Relational Instability in Couples Seeking Therapy: The Contribution of Attachment, Caregiving and Sex.

Attachment theory postulates that three behavioral systems-attachment, caregiving, and sex-are essential for optimal relationship functioning in couples. We examined the contribution of attachment insecurities, perceived partner support, and sexual satisfaction to relational instability in 274 couples seeking relationship therapy. The results underscore the importance of all three systems for relationship stability, showing that for both men and women, avoidance of intimacy, low perceived partner support, and low sexual satisfaction were significant and concurrent predictors of relational instability. As such, intervening on factors associated with all three behavioral systems might help reduce relationship instability in couples experiencing relationship distress.

Under, Over, or Optimal Commitment? Attachment Insecurities and Commitment Issues in Relationally Distressed Couples.

Using a new multidimensional model of relationship commitment, this study examined the association among attachment insecurities (avoidance and anxiety) and commitment (optimal, over, and under) in 159 relationally distressed, monogamous and mainly heterosexual couples. Dyadic analyses revealed that avoidant individuals reported less optimal and less over-commitment, as well as more under-commitment. Their partners also reported less over-commitment. Moreover, whereas anxious individuals reported more over-commitment, their partners reported less optimal commitment and more under-commitment. Moderation analyses showed that anxious individuals reported more optimal commitment when their partners reported very high levels of avoidance. The findings suggest nuanced implications for couple therapy.

The clinical representativeness of couple therapy outcome research.

The clinical representativeness of outcome studies is defined as the generalizability of recruitment processes, assessment/diagnostic procedures, treatment protocols, and therapeutic results from research settings to naturalistic treatment settings. The main goal of the present study was to examine the clinical representativeness of couple therapy in outcome studies. The data set was formed by 50 published clinical trials, including 34 couple therapy outcome studies for marital distress (CTMD) and 16 couple therapy outcome studies for comorbid relational and mental disorders (CTMD + C). The present findings showed that, overall, the clinical representativeness of couple therapy outcome studies is only fair (i.e., the mean global score is slightly lower than the midpoint of the rating scale used to assess representativeness). CTMD + C studies fared better than CTMD studies on many dimensions of clinical relevance. Studies in which pretherapy training was less intensive (for CTMD studies only), treatment was less structured, and therapists were more experienced showed larger effect sizes than those in which such was not the case.