Predicting the dyadic coping through self-esteem among infertile couples undergoing in vitro fertilization and embryo transfer: An actor-partner interdependence model

Background

The population of infertile couples receiving in vitro fertilization and embryo transfer in China is increasing gradually. The association of self-esteem and dyadic coping of infertile couples undergoing in vitro fertilization and embryo transfer has not been reported. This investigation aimed to examine the predictive effect of self-esteem of infertile couples undergoing in vitro fertilization and embryo transfer on coping strategies at the dyadic level.

Methods

A cross-sectional study involving 283 infertile couples was conducted at the Reproductive Center of Northwest Women and Children's Hospital in China. Participants were asked to complete two self-administered questionnaires, to assess self-esteem (Rosenberg Self-Esteem Scale) and dyadic coping (Dyadic Coping Inventory). Paired t-test and Pearson correlation were used to analyze the difference and correlation of variables between wife and husband. The actor-partner interdependence model was used to test the predictive effect of each individual's self-esteem on their own and their partners' dyadic coping.

Results

Infertile couples' self-esteem and dyadic coping are in the medium range. The self-esteem of wives and husbands can fully predict their own dyadic coping. Meanwhile, the husband's self-esteem can predict the wife's stress communication (β = 0.135, p = 0.025), support dyadic coping (β = 0.142, p = 0.019), and negative dyadic coping (β = 0.133, p = 0.024), and the wife's perceived partners' supportive dyadic coping (β = 0.147, p = 0.014) and negative dyadic coping (β = 0.144, p = 0.016). Similarly, the wife's self-esteem can predict the husband's supportive dyadic coping (β = 0.195, p < 0.001), and the husband's perceived partners' stress communication (β = 0.184, p = 0.003) and supportive dyadic coping (β = 0.180, p = 0.002).

Conclusion

The actor-partner analyses revealed insight into how infertile couples undergoing in vitro fertilization and embryo transfer interact and highlighted the importance of self-esteem in dyadic coping styles. Future psychological interventions can enhance self-esteem as an effective way to improve dyadic coping of infertile couples.

'It's not just about me': a qualitative study of couples' narratives about home death when one of the partners is dying of cancer

Background

Most cancer patients state a preference for home death. Care and support from primary caregivers are important to enable dying at home. A preference for home death from the perspective of couples has rarely been investigated.

Objectives

To explore how a preference for home death is understood and enacted in couples where one of the partners is dying of cancer.

Design

A qualitative interview research design with a narrative approach was used.

Methods

Five couples participated in dyad interviews. During the analysis, two interviews that particularly illuminated couples' shared and individual views were chosen as the primary cases.

Results

The interviews show, in two highly different ways, how a preference for home death is a significant relational matter. The interviews are presented as two cases: 'Struggles in an Unknown Terrain' and 'Reliance at the Kitchen Table'. They show how a preference for home death can be understood and enacted as a struggle or as reliance based on the couple's shared biography and the partner's ability to care for the partner during the end-of-life phase. The analysis highlighted the negotiations that underpin a preference for home death. In these negotiations, the couples drew on idealised understandings of home death. These ideas were supported by cultural values related to autonomy and independence as well as participation and citizenship. Thus, in the negotiations about being cared for and caring, legitimate dependency and the maintenance of a reciprocal relationship were balanced. The presence of healthcare professionals and medical devices in the home had to be balanced with the need to maintain a sense of self and an authentic home.

Conclusion

A relational perspective on a preference for home death made us attentive to couples' negotiations. These negotiations give couples the opportunity to re-evaluate and reconfirm individual and mutual needs in the end-of-life phase.

Replication and extension of the military family stress model: The after deployment adaptive parenting tools ADAPT4U study

The military family stress (MFS) model conceptualizes that wartime deployments and post-traumatic stress disorder (PTSD) symptoms are associated with couple, parenting, and child adjustment difficulties. The aim of this study was to replicate and extend the military family stress model by examining the associations among deployment length, PTSD symptoms, marital functioning, parenting practices, and child adjustment in a replication sample of both National Guard and Reserve (NG/R) as well as active-duty service member families. The MFS model is extended to test whether these relationships vary between mothers and fathers. The sample included 208 families enrolled in a randomized controlled trial of a parenting program for military families (94.4% of fathers and 21.6% of mothers were deployed). Replicating the MFS model, we specified parenting, marital quality, and child adjustment as latent variables and conducted multi-group structural equation models. Parenting practices were positively associated with marital quality and child adjustment. PTSD symptoms were negatively associated with marital quality. The indirect effect from PTSD symptoms to parenting practices through marital quality was marginally significant. The indirect effect from marital quality to child adjustment through parenting practices was significant. There were no significant gender differences between the two structural models. This study provides empirical support for the MFS model. Results demonstrate that deployment-related stressors are significantly associated with parent and family functioning. Parenting programs for military families might effectively target similar risk processes among both mothers and fathers.

Satisfaction, Intimacy and Conflict in Canadian Couples: An Analysis of Change from Adolescence to Adulthood

Romantic relationship qualities are likely to change from adolescence to adulthood. Therefore, we undertook a longitudinal study to examine changes in satisfaction, intimacy, and conflict over this period by simultaneously testing the effects of age, relationship length, and their interaction. These qualities were measured at nine-time points from ages 16 to 30 in a Canadian sample of 337 participants (62.9% women) who reported being in a romantic relationship at least once over this period. The results of multilevel analyses show that satisfaction, intimacy, and conflict decline with age but increase with relationship length. Moreover, age and relationship length were found to have a significant interactive effect on satisfaction and intimacy.

Sexual and reproductive health-related questions and concerns of newly married couples: A qualitative content analysis

Background and Aims

Approximately half of Iranian marring couples have poor sexual knowledge and attitudes. This article delves into the main concerns and queries regarding sexual and reproductive health among Iranian newly married couples.

Methods

We conducted a content analysis of the sexual and reproductive health questions and concerns that were anonymously submitted by newly married couples to the researcher via social media in 2021-2022.

Results

A total of 141 questions and concerns that were related to sexual and reproductive health were considered for content analysis. Findings illustrated two main categories: (1) the need to create a reproductive life plan, and (2) the need for sexual knowledge and counseling. The first category consisted of three subcategories: "Poor contraceptive knowledge," "Need for support in case of a missed period or unplanned pregnancy," and "Need for preconception care." The second category included three subcategories: "Concern regarding virginity," "Sexual problems on the honeymoon," and "Sexual problems in newlyweds."

Conclusion

Iranian newly married couples need long-term specialized services addressing their reproductive life planning and sexual knowledge needs. Integrating reproductive life planning and comprehensive sex education into the primary care services for newly married couples can help to reduce delayed childbearing, unintended pregnancy, unsafe and illegal abortion, and subsequent infertility.

Learning to flourish in a new reality: a thematic analysis of couples' experience of participation in a positive psychology intervention post-stroke

PURPOSE

Explore the experiences of couples engaging in a positive psychology intervention post-stroke (ReStoreD: Promoting Resilience after Stroke in Dyads).

MATERIALS AND METHODS

This is a secondary analysis of qualitative data collected following an 8-week self-administered dyadic positive psychology intervention (Clinical Trial number: NCT03335358). Participants included dyads consisting of one partner who had a stroke at least three months prior and their cohabiting partner. Couples had to be community-dwelling and one or both had to report depressive symptoms. A thematic analysis was conducted on semi-structured feedback interviews from 26 dyads (n = 77 interviews).

RESULTS

Two primary themes with multiple secondary themes were identified, depicting the experiences of couples post-stroke while engaging in the ReStoreD intervention. Primary and secondary themes included: changes in self (learning about the self, building new coping strategies, and acting with intention) and changes in the relationship (awareness of spouse, spending more positive time together, being more intentional in the relationship, and increased/improved communication).

CONCLUSIONS

Individuals and couples post-stroke often experience negative mood changes, poor health outcomes, and decreased participation. Implementation of ReStoreD activities in the clinical setting can be a valuable and impactful way to encourage and foster positive experiences and re-engagement post-stroke.Implications for RehabilitationThrough dyadic positive psychology intervention activities, rehabilitation professionals can build upon existing strengths and resources to encourage couples to increase their awareness and development of positive coping strategies as individuals and couples.Positive psychology intervention activities can be implemented by rehabilitation professionals at inpatient and outpatient settings through self-directed, low-cost, and time-efficient strategies to increase engagement in positive activities at home.

What's love got to do with it? Relationship quality appraisals and quality of life in couples facing cardiovascular disease

Objective

Changes in couples' relationship quality are common post-cardiac event but it is unclear how relationship quality is linked to patients' and spouses' quality of life (QoL). The purpose of the present study was to examine the association between relationship quality on QoL in patient-spouse dyads within six months of a cardiac event.

Methods

Participants (N = 181 dyads; 25.9% female patients), recruited from a large cardiac hospital, completed validated questionnaires measuring demographic, relationship (Dyadic Adjustment Scale; DAS) and QoL variables (Heart-QoL & Quality of life of Cardiac Spouses Questionnaire). An Actor-Partner Interdependence Model was used to investigate actor (i.e. responses influencing their own outcome) and partner effects (responses influencing their partner's outcome) of relationship quality and QoL.

Results

Patients' and spouses' perceptions of relationship quality were in the satisfied range (DAS > 108; 65% of sample) and, as expected, patients reported lower general physical QoL than did their spouse (t(180) = -10.635, p < .001). Patient and spouse relationship quality appraisals were positively associated with their own physical (patient β = .25; spouse β = .05) and emotional/social (patient β = .21; spouse β = .04) QoL. No partner effects were identified.

Conclusion

High quality relationship appraisals appear to matter for patients' and spouses' QoL after the onset of CVD.

In it Together: Relationship Transitions and Couple Concordance in Health and Well-Being

Events that change the family system have the potential to impact couple dynamics such as concordance, that is, partner similarity in health and well-being. This project analyzes longitudinal data (≥ two decades) from both partners of up to 3,501 German and 1,842 Australian couples to investigate how couple concordance in life satisfaction, self-rated health, mental health, and physical health might change with transitioning to parenthood and an empty nest. Results revealed couple concordance in intercepts (averaged r = .52), linear trajectories (averaged r = .55), and wave-specific fluctuations around trajectories (averaged r = .21). Concordance in linear trajectories was stronger after transitions (averaged r = .81) than before transitions (averaged r = .43), whereas no systematic transition-related change in concordance of wave-specific fluctuations was found. Findings emphasize that shared transitions represent windows of change capable of sending couples onto mutual upward or downward trajectories in health and well-being.

Contributions of Demand/Withdraw Processes and Alcohol Consumption on Emotional Flooding in Distressed Violent versus Distressed Non-Violent Couples

Purpose

Although alcohol-related intimate partner violence (IPV) is a serious public health problem, the mechanisms underlying this association are poorly understood. For instance, prior research has shown differences in distressed violent (DV) and distressed nonviolent (DNV) couples' demand/withdraw communication and the extent to which they become emotionally flooded (i.e., physiologically aroused) in response to conflict. Additionally, alcohol use is associated with increased demand/withdraw communication, IPV, and emotional flooding. Therefore, the present study sought to clarify the association between demand/withdraw communication and emotional flooding among relationally couples who use alcohol and who do and do not experience IPV.

Methods

Relationally distressed couples (Mage =30.1 years) reported on their physical aggression, demand/withdraw communication, emotional flooding, and total number of drinks during the past six months. Couples were denoted as DV (N = 58) if at least one partner reported IPV and DNV (N = 29) if neither partner reported IPV. Actor-partner interdependence modeling was used to test whether couple type (DV versus DNV) moderates the link between demand/withdraw behavior and emotional flooding.

Results

With one exception, alcohol use was unrelated to any of the processes under investigation in the current study. Moreover, men's and women's report of a woman-demand/man-withdraw pattern and man-demand/woman-withdraw pattern, respectively, were positively associated with each partner's own emotional flooding. Couple type (DV vs DNV) did not moderate these associations.

Conclusions

The present results highlight the need for sensitive measures that can capture the nuanced processes that underlie IPV in couples who use alcohol.

Psychological Aspects of Infertility - Results from an Actor-Partner Interdependence Analysis

Introduction For some patients, undergoing medical treatment for infertility is a cause of major emotional stress which the couple needs to deal with together; it can be said that infertility is a shared stressor. From the literature it is known that a subjectively perceived sense of self-efficacy supports the patient's ability to cope adaptively with an illness. As the basis for this study, we assumed that high levels of self-efficacy are associated with low psychological risk scores (e.g., for anxiety or depressiveness), both in the patient themselves and in their partner. Accordingly, in infertility patients, targeted support to promote helpful self-efficacy expectations could represent a new counselling strategy that could enable psychologically vulnerable patients to better cope with the treatment procedure and treatment failures of medically assisted reproduction, making these patients less at risk with regard to psychosocial factors. Methods 721 women and men attending five fertility centers in Germany (Heidelberg, Berlin), Austria (Innsbruck), and Switzerland (St. Gallen, Basel) completed the SCREENIVF-R questionnaire to identify psychological risk factors for amplified emotional problems, as well as the ISE scale to measure self-efficacy. Using paired t-tests and the actor-partner interdependence model, we analyzed the data of 320 couples. Results Considering the study participants as couples, women had a higher risk score than men for four out of five risk factors (depressiveness, anxiety, lack of acceptance, helplessness). In all of the risk areas, it was possible to identify a protective effect from self-efficacy on the patient's own risk factors (actor effect). There was a negative correlation between the men's self-efficacy level and the women's feelings of depressiveness and helplessness (partner effect, man → woman). The women's self-efficacy levels had a positive correlation with acceptance and access to social support in the men (partner effect, woman → man). Conclusion Because infertility is generally something that a couple has to deal with together, future studies should focus on couples as the unit of analysis instead of just analyzing the men and women separately. In addition, couples therapy should be the gold standard in psychotherapy for infertility patients.

Dyadic approach to maturity to parenthood: multilevel study on attachment in expectant and non-expectant couples

OBJECTIVE

This study examined links between attachment styles and maturity to parenthood and its dimensions across different age groups of childless young adult couples. The role of developmental factors (age, assuming parental role) for maturity to parenthood was also investigated.

BACKGROUND

Relational and individual factors have both been confirmed to be crucial for the transition to parenthood. The concept of maturity to parenthood has been linked to individual values, personality traits, and close relationships. However, the question arises whether maturity to parenthood is related to one of the most crucial concepts in family psychology - attachment.

METHOD

Three hundred heterosexual young adult couples aged 20-35 years (M_age  = 26.20; SD  = 3.63) took part. Couples were divided into three groups: 1) 110 couples aged 20-25 (emerging adulthood); 2) 90 couples aged 26-35 (young adulthood); and 3) 100 couples aged 20-35 expecting their first child (third trimester of pregnancy). The main questionnaires used were the Maturity to Parenthood Scale and Close Relationship Experience Scale.

RESULTS

The results indicated that the more avoidant couples had lower maturity to parenthood. A moderation effect of group (pregnancy) was also observed - the effect of attachment-related avoidance was weaker in expectant couples. Women presented higher overall and behavioural maturity to parenthood than men. Furthermore, higher life satisfaction were associated with greater maturity to parenthood.

CONCLUSION

Maturity to parenthood is also created in the dyadic context. When related to lower attachment avoidance, it might greatly facilitate transition to parenthood and future parent - child relations.

Sexual communication patterns in couples with vulvodynia-a case-control behavioral observation study

BACKGROUND

Sexual communication is a common target in psychological treatments for vulvodynia, and associations with sexual function and distress, as well as pain intensity, have been demonstrated. However, structured observations of the communication patterns of couples with vulvodynia are lacking, as these are needed to guide treatment efforts.

AIM

To explore (1) the sexual communication patterns in couples with vulvodynia in terms of observed communication quality (operationalized as validating and invalidating responses), self-reported sexual assertiveness, and self-disclosure and (2) associations between sexual communication quality and pain intensity.

METHODS

In a case-control design with within- and between-group comparisons, 62 couples engaged in videotaped discussions about their sexual relationship. Trained coders assessed the discussions by rating sexual communication (validation and invalidation) according to a structured behavioral coding scheme. Group differences in sexual communication quality were examined with parametric and nonparametric tests. Dyadic associations among observed communication quality, self-rated sexual assertiveness, and self-disclosure were examined within the actor-partner interdependence model. Multiple regression was used to test the predictive value of partners' validation/invalidation on the pain intensity of the women with vulvodynia.

OUTCOMES

Observed communication quality (ie, validation and invalidation), self-reported sexual assertiveness, self-disclosure, and pain intensity.

RESULTS

Partners of women with vulvodynia were more invalidating toward their partners than those of women without pain. There were no significant differences in validating/invalidating communication between women in the 2 groups or in validation between partners. Partners' validating communication were significantly associated with women's lower pain intensity. The sexual communication patterns differed between couples with and without vulvodynia, and the associations between validating/invalidating responses and sexual assertiveness were stronger in the vulvodynia group than in the group without pain. Results on validation/invalidation and self-disclosure were inconclusive.

CLINICAL IMPLICATIONS

The results indicate a need to direct treatment interventions toward couples' sexual communication quality (ie, levels of validation and invalidation).

STRENGTHS AND LIMITATIONS

Strengths include systematic behavioral coding and dyadic analyses. Limitations include the cross-sectional design and self-selection of participants.

CONCLUSION

This study demonstrated sexual communication patterns specific to couples with vulvodynia, and we conclude that validation and invalidation are important components of the sexual communication of couples with vulvodynia as they relate to sexual assertiveness, women's self-disclosure, and pain intensity.

The proactive-reactive classification of intimate partner violence offenders: A multi-method approach to classification

BACKGROUND

Men who commit violence against an intimate partner differ in their motives. Classifying the proactivity of men's partner violence may reveal important differences that could be treatment targets.

AIMS

To examine the differences between proactive and reactive partner violence based on coded descriptions of past violent events.

METHOD

Community cohabiting couples reporting intimate partner violence were recruited via advertisements. Men and women were independently interviewed about past male-to-female violent events. The narratives of a male perpetrator and a female victim were coded using a Proactive-Reactive coding system, yielding three categories of violence: reactive, mixed proactive/reactive and proactive. The three categories were compared for differences in personality disorder features, attachment, psychophysiological reactivity during a conflict discussion task, and a self- and partner report of men's proactive and reactive aggressive tendencies.

RESULTS

The results revealed a 54% classification agreement between perpetrator and victim reports. No differences were found on personality or attachment measures between the groups regardless of gender of the reporter. Reactive violence was related to a tendency to self-report more reactive aggression and higher heart rate reactivity during a laboratory conflict discussion compared to the group reporting both proactive and reactive violent incidents.

CONCLUSION

This study suggests that a coding system for intimate partner violence can be applied to community volunteers, and it is a reliable report and valid. However, there are discrepancies when the coding is based on the perpetrator or victim reports.

Affective or cognitive interpersonal emotion regulation in couples: an fNIRS hyperscanning study

Sadness regulation is crucial for maintaining the romantic relationships of couples. Interpersonal emotion regulation, including affective engagement (AE) and cognitive engagement (CE), activates social brain networks. However, it is unclear how AE and CE regulate sadness in couples through affective bonds. We recruited 30 heterosexual couple dyads and 30 heterosexual stranger dyads and collected functional near-infrared spectroscopy hyperscanning data while each dyad watched sad or neutral videos and while the regulator regulated the target's sadness. Then, we characterized interbrain synchronization (IBS) and Granger causality (GC). The results indicated that AE and CE were more effective for couples than for strangers and that sadness evaluation of female targets was lower than that of male targets. CE-induced IBS at CH13 (BA10, right middle frontal gyrus) was lower for female targets than for male targets, while no gender difference in AE was detected. GC change at CH13 during CE was lower in the sad condition for male targets than for female targets, while no gender difference in AE was discovered. These observations suggest that AE and CE activate affective bonds but that CE was more effective for regulating sadness in female targets, revealing different neural patterns of cognitive and affective sadness regulation in couples.

Obstacles and facilitators of cancer-related dyadic efficacy experienced by couples coping with non-metastatic cancers

Introduction

Cancer-related dyadic efficacy is an individual's confidence to work together with a partner to conjointly manage the effects of cancer and its treatment. In other health contexts, higher levels of dyadic efficacy have been associated with fewer symptoms of psychological distress and higher ratings of relationship satisfaction. The aim of the current study was to explore patient and partner perspectives on what obstructs and facilitates cancer-related dyadic efficacy.

Methods

These aims were accomplished through a secondary analysis of data collected as a part of a collective qualitative case study. Participants (N = 17 participants) were patients undergoing treatment or recently completed treatment (within 6 months) for a non-metastatic cancer and their partners. To enable in-depth discussions among participants, data was collected through five focus groups. Participants described obstacles and facilitators of dyadic efficacy as dimensions of a common influence. Consistent with these descriptions, reflexive thematic analysis was used to identify influences on cancer-related dyadic efficacy and their subsequent obstructive and facilitative dimensions.

Results

Four main categories of influence with the potential to obstruct or facilitate cancer-related dyadic efficacy were identified along with their subthemes: appraisals of the couple relationship (quality and togetherness), communication (pattern and interest in information), coping (strategy and evaluation), and responses to change (in tasks and roles and sex life). Eight obstructive and seven facilitative dimensions of these subthemes were described.Discussion: This first analysis of obstacles and facilitators of couples' cancer-related dyadic efficacy capitalized on the experiential expertise of individuals with cancer and their partners. These thematic results are instructive for the design of dyadic efficacy-enhancing interventions for couples coping with cancer.

Partner responses to low desire among couples coping with male hypoactive sexual desire disorder and associations with sexual well-being

BACKGROUND

Hypoactive sexual desire disorder (HSDD) is characterized by persistently low desire and associated distress. Low desire is one of the most common sexual complaints among men and is associated with poor well-being. Interpersonal factors are key to understanding low desire, yet there are few dyadic studies of HSDD in men. Previous work on genito-pelvic pain and low desire in women has established that greater facilitative (eg, affectionate) partner responses are associated with greater sexual satisfaction and function and that more negative (eg, critical) or solicitous (eg, sympathetic, avoidant) partner responses are associated with lower sexual satisfaction and function. Examining how partner responses are associated with adjustment to HSDD may shed light on the interpersonal dynamics of this understudied sexual dysfunction.

AIM

In a cross-sectional study, we examined whether partner responses to low desire in men were associated with sexual desire, sexual satisfaction, and sexual distress for both members of the couple.

METHODS

Men with HSDD and their partners (N  =  67 couples) completed measures of facilitative, negative, and avoidant partner responses to men's low sexual desire-as perceived by the man with HSDD and self-reported by their partner-and sexual desire, sexual satisfaction, and sexual distress. Data were analyzed using multilevel modeling guided by the actor-partner interdependence model.

OUTCOMES

Outcomes included the partner-focused subscale of the Sexual Desire Inventory-2, Global Measure of Sexual Satisfaction, and Sexual Distress Scale-Revised.

RESULTS

When men with HSDD perceived more facilitative partner responses to their low desire, they and their partners reported greater sexual satisfaction. When men with HSDD perceived and their partners self-reported more negative partner responses, they each reported lower sexual satisfaction. In addition, when men with HSDD perceived more avoidant partner responses, their partners reported greater sexual distress. Partner responses were not associated with sexual desire for either member of the couple.

CLINICAL IMPLICATIONS

Findings support the importance of the interpersonal context for HSDD in men and suggest potential future targets of treatment when working with affected couples.

STRENGTHS AND LIMITATIONS

This study is one of the only dyadic studies of HSDD in men, as assessed via clinical interview or self-report symptoms reviewed by the clinical team. Despite our best efforts to recruit this sample over 6 years, the small size limited power to detect all predicted effects.

CONCLUSION

More facilitative and fewer negative or avoidant partner responses to low desire are associated with greater sexual well-being in couples coping with HSDD.

Examining intervention hours attended for couples randomly assigned to receive relationship education

Relationship education (RE) has shown promise as an effective intervention for couples. Yet, challenges exist with retaining low-income couples and federal funding required that grantees provide at least 12 h of core content. We conducted a follow-up analysis to a randomized trial of RE with low-income couples. We focused on couples randomly assigned to the treatment (N = 579) and examined the influence of intervention hours on emotion regulation, dyadic coping, and individual distress at 1 and 6-month follow-up. Results of longitudinal actor-partner interdependence models indicated that women who completed the program reported fewer difficulties in emotion regulation at 6-month follow-up than women who attended fewer intervention hours. Additionally, men who completed reported more individual distress at 1-month follow-up than men who attended fewer hours. Given that most couples were Hispanic, we conducted an exploratory analysis to examine language as a covariate with mixed results.

"Ultimately, You Realize You're on Your Own": The Impact of Prostate Cancer on Gay and Bisexual Men Couples

An estimated one in three gay and bisexual (GB) male couples receive a prostate cancer (PCa) diagnosis over their life course with limited understanding of the impacts on their relationships. Psychological distress related to PCa diagnosis and treatment-related side effects have been shown to disrupt established GB partnership dynamics. Communication barriers often develop within GB relationships affected by PCa, further exacerbating couple tensions, isolating partners, and lowering quality of life for both patients and partners. In order to elaborate on these phenomena following a PCa diagnosis, we conducted focus group discussions with GB men in relationships. Men were recruited nationally through PCa support groups, and after completing consent procedures, they were invited to one of two focus group discussions conducted through video conference. Topics discussed included the diagnosis and medical decision making pertaining to PCa; healthcare provider experiences; the emotional, physical, and sexual impact of PCa diagnosis and treatment; sources of support and appraisal of resources; and partner involvement and communication. There were twelve GB men who participated in focus group discussions that were audio-recorded and transcribed, and analyzed using a thematic approach. GB couple experiences with PCa during and after treatment choice and recovery identified common patient-provider communication barriers. In particular, GB men reported difficulties in disclosing their sexuality and relationship to their providers, limiting conversations about treatment choice and partner engagement in care. Both patients and partners experienced times of being alone after treatment, either by choice or to give space to their partner. However, partners often did not explicitly discuss their preferences for being alone or together, which resulted in partners' disengagement in their relationship and the prostate cancer healthcare process. This disengagement could blunt the notable PCa survival benefits of partnership for GB men.

Mobility is Associated with Higher-risk Sexual Partnerships Among Both Men and Women in Co-resident Couples in Rural Kenya and Uganda: A Longitudinal Cohort Study

Population mobility is associated with higher-risk sexual behaviors in sub-Saharan Africa and is a key driver of the HIV epidemic. We conducted a longitudinal cohort study to estimate associations between recent mobility (overnight travel away from home in past six months) or migration (changes of residence over defined geopolitical boundaries) and higher-risk sexual behavior among co-resident couples (240 couples aged ≥ 16) from 12 rural communities in Kenya and Uganda. Data on concurrent mobility and sexual risk behaviors were collected every 6-months between 2015 and 2020. We used sex-pooled and sex-stratified multilevel models to estimate associations between couple mobility configurations (neither partner mobile, male mobile/female not mobile, female mobile/male not mobile, both mobile) and the odds of higher-risk (casual, commercial sex worker/client, one night stand, inherited partner, stranger) and concurrent sexual partnerships based on who was mobile. On average across all time points and subjects, mobile women were more likely than non-mobile women to have a higher-risk partner; similarly, mobile men were more likely than non-mobile men to report a higher-risk partnership. Men with work-related mobility versus not had higher odds of higher-risk partnerships. Women with work-related mobility versus not had higher odds of higher-risk partnerships. Couples where both members were mobile versus neither had greater odds of higher-risk partnerships. In analyses using 6-month lagged versions of key predictors, migration events of men, but not women, preceded higher-risk partnerships. Findings demonstrate HIV risks for men and women associated with mobility and the need for prevention approaches attentive to the risk-enhancing contexts of mobility.

Understanding the sexual health perceptions, concerns, and needs of female partners of prostate cancer survivors

BACKGROUND

Prostate cancer (PCa) and its treatments can have a significant negative impact on the sexual health of survivors and couples, but few studies have specifically examined the impact of PCa-related sexual dysfunction on female partners of survivors.

AIM

Our objective was to perform a qualitative study to comprehensively characterize female partners' perceptions of the implications of PCa on their sex lives, as well as partners' sexual health concerns and unmet needs.

METHODS

We conducted semi-structured telephone interviews about sexual health and unmet needs with female partners of PCa survivors recruited from multiple clinical locations and support groups for PCa caregivers from September 2021 to March 2022. Interviews were audio-recorded, transcribed verbatim, and independently coded. Participants were recruited until thematic saturation was achieved.

OUTCOMES

Outcomes of this study were female partner sexual health concerns and unmet needs.

RESULTS

Among 12 participants, the median age was 65 (range 53 to 81) years, 9 were White, the median time since their partner's PCa diagnosis was 2.25 years (range 11 months to 20 years), and a majority reported that their partner had undergone radical prostatectomy, radiation, and/or hormonal therapy. Major emergent themes pertained to the significant impact of age- and PCa-related sexual dysfunction on female sexual quality of life, the dyadic nature of sexual dysfunction and recovery, the role of the partner in coping with and adjusting to sexual dysfunction, difficulties communicating about sexual dysfunction in an intimate relationship, a lack of physician-led sexual health counseling and support, and the benefit of peer interactions and proactive information seeking in addressing unmet sexual health needs.

CLINICAL IMPLICATIONS

Future efforts should continue to explore the impact of PCa on partner sexual health and address unmet needs through sexual health education and support.

STRENGTHS AND LIMITATIONS

In this study, we identified female partners' sexual health concerns both related to and independent of PCa survivor sexual health. Limitations include exclusion of male partners of survivors and potential responder bias, as partners who agreed to participate may have experienced more sexual health concerns.

CONCLUSION

We found that female partners experience PCa-related sexual dysfunction as a couple's disease, grief due to age- and PCa-related sexual losses, and a lack of physician-led sexual health counseling and information. Our results highlight the importance of including partners of PCa survivors in the sexual recovery process and of developing sexual care programs to address partners' unmet sexual health needs.

Positive and negative family communication and mental distress: Married service members during a non-combat deployment

This study examines whether married service member perceptions of positive or negative communication moderate the relationship between how frequently they communicate home during a deployment and their mental distress. Participants included 382 married service members who completed surveys regarding their marital relationships, communication, and mental health while on a non-combat deployment. Though marital satisfaction was not significantly associated with service member reports of their mental distress, perceptions of negative (β = 4.32, SE = 0.59, p < 0.001) and positive communication (β = -1.32, SE = 0.57, p < 0.05) were. Further, significant interactions between frequency of communication and the perception of negative (β = 0.54, SE = 0.13, p < 0.001) and positive (β = 0.17, SE = 0.07, p < 0.01) communication suggest positive communication may be protective for service members while frequent, negative communication can exacerbate distress. Findings highlight the importance of engaging families in planning and skill building to support healthy communication across the deployment cycle.

A scoping review of psychosocial interventions to enhance the relationship of couples living with dementia

When dealing with the challenges of dementia, spousal relationships have a central role to play in outcomes such as quality of care and emotional wellbeing. Dementia places strain on these relationships and so it is important to develop interventions to support them. This review maps out what interventions have been employed in this context. Searches of PsycInfo, PsycArticles, CINAHL, Embase, MEDLINE, and Web of Science were conducted to find studies describing interventions that aimed to improve some aspect of the relationship. Thirty-four studies were identified. A wide range and diversity of interventions were described, including life review, psychotherapy and ones focused on communication or creative activity. Reported benefits included meaningful interaction, emotional connection, reduced conflict and negativity, an increase in mutual support, and greater equality in the relationship. However, these can only be considered as potential rather than proven benefits because of the lack of methodological rigour of most of the studies. Future research on this topic would benefit from a closer links with research on the impact that dementia can have on spousal relationships, and from the use of stronger methodology.

Relationship Functioning and Gut Microbiota Composition among Older Adult Couples

An emerging area of research extends work on couple functioning and physical health to gut health, a critical marker of general health and known to diminish with age. As a foray into this area, we conducted a pilot study to (1) determine the feasibility of remote data collection, including a fecal sample, from older adult couples, (2) examine within-couple concordance in gut microbiota composition, and (3) examine associations between relationship functioning and gut microbiota composition. Couples (N = 30) were recruited from the community. The participants' demographic characteristics were as follows: M (SD) age = 66.6 (4.8), 53% female, 92% White, and 2% Hispanic. Two of the couples were same-sex. All 60 participants completed self-report measures and supplied a fecal sample for microbiome analysis. Microbial DNA was extracted from the samples, and the 16S rRNA gene V4 region was amplified and sequenced. The results indicated that individuals shared more similar gut microbial composition with their partners than with others in the sample, p < 0.0001. In addition, individuals with better relationship quality (greater relationship satisfaction and intimacy and less avoidant communication) had greater microbial diversity, p < 0.05, a sign of healthier gut microbiota. Further research with a larger and more diverse sample is warranted to elucidate mechanisms.

Relationship dynamics associated with emotional IPV perpetration and victimization: A meta-analysis

Emotional intimate partner violence (IPV) is the most common form of IPV and frequently co-occurs with other forms of IPV. Risk factors of IPV can give insight to potential pathways and consequences associated with IPV, enhancing treatment efforts. This meta-analysis examined relationship dynamics associated with IPV perpetration and victimization. Our study found victimization of controlling behavior, demand/withdrawal relationship pattern, perpetration of controlling behavior, jealousy, relationship distress, perpetrator's power in the relationship, anxious attachment, and traditional gender roles were all significantly associated with IPV perpetration. For IPV victimization, victimization of controlling behaviors, fear of the perpetrator, relationship distress, anxious and avoidant attachment, and traditional gender roles were all found to be significantly associated. Relationship satisfaction was found to be negatively associated with emotional IPV perpetration and victimization. Implications for clinicians are discussed.

Positive illusions about dyadic perspective-taking as a moderator of the association between attachment insecurity and marital satisfaction

Attachment insecurity (i.e., attachment anxiety or avoidance) puts people at risk for dissatisfying relationships. However, the dyadic regulation model of insecurity buffering suggests that an understanding and responsive partner may help insecure individuals to regulate emotions, thus improving couples' relationships. It may also be that perceiving partners as understanding and empathic, especially in an exaggeratedly positive way (i.e., positive illusions) will buffer insecurity. In 196 mixed-gender newlywed couples, we investigated whether spouses' positive illusions about partner's dyadic perspective-taking moderated the association between spouses' attachment insecurity and spouses' and partners' marital satisfaction over two years. Positive illusions generally predicted more satisfying relationships and attachment avoidance consistently predicted more dissatisfying relationships. There were also several instances where multilevel modeling indicated that positive illusions of dyadic perspective-taking buffered the negative effects of attachment avoidance on relationship satisfaction. However, there was also potentiation such that in two instances, positive illusions about dyadic perspective-taking strengthened the association between spouses' insecurity (husbands' attachment anxiety and wives' attachment avoidance) and subsequent marital dissatisfaction. In the moment, positive illusions about dyadic perspective-taking may allow spouses to feel happy in their relationship despite fear of emotional intimacy; however, positive illusions may not continue to buffer effects of insecurity on subsequent relationship satisfaction and may even be harmful in the face of insecurity.

Sexual Health Outcomes of Adolescent and Young Adult Colorectal Cancer Survivors and Their Partners: Protocol of a Dyadic Mixed Methods Study

BACKGROUND

Sexual dysfunction represents a critical aspect of quality of life for adolescent and young adult cancer survivors. Studies have consistently documented that adolescents and young adults report greater psychological and physical morbidity than older survivors and healthy peers, including elevated rates of sexual dysfunction, often accompanied by lower satisfaction with sex life and delays in meeting sexual milestones. Moreover, sexual dysfunction, body image concerns, and fertility status affect their confidence in being both physically and emotionally intimate. Despite this evidence, limited research has investigated the influence of psychosocial and interpersonal factors on sexual health outcomes reported by this group. This constitutes a significant gap in the provision of comprehensive sexual health care for adolescent- and young adult-onset cancer survivors, especially since greater emphasis has been recently placed on the biopsychosocial model of sexuality and dyadic approaches to intervention and treatment. In comparison to other cancer types, the incidence of colorectal cancer (CRC) has been increasing at an alarming rate for the adolescent and young adult group. Patients with early-onset CRC experience elevated rates of sexual dysfunction, psychological distress, and social and physical burden, often resulting from issues with bowel control, incontinence, and body image.

OBJECTIVE

This study uses an explanatory sequential mixed methods approach to (1) characterize sexual function, sexual distress, dyadic coping, infertility-related distress, relationship and mental health outcomes of adolescent and young adult CRC survivors within the first 5 years post diagnosis and their partners; (2) examine the reciprocal influence of sexual function and dyadic coping behaviors on sexual distress; and (3) identify interpersonal or couple characteristics associated with coping with sexual dysfunction and its associated distress.

METHODS

Participating couples (n=60) will complete a quantitative web-based survey investigating sexual function, sexual distress, dyadic coping, infertility-related distress, emotional functioning, relationship satisfaction, and body image (cancer survivors only). A subset of 20 couples will participate in an in-depth dyadic interview with 2 members of the research team to further explore couple-based strategies implemented to cope with cancer-related sexual dysfunction and distress.

RESULTS

The study received institutional review board approval. Recruitment and enrollment of couples began in July 2022.

CONCLUSIONS

Results will provide a deeper understanding of the challenges couples experience as they navigate sexual intimacy after CRC treatment by highlighting the role of interpersonal processes. These findings will inform a dyadic intervention for young couples at risk of greater sexual distress in the aftermath of CRC.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/41831.

Promoting resilience to depression among couples during pregnancy: The protective functions of intimate relationship satisfaction and self-compassion

Pregnancy, while often marked by joy, may pose considerable risk for depression among parents. Against a backdrop of adverse life events, expectant parents may be even more vulnerable to developing symptoms of depression during the prenatal period. Thus, it is critical to identify sources of resilience that might facilitate a successful transition to parenthood among couples who have a history of adversity. Prior work suggests that interpersonal and intrapersonal factors associated with resilience, such as intimate relationship satisfaction and self-compassion (i.e., self-kindness, common humanity, and mindfulness), have the potential to attenuate prenatal depression among couples with a history of stressful life experiences. We tested this possibility in a sample of 159 couples navigating pregnancy. As predicted, a greater number of prior stressful life experiences was associated with increased depression symptom severity for both mothers and fathers. However, moderation analyses revealed the positive link between cumulative stressful life experiences and depression symptom severity was attenuated among mothers who reported greater self-compassion in the form of feelings of common humanity, and fathers who reported higher levels of intimate relationship satisfaction and self-compassion in the form of mindfulness. Findings suggest enhancing intimate relationship satisfaction and self-compassion among expectant couples may be valuable in attenuating prenatal depression among those with a greater history of adversity.

A mixed-methods study of relationship stigma and well-being among sexual and gender minority couples

Research has documented associations between relationship stigma, relationship quality and adverse health outcomes among sexual and gender minority couples. However, this work focused primarily on one aspect of an individual's or a couple's identity rather than understanding the intersections of multiple, stigmatized social identities. As part of a larger project focused on testing the efficacy of a couples-based intervention to improve HIV medication adherence, 144 couples completed measures of relationship stigma, relationship quality, mental health, and substance use. A subset of 25 participants completed in-depth interviews to better understand the phenomenon of relationship stigma and its impact on their relationships. Quantitative results demonstrated that greater relationship stigma was associated with reduced relationship satisfaction and commitment, as well as greater closeness discrepancy and depressive symptoms. Qualitative findings provided nuanced insights into forms of relationship stigma that often intersected with other types of stigma and related forces of social and structural violence. Results also demonstrated the differential impact that relationship stigma had on couples and the ways in which individuals make adjustments to cope with or actively combat societal stigma. Findings illustrate the importance of attending to intersecting forms of stigma in addressing the well-being of sexual and gender minority couples.

A randomized comparison of group mindfulness and group cognitive behavioral therapy vs control for couples after prostate cancer with sexual dysfunction

BACKGROUND

Sexual dysfunction is the most common and most distressing consequence of prostate cancer (PCa) treatment and has been shown to directly affect the sexual function and quality of life of survivors' partners. There are currently no established therapies to treat the emotional and psychological burden that sexual issues impose on the couple after PCa.

AIM

Our study examined the impact of 2 therapies-cognitive behavioral therapy (CBT) and mindfulness therapy-on sexual, relational, and psychological outcomes of PCa survivor and partner couples.

METHODS

PCa survivors (n = 68) who self-reported current sexual problems after PCa treatments and their partners were randomized to 4 consecutive weeks of couples' mindfulness therapy, couples' CBT, or no treatment (control).

OUTCOMES

Couples' sexual distress, survivors' sexual satisfaction, and couples' relationship satisfaction, quality of life, psychological symptoms (anxiety and depression), and trait mindfulness were measured at baseline, 6 weeks after treatment, and 6 months after treatment.

RESULTS

Sexual distress and sexual satisfaction were significantly improved 6 weeks after the CBT and mindfulness interventions as compared with the control group, but only sexual distress remained significantly improved at 6 months. Relationship satisfaction decreased and more so for partners than survivors. There were increases in domains of quality of life for survivors vs their partners 6 months after treatments and an overall increase in general quality of life for couples 6 weeks after mindfulness. There were no significant changes in psychological symptoms and trait mindfulness. Qualitative analysis showed that the mindfulness intervention led to greater personal impact on couple intimacy after the study had ended.

CLINICAL IMPLICATIONS

CBT and mindfulness can be effective treatments for helping couples adapt to and cope with changes to their sexual function after PCa treatments and could help improve the most common concern for PCa survivors-that is, couples' sexual intimacy-after cancer, if added to routine clinical care.

STRENGTHS AND LIMITATIONS

We used established standardized treatment manuals and highly sensitive statistical methodology and accounted for covariable factors and moderators of primary outcomes. Due to difficulty in recruitment, we had a smaller control group than treatment, reducing our power to detect between-group differences. Our sample was mostly White, heterosexual, and affluent, thereby limiting the generalizability.

CONCLUSION

This is the first randomized clinical trial to test and demonstrate benefits among PCa survivors and partners' sexual outcomes after CBT and mindfulness as compared with a nontreatment control group.

The Influence of Home-Based Music Therapy Interventions on Relationship Quality in Couples Living with Dementia-An Adapted Convergent Mixed Methods Study

Relationship quality is important for well-being and quality of life in couples living with dementia. Home-based music therapy interventions may be conducted with the aim of enhancing relationship quality. However, the effects or influences of such interventions are only briefly investigated in previous studies. This study's aim was to identify how a 12-week home-based music therapy intervention may influence relationship quality in couples living with dementia, through an adapted convergent mixed methods design. In this case, 68 participating couples from the HOMESIDE RCT study, and four individually recruited couples, received the music therapy intervention. Relationship quality for all participants was measured by the standardized Quality of Caregiver-Patient Relationship scale, and qualitative interviews were conducted with the four individually recruited participants at baseline and post intervention. Quantitative analysis indicated no statistically significant intervention effect. However, relationship quality remained stable over the intervention period. The qualitative analysis identified that the music therapy interventions primarily led to positive emotions, closeness, intimacy, and communication between the persons with dementia and their care partners. Intervention influences could also be ambiguous, as sharing music experiences might involve a risk of evoking vulnerabilities or negative emotional responses.

Does income moderate basic relationship processes?

Objective

This study explores whether household income moderates the predictive association from adaptive processes (positive and negative interactions and commitment), enduring vulnerabilities (psychological distress), and stressors (financial strain) to future relationship satisfaction?

Background

Theory and research have long conceptualized socioeconomic status as a predictor of couple relations, but recent work questions whether socioeconomic status may moderate basic couple relationship processes.

Method

This study used data from a U.S. national sample of 927 adults aged 18-34 years in a cohabiting (marital or nonmarital) different-sex partnership (66% female; 22% non-White; 47% earned a high school diploma or GED as their highest education credential) surveyed five times at 4-to 6-month intervals. A series of latent curve models with structured residuals were used to examine between- and within-person associations.

Results

Robust between-persons associations emerged consistent with prior literature (e.g., those with more positive and less negative interactions, higher commitment, lower psychological distress, and less financial strain reported higher relationship satisfaction). One robust longitudinal association emerged at the within-person level: higher than typical negative interactions predicted intraindividual decreases in future relationship satisfaction. Within-person associations were more evident in the cross-section: at times when positive interactions and commitment were higher than one's own average and negative interactions and psychological distress were lower than average, relationship satisfaction was also higher than average. Income did not moderate any links with future relationship satisfaction.

Conclusion

Results suggest that basic longitudinal processes in relationships operate consistently across income level.

Couples' experiences with sexuality after spinal cord injury

PURPOSE

To explore sexuality after spinal cord injury (SCI) from the perspectives of individuals with SCI and their romantic partners.

METHODS

A sample of 8 Canadian adults with SCI (6 men, 2 women) and their partners participated in this study (N = 16). Semi-structured dyadic and individual interviews were conducted, discussions surrounding sexuality and intimacy were extracted, and a qualitative description of the interview data was performed using thematic analysis.

RESULTS

Three major themes were identified: the changing definition of sex; emotions; and practical support. Couples' conversations around the changing definition of sex after SCI addressed the taboo topic of sexuality and the importance of communication between couples, peers, and healthcare providers. Emotions included fears of losing intimacy, embarrassment in managing bladder and bowel interference, and acceptance in balancing being a romantic partner and a caregiver. Finally, couples reported challenges accessing practical support including medical interventions and sexual health nurses, but saw value in peer mentorship programs.

CONCLUSION

Couples explored a changing definition of sex following SCI that was complicated by the taboo nature of discussing sexuality, experienced a range of emotions throughout the recovery process, and had difficulties navigating the healthcare system for appropriate support.IMPLICATIONS FOR REHABILITATIONHealthcare professionals should promote discussion and provide support for sexuality following SCI, but during initial rehabilitation may be too early.Healthcare providers should prepare people with SCI and their partners for the inevitable trial-and-error process involved in sexual rehabilitation.Rehabilitation professionals could direct couples to SCI peer mentorship programs to help normalize the experiences and emotions of sexual rehabilitation.

The relationship of marital adjustment and posttraumatic growth in female breast cancer patients and their husbands

Posttraumatic growth (PTG) is very important for breast cancer couples to cope with cancer. Individual marital adjustment can affect PTG, however, it is still unknown that the effect of marital adjustment on one's own and their spouses' PTG in breast cancer couples. To investigate the status of PTG and marital adjustment and explore the relation between PTG and marital adjustment in breast cancer patient-husband dyads. General data, marital adjustment and PTG scores of breast cancer patients (N = 206) and their husbands (N = 206) were collected through a general information questionnaire, the Post-traumatic Growth Inventory (PTGI) and Marital Adjustment Test (MAT). T-tests and structural equation models were applied to explore the relations between marital adjustment and PTG among breast cancer patients and their husbands. The PTG among breast cancer patients was significantly higher than among their husbands (P < 0.05); the score of patients' marital adjustment was 96.18 ± 22.08, and that of their husbands was 96.22 ± 22.27. The participants' marital adjustment had a positive predictive effect on their own PTG (P < 0.05), and patients' marital adjustment also had a positive predictive effect on their husbands' PTG (P < 0.05). Breast cancer patients experienced more PTG than their husbands; patients' PTG was promoted by their own marital adjustment, while husbands' PTG was promoted by both their own and the patient's marital adjustment. In order to improve breast cancer patients' and their husbands' PTG, it is essential to promote their marital adjustment.

A descriptive literature review of early research on COVID-19 and close relationships

This in-depth critical review investigates the impact of COVID-19 on personal relationships from the start of the pandemic in early 2020 to September 2021. Research examining six themes are identified and described in detail: the impact of COVID-19 on (1) family and intimate relationships; (2) LGBTQ+ relationships; (3) how COVID-19 is linked to technologically mediated communication and personal relationships; (4) potential shifts in sexual behaviors and desire; (5) potential shifts in relational conflict and intimate partner violence; and (6) constructive aspects of personal relationships, which is a broad theme that includes outcomes such as resilience, relational quality, coping, and social support. Findings for overarching patterns are offered to highlight implications for current research and identify future directions to consider when continuing to study personal relationships during the COVID-19 pandemic and similar future crises.

Parent couple conflict and emotional and behavioral problems in youth with autism: Longitudinal investigation of bidirectional effects

Families of youth with autism spectrum disorder (ASD) are vulnerable to maladaptive psychosocial experiences, including elevated youth emotional and behavioral problems (EBPs) and poor parent couple relationship outcomes. Yet, the extent to which these family psychosocial experiences are intertwined has been given little research attention. The present study longitudinally investigated the bidirectional associations between parent couple conflict (PCC) and youth EBPs in 188 families of children and adolescents with ASD (initially aged 5 to 12 years) across four time points (T1, T2, T3, T4), each spaced 12 months apart. Mother- and father-report of youth EBPs and PCC were entered into a cross-lagged panel model. After adjusting for youth age and intellectual disability status and parent education and couple relationship length, the results indicated that father-report of PCC predicted increased youth EBPs 12 months later (T1→T2 and T2→T3). In addition, father-report of youth EBPs predicted increased PCC 12 months later (T3→T4). Mother-report did not demonstrate cross-lagged effects. The findings suggest that fathers' perceptions of PCC and youth emotional and behavioral functioning are transactionally related, highlighting the need for family-wide interventions.

An exploration of potential pressures to engage in parenting accommodation of PTSD symptoms for military couples

In the context of service member posttraumatic stress disorder (PTSD) symptoms, intimate partners may experience pressure to take over parenting roles and run interference between the service member and the children; that is, to engage in partner accommodation focal to parenting. The current study quantitatively assessed potential pressures to engage in parenting accommodation (PPEPA) in a sample of 207 female partners married to male service members with at least one child in the home and the convergence of PPEPA with service member PTSD symptoms, general partner accommodation, couple functioning, parenting, and child functioning. Partners' reports of PPEPA were associated with higher levels of service member PTSD symptoms and partners' general accommodation of PTSD symptoms. When controlling for service member PTSD symptoms and general partner accommodation, partner reports of PPEPA still accounted for unique variance in lower parenting alliance (as reported by both service member and partner), lower levels of service members' reports of closeness with children in the home, higher levels of harsh parenting by both the service member and partner, and greater child behavioral difficulties. Findings support PPEPA as related to partners' accommodative responses to PTSD but demonstrating unique associations with parenting alliance, parenting, and child outcomes. Parenting interventions in the context of PTSD may benefit from conjoint or family approaches that attend to the intersection of PTSD and broader family functioning, including pressures to engage in accommodation focal to the parenting domain.

Sexual boredom and sexual desire in long-term relationships: a latent profile analysis

BACKGROUND

Research suggests a general link between sexual boredom and sexual desire, but its understanding is currently very limited.

AIM

To identify distinct (latent) groups of women and men in long-term relationships based on their reported levels of sexual boredom and sexual desire.

METHODS

Latent profile analysis (LPA) was conducted in an online sample of 1223 Portuguese participants aged 18 and 66 years (mean ± SD, 32.75 ± 6.11), using indicators of sexual boredom and partner-related, attractive other-related, and solitary sexual desire to categorize participants. Multinomial logistic regression analysis was carried out to explore predictors and correlates of the latent profiles.

OUTCOMES

Sexual boredom was assessed by the Sexual Boredom Scale, while sexual desire was measured with the Sexual Desire Inventory.

RESULTS

As compared with women, men reported higher levels of sexual boredom and sexual desire. LPA indicated 3 profiles in women and 2 profiles in men. Among women, P1 was characterized by above-average sexual boredom, below-average partner- and attractive other-related sexual desire, and very low solitary sexual desire; P2 by below-average sexual boredom, attractive other-related sexual desire, and solitary sexual desire and above-average partner-related sexual desire; and P3 by above-average sexual boredom, attractive other-related sexual desire, and solitary sexual desire and below-average partner-related sexual desire. In men, P1 was characterized by high sexual boredom, above-average partner-related sexual desire, and high attractive other-related and solitary sexual desire and P2 by below-average sexual boredom and above-average partner-related, attractive other-related, and solitary sexual desire. The latent profiles did not differ according to relationship duration. Overall, the sole consistent correlate of the latent categorization was sexual satisfaction.

CLINICAL IMPLICATIONS

In women, above-average levels of sexual boredom were linked to below-average levels of partner-related desire, which suggests likely benefits of helping the couple to minimize or cope better with their sexual routines. In men, participants in the 2 profiles did not differ in partner-related sexual desire, suggesting that clinical interventions dealing with male sexual boredom should investigate factors beyond the current relationship.

STRENGTHS AND LIMITATIONS

This study explored different facets of sexual desire and used LPA, rendering advantages over previous research. The male sample has lower statistical power than the female sample.

CONCLUSION

Patterns of sexual boredom and sexual desire among individuals in long-term monogamous relationships are distinct and consistently related to sexual satisfaction in women and men and to relationship satisfaction among only women, which have important clinical ramifications.

Compassionate mind training for ex-service personnel with PTSD and their partners

Posttraumatic stress disorder (PTSD) is a significant issue for a substantial proportion of Australian ex-service personnel. In addition to the functional impact on individuals, PTSD can have a significant impact on intimate partner relationships. Research has demonstrated that practicing compassion and self-compassion may be an important component of psychological therapy for survivors of trauma, while also demonstrating benefits to intimate relationships. This pilot study aimed to investigate the utility of a Compassionate Mind Training intervention for ex-service personnel with PTSD and their partners. An uncontrolled, within-subjects, longitudinal design was utilized with assessment at pre-intervention, post-intervention and 3-month follow-up. Twenty-four participants attended 12 biweekly group sessions. Self-report measures of compassion, quality of life and psychological symptoms were administered at each time point. Findings demonstrated a significant reduction in fears of compassion and PTSD symptoms for ex-service personnel at 3-month follow-up and a reduction in depressive symptoms and increase in quality-of-life and social safeness at post-intervention. Additionally, significant reductions in anxiety, stress, external shame and self-criticism at 3-month follow-up were found, and couples reported significant increases in relationship satisfaction. Findings from this pilot study demonstrate promising outcomes, warranting further investigation in a larger randomized controlled trial of Compassionate Mind Training for ex-service personnel and their partners.

Attachment insecurities and under-commitment in distressed couples: The role of positive and negative partner behaviors

Research has rarely considered intermediate variables in the association between attachment insecurities and relationship commitment. Based on attachment theory and Rusbult's Investment Model, we tested whether positive and negative partner behaviors explain this association in 91 distressed couples undergoing therapy. Path analyses based on the Actor-Partner Interdependence Model revealed that individuals with attachment avoidance reported perceiving fewer positive behaviors from their partner, which was associated with their own higher under-commitment. Partners of individuals with avoidance also reported perceiving fewer positive partner behaviors, which was in turn associated with their own higher under-commitment. Partners of individuals with attachment anxiety perceived more positive behaviors from their partner, which was associated to their own lower under-commitment. Perceived negative partner behaviors were only directly associated with higher under-commitment. These findings imply that perceived positive partner behaviors may be a key aspect to target in relationship therapy in couples who present with high attachment insecurities.

Construction and validation of Rejection Sensitive Expectation, Perception, and Reaction Questionnaire-Partner (RSEPR-P)

The Rejection Sensitive Expectation, Perception, and Reaction Questionnaire-Partner (RSEPR-P) was developed to assess rejection expectation, perception of rejection, and reactions to perceived rejection among intimate partners. This article details the construction and validation procedures, including item pool generation, factor analysis, and the estimation of reliability and validity. The researchers examined the psychometric properties of RSEPR-P in a community sample of 151 participants. Confirmatory factor analysis (CFA) with the final 24 items suggested four-factor loading with each subscale loading on a separate factor. The subscales had good to excellent internal consistency. In support of the convergent validity, RSEPR-P exhibited robust correlations with rejection sensitivity-personal, mindfulness, marital adjustment, and self-esteem measures. A 6-month test-retest reliability was established. RSEPR-P is proposed to have potential therapeutic and research utility.

Answering the ethical call of the other: A test of the Strong Relationality Model of Relationship Flourishing

The philosophical framework of strong relationality has gained greater attention in scholarship and yet empirically testing models built on this important framework are rare. The present study tests predictions made by the Strong Relationality Model of Relationship Flourishing (SRM), which centers on the role of Ethical Responsiveness for relationship health. In doing so, we introduce common fate modeling as a methodological approach for strong relationality research. We used longitudinal data from 1512 couples collected as part of the German longitudinal panel study of families. Results support the Strong Relationality Model's prediction that Ethical Responsiveness (as measured by perceived partner support) positively alters the impact of stress on Gratitude-Recognition (elements of the Responsible Action domain of the SRM), which then increases couples' intimacy (an element of the Relational-Connectivity domain of the SRM). Recommendations for clinical assessment and intervention are given as well as recommendations for future research on the Strong Relationality Model.

University-church partnerships: A mechanism to enhance relationship health

Romantic relationship distress leads to decreased satisfaction and dissolution. While therapy is effective for helping distressed couples, it is often inaccessible due to cost, time, and childcare barriers. Churches are often able to offer lower-cost services and provide childcare. In partnership with a network of local churches, university staff trained lay leaders to deliver an evidence-based relationship education program and collected data from 97 couples to evaluate pre- to post-workshop changes in couple functioning. Multilevel modeling was used to examine changes from pre- to post-workshop and thematic analysis was used to analyze open-ended feedback responses. Results showed improvements in communication, relationship satisfaction, commitment, and intimacy safety, with the largest effect found for communication. Participants also reported improved communication skills were one of the most beneficial parts of the program. Through the partnership with a university, churches can offer and rigorously evaluate evidence-based programs to strengthen couple relationships in their communities.

Changes in couple, parenting, and individual functioning following Family Expectations program participation

The current study investigated changes in couple, parenting, and individual functioning following participation in Family Expectations, a relationship and parenting education program for new or expectant parents. The sample comprised 339 couples who participated in most sessions of the Family Expectations program and completed assessments at three different time points over a 12-month period. Study analyses examined: (a) change shortly following completion of the program, (b) associations between short-term change and subsequent change in outcomes at 12-month follow-up, and (c) differences in short-term change between married and unmarried couples. Significant improvements were observed in all three domains at short-term follow-up. Short-term changes, particularly for psychological distress, were predictive of long-term change in multiple domains. Few moderation effects by marital status were evident; those that appeared suggested stronger effects for married participants compared to unmarried. Study findings inform ongoing discussions into the utility of federally-funded relationship and parenting programming.

"We're in this together": Attachment insecurities, dyadic coping strategies, and relationship satisfaction in couples involved in medically assisted reproduction

Attachment is an important predictor of relationship satisfaction and attachment insecurities are a risk factor for couples under stress. Drawing from the Vulnerability-Stress-Adaptation model, we investigated whether dyadic coping strategies (DCS) would explain the links between attachment insecurities and relationship satisfaction in 97 couples involved in medically assisted reproduction (MAR). Path analyses revealed that for women and men, attachment insecurities (anxiety, avoidance) were associated with their own lower relationship satisfaction through their lower use of positive DCS. Attachment avoidance was also associated with participants' own lower relationship satisfaction through their own lower use of negative DCS. Men's attachment avoidance was also related to their partner's lower relationship satisfaction via their own and their partner's lower use of positive DCS. The findings suggest that promoting the use of positive DCS may be important to preserve relationship satisfaction in couples involved in MAR.

What to expect physiologically when you're expecting couples in therapy: A Changing Hearts and Minds in relationshiPS (CHAMPS) descriptive study

Recent efforts to improve marital therapy interventions have begun investigating psychophysiologic processes in therapy. These studies are novel and represent initial investigations into relevant phenomena associated with the therapy process. Grounded in Polyvagal Theory, this study introduces an on-going multimethod couple therapy process research (CHAMPS) and highlights the importance of establishing norms among distressed couples in therapy, which can provide context for other studies' results and instigate further investigation of physiology in marital therapy. Using a sample of 24 married, heterosexual couples (N = 48), we examine trends in markers of sympathetic (SNS) and parasympathetic nervous system (PNS) functioning; namely, electrodermal activity (SNS), cardiac impedence (SNS), and respiratory sinus arrhythmia (PNS) before and during therapy sessions and shifts in these measures over the course of four therapy sessions. We discuss clinical implications and provide recommendations for further investigations.

Is it really that important to you? How the topics of conflict and emotional reactions to conflicts explain the associations between attachment insecurities and relationship satisfaction

This study sought to examine the intermediary roles of different topics of conflict and negative emotions following conflicts in the associations between attachment insecurities and relationship satisfaction in a sample of 253 mixed-gender couples from the community. Results from path analyses based on the Actor-Partner Interdependence Model showed that attachment anxiety and attachment avoidance were associated with the perception, in both partners, of experiencing more conflicts in the relationship. In turn, the more participants perceived conflicts related to major issues and daily annoyances, the more they reported negative emotions following conflicts and lower relationship satisfaction. Participants' report of conflicts related to major issues was also related to their partner's lower relationship satisfaction. Findings highlight the significance of accounting for the topics on which couples argue and of using an attachment-based framework to help couples deal with the negative emotions that they experience following conflicts.

The associations of COVID-19 percent positivity rate, relationship quality, and season with daily anxiety and depression in couples living in NYC

Background

The COVID-19 pandemic changed nearly every aspect of daily life and had detrimental effects on mental health. Yet, impacts have been heterogeneous. We tested whether fluctuations in local COVID-19 percent positivity rates were associated with daily anxiety and depression in couples living in NYC, as well as whether these associations varied by relationship quality or season. We expected that adverse impacts of COVID-19 may be attenuated by high-quality relationships and during warmer months, or that people may habituate over time.

Methods

Data on seven-day rolling average COVID-19 percent positive rate each day in NYC were merged with a 14-day dyadic diary study of cohabiting couples living in NYC between August 2020 through April 2021 (232 individuals from 116 couples; mean age 28.42 years, 52.59% female, 53.02% White). Dyadic multilevel models estimated the association COVID-19 positivity rate, season (sine and cosine of the calendar date), baseline relationship quality, and all two-and three-way interactions of these variables with daily anxiety and depression. Covariates included weekend and COVID-positive case within the couple.

Results

Anxiety and depression mirrored COVID-19 positivity rates, and there was some evidence for habituation over time. Significant two-and three-way interactions suggested that being in a high-quality relationship buffered the association of COVID-19 positivity rate with both anxiety and depression during months when cases were low. Anxiety was elevated for individuals in high- (v. low-) quality relationships during the December-January surge.

Conclusion

Seven-day rolling average COVID-19 percent positivity rate was associated with daily anxiety and depression among couples living in NYC. There was some evidence that individuals habituated to this stressor over time and that high-quality relationships were protective for mental well-being; however, there was some suggestion that couples in high-quality relationships may have engaged in processes such as co-rumination during surges, worsening their daily anxiety.

The link between infertility-related distress and psychological distress in couples awaiting fertility treatment: a dyadic approach

While there is broad evidence to suggest that individual stress increases, and that high couple relationship quality reduces the risk for psychological distress, our understanding of these associations in couples dealing with infertility remains limited. In this cross-sectional study, we used dyadic data-analysis (Actor-Partner Interdependence Model; APIM) to examine the effects of infertility-related distress (experienced as an individual risk factor) and couple relationship quality (experienced as a couple-based resource), on psychological distress in a sample of 116 infertile couples. 59% of women and 23% of men reported clinical levels of psychological distress, 71% of women and 45% of men reported infertility-related distress, and 3% of participants reported low couple relationship quality. Infertility-related distress predicted psychological distress at the individual level ('actor effects') while men's infertility-related distress predicted women's psychological distress (partner effect'). Women without medically assisted reproduction (MAR) treatment exposure reported significantly higher couple relationship quality than women with MAR exposure, and men without treatment exposure reported significantly lower infertility-related distress than men with exposure. The level of psychological distress depended on whether both or neither of the partners, or only one partner reported infertility-related distress. Couple relationship quality was not associated with distress, which may imply that dyadic dimensions other than overall satisfaction could be relevant in supporting couples facing infertility.

"I think it's communication and trust and sharing everything": Qualitative evidence for a model of healthy intimate relationships in Black women living with HIV and men in KwaZulu-Natal, South Africa

In South Africa, couple-based interventions (CBIs) have been used to increase HIV testing, reduce HIV transmission, and shift relationship dynamics. To understand local definitions of healthy relationships, this study sought to collect qualitative data on a model of healthy relationships in a semi-rural area of KwaZulu-Natal, South Africa. We conducted semi-structured qualitative interviews with HIV-positive women (n = 15) and men of mixed HIV status (n = 15) who were in heterosexual, monogamous relationships (not with each other). Thematic analyses guided coding. Three primary healthy relationship behaviour themes emerged, labelled open communication, couple-level problem-solving, and active relationship building, which were related to various relationship facets (trust, support, respect, commitment, and connection). We purposively explored contextual themes, namely the role of HIV, positive community involvement, and power dynamics, to better situate the healthy relationship behaviour themes. HIV was not central to relationship conceptualisations and three different power structures (shared power/flexible gender norms, shared power/traditional gender norms, male-dominated power/traditional gender norms) were described as being healthy. This model of healthy relationships is similar to observed definitions in other African countries and in high-income settings. Findings can inform HIV programming content for couples in KwaZulu-Natal, particularly the active relationship building component.