Couple Therapy with Veterans: Early Improvements and Predictors of Early Dropout.

Family services within Veterans Affairs Medical Centers fulfill an important role in addressing relationship distress among Veterans, which is highly prevalent and comorbid with psychopathology. However, even for evidence-based couple therapies, effectiveness is weaker compared to controlled studies, maybe because many Veteran couples drop out early and do not reach the "active" treatment stage after the 3-4 session assessment. In order to improve outcomes, it is critical to identify couples at high risk for early dropout, and understand whether couples may benefit from the assessment as an intervention. The current study examined (a) demographics, treatment delivery mode, relationship satisfaction, and psychological symptoms as predictors of dropout during and immediately following the assessment phase, and (b) changes in relationship satisfaction during assessment. 174 couples completed questionnaires during routine intake procedures. The main analyses focused on 140 male Veterans and their female civilian partners; 36.43% dropped out during the assessment phase and 24.74% of the remaining couples immediately following the first treatment session. More severe depressive symptoms in non-Veteran partners were associated with dropout during assessment. Relationship satisfaction improved significantly during the assessment phase for couples who did not drop out, with larger gains for non-Veteran partners. No demographics or treatment delivery mode were associated with dropout. Although more research is needed on engaging couples at risk for early dropout and maximizing early benefits, the findings suggest that clinicians should attend to the civilian partner's and Veteran's depressive symptoms at intake and consider the assessment part of active treatment.

Conservative Beliefs, Attitudes Toward Bisexuality, and Willingness to Engage in Romantic and Sexual Activities With a Bisexual Partner.

Negative attitudes toward bisexuals have been documented among heterosexuals as well as lesbians/gay men, and a common theme is that bisexuals would not be suitable romantic or sexual partners. While gender, sexual orientation, and attitudes toward bisexuality influence people's willingness to engage in romantic or sexual activities with a bisexual partner, there are other individual differences that may contribute. The current study examined the associations between four types of conservative beliefs and willingness to engage in romantic/sexual activities with a bisexual partner in a sample of heterosexuals and lesbians/gay men (N = 438). Attitudes toward bisexuality were examined as a mediator of these associations. In general, results indicated that higher social dominance orientation, political conservatism, and essentialist beliefs about the discreteness of homosexuality were associated with lower willingness to engage in romantic/sexual activities with a bisexual partner. Further, more negative attitudes toward bisexuality mediated these associations. There were several meaningful differences in these associations between heterosexual women, heterosexual men, lesbian women, and gay men, suggesting that influences on people's willingness to be romantically or sexually involved with a bisexual partner may differ for different gender and sexual orientation groups. Implications for reducing stigma and discrimination against bisexual individuals are addressed.

The path to couples therapy: A descriptive analysis on a Veteran sample.

The current study uses descriptive data from a sample of Veterans and their partners (N = 97 opposite-sex couples) presenting to a Veterans Affairs Medical Center (VAMC). The purpose of this investigation was to examine 1) the problems couples face prior to seeking treatment; 2) how long it took couples to seek treatment; 3) what attempts couples made to improve their relationship prior to couples therapy. We also examined how these treatment initiation factors were related to relationship distress and expectations for therapy. Results suggest the relationship problems that precede Veteran couples seeking treatment are varied (e.g., stressors outside of relationship, communication problems, lack of trust) and agreement between partners on type of relationship problem is not predictive of relationship satisfaction, perception of relationship problem severity, nor expectations for therapy. Partners tend to wait approximately 4-7 years before pursuing couples therapy to resolve relational concerns. The length of time partners wait to pursue therapy is positively associated with optimistic expectations for therapy. In addition, prior to treatment initiation, partners tend to make multiple attempts to improve their relationship (M = 1.79 attempts for men; M = 2.40 attempts for women) and the number of unique attempts made to improve the relationship is associated with greater distress and more negative perceptions of relationship problem severity. Findings have implications for identifying Veteran couples who may be more or less receptive to intervention and informing the development of a stepped-care approach for couples treatment referral and planning.

Neural Biomarker and Early Temperament Predict Increased Internalizing Symptoms After a Natural Disaster.

OBJECTIVE: Although most people will experience a traumatic event at some point in their life, only some will develop significant psychological symptoms in the aftermath. In the current study, we use a preexisting longitudinal study located in Long Island to examine the impact of Hurricane Sandy on internalizing symptoms in a large sample of children. We focused on temperamental fear and a biomarker of risk for anxiety, the error-related negativity (ERN). The ERN is a negative deflection in the event-related potential (ERP) occurring when individuals make mistakes and is increased in anxious individuals. METHOD: The final sample consisted of 223 children who had undergone an observational assessment of fear at age 3 years and an electroencephalogram assessment of the ERN at age 6 years. At the age 9 year assessment, internalizing symptoms were assessed, and then again after the hurricane (∼65 weeks later). RESULTS: A significant three-way interaction among fearfulness, hurricane stressors, and the ERN in predicting posthurricane increases in internalizing symptoms suggested that children who were high in fear at age 3 years and experienced elevated hurricane stressors were characterized by subsequent increases in internalizing symptoms, but only when they were also characterized by an increased ERN at age 6 years. CONCLUSION: These findings support a diathesis-stress model, suggesting that early temperament and prestressor biological markers confer risk for increased psychological symptoms following environmental stressors.

Negative emotionality and its facets moderate the effects of exposure to Hurricane Sandy on children's postdisaster depression and anxiety symptoms.

According to diathesis-stress models, temperament traits such as negative emotionality (NE) may moderate the effects of stressors on the development of symptoms of psychopathology, although little research has tested such models in children. Moreover, there are few data on whether specific facets of NE (sadness, fear, or anger) may specifically moderate the effects of stress on depression versus anxiety. Finally, there is a paucity of research examining whether childhood temperament moderates the effect of disaster exposure on depressive or anxiety symptoms. Hurricane Sandy, which affected many thousands of people in New York State and the surrounding regions in October 2012, offers a unique opportunity to address these gaps. Seven to eight years prior to Hurricane Sandy, 332 children 3 years old completed lab-based measures of NE and its facets. Six years later, when they were 9 years old, each mother rated her child's depressive and anxiety symptoms. Approximately 8 weeks post-Sandy (an average of 1 year after the age 9 assessment), mothers again rated their child's depressive and anxiety symptoms, as well as a measure of exposure to stress from Hurricane Sandy. Adjusting for symptom levels at age 9, higher levels of stress from Hurricane Sandy predicted elevated levels of depressive symptoms only in participants with high levels of temperamental sadness and predicted elevated levels of anxiety symptoms only in participants high in temperamental fearfulness. These findings support the role of early childhood temperament as a diathesis for psychopathology and highlight the importance of considering facets of temperament when examining their relationship to psychopathology. (PsycINFO Database Record

Rumination mediates the association between cyber-victimization and depressive symptoms.

The current study examined the 3-week prospective associations between cyber-victimization and both depressive symptoms and rumination. In addition, a mediation model was tested, wherein rumination mediated the association between cyber-victimization and depressive symptoms. Participants (N = 565 college-age young adults) completed online surveys at two time points 3 weeks apart. Results indicated that cyber-victimization was associated with increases in both depressive symptoms and rumination over time. Furthermore, results of the path analysis indicated that cyber-victimization was associated with increases in rumination over time, which were then associated with greater depressive symptoms, providing support for the proposed mediation effect for women, but not men. Findings extend previous correlational findings by demonstrating that cyber-victimization is associated with increases in symptomatology over time. Findings also suggest that the negative consequences of cyber-victimization extend beyond mental health problems to maladaptive emotion regulation. In fact, rumination may be a mechanism through which cyber-victimization influences mental health problems, at least for women. Mental health professionals are encouraged to assess cyber-victimization as part of standard victimization assessments and to consider targeting maladaptive emotion regulation in addition to mental health problems in clients who have experienced cyber-victimization.

Appraisals of daily romantic relationship experiences in individuals with borderline personality disorder features.

The current study examined the relationship between borderline personality disorder (BPD) features and appraisals of daily romantic relationship experiences. The sample included 114 ethnically diverse, young adult dating couples (total N = 228). Participants completed a 14-day daily diary study and reported negative impact and emotional loss to their romantic partner in response to daily positive and negative self-initiated and partner-initiated romantic experiences. Results indicated that BPD features, even when controlling for relationship satisfaction, total number of relationship experiences, and depressive symptoms, were associated with reporting greater negative impact and greater emotional loss to both partner-initiated negative and positive experiences. BPD features were generally not associated with reporting greater negative impact and emotional loss in response to self-initiated negative and positive experiences. The results suggest that individuals with BPD features have a negative interpretation bias to both negative and positive experiences and the effect is generally specific to partner-initiated experiences. Negative appraisals may be one mechanism underlying interpersonal dysfunction in those with BPD features and interventions that directly assess and target these cognitive biases may help improve individual well-being and overall couple functioning.

Frequency and Quality of Social Networking Among Young Adults: Associations With Depressive Symptoms, Rumination, and Corumination.

Two studies examined associations between social networking and depressive symptoms among youth. In Study 1, 384 participants (68% female; mean age = 20.22 years, SD = 2.90) were surveyed. In Study 2, 334 participants (62% female; M age = 19.44 years, SD = 2.05) were surveyed initially and 3 weeks later. Results indicated that depressive symptoms were associated with quality of social networking interactions, not quantity. There was some evidence that depressive rumination moderated associations, and both depressive rumination and corumination were associated with aspects of social networking usage and quality. Implications for understanding circumstances that increase social networking, as well as resulting negative interactions and negative affect are discussed.