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1.
J Sex Marital Ther ; 49(1): 1-16, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35451914

RESUMO

Sexual activity occurs among a large portion of young adults and adolescents, including high school students. While about 40% of high school students nationwide have engaged in sexual intercourse, more information is needed about how individual characteristics may relate to larger patterns of adolescent sexual behavior. This exploratory study utilized a latent class analysis (LCA) to identify clusters of high school students (N = 801) based on demographic characteristics, sexual refusal skills, healthy relationship skills, sociosexuality, internalizing symptoms, alcohol use, various forms of social support (i.e., parents, friends, teachers), and sexual activity at baseline to predict their sexual behavior at a 6-month follow-up. Four unique latent classes were identified based on these baseline predictors. Distinctions in the profiles of high schoolers varied significantly by internalizing symptoms, race/ethnicity, sexually conservative attitudes, and social support in the prediction of adolescent sexual activity at 6-months. This study contributes to the investigation of demographic, social, psychological, attitudinal, and behavioral factors that may distinguish high school students from one another in terms of their longitudinal rates of sexual activity.


Assuntos
Comportamento do Adolescente , Coito , Adolescente , Adulto Jovem , Humanos , Análise de Classes Latentes , Comportamento Sexual , Consumo de Bebidas Alcoólicas , Comportamento do Adolescente/psicologia , Estudantes/psicologia
2.
Arch Sex Behav ; 52(1): 233-241, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36169774

RESUMO

Youth sex and relationship education programs aim to improve adolescent well-being by changing their knowledge, beliefs, and attitudes regarding sex and their health. However, there is a gap in existing research linking these cognitive targets to relevant behaviors, and a particular dearth of data on links with sexual behaviors. The current study tested longitudinal links between cognitive factors related to sex (attitudes about sex, normative beliefs, risk-avoidant intentions, and confidence in refusal skills) and outcomes of sexual behaviors (recent sexual encounters, number of sexual partners, and frequency of condom use). Data were drawn from three waves of data from a panel study of US high-school students and were analyzed using cross-lagged structural equation modeling. We hypothesized direct, reciprocal links between intentions and behaviors, but this hypothesis was not supported. Instead, more conservative attitudes about sex emerged as the most consistent prospective predictor of fewer sexual encounters and sexual partners, though with small effect sizes (ßs = - .08 to - .131, ps < .05). Further, bidirectional interrelationships were observed among several of the cognitive and behavioral variables over time. These results highlight attitudes about sex as a potentially useful intervention target, but also suggest that sex and relationship education curricula and evaluations should consider multiple pathways of links between cognition and behavior. Continued research is needed on causal links between adolescents' sexual attitudes, knowledge, intentions, and behavior.


Assuntos
Preservativos , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Adolescente , Comportamento Sexual , Parceiros Sexuais , Sexo Seguro
3.
Fam Process ; 62(1): 201-215, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-35233770

RESUMO

The federal government, through the Administration for Children and Families (ACF), has funded community-based relationship education programs for couples, individuals, and families, with a strong focus on serving economically disadvantaged and racially diverse families. This study evaluated the impact of a 36-hour, workshop-based couple relationship education program that was funded by ACF using a randomized controlled trial (RCT) design and intent-to-treat (ITT) analyses. Participants were 1320 couples who were either expecting a baby or had a baby within the past 3 months, at the time of enrollment. Follow-up surveys were administered 12 months later. Analyses evaluated program impacts on relationship stability, constructive communication, and destructive conflict compared to a no-treatment control group. Analyses showed a statistically significant impact of the program on destructive conflict (d = 0.10) but not on constructive communication (d = 0.06) or stability (dCox  = 0.10). Based on findings from previous evaluations, we also examined whether participants' levels of sociodemographic disadvantage moderated these effects. There was significant moderation by sociodemographic disadvantage on constructive communication and destructive conflict, but not on stability. Effects were observed for those at higher levels of sociodemographic disadvantage.


Assuntos
Comunicação , Motivação , Criança , Humanos , Avaliação de Programas e Projetos de Saúde
4.
Fam Process ; 61(3): 1062-1079, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-34845722

RESUMO

The current study presents implementation and impact data from a cluster randomized trial of a youth relationship education curriculum. High school students (n = 1,135) were randomized at the school level to receive curricula-as-usual or a healthy relationships program delivered by facilitators who were not employed by the high schools. Program evaluators reported high engagement and students indicated high satisfaction with the program, but multilevel models showed no statistically significant impacts on healthy relationship skills, attitudes, and behaviors at three and nine months post-intervention. Strengths and limitations of the research design and program implementation, as well as implications for evaluating youth relationship education more broadly, are discussed.


El estudio actual presenta datos de implementación e impacto de una prueba controlada aleatoriade una intervención de educación sobre relaciones para juveniles. Los estudiantes de secundaria (n= 1,135) fueron asignados al azar a nivel escolar para recibir un plan de estudios como decostumbre o un programa de relaciones saludables entregado por facilitadores que no eranempleados de las escuelas secundarias. Evaluadores de programas informaron un alto compromisoy los estudiantes indicaron una alta satisfacción con el programa, pero los modelos multinivel nomostraron impactos estadísticamente significativos en las habilidades de relación saludable,actitudes, y comportamientos a los tres y seis meses después de la intervención. Se discutefortalezas y limitaciones del diseño de la investigación y la implementación del programa, asícomo las implicaciones para la evaluación de los jóvenes.


Assuntos
Currículo , Instituições Acadêmicas , Adolescente , Humanos , Avaliação de Programas e Projetos de Saúde , Estudantes
5.
Fam Process ; 61(1): 259-277, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-33904162

RESUMO

A large and diverse literature has shown that parent-child relationship quality shapes development to affect later romantic relationship functioning. Guided by the developmental psychopathology framework, the current systematic review aimed to characterize the links between two major subtypes of parent-child relationship quality (parent-child attachment security and interaction quality) and several romantic relationship outcomes (i.e., adjustment, attachment security, aggression, and observed interaction quality), as well as to identify mechanisms accounting for these associations. We focused on studies that included both members of a couple/partnership for dyadic assessment of romantic relationship functioning, to more accurately and fully capture both partners' perspectives. A total of 40 articles met inclusion criteria, most of which sampled early/emerging adult couples between the ages of 18 and 26 years. Findings suggest that parent-child attachment security and interaction quality have similar associations with dyadic romantic relationship functioning, with the strongest evidence of effects on romantic relationship adjustment and observed interactions between romantic partners. Many studies found gender differences in effects, as well as cascading effects across development and over the course of a relationship. We argue that it is important for future studies to explore effects of one partner's parent-child relationship quality history on the other partner's romantic relationship adjustment and behavior, and to evaluate the extent to which parent-child attachment security mediates associations between parent-child interaction quality and romantic relationship functioning.


Se ha demostrado en publicaciones completas y variadas que la calidad de la relación entre padres e hijos determina el desarrollo de una manera que influye en el funcionamiento posterior de las relaciones amorosas. Guiado por el marco de la psicopatología evolutiva, el presente análisis sistemático tuvo como finalidad caracterizar los vínculos entre dos grandes subtipos de calidad de la relación entre padres e hijos (seguridad en el apego entre padres e hijos y calidad de la interacción) y varias consecuencias en las relaciones amorosas (p. ej.: adaptación, seguridad en el apego, agresión y calidad de la interacción observada), así como identificar los mecanismos que dan cuenta de estas asociaciones. Nos centramos en estudios que incluyeron tanto a integrantes de una pareja/asociación para la evaluación diádica del funcionamiento de las relaciones amorosas con el fin de captar más precisa y completamente las perspectivas de ambos integrantes de la pareja. Cuarenta artículos en total cumplieron con los criterios de inclusión, la mayoría de los cuales usaron como muestras a parejas de adultos emergentes de entre 18 y 26 años. Los resultados indican que la seguridad en el apego entre padres e hijos y la calidad de la interacción tienen asociaciones similares con el funcionamiento diádico de las relaciones amorosas, y que los indicios más claros de los efectos están en la adaptación de las relaciones amorosas y las interacciones observadas entre los integrantes de la relación amorosa. En muchos estudios se hallaron diferencias de género en los efectos, así como efectos dominó a lo largo del desarrollo y durante el transcurso de una relación. Sostenemos que es importante para estudios futuros analizar los efectos del historial de la calidad de la relación entre padres e hijos de uno de los integrantes de la pareja en la adaptación a la relación amorosa y la conducta del otro integrante de la pareja, y evaluar hasta qué punto la seguridad en el apego entre padres e hijos actúa como mediadora de las asociaciones entre la calidad de la interacción entre padres e hijos y el funcionamiento de la relación amorosa.


Assuntos
Relações Interpessoais , Apego ao Objeto , Adolescente , Adulto , Humanos , Relações Pais-Filho , Adulto Jovem
6.
Fam Process ; 61(3): 966-969, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36000213

RESUMO

The focus of this special section is impact studies that were conducted as part of the Administration for Children and Families' Healthy Marriage and Responsible Fatherhood initiative. This initiative has led to more than 2 million people receiving relationship education and fatherhood programs across the United States over the last two decades. Community organizations develop these programs, select their curricula and content, and run these programs in their local communities. Many programs funded in the 2015-2020 cohort of grantees included randomized controlled trials of program effectiveness; some of these studies are presented in this issue, with the goal of marrying the field of program evaluation and family science.


Assuntos
Casamento , Criança , Escolaridade , Humanos , Avaliação de Programas e Projetos de Saúde , Estados Unidos
7.
Fam Process ; 61(3): 1134-1143, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35146754

RESUMO

The field of relationship science has called for more research on the impact of relationship education on child outcomes, yet studies in this area remain sparse, particularly regarding maternal and infant health at birth. Research on group prenatal care demonstrates that individual-oriented group interventions have a positive impact on infant birth outcomes, suggesting the need to consider the impacts of other forms of group programming for women. The current study examined the impact of MotherWise, an individual-oriented relationship education and brief case management/coaching program for minority and low-income pregnant women, on birth outcomes. The study sample included 136 women who enrolled in a larger randomized controlled trial of MotherWise during early pregnancy. Although statistical power was limited due to the sample size and the effects were not outright significant at p < 0.05, results indicated that the effects of MotherWise on birth outcomes were small to moderate in size (0.23 for birthweight, 0.46 for preterm birth) and suggest important avenues for future tests of relationship education programs and their impacts on maternal and infant health. The current study suggests that relationship education during pregnancy could directly impact women's and infant's health.


Assuntos
Escolaridade , Cuidado Pré-Natal , Feminino , Humanos , Lactente , Recém-Nascido , Gravidez , Nascimento Prematuro , Cuidado Pré-Natal/métodos
8.
Fam Process ; 61(3): 1045-1061, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-34383314

RESUMO

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.


Assuntos
Terapia de Casal , Teorema de Bayes , Terapia de Casal/métodos , Divórcio , Emoções , Humanos , Pobreza
9.
J Sex Marital Ther ; 47(2): 130-146, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33107786

RESUMO

Pornography viewing has been cross-sectionally and longitudinally linked to poorer romantic relationship quality. However, only a few studies have looked at (1) the associations of changes in pornography viewing over time with relationship characteristics, (2) differential impacts of watching alone and watching with one's partner, and (3) how gender moderates these associations. The current study utilizes multilevel modeling to assess for between- and within-subject effects of watching pornography alone versus together on romantic relationship quality over time. A random national sample of 1,234 individuals, who began the study in unmarried heterosexual romantic relationships of at least 2 months' duration, completed five waves of mail-in surveys over a 20-month period. Watching pornography alone was generally associated with poorer relationship quality for men (e.g., lower relationship adjustment and commitment, less emotional intimacy), but better relationship quality for women. People who reported watching more pornography with their partner reported more relationship intimacy and increases in watching together over time were associated with increases in sexual intimacy. Both watching alone and watching together were related to higher levels of psychological aggression between partners, with few differences by gender. Implications for sex education, relationship education, and couples therapy will be discussed.


Assuntos
Literatura Erótica , Parceiros Sexuais , Feminino , Heterossexualidade , Humanos , Masculino , Comportamento Sexual , Inquéritos e Questionários
10.
J Trauma Stress ; 34(3): 596-606, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33372361

RESUMO

When service members manifest symptoms of posttraumatic stress disorder (PTSD), intimate partners may engage in behaviors to accommodate their partners' experiences (e.g., helping service members avoid situations that could make them uncomfortable, not expressing own thoughts and feelings to minimize PTSD-related conflict), which may inadvertently serve to maintain or increase PTSD symptoms over time. In a sample of 274 male service member/female civilian couples, we evaluated hypothesized bidirectional pathways between self-reported service member PTSD symptoms and partner accommodation, assessed four times over an approximately 18-month period. A random-intercept cross-lagged panel model disaggregating between and within effects revealed that, on average, couples in which the service member had higher levels of total PTSD symptoms also scored higher in partner accommodation, between-couple correlation, r = .40. In addition, at time points when service members' PTSD symptoms were higher relative to their own average symptom level, their partners' level of accommodation was also higher than their personal average, within-couple correlation r = .22. Longitudinally, service member PTSD symptom scores higher than their personal average predicted subsequent increases in partner accommodation, ß = .19, but not vice versa, ß = .03. Overall, the findings indicate both stable and time-specific significant associations between service member PTSD symptoms and partner accommodation and suggest that higher levels of PTSD symptoms are a significant driver of later increases in partner accommodation. These findings add further support for treating PTSD in an interpersonal context to address the disorder and concomitant relational processes that can adversely impact individual and relational well-being.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Emoções , Feminino , Humanos , Relações Interpessoais , Masculino , Comportamento Sexual , Parceiros Sexuais
11.
Fam Process ; 60(2): 477-492, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-32681747

RESUMO

The current study evaluates the effects of having a baby on relationship quality and stability, contrasting married and unmarried cohabiting parents (N = 179; 38% unmarried cohabiting). Participants provided several waves of data, including time points before, during, and after pregnancy. Results indicated that cohabiting parents broke up at a significantly higher rate after having a baby compared to married parents. In terms of relationship quality, interrupted time-series analyses indicated that negative communication significantly increased after baby regardless of marital status. In addition, married parents had significantly higher levels of relationship satisfaction and commitment before baby compared to cohabiting parents but experienced modest declines in relationship satisfaction after baby. Cohabiting parents did not show such declines but remained lower in satisfaction throughout the study. Gender moderated commitment trajectories, such that married and cohabiting women demonstrated decreased commitment after baby, but married and cohabiting men demonstrated no significant changes in commitment. This study adds to the literature by examining both relationship stability and relationship quality trajectories from before pregnancy to after the birth of a baby among married and cohabiting parents in the same sample. Implications of these findings for practice and future research are discussed.


El presente estudio evalúa los efectos de tener un bebé en la calidad y la estabilidad de la relación, contrastando los padres casados y los concubinos convivientes (N = 179; 38 % concubinos convivientes). Los participantes proporcionaron varias series de datos que incluyeron momentos antes, durante y después del embarazo. Los resultados indicaron que los padres concubinos se separaron a un índice considerablemente mayor después de tener un bebé en comparación con los padres casados. En cuanto a la calidad de la relación, los análisis de series de tiempo interrumpido indicaron que la comunicación negativa aumentó considerablemente después del bebé independientemente del estado civil. Además, los padres casados tuvieron niveles considerablemente más altos de satisfacción con la relación y de compromiso antes del bebé en comparación con los padres concubinos, pero tuvieron leves reducciones de la satisfacción con la relación después del bebé. Los padres concubinos no demostraron esas disminuciones pero mantuvieron una satisfacción más baja a lo largo del estudio. El género moderó las trayectorias de compromiso, de manera que las mujeres casadas y las concubinas demostraron un menor compromiso después del bebé, pero los hombres casados y los concubinos no demostraron cambios significativos en el compromiso. Este estudio enriquece la bibliografía analizando tanto las trayectorias de estabilidad de la relación como de calidad de la relación desde antes del embarazo hasta después del nacimiento de un bebé entre padres casados y padres concubinos en la misma muestra. Se debaten las consecuencias de estos resultados para la práctica y las futuras investigaciones.


Assuntos
Características da Família , Casamento , Feminino , Humanos , Masculino , Estado Civil , Pais , Satisfação Pessoal , Gravidez
12.
Fam Process ; 60(3): 712-726, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33876831

RESUMO

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.


Assuntos
Terapia de Casal , Militares , Transtornos de Estresse Pós-Traumáticos , Cognição , Humanos , Projetos Piloto , Transtornos de Estresse Pós-Traumáticos/terapia , Resultado do Tratamento
13.
Prev Sci ; 21(6): 861-871, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32108304

RESUMO

Relationship distress is a pervasive problem in the USA that disproportionally impacts couples with low-income levels. The goal of the present study was to evaluate the effectiveness of two online relationship interventions, OurRelationship and ePREP, both of which were supported by a paraprofessional coach, in improving mental health and physical health behaviors with low-income couples. Couples (N = 742) were randomized to either intervention or a 6-month waitlist control group and assessed pre-, mid-, and post-intervention as well at 4 and 6 months after randomization. Results from multilevel models indicated that during treatment, compared to couples in the waitlist group, couples in the intervention groups reported significantly greater improvements in mental health that were small to moderate in magnitude (psychological distress, anger, problematic alcohol use, and perceived stress) as well as improvements in physical health/health behaviors (perceived health, insomnia, and exercise) that were small in magnitude. Furthermore, the differences between intervention and waitlist groups were maintained over follow-up. Treatment gains in both mental health and physical health behaviors were generally stronger for those who began treatment with greater difficulties in those areas. Implications of these findings with regard to intervention and policy are discussed.


Assuntos
Terapia de Casal/métodos , Intervenção Baseada em Internet , Saúde Mental , Pobreza , Cônjuges/psicologia , Adulto , Feminino , Comportamentos Relacionados com a Saúde , Nível de Saúde , Humanos , Masculino , Avaliação de Programas e Projetos de Saúde , Estados Unidos , Adulto Jovem
14.
Subst Use Misuse ; 55(8): 1228-1236, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32133907

RESUMO

Background: Partner Assisted Smoking Cessation Treatment (PACT) was designed to improve smoking abstinence rates by integrating evidence-based relationship education strategies to build effective couple support into standard cognitive behavioral smoking cessation treatment (CBT). Methods: This small randomized clinical trial examined the feasibility, acceptability, and efficacy of PACT versus CBT in improving couple support processes and smoking outcomes, focusing on effect sizes. Thirty-eight smokers and their nonsmoking partners were randomized to and completed either PACT or CBT. Both treatments included 8 weekly group sessions and nicotine replacement therapy. Results: Treatment credibility and satisfaction were high and comparable between conditions, though perceived helpfulness and treatment engagement were higher in PACT (ds = .48-.68). Compared to CBT, PACT showed no difference in effects on perceived partner support, small effects on observed social support behaviors (ds = .23 to .46), a medium effect on dyadic efficacy (d = .63), and a large effect on active listening (d = .85). Biochemically-verified smoking abstinence rates did not differ between conditions at 12-week follow-up (CBT: 27.3%, PACT: 37.5%). Conclusions: PACT may have stronger effects than standard CBT on treatment engagement and some couple support processes, but not abstinence. Program refinement and testing in larger samples are needed.


Assuntos
Terapia Cognitivo-Comportamental , Abandono do Hábito de Fumar , Terapia Comportamental , Humanos , Fumar , Dispositivos para o Abandono do Uso de Tabaco
15.
Matern Child Health J ; 23(6): 756-767, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30600519

RESUMO

Objective To measure the proportion of women screened for IPV during prenatal care; to assess the predictors of prenatal IPV screening. Methods We use the CDC's 2012 Pregnancy Risk Assessment Monitoring System, representative of births in 24 states and New York City (N = 28,581). We calculated descriptive and logistic regressions, weighted to deal with state-clustered observations. Results 49.2% of women in our sample reported being screened for IPV while pregnant. There were higher screening rates among women of color, and those who had not completed high school, never been married, received WIC benefits, initiated prenatal care in the first trimester, and were publicly insured. State screening rates varied (29.9-62.9%). Among states, mandated perinatal depression screening or training was positively associated with IPV screening. 3.6% of women in our sample reported prenatal IPV but were not screened during pregnancy. Conclusions for Practice Current efforts have not led to universal screening. We need to better understand when and why providers do not screen pregnant patients for IPV.


Assuntos
Seguro Saúde/estatística & dados numéricos , Violência por Parceiro Íntimo/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Grupos Raciais/estatística & dados numéricos , Maus-Tratos Conjugais/diagnóstico , Adolescente , Adulto , Feminino , Humanos , Cobertura do Seguro/estatística & dados numéricos , Violência por Parceiro Íntimo/legislação & jurisprudência , Programas de Rastreamento/legislação & jurisprudência , Serviços de Saúde Materna , Gravidez , Gestantes , Cuidado Pré-Natal/legislação & jurisprudência , Cuidado Pré-Natal/métodos , Fatores Socioeconômicos , Maus-Tratos Conjugais/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
16.
Fam Process ; 58(2): 273-286, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30306547

RESUMO

Couple therapy has been shown to be a meaningful way to improve couples' relationships. However, less information is known about couples' functioning prior to entering treatment in community settings, as well as how their relationship functioning changes from initiating therapy onward. This study examined 87 couples who began community-based couple therapy during a longitudinal study of couples in the military. The couples were assessed six times over the course of 3 years, including time points before and after starting couple therapy. Using an interrupted-time series design, we examined trajectories across the start of couple therapy in relationship satisfaction, divorce proneness, and negative communication. The results demonstrated that couples' relationship satisfaction was declining and both divorce proneness and negative communication were increasing prior to entering couple therapy. After starting couple therapy, couples' functioning on all three variables leveled off but did not show further change, but previous experience in relationship education moderated these effects. Specifically, those who were assigned to the relationship education program (vs. control) demonstrated greater reductions in divorce proneness and greater increases marital satisfaction after starting therapy; however, they also started more distressed.


Se ha demostrado que la terapia de pareja es una manera valiosa de mejorar las relaciones de las parejas. Sin embargo, se cuenta con menos información acerca del funcionamiento de las parejas antes de comenzar un tratamiento en entornos comunitarios, así como acerca de la manera en que el funcionamiento de su relación cambia desde el inicio de la terapia en adelante. Este estudio analizó a 87 parejas que comenzaron terapia de pareja basada en la comunidad durante un estudio longitudinal de parejas en las fuerzas armadas. Se evaluó a las parejas seis veces durante el transcurso de tres años, incluidos momentos específicos antes y después de comenzar la terapia de pareja. Utilizando un diseño de series de tiempo interrumpido, analizamos las trayectorias a lo largo del comienzo de la terapia de pareja en la satisfacción con la relación, la propensión al divorcio y la comunicación negativa. Los resultados demostraron que la satisfacción con la relación de la pareja estaba disminuyendo y que tanto la propensión al divorcio como la comunicacióin negativa estaban aumentando antes de comenzar la terapia de pareja. Después de comenzar la terapia de pareja, el funcionamiento de las parejas en las tres variables se nivelaron pero no demostraron otros cambios, aunque la experiencia previa en capacitación en relaciones moderó estos efectos. Específicamente, los que fueron asignados al programa de capacitación en relaciones (frente al grupo de control) demostraron una mayor reducción de la propensión al divorcio y un mayor aumento de la satisfacción conyugal después de comenzar la terapia, sin embargo, también comenzaron la terapia más angustiados.


Assuntos
Terapia de Casal , Relações Interpessoais , Casamento/psicologia , Satisfação Pessoal , Adulto , Divórcio/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
17.
Fam Process ; 58(1): 214-231, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30294892

RESUMO

This study examined characteristics of individuals that are associated with being in asymmetrically committed relationships (ACRs), defined as romantic relationships in which there was a substantial difference in the commitment levels of the partners. These ACRs were studied in a national sample of unmarried, opposite-sex romantic relationships (N = 315 couples). Perceiving oneself as having more potential alternative partners was associated with increased odds of being the less committed partner in an ACR compared to not being in an ACR, as was being more attachment avoidant, having more prior relationship partners, and having a history of extradyadic sex during the present relationship. Additionally, having parents who never married was associated with being the less committed partner in an ACR but parental divorce was not. Although fewer characteristics were associated with being the more committed partner within an ACR, more attachment anxiety was associated with increased odds of being in such a position compared to not being in an ACR. We also address how some findings change when controlling for commitment levels. Overall, the findings advance understanding of commitment in romantic relationships, particularly when there are substantial asymmetries involved. Implications for both research on asymmetrical commitment as well as practice (e.g., therapy or relationship education) are discussed.


Este estudio examinó características de individuos que se encuentran en relaciones comprometidas asimétricamente (RCA), definidas como relaciones románticas en las que hay una diferencia significativa en los niveles de compromiso de cada pareja. Estas RCA fueron estudiadas en una muestra nacional de relaciones románticas solteras con el sexo opuesto (N = 315 parejas). La autopercepción de tener más alternativas posibles de parejas se asoció a una probabilidad mayor de ser la pareja menos comprometida en una RCA en comparación con no estar en una RCA, así como de evitar más los apegos, tener más parejas previas, y tener un historial de sexo extradiádico durante la relación actual. Además, tener padres que nunca se casaron se asoció a ser la pareja menos comprometida en una RCA, pero no así el divorcio de los padres. Aunque se asociaron menos características a ser la pareja más comprometida en una RCA, se asoció más ansiedad de apego a una probabilidad mayor de encontrarse en dicha posición en comparación con no estar en una RCA. También abordamos el tema de cómo cambian algunos hallazgos al controlar niveles de compromiso. En conjunto, los hallazgos avanzan el entendimiento del compromiso en relaciones románticas, especialmente cuando incluye asimetrías significativas. Se discuten las implicaciones tanto para la investigación del compromiso asimétrico así como la práctica (p.ej. terapia o educación de relaciones).


Assuntos
Características da Família , Relações Interpessoais , Apego ao Objeto , Parceiros Sexuais/psicologia , Adulto , Ansiedade/psicologia , Feminino , Humanos , Masculino , Pais/psicologia , Adulto Jovem
18.
Arch Sex Behav ; 47(3): 681-692, 2018 04.
Artigo em Inglês | MEDLINE | ID: mdl-29185093

RESUMO

Despite a growing number of female same-gender (FSG) relationships, couples-based research and interventions have focused primarily on mixed-gender couples. Consequently, research has applied a heteronormative lens to understanding some relationship factors, including sexuality. The current study sought to provide descriptive data regarding frequency and conceptualizations of sex across partners in FSG relationships, as well as to analyze how relationship factors are associated with sexual satisfaction in this population. Participants (N = 206) were 103 adult FSG couples who had been together for at least 2 months. Individuals provided self-report data on how they conceptualized sex, and actor-partner models were utilized to assess relationship factors associated with sexual satisfaction. Findings indicated that women in FSG relationships hold broad definitions of sex, with the majority of behaviors conceptualized as sex, including acts that involved partnered genital touching. In dyadic actor-partner models, sexual satisfaction was predicted by several factors including sexual frequency, emotional intimacy, and sexual intimacy. Unexpectedly, higher desired sexual frequency was associated with lower sexual satisfaction; however, this finding only emerged after controlling for actual sexual frequency, suggesting that discrepancies between desired and actual sex frequency may be important for FSG couples. Implications for clinical practice with FSG couples are explored, including a strength-based focus on broad conceptualizations of sex within this population and targeting relationship factors associated with sexual satisfaction.


Assuntos
Homossexualidade Feminina , Orgasmo , Satisfação Pessoal , Comportamento Sexual , Adulto , Feminino , Humanos
19.
Fam Process ; 57(4): 915-926, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29577268

RESUMO

This study examined the within-family and between-family associations between fathers' military-related PTSD symptoms and parent ratings of children's behavioral and emotional problems. The sample included married couples (N = 419) with children composed of a civilian wife and an active-duty husband serving in the U.S. Army. Results indicate that changes in fathers' PTSD symptoms over time were associated with corresponding changes in both mothers' and fathers' reports of child behavioral and emotional problems. These within-family findings were independent from between-family effects, which showed that higher average PTSD symptomatology was associated with more overall behavioral and emotional problems for children. This study uses advances in statistical methodologies to increase knowledge about how PTSD symptoms and child problems are related, both across different families and over time within families.


Assuntos
Pai/psicologia , Família Militar/psicologia , Doenças Profissionais/psicologia , Relações Pais-Filho , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Pré-Escolar , Feminino , Humanos , Masculino , Cônjuges/psicologia , Estados Unidos
20.
Arch Sex Behav ; 46(8): 2301-2311, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28785917

RESUMO

Although there is a large body of research addressing predictors of relationship infidelity, no study to our knowledge has specifically addressed infidelity in a previous relationship as a risk factor for infidelity in a subsequent relationship. The current study addressed risk for serial infidelity by following adult participants (N = 484) longitudinally through two mixed-gender romantic relationships. Participants reported their own extra-dyadic sexual involvement (ESI) (i.e., having sexual relations with someone other than their partner) as well as both known and suspected ESI on the part of their partners in each romantic relationship. Findings from logistic regressions showed that those who reported engaging in ESI in the first relationship were three times more likely to report engaging in ESI in their next relationship compared to those who did not report engaging in ESI in the first relationship. Similarly, compared to those who reported that their first-relationship partners did not engage in ESI, those who knew that their partners in the first relationships had engaged in ESI were twice as likely to report the same behavior from their next relationship partners. Those who suspected their first-relationship partners of ESI were four times more likely to report suspicion of partner ESI again in their next relationships. These findings controlled for demographic risk factors for infidelity and held regardless of respondent gender or marital status. Thus, prior infidelity emerged as an important risk factor for infidelity in next relationships. Implications for novel intervention targets for prevention of serial relationship infidelity are discussed.


Assuntos
Relações Extramatrimoniais/psicologia , Casamento/psicologia , Comportamento Sexual/psicologia , Parceiros Sexuais/psicologia , Enganação , Feminino , Humanos , Masculino , Fatores de Risco
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