Traditional Versus Integrative Behavioral Couple Therapy for Significantly and Chronically Distressed Married Couples.

A randomized clinical trial compared the effects of traditional behavioral couple therapy (TBCT) and integrative behavioral couple therapy (IBCT) on 134 seriously and chronically distressed married couples, stratified into moderately and severely distressed groups. Couples in IBCT made steady improvements in satisfaction throughout the course of treatment, whereas TBCT couples improved more quickly than IBCT couples early in treatment but then, in contrast to the IBCT group, plateaued later in treatment. Both treatments produced similar levels of clinically significant improvement by the end of treatment (71% of IBCT couples and 59% of TBCT couples were reliably improved or recovered on the Dyadic Adjustment Scale; G. B. Spanier, 1976). Measures of communication also showed improvement for both groups. Measures of individual functioning improved as marital satisfaction improved. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Observed communication in couples two years after integrative and traditional behavioral couple therapy: Outcome and link with five-year follow-up.

Objective: To examine changes in observed communication after therapy termination in distressed couples from a randomized clinical trial. Method: A total of 134 distressed couples were randomly assigned to either traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979) or integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998). Videotaped samples of each couple's interactions were coded from pre-therapy, post-therapy, and 2-year follow-up assessments. At these 3 time points, each partner chose 1 current relationship problem to discuss. Relationship satisfaction was assessed at 2-year follow-up, and clinically significant treatment response and marital status were assessed 5 years after treatment. Results: Observed negativity and withdrawal decreased from therapy termination through the 2-year follow-up as expected, but problem solving did not change, and observed positivity decreased. IBCT produced superior changes from post-therapy to the 2-year follow-up assessment compared with TBCT. Post-therapy levels and changes in communication over follow-up were associated with wife satisfaction at 2-year follow-up; only post-therapy to 2-year follow-up changes in communication were associated with husband satisfaction at 2-year follow-up. Post-therapy levels of problem solving and changes in wives' positivity from pre-therapy to post-therapy were associated with 5-year relationship outcomes. We found some counterintuitive results with positivity, but they were no longer significant after controlling for withdrawal. Conclusions: We found support for improvements in observed communication following treatment termination, with IBCT demonstrating greater maintenance of communication improvement over follow-up. We found limited evidence of associations between communication and relationship outcomes at 5-year follow-up. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Couple and individual adjustment for 2 years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy.

Follow-up data across 2 years were obtained on 130 of 134 couples who were originally part of a randomized clinical trial comparing traditional versus integrative behavioral couple therapy (TBCT vs. IBCT; A. Christensen et al., 2004). Both treatments produced similar levels of clinically significant improvement at 2 years posttreatment (69% of IBCT couples and 60% of TBCT couples). Both treatments showed a "hockey-stick" pattern of change in which satisfaction dropped immediately after treatment termination but then increased for most of follow-up. The break point when couples reversed courses and gained in satisfaction occurred sooner for IBCT than TBCT couples, and those couples who stayed together generally fared better in IBCT than in TBCT. Finally, there was evidence of greater stability during follow-up in IBCT than in TBCT couples. There was little change in individual functioning over follow-up, but when change occurred it was strongly related to change in marital satisfaction. Given that this sample was selected for its significant and chronic distress, the data are encouraging about the long-term impact of behavioral couple therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrative behavioral couple therapy: An acceptance-based, promising new treatment for couple discord.

Although traditional behavioral couple therapy (TBCT) has garnered the most empirical support of any marital treatment, concerns have been raised about both its durability and clinical significance. Integrative behavioral couple therapy (IBCT) was designed to address some of these limitations by combining strategies for fostering emotional acceptance with the change-oriented strategies of TBCT. Results of a preliminary clinical trial, in which 21 couples were randomly assigned to TBCT or IBCT, indicated that therapists could keep the 2 treatments distinct, that both husbands and wives receiving IBCT evidenced greater increases in marital satisfaction than couples receiving TBCT, and that IBCT resulted in a greater percentage of couples who either improved or recovered on the basis of clinical significance data. Although preliminary, these findings suggest that IBCT is a promising new treatment for couple discord. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of response to treatment in a randomized clinical trial of marital therapy.

This study investigated demographic, intrapersonal, and interpersonal predictors of treatment response in a randomized clinical trial of 134 distressed married couples, which examined traditional (N. S. Jacobson & G. Margolin, 1979) and integrative (N. S. Jacobson & A. Christensen, 1996) behavioral couple therapy. Results based on hierarchical linear modeling revealed that interpersonal variables were the strongest predictors, but their effects were largely limited to predicting initial marital dissatisfaction; greater individual mental health was also associated with less distress initially. Couples who were married longer demonstrated stronger treatment gains, and exploratory analyses suggested that sexually dissatisfied couples showed slower initial, but overall more consistent, gains in the integrative versus the traditional approach. Findings are considered in light of the previous literature on predicting response to marital therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving Relationships: Mechanisms of Change in Couple Therapy.

In a sample of 134 married couples randomly assigned to traditional or integrative behavioral couple therapy (TBCT vs. IBCT), a multivariate hierarchical growth curve analysis using latent variable regression revealed that measures of communication, behavior frequency, and emotional acceptance acted as mechanisms of change. TBCT led to greater changes in frequency of targeted behavior early in therapy, whereas IBCT led to greater changes in acceptance of targeted behavior both early and late in therapy. In addition, change in behavioral frequency was strongly related to improvements in satisfaction early in therapy; however, in the 2nd half of therapy, emotional acceptance was more strongly related to changes in satisfaction. Research and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Reactivity to Positive and Negative Behavior in Distressed and Nondistressed Married Couples": Correction.

Reports an error in the original article by N. S. Jacobson et al ( Journal of Consulting & Clinical Psychology, 1982[Oct], Vol 50[5], 706-714). The zs were incorrectly printed as 2s on pages 710 and 711. (The following abstract of this article originally appeared in record 1983-00931-001.) Tested the reactivity hypothesis that distressed married couples react more to recent, high-valence events (positive or negative) than their nondistressed counterparts. 21 happily married couples and 20 couples seeking marital therapy collected nightly data in the home for 2 wks, recording both the frequency of positive, negative, and neutral events and global daily satisfaction ratings. Ss also completed the Dyadic Adjustment Scale. As in past studies, and consistent with a behavioral model of marital distress, distressed couples reported lower rates of positive behavior and higher rates of negative behavior than did nondistressed. Consistent with the hypothesis, distressed spouses were more reactive to recent events than were nondistressed. Their subjective satisfaction with the relationship depended to a greater degree on the frequency of recent positive or negative events than was the case for happily married couples. Evidence is provided that these reactivity differences were not simply a function of differences in behavioral frequencies and that the process reactivity is separable--both experimentally and statistically--from the frequency of positive and negative exchanges. The relationship between reactivity and other variables of interest is examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Marital interaction and depression": Correction to Schmaling and Jacobson.

Reports an error in "Marital interaction and depression" by Karen B. Schmaling and Neil S. Jacobson (Journal of Abnormal Psychology, 1990[Aug], Vol 99[3], 229-236). In this article, the measures in Table 1 were incorrectly listed. The third and fourth measures ought to read "Wife DAS" and "Husband DAS," respectively. (The following abstract of the original article appeared in record 1991-01471-001.) In this article, patterns of marital interaction as a function of depression and marital satisfaction are examined. The purpose of the study was to separate dysfunctional marital interaction patterns that were unique to depression from those that were associated with marital distress. The presence or absence of a depressed wife was crossed with level of marital satisfaction (distressed or nondistressed) to produce four groups of subject couples. Couples in which the wife was depressed exhibited more depressive behavior than did nondepressed couples, but only during discussion of a high conflict (as opposed to neutral) topic. Sex?×?Depression Level?×?Marital Satisfaction interactions were found for aggressive behavior: Depressed women in nondistressed relationships exhibited behavior that was characteristic of maritally distressed couples (high rates of aggression). In contrast, the husbands of these women exhibited behavior that one would expect in happily married couples (low rates of aggression). We failed to replicate previous findings that depressive behavior served a coercive function, although distressed couples, regardless of depression status, exhibited all the usual signs of negative dysfunctional interaction. [An erratum for this article will appear in Journal of Abnormal Psychology, 1990 (Nov), Vol 99(4). The measures in Table 1 were incorrectly listed in the original article.] (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infidelity and Behavioral Couple Therapy: Optimism in the Face of Betrayal.

Infidelity is a common issue with which distressed couples and their therapists grapple. However, there are no data on the efficacy of commonly used therapies to treat couples in which there has been an affair. In the present exploratory study, the authors examined the therapy outcomes of a sample of infidelity couples (n=19) who had participated in a randomized clinical trial of marital therapy (N=134). Results show that infidelity couples began treatment more distressed than noninfidelity couples; however, evidence suggests that couples who had an affair and who revealed this affair prior to or during therapy showed greater improvement in satisfaction than noninfidelity couples. Implications for therapy with infidelity couples are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

What about the kids? Parenting and child adjustment in the context of couple therapy.

Little research examines parenting and children's adjustment when couples engage in therapy. We examined how couples with and without children improve with couple therapy and whether they also report improvements in parenting and child adjustment. With up to twenty six sessions of couple therapy, 134 couples, 68 of whom had children, showed improved marital satisfaction during treatment, which was ultimately maintained over the 2-year follow-up, regardless of whether they had children. Couples married relatively longer, both with and without children, evidenced greater improvement. Couples with children reported less conflict over child rearing and better child adjustment during treatment, but only improvements in the former were maintained. Conflict over child rearing mediated the relationship between marital distress and child adjustment over therapy and the 2-year follow-up. These preliminary results suggest that couples in therapy may decrease their conflict over child rearing during treatment and they may be able to maintain these gains for at least two years following treatment; moreover, over the course of treatment, this decreased conflict is tied to improved child adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acceptance in romantic relationships: The Frequency and Acceptability of Partner Behavior Inventory.

Despite the recent emphasis on acceptance in romantic relationships, no validated measure of relationship acceptance presently exists. To fill this gap, the 20-item Frequency and Acceptability of Partner Behavior Inventory (FAPBI; A. Christensen & N. S. Jacobson, 1997) was created to assess separately the acceptability and frequency of both positive and negative relationship behaviors. Data from 12,752 community individuals, 415 community couples, and 134 couples seeking marital therapy indicated that the FAPBI comprises four factors: Affection, Closeness, Demand, and Violation. These factors were consistent across gender, relationship type, and sexual orientation. Furthermore, the factors were internally consistent, correlated with relationship satisfaction, and differentiated couples seeking marital therapy from nondistressed couples in the community. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reactivity to positive and negative behavior in distressed and nondistressed married couples.

Tested the reactivity hypothesis that distressed married couples react more to recent, high-valence events (positive or negative) than their nondistressed counterparts. 21 happily married couples and 20 couples seeking marital therapy collected nightly data in the home for 2 wks, recording both the frequency of positive, negative, and neutral events and global daily satisfaction ratings. Ss also completed the Dyadic Adjustment Scale. As in past studies, and consistent with a behavioral model of marital distress, distressed couples reported lower rates of positive behavior and higher rates of negative behavior than did nondistressed. Consistent with the hypothesis, distressed spouses were more reactive to recent events than were nondistressed. Their subjective satisfaction with the relationship depended to a greater degree on the frequency of recent positive or negative events than was the case for happily married couples. Evidence is provided that these reactivity differences were not simply a function of differences in behavioral frequencies and that the process reactivity is separable—both experimentally and statistically—from the frequency of positive and negative exchanges. The relationship between reactivity and other variables of interest is examined. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Les corrélats des attributions de causalité et de responsabilité des couples qui consultent en thérapie conjugale.

This exploratory study aimed to identify the clinical correlates of partner's attributions in 165 couples beginning couple therapy. Results revealed that marital satisfaction, the interpersonal problem of dominance, and psychological distress were significatively linked to men's attributions. Marital satisfaction, the interpersonal problem of the tendency to self-sacrifice, and women's age were significatively associated with women's attributions. At a dyadic level, only men's marital satisfaction was linked to women's causality attributions. The importance of studying both dyadic and individual correlates of attributions is emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Promoting healthy beginnings: A randomized controlled trial of a preventive intervention to preserve marital quality during the transition to parenthood.

Couples expecting their first child were randomly assigned to intervention (n = 28) and comparison groups (n = 38) to assess the efficacy of a couples intervention and examine marital satisfaction trajectories across the transition to parenthood. The primarily European American sample (M age = 30 years) completed assessments of marital satisfaction at 5 points from the final trimester of pregnancy to 66 months postpartum. Growth curve analyses indicated a normative linear decline in marital satisfaction. Intervention participants experienced significantly less decline than comparison participants, providing support for the efficacy of the intervention. Comparable childless couples (n = 13) did not show a decline in marital satisfaction. The results suggest that early family transitions that strain couple relationships provide critical opportunities for preventive interventions to strengthen marriage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sex role identity, marital satisfaction, and response to behavioral marital therapy.

Explored the relationships among masculinity, femininity, marital satisfaction, and response to behavioral marital therapy (BMT) using 44 married nonclinic couples (mean ages of males and females 33.7 and 31 yrs, respectively), 54 maritally distressed clinic couples receiving BMT, and 18 maritally distressed clinic couples placed on a waiting list; the mean ages of males and females in both distressed clinic groups were 32.1 and 29.9 yrs, respectively. Ss completed the Marital Adjustment Scale and masculinity and femininity scales derived from the California Psychological Inventory. Results indicate that for each sex, both femininity and masculinity were significantly correlated with self-reported marital satisfaction; the magnitude of the correlations between femininity and marital satisfaction was higher than the correlations between masculinity and marital satisfaction. Among clinic couples, androgyny was the least frequent sex-role identity for either husbands or wives; conversely, among nonclinic couples, there were more androgynous husbands and wives than there was any other sex-role type. In the clinic group, both husbands and wives showed statistically significant but small increases in masculinity after receiving 10 wks of BMT. Masculinity and femininity level prior to treatment also significantly predicted response to BMT. The potential importance of both masculinity and femininity in successful marriages is highlighted, and treatment implications are discussed. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Provider role attitudes, marital satisfaction, role overload, and housework: A dyadic approach.

Treating the marital dyad as the unit of analysis, this study examined the within-couple patterning of 272 dual-earner spouses' provider role attitudes and their longitudinal associations with marital satisfaction, role overload, and the division of housework. Based on the congruence of husbands' and wives' provider role attitudes, couples were classified into one of four types: (a) main-secondary, (b) coprovider, (c) ambivalent coprovider, and (d) mismatched couples. Nearly half of all spouses differed in their attitudes about breadwinning. A series of mixed model ANCOVAs revealed significant between- and within-couple differences in human capital characteristics, spouses' perceptions of marital satisfaction and role overload, and the division of housework across 3 years of measurement. Coprovider couples reported higher levels of marital satisfaction and a more equitable division of housework than the other couple groups. Wives in the ambivalent coprovider couples' group reported higher levels of role overload than their husbands to a greater extent than was found in the other couple groups. As the first study to adopt a dyadic approach that considers the meanings that both spouses in dual-earner couples ascribe to paid employment, these findings advance understanding of how dual-earner spouses' provider role attitudes serve as contexts for marital quality, behavior, and role-related stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couple discord and depression in couples during couple therapy and in depressed individuals during depression treatment.

The association between depression and relationship distress as well as the impact of treatment for the one on the other was examined across 2 treatment-seeking samples: individuals seeking treatment for depression (N = 120) and couples seeking marital therapy (N = 134 couples). Although there was a baseline association between depression and distress across the 2 samples, relationship distress was far more prevalent among those being treated for depression than was depression for those seeking marital therapy. There was a reliable association between changes in the primary problem (e.g., relationship distress in the couple therapy study) and changes in the secondary problem (e.g., depression in the couple therapy study). However, overall effects on secondary problems were quite small. Neuroticism played a complex, moderating role across the 2 samples, strengthening and weakening the association between depression and relationship distress depending on the sample and gender, replicating previous findings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of the Oregon model of Parent Management Training (PMTO) on marital adjustment in new stepfamilies: A randomized trial.

Effects of intervention with the Oregon model of Parent Management Training (PMTO?) on marital relationship processes and marital satisfaction in recently married biological mother and stepfather couples were examined. Sixty-seven of the 110 participating families were randomly assigned to PMTO, and 43 families to a non-intervention condition. Intervention had reliable positive indirect effects on marital relationship processes 24 months after baseline which in turn were associated with higher marital satisfaction. These indirect effects were mediated by the impact of PMTO on parenting practices 6 months after baseline. Enhanced parenting practices resulting from PMTO prevented escalation of subsequent child behavior problems at school. Consistent with a family systems perspective and research on challenges to marital quality in stepfamilies, improved co-parenting practices were associated with enhanced marital relationship skills and marital satisfaction as well as with prevention of child behavior problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychopathology and Marital Satisfaction: The Importance of Evaluating Both Partners.

Using path analysis and hierarchical linear modeling, the authors evaluated the associations between both partners' level of depression and anxiety, as measured by Minnesota Multiphasic Personality Inventory-2 (MMPI-2) content scales, and both partners' level of marital satisfaction among married couples (N = 774) that participated in the MMPI restandardization study (J. N. Butcher, W. G. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989). Results indicated that marital satisfaction was predicted by the person's own level of anxiety and depression (i.e., actor effects) and by his or her spouse's level of depression only (i.e., partner effects). Findings also indicated that (a) there were no significant gender differences in the magnitude of effects, (b) depression effects were significantly stronger than anxiety effects, (c) actor effects were significantly stronger than partner effects, and (d) there were interactions between actor and partner effects for depression only. (PsycINFO Database Record (c) 2010 APA, all rights reserved)