ĐĎॹá>ţ˙ y{ţ˙˙˙x˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙˙ěĽÁ3 đżBBbjbjC‡C‡ "x!í!íÝ=d˙˙˙˙˙˙lBBBBBBBVX5X5X585 œ5źV¤Qtd6d6d6d6d6d6d6d6#Q%Q%Q%Q%Q%Q%Q$S 8UœIQBd6d6d6d6d6IQHBBd6d6^QHHHd6>Bd6Bd6#QHd6#QH0HLL:żP,BB#Qd6X6 ůý˛sOĆV4X5˘8ö ëP #QtQ0¤QőP.ÔU˜F„ÔU#QHVVBBBBŮTreating Difficult Couples Questions from chapter 1 According to Campbell et al. (1976) what has the largest impact on a couple's overall life satisfaction? job income community physical health feelings about their relationship According to Kessler et al. (1994) what percent of people with a recent or active psychiatric disorder obtain professional help? 10% 20% 30% 40% 50% According to Bowlby (1969) individuals are vulnerable to depression when attachment bonds are disrupted communications levels are not adequate there is a family history of mood disorder a spouse abuses drugs or alcohol In dual drug abuse relationships, the longer the parties are abstinent, the less stable is their marriage. True False According to Markowitz et al. (1989) marital distress is associated with how greater a chance of having panic disorder? 3 times 5 times 7 times 9 times According to Ren (1997) what is related to relationship distress in marital and cohabiting participants? longevity blood pressure job satisfaction perceived health Research has found a relationship between high EE and all EXCEPT anxiety disorders relapse in schizophrenia eating disorders bipolar disorder The most common problem addressed in couple's therapy is power struggles unrealistic expectations sex communication Babcock et al. (1993) found that physical aggression was associated with poor communication greater power inequality financial stress substance abuse According to Uebelacker & Whisman (2002) depressed women more strongly believe that one must be a perfect sexual partner they do not meet their husband's expectations feedback equals criticism they are powerless in the relationship Questions from chapter 2 According to Gottman & Gottman (1999) how long do couples wait once they start having problems before seeking help? 1 year 2 years 3 years 4 years 6 years Individual or couple characteristics which influence or moderate therapy outcome are known as ICC effects IRR effects ATI effects BRR effects According to Johnson & Talitman (1997) favorable response to EFCT was predicted by women's trust in their partner's caring and lower defensiveness a positive therapeutic alliance lower impulsivity increased capacity for introspection An approach characterized by selecting specific techniques from diverse theoretical systems is eclecticism pluralism integration empirical pragmatism The second level of intervention in the author's pluralistic approach is strengthen the couple dyad promote relevant relationship skills challenge cognitive components of relationship distress address disabling relationship crises EFCT views distressed relationships as comprising insecure bonds blunted affect maladaptive schemas dysfunctional interactions Questions from chapter 3 According to Barlow et al. (1984) where does anxiety rank as a presenting complaint to primary-care physicians? 2nd 3rd 4th 5th Couples tend to maintain or increase their level of satisfaction as symptoms of agoraphobia decrease. True False The most widely researched, efficacious individual treatment for anxiety disorders is CBT IVD ERP RET Assessment of anxiety disorders considers all EXCEPT history of the individual's anxiety disorder the way the relationship and anxiety disorder interact The co-occurrence of other mood disorders overall couple functioning Baucom et al. (1998) identified 3 types of couple-based interventions which included all EXCEPT partner-assisted interventions disorder specific interventions general couple therapy cognitive restructuring therapy The technique which involves generating high levels of physiological arousal to tolerate rather than avoid is interoceptive exposure flooding in vivo desensitization implosion The presence of irrational obsessions followed by ritualistic compulsions describes ODD ADHD COPD OCD For people with GAD, Brown et al. (2001) suggest cognitive restructuring relaxation training worry exposure treatment exposure and response prevention Which of the following may not impact a couple's relationship directly? simple and social phobias OCD GAD panic disorder with agoraphobia Individuals with which type of Axis II diagnoses may experience significant anxiety? Cluster A Cluster B Cluster C Cluster D Questions from chapter 4 At the least severe end of the depression spectrum is dysthymia dysphoria major depressive disorder cyclothymia According to Hooley & Gotlib (2000) what is a predictor for relapse in a unipolar depressed patient? decreased libido increased alcohol use criticism from the spouse job dissatisfaction According to Cano & O'Leary (2000) what can increase the occurrence of depressive episodes? in-law conflict financial stress humiliating events health problems What is the best-studied couple treatment for depression? CBT BCT RET BVD According to Hirshfeld & Goodwin (1988) the lifetime risk of suicide for depressed people is as high as 5% 10% 15% 20% According to Weissman (1987) the rate of depression in women is three times that of men. True False Questions from chapter 5 The treatment which can assist partners in building a knowledge base about bipolar disorder and develop communication skills is IPT BCT CBT FFT According to Wendell et al. (2000) high EE parental and spousal relatives make more illness attributions affective attributions controllability attributions environmental attributions Which is NOT one of the primary assumptions of the FFT model? Couples benefit from empathic understanding by a concerned professional conjoint and individual therapy knowledge and acceptance of bipolar disorder learning skills for resolving conflicts What procedure is introduced toward the end of the FFT psychoeducational model? medication adherence training relapse prevention training communication enhancement training preparation for termination According to Falloon et al. (1984) what helps generalize skills to the home setting? problem-solving worksheets role play visualization in vivo reenactment What is the first line treatment for bipolar disorder? CBT FFT DBT psychoeducation pharmacotherapy Questions from chapter 6 What are characterized by deficits in emotional experience, behavioral expressiveness, and energy levels? negative symptoms cognitive impairments positive symptoms affective impairments Lifetime rates of substance abuse and dependence in clients with schizophrenia are 30% 40% 50% 60% According to Loranger (1984) less than 25% of women with schizophrenia marry, whereas 50-70% of men marry. True False According to Zubin & Spring (1997) what is a useful conceptual model for interactions in schizophrenia? stress diathesis model EE model stress-vulnerability model IPT-CM model The most well-established intervention for families in which one member has schizophrenia is CBT BFT BCT RET Which is NOT a step in Problem-Solving Training? define the problem evaluate solutions follow-up with implementation of the plan role play solutions Which is NOT an adjunctive treatment in couple work for schizophrenia? assertive community treatment supported employment cognitive-behavioral therapy for psychosis exposure and response prevention Questions from chapter 7 Critics of the DSM-IV definition of alcohol and drug use disorders stress that alcohol and drug use disorders are a unitary disease symptoms are the manifestation of a disease state the ICD-10 criteria should be used symptoms are acquired habits In the study by Halford & Osgarby (1993) what percent of men seeking marital therapy met the criterion for alcoholism? 33% 36% 39% 42% Which is NOT a behavioral couple therapy stage of change? precontemplation awareness contemplation action relapse All of the following are BCT behavioral assignments EXCEPT catch your partner doing something nice feeling charades caring day shared rewarding activities A difficulty with BCT for alcoholism is that the patient must choose between BCT and AA. True False Questions from chapter 8 According to LoPiccolo et al. (1985) couples presenting to sex therapy clinics often report problems related to communication sexual arousal disorders being in the normal range of marital satisfaction orgasmic disorders Which is NOT one of the four primary variables regarding sexual problems identified by Leiblum & Rosen (1991)? status and dominance verbal and nonverbal communication intimacy and trust sexual attraction and desire sexual scripts Which is NOT one of the four categories of sexual dysfunction delineated in the DSM? Problems of desire arousal orgasm genital pain conception Stuart et al. (1987) found that low desire in women is associated with deficits in all EXCEPT communication skill problem resolution attention trust A technique used to help the couple develop a heightened awareness of sensations and decrease focus on sexual performance is guided imagery systematic desensitization sensate focus sensitivity training What is used to teach ejaculatory control? systematic desensitization the squeeze technique cognitive restructuring orgasm consistency training Questions from chapter 9 What type of physical aggression will be seen most often among couples seeking marital therapy? common couple violence severe physical aggression patriarchal terrorism severe wife violence in self-defense Which theories of husband violence focus on marital interaction? intrapersonal theories sociocultural theories interpersonal theories sociobiological theories Which is NOT one of the three descriptive dimensions of batterer subtypes suggested by Holtzworth-Munroe and Stuart (1994)? environment/setting severity/frequency generality husband's psychopathology or personality disorders What is the most widely used measure of relationship violence? CTS RVI BVS BHI What is the first skill taught for managing behavior when angry? centering owning the emotion time outs progressive muscle relaxation Which is NOT one of the three components of anger discussed during anger recognition? physical spiritual cognitive behavioral The authors have found that maritally violent men often have difficulty with recognizing internal states substance abuse accepting positive feedback feeling expression Questions from chapter 10 Linehan (1993a) has reorganized the specific criteria of borderline personality disorder into multiple areas of functioning vulnerability intervention dysregulation Which is NOT a central dialectic to be resolved in treatment with couples? closeness versus conflict partner acceptance versus change actualization versus shame intimacy versus autonomy How are treatment targets assessed in DBT? mood calendars diary cards partner rating scales conflict tactics scales In DBT, the main difficulty is severe emotional misery in stage 1 stage 2 stage 3 stage 4 In which DBT stage do couples learn to transform conflict into closeness? stage 1 Stage 2 stage 3 stage 4 Questions from chapter 11 To clarify the distinction between delusions and persecutory ideas, Cameron (1974) uses the concept of a paranoid spectrum delusional spectrum delusional identity paranoid identity Delusions are first and foremost cognitions situational beliefs schemas Delusions involving unsupported beliefs of being secretly loved by another person are termed grandiose erotomanic somatic narcissistic There is no clear association between delusions and domestic violence. True False The tendency for married individuals to be more similar on certain traits that would be expected by chance alone is regression to the mean convergence class selection assorative mating What have Worthington & Drinkard (2000) proposed in promoting reconciliation in estranged couples? coordination of care psychopharmacology psychoeducation behavioral couple therapy Compliance with medications almost invariably falls off in individuals who have had a single psychotic episode. True False Questions from chapter 12 Narcissistic personality disorder is found in up to what percent of the clinical population? 16% 19% 22% 25% What approach to couple therapy for narcissistic disorder is presented? object relations behavioral couple therapy RET CBT Which task of couple assessment involves listening about whatever is on their minds? setting the frame listening to the unconscious following the affect creating psychological space What refers to the therapist's task of providing a safe psychological space over time? cocooning enveloping holding sheltering What refers to the therapist's task of tolerating the couple's anxiety over time? sheltering cocooning containing holding Questions from chapter 13 Perhaps the most significant criticism of the DSM-IV description of PTSD is that it is described as rare or unusual lacks inter-rater reliability overemphasizes trauma due to war lacks specificity in describing symptoms According to Finkelhor & Browne (1984) what is the primary defense against trauma-induced psychopathology? a secure bond avoidance minor tranquilizers rapid intervention Which model integrates a constructivist experiential approach with a systemic approach? CBT BCT EFT Object relations Questions from chapter 14 The model espoused for treating childhood sexual trauma emphasizes all EXCEPT assuming personal responsibility confronting the perpetrator problem solving underscoring being a survivor Which model for assessment and treatment of abuse is offered by McCarthy (1986)? levels of victimization the victim as survivor the couple's emotional relationship integrating vulnerabilities According to McCarthy (2002) what is a core component in couple sex therapy? sensate focus homework nonverbal communication the feedback session According to Maddock et al. (1998) which approach is fatally flawed for couple therapy? recovered memory rebirthing self-help victim advocacy Questions from chapter 15 Miller (1987) has which two types of information seekers? seekers and bludgers monitors and blunters wise and foolish cognitive and emotional Silberfarb et al. (1978) found that women in which phase of breast cancer reported more psychological distress? primary treatment final treatment palliative recurrent In addressing roles and role changes in the face of chronic illness, it is important to consider relations with in-laws children's needs loss of status caregiver burden Questions from chapter 16 Which is NOT one of the "3 D's"? delusion dementia delirium depression What is the third phase of adjustment in a marriage with cognitive impairment? figuring it out caregiving restructuring roles affirming A useful self-report for cognitive impairment is the Cognitive Retention Scale Memory for Simple Figures Test Boston Picture Vocabulary Test Memory and Behavior Checklist Questions from chapter 17 The third phase of grief is the acute mourning phase bargaining phase restorative phase anger phase Family systems theorists assert that loss is a transactional process unavoidable cyclical a process of integration From a couple relationship perspective, grief may launch what type of cycle? approach-avoidance pursuer-distancer bargaining-acceptance flight-flight McGoldrick (1991) suggests that assessment should utilize genograms children personality testing open-ended questions Which is NOT one of the four tasks of acute grief according to Worden (1991)? find others to help bear the grief accept the reality of loss experience the pain and grief adjust to an environment without the deceased withdraw the emotional energy According to Nolen-Hoeksema and Larson (1999) what is the core coping mechanism for grief? emotional expression reappraisal distraction taking action Questions from chapter 18 According to McLeod (1995) partners of people with psychiatric disorders are no more likely to meet criteria for disorders. 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