Saturday 1 November 2008

Marital relational disorders

,http://en.wikipedia.org/wiki/Relational_disorder#Kinds_of_relational_disorder

[edit] Kinds of relational disorder
The majority of research on relational disorders concerns three relationship systems: adult children and their parents, minor children and their parents, and the marital relationship. There is also an increasing body of research on problems in dyadic gay relationships and on problematic sibling relationships.[9]
Marital relational disorders
Marital disorders are divided into Marital Conflict Disorder Without Violence and Marital Abuse Disorder (Marital Conflict Disorder With Violence).[10] Couples with marital disorders sometimes come to clinical attention because the couple recognize long-standing dissatisfaction with their marriage and come to the clinician on their own initiative or are referred by an astute health care professional. Secondly, there is serious violence in the marriage which is -"usually the husband battering the wife" .[11] In these cases the emergency room or a legal authority often is the first to notify the clinician. Most importantly, marital violence "is a major risk factor for serious injury and even death and women in violent marriages are at much greater risk of being seriously injured or killed (National Advisory Council on Violence Against Women 2000)."[12] The authors of this study add that "There is current considerable controversy over whether male-to-female marital violence is best regarded as a reflection of male psychopathology and control or whether there is an empirical base and clinical utility for conceptualizing these patterns as relational."[13]
Recommendations for clinicians making a diagnosis of Marital Relational Disorder should include the assessment of actual or "potential" male violence as regularly as they assess the potential for suicide in depressed patients. Further, "clinicians should not relax their vigilance after a battered wife leaves her husband, because some data suggest that the period immediately following a marital separation is the period of greatest risk for the women. Many men will stalk and batter their wives in an effort to get them to return or punish them for leaving. Initial assessments of the potential for violence in a marriage can be supplimented by standardized interviews and questionnaires, which have been reliable and valid aids in exploring marital violence more systematically."[14]
The authors conclude with what they call "very recent information"[15] on the course of violent marriages which suggests that "over time a husband's battering may abate somewhat, but perhaps because he has successfully intimidated his wife. The risk of violence remains strong in a marriage in which it has been a feature in the past. Thus, treatment is essential here; the clinician cannot just wait and watch."[16] The most urgent clinical priority is the protection of the wife because she is the one most frequently at risk, and clinicians must be aware that supporting assertiveness by a battered wife may lead to more beatings or even death.[17]

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