Couples with Intimate Partner Violence Seeking Relationship Help: Associations and Implications for Self‐Help and Online Interventions

In‐person conjoint treatments for relationship distress are effective at increasing relationship satisfaction, and newly developed online programs are showing promising results. However, couples reporting even low levels intimate partner violence (IPV) are traditionally excluded from these interventions. To improve the availability of couple‐based treatment for couples with IPV, the present study sought to determine whether associations with IPV found in community samples generalized to couples seeking help for their relationship and whether web‐based interventions for relationship distressed worked equally well for couples with IPV. In the first aim, in a sample of 2,797 individuals who were seeking online help for their relationship, the levels and correlates of both low‐intensity and clinically significant IPV largely matched what is found in community samples. In the second aim, in a sample of 300 couples who were randomly assigned to a web‐based intervention or a waitlist control group, low‐impact IPV did not moderate the effects of the intervention for relationship distress. Therefore, web‐based interventions may be an effective (and easily accessible) intervention for relationship distress for couples with low‐intensity IPV.     

An approach to preventing coparenting conflict and divorce in low-income families: strengthening couple relationships and fostering fathers' involvement

In the context of current concern about levels of marital distress, family violence, and divorce, the SFI study is evaluating the effectiveness of an intervention to facilitate the positive involvement of low-income Mexican American and European American fathers with their children, in part by strengthening the men's relationships with their children's mothers. The study design involves a randomized clinical trial that includes assignment to a 16-week couples group, a 16-week fathers group, or a single-session control group. Couples in both group interventions and the control condition include partners who are married, cohabiting, and living separately but raising a young child together. This article presents the rationale, design, and intervention approach to father involvement for families whose relationships are at risk because of the hardships of their lives, many of whom are manifesting some degree of individual or relationship distress. We present preliminary impressions and qualitative findings based on our experience with 257 families who completed the pretest, and the first 160 who completed one postintervention assessment 9 months after entering the study. Discussion centers on what we have learned and questions that remain to be answered in mounting a multisite preventive intervention to strengthen relationships in low-income families.     

Relationship quality promotes the desire for closeness among distressed avoidantly attached individuals

Individuals who experience attachment avoidance tend to desire less closeness in their romantic relationships than others, especially when experiencing distress. However, emerging research suggests that avoidant individuals value social closeness and are more comfortable with it when they perceive that seeking closeness is welcomed. Thus, this research examined the relationship characteristics that might predict avoidant individuals seeking more closeness than they would otherwise. We investigated whether perceiving their relationship to be high quality would predict avoidant individuals desiring more closeness when distressed. We hypothesized that avoidant individuals who perceived their relationship to be high quality would desire greater closeness with their partners when distressed—counteracting their tendency to eschew relational closeness. A study of dating couples supported this hypothesis.     

Improving Young Male Couples’ Sexual and Relationship Health in the 2GETHER Program: Intervention Techniques,Environments of Care,and Societal Considerations

Young male couples are at high risk for acquiring human immunodeficiency virus (HIV). However, few HIV prevention programs meet the needs of young male couples that express an interest in how to maintain healthy relationships. As such, we developed 2GETHER, a couple-based program that integrates HIV risk reduction and sexual health information into a relationship education program specific to young male couples. 2GETHER was guided by cognitive-behavioral theories of HIV risk reduction and relationship functioning and was informed by a social–ecological perspective to address factors within and outside the couple that can impact sexual and relationship health. As a micro-level intervention, 2GETHER intervenes directly with couples via psychoeducation and cognitive-behavioral strategies to change couples’ communication patterns, sexual health behaviors, and relationship satisfaction. Successful implementation of 2GETHER requires mezzo-level interventions that create an affirming environment of care for sexual minority individuals and facilitators who are culturally competent in working with young male couples. Although macro-level interventions to change societal acceptance of and policies germane to sexual minority couples are beyond the scope of 2GETHER, we discuss how clinicians can advocate for systemic changes to improve sexual minority couples’ health, and how 2GETHER addresses the impact of such macro-level factors on the couple’s relationship. Our experience developing and testing 2GETHER indicates that HIV prevention programs for young male couples should reflect the unique contexts shaping sexual minority individuals’ relationships and lives, and that programs should intervene within and across multiple levels when possible to improve health for sexual minority men.     

The Relationship Between Social Support and Family Relationships Among Low-Income Couples Attending Relationship Education

Results are mixed for relationship education (RE) interventions with low-income couples. For couples who experienced positive changes, it is not clear what aspects of program models contributed to change. Many low-income couples attend government-funded RE with limited access to social and community resources. Program models often provide related resources complimentary to RE skill-building. We examined the relationship between income, social support, and family functioning for low-income, ethnically diverse couples (N = 856) who attended RE, as well as the mediating effects of social support on family functioning outcomes. Analyses included three separate dyadic models that examined associations among constructs at baseline and immediately following the RE intervention. Results demonstrated relationships between participants’ reported social support and family functioning such that (a) social support was associated with baseline family functioning for both men and women; (b) men’s baseline social support was influenced by women’s baseline family functioning; and (c) men’s and women’s social support change score had a positive influence on their own family functioning change score. However, social support was not a significant mediator of change in family functioning. Implications for RE practice and research are also discussed.     

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.     

Contextual Influences on Marriage

Abstract— Current proposals to promote and strengthen marriage among low-income populations focus on values and behavioral skills as primary targets of intervention. Marital research that examines contextual influences on marriage calls these emphases into question. Ethnographic and survey research reveal no evidence that populations experiencing higher rates of divorce value healthy marriages any less than other populations do. Longitudinal and observational research reveals two mechanisms through which the environment of a marriage may enhance or constrain effective relationship maintenance. First, some environments contain fewer sources of support and pose more severe challenges than others, presenting marriages in those environments with greater burdens than marriages in more supportive environments are faced with. Second, when demands external to the marriage are relatively high, even couples with adequate coping skills may have difficulty exercising those skills effectively. Together, such findings suggest that successful policies and interventions to strengthen marriages need to acknowledge the environments within which marriages take place.     

Comparing educational interventions: Correcting misperceived norms improves college students' mental health attitudes

This research targeted potential psychological contributors to college students' low levels of help‐seeking for mental distress using a field experiment. Researchers randomly assigned 520 undergraduates to 15‐min interventions: a novel, theory‐driven social norms intervention correcting misperceived distress, stigma, and help‐seeking norms; a general education intervention increasing mental health awareness; and a stress management active control condition. The norms intervention instilled more accurate perceptions of mental health norms and temporarily reduced perceived public stigma compared to other conditions. The norms and general education interventions improved attitudes toward seeking help for mental distress for at least 2 months, relative to the control. Effects on help‐seeking behavior were not observed in this timeframe. This research elucidates the robustness of brief social psychological mental health interventions on college campuses.     

The marriage checkup: increasing access to marital health care

Despite the ongoing prevalence of marital distress, very few couples seek therapy. Researchers and clinicians have increasingly been calling for innovative interventions that can reach a larger number of untreated couples. Based on a motivational marital health model, the Marriage Checkup (MC) was designed to attract couples who are unlikely to seek traditional tertiary therapy. The objective of the MC is to promote marital health for as broad a population of couples as possible, much like regular physical health checkups. This first paper from the largest MC study to date examines whether the MC engaged previously unreached couples who might benefit from intervention. Interview and survey data suggested that the MC attracted couples across the distress continuum and was perceived by couples as more accessible than traditional therapy. Notably, the MC attracted a substantial number of couples who had not previously participated in marital interventions. The motivational health checkup model appeared to encourage a broad range of couples who might not have otherwise sought relationship services to deliberately take care of their marital health. Clinical implications are discussed.     

Marriage in India: Clinical Issues

This article considers some of the common issues with which marital couples in India struggle. These issues arise from the way that Indian families are typically structured and the rules that govern family relationships. Ideas from the social constructionist and contextual approaches are suggested as helpful interventions.     

ROMANTIC PARTNERS' COPING STRATEGIES AND PATTERNS OF CORTISOL REACTIVITY AND RECOVERY IN RESPONSE TO RELATIONSHIP CONFLICT

Stress in close relationships can have significant negative consequences for mental health, physical health, and long-term relationship functioning. Dysregulated physiological responses to stress are potential pathways through which relationship stress may lead to these kinds of outcomes, and the ways in which individuals attempt to cope with relationship stress are likely to impact their physiological responses. However, our understanding of the specific coping strategies that predict physiological reactivity and recovery in these contexts is rather limited. This study explored relations between young adult college students' self-reported methods of coping with stress in their romantic relationships and their physiological reactivity to and recovery from negotiating conflict with their romantic partners. Partners' coping styles were also examined as predictors of physiological stress responses. One hundred and ninety opposite-sex couples (N = 380; modal length of relationship = 1-2 years) participated in an experimental conflict discussion task. Physiological stress reactivity to the task was assessed using salivary cortisol, a primary hormonal product of the hypothalamic-pituitary-adrenocortical (HPA) axis. Growth modeling of the cortisol levels before, during, and after the conflict task indicated that men who typically coped with relationship stress by seeking social support showed greater physiological reactivity to the conflict task. Partners' need for social support predicted stronger stress responses for both men and women, as well. While seeking social support is generally thought to be an adaptive coping strategy for couples, the results suggest that within the context of conflict negotiation in which receiving and providing support may be more difficult, seeking support from a partner is associated with greater phyisological stress.     

Protective Buffering by Service Members During Military Deployments: Associations with Psychological Distress and Relationship Functioning

To shield a romantic partner from potential distress due to stressors occurring during deployment, service members (SMs) may engage in protective buffering, or withholding information or concerns from a romantic partner. This study utilized data from 54 couples collected before, during, and after a military deployment to assess whether SMs engaged in protective buffering while deployed and the possible associations between buffering and psychological, relationship, and contextual factors. Only 2% of SMs indicated never engaging in protective buffering during a deployment. In bivariate analyses, only partners’ psychological distress prior to deployment was significantly associated (negatively) with protective buffering. In multilevel models with time nested within individuals, and individuals nested within couples, higher buffering was associated with less partner distress during deployment, but was also associated with higher SM distress both during and after deployment. In these multilevel models, protective buffering was not significantly associated with SM or partner marital satisfaction.     

The impact of interpersonal affective relationships and awareness on expertise seeking: A multilevel network investigation

Transactive memory theory suggests that general awareness of expertise location in a group is sufficient to predict expertise seeking. Yet expertise seeking is, at least in part, a social phenomenon between two individuals embedded in a network of social relationships. Taking a multilevel, network perspective, we examined the interplay of affective relationships and awareness on expertise seeking in groups. Hypotheses were tested using network data collected from 693 employees in 53 sales groups. HLM analysis results indicated that awareness of expertise distribution positively influenced the decision to seek expertise at all levels of analysis examined. In addition, both positive and negative affective relationships influenced expertise seeking, although their pattern of influence differed across different levels of analysis. More specifically, having either a positive or a negative affective relationship with another group member affected the decision to seek expertise from that person. Although having many positive relationships had a positive effect on expertise seeking, having many negative affective relationships had no effect. Moreover, having both an awareness and a positive affective relationship with another group member amplified their positive effect on expertise seeking. Last, individuals who had more negative affective ties were less likely to leverage the positive impact of each awareness relationship on expertise seeking.     

Establishing family foundations: intervention effects on coparenting, parent/infant well-being, and parent-child relations.

This study investigated the ability of a theoretically driven, psychosocial prevention program implemented through childbirth education programs to enhance the coparental relationship, parental mental health, the parent-child relationship, and infant emotional and physiological regulation. A sample of 169 heterosexual, adult couples who were expecting their 1st child was randomized to intervention and control conditions. The intervention families participated in Family Foundations, a series of 8 classes, delivered before and after birth, that was designed as a universal prevention program (i.e., it was applicable to all couples, not just those at high risk). Intent-to-treat analyses indicated significant program effects on coparental support, maternal depression and anxiety, distress in the parent-child relationship, and several indicators of infant regulation. Intervention effects were not moderated by income, but greater positive impact of the program was found for lower educated parents and for families with a father who reported higher levels of insecure attachment in close relationships. These findings support the view that coparenting is a potentially malleable intervention target that may influence family relationships as well as parent and child well-being.     

Maintenance of Gains in Relationship and Individual Functioning Following the Online OurRelationship Program

In the United States, more than 40% of marriages end in divorce and more than one third of intact marriages are distressed. Unfortunately, only a minority of couples seek couple therapy to improve their relationships. Online interventions, with their increased reach and reduced costs, offer the potential to improve relationships nationwide. The online OurRelationship program has been shown in previous nationwide studies to improve relationship and individual functioning. The present study examined whether initial gains in the OurRelationship program were maintained in the following year and whether the extent of maintenance varied across important demographic and individual factors. In this study, 151 distressed heterosexual couples (302 individuals) who were randomized to the OurRelationship program were assessed 3 and 12 months following the intervention. Initial gains in relationship satisfaction, relationship confidence, and negative relationship quality were maintained through 12 months; positive relationship quality significantly improved over follow-up. Furthermore, couples maintained their initial gains in depressive symptoms, perceived health, work functioning, and quality of life; anxious symptoms continued to significantly decrease over follow-up. Finally, there was no evidence that historically underserved groups—racial/ethnic minorities, lower income couples, or rural couples—experienced greater deterioration. In fact, Hispanic couples reported continued improvement in relationship confidence and negative relationship quality in the 12 months following the program. The ability of the OurRelationship program—an 8-hour, primarily self-help program—to create long-lasting improvements in distressed relationships indicates it may have the potential to improve the lives of distressed couples on a broad scale.     

Predictors of relationship adjustment among couples coping with a high risk of developing breast/ovarian cancer

This study investigated the association between supportive and collaborative processes and dyadic adjustment in 94 women at increased risk of breast/ovarian cancer and their partners. Participants were recruited through two familial cancer clinics. They completed mailed, self-report questionnaires that included measures of psychological distress, dyadic adjustment (consensus, cohesion and satisfaction) and couple predictor variables (perceived support and team approach). Most couples reported average-to-high levels of consensus, cohesion and satisfaction, with a small proportion of couples (6.4%) reporting scores that reached clinically significant levels of dyadic distress. Greater perceived support was associated with better dyadic consensus and satisfaction, and dyadic cohesion and satisfaction were higher among couples who reported greater use of a team approach. General distress did not moderate the association between dyadic coping and relationship quality. There were no significant relationships between intra-couple congruence on support or team approach, and dyadic adjustment. Most couples had a functional relationship in the face of the current health stressor, although a subgroup may be at elevated risk of negative psychological consequences, including further relationship strain. The results highlight that dyadic coping strategies are important factors involved in the quality of couples' relationship following genetic counselling for breast/ovarian cancer risk.     

The indirect effect of contextual factors on the emotional distress of infertile couples

Few studies were dedicated to study the role of contextual factors, such as the socioeconomic status and urban or rural residence in emotional distress of infertile couples. This study aimed to explore the impact of contextual factors on emotional distress, either directly or by affecting the importance of parenthood in one's life, which in turn affects emotional distress. In this cross-sectional study, 70 couples recruited during hormonal stimulation phase prior to in vitro fertilisation completed clinical and sociodemographic forms and self-report questionnaires assessing representations about the importance of parenthood and emotional distress. Path analysis using structural equation modelling was used to examine direct and indirect effects among variables. Results indicated that socioeconomic status and place of residence had an impact in emotional distress by affecting the representations about the importance of parenthood in one's life. Gender differences were found regarding model paths, suggesting that the social context may have a stronger influence on women's emotional distress than on their partners’ distress. When delineating psychological interventions, health care providers should consider that cultural values about children and parenthood contribute to shape the infertility experience.     

Female‐demand/male‐withdraw communication in Argentinian couples: A mediating factor between economic strain and relationship distress

Based on a dyadic version of R. D. Conger and colleagues' stress model, this study examined whether the demand/withdraw pattern in couples' communication mediates the association between partners' economic strain and their level of relationship distress. Data were from self‐report questionnaires completed by 144 heterosexual couples seeking psychotherapy at a community clinic in Argentina 3 years after a major national economic crisis. As hypothesized, results from a path model analysis suggested that (a) regardless of provider role, females tended to experience more economic strain than males did; (b) the female‐demand/male‐withdraw pattern, but not the male‐demand/female‐withdraw pattern, mediated the positive association between economic strain and relationship distress; and (c) both partners' levels of relationship distress were affected by both patterns of demand/withdraw communication. Gender differences are discussed based on the gender role expectations in Argentina and the stress coping and demand/withdraw communication literatures. Study limitations and implications of the findings for research, programmatic approaches, and therapeutic interventions for couples under economic stress are considered. This study makes important contributions to our understanding of gender differences and the role of demand/withdraw communication in couples' responses to economic strain.     

Distress in couples coping with cancer: a meta-analysis and critical review of role and gender effects

Research concerning distress in couples coping with cancer was integrated using meta-analysis and narrative critical appraisal. Individual levels of distress were determined more by gender than by the role of being the person with cancer versus that person's partner. That is, women reported consistently more distress than men regardless of their role (standardized mean difference = 0.31). The association between patient and partner distress within couples was only moderate (r = .29) but is sufficient to warrant further consideration of the notion that these couples react as an emotional system rather than as individuals. It is noteworthy that this association is not moderated by gender. With a general lack of comparison groups, the question of how much distress can be ascribed to the cancer experience cannot be answered decisively; elevations in distress are probably modest. We critically discuss these results, identify important unanswered questions, and indicate directions for future research. Attention needs to be directed toward factors other than cancer as direct influences of distress in these couples and to mediators and moderators of the cancer experience.     

Heteronormative Relationship Education for Same‐Gender Couples

In recent years, same‐gender group‐based relationship education has emerged as a viable intervention to prevent relationship distress among same‐gender couples. However, many of these programs are conducted in metropolitan areas and lack the ability to reach rural populations. The current study sought to investigate whether two wide‐reaching web‐based heteronormative relationship education programs could positively impact same‐gender relationships. In a sample of 49 same‐gender couples, heteronormative relationship education had small (Cohen's d = 0.16–0.39) but reliably positive effects on key areas of relationship functioning and perceived stress relative to a waitlist control group. Additionally, when same‐gender couples were matched with different‐gender individuals with similar baseline characteristics, no reliable differences between the two groups emerged even though the program effects were sometimes half as large for same‐gender couples. Finally, same‐gender participants were as satisfied with the program as the matched different‐gender individuals. Though the results of the present study indicate that heteronormative relationship education can be helpful for same‐gender couples, additional tailoring should be undertaken to ensure that same‐gender couples experience as much benefit as possible. Estimates from the current study could be used in future studies to detect what might be small‐sized differences.