a role for catastrophizing processes in understanding vulnerability to pain and posttrauma symptomatology and, thus, a possible mechanism for comorbidity between these conditions.
Few studies have investigated how attachment bonds between older parents and their adult children influence adult children's provision of care and older parents' seeking of support from kin. The aim of this study was to investigate how the attachment orientations of adult children (N = 119) and older parents (N = 148) predict family caregiving and perceptions of carer burden. Across both samples (that were unrelated), attachment dimensions were associated with current and future caregiving and care receiving and perceptions of carer burden, even when accounting for demographic variables, parental dependence and filial obligation. Specifically, attachment avoidance was associated negatively with adult children's future care of parents and positively with burden. In contrast, attachment anxiety was positively associated with older parents' seeking current support, perceptions of carer burden, and intentions to seek future support.
OBJECTIVEThis study evaluated the relations between posttraumatic stress disorder (PTSD) symptoms and poor family functioning in veterans and their partners.METHODData were collected from Caucasian veterans with PTSD (N = 1,822) and their partners (N = 702); mean age = 53.9 years, SD = 7.36. Veterans completed the Posttraumatic Checklist Military Version (PCL-M) and, along with their partners, completed the McMaster Family Assessment Device (FAD-12). Assessments were conducted at intake into a treatment program at 3 months and 9 months posttreatment.RESULTSStructural equation models (SEMs) were developed for veterans as well as for veterans and their partners. Poor family functioning for veterans at intake predicted intrusion (β = .08), hyperarousal (β = .07), and avoidance (β = .09) at 3 months posttreatment. At 3 months posttreatment, family functioning predicted hyperarousal (β = .09) and avoidance (β = .10) at 9 months. For veterans and their partners, family functioning at intake predicted avoidance (β = .07) at 3 months, and poor family functioning at 3 months predicted intrusion (β = .09) and hyperarousal (β = .14) at 9 months. The reverse pathways, with PTSD symptoms predicting poor family functioning, were only evident with avoidance (β = .06).CONCLUSIONFamily functioning may play a role in treatment for veterans.
A growing literature indicates that organizational and work demands place pressure on the partners and families of volunteer workers as it does on paid workers. This study evaluated a conceptual model integrating work-family conflict and stress crossover theoretical frameworks, to investigate the mechanisms by which emergency service volunteer work, specifically, predicts outcomes for the partners of volunteers. Matched data from 102 couples in which one partner was an Australian emergency services volunteer - firefighter, ambulance officer or emergency rescue volunteer - were analysed using structural equation modelling analyses. Findings suggested that one mechanism by which inter-role conflict related to partner adjustment was through elevated withdrawn marital behaviour and decreased intimacy reported by the couple, which indirectly affected partners' distress. This finding regarding withdrawn behaviour appears to be novel and may also be applicable to paid workers. Alternative mechanisms involving role overload and angry marital behaviour were not supported. These findings extend limited research which has adapted organizational theory to understand processes affecting volunteer workers, and advance conceptual accounts of the mechanisms through which the partners and families of workers are impacted by inter-role conflict.
Trends indicate overall declines in numbers of volunteer emergency service workers and suggest negative organisational factors impacting adversely on volunteers and organisations. Conflict between emergency service work and family is implicated in falling volunteer numbers, and there is thus a need for research on difficulties experienced in balancing volunteer work and family. The current study tested an adaptation of the work-family conflict (WFC) model originally proposed by Frone, Russell, and Cooper, in a sample of 102 couples in which one partner was an Australian emergency service volunteer. Results supported a model in which volunteer work-related antecedents, including time invested in on-call emergency activities and post-traumatic stress symptoms, had indirect links with outcomes, including volunteer burnout and their partners' support for the volunteer work role, through the effects of WFC. These results add to research using theoretical models of paid work processes to better understand the problems faced by volunteer workers, and identify specific antecedents and outcomes of WFC in the volunteer emergency services. Implications for future research and organisations reliant on volunteer workers are discussed.
A longitudinal framework was used to examine the competing hypotheses of (a) whether family functioning predicts changes in posttraumatic stress disorder (PTSD) symptoms or (b) whether PTSD symptoms predict changes in family functioning. Veterans (N = 311) admitted to a treatment program completed a series of questionnaires at 3 time points: at intake, from intake to completion of a treatment program, and at the 6-month follow-up. Alcohol use and general mental health symptoms were also measured at intake. A cross-lagged panel model using structural equation modeling analyses indicated that family functioning was a moderate predictor of PTSD symptoms at posttreatment and at the 6-month follow-up. PTSD was not a significant predictor of family functioning across time and alcohol use, and general mental health symptoms did not affect the overall findings. Further analyses of PTSD symptom clusters indicated that the avoidance symptom cluster was most strongly related to family functioning. Targeting family relationships for treatment may be important in the future for veterans with PTSD.
OBJECTIVE This study drew together research on anxious attachment, self-silencing, self-consciousness during sexual activity and bulimic symptoms. METHOD A mixed community/university sample of 225 women aged 18-63 (M = 30.24, SD = 10.44) and involved in an intimate relationship completed questionnaires. RESULTS Adverse relationship processes were significantly associated and each was also associated with bulimic symptoms. Self-consciousness during sexual activity was the best predictor of bulimic symptoms, followed by anxious attachment. Self-silencing was redundant when the other relationship processes were included in the regression. General psychopathology mediated the association between self-silencing and bulimic symptoms, and partially mediated associations between bulimic symptoms and both anxious attachment and self-consciousness during sexual activity. DISCUSSION Women with bulimic symptoms attempt to change themselves by engaging in adverse processes in intimate relationships to meet the perceived expectations of their partners. Targeting these relationship processes in therapy might further add to the success of relationship-oriented treatments (e.g. interpersonal therapy).
Protection to Australian communities from fire and other emergencies is provided mostly by volunteers. However, declining volunteer numbers have forced emergency service agencies to consider factors impacting adversely on volunteer retention. The current study provides an organisational perspective on the difficulties of balancing volunteering and family commitments through semi-structured interviews with managers of Australian volunteer firefighters. A thematic analysis of interviews identified several themes, including: volunteers' difficulty prioritising family needs ahead of brigade responsibilities; leaving household and business responsibilities with family members; a lack of time with family; and interruptions to family routines and activities. Findings are discussed in the context of existing research and a theoretical model of Work-Family Conflict, and inform recommendations for agencies to support families and minimise conflicts between volunteer firefighting and family life.
The protection of Australian rural communities from fire and other emergencies is provided mostly by volunteers. However, many fire agencies are facing concerns over falling volunteer numbers and are increasingly looking at factors potentially impacting on volunteering. Evidence suggests that family issues play a role in many volunteer resignations and could be contributing to declining volunteer numbers. Despite this, there is little research available on the families of rural volunteer firefighters and agencies have little evidence to inform strategies for supporting the families of their volunteers. In a preliminary effort to address this lack of knowledge, this review summarises the small amount of research available on rural families in general, and then volunteer firefighter families in particular. It then introduces a potentially useful model of Work-Family Conflict, which suggests that time-and strain-based pressures may be important sources of difficulty for spouses and partners balancing volunteer firefighter and family roles. This review concludes by summarising directions for future research that are important, if volunteer-based rural fire agencies are to develop policies to better support the families of their volunteers
Self-Verification Theory (Swann, 1987) predicts that people want others to see them as they see themselves. But does this theory hold for the (often irrational) self-views held by women with body dissatisfaction or eating disorders? To test this application of Self-Verification Theory, we investigated: (1) whether body dissatisfied women reported both seeking and receiving negative feedback from their relationship partners; (2) whether male partners who were willing to provide negative feedback were more likely to be body dissatisfied themselves; and (3) whether receiving self-consistent (negative) feedback was associated with relationship satisfaction. Forty-one couples in relationships that had been established for six months or more completed a set of anonymous questionnaires. Results demonstrated that, after controlling for body mass index (BMI), depression, and length of relationship, females' body dissatisfaction and eating problems were associated with desires for appearance-related negative feedback, which predicted, in turn, their male partners' tendency to provide such feedback. Male partners' own body dissatisfaction also predicted their willingness to offer feedback. Such findings support Self-Verification Theory. However, the receipt of negative feedback by body dissatisfied women was associated with lower (rather than higher) relationship satisfaction, contrary to predictions made by this theory.