The heterogeneity of intimate partner violence and its associations with distressed couples' emotional communication.

To understand the ways in which heterogeneous aspects of intimate partner violence (IPV) differentially influence partners' emotional expression during the conflict, the present study examined the unique and interactive effects among (a) types of IPV (psychological and/or physical), (b) directionality of IPV (unilateral or bilateral), and (c) couples' conversation topic (initiated by men or women) on the trajectories of emotional arousal in distressed, different-gender couples (N = 106). Vocally encoded emotional arousal (f0) was measured during couples' recorded conversations. Findings from growth-curve analyses demonstrated that the level of IPV, directionality of IPV, and conversation topic were associated with different patterns of emotional arousal. First, during the discussion of the woman's topic, escalation was observed among recipients of violence in relationships with high levels of unilateral IPV, while their partners-that is, perpetrators of IPV-demonstrated stable, flat trajectories. Second, during men's conversations, stable levels of arousal were predominantly observed among both partners in relationships with men's unilateral IPV and with bilateral psychological and physical IPV. Finally, for partners who engaged in low levels of IPV, men and women both showed escalating arousal across women's conversations; however, when discussing the man's topic, they demonstrated different patterns, with men escalating linearly and women maintaining stable levels of arousal. These findings converge to suggest a picture in which distressed partners who either engage in or experience IPV use "all-or-nothing" approaches to emotional expression during conflict-not only escalating but also containing or controlling their emotional arousal across various contexts. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dual-substance use disorder couples: An integrative review and proposed theoretical model.

Committed romantic relationships between two individuals with Substance Use Disorder (or dual-SUD couples) are prevalent. Dual-SUD couples have poor treatment engagement and outcomes. Research has established a reciprocal link between relationship dynamics (e.g., conflict, intimacy) and substance use. Thus, the couple's relationship presents a distinct social context for both partner's substance use. Dual-SUD couples face unique challenges due to substance use being a shared behavior that may serve as a rewarding source of compatibility, closeness, and short-term relationship satisfaction despite it being at the cost of other alternative sources of substance-free reinforcement. Yet, treatment options for these couples are scarce. Dual-maladaptive health behaviors (e.g., dual-substance use) are challenging to treat; however, theory and preliminary research suggests that transformation of couple's joint motivation toward adaptive health behavior change may result in a more satisfying relationship and improved treatment outcomes for both individuals. The current paper reviews the extant literature on dual-SUD couples from theoretical, empirical, and treatment research and proposes an expanded paradigm regarding how we understand dual-SUD couples with the aim of informing basic research and treatment development.

Dyadic associations and prediction of maternal and paternal sexual satisfaction in couples-Findings from an 18-year longitudinal study.

Background: : Sexual satisfaction is one of many crucial factors for the long-term success of romantic relationships. Longitudinal studies examining the dyadic associations between maternal and paternal factors in middle adulthood for predicting sexual satisfaction in later adulthood are scarce. Method: The German longitudinal intervention study "Future Family" followed families with at least one child over 18-years (Pre: N = 477, mothers: M = 35.2 years, fathers: M = 38.8 years, children: M = 4.1 years). At the time of the 18-year follow-up, N = 150 mothers (M = 54.1 years) were still living together with the biological fathers (M = 56.1 years; mean relationship duration: 32 years). Dyadic associations between individual and dyadic factors at Pre were analyzed with Actor-Partner Interdependence models to predict sexual satisfaction 18 years later. Results: Higher relationship quality was significantly associated with higher levels of one's own sexual satisfaction 18 years later. Higher levels of maternal and paternal mental health problems were linked to lower levels of sexual satisfaction in both the individual themselves and their partner. General life satisfaction of mothers and fathers only predicted their own sexual satisfaction. The model for dysfunctional parenting yielded no significant effects. Conclusions: The results indicate that relationship quality, mental health problems, and general life satisfaction of both parents could be starting points for preventive and therapeutic interventions to achieve long-term effects in sexual satisfaction in married couples.

Couples communication and cancer: Sequences and trajectories of behavioral affective processes in relation to intimacy.

Cancer poses a set of physical and emotional challenges to the patient, spouse, and their relationship. One challenge for couples is discussing cancer-related concerns in a manner that facilitates intimacy. Current couple-based interventions have been shown to have mixed efficacy, and little is known about how they bring about improvements. This study aims to expand our understanding of dyadic communication and intimacy to adapt and/or develop more effective interventions for couples coping with cancer. To accomplish this goal, the present study examined affective and behavioral processes associated with intimacy using the valence-affective-connection (VAC) framework and observational coding methods. Participants were 134 couples in which a patient was diagnosed with breast, colorectal, or lung cancer. Couples completed a battery of questionnaires, including a self-report measure of intimacy. Couples also completed a 15-min videotaped interaction about a cancer topic of their choosing, which was observationally coded for communication behavior and affective expression. Couples coping with cancer who reported higher versus lower intimacy engaged in qualitatively different levels, types, and patterns of communication behavior and affective expression. Specifically, couples who reported lower relationship intimacy used negative approach behavior and hard negative affect more frequently and for longer periods of time and were more likely to use avoidance-based communication. Higher intimacy couples were less likely to sustain the use of negative behavior and affect and displayed more reciprocity of positive joining affect. The study highlights important considerations for couple-based interventions and research in the context of cancer. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Concurrent and Prospective Associations Between Communicated Emotional Arousal and Adjustment Among Couples Coping With Cancer.

BACKGROUND: The experience of cancer can create considerable emotional distress for patients and their committed partners. How couples communicate about cancer-related concerns can have important implications for adjustment. However, past research has primarily utilized cross-sectional designs and retrospective self-reports of couple communication. While informative, little is known about how patients and partners express emotion during conversations about cancer, and how these emotional patterns predict individual and relational adjustment. PURPOSE: The current investigation examined how patterns of emotional arousal within couples' communication about cancer was associated with concurrent and prospective individual psychological and relational adjustment. METHODS: At baseline, 133 patients with stage II- breast, lung, or colorectal cancer and their partners completed a conversation about a cancer-related concern. Vocally expressed emotional arousal (f0) was extracted from recorded conversations. Couples completed self-report measures of individual psychological and relational adjustment at baseline and at 4, 8, and 12 months later. RESULTS: Couples who started the conversation higher in f0 (i.e., greater emotional arousal) reported better individual and relational adjustment at baseline. If the non-cancer partner had lower f0 relative to patients, this predicted worse individual adjustment across follow-up. Additionally, couples who maintained their level of f0 rather than decreasing later in the conversation reported improvements in individual adjustment across follow-up. CONCLUSIONS: Elevated emotional arousal within a cancer-related conversation may be adaptive for adjustment, as it may reflect greater emotional engagement and processing of an important topic. These results may suggest ways for therapists to guide emotional engagement to enhance resilience in couples experiencing cancer.

Cancer is a stressful experience for patients and their partners. We know that how couples communicate about cancer is important, but we do not know much about how couples express emotion during cancer conversations and how those emotional expressions affect well-being. Our study looked at how couples' emotional arousal within cancer conversations relate to individual and relationship well-being. At the beginning of the study, cancer patients and their partners had a conversation about cancer. Within these conversations, we tracked the emotional arousal expressed in their voices. Couples also completed surveys about their well-being at the beginning of the study and later in time (4, 8, and 12 months later). We found that couples who started the conversation with higher emotional arousal had better initial well-being. Couples who remained higher in arousal later in the conversation improved in their individual well-being over time. We also found that if the non-cancer partner was low in arousal compared with patients, this predicted worse well-being over time. More research is needed, but these findings suggest that being emotionally aroused during conversations about important topics like cancer might be helpful for well-being, potentially because couples are discussing concerns and not backing off when it feels challenging.

PTSD Symptom Cluster Severity Predicts Momentary Emotion Dynamics During Couple Conversations.

This study investigated the associations between momentary emotion dynamics and posttraumatic stress disorder (PTSD) symptoms. Using a sample of 61 couples (N = 122 individuals) in which all individuals were trauma exposed and at least one partner screened positive for PTSD, we examined the intra- and interpersonal regulation of vocally encoded emotional arousal (fundamental frequency [f0]) and how these momentary emotion regulatory patterns relate to specific PTSD symptoms during two couple conversations: one designed to elicit conflict and one to elicit intimacy. PTSD symptoms were assessed using a gold standard clinical interview. In both conversations, higher reexperiencing symptoms were associated with greater emotional inertia (i.e., more resistance to change in emotional state following deviation from one's emotional equilibrium), and higher avoidance symptoms were associated with less emotional inertia (i.e., quicker return to emotional equilibrium). In the intimacy conversations, individuals also responded to their partners' arousal. Furthermore, individuals whose partners exhibited higher emotional numbing symptoms exhibited more emotional inertia, suggesting that emotion regulation may be a function of both one's own and one's partner's PTSD symptoms. Attending to the interpersonal context of emotion dynamics during PTSD treatment may enhance outcomes.

Family therapy for persons with schizophrenia: neglected yet important.

Since the 1950s, the observed disturbances in family relationships in which a member has been diagnosed as having schizophrenia has led many systemic family therapists to the hypothesis that these family interactions may have preceded the onset of illness and contributed to it. However, attempts at using traditional family therapy with families of patients with schizophrenia were not successful or widely adopted. With the introduction of neuroleptic medication, the treatment of schizophrenia changed dramatically, and patients often returned to their family in varying stages of partial remission, increasing the burden on relatives. Furthermore, research based on the expressed emotion concept demonstrated that the chance of relapse increases by a factor of 2.5 when a patient returns to a high-EE-family in contrast to a low-EE-family environment; consequently, the vulnerability-stress model started to guide treatment development. Based on these developments, since 1980, several psychoeducational family management programs have been evaluated showing a significant reduction in relapse when compared to standard psychiatric care from 49 to 13%. To date, at least 50 RCT studies have been published showing the effectiveness of family interventions in various culturally diverse countries. Therefore, according to the NICE and other guidelines, family intervention should be offered to all families of people with psychosis who live with or are in close contact with the patient, in conjunction with neuroleptic treatment. Despite this strong recommendation, family involvement is under-implemented in mental health care, despite its strong scientific, economic, legal and moral basis. To improve the psychosocial health of patients with psychotic disorders and their relatives, more research is necessary, as well as more training for professionals in effective family interventions.

Responsivity to Interviewer during Interview-Based Assessment of Physical Intimate Partner Violence.

Objective: Interview assessments of intimate partner violence (IPV) may provide more accurate behavior frequency estimates than self-report questionnaires. However, concerns have been raised about whether participants underreport IPV during interviews due to an emotional response to the interviewer. Method: Participants were 42 mixed gender community couples (83 individuals) in which at least one partner endorsed physical IPV perpetration or victimization in their relationship. We examined whether participants were emotionally responsive to the interviewer during an interview about physical IPV. Responsivity was defined as the extent to which participants' emotional arousal, indexed by vocal fundamental frequency (f0), was predicted by interviewers' emotional arousal at the previous talk turn on a moment-by-moment basis. We then examined whether participants' responsivity predicted interview-based reporting of IPV relative to their own self-report on an IPV measure and to the highest other available report (including partner report). Results: Repeated measures actor-partner interdependence models conducted in a multi-level modeling framework indicated that, on average, participants were responsive to interviewers' emotional arousal, even when controlling for responsivity to their own arousal, and that responsivity varied across participants. However, participants' responsivity to interviewer arousal did not significantly predict reporting of IPV perpetration or victimization during the interview relative to their own self-report or to the highest other available report. Conclusions: Participants are emotionally responsive to interviewer arousal, but this responsivity does not appear to reduce interview-based reporting of IPV relative to self-report, supporting the utility of IPV interviews in clinical and research settings.

Evaluating a couple communication skills training (CCST) intervention for advanced cancer: study protocol for a randomized controlled trial.

BACKGROUND: For patients and their intimate partners, advanced cancer poses significant challenges that can negatively impact both individuals and their relationship. Prior studies have found evidence that couple-based communication skills interventions can to be beneficial for patients and partners. However, these studies have been limited by reliance on in-person treatment delivery and have not targeted couples at high risk for poor outcomes. This study tests the efficacy of a Couples Communication Skills Training (CCST) intervention delivered via videoconference for couples reporting high levels of holding back from discussing cancer-related concerns, a variable associated with poorer psychological and relationship functioning. METHODS: This RCT is designed to evaluate the efficacy of CCST in improving patient and partner relationship functioning (primary outcome). Secondary outcomes include patient and partner psychological functioning and patient symptoms and health care use. We also examine the role of objective and self-reported communication behaviors as mediators of treatment effects. Two hundred thirty patients with advanced lung, gastrointestinal, genitourinary, and breast cancer and their partners will be randomized to CCST or an education control intervention. Participants in both conditions complete self-reported outcome measures at baseline, mid-treatment, post-treatment, and 3 months post-treatment. Objective measures of communication are derived from video-recorded couple conversations collected at baseline and post-treatment. An implementation-related process evaluation (assessing implementation outcomes and potential barriers to/facilitators of implementation) will be conducted to inform future efforts to implement CCST in real-world settings. DISCUSSION: This trial can yield important new knowledge about effective ways to improve patient and partner adjustment to advanced cancer. TRIAL REGISTRATION: This study trial is registered at clinicaltrials.gov (Trial # NCT04590885); registration date: October 19, 2020.

Implementation intentions to express gratitude increase daily time co-present with an intimate partner, and moderate effects of variation in CD38.

Close social connections drive mental and physical health and promote longevity. Positive, other-focused behavior like expressing gratitude may be a key mechanism for increasing close bonds. Existing evidence consistent with this claim is predominantly correlational, likely driven by challenges in causally influencing and sustaining behavior change in the context of ongoing relationships. This 5-week field experiment with daily data from couples provides the first evidence for a brief, low-cost behavioral technique to increase everyday expressed gratitude to a romantic partner. Random assignment to the gratitude expression treatment (GET) increased the amount of time couples spent co-present in everyday life, from the weeks before GET to the weeks after, relative to the control condition. This effect was mediated by the change in expressed gratitude. Voluntary co-presence is an important behavioral indicator of close bonds in non-human animals. Further analyses with a functional genotype related to the oxytocin system (rs6449182) suggest a neurochemical pathway involved in the effects of expressing gratitude. Together, this evidence bridges animal and human research on bonding behavior and sets up future experiments on biopsychosocial mechanisms linking close bonds to health.

When the loss of positives feels negative: Exploring the loss of positive experiences in committed couples.

Despite romantic relationships being characterized by high positives (e.g., enjoyable activities, positive feelings) early in commitment, many couples experience a loss of positives over time. However, interventions are typically not as effective at enhancing positives as they are at reducing negatives (e.g., hostile conflict). Thus, it is important to understand why positives decrease and how to use interventions to enhance positives optimally. In this article, we present how the field has evolved to (a) heighten focus on positives independent of negatives, (b) identify trajectories of positives over time, and (c) clarify major factors which predict loss of positives. From a cognitive-behavioral couple therapy perspective, we offer therapeutic strategies that may hold promise for enhancing positives in relationships.

The role of intimate partner violence and relationship satisfaction in couples' interpersonal emotional arousal.

To inform interpersonal models of intimate partner violence (IPV), the present study examines patterns of vocally encoded emotional arousal during the conversations of mixed-gender couples who reported on the extent of physical and psychological IPV and degree of relationship satisfaction (N = 149). All couples completed two problem-solving discussions. Emotional arousal was measured continuously during each conversation using vocal fundamental frequency. Contrary to expectations, results demonstrated that trajectories of arousal differed based on gender, IPV, and relationship satisfaction. Within conversations, men demonstrated linear increases in arousal at higher levels of IPV, suggesting that men may either struggle to contain their emotions or use heightened emotional expression as a conflict strategy in relationships with more extensive IPV. Conversely, women exhibited different trajectories of arousal depending on the combinations of relationship satisfaction and couple IPV, except at higher levels of their own satisfaction. Specifically, when women reported being highly satisfied in their relationships, they demonstrated similarly shaped trajectories across all levels of IPV and men's satisfaction. Together, this suggests that women's higher relationship satisfaction may buffer their emotional expression, although this may not always be adaptive within the context of relationships with extensive IPV. Overall, this study offers insight into the dynamic interpersonal processes linked with relationship distress and IPV and implies the need for a more nuanced, interpersonal research agenda for IPV research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

For better or worse: Associations among psychopathology symptoms, interpersonal emotion dynamics, and gender in couples.

Communication has long been associated with the well-being of a couple's relationship, and it is also important to explore associations with individual well-being. This study examined the associations between emotions communicated within couple interactions and each partner's psychopathology symptoms concurrently and up to 3 years later. Vocally-encoded emotional arousal (f0) was measured during couples' (N = 56) conversations. Analyses examined each partner's trajectories of f0 and how each partner influenced the other's f0 across the conversation. The findings indicated that women experienced higher symptoms if they (a) decreased more steeply in f0 overall and (b) returned to their baseline in f0 more quickly. Moreover, women had higher symptoms if they had a steeper return to baseline because of men's elevated f0. In contrast, men experienced higher symptoms when men (a) more slowly returned to baseline and (b) changed their f0 trajectory because of women's elevated f0. That is, women who expressed less emotional arousal, independently and as a result of the influence of their male partner, experienced more symptoms. In contrast, men's symptoms were differentially associated with their own independent experience of emotional arousal (in which he experienced fewer symptoms when changing arousal more quickly) from how they responded to women's arousal. Given how differently men's and women's psychopathology were associated with emotional expression, these findings raise questions about how partners can communicate to protect their own and their partner's mental health in the short- and long-term. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Promoviendo una Alimentación Saludable (PAS) results: Engaging Latino families in eating disorder treatment.

Latinos/as are underrepresented in eating disorders clinical trials. This study compared results of a culturally adapted individual cognitive-behavioral treatment (CBT) for binge-spectrum eating disorders that included or excluded a family enhanced module (CBT + FE), in a proof-of-principle pilot study with a sample of Latina adults and one family member per patient. Twenty-five patients (Mage = 37 yrs) and 25 family members (Mage = 40 yrs) were randomized to CBT (n = 13) or CBT+ FE (n = 12). DSM-IV eating disorder diagnoses were: 48% (n = 12) bulimia nervosa, 28% (n = 7) binge-eating disorder, and 24% (n = 6) eating disorder not otherwise specified. Effect sizes favored CBT + FE on adherence and retention, and scores on treatment satisfaction and therapeutic alliance were high, indicating treatment acceptability. In spite of the hypothesis that family outcomes such as support, familism, cohesion, pride, family cultural conflict, burden, and marital satisfaction (in couples) would be superior in CBT + FE, the preliminary data were inconclusive and results were mixed. The hypothesis that eating disorder outcomes including global eating psychopathology, binge eating, and purging would improve in CBT + FE was not supported. There was some evidence that patients in CBT improved more particularly on binge eating, otherwise the groups had no differences. In conclusion, the results suggest that CBT + FE could enhance treatment adherence and retention, although this did not automatically translate to better family and symptom outcomes.

Love in the time of COVID-19: A brief report on relationship and individual functioning among committed couples in the United States while under shelter-in-place orders.

The COVID-19 pandemic in the United States has changed many aspects of people's daily life, including increased time at home in response to shelter-in-place orders, heightened stress about health effects of COVID-19, and shifts in other domains of life (e.g., employment). These lifestyle changes are likely to impact the well-being of individuals and their romantic relationships. This investigation examined how COVID-19 influenced couple and individual well-being in real-time during the early phase of the pandemic. Data were collected in early May 2020 during shelter-in-place orders in the United States. Participants in committed relationships (n = 332) completed an online survey assessing their experiences currently and before the pandemic. Results suggested that while couple functioning overall maintained or even improved, individual well-being was more negatively impacted by the pandemic. Moreover, some groups who are at higher risk of a poor health outcome from COVID-19 or experience unique challenges as a result of COVID-19 reported worse outcomes (e.g., those whose employment changed) while others did not decline in their psychological and couple functioning (e.g., Black individuals and older individuals). These findings suggest that the pandemic has had varied impacts on couples and individuals, as well as across different virus-related risk factors. Further research is needed to understand the nuanced effects of this pandemic on couples and individuals across time.

La pandemia de la COVID-19 en los Estados Unidos ha cambiado muchos aspectos de la vida diaria de las personas, por ejemplo, el aumento del tiempo que pasan en sus hogares en respuesta a órdenes de confinamiento, un estrés más elevado por los efectos de la COVID-19 en la salud, y cambios en otros aspectos de la vida (p. ej.: en el empleo). Estos cambios en el estilo de vida probablemente repercutan en el bienestar de las personas y en sus relaciones amorosas. En esta investigación se analizó cómo la COVID-19 influyó en el bienestar de las parejas y de los individuos en tiempo real durante la primera fase de la pandemia. A principios de mayo de 2020 se recopilaron datos durante las órdenes de confinamiento en los Estados Unidos. Los participantes que estaban en relaciones de pareja estables (n=332) contestaron una encuesta en línea donde se evaluaron sus experiencias de ese momento y las anteriores a la pandemia. Los resultados indicaron que, si bien el funcionamiento de la pareja en general se mantuvo o incluso mejoró, la pandemia afectó más negativamente el bienestar individual. Además, algunos grupos que tienen mayor riesgo de resultados desfavorables en la salud como consecuencia de la COVID-19 o enfrentan dificultades singulares como resultado de la COVID-19 informaron peores resultados (p. ej.: aquellos cuyos empleos cambiaron), mientras que otros no tuvieron un empeoramiento de su funcionamiento psicológico y de pareja (p. ej.: las personas de color y las personas mayores). Estos resultados sugieren que la pandemia ha tenido efectos variados en las parejas y en los individuos, así como entre los diferentes factores de riesgo relacionados con el virus. Se necesitan más investigaciones para comprender los efectos sutiles de esta pandemia en las parejas y en los individuos con el transcurso del tiempo.

Cognitive-behavioral couple therapy for same-sex female couples: A pilot study.

Despite comparable levels of relationship satisfaction and intimacy, same-sex couples break up faster and more often than different-sex couples, highlighting a need for quality couple therapy. Research suggests that culturally tailored services are desired by same-sex couples and may be more effective and better received. Although efficacious couple therapies exist to treat relationship distress, they have been overwhelmingly studied with different-sex couples. Sexual minority (SM) affirming couple therapies have not been systematically developed or evaluated. The current study involved developing and pilot testing a couple therapy tailored for distressed same-sex female couples. This treatment integrates the SM stress model with the empirically supported cognitive-behavioral couple therapy framework and is the first culturally tailored couple therapy for same-sex couples to be empirically evaluated. Therapists delivered the treatment in an open-trial format to a pilot sample of 11 same-sex female couples experiencing relationship distress and SM stress. Treatment was delivered with high adherence to the treatment manual. Participants reported high treatment satisfaction. As hypothesized, participants experienced significant decreases in relationship distress and improvements in couple coping with SM stress from pre- to post-therapy. Limitations precluded clear conclusions regarding anticipated improvements in individual mental health. Participants experienced comparable or stronger improvements in relationship functioning compared to couples in a similar benchmark study. Given this is a small pilot study, results are interpreted with caution. Implications for culturally tailoring evidence-based couple therapy for marginalized groups are discussed.

A pesar de los niveles comparables de satisfacción con la relación y de intimidad, las parejas del mismo sexo se separan más rápidamente y con más frecuencia que las parejas de distinto sexo, lo cual destaca la necesidad de una terapia de pareja de calidad. Las investigaciones indican que las parejas del mismo sexo desean recibir servicios adaptados a las culturas, los cuales pueden ser más eficaces y mejor recibidos. Aunque existen terapias de pareja eficaces para tratar el distrés en las relaciones, estas se han estudiado en su mayoría con parejas de distinto sexo. Las terapias de pareja dedicadas a las minorías sexuales no se han desarrollado ni evaluado sistemáticamente. El presente estudio implicó el desarrollo y la prueba piloto de una terapia de pareja adaptada para parejas femeninas del mismo sexo con distrés. Este tratamiento integra el modelo de estrés de las minorías sexuales con el marco de la terapia de pareja cognitivo-conductual respaldado empíricamente, y es la primera terapia de pareja adaptada culturalmente para parejas del mismo sexo que se evalúa empíricamente. Los terapeutas administraron el tratamiento en un formato de estudio abierto a una muestra piloto de 11 parejas femeninas del mismo sexo que sufrían distrés relacional y estrés por minoría sexual. El tratamiento se aplicó con una alta adhesión al manual de tratamiento. Las participantes informaron una alta satisfacción con el tratamiento. Como se planteó en la hipótesis, las participantes disminuyeron considerablemente el distrés relacional y mejoraron en el afrontamiento del estrés por minoría sexual de la pareja después de la terapia respecto de antes de la terapia. Las limitaciones impidieron sacar conclusiones claras con respecto a la previsión de mejorías en la salud mental individual. Las participantes tuvieron mejorías comparables o más marcadas en el funcionamiento de la relación respecto de las parejas de un estudio comparativo similar. Teniendo en cuenta que este es un estudio piloto pequeño, los resultados se interpretan con cautela. Se comentan las implicancias para adaptar culturalmente la terapia de pareja factual para grupos marginados.

Couple Communication in Cancer: Protocol for a Multi-Method Examination.

Cancer and its treatment pose challenges that affect not only patients but also their significant others, including intimate partners. Accumulating evidence suggests that couples' ability to communicate effectively plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models have been proposed to account for how couple communication impacts psychological and relationship adjustment: the social-cognitive processing (SCP) model and the relationship intimacy (RI) model. These models posit different mechanisms and outcomes, and thus have different implications for intervention. The purpose of this project is to test and compare the utility of these models using comprehensive and methodologically rigorous methods. Aims are: (1) to examine the overall fit of the SCP and RI models in explaining patient and partner psychological and relationship adjustment as they occur on a day-to-day basis and over the course of 1 year; (2) to examine the fit of the models for different subgroups (males vs. females, and patients vs. partners); and (3) to examine the utility of various methods of assessing communication by examining the degree to which baseline indices from different measurement strategies predict self-reported adjustment at 1-year follow up. The study employs a longitudinal, multi-method approach to examining communication processes including: standard self-report questionnaires assessing process and outcome variables collected quarterly over the course of 1 year; smartphone-based ecological momentary assessments to sample participant reports in real time; and laboratory-based couple conversations from which we derive observational measures of communicative behavior and affective expression, as well as vocal indices of emotional arousal. Participants are patients with stage II-IV breast, colon, rectal, or lung cancer and their spouses/partners, recruited from two NCI-designated comprehensive cancer centers. Results will be published in scientific journals, presented at scientific conferences, and conveyed to a larger audience through infographics and social media outlets. Findings will inform theory, measurement, and the design and implementation of efficacious interventions aimed at optimizing both patient and partner well-being.

Escalation and Regulation of Emotional Arousal in Couples Predicts Relationship Satisfaction Concurrently and 25 Years Later.

Relationship distress and divorce are major risk factors for the development or exacerbation of psychopathology and psychosocial impairments. Given that heightened negative emotions within couples' interactions may portend negative relationship outcomes, it is critical to understand how emotions unfold across a conversation and how partners may influence each other's immediate emotional experiences. This study examined whether these regulatory dynamics within one interaction predicted relationship satisfaction concurrently and 25 years later. Vocally-encoded emotional arousal (f0 ) was measured during couples' (N = 25 couples) conversations about a relationship issue. Across different analytical strategies, results demonstrate that one partner's f0 dynamics had immediate and long-term associations with the other partner's satisfaction. Partners were less satisfied if the other partner (a) expressed higher f0 overall and (b) escalated more in f0 across the conversation. Yet, partners were more satisfied when their f0 escalated across the conversation. Also, women specifically were more satisfied if their f0 remained elevated longer before regulating back to their emotional baseline. Thus, higher f0 was associated with higher satisfaction in the same partner, but associated with less satisfaction in the other partner-particularly when these emotions come from women. It may be that partners have to decide whether to prioritize expressing their emotions fully or limit expression in the service of their partner's happiness. These findings challenge us to think of ways to address this "win-lose" scenario so that couples can balance both partners' emotional needs and preserve relationship quality across the life span.

El distrés relacional y el divorcio son grandes factores de riesgo para el desarrollo o la exacerbación de alteraciones psicopatológicas y psicosociales. Teniendo en cuenta que las emociones negativas intensificadas dentro de las interacciones de las parejas pueden predecir consecuencias negativas en las relaciones, es fundamental comprender cómo se revelan las emociones a lo largo de una conversación y cómo los integrantes de la pareja pueden influenciar las experiencias emocionales inmediatas del otro. Este estudio examinó si esta dinámica reguladora dentro de una interacción predijo la satisfacción con la relación inmediatamente y 25 años después. Se midió la codificación vocal de la excitación emocional (f0 ) durante las conversaciones de las parejas (N = 25 parejas) acerca de un problema en la relación. Entre diferentes estrategias analíticas, los resultados demuestran que la dinámica de la f0 de uno de los integrantes de la pareja tuvo asociaciones inmediatas y a largo plazo con la satisfacción del otro integrante de la pareja. Los integrantes de la pareja se sentían menos satisfechos si el otro integrante de la pareja (a) expresaba una f0 más elevada en general y (b) escalaba más en la f0 durante la conversación. Sin embargo, los integrantes de la pareja estaban más satisfechos cuando su f0 escalaba a lo largo de la conversación. También, las mujeres estaban específicamente más satisfechas si su f0 se mantenía elevada más tiempo antes de regularla para volver a su momento basal emocional. Por lo tanto, una f0 más elevada se asoció con una mayor satisfacción en el mismo integrante de la pareja, pero se asoció con una menor satisfacción en el otro integrante de la pareja, particularmente cuando estas emociones vienen de las mujeres. Es posible que los integrantes de la pareja tengan que decidir si priorizar la expresión completa de sus emociones o limitar la expresión al servicio de la felicidad de su pareja. Estos resultados nos plantean el desafío de pensar en maneras de abordar esta situación en la que "se gana o se pierde", de manera que las parejas puedan equilibrar las necesidades emocionales de ambos integrantes de la pareja y conservar la calidad de la relación durante su tiempo de vida.

The development and evaluation of a brief intervention for male partners of women hospitalized for perinatal distress.

BACKGROUND: Perinatal distress (PD) is a term used to describe mood and anxiety disorders experienced during pregnancy or in the postpartum period. In acute cases of PD, inpatient hospitalization may be indicated. Although hospitalization tends to result in improved immediate safety outcomes, many patients are discharged when they are still experiencing acute symptomology. Interpersonal and environmental factors, particularly those that exist within intimate relationships, can significantly help or hinder patient progress. Partners are also affected by the patient's symptoms and often lacks the skills or knowledge to offer support. METHODS: The aim of the present investigation is to address PD through a dyadic lens by integrating partners into treatment. In this feasibility study, 20 partners of women hospitalized for PD were recruited to participate in an individually delivered, 90-minute intervention designed to improve partner understanding and support behaviors. RESULTS: Qualitative feedback from partners suggests that the intervention was acceptable and the high recruitment rates demonstrate strong feasibility. Additionally, partners reported significant gains in the context of their support self-efficacy for assisting patients to cope with distress. Patients reported that they were significantly more satisfied with the support that their partners were providing. LIMITATIONS: This was a feasibility study and as such, there was no control group, thereby limiting causal inferences about the intervention. CONCLUSIONS: These findings suggest that this intervention may serve to enhance the recovery of women hospitalized for PD by empowering partners through offering psychoeducation and skills for offering support.

Couple-based communication intervention for head and neck cancer: a randomized pilot trial.

OBJECTIVE: To test feasibility and preliminary efficacy of a couple-based supportive communication (CSC) intervention for head and neck cancer (HNC) delivered during patients' oncology treatment. METHODS: Twenty couples were randomly assigned to either a four-session CSC or a treatment-as-usual (TAU) condition. The CSC intervention primarily focused on increasing couple emotional disclosure, supportive listening, and social support. Patients and partners completed measures of individual and relationship functioning at baseline, post-intervention, and 6-month follow-up. RESULTS: Ninety-eight percent of CSC sessions were completed and couples reported high levels of satisfaction with the intervention. Between-group effect sizes indicated that patients and partners in CSC reported improvements in individual and relationship functioning, relative to those in the TAU condition. CONCLUSIONS: A couple-based communication intervention delivered during oncology treatment is feasible and acceptable in the context of HNC and may lead to improvements in individual and relationship functioning. Preliminary efficacy results are interpreted in the context of social-cognitive processing and intimacy theories. TRIAL REGISTRATION: The trial was registered on www.clinicaltrials.gov (NCT01785576) first posted on February 7, 2013.