Preventing marital distress through communication and conflict management training: A 4- and 5-year follow-up.

Reports the 4- and 5-yr follow-up results of evaluating the effects of a marital distress prevention program. The Prevention and Relationship Enhancement Program (PREP) is a 5-session program designed to teach couples effective communication and conflict management skills. At the 5-yr follow-up, intervention (as compared with control) couples had higher levels of positive and lower levels of negative communication skills and lower levels of marital violence. Data are also presented on couples who declined the program. Issues are discussed concerning selection effects, change mechanisms, and future directions for prevention research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investigating the effects of marriage and relationship education on couples' communication skills: A meta-analytic study.

This meta-analysis probes into previous research substantiating the positive effects of marriage and relationship education (MRE) on couples' communication skills. We reviewed 97 MRE research reports that yielded 143 distinct evaluation studies. We found modest evidence that MRE functions both as a universal prevention and as a selective or indicated prevention. That is, MRE demonstrates program effects at longer term follow-ups for well-functioning couples and at postassessment and shorter term follow-ups for more distressed couples. In addition, we found that observational assessments produced larger effects than self-report assessments, although interpreting the meaning of this difference is difficult. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of a compact psychoeducational group training program for married couples.

There is a lack of psychoeducational programs for married couples who, although subjectively concerned about their marriages, do not seek marital therapy. In this study, the efficacy of a cognitive-behavioral program delivered on a weekend by 2 trainers for groups of 4 couples was investigated. Couples (n?=?67) were recruited by newspaper announcements, then randomly assigned to the intervention program or a waiting-list control group. The program consisted of communication and problem-solving training, couples' discussions to clarify their relationship expectations, and exercises to enhance their sensual or sexual relationship. At postassessment, intervention couples emitted more positive verbal and nonverbal communication behaviors during a conflict discussion task than did control couples, who reported significantly more relationship problem areas and displayed more negative communication behaviors. At the 1-year follow-up, intervention couples reported fewer problem areas in comparison with preassessment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of age on neurohormonal activation and prognosis in patients with chronic heart failure

There is a lack of psychoeducational programs for married couples who, although subjectively concerned about their marriages, do not seek marital therapy. In this study, the efficacy of a cognitive-behavioral program delivered on a weekend by 2 trainers for groups of 4 couples was investigated. Couples (n = 67) were recruited by newspaper announcements, then randomly assigned to the intervention program or a waiting-list control group. The program consisted of communication and problem-solving training, couples' discussions to clarify their relationship expectations, and exercises to enhance their sensual or sexual relationship. At postassessment, intervention couples emitted more positive verbal and nonverbal communication behaviors during a conflict discussion task than did control couples, who reported significantly more relationship problem areas and displayed more negative communication behaviors. At the 1-year follow-up, intervention couples reported fewer problem areas in comparison with preassessment.     

A college suicide prevention model for American Indian students.

College student suicide prevention efforts are important to campus administrators and mental health professionals due to increasing concerns about managing suicidal students. This article describes the development and preliminary effectiveness of a campus suicide prevention program designed for American Indian (AI) students who are at higher risk for suicide compared with the general population. Using the medicine wheel as a guiding framework, the current prevention model integrates communication links between AI tribes and prevention program staff, educational and cultural programming, and spiritual ceremonies with the larger campus mental health resources available to students. A discussion of the barriers faced and solutions generated for implementing the program is offered, along with suggestions for disseminating this AI-specific prevention program to other universities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Determination of serum pancreatic polypeptide and its clinical significance in patients with end state renal failure

A screening program for the detection of Tay-Sachs disease (TSD) carriers in the ultra Orthodox community of Ashkenazi Jews has operated in Israel since 1986. The purpose of this program is the prevention of marriages of 2 heterozygotes. The screened individuals are mostly couples in the engagement process or students in religious high schools. Two mandatory requirements guide this program. First, anonymity of the tested individuals who are identified only by code numbers; second completion of the test results of couples in the engagement process within a few days. The screening program is performed by the determination of hexosaminidase A (Hex A) activity in serum which is repeated in serum and leukocyte extracts in couples where both partners were found in the heterozygote range in the initial tests. The minimal carrier frequency was estimated to be 1:26 or higher, which is higher then in the general Jewish Ashkenazi population. This higher carrier frequency apparently stems from the fact that most members of this community originate from central Europe where the TSD carrier frequency was previously reported to be the highest in the Ashkenazi population. Since the beginning of the screening program no TSD child has been born to newlywed couples of this community in Israel.     

Effects of family foundations on parents and children: 3.5 years after baseline.

This study investigated the ability of a psychosocial prevention program implemented through childbirth education programs to enhance the coparental and couple relationship, parental mental health, the parent-child relationship, and child outcomes. A sample of 169 heterosexual, adult couples expecting their first child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of eight classes delivered before and after birth, which was designed as a universal prevention program (i.e., applicable to all couples, not just those at high risk). Intent-to-treat analyses utilizing data collected from child age 6 months through 3 years indicated significant program effects on parental stress and self-efficacy, coparenting, harsh parenting, and children's emotional adjustment among all families, and maternal depression among cohabiting couples. Among families of boys, program effects were found for child behavior problems and couple relationship quality. These results indicate that a universal prevention approach at the transition to parenthood focused on enhancing family relationships can have a significant and substantial positive impact on parent and child well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prevention of marital distress: A longitudinal investigation.

This study examines the impact of an intervention designed to prevent divorce and marital distress. Both short- and long-term effects of a cognitive-behavioral marital distress prevention program were assessed. Forty-two couples planning marriage were matched and randomly assigned to intervention (n?=?21) and control (n?=?21) conditions. Couples participated in pre- and postintervention assessment sessions and in similar assessment sessions 1? years and 3 years later. The intervention emphasized communication and problem-solving skills, clarifying and sharing expectations, and sensual/sexual enhancement. Although postintervention results indicated that couples learned the skills taught in the program, no group differences emerged on self-report measures of relationship quality. At 1? years, intervention couples showed higher levels of relationship satisfaction than control couples. At 3 years, intervention couples showed higher levels of both relationship satisfaction and sexual satisfaction and lower levels of problem intensity. These data support cost-effective prevention programs for attacking the major social problem of divorce. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The development of a couple-based treatment for PTSD in returning veterans.

Military personnel deployed in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) show high levels of emotional distress and posttraumatic stress disorder (PTSD), and these deployment-related problems may be expected to have a devastating impact on their relationships. It is urgent that researchers develop couple-based treatments to reduce PTSD in OEF/OIF veterans and to reduce PTSD-related relationship problems. This article describes the development of a novel couple-based treatment for PTSD, called Structured Approach Therapy (SAT), that uses empathic communication training and stress inoculation procedures to help couples improve their ability to cope with trauma-related anxiety and a multicomponent emotion activation program to help couples reduce emotional numbing. The theoretical basis of the SAT Treatment Model is described, and the various treatment components are presented. The authors recommend that couple-based interventions be used to provide OEF/OIF veterans and their partners with empathic communication skills to discuss their thoughts and feelings about deployment and with dyadic coping skills to confront trauma-related aversive emotions and emotional numbing and return intimacy to their lives. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Long-term prediction of marital quality following a relationship education program: Being positive in a constructive way.

Relationship education programs such as Ehevorbereitung--Ein Partnerschaftliches Lernprogramm (Premarital Preparation--A Couples' Learning Program) and the Relationship Education and Relationship Enhancement Program (PREP) can help prevent marital distress among newlyweds. Thus, it is important to understand which couples respond best to the intervention and which couples respond less well. E. A. Schilling, D. H. Baucom, C. K. Burnett, E. A. Allen, and L. Ragland (2003) unexpectedly found that the more women increased positive communication in response to PREP, the more likely they were to become distressed in the subsequent 5 years. The current study explores similar issues, investigating a relationship education program in Germany. The current results indicate that couples are susceptible to future relationship distress if women demonstrate extreme increases in positive and decreases in negative communication after intervention. Implications are provided for adapting these relationship education programs in the future. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparison of a sexual enhancement and a communication training program on sexual and marital satisfaction.

A total of 30 volunteer couples were randomly assigned to a sexual enrichment, a communication training, or a wait-list control condition. The sexual enrichment and communication training groups met for 3-hr sessions, 1 day per week for 4 consecutive weeks. All three conditions were assessed immediately before, immediately after, and again 3 months after completion of the programs. Analyses of covariance revealed that wives who participated in the sexual enhancement program derived more pleasure from their sexual relationships than did wives in the other two groups. In addition, participants in the sexual enhancement program felt there was a greater amount of affectional expression, and rated their overall marital satisfaction as significantly improved. Couples participating in the communication training program also evinced limited changes in their sexual and marital relationships, whereas couples in the wait-list control condition reported no changes. We conclude that communication training is an important component in sexual enrichment programs and that more evaluative research is needed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital interactions of depressed men and women.

This article examined marital interactions in 50 couples with a depressed husband, 41 couples with a depressed wife, and 50 nondepressed control couples. As expected, couples with a depressed partner evidenced more disturbed marital interaction than control couples. Furthermore, couples with a depressed wife demonstrated less positive communication than couples with a depressed husband, notwithstanding the fact the depressed husbands exhibited greater depression severity than depressed wives. Findings are integrated with recent research on gender differences in affective expression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The impact of sex therapy on sexual behaviors and marital communication

The evaluation results of a short term intensive sex dysfunction workshop are presented. The evaluation research design involves before and after measures of sexual behaviors, sexual expectations, sexual communication, and marital communication. The results indicate that participants changed with regard to each of these variables. The workshop appears to impact couples in three ways: (1) there is a narrowing of the gap between actual and desired sexual behaviors, (2) there is improved sexual communication, and (3) there is improved marital communication. The results indicate that a combination of group instruction and individual therapy is an effective intervention technique in treating couples with sexual problems.     

Marital communication: Differences among maritally distressed, depressed, and nondistressed-nondepressed couples.

Explored differences in communication and perception of communication among 3 types of married couples: maritally distressed, in which the wife was depressed; maritally distressed only couples; and nondistressed-nondepressed couples. Findings revealed differences both in the patterns of communication and in the meanings these patterns have for the relationship. The results suggested that depression within the context of a distressed marriage is related to (1) more negative communication both toward and from the depressed person and (2) spouses' lower comprehension of each other's messages. Among the nondistressed couples, the more negative their communication, the more maritally satisfied they were. The suggestion is made that "negative communication" might be used in a constructive way by nondistressed couples, whereas negative communication might be detrimental to distressed couples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term group therapy for couples in a health maintenance organization.

Describes a 15-session group treatment program for couples in a health maintenance organization (HMO). The program demonstrates principles of efficiency, economy, integration of services, and prevention in an HMO. It is argued that the location of the program in a comprehensive organized health care setting enhances the efficacy of the treatment. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of leaders' working alliance in premarital education.

Premarital (and general relationship) education programs, as a prevention method, have been shown to have a positive effect on marital quality and can prevent divorce. However, it is unclear whether these positive effects are consistent across leaders who conduct premarital education programs. Examining the variability in relationship outcomes attributed to the leaders of premarital education programs, and the role of general therapeutic factors such as working alliance in explaining relationship outcomes, may help increase the effectiveness of these programs. Accordingly, this study examined 31 leaders who trained 118 couples (236 attendees) in a randomized clinical trial of the Prevention and Relationship Enhancement Program (PREP), a research-based and empirically supported premarital education program being compared with a treatment as usual track. The results demonstrated that couples' relationship outcomes from pre- to post-training varied on the basis of the leader who provided the premarital education training. Both training in PREP and aggregated leader working alliance quality (as rated by attendees) explained variability between leaders in change in attendees' observed negative and positive communication. Leaders' aggregated working alliance quality also explained change in relationship satisfaction. In addition, attendees' ratings of their leaders' working alliance predicted change in their relationship satisfaction and confidence, and attendees had higher positive communication when they reported better working alliance with their leader. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A cross-cultural examination of the relation of marital communication behavior to marital satisfaction.

Numerous studies have examined the communication behaviors of Western, primarily North American, couples and have demonstrated a robust and reliable association between marital satisfaction and couple communication. However, there has been relatively less attention given to the generalizability of these findings to non-Western couples. To address this issue, the authors conducted an observational study of marital communication among couples from 3 different cultural groups: 50 White American couples, 52 Pakistani couples in Pakistan, and 48 immigrant Pakistani couples in America. The results show that positive and negative communication behaviors were associated with marital satisfaction within each of the 3 cultural groups. However, the American group's marital satisfaction was more strongly related to marital communication behaviors than was that of the Pakistani group and, to a lesser extent, the immigrant group. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Establishing family foundations: Intervention effects on coparenting, parent/infant well-being, and parent-child relations.

This study investigated the ability of a theoretically driven, psychosocial prevention program implemented through childbirth education programs to enhance the coparental relationship, parental mental health, the parent-child relationship, and infant emotional and physiological regulation. A sample of 169 heterosexual, adult couples who were expecting their 1st child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of 8 classes, delivered before and after birth, that was designed as a universal prevention program (i.e., it was applicable to all couples, not just those at high risk). Intent-to-treat analyses indicated significant program effects on coparental support, maternal depression and anxiety, distress in the parent-child relationship, and several indicators of infant regulation. Intervention effects were not moderated by income, but greater positive impact of the program was found for lower educated parents and for families with a father who reported higher levels of insecure attachment in close relationships. These findings support the view that coparenting is a potentially malleable intervention target that may influence family relationships as well as parent and child well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Managing Affect and Differences Scale (MADS): A self-report measure assessing conflict management in couples.

In this article, the authors present a newly developed self-report measure that assesses specific communication skills that couples may use, particularly during conflict discussions. The authors present preliminary findings from 2 studies on this measure to support its validity and use in guiding and measuring the effectiveness of clinical interventions with couples. Specific clinical implications related to the development of this measure are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The marriage moments program for couples transitioning to parenthood: Divergent conclusions from formative and outcome evaluation data.

This article presents the results of a pilot study of the Marriage Moments program, designed to prevent relationship deterioration during the 1st year of parenthood. The self-guided, low-intensity program emphasizes strengthening marital virtues and partnership during this time of significant personal and family transition. One hundred fifty-five married couples participated in a randomized clinical trial with 2 psychoeducational treatment groups (a self-guided group and an instructor-encouraged group) and a comparable control group. Despite positive formative evaluation results from program participants, hierarchical linear modeling analyses failed to find significant Group × Time differences on spouses' reports of marital virtues and a set of relational outcome measures. This failure reinforces the need for psychoeducators to invest in outcome evaluation research before claiming program success. (PsycINFO Database Record (c) 2010 APA, all rights reserved)