Relationship satisfaction and metabolic health parameters: a cross-sectional study in Burkinabe population of older adults.

BACKGROUND: Over- and undernutrition coexist in many African countries and pose a threat to metabolic health. This study assessed the associations between relationship satisfaction and Body Mass Index (BMI), waist circumference (WC), and glycated hemoglobin (HbA1c), in a rural population of older adults in Burkina Faso. It also explored potential gender differences and the mediating role of depressive symptoms. METHODS: Data from the "Centre de Recherche en Santé de Nouna (CRSN) Heidelberg Aging Study (CHAS)," a cross-sectional population-based study conducted in 2018 in Burkina Faso, were used in our study. Hierarchical linear regression models were applied for each of the three outcome variables. Among 2291 participants aged 40 years or older who provided data on relationship satisfaction, 2221, 2223, and 2145 participants had BMI, waist circumference (WC), and HbA1c values respectively. RESULTS: Higher relationship satisfaction (CSI-4 score) was associated with increased BMI (ß = 0.05, p = 0.031) and WC (ß = 0.12, p = 0.039). However, the association of CSI-4 and BMI became non-significant after controlling for depressive symptoms (PHQ-9 score) and physical inactivity (BMI: ß = 0.04, p = 0.073). Depressive symptoms fully mediated the relationship between relationship satisfaction and BMI (ß = -0.07, p = 0.005). There was no significant association between relationship satisfaction and HbA1c. These results were consistent across genders and age groups. CONCLUSION: Higher relationship satisfaction may lead to increased body weight among Burkinabe adults aged 40 years and older, and depressive symptoms may be a mediator in this association.

High-Throughput and Format-Agnostic Mispairing Assay for Multispecific Antibodies Using Intact Mass Spectrometry.

Multispecific antibodies have gained significant importance in a broad indication space due to their ability to engage multiple epitopes simultaneously and to thereby overcome therapeutic barriers. With growing therapeutic potential, however, the molecular complexity increases, thus intensifying the demand for innovative protein engineering and analytical strategies. A major challenge for multispecific antibodies is the correct assembly of light and heavy chains. Engineering strategies exist to stabilize the correct pairing, but typically individual engineering campaigns are required to arrive at the anticipated format. Mass spectrometry has proven to be a versatile tool to identify mispaired species. However, due to manual data analysis procedures, mass spectrometry is limited to lower throughputs. To keep pace with increasing sample numbers, we developed a high-throughput-capable mispairing workflow based on intact mass spectrometry with automated data analysis, peak detection, and relative quantification using Genedata Expressionist. This workflow is capable of detecting mispaired species of ∼1000 multispecific antibodies in three weeks and thus is applicable to complex screening campaigns. As a proof of concept, the assay was applied to engineering a trispecific antibody. Strikingly, the new setup has not only proved successful in mispairing analysis but has also revealed its potential to automatically annotate other product-related impurities. Furthermore, we could confirm the assay to be format-agnostic, as shown by analyzing several different multispecific formats in one run. With these comprehensive capabilities, the new automated intact mass workflow can be applied as a universal tool to detect and annotate peaks in a format-agnostic approach and in high-throughput, thus enabling complex discovery campaigns.

Concurrent and Prospective Associations Between Communicated Emotional Arousal and Adjustment Among Couples Coping With Cancer.

BACKGROUND: The experience of cancer can create considerable emotional distress for patients and their committed partners. How couples communicate about cancer-related concerns can have important implications for adjustment. However, past research has primarily utilized cross-sectional designs and retrospective self-reports of couple communication. While informative, little is known about how patients and partners express emotion during conversations about cancer, and how these emotional patterns predict individual and relational adjustment. PURPOSE: The current investigation examined how patterns of emotional arousal within couples' communication about cancer was associated with concurrent and prospective individual psychological and relational adjustment. METHODS: At baseline, 133 patients with stage II- breast, lung, or colorectal cancer and their partners completed a conversation about a cancer-related concern. Vocally expressed emotional arousal (f0) was extracted from recorded conversations. Couples completed self-report measures of individual psychological and relational adjustment at baseline and at 4, 8, and 12 months later. RESULTS: Couples who started the conversation higher in f0 (i.e., greater emotional arousal) reported better individual and relational adjustment at baseline. If the non-cancer partner had lower f0 relative to patients, this predicted worse individual adjustment across follow-up. Additionally, couples who maintained their level of f0 rather than decreasing later in the conversation reported improvements in individual adjustment across follow-up. CONCLUSIONS: Elevated emotional arousal within a cancer-related conversation may be adaptive for adjustment, as it may reflect greater emotional engagement and processing of an important topic. These results may suggest ways for therapists to guide emotional engagement to enhance resilience in couples experiencing cancer.

Cancer is a stressful experience for patients and their partners. We know that how couples communicate about cancer is important, but we do not know much about how couples express emotion during cancer conversations and how those emotional expressions affect well-being. Our study looked at how couples' emotional arousal within cancer conversations relate to individual and relationship well-being. At the beginning of the study, cancer patients and their partners had a conversation about cancer. Within these conversations, we tracked the emotional arousal expressed in their voices. Couples also completed surveys about their well-being at the beginning of the study and later in time (4, 8, and 12 months later). We found that couples who started the conversation with higher emotional arousal had better initial well-being. Couples who remained higher in arousal later in the conversation improved in their individual well-being over time. We also found that if the non-cancer partner was low in arousal compared with patients, this predicted worse well-being over time. More research is needed, but these findings suggest that being emotionally aroused during conversations about important topics like cancer might be helpful for well-being, potentially because couples are discussing concerns and not backing off when it feels challenging.

Socially distanced teaching: The mental health impact of the COVID-19 pandemic on special education teachers.

Little is known about the impact of the COVID-19 pandemic on special education teachers. Of 468 surveyed across the United States, 38.4% met clinical criteria for generalized anxiety disorder, a rate 12.4 times greater than the U.S. population, and 37.6% for major depressive disorder, a rate 5.6 times greater than the population. Race/ethnicity, gender, or school funding was not related to mental health. The impact of the pandemic was moderate to extreme on stress (91%), depression (58%), anxiety (76%), and emotional exhaustion (83%).

Escalation and Regulation of Emotional Arousal in Couples Predicts Relationship Satisfaction Concurrently and 25 Years Later.

Relationship distress and divorce are major risk factors for the development or exacerbation of psychopathology and psychosocial impairments. Given that heightened negative emotions within couples' interactions may portend negative relationship outcomes, it is critical to understand how emotions unfold across a conversation and how partners may influence each other's immediate emotional experiences. This study examined whether these regulatory dynamics within one interaction predicted relationship satisfaction concurrently and 25 years later. Vocally-encoded emotional arousal (f0 ) was measured during couples' (N = 25 couples) conversations about a relationship issue. Across different analytical strategies, results demonstrate that one partner's f0 dynamics had immediate and long-term associations with the other partner's satisfaction. Partners were less satisfied if the other partner (a) expressed higher f0 overall and (b) escalated more in f0 across the conversation. Yet, partners were more satisfied when their f0 escalated across the conversation. Also, women specifically were more satisfied if their f0 remained elevated longer before regulating back to their emotional baseline. Thus, higher f0 was associated with higher satisfaction in the same partner, but associated with less satisfaction in the other partner-particularly when these emotions come from women. It may be that partners have to decide whether to prioritize expressing their emotions fully or limit expression in the service of their partner's happiness. These findings challenge us to think of ways to address this "win-lose" scenario so that couples can balance both partners' emotional needs and preserve relationship quality across the life span.

El distrés relacional y el divorcio son grandes factores de riesgo para el desarrollo o la exacerbación de alteraciones psicopatológicas y psicosociales. Teniendo en cuenta que las emociones negativas intensificadas dentro de las interacciones de las parejas pueden predecir consecuencias negativas en las relaciones, es fundamental comprender cómo se revelan las emociones a lo largo de una conversación y cómo los integrantes de la pareja pueden influenciar las experiencias emocionales inmediatas del otro. Este estudio examinó si esta dinámica reguladora dentro de una interacción predijo la satisfacción con la relación inmediatamente y 25 años después. Se midió la codificación vocal de la excitación emocional (f0 ) durante las conversaciones de las parejas (N = 25 parejas) acerca de un problema en la relación. Entre diferentes estrategias analíticas, los resultados demuestran que la dinámica de la f0 de uno de los integrantes de la pareja tuvo asociaciones inmediatas y a largo plazo con la satisfacción del otro integrante de la pareja. Los integrantes de la pareja se sentían menos satisfechos si el otro integrante de la pareja (a) expresaba una f0 más elevada en general y (b) escalaba más en la f0 durante la conversación. Sin embargo, los integrantes de la pareja estaban más satisfechos cuando su f0 escalaba a lo largo de la conversación. También, las mujeres estaban específicamente más satisfechas si su f0 se mantenía elevada más tiempo antes de regularla para volver a su momento basal emocional. Por lo tanto, una f0 más elevada se asoció con una mayor satisfacción en el mismo integrante de la pareja, pero se asoció con una menor satisfacción en el otro integrante de la pareja, particularmente cuando estas emociones vienen de las mujeres. Es posible que los integrantes de la pareja tengan que decidir si priorizar la expresión completa de sus emociones o limitar la expresión al servicio de la felicidad de su pareja. Estos resultados nos plantean el desafío de pensar en maneras de abordar esta situación en la que "se gana o se pierde", de manera que las parejas puedan equilibrar las necesidades emocionales de ambos integrantes de la pareja y conservar la calidad de la relación durante su tiempo de vida.

Narrative Identity, Metacognition, and Well-Being in Patients With Schizophrenia or HIV.

It has been proposed that schizophrenia reflects disturbances in personal identity, which include sense of personal agency, sense of belonging within a social group, and metacognition. Less is known about how these different processes are related to one another and to well-being outcomes. To study this, we measured themes of agency and communion in narrative identity in 29 individuals with schizophrenia and 29 individuals with HIV. All participants had previously been assessed on metacognitive abilities using the Indiana Psychiatric Illness Interview (IPII) and completed scales measuring hopelessness and self-esteem. For the present study, themes of agency and communion were coded from the IPII transcripts. Results indicated that participants with schizophrenia had lower levels of agency and communion compared with participants with HIV. More presence of agency and communion themes were related to better metacognitive abilities as well as less hopelessness and higher self-esteem across groups. Agency predicted variance in hopelessness after controlling for metacognitive abilities. The results suggest that although the construction of narrative identity may depend on metacognitive abilities, agency themes predict outcomes beyond metacognition.

Metacognitive Capacity Is Related to Self-Reported Social Functioning and May Moderate the Effects of Symptoms on Interpersonal Behavior.

Impairments in metacognition or the ability to form integrated senses of self and others have been linked to deficits in laboratory-based measures of social functioning in schizophrenia. This study examined whether self-reported social functioning was related to metacognition in 88 adults in a nonacute phase of schizophrenia. Concurrent assessments were made of metacognition with the Metacognition Assessment Scale-Abbreviated, social functioning with the Social Functioning Scale, symptoms with the Positive and Negative Syndrome Scale, and neurocognition with the Wisconsin Card Sorting Task. Univariate correlations revealed that self-reported social functioning was related to metacognition. Symptom severity was linked to interpersonal relationships, and overall metacognition was found to significantly moderate that relationship such that the effects of symptoms on function grew less as metacognitive capacity was stronger, independent of the effects of neurocognition. This may suggest the potential of metacognitive interventions to titrate the negative effects of symptoms on social function.

When the "U" is not Inverted: Trajectories of Expressed Emotional Arousal Predict Relationship Satisfaction.

Maladaptive emotional reactivity and dysfunctional communication during couple conflict are both destructive to couple functioning, and observational research has elucidated how conflict escalates. However, much of the evidence is based on measures that combine content (i.e., what was said) and the emotion with which it was said, which are then examined using sequential analyses. Despite the general presumptions about underlying emotional reactivity and escalation in negative emotions as part of relationship distress and deterioration, little empirical data are available that directly examine these continuous shifts in emotions. The current study examined concurrent and longitudinal associations between relationship satisfaction and trajectories of change in vocally expressed emotional arousal during couple conflict in 62 couples who participated in a relationship education program. Contrary to expectations and patterns found in distressed couples, trajectories followed a U-shape rather than an inverted U-shape curve, with steeper and more persistent decreases in emotional arousal predicting more stable relationship satisfaction over time. In addition, there were within-couple effects. These results suggest that early signs for relationship deterioration may be less in the form of overt escalation as would be seen in distressed couples. Instead, couples who subsequently deteriorate more are less effective in calming emotional arousal. They also are less able to remain at lower emotional arousal. It is possible that the more pronounced escalation toward the end of the conversation in more at-risk couples is a precursor of the greater escalation patterns seen in distressed couples; this should be examined empirically. Limitations and implications are discussed.

La reactividad emocional desadaptativa y la comunicación disfuncional durante el conflicto de pareja son destructivas para el funcionamiento de la pareja, y la investigación observacional ha dilucidado cómo escala el conflicto. Sin embargo, gran parte de la evidencia está basada en mediciones que combinan el contenido (p. ej.: lo que se dijo) y la emoción con la que se dijo, que luego se analizan usando análisis secuenciales. A pesar de las presunciones generales acerca de la reactividad emocional subyacente y la escalada de las emociones negativas como parte del distrés y el deterioro de la relación, existen pocos datos empíricos que analicen directamente estos cambios continuos en las emociones. El presente estudio analizó las asociaciones simultáneas y longitudinales entre la satisfacción con la relación y las trayectorias de cambio en la agitación emocional expresada vocalmente durante el conflicto de pareja en 62 parejas que participaron en un programa de capacitación en relaciones. Contrariamente a las expectativas y los patrones hallados en las parejas problemáticas, las trayectorias siguieron una forma de U en lugar de una curva con forma de U invertida, con disminuciones más pronunciadas y más constantes de la agitación emocional que predicen una satisfacción más estable con la relación en el transcurso del tiempo. Además, hubo efectos dentro de la pareja. Estos resultados sugieren que las primeras señales de deterioro de la relación pueden ser menores en forma de escalada abierta de lo que se vería en las parejas problemáticas. En cambio, las parejas que posteriormente se deterioran más son menos eficaces a la hora de calmar la agitación emocional. También son menos capaces de permanecer en una agitación emocional más baja. Es posible que la escalada más pronunciada hacia el final de la conversación en las parejas con mayor riesgo sea una precursora de los patrones de mayor escalada observados en las parejas problemáticas; esto debería analizarse empíricamente. Se debaten las limitaciones y las consecuencias.

The Association between Symptom Accommodation and Emotional Coregulation in Couples with Binge Eating Disorder.

Intense negative emotions and maladaptive behavioral strategies to reduce emotional distress occur not only in patients with various forms of psychopathology but also in their committed partners. One common strategy to reduce distress is for partners to accommodate to the symptoms of the disorder, which reduces distress short term but maintains symptoms long term. Accommodation is believed to be motivated by the partner reacting behaviorally to the patient's emotions, but the emotions of the partner in this context have yet to be examined. This pilot study examined how partner accommodation related to specific patterns of emotional coregulation between patients with binge eating disorder (BED) and their partners, before and after a couple-based intervention for BED. Vocally encoded emotional arousal was measured during couples' (n = 11) conversations about BED. As predicted, partners' emotional reactivity to patients' emotional arousal was associated with high accommodation before treatment. Thus, partners may use accommodation as a strategy to reduce both the patients' and their own distress. After treatment, partners' arousal was no longer associated with the patients' emotional arousal; instead, partners showed greater emotional stability over time, specifically when accommodation was low. Additionally, patients were less emotionally aroused after treatment. Therefore, treatment may have decreased overall emotionality of patients and altered the association between accommodation and partners' emotional reactivity. If replicated, this understanding of the emotional context associated with accommodation in BED can inform couple-based treatment by targeting specific emotional precipitants of behaviors that maintain symptoms.

La emociones negativas intensas y las estrategias conductuales desadaptativas para reducir el distrés emocional se producen no solo en pacientes con varias formas de psicopatología, sino también en sus parejas estables. Una estrategia común para disminuir el distrés es que las parejas se adapten a los síntomas del trastorno, lo cual reduce el distrés a corto plazo pero mantiene los síntomas a largo plazo. Se cree que la adaptación está motivada por la reacción conductual de la pareja a las emociones del paciente, pero las emociones de la pareja en este contexto aún no se han analizado. Este estudio piloto examinó cómo la adaptación de la pareja está relacionada con patrones específicos de corregulación emocional entre los pacientes con trastorno por atracón de alimentos y sus parejas, antes y después de una intervención en la pareja por trastorno por atracón de alimentos. Se midió la excitación emocional codificada en la voz durante conversaciones de las parejas (n = 11) acerca del trastorno por atracón de alimentos. Como se anticipó, la reacción emocional de las parejas a la excitación emocional de los pacientes estuvo asociada con una alta adaptación antes del tratamiento. Por lo tanto, las parejas pueden usar la adaptación como estrategia para reducir tanto el distrés de los pacientes como el propio. Después del tratamiento, la excitación de las parejas dejó de estar asociada con la excitación emocional de los pacientes. En cambio, las parejas demostraron una mayor estabilidad emocional con el tiempo, específicamente cuando la adaptación fue baja. Además, los pacientes estuvieron menos excitados emocionalmente después del tratamiento. En consecuencia, el tratamiento pudo haber disminuido la emocionalidad general de los pacientes y modificado la asociación entre la adaptación y la reacción emocional de las parejas. Si se reproduce, esta comprensión del contexto emocional asociada con la adaptación en los trastornos por atracón de alimentos puede fundamentar el tratamiento basado en la pareja abordando precipitantes emocionales específicos de conductas que mantienen los síntomas.

Biotransformation of Benzo[ a]pyrene by Three Rainbow Trout ( Onchorhynchus mykiss) Cell Lines and Extrapolation To Derive a Fish Bioconcentration Factor.

Permanent fish cell lines constitute a promising complement or substitute for fish in the environmental risk assessment of chemicals. We demonstrate the potential of a set of cell lines originating from rainbow trout ( Oncorhynchus mykiss) to aid in the prediction of chemical bioaccumulation in fish, using benzo[ a]pyrene (BaP) as a model chemical. We selected three cell lines from different tissues to more fully account for whole-body biotransformation in vivo: the RTL-W1 cell line, representing the liver as major site of biotransformation, and the RTgill-W1 (gill) and RTgutGC (intestine) cell lines, as important environment-organism interfaces, which likely influence chemical uptake. All three cell lines were found to effectively biotransform BaP. However, rates of in vitro clearance differed, with the RTL-W1 cell line being most efficient, followed by RTgutGC. Co-exposures with α-naphthoflavone as potent inhibitor of biotransformation, assessment of CYP1A catalytic activity, and the progression of cellular toxicity upon prolonged BaP exposure revealed that BaP is handled differently in the RTgill-W1 compared to the other two cell lines. Application of the cell-line-derived in vitro clearance rates into a physiology-based toxicokinetic model predicted a BaP bioconcentration factor (BCF) of 909-1057 compared to 920 reported for rainbow trout in vivo.

A pilot open trial of UNITE-BED: A couple-based intervention for binge-eating disorder.

OBJECTIVE: To evaluate the feasibility, acceptability, and preliminary efficacy of a couple-based intervention for binge-eating disorder (BED), called UNiting couples In the Treatment of Eating disorders-BED edition (UNITE-BED). METHOD: In an open pilot trial, 11 couples in which one or both adult partners had a diagnosis of DSM-5 threshold or sub-threshold BED participated in 22 weekly sessions of UNITE-BED. Patients also received individual treatment, outside of the context of the trial. Couples completed measures on treatment satisfaction, eating disorder symptom severity, depression, anxiety, emotion regulation, and relational functioning at post-treatment and 3-month follow-up. Statistical analyses were conducted to identify change over the course of treatment. RESULTS: UNITE was feasible and acceptable to the majority of couples (9% dropout; high satisfaction ratings). Objective binge abstinence was 81.8% and subjective binge abstinence was 45.5% by post-treatment. Patient binge-eating symptomatology reduced over the course of treatment with results maintained at follow up. Patients' depression symptoms decreased and patients' emotion regulation improved at both time points. DISCUSSION: Including partners in treatment for BED may be beneficial. Results support further evaluation of the efficacy of couple-based interventions for BED in larger randomized-controlled trials.

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.

Couple-based Intervention for Depression: An Effectiveness Study in the National Health Service in England.

This study represents an effectiveness study and service evaluation of a cognitive behavioral, couple-based treatment for depression (BCT-D) provided in London services that are part of the "Improving Access to Psychological Therapies" (IAPT) program in England. Twenty-three therapists in community clinics were trained in BCT-D during a 5-day workshop, followed by monthly group supervision for 1 year. The BCT-D treatment outcome findings are based on 63 couples in which at least one partner was depressed and elected to receive BCT-D. Eighty-five percent of couples also demonstrated relationship distress, and 49% of the nonclient partners also met caseness for depression or anxiety. Findings demonstrated a recovery rate of 57% with BCT-D, compared to 41% for all IAPT treatments for depression in London. Nonclient partners who met caseness demonstrated a 48% recovery rate with BCT-D, although they were not the focus of treatment. BCT-D was equally effective for clients regardless of the clinical status of the nonclient partner, suggesting its effectiveness in assisting both members of the couple simultaneously. Likewise, treatment was equally effective whether or not both partners reported relationship distress. The findings are promising regarding the successful application of BCT-D in routine clinical settings.

The Role of Relationship Adjustment in an Integrated Individual Treatment for PTSD and Substance Use Disorders Among Veterans: An Exploratory Study.

OBJECTIVE: Identifying factors that influence treatment outcomes of emerging integrated interventions for co-occurring posttraumatic stress disorder (PTSD) and substance use disorder is crucial to maximize veterans' health. Dyadic adjustment suffers among individuals with PTSD and substance use disorder and may be an important mechanism of change in treatment. This exploratory study examined the association between dyadic adjustment and treatment outcomes in individual integrated treatment for co-occurring PTSD and substance use disorder. METHODS: Participants were treatment-seeking veterans (N = 15) participating in a larger randomized controlled trial examining the efficacy of a novel integrated treatment for co-occurring PTSD and substance use disorder. Multiple regression analyses controlling for baseline symptom severity and independent sample t-tests were used to examine the relation between dyadic adjustment and treatment outcome variables including PTSD, substance use disorder, and depression symptom severity. RESULTS: Baseline dyadic adjustment was associated with session 12 PTSD symptom severity as measured by both the Clinician-Administered PTSD Scale (CAPS) and PTSD Checklist (PCL), such that participants with high dyadic adjustment had significantly lower session 12 CAPS and PCL scores compared to participants with low dyadic adjustment. Baseline dyadic adjustment was not associated with session 12 depression symptoms or frequency of substance use. CONCLUSIONS: These findings suggest that while the primary determinant of treatment outcome in this sample is the application of an evidence-based intervention, dyadic adjustment may play a role in individual treatment outcome for some treatment-seeking veterans. Data from this study were derived from clinical trial NCT01365247.

Cognitive-Behavioral Couple Therapies: Review of the Evidence for the Treatment of Relationship Distress, Psychopathology, and Chronic Health Conditions.

Cognitive-behavioral couple therapy (CBCT) is an approach to assisting couples that has strong empirical support for alleviating relationship distress. This paper provides a review of the empirical status of CBCT along with behavioral couple therapy (BCT), as well as the evidence for recent applications of CBCT principles to couple-based interventions for individual psychopathology and medical conditions. Several meta-analyses and major reviews have confirmed the efficacy of BCT and CBCT across trials in the United States, Europe, and Australia, and there is little evidence to support differential effectiveness of various forms of couple therapy derived from behavioral principles. A much smaller number of effectiveness studies have shown that successful implementation in community settings is possible, although effect sizes tend to be somewhat lower than those evidenced in randomized controlled trials. Adapted for individual problems, cognitive-behavioral couple-based interventions appear to be at least as effective as individual cognitive behavioral therapy (CBT) across a variety of psychological disorders, and often more effective, especially when partners are substantially involved in treatment. In addition, couple-based interventions tend to have the unique added benefit of improving relationship functioning. Findings on couple-based interventions for medical conditions are more varied and more complex to interpret given the greater range of target outcomes (psychological, relational, and medical variables).

Partner distress in the context of adult anorexia nervosa: the role of patients' perceived negative consequences of AN and partner behaviors.

OBJECTIVE: Romantic partners can play an important role in the recovery from anorexia nervosa (AN). It is important to understand partners' behaviors and variables associated with their own distress. The aim was to examine associations of patients' perceived negative consequences of AN, behavioral strategies employed by partners, and partner distress. METHOD: We used a cross-sectional design to assess associations between self-reports of patients' perceived negative consequences of AN, partners' caregiver distress, negative affect, relationship satisfaction, and observational coding measures of partners' behavioral strategies of change promotion and acceptance/validation. Sixteen adult patient-partner dyads in committed relationships were assessed at baseline of a couple-based intervention for AN. RESULTS: Partners' change promotion moderated the association between patients' perceived negative consequences of AN and partners' caregiver distress. Partners' acceptance/validation was associated with partners' negative affect. DISCUSSION: This report represents the first description of specific partner behaviors in the context of AN. Partners who reported the least distress were those who were trying to promote changes in AN behaviors in patients who reported high negative consequences of AN, and partners who were trying to show understanding of the patients' experience. Future studies should examine the impact of partner behaviors on AN treatment outcome.

Couple-Based Interventions for Adults With Eating Disorders.

A significant number of adults with eating disorders fail to achieve relief from the disorder, with many dropping out of treatment or relapsing. The standard treatment remains individual therapy despite partners being negatively affected and typically wanting to help in an effective and loving way. We propose that couple-based interventions, which leverage the support of a partner and the relationship in treatment, may improve outcome and recovery rates for adults with eating disorders. In this article, we survey the empirical literature supporting the treatment of adults in a couple context and describe our existing and emerging couple-based interventions for eating disorders.

Couple-based interventions for psychopathology: a renewed direction for the field.

This article provides a rationale and empirical support for providing couple-based interventions when one partner in a relationship is experiencing individual psychopathology. Several investigations indicate that relationship distress and psychopathology are associated and reciprocally influence each other, such that the existence of relationship distress predicts the development of subsequent psychopathology and vice versa. Furthermore, findings indicate that for several disorders, individual psychotherapy is less effective if the client is in a distressed relationship. Finally, even within happy relationships, partners often inadvertently behave in ways that maintain or exacerbate symptoms for the other individual. Thus, within both satisfied and distressed relationships, including the partner in a couple-based intervention provides an opportunity to use the partner and the relationship as a resource rather than a stressor for an individual experiencing some form of psychological distress. The authors propose that a promising approach to including the partner in treatment involves (a) integrating intervention principles from empirically supported interventions for individual therapy for specific disorders with (b) knowledge of how to employ relationships to promote individual and dyadic change. Based on this logic, the article includes several examples to demonstrate how couple-based interventions can be focused on a specific type of psychopathology, including encouraging empirical findings for these interventions. The article concludes with recommendations for how clinicians and researchers can adapt their knowledge of couple therapy to assist couples in which one partner is experiencing notable psychological distress or diagnosable psychopathology.

Parent-child emotion dynamics in families presenting for behavioral parent training: Is there a link with child behavior, parenting, and treatment outcome?

OBJECTIVE: Behavioral parent training (BPT) is the standard of care for early onset behavior disorders (BDs), however, not all families benefit. Emotion regulation (ER) is one potential mechanism underlying BPT outcomes, yet there are challenges in capturing intra- and interpersonal aspects of emotion regulation within parent-child interactions that are central to BPT. This study examined how vocally encoded emotional arousal unfolds during parent-child interactions and how parents and children influence each other's arousal (Aim 1), the links between these emotion dynamics, child behavior, and parenting at baseline (Aim 2), and BPT outcome (Aim 3). METHOD: Families of children with BDs (N = 45) completed two interaction tasks and measures of parenting and child behavior. Parent-child dynamics of vocal fundamental frequency (f0) were modeled using actor-partner interdependence models (APIMs) and coupled linear oscillators (CLOs). RESULTS: When considering relative levels of f0 from one talk turn to the next (APIMs), parents and children showed intrapersonal regulation and synchronizing reactivity to each other's f0. When considering the shape of oscillations (CLOs), parents and children showed intrapersonal regulation but no reactivity. Intrapersonal regulation of f0 during the interaction was slowed for parents with more maladaptive parenting and children with more behavior problems at baseline. CONCLUSIONS: This preliminary characterization of f0 in families presenting for BPT provides insights into the emotion dynamics potentially underlying parenting behavior and child behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

German and Italian validation of the Dyadic Coping Inventory-Sexual Minority Stress (DCI-SMS) scale.

Lesbian, gay, bisexual, and transgender individuals (hereafter people with minoritized sexual orientation and/or gender identities) have limited legal rights and access to resources because of their marginalized status in society. These limitations are associated with notable health disparities and increase experiences of minority stress. For those in a romantic relationship, being able to communicate and cope with one's partner-dyadic coping-can help buffer stress' deleterious effects on well-being. Given the promise of understanding how dyadic coping can mitigate experiences of sexual minority stress, the Dyadic Coping Inventory-Sexual Minority Stress (DCI-SMS) was recently created and validated with those living in the United States to assess how partners cope with sexual minority stress. Answering a global call to expand psychological science beyond a U.S. centric perspective, the purpose of this study was to validate the DCI-SMS in German and Italian using samples from Austria, Germany, Switzerland, and Italy, respectively. Confirmatory factor analysis results, along with tests of convergent and discriminant validity, and measurement invariance, suggest that the DCI-SMS is a valid measure of stress communication and dyadic coping behaviors for those in a same-gender relationship in the countries sampled. Important future directions include examining its efficacy in other countries, such as those with more adverse sociopolitical climates for people with minoritized sexual orientation and/or gender identities in a same-gender relationship. Limitations and future directions for research and clinical practice are presented. (PsycInfo Database Record (c) 2024 APA, all rights reserved).