Couples Attending a Fertility Clinic

Previous studies have examined the predictors of PFAS concentrations among pregnant women and children. However, no study has explored the predictors of preconception PFAS concentrations among couples in the United States. This study included 572 females and 279 males (249 couples) who attended a U.S. fertility clinic between 2005 and 2019. Questionnaire information on demographics, reproductive history, and lifestyles and serum samples quantified for PFAS concentrations were collected at study enrollment. We examined the PFAS distribution and correlation within couples. We used Ridge regressions to predict the serum concentration of each PFAS in females and males using data of (1) socio-demographic and reproductive history, (2) diet, (3) behavioral factors, and (4) all factors included in (1) to (3) after accounting for temporal exposure trends. We used general linear models for univariate association of each factor with the PFAS concentration. We found moderate to high correlations for PFAS concentrations within couples. Among all examined factors, diet explained more of the variation in PFAS concentrations (1-48%), while behavioral factors explained the least (0-4%). Individuals reporting White race, with a higher body mass index, and nulliparous women had higher PFAS concentrations than others. Fish and shellfish consumption was positively associated with PFAS concentrations among both females and males, while intake of beans (females), peas (male), kale (females), and tortilla (both) was inversely associated with PFAS concentrations. Our findings provide important data for identifying sources of couples' PFAS exposure and informing interventions to reduce PFAS exposure in the preconception period.

Partner Effects of Childhood Maltreatment: A Systematic Review and Meta-Analysis

Although several studies have shown that childhood maltreatment (CM) is associated with a host of negative consequences including romantic relationship difficulties for victims in adulthood, most overlooked the potential effects on the romantic partner. This systematic review and meta-analysis aims to comprehensively synthesize the literature on the association between a person's CM and their partner's individual and couple outcomes. We searched PubMed, PsycNET, Medline, CINAHL, and Eric using search strings related to CM and partner. We identified 3,238 articles after removal of duplicates; 28 studies met the inclusion criteria and relied on independent sample. The studies reported associations between a person's CM and a wide breadth of partner's negative couple outcomes (e.g., communication, sexuality) as well as intra-individual psychological difficulties (e.g., psychological distress, emotion, and stress reactivity). Meta-analytic results showed significant, but trivial to small associations between a person's CM and their partner's lower relationship satisfaction (r = -.09, 95% CI [-.14, -.04]), higher intimate partner violence (r = .08, [.05, .12]), and higher psychological distress (r = .11, [.06, .16]). These associations were similar for women and men and did not differ as a function of sample's mean age, proportion of cultural diversity, and publication year. These findings suggest that a person's CM is related to their partner's outcomes including to the partner's intra-individual outcomes. Prevention and intervention strategies should acknowledge that a person's CM may also affect their romantic partner, considering the couple as a reciprocal system, and offer victims' romantic partners specific services.

How does my partner see me? Metaperceptions of personality and couple satisfaction

This study examined the association between congruence in the two partners' perceptions and their relationship satisfaction. We considered congruence between metaperception and partner-perception (meta-partner) and between metaperceptions and self-rated personality (meta-self). The participants were 236 heterosexual couples. Each couple member reported couple satisfaction and personality traits (in terms of self-perception, partner-perception, and metaperception). The actor-partner interdependence model (APIM) revealed that individuals who believed to be viewed by their partner as more agreeable, conscientious, or emotionally stable than their partner saw them, were less likely to have a partner who was satisfied with the relationship. When metaperceptions of "Agreeableness" were higher than self-perceptions, relationship satisfaction for both the actor and the partner was higher. These findings may help to guide therapeutic and clinical interventions aimed at promoting relationship satisfaction in the context of family and couple therapy.

Investigating Father or Partner Involvement in Family Integrated Care in Neonatal Units: Protocol for a Prospective, Multicenter, Multiphase Study

BACKGROUND

Neonatal unit (NU) admissions for premature babies can last for months, which can significantly impact parental mental health (MH) with symptoms of depression, stress, and anxiety. Literature suggests fathers experience comparable MH symptoms to mothers. Family integrated care (FICare) is a culture where parents are collaborators and partners in caring for their hospitalized newborns. FICare improves infant outcomes and maternal MH. Similar reports on fathers are limited.

OBJECTIVE

The primary aim of this study is to investigate the impact of supporting father or partner engagement in FICare of preterm infants on their MH up to 6 weeks postdischarge. The secondary aim is to investigate the impact on maternal MH.

METHODS

This is a 2-phase study: phase 1 to gather baseline information and phase 2 to assess the impact of enhanced father or partner engagement in FICare on their MH, involving 2 NUs (tertiary and level 2). Enhanced FICare will be developed and introduced (eg, information booklet, workbook, classes, and a father peer-support group) alongside standard FICare practices. Father or partner MH will be assessed with semistructured qualitative interviews and validated questionnaires: Generalized Anxiety Disorder Assessment, Patient Health Questionnaire, and Parental Stressor Scale: Neonatal Intensive Care Unit from NU admission to 6 weeks postdischarge. Mothers will be assessed by focus groups and the same questionnaires. Descriptive statistics and appropriate comparative tests, such as the 2-tailed t test, will be used to analyze and compare phase 1 and 2 data. Qualitative data will be coded line by line with the use of NVivo (Lumivero) and thematically analyzed. Simultaneously, systematic reviews (SRs) of fathers' experiences of FICare and their MH outcomes will be conducted. The study was approved by the National Research Ethics Committee (22/EM/0140) in August 2022. A parent advisory group was formed to advise on the study methodology, materials, involvement of participant parents, and dissemination of study findings.

RESULTS

A recent SR demonstrated that data saturation is likely to be achieved by interviewing 9 to 17 participants. We will study a maximum of 20 parents of infants born at less than 33 weeks' gestation in each phase. As of October 2023, the study was ongoing. The SR studies are registered with the PROSPERO database (324275 and 306760). The projected end date for data collection is July 2024; data analysis will be conducted in November 2024 and publication will occur in 2025.

CONCLUSIONS

The study aims to demonstrate the feasibility of using a father or partner-sensitive FICare model for parents of premature babies with a positive impact on their MH. It will demonstrate the feasibility of providing FICare to extremely premature babies receiving intensive care. This study may support the development of inclusive FICare guidelines for nonbirthing parents and their extremely premature infants.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT06022991; https://classic.clinicaltrials.gov/ct2/show/NCT06022991.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/53160.

Associations Between Pornography Use Frequency and Intimate Partner Violence Perpetration Among Young Adult Couples: A 2-Year Longitudinal Study

Pornography use is a common sexual activity for many individuals including those in a romantic relationship. Some studies have shown that violent content depicted in pornography is a risk factor for perpetration of violence in real life. Even if most of these studies examined perpetration of violent behaviors in general, not specifically toward the intimate partner, some studies have shown that pornography use frequency is related to a greater perpetration of intimate partner violence (IPV), while other studies have found that it is not significantly related. However, most previous studies were cross-sectional, sampled individuals rather than couples, and did not include separately forms of IPV (e.g., physical, psychological, and sexual). The present study examined the associations between pornography use frequency and the perpetration of physical and psychological IPV, and sexual coercion among young adult couples. A convenience sample of 113 couples aged between 16 and 29 years old completed self-reported online questionnaires two times over a 2-year period. The results of autoregressive cross-lagged models showed that a person's pornography use frequency at Time 1 was related to their own higher sexual coercion perpetration 2 years later and that a person's sexual coercion perpetration was related to their partner's lower pornography use frequency 2 years later. However, no significant association between pornography use frequency and physical and psychological IPV emerged. In line with previous studies, our results suggest that pornography use represents an important risk factor for the perpetration of sexual coercion. Findings support the need to include education around pornography use in sexual violence prevention programs to avoid that young adults reproduce pornographic scripts in their sexuality.

Real-life users of hormonal or thermal male contraception: An analysis of female partners' motivation, experience, and satisfaction

BACKGROUND

Two male contraceptive methods that inhibit spermatogenesis currently exist: thermal male contraception and hormonal male contraception. Only five studies have been conducted on the acceptability of these methods among men; among women, only the hypothetical acceptability of such a male contraceptive approach as the sole contraception method used by a couple has been evaluated.

OBJECTIVES

To evaluate the motivation, experience, and satisfaction of female partners in couples using hormonal male contraception or thermal male contraception as the sole contraception.

MATERIALS AND METHODS

In this cross-sectional study, 123 male users of hormonal male contraception or thermal male contraception as the couple's sole contraception method were asked to invite their female partner to participate in an anonymous online survey. The questionnaire included 95 questions exploring population characteristics, contraceptive and pregnancy history, motivations for choosing hormonal male contraception or thermal male contraception, the experience of the women in the successive phase of use, relationships with their partner, and satisfaction with the contraception method.

RESULTS

The response rate among participating women was 69% (59/86). The two main reasons for choosing male contraceptive were the desire to share the contraception role in the couple (65%) and the desire of the man to take charge of the contraception (61%). The sexual satisfaction score increased significantly between the contraceptive methods used before hormonal male contraception or thermal male contraception and the phase of contraceptive use (p < 0.01). The overall satisfaction level with thermal male contraception or hormonal male contraception was rated at 3.7 ± 0.6 out of 4. Women mostly recommended hormonal male contraception or thermal male contraception because of the share of contraceptive responsibility and mental load (n = 23/54, 43%).

DISCUSSION

This population of women seemed to have struggled to find a contraceptive method that suited them, but most took advantage of thermal male contraception or hormonal male contraception and trusted their male partner to take charge of contraception use.

CONCLUSION

The positive evaluation from women in partnerships using thermal male contraception and hormonal male contraception should encourage the development of these methods.

Recognizing and Appreciating the Partner's Support Protects Relationship Satisfaction during Cardiac Illness

BACKGROUND

This study aimed to examine whether dyadic coping (DC) is associated with relationship satisfaction (RS) among couples facing cardiac diseases. Furthermore, the moderating role of both partners' anxiety and depression was tested.

METHODS

One hundred cardiac patients (81.5% men) and their partners (81.5% women) completed a self-report questionnaire during hospitalization. The Actor-Partner Interdependence Model (APIM) and moderation analyses were used to assess the above associations.

RESULTS

Results showed that positive DC was significantly related to higher levels of RS, and negative DC was related to lower levels of RS. Furthermore, patient and partner psychological distress significantly moderated the link between DC and RS: patient-perceived positive DC was associated with higher partner RS when partner depression was high; partner-perceived positive DC was associated with higher patient RS when patient anxiety was low; patient-perceived negative DC has associated with lower patient RS when patient anxiety and depression were high.

CONCLUSION

This study showed that positive DC is associated with a more satisfying relationship and identified under what conditions of cardiac-related distress this can happen. Furthermore, this study underlined the importance of examining DC in addition to the individual coping skills as a process pertaining to personal well-being and couple's outcomes.

Sexual counseling for female sexual interest/arousal disorders: a randomized controlled trial based on the "good enough sex" model

BACKGROUND

Female sexual interest/arousal disorder (FSIAD) is the most common female sexual disorder with adverse effects on women's health and interpersonal relationships.

AIM

This survey evaluated the effects of sexual counseling based on the "good enough sex" (GES) model on the sexual health variables of women with FSIAD.

METHODS

A randomized clinical trial with a 1:1 allocation ratio was conducted among 80 women with FSIAD in Iran in 2021. Eligible participants were randomly assigned to group A (women) and group B (couples). Women attended 4 weekly online group sexual counseling sessions based on the GES model, each lasting 120 minutes. In group B, husbands participated in sessions 2 and 3.

OUTCOMES

Women's sexual health parameters-including sexual desire, sexual satisfaction, sexual function, sexual distress, sexual communication, frequency of sexual intercourse, and dysfunctional beliefs-were evaluated before and 3 months after counseling. The significance threshold considered P < .007 due to Bonferroni correction.

RESULTS

After the intervention, all sexual parameters except sexual dysfunctional beliefs showed significant improvement (P < .001) in both groups. During the follow-up period, the average scores for all sexual variables were slightly higher in group B vs group A. The between-group difference was significant only for frequency of sexual intercourse (P < .01).

CLINICAL IMPLICATIONS

This study reaffirms the impact of the GES model as biopsychosocial therapy in managing female sexual problems. Considering men's reluctance to accompany their wives to sex clinics, counseling for women alone can play a significant role in solving sexual problems, especially in the case of FSIAD. Online sexual consultation offers cost and time savings, provides a secure space for discussing sensitive topics, and facilitates group program coordination. It ensures universal access to counseling, thereby addressing gender incompatibility issues. It is a powerful, interactive, and acceptable alternative to in-person visits, providing convenience and confidentiality for clients seeking sexual health support.

STRENGTHS AND LIMITATIONS

The following were among the survey strengths: conducting a randomized controlled trial on women with FSIAD by applying an appropriate model and scales, involving spouses, and evaluating online group sexual counseling. However, the results of this study may not be generalizable to women without partners.

CONCLUSION

The GES model, emphasizing intimacy and sexual dialogue, reduces unrealistic sexual expectations and improves women's sexual desire and overall health. Our results showed that instead of insisting on the physical presence of husbands in counseling sessions, clinicians should emphasize their emotional support and companionship during the treatment process.

Parent-couple satisfaction, parent depression, and child mental health in families with autistic children

Introduction

Within two-parent households, the parent-couple subsystem (marital or romantic partner relationship) is posited to shape the mental health of both parents and children. Autistic children and their parents have an elevated-risk for mental health problems. The present study longitudinally examined the mediating role of the quality of the parent-couple relationship in time-ordered pathways between changes in the mental health problems of autistic children and in parent depression symptoms at a within-family level.

Methodology

Using four time points of data collected on 188 families of autistic children (aged 5-12 years) across 3 years, the bidirectional associations between parent-couple relationship satisfaction, parent depressive symptoms, and child internalizing and externalizing mental health problems were investigated. Two multi-group (grouped by parent gender) complete longitudinal mediation models in structural equation modeling using Mplus software were conducted.

Results

Parent-couple relationship satisfaction mediated: (1) the association between higher parent depressive symptoms and higher child internalizing mental health problems 12 months later for both mothers and fathers, and (2) the association between higher child externalizing mental health problems and higher father depression symptoms 12 months later. Father depression symptoms mediated a pathway from lower parent-couple satisfaction to higher child internalizing mental health problems 12 months later, and mother depression symptoms mediated the pathway from higher child externalizing mental health problems to lower parent-couple satisfaction 12 months later.

Conclusion

Findings highlight the bidirectional and complex ways that parent and child mental health and the quality of the parent-couple relationship are entwined across time in families of autistic children. Family-wide interventions that address the needs of multiple family members and family systems are best suited to improve the mental health of parents and autistic children.

Impact of Cohabitation during Confinement on Older Adults' Negative Affect: What Specificity of Life as a Couple?

BACKGROUND

Social isolation is a risk factor for older adults' physical and psychological health. The beneficial effect of social connections in times of major health events is undeniable. Nevertheless, it remains unclear whether the positive effect of social support depends on the relationship type.

OBJECTIVES

This study aimed to investigate the influence of older adults' living conditions on the risk of experiencing negative affect during the first lockdown and post-lockdown.

DESIGN

An epidemiological study conducted during the COVID-19 crisis, at the time of the first lockdown, and 2 to 3 months following the lockdown.

SETTING

A subset sample of the PACOVID survey, a population-based survey of older adults.

PARTICIPANTS

Altogether, 277 participants were included into three groups depending on their living conditions: Group 1 "living alone" (n = 141); Group 2 "living with their spouse" (n = 106); Group 3 "living in cohabitation with relatives" (n = 30).

MEASUREMENTS

Mixed logistic regression analyses were used to study the change in the risk of experiencing negative affects over time according to the living conditions. The presence of negative affects during lockdown was assessed using three items from the 20-item Center for Epidemiologic Studies Depression Scale : «Do you feel sad?»; «Do you feel depressed?; «Do you feel lonely?

RESULTS

Participants living with their relatives or partner were significantly less likely to experience negative affect than those living alone during lockdown. Moreover, over time, only those living with their spouse had this lesser risk compared to those living alone.

CONCLUSIONS

These findings highlight the protective effect of social support over time and more specifically of that provided by the spouse. Couple functioning ought to be given consideration when studying the impact of health crisis situation on the mental health of older adults.

Association between behavioral patterns and depression symptoms: dyadic interaction between couples

Background

Behavioral patterns are sometimes associated with depression symptoms; however, few studies have considered the intra-couple effects. This study examined the effect of a spouses' behavioral patterns on depression symptoms within themself and in their spouse.

Methods

A total of 61,118 childbearing age participants (30,559 husband-wife dyads) were surveyed. The depression symptoms were assessed using the nine-item Patient Health Questionnaire (PHQ-9). The behavioral patterns were identified by the latent class analysis. The effects of behavioral patterns on the couple's own depression symptoms (actor effect) and their partner's depression symptoms (partner effect) were analyzed using the Actor-Partner Interdependence Model (APIM).

Results

Three behavioral patterns were identified: low-risk group, moderate-risk group, and high-risk group. The high risk of these behavior patterns would be associated with a higher score on the PHQ-9; for both husbands and wives, their behavioral patterns were positively associated with PHQ-9 scores (βhusband = 0.53, P < 0.01; βwife = 0.58, P < 0.01). Wives' behavioral patterns were also positively associated with their husbands' PHQ-9 scores (β = 0.14, P < 0.01), but husbands' behavioral patterns were not associated with their wives' PHQ-9 scores.

Conclusions

Wives' depression symptoms were affected only by their own behavioral patterns, whereas husbands' depression symptoms were influenced by both their own and their spouses' behavioral patterns.

An integrated intervention programme for couples facing colorectal cancer: A randomized controlled trial

BACKGROUND

Under the guidance of a preliminary Live with Love Conceptual Framework, a Caring for Couples Coping with Colorectal Cancer (4Cs: CRC) programme was designed specifically for colorectal cancer couples. The objectives of this study included examining the efficacy of the programme for couples adapting to colorectal cancer and comparing the effects of different intervention delivery modes (online, face-to-face and blended) on couple outcomes.

METHODS

A four-arm randomized controlled trial was conducted among Chinese colorectal cancer couples. Couples were randomly assigned to an online intervention, a face-to-face intervention, a blended intervention or a control group. Self-efficacy, dyadic coping, communication and dyadic outcomes (physical and mental health, negative and positive emotions and marital satisfaction) were evaluated at baseline and 6 weeks later. Analysis of variance (ANOVA) and repeated measures ANOVA were employed to assess between-group differences and within-group effects in the four groups, respectively.

RESULTS

A total of 179 couples completed the 6-week study and post-study assessments. The intervention showed generally medium-to-large effects across multiple measured outcomes, including self-efficacy, dyadic coping, communication, mental health, negative emotions and positive emotions for both patients and spouse caregivers. Additionally, interventions delivered through different modes produced equally significant effects on couple outcomes.

CONCLUSIONS

The integrated intervention programme is effective in improving cancer adaptation in colorectal cancer couples. Long-term follow-up and a mix of quantitative and qualitative assessments are crucial for further evaluation of the programme.

TRIAL REGISTRATION

Retroactive registration is under review.

How therapists respond to "uneven" alliances in couple and family therapy: A conversation-analytic study

This article examines how family and couple therapists respond to uneven alliances with their clients at the micro-level of therapeutic exchanges in the context of Interpersonal Process Recall (IPR) interviews. We operationalize uneven alliance with the interactional concept of asymmetry of affiliation. To this end, first, using conversation analysis (CA), we identify episodes of asymmetry of affiliation in the moment-by-moment conversation between the therapist and the client in therapy consultation. Second, applying CA to the IPR interview data, we examine how therapists orient to the episodes of the session in which the asymmetry of affiliation was identified. The findings demonstrate therapists' two key practices of orienting to the episodes of asymmetry of affiliation: (1) therapists' exclusive identification with one participant by typically invoking gender roles and (2) therapists' investigation of their agency in the emergence of asymmetry.

How men with alcohol use disorder perceive communication, couple satisfaction, relational boredom, and quality of life compared to wives: Findings from a hospital-based study

In India, use of alcohol between 10 and 70 years is increasing significantly as per the Government of India, Ministry of Social Justice & Empowerment. Chronic alcohol use in men can potentially disrupt their relationships with their wives in several ways, leading to poor communication, trust issues, emotional disconnection, physical abuse, financial strain, and neglecting responsibilities. These factors may reduce the quality of life of the couple and negatively impact the couple's overall well-being. This cross-sectional study assesses the communication, couple satisfaction, relational boredom, and quality of life of wives with alcoholic husbands admitted to inpatient psychiatry services (patients: n = 30; wives: n = 30). A social demographic data sheet, self-perceived communication in couples, couple satisfaction, relational boredom scale, and the World Health Organization's quality of life scales were used to collect data. All participants were chronic alcohol users and had used alcohol for over 10 years. The mean scores of couple satisfaction (p < .001) and quality of life were greater among husbands. In contrast, wives scored significantly higher in communication (p < .001) and relational boredom (p < .001) compared to husbands with alcohol use disorder. Furthermore, communication, couple satisfaction, relational boredom, and quality of life domains were negatively correlated (p < .001). In contrast, communication and relational boredom were positively correlated (p < .001). Men with alcohol use disorder perceived a satisfactory relationship and higher quality of life than did their wives.

[A father's perspective for today's young families?]

Today, the distribution of parental roles is organised around an equity that is more than justified, but has the consequence of creating a territorial watershed where the negotiation of values, opinions, wishes and deep-seated needs is constantly activated. Where societal definitions used to provide a framework and contentment for transactions within the couple, the new generation finds itself obliged to cooperate and redefine the spaces and roles of each, with intergenerational issues multiplied tenfold and marital crisis often heightened.

Effects of couple-based dyadic interventions on breast cancer patients and their intimate partners: A systematic review and meta-analysis

AIMS

To evaluate the effects of couple-based dyadic interventions on breast cancer patients and their intimate partners and compare the effects between interventions with different durations (<3 months; =3 months; >3 months).

DESIGN

A systematic review and meta-analysis.

DATA SOURCES

Six English databases, PubMed, Embase, Web of Science Core Collection, the Cochrane Library, Medline, PsycINFO, and three Chinese databases, China National Knowledge Infrastructure (CNKI), WanFang, and Weipu (VIP), from database inception to 19 February 2022.

REVIEW METHODS

The quality of the included RCTs was evaluated using the Cochrane risk-of-bias tool and the data analysis was performed by using RevMan 5.4 and Stata 15. The outcomes were categorized into five aspects: dyadic relationship, overall quality of life (QOL), physical health, psychological health and social adjustment.

RESULTS

Nineteen RCTs were included. For patients' overall effects, couple-based dyadic interventions can improve sexual frequency, psychological health (anxiety; depression; well-being; body image) and social adjustment (family function-cohesion; social function-total). In the subgroup analysis, it can adjust patients' relationship satisfaction (>3 months), sexual frequency (>3 months), depression (<3 months and >3 months), well-being (>3 months), and body image (3 months). For intimate partners, no statistically significant overall effects were found, and all results in the subgroup analyses showed no statistical significance.

CONCLUSIONS

The results revealed the different effects of couple-based dyadic interventions on dyads. It also suggested that tailored intervention duration should be a focus in future studies to obtain the potential actor-partner benefits.

IMPACT

This study revealed that the overall effects of the couple-based dyadic interventions include enhancing patients' sexual frequency, psychological health and social adjustment. Clinical practitioners should consider the intimate partners' outcomes and conduct couple-based dyadic interventions that contain more tailored elements to achieve better effects.

NO PATIENT OR PUBLIC CONTRIBUTION

Registration: The systematic review and meta-analysis of RCTs has been registered in PROSPERO (Number: CRD 42021286679).

The Role of Islamic Beliefs in Facilitating Acceptance of Cancer Diagnosis

Although survival rates for patients with cancer have increased, this disease continues to affect couples significantly. Religion and culture seem to be part of the therapeutic process for people with cancer. Despite the abundance of the Arab Muslim community in Western countries, there is a lack of documented data on Arab Muslim couples experiencing cancer. A simple exploratory qualitative study was conducted through semi-structured interviews on six married couples (n = 12) identifying with the Arab Muslim culture and being affected by cancer. An iterative data analysis was performed. Results were reported under the following themes: accepting illness through coping strategies provided by Muslim religious beliefs and practices, experiencing problems with the expression of needs and feelings within the couple, experiencing closeness within the family, and experiencing illness in the hospital setting as Muslims. Our results show that Islamic beliefs can facilitate acceptance of a cancer diagnosis. It is also noted that religion seems to unite spouses in supporting each other and maintaining hope in a difficult context. Communication issues may persist between a couple due to stressors related to cancer. The results of this study could raise awareness about the importance of exploring religious and spiritual beliefs when supporting couples affected by cancer.

Factors Associated with Depression in Infertile Couples: A Study in Thailand

BACKGROUND

Infertility can affect a couple's mental health and marital and social relationships. The study aimed to investigate the prevalence of depression among infertile couples and their relationships with other factors.

METHODS

This study employed a cross-sectional survey. Validated tools were used to assess anxiety and depression, marital satisfaction, personality traits and sufficiency economy. The actor-partner interdependence model (APIM) was used for dyadic analysis.

RESULTS

The prevalence of depression in infertile couples was 6.7%. Aggression, extraversion and neuroticism were significantly correlated with depression, whereas the expectation of having children, marital satisfaction and sufficiency economy were negatively correlated with depression. The APIM model suggested that neuroticism and marital satisfaction were significant predictors of depression. Partner effect between the expectation of having children and depression was observed (p = 0.039).

CONCLUSIONS

Like other populations, depression in infertile couples seems to be associated with aggression, extraversion and neuroticism. However, there are specific variables related to infertility that impact the depression levels of these couples. For instance, the expectation of having children can affect the partners of infertile couples, while the role of the sufficiency economy is a new factor that has been examined for depression in this sample and requires further exploration.

Successful pregnancies in post-kidney transplant couples: four case reports

Background

The fertility of female kidney transplant recipients is increasing with the progression of transplant management. This article aims to evaluate the clinical prognosis of mothers and newborns for post-kidney transplant couples.

Methods

From January 2019 to April 2022, a total of four couples, all kidney transplant recipients, were successfully prepared for pregnancy after a rigorous preconception evaluation, including three cases of natural conception and one case of in vitro fertilization. Data regarding the mother and newborn, including general clinical condition and laboratory results, were recorded and assessed throughout the pregnancy and up until 12 months after delivery.

Results

The mean conception age of the mothers was 34.8 years (30-38 years), and the mean interval between renal transplantation and pregnancy was 6.6 years (3.7-8.7 years). All deliveries were by cesarean section and took place without incident. There were three premature births (<37 weeks; average 35.1 weeks). In case 1 (in vitro fertilization), pre-eclampsia occurred during maternity, and this was the only case in which the fetal weight was less than 2,500 g (average 2,576.7 g). The mean Apgar score (1 min) was 7.8 (6-9) and reached 9 in all cases at 5 min. The mothers' eGFR rose during mid-gestation, decreased in late pregnancy, and was largely restored along with proteinuria 1 year postpartum. Postnatal evaluation at 6 months showed normal neurological development. In addition, NK cell and IFN-γ levels increased and Treg cell and IL-10 levels decreased along with the onset of pre-eclampsia.

Conclusions

Pregnancies can succeed in couples who are both kidney transplant recipients. However, there might be higher risks of infertility, prematurity, and low birth weight.

Do Brief Lab-Based Interventions Decrease Coercive Conflict Within Couples and Parent-Child Dyads?

Coercive conflicts between parents and children and between couples are implicated in the pathogenesis of a variety of psychological and physical health problems. Despite its seeming importance to population health, there are no widely available, easy-to-use methods with demonstrated efficacy to engage coercive conflict and reduce it. Identifying and testing potentially efficacious and disseminable micro-interventions (i.e., interventions that can be delivered in under 15 minutes via computer or paraprofessional) for targets with cross-cutting health implications, such as coercive conflict, is the focus of the National Institutes of Health Science of Behavior Change initiative. We experimentally tested four micro-interventions targeting coercive conflict in couple and parent-child dyads in a within-between design. There were mixed but supportive findings for the efficacy of most of the micro-interventions. Attributional reframing, implementation intentions, and evaluative conditioning all reduced coercive conflict as assessed by some but not all measures of observed coercion. No findings indicated any iatrogenic effects. Interpretation bias modification treatment improved at least one measure of coercive conflict for couples, but not for parents and children; additionally, it increased self-reported coercive conflict. Overall, these results are encouraging and suggest that very brief and highly disseminable micro-interventions for coercive conflict are a fruitful direction for inquiry. Optimizing micro-interventions and deploying them across the health care infrastructure could tremendously enhance family functioning and, in turn, health behaviors and health (ClinicalTrials.gov IDs: NCT03163082, NCT03162822).

Couples' We-Ness and Separateness During the COVID-19 Pandemic and Lockdown: A Longitudinal Perspective

This 5-wave longitudinal study aimed to monitor the feeling of we-ness and separateness over one year of the COVID-19 pandemic by examining partners' natural pronoun usage when reporting couple interactions. Compared to the start of the pandemic, a general decline of we-ness was found after one year. Moreover, the changes in couple we-ness were non-linear, resulting in an increase at the end of the strict lockdown, followed by a decrease. No change in couple separateness was found.

Lactobacillus crispatus-dominated vaginal microbiome and Acinetobacter-dominated seminal microbiome support beneficial ART outcome

INTRODUCTION

Despite the considerable progress made in assisted reproductive technologies (ART), the implantation rate of transferred embryos remains low and in many cases, the reasons for failure remain unclear. We aimed to determine the potential impact of female and male partners' reproductive tract microbiome composition on ART outcome.

MATERIAL AND METHODS

The ART couples (n = 97) and healthy couples (n = 12) were recruited into the study. The smaller healthy group underwent a careful selection according to their reproductive and general health criteria. Both vaginal and semen samples were subjected to 16S rDNA sequencing to reveal the bacterial diversity and identify distinct microbial community types. Ethics statement The study was approved by the Ethics Review Committee on Human Research of Tartu University, Tartu, Estonia (protocol no. 193/T-16) on 31 May 2010. Participation in the research was voluntary. Written informed consent was obtained from all study participants.

RESULTS

The men with Acinetobacter-associated community who had children in the past, had the highest ART success rate (P < 0.05). The women with bacterial vaginosis vaginal microbiome community and with L. iners-predominant and L. gasseri-predominant microbiome had a lower ART success rate than women with the L. crispatus-predominant or the mixed lactic-acid-bacteria-predominant type (P < 0.05). The 15 couples where both partners had beneficial microbiome types had a superior ART success rate of 53%, when compared with the rest of the couples (25%; P = 0.023).

CONCLUSIONS

Microbiome disturbances in the genital tract of both partners tend to be associated with couple's infertility as well as lower ART success levels and may thus need attention before the ART procedure. The incorporation of genitourinary microbial screening as a part of the diagnostic evaluation process may become routine for ART patients if our results are confirmed by other studies.

YES, WE COPE: Dyadic Coping as a Mediator Between Perceived Relationship Quality and Emotional Representation of COVID-19

Background

The COVID-19 pandemic has brought about social changes that have impacted the functioning and dynamics of couples in a romantic relationship, arising from the overwhelming amount of added stress they have endured. Specifically, the divorce rate in Portugal has increased after lockdown, which underscores the adverse consequences of COVID-19 on couples. A lower quality of the couple's relationship may worsen the emotional representation of COVID-19; however, the literature suggests that perceived partner dyadic coping responses have a great influence on adverse events. The aim of the present study was to assess the mediating role of partner coping in the association between relationship quality and emotional representation of COVID-19. We also sought to observe whether the length of the relationship moderates this association.

Methods

Participants (N = 528) were adults living in Portugal (84.7% female) currently in a romantic relationship with their current partner for at least 1 year. Online data collection.

Results

We found that relationship quality predicted COVID-19 emotional representation, but this association was fully mediated by total dyadic coping. This association was especially significant in couples with a shorter length of time in the relationship.

Conclusions

We point out the importance of dyadic coping as a protective factor against emotional distress to cope with the ongoing stressors associated with the COVID-19 pandemic. These data suggest the need for relationship education programs that promote positive coping between partners.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10608-023-10379-4.

The individual and societal price of non-adherence to continuous positive airway pressure, contributors and strategies for improvement

INTRODUCTION

Continuous positive airway pressure (CPAP) is the first line therapy for obstructive sleep apnea (OSA). CPAP is highly effective for improving symptoms and quality of life but the major issue is adherence, with up to 50% of OSA discontinuing CPAP in the first 3 years after CPAP initiation.

AREAS COVERED

We present the individual and societal cost of non-adherence to CPAP, factors associated with non-adherence to CPAP, as well as current strategies for improving adherence including telehealth, couples-based interventions and behavioral interventions. We also report on challenges and pitfalls for the visualization and analysis of CPAP remote monitoring platforms.

EXPERT OPINION

CPAP termination rates and adherence to therapy remain major issues despite technical improvements in CPAP devices. The individual and societal price of non-adherence to CPAP for OSA patients goes beyond excessive sleepiness and includes cardiovascular events, all-cause mortality, and increased health costs. Strategies for improving CPAP adherence should be individually tailored and aim to also improve lifestyle habits including physical activity and nutrition. Access to these strategies should be supported by refining visualization dashboards of CPAP remote monitoring platforms, and by disseminating telehealth and innovative analytics, including artificial intelligence.

Asymmetric rotations and dimerization driven by normal to modulated phase transition in 4-biphenylcarboxy coupled L-phenylalaninate

Amongst the derivatives of 4-biphenylcarboxylic acid and amino acid esters, the crystal structure of 4-biphenylcarboxy-(L)-phenylalaninate is unusual owing to its monoclinic symmetry within a pseudo-orthorhombic crystal system. The distortion is described by a disparate rotational property around the chiral centers (ϕ_chiral ≃ -129° and 58°) of the two molecules in the asymmetric unit. Each of these molecules comprises planar biphenyl moieties (ϕ_biphenyl = 0°). Using temperature-dependent single-crystal X-ray diffraction experiments we show that the compound undergoes a phase transition below T ∼ 124 K that is characterized by a commensurate modulation wavevector, q = δ(101), δ = ½. The (3+1)-dimensional modulated structure at T = 100 K suggests that the phase transition drives the biphenyl moieties towards noncoplanar conformations with significant variation of internal torsion angle (ϕ^max_biphenyl ≤ 20°). These intramolecular rotations lead to dimerization of the molecular stacks that are described predominantly by distortions in intermolecular tilts (θ_max ≤ 20°) and small variations in intermolecular distances (Δd_max ≃ 0.05 Å) between biphenyl molecules. Atypical of modulated structures and superstructures of biphenyl and other polyphenyls, the rotations of individual molecules are asymmetric (Δϕ_biphenyl ≈ 5°) while ϕ_biphenyl of one independent molecule is two to four times larger than the other. Crystal-chemical analysis and phase relations in superspace suggest multiple competing factors involving intramolecular steric factors, intermolecular H-C...C-H contacts and weak C-H...O hydrogen bonds that govern the distinctively unequal torsional properties of the molecules.

More than one way to say I love you: An Internet-based intervention for training flexible thinking in romantic relationships

OBJECTIVES

This study developed and pilot-tested an adaptation of Cognitive Bias Modification (CBM) to target two aspects of relational flexibility in couples: the ability to generate alternative perspectives, and the ability to respond nondefensively when alternative partner perspectives are raised within challenging relationship situations (referred to as flexibility in partner perspectives).

METHODS

CBM-FlexC training materials were developed in Phase 1, and expert users (N = 4) and end-point users (N = 7) provided qualitative feedback. Feasibility and preliminary efficacy of CBM-FlexC were evaluated in Phase 2, using an online sample of distressed couples (N = 18). Using a multiple baseline design, participants completed three baseline assessments, six CBM-FlexC sessions over 2 weeks, and a 1-month follow-up.

RESULTS

CBM-FlexC training resulted in greater flexibility in partner perspectives, relationship satisfaction, and general psychological flexibility compared to baseline, and improvements were maintained 1-month after training when using mixed-effects models. However, analyses of reliable change (based on graphical inspection and the Reliable Change Index) indicated that most participants did not experience reliable improvement in flexibility in partner perspectives, or relationship satisfaction.

CONCLUSION

This pilot study provides some positive signals regarding the potential efficacy of CBM-FlexC, while pointing to the need for further development to strengthen its effects.

Paraben exposure and couple fecundity: a preconception cohort study

STUDY QUESTION

Is pre-conception exposure to parabens associated with fecundity in couples of childbearing age?

SUMMARY ANSWER

Paraben exposure in female partners was associated with reduced couple fecundity and anti-Müllerian hormone (AMH) might be one of the possible mediators.

WHAT IS KNOWN ALREADY

The reproductive toxicity of parabens, a class of widely used preservatives, has been suggested but evidence regarding their effects on couple fecundity is scarce.

STUDY DESIGN, SIZE, DURATION

In this couple-based prospective cohort study, a total of 884 pre-conception couples who participated in the Shanghai Birth Cohort between 2013 and 2015 were included.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Concentrations of six parabens were measured in urine samples collected from couples. Malondialdehyde, C-reactive protein, and AMH were assessed in female partners. The outcomes included couple fecundability (time-to-pregnancy, TTP) and infertility (TTP > 12 menstrual cycles). Partner-specific and couple-based models were applied to estimate the associations. The joint effect of paraben mixture on couple fecundity was estimated by quantile-based g-computation (q-gcomp). Mediation analysis was used to assess the mediating roles of oxidative stress, inflammation and ovarian reserve.

MAIN RESULTS AND THE ROLE OF CHANCE

A total of 525 couples (59.4%) conceived spontaneously. In the partner-specific model, propyl paraben (PrP), butyl paraben (BuP), and heptyl paraben (HeP) in female partners were associated with reduced fecundability (fecundability odds ratio (95% CI): 0.96 (0.94-0.98) for PrP; 0.90 (0.87-0.94) for BuP; 0.42 (0.28-0.65) for HeP) and increased risk of infertility (rate ratio (95% CI): 1.06 (1.03-1.10) for PrP; 1.14 (1.08-1.21) for BuP; 1.89 (1.26-2.83) for HeP). Similar associations were observed in the couple-based model. AMH played a significant mediation role in the association (average causal mediation effect (95% CI): 0.001 (0.0001-0.003)). Paraben exposure in male partners was not associated with couple fecundity. The joint effect of paraben mixture on couple fecundity was non-significant.

LIMITATIONS, REASONS FOR CAUTION

Self-reported pregnancy and single urine sample may lead to misclassification. The mediation analysis is limited in that levels of sex hormones were not measured. The inclusion of women with irregular menstrual cycles might affect the results. It is possible that the observed association was due to reverse causation.

WIDER IMPLICATIONS OF THE FINDINGS

This is the first study to assess the effects of paraben exposure on couple fecundity in Asians. Given the widespread exposure to parabens in couples of childbearing age, the present findings may have important public health implications.

STUDY FUNDING/COMPETING INTEREST(S)

This study was supported in part by the National Natural Science Foundation of China (41991314), the Shanghai Science and Technology Development Foundation (22YF1426700), the Science and Technology Commission of Shanghai Municipality (21410713500), and the Shanghai Municipal Health Commission (2020CXJQ01). All authors declare no conflict of interest.

TRIAL REGISTRATION NUMBER

N/A.

The effectiveness of WeChat couple-based psychosocial support for gynaecological cancer: A randomised controlled trial

OBJECTIVE

This study aimed to evaluate the effectiveness of an 8-week electronic couple-based psychosocial support platform (WeChat) for gynaecological cancer.

DESIGN

Randomised controlled trial.

SETTING

Oncology hospital in Shaanxi Province, China.

PARTICIPANTS

A total of 98 dyads of women with gynaecological cancer and their intimate male partners were included.

METHODS

Couple dyads were randomly allocated to either the WeChat couple-based psychosocial support or to a control group receiving eight WeChat articles on general education content related to diet and exercise.

MAIN OUTCOME MEASURES

The primary outcome was sexual function assessed with the Female Sexual Function Index. The secondary outcomes of relationship satisfaction and quality of life were assessed with the Chinese version of Revised Dyadic Adjustment Scale, Functional Assessment of Cancer Therapy-General and The World Health Organization Quality of Life BREF. These outcomes were assessed before randomisation, and immediately and 3 months after the intervention.

RESULTS

The study showed that the sexual function of women participants in the intervention group did not reach a significant level compared with the control group. Relationship satisfaction in the intervention programme improved significantly (adjusted mean difference 4.7, 95% confidence interval [CI] 2.0-7.4; p = 0.001) and quality of life (QoL 6.9, 95% CI 0.5-13.3; p = 0.035) 3 months after the intervention in women with gynaecological cancer. The intervention programme also showed significant positive effects on optimising relationship satisfaction (adjuste mean difference 3.0, 95% CI 0.3-5.7; p = 0.027) of male partners.

CONCLUSIONS

The results provided additional knowledge and an evidence base for the application of the support programme to improve relationship satisfaction and QoL among couples living with gynaecological cancer.

Couple-Based Communication Interventions for Cancer Patient-Spousal Caregiver Dyads' Psychosocial Adaptation to Cancer: A Systematic Review

(1) Background: Effective communication among couples in which one has been diagnosed with cancer is critical to improve their psychosocial adaptation to cancer. The objective of this review was to explore the characteristics and measurement outcomes of existing couple-based communication interventions in the cancer context. (2) Methods: Eight electronic databases were searched from database initiation to August 2022 to identify eligible articles. Hand searching was also performed on the included articles' reference lists and authors. (3) Results: A total of 14 intervention studies were eligible to be included in this review. Cancer couples with distress or communication problems before intervention were more likely to benefit from the couple-based communication interventions. Positive outcomes were reported, including an improvement in relationship functioning (including mutual communication, intimacy, and relationship satisfaction) and individual functioning (including a decline of anxiety, depression and cancer-related concerns, and an increase in psychological adjustment and quality of life). (4) Conclusions: These findings supported the importance of improving mutual communication behaviors to promote cancer patient-spousal caregiver dyads' psychosocial adaptation to cancer. While most included studies were conducted in western countries and the sample size was relatively small, more research is warranted to develop more efficacious couple-based communication interventions.

Dyadic effects of enacted stigma, internalized homophobia, and communal coping on depressive symptoms among cisgender sexual minority male couples

The present study investigated the dyadic direct and indirect effects of enacted stigma on depressive symptoms via internalized homophobia and whether communal coping moderated the effects of enacted stigma on internalized homophobia and depressive symptoms. Hypotheses were tested using actor-partner interdependence models with a sample of 543 cisgender sexual minority male couples. Results showed both partners' enacted stigma experiences were associated with elevated levels of internalized homophobia via actor and partner effects. Internalized homophobia was only associated with elevated depressive symptoms via actor effects. Indirect effects analysis suggested that internalized homophobia mediated the actor and partner influence of enacted stigma on depressive symptoms. Communal coping moderated the direct effects of enacted stigma on internalized homophobia and attenuated the conditional indirect actor and partner effects of enacted stigma on depressive symptoms. Findings underscore the role of intimate relationship processes in understanding the impacts of enacted stigma on depressive symptoms.

Prevention and treatment of human papillomavirus in men benefits both men and women

Men should not be overlooked in research on human papillomavirus (HPV) and its associated genital diseases. This is because men infected with HPV are not only at higher risk of genital cancers, but also increase their partners' risk of HPV infection and reinfection through sexual contact. Herein, we summarized the state of knowledge regarding the prevention and treatment of HPV infection in men as well as the possible effects of the prevention and treatment of HPV in men on their female partners. Condom use, smoking cessation, male circumcision, and HPV vaccination for men each play an important role in preventing HPV infection within heterosexual couples. Additionally, men could choose to test for certain types of HPV, such as the oncogenic HPV16 or HPV18 strains, as part of a routine screening program when their partner is positive for HPV. Although there is no recognized treatment for HPV infection as of yet, immunotherapy drugs, such as toll-like receptor agonists, therapeutic HPV vaccines, and immune checkpoint inhibitors, have shown promising results in clinical trials and in actual clinical practice. HPV infection in men also increases the risk of cervical cancer in their female partners. Because of the high partner concordance for HPV demonstrated in prior research, the prevention and treatment of HPV in men should be explored more comprehensively in future research.

Developing OurSleepKit: A Couple-focused mHealth Tool to Support Adherence to Positive Airway Pressure Treatment

BACKGROUND AND AIM

Existing interventions promoting positive airway pressure (PAP) adherence focus only on the diagnosed individual, despite the fact that partners are often the most impacted by obstructive sleep apnea (OSA), and are delivered mostly by health professionals, with limited success. The goal of this work is to develop a prototype of OurSleepKit, a couple-focused mobile health (mHealth) tool to coach mutual engagement and promote adherence to PAP treatment.

METHODS

We used an iterative participatory approach working with future end users of OurSleepKit to support the development of this prototype. We conducted a total of 14 semi-structured in-depth open-ended dyadic interviews with OSA patients and their partners. Phase 1 of the development was to inform key functions of an engaging tool. Phase 2 focused on developing functions to engage positive conversation in the dyad and obtained feedback for this initial prototype.

RESULTS

The OurSleepKit prototype was developed and demonstrated high acceptability and engagement. Three key functions included periodic assessments based on developmental stages of PAP treatment, a Coaching Board which provides customized and dynamically updated support content - primarily brief story-telling videos featuring real-life couples' experiences - and timely tailored prompts (for action, learning, and conversation) through push notifications in the evening to facilitate positive conversation in the dyad and offer in-the-moment support for PAP use.

CONCLUSIONS

Going beyond the traditional and prevailing view of PAP use as an individual phenomenon, OurSleepKit is a novel mHealth intervention engaging both the patient and partner holding great promise to promote PAP adherence.

Engaging in coparenting changes in couple therapy: Two contrasting cases

Following the task analysis method, this study aimed to confirm the relevance of our model of resolving coparenting dissatisfaction to differentiate between two contrasting couples undergoing couple therapy. The model under study described the steps through which couples resolve coparenting issues in couple therapy for parents. Two contrasting couples were selected from a sample of parents undergoing systemic couple therapy. We analyzed videotaped discussions about the couple's coparenting relationship to select one couple whose interaction quality improved after therapy and one couple who worsened. Records of therapy sessions were rated by two independent coders to verify whether the model of coparenting change was present. Results showed that the couple that improved after therapy presented almost all the steps of the model whereas the couple that worsened after therapy presented only two steps. This study supported the relevance of the model and its various components to discriminate between two contrasting cases.

Pharmacotherapy for Obstructive Sleep Apnoea and Coupled Life: A Descriptive Phenomenological Study of a Complex Interaction

BACKGROUND

Obstructive Sleep Apnoea (OSA) is a common chronic sleep-related breathing disorder. Drug therapy is a recent approach to treating OSA, and no data is available regarding its effects on a couple's life. The aim of this study was to investigate the impact on couples' lives of a novel drug treatment for OSA.

METHODS

Participants of a trial on new drug therapy (reboxetine plus oxybutynin) for OSA were interviewed. The study was conducted using a descriptive phenomenological approach by Sundler et al. Results: Ten patients and six of their partners were recruited through a purposive sampling between February and April 2021. The results indicate that drug treatment of OSA had a favourable impact on the couples' lives. Pharmacotherapy improved self-reported sleep quality, as the absence of CPAP allows people to sleep closer to the bed partner and because the patient does not have to sleep in a forced position. Moreover, the couples developed teamwork from the beginning which appeared to be crucial during the trial, especially when some difficulties and adverse events occurred.

CONCLUSIONS

This study presents the presence of a positive closed loop that could be considered a predictor of adherence to drug therapy.

Thermal male contraception: A study of users' motivation, experience, and satisfaction

PURPOSE

The aim of this study is to evaluate the motivations, experience, and acceptability of thermal male contraception (TMC) in male partners of couples requesting the use of TMC as the only couple contraceptive.

MATERIALS AND METHODS

To the 72 men of couples seeking male contraception and using TMC between 2011 and 2019, we suggested an anonymous online survey (93 questions) exploring population characteristics, contraceptive histories, motivations for choosing TMC, patient experience at the successive phases of use, relations with partner and environment, and satisfaction with this method.

RESULTS

Sixty-seven men agreed to participate (93% response rate); 63 responses were complete and were analyzed (94% participation rate). The main motivations for choosing TMC were "not using hormones" (n = 59/63, 94%) and using a method regarded as "natural" (n = 49/63, 78%). Most of the men surveyed (68%) adopted the method in less than 2 weeks. During the contraception use phase (n = 59 men), they described significantly improved sexual satisfaction, compared to that experienced with their previous contraceptive methods, and they reported high confidence (100% rather/totally confident partner) and support (88% rather/totally supporting partner) from their partner. Most men (n = 35/59, 59%) also reported improved self-esteem. The main negative point was discomfort, reported by 24% of the men. The overall satisfaction score of using this method was 3.78 ± 0.46/4, and 100% of the men reported that they would recommend the method to other men.

DISCUSSION AND CONCLUSION

Men using TMC successfully assumed the responsibility for and performed a daily task to provide couple contraception. This positive evaluation, together with the already published contraceptive efficacy and reversibility of TMC, should encourage the development of this method.

Dyadic Experiences and Psychosocial Management of Couples Facing Advanced Cancer: A Systematic Review of the Literature

Background

Cancer diagnosis and treatment represent a real upheaval both for the patient and for his or her life partner. Adjustment to cancer has been widely studied at the individual level, however, there is little in the literature about the experiences of the couple as an entity. This is especially true with regard to a population facing advanced cancer. This systematic review aimed to make an inventory of 1) the current knowledge relating to the experience of the patient-partner dyad when confronted with advanced cancer, and 2) the psychosocial interventions specifically centered on this dyad.

Method

This review was conducted using the Cochrane methodology. The eligibility criteria for the literature review were: one of the members of the dyad being treated for advanced cancer, dyad composed of the patient and his/her life partner. Databases from PubMed, PsycArticle, PsycInfo, Psychology and Behavioral Sciences Collection and Scopus were investigated. A thematic content analysis on the basis of admitted articles made it possible to respond to each of our research objectives.

Results

Three hundred eighty-nine citations were found. Twenty were admitted to the systematic review of the literature. It highlighted the following experiences of the advanced cancer patient-life partner dyad: uncertainty about the future, disjointed time, intrusion into the couple's intimacy, attachment style and caregiving within the couple, couple's adjustment to cancer symptomatology, the couple's supportive care needs, role changes, nature of communication within the couple, anticipation of the coming death, and the meanings and beliefs around death. This review also describes the range of couple therapies used in the context of advanced cancer: emotionally focused-couple therapy, existential therapy, art therapy, support therapy and couple communication and intimacy promotion. These therapies seem to have individual beneficial effects for both the patient and his or her life partner as well as improving marital functioning.

Conclusions

These results clearly highlight that consideration of the couple and communication within the couple during care are fundamental to dyadic adjustment to advanced cancer. Further studies (qualitative and quantitative) are needed to better understand the couple's experience in order to adapt the management of the couple facing advanced cancer.

Dyadic effects on depressive symptoms of spouse caregivers and their care recipients: evidence from China

OBJECTIVES

The likelihood of providing care to a spouse in middle and older ages has increased as life expectancy increases, but knowledge about how the caregiver and care recipient influence each other's mental health is limited. This study examined whether a partner's physical, cognitive, and mental health in a spousal caregiving dyad are associated with the other partner's depressive symptoms in China and whether the dyadic effects vary by gender.

METHODS

This study used data from Wave 3 (2015) and Wave 4 (2018) follow-up surveys of the China Health and Retirement Longitudinal Study (CHARLS). The analytic sample featured 1,245 dyads of care recipients aged 45 or older and their spouse caregivers. The Actor-Partner Interdependence Model was used to test the dyadic effects among all couples in the analytic sample, couples with wife caregivers and couples with husband caregivers, respectively.

RESULTS

We found that caregiver's depressive symptoms at Wave 3 were significantly associated with care recipient's depressive symptoms at Wave 4 in the full sample. Regardless of caregiver or care recipient roles, wives' mental health was impacted by their husbands' depressive symptoms, but not vice versa. Wife recipient's cognitive impairment was associated with husband caregiver's lower depressive symptoms.

CONCLUSION

This study sheds light on the mental health of couples in the context of caregiving in China. The findings indicate that interventions to support couples in a caregiving dyad need to consider the influence they have on each other, and the gender and health conditions of each in the dyad.

Changes in Attachment and Commitment in Couples Transitioning to Parenthood

This study examined whether attachment predicts changes in commitment and whether commitment predicts changes in attachment in both partners during the transition to parenthood. Both partners of 93 couples completed online questionnaires individually at the second trimester of pregnancy and at 4 months postpartum. Autoregressive cross-lagged path analyses based on the Actor-Partner Interdependence Model tested the bidirectional associations between attachment dimensions (anxiety and avoidance) and three modes of commitment (optimal, over-commitment, and under-commitment). Results revealed that for both partners, prenatal attachment avoidance was associated with a decrease in optimal commitment and an increase in under-commitment from pre- to postpartum. Fathers' attachment anxiety was associated with a decrease in mothers' under-commitment. Furthermore, prenatal optimal commitment was associated with a decrease in attachment avoidance, whereas under-commitment was associated with an increase in attachment avoidance. Fathers' prenatal over-commitment was associated with an increase in their own attachment anxiety and avoidance. These results highlight how attachment insecurities and relationship commitment interrelate during this major transition.

Emotional and Sexual Adaptation to Colon Cancer: Perceptual Congruence of Dyadic Coping Among Couples

Context

Colon cancer is the 3rd most common cancer in the world. The diagnosis leads the patient and his relatives into a process of mourning for their health and previous life. The literature highlights the impact of the disease on couples. Cancer can either alter or strengthen the relationship. The disease will directly or indirectly affect both partners. Such impact starts with the diagnosis and lasts long after treatments. No study has analyzed both emotional and sexual interactions between partners throughout the illness so far.

Objective

This research aims to identify and describe whether congruence within couples tends to improve emotional and sexual adjustment.

Method

Thirteen couples took part in this research by answering a set of questionnaires investigating, in particular, dyadic coping strategies, marital and sexual satisfaction. Non-parametric analyses were performed on the quantitative data.

Results

Emotional satisfaction is good among the couples in our study. There are important similarities in partners’ emotional adjustment. Patients who are most satisfied with their couple typically have a partner who is also satisfied. This was an expected result based on the literature. Overall, sexual satisfaction is described as average, which is either related to a low frequency of sexual intercourse, or a gap between the ideal and actual frequency of intercourse. In terms of dyadic coping, similarities within couples tend to improve emotional and sexual adjustment. Couples in which communication about stress between the patient and their partner is congruent tend to report good marital satisfaction. We found the same results for delegated coping of both the patient and the partner, and for negative coping of the partner. Sexual adjustment is linked to a similar perception within the couple of a common dyadic coping.

Conclusion

Emotional and sexual adjustment is largely linked to the quality of the partner’s support. The congruence of couple support strategies has been identified as an important factor in emotional satisfaction. In addition, the more couples implement joint stress management, the better their sexual satisfaction.

The flourishing scholarship of psychosocial oncology viewed across 30 years through the lens of this journal, Psycho-Oncology

OBJECTIVE

This issue celebrates the 30th anniversary of Psycho-Oncology as a journal, a home for scholarship integrating the psychological, social and behavioural dimensions of cancer. Psycho-oncology developed as an evidence-based discipline to offer an alternative to unproven therapies and to optimise coping and support for patients with cancer and their families.

METHODS

A review of key articles was undertaken for this editorial.

RESULTS

Empirical studies have defined the prevalence of morbidity arising from cancer and the acute, longer-term and late effects of its varied treatments. Interventions have been adapted to respond to existential challenges, death anxiety, fear of recurrence, disease progression, palliative care and have been continued into bereavement. Mixed modality treatments have combined psychotropic and psychotherapeutic interventions. Survivorship studies have examined rehabilitation, fertility, sexuality, body image and relational impacts of illness.

CONCLUSION

This journal has helped the discipline to flourish by publishing the innovative outputs of its community of researchers.

Role of Human Leukocyte Antigen Allele Sharing in Human Papillomavirus Infection Transmission Among Heterosexual Couples: Findings From the Hitch Cohort Study

Background

Human leukocyte antigen (HLA) polymorphism influences innate and adaptive immune responses. Among heterosexual couples in the HPV Infection and Transmission Among Couples Through Heterosexual Activity (HITCH) cohort study, we examined whether allele sharing in a couple predicted the partners’ infections with the same human papillomavirus (HPV) type.

Methods

We tested genital samples from 271 couples for 36 HPV genotypes by polymerase chain reaction. We used direct DNA sequencing to type HLA-B07, -DRB1, -DQB1 and -G. Generalized estimating equations were used to examine the associations between the extent of allele sharing and HPV type concordance in which at least 1 of the partners was HPV positive.

Results

We identified 106 different HLA alleles. The most common HLA alleles among couples were G*01:01:01 (95.6%), G*01:01:02 (60.1%), DQB1*03:01 (57.2%), and DRB1*07:01 (46.9%). Allele sharing was as follows: 19.6% shared none, 43.2% shared 1 only, 25.1% shared 2, and 12.5% shared 3–5. Irrespective of HLA class, grouped or in combination, the extent of allele sharing was not a significant predictor of type-specific HPV concordance in a couple (odds ratio, 1.1 [95% confidence interval, .5–2.1], for 3–5 vs none).

Conclusions

We found no evidence that the extent of HLA allele concordance influences the likelihood of HPV transmission in newly formed heterosexual couples.

A Systematic Review: The Effect of Cancer on the Divorce Rate

Introduction

Research on the impact of cancer on close relationships brings up conflicting results. This systematic review collects empirical evidence on the research questions whether a cancer diagnosis in general or the type of cancer affects the divorce rate.

Materials and Methods

This systematic review was conducted according to the guidelines of the Cochrane Collaboration and the PRISMA statement. The following electronic databases were searched: Web of Science, Ovid SP MEDLINE, PsycINFO, PsyINDEX, CINAHL, ERIC. Risk of bias assessment was performed with the preliminary risk of bias for exposures tool template (ROBINS-E tool). The grading of methodological quality was assessed with the Newcastle-Ottawa Scale.

Results

Of 13,929 identified records, 15 were included in the qualitative synthesis. In 263,616 cancer patients and 3.4 million healthy individuals, we found that cancer is associated with a slightly decreased divorce rate, except for cervical cancer, which seems to be associated with an increased divorce rate.

Discussion

According to this systematic review, cancer is associated with a tendency to a slightly decreased divorce rate. However, most of the included studies have methodologic weaknesses and an increased risk of bias. Further studies are needed.

Facilitators and barriers to getting obstructive sleep apnea diagnosed: perspectives from patients and their partners

STUDY OBJECTIVES

Obstructive sleep apnea (OSA) is a prevalent and debilitating condition that is significantly underdiagnosed. The majority of adults sleep with someone-a partner. Partners can play a significant role in the patient's OSA diagnosis. The goal of this work is to describe facilitators and barriers to OSA diagnosis as discussed by patients with OSA and their partners.

METHODS

This was a qualitative secondary analysis with results drawn from 20 dyadic interviews, conducted 1 couple at a time, in 20 newly diagnosed adult patients with OSA and their partners. Qualitative interview data were analyzed using conventional content analysis.

RESULTS

Facilitators of OSA diagnosis were partners pushing patients to seek care, patients actively seeking care, and care providers identifying the patient's risk of OSA. Barriers to OSA diagnosis were patients' lack of serious attention to symptoms, patients' negative perceptual framing of diagnosis and treatment of OSA, and poor coordination of health care services.

CONCLUSIONS

We recommend engaging partners in the OSA diagnosis and developing educational and behavioral interventions to raise public awareness about OSA. It is important to educate clinicians on atypical presentations of OSA. Further investigation is needed to evaluate the impact of health care services on OSA diagnosis.

CITATION

Ye L, Li W, Willis DG. Facilitators and barriers to getting obstructive sleep apnea diagnosed: perspectives from patients and their partners. J Clin Sleep Med. 2022;18(3):835-841.

Study on the Interdependent Relationship between the Marital Satisfaction Variable and the Psychosocial Impact of Infertility and Anxiety Disposition, According to Gender

This study assessed the relationship between the marital satisfaction variable and the psychosocial impact of infertility and anxiety disposition, testing for possible gender-based differences. Comparisons performed on 87 couples did reveal differences and analyses disclosed that depression, anxiety and quality of life can influence the assessment each partner makes of their relationship, through an interdependent process. One partner's marital satisfaction can be influenced by those variables in the other partner. These findings indicate that psychosocial care for infertile couples must involve both partners and that they should be made aware of the effect of interdependence on marital satisfaction.

Couple Therapy With MDMA-Proposed Pathways of Action

MDMA's first identified potential as a therapeutic catalyst was for couple therapy. Early work in the 1970s and 1980s explored its potential amongst seasoned psychotherapists and their clients. With the completion of the first pilot trial of MDMA-assisted psychotherapy with couples for PTSD, and as the possibility of conducting MDMA-assisted psychotherapy trials expands due to new regulatory frameworks, we have an opportunity to explore and investigate how and why MDMA-assisted couples therapy works. This theoretical paper will explore the neurobiological and neurochemical effects of MDMA in a relational context, the emotional, behavioral, cognitive and somatic effects within a dyadic frame, and how empathy, communication, perception of social connection/support, non-avoidance, openness, attachment/safety, bonding/social intimacy and relationship satisfaction, are all impacted by MDMA, and can be harnessed to facilitate systems-level and interpersonal healing and growth. A model to support MDMA-assisted couple therapy is introduced, and future directions, including implications for intervention development and delivery, will be elucidated.

Self- and other-efficacy are related to current smoking during a quit attempt: a daily diary study in single-smoking couples

OBJECTIVE

Self-efficacy is an important predictor of smoking cessation. Partners' confidence in the other partner's health behaviour, or other-efficacy, seems predictive of beneficial health outcomes, but has not yet been examined with respect to smoking cessation. This diary study examined whether daily fluctuations and general levels of non-smoking partners' other-efficacy relates to same- and next-day smoking, over and above smokers' own self-efficacy.

DESIGN

Smokers and their non-smoking partners (169 couples) participated in an intensive longitudinal study over 21 days with end-of-day diaries, starting on the day of planned cessation.

MAIN OUTCOME MEASURES

Smoking abstinence.

RESULTS

Smokers who had higher self-efficacy than other smokers in the sample had a lower probability of smoking on a given day, regardless of smoking the previous day. On days with higher self-efficacy and other-efficacy than usual, smokers had a lower probability of smoking.

CONCLUSION

To start the quit attempt with high self-efficacy, and maintain it throughout the quit attempt seems important for successful abstinence, as this might help to overcome a lapse. This is the first study to show that other-efficacy is related to smoking behaviour. However, more research is needed regarding the temporal order of smoking and efficacy, from both smokers and spouses.

Challenges experienced and resources identified by young to midlife couples 1-3 years post-cancer diagnosis

OBJECTIVE

The purpose of this study was to explore what young to midlife couples viewed as their strengths as a couple and the greatest challenges in their experience with cancer 1-3 years post-diagnosis.

METHODS

We used qualitative content analysis to extract common themes from open-ended questions from 42 cancer survivors and their partners (aged 27-58). Patterns of themes by age and gender of the survivor were also explored.

RESULTS

Couples described both positive and negative impacts of the cancer experience: (1) strengthened the relationship, bringing couples closer together; (2) brought emotional strain to many areas of life, especially for partners; (3) created positive changes in lifestyle and new priorities for the couple; (4) created strain in the couple's relationship and intimacy; and (5) altered the role of family in supporting the couple. Couples also described four key strengths in dealing with the cancer experience: (1) drawing strength from shared love and mutuality; (2) communicating openly, even about the difficult stuff; (3) working together as a team to support each other; and (4) drawing strength from shared values and goals. Couples reported unmet needs related to the emotional and relational strain of the cancer experience, managing longer term survivor symptoms, fertility and physical intimacy, and lack of support or attention to the partner who often assumed the role of care partner.

CONCLUSIONS

Themes are discussed in light of current dyadic concepts and importance of couple-based interventions.

Pilot Validation Study on the Tavistock Relationships Observational Scale for the Assessment of the Quality of Dyadic Relationships in Couples in Which One Partner Has Dementia

BACKGROUND AND PURPOSE

Many people with dementia are cared for by their spouses. Poor quality of the dyadic relationship is a known risk factor for carer burden and mistreatment of the person with dementia. This study aimed to design and cross validate the Tavistock Relationships Observational Scale (TROS) for assessment of the quality of the relationship in such couples.

METHODS

The study was conducted within the context of the therapeutic intervention with n = 11 couples. Couples' video-recorded interactions were assessed independently by three psychologists using the 13-item TROS.

RESULTS

Cronbach alphas of the scale computed for the three raters were in the range 0.76-0.88 (on average 0.83), thus demonstrating high internal consistency of the scale. Fleiss Kappa coefficient for the three rates computed for 22 assessed videos ranged between 0.45 (moderate agreement) and 0.85 (almost perfect agreement) with 50% of coefficients being above 0.50, suggesting the good performance of the TROS in terms of yielding a satisfactory inter-rater agreement. The TROS also showed good external validity when using as validation criteria caregiving partner's burden (measured with the Zarid Burden Interview: the scales Social burden [Rho = -0.65, p = 0.021] and Role strain [Rho = -0.68, p = 0.014]), depression of the person with dementia (measured with the Cornell Scale for Depression in Dementia: Rho = -0.78, p = 0.020), and relationship satisfaction of the caregiving partner (measured with the dyadic adjustment scale: Rho = 0.52, p = 0.038). The TROS also showed a good capacity to detect the change in scores from time 1 to time 2; moreover, power analysis showed that the TROS can detect the change in scores even in very small samples (n = 5 couples).

CONCLUSIONS

The TROS may be a useful tool for a standardized assessment of the quality of dyadic relationships in couples with dementia in research, nursing, or clinical settings to assist clinical psychologist, nurses, or social workers in a preliminary evaluation of the situation of couples with dementia, to choose a suitable care or intervention, to assess the effectiveness of interventions focusing on improvement of dyadic relationships, or to assess the risk of spousal abuse or neglect of a person with dementia.

Relationship Dynamics among Couples Dealing with Breast Cancer: A Systematic Review

Most studies have been concerned with the experiences and needs of women with breast cancer and spouses/partners separately. In this review, the relationship dynamics that characterize the couple’s experience of breast cancer treatment were investigated. Findings will inform both researchers and professionals in the area of oncology. A systematic literature search was performed in CINAHL, PsychINFO, MEDLINE, Scopus and Web of Science. A checklist for qualitative and observational studies was used to evaluate the methodological quality of the studies. Seventeen studies were included, and the synthesis of the literature revealed five domains that characterized the dyadic process: dyadic coping strategies, psychosocial support, communication, the couple’s sexual life and spirituality. The included studies provide the basis for knowledge and awareness about the experience of couples with cancer, the specific dimensions enacted during the breast cancer treatment path and the type of responses that are associated with a positive couple’s adjustment to the disease.

[Understanding violence against women to improve the support provided]

It is necessary to define violence against women and to understand the context in which it occurs in order to identify it. It can take several forms. The different strategies used by the abuser to exert control over the victim favour a climate of fear and loss of self-confidence. Finding herself in a form of dependency, it is difficult for the victim to leave her abuser; often she does so primarily for her children's sake.