Differentiation, perceived stress and therapeutic alliance as key factors in the early stage of couple therapy

Abstract Background The COVID-19 pandemic brings unprecedented uncertainty and stress. This study aimed to characterize general sleep status among Chinese residents during the early stage of the outbreak and to explore the network relationship among COVID-19 uncertainty, intolerance of uncertainty, perceived stress, and sleep status. Methods A cross-sectional correlational survey was conducted online. A total of 2534 Chinese residents were surveyed from 30 provinces, municipalities, autonomous regions of China and regions abroad during the period from February 7 to 14, 2020, the third week of lockdown. Final valid data from 2215 participants were analyzed. Self-report measures assessed uncertainty about COVID-19, intolerance of uncertainty, perceived stress, and general sleep status. Serial mediation analysis using the bootstrapping method and path analysis were applied to test the mediation role of intolerance of uncertainty and perceived stress in the relationship between uncertainty about COVID-19 and sleep status. Results The total score of sleep status was 4.82 (SD = 2.72). Age, place of residence, ethnicity, marital status, infection, and quarantine status were all significantly associated with general sleep status. Approximately half of participants (47.1%) reported going to bed after 12:00 am, 23.0% took 30 min or longer to fall asleep, and 30.3% slept a total of 7 h or less. Higher uncertainty about COVID-19 was significantly positively correlated with higher intolerance of uncertainty (r = 0.506, p < 0.001). The mediation analysis found a mediating role of perceived stress in the relationship between COVID-19 uncertainty and general sleep status (β = 0.015, 95%C.I. = 0.009–0.021). However, IU was not a significant mediator of the relationship between COVID-19 uncertainty and sleep (β = 0.009, 95%C.I. = − 0.002–0.020). Moreover, results from the path analysis further showed uncertainty about COVID-19 had a weak direct effect on poor sleep (β = 0.043, p < 0.05); however, there was a robust indirect effect on poor sleep through intolerance of uncertainty and perceived stress. Conclusions These findings suggest that intolerance of uncertainty and perceived stress are critical factors in the relationship between COVID-19 uncertainty and sleep outcomes. Results are discussed in the context of the COVID-19 pandemic, and practical policy implications are also provided.

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Understanding the Processes Causing the Early Intensification of Hurricane Dorian through an Ensemble of the Hurricane Analysis and Forecast System (HAFS)

Atmosphere ◽

10.3390/atmos12010093 ◽

2021 ◽

Vol 12 (1) ◽

pp. 93

Author(s):

Andrew Hazelton ◽

Ghassan J. Alaka ◽

Levi Cowan ◽

Michael Fischer ◽

Sundararaman Gopalakrishnan

Keyword(s):

Tropical Cyclone ◽

Large Scale ◽

Early Stage ◽

Early Period ◽

Storm Track ◽

Key Factors ◽

Complex Interplay ◽

Forecast System ◽

Model Initialization

The early stages of a tropical cyclone can be a challenge to forecast, as a storm consolidates and begins to grow based on the local and environmental conditions. A high-resolution ensemble of the Hurricane Analysis and Forecast System (HAFS) is used to study the early intensification of Hurricane Dorian, a catastrophic 2019 storm in which the early period proved challenging for forecasters. There was a clear connection in the ensemble between early storm track and intensity: stronger members moved more northeast initially, although this result did not have much impact on the long-term track. The ensemble results show several key factors determining the early evolution of Dorian. Large-scale divergence northeast of the tropical cyclone (TC) appeared to favor intensification, and this structure was present at model initialization. There was also greater moisture northeast of the TC for stronger members at initialization, favoring more intensification and downshear development of the circulation as these members evolved. This study highlights the complex interplay between synoptic and storm scale processes in the development and intensification of early-stage tropical cyclones.

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Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution

Frontiers in Psychology ◽

10.3389/fpsyg.2021.640955 ◽

2021 ◽

Vol 12 ◽

Author(s):

David Dias Neto ◽

Ana Nunes da Silva ◽

Magda Sofia Roberto ◽

Jelena Lubenko ◽

Marios Constantinou ◽

...

Keyword(s):

Perceived Stress ◽

Illness Perceptions ◽

Early Stage ◽

Self Regulation ◽

Illness Perception ◽

Preventive Behaviors ◽

Illness Perception Questionnaire ◽

National Differences ◽

Comprehensive Picture ◽

Regulation Model

Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors.Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors.Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context.Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.

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Therapeutic alliance and progress in couple therapy: multiple perspectives

Journal of Family Therapy ◽

10.1111/j.1467-6427.2010.00503.x ◽

2010 ◽

Vol 33 (1) ◽

pp. 42-65 ◽

Cited By ~ 10

Author(s):

Tatiana Glebova ◽

Suzanne Bartle-Haring ◽

Rashmi Gangamma ◽

Michael Knerr ◽

Robin Ostrom Delaney ◽

...

Keyword(s):

Therapeutic Alliance ◽

Couple Therapy ◽

Multiple Perspectives

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Enhancing behavioral couple therapy: Addressing the therapeutic alliance, hope, and diversity

Cognitive and Behavioral Practice ◽

10.1016/s1077-7229(05)80045-8 ◽

2005 ◽

Vol 12 (1) ◽

pp. 102-112 ◽

Cited By ~ 8

Author(s):

Shalonda Kelly ◽

Gayle Y. Iwamasa

Keyword(s):

Therapeutic Alliance ◽

Couple Therapy

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Studying Nonverbal Synchrony in Couple Therapy—Observing Implicit Posture and Movement Synchrony

Contemporary Family Therapy ◽

10.1007/s10591-020-09555-5 ◽

2020 ◽

Author(s):

Petra Nyman-Salonen ◽

Anu Tourunen ◽

Virpi-Liisa Kykyri ◽

Markku Penttonen ◽

Jukka Kaartinen ◽

...

Keyword(s):

Therapeutic Alliance ◽

Couple Therapy ◽

Therapy Process ◽

Joint Effort ◽

Coding Scheme ◽

Movement Synchrony ◽

Almost All ◽

The Relationship ◽

Nonverbal Synchrony

AbstractResearch on nonverbal synchrony (movement coordination) in psychotherapy has recently attracted increased attention. Nonverbal synchrony has been shown to relate to the therapeutic alliance and outcome. However, research on nonverbal synchrony in couple therapy remains scarce. In this study, we examined the therapy process of one couple in detail and created a coding scheme to depict posture and movement synchrony. In this case study, we found that the relationship between nonverbal synchrony and the therapeutic alliance was complex. During the therapy process, the amount of nonverbal synchrony varied, as did the participants’ evaluations of the alliance. In couple therapy nonverbal synchrony could affect both the persons involved in it and the persons observing it. In one of the sessions, almost all the synchronies occurred between the female client and one of the therapists, and all except the female client evaluated the alliance to be weaker. In this case study, there were two therapists present, and the co-therapists’ synchrony was found to be important for the male client’s evaluations of the alliance. When there was more synchrony between the therapists, he evaluated the alliance to be stronger. Interestingly, the co-therapists’ synchrony seemed to peak in sessions that succeeded sessions with a weaker alliance, as if the therapists were implicitly making a joint effort to strengthen the alliance. A short episode from one session is given to illustrate the findings. Our coding scheme enables studying nonverbal synchrony (posture and movement synchrony) in couple therapy and combining the research results to other temporally precise data obtained from the sessions. More research is needed to validate the method.

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