Relations Between Stress-Adapted Communication Skills and Toxic Social Networks Among Young Adults with Childhood Adversity.

Adverse childhood experiences are associated with deleterious outcomes across the lifespan. However, some individuals who grow up in adverse environments may develop stress-adapted skills or resilience factors that enable them to function in their current lived environments. This study explored whether communication is a stress-adapted skill among young adults with co-occurring forms of childhood adversity and the extent to which these communication skills are implicated in toxic social networks. This cross-sectional study included 384 young adults, ages 18-35 years, who completed an online survey. Mixture modeling was used to conduct latent class models estimating subgroups of young adults with co-occurring forms of early adversity; then, regression models estimated the association between communication skills and toxic social networks among subgroups. Four latent classes were identified: (1) high childhood adversity; (2) high to moderate household dysfunction and emotional abuse; (3) high emotional abuse and moderate physical abuse and emotional neglect; and (4) low or no childhood adversity. Results from regression models indicate that participants classified in the high emotional abuse and moderate physical abuse and emotional neglect class had more adaptive communication skills with friends than their counterparts in the low or no childhood adversity class, and participants in the high childhood adversity or low or no childhood adversity classes with higher communication skills were less likely to report toxic social networks. Findings suggest that stress-adapted communication skills may be one resilience factor that supports adaptation among young adults with early adversity exposures.

Mindful Partnering: Introducing a Theoretical Construct and Testing Psychometric Properties of the Mindful Partnering Measure.

Although evidence suggests many benefits of mindfulness, interpersonal forms of mindfulness are understudied. We present the conceptualization of a novel theoretical construct, mindful partnering, as interpersonal mindfulness with ones' romantic partner; we also present initial validation of the Mindful Partnering Measure (MPM). Participants were 599 individuals from: 1) an undergraduate student sample recruited from a University subject pool (used for exploratory factor analyses, N= 335) and 2) a sample of married adults that was recruited through Mechanical Turk (used for confirmatory factor analyses, N= 264, subsets used for construct validity N= 147, and test-retest analyses N= 53). Results of the EFA and CFA supported a five-factor structure with the subscales: (1) mindful awareness, (2) nonreactivity, (3) emotional awareness, (4) acceptance/compassion, and (5) self-compassion. Tests of internal consistency, construct validity, and test-retest reliability in the sample of married adults provided evidence for reliability and validity of the total MPM to assess mindful partnering, as well as the mindful awareness and acceptance/compassion subscales. However, the other subscales did not demonstrate adequate test-retest reliability. Use of this measure in further research will allow for the study of the potential correlates and benefits of mindful partnering to further our understanding of this novel construct.

Psychosocial and Biological Outcomes of Immersive, Mindfulness-Based Treks in Nature for Groups of Young Adults and Caregivers Affected by Cancer: Results from a Single Arm Program Evaluation from 2016-2021.

The COVID-19 pandemic has left many individuals suffering from "connection deficit disorder" given changes to the way we work, go to school, socialize, and engage in daily activities. Young adults affected by cancer between the ages of 18-39 have known this connection deficit long before the pandemic. Being diagnosed and treated for cancer during this time can significantly disrupt engagement in important educational, career, social, and reproductive pursuits, and contribute to increased stress, anxiety, depression, and other negative outcomes. Experiencing meaningful connection-with nature, with peers who understand, and with oneself, may help assuage this adverse effect of disconnect. A single arm within-subjects program evaluation was conducted to examine outcomes following participation in immersive, multi-night, mindfulness-based treks in nature in a sample of young adults (n = 157) and caregivers (n = 50) affected by cancer from 2016-2021. Pre to post-trek changes included significant (p < 0.001) self-reported improvements in feeling connected to nature (d = 0.93-0.95), peers (d = 1.1-1.3), and oneself (d = 0.57-1.5); significant (p < 0.001) improvements on PROMIS Anxiety (d = 0.62-0.78), Depression (d = 0.87-0.89), and Sleep Disturbance (d = 0.37-0.48) short forms; and significant (p < 0.05) changes in pro-inflammatory biomarkers (d = 0.55-0.82). Connection-promoting experiences like this have the potential to improve health and wellbeing in this population and serve as a model for others.

The Alliance-Outcome Association in Couple Therapy: A Common Fate Model.

The working alliance has been shown to be a robust predictor of couple therapy outcomes. However, there are still questions regarding the best way to conceptualize and analyze the association between the alliance and outcomes in the couple therapy context. This study presents results from a relatively novel analytic approach for evaluating the alliance and therapy outcomes via the shared influence model (i.e., common fate statistical methodology) with 93 couples who had at least three sessions. Examining the alliance in couple therapy this way allows for nuance in conceptualizing the process of the alliance among partners and the therapist in couple therapy. Empirically, the question that remains is whether the shared experience of the alliance between partners is a stronger predictor of therapy outcome as compared to the unique individual experiences of the alliance. This approach has not yet been utilized to model the couple alliance-outcome association. Results revealed that the shared influence model demonstrated a significant association between the alliance and therapy outcome. Specifically, the couple-level alliance construct was adequately represented from the partners' alliance ratings with the therapist, and couples that report higher shared alliance experiences were also likely to have better therapy outcomes. These findings suggest that conceptualizing and analyzing the alliance at the couple level may be strongly advantageous. Implications for research and practice are provided.

Se ha demostrado que la alianza terapéutica es un predictor fiable de los resultados de la terapia de pareja. Sin embargo, aún quedan preguntas con respecto a la mejor manera de conceptualizar y analizar la asociación entre la alianza y los resultados en el contexto de la terapia de pareja. Este estudio presenta resultados de un enfoque analítico relativamente innovador para evaluar la alianza y los resultados de la terapia mediante el modelo de influencia compartida (p. ej.: metodología estadística del destino común) con 93 parejas que tuvieron al menos tres sesiones. Analizar la alianza en la terapia de pareja de esta manera permite matices a la hora de conceptualizar el proceso de la alianza entre los integrantes de la pareja y el terapeuta en la terapia de pareja. Empíricamente, la pregunta que queda pendiente es si la experiencia compartida de la alianza entre los integrantes de la pareja es un predictor más fiable de los resultados de la terapia en comparación con las experiencias individuales únicas de la alianza. Este enfoque aún no se ha utilizado para interpretar la asociación entre la alianza de la pareja y los resultados. Los resultados revelaron que el modelo de influencia compartida demostró una asociación significativa entre la alianza y los resultados de la terapia. Específicamente, el constructo de la alianza a nivel de la pareja se representó adecuadamente a partir de las valoraciones de la alianza de los integrantes de la pareja con el terapeuta, y las parejas que informan más experiencias de alianza compartida también fueron propensas a tener mejores resultados en la terapia. Estos datos sugieren que puede ser enormemente ventajoso conceptualizar y analizar la alianza a nivel de la pareja. Se explican las consecuencias para la investigación y la práctica.

Benchmarking Community-Based Couple Therapy: Considering Measurement Reactivity.

Couple therapy has been shown to be effective in randomized clinical trials; however, results from naturalistic couple therapy have been less consistent. This study utilized a benchmarking approach to compare the effectiveness of couple therapy in a community-based setting with findings from efficacy treatments, such as treatment within randomized clinical trials. The current study is the largest couple therapy sample published to date (N = 3,347 couples). Clients in couple therapy were asked to provide initial and weekly ratings of symptomology on the Outcome Questionnaire (OQ-45.2). We found that treatment effect sizes found at community clinics were smaller than efficacy studies (i.e., the benchmark). However, when taking into account measurement reactivity, the effect sizes were comparable. This is the first benchmarking study for community-based couple therapy, allowing for meaningful comparisons and understanding of outcomes in real-world couple therapy. Implications for the field are offered in terms of evaluating community-based psychotherapy studies with benchmarking for couple therapy. Results of this study provide clinicians and researchers a way to meaningfully compare couple therapy outcomes, accounting for differences in community-based practices and randomized clinical trials. This benchmark also underscores the impact of measurement sensitivity, an issue commonly overlooked in psychotherapy research and practice.

Se ha demostrado que la terapia de pareja es eficaz en los ensayos clínicos aleatorizados, sin embargo, los resultados de la terapia de pareja naturalista han sido menos consecuentes. Este estudio utilizó un enfoque comparativo para comparar la eficacia de la terapia de pareja en un entorno basado en la comunidad con hallazgos de los tratamientos de eficacia, como los tratamientos dentro de los ensayos clínicos aleatorizados El presente estudio es la muestra más grande de terapia de pareja publicado hasta la fecha (N = 3347 parejas). Se pidió a los pacientes en terapia de pareja que proporcionen calificaciones iniciales y semanales de la sintomatología en el cuestionario para evaluación de resultados (OQ-45.2).Descubrimos que los tamaños del efecto de los tratamientos hallados en las clínicas comunitarias fueron más pequeños que los de los estudios de eficacia (p. ej.: el estudio comparativo). Sin embargo, cuando se tomó en cuenta la reactividad a la medición, los tamaños del efecto fueron comparables. Este es el primer estudio comparativo para la terapia de pareja basada en la comunidad, el cual permite comparaciones significativas y comprensión de los resultados en la terapia de pareja en el mundo real. Se ofrecen las implicancias para el área en cuanto a la evaluación de los estudios de la psicoterapia basada en la comunidad con evaluación comparativa de la terapia de pareja. Los resultados de este estudio proporcionan a los clínicos y a los investigadores una manera de comparar significativamente los resultados de la terapia de pareja, así como de explicar las diferencias en las prácticas basadas en la comunidad y en los ensayos clínicos aleatorizados. Esta evaluación comparativa también subraya el efecto de la sensibilidad a la medición, una cuestión comúnmente pasada por alto en la investigación y la práctica de la psicoterapia.

Changes in Commitment and Sexual Satisfaction: Trajectories in Couple Therapy.

The purpose of this study was to examine the covarying relationship between commitment and sexual satisfaction in committed relationships throughout the course of couple therapy. A sample of 366 heterosexual couples completed questionnaires regarding sexual satisfaction and commitment at each of the first five sessions of couple therapy. Cross-lagged panel analyses revealed that, between the first and second therapy sessions, there was a bidirectional relationship between commitment and sexual satisfaction, with each variable at the first session predicting the other at the second session. In addition, sexual satisfaction at the second session predicted commitment at the third session.

Testing the convergent and discriminant validity of the Systemic Therapy Inventory of Change Initial scales.

OBJECTIVE: The Systemic Therapy Inventory of Change (STIC®) is the first multi-systemic and multi-dimensional measurement and feedback system designed for assessment in family, couple, and individual functioning. Patients fill out the STIC Initial before the first session to identify treatment targets and provide starting values for subsequent assessments of trajectories of change. This study tested the construct validity of five of the six STIC Initial scales. METHODS: We administered both the STIC Initial and a set of validity measures to a relatively large sample of patients. Convergent and discriminant validity were tested using both an examination of observed correlations and confirmatory factor analysis (CFA). RESULTS: The correlations among the observed measures showed that the convergent validity coefficients were generally large, whereas the discriminant validity coefficients were moderate to small. Similarly, CFAs suggested that the STIC total scales and subscales are good indicators of the factors they were intended to measure and that the STIC total scales and subscales are weakly related to the factors they were intended to not measure. CONCLUSION: The results supported the convergent and discriminant validity of the five scales of the STIC Initial. Clinical or methodological significance of this article: The clinical significance of this article is that it demonstrates that the STIC Initial should be useful for identifying treatment targets including both which systems, in addition to the facets within each system, that require targeting. The methodological significance is twofold. First, the use of CFA for testing convergent and discriminant validity is still relatively rare. Second, we demonstrated how to use CFA for a more stringent test of discriminant validity compared with the original approach described by Cole ( 1987 ).

Relationship education in community settings: effectiveness with distressed and non-distressed low-income racial minority couples.

Couple relationship education (CRE) programs are intended to prevent negative couple outcomes, however, some evidence suggests couples in greater distress may still benefit. The current study examined pre- and postchanges in relationship functioning of 362 low-income African American and Hispanic couples. Outcomes (dedication and communication) were assessed by examining differences between two distinct groupings of couples; distressed (both partners reporting clinically significant distress) and nondistressed (neither partner reporting clinically significant distress) couples. Distressed couples at predemonstrated large-sized gains in all outcome variables, as compared to nondistressed couples. Those who participated in the single-couple format demonstrated lower gains in positive communication as compared to those in the group format. Implications for distressed couples in CRE programs are offered.

The alliance in relationship education programs.

Couple relationship education (CRE) programs are associated with positive romantic relationship outcomes; however, the mechanisms by which these gains occur are less understood. The current study (122 couples) utilized actor-partner modeling to examine the association between the therapeutic alliance and dedication and negative and positive communication for racial/ethnic minority couples. Additionally, we examined whether gender and delivery format moderated these relationships. Results demonstrated that both men's and women's alliance scores were significantly related to their own outcomes. Higher ratings of alliance were related to partner outcomes for men only. The association between partners' alliance and dedication outcomes was stronger within the group format as compared to the couple format. Implications for leaders of CRE programs are offered.

Heightening in couple therapy.

Across couple therapeutic modalities, heightening interventions have been proposed as a mechanism of change. The current article describes how behavioral and emotion-focused heightening techniques can be facilitated in couple therapy. We provide actual case examples of psychotherapist interventions aimed at heightening couples' relational or emotional interaction. Ultimately, heightening encourages couples to confront difficult topics together, express vulnerable emotions, and make new meaning of the lived experiences that might be interfering with the quality of their relationship.

Perceptions of partner's deception in friends with benefits relationships.

Friends-with-benefits relationships combine elements of friendship with sexual intimacy. Using hierarchical regression, the authors examined perceived deception in 310 relationships. In comparison with men, women reported greater deception by their friends-with-benefits partner. Perceived deception was inversely related to awareness of relational risk factors and directly related to anxious attachment, more sexual interactions as compared with friendship interactions in the relationship, and more favorable attitudes toward ambiguous commitment. Awareness of relational risk factors moderated the association between anxious attachment and perceptions of being deceived as awareness of relational risk factors was only negatively associated with perceived deception for those with lower levels of anxious attachment. Last, gender moderated the association between perceptions of being deceived and anxious attachment in that more anxious attachment was related to perceived deception for women, but not men. In particular, anxious attachment did not predict perceptions of deception for men, but greater degrees of anxious attachment for women increased perceptions of deception. Recommendations for assisting young adults to navigate this relational style are offered.

Toward a more complete understanding of reactions to hooking up among college women.

Hooking up, a relatively common behavior among young adults, refers to a casual sexual encounter, ranging from kissing to sexual intercourse, without an expectation of ongoing physical encounters or relational commitment. Reactions to hooking up have examined psychosocial outcomes as a proxy for specific reactions. The present study examined the reactions of 190 college women, with a specific focus on the effect of hooking up on their social/peer network, their sexual/romantic sense of self, and their academic performance. Results demonstrated large positive effects for sexual/romantic reactions and social/academic engagement reactions in comparison with negative personal reactions. In addition, higher ratings of anxious attachment, loneliness, and relational/intimacy sex motives were related to less positive reactions, highlighting the importance of attachment and motivations behind hookup experiences. Implications for educational practice and future research are offered.

Dismantling study of prevention and relationship education program: the effects of a structured communication intervention.

Couples Relationship Education (CRE) programs have been shown to improve many facets of relationship functioning; however, less is known about the specific effects of various components of CRE programs. The current study examined two versions of the Prevention and Relationship Education Program (PREP), one where a structured communication intervention was taught and one where it was not. Outcome variables included couples' communication behaviors, communication patterns, and overall relationship adjustment. Twenty-six couples (52 participants) completed a 4-week, 12-hr PREP workshop. Generally, the couples reported low to moderate relationship distress. Study measures were completed preintervention, 4-6 weeks post, and 6 months post. Couples in the structured communication condition reported more positive and fewer negative communication behaviors at 6-month follow up and they reported faster gains in positive communication behaviors compared with the no structured communication group. Both groups reported decreased negative communication patterns and no change in relationship adjustment; these changes were statistically similar for both groups. Implications for couples' communications and relationship education programs are discussed.

Alliance in action: a new measure of clients' perceptions of therapists' alliance activity.

We developed a new measure, Alliance in Action (AiA), which assesses clients' perceptions of therapist behavior related to fostering and maintaining the alliance. Clients (N=170) were treated by 42 therapists. All clients were currently in therapy. The results of a factor analysis revealed four subscales to the AiA, which reflected clients' perceptions of their therapists' behavior to monitor the therapeutic relationship, the goals for therapy, and progress towards client goals. A fourth subscale emerged that reflected clients' perceptions of therapist avoidance of eliciting feedback. The AiA subscales demonstrated alphas above .70 and they were associated with client-rated alliance and session outcomes in univariate correlation tests. In multilevel models, three of the four subscales were associated with alliance and session outcomes. The AiA may be helpful in understanding how the therapeutic alliance functions in therapy.

The effectiveness of PREP with lower-income racial/ethnic minority couples.

The current study examined the effectiveness of the Prevention and Relationship Enhancement Program (PREP) with lower-income and racial/ethnic minority (African American and Latino/a) couples. Additionally, we tested whether relationship outcomes varied based on the delivery format (i.e., group format vs. couple format). The sample included 321 unmarried couples expecting a child or who have a child 3 month old or younger. The couples participated in 16 hr of PREP via a group or a couple format over the course of 2-3 months. Couples relationship quality was assessed prior to and directly after the program. The results showed that men and women demonstrated significant gains in their communication skills, relationship functioning, friendship, dedication, and relationship confidence. Couples who participated in PREP via the couple format had better outcomes on three of the seven relational outcomes as compared to couples who participated in PREP via the group format.

I get no respect: the relationship between betrayal trauma and romantic relationship functioning.

The current study explored the association among young adults' (N = 86) experiences of betrayal traumas (interpersonal trauma perpetrated by someone close) prior to age 18, psychological well-being, attachment styles, and romantic relationship function (i.e., dedication, relationship adjustment, and perceived partner respect). Based on betrayal trauma theory, we posited that participants' reports of betrayal traumas would be negatively related to their perceptions of respect from their partner but would not relate to their perceptions of relationship adjustment or dedication. Furthermore, we expected that the relationship between betrayal traumas and respect would be mediated by participants' attachment style and psychological well-being. Results identified a negative association between betrayal traumas and psychological well-being and a positive association between betrayal trauma and anxious and avoidant attachment. Betrayal traumas were also shown to be negatively related to partner respect and not significantly associated with dedication and relationship adjustment. Anxious attachment and psychological well-being were significant mediators for the relationship between betrayal traumas and perceived respect.

Working through: in-session processes that promote between-session thoughts and activities.

This study examined whether clients' ratings of the working alliance as well as their perception of cognitive-behavioral (CB) and psychodynamic-interpersonal (PI) techniques (delivered by therapists who used both) were associated with clients' intersession processes (i.e., their thoughts about therapy and therapeutic activity between sessions). Seventy-five clients who were currently in therapy at a large university counseling center participated in the current study. Multilevel regression analyses demonstrated that alliance and clients' perceptions of their therapists' use of PI techniques were positively associated with clients' general thoughts about therapy between sessions. Also, stronger alliances were associated with more therapeutic activities between sessions and more positive (and less negative) thoughts about therapy between sessions. In addition, clients at later sessions who described their therapists as using more PI techniques also reported engaging in more therapeutic activities between sessions (after controlling for the variance in the other variables, such as use of CB techniques). Clients' perceptions of their therapists' use of CB techniques in the most recent session were not related to thinking about therapy or therapeutic activities after controlling for the variance in the other variables.