Profiles of Low-Income Help-Seeking Couples and Implications for Intervention Gains: A Couple-Centered Approach.

Using a couple-centered approach, the current study seeks to understand (a) the specific ways in which help-seeking couples vary in how their relationship satisfaction changes over time, (b) whether there are important differences in relationship characteristics at the beginning of the interventions, and (c) whether couples with distinct relationship characteristics benefit equally from effective online relationship programs. Mixed-gender low-income couples (Ncouple = 659) seeking help for their relationship were randomly assigned to one of two online relationship programs (n = 432) or the wait-list control group (n = 227). Latent profile analyses were conducted to identify (a) trajectory profiles with both partners' relationship satisfaction assessed at baseline, during, and postprogram, and at 2- and 4-month follow-ups; and (b) baseline couple profiles with indicators of baseline communication, commitment, emotional support, and sexual satisfaction reported by both partners. Four unique satisfaction trajectories were identified: women-small-men-medium improvement (39%), men-only decline (25%), large improvement (19%), and women-only improvement (17%). Five unique baseline couple profiles were identified: conflictual passionate (30%), companionate (22%), men-committed languishing (22%), satisfied (16%), and languishing (10%). Compared to control couples, intervention couples' odds of following the large improvement trajectory increased and their odds of following the men-only decline trajectory decreased; the odds of following the other two intermediate trajectories did not differ by intervention status. Moreover, couples with more distressed baseline profiles were more likely to follow trajectories characterized by greater satisfaction gains regardless of their intervention status. However, program effects did not differ based on baseline couple profiles, suggesting that a universal approach may be sufficient for delivering online relationship programs to improve relationship satisfaction in this population.

Pretreatment relationship characteristics predict outcomes from an uncontrolled trial of intensive, multicouple group PTSD treatment.

Cognitive behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD; Monson & Fredman, 2012) is associated with improvements in patients' and partners' mental health and relationship satisfaction. Some pretreatment relationship characteristics have predicted CBCT for PTSD outcomes for patients, but findings were limited to a single community sample consisting primarily of female patients with male partners. A better understanding of whether pretreatment relationship characteristics predict outcomes in other patient populations and whether there are partners who may be particularly responsive to couple therapy for PTSD could optimize treatment matching. This study investigated whether pretreatment partner accommodation and relationship satisfaction predicted patient and partner treatment outcomes from an uncontrolled trial of an abbreviated, intensive, multicouple group version of CBCT for PTSD conducted with 24 active-duty military or veteran couples (96% male patients/female partners). In general, changes in patients' PTSD and comorbid symptoms and relationship satisfaction did not vary by pretreatment partner accommodation or patients' own pretreatment relationship satisfaction. In contrast, pretreatment relationship characteristics predicted partner outcomes. Partners who engaged in higher levels of accommodation pretreatment and partners who reported lower levels of pretreatment relationship satisfaction experienced greater declines in psychological distress following treatment. Also, partners who began the study relationally distressed exhibited significant increases in relationship satisfaction following treatment, whereas those who were not relationally distressed did not. Findings suggest that improvements generally do not vary by pretreatment relationship characteristics for patients, whereas partners who begin treatment with elevated relationship risk factors may be especially likely to experience improvement across outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A randomized controlled trial of the online OurRelationship program with varying levels of coach support.

Online programs that reduce relationship distress fill a critical need; however, their scalability is limited by their reliance on coach calls. To determine the effectiveness of the online OurRelationship program with varying levels of coach support, we conducted a comparative effectiveness trial with 740 low-income couples in the United States. Couples were randomly assigned to full-coach (ncouples = 226; program as originally designed), automated-coach (ncouples = 145; as a stand-alone program with tailored automated emails only), contingent-coach (ncouples = 145; as an adaptive program where tailored automated emails are followed by more coaching if couples did not meet progress milestones), or a waitlist control condition (ncouples = 224). All analyses were conducted within a Bayesian framework. Completion rates were comparable across conditions (full-coach: 65 %, automated-coach: 59 %, contingent-coach: 54 %). All intervention couples reported reliable pre-post gains in relationship satisfaction compared to waitlist control couples (dfull = 0.46, dcontingent = 0.47, and dautomated = 0.40) with no reliable differences across intervention conditions. Over four-month follow-up, couples in full- and contingent-coach conditions maintained gains in relationship satisfaction and couples in the automated-coach condition continued to improve. Given the comparable completion rates and minimal differences in effect sizes across intervention conditions, all three coaching models appear viable; therefore, the choice of model can vary depending on available resources as well as couple or stakeholder preferences. This study was preregistered (ClinicalTrials.govNCT03568565).

Associations among Financial Well-Being, Daily Relationship Tension, and Daily Affect in Two Adult Cohorts Separated by the Great Recession.

Financial well-being may be an important context for daily emotional reactivity to relationship tension (e.g., arguments) whose salience varies across historical time or as a function of exposure to economic downturns. This study investigated how emotional reactivity, operationalized as daily fluctuations in negative and positive affect associated with the occurrence of daily relationship tension, varied by financial well-being among those who were and were not exposed to the Great Recession of 2008. Two matched, independent subsamples of partnered individuals from the National Study of Daily Experiences completed identical 8-day diary protocols, one before the Great Recession (n = 587) and one after (n = 351). Individuals reported higher negative affect and lower positive affect on days when relationship tension occurred. Further, results indicated that negative affect reactivity, but not positive affect reactivity, was moderated by both financial well-being and cohort status. For the pre-recession cohort, negative affect reactivity was stronger among those with lower financial well-being. However, among the post-recession cohort, financial well-being did not moderate negative affect reactivity to relationship tension. Findings highlight the utility of considering major societal events, such as economic downturns, to understand variability in emotional reactivity to day-to-day relationship tension in the context of financial well-being, as the salience of financial well-being in the ways relationship tension and negative affect are related on a daily basis appears to vary by historical context.

Effects of online relationship programs for low-income couples during the perinatal period.

Low-income couples experience increased stress and declines in relationship quality during the perinatal period. They also encounter many barriers to accessing relationship services. Using a subsample of low-income perinatal couples (n = 180) from two randomized controlled trials, the current study examined the impact of online relationship interventions, OurRelationship (OR) and ePREP, in a Bayesian framework. From pre to post, relative to waitlist control couples, couples in OR and ePREP experienced improvements in relationship quality (Mean d = 0.51) and psychological distress (Mean d = 0.28); OR couples, relative to waitlist control couples, also experienced improvements in perceived stress (Mean d = 0.33). These improvements were maintained through four-month follow-up and did not differ across gender. These findings suggest brief online relationship interventions may be an important resource for low-income perinatal couples.

PTSD Symptom Cluster Severity Predicts Momentary Emotion Dynamics During Couple Conversations.

This study investigated the associations between momentary emotion dynamics and posttraumatic stress disorder (PTSD) symptoms. Using a sample of 61 couples (N = 122 individuals) in which all individuals were trauma exposed and at least one partner screened positive for PTSD, we examined the intra- and interpersonal regulation of vocally encoded emotional arousal (fundamental frequency [f0]) and how these momentary emotion regulatory patterns relate to specific PTSD symptoms during two couple conversations: one designed to elicit conflict and one to elicit intimacy. PTSD symptoms were assessed using a gold standard clinical interview. In both conversations, higher reexperiencing symptoms were associated with greater emotional inertia (i.e., more resistance to change in emotional state following deviation from one's emotional equilibrium), and higher avoidance symptoms were associated with less emotional inertia (i.e., quicker return to emotional equilibrium). In the intimacy conversations, individuals also responded to their partners' arousal. Furthermore, individuals whose partners exhibited higher emotional numbing symptoms exhibited more emotional inertia, suggesting that emotion regulation may be a function of both one's own and one's partner's PTSD symptoms. Attending to the interpersonal context of emotion dynamics during PTSD treatment may enhance outcomes.

Web-Based Relationship Education and Pornography-Related Behaviors: A Single-Group Design During the COVID-19 Pandemic.

Research surrounding pornography and its impact on individual and relationship functioning is a frequent and ongoing debate in the current literature. However, recent meta-analyses and aggregated studies suggest that relationship distress is associated with higher levels of general pornography use. This may be a reason why a significant number of men and women view pornography and seek help for their use. In the present study, we explored whether participation in the OurRelationship program, a web-based relationship education program that has been empirically shown to reduce relationship distress but is not tailored to reduce general pornography use, was associated with reliable changes in pornography-related behaviors. In a sample of low-income and diverse couples (N = 314 couples; 628 individuals), we observed high completion rates (64.3%) as well as reliable, small-sized decreases in the frequency and duration of pornography use for the average couple (d = 0.12-0.13). Furthermore, post hoc analyses found that individuals who began the program viewing pornography daily reported reliability-larger decreases in pornography-related behaviors (d = 0.32-0.90) than those who viewed pornography less frequently. However, we did not see reliable changes in couples' arguments about pornography use or perceptions of problematic use. The findings were generally not moderated by gender or lifestyle changes due to the COVID-19 pandemic. Clinicians struggling to reduce their client's general pornography use may consider including a focus on improving general romantic relationship functioning.

Trajectories of parent and child well-being across the pandemic year: Role of financial strain, social distancing, and COVID-19 prevalence.

Existing research demonstrated large deteriorations in parent, child, and family well-being within 2 months after the onset of the COVID-19 pandemic. Yet, little is known about the trajectories of families' adjustment in the following months, including what risk factors are associated with changes in families' adjustment. The current study examined (1) change in the parent, child, and family well-being over time; (2) associations of pandemic-related stressors, financial and social distancing-associated stress, with well-being between and within families; and (3) the role of local COVID-19 prevalence, prior participation in family-focused prevention, and parent gender. From April 2020 to January 2021, 393 parents from 235 families reported five times on parent mental health, child behavior problems, family relationships, and pandemic-related stressors. Findings indicate that, across all domains of well-being, there was either little change across the 8 months or a small degree of recovery followed by a shift to further deterioration. On average, parents experiencing greater pandemic-related stressors also reported poorer functioning in all domains; monthly fluctuations in pandemic-related stressors were also associated with fluctuations in parent mental health and child behavior problems. In some domains, the links between pandemic-related stressors and parent and child well-being were stronger among families living in areas with overall higher COVID-19 prevalence rates. Parents' experiences during the pandemic did not differ systematically across prior intervention participation or parent gender. Taken together, findings suggest a need for supportive interventions to help families navigate extended periods of crisis.

Longitudinal Associations Among Service Members' PTSD Symptoms, Partner Accommodation, and Partner Distress.

Romantic partners' accommodation of trauma survivors' posttraumatic stress disorder (PTSD) symptoms (e.g., participating in avoidance and safety behaviors, not expressing one's thoughts and feelings) is a putative mechanism linking PTSD symptoms and partner distress, but this hypothesis has never been empirically tested. The current study investigated this proposed within-couple mediation process from service members' PTSD symptoms to partners' depressive symptoms and relationship satisfaction through partner accommodation, as well as between-couple associations among these constructs and the possible moderating role of partners' conflict avoidance and helplessness (CAH) motivations for accommodating service members' PTSD symptoms. We examined these questions in 272 male service member/female civilian couples assessed four times over an 18-month period using the multiple-group version of the random intercept cross-lagged panel model. Within couples, service members' higher levels of PTSD symptoms at one time point significantly predicted partners being more accommodating at the next time point (ßs = .14-.19), which, in turn, significantly predicted higher levels of partner depressive symptoms at the subsequent time point (ßs = .09-.19) but did not predict partners' subsequent relationship satisfaction. At the between-couple level, partner accommodation was significantly positively associated with partners' depressive symptoms only among those endorsing high CAH motivations for accommodation (r = .50). In addition, accommodation was significantly negatively associated with partners' relationship satisfaction regardless of CAH motivation level (rs = -.43 to -.49). These findings are discussed in light of the potential for couple-based treatments for PTSD to enhance partner individual and relational well-being.

Does coparenting improve during the OurRelationship program? Explorations within a low-income sample during the COVID-19 pandemic.

Low-income couples are at an increased risk for relationship instability and divorce, which can have residual impacts on coparenting between the two partners. Growing evidence suggests that brief online relationship education programs can be an effective tool for alleviating relationship distress among low-income couples. However, findings remain mixed when it comes to whether benefits from relationship-focused programs not explicitly addressing coparenting spillover to coparenting among those with children. This preregistered study sought to investigate whether couples participating in an evidence-based online relationship-focused intervention, the OurRelationship program, experienced improvements in coparenting during the coronavirus disease 2019 (COVID-19) pandemic. To expand on the existing literature, coparenting outcomes assessed included partners' gatekeeping behaviors in addition to coparenting satisfaction, given their important implications for partner involvement in parenting. We also examined the extent to which changes in coparenting were moderated by pre-post gains in relationship satisfaction, child gender, division of childcare, and pandemic disruptions. In a sample of 136 low-income couples (N = 272 individuals) and a one-group/pre-post design, we found medium-sized gains in relationship satisfaction (Cohen's d = .76) and small-sized improvements in all coparenting aspects assessed (|d|s = .29-.39). Couples with greater gains in relationship satisfaction experienced greater improvements in coparenting; further, coparenting changes were robust to other moderators. Taken together, findings suggested that brief online relationship education programs, such as the OurRelationship program, may be a promising option to improve coparenting among relationally distressed low-income couples with children during a global health crisis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Religious Coping and Gender Moderate Trajectories of Marital Love among Black Couples.

An increasing body of work documents the roles of religion and spirituality in Black American marriages. We built on this research to examine religious coping as a potential cultural resource for Black marriages using a dyadic analytic approach with longitudinal data. Specifically, we investigated the effects of positive (i.e., sense of spiritual connectedness) and negative (i.e., spiritual tension or struggle) religious coping on trajectories of marital love reported by wives and husbands in 161 Black, married, mixed-gender couples, and we tested the potential moderating role of spouse gender. At baseline, spouses reported on their religious coping, and they rated their marital love at baseline and during two additional home interviews conducted annually. Data were analyzed using growth curve modeling within an Actor-Partner Interdependence Modeling framework. Husbands who reported more positive religious coping at baseline exhibited relatively high and stable marital love over time, whereas those who reported less positive religious coping reported less love at baseline and exhibited declines in love over time. Wives who reported less negative religious coping at baseline were higher in marital love initially but showed declines over time, whereas those who reported more negative religious coping at baseline were lower in marital love initially but showed increases in love over time. Results highlight the importance of further research on the role of religion and religious coping in Black couples' marital experiences and suggest differential roles of positive and negative religious coping for men's and women's marital love. Clinical and policy implications are discussed.

Cada vez más investigaciones documentan los papeles que desempeñan la religión y la espiritualidad en los matrimonios afroestadounidenses. Utilizamos estas investigaciones como punto de partida para analizar el afrontamiento religioso como posible recurso cultural para los matrimonios de color usando un método analítico diádico con datos longitudinales. Específicamente, investigamos los efectos del afrontamiento religioso positivo (p. ej.: la sensación de conexión espiritual) y negativo (p. ej.: la tensión o la lucha espiritual) en las trayectorias del amor conyugal informado por esposas y esposos en 161 parejas de color, casadas y de género mixto, y evaluamos el posible rol moderador del género del cónyuge. En el momento basal, los cónyuges informaron sobre su afrontamiento religioso y calificaron su amor conyugal en el momento basal y durante otras dos entrevistas en el hogar realizadas anualmente. Se analizaron los datos usando el modelo de curva de crecimiento dentro de un marco del modelo de interdependencia actor-pareja. Los esposos que informaron un afrontamiento religioso más positivo en el momento basal demostraron un amor conyugal relativamente alto y estable con el paso del tiempo, mientras que los que informaron un afrontamiento menos positivo indicaron menos amor en el momento basal y demostraron disminuciones en el amor con el paso del tiempo. Las esposas que informaron menos afrontamiento religioso negativo en el momento basal tuvieron un amor conyugal más alto inicialmente, pero demostraron disminuciones con el paso del tiempo, mientras que aquellas que informaron un afrontamiento religioso más negativo en el momento basal tuvieron menos amor conyugal inicialmente, pero demostraron aumentos del amor con el paso del tiempo. Los resultados destacan la importancia de realizar más investigaciones sobre el papel que desempeñan la religión y el afrontamiento religioso en las experiencias conyugales de las parejas de color, y sugieren que el afrontamiento religioso positivo y negativo desempeña distintos roles en el amor conyugal de los hombres y las mujeres. Se comentan las implicancias clínicas y políticas.

Online relationship education for help-seeking low-income couples: A Bayesian replication and extension of the OurRelationship and ePREP programs.

Low-income couples are at increased risk for relationship instability and divorce. In response, online relationship education programs such as ePREP and OurRelationship have been developed to more easily reach this population. A previous trial indicated that these programs promote relationship functioning (Doss et al., 2020) and individual well-being (Roddy et al., 2020a). However, given that these effects were notably larger than previous studies of in-person relationship education and approached effect sizes observed in couple therapy, it is possible that the magnitude of these effects was somewhat spurious; therefore, these findings need replication. The current manuscript seeks to replicate these programs' previous effects on relationship functioning and determine whether these effects are stable. Using a sample of 671 low-income couples seeking relationship help (N = 1337 individuals) and Bayesian estimation, the current study replicated previous findings that the OurRelationship and ePREP programs offered with four coaching calls produced reliable improvements in relationship functioning relative to a 6-month waitlist control group. There were no statistically reliable differences between the two active interventions. Bayesian analyses indicated that the effects of the two online programs were larger than the average effects of in-person relationship education for low-income couples reported in previous studies, roughly equivalent to efficacy studies of in-person relationship education reported in previous studies, smaller than those that resulted from the OurRelationship program delivered to distressed couples without an income requirement and smaller than couple therapy.

Las parejas de bajos recursos tienen mayor riesgo de inestabilidad en las relaciones y de divorcio. En respuesta a esto, se han desarrollado programas de educación sobre las relaciones, como ePREP y OurRelationship, con el fin de llegar más fácilmente a esta población. Un ensayo previo indicó que estos programas promueven el funcionamiento de las relaciones (Doss et al., 2020) y el bienestar individual (Roddy et al., 2020a). Sin embargo, teniendo en cuenta que estos efectos fueron notablemente mayores que los de estudios previos de la educación presencial sobre las relaciones y que abordaron tamaños del efecto observados en la terapia de pareja, es posible que la magnitud de estos efectos fuera de alguna manera falsa, por lo tanto, estos resultados necesitan repetirse. En el presente manuscrito se busca reproducir los efectos previos de estos programas en el funcionamiento de la relación y determinar si estos efectos son estables. Utilizando una muestra de 671 parejas de bajos recursos que buscaban ayuda para las relaciones (N = 1337 personas) y el cálculo bayesiano, el presente estudio reprodujo los resultados anteriores que ofrecieron los programas OurRelationship y ePREP con cuatro llamados de capacitación, generando mejoras fiables en el funcionamiento de la relación respecto de un grupo de referencia en lista de espera de seis meses. No hubo diferencias estadísticamente fiables entre las dos intervenciones activas. Los análisis bayesianos indicaron que los efectos de los dos programas virtuales fueron mayores que los efectos promedio de la educación presencial sobre las relaciones para parejas de bajos recursos informados en estudios previos, aproximadamente equivalentes a los de los estudios de eficacia de la educación presencial sobre las relaciones informados en estudios previos, menores que los obtenidos del programa OurRelationship impartido a parejas con distrés sin requisitos de ingresos, y menores que los de la terapia de pareja.

Relational impacts of capitalization in early parenthood.

Relationship difficulties are common during the transition to parenthood and may persist for years. Strategies that enhance couples' daily relational experiences early in the parenting years may serve a protective role. In general, engaging in a capitalization attempt (i.e., sharing personal good news) with one's romantic partner and perceiving the partner to be responsive are associated with better relationship outcomes among committed couples. However, it is unknown whether these relational benefits extend to the early parenting years or to other relational domains such as coparenting, which plays a central role in family functioning. The current study examined same-day associations between couples' capitalization process and relationship closeness and perceived coparenting support in a dyadic context during the first year of parenthood. A subsample of primarily non-Hispanic White coresident mixed-gender couples who participated in a randomized controlled trial of a transition to parenthood program (N = 141) completed daily diaries at 10 months postpartum for 8 consecutive days. On days when mothers shared, both partners reported greater closeness. On days when fathers shared, mothers reported greater closeness and perceived coparenting support. Furthermore, perceived partner responsiveness was associated with greater closeness for both partners and greater coparenting support for fathers. Fathers also perceived greater closeness and coparenting support on days when mothers shared about the child. Findings highlight the potential benefits of capitalization in early parenthood for both closeness and perceived coparenting support and suggest that capitalization may be a low cost, high yield strategy for enhancing new parents' daily relational experiences. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Anxiety, depression and PTSD among children and their parent during 2019 novel coronavirus disease (COVID-19) outbreak in China.

Home quarantine may lead to families developing a variety of psychological distress. The purpose of this study was to examine the psychological status of children and their parent during 2019 coronavirus disease (COVID-19) outbreak in China. Data were collected from children (n = 1360) and their parent (n = 1360) in China using online survey during February 2020. Demographic information, media exposure, and psychological status including anxiety, depression and posttraumatic stress disorder (PTSD) symptoms were assessed using self-report measures. The results indicated that, for children, 1.84% experienced moderate anxiety, 2.22% experienced depression and 3.16% met the diagnostic criteria for PTSD; for parent, 1.18%, 0.01% and 3.60% experienced moderate anxiety, severe depression, and moderate depression, respectively, and 3.53% met the diagnostic criteria for PTSD. Moreover, excessive media exposure (ß = -0.08 ~ 0.13, ps < 0.05) was a risk factor for anxiety and PTSD for children, a positive factor against anxiety and depression for parent. Being a mother (ß = 0.07 ~ 0.21, ps < 0.01), being younger (ß = -0.09 ~ -0.07, ps < 0.05), lower levels of educational attainment (ß = -0.17 ~ -0.08, ps < 0.01) and family monthly income (ß = -0.17 ~ -0.11, ps < 0.05) were risk factors for anxiety, depression and PTSD for parent. Findings suggested that children and their parent in non-severe area didn't suffer major psychological distress during the outbreak. Factors associated with lower levels of mental health problems were identified to inform the use of psychological interventions to improve the mental health of vulnerable groups during the pandemic.

Effectiveness of cognitive behavioral conjoint therapy for posttraumatic stress disorder (PTSD) in a U.S. Veterans Affairs PTSD clinic.

Cognitive behavioral conjoint therapy (CBCT) for posttraumatic stress disorder (PTSD) is a 15-session conjoint treatment for PTSD designed to improve PTSD symptoms and enhance intimate relationship functioning. Numerous studies of CBCT for PTSD document improvements in patient PTSD and comorbid symptoms, partner mental health, and relationship adjustment. However, little is known about its effectiveness in real-world clinical settings. Using an intention-to-treat sample of couples who participated in CBCT for PTSD in an outpatient U.S. Veterans Affairs (VA) PTSD clinic (N = 113), trajectories of session-by-session reports of veterans' PTSD symptoms and both partners' relationship happiness were examined. Across sessions, there were significant reductions in veteran-rated PTSD symptoms, d = -0.69, and significant increases in veteran- and partner-rated relationship happiness, ds = 0.36 and 0.35, respectively. Partner ratings of veterans' PTSD symptoms increased before significantly decreasing, d = -0.24. Secondary outcomes of veteran and partner relationship satisfaction, ds = 0.30 and 0.42, respectively; veteran and partner depressive symptoms, ds = -0.75 and -0.29, respectively; and partner accommodation of PTSD symptoms, d = -0.44, also significantly improved from pre- to posttreatment. The findings suggest that CBCT for PTSD was effective for decreasing PTSD and comorbid symptoms in veterans, as well as for improving relationship functioning and partners' mental health, among a sample of real-world couples seeking treatment in a VA PTSD specialty clinic.

Secondary individual outcomes following multicouple group therapy for posttraumatic stress disorder: An uncontrolled pilot study with military dyads.

Cognitive-behavioral conjoint therapy (CBCT) for posttraumatic stress disorder (PTSD) has demonstrated efficacy for improving PTSD and comorbid symptoms and relationship adjustment. To enhance treatment efficiency and scalability, we developed a 2-day, abbreviated, intensive, multicouple group version of CBCT for PTSD (AIM-CBCT for PTSD). Prior work demonstrated that AIM-CBCT for PTSD wasassociated with reductions in PTSD and comorbid symptoms in a sample of 24 post-9/11 active duty military or veteran couples who received the treatment in a retreat format over a single weekend. The current study investigated secondary outcomes regarding trauma-related cognitions, psychosocial impairment, and insomnia. For trauma-related cognitions, reductions were nonsignificant and small at 1-month follow-up, ds = -0.14 to -0.32. However, by 3-month follow-up, there were significant, medium effect size reductions in total trauma-related cognitions, d = -0.68, and negative views of self and others, ds = -0.64 and -0.57, respectively, relative to baseline. There was also a nonsignificant, small-to-medium effect-size reduction in self-blame, d = -0.43, p = .053, by 3-month follow-up. For psychosocial impairment, there were significant and medium-to-large and large effect size reductions by 1- and 3-month follow-ups, ds = -0.73 and -0.81, respectively. There were nonsignificant, small effect size reductions in insomnia at both 1- and 3-month follow-ups relative to baseline, ds = -0.30 and -0.34, respectively. These findings suggest that AIM-CBCT for PTSD is associated with reductions in maladaptive posttraumatic cognitions and psychosocial impairment but that adjunctive interventions may be needed to address insomnia.

Make up or break up? Charting the well-being of low-income help-seeking couples through the breakup process.

Divorce or separation concerns have typically been identified as a common reason why couples seek treatment for their relationship. However, to our knowledge, no study has investigated the breakup process in a help-seeking sample. Using a low-income sample of individuals who broke up with their partner during a large randomized controlled trial investigating the effects of two web-based relationship education programs (NBroke up = 286), and a matched sample of individuals who did not break up (NMatched = 286; NTotal = 572), the current study sought to: (a) examine changes in individual functioning and co-parenting among those who broke up; (b) examine post-breakup differences in changes between those who did and did not break up; and (c) identify moderators of any differential post-breakup functioning between those who did and did not break up. Results revealed that web-based relationship education leads to decreases in psychological and perceived stress prior to the breakup. After matching on pre-breakup characteristics, no post-breakup differences in individual functioning or co-parenting were found between those who did and did not break up. Furthermore, few variables moderated individuals' adjustment to breaking up. Therefore, breaking up may not be as detrimental to individual well-being as once anticipated. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Closer Examination of Relational Outcomes from a Pilot Study of Abbreviated, Intensive, Multi-Couple Group Cognitive-Behavioral Conjoint Therapy for PTSD with Military Dyads.

Cognitive-behavioral conjoint therapy for posttraumatic stress disorder (CBCT for PTSD) is associated with improvements in patients' PTSD symptoms, partners' psychological distress, and relationship satisfaction. However, little is known about whether CBCT for PTSD is associated with changes in other relationship domains that have theoretical and clinical relevance to the relational context of PTSD. The current study is a secondary analysis of relational outcomes from an uncontrolled, within-group trial designed to examine whether an abbreviated, intensive, multi-couple group version of CBCT for PTSD (AIM-CBCT for PTSD) delivered in a retreat during a single weekend was associated with improvements in PTSD symptoms and relationship satisfaction. In this investigation, we examined whether AIM-CBCT for PTSD is also associated with improvements in ineffective arguing, supportive dyadic coping by partner, joint dyadic coping, and partners' accommodation of patients' PTSD symptoms. Participants were 24 couples who included a post-9/11 U.S. service member or veteran with PTSD. At 1- and 3-month follow-up, patients reported significant reductions in couples' ineffective arguing (ds = -.71 and -.78, respectively) and increases in supportive dyadic coping by partners relative to baseline (ds = .50 and .44, respectively). By 3-month follow-up, patients also reported significant increases in couples' joint dyadic coping (d = .57), and partners reported significant reductions in their accommodation of patients' PTSD symptoms (d = -.44). Findings suggest that AIM-CBCT for PTSD is associated with improvements in multiple relationship domains beyond relationship satisfaction but that these may be differentially salient for patients and partners.

La terapia cognitivo-conductual conjunta para el trastorno por estrés postraumático (TCC para el TEPT) está asociada con mejoras en los síntomas de TEPT de los pacientes, en el distrés psicológico de sus parejas y en la satisfacción con la relación. Sin embargo, se sabe poco acerca de si la TCC para el TEPT está asociada con cambios en otros aspectos de la relación que son de interés teórico y clínico para el contexto relacional del TEPT. El presente estudio es un análisis secundario de los resultados relacionales de un ensayo intragrupal no controlado diseñado para analizar si una versión grupal multipareja, intensiva y abreviada de la TCC para el TEPT (MIA-TCC para el TEPT) practicada en un retiro durante un solo fin de semana estuvo asociada con mejoras en los síntomas de TEPT y en la satisfacción con la relación. En esta investigación, analizamos si la MIA-TCC para el TEPT también está asociada con mejoras en las discusiones ineficaces, en el afrontamiento diádico comprensivo de la pareja del paciente, en el afrontamiento diádico conjunto y en la adaptación de las parejas de los pacientes a sus síntomas de TEPT. Los participantes fueron 24 parejas en las que había un miembro o veterano de las Fuerzas Armadas de los Estados Unidos que prestó servicio con posterioridad al 11/9 y que tenía TEPT. En el seguimiento del mes y de los tres meses, los pacientes informaron reducciones significativas de las discusiones ineficaces de la pareja (ds = -0.71 y -0.78, respectivamente) y aumentos del afrontamiento diádico comprensivo de sus parejas en relación con el momento basal (ds = 0.50 y 0.44, respectivamente). En el seguimiento de los tres meses, los pacientes también informaron aumentos significativos del afrontamiento diádico conjunto de las parejas (d = 0.57), y sus parejas informaron reducciones significativas de su adaptación a los síntomas de TEPT de los pacientes (d = -0.44). Los resultados sugieren que la MIA-TCC para el TEPT está asociada con mejoras en varios aspectos de las relaciones aparte del de la satisfacción en la pareja, pero que estos pueden tener una importancia diferente para los pacientes y sus parejas.

Coparenting and parenting outcomes of online relationship interventions for low-income couples.

Web-based relationship programs are effective in improving low-income couples' relationship functioning. However, little is known about: (a) whether parenting couples presenting for relationship help also have difficulties in coparenting and parenting, (b) whether relationship-focused programs can improve these two domains, and (c) whether program effects differ across baseline levels of those domains. We examined these questions in a parenting subsample (Nindividuals = 934) and a coparenting subsample (Ndyads = 342) of low-income couples participating in a randomized controlled trial of two web-based relationship education programs-the OurRelationship (OR) program and the ePREP program. Although the majority of participants were relationally distressed at baseline, most coparents (83%) reported parenting well together. Parents "often" engaged in nurturing behaviors and "hardly ever" or "sometimes" felt overwhelmed by their parenting responsibilities. Among parents who had engaged in the harsh verbal discipline (59%) and physical discipline (28%) in the past month, the average frequency was 4.08 and 5.50 times per month, respectively. Moreover, compared to waitlist control parents, parents in OR but not ePREP reported significantly greater improvements in parental nurturance and harsh verbal discipline during the program. There was no evidence of program effects on coparenting, physical discipline, or parenting stress for OR or ePREP, nor was there any evidence of baseline functioning moderating program effects. Findings suggested that most low-income parents seeking relationship help did not have severe problems in coparenting or parenting and that effective relationship programs without a focus on coparenting and/or parenting had somewhat limited effects on these domains. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Heteronormative Relationship Education for Same-Gender Couples.

In recent years, same-gender group-based relationship education has emerged as a viable intervention to prevent relationship distress among same-gender couples. However, many of these programs are conducted in metropolitan areas and lack the ability to reach rural populations. The current study sought to investigate whether two wide-reaching web-based heteronormative relationship education programs could positively impact same-gender relationships. In a sample of 49 same-gender couples, heteronormative relationship education had small (Cohen's d = 0.16-0.39) but reliably positive effects on key areas of relationship functioning and perceived stress relative to a waitlist control group. Additionally, when same-gender couples were matched with different-gender individuals with similar baseline characteristics, no reliable differences between the two groups emerged even though the program effects were sometimes half as large for same-gender couples. Finally, same-gender participants were as satisfied with the program as the matched different-gender individuals. Though the results of the present study indicate that heteronormative relationship education can be helpful for same-gender couples, additional tailoring should be undertaken to ensure that same-gender couples experience as much benefit as possible. Estimates from the current study could be used in future studies to detect what might be small-sized differences.

En los últimos años, la capacitación en relaciones grupal y del mismo sexo ha surgido como una intervención viable para prevenir el distrés relacional entre parejas del mismo género. Sin embargo, muchos de estos programas se realizan en áreas metropolitanas y no pueden llegar a las poblaciones rurales. El presente estudio tuvo como finalidad investigar si dos programas de capacitación heteronormativa en relaciones, por Internet y de amplio alcance podrían tener un efecto positivo en las relaciones del mismo género. En una muestra de 49 parejas del mismo género, la capacitación heteronormativa en relaciones tuvo efectos pequeños (d de Cohen = 0.16-0.39) pero fiablemente positivos en áreas clave del funcionamiento relacional y del estrés percibido respecto de un grupo control en lista de espera. Además, cuando las parejas del mismo género se igualaron con personas de diferente género con características iniciales similares, no surgieron diferencias fiables entre los dos grupos, aunque los efectos del programa fueron a veces de la mitad para las parejas del mismo género. Finalmente, los participantes del mismo género estuvieron tan satisfechos con el programa como las personas de diferente género con quienes se las igualó. Aunque los resultados del presente estudio indican que la capacitación heteronormativa en relaciones puede ser útil para parejas del mismo género, deberían realizarse más adaptaciones para garantizar que las parejas del mismo género tengan todos los beneficios posibles. En futuros estudios podrían usarse cálculos del presente estudio para detectar las posibles diferencias pequeñas.