Marital distress, depression, and attributions: Is the marital distress-attribution association an artifact of depression?

We examined whether the association between marital distress and attributions is an artifact of depression. Study 1 showed that the attributions of 40 wives recruited from the community accounted for variance in their marital satisfaction after the effects of depression had been taken into account. Study 2 compared the attributions of 20 clinically depressed and maritally distressed wives (respondents to an advertisement offering therapy for depression and marital problems), 20 nondepressed but distressed wives (clients seeking marital therapy at a clinic), and a control group of 20 nondepressed and nondistressed wives (respondents to an advertisement for participants in a research project). The first two groups did not differ in attributions, but the attributions of both groups differed from those of the control group. Both studies therefore suggest that the association between attributions and marital satisfaction is not due to depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The marital intake interview: A multimethod criterion validity assessment.

Assessed the validity of an initial intake interview with 12 couples seeking marital therapy (dissatisfied) and 16 couples seeking marital enhancement (satisfied). Ss (mean age 26.07 yrs) were interviewed with spouses together or separated. Interview items focused on marital satisfaction and perception, demographic variables, and comfort in making assertive responses. Couples were then administered several marital satisfaction and assertion questionnaires (e.g., Marital Adjustment Scale, Dyadic Adjustment Scale). Each couple also participated in a structured analog communication assessment in which they discussed a problem area in their marriage. The verbal interchanges during the communication exercises were coded by trained observers. Results suggest (a) a high degree of discriminant validity for the marital interview, (b) higher interspouse correlations for interview items during joint interviews, (c) higher indices of criterion-related validity for separate interviews, and (d) a significant relationship between the reactivity of joint interviews and the social sensitivity of the interview item. (34 ref) (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)     

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)     

Criteria for diagnosing when to do sex therapy in the primary relationship.

Examined the diagnosis and treatment records of 30 couples (aged 22–51 yrs) to determine why some couples did not respond to sex therapy. Findings led to criteria for diagnosing whether to do sex therapy as a treatment of choice. Criteria include (1) absences of a physical problem, (2) absence of another primary problem (e.g., depression), (3) presence of bona fide sexual dysfunction in one or both partners as defined in DSM-III, (4) presence of belief that therapy works, (5) absence of interfering situational events, and (6) presence of basic relationship requirements. A 5-session format for diagnoses is proposed. In Session 1, the couple is interviewed regarding reasons for seeking help; in Sessions 2 and 3, partners are interviewed individually; following Session 3, co-therapists meet to discuss the material collected; in Sessions 4 and 5, the therapists review and summarize the material collected with the couple. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conflict and collaboration in middle-aged and older couples: II. Cardiovascular reactivity during marital interaction.

Marital strain confers risk of cardiovascular disease (CVD), perhaps though cardiovascular reactivity (CVR) to stressful marital interactions. CVR to marital stressors may differ between middle-age and older adults, and types of marital interactions that evoke CVR may also differ across these age groups, as relationship contexts and stressors differ with age. The authors examined cardiovascular responses to a marital conflict discussion and collaborative problem solving in 300 middle-aged and older married couples. Marital conflict evoked greater increases in blood pressure, cardiac output, and cardiac sympathetic activation than did collaboration. Older couples displayed smaller heart rate responses to conflict than did middle-aged couples but larger blood pressure responses to collaboration—especially in older men. These effects were maintained during a posttask recovery period. Women did not display greater CVR than men on any measure or in either interaction context, though they did display greater parasympathetic withdrawal. CVR to marital conflict could contribute to the association of marital strain with CVD for middle-aged and older men and women, but other age-related marital contexts (e.g., collaboration among older couples) may also contribute to this mechanism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spouses' reasons for not reporting existing marital aggression as a marital problem.

Questionnaires and clinical interviews reveal that over 60% of couples seeking marital therapy experience physical violence in their relationship. However, fewer than 10% of these couples spontaneously report or identify the violence as a presenting problem. Spouses' explanations for not spontaneously reporting couple violence were examined in 136 clinic couples. The top 3 reasons were as follows: (a) It is not a problem, (b) it is unstable or infrequent, and (c) it is secondary to or caused by other problems. There were no gender differences in this regard. Further, there were no differences regarding explanations offered for failure to report partner violence versus own violence. However, differences were found between mildly and severely aggressive spouses and between husband-to-wife and wife-to-husband violence. (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)     

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)     

Moderators of the association between relationship discord and major depression in a national population-based sample.

Although there is a well-documented association between relationship discord and depression, many individuals experience either discord or depression without experiencing the other. To understand this phenomenon, the authors evaluated moderators of the association between relationship discord and major depression among married or cohabiting individuals in the National Comorbidity Survey (N=2,538; R. C. Kessler et al., 1994). Potential moderators included demographics, personality characteristics, parental depression, and childhood loss. Only one significant moderator was found: There was a stronger association between discord and depression for married people (vs. cohabiters). Among married individuals only, neuroticism also served as a moderator: Individuals higher in neuroticism showed a stronger association between discord and depression. In general, findings suggest that when a person or family presents with one problem (e.g., relationship discord), it is important to evaluate and potentially treat the other problem (e.g., depression) as well. (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)     

Construct of attributional style in depression and marital distress.

Although important theoretically, consistency in attribution responses or attributional style has rarely been investigated empirically. The responses of 150 couples were used to examine whether consistency of attribution responses within attribution dimensions and consistency in the pattern of responses across attribution dimensions were associated with adaptational outcomes. Replicating previous findings, mean attribution scores correlated with depression and with marital distress. Consistency of attribution responses was unrelated to either adaptational outcome, whereas (1) theoretically derived pessimistic and optimistic attribution patterns were related to depression scores and (2) benign and nonbenign marital attribution patterns were related to marital satisfaction scores. The implications of these findings for the level at which attributional style is best conceptualized are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Demand-withdraw communication in severely distressed, moderately distressed, and nondistressed couples: Rigidity and polarity during relationship and personal problem discussions.

This study investigated demand-withdraw communication among 68 severely distressed couples seeking therapy, 66 moderately distressed couples seeking therapy, and 48 nondistressed couples. Self-report and videotaped discussions replicated previous research, demonstrating that greater demand-withdraw during relationship problem discussions was associated with greater distress and that overall, wife-demand/husband-withdraw was greater than husband-demand/wife-withdraw. Results extended the conflict structure view of demand-withdraw by indicating that this gender polarity in demand-withdraw roles varied in strength and direction depending on who chose the topic for discussion, distress level, and marriage length. Further, in videotaped personal problem discussions, typical gender patterns of demand-withdraw were reversed. Across the relationship and personal problem discussions, a pattern of gender polarity emerged when husbands held the burden of changing. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couple resilience to economic pressure

Over 400 married couples participated in a 3-year prospective study of economic pressure and marital relations. The research (a) empirically evaluated the family stress model of economic stress influences on marital distress and (b) extended the model to include specific interactional characteristics of spouses hypothesized to protect against economic pressure. Findings provided support for the basic mediational model, which proposes that economic pressure increases risk for emotional distress, which, in turn, increases risk for marital conflict and subsequent marital distress. Regarding resilience to economic stress, high marital support reduced the association between economic pressure and emotional distress. In addition, effective couple problem solving reduced the adverse influence of marital conflict on marital distress. Overall, the findings provided substantial support for the extended family stress model.     

Introduction to special section on couples and couple therapy.

Introduces the special section on couples and couple therapy, which brings together representative, state-of-the-art contributions from both basic and applied research on couples. Two contributions from the basic research domain attempt to better understand the interactional dynamics of normal marriages; both also have implications for marital and relationship distress. Two articles focus specifically on domestic violence. In the domain of clinical research, there are four articles that examine outcome and change mechanisms, the process of change within emotionally focused couple therapy, predictors of short- and long-term outcome after behavioral or insight-oriented marital therapy, and findings from a research program on preventing marital discord. The section closes with a commentary in which the articles are put into a broader context, and the interaction between basic and applied research is emphasized. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Coexisting difficulties and couple therapy outcomes: Psychopathology and intimate partner violence.

Couples presenting for treatment of relationship distress often experience additional problems, including individual psychopathology and intimate partner violence (IPV). Both issues are associated with current and future poor relationship functioning in nontreatment samples, but relatively little is understood about their association with initial presentation and outcomes in couple therapy. The current study examined these associations in a sample of 177 heterosexual couples who received therapy at two Veteran's Affairs clinics. Unlike most studies of couple therapy outcomes, couples were not excluded from treatment specifically because of high levels of psychopathology or IPV. Results of Actor Partner Interdependence Model (APIM) analyses revealed actor and partner effects of depression, actor effects of anxiety, and partner effects of IPV on initial relationship satisfaction, such that greater coexisting difficulties were associated with poorer initial satisfaction. However, improvement in relationship satisfaction over the course of therapy was not associated with psychopathology, and, contrary to hypothesis, was positively associated with men's IPV prior to treatment, even when initial level of satisfaction was controlled. The results suggest that coexisting symptoms of psychopathology or IPV may not necessarily interfere with therapy outcomes and, indeed, therapy may have positive effects for couples with these problems. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Outcomes of couples with infidelity in a community-based sample of couple therapy.

Infidelity is an often cited problem for couples seeking therapy, but the research literature to date is very limited on couple therapy outcomes when infidelity is a problem. The current study is a secondary analysis of a community-based sample of couple therapy in Germany and Austria. Outcomes for 145 couples who reported infidelity as a problem in their relationship were compared with 385 couples who sought therapy for other reasons. Analyses based on hierarchical linear modeling revealed that infidelity couples were significantly more distressed and reported more depressive symptoms at the start of therapy but continued improving through the end of therapy and to 6 months posttherapy. At the follow-up assessment, infidelity couples were not statistically distinguishable from non-infidelity couples, replicating previous research. Sexual dissatisfaction did not depend on infidelity status. Although there was substantial missing data, sensitivity analyses suggested that the primary findings were not due to missing data. The current findings based on a large community sample replicated previous work from an efficacy trial and show generally optimistic results for couples in which there has been an affair. (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)