Predictors of participation and attrition in a health promotion study involving psychiatric outpatients.

Participant selection biases can reduce the generalizability of research findings and lead to misestimates of intervention effectiveness. The authors examined factors associated with study participation and attrition among psychiatric outpatients recruited for the initial phase of a health promotion trial. Medical records were reviewed to obtain HIV-risk and substance abuse data, as well as psychiatric and demographic characteristics of potential participants. Of 895 eligible outpatients, 67% (n=601) consented to participate, among whom 69% (n=415) completed all baseline appointments. Compared with nonconsenters, consenters were more likely to be at risk for drug problems and to receive care from clinics serving more impaired patients. Study completion was associated with older age, a psychiatric diagnosis other than adjustment disorder and a recent sexually transmitted disease diagnosis. These findings suggest that patients who could most benefit from risk reduction interventions are more likely to participate. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Timing Is Everything: Pre-Engagement Cohabitation and Increased Risk for Poor Marital Outcomes.

Data from a longitudinal study were used to examine differences among couples that cohabited before engagement, after engagement, or not until marriage. Survey data and objectively coded couple interaction data were collected for 136 couples (272 individuals) after engagement (but before marriage) and 10 months into marriage. At both time points, the before-engagement cohabiters (59 couples) had more negative interactions, lower interpersonal commitment, lower relationship quality, and lower relationship confidence than those who did not cohabit until after engagement (28 couples) or marriage (49 couples), even after controlling for selection factors and duration of cohabitation. Our findings suggest that those who cohabit before engagement are at greater risk for poor marital outcomes than those who cohabit only after engagement or at marriage, which may have important implications for future research on cohabitation, clinical work, and social policy decisions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Infant birth weight among women with or at high risk for HIV infection: The impact of clinical, behavioral, psychosocial, and demographic factors.

The purpose of these analyses was to provide a prospective examination of the impact of HIV on birth weight using clinical, behavioral, psychosocial, and demographic correlates. 319 HIV-positive and 220 HIV-negative pregnant women matched for HIV risk factors (i.e., drug use and sexual risk behaviors) were interviewed during the 3rd trimester of pregnancy and 6 weeks postpartum. Medical chart reviews were also conducted for the HIV-seropositive pregnant women to verify pregnancy-related and birth outcome data. In a logistic regression analysis, controlling for parity and gestational age, women who were HIV seropositive were 2.6 times more likely to have an infant with low birth weight. Black women and those who did not live with their partners were more than 2 times as likely to have infants with low birth weight, and those who smoked were 3.2 times more likely to have infants with low birth weight. Knowing that women with HIV, those who are Black, and those not living with a partner are at highest risk for adverse birth outcomes can help those in prenatal clinics and HIV specialty clinics to target resources and develop prevention interventions. This is particularly important for women with HIV because birth weight is associated with risk of HIV transmission from mother to child. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Three-year follow-up of same-sex couples who had civil unions in Vermont, same-sex couples not in civil unions, and heterosexual married couples.

This study was a 3-year follow-up of 65 male and 138 female same-sex couples who had civil unions in Vermont during the 1st year of that legislation. These couples were compared with 23 male and 61 female same-sex couples in their friendship circles who did not have civil unions and with 55 heterosexual married couples (1 member of each was a sibling to a member of a civil union couple). Despite the legalized nature of their relationships, civil union couples did not differ on any measure from same-sex couples who were not in civil unions. However, same-sex couples not in civil unions were more likely to have ended their relationships than same-sex civil union or heterosexual married couples. Compared with heterosexual married participants, both types of same-sex couples reported greater relationship quality, compatibility, and intimacy and lower levels of conflict. Longitudinal predictors of relationship quality at Time 2 included less conflict, greater level of outness, and a shorter relationship length for men in same-sex relationships and included less conflict and more frequent sex for women in same-sex relationships at Time 1. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early development of relationship quality in heterosexual married, heterosexual cohabiting, gay, and lesbian couples.

33 heterosexual married, 34 heterosexual cohabiting, 41 gay, and 47 lesbian monogamous couples who were living together and did not have children living with them completed a demographic questionnaire, the Dyadic Adjustment Scale, and a relationship beliefs inventory. Comparisons were made among the 4 types of couples at 3 stages of relationship development—blending (Year 1), nesting (Years 2 and 3), and maintaining (Years 4 and 5)—on 5 dimensions of relationship quality: agreement, satisfaction with affection and sex, low tension, shared activity, and beliefs regarding sexual perfection. Findings show that the type of couple did not interact with stage of relationship. Married couples reported less tension than heterosexual cohabitating couples, and a curvilinear relation was found between stage of relationship development and satisfaction with affection and sex, shared activity, and beliefs regarding sexual perfection. The absolute difference between partners' scores varied only by stage of relationship. Blending partners' shared-activity scores were more similar than those of either nesting or maintaining partners. Results suggest that stage of relationship is a robust predictor of relationship quality. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Investigating the relationship between economic status and HIV risk

Although anecdotal information suggests that there is a relationship between socioeconomic status and HIV risk, there have been few investigations of that possible relationship. Understanding that relationship can have important implications for designing and implementing prevention programs. This study investigated the relationship between indicators of socioeconomic status and HIV prevalence in Massachusetts using seroprevalence data from publicly funded test sites. HIV seroprevalence was found to differ depending on demographic groups and the health care insurance/provider. Those who had no insurance or were Medicaid recipients had higher rates of HIV infection. Homeless individuals were also at higher risk. Further, low-income ZIP codes in Massachusetts were four times more likely to have high seroprevalence rates among residents voluntarily testing for HIV. Thus, HIV seroprevalence appears to be associated with socioeconomic status in this group of voluntarily tested individuals.     

Ethnicity and acculturation: Assessing Mexican American couples' relationships using the Marital Satisfaction Inventory—Revised.

This study compared the marriages of 75 Mexican American and 66 non-Hispanic White American couples sampled from the same geographic region of the southwestern U.S., using the Marital Satisfaction Inventory—Revised (MSI—R) . Analyses of internal consistency and scales' intercorrelations provided partial support for the structural equivalence of MSI-R scales across both samples. Multivariate analyses indicated modestly higher levels of relationship distress among the Mexican American couples, although group differences dissolved after controlling for demographic variables other than ethnicity. Ratings of higher acculturation among Mexican American couples were modestly related to higher levels of marital distress for wives but unrelated to relationship satisfaction for husbands. Implications of findings for the study of Mexican American marriages and interventions with clinically distressed couples are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Couples' groups for parents of preschoolers: Ten-year outcomes of a randomized trial.

This paper reports the results of a 10-year follow-up of two variations of a couples' group preventive intervention offered to couples in the year before their oldest child made the transition to kindergarten. One hundred couples were randomly assigned to (1) a low-dose control condition, (2) a couples' group meeting for 16 weeks that focused more on couple relationship issues among other family topics, or (3) a couples' group meeting for 16 weeks that focused more on parenting issues among other family issues, with an identical curriculum to condition (2). Earlier papers reported that both variations of the intervention produced positive results on parent-child relationships and on the children's adaptation to kindergarten and first grade, and that the groups emphasizing couple relationships also had additional positive effects on couple interaction quality. The present paper uses growth curve analyses to examine intervention effects extending from the children's transition to kindergarten to the transition to high school—10 years after the couples groups ended. There were 6-year positive effects of the pre-kindergarten interventions on observed couple interaction and 10-year positive effects on both parents' marital satisfaction and the children's adaptation (hyperactivity and aggression). Discussion includes a focus on the implications of these results for family policy, clinical practice, and the need to include a couples focus in preventive interventions to strengthen family relationships and enhance children's adaptation to school. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Physical aggression in unmarried relationships: The roles of commitment and constraints.

Using commitment theory, the present study explored longitudinal associations between physical aggression and various aspects of commitment and relationship stability. Participants (N = 1,278) were unmarried adults between the ages of 18 and 35 who were in a heterosexual romantic relationship at the time of the initial assessment. Of these, 51.6% reported never experiencing physical aggression in their current relationship, 12.8% reported experiencing physical aggression in the past, but not in the last year, and 35.6% reported experiencing physical aggression in the last year. As hypothesized, those who had experienced aggression in the last year were more likely to have broken up 1 year later. They also generally reported lower levels of dedication and higher levels of constraint commitment compared with those with no history of physical aggression. Among those who had experienced aggression in the last year, constraints and other commitment-related variables explained more about who broke up over time than did relationship adjustment alone, indicating the importance of measuring commitment constructs in future research about which aggressive couples are most likely to end their relationships. Clinical implications of these results are discussed, particularly in regard to preventive relationship education programs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Can skills training prevent relationship problems in at-risk couples? Four-year effects of a behavioral relationship education program.

Eighty-three couples were stratified into groups at high and low risk for relationship distress and randomized to either the Self-Regulatory Prevention and Relationship Enhancement Program (Self-PREP) or a control condition. As predicted, there were differential effects of Self-PREP on high-risk and low-risk couples. Because of low statistical power, results must be interpreted cautiously, but at 1-year follow-up high-risk couples in Self-PREP showed trends toward better communication than control couples. However, there was no difference in the communication of Self-PREP and control low-risk couples. High-risk couples receiving Self-PREP exhibited higher relationship satisfaction at 4 years than control couples, but in low-risk couples relationship satisfaction was higher in the control condition. High-risk couples seemed to benefit from skills-based relationship education, but low-risk couples did not. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interaction of sex role self-concept with relationship quality and relationship beliefs in married, heterosexual cohabiting, gay, and lesbian couples.

Examined the relationship between sex-role self-concept (masculine, feminine, undifferentiated, and androgynous) and relationship quality and dysfunctional relationship beliefs among 44 married (mean age 29.68 yrs), 35 heterosexual cohabiting (mean age 28.68 yrs), 50 homosexual (mean age 31.28 yrs), and 56 lesbian (mean age 31.18 yrs) couples. Ss completed questionnaires on demographic and background information, the Bem Sex-Role Inventory, a relationship beliefs inventory, and relationship quality assessments. Individual partner analyses revealed that relationship quality and relationship beliefs differed by Ss' sex-role self-concept. Androgynous and feminine Ss reported higher relationship quality than masculine and undifferentiated Ss; androgynous Ss had fewer "disagreement is destructive" beliefs than feminine Ss; and androgynous Ss had fewer "partner cannot change" beliefs than undifferentiated Ss. Couple analyses showed a relation between partners' sex-role self-concept only for the heterosexual cohabiting couples. For these couples, masculine men tended to pair with feminine or undifferentiated women, and androgynous partners tended to pair together. Relative to other couples, those in which one or both partners were androgynous or feminine reported the highest relationship quality; couples in which one or both partners were undifferentiated or masculine reported the lowest. These effects did not vary by type of couple. It is concluded that sex-role self-concept is a robust factor in appraisals of relationship quality. (19 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preadoptive factors predicting lesbian, gay, and heterosexual couples' relationship quality across the transition to adoptive parenthood.

The authors examined preadoptive factors as predictors of relationship quality (love, ambivalence, and conflict) among 125 couples (44 lesbian couples, 30 gay male couples, and 51 heterosexual couples) across the 1st year of adoptive parenthood. On average, all new parents experienced declines in their relationship quality across the 1st year of parenthood regardless of sexual orientation, with women experiencing steeper declines in love. Parents who, preadoption, reported higher levels of depression, greater use of avoidant coping, lower levels of relationship maintenance behaviors, and less satisfaction with their adoption agencies reported lower relationship quality at the time of the adoption. The effect of avoidant coping on relationship quality varied by gender. Parents who, preadoption, reported higher levels of depression, greater use of confrontative coping, and higher levels of relationship maintenance behaviors reported greater declines in relationship quality. These findings have implications for professionals who work with adoptive parents both pre- and postadoption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer relations among adolescents with female same-sex parents.

This study examined associations among family type (same-sex vs. opposite-sex parents), adolescent gender, family and relationship variables, and the peer relations of adolescents. Participants included 44 adolescents parented by same-sex female couples and 44 adolescents parented by opposite-sex couples, matched on demographic characteristics and drawn from a national sample. On both self-reported and peer-reported measures of relations with peers, adolescents were functioning well, and the quality of their peer relations was not associated with family type. Regardless of family type, adolescents whose parents described closer relationships with them reported higher quality peer relations and more friends in school and were rated as more central in their friendship networks. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Love, marriage, and divorce: Newlyweds' stress hormones foreshadow relationship changes.

Neuroendocrine function, assessed in 90 couples during their first year of marriage (Time 1), was related to marital dissolution and satisfaction 10 years later. Compared to those who remained married, epinephrine levels of divorced couples were 34% higher during a Time 1 conflict discussion, 22% higher throughout the day, and both epinephrine and norepinephrine were 16% higher at night. Among couples who were still married, Time 1 conflict ACTH levels were twice as high among women whose marriages were troubled 10 years later than among women whose marriages were untroubled. Couples whose marriages were troubled at follow-up produced 34% more norepinephrine during conflict, 24% more norepinephrine during the daytime, and 17% more during nighttime hours at Time 1 than the untroubled. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuroticism, marital violence, and the moderating role of stress and behavioral skills.

Do high levels of neuroticism predict intimate partner violence (IPV)? Although neuroticism may predispose partners to increased risks of IPV perpetration, the extent to which it predicts such perpetration is likely to depend on the broader context of the relationship. Consistent with this prediction, the current longitudinal study of 169 community couples revealed that the effects of neuroticism on IPV perpetration over the first 4 years of marriage were moderated by observations of problem-solving behavior and objective ratings of chronic stress. Specifically, although husbands and wives who scored higher on a measure of neuroticism at the outset of marriage engaged in more IPV throughout the marriage on average, those who possessed more effective problem-solving skills or experienced lower levels of stress were significantly less likely to engage in IPV. Results highlight the importance of considering the broader relationship context when examining predictors of specific interpersonal processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Power and violence: The relation between communication patterns, power discrepancies, and domestic violence.

Hypothesized that power discrepancies in the marital relationship, where the husband is subordinate, serve as risk factors for husband-to-wife violence. The construct of marital power was assessed from 3 power domains operationalized by discrepancies in economic status, decision-making power, communication patterns, and communication skill. Three groups of married couples (N?=?95) were compared: domestically violent (DV), maritally distressed/nonviolent, and maritally happy/nonviolent. DV couples were more likely than the 2 nonviolent groups to engage in husband-demand/wife-withdraw interactions. Within the DV group, husbands who had less power were more physically abusive toward their wives. Thus, violence may be compensatory behavior to make up for husbands' lack of power in other arenas of marriage. Difficulties in assessing marital power and future direction for the study of power and violence are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of sexual mixing across age and ethnic groups to herpes simplex virus-2 among unmarried heterosexual adults with multiple sexual partners.

Sexual mixing is important to understanding how sexually transmitted diseases (STDs) spread in the general population, and, identifying people who mix across social groups aids HIV-STD prevention. The authors examined (a) the extent to which people have sexual partners from other sexual networks (disassortative mixing) in a probability sample of unmarried heterosexual adults reporting multiple sexual partners (N?=?545) and (b) the relationship between mixing and Herpes Simplex Virus-2 (HSV-2). After demographic variables and number of lifetime sexual partners were controlled for, heavy mixers were significantly more likely to be HSV-2 positive. Degree of mixing down produced the most powerful relationship to HSV-2. Age, education, ethnicity, and a history of incarceration or IV drug use were found to distinguish between light and heavy mixers, although differences between ethnic and age mixing were observed. The results have implications for understanding HIV-STD transmission and for directing interventions toward population segments at high risk for transmitting HIV-STDs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Do couples at high risk of relationship problems attend premarriage education?

The effectiveness of premarriage education is limited by whether couples at high risk of future marital problems attend such education. In the current study, 374 newly married couples were assessed on a range of risk factors for future marital problems as well as whether they had attended marriage education. Couples with certain indices of relationship risk (nonreligious and premarital cohabitation) were underrepresented in premarriage education. Suggestions are offered to attract more couples, particularly those at high risk for future problems, to relationship education. (PsycINFO Database Record (c) 2010 APA, all rights reserved)