Neural correlates of irritability symptom relief in adolescents pre- and post-trauma-focused cognitive behavioral therapy: A pilot study on reward processing.

Despite that Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a first-line, evidence-based treatment for youths experiencing trauma-related symptoms, treatment responses vary and it remains unclear for whom and how this treatment works. In this context, we examined pre-treatment neural reward processing and pre- vs. post-treatment changes in neural reward processing, in relation to irritability - a transdiagnostic and dimensional feature present in multiple trauma-related syndromes, following TF-CBT. Adolescents (N = 22) with childhood trauma history completed a child-friendly monetary incentive delay task during fMRI acquisition, prior to and after the treatment, and irritability symptoms were assessed at five time points over the course of the treatment. Individual irritability slopes (i.e., irritability change rate) and intercepts (i.e., initial irritability level), generated by linear growth curve modeling, were integrated with fMRI data. Repeated ANCOVAs demonstrated that both pre-treatment neural response to reward and pre- vs. post-treatment changes in neural reward processing correlated with irritability symptom relief, such that opposite baseline neural reward processing profiles and differential changing patterns were observed in individuals showing irritability symptom relief vs. not. Together, our findings provide proof of concept that integrating brain information with clinical information has the potential to identify predictors and mechanisms of symptom relief.

Refugee posttraumatic growth: A grounded theory study.

In response to the unprecedented refugee crisis around the world, a growing body of research has focused on psychological distress among individuals and families forced to flee their homelands. Less attention has been directed toward understanding resilience, adaptation, and growth among this population. This grounded theory study explored the posttraumatic growth experiences of Middle Eastern and Afghan refugees resettled in the United States. The principal researcher conducted 23 interviews with seven couples and 16 individuals aged 25 to 67 years, from Afghanistan, Iraq, Iran, and Syria. This study aimed to explore how refugees understand, process, overcome, and grow from the trauma and adversity they have experienced. Findings were used to delineate a model of the process through which refugees experience posttraumatic growth. The overarching theme of moving forward had five specific growth themes: increased awareness of context; tolerating uncertainty; spiritual/religious attunement; consideration of others; and integrating into society. Findings shed light on the complex process of growth and adaptation in the aftermath of war and forced migration. The model can serve as a tool for clinicians to facilitate more empowering posttraumatic narratives with refugee clients rooted in growth experiences.

Families post-release: Barriers and pathways to family therapy.

Family therapy has helped repair relational ruptures and restore stability within families for decades. However, service can be inaccessible and underutilized among many minoritized and stigmatized groups, including families post-release. Harmful sociocultural and relational experiences pose considerable risks to families before, during, and after incarceration. While not exhaustive, this article highlights potential attitudinal, relational, and logistical obstacles to family therapy engendered by therapists, clients, or both. Feasible and accessible clinically oriented conceptual and practical pathways of support to combat such obstacles are outlined to help therapists attract and retain families post-release.

Thematic analysis of therapists' experiences integrating EMDR and EFT in couple therapy: Theoretical and clinical complementarity, and benefits to client couples.

In this article, we present partial findings from a thematic analysis study that examined integrating emotionally focused therapy (EFT) and eye-movement desensitization and reprocessing (EMDR) as clinical frameworks in couple therapy. The purpose of the study is to better understand how therapists integrate EFT and EMDR therapy in their clinical work. Thirteen licensed therapists (n = 13) trained in EFT and EMDR were interviewed about their experiences integrating these two models in their couple therapy practice. The findings included in this article are related to how these models complement each other as well as the clinical benefits associated with their integration. Findings provide preliminary evidence that there are benefits and challenges when integrating both models, although we emphasize complementarity in this article. Limitations and implications for future research on the integration and efficacy of these two models are also discussed.

The EIS Model: A Pilot Investigation of a Multidisciplinary Sex Therapy Treatment.

Marital couples not experiencing a satisfying sexual relationship are less satisfied in their overall relationship. There is, however, a paucity of controlled outcome studies researching the effectiveness of sex therapy interventions. This study was a pilot investigation of a new manual-based sex therapy called the EIS (empathy, intimacy, and sexual satisfaction) model. Results showed significant improvement in sexual and marital satisfaction, marital intimacy, and verbal sexual intimacy for men and women, and sexual function for women. Effect sizes were large for these variables and posttreatment differences. Results provide initial support for the theory and interventions of the EIS model. Treatment should include addressing vulnerable communication, relational intimacy, conflict resolution, sexual functioning, sexual medicine care, and sensual and sexual skills.

Relationship Dissolution and Psychologically Aggressive Dating Relationships: Preliminary Findings From a College-Based Relationship Education Course.

This study evaluated the impact of a relationship education program, delivered as part of a college course, among students (N = 152) who reported experiencing psychological aggression in their exclusive dating relationship. Preliminary results showed that compared to those in the control group, participants receiving relationship education were significantly more likely to end their romantic relationship, even after controlling for relationship satisfaction. Furthermore, when relationship termination occurred, those in the intervention group were significantly more likely to attribute the breakup to their participation in the class as compared to those in the control group. The tentative findings are an important preliminary step in assessing the benefits of relationship education in reducing the risk of psychological aggression among college students.

Trading Later Rewards for Current Pleasure: Pornography Consumption and Delay Discounting.

Internet pornography is a multi-billion-dollar industry that has grown increasingly accessible. Delay discounting involves devaluing larger, later rewards in favor of smaller, more immediate rewards. The constant novelty and primacy of sexual stimuli as particularly strong natural rewards make Internet pornography a unique activator of the brain's reward system, thereby having implications for decision-making processes. Based on theoretical studies of evolutionary psychology and neuroeconomics, two studies tested the hypothesis that consuming Internet pornography would relate to higher rates of delay discounting. Study 1 used a longitudinal design. Participants completed a pornography use questionnaire and a delay discounting task at Time 1 and then again four weeks later. Participants reporting higher initial pornography use demonstrated a higher delay discounting rate at Time 2, controlling for initial delay discounting. Study 2 tested for causality with an experimental design. Participants were randomly assigned to abstain from either their favorite food or pornography for three weeks. Participants who abstained from pornography use demonstrated lower delay discounting than participants who abstained from their favorite food. The finding suggests that Internet pornography is a sexual reward that contributes to delay discounting differently than other natural rewards. Theoretical and clinical implications of these studies are highlighted.

Extradyadic involvement and relationship dissolution in heterosexual women university students.

This study examined the role of extradyadic involvement (EDI) in heterosexual dating relationships among young adult females (N = 539). A considerable percentage of participants (36 %) reported that they had engaged in an extradyadic emotional or sexual relationship within the last 2 months. Results from logistic regression analyses supported the general hypothesis that emotional and sexual EDI were both significantly associated with relationship dissolution. These associations remained strong even after controlling for participants' age, relationship duration, and relationship quality. The findings also showed that the strength of the association between acts of emotional or sexual extradyadic behaviors and relationship dissolution was linked to relationship quality, gender of the actor, and type of EDI (emotional vs. sexual). Specifically, compared to participants who reported poor relationship quality, those who reported high relationship quality were more likely to end the partnership if they reported emotional or sexual EDI. Findings suggest that individuals in higher quality relationships appear to have considerably more to lose in their relationship when emotional or sexual EDI occurs. This, in part, may be because the more satisfactory the relationship the more disillusionment one may feel when betrayed by their romantic partner. Overall, the present findings underscore the multifaceted nature of the relationships between EDI and relationship dissolution. We call for more research that rigorously examines what contextual factors influence young adults in dating relationships to dissolve relationships following EDI.

Emerging adults' expectations for pornography use in the context of future committed romantic relationships: a qualitative study.

Using qualitative content analysis from the written comments of 404 primarily heterosexual college students, we examined (1) their expectations for pornography use while married or in a committed long-term relationship and (2) variations by gender. Four prominent groups emerged. A majority of men (70.8 %) and almost half of women (45.5 %) reported circumstances (alone or with their partners) wherein pornography use was acceptable in a relationship and several conditions for, and consequences associated with, such use also emerged. Another group (22.3 % men; 26.2 % women) viewed pornography use as unacceptable because of being in a committed relationship whereas a third group (5.4 % men; 12.9 % women) reported that pornography use was unacceptable in any context or circumstance. A final group emerged of a few women (10.4 %) who stated that a partner's use of pornography was acceptable, but they did not expect to use it personally. Implications for relationship education among emerging adults and future research on pornography use within the context of romantic relationships are discussed.

Compassion fatigue in marriage and family therapy: implications for therapists and clients.

Given that marriage and family therapists are exposed to a wide range of circumstances that leave them uniquely vulnerable to experiencing compassion fatigue, it is important to examine the stresses and hazards they face and what those consequences mean for both themselves and clients. It is essential that they identify how compassion fatigue negatively affects the therapeutic relationship and overall treatment outcome as well as that of the personal life of the family therapist. The marriage and family therapist is responsible and ethically obligated to identify and implement ways in which he or she can prevent and remedy compassion fatigue.

Critical failures in a regional network of residential treatment facilities.

The present descriptive case study reports on the state of treatment services and environmental settings in adolescent residential treatment facilities (RTFs) conducted as part of the Residential Treatment Center Evaluation Project. The project frequently uncovered poor quality of care exposing youth to deleterious conditions. Observations related to harsh treatment practices, psychiatric practice and medication management, educational and aftercare planning, and general treatment planning were closely examined. The analysis indicated that accreditation and licensing are insufficient to assure the quality of the service process in RTFs. Future research should address the relationship between treatment quality and treatment outcome. Efforts should also be made to develop strategies for organizational change to support high-quality services in RTFs.

Enhancing sexual desire and intimacy via the metaphor of a problem child: utilizing structural-strategic family therapy.

This article explores structural-strategic family therapy as a treatment modality for couples with problems of intimacy and sexual desire. Parents whose presenting problem involves a child with problematic behavior may also struggle with problems in their intimate relationship. Instead of speaking to these problems directly, however, the couple may communicate about their intimate problems via the metaphor of their "problem" child. Structural-strategic family therapy can then be utilized to strengthen the parental subsystem by establishing a parenting team, which in turn nourishes the partner subsystem. Success is then measured not only by improvements in the child's behavior, but also by the enhancement of intimacy and sexual desire between partners.