Gary R. Birchler

A behavioral analysis of problem solving in distressed and nondistressed married and stranger dyads.

The present study compared the problem solving behavior of distressed andnondistressed married couples, and explored the “state” vs. “trait” nature of problem solving behavior through comparison of married and stranger dyads. Behavioral codings obtained from spouse and stranger interactions around a standard conflict eliciting task provided the measure of problem solving behavior. Distressed married couples, relative to nondistressed married couples, emitted a significantly greater proportion of negative problem solving behavior, and a significantly smaller proportion of positive problem solving behavior. As compared with stranger dyads, the problem solving behavior of nondistressed marital dyads tended to be more negative and more positive, whereas distressed marital dyads were more negative and less positive. The implications of these finding for marital therapy and research were discussed.

The Occurrence of Male-to-Female Intimate Partner Violence on Days of Men's Drinking: The Moderating Effects of Antisocial Personality Disorder.

In this study, the moderating effects of antisocial personality disorder (ASPD) on the day-to-day relationship between male partner alcohol consumption and male-to-female intimate partner violence (IPV) for men entering a domestic violence treatment program (n=170) or an alcoholism treatment program (n=169) were examined. For both samples, alcohol consumption was associated with an increased likelihood of nonsevere IPV among men without a diagnosis of ASPD but not among men with ASPD (who tended to engage in nonsevere IPV whether they did or did not drink). Drinking was more strongly associated with a likelihood of severe IPV among men with ASPD compared with those without ASPD who also drank. These results provide partial support for a multiple threshold model of intoxication and aggression.

Behavioral couples therapy for drug-abusing patients: effects on partner violence

Using data from a previous investigation, the purpose of the present study was to examine the effect of Behavioral Couples Therapy (BCT) on the prevalence of partner violence among married or cohabiting substance-abusing men (N = 80). Participants were randomly assigned to receive either BCT or individual-based treatment (IBT). The proportion of couples who engaged in male-to-female physical aggression was not different during the year before treatment for dyads in BCT (n = 17, 43%) and IBT (n = 19, 48%). However, a smaller proportion of couples in the BCT condition reported male-to-female physical aggression during the year after treatment (n = 7, 18%) than those in the IBT condition (n = 17, 43%). Dyadic adjustment, frequency of heavy drinking, and frequency of drug use during the year after treatment mediated the relationship between type of treatment and the prevalence of male-to-female physical aggression.

Drug-abusing patients and their intimate partners: dyadic adjustment, relationship stability, and substance use.

The dyadic adjustment and substance use of couples with a drug-abusing husband (n = 94), couples with a drug-abusing wife (n = 36), couples in which both partners abused drugs (n = 87), and non-substance-abusing conflicted couples (n = 70) were examined. For couples with 1 drug-abusing partner, a higher percentage of days abstinent during the year before treatment for drug abuse was associated with a higher level of relationship satisfaction. When both partners abused drugs, the relationship between percentage of days abstinent and relationship satisfaction became stronger and more negative as the time partners spent together using drugs increased. A higher percentage of days abstinent was associated with relationship stability for couples with 1 drug-abusing partner during and 1 year after treatment; for couples in which both partners abused drugs, a higher percentage of days abstinent was associated with relationship instability.

Depression in spouses of chronic pain patients : the role of patient pain and anger, and marital satisfaction

&NA; Although several studies have shown that spouses of chronic pain patients may experience clinically significant depressive symptoms few studies have comprehensively examined the role of both patient and spouse‐related factors in the development and maintenance of this emotional distress. Twenty‐nine married male chronic benign low back pain patients and their spouses were recruited in order to examine the role of patient, spouse, and marital factors in spouse depressive symptomatology. The results indicated that 28% percent of the spouses in the sample reported significantly depressed mood. A 2‐stage regression analysis was employed that revealed 3 significant predictors of spouses depressed mood, namely patients average pain, patients reported levels of anger and hostility, and the spouses level of marital satisfaction. These findings are discussed in terms of their implications for clinical interventions for pain patients and their families.

Behavioral couples therapy for female substance-abusing patients: Effects on substance use and relationship adjustment.

Married or cohabiting female drug-abusing patients (N = 75) were randomly assigned to either a behavioral couples therapy condition (BCT; n = 37), which consisted of group, individual, and behavioral couples therapy sessions, or to an equally intensive individual-based treatment condition (IBT; n = 38), which consisted of group and individual counseling. During most of the 1-year follow-up, compared with participants who received IBT, those who received BCT reported (a) fewer days of substance use, (b) longer periods of continuous abstinence, (c) lower levels of alcohol, drug, and family problems, and (d) higher relationship satisfaction. However, differences in relationship satisfaction and number of days of substance use dissipated over the course of the posttreatment follow-up period and were not significantly different by the end of 1 year.

Learning sobriety together: A randomized clinical trial examining behavioral couples therapy with alcoholic female patients.

Married or cohabiting female alcoholic patients (n = 138) and their non-substance-abusing male partners were randomly assigned to 1 of 3 equally intensive interventions: (a) behavioral couples therapy plus individual-based treatment (BCT; n = 46), (b) individual-based treatment only (IBT; n = 46), or (c) psychoeducational attention control treatment (PACT; n = 46). During treatment, participants in BCT showed significantly greater improvement in dyadic adjustment than those in IBT or PACT; drinking frequency was not significantly different among participants in the different conditions. During the 1-year posttreatment follow-up, compared with participants who received IBT or PACT, participants who received BCT reported (a) fewer days of drinking, (b) fewer drinking-related negative consequences, (c) higher dyadic adjustment, and (d) reduced partner violence.

A national survey of the use of couples therapy in substance abuse treatment

Although results from multiple studies conducted over the last two decades indicate that Behavioral Couples Therapy (BCT) is an effective treatment for married or cohabiting alcohol- and drug-abusing patients, both in terms of reduced substance use and improved relationship satisfaction, it is unclear whether BCT or other types of couples-based interventions are used in community-based substance abuse treatment programs. In the present study, program administrators (e.g., executive directors, clinical directors, staff physicians) from 398 randomly selected community-based outpatient substance abuse treatment programs in the U.S. were interviewed regarding use of different family- and couples-based therapies in their programs. According to the program administrators, 27% of the programs provided some type of couples-based treatment. However, less than 5% of the agencies used behaviorally oriented couples therapy and none used BCT specifically. Recommendations for researchers and clinicians to increase the use of BCT in community-based treatment programs are provided.

The role of pain behaviors in the modulation of marital conflict in chronic pain couples.

&NA; Sixty‐one married male chronic benign back pain patients and their spouses were recruited in order to examine the relationship between marital conflict/stress and patient pain behaviors. The results suggest that marital conflict in pain couples is associated with increases in subsequent display of pain behaviors which, in turn, are associated with greater negative affective responses and more punitive behaviors by the spouse. A positive association was found between punitive spouse behaviors and patient physical and psychosocial impairment. The findings are discussed in terms of their clinical implications and the need for further experimental study of these relationships.

The timeline followback spousal violence interview to assess physical aggression between intimate partners: Reliability and validity:

The psychometric properties of the Timeline Followback Spousal Violence interview (TLFB-SV), a calendar method used to assess daily patterns and frequency of spousal violence, were evaluated. Men (N = 104) entering a spousal violence treatment program, along with their female partners, were interviewed with the TLFB-SV at pretreatment, posttreatment, and quarterly thereafter for 1 year and asked to identify days of male-to-female and female-to-male physical aggression that had occurred between them. For posttreatment and follow-up interviews, participants maintained a weekly diary, in which they catalogued the days on which acts of spousal violence occurred. The subscale scores derived from the TLFB-SV, the proportion of days of any violence, and proportion of days of severe violence for each partner were calculated for each assessment interval. The TLFB-SV subscales had excellent temporal stability and concurrent and discriminant validity. Interpartner agreement on TLFB-SV subscale scores and agreement between partners on days when spousal violence occurred was low at pretreatment, but was high for the other assessment periods.