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Crenshaw AO, Libet J, Petty K, Teves JB, Huang A, Mitchell J. Subjective emotion trajectories in couple therapy and associations with improvement in relationship satisfaction. FAMILY PROCESS 2023; 62:1542-1554. [PMID: 36575606 DOI: 10.1111/famp.12843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/02/2022] [Accepted: 11/02/2022] [Indexed: 06/17/2023]
Abstract
Existing couple therapies are generally effective for reducing romantic relationship distress and divorce, but therapy outcomes remain poor for many. Outcomes can be improved through greater understanding of session-by-session therapeutic processes, particularly in real-world treatment settings. Modern couple therapy models commonly emphasize the importance of emotional experiences as key change processes, yet few empirical studies have tested the merits of this focus. The present study addresses this limitation by examining trajectories of subjective emotions and their association with change in a key relationship outcome, relationship satisfaction, among military veterans and their partners at a VA Medical Center. Partners rated their relationship satisfaction prior to couple therapy sessions and subjective emotions immediately after sessions. Consistent with hypotheses, both hard (e.g., anger) and soft (e.g., sadness) negative emotions decreased significantly over the course of therapy. Those couples with greater decreases in hard negative, but not soft negative, emotions showed significantly more improvement in relationship satisfaction. Positive emotions did not significantly change across couples in general, but those couples whose positive emotions did increase also showed more improvement in relationship satisfaction. These results suggest change in subjective emotions may be one process underlying improvement in couple therapy and lend empirical support to the emphasis on emotion-based change processes underlying acceptance-based and emotion-focused couple therapies.
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Affiliation(s)
- Alexander O Crenshaw
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Julian Libet
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Karen Petty
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Jenna B Teves
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
- Medical University of South Carolina, Charleston, South Carolina, USA
| | - Alice Huang
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
| | - Jerez Mitchell
- Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
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2
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Weber DM, Baucom BRW, Baucom DH, Fischer MS, Ramos K, Romano JM, Porter LS, Langer SL. Concurrent and Prospective Associations Between Communicated Emotional Arousal and Adjustment Among Couples Coping With Cancer. Ann Behav Med 2023; 57:753-764. [PMID: 37178456 PMCID: PMC10441863 DOI: 10.1093/abm/kaad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The experience of cancer can create considerable emotional distress for patients and their committed partners. How couples communicate about cancer-related concerns can have important implications for adjustment. However, past research has primarily utilized cross-sectional designs and retrospective self-reports of couple communication. While informative, little is known about how patients and partners express emotion during conversations about cancer, and how these emotional patterns predict individual and relational adjustment. PURPOSE The current investigation examined how patterns of emotional arousal within couples' communication about cancer was associated with concurrent and prospective individual psychological and relational adjustment. METHODS At baseline, 133 patients with stage II- breast, lung, or colorectal cancer and their partners completed a conversation about a cancer-related concern. Vocally expressed emotional arousal (f0) was extracted from recorded conversations. Couples completed self-report measures of individual psychological and relational adjustment at baseline and at 4, 8, and 12 months later. RESULTS Couples who started the conversation higher in f0 (i.e., greater emotional arousal) reported better individual and relational adjustment at baseline. If the non-cancer partner had lower f0 relative to patients, this predicted worse individual adjustment across follow-up. Additionally, couples who maintained their level of f0 rather than decreasing later in the conversation reported improvements in individual adjustment across follow-up. CONCLUSIONS Elevated emotional arousal within a cancer-related conversation may be adaptive for adjustment, as it may reflect greater emotional engagement and processing of an important topic. These results may suggest ways for therapists to guide emotional engagement to enhance resilience in couples experiencing cancer.
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Affiliation(s)
- Danielle M Weber
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brian R W Baucom
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Melanie S Fischer
- Institute of Medical Psychology, University Hospital Heidelberg, Heidelberg University, Heidelberg, Germany
| | - Katherine Ramos
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Joan M Romano
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Laura S Porter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Shelby L Langer
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
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3
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Opladen V, Tanck JA, Baur J, Hartmann AS, Svaldi J, Vocks S. Body exposure and vocal analysis: validation of fundamental frequency as a correlate of emotional arousal and valence. Front Psychiatry 2023; 14:1087548. [PMID: 37293400 PMCID: PMC10244733 DOI: 10.3389/fpsyt.2023.1087548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 04/04/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction Vocal analysis of fundamental frequency (f0) represents a suitable index to assess emotional activation. However, although f0 has often been used as an indicator of emotional arousal and different affective states, its psychometric properties are unclear. Specifically, there is uncertainty regarding the validity of the indices of f0mean and f0variabilitymeasures (f0dispersion, f0range, and f0SD) and whether higher or lower f0 indices are associated with higher arousal in stressful situations. The present study therefore aimed to validate f0 as a marker of vocally encoded emotional arousal, valence, and body-related distress during body exposure as a psychological stressor. Methods N = 73 female participants first underwent a 3-min, non-activating neutral reference condition, followed by a 7-min activating body exposure condition. Participants completed questionnaires on affect (i.e., arousal, valence, body-related distress), and their voice data and heart rate (HR) were recorded continuously. Vocal analyses were performed using Praat, a program for extracting paralinguistic measures from spoken audio. Results The results revealed no effects for f0 and state body dissatisfaction or general affect. F0mean correlated positively with self-reported arousal and negatively with valence, but was not correlated with HRmean/maximum. No correlations with any measure were found for any f0variabililtymeasures. Discussion Given the promising findings regarding f0mean for arousal and valence and the inconclusive findings regarding f0 as a marker of general affect and body-related distress, it may be assumed that f0mean represents a valid global marker of emotional arousal and valence rather than of concrete body-related distress. In view of the present findings regarding the validity of f0, it may be suggested that f0mean, but not f0variabilitymeasures, can be used to assess emotional arousal and valence in addition to self-report measures, which is less intrusive than conventional psychophysiological measures.
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Affiliation(s)
- Vanessa Opladen
- Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Julia A. Tanck
- Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
| | - Julia Baur
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Andrea S. Hartmann
- Department of Psychology, Experimental Clinical Psychology, University of Konstanz, Konstanz, Germany
| | - Jennifer Svaldi
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Silja Vocks
- Department of Clinical Psychology and Psychotherapy, Osnabrück University, Osnabrück, Germany
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4
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Development and Validation of the Flexibility in Partner Perspectives Scale. CONTEMPORARY FAMILY THERAPY 2022. [DOI: 10.1007/s10591-022-09653-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wojda AK, Baucom DH, Weber DM, Heyman RE, Smith Slep AM. The role of intimate partner violence and relationship satisfaction in couples' interpersonal emotional arousal. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:385-395. [PMID: 34472937 PMCID: PMC8888773 DOI: 10.1037/fam0000911] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
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).
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Weber DM, Fischer MS, Baucom DH, Baucom BRW, Engl J, Thurmaier F, Wojda AK, Hahlweg K. Escalation and Regulation of Emotional Arousal in Couples Predicts Relationship Satisfaction Concurrently and 25 Years Later. FAMILY PROCESS 2021; 60:251-269. [PMID: 32974923 DOI: 10.1111/famp.12597] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Relationship distress and divorce are major risk factors for the development or exacerbation of psychopathology and psychosocial impairments. Given that heightened negative emotions within couples' interactions may portend negative relationship outcomes, it is critical to understand how emotions unfold across a conversation and how partners may influence each other's immediate emotional experiences. This study examined whether these regulatory dynamics within one interaction predicted relationship satisfaction concurrently and 25 years later. Vocally-encoded emotional arousal (f0 ) was measured during couples' (N = 25 couples) conversations about a relationship issue. Across different analytical strategies, results demonstrate that one partner's f0 dynamics had immediate and long-term associations with the other partner's satisfaction. Partners were less satisfied if the other partner (a) expressed higher f0 overall and (b) escalated more in f0 across the conversation. Yet, partners were more satisfied when their f0 escalated across the conversation. Also, women specifically were more satisfied if their f0 remained elevated longer before regulating back to their emotional baseline. Thus, higher f0 was associated with higher satisfaction in the same partner, but associated with less satisfaction in the other partner-particularly when these emotions come from women. It may be that partners have to decide whether to prioritize expressing their emotions fully or limit expression in the service of their partner's happiness. These findings challenge us to think of ways to address this "win-lose" scenario so that couples can balance both partners' emotional needs and preserve relationship quality across the life span.
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Affiliation(s)
- Danielle M Weber
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Donald H Baucom
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Joachim Engl
- Institut für Forschung und Ausbildung in Kommunikationstherapie, Munich, Germany
| | - Franz Thurmaier
- Institut für Forschung und Ausbildung in Kommunikationstherapie, Munich, Germany
| | | | - Kurt Hahlweg
- Technische Universität Braunschweig, Braunschweig, Germany
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7
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Fundamental frequency during cognitive preparation and its impact on therapy outcome for panic disorder with Agoraphobia. Behav Res Ther 2020; 135:103728. [PMID: 32987282 DOI: 10.1016/j.brat.2020.103728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 08/04/2020] [Accepted: 09/14/2020] [Indexed: 01/31/2023]
Abstract
BACKGROUND Cognitive preparation plays a crucial role in CBT with exposure for panic disorder and agoraphobia. High emotional arousal while developing the exposure rationale might impair patients' cognitive capacities for processing information about treatment and impede therapeutic outcome. OBJECTIVE This study investigates whether patients' vocally encoded emotional arousal, assessed by fundamental frequency (f0), during rationale development is associated with premature treatment dropout, insight into the rationale, and symptom reduction. METHODS Patients' (N = 197, mean age 36.1 years, 79.2% female) f0 during rationale development was measured based on treatment videos from a randomized controlled trial of CBT for panic disorder and agoraphobia. Insight was rater assessed. Symptom severity was self- and rater assessed at the beginning and end of therapy. RESULTS Higher f0 mean during rationale development was associated with lower probability of insight and less reduction in avoidance behavior. f0 was not associated with dropout. Insight was associated with lower probability of dropout and partially mediated the association between f0 and avoidance reduction. DISCUSSION This study highlights the importance of emotional arousal during cognitive preparation for exposure. Therapists should ensure that patients are not too highly aroused while learning about the exposure rationale as an important step in treatment.
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8
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Antoine P, Andreotti E, Congard A. Positive psychology intervention for couples: A pilot study. Stress Health 2020; 36:179-190. [PMID: 31943738 DOI: 10.1002/smi.2925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 12/29/2019] [Accepted: 01/07/2020] [Indexed: 01/07/2023]
Abstract
In this randomized study, a multicomponent, theory-driven, autonomous self-help positive psychology intervention (PPI) for couples was examined. This intervention was not designed for distressed couples but rather to address autonomous couples with a good initial level of functioning who, nonetheless, wished to improve it. The objective was to assess the efficacy of the PPI on satisfaction with life, affective life, communication patterns, and dyadic adjustment in each member of the dyad. The 4-week PPI encompassed dyadic and individual daily activities. Thirty-eight couples were assigned to an intervention group (n = 20 couples) or a waiting list control (WLC) group (n = 18 couples). Assessments were conducted prior to and after the PPI, with an immediate post-test and a follow-up. Ninety-two percent of the PPI was completed by the participants. Linear mixed models revealed improvements in positive emotions, communication patterns of mutuality, and dyadic adjustment from the pretest to the immediate post-test in the intervention group compared with the WLC group. Effects of dyadic adjustment were maintained from pretest to 1-month follow-up in the intervention group. This pilot study suggests that the realization of intentional dyadic activities presents an interesting approach to contribute to individual positive emotions and dyadic functioning.
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Affiliation(s)
- Pascal Antoine
- CNRS, UMR 9193-SCALab-Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
| | - Eva Andreotti
- CNRS, UMR 9193-SCALab-Sciences Cognitives et Sciences Affectives, Univ. Lille, Lille, France
| | - Anne Congard
- Laboratoire de psychologie des Pays de la Loire, LPPL, EA 4638, Univ. Nantes, Nantes, France
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9
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Weber DM, Fischer MS, Baucom DH, Baucom BRW, Kirby JS, Runfola CD, Matherne CE, Bulik CM. The Association between Symptom Accommodation and Emotional Coregulation in Couples with Binge Eating Disorder. FAMILY PROCESS 2019; 58:920-935. [PMID: 30229890 DOI: 10.1111/famp.12391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Intense negative emotions and maladaptive behavioral strategies to reduce emotional distress occur not only in patients with various forms of psychopathology but also in their committed partners. One common strategy to reduce distress is for partners to accommodate to the symptoms of the disorder, which reduces distress short term but maintains symptoms long term. Accommodation is believed to be motivated by the partner reacting behaviorally to the patient's emotions, but the emotions of the partner in this context have yet to be examined. This pilot study examined how partner accommodation related to specific patterns of emotional coregulation between patients with binge eating disorder (BED) and their partners, before and after a couple-based intervention for BED. Vocally encoded emotional arousal was measured during couples' (n = 11) conversations about BED. As predicted, partners' emotional reactivity to patients' emotional arousal was associated with high accommodation before treatment. Thus, partners may use accommodation as a strategy to reduce both the patients' and their own distress. After treatment, partners' arousal was no longer associated with the patients' emotional arousal; instead, partners showed greater emotional stability over time, specifically when accommodation was low. Additionally, patients were less emotionally aroused after treatment. Therefore, treatment may have decreased overall emotionality of patients and altered the association between accommodation and partners' emotional reactivity. If replicated, this understanding of the emotional context associated with accommodation in BED can inform couple-based treatment by targeting specific emotional precipitants of behaviors that maintain symptoms.
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Affiliation(s)
- Danielle M Weber
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Melanie S Fischer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian R W Baucom
- Department of Psychology, University of Utah, University of Utah, Salt Lake City, UT
| | - Jennifer S Kirby
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Cristin D Runfola
- Department of Psychiatry, University of North Carolina at Chapel Hill
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
| | - Camden E Matherne
- Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Cynthia M Bulik
- Department of Psychiatry, University of North Carolina at Chapel Hill
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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10
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Relationship intimacy processes during treatment for couple-focused interventions for prostate cancer patients and their spouses. JOURNAL OF PSYCHOSOCIAL ONCOLOGY RESEARCH & PRACTICE 2019; 1. [PMID: 36237825 PMCID: PMC9554946 DOI: 10.1097/or9.0000000000000007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objective: In a previously published trial, we compared the effect of an
intimacy-enhancing therapy (IET) and a General Health and Wellness
intervention (GHW) on psychological and relationship outcomes among men
diagnosed with localized prostate cancer and their partners. Results
suggested partial effects of IET on psychological adjustment and
relationship satisfaction. To understand these partial effects, the first
aim of this study was to evaluate self-disclosure, perceived partner
disclosure, perceived partner responsiveness, and levels of intimacy rated
after sessions, and the second aim of this study was to examine the role of
pre-treatment holding back on these intimacy processes. Methods: A total of 156 couples who participated in treatment reported on
self- and perceived partner disclosure, responsiveness, and intimacy during
sessions. Participants rated levels of holding back before treatment. Linear
growth models were estimated using multilevel modeling. Each intimacy
process variable was predicted to be a function of time, role, condition,
and all interactions among these variables. The effects of own and partner
pretreatment holding back on average intimacy process and change in intimacy
process were tested in moderated growth models. Results: Self- and perceived partner disclosure were significantly higher
during IET sessions than GHW sessions. Self-disclosure, perceived partner
disclosure, and perceived partner responsiveness increased in both IET and
GHW. Intimacy was not higher and did not increase more in IET compared with
GHW. Participants who held back reported that their partner disclosed less
to them during sessions, perceived that their partner was less responsive to
them during sessions, and reported less intimacy during sessions. Partners
of participants who held back were seen as less responsive and their
interactions were seen as less intimate. Conclusions: Although IET focused on enhancing couples’ responsiveness and
intimacy, it did not have a stronger effect on these processes during
sessions than GHW. The lack of an effect may, in part, be because of the
fact that IET did not help those couples who may have been in the greatest
need for it because they held back more.
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Fischer MS, Baucom BRW, Baucom DH, Sheng E, Atkins DC, Hahlweg K. When the "U" is not Inverted: Trajectories of Expressed Emotional Arousal Predict Relationship Satisfaction. FAMILY PROCESS 2019; 58:463-477. [PMID: 30412301 DOI: 10.1111/famp.12406] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Maladaptive emotional reactivity and dysfunctional communication during couple conflict are both destructive to couple functioning, and observational research has elucidated how conflict escalates. However, much of the evidence is based on measures that combine content (i.e., what was said) and the emotion with which it was said, which are then examined using sequential analyses. Despite the general presumptions about underlying emotional reactivity and escalation in negative emotions as part of relationship distress and deterioration, little empirical data are available that directly examine these continuous shifts in emotions. The current study examined concurrent and longitudinal associations between relationship satisfaction and trajectories of change in vocally expressed emotional arousal during couple conflict in 62 couples who participated in a relationship education program. Contrary to expectations and patterns found in distressed couples, trajectories followed a U-shape rather than an inverted U-shape curve, with steeper and more persistent decreases in emotional arousal predicting more stable relationship satisfaction over time. In addition, there were within-couple effects. These results suggest that early signs for relationship deterioration may be less in the form of overt escalation as would be seen in distressed couples. Instead, couples who subsequently deteriorate more are less effective in calming emotional arousal. They also are less able to remain at lower emotional arousal. It is possible that the more pronounced escalation toward the end of the conversation in more at-risk couples is a precursor of the greater escalation patterns seen in distressed couples; this should be examined empirically. Limitations and implications are discussed.
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Affiliation(s)
- Melanie S Fischer
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian R W Baucom
- Department of Psychology, University of Utah, Salt Lake City, UT
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Elisa Sheng
- Center for the Study of Health Risk Behaviors, University of Washington, Seattle, WA
| | - David C Atkins
- Center for the Study of Health Risk Behaviors, University of Washington, Seattle, WA
| | - Kurt Hahlweg
- Technische Universität Braunschweig, Braunschweig, Germany
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12
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Rosen NO, Bergeron S. Genito-Pelvic Pain Through a Dyadic Lens: Moving Toward an Interpersonal Emotion Regulation Model of Women's Sexual Dysfunction. JOURNAL OF SEX RESEARCH 2019; 56:440-461. [PMID: 30252510 DOI: 10.1080/00224499.2018.1513987] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Researchers and clinicians alike widely acknowledge the inherently interpersonal nature of women's sexual dysfunctions given that both partners impact and are impacted by these difficulties. Yet theoretical models for understanding the role of interpersonal factors in women's sexual dysfunctions are severely lacking and have the potential to guide future research and inform more effective interventions. The most widely studied sexual dysfunction in women that has espoused a dyadic approach by including both members of affected couples is genito-pelvic pain/penetration disorder (GPPPD). In this article we use the example of GPPPD to introduce a novel interpersonal emotion regulation model of women's sexual dysfunction. We first review current knowledge regarding distal and proximal interpersonal factors in GPPPD. Then, we describe our theoretical model and consider relevant pain and sex-related research on emotion regulation processes-emotional awareness, expression, and experience-in the context of GPPPD, including sexual function, satisfaction, and distress. Next, we review how existing theories from the fields of chronic pain and sex and relationships research have informed our model and how our model further builds on them. Finally, we discuss the implications of our model and its applications, including to other sexual dysfunctions in women.
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Affiliation(s)
- Natalie O Rosen
- a Department of Psychology and Neuroscience , Dalhousie University
- b Department of Obstetrics and Gynecology , IWK Health Centre
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Solomon DT, Nietert PJ, Calhoun C, Smith DW, Back SE, Barden E, Brady KT, Flanagan JC. Effects of Oxytocin on Emotional and Physiological Responses to Conflict in Couples with Substance Misuse. ACTA ACUST UNITED AC 2019; 7:91-102. [PMID: 30740265 DOI: 10.1037/cfp0000103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Social stress, especially dyadic conflict among couples, is an important correlate of addiction. Several authors have suggested that the neuropeptide oxytocin (OT) may be useful in the treatment of couples with substance misuse. However, the literature examining OT among couples is scant and has yielded mixed findings. The current study examined the effects of OT versus placebo on emotional (e.g., warmth and anger) and physiological (e.g., skin conductance and heart rate) reactivity to a conflict resolution task in 30 heterosexual couples (N=60) in which one or both members misused substances. Using a randomized, double-blind, placebo-controlled design, both partners within each dyad were randomized to the same treatment condition. Participants completed a standardized conflict resolution task at baseline and 45 minutes following drug self-administration. Physiological measures were examined continuously during the laboratory tasks and emotional reactivity was self-reported at baseline and at 5 time points over the course of 1 hour following the second conflict resolution task. Results of a multi-level growth curve model accounting for baseline scores, gender and drug condition indicate that positive emotional experiences and skin conductance measures increased over the 5 time points. Neither drug condition nor gender was significantly related to outcomes, and no interaction effects were observed. These findings highlight the complexities involved in translational OT research and suggest that the impact of OT on key outcomes requires further exploration in regards to OT's potential therapeutic benefit.
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Affiliation(s)
| | | | - Casey Calhoun
- Medical University of South Carolina, Charleston, SC
| | | | - Sudie E Back
- Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VAMC, Charleston, SC
| | - Eileen Barden
- Medical University of South Carolina, Charleston, SC
| | - Kathleen T Brady
- Medical University of South Carolina, Charleston, SC.,Ralph H. Johnson VAMC, Charleston, SC
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14
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Starks TJ, Millar BM, Doyle KM, Bertone P, Ohadi J, Parsons JT. Motivational interviewing with couples: A theoretical framework for clinical practice illustrated in substance use and HIV prevention intervention with gay male couples. PSYCHOLOGY OF SEXUAL ORIENTATION AND GENDER DIVERSITY 2018; 5:490-502. [PMID: 30581887 PMCID: PMC6300150 DOI: 10.1037/sgd0000297] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Epidemiological data indicate the need to address substance use and sexual HIV transmission risk among gay and bisexual men in relationships. While brief Motivational Interviewing (MI) delivered to the individual has shown efficacy in reducing sexual HIV risk with casual partners and substance use, the application of MI with couples has received less attention. Most studies of MI with couples have conceptualized the "spouse" or partner as an adjunct participant in the treatment of an identified client. We propose a theoretical framework for conducting MI with a couple, which approaches the couple as the identified client, and may be adopted when either one or both partners engage in the target behavior. We then discuss similarities between MI-processes conceptualized with our proposed framework and those that are salient in existing couples therapies. We utilize case examples from brief MI sessions targeting substance use and sexual HIV risk in gay male couples to illustrate three phenomena unique to the implementation of MI with couples: 1) interpersonal ambivalence; 2) the role of dyadic functioning in tolerating and resolving interpersonal ambivalence; and 3) joint goal formation as a prerequisite to the planning phase of MI. Connecting these phenomena with the transformation of motivation and accommodation processes outlined in Couples Interdependence Theory, this paper suggests that brief MI may be a promising modality for substance use and HIV risk reduction interventions with couples generally and gay couples specifically.
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Affiliation(s)
- Tyrel J. Starks
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave, New York, NY 10065, USA
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, 365 5th Ave, New York, NY 10034, USA
| | - Brett M. Millar
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
| | - Kendell M. Doyle
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
| | - Paula Bertone
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
| | - Jonathan Ohadi
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
| | - Jeffrey T. Parsons
- Center for HIV/AIDS Educational Studies and Training (CHEST), 142 West 36 Street, 9 Floor, New York, NY 10018, USA
- Department of Psychology, Hunter College of the City University of New York (CUNY), 695 Park Ave, New York, NY 10065, USA
- Doctoral Program in Health Psychology and Clinical Science, The Graduate Center of CUNY, 365 5th Ave, New York, NY 10034, USA
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Abstract
This review highlights recent advances in research addressing intimate partner relationships and health. Consideration of the strong mutual influences that the members of a couple have on each other's mental and physical health trajectories provides a new way to view the health implications of couples' convergence or interdependence; marital closeness can have a clear downside when one partner has mental or physical health problems. Couples' interconnectedness can also be leveraged to promote better treatment outcomes. Major themes include the pivotal role of depression and the importance of gender differences in the pathways from the marital relationship to physiological functioning and health. The health risks and benefits of support are weighed. Additionally, two prominent emerging paths from marital distress to poor health are emphasized: sleep problems and metabolic alterations that promote obesity and its comorbidities.
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Affiliation(s)
- Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, Ohio; ,
- Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Stephanie J Wilson
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, Ohio; ,
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16
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Kiecolt-Glaser JK, Wilson SJ. Lovesick: How Couples' Relationships Influence Health. Annu Rev Clin Psychol 2017. [PMID: 28301763 DOI: 10.1146/annurevclinpsy-032816-045111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
This review highlights recent advances in research addressing intimate partner relationships and health. Consideration of the strong mutual influences that the members of a couple have on each other's mental and physical health trajectories provides a new way to view the health implications of couples' convergence or interdependence; marital closeness can have a clear downside when one partner has mental or physical health problems. Couples' interconnectedness can also be leveraged to promote better treatment outcomes. Major themes include the pivotal role of depression and the importance of gender differences in the pathways from the marital relationship to physiological functioning and health. The health risks and benefits of support are weighed. Additionally, two prominent emerging paths from marital distress to poor health are emphasized: sleep problems and metabolic alterations that promote obesity and its comorbidities.
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Affiliation(s)
- Janice K Kiecolt-Glaser
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, Ohio; ,
- Department of Psychiatry and Behavioral Health, College of Medicine, The Ohio State University, Columbus, Ohio
| | - Stephanie J Wilson
- Institute for Behavioral Medicine Research, College of Medicine, The Ohio State University, Columbus, Ohio; ,
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17
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Fischer MS, Baucom DH, Baucom BR, Abramowitz JS, Kirby JS, Bulik CM. Disorder-specific patterns of emotion coregulation in couples: Comparing obsessive compulsive disorder and anorexia nervosa. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2017; 31:304-315. [PMID: 27748615 PMCID: PMC5378591 DOI: 10.1037/fam0000251] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Impaired emotion regulation and maladaptive strategies to manage distress are central to psychopathology, including obsessive-compulsive disorder (OCD) and anorexia nervosa (AN). Emotion regulation can be fostered or thwarted by romantic partners, and the tendency to rely on interpersonally oriented emotion regulation may vary by disorder. This study examined coregulation as a form of interpersonal emotion regulation in OCD and AN. We hypothesized that OCD is associated with exaggerated and AN with diminished coregulation, and that OCD patients have greater overall levels of emotional arousal than AN patients. Greater symptom severity was expected to exacerbate these opposing tendencies. Vocally encoded emotional arousal was measured during couple conversations in 34 AN patients, 18 OCD patients, and their partners. Two indicators of coregulation (covariation and coupling) were analyzed using cross-lagged actor-partner interdependence and coupled linear oscillator models. As hypothesized, OCD was associated with greater overall emotional arousal than AN. Symptom severity was not associated with emotional arousal or coregulation. Covariation differed in the opposite direction of the hypothesis; there was no difference in coupling. AN patients exhibited consistent coregulation, indicating high reactivity to partners' emotional arousal which may contribute to interpersonal avoidance. OCD couples showed limited predictability of patients' arousal over time, while partners were affected by the patients' emotional arousal; thus, symptom accommodation may in part be partners' attempts at managing their own distress along with the patients'. A better understanding of interpersonal emotion regulation in OCD and AN can inform treatment by targeting interaction patterns that may maintain symptoms. (PsycINFO Database Record
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Affiliation(s)
- Melanie S Fischer
- Department of Psychology and Neuroscience, University of North Carolina
| | - Donald H Baucom
- Department of Psychology and Neuroscience, University of North Carolina
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