Carl Marci - Academia.edu (original) (raw)

Papers by Carl Marci

Jar, 2006

... of emo-tions, humans have limited ability to describe their emotional world; (3) emotional an... more ... of emo-tions, humans have limited ability to describe their emotional world; (3) emotional and memory systems are dynamic ... context-sensitive method for determining a biologically based moment-to-moment measure of emotional engagement in an audience in response to a ...

As Westen et al (2003) elucidate, the empirical validation of treatment models tends to remain ri... more As Westen et al (2003) elucidate, the empirical validation of treatment models tends to remain rigidly focused on treatment outcomes,and misses important information about what is efficacious about a given treatment. In this response to Weston et al., we argue that focusing on treatment packages as a whole represents too high a level of abstraction, far removed from the

Psychological Bulletin, 2004

In this comment, J. S. Ablon and C. Marci argue that focusing on the empirical validation of manu... more In this comment, J. S. Ablon and C. Marci argue that focusing on the empirical validation of manualized treatment packages misses important information about what is efficacious about a given treatment. Psychotherapy process has demonstrated that treatments may promote change in ways other than their underlying theories claim. Manualized therapies may appear distinct despite important similarities in dyadic interaction. These functional similarities in the emergent transactional process between therapist and patient may help explain the difficulty demonstrating differential outcomes across brands of brief therapy. Rather than focus on treatment packages targeting patient symptomatology, the authors recommend a shift in focus to the empirical validation of change processes coconstructed by therapist and patient in naturalistic settings.

Applied Psychophysiology and Biofeedback, 2013

Personality's link to emotional experience has been demonstrated, but specific biological respons... more Personality's link to emotional experience has been demonstrated, but specific biological responses to emotion as a function of personality have not been wellestablished. Here, the association between personality and physiological responses (heart rate, skin conductance, and respiration) to emotional videos was assessed. Onehundred sixty-nine participants self-reported on their Big 5 personality traits and underwent ambulatory monitoring as they watched four brief video clips from primetime television content showing scenes containing violence, fear, sadness, and tension. Generally, the negatively-toned emotional scenes provoked increases in skin conductance response and declines in heart rate. We found that physiological outcomes depended on the particular emotional scene and on personality, most notably Extraversion and Neuroticism. Extraversion, and to a lesser degree, Neuroticism, were associated with increases in autonomic arousal responses to the scenes. Gender also interacted with personality to predict responses, such that women who scored higher on measures of Extraversion, Neuroticism, and Conscientious tended to show more physiological arousal than men. Overall, the emotional scenes evoked increases in arousal and more controlled attention. The findings are discussed in context of the limited capacity model and shed light on how personality and gender affect physiological reactions to emotional experiences in everyday life.

Applied Psychophysiology and Biofeedback, 2006

This preliminary study investigated the effect of emotional distance on psychophysiologic concord... more This preliminary study investigated the effect of emotional distance on psychophysiologic concordance and perceived empathy in a clinical population. Participants included 20 adult outpatients from a mental health clinic that underwent a brief semi-structured interview with a trained psychiatrist in either an emotionally neutral or an emotionally distant condition. Simultaneous skin conductance (SC) levels of the patient and interviewer were recorded and used to calculate a measure of psychophysiologic concordance. Interviewer gaze was rated by an independent observer and used as a proxy indicator of emotional distance. Observer ratings of interviewer gaze, SC concordance, and patient ratings of perceived interviewer empathy were significantly lower in the emotionally distant condition compared with the emotionally neutral condition (p < 0.05). Results suggest that increased emotional distance is associated with decreased psychophysiologic concordance and reduced subjective ratings of perceived empathy. The observed differences in psychophysiologic concordance support the use of this measure as a potential marker of empathy in a clinical population in an interview setting.

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Psychosomatic Medicine, Sep 1, 2009

To determine whether placebo responses can be explained by characteristics of the patient, the pr... more To determine whether placebo responses can be explained by characteristics of the patient, the practitioner, or their interpersonal interaction. We performed an analysis of videotape and psychometric data from a clinical trial of patients with irritable bowel syndrome who were treated with placebo acupuncture in either a warm empathic interaction (Augmented, n = 96), a neutral interaction (Limited, n = 97), or a waitlist control (Waitlist, n = 96). We examined the relationships between the placebo response and a) patient personality and demographics; b) treating practitioner; and c) the patient-practitioner interaction as captured on videotape and rated by the Psychotherapy Process Q-Set. Patient extraversion, agreeableness, openness to experience, and female gender were associated with placebo response, but these effects held only in the augmented group. Regression analyses controlling for all other independent variables suggest that only extraversion is an independent predictor of placebo response. There were significant differences between practitioners in outcomes; this effect was twice as large as the effect attributable to treatment group assignment. Videotape analysis indicated that the augmented group fostered a treatment relationship similar to a prototype of an ideal healthcare interaction. Personality and gender influenced the placebo response, but only in the warm, empathic, augmented group. This suggests that, to the degree a placebo effect is evoked by the patient-practitioner relationship, personality characteristics of the patient will be associated with the placebo response. In addition, practitioners differed markedly in effectiveness, despite standardized interactions. We propose that the quality of the patient-practitioner interaction accounts for the significant difference between the groups in placebo response.

American Journal of Psychotherapy, Feb 1, 2005

Psychophysiologic measures, such as skin conductance and heart rate, have been used in both psych... more Psychophysiologic measures, such as skin conductance and heart rate, have been used in both psychotherapy process research and clinical practice. We present a case report of a patient and therapist who participated in a process-oriented psychotherapy research protocol using simultaneous measures of skin conductance. Data from the research protocol were used to broaden an empathic understanding of the patient, which facilitated insight and enhanced the exploration of conscious and unconscious processes that originated in the past and have come to dominate the present--the core of psychodynamic theories of change. The case illustrates the clinical relevance of psychophysiology and its use as a potential bridge between psychotherapy research and the theory and practice of psychotherapy. The implications of the case in support of the role of empathy in psychotherapy are discussed.

Psychiatry Research, May 30, 2007

Distinct factors have been identified as potential predictors of antidepressant treatment respons... more Distinct factors have been identified as potential predictors of antidepressant treatment response. Although autonomic function changes have been described in depressive subjects, their value as predictors of antidepressant response has not been systematically evaluated. Eight un-medicated patients with major depressive order (MDD) have their skin conductance (SC) and heart rate variability (HRV) measured at basal condition and during four induced emotional states: happy, angry, sad and neutral. The high frequency (HF) and low frequency (LF) power parameters of HRV were assessed. Subsequently, patients were treated with fluoxetine 20 mg/day for 8 weeks. The antidepressant response was measured with the Beck Depression Inventory (BDI). The BDI percentage reduction correlated significantly with HRV responses during sad condition in LF power, and during happy condition with LF/HF ratio. The BDI percentage reduction also correlated significantly with HR responses in happy and in neutral conditions, and also with SC responses in neutral condition. These preliminary findings indicate that automatic responses to induced emotions may predict antidepressant response in MDD patients. Confirmatory studies are warranted.

Psychological Bulletin, Jul 1, 2004

This article provides a critical review of the assumptions and findings of studies used to establ... more This article provides a critical review of the assumptions and findings of studies used to establish psychotherapies as empirically supported. The attempt to identify empirically supported therapies (ESTs) imposes particular assumptions on the use of randomized controlled trial (RCT) methodology that appear to be valid for some disorders and treatments (notably exposure-based treatments of specific anxiety symptoms) but substantially violated for others. Meta-analytic studies support a more nuanced view of treatment efficacy than implied by a dichotomous judgment of supported versus unsupported. The authors recommend changes in reporting practices to maximize the clinical utility of RCTs, describe alternative methodologies that may be useful when the assumptions underlying EST methodology are violated, and suggest a shift from validating treatment packages to testing intervention strategies and theories of change that clinicians can integrate into empirically informed therapies.

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... DOI: 10.1080/17439760902819576 Zachary Warren a * , Nancy Etcoff b , Benjamin Wood c , Chris ... more ... DOI: 10.1080/17439760902819576 Zachary Warren a * , Nancy Etcoff b , Benjamin Wood c , Chris Taylor a & Carl D. Marci b pages 234-242. ... 2002. An empirical reflection on the smile , Lewiston, NY: Edwin Mellen Press. View all references). ...

Cognitive Affective and Behavioral Neuroscience, Sep 1, 2007

The present study combined measures of regional cerebral blood flow (rCBF) using positron emissio... more The present study combined measures of regional cerebral blood flow (rCBF) using positron emission tomography (PET) with measures of the autonomic nervous system using skin conductance (SC), heart rate (HR), and the high frequency band of heart rate variability (HRV) in ten healthy participants who were exposed to autobiographical scripts of memories for three target emotions: anger, happiness, and sadness. According to the results, anger was the only emotion to show a significant increase in sympathetic activity, accompanied by a significant decrease in HRV when compared with a neutral script. Anger was also the only emotion to show significant changes in rCBF in the prefrontal cortex. By contrast, the results for the happy and sad conditions showed no significant increase in sympathetic activity and no changes in rCBF in the prefrontal cortex in comparison with the neutral script. The findings suggest that a relative increase in sympathetic activity with a reciprocal decrease in parasympathetic activity may be necessary to generate frontal activity in autobiographical recall of emotions.

Handbook of Evidence-Based Psychodynamic Psychotherapy, 2009

ABSTRACT There is a rich history of measuring physiologic responses between patient and clinician... more ABSTRACT There is a rich history of measuring physiologic responses between patient and clinician that has infused psychodynamic psychotherapy research for over half a century. The findings complement research outside of psychotherapy that increasingly supports a significant relationship between physiological, emotional, and psychological states [1]. Indeed, investigations into how physiologic parameters change during psychotherapy offer a unique opportunity to inform clinical practice, improve training of clinicians, and illuminate change processes unique to human dyadic relationships [2]. The goal of this chapter is to review the history of physiologic monitoring during psychodynamic psychotherapy and present recent findings that complement neuroimaging results and support recent advances in interpersonal neurobiology and social neuroscience. A clinical case from a research protocol is described that demonstrates the power of insights derived from physiologic measurement and illustrates the challenges of breaking through unconscious defenses in the process of psychodynamic psychotherapy.

Psychotherapy (Chicago, Ill.), 2006

The present study examined the relationship among contemplation stage of readiness to change, for... more The present study examined the relationship among contemplation stage of readiness to change, formation of an early therapeutic alliance, and psychological distress following the first session of psychotherapy. Significant correlations between the contemplation scores and the therapeutic alliance were found for patients in the contemplation stage. Although contemplation scores were not a factor in return for a second session of psychotherapy, the bond subscale of the alliance inventory did significantly contribute to whether patients returned for therapy. Patient psychological distress was not a significant factor in predicting the early alliance. Results indicate a need for further focus on contemplation with its inherent ambivalence, its relationship to alliance, and continuation in early psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

American journal of psychotherapy, 2005