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)     

Infidelity in Couples Seeking Marital Therapy.

The revelation of an affair is often an emotionally explosive event for a couple, yet little is known about specific individual and relationship factors that accompany infidelity. The present study examined the qualities of individuals and couples that differentiate couples with (n = 19) and without (n = 115) infidelity using couples from a randomized clinical trial of marital therapy. Findings indicated that couples with infidelity showed greater marital instability, dishonesty, arguments about trust, narcissism, and time spent apart. Gender also proved to be a significant moderator of several effects. Men who had participated in affairs showed increased substance use, were older, and were more sexually dissatisfied. Results offer initial clues to concomitants of affairs for couple therapists. (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)     

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)     

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)     

Causal attributions of married couples: When do they search for causes? What do they conclude when they do?

Administered an attribution questionnaire and a partner behavior checklist to 20 nondistressed and 22 distressed couples (as determined by a dyadic adjustment scale). Instruments contained indirect and direct probes. Wives were aged 20–59 yrs; husbands were aged 20–61 yrs; 11 distressed couples had been referred to a clinic for marital therapy. Spouses were asked about frequent as well as infrequent relationship events and about partner behaviors that had positive or negative impacts on the recipient. Attributions were coded for content and contribution to the relationship. Results show that husbands in unsatisfying relationships reported more attributional thoughts than did happily married husbands, whereas wives in the 2 groups did not differ. Behaviors having negative impacts elicited more attributional activity than did positive behaviors. Behavioral frequency and impact interacted in ways contrary to predictions. Finally, distressed couples were particularly likely to report distress-maintaining attributions and were particularly unlikely to report relationship-enhancing attributions when compared with their nondistressed counterparts. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predicting sexual infidelity in a population-based sample of married individuals.

Predictors of 12-month prevalence of sexual infidelity were examined in a population-based sample of married individuals (N = 2,291). Predictor variables were organized in terms of involved-partner (e.g., personality, religiosity), marital (e.g., marital dissatisfaction, partner affair), and extradyadic (e.g., parenting) variables. Annual prevalence of infidelity was 2.3%. Controlling for marital dissatisfaction and demographic variables, infidelity was predicted by greater neuroticism and lower religiosity; wives' pregnancy also increased the risk of infidelity for husbands. In comparison, self-esteem and partners' suspected affair were predictive of infidelity when controlling for demographic variables but were not uniquely predictive of infidelity when also controlling for marital dissatisfaction. Religiosity and wives' pregnancy moderated the association between marital dissatisfaction and infidelity. (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)     

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)     

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)     

Systemic-constructivist couple therapy (SCCT): Description of approach, theoretical advances, and published longitudinal evidence.

The systemic-constructivist approach to studying and benefiting couples was derived from qualitative and quantitative research on distressed couples over the past 10 years. Systemic-constructivist couple therapy (SCCT) is the clinical intervention that accompanies the approach. SCCT guides the therapist to work with both the intrapersonal and the interpersonal aspects of marriage while also integrating the social-environmental context of the couple. The theory that underlies SCCT is explained, including concepts such as we-ness and interpersonal processing. The primary components of the therapy are described. Findings described previously in an inaugural monograph containing extensive research demonstrating the long-term utility of SCCT are reviewed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of cotherapists versus single therapists and immediate versus delayed treatment in behavioral marital therapy.

Evaluated the overall effectiveness of behavioral marital therapy (BMT) in aiding distressed couples, and explored the relative effectiveness of (a) cotherapists vs single therapists and (b) immediate treatment vs delayed treatment, which resulted from placing couples on a waiting list. 30 maritally distressed couples (aged 19–59 yrs) were randomly assigned to 1 of 6 treatment conditions, with 5 couples per condition: (a) immediate treatment by Therapist A; (b) immediate treatment by Therapist B; (c) immediate treatment by Therapists A and B as a cotherapy team; (d) delayed treatment by Therapist A; (e) delayed treatment by Therapist B; or (f) delayed treatment by Therapists A and B as a cotherapy team. Ss were administered a battery of tests that included the Marital Adjustment Test and Areas-of-Change Questionnaire. Results indicate that BMT was more effective than no treatment on both self-report measures and 1 of 2 behavioral measures, thus affirming the overall effectiveness of the treatment. A cotherapy team and single therapists were equally effective in producing treatment changes. In addition, overall there were no significant differences between couples receiving therapy immediately and couples treated after a 10-wk waiting period. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological profiles of violent and nonviolent maritally distressed couples.

Compared 42 couples seeking counseling who had equal levels of marital distress but different levels of violence. 32 couples had experienced at least 1 episode of physical assault in the last year. Measures included the Profile of Mood States, the Index of Self-Esteem, assessments of violence in family and peer milieus, and assessment of alcohol use. More violent males reported alcohol problems than distressed males. Women in violent couples were significantly more anxious, confused, fatigued, and marginally more depressed than maritally distressed women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of Behavioral Marital Therapy: A Meta-Analysis of Randomized Controlled Trials.

This meta-analysis summarizes results from 30 randomized experiments that compare behavioral marital therapy with no-treatment control with distressed couples. Results showed that behavioral marital therapy is significantly more effective than no treatment (d=.585). Although behavioral marital therapy research studies tend to be conducted under conditions that are less clinically representative than other samples of studies, representativeness was not significantly related to outcome. However, evidence also suggested that publication bias may exist in this literature whereby small sample studies with small effects are systematically missing compared with other studies. This bias may inflate the effects of behavioral marital therapies reported in previous meta-analyses, though we also explore a number of alternative explanations for this small sample bias. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Communication patterns and response to treatment among depressed and nondepressed maritally distressed couples.

Compared 35 maritally distressed couples assigned to 1 of 3 cognitive behavioral marital therapy (BMT) groups. Groups represented (1) couples in which 1 spouse was depressed at pretest, (2) couples in which 1 spouse showed psychopathology other than depression, and (3) couples who showed no symptoms of individual psychopathology. Ss were administered, pre- and posttreatment, the Dyadic Adjustment Scale and the Minnesota Multiphasic Personality Inventory (MMPI). Pretreatment couples in Group 1 were the oldest and the least maritally satisfied, and expressed the most negative communication. 12 wks of BMT was an effective treatment modality for all groups when compared with a group of 12 couples on a wait list. BMT significantly increased marital adjustment for all 3 treatment groups and decreased the rates of negative communication. BMT significantly decreased the level of depression in Group 1 and the level of psychopathology in Group 2. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spouses as observers of the events in their relationship.

Investigated the reliability of spouses as observers of the behaviors that occur in their own marital relationships. 16 distressed and 20 nondistressed couples (as measured by Dyadic Adjustment Scale) were paid to collect data in the home on 21 consecutive evenings. Spouses completed a behavioral checklist in which they independently indicated which of 409 behaviors had occurred during the preceding 24 hrs. The average agreement for all couples was 47.8%. Nondistressed couples exhibited significantly greater consensus than did distressed couples. However, when comparisons were made on selected individual categories of behavior, differences between distressed and nondistressed couples held up only for percentage agreement. Suggestive evidence is presented that inferential items were less reliably coded than noninferential. Discussion centers on the implications for viewing spouse-collected data as observational data, possible innovations in data collection procedures that could result in more reliable recording, and theoretical implications of the low rate of consensus between spouses. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prediction of response to treatment in a randomized clinical trial of couple therapy: A 2-year follow-up.

Many studies have examined pretreatment predictors of immediate posttreatment outcome, but few studies have examined prediction of long-term treatment response to couple therapies. Four groups of predictors (demographic, intrapersonal, communication, and other interpersonal) and 2 moderators (pretreatment severity and type of therapy) were explored as predictors of clinically significant change measured 2 years after treatment termination. Results demonstrated that power processes and expressed emotional arousal were the strongest predictors of 2-year response to treatment. Moderation analyses showed that these variables predicted differential treatment response to traditional versus integrative behavioral couple therapy and that more variables predicted 2-year response for couples who were less distressed when beginning treatment. Findings are discussed with regard to existing work on prediction of treatment response, and directions for further study are offered. (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)     

Low-level relationship aggression and couple therapy outcomes.

Increasing evidence supports the efficacy of conjoint therapies that focus on intimate partner violence for couples who engage in mild to moderate physical aggression but want to preserve the relationship and end the aggression. However, there has been no examination of how this population responds to couple therapy that does not have a specific focus on aggression. This lacuna in the research literature is of concern because couples with a history of low-level aggression often seek couple therapy, but couple therapy without a focus on violence is thought to potentially exacerbate aggression. In the current study, the authors examined the efficacy of non-aggression-focused behavioral couple therapy for couples with and without a history of mild physical aggression. One hundred thirty-four couples, 45% of whom had experienced low-level aggression in the year prior to therapy, completed up to 26 sessions of couple therapy and 2 years of follow-up assessments. Results demonstrated no significant differences in relationship and individual outcomes by history of aggression. In addition, couples maintained very low levels of physical aggression during and after treatment and showed reductions in psychological aggression when relationship and individual functioning improved. (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)