Longitudinal association between marital dissatisfaction and alcohol use disorders in a community sample.

The prospective association between marital dissatisfaction and alcohol use disorders (abuse and/or dependence) was evaluated in a randomly selected community sample. Married individuals (N=1,675) from the New Haven Epidemiologic Catchment Area project who did not have a current alcohol use disorder at baseline were followed prospectively for 12 months. Results indicated that baseline marital dissatisfaction was significantly associated with alcohol use disorder diagnosis during follow-up, with dissatisfied spouses being 3.7 times more likely than satisfied spouses to have a diagnosis of current alcohol use disorder at follow-up. The longitudinal association between baseline marital dissatisfaction and current alcohol use disorder diagnosis at follow-up remained significant when controlling for baseline demographic variables and history of alcohol use disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impairment and distress associated with relationship discord in a national sample of married or cohabiting adults.

The clinical importance of relationship discord was examined through evaluating the association between relationship discord and multiple measures of impairment and psychological distress in a population-based sample of married and cohabiting adults (N = 2,677). In comparison to people that were not in discordant relationships, individuals in discordant relationships reported greater social role impairment with relatives and friends and greater work role impairment. They also reported higher levels of general distress and poorer perceived health and were more likely to report suicide ideation. With the exception of suicide ideation, the associations between relationship discord and impairment and psychological distress remained significant when controlling for current mood, anxiety, and substance use disorders, suggesting that relationship discord is incrementally related to impairment and psychological distress over and above the effects of psychiatric disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital distress and the metabolic syndrome: Linking social functioning with physical health.

Mechanisms by which poor relationship functioning contributes to poor health are not fully understood. We conducted a study to evaluate the association between marital distress and the metabolic syndrome (MetS), which refers to a clustering of characteristics that have individually been shown to be associated with elevated risk of cardiovascular disease and diabetes and which collectively have been shown to increase risk for cardiovascular disease, diabetes, stroke, and mortality. A population-based English sample of couples (N = 671 couples) in which both partners were between the ages of 52 and 79 years old completed a self-report measure of marital distress and a nurse visit that included collection of blood pressure, blood samples, and anthropometric measures. Results indicated that for women, after controlling for demographic variables, greater marital distress was significantly associated with increasing likelihood of meeting criteria for the MetS and with the individual MetS criteria of elevated blood pressure and elevated fasting glucose. The association between marital distress and the MetS remained significant for women when additionally controlling for depressive symptoms and health habits (smoking status, physical activity). Marital distress was not significantly associated with the MetS or any of the individual MetS criteria for men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital distress and mental health care service utilization.

Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for specific sectors of treatment providers, including psychiatrist, other mental health provider, other medical provider, and religious services provider. Interviews were used to assess past-year service utilization and presence of anxiety, mood, and substance use disorders. Results: Approximately 12% of married individuals sought help for problems with their emotions, nerves, or substance use during the 12 months preceding the interview. Marital distress was significantly associated with (a) overall mental health service utilization and service utilization provided by each of the sectors of providers when controlling for demographic variables and (b) overall mental health service utilization and receiving treatment from a psychiatrist when additionally controlling for past-year anxiety, mood, or substance use disorders. There was little evidence that the associations between marital distress and service utilization were moderated by gender or presence of psychiatric disorders. Conclusion: The finding that marital distress is associated with greater mental health care service utilization suggests that clinicians should assess both individual and relationship factors among individuals presenting for treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital problem-solving behavior in depression and marital distress.

The present study examined the effects of depression and marital distress on behavior during a marital problem-solving interaction. A complete factorial design combined the presence or absence of a depressed wife with the presence or absence of marital distress, to produce four groups of participant couples. An increase in depressive behavior was the sole unique contribution of a depressed wife, occurring regardless of the level of marital distress. Increased aggressive behavior and decreased facilitative behavior were found to characterize the interactions of maritally distressed couples and were not influenced by depression. Resolution-oriented behavior remained unchanged as a result of either depression or marital distress. The results indicate that marital distress, in addition to depression, should be considered as a source of dysfunctional behavior in marital interactions involving depressed individuals. (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)     

Anxiety disorders and intimate relationships: A study of daily processes in couples.

Although adults with anxiety disorders often report interpersonal distress, the degree to which anxiety is linked to the quality of close relationships remains unclear. The authors examined the relational impact of anxiety by sampling the daily mood and relationship quality of 33 couples in which the wife was diagnosed with an anxiety disorder. Use of a daily process design improved on prior methodologies by capturing relational processes closer to their actual occurrence and in the setting of the diagnosed partner’s anxiety. Analyses revealed significant associations between wives’ daily anxiety and both partners’ perceptions of relationship quality. Associations were moderated by anxiety-specific support. Results also indicated significant concordance between wives’ daily anxiety and husbands’ distress. Concordance was stronger for husbands who reported frequent accommodation of wives’ anxiety symptoms. Findings are discussed in the context of existing evidence on the social costs of anxiety disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital dissatisfaction and psychiatric disorders: Results from the national comorbidity survey.

The association between marital dissatisfaction and 12-month prevalence rates of Diagnostic and Statistical Manual of Mental Disorders (3rd ed., rev., 1987) Axis I psychiatric disorders was examined in married respondents from the National Comorbidity Survey (N?=?2,538). Results indicate that marital dissatisfaction was associated with the presence of any disorder, any mood disorder, any anxiety disorder, and any substance-use disorder; dissatisfaction was also associated with 7 of 12 specific disorders for women and 3 of 13 specific disorders for men. To evaluate the unique association between marital dissatisfaction and psychiatric disorders, analyses were conducted controlling for comorbid disorders. Covariance analyses generally attenuated the bivariate associations between marital dissatisfaction and specific disorders and groupings of disorders. Results indicate that marital dissatisfaction was uniquely related to major depression and posttraumatic stress disorder for women and dysthymia for men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding general and specific connections between psychopathology and marital distress: A model based approach.

Marital distress is linked to many types of mental disorders; however, no study to date has examined this link in the context of empirically based hierarchical models of psychopathology. There may be general associations between low levels of marital quality and broad groups of comorbid psychiatric disorders as well as links between marital adjustment and specific types of mental disorders. The authors examined this issue in a sample (N = 929 couples) of currently married couples from the Minnesota Twin Family Study who completed self-report measures of relationship adjustment and were also assessed for common mental disorders. Structural equation modeling indicated that (a) higher standing on latent factors of internalizing (INT) and externalizing (EXT) psychopathology was associated with lower standing on latent factors of general marital adjustment for both husbands and wives, (b) the magnitude of these effects was similar across husbands and wives, and (c) there were no residual associations between any specific mental disorder and overall relationship adjustment after controlling for the INT and EXT factors. These findings point to the utility of hierarchical models in understanding psychopathology and its correlates. Much of the link between mental disorder and marital distress operated at the level of broad spectrums of psychopathological variation (i.e., higher levels of marital distress were associated with disorder comorbidity), suggesting that the temperamental core of these spectrums contributes not only to symptoms of mental illness but to the behaviors that lead to impaired marital quality in adulthood. (PsycINFO Database Record (c) 2011 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)     

Marital discord and well-being in older adults: Is the association confounded by personality?

The associations between marital discord and multiple measures of well-being (depression, anxiety, life satisfaction, and self-esteem) were evaluated in a population-based sample of 416 couples in which the husband was 65 years or older. Results indicated that greater marital discord was associated with greater depression and lower life satisfaction and self-esteem. Furthermore, the associations between marital discord and well-being remained significant when statistically controlling for the rival explanation of the Big Five personality traits. Finally, there was little evidence for gender differences in the magnitude of the associations between marital discord and well-being. Findings suggest that marital discord is an important correlate of multiple measures of well-being in older individuals and that this association is not confounded by the Big Five personality traits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Personality disorder symptoms and marital functioning.

Pathological personality is strongly linked with interpersonal impairment, yet no study to date has examined the relationship between concurrent personality pathology and dysfunction in marriage--a relationship that most people find central to their lives. In a cross-sectional study of a community sample of married couples (N = 82), the authors used multilevel modeling to estimate the association of self- and spouse-reported symptoms of personality disorder (PD) with levels of marital satisfaction and verbal aggression and perpetration of physical violence. Inclusion of self- and spouse report of total PD symptoms resulted in improved model fit and greater variance explained, with much of the improvement coming after the addition of spouse report. The incremental validity of spouse report for several of the 10 PD scales was supported for marital satisfaction and verbal aggression, particularly for the Borderline and Dependent PD scales. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The premarital communication roots of marital distress and divorce: The first five years of marriage.

Using data from 210 couples who provided data across the first 5 years of marriage, we examined how premarital communication quality was related to divorce and later distress. The results showed that premarital observed negative and positive communication nearly reached significance as predictors of divorce, while self-reported negative communication was significantly associated with divorce. In terms of marital adjustment, we found that both premarital observed and self-reported negative premarital communication (but not observed positive communication) were associated with lower adjustment during the first 5 years of marriage. The most important questions addressed in this study pertain to how positive and negative dimensions of communication change over time and how these changes are related to being distressed or nondistressed after 5 years of marriage. This is the first study, to our knowledge, to examine the changes in communication over time that are so central to theories of the development of marital distress and for research-based interventions. We found that all couples showed decreases in negative communication over time, but the nondistressed group declined significantly more than the distressed group in negative communication, suggesting they are handling negative emotions better. Implications for future research on the development of relationship distress and for enhancing research-based couples' intervention programs are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting marital distress and dissolution: Refining the two-factor hypothesis.

Measures of communication, hostility, and neuroticism taken from 85 couples from Germany before marriage were used to predict marital outcomes 5 years later. Hostility and neuroticism discriminated between couples who separated or divorced after 5 years and those who remained married, whereas communication discriminated between married-satisfied and married- dissatisfied couples. Only hostility and neuroticism predicted marital satisfaction at 18 months, suggesting that these factors contribute to rapid, early declines in marital functioning. The authors conclude that poor communication alone cannot account for the full range of marital outcomes and that skill-based models of marriage can be strengthened by considering relatively rare exchanges between partners (e.g., aggression) and their enduring vulnerabilities (e.g., neuroticism). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital status and satisfaction five years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy.

Objective: To follow distressed married couples for 5 years after their participation in a randomized clinical trial. Method: A total of 134 chronically and seriously distressed married couples were randomly assigned to approximately 8 months of either traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979) or integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998). Marital status and satisfaction were assessed approximately every 3 months during treatment and every 6 months for 5 years after treatment. Results: Pre- to posttreatment effect sizes on marital satisfaction were d = 0.90 for IBCT and d = 0.71 for TBCT, which were not significantly different. However, data through 2-year follow-ups revealed statistically significant superiority of IBCT over TBCT in relationship satisfaction, but subsequent data showed increasing similarity and nonsignificant differences in outcome. At 5-year follow-up for marital satisfaction relative to pretreatment, effect sizes were d = 1.03 for IBCT and d = 0.92 for TBCT; 50.0% of IBCT couples and 45.9% of TBCT couples showed clinically significant improvement. Relationship status, obtained on all 134 couples, revealed that 25.7% of IBCT couples and 27.9% of TBCT couples were separated or divorced. These follow-up data compared favorably to other, long-term results of couple therapy. Conclusion: TBCT and IBCT both produced substantial effect sizes in even seriously and chronically distressed couples. IBCT produced significantly but not dramatically superior outcomes through the first 2 years after treatment termination but without further intervention; outcomes for the 2 treatments converged over longer follow-up periods. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Screening for marital and relationship discord.

Based on recent findings suggesting that marital discord is taxonic (i.e., that couples in discordant relationships differ qualitatively, and not just quantitatively, from couples in nondiscordant relationships), this study was designed to develop a brief screening measure for detecting the relationship discord taxon. A national, representative sample of 1,020 married couples completed the Marital Satisfaction Inventory—Revised. Data from this sample were used to create a 10-item screening measure. Using the cut scores from the original study that found evidence of taxonicity as a point of reference, the 10-item screen demonstrated good diagnostic performance in assessing the relationship discord taxon. Taxon classification based on the brief scale demonstrated good short-term stability. The scale is easily administered and scored, making it appropriate for use in clinical and research settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital status and quality in middle-aged women: Associations with levels and trajectories of cardiovascular risk factors.

The current study compared cardiovascular risk profiles and trajectories (i.e., within-person changes) of women who were married or cohabitating and who had high relationship satisfaction with those of women with moderate or low satisfaction and with those of women who were single, divorced, and widowed. Participants were 493 women from the Healthy Women Study, a prospective investigation of health during and after the menopausal transition. Risk factors were measured across more than 5 occasions and 13 years, on average. Data were analyzed using a multilevel modeling technique. Overall, women in relationships with high satisfaction had lower levels of biological, lifestyle, and psychosocial risk factors when compared with the other groups. In some cases, women in satisfying marriages also showed a lower risk trajectory on risk factors relative to other women. Hence, marriage appears to confer health benefits for women, but only when marital satisfaction is high. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Linking dimensional models of internalizing psychopathology to neurobiological systems: Affect-modulated startle as an indicator of fear and distress disorders and affiliated traits.

Integrative hierarchical models have sought to account for the extensive comorbidity between various internalizing disorders in terms of broad individual difference factors these disorders share. However, such models have been developed largely on the basis of self-report and diagnostic symptom data. Toward the goal of linking such models to neurobiological systems, we reviewed studies that have employed variants of the affect-modulated startle paradigm to investigate emotional processing in internalizing disorders as well as personality constructs known to be associated with these disorders. Specifically, we focused on four parameters of startle reactivity: fear-potentiated startle, inhibition of startle in the context of pleasant stimuli, context-potentiated startle, and general startle reactivity. On the basis of available data, we argue that these varying effects index differing neurobiological processes related to mood and anxiety disorders that are interpretable from the standpoint of dimensional models of the internalizing spectrum. Further, we contend that these empirical findings can feed back into and help reshape conceptualizations of internalizing disorders in ways that make them more amenable to neurobiological analysis. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of self-disclosure in psychotherapy and marriage.

This study compared patterns of self-disclosure in psychotherapy and marriage. Participants (48 married, current psychotherapy patients, mean age = 42) completed a 101-item Disclosure to Therapist Inventory and a companion measure, a 101-item Disclosure to Spouse Inventory. Results indicated a pattern of greater disclosure to one's therapist in regard to issues involving despair (e.g., feelings of depression), and to one's spouse in regard to procreation and body concerns (e.g., birth control) and values (e.g., feelings about religion, race, or politics). Issues involving sex were infrequently discussed in either context. Discrepancy scores (differences between extent of disclosure and perceived importance) were greater in the spouse condition. Outcome predictors varied by situation, with overall disclosure predicting therapeutic outcome and both overall disclosure and discrepancy scores predicting marital satisfaction. Findings suggest that although there is substantial overlap in issues discussed in these two contexts, certain intimate disclosures are perceived as situation-specific. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Gender differences in psychiatric comorbidity among adolescents with substance use disorders.

The authors examined gender differences in rates of comorbid psychiatric disorders among adolescents with 1 or more psychoactive substance use disorders. Baseline diagnostic data were obtained from 135 adolescents, ages 12 to 19, and their parents-guardians, who participated in a study to develop and efficacy test Integrated Family and Cognitive-Behavioral Therapy. Rates of attention-deficit/hyperactivity disorder and conduct disorder were higher among drug-abusing male adolescents compared with drug-abusing female adolescents. However, high rates of disruptive behavior disorders also characterized drug-abusing female adolescents. Similarly, drug-abusing female adolescents exhibited a higher rate of major depression compared with drug-abusing male adolescents. However, rates of dysthymia, double depression (i.e., major depression and dysthymia), and bipolar disorder were equivalent between genders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)