Coping strategies, illness perceptions, and relationship dynamics contribute to female sexual function and sexual distress in Sjögren's syndrome.

BACKGROUND: Sexual dysfunction and sexual distress are common complaints for women with the autoimmune rheumatic disease Sjögren's syndrome (SS); however, the role of psychosocial and interpersonal factors has not previously been explored in SS. AIM: This study investigated whether psychosocial variables, such as coping strategies, illness perceptions, and relationship dynamics, contributed to sexual function and sexual distress for women with SS. METHODS: Participants with SS completed an online cross-sectional survey that included prevalidated questionnaires assessing sexual function, sexual distress, disease-related symptom experiences, cognitive coping strategies, illness perceptions, relationship satisfaction, and partners' behavioral responses. Multiple linear regression was used to identify factors significantly associated with sexual function (total Female Sexual Function Index [FSFI] score) and sexual distress (total Female Sexual Distress Scale score) for women with SS. OUTCOMES: Study outcome measures were the FSFI, Female Sexual Distress Scale, EULAR SjÓ§gren's Syndrome Patient Reported Index, numeric rating scale for vaginal dryness (0-10), Profile of Fatigue and Discomfort, Cognitive Emotion Regulation Questionnaire (CERQ), Brief Illness Perceptions Questionnaire (B-IPQ), West Haven-Yale Multidimensional Pain Inventory (WHYMPI), and Maudsley Marital Questionnaire. RESULTS: A total of 98 cisgender women with SS participated in the study (mean age = 48.13 years, SD = 13.26). Vaginal dryness was reported by 92.9% of participants, and clinical levels of sexual dysfunction (total FSFI score <26.55) were observed in 85.2% (n = 69/81) of cases. More vaginal dryness, lower CERQ positive reappraisal, and higher CERQ catastrophizing were significantly associated with poorer self-rated sexual function (R2 = 0.420, F3,72 = 17.394, P < .001). Higher CERQ rumination, lower CERQ perspective, lower WHYMPI distracting responses, and higher B-IPQ identity were significantly associated with higher sexual distress (R2 = 0.631, F5,83 = 28.376, P < .001). CLINICAL IMPLICATIONS: This study suggests that interpersonal and psychosocial factors are important contributors to sexual function and distress in women with SS and that the development of psychosocial interventions for this population is warranted. STRENGTHS AND LIMITATIONS: This study is one of the first to explore the impacts of coping strategies, illness perceptions, and relationship dynamics on sexual function and sexual distress for women with SS. Limitations of our study include its cross-sectional nature and narrow sample demographic, which limit the generalizability of our results to other population groups. CONCLUSION: Women with SS who utilized adaptive coping strategies had better sexual function and lower levels of sexual distress than women who utilized maladaptive coping strategies.

Supportive couple relationships buffer against the harms of HIV stigma on HIV treatment adherence.

INTRODUCTION: HIV stigma can impact couple relationships through stress or bring partners closer through shared experiences. Conversely, couple relationships may protect against the harms of stigma, including anticipated stigma on negative health outcomes. Yet few studies have assessed the potential link between HIV stigma, relationship dynamics, and antiretroviral therapy (ART) adherence. Using dyadic data from a cross-sectional study of Malawian couples living with HIV, we tested associations between anticipated stigma and: 1) relationship dynamics (e.g., trust, sexual satisfaction, communication) and partner support; and 2) self-reported ART adherence. METHODS: Heterosexual couples (211 couples, 422 individuals) with at least one partner on ART were recruited from clinics in Zomba, Malawi. Partners completed separate surveys on anticipated stigma, relationship dynamics, and ART adherence. Linear mixed models evaluated associations between anticipated stigma and relationship dynamics, and whether associations varied by gender. Generalized estimating equation models tested for associations between anticipated stigma and high ART adherence (90-100% vs. < 90%) at the individual level, and whether they were moderated by relationship dynamics at the couple level. RESULTS: Couples' relationship length averaged 12.5 years, 66.8% were HIV sero-concordant, and 95.6% reported high ART adherence. In multivariable models, sexual satisfaction (ß = -0.22, 95%CI = -0.41;-0.03, p = 0.020) and partner social support (ß = -0.02, 95%CI = -0.04;-0.01, p < 0.01) were negatively associated with anticipated stigma. Significant interaction effects showed that adherence is moderated in couples with higher partner support and sexual satisfaction such that adherence is lowest when anticipated stigma is high and social support is low, and that adherence is lowest when anticipated stigma is high and sexual satisfaction is low. CONCLUSIONS: Increased anticipated stigma is most associated with lower ART non-adherence at lower levels of social support and sexual satisfaction. Conversely, supportive and fulfilling relationships may buffer the negative association between stigma and ART adherence. Couples' interventions that focus on improving communication and support systems within couples could reduce the negative impacts of anticipated stigma on couples living with HIV.

Barriers and facilitators for sustainable weight loss in the pre-conception period among Danish women with overweight or obesity - a qualitative study.

BACKGROUND: The prevalence of overweight or obesity in women of reproductive age continues to increase. A high pre-pregnancy body mass index (BMI) has been shown to increase the risk of pregnancy complications and predispose offspring to childhood obesity. However, little is known about factors affecting women's ability to achieve sustainable weight management and very few studies have applied behavior change theory to qualitative data. AIM: This study aimed to explore barriers and facilitators for weight management among women with overweight or obesity, who wanted to lose weight before pregnancy. METHODS: We conducted semi-structured interviews with 17 women with a BMI ≥ 27 kg/m2, who planned to become pregnant in the near future. Data were analyzed using an abductive approach and the Capability, Opportunity, Motivation, and Behavior model was applied as a conceptual framework. RESULTS: The women's strongest motivator for pre-conception weight loss was their ability to become pregnant. Barriers to successful weight management included their partners' unhealthy behaviors, mental health challenges, competing priorities, and internalized weight stigmatization. The women described careful planning, partners' health behaviors, social support, and good mental health as facilitators for sustainable weight management. CONCLUSION: Our study provides insights into factors affecting weight management among women with overweight or obesity in the pre-conception period. Future interventions on weight management require a holistic approach, including a focus on social support, especially from the partner, and mental health, as well as an effort to limit internalized weight stigma.

Relationship Dynamics are Associated with Self-Reported Adherence but not an Objective Adherence Measure in Malawi.

Couple relationships can be leveraged to improve adherence to antiretroviral therapy (ART), but few studies have identified relationship factors to target in interventions in sub-Saharan Africa. We conducted a cross-sectional study with 211 couples in southern Malawi with at least one partner on ART to test for associations between ART adherence and relationship dynamics (intimacy, trust, relationship satisfaction, unity, commitment, and partner support). We measured ART adherence through subjective measures (patient and partner reports) and an objective measure (ART drug levels in hair) and hypothesized that more positive relationship dynamics (e.g., higher intimacy) would be associated with better adherence. Multi-level logistic and linear regression models were used to evaluate study hypotheses, controlling for the clustering of individuals within couples. High levels of adherence were found by all three measures. Unity, satisfaction, and partner support were associated with higher patient and partner reports of adherence, and additional relationship dynamics (intimacy, trust) were associated with higher partner reported adherence. No associations were found between relationship dynamics and drug levels in hair, although drug levels were high overall. Future studies should perform longitudinal assessments of relationship dynamics and objective metrics of adherence, and examine these associations in populations with lower adherence levels such as young women or individuals starting ART.

Maternal Pregnancy Wantedness and Perceptions of Paternal Pregnancy Wantedness: Associations with Perinatal Mental Health and Relationship Dynamics.

OBJECTIVES: This study examined maternal pregnancy wantedness and perceptions of paternal wantedness, and their associations with maternal perinatal mental health symptoms and relationship dynamics. METHODS: Low-income, ethnically-diverse pregnant women (N = 101, Mage = 29.10 years, SDage = 6.56, rangeage = 18-44; 37% Latina, 22% African-American, 20% White, 21% biracial/multiracial/other) completed semi-structured interviews of pregnancy wantedness coded by trained raters, and standardized instruments of depression and PTSD symptoms during pregnancy and at 3-4-months postpartum. RESULTS: While maternal pregnancy wantedness (rated from 0-Predominately Ambivalent, 1-Mixed, and 2-Predominately Positive) showed no significant associations, a couple-level scale that combined maternal wantedness and her perceptions of paternal wantedness (Equally Positive Wantedness, Mom Wants More, Dad Wants More and Equally Ambivalent) showed several significant associations. Compared to women in the Equally Positive group, women in the Mom Wants More group had significantly higher prenatal and postnatal depression symptoms, prenatal PTSD symptoms, and prenatal and postnatal relationship conflict; and lower prenatal and postnatal relationship support. Women in the Mom Wants More group also had significantly higher prenatal and postnatal depression symptoms and prenatal conflict; and lower prenatal support than women in the Dad Wants More group. CONCLUSIONS FOR PRACTICE: Women who perceive themselves as wanting the pregnancy more than their baby's father are at higher risk for mental health and relationship problems than women who perceive themselves and their partners as equally ambivalent. Providers should ask women about their perceptions of partners' pregnancy wantedness to inform delivery of targeted mental health and relationship-based intervention during pregnancy.

Relationship dynamics with male partners among girls in low-income communities of Ibadan, Nigeria: Risk for violence and health related consequences.

INTRODUCTION: This study explored the motivations for and relationship dynamics that may promote girls' vulnerability for intimate partner violence and sources of support reported in unhealthy relationships among girls residing in low-income communities in Ibadan, Nigeria. METHODS: Focus group discussions (n = 14; 122 girls) were conducted among girls aged 15-19 years, who reported having been in a relationship lasting at least 3 months. Girls were recruited from schools and worksites where partner violence has been reported in high proportions. Data were analysed using conceptual content analyses and independently coded by two researchers. RESULTS: Adolescent girls reported keeping their relationships secret from their parents. While girls reported that sometimes relationships were out of love, relationships were also often motivated by girls' financial need. The financial and secretive nature of these relationships appeared to place girls at risk for intimate partner violence, with sexual coercion, resulting in multiple adverse social and health outcomes, including sexually transmitted infections and unintended pregnancy. Girls reported that leaving an abusive relationship is especially difficult when girls rely financially, were sexually involved, pregnant, or have had a child with the male partner. Friends/peers, rather than girls' family, were often the source of support for intimate partner violence. CONCLUSION: Early identification of unhealthy relationships and supporting girls to be financially independent appear to be critical to reduce vulnerability to violence. Peer-based interventions may be most appropriate, given that girls' friends, rather than parents, were most often the source of support for intimate partner violence and other relationship challenges.

Women's perspectives on relationship dynamics with their partners and their role in HIV acquisition, HIV disclosure, hormonal contraceptive uptake, and condom use.

Background: Limited information exists about relationship dynamics and their role in HIV acquisition, HIV disclosure, hormonal contraceptive uptake, and condom use among women in Malawi.Methods: Ninety-seven women aged 18-45 years were randomly assigned to initiate the depot medroxyprogesterone acetate injectable or levonorgestrel implant from May 2014 to April 2015 in Lilongwe, Malawi. Women were recruited after randomisation to participate in semi-structured interviews about HIV and family planning using purposive sampling. Interviews were thematically analysed using within and between group comparisons.Results: We conducted individual interviews and/or focus group discussions with 41 women: 30 (73%) women living with HIV and 11 (27%) women not living with HIV. Most women living with HIV who participated in in-depth interviews disclosed their status to their partners, and most partners agreed to get HIV tested only after disclosure. Nearly all women said their partners agreed to use condoms, but few used them consistently. Nearly all women believed their current and former partners had outside partners. Most women living with HIV who participated in in-depth interviews believed their current or other serious partners were the source of their infection. Some women thought their partner's infidelity was due to their partner's disinterest in sex with them during menstrual/ breakthrough bleeding. Some women included their partners in contraceptive decision-making when the partner was supportive.Discussion: Relationship dynamics affected decision-making for contraceptive and condom use, as well as serodisclosure for the women living with HIV in the study. All women reported challenges with consistent condom use with their male partners, although contraceptive use was generally more acceptable. Women included their partners in their decision-making concerning contraceptive use when they were supportive.

The Influence of Relationship Dynamics and Sexual Agreements on Perceived Partner Support and Benefit of PrEP Use Among Same-Sex Male Couples in the U.S.

Use of Pre-exposure prophylaxis (PrEP) for HIV prevention by men who have sex with men (MSM) may be impacted by relationship dynamics. We assessed perceived partner support of PrEP use and benefit of PrEP by relationship characteristics among male couples. Baseline data from a randomized control trial of video-based HIV counseling and testing among male couples in the U.S. were used in adjusted multilevel regression models to assess individual and dyadic characteristics. Among 659 participants, 73.3% thought their partner would be supportive of their PrEP use; 26.7% reported their partner would not support PrEP use, which was significantly associated with intimate partner violence (IPV) (p = 0.008). Most (57.7%) did not believe PrEP would be beneficial to them or their partner. Couples with a sexual agreement allowing outside partners were significantly associated with higher perceived support of partners for PrEP (p < 0.001) and benefit of PrEP use (p < 0.001). Perceived partner support of PrEP was high but perceived benefit of PrEP was low, both shaped by relationship dynamics that highlight the need for tailored dyadic interventions. The association between perceived PrEP support and IPV points to the need to integrate relationship contexts in HIV prevention programs.

The Dynamics of Intimate Relationships and Contraceptive Use During Early Emerging Adulthood.

We investigate the immediate social context of contraceptive behaviors: specifically, the intimate relationship. We use the Relationship Dynamics and Social Life (RDSL) study (2008-2012), based on a random sample of 1,003 women ages 18-19 residing in a Michigan county. Women were interviewed weekly for 2.5 years, resulting in an age range of 18-22. We test three sets of hypotheses about change over time within a relationship, using relationship-level within-between models, which compare a couple's contraceptive behaviors across different times in the relationship. First, we find that a couple is less likely to use contraception when the relationship is more intimate and/or committed and that a couple becomes less likely to use contraception over time, regardless of intimacy and commitment. Second, we find that a couple using contraception becomes increasingly likely to choose hormonal over coital methods, but this change occurs as a relationship endures and is unrelated to intimacy and/or commitment. Third, we find that a condom-using couple's consistency does not decline when there is conflict; rather, consistency of condom use declines over time regardless of the relationship's characteristics. We also demonstrate that conflict and power imbalance increase reliance on hormonal methods among those using contraception; conflict decreases consistency among withdrawal (but not condom) users; and nonmonogamy increases reliance on condoms and decreases withdrawal consistency. The strong and consistent link between duration and contraceptive behaviors-regardless of intimacy, commitment, conflict, or power imbalance-suggests that the continual vigilance required for long-term contraceptive use is difficult during early emerging adulthood.

A Dyadic Investigation of Relationship Dynamics and Depressive Symptoms in HIV-Affected Couples in Malawi.

Depression is the leading cause of disability worldwide with health implications for people living with HIV. Primary partnerships like marriage could be protective against depression but may worsen depression depending on the relationship quality. We examined depression and its association with relationship dynamics in a cross-sectional sample of 211 HIV-affected married couples in Malawi. We fit multivariable multilevel linear regression models for depressive symptoms. Men and women reported similar levels of depressive symptoms; 28% had a score indicative of probable depression. Almost half of couples had at least one partner with probable depression. In the adjusted models, equality (B = - 0.22; p < 0.01) and unity (B = - 0.94; p < 0.05) were associated with fewer depressive symptoms while individuals with more experiences of physical (B = 0.81; p < 0.01), sexual (B = 0.87; p < 0.01), and emotional violence (B = 1.52; p < 0.001) had higher levels of depressive symptoms. Couples-based interventions aiming to improve relationships may address depression, especially in settings with inadequate mental health services.

Observed Family and Friendship Dynamics in Adolescence: a Latent Profile Approach to Identifying "Mesosystem" Adaptation for Intervention Tailoring.

Nuanced understanding of adolescents' interpersonal relationships with family and peers is important for developing more personalized interventions that prevent problem behaviors and adjustment issues. We used latent profile analysis (LPA) to classify a community sample of 784 adolescents with respect to their observed relationship dynamics with friends and family using videotaped observations and five-minute audiotaped speech samples collected at ages 16-17. The resulting latent classes served to predict behavioral and emotional health in early adulthood. The LPA of the video- and audio-coded observational variables revealed a three-class model: (1) the healthy relationship group (n = 587), representing low levels of deviant and drug use talk with friends and positive, noncoercive relationship with parents; (2) the disaffected group (n = 90), representing high levels of drug use talk with friends and negativity about their parent(s) in the five-minute speech sample; and (3) the antisocial group (n = 107), representing high levels of deviant talk, drug use talk, coercive joining with friends, and coerciveness in family interactions. In contrast to the healthy relationship group, the disaffected group showed elevated risk for substance use problems and depression and the antisocial group showed higher risk for substance use problems and committing violent crimes in early adulthood. Outcome differences between disaffected and antisocial groups were mostly nonsignificant. We discuss the viability of applying these findings to tailoring and personalizing family-based interventions with adolescents to address key dynamics in the family and friendship relationships to prevent adult substance use problems, depression, and violence.

Youth and young adult dating relationship dynamics and subsequent abusive outcomes.

INTRODUCTION: In order to prevent youth and young adult partner abuse, it is necessary to have a better understanding of dating relationship dynamics as the context for potential abusive interactions. METHODS: Youth and young adults (ages 10-18 at baseline) were surveyed along with a matched parent/caregiver. Data, including parent and youth responses (n = 437 youth/parent dyads), are drawn from the nationally representative Survey on Teen Relationships and Intimate Violence (STRiV). RESULTS: Applying latent class analytic techniques with seven different positive and problematic descriptors of dating relationships, this study found four classes of relationship dynamics representing healthy, unhealthy, intense, and disengaged relationships. The intense relationship dynamic class exhibits the strongest associations with reports of any youth and young adult partner abuse, as well as distinctly with the subtypes of psychological, physical, and sexual victimization and perpetration. CONCLUSIONS: Results demonstrate the importance of clinicians, parents and other responsible adults attending to an array of youth and young adult dating relationship dynamics rather than single indicators, to assess youth and young adult risk for involvement in abusive relationships.

Comparing same- and different-sex relationship dynamics: Experiences of young adults in Taiwan.

BACKGROUND: Few studies of same-sex relationships are able to capture the dynamics of these relationships from formation to dissolution, and even fewer provide evidence on these dynamics in a non-Western context. OBJECTIVE: Using retrospective relationship history data collected from a nationally representative sample of young adults, this study compares the processes of forming and terminating relationships between same- and different-sex couples in Taiwan, an Asian society featuring both strong parental influences on children's mate selection and an ongoing legislative effort to legalize same-sex marriage. RESULTS: Results from event-history models show that factors associated with relationship formation and dissolution are largely similar for same- and different-sex unions and that same-sex relationships do not have higher dissolution rates. Nevertheless, premarital coresidence with parents, which is likely to amplify parental influences on children's mate selection, deters the entry into and accelerates the dissolution of same-sex relationships more than it does different-sex relationships. Moreover, same-sex relationships are more heterogamous in family economic background, but more homogamous in age and education level, than different-sex ones. CONTRIBUTION: This study is among the first to provide evidence on the dynamics of same- and different-sex relationships in a non-Western context. Aside from a few differences between same- and different-sex relationships related to parental influences, our study provides strong evidence that same- and different-sex couples experience intimacies in similar ways-even in a relatively conservative cultural context like Taiwan.

Relationship Factors Associated with Sexual Risk Behavior and High-Risk Alcohol Consumption Among Latino Men Who Have Sex with Men: Challenges and Opportunities to Intervene on HIV Risk.

The HIV epidemic continues to be a major public health concern, affecting communities with varying prevention and treatment needs. In the U.S., Latino men who have sex with men (MSM) bear a disproportionate burden of HIV incidence. While recent studies have highlighted the relevance of relationship factors for HIV transmission among MSM generally, the unique needs and experiences of Latino MSM have received relatively little attention. Consequently, associations between relationship factors and HIV risk among Latino MSM remain unknown. This mixed-method study examined relationship status and dynamics and potential HIV-related risk behaviors among Latino MSM. Quantitative analyses with 240 Latino MSM investigated associations between relationship status and engagement in condomless anal intercourse (CAI). Focus groups with 20 Latino male couples and 10 health service providers explored the impact of relationship dynamics on sexual behaviors, as well as opportunities to intervene on HIV risk. The majority of participants were predominantly Spanish speaking, most screened positive for high-risk alcohol consumption in the past month, more than half engaged in CAI in the past 3 months, and a majority reported multiple sexual partners in this period. Among participants in same-sex relationships (n = 175), approximately half reported multiple partners in the previous 3 months and more than two-thirds reported CAI in this time period. Being in a same-sex relationship was positively associated with high-risk alcohol consumption and being age 30 or older and negatively associated with having multiple partners. Moreover, being in a same-sex relationship significantly increased the likelihood that participants would report engaging in CAI. Qualitative analyses identified themes related to relationship dynamics and sexual behavior, as well as opportunities to intervene on HIV risk. Despite the challenges encountered by Latino male couples, most participants expressed commitment to and support for their partners. As such, prevention efforts involving Latino male couples must address relationship dynamics and the role they play in sexual health, including safer sex practices.

'I told her this is your life': relationship dynamics, partner support and adherence to antiretroviral therapy among South African couples.

Despite the important role of social relationships for health and wellbeing, little is known about how primary partners affect adherence to HIV care and treatment. We qualitatively explored how relationship dynamics and partner support influence adherence among couples from KwaZulu-Natal, South Africa. Twenty-four heterosexual couples with at least one HIV-positive partner completed semi-structured interviews on topics including relationship dynamics (intimacy or emotional closeness, communication, violence), experiences with HIV care and treatment and HIV-related social support. The majority of couples were seroconcordant HIV-positive (92%) and both on antiretroviral therapy (ART) (63%). Participants described how primary partners both interfered with and supported adherence. Negative forms of influence included relationship conflict, which resulted in forgetfulness to take pills, and men's attempt to control use of ART. However, participants were more likely to highlight positive forms of influence on adherence, which included social support (instrumental, informational and emotional), intimacy and commitment. The findings also suggest a reciprocal relationship between ART and relationships such that couple ART use may enhance relationship quality. Primary partners are important pillars of support for ART adherence, especially in contexts of high unemployment and poverty. Future interventions that encourage and leverage these supportive relationships could improve ART adherence among heterosexual couples in similar settings.

Relationship Dynamics and Partner Beliefs About Viral Suppression: A Longitudinal Study of Male Couples Living with HIV/AIDS (The Duo Project).

Accurate beliefs about partners' viral suppression are important for HIV prevention and care. We fit multilevel mixed effects logistic regression models to examine associations between partners' viral suppression beliefs and objective HIV RNA viral load tests, and whether relationship dynamics were associated with accurate viral suppression beliefs over time. Male couples (N = 266 couples) with at least one HIV-positive partner on antiretroviral therapy completed five assessments over 2 years. Half of the 407 HIV-positive partners were virally suppressed. Of the 40 % who had inaccurate viral load beliefs, 80 % assumed their partner was suppressed. The odds of having accurate viral load beliefs decreased over time (OR = 0.83; p = 0.042). Within-couple differences in dyadic adjustment (OR = 0.66; p < 0.01) and commitment (OR = 0.82; p = 0.022) were negatively associated with accurate viral load beliefs. Beliefs about a partner's viral load may factor into sexual decision-making and social support. Couple-based approaches are warranted to improve knowledge of partners' viral load.

The Dynamics of Intimate Relationships and Violent Victimization Among Young Women.

Despite the fact that intimate partner violence (IPV) occurs within intimate relationships, we know relatively little about the characteristics of those intimate relationships, and even less about how IPV changes across time within different relationships. We use the Relationship Dynamics and Social Life (RDSL) study, based on a random sample of 1003 18-19-year-old women residing in a Michigan county. Women were interviewed weekly for 2.5 years, resulting in an age range of 18 through 22. We estimate hybrid "within-between" regression models, which allows us to directly compare the same woman's risk of experiencing IPV across her different relationships, varied in terms of resources, balance of power, conflict, childbearing, relationship type, and duration. Our analyses demonstrate that power imbalance in intimate relationships, non-monogamous and unstable relationships, relationships with men who are not the father of a woman's existing children, and serious relationships (especially stayover and cohabiting) place young women in their late teens and early twenties at particularly high risk of multiple dimensions of IPV. Our fixed-effects modeling strategy isolated the increase in IPV risk that is due to these characteristics and experiences within intimate relationships from the risk due to young women being at high risk of IPV for other reasons who might tend to choose these types of relationships. The elevated risk of IPV in relationships with these characteristics and experiences supports a causal link between them. Our research supports the potential efficacy of interventions that reduce conflict, equalize power within relationships, and encourage women-especially young mothers-to delay serious relationships.

Relationship Dynamics and Abusive Interactions in a National Sample of Youth and Young Adults.

Stemming intimate partner violence among adults demands earlier education and skill-building supportive of healthy youth and young adult dating relationships. The current U.S.-based study examines a spectrum of youth and young adult relationship dynamics (RDs), inclusive of abusive interactions. In a nationally representative cohort of youth aged 10-18 at baseline and one parent or caregiver, survey responses regarding RDs from 618 participants ages 15-23 at wave 5 follow-up were analyzed. Latent class analysis of four positive dynamics, six problematic dynamics, and three scales of adolescent relationship abuse (ARA) were estimated, yielding four latent profiles of dating RDs. Relationships characterized by Unhealthy and Intense RDs both exhibited high probability of ARA but differed from each other in terms of other positive and problematic dynamics. Relationships characterized by Disengaged RDs had lower probability of ARA but elevated probability of awkward communications, negative feelings, social liability, and other challenging dynamics. Several baseline covariates were significantly associated with profiles of dating RDs approximately 5 years later. Younger participants were more likely to subsequently fall in an Intense or Disengaged RDs profile, as were participants with baseline emotional health problems. Further, classification in the Unhealthy RDs profile was less likely for participants reporting a better baseline relationship with their parents and more likely for those exposed to violence in childhood. These findings suggest that in addition to developmental maturity, youth and young adults would benefit from closer investigation and processing of past emotional and relational issues and traumas to foster healthier dating relationships.

Emotionally focused couple therapy in cancer survivor couples with marital and sexual problems: a replicated single-case experimental design.

Objective: The current research examined the effect of Emotionally Focused Couples Therapy (EFCT) on perceived intimacy, affect, and dyadic connection in cancer survivor couples with relationship challenges. Method: In this longitudinal replicated single-case study, positive and negative affect, intimacy, partner responsiveness, and expression of attachment-based emotional needs were reported every 3 days before and during treatment. Thirteen couples, with one partner having survived colorectal cancer or breast cancer, participated for the full duration of the study. Statistical analysis of the data was performed using randomization tests, piecewise regression, and multilevel analyses. Results: Adherence to the therapeutic protocol was tested and found adequate. Compared with baseline, significant positive effects on affect variables were found during the therapeutic process. Positive affect increased and negative affect decreased. Partner responsiveness, perceived intimacy, and the expression of attachment-based emotional needs improved, but only in the later phase of treatment. Results at the group level were statistically significant, whereas effects at the individual level were not. Discussion: This study found positive group-level effects of EFCT on affect and dyadic outcome measures in cancer survivors. The positive results warrant further research, including randomized clinical trials, to replicate these effects of EFCT in cancer survivor couples experiencing marital and sexual problems.

Understanding the effect of adverse childhood experiences on the risk of engaging in physical violence toward an intimate partner: The influence of relationship, social psychological, and sociodemographic contextual risk factors.

BACKGROUND: Adverse childhood experiences (ACEs) increase the risk of engaging in intimate partner violence (IPV) in later life. OBJECTIVE: This study investigates the association between ACEs and engaging in physical violence toward a romantic partner in emerging adulthood while also accounting for proximal life experiences, including social psychological, intimate relationship, and sociodemographic characteristics. PARTICIPANTS AND SETTING: This study draws on two waves of data from the Toledo Adolescent Relationships Study, a 19-year population-based longitudinal cohort study of adolescents transitioning to adulthood from Lucas County, Ohio (United States). This investigation includes 878 (399 men and 479 women) emerging adults. METHODS: To evaluate the association between ACEs and IPV perpetration, two waves of survey data were used, collected in 2001 and 2011-2012. RESULTS: ACEs had a cumulative effect on IPV, where each additional ACE increased the odds of engaging in IPV by 51.0 % (p < 0.001). However, current drug use (OR = 1.131, p < 0.05), arguments between partners (OR = 1.517, p < 0.01), partner mistrust (OR = 1.663, p < 0.001), and jealousy and control (OR = 1.412, p < 0.001) were also significant correlates of IPV reports. CONCLUSIONS: ACEs are a significant predictor of IPV perpetration among emerging adults, even when accounting for more proximal risk factors. These findings suggest that individuals working with clients who engage in IPV would do well to address the long-term trauma impacts of early life adversity in addition to more proximal risk factors to reduce the risk of continued violence.