Overlap of relationship distress and intimate partner violence in community samples

Mixed-gender couples presenting for couple therapy are at 2-3 times higher risk for physical intimate partner violence (IPV) than community couples. However, it is unclear if this elevation of relative risk is the same in the general population because relationship distress and treatment-seeking are often confounded. We used archival data from three representative U.S. civilian samples and one representative U.S. Air Force sample to test the hypothesis that clinically significant relationship distress is associated with increased risk of various forms of IPV. In these community samples, those in mixed-gender distressed relationships were at 2-3 times higher risk than those in nondistressed relationships for any physical IPV during the past year and at 3-6 times higher risk for clinically significant psychological and physical IPV during the past year. Given that the increase in IPV risk is similar for individuals in distressed community relationships and therapy-seeking relationships, the prior findings of the elevated rates of IPV in clinical samples are unlikely to be due to therapy-seeking. Although epidemiological risk involves statistical, not causal, associations, the increased co-occurrence of IPV in distressed mixed-gender couples fits with numerous theories of IPV and has implications for both screening and future research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Couple therapy in the 2020s: Current status and emerging developments

This paper provides a critical analysis and synthesis of the current status and emerging developments in contemporary couple therapy. Its narrative centers on the evolution of couple therapy into a prominent intervention modality and coherent body of practice. The review begins with the consideration of the field's strong empirical underpinnings derived from research on couple therapy and basic relational science. Couple therapy comprises the widely accepted method for reducing relationship distress and enhancing relationship quality. Moreover, both as a stand-alone intervention and in conjunction with other treatment formats, couple-based interventions have garnered considerable empirical support for their effectiveness in addressing a broad spectrum of specific relational dysfunctions as well as individual emotional and physical health problems. We highlight the convergence of methods through common factors, shared strategies, and remarkably similar arrangements across approaches. Our review also points to key differences among approaches, the importance of recognizing respective strengths and limitations linked to these differences, and building on differences across models when selecting and tailoring interventions for a given couple. The discussion concludes with a consideration of recent trends in the field including the impact of telehealth and related digital technologies, the expansion of specific treatments for specific problems and diverse populations, the interface of couple therapy with relationship education, and enduring challenges as well as new opportunities addressing broader systemic and global dynamics.

Combat exposure and mental health outcomes: The incremental impact of nonsexual harassment on women veterans

Objective: This study investigated the impact of combat exposure and nonsexual harassment (verbal and nonverbal behaviors that convey negative and harmful attitudes on the basis of minority status) on mental health functioning in female veterans who were deployed Afghanistan and Iraq. Method: Participants (N = 134) completed measures of combat exposure, nonsexual harassment, PTSD, depression, and alcohol use. Results: Binary logistic regression models indicated nonsexual harassment was significantly associated with later symptoms of PTSD and depression, but not problem drinking; combat exposure was significantly associated with symptoms of PTSD and alcohol use, but not depression. Relative risk ratios indicated that for women with even minimal exposure to combat, experiencing nonsexual harassment significantly increased the likelihood of manifesting PTSD, depression, and problem drinking symptoms that met at least minimum threshold for clinical diagnoses. The impact of nonsexual harassment resulted in an almost 4 times greater risk for PTSD symptoms and problem drinking and up to 6 times greater risk for depression when experienced concurrently with combat exposure. Conclusions: Although nonsexual harassment does not pose the same physical threat as assault from enemy fire, findings suggest that it does pose an invisible threat to mental health and contribute to understanding and contextualizing the impact of nonsexual harassment on female veterans' psychological well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Love and war: Prospective associations between relationship distress and incidence of psychiatric disorders in active-duty Army personnel

Research with probability samples of civilians has found that marital distress is associated with incidence of several psychiatric disorders. However, there is little longitudinal research on marital distress and incidence of psychiatric disorders in military personnel. This study examined the prospective association between marital distress and incidence of major depressive episode (MDE), generalized anxiety disorder (GAD), panic disorder, posttraumatic stress disorder (PTSD), and substance use disorder in a probability sample of active-duty soldiers from the U.S. Army (N = 934). Results indicated that among individuals who did not meet diagnostic criteria for the associated disorder at baseline, marital distress at baseline was associated with 30-day incidence of MDE, GAD, and PTSD assessed 5 years later. These results support continued research on the role of marital distress and the onset and course of psychopathology in active-duty military personnel and suggest that couple-based interventions designed to prevent or reduce marital distress may be effective in the prevention and treatment of psychopathology in military personnel. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Couples in arms: Marital distress, psychopathology, and suicidal ideation in active-duty Army personnel

Although distress in intimate relationships such as marriage is positively associated with psychiatric symptoms and disorders and suicidal ideation in probability samples of the civilian population in the United States, relatively little is known regarding these associations in probability samples of active-duty military personnel. The present study evaluated the association between marital distress and past-30-day prevalence of psychiatric disorders (i.e., mood, anxiety, and substance use disorders) and suicidal ideation in a sample of 8,669 married active-duty soldiers in the U.S. Army who participated in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Results indicated that marital distress was significantly and positively associated with past-30-day prevalence of major depressive disorder, generalized anxiety disorder, panic disorder, posttraumatic stress disorder, and substance use disorder, as well as past-30-day prevalence of suicidal ideation. These associations were incremental to shared associations with demographics and co-occurring psychiatric disorders. The findings support continued research on the association between relationship distress and psychopathology in active-duty service personnel, and suggest the potential utility of adapting existing, evidence-based couple interventions for the prevention and treatment of psychopathology or relationship distress, currently in use in veteran and civilian settings, for use with active-duty military personnel and their partners. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Dyadic Coping in Couple Therapy Process: An Exploratory Study

This study aimed at moving beyond previous research on couple therapy efficacy by examining moment-by-moment proximal couple and therapist interactions as well as final treatment outcomes and their reciprocal association. Seven hundred four episodes of dyadic coping within 56 early therapy sessions, taken from 28 married couples in treatment, were intensively analyzed and processed using a mixed-methods software (T-LAB). Results showed that negative dyadic coping was self-perpetuating, and therapists tended to passively observe the negative couple interaction; on the contrary, positive dyadic coping appeared to require a therapist's intervention to be maintained, and successful interventions mainly included information gathering as well as interpreting. Couples who dropped out of treatment were not actively engaged from the outset of therapy, and they used more negative dyadic coping, whereas couples who successfully completed treatment showed more positive dyadic coping very early in therapy. Results highlight the role of therapist action and control as critical to establishing rapport and credibility in couple therapy and suggest that dyadic coping patterns early in therapy may contribute to variable treatment response.

The risk for marital infidelity across a year-long deployment

Military deployment can create significant relationship strain. Although most couples navigate the challenges of deployment successfully, this period may render some couples more vulnerable to adverse relationship outcomes such as infidelity due to a convergence of factors including geographic separation and reduced emotional and physical intimacy. Despite anecdotal reports of increased rates of infidelity during deployment, empirical findings are lacking. This study used a prospective design to examine the prevalence and risk factors of infidelity across the deployment cycle including a year-long deployment to Iraq. A total of 63 married male Airmen were assessed both pre- and 6-9 months postdeployment. The rate of sexual infidelity prior to deployment (21%) was commensurate with the lifetime rate of sexual involvement outside the marriage in representative community samples of men. Across the deployment period, the prevalence of sexual infidelity was strikingly high (22.6%) compared with annual community estimates (1.5-4%; Allen et al., 2005). Findings demonstrated that service members with a prior history of separation, steps toward divorce, and relationship distress prior to deployment had elevated risk for infidelity over the deployment cycle. Moreover, roughly 75% of Airmen who experienced infidelity over the deployment cycle divorced by 6-9 months postdeployment whereas only 5% of service members without infidelity divorced during this same time period. Considering well-documented adverse impacts of infidelity and divorce, the current findings may assist in identifying military couples at risk for infidelity and informing targeted prevention or early intervention strategies for these couples prior to or immediately following deployment. (PsycINFO Database Record

A Cross-National Comparison of Mexican and Mexican American Couples Using the Marital Satisfaction Inventory–Revised (Spanish)

This study examined psychometric properties of the Spanish translation of the Marital Satisfaction Inventory–Revised (MSI-R) in a sample of 71 Spanish-speaking couples in Mexico. Results from this sample were compared to findings obtained from 65 Mexican American couples who completed the MSI-R in Spanish. Both the internal consistency and factor structure of the Spanish MSI-R with Mexican couples were found to be comparable to findings on the Spanish MSI-R for Mexican American couples. Moreover, multivariate analysis indicated no significant mean profile differences between these two groups as a function of nationality, gender, or nationality-by-gender interaction. These findings offer initial evidence toward establishing the appropriateness of the Spanish MSI-R for use with Spanish-dominant Mexican couples.

Utility of the Spanish Translation of the Marital Satisfaction Inventory–Revised in Spain

This study examined psychometric characteristics of the Spanish translation of the Marital Satisfaction Inventory–Revised (MSI-R) in a community sample of 205 couples from Spain. Overall, analyses of the scales’ internal consistency compared favorably with findings for both the English and Spanish versions of this instrument with U.S. samples. Confirmatory factor analyses revealed similar scale factor structures across the original measure and Spanish translation, lending further support to using the MSI-R with couples from diverse cultural backgrounds whose sole or preferred language is Spanish. Mean profile comparisons between the current Spanish sample and the original standardization sample revealed significant differences on several scales. Implications of findings for clinical applications and further research are discussed.

Help-seeking among airmen in distressed relationships: Promoting relationship well-being

Although a substantial proportion of service members returning from a combat deployment report individual emotional and behavioral disorders as well as intimate relationship difficulties, previous studies indicate that only a minority actually seek mental health services. Little is known about factors that predict help-seeking in this population. We first review key findings from the literature on help-seeking in military and veteran populations, including mixed findings regarding the role of perceived stigma and attitudes toward mental health treatment. We then present data from a longitudinal study of United States Air Force Security Forces following a year-long high-risk deployment to Iraq-including findings regarding who seeks help, for what problems, and from which providers. We also examine whether these findings differ for Airmen in a married or committed relationship versus nonpartnered Airmen and, for the former group, whether findings differ for those in a distressed versus nondistressed relationship. Finally, we discuss implications of these findings for extending couple-based interventions to service members and veterans, and describe a multitiered "stepped" approach for promoting relationship resiliency.

Coming home: A prospective study of family reintegration following deployment to a war zone

The consequences of deployment extend beyond the service member to impact the entire family. The current investigation evaluated the unique challenges of family reintegration for partnered service members using a prospective design. In total, 76 partnered service members who deployed on a year-long, high-risk mission to Iraq were assessed across the entirety of the deployment cycle, i.e., pre-, during, and postdeployment. At follow-up, nearly 1 in 5 partnered service members reported moderate to severe difficulties in multiple aspects of family reintegration. Prospective interpersonal indicators such as preparations for deployment as a couple, shared commitment to the military, and predeployment relationship distress predicted postdeployment family reintegration difficulties. Significant interpersonal risk factors were medium to large in their effect sizes. Airmen's willingness to disclose deployment- and combat-related experiences, and postdeployment relationship distress served as concurrent interpersonal correlates of difficulties with family reintegration. Intrapersonal factors, including posttraumatic stress symptoms and alcohol misuse were concurrently related to challenges with family reintegration; predeployment alcohol misuse also predicted subsequent family reintegration difficulties. Additional analyses indicated that pre- and postdeployment relationship distress, combat disclosure, and postdeployment alcohol misuse each contributed to family reintegration when controlling for other intra- and interpersonal risk factors. Implications for prevention and early intervention strategies as well as future research are discussed.

Development of a multilevel prevention program for improved relationship functioning in active duty military members

The relationships and families of active duty (AD) service members have been tremendously strained by deployments and high operations' tempo. This study involves the first steps in developing a multilevel approach to preventing relationship problems that integrates universal, selective, and indicated prevention/intervention. Such an approach has tremendous empirical support for parenting problems, but no similar program exists for couple problems. We conducted two studies with U.S. Air Force Security Forces members. Study 1 elicited the target population's topics of highest interest. For almost all topics, 70% to 95% of participants who desired information reported being underserved by current prevention offerings (i.e., not receiving needed information). Using the top topics generated in Study 1, we developed prevention information/action planning sheets on 18 relationship issues. In Study 2, we had AD members who gave feedback on the form and content of the sheets. Overall, AD members believed that the sheets were moderately to very useful and were presented well, had pithy but comprehensive information and conveyed the content well. Results imply that a multilevel approach may be a useful complement to formal services in meeting underserved military members' needs and that further research and development of this dissemination vector for evidence-based information is warranted.

Assessing Intimate Relationships of Chinese Couples in Taiwan Using the Marital Satisfaction Inventory-Revised

The current study examined the psychometric characteristics of the Chinese translation of the Marital Satisfaction Inventory-Revised (MSI-R) in a community sample of 117 couples from Taiwan. The Chinese MSI-R demonstrated moderate to strong internal consistency. Confirmatory factor analysis revealed similar scale factor structures in the Taiwanese and U.S. standardization samples. Mean profile comparisons between the current Taiwanese sample and the original MSI-R standardization sample revealed statistically significant but small differences on several subscales. Overall, the psychometric characteristics of the Chinese MSI-R lend support to its use with couples from diverse cultural backgrounds whose sole or preferred language is Chinese. It may also be appropriate to use the MSI-R in clinical settings for prevention or intervention efforts directed at Chinese-speaking couples. The implications of these findings for clinical and research purposes are discussed.

Predictors of Suicidal Ideation Across Deployment: A Prospective Study

OBJECTIVE

Concurrent and prospective predictors of suicidal ideation were examined in a sample of 318 United States Air Force Security Forces across a 1-year deployment in Iraq and 6- to 9-month follow-up.

METHOD

Participants included 294 male and 24 female Airmen ranging in age from 18 to 46 years, predominantly (67%) Caucasian. Measures included self-reports of postdeployment suicidal ideation, posttraumatic stress and depressive symptoms, alcohol use, combat experiences, relationship distress, social support, and postdeployment readjustment.

RESULTS

Problem drinking before deployment prospectively predicted postdeployment suicidal ideation in univariate analyses. Depressive symptoms and problem drinking were significant independent predictors of postdeployment suicidal ideation. Findings demonstrated a ninefold increase in suicidal ideation among service members with even mild depressive symptoms if moderate problem drinking was also present.

CONCLUSIONS

Predeployment problem drinking may serve as a modifiable target for early intervention of suicidal ideation. Findings illuminate the compound risk of comorbid depressive symptoms and moderate problem drinking in predicting suicidal ideation.

Gay and lesbian couples in Italy: comparisons with heterosexual couples

Assessing couple relationships across diverse languages and cultures has important implications for both clinical intervention and prevention. This is especially true for nontraditional relationships potentially subject to various expressions of negative societal evaluation or bias. Few empirically validated measures of relationship functioning have been developed for cross-cultural applications, and none have been examined for their psychometric sufficiency for evaluating same-sex couples across different languages and cultures. The current study examined the psychometric properties of an Italian translation of the Marital Satisfaction Inventory - Revised (MSI-R), a 150-item 13-scale measure of couple relationship functioning, for its use in assessing the intimate relationships of gay and lesbian couples in Italy. Results for these couples were compared to data from heterosexual married and unmarried cohabiting couples from the same geographical region, as well as to previously published data for gay, lesbian, and unmarried heterosexual couples from the United States. Findings suggest that, despite unique societal pressures confronting Italian same-sex couples, these relationships appear resilient and fare well both overall and in specific domains of functioning compared to heterosexual couples both in Italy and the United States.

Intimate partner communication from the war zone: a prospective study of relationship functioning, communication frequency, and combat effectiveness

This study examined (a) the association between relationship functioning prior to and during deployment, and the frequency of communication during deployment; and (b) the association between relationship functioning and depression during deployment and their influence on service members' ratings of duty performance. Participants were 144 partnered Airmen assessed immediately before and during a one-year high-risk deployment to Iraq. Results showed an overall high frequency of partner communication during deployment. High relationship distress at predeployment predicted lower frequency of communication during deployment. Changes in relationship distress from before deployment to during deployment independently predicted frequency of communication, above and beyond predeployment distress levels. Level of relationship distress and depression during deployment independently predicted service members' ratings of impact on duty performance.

Impact of combat deployment on psychological and relationship health: a longitudinal study

Although previous research has indicated an elevated prevalence of posttraumatic stress disorder (PTSD) and other mental health problems among veterans of Operations Iraqi Freedom and Enduring Freedom following deployment, most of this research has been cross-sectional and has focused on a limited range of military groups and outcome criteria. This investigation was a longitudinal study of U.S. Air Force security forces assigned to a year-long high-threat ground mission in Iraq to determine the degree to which airmen's emotional and behavioral health and committed relationships were adversely impacted by an extended deployment to a warzone. Participants were a cohort of 164 security forces airmen tasked to a 365-day deployment to train Iraqi police. Airmen completed study measures both prior to and 6-9 months following deployment. Rates of deterioration in individual and interpersonal adjustment were both significant and medium to large in magnitude of effect, d = 0.43 to 0.90. Results suggest that the negative effects of deployment are related to levels of traumatic experiences and do not spontaneously remit within the first 6-9 months following return from deployment-particularly among those service members having relatively lower levels of social support.

Combat disclosure in intimate relationships: mediating the impact of partner support on posttraumatic stress

Although previous research has shown a negative relation between partner support and posttraumatic stress disorder (PTSD) symptom severity among military service members following deployment, the mediating mechanisms of this effect remain poorly understood. This study examined willingness to disclose deployment- and combat-related experiences as a mediating mechanism underlying the linkage between intimate partner support and PTSD symptom severity in a sample of 76 U.S. Air Force service members deployed to Iraq in a year-long, high-risk mission. Airmen's reports of overall social support, and partner support specifically, significantly predicted concurrent postdeployment PTSD symptom severity. Subsequent mediation analyses demonstrated that level of disclosure of deployment- and combat-related experiences by service members to their intimate partners accounted for a significant portion of the relation between partner support and postdeployment PTSD symptom severity. The level of Airmen's disclosure was also inversely related to levels of relationship distress. Implications of these findings for prevention and intervention strategies and for further research are discussed.

Tobacco use during military deployment

INTRODUCTION

Tobacco use among military personnel is associated with significant health care expenditures, lost productivity, and compromised combat readiness. The prevalence remains high among military personnel and may increase in high-risk situations such as deployment. We assessed the prevalence of tobacco use across the deployment cycle, changes in tobacco use (nonuse, continued use, initiation/harm escalation, cessation/harm reduction) during deployment, and the impact of deployment history on tobacco use.

METHOD

Cigarette smoking, smokeless tobacco (ST) use, and dual tobacco use were evaluated among 278U.S. Air Force Security Forces personnel undertaking a 1-year deployment to a high-threat combat environment. Multinomial regression was used to examine prediction of tobacco use patterns both cross-sectionally and longitudinally.

RESULTS

More than half (53%-63%) of all Security Forces used tobacco at all stages of the deployment cycle. Individual tobacco use trajectories showed significant differences in prevalence rates of initiation/harm escalation and cessation/harm reduction when comparing the transition from predeployment to the deployed environment versus returning to postdeployment status. Airmen who had deployed more than once previously had a higher likelihood of using ST use at predeployment and engaging in dual tobacco use during deployment.

CONCLUSIONS

Findings suggest the potential benefit of targeted or universal interventions at each stage of the deployment cycle to reduce the onset, maintenance, or escalation of tobacco use behaviors in the U.S. military.

Integrative approaches to couple therapy: implications for clinical practice and research

Although meta-analyses affirm that various treatments for couple distress produce statistically and clinically significant outcomes, research findings also indicate that a large percentage of couples fail to benefit or subsequently deteriorate following current therapies. Based on these findings, we advocate potential advantages of integrative approaches to couple therapy. We distinguish among assimilative, transtheoretical, and pluralistic approaches to integration and describe exemplars of each. Integrative approaches to couple therapy are compared to distillatory or common factors approaches emphasizing common elements of treatment components, therapist characteristics, and client or relationship attributes. We argue that clinical practice of integrative approaches to couple therapy requires conceptual and clinical decision-making skills transcending those of any one theoretical modality and emphasizing the selection, sequencing, and pacing of diverse interventions in a coherent manner. We conclude with implications of integrative couple-based treatments for future research.

Screening for marital and relationship discord

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

Is marital discord taxonic and can taxonic status be assessed reliably? Results from a national, representative sample of married couples

Addressing potential weaknesses in an earlier investigation, the authors examined the latent structure of marital discord using 4 product indicators from the Marital Satisfaction Inventory-Revised (Snyder, 1997) in a representative sample of community couples (N = 1,020). Results from 3 taxometric procedures suggested that marital discord is taxonic, with an estimated base rate of .31. Cut scores for classifying members of this marital discord taxon were identified. Additional analyses with several data sets of community and clinic couples provided evidence that the marital discord taxon classification demonstrated good (a) 6-week test-retest reliability, (b) criterion validity (i.e., differences in taxon prevalence in community vs. clinic couples), and (c) construct validity (i.e., correlations with therapist ratings of relationship quality). These results suggest that discordant couples differ qualitatively and not just quantitatively from nondiscordant couples and that user friendly methods, suitable for a range of research and clinical applications, can be used to identify marital discord.

Is marital discord taxonic and can taxonic status be assessed reliably? Results from a national, representative sample of married couples

Addressing potential weaknesses in an earlier investigation, the authors examined the latent structure of marital discord using 4 product indicators from the Marital Satisfaction Inventory-Revised (Snyder, 1997) in a representative sample of community couples (N = 1,020). Results from 3 taxometric procedures suggested that marital discord is taxonic, with an estimated base rate of .31. Cut scores for classifying members of this marital discord taxon were identified. Additional analyses with several data sets of community and clinic couples provided evidence that the marital discord taxon classification demonstrated good (a) 6-week test-retest reliability, (b) criterion validity (i.e., differences in taxon prevalence in community vs. clinic couples), and (c) construct validity (i.e., correlations with therapist ratings of relationship quality). These results suggest that discordant couples differ qualitatively and not just quantitatively from nondiscordant couples and that user friendly methods, suitable for a range of research and clinical applications, can be used to identify marital discord.

Predictors of intimacy in couples' discussions of relationship injuries: an observational study

The interpersonal process model of intimacy (H. T. Reis & P. Shaver, 1988) proposes that self-disclosure and empathic responding form the basis of intimate interactions. This study examined this model in 102 community couples who completed intimacy measures following videotaped discussions about relationship injuries occurring both within and outside the relationship. Observational assessments of self-disclosure and empathic responding, as well as their respective components, were related to self-reported ratings of post-interaction intimacy. Men's own disclosure and empathic responding predicted their feelings of intimacy, whereas women's intimacy was predicted by their partner's disclosure and empathic responding. Self-disclosure and empathic responding appear to be important behavioral determinants of intimate feelings, but the manner in which they influence intimacy differs according to gender.

Sexual infidelity in a national survey of American women: differences in prevalence and correlates as a function of method of assessment

The purposes of this study were (a) to estimate the annual prevalence of, and to identify the predictors of, sexual infidelity in a population-based sample of married women (N = 4,884); and (b) to evaluate whether the prevalence and predictors of infidelity varied as a function of whether the assessment of infidelity was based on a face-to-face interview versus a computer-assisted self-interview. Annual prevalence of infidelity was much smaller on the basis of the face-to-face interview (1.08%) than on the computer-assisted self-interview (6.13%). Although many of the predictor variables replicated results from previous studies (e.g., demographic variables, religiosity, sexual experience), findings also indicated that childhood sexual abuse (i.e., forced sex) predicted greater probability of infidelity. Finally, the magnitude of the association with infidelity for 4 of the 9 predictor variables differed between the 2 methods for assessing infidelity. This study's findings underscore the importance of assessing infidelity with methods such as computer-assisted self-interviews that minimize the influence of social desirability and impression management.

Sexual infidelity in a national survey of American women: differences in prevalence and correlates as a function of method of assessment

The purposes of this study were (a) to estimate the annual prevalence of, and to identify the predictors of, sexual infidelity in a population-based sample of married women (N = 4,884); and (b) to evaluate whether the prevalence and predictors of infidelity varied as a function of whether the assessment of infidelity was based on a face-to-face interview versus a computer-assisted self-interview. Annual prevalence of infidelity was much smaller on the basis of the face-to-face interview (1.08%) than on the computer-assisted self-interview (6.13%). Although many of the predictor variables replicated results from previous studies (e.g., demographic variables, religiosity, sexual experience), findings also indicated that childhood sexual abuse (i.e., forced sex) predicted greater probability of infidelity. Finally, the magnitude of the association with infidelity for 4 of the 9 predictor variables differed between the 2 methods for assessing infidelity. This study's findings underscore the importance of assessing infidelity with methods such as computer-assisted self-interviews that minimize the influence of social desirability and impression management.

Assessing family-of-origin functioning in Mexican American adults: retrospective application of the family environment scale

Although both theoretical and empirical literature suggests that individuals' family-of-origin experiences affect subsequent relationship functioning as adults, few studies have examined the appropriateness of family assessment techniques when applied retrospectively for use in either theory development or clinical applications. This study examined psycho-metric characteristics of the Family Environment Scale (FES) when used retrospectively with Mexican Americans to assess their families-of-origin. Findings provided qualified support for the internal consistency of the FES and showed significant mean profile differences for this population across gender and when compared to the normative sample for this measure. Retrospective reports on the FES related to independent measures of family history of distress and, to a lesser extent, with current relationship functioning, providing preliminary support for the criterion-related validity of the FES when adapted for retrospective assessment. Limitations and implications of findings for further research are discussed.

Treating Affair Couples: Clinical Considerations and Initial Findings

Infidelity can have devastating effects on couples’ relationships. Not only are couples typically confused and uncertain about how to proceed, but couple therapists also report that treating infidelity is one of their greatest clinical challenges. In the current article, we present a conceptual model of response to infidelity with a corresponding infidelity-specific, couple-based intervention. This intervention incorporates interventions from cognitive-behavioral, insight-oriented, trauma-based, and forgiveness approaches to working with couples. In addition to this intervention created specifically for treating infidelity, we discuss how existing, empirically supported couple therapies such as traditional behavioral couple therapy (TBCT) and integrative behavioral couple therapy (IBCT) approach the treatment of infidelity. Finally, we present preliminary findings from two small treatment studies that provide initial, encouraging findings for the utility of the infidelity-specific intervention as well as TBCT and IBCT for treating infidelity.

Evidence-based approaches to assessing couple distress

This article describes a conceptual framework for couple-based assessment strategies grounded in empirical findings linking couple distress to a broad range of both individual and relationship characteristics. These characteristics can contribute to, exacerbate, or result from relationship problems. On the basis of these findings, the authors articulate specific targets of clinical inquiry reflecting relationship behaviors, cognitions, and affect as well as features of individual distress. Guided by this framework, empirically supported assessment strategies and techniques emphasizing relationship functioning across diverse methods are proposed, including the clinical interview, analog behavioral observation, and both self- and other-report measures. Discussion concludes with specific recommendations regarding clinical assessment of couple distress and directions for further research.

Current Status and Future Directions in Couple Therapy

Couple therapy research affirms that various approaches to couple treatment produce statistically and clinically significant improvement for a substantial proportion of couples in reducing overall relationship distress. Recent studies have extended these findings in indicating the effectiveness of couple-based interventions for a broad range of coexisting emotional, behavioral, or physical health problems in one or both partners. In contrast to these encouraging results, research also indicates that a sizeable percentage of couples fail to achieve significant gains from couple therapy or show significant deterioration afterward. Research on processes of change and predictors of treatment outcome in couple therapy provides preliminary evidence regarding factors potentially contributing to variable treatment response. The chapter concludes with 12 recommendations regarding future directions in couple therapy research and clinical training.

Methodology in family science: introduction to the special issue

Methodology influences every facet of scientific inquiry including the processes of framing questions, operationalizing constructs, sampling individuals within populations and observations within persons, analyzing data, and bringing meaning to the results. This introduction to the special issue on methodology emphasizes the recursive interaction of research methodology and theories underlying family science. Because the science of family psychology is richly complex, so too must the methods for examining couple and family phenomena be equally diverse. Articles comprising this special issue vary in their emphasis on research design versus data-analytic techniques and on confirmatory versus discovery-oriented strategies. The special issue is intended to advance not only the conduct of family science but also the understanding and integration of an increasingly complex research literature by those engaged in education and clinical interventions. ((c) 2005 APA, all rights reserved).

Analyzing nonindependent outcomes in couple therapy using the actor-partner interdependence model

The nonindependent components of couple data require data-analytic strategies tailored to the interpersonal processes occurring between relationship partners. This article examines the benefits of a specifically dyadic analytic method, the actor-partner interdependence model (APIM), for evaluating interpartner influence across time. Both conceptual and methodological features of the APIM are exemplified by applying this model to observations of negative and positive affect and global distress in spouses participating in a randomized trial of couple therapy. In addition to elucidating specific advantages of the APIM relative to alternative data-analytic strategies, the current results shed new light on previous findings from a comparative treatment outcome study evaluating behavioral and insight-oriented approaches to couple therapy.

Treating couples recovering from infidelity: An integrative approach

Infidelity is one of the most difficult problems to address in couple therapy, most likely because it involves a traumatic relationship event that alters the ways in which couples process information about each other and established behavioral patterns. We present a three-stage treatment designed to address the cognitive, behavioral, and emotional sequelae of affairs that integrates cognitive-behavioral and insight-oriented strategies with the literatures on traumatic response and forgiveness. A case study with pretreatment, posttreatment, and 6-month follow-up data is presented to illustrate the treatment methods.

Treating infidelity: Clinical and ethical directions

This article addresses clinical and ethical directions in treating clients coping with infidelity. Developing competence in this domain requires familiarity with empirical research regarding infidelity, individual and cultural differences involving non-monogamy, and assessment and intervention skills related to treating infidelity. Practical directions will entail distinguishing among responsibilities to individual partners versus their relationship and managing related potential conflicts of interest with other involved parties. Confidentiality assumes increased complexity when confronting undisclosed infidelity in couple therapy and when a client engaging in high-risk behaviors for contracting STDs or testing seropositive for HIV has not informed his or her partner(s). Finally, we discuss therapists' need to concretely articulate their values that influence treatment of infidelity.

An integrative intervention for promoting recovery from extramarital affairs

The discovery or disclosure of an extramarital affair can have a devastating impact on partners, both individually and on the relationships. Research suggests that affairs occur relatively frequently in relationships and are a common presenting problem in couple therapy. However, despite their prevalence, there is little empirical treatment research in this area, and most therapists describe this problem as one of the more difficult to treat. In this study, we used a replicated case-study design to explore the efficacy of an integrative treatment designed to help couples recover from an affair. Six couples entered and completed treatment. The majority of these couples were less emotionally or maritally distressed at the end of treatment, and the injured partners reported greater forgiveness regarding the affair. Details of the intervention, suggested adaptations of the treatment, and areas for future research are discussed.

Treating distressed couples with coexisting mental and physical disorders: directions for clinical training and practice

Relationship difficulties frequently coexist with significant emotional, behavioral, and physical health problems in one or both partners. Moreover, couple therapists report individual emotional and behavioral disorders as among the most difficult problems that they encounter in clinical practice. In this article, we summarize empirical evidence regarding the association between relationship distress and the onset, course, and treatment of mental and physical health problems. Based on these findings, we propose five critical implications for clinical training and the practice of couple therapy.

Assessing nontraditional couples: validity of the marital satisfaction inventory--revised with gay, lesbian, and cohabiting heterosexual couples

Thirty-one gay male couples and 28 lesbian couples were compared with 36 cohabiting heterosexual couples using the Marital Satisfaction Inventory-Revised (MSI-R), a multidimensional measure of relationship functioning intended for use with both traditional and nontraditional couples. Analyses of scales' internal consistency and factor structure supported the construct validity of this measure with nontraditional couples. Analyses of mean profiles on the MSI-R indicated that cohabiting opposite-gender and same-gender couples were more alike than different, and were more similar to nondistressed samples of married heterosexual couples from the general community than to couples in therapy. Implications of current findings for clinical assessment and intervention are considered, and directions for future research are proposed.

Reliability and equivalence of the Spanish translation of the Marital Satisfaction Inventory--Revised (MSI-R)

This study examined the reliability and linguistic equivalence of the Spanish translation of the Marital Satisfaction Inventory--Revised (MSI-R) in a sample of 86 bilingual Mexican American couples. Overall, findings provided preliminary support for using this translation of the MSI-R with respondents whose preferred language is Spanish. Coefficients of internal consistency and temporal stability for scales constituting the Spanish MSI-R averaged .72 and .75, respectively. Linguistic equivalence coefficients for respondents completing the MSI-R in both languages averaged .69. Multivariate analyses of variance indicated no significant effect for language of administration on MSI-R scale scores. Discussion emphasizes caveats in using the Spanish MSI-R and directions for further research.

Relationship satisfaction of Mexican American and non-Hispanic white American interethnic couples: issues of acculturation and clinical intervention

Despite the increasing prevalence of interethnic marriages, remarkably little empirical literature exists for guiding clinical interventions offered to these couples. This study compared the marriages of 72 couples with one Mexican-American partner and one non-Hispanic White American partner, 75 Mexican-American couples, and 66 non-Hispanic White couples. Overall, the interethnic couples were more similar to non-Hispanic White couples than they were to Mexican-American couples across multiple domains, with the latter group indicating modestly higher levels of relationship distress. Among interethnic couples, Mexican-American wives' level of acculturation related significantly to both their own marital- and parental-role orientation and to distress in their relationships with children, as well as to their husbands' marital distress regarding child rearing and the couple's interactions regarding finances. Implications for clinical interventions with Mexican- and White-American interethnic couples are discussed.

Computer-assisted judgment: defining strengths and liabilities

Clinicians often fail to recognize limitations in their own subjective judgments, make use of well-developed mechanical-prediction methods, or carefully evaluate which computer-based aids warrant their consideration. This article addresses issues regarding computer-based test interpretations (CBTIs) and computer-based decision making. Comments highlight conclusions reached by other contributors to this Special Section, additional literature bearing on these observations, and implications for consumers of computer-assisted techniques and researchers developing or evaluating these methods. The future of computer-assisted assessment depends on educating clinicians and researchers to be better consumers of existing as well as emerging technologies in this domain.

Effects of posttraumatic stress and acculturation on marital functioning in Bosnian refugee couples

Forty Bosnian refugee couples living in the United States completed a translated version of the PTSD Symptom Scale--Self Report, the Behavioral Acculturation Scale, the Marital Satisfaction Inventory--Revised, and a demographic questionnaire. Posttraumatic stress disorder (PTSD) symptomatology was the best predictor of marital functioning and was related negatively to acculturation. After controlling for PTSD, acculturation did not predict marital functioning. Wives' marital satisfaction was best predicted by husbands' PTSD, husbands' acculturation, and their own PTSD. Husbands' marital satisfaction was not predicted significantly by any of these variables. These findings suggest several implications for mental health professionals dealing with refugees and other traumatized populations.