Sociodemographic Correlates of Mental Health Treatment Seeking Among College Students: A Systematic Review and Meta-Analysis

OBJECTIVE

College students have high rates of mental health problems and low rates of treatment. Although sociodemographic disparities in student mental health treatment seeking have been reported, findings have not been synthesized and quantified. The extent to which differences in perceived need for treatment contribute to overall disparities remains unclear.

METHODS

A systematic search of PubMed, PsycInfo, and Embase was conducted. Studies published between 2007 and 2022 were included if they reported treatment rates among college students with mental health problems, stratified by sex, gender, race-ethnicity, sexual orientation, student type, student year, or student status. Random-effects models were used to calculate pooled prevalence ratios (PRs) of having a perceived need for treatment and of receiving treatment for each sociodemographic subgroup.

RESULTS

Twenty-one studies qualified for inclusion. Among students experiencing mental health problems, consistent and significant sociodemographic differences were identified in perceived need for treatment and treatment receipt. Students from racial-ethnic minority groups (in particular, Asian students [PR=0.49]) and international students (PR=0.63) reported lower rates of treatment receipt than White students and domestic students, respectively. Students identifying as female (sex) or as women (gender) (combined PR=1.33) reported higher rates of treatment receipt than students identifying as male or as men. Differences in perceived need appeared to contribute to some disparities; in particular, students identifying as male or as men reported considerably lower rates of perceived need than students identifying as female or as women.

CONCLUSIONS

Findings highlight the need for policy makers to address barriers throughout the treatment-seeking pathway and to tailor efforts to student subgroups to reduce treatment disparities.

Gamified Assessment of the Emotion-Regulation Abilities in Youths: Validation of the REThink Online Game-Based Assessment System

Objective: Emotional problems in the youth population are a major issue that can have a significant negative impact for their future development as adults. Their emotion regulation (ER) abilities represent a preventive measure for those emotional problems. REThink is an online therapeutic game that was proved to be effective in rigorous studies, and is based on the rational emotive behavioral therapy, with seven levels built to train various emotional regulation skills. Each level has a section that can be used for the assessment of the targeted skills within the level. The present study aimed at investigating the reliability and validity of the evaluation modules from the REThink game regarding the assessment of ER abilities in children/adolescents. Methods: In accordance with established guidelines, 110 children and adolescents aged 8-14 years old were recruited. Following parental informed consent, the participants filled out the standard questionnaires and, subsequently, they played the evaluation module of the REThink game. The reliability aspect was investigated by evaluating internal consistency, while validity was evaluated by using concurrent and predictive validity analyses. Results: The results revealed statistically significant positive associations between the game scores obtained by the participants and the emotion regulation scale. In terms of predictive validity, there were significant negative associations between game scores and the presence of emotional and behavioral problems. Moreover, in terms of the reliability of the REThink game, an acceptable value for the internal consistency was observed. Conclusion: In conclusion, the REThink therapeutic game was proved to be a valid measure for assessing emotion regulation abilities in children and adolescents. Clinical Trial Registration No. NCT04788901.

Are gains in emotional symptoms and emotion-regulation competencies after the REThink therapeutic game maintained in the long run? A 6-month follow-up

Emotional disorders are the most prevalent mental health conditions affecting children and adolescents. Thus, it becomes essential to develop and test early intervention strategies that are accessible, attractive, and can effectively improve their emotional functioning. A randomized control trial compared the prevention effects of the REThink therapeutic game to those of a standard face-to-face prevention program, and a waitlist which was transformed at follow-up into care as usual. Out of 142 healthy children and adolescents who completed the intervention stage, 137 (mean age: 12.84, SD: 1.97) completed a follow-up assessment measuring emotional symptoms, depressive mood and emotion regulation. We also tested potential moderators of its long-term effects, such as parental psychological control, parent attachment and childhood trauma. Our results highlighted the fact that the REThink intervention had a durable impact on the children's mental health and their ability to regulate their emotions. Moreover, we found that trauma, parent psychological control and parent attachment moderated the maintenance of the improvements. Future research needs to further document how to personalize the game and prevention program components to better address the characteristics of the youths at risk for mental health problems. ClinicalTrials.gov NCT03308981, from 13.10.2017.

The efficacy of online parenting interventions in addressing emotional problems in children and adolescents: A meta-analysis of randomized controlled trials

BACKGROUND

Parenting interventions offer opportunities for reducing emotional problems in children and adolescents, based on addressing parental risk and protective factors. Online parenting interventions were developed more recently to increase access to interventions for parents, and the aim of this systematic review and meta-analysis is to investigate their efficacy.

METHODS

We conducted a meta-analysis pooling studies that tested online parenting interventions having as outcome emotional problems in children/adolescents. We considered as secondary outcome parent mental health and moderation effects for the type of population, intervention characteristics, and risk of bias.

RESULTS

Thirty-one studies met the inclusion criteria and were included in the meta-analysis. For child/adolescent emotional problems, at post-intervention, 13 studies were pooled, yielding an ES of g = -0.26 (95% CI [-0.41, -0.11]; p < .001) favoring the online parental interventions over wait-list, while at follow-up five RCTs were pooled, yielding an ES of g = -0.14 (95% CI [-0.25, -0.02]; p = .015) favoring the parental online interventions over wait-list. Moderation analyses suggest that longer online parenting programs are more effective in improving child emotional problems.

CONCLUSIONS

Online parent programs have positive effects on reducing emotional symptoms in children and adolescents. Future research will need to develop and investigate the efficacy of the programs that can personalize their contents and delivery methods.

Preventing mental illness in children that experienced maltreatment the efficacy of REThink online therapeutic game

Exposure to child maltreatment (CM) is considered to predispose children to devastating consequences in terms of mental health. Thus, it is a public health priority to provide these children with early preventive interventions that are accessible on a large scale, adapted to their needs, and effective in supporting their mental health. Here we report a randomized control trial to test the efficacy of the REThink online therapeutic game, as compared with a Care as Usual (CAU) control group in the prevention of mental illness in maltreated children. Out of 439 children aged 8-12 that were recruited, 294 children with self-reported maltreatment histories were included in the current study, and were allocated, 146 participants in the REThink group and 148 participants in the CAU group. All children completed pre- and post-intervention assessments measuring mental health, emotion regulation, and irrational cognitions. We also tested potential moderators for these effects, such as the severity of CM and the security of parent attachment. Our results show that children receiving the REThink game intervention outperform the CAU group at post-test, showing a significantly lower level of emotional problems, mental health difficulties, use of maladaptive emotion-regulation strategies such as catastrophizing, rumination, and self-blame, and irrational cognitions. Moreover, children with higher CM severity benefit the most from the REThink game, while children with lower parent attachment security benefit the least. Future research is needed, to investigate the long-term efficacy of the REThink game in promoting the mental health of children exposed to CM.

Positive Attention Bias Trained during the Rethink Therapeutic Online Game and Related Improvements in Children and Adolescents' Mental Health

Attentional bias towards positive stimuli is considered a resilience factor for mental health and well-being. The aim of the present study was to analyze the effects of an attentional bias training for positive faces in a preventive therapeutic game for children and adolescents. The sample of 54, which consisted of children and adolescents aged between 10-16 years, played the REThink game, which included an attentional bias training level based on the visual search paradigm, where children had the task to quickly find the happy face among other angry faces. We measured mental health, and positive and negative emotions and analyzed their associations between changes in attention bias. Attentional bias indicators demonstrated acceptable reliability and results showed that increases in attentional bias towards positive faces were associated with improvements in children and adolescents' conduct problems, hyperactivity, and peer relationship problems. Overall, our results support the protective role of training attentional bias towards positive faces as part of a preventive therapeutic game for children and adolescents.

Family still matters: Human social motivation across 42 countries during a global pandemic

The COVID-19 pandemic caused drastic social changes for many people, including separation from friends and coworkers, enforced close contact with family, and reductions in mobility. Here we assess the extent to which people's evolutionarily-relevant basic motivations and goals—fundamental social motives such as Affiliation and Kin Care—might have been affected. To address this question, we gathered data on fundamental social motives in 42 countries (N = 15,915) across two waves, including 19 countries (N = 10,907) for which data were gathered both before and during the pandemic (pre-pandemic wave: 32 countries, N = 8998; 3302 male, 5585 female; M_age = 24.43, SD = 7.91; mid-pandemic wave: 29 countries, N = 6917; 2249 male, 4218 female; M_age = 28.59, SD = 11.31). Samples include data collected online (e.g., Prolific, MTurk), at universities, and via community sampling. We found that Disease Avoidance motivation was substantially higher during the pandemic, and that most of the other fundamental social motives showed small, yet significant, differences across waves. Most sensibly, concern with caring for one's children was higher during the pandemic, and concerns with Mate Seeking and Status were lower. Earlier findings showing the prioritization of family motives over mating motives (and even over Disease Avoidance motives) were replicated during the pandemic. Finally, well-being remained positively associated with family-related motives and negatively associated with mating motives during the pandemic, as in the pre-pandemic samples. Our results provide further evidence for the robust primacy of family-related motivations even during this unique disruption of social life.

Fundamental social motives measured across forty-two cultures in two waves

How does psychology vary across human societies? The fundamental social motives framework adopts an evolutionary approach to capture the broad range of human social goals within a taxonomy of ancestrally recurring threats and opportunities. These motives—self-protection, disease avoidance, affiliation, status, mate acquisition, mate retention, and kin care—are high in fitness relevance and everyday salience, yet understudied cross-culturally. Here, we gathered data on these motives in 42 countries (N = 15,915) in two cross-sectional waves, including 19 countries (N = 10,907) for which data were gathered in both waves. Wave 1 was collected from mid-2016 through late 2019 (32 countries, N = 8,998; 3,302 male, 5,585 female; M_age = 24.43, SD = 7.91). Wave 2 was collected from April through November 2020, during the COVID-19 pandemic (29 countries, N = 6,917; 2,249 male, 4,218 female; M_age = 28.59, SD = 11.31). These data can be used to assess differences and similarities in people’s fundamental social motives both across and within cultures, at different time points, and in relation to other commonly studied cultural indicators and outcomes.

Measurement(s)	Motivation • Emotional Well-being • Socioeconomic Indicator • Culture • Cultural Diversity
Technology Type(s)	survey method • digital curation
Sample Characteristic - Organism	Homo sapiens
Sample Characteristic - Location	Australia • Austria • Bolivia • Brazil • Bulgaria • Canada • Chile • China • Colombia • Czech Republic • Germany • Hong Kong • India • Israel • Italy • Japan • Kenya • Lebanon • Mexico • The Netherlands • New Zealand • Nigeria • Pakistan • Peru • The Philippines • Portuguese Republic • Romania • Russia • Saudi Arabia • Senegal • Serbia • Singapore • Slovak Republic • South Korea • Spain • Sweden • Thailand • Turkey • Uganda • Ukraine • United Kingdom • United States of America

Eating Behavior-Choice or Reconstruction of Past Experience? A Randomized Clinical Trial of Changing Eating Intentions of Healthy Adults Through Hypnotic Suggestions

Recent meta-analyses have shown that psychological interventions have a small to medium effect on weight loss. We propose here a different approach to changing eating intentions. According to the Free Will literature, people decide to act before they acknowledge it, and they decide based on the reconstruction of previous experiences. The action can thus be inhibited immediately (max 100 ms) after awareness. We wanted to test if intervention based on this model, using hypnotic suggestions, can effectively change the intentions of eating. This study aims to identify which format of hypnotic suggestion can be more effective in changing eating intentions regarding high-calorie foods. Therefore, 88 healthy adult participants randomized in four groups received one session of hypnotic induction and suggestions or placebo. We measured the eating intentions through a computer task in which participants could choose pictures of low and high caloric food before, during, and after hypnosis. For the within-subject effect, results showed that two types of hypnotic suggestions significantly impacted the intentions of eating on high-calorie foods with large-effect, namely Cognitive Rehearsal (d = 0.81, p < .001) and Memory Substitution (d = 0.82, p < .001). After controlling for pretest ratings, we found a significant between-effect: the Cognitive Rehearsal group differed significantly from the Control in terms of intentions of eating (d = 0.85, p < .05). We conclude that hypnosis with Cognitive Rehearsal suggestions can help to positively impact the intentions of eating.

Do Improvements in Therapeutic Game-Based Skills Transfer to Real Life Improvements in Children's Emotion-Regulation Abilities and Mental Health? A Pilot Study That Offers Preliminary Validity of the REThink In-game Performance Scoring

Therapeutic or serious games are considered innovative ways of delivering psychological interventions especially suited for children and adolescents, which can have a positive impact on mental health, while also being fun and easily accessible online. While most serious games for children and adolescents address specific issues, such as anxiety or depression, preventive measures received less attention. REThink is an online therapeutic game designed as a stand-alone prevention tool, aiming to increase resilience in healthy children and adolescents in a Rational Emotive Behavioral Therapy framework (David et al., 2019). The aim of this pilot study was to investigate the validity of in-game performance measurements or scores as indicators of the game effectiveness in building real life emotion-regulation abilities. We analyzed how scores of different game levels (addressing different skills) are associated with improvements in mental health and emotion regulation abilities. Our preliminary results suggest that in-game performance at some levels (scores) consistently reflect improvements in psychological functioning, while in-game performance at other levels are less associated with changes in real life self-reported psychological functioning. These results offer important information about which levels can be used as preliminary indicators of psychological improvements, and which levels need to be revised in terms of task or scoring. Overall, results of our study offer preliminary validation of REThink's game scoring system, while also suggesting the elements to be refined.

Effectiveness of Outpatient Rational Emotive Behavior Therapy Over One Decade

OBJECTIVE

The aim of this article was to explore the effectiveness of rational emotive and cognitive-behavioral therapy (REBT) in a clinical setting.

METHODS

This study included 349 patients of the Albert Ellis Institute who sought psychotherapy from 2007 to 2016. Analyses were conducted by using the intent-to-treat principle, and outcomes were measured after three sessions of therapy (to measure early response) and at the end of 20 sessions. Outcome Questionnaire-45 was used to measure patient functioning.

RESULTS

Patients reported significant improvements in their functioning after participating in REBT, with a medium effect size for early response after three sessions of psychotherapy and at the end of the 20 sessions.

CONCLUSIONS

The authors' findings documented that REBT can be effectively transported from a research setting to clinical practice.

Effectiveness of the REThink therapeutic online video game in promoting mental health in children and adolescents

Although evidence-based interventions exist, estimates suggest that about 60% percent of children and adolescents with mental health disorders do not receive the treatment they need. In this context, one expanding strategy for increasing access to mental health care for children and adolescents is the use therapeutic, or serious, games. REThink is one such therapeutic game, developed to offer a CBT-based prevention that was documented in a controlled trial to develop psychological resilience in children and adolescents, aged between 10 and 16, helping them learn healthy strategies for coping with dysfunctional negative emotions such as anxiety, anger and depression. This study aims to test the effectiveness of the REThink therapeutic online video game in promoting emotional health in children and adolescents in a pilot study. Participants (N = 31), aged between 10 and 16 years, were recruited on a volunteer basis from a school. Emotional problems, irrational beliefs, negative automatic thoughts, rational beliefs, and problem solving abilities were assessed pre- and post-using the therapeutic game. We also measured participants' satisfaction with the game. Results obtained show improvements in terms of emotional problems of the youths, their irrational beliefs, negative automatic thoughts and high levels of intervention satisfaction. of this study are in support of the previous findings suggesting that the REThink online game can be a valuable tool for large-scale mental health efforts aimed at the prevention of emotional disorders in children and adolescents, in accordance with evidence-based prevention protocols.

Family Matters: Rethinking the Psychology of Human Social Motivation

What motives do people prioritize in their social lives? Historically, social psychologists, especially those adopting an evolutionary perspective, have devoted a great deal of research attention to sexual attraction and romantic-partner choice (mate seeking). Research on long-term familial bonds (mate retention and kin care) has been less thoroughly connected to relevant comparative and evolutionary work on other species, and in the case of kin care, these bonds have been less well researched. Examining varied sources of data from 27 societies around the world, we found that people generally view familial motives as primary in importance and mate-seeking motives as relatively low in importance. Compared with other groups, college students, single people, and men place relatively higher emphasis on mate seeking, but even those samples rated kin-care motives as more important. Furthermore, motives linked to long-term familial bonds are positively associated with psychological well-being, but mate-seeking motives are associated with anxiety and depression. We address theoretical and empirical reasons why there has been extensive research on mate seeking and why people prioritize goals related to long-term familial bonds over mating goals. Reallocating relatively greater research effort toward long-term familial relationships would likely yield many interesting new findings relevant to everyday people’s highest social priorities.

Global Study of Social Odor Awareness

Olfaction plays an important role in human social communication, including multiple domains in which people often rely on their sense of smell in the social context. The importance of the sense of smell and its role can however vary inter-individually and culturally. Despite the growing body of literature on differences in olfactory performance or hedonic preferences across the globe, the aspects of a given culture as well as culturally universal individual differences affecting odor awareness in human social life remain unknown. Here, we conducted a large-scale analysis of data collected from 10 794 participants from 52 study sites from 44 countries all over the world. The aim of our research was to explore the potential individual and country-level correlates of odor awareness in the social context. The results show that the individual characteristics were more strongly related than country-level factors to self-reported odor awareness in different social contexts. A model including individual-level predictors (gender, age, material situation, education, and preferred social distance) provided a relatively good fit to the data, but adding country-level predictors (Human Development Index, population density, and average temperature) did not improve model parameters. Although there were some cross-cultural differences in social odor awareness, the main differentiating role was played by the individual differences. This suggests that people living in different cultures and different climate conditions may still share some similar patterns of odor awareness if they share other individual-level characteristics.

Women's preferences for men's facial masculinity are strongest under favorable ecological conditions

The strength of sexual selection on secondary sexual traits varies depending on prevailing economic and ecological conditions. In humans, cross-cultural evidence suggests women’s preferences for men’s testosterone dependent masculine facial traits are stronger under conditions where health is compromised, male mortality rates are higher and economic development is higher. Here we use a sample of 4483 exclusively heterosexual women from 34 countries and employ mixed effects modelling to test how social, ecological and economic variables predict women’s facial masculinity preferences. We report women’s preferences for more masculine looking men are stronger in countries with higher sociosexuality and where national health indices and human development indices are higher, while no associations were found between preferences and indices of intra-sexual competition. Our results show that women’s preferences for masculine faces are stronger under conditions where offspring survival is higher and economic conditions are more favorable.

Changes in irrational beliefs are responsible for the efficacy of the REThink therapeutic game in preventing emotional disorders in children and adolescents: mechanisms of change analysis of a randomized clinical trial

The mechanisms of change are rarely investigated in the field of gamified interventions for preventing emotional disorders in children and adolescents despite the wide recognition for the advantages they offer as prevention tool. Therefore, the aim of the present study was to investigate the mechanisms of change of a therapeutic game (REThink), specifically mediators and moderators of its efficacy. We conducted a randomized controlled trial, involving 165 children (age range 10-16 years), who were randomly distributed across three groups: the REThink group (N = 54), the Rational Emotive Behavior Education group (N = 55) and the Waitlist condition (N = 56). Results indicated that changes in irrational beliefs were significant mediators for the REThink intervention on depressive mood and overall negative emotions. Age did not moderate the effect of REThink, which indicates that the program was equally effective for children and adolescents.Trial Registration ClinicalTrials.gov NCT03308981.

Is REThink therapeutic game effective in preventing emotional disorders in children and adolescents? Outcomes of a randomized clinical trial

Therapeutic games represent a promising solution for addressing emotional difficulties in youths. The aim of the present study was to investigate the effectiveness of the REThink game, in helping children and adolescents, to develop psychological resilience. Therefore, 165 children aged between 10 and 16 years were randomly assigned in one of the three groups: 54 participants in the REThink condition, 55 participants in the Rational Emotive Behavior Education condition, and 56 participants in the waitlist condition. Results indicated that the REThink intervention had a significant impact on emotional symptoms (a moderate-effect size, d = 0.46) and on depressive mood (a large-effect size, d = 0.84). Furthermore, REThink had a significant impact on children's ability to regulate their emotions, with a significant effect on emotional awareness (d = 0.64), and on the ability for emotional control (d = 0.69). In conclusion, the implications of the REThink game are discussed in relationship with resiliency building programs designed for youths. TRIAL REGISTRATION: ClinicalTrials.gov NCT03308981.

Managing Distress Using Mobile Prescriptions of Psychological Pills: A First 6-Month Effectiveness Study of the PsyPills App

Background: Although numerous mental health apps are commercially available, only a few of them have been empirically tested. PsyPills is an interactive and personalized mobile application, based on emotion regulation research and Rational Emotive Behavior Therapy principles, that can function as a stand-alone intervention aimed at offering immediate stress relief. Objective: In this paper, we describe the newly developed PsyPills app and present data obtained at 6 months after its release regarding its effectiveness for stress management. Methods: 115 users aged 15-79 years old (M = 39.01, SD = 13.49) accessed the app during the first 6 months after its release and were thus included in the study. Distress and specific cognitive processes were collected using visual analog scale measures. Results: Most users accessed the app with the purpose of searching anxiety relief and most often reported work-related distress. Seventy-Four users accessed PsyPills between 1 and 11 times (M = 2.68, SD = 2.59), and received 258 psychological prescriptions in total. PsyPills was effective in terms of reducing the frequency of dysfunctional emotions, such that significantly more users reported feeling functional emotions after accessing the application and reading its personalized prescriptions than those reporting not being able to change it [χ² (1, N = 52) = 52.00 p < 0.001]. Using reminders of the psychological pill at specific times during the day made the PsyPills app more effective. Conclusions: Based on initial data on its first 6-month usage, the PsyPills app appears to be promising in terms of offering stress relief. However, future studies need to use golden standard design and investigate its efficacy as an adjunctive intervention.

Corrigendum: Marital Satisfaction, Sex, Age, Marriage Duration, Religion, Number of Children, Economic Status, Education, and Collectivistic Values: Data from 33 Countries

[This corrects the article on p. 1199 in vol. 8, PMID: 28785230.].

Online Coaching of Emotion-Regulation Strategies for Parents: Efficacy of the Online Rational Positive Parenting Program and Attention Bias Modification Procedures

Parenting programs are currently treatment of choice for behavioral disorders in children and one of their main components is reducing the negativity bias in the child-parent dyad. The Rational Positive Parenting Program (rPPP) is a program with a special focus on parent emotion-regulation functional reappraisal strategies, which has recently received consistent support for reducing child externalizing and internalizing disorders. In the last years, online interventions were proliferated and the Attention Bias Modification (ABM) becoming a promising implicit therapeutic intervention based on attention deployment emotion-regulation strategy, or adjunctive module to usual treatments, with results in multiple domains, varying from pain to self-esteem and emotional disorders (e.g., anxiety). We conducted two studies to investigate (1) the efficacy of the ABM procedures applied to parents and (2) the efficacy of the online version of the rPPP augmented with an ABM module. A total of 42 parents of children aged 2-12 years old participated in the first study, being allocated either to the ABM training or wait-list. Positive results were reported by the parents participating in the ABM group for own distress, satisfaction, positive interactions with the child, and child's strengths. In the second study, 53 parents and their children were allocated either in the rPPP group or in the rPPP + ABM group. Results show that ABM training can boost the effects of the rPPP on the strengths of children reported by the parents after the intervention. Findings are discussed in the light of limited research on using online tools for coaching effective emotion-regulation strategies for parents.

Preferred Interpersonal Distances: A Global Comparison

Human spatial behavior has been the focus of hundreds of previous research studies. However, the conclusions and generalizability of previous studies on interpersonal distance preferences were limited by some important methodological and sampling issues. The objective of the present study was to compare preferred interpersonal distances across the world and to overcome the problems observed in previous studies. We present an extensive analysis of interpersonal distances over a large data set ( N = 8,943 participants from 42 countries). We attempted to relate the preferred social, personal, and intimate distances observed in each country to a set of individual characteristics of the participants, and some attributes of their cultures. Our study indicates that individual characteristics (age and gender) influence interpersonal space preferences and that some variation in results can be explained by temperature in a given region. We also present objective values of preferred interpersonal distances in different regions, which might be used as a reference data point in future studies.

The Associations of Dyadic Coping and Relationship Satisfaction Vary between and within Nations: A 35-Nation Study

OBJECTIVE

Theories about how couples help each other to cope with stress, such as the systemic transactional model of dyadic coping, suggest that the cultural context in which couples live influences how their coping behavior affects their relationship satisfaction. In contrast to the theoretical assumptions, a recent meta-analysis provides evidence that neither culture, nor gender, influences the association between dyadic coping and relationship satisfaction, at least based on their samples of couples living in North America and West Europe. Thus, it is an open questions whether the theoretical assumptions of cultural influences are false or whether cultural influences on couple behavior just occur in cultures outside of the Western world.

METHOD

In order to examine the cultural influence, using a sample of married individuals (N = 7973) from 35 nations, we used multilevel modeling to test whether the positive association between dyadic coping and relationship satisfaction varies across nations and whether gender might moderate the association.

RESULTS

RESULTS reveal that the association between dyadic coping and relationship satisfaction varies between nations. In addition, results show that in some nations the association is higher for men and in other nations it is higher for women.

CONCLUSIONS

Cultural and gender differences across the globe influence how couples' coping behavior affects relationship outcomes. This crucial finding indicates that couple relationship education programs and interventions need to be culturally adapted, as skill trainings such as dyadic coping lead to differential effects on relationship satisfaction based on the culture in which couples live.