Brian R. Baucom

Marital Status and Satisfaction Five Years Following a Randomized Clinical Trial Comparing Traditional versus Integrative Behavioral Couple Therapy.

OBJECTIVE To follow distressed married couples for 5 years after their participation in a randomized clinical trial. METHOD A total of 134 chronically and seriously distressed married couples were randomly assigned to approximately 8 months of either traditional behavioral couple therapy (TBCT; Jacobson & Margolin, 1979) or integrative behavioral couple therapy (IBCT; Jacobson & Christensen, 1998). Marital status and satisfaction were assessed approximately every 3 months during treatment and every 6 months for 5 years after treatment. RESULTS Pre- to posttreatment effect sizes on marital satisfaction were d = 0.90 for IBCT and d = 0.71 for TBCT, which were not significantly different. However, data through 2-year follow-ups revealed statistically significant superiority of IBCT over TBCT in relationship satisfaction, but subsequent data showed increasing similarity and nonsignificant differences in outcome. At 5-year follow-up for marital satisfaction relative to pretreatment, effect sizes were d = 1.03 for IBCT and d = 0.92 for TBCT; 50.0% of IBCT couples and 45.9% of TBCT couples showed clinically significant improvement. Relationship status, obtained on all 134 couples, revealed that 25.7% of IBCT couples and 27.9% of TBCT couples were separated or divorced. These follow-up data compared favorably to other, long-term results of couple therapy. CONCLUSION TBCT and IBCT both produced substantial effect sizes in even seriously and chronically distressed couples. IBCT produced significantly but not dramatically superior outcomes through the first 2 years after treatment termination but without further intervention; outcomes for the 2 treatments converged over longer follow-up periods.

Community-based prevention of marital dysfunction: multilevel modeling of a randomized effectiveness study.

This study is a cluster randomized controlled trial of the Prevention and Relationship Enhancement Program (PREP; H. J. Markman, S. M. Stanley, & S. L. Blumberg, 2001). Fifty-seven religious organizations (ROs), consisting of 217 newlywed couples, were randomly assigned to 1 of 3 intervention conditions: PREP delivered by university clinicians (U-PREP), PREP delivered by RO clergy (ROPREP), and naturally occurring (NO) marriage preparation. Self-reported relationship satisfaction, negative behavior, and positive behavior were assessed at preintervention, postintervention, and 1-year follow-up. Trajectories of relationship satisfaction showed no change over time and did not differ across conditions. Trajectories of negative behavior for RO-PREP wives showed significantly greater linear declines in comparison with NO trajectories. Trajectories of positive behavior for NO and U-PREP partners showed significant declines compared with RO-PREP trajectories. Effectiveness, transportability, and dissemination of marital distress prevention programs in community settings are discussed.

Startle modulation before, during and after exposure to emotional stimuli

Although affective modulation of the startle reflex is a highly replicable effect, the majority of studies have administered startle probes during exposure to affective stimuli. To examine more comprehensively the temporal course of startle potentiation, we assessed blink modulation before, during and immediately after exposure to positive, negative and neutral pictures. During each trial, cues about the affective content of pictures were presented, after which acoustic startle probes were delivered either before picture onset, during picture onset or immediately after picture offset. As expected, we observed a linear relation between picture valence and startle amplitude during picture viewing. Surprisingly, startle amplitude was larger while anticipating pleasant and unpleasant pictures relative to neutral pictures. No significant effects were observed during the offset phase. These results indicate that startle modulation is conditional upon temporal factors linked to stimulus onset and offset.

Prediction of response to treatment in a randomized clinical trial of couple therapy: a 2-year follow-up.

Many studies have examined pretreatment predictors of immediate posttreatment outcome, but few studies have examined prediction of long-term treatment response to couple therapies. Four groups of predictors (demographic, intrapersonal, communication, and other interpersonal) and 2 moderators (pretreatment severity and type of therapy) were explored as predictors of clinically significant change measured 2 years after treatment termination. Results demonstrated that power processes and expressed emotional arousal were the strongest predictors of 2-year response to treatment. Moderation analyses showed that these variables predicted differential treatment response to traditional versus integrative behavioral couple therapy and that more variables predicted 2-year response for couples who were less distressed when beginning treatment. Findings are discussed with regard to existing work on prediction of treatment response, and directions for further study are offered.

Gender, topic, and time in observed demand-withdraw interaction in cross- and same-sex couples.

The demand-withdraw interaction pattern has been extensively studied and consistently linked to relationship quality in cross-sex relationships, but it has received little study using observational data in same-sex relationships. Demand-withdraw behavior, which occurs when 1 partner makes a complaint or request for a change and the other partner avoids the request or withdraws from the discussion (Christensen, 1988), was observationally coded in the problem-solving interactions of 75 (20 unmarried lesbian, 15 unmarried gay male, 20 unmarried straight cohabiting, and 20 married straight) couples. Results revealed that same- and cross-sex couples engage in demanding and withdrawing behaviors in highly similar ways. For all couples, partners demanded at a higher level during their own issue than during their partners issue, and withdrew at a higher level during their partners issue than during their own issue. Women demanded at higher levels than men, and men withdrew at higher levels than women. All partners were more likely to be in a demanding role during their own topic than during their partners topic. Polarization was greater in woman-selected than in man-selected topics. Demanding increased over the course of the interaction, whereas no time effect was found for withdrawing. Higher levels of each partners demanding were associated with lower levels of their own withdrawing and higher levels of their partners withdrawing. Finally, higher levels of total demand-withdraw behaviors were associated with lower levels of relationship satisfaction for all couple types. Implications of results for refinement of models of demand-withdraw behavior are discussed.

Emotion dysregulation and dyadic conflict in depressed and typical adolescents: Evaluating concordance across psychophysiological and observational measures

Many depressed adolescents experience difficulty in regulating their emotions. These emotion regulation difficulties appear to emerge in part from socialization processes within families and then generalize to other contexts. However, emotion dysregulation is typically assessed within the individual, rather than in the social relationships that shape and maintain dysregulation. In this study, we evaluated concordance of physiological and observational measures of emotion dysregulation during interpersonal conflict, using a multilevel actor-partner interdependence model (APIM). Participants were 75 mother-daughter dyads, including 50 depressed adolescents with or without a history of self-injury, and 25 typically developing controls. Behavior dysregulation was operationalized as observed aversiveness during a conflict discussion, and physiological dysregulation was indexed by respiratory sinus arrhythmia (RSA). Results revealed different patterns of concordance for control versus depressed participants. Controls evidenced a concordant partner (between-person) effect, and showed increased physiological regulation during minutes when their partner was more aversive. In contrast, clinical dyad members displayed a concordant actor (within-person) effect, becoming simultaneously physiologically and behaviorally dysregulated. Results inform current understanding of emotion dysregulation across multiple levels of analysis.

Does Dampened Physiological Reactivity Protect Youth in Aggressive Family Environments

Is an attenuated physiological response to family conflict, seen in some youth exposed to early adversity, protective or problematic? A longitudinal study including 54 youth (average age 15.2 years) found that those with higher cumulative family aggression exposure showed lower cortisol output during a laboratory-based conflict discussion with their parents, and were less likely to show the normative pattern of increased cortisol reactivity to a discussion they rated as more conflictual. Family aggression interacted with cortisol reactivity in predicting youth adjustment: Adolescents from more aggressive homes who were also more reactive to the discussion reported more posttraumatic stress symptoms and more antisocial behavior. These results suggest that attenuated reactivity may protect youth from the negative consequences associated with aggressive family environments.

The Association of Therapist Empathy and Synchrony in Vocally Encoded Arousal

Empathy is a critical ingredient in motivational interviewing (MI) and in psychotherapy generally. It is typically defined as the ability to experience and understand the feelings of another. Basic science indicates that empathy is related to the development of synchrony in dyads. However, in clinical research, empathy has proved difficult to operationalize and measure, and has mostly relied on the felt sense of observers, clients, or therapists. We extracted estimates of therapist and standardized patient (SP) vocally encoded arousal (mean fundamental frequency; mean f₀) in 89 MI sessions with high and low empathy ratings from independent observers. We hypothesized (a) therapist and SP mean f₀ would be correlated and (b) the correlation of therapist and SP mean f₀ would be greater in sessions with high empathy as compared with low. On the basis of a multivariate mixed model, the correlation between therapist and SP mean f₀ was large (r = .71) and close to 0 in randomly assigned therapist-SP dyads (r = -.08). The association was higher in sessions with high empathy ratings (r = .80) than in sessions with low ratings (r = .36). There was strong evidence for vocal synchrony in clinical dyads as well as for the association of synchrony with empathy ratings, illustrating the relevance of basic psychological processes to clinical interactions. These findings provide initial evidence for an objective and nonobtrusive method for assessing therapist performance. Novel indicators of therapist empathy may have implications for the study of MI process as well as the training of therapists generally. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

That's aggravating, very aggravating: is it possible to classify behaviors in couple interactions using automatically derived lexical features?

Psychology is often grounded in observational studies of human interaction behavior, and hence on human perception and judgment. There are many practical and theoretical challenges in observational practice. Technology holds the promise of mitigating some of these difficulties by assisting in the evaluation of higher level human behavior. In this work we attempt to address two questions: (1) Does the lexical channel contain the necessary information towards such an evaluation; and if yes (2) Can such information be captured by a noisy automated transcription process. We utilize a large corpus of couple interaction data, collected in the context of a longitudinal study of couple therapy. In the original study, each spouse was manually evaluated with several sessionlevel behavioral codes (e.g., level of acceptance toward other spouse). Our results will show that both of our research questions can be answered positively and encourage future research into such assistive observational technologies.

The Language of Demand/Withdraw: Verbal and Vocal Expression in Dyadic Interactions

Associations between vocally expressed emotional arousal, influence tactics, and demand/withdraw behavior were examined in a treatment-seeking sample of 130 seriously and stably distressed, married, heterosexual couples and in a community sample (N = 38) of 18 married heterosexual and 20 dating heterosexual couples. Fundamental frequency was used to measure emotional arousal, and computational linguistics were used to measure influence tactics. Higher levels of demand/withdraw behavior were associated with greater use of manipulative and controlling influence tactics, higher levels of emotional arousal, and less frequent use of cooperative and compromising influence tactics. Overall, demanders tended to express more arousal and to use more influence tactics than withdrawers. Both influence tactics and emotional arousal were uniquely associated with demand/withdraw behavior. Implications of results are discussed for refining theories of demand/withdraw interaction.