It is quite common to see maritally distressed patients that are depressed, and depression is often associated with marital distress. How could we determine which one is the cause and which one is the effect?
Also, what would be the impact on treatment (e.g. should we start to treat depression first, start couples therapy, or have both treatments?)
Interesting question. Chicken or egg? Are we seeing both clients presenting with depression? I would suggest an in- depth assessment with you choice of instrument for depression. If you discover from that the degree of depression involved, I would suggest considering CBT for the depression and judging tentatively when it would be best to begin couples therapy, if it is still needed. Not knowing the source of the relational problem makes this suggestion extremely generic.
The real problem is that of associated depressive signs wich worsen inter-personnal relationship.
The slope worsens function of the disregulated engine but does not, by itself, disregulate the lithining!
One type of statistical analysis that will help you prove causation is path analysis. I enjoy this type of process as it is visual and lends itself to HLM and SAS. This type of analysis would expose the origin of the problem.
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