Relationship Discord Research Articles

The role of mutually responsive orientation in promoting relationship satisfaction for first-time and experienced parents: An investigation from pregnancy to toddlerhood

The transition to parenthood creates a context for family reorganization that can place couples at risk for declining relationship satisfaction; however, few studies have examined the experiences of parents navigating this transition while parenting other children in the home. Further, there is a critical need to identify factors explaining unique trajectories of relationship satisfaction and determine whether these factors serve similar functions for first-time versus experienced parents. The goal of the present study was to examine relationship satisfaction across the pregnancy-postpartum transition for not only first-time, but also experienced parents, and identify prenatal couple dynamics and contextual factors that explain individual differences in these trajectories across parenting groups. We pursued these aims in a sample of 152 mixed-sex couples, across five waves of data spanning pregnancy to 2 years postpartum. First-time and experienced parents demonstrated unique trajectories of relationship satisfaction across the transition to parenthood. Greater mutually responsive orientation (i.e., MRO; an established system of attunement, reciprocity, cooperation, and warmth) between partners during pregnancy was associated with higher overall levels of relationship satisfaction spanning pregnancy to 2 years postpartum for first-time mothers and low-income experienced mothers and less relationship satisfaction decline over time for low-income experienced fathers. The present study replicates past work suggesting that experienced parents are also at risk for relationship discord across the pregnancy-postpartum transition and identifies prenatal MRO as a dyadic relationship quality that maintains and promotes satisfaction across this transition, warranting closer attention in future research and interventions.

Contribution of the alternative model for DSM-5 personality disorders to relationship satisfaction.

Personality is a central factor associated with relationship discord, conflicts, and separation, as well as with dyadic adjustment and relationship stability. The Alternative Model for Personality Disorders (AMPD) of the DSM-5 offers a hybrid model for understanding personality based on personality dysfunction (Criterion A) and pathological domains and facets (Criterion B). So far, few studies have integrated this model into the understanding of relationship quality. Therefore, the aim of this study was to examine the contribution of Criterion B to relationship satisfaction in individuals involved in an intimate relationship. We also explored the joint contribution of Criteria A and B, as well as their interaction effects, to relationship satisfaction. Participants were drawn from two clinical samples: patients with personality disorders (PD; N = 101) and clients consulting in private practice clinics (PPC; N = 350). They completed self-report questionnaires assessing relationship satisfaction and AMPD Criteria A (only for PPC sample) and B. Hierarchical regressions showed that, for the PD sample, the Detachment and Negative Affectivity domains, especially the pathological facets of Intimacy Avoidance and Separation Insecurity, explained 22.5% of relationship satisfaction's variance. For PPC clients, Detachment, Negative Affectivity, and Antagonism domains, and especially the pathological facets of Intimacy Avoidance, Anxiousness, and Grandiosity, contribute significantly to relationship satisfaction, explaining 14.8% of its variance. Criterion A elements did not evince incremental value to the regression models in the PPC sample, and no Criteria A and B interaction effects were found. Clinical implications as well as limitations of the study are discussed.

Prevalence of sexual desire and arousal difficulties among women veterans: A retrospective cohort design.

Low sexual desire and arousal are associated with several negative health outcomes, including reduced quality of life, depression, anxiety, and relationship discord. Although women veterans have high rates of risk factors for sexual dysfunctions (e.g., elevated rates of trauma, depression, anxiety), research on their sexual functioning is lacking. Using a retrospective cohort design, we examined the prevalence of documented sexual desire and arousal disorder diagnoses or symptoms, using International Classification of Diseases, 10th Revision codes, among 790,726 women veterans receiving care in the Veterans Health Administration (VHA). In fiscal year 2020, these symptoms and disorders were documented for only 0.19% (n = 1,494) of women veterans receiving care and symptoms of low sexual desire were documented more frequently than formal desire and arousal diagnoses. Most women veterans with desire and arousal problems were married (53.88%), and most (52.28%) were prescribed antidepressants. Mental health (MH) treatment for desire and arousal difficulties was commonly delivered in person (as compared to telephone or telehealth). Psychologists primarily treated desire and arousal concerns, providing an average of 2.81 MH encounters (SD = 7.53) compared to an average of 1.62 (SD = 5.25) MH encounters by social workers and 1.22 (SD = 2.53) by psychiatrists. Problems with low sexual desire and arousal are likely underassessed and undertreated within the VHA. Better assessment of women veterans' low desire and arousal is warranted to improve their well-being and quality of life. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

(056) Dyadic Approaches in Oncosexology: Understanding the Relationship between Couples’ Coping and Sexual Satisfaction among Young Adult Breast Cancer Patients and Their Partners

Abstract Introduction Recent evidence supports bio-psycho-social and non-linear models of sexual functioning. These models expand current understanding of cancer-related sexual health problems to include interpersonal factors such as relationship discord, fear of intimacy, and lack of communication (Bober & Varela, 2012). Sexual satisfaction, defined as “an affective response arising from one’s subjective evaluation of the positive and negative dimensions associated with one’s sexual relationship” (Lawrence & Byers, 1995; p. 268), is regarded as an important metric of sexual health and wellbeing. However, most studies have included only one member of the couple, and little is known about how each partner’s coping may mutually contribute to sexual satisfaction. We examined the reciprocal influence of couples’ coping behaviors on the individual’s and the partner’s sexual satisfaction. Objective The present work describes the relationship between couples’ coping behaviors and satisfaction with sexual relationship among young adult breast cancer patients and partners. Methods A sample of 40 romantic couples receiving care at an NCI-designated comprehensive cancer center completed cross-sectional online surveys. Validated questionnaires of satisfaction with sexual relationship (GMSEX), sexual function (IIEF, FSFI), and couple coping [Dyadic Coping Inventory, (DCI)] were administered. Couple coping includes both partners’ strategies implemented to manage their own and their partners’ distress, as well as shared coping behaviors. Items are organized in multiple subscales: stress communication, supportive, delegate, negative, and common dyadic coping. Stress communication refers to the strategies implemented by the partners to communicate to each other that they are stressed. Supportive dyadic coping occurs when one partner implements problem- and/or emotion-focused coping strategies to support the other person. Delegated dyadic coping occurs when one partner takes over responsibilities to reduce their partner’s stress. Negative dyadic coping includes behaviors that are hostile, ambivalent, and superficial. Common dyadic coping indicates coordinated responses between partners. Descriptive statistics and paired sample t-tests were used to assess differences between partners’ measures. In addition, confirmatory factor analysis (CFA) was used to estimate measurement models using Mplus8, while the pooled regression approach was utilized to estimate the Actor-Partner Interdependence Model (APIM). Results In the present sample, supportive and delegated dyadic coping behaviors contributed to greater sexual satisfaction for both partners, whereas only an actor effect was detected for stress communication, negative, and common dyadic coping. Significant differences were identified between partners, with breast cancer patients reporting higher stress communication (p<.05), partner-reported supportive (p<.05) and delegated coping behaviors (p<.05). Male partners rated higher patients’ engagement in stress communication behaviors (p<.05). In addition, more than one-half of patients screened positive for clinically significant sexual dysfunction (60.6%), compared to 20% of their partners. Conclusions These results provide evidence about the importance of dyadic approaches to investigating sexual satisfaction and functioning post-cancer treatment. Stress communication exerted an individual, rather than mutual, influence on sexual satisfaction of patients and partners. Delegated and supportive dyadic coping styles resulted in reciprocal influence and were associated with the higher sexual satisfaction among dyad members. Additional research is needed to confirm these findings in larger samples of cancer patients and develop effective interventions. Disclosure No

Association of parental divorce, discord, and polygenic risk with children's alcohol initiation and lifetime risk for alcohol use disorder.

Parental divorce and discord are associated with poorer alcohol-related outcomes for offspring. However, not all children exposed to these stressors develop alcohol problems. Our objective was to test gene-by-environment interaction effects whereby children's genetic risk for alcohol problems modifies the effects of parental divorce and discord to predict alcohol outcomes. The sample included European (EA; N=5608, 47% male, Mage ~ 36 years) and African (AA; N=1714, 46% female, Mage ~ 33 years) ancestry participants from the Collaborative Study on the Genetics of Alcoholism. Outcomes included age at initiation of regular drinking and lifetime DSM-5 alcohol use disorder (AUD). Predictors included parental divorce, parental relationship discord, and offspring alcohol problems polygenic risk scores (PRSALC ). Mixed effects Cox proportional hazard models were used to examine alcohol initiation and generalized linear mixed effects models were used to examine lifetime AUD. Tests of PRS moderation of the effects of parental divorce/relationship discord on alcohol outcomes were examined on multiplicative and additive scales. Among EA participants, parental divorce, parental discord, and higher PRSALC were associated with earlier alcohol initiation and greater lifetime AUD risk. Among AA participants, parental divorce was associated with earlier alcohol initiation and discord was associated with earlier initiation and AUD. PRSALC was not associated with either. Parental divorce/discord and PRSALC interacted on an additive scale in the EA sample, but no interactions were found in AA participants. Children's genetic risk for alcohol problems modifies the impact of parental divorce/discord, consistent with an additive model of diathesis-stress interaction, with some differences across ancestry.

Distress and impacts on daily life from appearance changes due to cancer treatment: A survey of 1,034 patients in Japan.

This study aimed to clarify the psychosocial difficulties and impacts that cancer patients face from appearance changes, in order to develop a patient support program. An online survey was administered to patients registered with an online survey company who met the eligibility criteria. The study population was randomly selected from gender and cancer types to create a sample that reflected the proportion of cancer incidence rates in Japan as much as possible. Out of a total of 1034 respondents, 601patients (58.1%) experienced appearance change. Symptoms that were reported to have a high distress level and prevalence rate, and that widely required provision of information were such as alopecia (22.2%), edema (19.8%) and eczema (17.8%). Distress levels and personal assistance requirements were high particularly for patients who experienced stoma placement and mastectomy. More than 40% of patients who experienced appearance change had quit or were absent from work or school, and reported that their social activities were negatively affected by the visually notable changes in their appearance. Concerns about "receiving pity from others" or about "the exposure of cancer" due to their appearance change also led patients to reduce outings (β = 0.32 and β = 0.31 respectively, p < 0.001) and social interactions with others (β = 0.34 and β = 0.36 respectively, p < 0.001) and increased the discord in human relationships (β = 0.21 and β = 0.19 respectively, p < 0.001). Results from this study indicate the areas in which more support is required from healthcare professionals, as well as the need for interventions for patient cognition to avoid maladaptive behaviors in cancer patients who experience appearance changes.

Needed: Relationship and ProblemSolving Treatment Trials for Men with Traumatic Brain Injury

In developed countries, Traumatic Brain Injury (TBI) affects approximately 12% of adults, and men are significantly more likely to sustain a TBI than women. Data are presented that document the differential adverse impact of TBI on hospitalization and death rates of men. Data are also presented on the differential effects of TBI on intimate relationships of men and women with a special focus on marital dissolution. Two large national studies in the US showed that the divorce rates of men are markedly higher for men than women. TBI should be conceptualized as a disease that affects families for it has long been known that caregivers carry a significant burden and suffer their own depression, anxiety, and relationship discord. A conceptual analysis of the treatment outcome literature with TBI patients and their caregivers led us to the concerning conclusion that there is a crucial need for treatment outcome trials with both patients and caregivers. Promising emerging evidence from controlled trials suggests that problem-solving therapy and relationship therapy with TBI patients and their caregivers should be treatment priorities with replications and extensions.

The social origins of obesity within and across generations.

We propose a model for obesity development that traces a considerable part of its origins to the social domain (mainly different forms of prolonged social adversity), both within and across generations, working in tandem with a genetic predisposition. To facilitate overview of social pathways, we place particular focus on three areas that form a cascading sequence: (A) social adversity within the family (parents having a low education, a low social position, poverty and financial insecurity; offspring being exposed to gestational stress, unmet social and emotional needs, abuse, maltreatment and other negative life events, social deprivation and relationship discord); (B) increasing levels of insecurity, negative emotions, chronic stress, and a disruption of energy homeostasis; and (C) weight gain and obesity, eliciting further social stress and weight stigma in both generations. Social adversity, when combined with genetic predisposition, thereby substantially contributes to highly effective transmission of obesity from parents to offspring, as well as to obesity development within current generations. Prevention efforts may benefit from mitigating multiple types of social adversity in individuals, families, and communities, notably poverty and financial strain, and by improving education levels.

Genetic nurture effects for alcohol use disorder.

We tested whether aspects of the childhood/adolescent home environment mediate genetic risk for alcohol problems within families across generations. Parental relationship discord and parental divorce were the focal environments examined. The sample included participants of European ancestry (N = 4806, 51% female) and African ancestry (N = 1960, 52% female) from the high-risk Collaborative Study on the Genetics of Alcoholism. Alcohol outcomes in the child generation included lifetime criterion counts for DSM-5 Alcohol Use Disorder (AUD), lifetime maximum drinks in 24 h, age at initiation of regular drinking, and age at first alcohol intoxication. Predictors in the parent generation included relationship discord, divorce, alcohol measures parallel to those in the child generation, and polygenic scores for alcohol problems. Parental polygenic scores were partitioned into alleles that were transmitted and non-transmitted to the child. The results from structural equation models were consistent with genetic nurture effects in European ancestry families. Exposure to parental relationship discord and parental divorce mediated, in part, the transmission of genetic risk for alcohol problems from parents to children to predict earlier ages regular drinking (βindirect = -0.018 [-0.026, -0.011]) and intoxication (βindirect = -0.015 [-0.023, -0.008]), greater lifetime maximum drinks (βindirect = 0.006 [0.002, 0.01]) and more lifetime AUD criteria (βindirect = 0.011 [0.006, 0.016]). In contrast, there was no evidence that parental alleles had indirect effects on offspring alcohol outcomes via parental relationship discord or divorce in the smaller number of families of African ancestry. In conclusion, parents transmit genetic risk for alcohol problems to their children not only directly, but also indirectly via genetically influenced aspects of the home environment. Further investigation of genetic nurture in non-European samples is needed.

Elixir of love or venom of violence: When does a drinking event result in couple intimacy or couple conflict?

The short-term consequences of drinking events may be positive or negative. Most studies have considered only one outcome, but people may experience different alcohol outcomes on different occasions, depending on the circumstances. The present study sought to identify predictors of drinking events that resulted in couple intimacy, conflict, or neither outcome using existing data from a 30-day ecological momentary assessment (EMA) study. Participants were a community sample of partnered, moderately drinking adults with a recent history of verbal or physical partner aggression (N = 249 couples). They provided reports of drinking events, intimacy and conflict events, and ratings of relationship harmony and discord in three randomly signaled reports each day. Mixed-effects multinomial analyses were used to compare predictors of drinking events that, within three hours, resulted in intimacy, conflict, or neither outcome. Consistent with previous research, characteristics of the drinker (individual tendencies to experience intimacy or conflict) and characteristics of the drinking event (alcohol quantity, drinking companions) both predicted drinking outcomes. Moreover, the pre-drinking relationship context predicted post-drinking relationship outcomes, consistent with the idea that alcohol focuses attention on salient contextual cues. Specifically, greater pre-drinking relationship harmony predicted greater likelihood of experiencing intimacy after drinking, whereas greater pre-drinking relationship discord predicted greater likelihood of experiencing conflict after drinking. In summary, characteristics of the drinker, the drinking event, and the pre-drinking relationship context contribute to the likelihood that a given drinking event will have short-term positive or negative relationship outcomes.

Maternal psychological control and mother-adolescent conflict discussion quality: Different perceptions are key.

Parental psychological control is associated with poor adolescent outcomes, but little research has examined discrepancies between observed and perceived psychological control in predicting conversational outcomes. The present study used a multimethod, multi-informant approach to examine whether independent and joint associations between observer, adolescent, and mother perceptions of maternal psychological control during mother-adolescent conflict discussions were associated with adolescents' and mothers' perceptions of the quality of these conversations. Mother-adolescent dyads (N = 123 dyads) participated in a conflict discussion and subsequently reported on their satisfaction with the process and outcome of the discussion. Mothers' behavior was coded for psychological control and mothers and adolescents separately reported on mothers' psychological control during the discussion. Findings indicate that higher adolescent-perceived psychological control was associated with poorer adolescent- and mother-reported discussion quality controlling for overall relationship discord. Central to our hypotheses, observer, adolescent, and mother perceptions of psychological control significantly interacted with one another to predict discussion quality, though the specific pattern of findings varied across mother- and adolescent-reported discussion quality. Findings suggest that adolescent perceptions of discussion quality are poorest when adolescents attribute psychologically controlling behavior to mothers, particularly when mothers and outside observers report relatively lower levels of psychological control. This study highlights the importance of adolescent perceptions of parents' behavior and of obtaining information about behavior during parent-adolescent conversations from multiple reporters (observers, adolescents, and parents) to develop targeted interventions with parents and adolescents managing conflict. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Interpersonal Competence: A Mediator Between ODD Problems and Parent-Child Relationship Discord.

A central requirement of Oppositional Defiant Disorder (ODD) consists of difficulties with interpersonal relationships. As emerging adults' transition into adulthood and seek more autonomy from parents, it is important to examine how ODD problems and parent-child discord are indirectly associated through interpersonal competencies. The current study examined the indirect effects between ODD problems in emerging adults and parent-child discord through multiple interpersonal competencies as well as the additional differences among parent-child gender dyads. Emerging adults (N = 599 individuals aged 18 to 25 years; M = 19.60, SD = 1.40; 68% females) were recruited via an online research platform and completed online survey measures of ODD problems, parent-child relationship discord, and interpersonal competence. Indirect effects were significant for the mother-daughter dyad only. Additional results, limitations, and implications are discussed.

Role of parental divorce and discord in the intergenerational transmission of alcohol use disorder

BackgroundAlcohol use disorder (AUD) has a strong familial component, and is associated with divorce and relationship discord. The purpose of this study was to test whether exposure to parental divorce and parental relationship discord contributes to the intergenerational transmission of AUD. MethodsThe sample included N = 9005 adult twins (43% female) from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders. Participant AUD diagnoses were derived from structured clinical interviews based on DSM-IV alcohol dependence. Participants also reported on parental divorce and parental AUD. In addition, direct psychiatric interview data and measures of relationship discord were available for a subsample of parents of female-female twin pairs (855 mothers, 617 fathers). Indirect effects models were fit and tested using a robust maximum likelihood estimator with Monte Carlo integration. ResultsPath and structural equation modeling results provided strong support for the intergenerational transmission of AUD, and indicated that parental AUD had indirect effects on offspring AUD through exposure to parental divorce and parental relationship discord. Effects were consistent across males and females. ConclusionsIn a population-based adult twin sample, exposure to parental divorce and relationship discord appears to be important for understanding the intergenerational transmission of AUD. These effects are broadly consistent with the idea of genetic nurturance, whereby parents transmit genetic risk for alcohol use disorder to their children indirectly via heritable aspects of the home environment. Ultimately, this etiological information could bolster engagement with skills-based therapeutic efforts used in substance-related preventive interventions for divorced or distressed families.

An Introduction, Review, and Conceptual Analysis of Mattering as an Essential Construct and an Essential Way of Life

While the importance of having self-esteem is widely recognized and has been studied extensively, another core component of the self-concept has been relatively neglected—a sense of mattering to other people. In the current article, it is argued that mattering is an entirely unique and complex psychological construct with great public appeal and applied significance. The various ways of assessing mattering are reviewed and evidence is summarized, indicating that mattering is a vital construct in that deficits in mattering are linked with consequential outcomes at the individual level (i.e., depression and suicidal tendencies), the relationship level (i.e., relationship discord and dissolution), and the societal level (i.e., delinquency and violence). Contemporary research is described which shows that mattering typically predicts unique variance in key outcomes beyond other predictor variables. Mattering is discussed as double-edged in that mattering is highly protective but feelings of not mattering are deleterious, especially among people who have been marginalized and mistreated. The article concludes with an extended discussion of key directions for future research and an overview of the articles in this special issue. It is argued that a complete view of the self and personal identity will only emerge after we significantly expand the scope of inquiry on the psychology of mattering.

Women’s Help-Seeking Behaviors for Sexual Health Issues and the Related Factors: A Cross-Sectional Study from Iran

Delay in help-seeking for sexual health issues may lead to relationship discord and impact the quality of life. The study aimed to explore the factors related to HSBs (help seeking behaviors) for sexual health issues and to determine the role of negative attitudes relating to sexual concerns in the HSBs of Iranian women. This cross-sectional study was performed in 2020. Participants were 390 randomly selected women from Rasht, Iran. The data were collected using a demographic and a sexual history checklist, the Female Sexual Function Index-6-item (FSFI-6), the Attitudes-related Sexual Concern Scale (ASCS), and a help-seeking behavior questionnaire. Formal help-seeking in women with sexual concern was 16.2% and 48.6% engaged informal HSB. Informal HSB was associated with younger age (OR = 0.93; CI = 0.89–0.97), having a university degree (OR = 3.42; CI = 1.89–6.18), sexual abuse in adulthood (OR = 2.59; CI = 1.07–6.26) and lower negative attitudes-related sexual concerns (OR = 0.53; CI = 0.32–0.87). Formal HSB was related to having a university degree (OR = 3.03; CI = 1.32–6.98) and history of a chronic disease (OR = 3.43; CI = 1.68–6.98). Negative attitudes relating to sexual concerns greatly impact informal HSBs of women, so it should be considered in their health care programming.

Editorial: Individual versus Dyadic Processes: Health and Relationship Outcomes

Building strong relationships is a fundamental human need, and finding an intimate partner is evolutionary important for survival and procreation (Buss and Schmitt, 1993). Once established, intimate relationships entail interpersonal support processes that are fundamental to growth, development and coping with life's adversities (Feeney and Collins, 2015). Intimate partners have a strong mutual influence over on each other's health and stress experiences (Randall and Bodenmann, 2017; Sbarra and Coan, 2018). The number and quality of intimate relationships are associated with many health outcomes including immunological and endocrine responses (Hostinar et al., 2014), cardiovascular disease and cancer (Farrell and Stanton, 2019) as well as length of life (Holt-Lunstad et al., 2017). At the same time, discord in intimate relationships is involved in the onset, severity, and progression of a wide range of diseases, as well as in the severity, progression, treatment, and recovery from mental health disorders (Dunkel Schetter, 2017). Research consistently indicate that individual processes and conditions may also affect health. Most often studied, the big five personality traits interact to predict sexual health (Allen and Walter, 2018) or mental treatment outcomes (Bucher et al., 2019). Considering illness as an individual cognition, Singer and his colleagues (Singer et al., 2010) found that one-third of the cancer patients in acute care hospitals is suffering from mental health disorders, depression being the most common psychiatric condition (Singer et al., 2010). Moreover, individual processes and conditions may also affect relationship outcomes. For example, self-reported and partner-perceived reported personality traits (Weidmann et al., 2016), attachment insecurity (Candel and Turliuc, 2019), emotional regulation (Bloch et al., 2014) or emotional intelligence (Malouff et al., 2014) were found to play important roles in predicting relationship satisfaction. Finally, various dyadic processes are important predictors of relationships outcomes. Yoo et al. (2014) found that sexual satisfaction significantly predicted emotional intimacy, and that both variables mediated the association between spouse's communication and their own relationship satisfaction, for both husbands and wives. Relationship stress is a mediator between external stress and marital communication or marital quality (Ledermann et al., 2010). Further, marital communication mediates the association of relationship stress with marital quality. Also, dyadic coping strongly predicts relationship satisfaction regardless of gender, its aggregated positive forms being a stronger predictor of relationship satisfaction than the aggregated negative ones (Falconier et al., 2015). Systematically analysing both individual and dyadic processes, Joel and her colleagues (Joel et al., 2020) used machine learning techniques to predict relationship quality across 43 dyadic longitudinal datasets of 11,196 romantic couples (Joel et al., 2020). Their findings indicate that the top individual-difference predictors of relationship quality were life satisfaction, negative affect, depression, attachment avoidance, and attachment anxiety, and the top relationship-specific predictors of relationship quality were perceived-partner commitment, appreciation, sexual satisfaction, perceived-partner satisfaction, and conflict (Joel et al., 2020).

Psychometric properties of the Marital Adjustment Scale during cognitive therapy for depression: New research opportunities.

Poor dyadic adjustment in marital or similar relationships is common among patients seeking individual cognitive therapy (CT) for major depressive disorder (MDD). Here we examined the psychometric properties of the marital adjustment subscale (MAS) of the Social Adjustment Scale-Self-report (SAS-SR; Weissman & Bothwell, 1976). Among married or cohabiting patients receiving individual CT for recurrent MDD (N = 306) in the context of two randomized controlled trials, the MAS demonstrated moderate internal consistency and test-retest reliability, strong convergence with the Dyadic Adjustment Scale (Spanier, 1976), and moderate relations with interpersonal problems and depressive symptoms. Controlling baseline depressive symptom severity, greater pre-CT relationship discord on the MAS predicted less reduction in depressive symptom severity and lower odds of depression remission during CT. These results support the reliability, validity, and potential utility of the MAS. Using the MAS may help investigators "mine" existing data sets including the SAS-SR to further understanding of dyadic functioning and its potential impact on depression treatment and other health outcomes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

053 Proper Assessment for Cosmeto-gynecological Interventions: The Need to Evaluate the Relationship Discord, Body Dysmorphic Syndrome, and the Correct Energy-Based Technology

Only 10% of women who undergo vaginal rejuvenation procedures report that there was an external influence (friend, partner or spouse) that influenced their decision for the cosmetic/ functional procedure. Despite this fact, it is estimated that between 6-53% of women who complete these procedures may suffer from some form of body dysmorphic syndrome (BDS). The importance of proper assessment for women undergoing cosmetic and/or functional procedures cannot be underscored. Relationship discord, partner coercion and female BDS need to be properly evaluated before any woman should be considered an appropriate candidate for interventions such as genital surgery, laser and radiofrequency treatments. In addition, the basic tenets of available energy-based technologies, the scientific data supporting the use of each in the clinical setting. The primary differences between energy-based device ( laser versus radiofrequency) outcomes are important considerations prior to any vaginal cosmetic procedures.

Cognitive-Behavioral Conjoint Therapy for PTSD: A Case Study of a Transgender Male Co-Parenting With Former Spouse and Perpetrator of Domestic Violence

Posttraumatic Stress Disorder (PTSD) symptoms have shown to contribute to intimate relationship discord (Taft et al., 2011). Cognitive-Behavioral Conjoint Therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012) is an evidence-based treatment for PTSD effective at significantly decreasing PTSD symptoms and increasing relationship satisfaction among dyads (Macdonald et al., 2016). To date, there has only been one case study examining the effectiveness of CBCT for PTSD with a sexual minority couple, (same-sex female couple) leaving uncertainty of the effectiveness of this treatment for other sexual minority couples. This case study examined a married couple’s response to treatment, in which the patient identified as a transgender male and his spouse identified as a cisgender female. The patient was diagnosed with PTSD per a Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) total score of 45 (of a maximum of 80). On the CAPS-5, the patient reported a first sexual encounter rape at age 15, from his first marriage with his ex-husband, whom he was dating at the time, as his index trauma. Of note, the patient and his wife currently co-parent two children with the patient’s ex-husband, who perpetrated daily sexual assaults for years during their marriage. Pre-treatment relationship happiness for the couple was “a little unhappy” on the Dyadic Adjustment Scale (DAS) Relationship Happiness Scale. Patient was also diagnosed with Dysthymia and responded well to continued Bupropion for depression. Following completion of the 15-session CBCT for PTSD protocol, the patient’s diagnosis of PTSD was determined to be in remission as evidenced by a post-treatment CAPS-5 total score of 7. At post-treatment the patient rated his relationship happiness as “happy” and his partner “very happy” on the DAS. The couple demonstrated clinically meaningful changes in areas of PTSD and relationship happiness. Functional improvements were also reported in the patient pursuing new employment and hobbies, improved co-parenting between the patient and his wife, improved sexual functioning, and decreased depression symptoms. Treatment gains were maintained at a 1-month and 3-month follow-up. These results demonstrate the effective use of CBCT for PTSD with a sexual minority couple that has continued co-parenting contact with a perpetrator of domestic violence.

Interventions for Couples.

Because relationship discord and dissolution are common and costly, interventions are needed to treat distressed couples and to prevent distress among vulnerable couples. We review meta-analytic evidence showing that 60-80% of distressed couples benefit from behavioral and emotion-focused approaches to couple therapy, but we also note that treatment effects are weaker in actual clinical practice than in controlled studies, dissipate following treatment for about half of all couples, and may be explained by factors that are common across models. Meta-analyses of prevention programs reveal reliable but smaller effects, reflecting a need to know more about whether and how communication mediates effects, about how risk and diversity moderate effects, and about how technology-enabled interventions can reduce attrition in vulnerable populations. Interventions for couples are improving and expanding, but critical questions remain about how and for whom they work.