Daily patterns of stress and conflict in couples: Associations with marital aggression and family-of-origin aggression

Opening the Black Box of Family-Based Treatments: An Artificial Intelligence Framework to Examine Therapeutic Alliance and Therapist Empathy

The evidence-based treatment (EBT) movement has primarily focused on core intervention content or treatment fidelity and has largely ignored practitioner skills to manage interpersonal process issues that emerge during treatment, especially with difficult-to-treat adolescents (delinquent, substance-using, medical non-adherence) and those of color. A chief complaint of "real world" practitioners about manualized treatments is the lack of correspondence between following a manual and managing microsocial interpersonal processes (e.g. negative affect) that arise in treating "real world clients." Although family-based EBTs share core similarities (e.g. focus on family interactions, emphasis on practitioner engagement, family involvement), most of these treatments do not have an evidence base regarding common implementation and treatment process problems that practitioners experience in delivering particular models, especially in mid-treatment when demands on families to change their behavior is greatest in treatment - a lack that characterizes the field as a whole. Failure to effectively address common interpersonal processes with difficult-to-treat families likely undermines treatment fidelity and sustained use of EBTs, treatment outcome, and contributes to treatment dropout and treatment nonadherence. Recent advancements in wearables, sensing technologies, multivariate time-series analyses, and machine learning allow scientists to make significant advancements in the study of psychotherapy processes by looking "under the skin" of the provider-client interpersonal interactions that define therapeutic alliance, empathy, and empathic accuracy, along with the predictive validity of these therapy processes (therapeutic alliance, therapist empathy) to treatment outcome. Moreover, assessment of these processes can be extended to develop procedures for training providers to manage difficult interpersonal processes while maintaining a physiological profile that is consistent with astute skills in psychotherapeutic processes. This paper argues for opening the "black box" of therapy to advance the science of evidence-based psychotherapy by examining the clinical interior of evidence-based treatments to develop the next generation of audit- and feedback- (i.e., systemic review of professional performance) supervision systems.

Predictors of harsh parenting practices and inter-partner conflict during the COVID-19 pandemic in Ontario, Canada: a cross-sectional analysis from the Ontario Parent Survey

OBJECTIVES

Guided by the bioecological model, the purpose of this study was to examine the associations of (1) individual level factors (sociodemographic, health behaviour and mental health), (2) family (micro) level COVID-19 experiences (difficulty with household management, managing child mood and behaviour, and pandemic-related positive experiences) and (3) community (macro) level factors (residential instability, ethnic concentration, material deprivation and dependency, an indicator of age and labour force) with harsh parenting practices and inter-partner conflict during the early lockdown of the COVID-19 pandemic in Ontario, Canada.

DESIGN

A cross-sectional analysis of data from the Ontario Parent Survey.

SETTING

A convenience sample of 7451 caregivers living in Ontario, Canada, at the time of baseline data collection (May-June 2020).

PARTICIPANTS

Caregivers aged 18 years and older with children 17 years or younger.

OUTCOME MEASURES

Parenting practices over the past 2 months was assessed using a published modification of the Parenting Scale. The frequency of inter-partner conflict over the past month was assessed using the Marital Conflict scale.

RESULTS

Individual (sociodemographic factors, alcohol use, and higher depressive and anxiety symptoms) and family (difficulties with managing the household and child mood and behaviour) level factors were positively associated with inter-partner conflict and harsh parenting practices. Having fewer positive experiences (eg, performing activities with children), and economic adversity at the family level were positively associated with inter-partner conflict but inversely associated with harsh parenting. At the community level, residential instability was negatively associated with harsh parenting practices.

CONCLUSIONS

Individual and family level factors were associated with harsh parenting and inter-partner conflict. The associations of fewer positive experiences and economic hardship with harsh parenting practices may be more complex than initially thought. Efforts that raise awareness and address caregiver mental health concerns are needed as part of the pandemic response to promote positive inter-partner and parent-child interactions.

Conceptualizing the Role of Parent and Child Emotion Regulation in the Treatment of Early-Onset Behavior Disorders: Theory, Research, and Future Directions

Behavior disorders (BDs) are common and costly, making prevention and early-intervention a clinical and public health imperative. Behavioral Parent Training (BPT) is the standard of care for early-onset (3-8 years old) BDs, yet effect sizes vary and wane with time suggesting the role of underlying factors accounting for variability in outcomes. The literature on emotion regulation (ER), which has been proposed as one such underlying factor, is reviewed here, including a brief overview of ER, theory and research linking ER, externalizing symptoms, and/or BDs, and still largely preliminary work exploring the role of parent and child ER in BPT outcomes. Research to date provides clues regarding the interrelationship of ER, BDs, and BPT; yet, determining whether adaptations to BPT targeting ER are necessary or useful, for whom such adaptations would be most important, and how those adaptations would be implemented requires addressing mixed findings and methodological limitations. To guide such work, we propose a conceptual model elucidating how standard BPT may impact ER and processes linked to ER, which we believe will be useful in organizing and advancing both basic and applied research in future work.

Daily diabetes-specific family conflict, problems, and blood glucose during adolescence

Diabetes-related family conflict is widely regarded as a risk factor for diabetes outcomes, yet it has not been examined on a daily basis. Parental acceptance may attenuate the degree to which family conflict is associated with diabetes outcomes. The present study examined (a) within- and between-person fluctuations in diabetes problems and family conflict, (b) within- and between-person links between conflict and blood glucose (BG) mean, and (c) whether parental acceptance moderated these associations. One hundred eighty adolescents (Mage = 12.92 years) with T1D completed a 14-day diary measuring diabetes problems, conflict with mother, conflict with father, and parental acceptance at the end of each day. Daily average BG values were calculated from glucometer readings. Higher diabetes problems on average across the 14-day diary were associated with more average conflict with mothers (between-person), but daily fluctuations in the number of diabetes problems were not related to daily conflict (within-person). Adolescents with higher conflict with mothers and fathers on average across the 14 days had higher BG means (between-person); however, on days when adolescents reported higher conflict, they had greater risk for low BG (within-person). Daily parental acceptance did not moderate associations between problems and conflict nor conflict and BG mean. This study was the first to examine daily diabetes-specific conflict with mothers and fathers during adolescence. The number of diabetes problems did not predict daily conflict. Fluctuations in daily conflict were associated with greater risk for low BG, underscoring the need for future research examining in-the-moment relations among conflict and BG extremes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The relationship between mental health and violence toward women during the COVID-19 pandemic

The COVID-19 pandemic has a number of psychological consequences for societies, especially women. This study was conducted to determine the relationship between mental health and violence toward women during the COVID-19 pandemic in Iran.This study was conducted on during late October to November 2020 (N = 400). Demographic information questionnaire, General Health Questionnaire(GHQ-12) and violence toward women inventory(VTWI) were used.The results showed that violence was higher among employed women. Also, the results showed that VTW was higher in women with 3 children, high school degree, family income under 3 million and women over 40 years old. Findings showed that the mean mental health of women at the COVID-19 pandemic was moderate (15.14 ± 8.8). Also, with increasing psychological and economic violence, their mental health decreases. Therefore, it is suggested that policy makers and planners, apart from the physical effects of the COVID-19 pandemic, pay attention to its psychological dimension, especially for women, and try to allocate funds to maintain and promote mental health and family.

Dynamic associations between stress and relationship functioning in the wake of COVID-19: Longitudinal data from the German family panel (pairfam)

Individuals all across the world experienced significant disruptions in their personal and family life with the outbreak of the new coronavirus disease 2019 (COVID-19). The current study investigated dynamic associations between stress and relationship functioning over time in the face of the COVID-19 pandemic. Perceived stress, relationship satisfaction, and relationship quality (appreciation, intimacy, conflict) were reported by 1483 young to middle-aged participants who were in a romantic relationship and lived with their partner in 2018/2019 and in May-July 2020 (a few months after the onset of COVID-19). Data were analyzed using bivariate latent change score models. Relationship functioning (satisfaction, appreciation, intimacy) showed small decreases from before to during the pandemic. Contrary to expectations, levels of perceived stress also decreased on average from before to during the pandemic. Changes in relationship functioning were correlated with changes in stress over time, so that participants with greater decreases in relationship satisfaction, appreciation, and intimacy and greater increases in conflict from before to during the pandemic showed lesser decreases/greater increases in stress. Higher pre-pandemic relationship satisfaction was associated with greater decreases/lesser increases in stress from before to during the pandemic. Pre-pandemic levels of other measures of relationship functioning or stress were not associated with changes in outcomes over time. Results add to the literature demonstrating that stress is closely intertwined with the functioning of intimate relationships. Furthermore, they suggest that greater relationship satisfaction may serve as a protective factor for stressful life events.

Explaining Heterogeneity of Daily Conflict Spillover in the Family: The Role of Dyadic Marital Conflict Patterns

In this multi-informant, longitudinal, daily diary study, we investigated whether long-term dyadic patterns of marital conflict resolution explain the heterogeneity in short-term day-to-day cross-lagged associations between marital conflict intensity and mother-adolescent conflict intensity. The sample consisted of 419 adolescents (44.6% girls, M_age  = 13.02, SD = 0.44, at T1; M_age  = 17.02, SD = 0.44, at T5), their mothers (N = 419, M_age  = 44.48, SD = 4.17, at T1), and their fathers (N = 419, M_age  = 46.76, SD = 4.99, at T1). Mothers and fathers reported on their marital conflict resolution strategies annually across 5 years. Mother-father daily conflict intensity (mother-reported) and mother-adolescent daily conflict intensity (mother- and adolescent-reported) were assessed for 75 days across 5 years. We hypothesized that long-term marital conflict resolution patterns would moderate the short-term daily dynamics of conflict between the marital and the mother-adolescent dyads. Latent Class Growth Analysis revealed four types of families based on long-term dyadic marital conflict resolution, including families where mostly constructive or mostly destructive conflict resolution was used. Dynamic Structural Equation Modeling was used to investigate the daily levels and short-term daily dynamics of conflict, revealing that for most families there were no day-to-day lagged associations between marital conflict and mother-adolescent conflict. Results showed that long-term conflict resolution patterns did not moderate the short-term dynamics of daily conflict. However, differences among long-term marital conflict resolution patterns were found in the levels of daily conflict, such that in families with long-term destructive conflict resolution patterns, daily conflict intensity was higher.

Conceptualizing Emotion Regulation and Coregulation as Family-Level Phenomena

The ability to regulate one’s emotions is foundational for healthy development and functioning in a multitude of domains, whereas difficulties in emotional regulation are recognized as a risk factor for a range of adverse outcomes in childhood, adolescence, and adulthood. Caregivers play a key role in cultivating the development of emotion regulation through coregulation, or the processes by which they provide external support or scaffolding as children navigate their emotional experiences. The vast majority of research to date has examined coregulation in the context of caregiver–child dyads. In this paper, we consider emotion regulation and coregulation as family-level processes that unfold within and across multiple family subsystems and explore how triadic and whole family interactions may contribute to the development of children’s emotion regulation skills. Furthermore, we will examine the implications of a family-centered perspective on emotion regulation for prevention of and intervention for childhood emotional and behavioral disorders. Because emotion regulation skills undergo such dramatic maturation during children’s first several years of life, much of our focus will be on coregulation within and across the family system during early childhood; however, as many prevention and intervention approaches are geared toward school-aged children and adolescents, we will also devote some attention to later developmental periods.

The effectiveness of cognitive developmental hypnotherapy on differentiation of self, meaning in life and marital conflicts in married women

The aim of the present study is to investigate the effectiveness of Cognitive Developmental Hypnotherapy (CDH) on Differentiation of Self, Meaning in Life and Marital Conflicts in married women. The method is quasi-experimental pretest and posttest with a control group. The statistical population of this study includes married women who came to FUM Counseling and Psychological Services Center to receive psychological services. The sample of this study included 40 married women who were selected by targeted sampling method and randomly assigned to two experimental and control groups. Participants in the pretest and posttest study answered the Differentiation of Self Inventory, the Marital Conflicts questionnaire by Sanaei, and the Meaning in Life questionnaire. The research data were analyzed using ANCOVA and MANCOVA with SPSS-21. The findings showed CDH led to an increase in Differentiation of Self and Meaning in life, and a reduction in Marital Conflicts in women. Accordingly, CDH through using techniques such as induction and empowerment of the Ego is effective in marital conflicts of married women. Therefore, using it as a means to improve the quality of married women's lives is recommended.

Seria o Ciúme Mediador entre as Experiências na Família de Origem e a Violência Física na Conjugalidade?

Resumo A violência conjugal é um fenômeno multideterminado, o qual sofre impacto de experiências precoces e atuais. O objetivo deste estudo foi testar um modelo teórico no qual o ciúme é mediador entre as experiências na família de origem e a violência física conjugal. Trata-se de um estudo com delineamento quantitativo, transversal e explicativo. Contou com uma amostra de 600 pessoas, de 18 a 65 anos, residentes em 13 estados brasileiros. Os instrumentos foram questionário sociodemográfico, FBQ, CTS2 e ICR, em uma coleta por formulário eletrônico na internet. Modelagem de equações estruturais foi utilizada para testar a validade empírica do modelo teórico. Os resultados indicaram que o ciúme media parcialmente as experiências na família de origem e a ocorrência da violência conjugal. Os dados apontam para a necessidade de atenção ao ciúme nos relacionamentos amorosos, como forma de atuar na prevenção às situações de violência conjugal.

Stress and Anxiety in Couples Who Conceive via In Vitro Fertilization Compared With Those Who Conceive Spontaneously

OBJECTIVE

To determine the feasibility of recruitment and explore whether women and their partners who conceive via in vitro fertilization (IVF) experience greater levels of stress and anxiety during pregnancy compared to each other and compared to couples who conceive spontaneously.

DESIGN

Longitudinal, descriptive, pilot study.

SETTING

Recruitment was conducted at three sites in the United States (two fertility clinics and one well-woman clinic).

PARTICIPANTS

Informed consent was obtained from 48 women and their partners (22 IVF couples and 26 spontaneous conception [SC] couples).

METHODS

During each trimester, participants completed the Perceived Stress Scale, the State-Trait Anxiety Inventory, and the Pregnancy-Related Anxiety Measure to assess their levels of stress and anxiety. We used hierarchical linear mixed-effects models for repeated measures adjusting for woman and partner nesting effects to conduct trajectory analyses to test for group differences in stress and anxiety levels.

RESULTS

Recruitment goals were met (31 IVF and 27 SC couples gave informed consent and 22 IVF and 26 SC couples completed questionnaires). We found no significant group main or group by time interaction effects on anxiety and stress. However, pregnant women had significantly higher mean state and pregnancy-related anxiety scores than their male partners. Of interest, the women showed a gradual reduction in state and pregnancy-related anxiety across trimesters, whereas pregnancy-related anxiety of their partners gradually increased.

CONCLUSION

Among our participants, IVF did not increase risk for stress, state anxiety, or pregnancy-related anxiety, which provides reassurance during patient counseling. Although pregnant women overall experienced greater state and pregnancy-related anxiety than men, we found that levels in women decreased closer to birth, which may contribute to successful emotional transition to parenthood. Men's experiences with anxiety require additional investigation given the recent attention to male postpartum depression.

Family-of-origin aggression, dating aggression, and physiological stress reactivity in daily life

Individuals exposed to aggression and who perpetrate aggression against others show differences in their physiological activation during stress; the goal of the present study is to investigate physiological stress reactivity as a factor contributing to the intergenerational transmission of aggression. To test associations between family-of-origin aggression (FOA), physiological reactivity in daily life, and dating aggression perpetration, we used ecological momentary assessment to monitor fluctuations in young adult (M_age = 23.1 years) dating couples' electrodermal activity (EDA) over an entire day and examined how naturally-occurring bouts of annoyance between partners relate to EDA, FOA, and dating aggression perpetration. Dating perpetration was linked to lower general levels of EDA in both men and women, while FOA was linked to lower general levels of EDA in men only. For women, multi-group, multilevel models showed that FOA and dating aggression perpetration moderated the association between feeling annoyed and EDA, such that those with greater FOA and dating aggression perpetration showed greater EDA reactivity during naturally-occurring relationship stress. Furthermore, this pattern of EDA reactivity mediated the link between FOA and dating aggression perpetration in women. These results provide evidence that FOA and dating aggression perpetration are linked to patterns of physiological responsivity in everyday life and suggest that these patterns could be important factors contributing to the intergenerational transmission of aggression.

Marital distress, depression, and a leaky gut: Translocation of bacterial endotoxin as a pathway to inflammation

BACKGROUND

Marital distress and depression work in tandem to escalate risks for inflammation-related disorders. Translocation of bacterial endotoxin (lipopolysaccharide, LPS) from the gut microbiota to blood circulation stimulates systemic inflammatory responses.

METHODS

To investigate increased gut permeability (a "leaky gut") as one potential mechanistic pathway from marital distress and depression to heightened inflammation, this secondary analysis of a double-blind, randomized crossover study examined serial assessments of two endotoxin biomarkers, LPS-binding protein (LBP) and soluble CD14 (sCD14), as well as C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) during two separate 9.5 h visits. The 43 (N = 86) healthy married couples, ages 24-61 (mean = 38.22), discussed a marital disagreement during both visits; behavioral coding of these interactions provided data on hostile marital behaviors, a hallmark of marital distress. The Structured Diagnostic Interview for DSM-IV assessed participants' mood disorder history.

RESULTS

Participants with more hostile marital interactions had higher LBP than those who were less hostile. Additionally, the combination of more hostile marital interactions with a mood disorder history was associated with higher LBP/sCD14 ratios. Higher LBP and LBP/sCD14 were associated with greater CRP production; for example, only 21% of low LBP participants (lowest quartile) had average CRP across the day > 3, compared to 79% of those in the highest quartile. Higher sCD14 was associated with higher IL-6.

CONCLUSIONS

These bacterial LPS translocation data illustrate how a distressed marriage and a mood disorder history can promote a proinflammatory milieu through increased gut permeability, thus fueling inflammation-related disorders.

Couple relationship education program "Living as Partners": evaluation of effects on marital quality and conflict

Relationship education programs are strategies that can favor better marital quality and conflict management between spouses. The relationship education program “Living as Partners: Turning Challenges into Opportunities” seeks to promote the couples’ learning of conflict resolution strategies and better quality levels in the relationship. This study evaluates the capacity of this program to produce results regarding marital quality and three dimensions of the couple’s conflict: frequency, intensity, and resolution strategies. Data from 41 couples were analyzed before and after the program, and a follow-up after 5 months (n = 33 couples) were conducted as well (single group, pre-test, post-test, and follow-up quasi-experimental design). Results show that the program produced immediate effects in all the outcome variables, which remained significant after 5 months, except for marital quality and for the strategy of compliance. These outcomes showed effect sizes ranging from low to high levels. The study presents evidence about the ability of the “Living as Partners” program to produce improvements in couple’s conflict indicators, addressing an unexplored field of research and intervention focused on Brazilian cultural specificities.

Parenting stress mediates the association between negative affectivity and harsh parenting: A longitudinal dyadic analysis

The current study examined parenting stress (disaggregated into personal distress and child rearing stress) at 12 months postpartum as a mediator of the longitudinal association between parental negative affectivity at 6 months postpartum and harsh parenting at 3 years postpartum for first-time parents with a child transitioning from late toddlerhood to the early preschool years. Analyses were conducted using Mediation for Actor Partner Interdependence Modeling in a sample of 164 couples who participated in a randomized controlled trial of a universal, couple-based transition to parenthood program. There were indirect actor effects of negative affect on a parent's own harsh parenting through both dimensions of parenting stress, with a stronger mediating effect for personal distress than child rearing stress. There were also indirect partner effects of negative affect on one's partner's harsh parenting through the partner's parenting stress, with a stronger indirect partner effect from mothers' negative affect to fathers' harsh parenting than vice versa. Specifically, the mediating effect of personal distress was found for both mothers and fathers, whereas the mediating effect of child rearing stress was found from mothers' negative affect to fathers' harsh parenting only. Findings highlight the importance of a dyadic approach in examining the longitudinal association between negative affect and harsh parenting and suggest that reducing parenting stress in the first year postpartum may decrease the risk of future harsh parenting among couples in which one or both partners experience negative affectivity. (PsycINFO Database Record