Département des Sciences de santé Communautaire, Service de Toxicomanie, Université de Sherbrooke, Campus de Longueuil, 1111, rue St-Charles Ouest, Tour Ouest, Bureau 500, Longueuil, QC, Canada J4K 5G4. email@example.com
The study of the effectiveness of treatment for pathological gambling constitutes a field that is still largely unexplored. To date, the models assessed primarily target the individual and include little or no involvement of the family circle. Yet, the deleterious effects of gambling on loved ones and especially spouses are well recognized. Further, the addition of a couple modality to individual treatment has been shown to be effective on many levels in the treatment of substances use disorders. This article therefore proposes a critical review of (1) the literature providing a better understanding of the complex interactions between the couple relationship and pathological gambling, (2) studies on the effects of couple therapies on gamblers and their partners. We then present the therapeutic model developed by our team of clinician-researchers in collaboration with actors from Québec clinical settings: Adapted Couple Therapy (ACT) for pathological gamblers. In the Québec context, this model will serve as a complement to an individual cognitive-behavioral treatment model that has been proven effective and is employed throughout the Canadian province. The assessment of couple therapies could reveal avenues of solutions to better assist pathological gamblers who tend to drop-out of treatment and relapse.
The clinical representativeness of outcome studies is defined as the generalizability of recruitment processes, assessment/diagnostic procedures, treatment protocols, and therapeutic results from research settings to naturalistic treatment settings. The main goal of the present study was to examine the clinical representativeness of couple therapy in outcome studies. The data set was formed by 50 published clinical trials, including 34 couple therapy outcome studies for marital distress (CTMD) and 16 couple therapy outcome studies for comorbid relational and mental disorders (CTMD + C). The present findings showed that, overall, the clinical representativeness of couple therapy outcome studies is only fair (i.e., the mean global score is slightly lower than the midpoint of the rating scale used to assess representativeness). CTMD + C studies fared better than CTMD studies on many dimensions of clinical relevance. Studies in which pretherapy training was less intensive (for CTMD studies only), treatment was less structured, and therapists were more experienced showed larger effect sizes than those in which such was not the case.
The aim of the study was to identify the unique contribution of three sets of contextual factors (maternal supports, family problems and characteristics of the sexual aggression) on adolescents' post-disclosure symptoms. All participants were abused by a family member.
A total of 71 adolescents girls were recruited from youth center services across Quebec. Psychological distress was evaluated with "Trauma Symptoms Checklist for Children" (TSC-C; Briere, 1989). Adolescents also completed self-report instruments and semi-structured interviews to evaluate contextual factors.
Regression analyses indicated that general maternal support explain more variance in most of TSC-C symptoms than maternal response to disclosure. Analysis highlight that alcohol problems in family and various characteristics of sexual aggression explain a unique part of variance of several symptoms.
The discussion addresses the need to continue to explore these questions with more specific instruments to evaluate family problems. A large spectrum of symptoms should also be considered.
Three groups of girls who were sexually abused (by either brothers, fathers, or stepfathers) were compared. The purpose was to identify the differing characteristics of the abuse, the family environments, and the psychosocial distress of these children.
Seventy-two girls aged between 5 and 16 were assigned to one of the three groups. Subjects were matched between groups on the basis of their actual age. Children completed measures of traumatic stress; their mothers completed the Child Behavior Checklist-Parent Report Form (CBCL) and other self-report questionnaires on family characteristics. Workers in child protective services completed information regarding the nature and severity of the abuse.
Results suggested few differences in the characteristics of sexual abuse between the three groups. However, penetration was much more frequent in the sibling incest group (70.8%) than in the stepfather incest (27.3%) or father incest (34.8%) groups. Ninety percent of the victims of fathers and brothers manifested clinically-significant distress on at least one measure, whereas 63.6% of stepfather victims did. Compared with father and stepfather perpetrators, brothers were raised in families with more children and more alcohol abuse.
The authors conclude that the characteristics of brother-sister incest and its associated psychosocial distress did not differ from the characteristics of father-daughter incest These findings suggest that theoretical models and clinical practices should be adjusted accordingly and that sibling incest should not necessarily be construed as less severe or harmful than father-daughter incest.
Maternal diet can result in exposure to environmental contaminants including dioxins which may influence foetal growth. We investigated the association between maternal diet and birth outcomes by defining a dioxin-rich diet. We used validated food frequency questionnaires to assess the diet of pregnant women from Greece, Spain, United Kingdom, Denmark and Norway and estimated plasma dioxin-like activity by the Dioxin-Responsive Chemically Activated LUciferase eXpression (DR-CALUX®) bioassay in 604 maternal blood samples collected at delivery. We applied reduced rank regression to identify a dioxin-rich dietary pattern based on dioxin-like activity (DR-CALUX®) levels in maternal plasma, and calculated a dioxin-diet score as an estimate of adherence to this dietary pattern. In the five country population, dioxin-diet score was characterised by high consumption of red and white meat, lean and fatty fish, low-fat dairy and low consumption of salty snacks and high-fat cheese, during pregnancy. The upper tertile of the dioxin-diet score was associated with a change in birth weight of -121g (95% confidence intervals: -232, -10g) compared to the lower tertile after adjustment for confounders. A small non-significant reduction in gestational age was also observed (-1.4days, 95% CI: -3.8, 1.0days). Our results suggest that maternal diet might contribute to the exposure of the foetus to dioxins and dioxin-like compounds and may be related to reduced birth weight. More studies are needed to develop updated dietary guidelines for women of reproductive age, aiming to the reduction of dietary exposure to persistent organic pollutants as dioxins and dioxin-like compounds.
The present study investigated sexual at-risk behaviors of sexually abused adolescent girls. Variables of interest were presence of consensual sexual activity, age at first consensual intercourse, number of sexual partners, condom use, and pregnancies. Participants were 125 sexually abused adolescent girls aged 12 to 17 years. Results showed that severity of sexual abuse (e.g., penetration, multiple perpetrators, physical coercion, multiple incidents of abuse) was related to a greater number of sexual at-risk behaviors. For instance, adolescents with a history of sexual abuse involving penetration were 13 times as likely to have been pregnant. Although family characteristics were significantly associated with being sexually active, their effect proved non-significant in the final hierarchical regression. Regression analyses clearly showed that the likelihood of engaging in sexual at-risk behaviors increased as a function of the number of severity factors.