Resolving disease management problems in European-American and Latino couples with type 2 diabetes: the effects of ethnicity and patient gender

The management of type 2 diabetes requires major life style changes. How patients and family members resolve disagreements about disease management affects how well the disease is managed over time. Our goal was to identify differences in how couples resolved disagreements about diabetes management based on ethnicity and patient gender. We recruited 65 Latino and 110 European-American (EA) couples in which one spouse had type 2 diabetes. Couples participated in a 10-minute videotaped, revealed differences interaction task that was evaluated with 7 reliable observer ratings: warm-engagement, hostility, avoidance, amount of conflict resolution, off-task behavior, patient dominance, and dialogue. A series of 2 x 2, Ethnicity x Sex ANOVAs indicated significant effects for Ethnicity and for the Ethnicity x Sex interaction, but not for Sex. Latino couples were rated as significantly more emotionally close, less avoidant, less hostile toward each other, and had less dominant patients than EA couples; however, Latino couples achieved significantly less problem resolution and were more frequently off-task than EA couples. These findings were qualified by patient gender. The findings highlight important differences     

A multidimensional examination of marital conflict and subjective health over 16 years

Guided by stress process perspectives, this study conceptualizes marital conflict as a multidimensional stressor to assess how three aspects of conflict—frequency of disagreements, breadth of disagreements, and cumulative disagreements—impact subjective health. Longitudinal data of married couples spanning 16 years (n = 373 couples) were analyzed using multilevel modeling. For husbands, more frequent disagreements than usual within a given year were associated with poorer subjective health. For wives, the greater cumulative effects of disagreements over 16 years were harmful for subjective health. We discuss how gendered self‐representations and relationship power issues help explain the findings. This research demonstrated the importance of examining multiple aspects of marital conflict to reveal that their subjective health consequences function differently for wives and husbands.     

Marital Interactions,Family Intervention,and Disagreements: A Daily Diary Study in a Low‐income Sample

Little research has examined associations between low‐income married couples’ daily interactions and severity of disagreements. Similarly, few researchers have considered how family‐strengthening interventions for low‐income couples may affect the quality of daily interactions and associations between interactions and conflict experiences. This study aims to fill these gaps in the literature by leveraging daily diary data from a random assignment study of a family‐strengthening intervention with low‐income husbands and wives 30 months postenrollment. Married couples randomly assigned to the intervention participated in 10 weeks of relationship education services. Control group couples received no services. Thirty months postrandom assignment, participants reported on the severity of daily marital disagreements over a 15‐day period, as well as their positive and negative emotions during inter‐spousal interactions. Multi‐level models demonstrated associations between reports of emotions in interactions and severity of disagreements. In addition, wives assigned to the family strengthening program reported fewer negative emotions during interactions at follow‐up than wives in the control condition. Finally, negative associations between positive emotions in interactions and severity of disagreements were stronger for wives assigned to the intervention, while positive associations between negative emotions in interactions and severity of disagreements were weaker for wives assigned to the intervention. Implications for future research and intervention development are discussed.     

Conflict and support interactions in marriage: An analysis of couples’ interactive behavior and on‐line cognition

The present study examined the similarities and differences in couples’ interactive behavior and interaction‐based cognition that emerged in comparisons of conflict and support interactions in marriage. In a laboratory experiment, 53 couples were randomly assigned to the conditions of a 2 (type of interaction: conflict vs. support) × 2 (initiator of interaction: man vs. woman) factorial design. Partners provided questionnaire data and participated in a joint interaction and video review task. The data revealed substantial behavioral similarities (i.e., some classes of validation/facilitation behaviors and neutral problem‐solving behaviors) as well as behavioral differences (i.e., some classes of invalidation/oppositional behaviors) between conflict and support interactions, controlling for levels of marital satisfaction. Partners’ interaction‐based cognition (e.g., feeling understood, satisfied) was especially affected by classes of validation/facilitation behaviors and was consistently related to marital satisfaction. In broad terms, the impact of a particular behavior on partners’ ongoing cognition did not depend on the interaction domain (conflict vs. support) in which the behavior occurred.     

Investigating Inter-Christian and Intercultural Couples Associated with the Greek Orthodox Archdiocese of America: A Qualitative Research Project

This qualitative research project described individual, marital, and family challenges from the perspective of 376 intermarried respondents associated with the Greek Orthodox Archdiocese of America. Participants' observations generally suggested that their religious and cultural differences enriched their own and their family's well-being. However, some participants described pervasive and lingering unresolved couple disagreements linked to their religious and cultural differences. These differences seemed to have a decidedly negative impact on individual, couple, and family well-being. Clinical implications suggest that intermarried couples' different religious and cultural backgrounds may be interconnected to the presenting problem(s) of couples.     

Methodological issues in growth‐curve analyses with married couples

Because longitudinal data are increasingly being used to test predictions regarding close relationships, researchers are also increasingly being confronted with methodological issues unique to the analysis of longitudinal data. In this paper, four issues in conducting growth‐curve analyses with married couples are examined: assessing statistical assumptions about homoscedastic and independent errors, handling information about missing data, dealing with couples with only one assessment, and estimating quadratic effects. Each issue is illustrated with actual data, and syntax from the multilevel module in LISREL 8.52 is provided for specific analyses. Guidelines are presented for helping researchers think through each issue with their own data set.     

Perceived antecedents of marital satisfaction among Turkish,Turkish‐Dutch,and Dutch couples

We studied mainstream couples in The Netherlands and Turkey as well as Turkish‐Dutch immigrant couples to address cultural factors associated with marital satisfaction. A total of 13 Turkish (mainstream couples living in Turkey), 19 Turkish‐Dutch (Turkish immigrant couples living in The Netherlands), and 17 Dutch (mainstream couples living in The Netherlands) married dyads (total of 98 individuals) were independently interviewed about positive and negative characteristics of marriages, determinants of general marital satisfaction and dissatisfaction, spousal communication, marital conflict, and marital roles. Multivariate tests revealed ethnic group differences on all marriage‐related domains except the conflict resolution strategies. However, univariate analyses showed differences in few themes within domains; main differences were assessed between the Turkish/Turkish‐Dutch (who put more emphasis on children and economical aspects) and Dutch couples (who put more emphasis on behavior, and personality of the spouse, reciprocity, emotional sharing, and psychological roles). Turkish‐Dutch couples were more similar to Turkish than to Dutch couples. Results were discussed in light of the socioeconomic development and cultural value theories, which are believed to provide a useful framework for understanding the role of culture in marital satisfaction.     

Finer Distinctions: Variability in Satisfied Older Couples’ Problem‐Solving Behaviors

This study utilized observational and self‐report data from 64 maritally satisfied and stable older couples to explore if there were meaningful differences in how couples approached marital disagreements. Using a typology approach to classify couples based on their behaviors in a 15‐minute problem‐solving interaction, findings revealed four types of couples: (1) problem solvers (characterized by both spouses’ higher problem‐solving skills and warmth), (2) supporters (characterized by both spouses’ notable warmth), (3) even couples (characterized by both spouses’ moderate problem‐solving skills and warmth), and (4) cool couples (characterized by both spouses’ greater negativity and lower problem‐solving skills and warmth). Despite the differences in these behaviors, all couples had relatively high marital satisfaction and functioning. However, across nearly all indices, spouses in the cool couple cluster reported poorer marital functioning, particularly when compared to the problem solvers and supporters. These findings suggest that even modest doses of negativity (e.g., eye roll) may be problematic for some satisfied couples later in life. The implications of these typologies are discussed as they pertain to practitioners’ efforts to tailor their approaches to a wider swath of the population.     

When the “U” is not Inverted: Trajectories of Expressed Emotional Arousal Predict Relationship Satisfaction

Maladaptive emotional reactivity and dysfunctional communication during couple conflict are both destructive to couple functioning, and observational research has elucidated how conflict escalates. However, much of the evidence is based on measures that combine content (i.e., what was said) and the emotion with which it was said, which are then examined using sequential analyses. Despite the general presumptions about underlying emotional reactivity and escalation in negative emotions as part of relationship distress and deterioration, little empirical data are available that directly examine these continuous shifts in emotions. The current study examined concurrent and longitudinal associations between relationship satisfaction and trajectories of change in vocally expressed emotional arousal during couple conflict in 62 couples who participated in a relationship education program. Contrary to expectations and patterns found in distressed couples, trajectories followed a U‐shape rather than an inverted U‐shape curve, with steeper and more persistent decreases in emotional arousal predicting more stable relationship satisfaction over time. In addition, there were within‐couple effects. These results suggest that early signs for relationship deterioration may be less in the form of overt escalation as would be seen in distressed couples. Instead, couples who subsequently deteriorate more are less effective in calming emotional arousal. They also are less able to remain at lower emotional arousal. It is possible that the more pronounced escalation toward the end of the conversation in more at‐risk couples is a precursor of the greater escalation patterns seen in distressed couples; this should be examined empirically. Limitations and implications are discussed.     

Empathic accuracy and cognitions during conflict: An in‐depth analysis of understanding scores

Empathic accuracy research indicates that partners achieve only moderate success at reading each other's thoughts. The current study identifies specific patterns of online thought that contribute to empathic inaccuracy during conflict interactions. Married/cohabiting partners completed a conflict interaction and reported their own thoughts during video‐assisted recall of the interaction, also inferring the thoughts of the other partner. Content analysis of these online thoughts demonstrated a high degree of mindfulness about the process of communication, along with a perspective bias, in which partners tended to construe their own communication as constructive and the other partner's communication as avoidant and confrontational. Specific mind‐reading errors linked to both the thematic content and affective tone of online thought predicted lower overall empathic accuracy.     

Topics of Marital Conflict in the Everyday Lives of Empty Nest Couples and Their Implications for Conflict Resolution

To improve our understanding of marriage experiences during midlife, diary reports of naturalistic marital conflict were collected from 55 couples who were parents of grown children who had left the home. Communication, chores, and habits were the most frequent sources of disagreements reported by husbands and wives. Hierarchical linear models tested the unique associations between multiple conflict topics and interaction characteristics (length, recurrence, initiator, and importance) and constructive, angry, and depressive resolution strategies. Husbands and wives similarly rated money and habits as recurrent topics and conflicts concerning money and children as holding relatively high levels of current and long-term importance to the relationship. Compared with other topics, husbands and wives consistently perceived conflicts concerning habits and communication as being handled in relatively angry ways (e.g., defensiveness) and marital conflicts about children as eliciting greater depressive conflict (e.g., withdrawal, sadness). Husbands also viewed conflicts concerning relatives and commitment as being handled in relatively depressive ways. The findings explicate substantive sources of midlife marital disagreements and offer future research and clinical directions.     

The experiences of therapists using a new client‐centred psychometric instrument,PSYCHLOPS (Psychological Outcome Profiles)

PSYCHLOPS (‘Psychological Outcome Profiles’) is a newly developed client‐generated psychometric instrument which can be used as an outcome measure. Uniquely, it asks clients to state their own problems, in their own words. As part of its validation, we used it alongside an existing measure, CORE‐OM (‘Clinical Outcomes Routine Evaluation – Outcome Measure’). Based on a qualitative methodology, we report here on the first‐hand experiences of four therapists using both instruments. The key themes that emerged from therapists’ responses were feasibility, validity and usefulness. Both questionnaires were perceived as complementing each other, the qualitative information from PSYCHLOPS balancing the quantitative information from CORE‐OM and that both could contribute to the therapist‐client interaction. The key features of PSYCHLOPS are likely to prove attractive to therapists and should increase acceptance and uptake of outcome measures.     

More than One Way to Get There: Pathways of Change in Coparenting Conflict after a Preventive Intervention

This study explored pathways of change in the levels of conflict couples experienced after Supporting Father Involvement, an evidence‐based, prevention‐oriented couples and parenting intervention that included a diverse low‐income and working class group of participants. Pathways of change were examined for couples with baseline conflict scores that were initially low, medium, and high. The growth mixture model analysis found that the best‐fitting model for change in couples' conflict was represented by three distinctly different change patterns. The intervention was most successful for High‐Conflict couples. This finding contributes to a growing literature examining variations in how relationships change over time and the process of change, especially for couples in distress. This study supports further investigation into the impact and costs associated with universal interventions versus those that target specific groups of higher risk families.     

Marital conflict patterns: Links with family conflict and family members’perceptions of one another

The goal of this study was to explore the effects of marital conflict on conflict patterns in the family, and on family members’perceptions of one another. Sixty‐eight two‐parent families with adolescent twins participated, with parents reporting on the conflict patterns used by the marital dyad, and by themselves in interaction with each of their twins, and adolescent twins reporting on their interactions with each other. In addition, all four family members engaged in a videotaped decision‐making interaction and then made global ratings of each other on five dimensions. Links were obtained between marital conflict patterns and parent‐child conflict patterns, and between parent‐child conflict patterns and those used in sibling relationships. In contrast, marital conflict patterns were unrelated to sibling conflict patterns. Similarly, links were found between marital conflict and fathers’perceptions of their children, and between father‐child conflict and children's perceptions of each other. The results are discussed in terms of theoretical models of conflict resolution and the transmission of conflict patterns within the family.     

How job demands affect partners' experience of exhaustion: integrating work-family conflict and crossover theory

This study among 168 couples of dual-earner parents uses insights from previous work-family conflict and crossover research to propose an integrative model delineating how job demands experienced by men and women carry over to the home domain. The authors hypothesized that for both men and women, job demands foster their own work-family conflict (WFC), which in turn contributes to their partners' home demands, family-work conflict (FWC), and exhaustion. In addition, they hypothesized that social undermining mediates the relationship between individuals' WFC and their partners' home demands. The results of structural equation modeling analyses provided strong support for the proposed model. The hypothesis that gender would moderate the model relationships was rejected. These findings integrate previous findings on work-family conflict and crossover theories and suggest fluid boundaries between the work and home domains.     

Coping with work and family: How do dual‐earners interact?

Juggling the demands of both work and family has become increasingly difficult, especially for dual‐earner households; nevertheless, families have developed strategies to deal with work‐family challenges. This paper uses couple level analyses (APIM models) with 100 dual‐earner couples to provide insight about partners' mutual influence on the use of work‐family coping strategies. The results show that women's use of coping strategies is more associated with work‐family conflict and work‐family enrichment than men's coping. In addition, using partner coping, having a positive attitude towards multiple roles, using planning and management skills and avoiding having to cut back on professional responsibilities is associated with better outcomes (more enrichment and less conflict). Surprisingly, the use of childcare facilities is associated with women's conflict and partner effects were only found concerning the use of management and planning skills. These skills, however, have distinct effects for men and women's outcomes: their use by men reduces their own conflict but increases their wives', while their use by women decreases their own conflict and increases their own and their partner's enrichment. These results point to the fact that gender roles continue to be a hallmark of work‐family issues. Our design and results point out the need for new interventions that take couple interdependences into account.     

When Harry and Sally met Dick and Jane: Creating closeness between couples

This study investigated how friendships between couples form and implications for within‐couple process. Sixty couples were randomly assigned to 1 of 2 conditions where they engaged in a 45‐min interaction with another couple. In 1 condition, couples carried out self‐disclosure tasks; in the other, couples engaged in nonemotional small talk. Compared to the small‐talk condition, those in the high‐disclosure condition felt closer to the couples they interacted with and were more likely to meet up with them again during the following month. Further, couples in the high‐disclosure condition felt closer to their own partners. Actor–partner interdependence model analyses showed these effects to be mediated by increases in positive affect. Implications for studying the interplay of social networks and romantic relationships are discussed.     

Attachment and spousal caregiving

A community sample of 362 married couples participated in a study of attachment and spousal caregiving, which combined qualitative and quantitative components. The qualitative component focused on actual experiences of caregiving, assessed by participants' semi‐structured accounts of a situation involving their role as caregiver for their spouse. Attachment styles and their underlying dimensions (comfort with closeness, anxiety over relationships) were related to the type of support provided, the coping strategies used in the situation, caregivers' feelings about the quality of their care, perceived effects on the couple bond, and the emotional tone of the accounts. The quantitative component tested a theoretical model of factors predicting willingness to provide care for the spouse if he or she should become dependent in later life. Measures of attachment and caregiving styles, attachment to spouse, and anticipated burden provided reliable prediction of willingness to care. The results support the conceptualization of attachment and caregiving as interrelated features of marital bonds, and they have important implications for patterns of family caregiving.     

Studying Multivariate Change Using Multilevel Models and Latent Curve Models

In longitudinal research investigators often measure multiple variables at multiple points in time and are interested in investigating individual differences in patterns of change on those variables. In the vast majority of applications, researchers focus on studying change in one variable at a time. In this article we consider methods for studying relations1.1ips between patterns of change on different variables. We show how the multilevel modeling framework, which is often used to study univariate change, can be extended to the multivariate case to yield estimates of covariances of parameters representing aspects of change on different variables. We illustrate this approach using data from a study of physiological response to marital conflict in older married couples, showing a substantial correlation between rate of linear change on different stress-related hormones during conflict. We also consider how similar issues can be studied using extensions of latent curve models to the multivariate case, and we show how such models are related to multivariate multilevel models.     

原生家庭父母冲突、 夫妻冲突解决模式与婚姻质量的关系:基于主客体互倚模型的分析

采用问卷调查法,对263对夫妻的原生家庭父母冲突、 夫妻冲突解决模式和婚姻质量进行测量.结果表明,(1)个体的原生家庭父母冲突与自身以及配偶的婚姻质量呈显著负相关;(2)丈夫的原生家庭冲突可以预测自身以及妻子的冲突解决模式,妻子的原生家庭冲突可预测丈夫的冲突解决模式;(3)丈夫夫妻冲突解决模式在双方原生家庭父母冲突对自...