Commitment: A variable in women's response to marital therapy

Abstract

The relationship between commitment to one's marriage at the onset of therapy and changes during marital therapy was examined. In a sample of 42 couples seeking marital therapy, wives' commitment level accounted for a significant amount of unique variance in marital satisfaction before therapy and gains in marital satisfaction resulting from therapy. In keeping with earlier findings, results for men were less striking, and often nonsignificant. The importance of considering the variable of commitment in marital research is discussed.     

Couples in Therapy: Actor-Partner Analyses of the Relationships Between Adult Romantic Attachment and Marital Satisfaction

This study was the first to investigate the relationship between adult romantic attachment and marital satisfaction in a clinical sample of 172 distressed couples seeking therapy. Fifty-six therapy-seeking nondistressed couples were also assessed for comparison. Analyses of variance showed that attachment avoidance was a distinctive characteristic of distressed couples. Actor-partner analyses revealed that attachment avoidance (for men and women) and attachment anxiety (for women only) were predictive of marital dissatisfaction for distressed couples. Gender-stereotype discordant partner effects were also found. Results suggest that attachment orientations (especially avoidance) are relevant predictors of marital dissatisfaction in distressed couples seeking therapy, and that couple therapists can gain important information by assessing partners’ attachment orientations.     

A comparison of sexually dysfunctional, maritally disturbed and well-adjusted couples

Married couples seeking sex therapy, marital therapy, or no form of therapy were compared with respect to personality, sexual and marital functioning. The Sexual Dysfunction and Marital Difficulties groups (15 and 10 couples respectively) were obtained from the waiting lists of a sexual dysfunction service and marital therapy unit. Non-Problem subjects (15 couples) were from a volunteer sample. Personal adjustment, sexual and marital functioning were assessed by means of the Eysenck Personality Inventory, a Sexual Behavior Questionnaire, the Locke-Wallace Marital Adjustment Survey, and the Azrin Marital Happiness Scale. Results indicated that although all three groups were within the normal range, problem couples had higher ‘neuroticism’ scores than did Non-Problem couples. Marital Problem couples were the most debilitated. Their marital adjustment was lowest, and their sexual functioning was comparable to the Sexual Dysfunction group. Marital adjustment of the Sexual Dysfunction couples was significantly higher than that of the Marital Difficulties couples. Therapeutic and theoretical implications of the differentiating characteristics in the three couple categories are discussed.     

Treatment‐as‐Usual for Couples: Trajectories Before and After Beginning Couple Therapy

Couple therapy has been shown to be a meaningful way to improve couples’ relationships. However, less information is known about couples’ functioning prior to entering treatment in community settings, as well as how their relationship functioning changes from initiating therapy onward. This study examined 87 couples who began community‐based couple therapy during a longitudinal study of couples in the military. The couples were assessed six times over the course of 3 years, including time points before and after starting couple therapy. Using an interrupted‐time series design, we examined trajectories across the start of couple therapy in relationship satisfaction, divorce proneness, and negative communication. The results demonstrated that couples’ relationship satisfaction was declining and both divorce proneness and negative communication were increasing prior to entering couple therapy. After starting couple therapy, couples’ functioning on all three variables leveled off but did not show further change, but previous experience in relationship education moderated these effects. Specifically, those who were assigned to the relationship education program (vs. control) demonstrated greater reductions in divorce proneness and greater increases marital satisfaction after starting therapy; however, they also started more distressed.     

Unrealistic beliefs of clinical couples: Their relationship to expectations,goals and satisfaction

Abstract

Forty-seven marital therapy couples completed inventories measuring unrealistic beliefs about self and unrealistic beliefs about marital relationships. In addition, they completed questionnaire measures of their expectations and goals for therapy and their levels of marital satisfaction. As hypothesized, the clients' unrealistic beliefs, particularly those regarding relationships, were negatively associated with their estimated chance for improvement in therapy, desire to improve rather than terminate the relationship, preference for marital versus individually oriented treatment, and overall marital satisfaction. These results are consistent with the theoretical rationale for cognitive therapy with clinical couples and suggest specific targets for intervention in this process. Directions for future research are discussed.     

Using Acceptance and Commitment Therapy to Treat Distressed Couples: A Case Study With Two Couples

Although the field of couple therapy has made significant strides in recent years, there continues to be a need for theoretically sound and empirically supported treatments. The current case study examines whether Acceptance and Commitment Therapy (ACT), an experiential acceptance-based behavior therapy, can be effective in treating distressed couples. Although ACT has demonstrated effectiveness in treating a variety of disorders in individuals, it has not been systemically applied to the treatment of couple distress, and the current study is the first empirical examination of ACT for the treatment of couples. Two married couples participated in the study. A number of core ACT interventions were modified to treat couples in a conjoint format. Cognitive defusion exercises were used to help couples reduce their fusion with and the believability of negative thoughts and feelings related to the relationship. Mindfulness and acceptance techniques were used to help couples increase awareness of their reactions to negative relationship cycles. Finally, value-directed action was used to help partners act in ways consistent with relationship values even in the presence of unwanted thoughts and feelings. The results of this preliminary case study suggest that ACT may be effective in increasing marital adjustment and satisfaction, and in reducing interpersonal and psychological distress in couples. Future studies with larger samples and more controlled designs are needed to build on the results from this single-case study.     

The Seven-Item Short Form of the Dyadic Adjustment Scale: Further Evidence for Construct Validity

Two studies examine psychometric aspects of the seven-item version of the Dyadic Adjustment Scale (DAS) (Spanier, 1976). In Study 1, data from 148 heterosexual clients seeking marital therapy services and 122 heterosexual couples in the community were used to assess the criterion validity of the DAS-7. The measure differentiated between clinic and community participants and between marriages classified as distressed or adjusted based on the full DAS score. In Study 2, the reliability and convergent validity of the DAS7, when administered as a separate scale, was assessed in a community sample of 162 participants who were married or were in cohabiting heterosexual relationships. Obtained values were comparable to those reported in previous research in which the DAS-7 was obtained by extracting items from participants' full DAS. These results demonstrate that the DAS-7 is a psychometrically sound short form for assessing marital adjustment.     

Relationship factors in the treatment of sexual dysfunction

The role of marital harmony in the development, assessment and treatment of sexual dysfunction is addressed in the present study. Twelve couples with mixed sexual dysfunctions received both sex therapy and marital therapy in a balanced cross-over design. The major variables investigated were therapy outcome on measures of sexual satisfaction and marital adjustment as a function of treatment modality (sexual or marital) and relationship functioning. Findings showed significant differences in outcome between treatment approaches with a strong mediating effect of relationship factors. Limited interpersonal understanding and inaccurate perceptual agreement in relationship functioning characterized those couples who failed to exhibit a differential response to treatment in favour of sex therapy over marriage therapy. Implications of these findings for the assessment and treatment of sexual dysfunction are discussed.     

Multiplicity Within and Between: Addressing Multiple Roles Through Role Profiles in Couples

The purpose of this study is to test the validity of a personality assessment, Role Profiles, by exploring the relationship between role balance and individual well-being and the relationship between couples’ role profiles similarity and their marital satisfaction. Twenty couples were recruited and completed the assessments. This study partially supported Role Profiles’ validity and the findings were consistent with previous studies: individuals with higher role confusion were more likely to report lower self-esteem, and couples who shared many identical roles in their roles profiles were more likely to report higher marital satisfaction. The utility of Role Profiles as a clinical assessment in couples therapy is discussed.     

Couples in marital distress: a study of personality factors as measured by the MMPI-2

This study examines the relationship between Minnesota Multiphasic Personality Inventory-2 (MMPI-2) measured personality characteristics and marital distress and provides empirical validation for using the MMPI-2 with a marital therapy population. Studied were 150 couples in marital therapy and 841 normal couples who participated in the MMPI-2 restandardization study. The MMPI-2, a biographical form, a partner rating form, and the Dyadic Adjustment Scale (DAS) were administered to all couples. The marital counseling group resembled previous marital counseling samples studied with the MMPI and scored significantly higher than the normative sample on several MMPI-2 scales. Relationships between the DAS and MMPI-2 clinical and content scale scores are reported. The Psychopathic Deviate (Pd) clinical scale and Family Problems (FAM) content scale were the most powerful group discriminators and strongest correlates of the DAS; their use as indices of marital distress is tested. The meaning of Pd as an index in assessing personality factors in marital distress is explored.     

Developmental Changes in Content of Movement Responses

This study examines the relationship between Minnesota Multiphasic Personality Inventory-2 (MMPI-2) measured personality characteristics and marital distress and provides empirical validation for using the MMPI-2 with a marital therapy population. Studied were 150 couples in marital therapy and 841 normal couples who participated in the MMPI-2 restandardization study. The MMPI-2, a biographical form, a partner rating form, and the Dyadic Adjustment Scale (DAS) were administered to all couples. The marital counseling group resembled previous marital counseling samples studied with the MMPI and scored significantly higher than the normative sample on several MMPI-2 scales. Relationships between the DAS and MMPI-2 clinical and content scale scores are reported. The Psychopathic Deviate (Pd) clinical scale and Family Problems (FAM) content scale were the most powerful group discriminators and strongest correlates of the DAS; their use as indices of marital distress is tested. The meaning of Pd as an index in assessing personality factors in marital distress is explored.     

The Longitudinal Association of Marital Confidence,Time Spent Together,and Marital Satisfaction

Using three waves of dyadic data collected at 18‐month intervals from a community‐based sample of 610 newly married heterosexual couples (1 220 individuals), we examined the relationship between marital confidence, time spent together, and marital satisfaction using a modified actor‐partner interdependence model. Results indicate that after controlling for marital satisfaction and time spent together at Time 1, marital confidence around the time of marriage was associated with marital satisfaction approximately 3 years later. In addition, marital confidence was associated with how much time husbands and wives spent together at Time 2, which was related to marital satisfaction at Time 3. Tests of the mediating paths from marital confidence to marital satisfaction trended toward significance. The results suggest the importance of assessing for relationship confidence when working with couples in the early stages of their relationship.     

The Meta Marriage: Links Between Older Couples' Relationship Narratives and Marital Satisfaction

Drawing upon a relatively understudied population and a unique observational task, the current study sought to examine how older couples' interactional behaviors during a relationship narrative task were associated with marital satisfaction over time. Using observational data from a sample of 64 older, higher‐functioning married couples, we analyzed a series of Actor–Partner Independence Models (APIM) to explore how couples' interactional behaviors during a relationship narrative task were associated with spouses' marital satisfaction both concurrently and one year later. Analyses revealed that spouses' behaviors (e.g., expressions of positive affect, negative affect, communication skills, engagement) were associated with their self‐reported marital satisfaction both at the time of the narrative and with changes in marital satisfaction. We found particularly robust evidence for the role of husbands' negative affect during the narrative task in predicting changes in both spouses' marital satisfaction over time. Our results indicate that researchers and clinicians should carefully consider the influence of development on the associations between spouses' behaviors and marital satisfaction. Further, those seeking to improve marriages in later life may need to consider the meaningful role that gender appears to play in shaping the marital experiences of older couples.     

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.     

Personality Factors,Attachment Styles and Coping Strategies in Couples with Good and Poor Marital Quality

Marital quality in connection to its demographical and psychological correlates has been studied extensively in the West. In India also, it has been given considerable attention, but adequate exploration of relevant psychological variables is still wanting. The present study was conceptualized in this context to explore differences in the Personality factors, Attachment styles and Coping strategies in couples with good and poor marital quality. Data were collected from 90 couples for initial screening. Finally 20 couples with good marital quality and 20 couples with poor marital quality were selected based on scores of Marital Quality Scale. The tools used for screening were Marital Quality Scale and General Health Questionnaire-28. Other tools consisted of Neo Five Factor Inventory, Attachment style Questionnaire, and Coping Check list. Analysis revealed that the husbands with poor marital quality had higher neuroticism, less extraversion, less secure attachment style, less problem focused coping and acceptance, and greater denial than those with good marital quality. Wives with poor marital quality differed significantly from the wives with good marital quality in terms of less religious coping, acceptance and social support. The findings of the study may be utilized for advising maritally distressed couples by enhancing their coping resources and utilizing attachment potentials for furtherance of quality of married life.     

A Caring Framework for Enhancing Couples Therapy

As couples move away from role oriented patterns of relating they enter a transitional phase where marital expectations are less clearly defined. Frequently couples seeking therapy complain of a lack of caring in their relationships. They also express confusion about the appropriateness of their desire for more caring. In this article the authors present a caring framework based on their research with couples in "vital-total" marriages. They also suggest several ways this caring framework can be used in clinical work with couples.     

Multiple approaches to the treatment of violent couples

Abstract

The relationship of the discrepancy between couple's actual level of intimacy and desired level of intimacy and marital adjustment was explored using data from 185 randomly selected couples who completed the Personal Assessment of Intimacy in Relationships and the Marital Adjustment Test. Multivariate and univariate regression analyses indicated that the discrepancy between actual and desired intimacy of husbands and wives was highly predictive of marital adjustment (R²=.665). Particularly interesting was that couples with low intimacy scores who did not desire more intimacy had good marital adjustment. The relationship between intimacy and marital adjustment was curvilinear, and wives' marital adjustment was more affected by intimacy than husbands'. Implications for marital therapy are discussed.     

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.     

Bidirectional Associations Between Newlyweds' Marital Satisfaction and Marital Problems over Time

Prevailing views of marital functioning generally adopt the view that marital problems predict decreases in marital satisfaction, but alternative theoretical perspectives raise the possibility that lowered satisfaction can also predict increases in problems. The current study sought to integrate and compare these perspectives by examining the bidirectional cross‐lagged associations between newlyweds' reports of their marital satisfaction and marital problems over the first 4 years of marriage. Using annual assessments from 483 heterosexual newlywed couples, we find evidence for problem‐to‐satisfaction linkages as well as satisfaction‐to‐problem linkages. Satisfaction was a stronger predictor of marital problems early in marriage but not as time passed; by Year 4 only problem‐to‐satisfaction linkages remained significant. These findings are consistent with the idea that couples with more problems go on to report lower levels of satisfaction and couples with lower levels of satisfaction go on to report more marital problems. This dynamic interplay between global judgments about relationship satisfaction and ongoing specific relationship difficulties highlights the value of examining bidirectional effects to better understand marital functioning over time.     

Emotion regulation dimensions and relationship satisfaction in clinical couples

The present study explored the relation between the multidimensional construct of emotion regulation and relationship satisfaction in 104 couples seeking couple or family therapy. Satisfaction was assessed via the Dyadic Satisfaction Subscale of the Dyadic Adjustment Scale, whereas the Difficulties in Emotion Regulation Scale was used to assess the 6 dimensions of emotion regulation (acceptance, goals, impulse, awareness, strategies, clarity). Significant relations were found between relationship satisfaction and acceptance, impulse, awareness, and strategies. Relations were not always found in expected directions, and although actor effects were found for both genders, only women displayed partner effects. Findings point to the importance of considering context when studying emotion regulation and highlight the clinical importance of evaluating its specific dimensions.