Interrelatedness of women's health-behaviour cognitions: A dyadic study of female family members on carrying heavy loads during pregnancy in Nepal

OBJECTIVES

Decisions about reproductive health are often influenced by women's female family members, particularly in low-resource contexts. However, previous research has focused primarily on individual behavioural determinants. We investigated the interrelatedness of female family members' reproductive health behaviour with a dyadic version of an extended health action process approach. We investigated this for carrying heavy loads during pregnancy and postpartum, a risk factor for reproductive health in many low-income countries such as Nepal.

DESIGN

This cross-sectional study included dyads of daughters-in-law and mothers-in-law in rural Nepal (N = 476, nested in 238 dyads).

METHODS

Dyads of daughters- and mothers-in-law were surveyed about avoiding carrying heavy loads during pregnancy and postpartum. The effects of a woman's cognitions and her female dyadic partner's cognitions on their intention and behaviour about avoiding carrying loads were estimated using linear mixed models.

RESULTS

The results showed that a mother-in-law's cognitions were related to her daughter-in-law's intentions and vice versa. The mother-in-law's cognitions were also related to the daughter-in-law's behaviour. The mother-in-law's self-efficacy and injunctive norms related to the daughter-in-law's intention and behaviour over and above the daughter-in-law's own self-efficacy and injunctive norms.

CONCLUSION

Female Nepali family members' cognitions about carrying heavy loads during pregnancy and postpartum are interrelated. Including female family members in interventions to help women manage their reproductive health in low-resource populations seems promising. These novel findings add to the growing body of research indicating the importance of including a dyadic perspective when understanding and changing health behaviour.

A correlated traits correlated (methods - 1) multitrait-multimethod model for augmented round-robin data

We didactically derive a correlated traits correlated (methods - 1) [CTC(M - 1)] multitrait-multimethod (MTMM) model for dyadic round-robin data augmented by self-reports. The model is an extension of the CTC(M - 1) model for cross-classified data and can handle dependencies between raters and targets by including reciprocity covariance parameters that are inherent in augmented round-robin designs. It can be specified as a traditional structural equation model. We present the variance decomposition as well as consistency and reliability coefficients. Moreover, we explain how to evaluate fit of a CTC(M - 1) model for augmented round-robin data. In a simulation study, we explore the properties of the full information maximum likelihood estimation of the model. Model (mis)fit can be quite accurately detected with the test of not close fit and dynamic root mean square errors of approximation. Even with few small round-robin groups, relative parameter estimation bias and coverage rates are satisfactory, but several larger round-robin groups are needed to minimize relative parameter estimation inaccuracy. Further, neglecting the reciprocity covariance-structure of the augmented round-robin data does not severely bias the remaining parameter estimates. All analyses (including data, R scripts, and results) and the simulation study are provided in the Supporting Information. Implications and limitations are discussed.

Illness uncertainty and quality of life in patients with advanced cancer and their family caregivers: An actor-partner interdependence model analysis

OBJECTIVE

The relationship between illness uncertainty and quality of life (QOL) has been examined for either the patient or caregiver, but not among the patient-caregiver dyads. This study examined relationships between illness uncertainty and QOL among patients with advanced cancer and family caregivers.

METHODS

We conducted a secondary analysis of data from a randomized clinical trial that examined the effects of a dyadic-based intervention on psychological outcomes for patients with advanced cancer and family caregivers (N = 484 dyads). Illness uncertainty and QOL were measured using the shorten version of the Mishel Uncertainty in Illness Scale for Adult and the Functional Assessment of Cancer Therapy, respectively. The actor-partner interdependence model was used to examine whether an individual's uncertainty (either a patient's or caregiver's) was associated with their own QOL (i.e., an actor effect) and/or their partner's QOL (i.e., a partner effect).

RESULTS

Significant actor effects included a negative association between patients' uncertainty and their own QOL (b = -0.422; p < 0.001) and a negative association between caregivers' uncertainty and their own QOL (b = -0.408; p < 0.001). In terms of partner effects, patients' uncertainty was negatively associated with caregivers' QOL (b = -0.095; p < 0.01). No partner effect was found for caregivers, suggesting that caregivers' uncertainty was not related to patients' QOL.

CONCLUSIONS

Study findings support targeted interventions offered to both patients and their family caregivers to manage their illness uncertainty and improve their QOL.

Military-related stress, self-efficacy, and anxiety: Investigating the role of marital quality in military couples

This study utilizes a stress process framework in conjunction with a crossover perspective to conceptualize how stress, specifically military-related stress, manifests within individuals and couples. An actor-partner interdependence mediation modeling approach was used in a cross-sectional sample of 243 military couples to examine whether difficulties managing military-related stress may erode one's own self-efficacy and, in turn, contribute to greater anxiety (actor effects) and/or one's partner's self-efficacy and, in turn, anxiety (partner effects). Further, the potential moderating impact of marital quality was explicated in the model to understand if greater marital quality might buffer the impact of military-related stress. There was support for the stress process model primarily regarding actor effects; fewer partner effects emerged. One's own perceptions of military-related stress, specifically higher stress, were related to lower levels of their own self-efficacy, and, consequently, higher anxiety, but military-related stress did not directly affect the partner's self-efficacy or anxiety. Both service members' and civilian spouses' marital quality had ramifications for civilian spouses' self-efficacy, specifically a buffering effect; that was not the case regarding civilian spouse effects on the military member. Findings point to specific ways in which military stressors have implications for personal well-being, the role of a strong couple relationship in buffering stress, especially for civilian spouses, and concomitant leverage points for supporting both individual and couple well-being.

Depressive Symptom Trajectories and Cognition Among Older American Couples: A Dyadic Perspective

OBJECTIVES

This study examined whether trajectories of depressive symptoms of one spouse are associated with the other spouse's memory.

METHODS

Longitudinal data from the Health and Retirement Study (2004-2016) were used (N = 5690 heterosexual couples). Latent-class growth analysis and structural equation models examined the actor and partner effects of depressive symptom trajectories on memory.

RESULTS

Four depressive symptom trajectories were identified (i.e., persistently low, increasing, decreasing, and persistently high). Compared to the low trajectory group, the increasing and persistently high trajectories were associated with worse memory for both men and women. While none of the wives' depressive symptom trajectories was significantly associated with husbands' memory (p > .05), husbands' decreasing trajectory was linked to wives' better memory (β = 0.498, 95% CI = 0.106, 0.890).

DISCUSSION

Older adults with increasing and persistently high depressive symptoms may experience worse memory. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses' memory.

Spillover and crossover effects of exposure to work-related aggression and adversities: A dyadic diary study

The past two decades have produced extensive evidence on the manifold and severe outcomes for victims of aggression exposure in the workplace. However, due to the dominating individual-centered approach, most findings miss a social network perspective. Consequently, knowledge of negative spillover to different life-domains or crossover to uninvolved individuals alongside a detailed understanding of the involved transmission processes remains scarce. By integrating social aggression theorizing, the present study investigated transmission routes (emphatic, behavioral) of experienced adversities and aggression at work toward perpetration of aggressive behavior and potential spillover and crossover effects into the private life domain in a diary study of 72 mixed dyads. Analyses of mediation based upon the Actor-Partner Interdependence Model revealed an association between the frequency of perpetrating aggressive behavior in the work context and a spillover into the private life domain via aggression-promoting internal states (emotions, cognitions, arousal). Based on the different patterns of mediation, it appears that adversities follow a mental transmission process, whereby experienced aggression displayed behavioral assimilation. In contrast, no crossover effects of exposure to adversities or aggression at work to a study partner at home could be detected. Practical and theoretical implications as well as limitations and ideas for future work are discussed.

More than the sum of their parts: A dyad-centered approach to understanding adolescent sexual behavior

BACKGROUND

Research has documented multiple levels of influences on adolescent sexual behavior, but has generally focused less on the relational nature of this behavior. Studies with dyadic data have provided important findings on relationship process, including the role of gender in different-sex dyads. However, both of these bodies of literature typically utilize a variable-centered approach, which examines average influences of particular variables on sexual behavior. This study expands upon this research by presenting a dyad-centered approach to adolescent sexual behavior that can identify types of couples based on patterns of multidimensional risk and protective factors.

METHODS

I demonstrate the dyad-centered approach using data from different-sex dyads in the National Longitudinal Study of Adolescent to Adult Health to uncover profiles marked by individual, parent, peer, and religion predictors for both male and female partners.

RESULTS

Analyses uncovered five classes of dyadic influences, four of which were marked by relative similarity between partners and one marked by lesser approval of sex for women compared to men. Dyads marked by both partners intending to have sex and being in a context that is more approving of sex were more likely to engage in sexual intercourse.

CONCLUSIONS

Findings demonstrate the heterogeneity of influences and intentions to have sex among adolescent couples, and identify profiles of dyads who are more likely to engage in sexual intercourse. This approach can explicate dyadic processes involved in sexual behavior and the types of couples that exist in a population, leading to more tailored and efficacious interventions.

Accounting for auto-dependency in binary dyadic time series data: A comparison of model- and permutation-based approaches for testing pairwise associations

Many theories have been put forward on how people become synchronized or co-regulate each other in daily interactions. These theories are often tested by observing a dyad and coding the presence of multiple target behaviours in small time intervals. The sequencing and co-occurrence of the partners' behaviours across time are then quantified by means of association measures (e.g., kappa coefficient, Jaccard similarity index, proportion of agreement). We demonstrate that the association values obtained are not easy to interpret, because they depend on the marginal frequencies and the amount of auto-dependency in the data. Moreover, often no inferential framework is available to test the significance of the association. Even if a significance test exists (e.g., kappa coefficient) auto-dependencies are not taken into account, which, as we will show, can seriously inflate the Type I error rate. We compare the effectiveness of a model- and a permutation-based framework for significance testing. Results of two simulation studies show that within both frameworks test variants exist that successfully account for auto-dependency, as the Type I error rate is under control, while power is good.

Analyzing Stability and Change in Dyadic Attachment: The Multi-Rater Latent State-Trait Model With Autoregressive Effects

Previous research suggests that parental attachment is stable throughout emerging adulthood. However, the relationships between the mutual attachments in the dyads of emerging adults and their parents are still unclear. Our study examines the stability and change in dyadic attachment. We asked 574 emerging adults and 463 parents at four occasions over 1 year about their mutual attachments. We used a latent state-trait model with autoregressive effects to estimate the time consistency of the attachments. Attachment was very stable, and earlier measurement occasions could explain more than 60% of the reliable variance. Changes of attachment over time showed an accumulation of situational effects for emerging adults but not for their parents. We estimated the correlations of the mutual attachments over time using a novel multi-rater latent state-trait model with autoregressive effects. This model showed that the mutual attachments of parents and emerging adults were moderately to highly correlated. Our model allows to separate the stable attachment from the changing attachment. The correlations between the mutual attachments were higher for the stable elements of attachment than for the changing elements of attachment. Emerging adults and their parents share a stable mutual attachment, but they do not share the changes in their respective attachments.

Gender Specificity of Spousal Concordance in the Development of Chronic Disease among Middle-Aged and Older Chinese Couples: A Prospective Dyadic Analysis

This study aimed to explore the gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. Data of 3420 couples were obtained from the China Health and Retirement Longitudinal Study (CHARLS). Multivariate logistic regression was used to analyze the incidence of chronic disease development over 4 years, conditional on the spousal baseline chronic disease status; and stepwise adjusting for the couples’ sociodemographic characteristics (i.e., age, education, retirement status and household income), and their individual lifestyle (i.e., smoking, drinking, exercise, social participation and BMI) all measured at baseline. The incidence of chronic diseases after 4 years of follow-up was 22.95% in the husbands (605/2636) and 24.71% in the wives (623/2521). Taking the couples’ baseline sociodemographic and lifestyle covariates into account, husbands whose wife had chronic diseases at baseline showed an increased risk of developing chronic diseases over 4 years (OR_adjusted = 1.24, 95%CI: 1.02, 1.51), but this risk was not statistically-significant for wives (OR_adjusted = 0.88, 95%CI: 0.71, 1.08). Our study identified gender specificity of spousal concordance in the development of chronic diseases among middle-aged and older Chinese couples. This finding may contribute to the design of couple-based intervention for disease prevention and management for community-dwelling older adults.

Association between relationship characteristics and willingness to use PrEP among same-sex male couples: a cross-sectional actor-partner analysis in Guangzhou, China

The association between relationship characteristics and pre-exposure prophylaxis (PrEP) acceptability among same-sex male couples has been limitedly examined. Dyadic survey data of 139 concordant HIV-negative same-sex male couples in Guangzhou, China were collected. The willingness to use PrEP was measured assuming that the participant's partner was HIV-positive. The actor-partner interdependence model was used to examine how one's relationship characteristics affected the PrEP willingness of the subject and his partner. Most participants (79.5%) were willing to use PrEP. The two individuals of the couple were distinguished by sex role in relationship, namely one usually playing the insertive role and the other usually playing the receptive role in anal intercourse. The former was labeled as "top" and the latter labeled as "bottom". The PrEP willingness of the top partner increased when he would think his partner is having sex with other people if the partner requests condom use in relationship (AOR: 5.74, 95% CI: 1.10-29.87), and decreased when his partner would get violent upon condom use requests in relationship (AOR: 0.19, 95% CI: 0.04-0.88). The PrEP willingness of the bottom partner increased when he trusted his partner (AOR: 1.13, 95% CI: 1.02-1.25) and when he or his partner disclosed the relationship to parents (AOR: 10.57, 95% CI: 1.91-58.61). Considering the sex role and relationship characteristics in couple-based interventions are important to optimize PrEP uptake among HIV-discordant same-sex male couples.

Partners' Relationship Mindfulness Promotes Better Daily Relationship Behaviours for Insecurely Attached Individuals

Attachment anxiety and avoidance are generally associated with detrimental relationship processes, including more negative and fewer positive relationship behaviours. However, recent theoretical and empirical evidence has shown that positive factors can buffer insecure attachment. We hypothesised that relationship mindfulness (RM)-open or receptive attention to and awareness of what is taking place internally and externally in a current relationship-may promote better day-to-day behaviour for both anxious and avoidant individuals, as mindfulness improves awareness of automatic responses, emotion regulation, and empathy. In a dyadic daily experience study, we found that, while an individual's own daily RM did not buffer the effects of their own insecure attachment on same-day relationship behaviours, their partner's daily RM did, particularly for attachment avoidance. Our findings for next-day relationship behaviours, on the other hand, showed that lower (vs. higher) prior-day RM was associated with higher positive partner behaviours on the following day for avoidant individuals and those with anxious partners, showing this may be an attempt to "make up" for the previous day. These findings support the Attachment Security Enhancement Model and have implications for examining different forms of mindfulness over time and for mindfulness training.

A Dyadic IRT Model

We propose a dyadic Item Response Theory (dIRT) model for measuring interactions of pairs of individuals when the responses to items represent the actions (or behaviors, perceptions, etc.) of each individual (actor) made within the context of a dyad formed with another individual (partner). Examples of its use include the assessment of collaborative problem solving or the evaluation of intra-team dynamics. The dIRT model generalizes both Item Response Theory models for measurement and the Social Relations Model for dyadic data. The responses of an actor when paired with a partner are modeled as a function of not only the actor's inclination to act and the partner's tendency to elicit that action, but also the unique relationship of the pair, represented by two directional, possibly correlated, interaction latent variables. Generalizations are discussed, such as accommodating triads or larger groups. Estimation is performed using Markov-chain Monte Carlo implemented in Stan, making it straightforward to extend the dIRT model in various ways. Specifically, we show how the basic dIRT model can be extended to accommodate latent regressions, multilevel settings with cluster-level random effects, as well as joint modeling of dyadic data and a distal outcome. A simulation study demonstrates that estimation performs well. We apply our proposed approach to speed-dating data and find new evidence of pairwise interactions between participants, describing a mutual attraction that is inadequately characterized by individual properties alone.

"Will you complete this survey too?" Differences between individual versus dyadic samples in relationship research

This study examines the ways in which collecting data from individuals versus couples affects the characteristics of the resulting sample in basic research studies of romantic relationships. From a nationally representative sample of 1,294 individuals in a serious romantic relationship, approximately half of whom were randomly selected to invite their partner to participate in the study, we compare relationship, individual, and demographic characteristics among 3 groups: individuals randomized to invite their partner and whose partner participated in the study, individuals randomized to invite their partner but whose partner did not participate, and individuals who were not randomized to invite their partner. Results indicated that individuals whose partner participated reported the highest levels of relationship and individual well-being relative to comparison groups, as well as individuals who participated alone despite being asked to invite their partner, reported the lowest levels of relationship and individual well-being relative to comparison groups. Effect size magnitudes indicated the strongest group differences with respect to relationship variables, particularly cognitive appraisals of overall relationship stability and satisfaction. Implications for romantic relationship research and study design are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Stress and Dyadic Coping in Personal Projects of Couples - A Pattern-Oriented Analysis

Relational accounts of goal striving have barely considered dyadic coping as an element of the process, nor has dyadic coping research utilized the unique advantages of the goal construct (e.g., in form of personal project assessment) so far. Therefore, the primary aim of the present study was to explore stress and dyadic coping experiences associated with the personal projects of partners in a close relationship. Moreover, we approached data analysis in a pattern-oriented way, instead of using variable-centered linear models. We used cross-sectional data from 270 married and cohabiting Hungarian heterosexual couples (mean age 40.1 ± 11.2 and 37.8 ± 10.9 years for male and female partners, respectively). Partners individually completed an adapted version of the Personal Project Assessment procedure. First, they named an important but stressful personal project. Respondents appraised their experiences with the chosen personal project along several predefined aspects. These included: (1) stress experiences; (2) dyadic coping, using the adapted Dyadic Coping Inventory; (3) positive emotions; and (4) sense of community. The Relationship Assessment Scale was also assessed. Cluster analysis of both partners' stress experiences, positive and negative dyadic coping strategies in their own personal projects revealed six relationship-level clusters. Cluster solutions represented typical variations of the stress and dyadic coping patterns of the couples, and could be arranged in a three- (lower, medium, and higher stress) by-two (positively vs. negatively balanced dyadic coping pattern) array. Further analyses indicated the general trend that couples with lower (vs. higher) stress together with more positively (vs. negatively) balanced dyadic coping may have experienced better functioning in projects (more positive emotions and higher sense of community) and higher relationship satisfaction. Results confirm that the partners' pursuit of their personal projects is embedded in their relationship, and their functioning in these projects may partly depend on dyadic coping with the stress that arises during the accomplishment of the project. By using a pattern-oriented approach to dyadic data, we were able to distill stress and coping patterns that capture the specific types of couples' relationships and indicate the non-linear and multidimensional nature of stress and dyadic coping processes.

Indistinguishability tests in the actor-partner interdependence model

When considering dyadic data, one of the questions is whether the roles of the two dyad members can be considered equal. This question may be answered empirically using indistinguishability tests in the actor-partner interdependence model. In this paper several issues related to such indistinguishability tests are discussed: the difference between maximum likelihood and restricted maximum likelihood based tests for equality in variance parameters; the choice between the structural equation modelling and multilevel modelling framework; and the use of sequential testing rather than one global test for a set of indistinguishability tests. Based on simulation studies, we provide guidelines for best practice. All different types of tests are illustrated with cross-sectional and longitudinal data, and corroborated with corresponding R code.

A Dyadic Data Analytic Primer: An Illustration with Mexican-origin Couples

Dyadic matched-pairs (each person paired with one other person) research designs that include parallel data from both members of a relationship dyad provide a rigorous method for examining questions of interdependence. These designs require the use of analytic methods that account for statistical dependencies due to dyad member characteristics and environments. Using structural equation modeling, we illustrate two alternative analytic approaches for distinguishable (nonexchangeable) two-wave dyadic data: (a) a hybrid of the two-intercept and actor-partner interdependence models and (b) a difference model. Few studies have used these rigorous analytic approaches to analyze dyadic data with Latinos, despite demographic shifts in the U.S. and the cultural relevance of family values and relationship interdependence for this population. As such, our illustrative data were drawn from a larger longitudinal study of Mexican-origin families, with husbands and wives both reporting on somatic symptoms and marital negativity (N = 246 marital dyads). Results revealed that Mexican-origin spouses' somatic symptoms related to increases in partners' marital negativity five years later. Prior levels of wives' marital negatively linked to more discrepancies in marital negativity five years later, whereas husbands' marital negativity related to fewer discrepancies. We conclude by discussing the benefits of prospective dyadic data designs for researchers examining questions related to Latino populations.

Examining Couple Functioning and Alcohol use Among Latino Couples: A Dyadic Data Analysis

BACKGROUND

Prior research suggests that Latinos are at higher risk of alcohol use as compared to their counterparts (NSDUH, 2014). However, little work has been conducted to understand alcohol use among Latinos systemically and more research is needed to better understand the impact of couple functioning on alcohol use among Latino couples.

OBJECTIVES

The current study aimed to examine how each partner's perception of couple functioning impacted alcohol use in Latino dyads.

METHODS

Using data from 329 Latino dyads from the Building Strong Families (BSF) Project, a structural equation model examining the actor-partner interactions between partner perceptions of couple functioning and each person's alcohol use was analyzed.

RESULTS

Correlation analysis revealed that the dyad's perceptions of couple functioning were positively correlated. Results from the APIM model indicated male's perceptions of couple functioning was positively associated with his own alcohol use, whereas female's perceptions of couple functioning was not significantly related to either partner's alcohol use. Conclusions/Importance: The findings may help clinicians, researchers, and policy makers to better conceptualize how couple functioning may impact alcohol use among Latino dyads.

The Relationship between Intimacy Change and Passion: A Dyadic Diary Study

In the current study we investigated the association between intimacy and passion by testing whether increases in intimacy generates passion (Baumeister and Bratslavsky, 1999). Furthermore, we examined whether there are partner effects in intimacy change and passion link. Couples (N = 75) participated in a 14-day long diary study. Dyadic multilevel analyses with residualized intimacy change scores showed that both actors’ and partners’ intimacy change positively predicted actor’s passion. However, analyses also showed that residualized passion change scores positively predicted intimacy. Although these findings provide some empirical evidence for the intimacy change model, in line with the previous research (Rubin and Campbell, 2012), they also suggest that it is not possible to discern whether intimacy increment generates passion or passion increment generates intimacy.

The Relationship Timeline: A Method for the Study of Shared Lived Experiences in Relational Contexts

Lifeline methods-graphic illustrations of the pathways of lived experience traveled by individuals from birth to anticipated death-have been useful in the study of lived experience. Existing lifeline methods and research focus on the individual experience; absent from this literature are the collective experiences of those in intimate relationships. In this paper, based on our research with 120 same-sex couples, we present a method to allow for the joint creation of relationship timelines, which serve as the basis for eliciting dyadic data in multiple forms: graphic representations of relationship development through couples' creation of a timeline of key events and periods; qualitative narratives of couples' shared experiences; and quantitative ratings of significant events and periods in their lives together. Lessons learned from the application of this Relationship Timeline Method are discussed, as are implications for future study of the shared lived experience.

Does Personality Matter in Diabetes Adherence? Exploring the Pathways between Neuroticism and Patient Adherence in Couples with Type 2 Diabetes

BACKGROUND

Personality has received some attention in the Type 2 diabetes literature; however, research has not linked personality and diabetes adherence behaviors (diet and exercise), identified pathways through which they are associated, nor taken into consideration important contextual factors that influence behavior (the patient's partner).

METHODS

Dyadic data from 117 married, heterosexual couples in which one member is diagnosed with Type 2 diabetes was used to explore associations between each partner's neuroticism and patient dietary and exercise adherence through the pathways of negative affect, depression symptoms, and couple-level diabetes efficacy (both patient and spouse report of confidence in the patient's ability to adhere to diabetes management regimens).

RESULTS

Results revealed that higher levels of neuroticism were associated with lower patient dietary and exercise adherence through (1) higher levels of depression symptoms (for patients' neuroticism) and negative affect (for spouses' neuroticism), and (2) lower levels of couple-level diabetes efficacy.

CONCLUSIONS

The results from this study provide evidence that both patient and spouse personality traits are associated with patient dietary and exercise adherence through increased emotional distress-albeit different emotional pathways for patients and spouses-and lower couple confidence in the patients' ability to manage their diabetes.

The Role of Attachment Behaviors in the Link between Relationship Satisfaction and Depression in Clinical Couples: Implications for Clinical Practice

Using dyadic, clinical data from 104 couples in committed relationships, the purpose of this study was to determine whether relationship satisfaction was associated with depression through perceived partner attachment behaviors-accessibility, responsiveness, and engagement-for both men and women. We found that one's satisfaction in the relationship was the lens through which they viewed their partner's attachment behaviors and-women's relationship satisfaction was the lens through which her male partner viewed her attachment behaviors. Finally, women's relationship satisfaction is associated with both individuals' depression through her perceived partner's accessibility, responsiveness, and engagement. The findings from this study are important because they provide clinically relevant and mutable constructs in which clinicians can intervene at an attachment level in distressed marriages with depressed partners.

Associations Between Economic Pressure and Diabetes Efficacy in Couples With Type 2 Diabetes

Objective

The purpose of this study was to explore dyadic associations between economic pressure and diabetes self-efficacy via emotional distress in patients with type 2 diabetes and their partners.

Background

Understanding how economic pressure is associated with successful diabetes management is an important area for research, as couples with type 2 diabetes can incur heavy economic pressures that could likely influence diabetes outcomes.

Method

Data from 117 married couples were used to test actor-partner associations using moderated mediation analyses in a structural equation modeling framework. Problem-solving communication was tested as a possible moderator of the economic pressure-emotional distress pathway.

Results

Results revealed that greater patient economic pressure was associated with lower patient and spouse confidence in the patient's diabetes management ability through higher levels of patient emotional distress. The deleterious association between economic pressure and emotional distress was less pronounced when spouses reported more effective problem-solving communication.

Conclusion

These results provide evidence that the economic pressure couples with type 2 diabetes face may reduce the patient and spouse's confidence in the patient's diabetes management ability.

Implications

This study demonstrates the importance of couple's relationship processes in buffering the impact of economic pressure on diabetes management, providing a clear target for intervention and education efforts.

How Best to Obtain Valid, Verifiable Data Online From Male Couples? Lessons Learned From an eHealth HIV Prevention Intervention for HIV-Negative Male Couples

Background

As interest increases in the development of eHealth human immunodeficiency virus (HIV)-preventive interventions for gay male couples, Web-based methods must also be developed to help increase the likelihood that couples enrolled and data collected from them represent true unique dyads. Methods to recruit and collect reliable and valid data from both members of a couple are lacking, yet are crucial for uptake of novel sexual health and HIV-prevention eHealth interventions. Methods to describe best practices to recruit male couples using targeted advertisements on Facebook are also lacking in the literature, yet could also help in this uptake.

Objective

The objective of our study was to describe challenges and lessons learned from experiences from two phases (developmental phase and online randomized controlled trial [RCT]) of an eHealth HIV-prevention intervention for concordant HIV-negative male couples in terms of (1) recruiting male couples using targeted advertisements on Facebook, (2) validating that data came from two partners of the couple, and (3) verifying that the two partners of the couple are in a relationship with each other.

Methods

The developmental phase refined the intervention via in-person focus groups, whereas the pilot-testing phase included an online RCT. For both phases, couples were recruited via targeted Facebook advertisements. Advertisements directed men to a study webpage and screener; once eligible, participants provided consent electronically. A partner referral system was embedded in the consenting process to recruit the relationship partner of the participant. Both men of the couple had to meet all eligibility criteria—individually and as a couple—before they could enroll in the study. Verification of couples’ relationships was assessed via the concurrence of predetermined screener items from both partners, done manually in the developmental phase and electronically in the pilot-testing phase. A system of decision rules was developed to assess the validity that data came from two unique partners of a couple.

Results

Several important lessons were learned from these experiences, resulting in recommendations for future eHealth studies involving male couples. Use of certain “interests” and types of images (eg, shirtless) in targeted Facebook advertisements should be avoided or used sparingly because these interests and types of images may generate adverse reactions from a broader audience. Development of a systematic approach with predetermined criteria and parameters to verify male couples’ relationships is strongly recommended. Further, researchers are encouraged to develop a system of decision rules to detect and handle suspicious data (eg, suspicious email addresses/names, multiple entries, same IP address used in multiple entries) to help validate the legitimacy of male couples’ relationships online.

Conclusions

These lessons learned combined with recommendations for future studies aim to help enhance recruitment efforts and the validity and reliability of collecting dyadic data from male couples for novel eHealth HIV-preventive interventions.

Can You Be Hit by Your Partner and Be Intensely in Love?

This study examines, in a multilevel context, the influence of intensity of love at an individual level on couples' mean reports of psychological and physical aggression in a sample of 2,988 adult couples of both sexes from the Region of Madrid. The percentages of intimate partner aggression considering the highest report of aggression in the couple were around 60% of psychological aggression and 15% of physical aggression. Multilevel models confirm that individuals who were less intensely in love reported a higher level of psychological aggression. Concerning physical aggression, men who declared they were less intensely in love reported a higher level of physical aggression by their partners, but this pattern was not found in the women. Therefore, psychological aggression plays a more relevant role in the intensity of love than physical aggression.

HIV-negative male couples' attitudes about pre-exposure prophylaxis (PrEP) and using PrEP with a sexual agreement

One efficacious strategy to help prevent HIV is oral pre-exposure prophylaxis (PrEP), a daily regimen of antiretroviral treatment taken by HIV-negative individuals. Two of the recommendations of Centers for Disease Control and Prevention (CDC) guidelines for PrEP pertain to being in a relationship (i.e., male couples). Despite the recognition of how primary partners in male couples' relationships shape HIV risk and CDC's PrEP guidelines, there is a paucity of data that examine HIV-negative male couples' attitudes toward PrEP use and using PrEP with a sexual agreement. A sexual agreement is an explicit agreement made between two individuals about what sex and other related behaviors may occur within and outside of their relationship. In this qualitative study, we examine HIV-negative male couples' attitudes toward PrEP use and whether they thought PrEP could be integrated into a sexual agreement. Data for this study are drawn from couple-level interviews conducted in 2014 with 29 HIV-negative male couples who had a sexual agreement and were from Atlanta or Detroit. Both passive (e.g., flyers) and active (e.g., targeted Facebook advertisements) recruitment methods were used; the sample was stratified by agreement type. Thematic analysis was applied to identify the following themes regarding HIV-negative male couples' attitudes toward PrEP use: (1) PrEP and condom use; (2) concerns about PrEP (e.g., effectiveness, side effects, and promoting sexually risky behavior); and (3) accessibility of PrEP. Some thought PrEP could be a part of couples' agreement because it could help reduce sexual anxiety and sexual risk, and would help keep the couple safe. Others described PrEP use with an agreement as something for "others". Some were also concerned that incorporating PrEP could usurp the need for a sexual agreement in a couples' relationship. These themes highlight the need to improve informational messaging and promotion efforts about PrEP among HIV-negative male couples who may benefit from using it.

The association between family factors and child behaviour problems using dyadic data

BACKGROUND

Parental psychopathology and family issues are key influence factors to child behaviour problems. This study aimed to investigate the dyadic impact of maternal and paternal depression and perceived family functioning on child behaviour problems.

METHODS

Both maternal and paternal depression, perceived family functioning and reported child behaviour problems were collected, respectively. Because of the interdependent characteristic of dyadic data, structural equation modelling was used to examine the relationship among all variables and the mutual influence between mother and father.

RESULTS

Results showed that father-perceived family functioning mediated the relationship between parental depression and child behaviour problems, but mother-perceived family functioning did not show this mediation effect. Meanwhile, maternal and paternal depression influenced both of their own and their partner's perceived family functioning.

CONCLUSIONS

The findings indicated that paternal psychopathology and family functioning should not be overlooked in child behaviour development. In addition, this study underscored the importance to investigate the different impact of father and mother on child development within a dyadic unit.

Intensity of Love in a Community Sample of Spanish Couples in the Region of Madrid

Intensity of love was examined in a representative community sample of 2,988 couples, from the Region of Madrid (Spain). Gender differences revealed no significant differences in intensity of love. Twenty-five percent of the participants who were in a relationship of less than 10 years and eleven percent of the participants in a relationship of more than 30 years reported being "very intensely in love" F(3, 5.972) = 191.32, p < .001, ηp 2 = 0.08. The cognitive variables, thinking positively about the partner and thinking about the partner when apart, were significant predictors of the intensity of long-term love for both men and women. Affection was also positively associated with intense love for men (r = .47, p < .001) and women (r = .52, p < .001); sexual intercourse was for women (r = .36, p < .001) but not for men. Wanting to know the whereabouts of partner was associated with the intensity of love for women (r = .15, p < .05), but not for men. Engaging in novel activities with partner was not associated with intense love for male or females. As predicted, love declined significantly in the first decade of marriage, but not much after that. The percentage of men and women who reported being intensely in love was lower than that obtained in the U.S.

An approximate measurement invariance approach to within-couple relationship quality

This study aimed at demonstrating the usefulness and flexibility of the Bayesian structural equation modeling approximate measurement invariance (BSEM-AMI) approach to within-couple data. The substantive aim of the study was investigating partner differences in the perception of relationship quality (RQ) in a sample of intact couples (n = 435) drawn from the first sweep of the Millenium Cohort Study. Configural, weak and strong invariance models were tested using both maximum likelihood (ML) and BSEM approaches. As evidence of a lack of strong invariance was found, full and partial AMI models were specified, allowing nine different prior variances or "wiggle rooms." Although we could find an adequately fitting BSEM-AMI model allowing for approximate invariance of all the intercepts, the two-step approach proposed by Muthén and Asparouhov (2013b) for identifying problematic parameters and applying AMI only to them provided less biased results. Findings similar to the ML partial invariance model, led us to conclude that women reported a higher RQ than men. The results of this study highlight the need to inspect parameterization indeterminacy (or alignment) and support the efficacy of the two-step approach to BSEM-AMI.

Discrepancies between couples' perceptions of family functioning in child-rearing Japanese families

This study examined discrepancies in couples' family functioning scores on the Japanese version of the Feetham Family Functioning Survey, which evaluates both internal and external family functioning, and the relationship of family demographic characteristics to such discrepancies. Participants were 313 husband and wife pairs with child(ren) attending nursery school. The discrepancies were significantly related to: the presence of a family member living with a disease/illness; the number of children; mean age of the children; and annual household income. A possible factor that may explain the discrepancies was question design, that is, use of "you" or "your," and the inclusion of questions concerning intrafamily issues. The findings indicated that family-related perceptions by each individual family member may differ. Nurses should therefore be aware that information from just one family member will not necessarily represent the family's actual situation.

Aspects of gay male couples' sexual agreements vary by their relationship length

Few HIV-preventing interventions exist for gay male couples in the USA, yet estimates indicate that between one- and two-thirds of US men who have sex with men acquire HIV while in a primary relationship (e.g., gay male couples). In response to these statistics, research has been conducted to better understand gay male couples' relationships, including their sexual agreements. Many gay male couples in the USA establish a sexual agreement, which is an explicit mutual understanding between two main partners about what sexual and other behaviors they agree to engage in and with whom while in the relationship. Although some research about sexual agreements has been conducted, little is known on whether aspects of gay male couples' sexual agreements (e.g., establishment, type, and adherence) vary as a function of their relationship length. The present study aimed to fulfill this gap of knowledge, which may lead to a better understanding of how agreements can be used for developing HIV/sexually transmitted infection (STI) prevention interventions. A national, cross-sectional, Internet-based study was used to collect dyadic data from 361 US gay male couples. Men in each couple completed the questionnaire independently. All analyses were employed at the couple level. Our findings showed that the longer the couples had been in their relationship, the more likely they would concur about having a sexual agreement. As relationship length increased, the proportion of couples who disagreed about their current agreement type increased. No direct trend was found for recent adherence to an agreement; however, the likelihood of ever breaking an agreement increased as relationship length increased. Findings from this study indicate there is a need to help gay male couples' establish and maintain their agreements, particularly for those who are in their early formative stages, as well as, for those who are experiencing challenges and/or changes in their relationships.

Health problems and marital satisfaction among older couples

OBJECTIVE

Older couples are likely to be confronted with health problems of both spouses and these health problems may negatively influence their marital satisfaction. The present study examined these possible negative effects using a dyadic perspective.

METHOD

Data from 78 independently living older couples were analyzed using the Actor-Partner Interdependence Model (APIM). Health problems were modeled as a latent factor of functional disability, the number of chronic diseases, and self-rated health. The couple's health context, that is, similarity or dissimilarity, was examined with an actor-partner interaction variable.

RESULTS

For wives, spousal health problems were negatively associated with their marital satisfaction, but only under the condition that their own health was relatively good. For husbands, neither own nor spousal health problems were associated with their marital satisfaction.

DISCUSSION

Future research focusing on older couples needs to consider the couple's health context next to health at the individual level.

"Couples as Partners and Parents over Children's Early Years"

We used data from the Fragile Families and Child Wellbeing Study to examine how couple relationship quality and parental engagement are linked over children's early years-when they are infants, toddlers, and preschoolers. Our sample included 1,630 couples that were coresident over years 1 to 3 and 1,376 couples that were coresident over years 3 to 5 (1,196 over both periods). Overall, we found that better relationship quality predicted greater parental engagement for both mothers and fathers-especially in the infant to toddler years; in contrast, we found little evidence that parental engagement predicted future relationship quality. Married and cohabiting couples were generally similar in how relationship quality and parenting were linked.

Marital Conflict Behaviors and Implications for Divorce over 16 Years

This study examined self-reported marital conflict behaviors and their implications for divorce. Husbands and wives (N = 373 couples; 47% White American, 53% Black American) reported conflict behaviors in years 1, 3, 7, and 16 of their marriages. Individual behaviors (e.g., destructive behaviors) and patterns of behaviors between partners (e.g., withdrawal-constructive) in Year 1 predicted higher divorce rates. Wives' destructive and withdrawal behaviors decreased over time, whereas husbands' conflict behaviors remained stable. Husbands reported more constructive and less destructive behaviors than wives and Black American couples reported more withdrawal than White American couples. Findings support behavioral theories of marriage demonstrating that conflict behaviors predict divorce and accommodation theories indicating that conflict behaviors become less negative over time.

Trajectories of Conflict over Raising Adolescent Children and Marital Satisfaction

The present study examined trajectories of marital satisfaction among couples with adolescent children and evaluated how changes in parents' conflict over raising adolescent children were associated with changes in marital satisfaction over four years. Using a prospective, longitudinal research design and controlling for family socioeconomic status, dyadic growth curve analysis from a sample of 431 couples with adolescent children indicated that marital satisfaction decreased over time for parents with adolescent children, and that the trajectories for mothers and fathers were substantially linked. More importantly, the study demonstrated that increases or decreases in parents' marital conflict over raising adolescent children were associated with corresponding decreases or increases in marital satisfaction for both mothers and fathers.

Sensitivity of MRQAP Tests to Collinearity and Autocorrelation Conditions

Multiple regression quadratic assignment procedures (MRQAP) tests are permutation tests for multiple linear regression model coefficients for data organized in square matrices of relatedness among n objects. Such a data structure is typical in social network studies, where variables indicate some type of relation between a given set of actors. We present a new permutation method (called "double semi-partialing", or DSP) that complements the family of extant approaches to MRQAP tests. We assess the statistical bias (type I error rate) and statistical power of the set of five methods, including DSP, across a variety of conditions of network autocorrelation, of spuriousness (size of confounder effect), and of skewness in the data. These conditions are explored across three assumed data distributions: normal, gamma, and negative binomial. We find that the Freedman-Lane method and the DSP method are the most robust against a wide array of these conditions. We also find that all five methods perform better if the test statistic is pivotal. Finally, we find limitations of usefulness for MRQAP tests: All tests degrade under simultaneous conditions of extreme skewness and high spuriousness for gamma and negative binomial distributions.