Longitudinal anxiety in couples during a global pandemic: Considering loss, attachment behaviors, and trauma coping self-efficacy

The COVID-19 (SARS-COV-2) pandemic has had a significant impact on multiple domains of daily functioning in communities, families, and couples. Research on couple dynamics amid mass stress events using dyadic data is still limited. As such, the current study employed a cross-lagged panel design with 535 cisgender, heterosexual couples to explore longitudinal paths between pandemic-related loss, attachment behaviors, trauma coping self-efficacy, and anxiety symptoms. Data were collected at three time points between April and October 2020. The findings demonstrated the potentially mobilizing nature of loss. Higher levels of loss associated with higher levels of attachment behaviors in partners later and higher levels of trauma coping self-efficacy for men in a partner effect at one lag. Higher levels of attachment behaviors generally associated with improved trauma coping self-efficacy at the next wave within and across partners, and higher levels of trauma coping self-efficacy appeared to offset later anxiety within partners. On the other hand, within partners, greater loss is associated with lower levels of attachment behaviors within partners across time. Furthermore, higher anxiety is associated with lower levels of TCSE and higher levels of loss within partners across most lags. Finally, higher trauma coping self-efficacy is associated with less loss within men at one lag, and greater loss within men at the later lag, which may demonstrate stress and efforts to mobilize to meet it. Indirect effects were found implying the intermediary nature of anxiety and trauma coping self-efficacy in explaining wave 3 anxiety. Implications for practice and further research are discussed.

COVID-19 distress and interdependence of daily emotional intimacy, physical intimacy, and loneliness in cohabiting couples

Introduction

COVID-19 has had a profound impact on relationship functioning, though effects have been heterogeneous. Reasons for divergent effects on relationship functioning remain unclear. Theoretical models suggest that it is not just stress exposure that leads to adverse relationships outcomes, but also subjective response to these stressors. Using data from a 14-day intensive longitudinal study of romantic dyads, we hypothesized that COVID-19-related distress would adversely impact one's own and one's partner's report of relationship functioning, on average. Interdependence at the between-couple and within-couple level was also examined.

Methods

Participants were 104 female-male romantic couples cohabiting the New York metropolitan area (Mage = 28.86, SDage = 7.69) between August 2020 - April 2021. Couples reported COVID-19 distress during a baseline interview and daily relationship functioning for 14 days. Multilevel models were specified for six outcomes simultaneously: female and male partner daily physical intimacy, emotional intimacy, and loneliness. Interrelationships of the intercepts of the six outcomes were specified, reflecting between-couple associations of each partner's stable outcome tendencies. Interrelationships of the daily residuals of the six outcomes were also specified, reflecting within-couple associations at the daily level.

Results

Female partner COVID-19 distress was inversely associated with her own emotional and physical intimacy and positively associated with her own and her partner's loneliness. Male COVID-19 distress was associated with his own loneliness only. There was significant interdependence at the between- and within-couple level, such that greater loneliness in either partner was associated with less intimacy in each member of the couple.

Discussion

Only one partner effect for COVID-19 distress emerged, such that female partner distress was associated with male partner loneliness; however, interdependence at the between- and within-couple level suggested that distress may adversely impact relational well-being over time. Future studies should examine reciprocal relationships between COVID-19-related distress and relationship functioning.

Couples-based interventions to promote PAP adherence among older adults: a qualitative study of patients, partners, and providers

STUDY OBJECTIVES

Bed partners play a critical role in the treatment of obstructive sleep apnea and are affected by the treatment (or lack thereof) of their partner's obstructive sleep apnea, but few studies have included partners formally in treatment. In this qualitative study, we examine key stakeholder perspectives (patient, bedpartner, and sleep medicine provider) to inform the development of a novel, couples-based intervention to promote adherence to positive airway pressure (PAP) and sleep health among older adult couples.

METHODS

We conducted 3 focus group discussions with patients with obstructive sleep apnea/using PAP and their partners and 3 focus group discussions with sleep medicine providers. A standard interview guide was used to gather stakeholder input: (1) to understand interdependence of sleep among couples with sleep apnea; (2) to understand collaborative strategies that couples are currently using to address their sleep health challenges, including their perceptions of what is helpful vs not helpful; and (3) feasibility of the intervention design and delivery. Interviews were transcribed and thematically analyzed.

RESULTS

Participants (n = 25) included 9 patients, 7 partners, and 9 providers. Analysis of the discussion identified themes within the 3 topics addressed in the focus group discussions: (1) interdependence of sleep health among couples, (2) collaboration and other dyadic strategies for increasing PAP use, and (3) facilitators and barriers to a couples-based PAP adherence intervention. Results of the focus group discussions provided new insights into collaborative strategies that could be used to enhance the sleep health of both patients and partners. Patient/partners reported that a couples-based treatment could reduce common frustrations experienced by new PAP users, thereby benefiting their relationship. However, barriers to couples-based treatment included patients and partners feeling overwhelmed and reluctance to discuss intimacy. Providers recognized the benefits of involving partners but reported concern about exacerbating conflict in the couple.

CONCLUSIONS

Results indicate that couples and providers are enthusiastic about couples-based treatment that addresses their individual and dyadic sleep health challenges and identified important barriers that will need to be addressed to enhance uptake by clinicians and participation/retention of couples.

CITATION

Baron KG, Troxel WM, Galway S, et al. Couples-based interventions to promote PAP adherence among older adults: a qualitative study of patients, partners, and providers. J Clin Sleep Med. 2022;18(11):2627-2634.

A race against time: couples' lived diagnostic journeys to young-onset dementia

PURPOSE

Young onset dementias (YOD) - typically defined by symptom onset before age 65 - are frequently overlooked in medical and community settings. Persons with YOD and their spouses face logistical and emotional challenges on their journey to a diagnosis (e.g. uncertainty about symptoms, lack of medical knowledge, emotional distress). An in-depth understanding of couples' experiences before and immediately following a YOD diagnosis is warranted to inform early psychosocial services for couples.

METHODS

We utilized dyadic qualitative semi-structured interviews (N = 23) to better understand the nuances of couples' pre-diagnostic and diagnostic experiences with YOD. We used a hybrid of deductive and inductive analytic strategies to identify couple-level themes.

RESULTS

Fifteen couple-level themes were extracted within four domains: (1) early indicators of symptoms, (2) obtaining a diagnosis, (3) experiences with health care providers, and (4) emotional reactions to the diagnosis. Couples expressed difficulties communicating about early symptoms, receiving accurate and timely diagnostic information, and managing multiple emotions. They described the value of working together to manage care, gain information, establish positive relationships with providers, and promote adjustment.

CONCLUSION

Findings highlight the shared experiences of couples during the early stages of YOD, including the importance of strong communication with each other and providers. Early and accessible psychosocial services that help couples cope with and communicate about individual and shared stressors are warranted.

Exploring Insecure Romantic Attachment and Justifications for the Use of Intimate Partner Psychological Aggression in Couples

The attachment theory has commonly been used to examine intimate partner psychological aggression (IPPA), but few studies have examined its association with self-reported justifications for one's own use of IPPA. Behaviors, including the use of IPPA, are influenced, maintained, and function within the context of their justifications, highlighting the importance of investigating these justifications to obtain a clearer picture of IPPA. This study examined whether insecure romantic attachment (i.e., attachment anxiety and attachment avoidance) in both partners of a couple was associated with their justifications for their own use of IPPA. A community sample of 81 mixed-sex couples who reported using IPPA in the last year completed self-reported questionnaires on adult romantic attachment and their justifications for their use of IPPA. Results of a path analysis based on the actor-partner interdependence model revealed moderate positive associations between attachment anxiety and one's use of internal and external justifications for their IPPA perpetration in men and women. An unexpected dyadic positive association is discussed. These results suggest that the use of justifications for one's use of IPPA may reflect a strategy of hyperactivation that could contribute to the cycle of psychological aggression. Uncovering the function of these justifications could provide important therapeutic benefits, which are discussed in the study's implications.

Making the Case for Joint Decision-Making in Future Multipurpose Prevention Technology (MPT) Choice: Qualitative Findings on MPT Attribute Preferences from the CUPID Study (MTN-045)

Introduction

Young women in sub‐Saharan Africa account for two‐thirds of all new HIV infections and face high rates of unintended pregnancy. Multipurpose prevention technologies (MPTs) are promising products under development that are designed to simultaneously prevent HIV and unintended pregnancy. Since MPTs will be used in the context of sexual relationships, ensuring acceptability and use requires understanding the role of male partners in MPT use decision‐making.

Methods

This paper draws on qualitative data from 39 couples enrolled in the Microbicide Trials Network (MTN) 045 study, conducted in 2019–2020. Partners completed a discrete choice experiment (DCE), first separately and then jointly, to measure preferences for future MPT attributes and then completed a qualitative interview. We also draw on quantitative data from interviewer observation about who dominated the decision‐making process during the joint DCE. Content analysis was used to examine (1) how couples made decisions on existing non‐MPT HIV and pregnancy prevention products; (2) how couples made decisions on future ideal‐MPT product during the DCE; and (3) how these decision‐making processes varied by decision‐making dominance (10 male, 10 female and 19 equal) and interview type (19 joint and 20 separate).

Results

Existing non‐MPT product decisions focused on trust between partners and product attributes, while future ideal‐MPT product decisions exclusively focused on product attributes. Across existing and future products, preferences for product attributes varied by gender. Male partners were most concerned with limiting side effects impacting sexual pleasure, female partners were most concerned with limiting side effects causing physical symptoms and both were concerned with the return to fertility. Across all dominance and interview types, couples reported making decisions together and female partners were often able to negotiate with male partners for their preferred product or set of product attributes.

Conclusions

Research activities in this study provided an opportunity for couples to openly present their product attribute preferences to their partner, learn about their partner's attribute preferences, negotiate for their ideal set of attributes and ultimately choose attributes that benefited the couple without disempowering the female partner. Future research should focus on the utility of couple‐based decision‐making aids or similar tools for facilitating joint MPT decision‐making.

Typologies of Stressful Life Events and Their Association With Sexual Risk Behaviors and Communication Among Justice-Involved Males and Their Female Sex Partners

Stressful life events are prevalent among justice-involved populations and are associated with sexual risk behaviors and partner communication regarding safe-sex practices. We describe patterns of stress exposure for heterosexual couples (where males are under community supervision) and how stress patterns are associated with sexual risk behaviors and communication (460 individuals; 230 couples). Latent class analysis identified patterns of stress. Multinominal logistic regression models identified associations between sex, race, ethnicity, and stress classes. Multilevel Poisson regression models described relationships between sexual risk behaviors and frequency of communication about condoms/HIV, and stress classes. We found four classes that differed by sex, race, and ethnicity and were associated with the number of sexual partners, condom use self-efficacy, discussing condoms with partner, and discussing HIV prevention with partner. Partner class was associated with the number of sexual partners. Findings inform future assessment/interventions for sexual health that consider patterns of stress and demographics.

The Loss in Connection with Catastrophes (LICCS) Scale: Understanding couple outcomes

This study presented the design of the Loss in Connection with Catastrophes Scale (LICCS). Information regarding reliability and validity were presented, alongside the potential uses of this instrument in research and clinical settings. Furthermore, the importance of attending to couple and family relationships in disaster studies was proposed, and preliminary dyadic findings examining the LICCS with a sample of heterosexual couples (N = 240) as a correlate of mental and relational well-being were set forth. The overall findings suggest (a) resource loss as well as indicators of mental and relational well-being were associated among couples and (b) greater resource loss was associated with greater distress within and between partners. This study was important in that it is one of only a few in the past two decades to utilize dyadic data in the study of couples and disasters. Directions for future study using the LICCS to understand loss processes were addressed.

Association between perceived partner support and lifestyle in mother-father dyads expecting a first child

Background

A healthy lifestyle during pregnancy is important for the health of mother and child. However, unfavorable physical activity (PA) and dietary changes are observed in pregnant women and their partner. Partner's influence on lifestyle has been reported by expectant women and men. The first aim was to analyze associations between perceived partner support on expectant parents own as well as their partner's moderate-to-vigorous intensity PA (MVPA) levels and dietary intake. Secondly, this study aimed to investigate intra-couple associations of MVPA, dietary intake and perceived support.

Methods

A total of 152 heterosexual couples were recruited between week 8 and 10 of gestation by means of convenience sampling. Objective anthropometric and 7-day MVPA measurements were performed at 12 weeks of gestation. An online questionnaire was used to assess dietary intake, perceived partner support and socio-demographic characteristics. An Actor-Partner Interdependence Model for distinguishable dyads was constructed to examine the relationship between perceived partner support and both own's (i.e., actor-effect) and the partner's (i.e., partner-effect) MVPA levels, intake of fruits and vegetables, and an "avoidance food group."

Results

For pregnant women, perceived support from their partner was significantly associated with women's own MVPA levels (i.e., actor-effect; estimate = 0.344, SE = 0.168, p = 0.040) as well as the MVPA levels of the men (i.e., partner-effect; estimate = 0.717, SE = 0.255, p = 0.005). No significant actor- nor partner-effects were found for the expectant fathers. For none of the sexes significant actor-effects were found for fruit/vegetables and "avoidance food group" intake. For pregnant women, there was a positive partner-effect for fruit and vegetable intake (estimate = 7.822, SE = 1.842, p < 0.001) and a negative partner-effect for the "avoidance food group" intake (estimate = -16.115, SE = 3.629, p < 0.001). Positive correlations were found for perceived MVPA support (r = 0.40, p < 0.001), MVPA levels (r = 0.24, p = 0.007) and food intake from the "avoidance food group" (r = 0.28, p = 0.005) between partners.

Conclusion

This study shows that male partners can act as significant facilitators for women. Partners may be an important target when promoting MVPA during pregnancy. Additionally, supportive couples seem to strengthen each other in keeping a healthy lifestyle in early pregnancy. These results justify couple-based interventions in the promotion of a healthy lifestyle during the transition to parenthood.

Clinical trial registration

Clinicaltrials.gov, identifier: NCT03454958.

Relationship education for women during pregnancy: The impact of MotherWise on birth outcomes

The field of relationship science has called for more research on the impact of relationship education on child outcomes, yet studies in this area remain sparse, particularly regarding maternal and infant health at birth. Research on group prenatal care demonstrates that individual-oriented group interventions have a positive impact on infant birth outcomes, suggesting the need to consider the impacts of other forms of group programming for women. The current study examined the impact of MotherWise, an individual-oriented relationship education and brief case management/coaching program for minority and low-income pregnant women, on birth outcomes. The study sample included 136 women who enrolled in a larger randomized controlled trial of MotherWise during early pregnancy. Although statistical power was limited due to the sample size and the effects were not outright significant at p < 0.05, results indicated that the effects of MotherWise on birth outcomes were small to moderate in size (0.23 for birthweight, 0.46 for preterm birth) and suggest important avenues for future tests of relationship education programs and their impacts on maternal and infant health. The current study suggests that relationship education during pregnancy could directly impact women's and infant's health.

Concurrent randomized control trials of the 1-year efficacy of two couple relationship education programs: ELEVATE and Couples Connecting Mindfully

A long-standing university-community partnership used a longitudinal randomized control trial to implement and evaluate two couple relationship education (CRE) curricula, ELEVATE and Couples Connecting Mindfully (CCM), among an economically and racially diverse population of adult couples. Married and non-married couples (n = 929 couples) completed baseline surveys and were randomly assigned to either one of the two program groups or to the control group by implementation site. Follow-up surveys were collected at 2 months, 6 months, and 1 year after baseline. Using an intent-to-treat approach, growth curve modeling comparisons of trajectories indicated program effects at 1 year post-baseline in key outcome areas. Both the ELEVATE and the CCM group reported significant gains in couple relationship skills, couple quality, and family harmony over time compared to the control group that experienced either no change or declines. Further, the ELEVATE group also demonstrated positive program effects on measures of mental health and sleep quality. An assessment of the central premise of CRE indicated that the immediate post-program improvements in couple relationship skills predicted later couple quality for both program groups. This study indicates that both ELEVATE and CCM can be considered evidence-based CRE programs for use with a broad population of couples.

Does coparenting improve during the OurRelationship program? Explorations within a low-income sample during the COVID-19 pandemic

Low-income couples are at an increased risk for relationship instability and divorce, which can have residual impacts on coparenting between the two partners. Growing evidence suggests that brief online relationship education programs can be an effective tool for alleviating relationship distress among low-income couples. However, findings remain mixed when it comes to whether benefits from relationship-focused programs not explicitly addressing coparenting spillover to coparenting among those with children. This preregistered study sought to investigate whether couples participating in an evidence-based online relationship-focused intervention, the OurRelationship program, experienced improvements in coparenting during the coronavirus disease 2019 (COVID-19) pandemic. To expand on the existing literature, coparenting outcomes assessed included partners' gatekeeping behaviors in addition to coparenting satisfaction, given their important implications for partner involvement in parenting. We also examined the extent to which changes in coparenting were moderated by pre-post gains in relationship satisfaction, child gender, division of childcare, and pandemic disruptions. In a sample of 136 low-income couples (N = 272 individuals) and a one-group/pre-post design, we found medium-sized gains in relationship satisfaction (Cohen's d = .76) and small-sized improvements in all coparenting aspects assessed (|d|s = .29-.39). Couples with greater gains in relationship satisfaction experienced greater improvements in coparenting; further, coparenting changes were robust to other moderators. Taken together, findings suggested that brief online relationship education programs, such as the OurRelationship program, may be a promising option to improve coparenting among relationally distressed low-income couples with children during a global health crisis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

A randomized trial of relationship education using Within Our Reach for economically vulnerable couples

Couples relationship education is grounded in teaching couples' skills and strategies to form and sustain healthy relationships. The purpose of this investigation was to examine the impact of a relationship education intervention on emotion regulation, individual distress, dyadic coping, and relationship adjustment utilizing a randomized control trial for economically vulnerable couples. The analysis sample included 1418 couples (2836 individuals) who were randomly assigned to receive the 12-h Within Our Reach curriculum immediately, or to a wait-list control group. We estimated multilevel growth curve models over time among outcomes between treatment and wait-list control conditions. Treatment group couples demonstrated statistically significant improvements over the 6-month study period on emotional regulation and dyadic coping when compared to their wait-list group counterparts. Although models showed improvements in individual distress and relationship adjustments, these improvements did not amount to statistically significant group differences. Implications and limitations are also noted.

Relationship quality and objectively measured physical activity before and after implementation of COVID-19 stay-home orders

In a sample of 28 individuals cohabiting with a partner in NYC, Boston, or Chicago, this study tested whether implementation of stay-home orders to combat the spread of COVID-19 disrupted physical activity and whether high-quality romantic relationships buffered adverse effects. Participants provided FitBit data between February and October, 2020. Stay-home orders were associated with a reduction in daily step counts, B = -1595.72, p = 0.018, increased sedentary minutes, B = 33.75, p = 0.002, and reduced daily minutes of light and moderate physical activity, B = -25.01, p = 0.011; B = -0.72, p = 0.021. No moderation effects emerged.

What happens when romantic couples discuss personal loss? Relational, emotional, and physiological impacts

Does talking about loss with a romantic partner have salutary personal and relationship effects? Prior evidence reveals the benefits of emotional disclosure in couple relationships, yet disclosure about loss has been overlooked in research on couple communication. Using a novel communication paradigm with young-adult heterosexual romantic partners (N = 114 couples), we investigated emotions, physiological arousal (skin conductance responses [SCR]), and relationship closeness when narrating a personal loss and listening to the partner's loss, and compared these loss discussions to discussions about desired relationship changes. Based on partners' self-reports, narrating loss elicited more vulnerable and, unexpectedly, more antagonistic emotions. Both narrating and listening to loss produced higher self-reported partner closeness, compared to discussing change. In support of the physiological benefits of disclosure, women's SCRs decreased over the discussion when they narrated their own loss. However, both women and men as listeners show a general trend of increasing SCRs over the discussion, suggesting the challenges of being a responsive partner. Moreover, in line with the putative protective effects of partners' biological interdependencies, partner closeness also was higher when both partners showed synchronous decreasing SCR as women narrated their loss. Although limited to young couples in relatively short relationships, these findings reveal some potential benefits of talking about loss in the context of romantic relationships. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Love in the time of COVID-19: A systematic mapping review of empirical research on romantic relationships one year into the COVID-19 pandemic

The COVID-19 pandemic has affected nearly every area of daily life, including romantic relationships. With the pandemic still ongoing, this study reviewed the existing scholarly literature to document the status of empirical research on how COVID-19 has affected couples during its first year. Studies were identified through searching five databases as well as sources of gray literature. Overall, 42 studies on committed romantic relationships during the first year of the pandemic were identified. The mapping process revealed four main themes: (1) relationship quality; (2) sexuality; (3) couple daily adjustment; and (4) intimate partner violence. The findings suggest that the way romantic relationships were affected by the pandemic depends on a variety of demographic, individual, and couple-level factors. Implications include a call for both the development of evidence-based interventions that consider the current findings and further research to continue exploring the clinical implications of future findings to promote healthy intimate relationships during the ongoing global pandemic.

Couple variables predicting retention in a brief intervention and research

Therapy is an effective form of treatment for couple distress; yet, research shows that 20%-60% of couples terminate treatment prematurely. Predictors of couple retention in therapy and research are unclear, particularly for couples from marginalized populations, which has important implications for the quality and generalizability of research results, and the benefits derived from therapy are limited when participants are not retained. The purpose of this study (N = 1310) was to identify couple-level variables that predict (1) retention in a brief, two-session couple intervention (The Relationship Checkup) delivered as a home visitation program and (2) retention in research participation at 1- and 6-month follow-up. Hypotheses were tested using a two-level multi-level model. Couples are significantly less likely to be retained in the brief intervention if (1) at least one partner identifies as Asian, Pacific Islander, or Native American, (2) at least one partner identifies as Hispanic/Latinx, or (3) both partners report mental or emotional health as a concern in their relationship. Couples are significantly less likely to be retained in research if (1) at least one partner identifies as Asian, Pacific Islander, or Native American (1 month only), (2) at least one partner identifies as Hispanic/Latinx (1 and 6 months), (3) if either partner reports clinically significant relationship distress at baseline (1 and 6 months), or (4) if either partner reports relationship aggression at baseline (6 months only). These findings are discussed with relevance to clinicians and researchers to recruit and retain more diverse and marginalized participants in couple interventions and follow-up research.

Women and Men are the Barometers of Relationships: Testing the Predictive Power of Women's and Men's Relationship Satisfaction

There is a longstanding belief in relationship science and popular opinion that women are the barometers in mixed-gender relationships such that their perceptions about the partnership carry more weight than men's in predicting future relationship satisfaction, but this idea has yet to be rigorously tested. We analyze data from two studies to test within-person links between men's and women's relationship satisfaction on their own and their partner's next-day and next-year satisfaction. Study 1 combined nine daily diary datasets from Canada and the United States with 901 mixed-gender couples who provided 29,541 daily reports of relationship satisfaction. Study 2 analyzed five annual waves of data from the German Family Panel (pairfam) that surveyed 3,405 mixed-gender couples who provided 21,115 relationship satisfaction reports. Latent curve models with structured residuals (LCM-SR) revealed that in both studies, men's and women's relationship satisfaction significantly predicted their own and their partner's relationship satisfaction, with no gender differences in the magnitude of these effects. Results underscore the interdependence of romantic partners' satisfaction and indicate that both men and women jointly shape romantic relationship satisfaction.

The role of emotion regulation in couples' stress communication and dyadic coping responses

Partners' ability to cope together in the face of stress-commonly known as dyadic coping (DC)-can promote individual and couple well-being. However, little is known about the predictors of DC, including partners' emotion regulation. This study examined (a) whether emotion regulation abilities are associated with partners' DC responses, and (b) whether these associations are mediated by partners' engagement in stress communication in a community sample of different-gender couples (N = 239). Couples completed self-report measures to assess their stress communication and DC responses (supportive, negative, and common DC) and six dimensions of emotion regulation (emotional awareness, acceptance, clarity, goal-orientation, regulation strategies, and impulse control). Results from structural equation modelling analysis confirmed expected associations between stress communication and partners' supportive and common DC responses. Additionally, only associations with women's emotion regulation emerged significant. First, women's emotional awareness was associated with more supportive DC from men and common DC through increases in women's stress communication. Second, women who endorsed emotional acceptance engaged in less supportive DC towards their partner. Third, women's goal-orientation was associated with less supportive DC from each partner and common DC through decreases in men's stress communication. There were no associations with men's emotion regulation. Collectively, findings suggest that although women may manage their negative emotions in ways that are adaptive for their individual well-being, these benefits may not always affect relationship functioning in the same way. Clinical implications and future research directions are discussed.

The work-family interface and the COVID-19 pandemic: A systematic review

In an unprecedented fashion, COVID-19 has impacted the work-family interface since March 2020. As one of the COVID-19 pandemic consequences, remote work became widely adopted. Furthermore, it is expected that other pandemics will occur in the future. Hence, this context represents a chance to gain deeper insight into telecommuters' work and family spheres. Following PRISMA guidelines, the present narrative review aims to synthesise the COVID-19 impact on the work-family interface. Out of 121 screened references, 32 articles that measure at least one of the following variables-work-family conflict (25), work-family enrichment (3), work-family balance (8), and boundary management (21) were included. A thematic analysis using NVIVO12 was conducted, from which eight topics emerged: "paid workload, unpaid workload, and gender"; "well-being and gender"; "job resources, job demands, and gender"; "couples and gender"; "parenting and gender"; "occurrence of work-family enrichment with work-family conflict and gender"; "enforced blurred boundaries, its management, and gender"; "boundary management impact on work-family conflict, work-family enrichment, and work-family balance." Overall, studies point out that COVID-19 had a complex effect on both work-family conflict and work-family balance, making it difficult to state whether these variables were mitigated or augmented. Findings demonstrated that COVID-19 produced little changes in work-family enrichment. As for the COVID-19 impact on work-family boundary management, individuals had to create new tactics to manage them due to the absence of boundaries between both systems. Besides, due to traditional gendered roles, the COVID-19 health crisis seems to have brought additional hurdles to couples and women.

Systematic Review Registration

[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021278254], identifier [CRD42021278254].

Dyadic Links Between Health Changes and Well-Being: The Role of Non-Spousal Confidants

Although the marital relationship is often the primary source of emotional support in adulthood, sole reliance on the spouse to discuss health-related issues may be harmful to the well-being of both partners. The first aim of this study was to examine whether declines in health during later life would be associated with poorer psychological well-being in self and partner. We further investigated whether declining health would have a stronger impact on own and partner psychological well-being in the absence of non-spousal health confidants. Longitudinal actor-partner interdependence models (APIMs) were used to test both hypotheses with dyadic data from Wave 2 (2010-2011) and Wave 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP). Contrary to prediction, increased anxiety following spousal declines in gait speed and cognitive function occurred for those whose spouse did (rather than did not) have additional health confidants. A much fuller understanding is needed in regard to whether close relationships provide resources or present unwanted complications to dyadic coping, and the processes by which effects occur.

"Micro-cultures" of conflict: Couple-level perspectives on reasons for and causes of intimate partner violence in young adulthood

OBJECTIVE

To highlight the development of young adult couples' shared understandings about reasons for conflict in their relationships, views about why some disagreements included the use of aggression ("causes"), and gendered perspectives on these relationship dynamics.

BACKGROUND

Feminist theories have centered on relationship dynamics associated with intimate partner violence (IPV), but have focused primarily on men's concerns (e.g., jealousy) and use of violence as a means of control over female partners. The current analysis drew on symbolic interaction theory as a framework for exploring couple-level concerns, and ways in which dyadic communication contributes to these understandings, or what can be considered "micro-cultures" of conflict.

METHOD

The study relied on in-depth interviews with a heterogeneous sample of IPV-experienced young adults who had participated in a larger longitudinal study (Toledo Adolescent Relationships Study [TARS]) and separate interviews with their partners (n = 90).

RESULTS

Analyses revealed that women's concerns about men's actions (e.g., infidelity) were frequently cited as reasons for serious conflicts, and showed significant concordance in partners' reports. Shared understandings sometimes extended to views on the role of more distal causes (e.g., family background) and the meaning(s) of each partner's use of aggression. Gendered dynamics included men's tendency to minimize women's concerns, and both partners' more open discussions of women's perpetration.

CONCLUSIONS

Theories of IPV and associated programmatic efforts should include attention to the social construction of these "micro-cultures," as these shared meanings affect behavior, are potentially malleable, and add to the more intuitive focus on one-sided forces of control and constraint.

Factors associated with individual and couple participation in online sexual health research with Latinx sexual minority men

Latinx sexual minority men (LSMM) have higher rates of HIV incidence than most other ethnic and racial groups. Given that transmission risk is higher among primary partners, it is critical to identify factors that would facilitate partner recruitment into couples-based sexual health research studies. The present study utilizes a sample of index participants (n= 625), which includes 530 LSMM who did not recruit their partner and 95 LSMM who successfully did so (N = 625). Participants completed measures of communication styles and cultural values of masculinity. Findings suggest that caballerismo (chivalry/nurturing) and constructive communication were significantly and positively associated with the odds of recruiting one's partner in an interaction model. Consideration of cultural factors and communication style may enhance the efficiency of recruitment of LSMM and facilitate partner engagement.

Ambivalence experienced by infertile couples undergoing IVF: a qualitative study

The emotional consequences of infertility are well documented. However, relatively few studies have emphasized the dyadic emotional interaction within couples, despite infertility being a shared life event. This study adopted a dyadic (between two people) approach to explore the emotional complexity that infertile couples face. A descriptive qualitative study was conducted with 24 participants, including eight infertile couples and eight wives undergoing infertility treatments. Conjoint and individual interviews were conducted through purposive sampling in a large fertility centre in Tianjin, China, between June and August 2015. Thematic analysis identified two main themes: (i) 'decisional ambivalence', with subthemes of 'ambivalent attitudes towards treatment', 'uncertainty about treatment outcomes', and 'treatment-related lifestyle changes'; and (ii) 'relational ambivalence' which included subthemes of 'intergenerational ambivalence' and 'partner ambivalence'. Complex emotions of ambivalence among infertile couples were common as infertility clearly shattered their assumptive world on family formation. With complex entanglement of mixed emotions, ambivalence was intimately associated with cultural norms, social expectations, and active or over engagement of family members in Chinese societies. Since ambivalence could threaten mental and physical health during pregnancy, healthcare professionals should be prepared to assist infertile couples with identifying, articulating, and normalizing decisional and relational ambivalence during the treatment process.

Understanding the emotional landscape in the withdrawer re-engagement and blamer softening EFCT change events

The heart of change in emotionally focused couple therapy (EFCT) involves accessing key emotions and using them to redefine the self and create new relational responses. Two EFCT change events, withdrawer re-engagement and blamer softening, represent the emotion and relationship restructuring process with couples who are stuck in blame-withdraw interactions. These change events involve facilitating greater accessibility, responsiveness, and emotional engagement between more avoidant and anxious partners. This study tracked in-session emotional states and sequences in each of these change events. Findings highlight the importance of primary and softer emotional expressions. Specific emotional states characterize the two EFCT change events with adaptive grief/hurt being unique to withdrawer re-engagement and rejecting anger distinguishing blamer softening. Sequential patterns of emotional states were identified particularly for withdrawer re-engagement where grief/hurt was followed by acceptance and agency. Clinical implications consider the role of emotional transformation and emotional expansion in the EFCT change process.

Thematic analysis of therapists' experiences integrating EMDR and EFT in couple therapy: Theoretical and clinical complementarity, and benefits to client couples

In this article, we present partial findings from a thematic analysis study that examined integrating emotionally focused therapy (EFT) and eye-movement desensitization and reprocessing (EMDR) as clinical frameworks in couple therapy. The purpose of the study is to better understand how therapists integrate EFT and EMDR therapy in their clinical work. Thirteen licensed therapists (n = 13) trained in EFT and EMDR were interviewed about their experiences integrating these two models in their couple therapy practice. The findings included in this article are related to how these models complement each other as well as the clinical benefits associated with their integration. Findings provide preliminary evidence that there are benefits and challenges when integrating both models, although we emphasize complementarity in this article. Limitations and implications for future research on the integration and efficacy of these two models are also discussed.

Change Mechanism of Cognitively-Based Compassion Training for Couples with Depression: An Exploratory Empirical Investigation of Process Variables

Objective: Compassion training seems to be a promising intervention for couples to improve individual psychopathology and relationship quality. Beyond studying the efficacy of training such as Cognitively-Based Compassion Training for Couples (CBCT-fC), it is important to gain insights into the putative mechanisms along the process. Methods: Theoretically derived presumed mechanisms of compassion training (clarification of values, self-regulation, decentering, and exposure) and additional therapeutic factors (emotional bond, social learning, and clarification of meaning) were studied over the course of a 10-session-long group-based CBCT-fC among women with depressive disorders. Results: Dyadic growth curve models indicated that emotional bond, social learning, and clarification of meaning increase over time in both partners. In decentering and clarification of values, women who suffered from depression showed a larger increase than men, while men had higher values at the start of the training. Conclusions: Women with depression seem to benefit from CBCT-fC in terms of an increase in decentering and value clarification, important mechanisms of compassion training. This study is the first to show that theoretically derived mechanisms of compassion and additional therapeutic factors can describe the process along secular contemplative training sessions, which are increasingly implemented in the health care system. Future studies should explore the relationship of mechanisms and the outcome along the process of the training. Study Registration: Trial registration number NCT03080025.

Perceptions of Partners' Fertility Preferences and Women's Covert Contraceptive Use in Eight sub-Saharan African Countries

Covert use of contraception is a common but underreported and understudied phenomenon where one partner uses contraception without the other's knowledge. We used Demographic and Health Survey couple data to examine the relationship between wives’ perceptions of husbands’ fertility preferences and type of contraceptive use (overt vs. covert) in Benin, Ethiopia, Kenya, Mali, Nigeria, Sierra Leone, Uganda, and Zambia using logistic regression. Wives who perceived that their husbands wanted more children than them had increased odds of using covertly, compared to those who perceived that husbands wanted the same number of children in all countries except Benin, and the strength of the relationships ranged from adjusted odds ratio (aOR) 2.89 (95 percent confidence interval (CI) 1.75–4.76) in Zambia to aOR 4.01 (95 percent CI 1.68–9.58) in Mali. Wives who reported not knowing their husbands’ fertility preferences had increased odds of using covertly compared to wives who perceived that their husbands wanted the same number of children in all countries except Zambia, ranging from aOR 2.02 (95 percent CI 1.11–3.69) in Ethiopia to aOR 3.82 (95 percent CI 2.29–6.37) in Kenya. Our findings indicate that efforts to increase partner engagement to align couple's fertility preferences may encourage overt use.

A Mixed Methods Systematic Review

OBJECTIVES

To review current quantitative and qualitative evidence on the physical and mental health outcomes and participant experiences following mindfulness-based interventions (MBIs) for couples over the age of 65.

METHODS

The search strategy used PubMed; Web of Science; PsycInfo; The Dementia Evidence Toolkit; NIH RePORTER; NIH Clinical Trials.gov and Scopus databases and followed the JBI framework.

RESULTS

Four studies were included, of these, three were described as patient-carer dyads. Overall, the studies suggested that standardized, eight-week mindfulness interventions may be feasible for older adult independent couples and caregiving dyads, including people with cognitive decline, but the available evidence should be considered with caution.

CONCLUSIONS

Further high-quality studies investigating specific older adult dyads with sensitive and appropriate outcome measures are needed.

CLINICAL IMPLICATIONS

Whilst older adult mindfulness groups delivered to couples are feasible, conclusions about the effects of mindfulness on older adult caregiving and/or romantic couples are impossible to establish.

Health Promotion Behaviors of Pregnant Couples in the COVID-19 Pandemic: Actor-Partner Interdependence Model

Pregnancy during the pandemic may be a stressful life event. This cross-sectional study aimed to identify the actor and partner effects of the fear of COVID-19, depression, posttraumatic growth, and marital adjustment on the health promotion behaviors of pregnant couples during the COVID-19 pandemic in Korea. Data were collected from 123 pregnant couples using a structured questionnaire. The data were analyzed using the Actor-Partner Interdependence Model (APIM). The actor effects of the fear of COVID-19, depression, and posttraumatic growth on the health promotion behaviors of pregnant women and their spouses were significant. Furthermore, both actor and partner effects of husbands' marital adjustment on health promotion behaviors were significant. When carrying out nursing intervention for the health promotion of pregnant couples, programs aimed at reducing depression and improving posttraumatic growth in pregnant couples should be included. In addition, improving marital adjustment will positively affect the health promotion behaviors of pregnant couples. The findings highlight the important role of healthcare providers in assessing depressive symptoms and fear of COVID-19 in pregnant couples and providing support to promote health behaviors as part of prenatal care.

Loneliness and Emancipation: A Multilevel Analysis of the Connection between Gender Inequality, Loneliness, and Social Isolation in the ISSP 2017

The present article analyzes the connection between, on the one hand, gender equality and, on the other hand, loneliness and social isolation. It hypothesizes that modern relational institutions that support gender equality, such as no-fault divorce laws, reduce loneliness in close relationships. This hypothesis is put to the test through a multilevel analysis of the International Social Survey Program (ISSP) 2017. The analysis reveals that the data agree, to a large extent, with the theoretical arguments. The prevalence of loneliness is higher in countries with higher levels of gender inequality (as measured by the Gender Inequality Index (GII)). This can be attributed to a moderation effect; at lower levels of gender inequality, partnerships provide better protection from loneliness. These results are robust to controls for demographic composition, level of health, educational attainment, income poverty, and interview mode. Last, the analyses show that the threat of emotional isolation is more widespread in countries with low gender inequality. These findings, however, are only significant before controlling for demographic composition, level of health, educational attainment, income poverty, and interview mode, and they require further analysis. The concluding section relates these findings to the popular tendency to argue that modern society has created a “loneliness epidemic” and discusses policy implications.

The Hold me Tight Program for Couples Facing Huntington's Disease

BACKGROUND

A positive predictive genetic test for Huntington's disease (HD) can be a life-changing event for both carriers and their partners, leading to lower wellbeing and increasing the risk for separation and divorce. The 'Hold me Tight' program (HmT), based on emotionally focused couples' therapy, aims at strengthening the couple bond by targeting attachment needs.

OBJECTIVE

This study investigates whether the HmT program helps couples strengthen their relationship, as an investment in a future where the disease will affect life in many ways.

METHODS

In a multiple baseline design using three baselines of varying length, 15 couples of presymptomatic HD-carriers and their partners were included. In three consecutive groups, couples underwent the intervention (an adapted version of the 8-session HmT program) in four weekly sessions and completed self-report questionnaires throughout the study period of 19 weeks (17 measurements). Attachment style was assessed at baseline, resilience at baseline and at the end of the follow-up, while relationship satisfaction and wellbeing were measured weekly. A multi-level model was applied to the data.

RESULTS

Over the course of the study, wellbeing and relationship satisfaction significantly improved; resilience, however, did not. Furthermore, all three outcome measures were moderated by attachment style, with more securely attached individuals showing better outcomes.

CONCLUSION

HmT improved wellbeing and relationship satisfaction of couples facing HD. Due to these improvements and high patient acceptability rates, this program could become a standardized procedure in HD care. The program could be adapted for other populations, e.g., couples facing other genetic neurological disorders.

Religiosity, Sexual Satisfaction, and Relationship Satisfaction: The Moderating Role of Sexual Mindfulness and Sexual Sanctification

There are a variety of conditions under which religiosity may be positively or negatively associated with sexual and relationship satisfaction. To better understand these conditions, we conducted two studies using two separate samples: one with individuals (1,695 individuals), and one with couples (481 dyads), to test how sexual sanctification and sexual mindfulness moderate these associations. Across studies sexual mindfulness was positively associated with sexual and relationship satisfaction for the individual and partner, but there was no evidence for moderation; sexual sanctification was consistently associated with higher sexual and relationship satisfaction, and in some cases moderated the association between religiosity and both sexual and relationship satisfaction for women and men. In Study 1, religiosity was associated with lower sexual and relationship satisfaction for both men and women when sexual sanctification was low, but not with either type of satisfaction when sexual sanctification was high. In Study 2, religiosity was positively associated with sexual satisfaction for men but only when sexual sanctification was high. The combined evidence indicates that sexual sanctification may be one factor that distinguishes whether religion helps or hinders sexual and relationship satisfaction.

Helicobacter pylori acquisition rates and the associated risk factors amongst newlywed couples; a prospective cohort study in Tehran, Iran

BACKGROUND

The rates and routes of Helicobacter pylori transmission, in a high prevalent country like Iran, with gastric cancer as the leading cause of male cancer mortality is of essence. Here, we have studied the H. pylori-associated risk factors and the likelihood of interspousal transmission.

METHODS

In a cohort of 686 young prewed couples, questionnaires were self-administered and serum samples were collected, for assessment of risk factors and sero-status of H. pylori, at baseline and follow-up. Of the 475 H. pylori single- or double-seronegative couples, 201 returned for follow-up. The average follow-up duration was 2.2 (SD 0.6) years, with a total of 560.1 person-years. Logistic regression and Cox regression models were used to estimate the odds ratios (ORs) and hazard ratios (HRs).

RESULTS

The risk of infection was higher in men than women (OR:1.3, 95%CI:1.0-1.8) and among metropolitan than rural residents (OR=1.4, 95%CI:1.1-1.9). The risk of infection was significantly higher among those with three siblings (OR=1.6, 95%CI:1.1-2.2), and four or more siblings (OR=1.4, 95%CI:1.0-1.9), in reference to those with one or no siblings. H. pylori acquisition occurred in 10.9% (27/247) of the H. pylori seronegative participants. The risk of acquisition was significantly higher in older aged (HR=1.2, 95%CI: 1.1-1.3) and higher educated (HR=0.2, 95%CI:0.1-0.9) participants, than younger and illiterate subjects, respectively. Our analysis did not find any evidence for interspousal transmission (HR=1.0, 95%CI: 0.4-2.2).

CONCLUSION

Although we detected H. pylori acquisition in the young adult Iranian population, our findings did not support interspousal transmission, as a mode of adult H. pylori aquisition.

A Cohort Study of Associations With Patient, Partner and Relationship-Related Factors

Objective

Breast cancer may profoundly affect a couple’s sex life. The present study examines whether patient-, partner- and relationship-related characteristics are associated with sexual activity of couples following breast cancer diagnosis in the treatment phase and over time.

Methods

Women with breast cancer and their male cohabiting partners participated in a longitudinal study in Denmark. Logistic regression was used to examine associations of patient-, partner- and relationship-related characteristics at baseline (≤4 months following surgery) with couples’ sexual activity at baseline, 5 and 12 months later. The longitudinal analyses were stratified for couples’ sexual activity status at baseline.

Results

A total of 722, 533 and 471 couples were included in the analyses at baseline, 5- and 12-months follow-up, respectively. Older age, depressive symptoms and lower vitality of patients were associated with lower odds of couples’ sexual activity at baseline; chemotherapy treatment and older age of patients were associated with lower odds at 5-months follow-up in couples who were not sexually active at baseline. Higher ratings of emotional closeness, affectionate behavior and satisfaction with dyadic coping were associated with higher odds for sexual activity at baseline and over time in couples who were sexually active at baseline.

Conclusion

Sexual counseling during cancer treatment and rehabilitation should include a couple perspective. Relationship-related variables may be a protective factor for remaining sexually active after breast cancer diagnosis. Interventions could focus on strengthening these factors. Health professionals also need to consider the patients’ breast cancer treatment, vitality, and emotional distress in counselling on sexuality.

Do empathy and oxytocin predict responsiveness to a crying infant simulator in expecting and non-expecting couples? A multilevel study

Infant crying is a strong emotional stimulus that elicits caregiving responses in adults. Here we examine the role of empathy (measured with the Polish version of Interpersonal Reactivity Index) and salivary oxytocin in modulating sensitive responsiveness to a crying infant simulator in two groups of heterosexual couples: 111 expecting or 110 not expecting a baby. Sensitive responsiveness was observed during a standardized procedure using the Ainsworth Sensitivity Scale while participants took care of the infant simulator, both individually and as a couple. Other-oriented empathy predicted elevated levels of individual but not couple sensitive responsiveness. More OT reactivity to crying predicted less responsiveness in non-expecting couples, which might be explained by their stronger focus on task performance. This study uniquely combined hormonal, observational and self-report measures in couples, and showed that personality and hormonal correlates of sensitive responsiveness might be studied before the child's birth with the use of infant simulators.

Dyadic Profiles of Couples Coping With Body Image Concerns After Breast Cancer: Preliminary Results of a Cluster Analysis

Breast cancer treatments have multiple adverse effects, including concerns about body appearance and function that are experienced by most patients. Altered body image negatively affects mental health, social, and relationship functioning. While the relationship with a partner is critical for patients’ psychological wellbeing and partners can promote positive body image, limited research has investigated individual and relational factors affecting the experience of both. This cross-sectional study aimed at (1) exploring rates of body image concerns among breast cancer patients, and (2) identifying dyadic profiles among participating dyads. Couples composed by patients who had undergone surgery and their romantic partners (n = 32) were recruited from the Breast Unit of a hospital in northern Italy. Both partners completed measures of personality characteristics (BFQ-2), psychological distress (HADS), coping flexibility (PACT), dyadic coping (DCQ), and closeness (IOS). Body image (BIS) and adjustment to cancer (Mini-MAC) measures were completed by patients only. K-mean cluster analyses identified 2-cluster solution among patients and partners, respectively. “Active patients” (cluster-1) reported low rates of body image concerns (p < 0.001), anxious preoccupation, negative dyadic coping, and self-oriented stress communication (p < 0.05), compared to “worried patients” (cluster-2). “Comfortable partners” (cluster-1) reported lower anxiety and depression (p < 0.001), self-oriented negative dyadic coping and closeness (p < 0.05) than “uncomfortable partners” (cluster-2). Three different dyadic profiles emerged: functional, dysfunctional, and ambivalent. Significant variations (p < 0.05) by anxiety, depression, and delegating dyadic coping existed. Results indicate there are groups of couples at greater risk for impaired psychological distress and body image concerns, which should be addressed in the context of dyadic psychosocial interventions.

The Impact of Pandemic on Couples With Cancer: Examining the Role of Cancer-Related Communication on Cancer-Related Distress Via the Actor-Partner Interdependence Model

The present study draws attention to the significance of considering cancer-related communication on cancer-related distress through the vulnerability-stress-adaptation model among couples with cancer during the pandemic. This is a quantitative dyadic study with a sample of 80 couples (N = 160). Dyadic data were analyzed among couples with cancer to examine the within-person (actor effects) and between-partner (partner effects) associations among links between cancer-related communication and cancer-related distress through the use of actor-partner interdependence models. Significant actor and partner effects were found for cancer-related communication in partners facing cancer, a factor that predicted cancer-related distress. The findings underscore the need to adopt a systemic perspective that accounts for multiple, simultaneous adaptive processes including cancer-related communication as influences on cancer-related distress in the time of COVID-19.

The politics of vulnerable masculinity in couple therapy

Couple therapy and related literature has problematized men's emotional inexpressiveness as constraining for men and as contributing to men's privileged and dominating position vis-à-vis women. Fostering men's emotionality in and outside of therapy has been proposed as a way to improve men's well-being and relationships and promote gender equality. Critical masculinity scholars have noted that many men now enact vulnerable ("softer") and emotional forms of masculinity. Yet, there is lack of insight into how such enactment may intersect with gender inequality. This article presents a critical thematic analysis of 30 transcribed videotaped couple therapy sessions focusing on the performance of men's affective masculinities and the political dimensions of men's increasing emotionality within couple therapy. The study shows that vulnerable masculinities, although argued as bearing the potential to foster relational and social change, may also obscure continuing commitment to dominant masculinity norms. Implications for practice are discussed.

Partner Support and Connection Protect Couples During Pregnancy: A Daily Diary Investigation

OBJECTIVE

The objective of the current study was to examine associations between daily subjective stress and relationship satisfaction as a function of two protective factors-partner support and connection (i.e., intimacy, passion, and commitment)-among couples during pregnancy.

BACKGROUND

Stress brought into the intimate relationship by each partner is often associated with relational dissatisfaction and discord, referred to as stress spillover. Although much research has focused on risk for poor relational outcomes associated with partner stress, it is equally important to focus on resilience.

METHOD

We examined this phenomenon among 154 couples navigating pregnancy. Couples attended an initial laboratory session and then completed daily diary measures from home across 14 days.

RESULTS

Multilevel modeling techniques revealed that higher daily subjective stress than usual was negatively associated with relationship satisfaction that day for fathers and mothers, and partner support and connection attenuated this link to a significant degree. As these protective factors increased, the strength of the negative association between daily stress and relationship satisfaction decreased for both parents. Exploratory analyses showed no significant within-person associations between daily stress and next-day relationship satisfaction at any level of support or connection.

CONCLUSION

These findings add innovative components to the investigation of the spillover process, including the examination of this process among couples during pregnancy, utilization of daily diary methods to study this phenomenon on a micro-level over time, and identification of protective factors mitigating daily stress spillover.

Dimensions of couples' sexual communication, relationship satisfaction, and sexual satisfaction: A meta-analysis

Despite consistent evidence that sexual communication positively correlates with relationship and sexual satisfaction, there has been empirical murkiness regarding which aspects of sexual communication matter more or less for relationship and sexual satisfaction. A systematic meta-analysis was conducted to investigate if the strength of the association between sexual communication and relationship and sexual satisfaction varied by dimensions of sexual communication and individual, interpersonal, and cultural factors. The meta-analysis included 93 studies with 209 unique effect sizes, which represented 38,499 unique individuals in a current relationship. The multilevel meta-analysis evidenced a positive association between sexual communication and both relationship (r = .37) and sexual satisfaction (r = .43). For relationship satisfaction and sexual satisfaction, the effect size for quality of sexual communication (r = .43; .52) was larger compared to the frequency of sexual communication (r = .31; .31) and sexual self-disclosure (r = .28; .39). After controlling for the average age and relationship length of the sample, samples with married participants (r = .49) had larger effect sizes compared to samples with mixed relationship statuses (r = .35). Higher levels of individualism (b = .003) strengthened, and higher levels of gender inequality (b = -.06) weakened, the association between sexual communication and sexual satisfaction. Finally, when sociosexuality was low, sexual communication had a large association with relationship satisfaction for men (r = .69) and a small association for women (r = .16). Measurement, sample characteristics, and cultural factors have an important role in understanding the link between partners' sexual communication and their relationship and sexual satisfaction. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Affair recovery: Exploring similarities and differences of injured and involved partners

Infidelity is associated with negative effects on couples' relationships, yet some couples are able to overcome these and rebuild their relationship. Few studies have examined this process for couples who stay together after an affair. With a sample of 18 individuals (nine couples), this study explored similarities and differences between injured (i.e., partner who did not have the affair) and involved (i.e., partner who had the affair) partners' experiences across three categories of affair recovery: (a) commitment to the relationship, (b) dimensions of the attachment bond, and (c) healing process. Thematic analysis revealed similarities amongst both partners across categories: (a) frequent and quality communication, (b) mechanisms for rebuilding safety and trust, and (c) the importance of forgiveness. However, partners' experiences varied regarding (a) responses to needs for comfort, (b) their sexual relationship, and (c) responding to reminders. A discussion of these key findings and clinical implications are included.

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).

How diverse are the samples used to study intimate relationships? A systematic review

The social and behavioral sciences have long suffered from a lack of diversity in the samples used to study a broad array of phenomena. In an attempt to move toward a more contextually-informed approach, multiple subfields have undertaken meta-science studies of the diversity and inclusion of underrepresented groups in their body of literature. The current study is a systematic review of the field of relationship science aimed at examining the state of diversity and inclusion in this field. Relationship-focused papers published in five top relationship science journals from 2014-2018 (N = 559 articles, containing 771 unique studies) were reviewed. Studies were coded for research methods (e.g., sample source, dyadic data, observational data, experimental design) and sample characteristics (e.g., age, education, income, race/ethnicity, sexual orientation). Results indicate that the modal participant in a study of romantic relationships is 30 years old, White, American, middle-class, college educated, and involved in a different-sex, same-race relationship. Additionally, only 74 studies (10%) focused on traditionally underrepresented groups (i.e., non-White, low-income, and/or sexual and gender minorities). Findings underscore the need for greater inclusion of underrepresented groups to ensure the validity and credibility of relationship science. We conclude with general recommendations for the field.

TrueNTH Sexual Recovery Intervention for couples coping with prostate cancer: Randomized controlled trial results

BACKGROUND

Despite significant sexual dysfunction and distress after localized prostate cancer treatment, patients typically receive only physiologic erectile dysfunction management. The authors performed a randomized controlled trial of an online intervention supporting couples' posttreatment recovery of sexual intimacy.

METHODS

Patients treated with surgery, radiation, or combined radiation and androgen deprivation therapy who had partners were recruited and randomized to an online intervention or a control group. The intervention, tailored to treatment type and sexual orientation, comprised 6 modules addressing expectations for sexual and emotional sequelae of treatment, rehabilitation, and guidance toward sexual intimacy recovery. Couples, recruited from 6 sites nationally, completed validated measures at the baseline and 3 and 6 months after treatment. Primary outcome group differences were assessed with t tests for individual outcomes.

RESULTS

Among 142 randomized couples, 105 patients (mostly surgery) and 87 partners completed the 6-month survey; this reflected challenges with recruitment and attrition. There were no differences between the intervention and control arms in Patient-Reported Outcomes Measurement Information System Global Satisfaction With Sex Life scores 6 months after treatment (the primary outcome). Three months after treatment, intervention patients and partners reported more engagement in penetrative and nonpenetrative sexual activities than controls. More than 73% of the intervention participants reported high or moderate satisfaction with module content; more than 85% would recommend the intervention to other couples.

CONCLUSIONS

Online psychosexual support for couples can help couples to connect and experience sexual pleasure early after treatment despite patients' sexual dysfunction. Participants' high endorsement of the intervention reflects the importance of sexual health support to couples after prostate cancer treatment.

LAY SUMMARY

This study tested a web-based program supporting couples' sexual recovery of sexual intimacy after prostate cancer treatment. One hundred forty-two couples were recruited and randomly assigned to the program (n = 60) or to a control group (n = 82). The program did not result in improvements in participants' satisfaction with their sex life 6 months after treatment, but couples in the intervention group engaged in sexual activity sooner after treatment than couples in the control group. Couples evaluated the program positively and would recommend it to others facing prostate cancer treatment.

Changes in the Sexual Behavior of Partners in Each Trimester of Pregnancy in Otwock in Polish Couples

The aim of this study was to improve knowledge regarding pregnant couples by assessing changes in their sexual behavior, the reasons for the frequency and forms of intercourse, and the self-sexuality of partners in each trimester of pregnancy. As a result, 100 couples were qualified to take part in the final study, with 100 men and 100 women examined at intervals equivalent to the trimesters of pregnancy. These women (n = 100) and men (n = 100) were partners. Each of the studied couples was assessed in the trimesters of pregnancy. A prospective examination was conducted based on the observation of the same people, which were heterosexual couples, throughout pregnancy. The data used in the study was obtained using Davies’ Sexual Satisfaction Scale (DSSS), as well as an original survey on the sexuality of people during pregnancy (SARSS). The survey allowed us to obtain sociodemographic (metrics) information along with information regarding the sexual activity, satisfaction, and sexual attraction of the partners. All questionnaire questions were answered in paper form. There was a statistically significant drop in sexual intercourse from the first trimester in the second and third trimesters. The frequency of masturbation increased in men and decreased in women. The most common cause of sexual abstinence during the pregnancy was cited as fear for the fetus by all genders. A statistical analysis indicated that the average overall scores of the DSSS for the examined women in the first trimester of pregnancy were statistically significantly higher than in the two subsequent trimesters (p < 0.05). Sexual satisfaction, measured through both DSSS and SARSS, was also strongly correlated with the level of satisfaction in the assessment of the partner relationship and with the sense of one’s own attractiveness (p < 0.05). Changes in sexual behavior and sexual problems are often exposed or worsened during a first pregnancy and can have negative impacts on a person and the future of relationships. Medical staff should be trained in the assessment of sexual difficulties in people during pregnancy, in order to conduct reliable education and increase the awareness of couples regarding sexual and reproductive health.

Couple Connectedness in the Time of COVID-19

The COVID-19 pandemic has resulted in unprecedented global morbidity and mortality which altered people's daily lives, as well as created multiple societal challenges. One significant problem posed by this unique stressor is maintaining healthy intimate relationships, which are linked to mental and physical health. The literature has shown that the pandemic has exacerbated issues for couples such as financial difficulties, a lack of privacy, medical issues, and family and professional concerns. The pandemic has also forced all healthcare systems, hospitals, and clinics to quickly incorporate telehealth services. The number of requests for mental health consultations has risen to the point where demand exceeds supply. This paper provides an overview of ways couples can stay emotionally connected during this time as well as provide future directions for therapists to help couples develop or improve adaptive relationship mechanisms.

Dementia and its impacts on the intimate, sexual couple relationship: A systematic review of qualitative research studies

OBJECTIVE

There is growing evidence for the need to recognize persons with dementia as sexual beings who wish to continue expressing their sexuality, including within their couple relationship. The aim of this literature review was to investigate empirical qualitative studies that examined sexuality and sexual intimacy in the couple relationship when one spouse has dementia.

METHOD

A systematic literature review was performed in January 2021, five data bases were searched: Pubmed, MedLine, Lilacs, Scopus, and SciELO. The references of articles included in the review were screened together with the references of other relevant reviews.

RESULTS

Nine studies were identified that investigated sexuality and sexual intimacy from the perspective of the couple living with dementia or from the perspective of the spouse. The analysis identified four key themes: addressing dementia and sexuality; challenges to maintaining sexuality within the couple relationship; forms of sexual expression; and the desire to be seen as a sexual being.

CONCLUSION

Despite evidence of the importance of sexuality in later life and the positive effects it has on the quality of the couple relationship, research has identified the difficulty of destigmatizing sexuality and older persons, particularly when considering couples affected by dementia. Further research is required to better understand how living with the illness impacts sexual expression and the intimacy of the couple relationship.

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.

'Just have some IVF!': A longitudinal ethnographic study of couples' experiences of seeking fertility treatment

We present findings from a longitudinal ethnographic study of infertile couples seeking treatment following initial GP referral to specialist fertility services. Repeated observations and interviews were undertaken with the same 14 heterosexual participants over an 18-month period. Heterosexual, non-donor couples comprise the majority of fertility clinic patients; however, research interest in this group has dwindled over time as IVF cycles have increased. In the United Kingdom, IVF is presented as a logical response to involuntary childlessness, and as an entirely predictable, and linear, course of action. The market is well-developed and often patients' first experience of privatised health care in the NHS. Our couples were challenged by this, and while they felt expected to move on to IVF, some wished to explore other options. While IVF is ubiquitous, the discomfort and challenge around fertility treatments remain; experiences are prolonged and characterised by recursive narratives and expressions of disequilibrium, which are rarely acknowledged and reflected in ongoing clinic-patient interactions. Our findings develop understanding of the process of 'mazing' (Image - The Journal of Nursing Scholarship, 1989, 21, 220), the pursuit of parenthood, by showing that the routine and normative status of IVF, at least in the current health care context, is at odds with the lived experiences of individuals.