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"Self-report measures of coercive process in couple and parent-child dyads": Correction

Mitnick, Danielle M; Lorber, Michael F; Smith Slep, Amy M; Heyman, Richard E; Xu, Shu; Bulling, Lisanne J; Nichols, Sara R; Eddy, J Mark
Reports an error in "Self-report measures of coercive process in couple and parent-child dyads" by Danielle M. Mitnick, Michael F. Lorber, Amy M. Smith Slep, Richard E. Heyman, Shu Xu, Lisanne J. Bulling, Sara R. Nichols and J. Mark Eddy (Journal of Family Psychology, 2021[Apr], Vol 35[3], 388-398). In the original article, the full acknowledgment of funding was missing in the author note and should have read "This work was supported by the National Institutes of Health (NIH) Science of Behavior Change Common Fund Program and the National Institute of Dental and Craniofacial Research through an award administered by the National Institute of Dental and Craniofacial Research [1UH2DE025980-01]." The online version of this article has been corrected. (The following abstract of the original article appeared in record 2020-49926-001). One of the most influential behavioral models of family conflict is G. R. Patterson's (1982) coercive family process theory. Self-reports for behaviors related to coercion (e.g., hostility toward a family member) abound; however, there are no self-report measures for coercive process itself, which is, by definition, a dyadic process. Operationalizations of coercive process are measured with behavioral observation, typically including sequential analyzed, microcoded behaviors. Despite its objectivity and rigor, coding of behavior observation is not always feasible in research and applied settings because of the high training, personnel, and time costs the observation requires. Because coercive process has been shown to predict a host of maladaptive outcomes (e.g., parent-child conflict, aggression, negative health outcomes) and given the complete absence of self-report measures of coercive process, we recently designed brief questionnaires to assess coercive process in couple (Couple Coercive Process Scale [CCPS]) and parent-child interactions (Parent-Child Coercive Process Scale [PCCPS]) and tested them via Qualtrics participant panels in samples recruited to mirror socioeconomic generalizability to U.S. Census data. The CCPS and PCCPS exhibited initial evidence of psychometric quality in measuring coercive process in couple and parent-child dyads: Both measures are unifactorial; have evidence of reliability, especially at higher levels of coercive process; and demonstrate concurrent validity with constructs in their nomological networks, with medium to large effect sizes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
PMID: 35324252
ISSN: 1939-1293
CID: 5220522

Systematic Review of the Military Career Impact of Mental Health Evaluation and Treatment

Heyman, Richard E; Slep, Amy M Smith; Parsons, Aleja M; Ellerbeck, Emma L; McMillan, Katharine K
INTRODUCTION/BACKGROUND:Military leaders are concerned that active duty members' fear of career impact deters mental health (MH) treatment-seeking. To coalesce research on the actual and perceived consequences of MH treatment on service members' careers, this systematic review of literature on the U.S. Military since 2000 has been investigating the following three research questions: (1) is the manner in which U.S. active duty military members seek MH treatment associated with career-affecting recommendations from providers? (2) Does MH treatment-seeking in U.S. active duty military members impact military careers, compared with not seeking treatment? (3) Do U.S. active duty military members perceive that seeking MH treatment is associated with negative career impacts? MATERIALS AND METHODS/METHODS:A search of academic databases for keywords "military 'career impact' 'mental health'" resulted in 653 studies, and an additional 51 additional studies were identified through other sources; 61 full-text articles were assessed for eligibility. A supplemental search in Medline, PsycInfo, and Google Scholar replacing "career impact" with "stigma" was also conducted; 54 articles (comprising 61 studies) met the inclusion criteria. RESULTS:As stipulated by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, studies were summarized on the population studied (U.S. Military Service[s]), sample used, intervention type, comparison group employed, outcome variables, and findings. Self-referred, compared with command-directed, service members appear to be less likely to face career-affecting provider recommendations in non-deployed and deployed settings although the data for the latter are not consistent. Of the two studies that tested if MH treatment actually negatively impacts military careers, results showed that those who sought treatment were more likely to be discharged although the casual nature of this relationship cannot be inferred from their design. Last, over one-third of all non-deployed service members, and over half of those who screened positive for psychiatric problems, believe that seeking MH treatments will harm their careers. CONCLUSIONS:Despite considerable efforts to destigmatize MH treatment-seeking, a substantial proportion of service members believe that seeking help will negatively impact their careers. On one hand, these perceptions are somewhat backed by reality, as seeking MH treatment is associated with a higher likelihood of being involuntarily discharged. On the other hand, correlational designs cannot establish causality. Variables that increase both treatment-seeking and discharge could include (1) adverse childhood experiences; (2) elevated psychological problems (including both [a] the often-screened depression, anxiety, and posttraumatic stress problems and [b] problems that can interfere with military service: personality disorders, psychotic disorders, and bipolar disorder, among others); (3) a history of aggressive or behavioral problems; and (4) alcohol use and abuse. In addition, most referrals are self-directed and do not result in any career-affecting provider recommendations. In conclusion, the essential question of this research area-"Does seeking MH treatment, compared with not seeking treatment, cause career harm?"-has not been addressed scientifically. At a minimum, longitudinal studies before treatment initiation are required, with multiple data collection waves comprising symptom measurement, treatment, and other services obtained, and a content-valid measure of career impact.
PMID: 34322709
ISSN: 1930-613x
CID: 4995752

Spouse caregivers' identification of the patient as their primary support person is associated with better patient psychological well-being

Otto, Amy K; Vadaparampil, Susan T; Heyman, Richard E; Ellington, Lee; Reblin, Maija
Examine the impact of the primary-support person (PSP) role on advanced cancer patient and spouse caregiver psychological well-being, above and beyond the effects of relationship satisfaction.
PMID: 35486591
ISSN: 1540-7586
CID: 5217832

Impact of Relationship and Communication Variables on Ambulatory Blood Pressure in Advanced Cancer Caregivers

Otto, Amy K; Soriano, Emily C; Birmingham, Wendy C; Vadaparampil, Susan T; Heyman, Richard E; Ellington, Lee; Reblin, Maija
BACKGROUND:Cancer impacts both patients and their family caregivers. Evidence suggests that caregiving stress, including the strain of taking on a new role, can elevate the risk of numerous health conditions, including high blood pressure (BP). However, the caregiver's psychosocial experiences, including their interpersonal relationship with the patient, may buffer some of the negative physiological consequences of caregiving. PURPOSE/OBJECTIVE:To examine the influence of psychosocial contextual variables on caregiver ambulatory BP. METHODS:Participants were 81 spouse-caregivers of patients with advanced gastrointestinal or thoracic cancer. For an entire day at home with the patient, caregivers wore an ambulatory BP monitor that took readings at random intervals. Immediately after each BP reading, caregivers reported on physical circumstances (e.g., posture, activity) and psychosocial experiences since the last BP measurement, including affect, caregiver and patient disclosure, and role perceptions (i.e., feeling more like a spouse vs. caregiver). Multilevel modeling was used to examine concurrent and lagged effects of psychosocial variables on systolic and diastolic BP, controlling for momentary posture, activity, negative affect, and time. RESULTS:Feeling more like a caregiver (vs. spouse) was associated with lower systolic BP at the same time point. Patient disclosure to the caregiver since the previous BP reading was associated with higher diastolic BP. No lagged effects were statistically significant. CONCLUSIONS:Caregivers' psychosocial experiences can have immediate physiological effects. Future research should examine possible cognitive and behavioral mechanisms of these effects, as well as longer-term effects of caregiver role perceptions and patient disclosure on caregiver psychological and physical health.
PMID: 34244701
ISSN: 1532-4796
CID: 5088042

The role of intimate partner violence and relationship satisfaction in couples' interpersonal emotional arousal

Wojda, Alexandra K; Baucom, Donald H; Weber, Danielle M; Heyman, Richard E; Slep, Amy M Smith
To inform interpersonal models of intimate partner violence (IPV), the present study examines patterns of vocally encoded emotional arousal during the conversations of mixed-gender couples who reported on the extent of physical and psychological IPV and degree of relationship satisfaction (N = 149). All couples completed two problem-solving discussions. Emotional arousal was measured continuously during each conversation using vocal fundamental frequency. Contrary to expectations, results demonstrated that trajectories of arousal differed based on gender, IPV, and relationship satisfaction. Within conversations, men demonstrated linear increases in arousal at higher levels of IPV, suggesting that men may either struggle to contain their emotions or use heightened emotional expression as a conflict strategy in relationships with more extensive IPV. Conversely, women exhibited different trajectories of arousal depending on the combinations of relationship satisfaction and couple IPV, except at higher levels of their own satisfaction. Specifically, when women reported being highly satisfied in their relationships, they demonstrated similarly shaped trajectories across all levels of IPV and men's satisfaction. Together, this suggests that women's higher relationship satisfaction may buffer their emotional expression, although this may not always be adaptive within the context of relationships with extensive IPV. Overall, this study offers insight into the dynamic interpersonal processes linked with relationship distress and IPV and implies the need for a more nuanced, interpersonal research agenda for IPV research. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
PMID: 34472937
ISSN: 1939-1293
CID: 4995722

Impact of expectation violation on relationship satisfaction across the transition to parenthood

Mitnick, Danielle M; Heyman, Richard E; Slep, Amy M Smith; Giresi, Jill; Shanley, Jacqueline E
This study examined whether violations of partner expectations-and attributions and perceptions of these violations-are associated with relationship satisfaction across the transition to parenthood. First-time parents (N = 99) mixed-sex couples completed mail-in packets during pregnancy (Time 1; T1) and when their babies were 3-5 months old (Time 2; T2). Hypotheses were largely confirmed. Multilevel modeling results indicated a significant T1-to-T2 decrease in relationship satisfaction. Expectation violations significantly predicted change in satisfaction; undermet expectations are associated with decreased satisfaction. T2 perception of expectation confirmation predicted change in satisfaction at T2 and moderated the relationship between expectation violation and relationship satisfaction. Likewise, benign postnatal attributions were significantly associated with the change in satisfaction at T2 and moderated the relationship between expectation violation and relationship satisfaction. Clinical and research implications are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
PMID: 34110846
ISSN: 1939-1293
CID: 4905492

Couples' Anger Dynamics during Conflict: Interpersonal Anger Regulation, Relationship Satisfaction, and Intimate Partner Violence

Slep, Amy M; Heyman, Richard E; Lorber, Michael F; Tiberio, Stacey S; Casillas, Katherine L
We tested hypotheses about moment-to-moment interpersonal influences on anger during couples' conflict, and the association of those anger dynamics with relationship satisfaction and intimate partner violence (IPV). Displayed anger was coded from laboratory observations of cohabiting couples (N = 197); experienced anger was assessed via a video-recall procedure. Credible, but variable, associations were found in which a person's anger display at one moment was linked to change in the partner's anger display and experience in the next moment. Women's anger experience was more strongly influenced by men's anger displays in couples with higher levels of IPV and couples with lower levels of relationship satisfaction. The displayed anger of men who perpetrated higher levels of IPV was more strongly influenced by women's anger displays. Overall, when individuals displayed higher intensity anger, partners reacted with increasingly angry feelings but decreasingly angry displays. Results suggest that anger dynamics relate to dyadic processes and that dynamics relate to important relationship outcomes. Dyadic anger dynamics might prove a worthy intervention target.
PMID: 33511642
ISSN: 1545-5300
CID: 4777072

The Psychosocial Impact of Spouse-Caregiver Chronic Health Conditions and Personal History of Cancer on Well-being in Patients With Advanced Cancer and Their Caregivers

Ketcher, Dana; Otto, Amy K; Vadaparampil, Susan T; Heyman, Richard E; Ellington, Lee; Reblin, Maija
CONTEXT/BACKGROUND:Caregiving during advanced cancer presents many physical and psychological challenges, especially for caregivers who are coping with their own history of cancer or their own chronic health conditions. There is growing recognition that caregiver health and patient health are interdependent. OBJECTIVES/OBJECTIVE:The objective of this study was to use quantitative and interview data to examine and explore the impact of a caregiver's personal cancer history and chronic health conditions on the psychosocial well-being of both the caregiver and patient. METHODS:This was a secondary analysis of data from 88 patients with advanced lung/gastrointestinal cancer and their spouse-caregivers. Participants self-reported subjective health, chronic health conditions (including cancer), anxiety and depression symptoms, and social support and social stress. Caregivers self-reported caregiving burden and preparedness for caregiving. Caregivers also completed semistructured interviews. RESULTS:Participants were mostly white, non-Hispanic, and in their mid-60s. Caregivers reported 1.40 (SD = 1.14) chronic conditions on average; 11 reported a personal history of cancer ("survivor-caregivers"). The number of caregiver chronic health conditions was positively associated with patient depression symptoms. Patients of survivor-caregivers also reported more depression symptoms than patients of caregivers without cancer (t(85) = -2.35, P = 0.021). Survivor-caregivers reported higher preparedness for caregiving than caregivers without cancer (t(85) = -2.48, P = 0.015). Interview data enriched quantitative findings and identified factors that may drive patient depression, including emotions such as resentment or guilt. Experiencing cancer personally may provide caregivers unique insight into the patient experience. CONCLUSION/CONCLUSIONS:Providers should be aware of caregiver chronic conditions and cancer history, given the potential negative effects on patient psychosocial well-being.
PMID: 33348028
ISSN: 1873-6513
CID: 4770912

The lump-versus-split dilemma in couple observational coding: A multisite analysis of rapid marital interaction coding system data

Heyman, Richard E; Otto, Amy K; Reblin, Maija; Wojda, Alexandra K; Xu, Shu
Historically, observational couple communication researchers have oscillated between splitting behaviors into narrowly defined discrete codes and grouping behaviors into broader codes-sometimes within the same study. We label this the "lump-versus-split dilemma." Coding across a decade and 11 investigators were used to recommend the most meaningful number of codes to use when observing couples' conflict. We combined data from 14 studies that used the Rapid Marital Interaction Coding System (RMICS) to score communication behavior during different-sex couples' conflict interactions. In each study, couples completed at least one 10-min, video-recorded conflict discussion. Communication during these interactions was coded by trained research staff using RMICS; all codes were compiled into a single data set for descriptive analysis and exploratory factor analyses (EFAs). The final sample comprised N = 2,011 couples. Several RMICS codes were extremely infrequent-specifically, distress-maintaining attributions, psychological abuse, withdrawal, dysphoric affect, and relationship-enhancing attributions. By far, the most frequent code was constructive problem discussion. EFAs yielded two factors for both women and men. Factor 1 (Negative) contained two items: distress-maintaining attributions and hostility. Factor 2 (Nonnegative) contained constructive problem discussion and humor (and, for women only, acceptance). Results side heavily with the "lump" camp in the lump-versus-split dilemma in couple observational coding. These RMICS factor analysis results converge with those from other systems and imply that the microanalytic "splitting" era in couples coding should draw to a close, with future studies instead focused on negative, neutral, and positive codes. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
PMID: 33180516
ISSN: 1939-1293
CID: 4673242

Evaluating the Relationship Between Intimate Partner Violence-Related Training and Mental Health Professionals' Assessment of Relationship Problems

Burns, Samantha C; Kogan, Cary S; Heyman, Richard E; Foran, Heather M; Slep, Amy M Smith; Domínguez-Martínez, Tecelli; Grenier, Jean; Matsumoto, Chihiro; Reed, Geoffrey M
Intimate partner violence (IPV) is a serious public health problem associated with increased risk of developing mental health conditions. Assessment of IPV in mental health settings is important for appropriate treatment planning and referral; however, lack of training in how to identify and respond to IPV presents a significant barrier to assessment. To address this issue, the World Health Organization (WHO) advanced a series of evidence-based recommendations for IPV-related training programs. This study examines the relationship between mental health professionals' experiences of IPV-related training, including the degree to which their training resembles WHO training recommendations, and their accuracy in correctly identifying relationship problems. Participants were psychologists and psychiatrists (N = 321) from 24 countries who agreed to participate in an online survey in French, Japanese, or Spanish. They responded to questions regarding their IPV-related training (i.e., components and hours of training) and rated the presence or absence of clinically significant relationship problems and maltreatment (RPM) and mental disorders across four case vignettes. Participants who received IPV-related training, and whose training was more recent and more closely resembled WHO training recommendations, were more likely than those without training to accurately identify RPM when it was present. Clinicians regardless of IPV-related training were equally likely to misclassify normative couple issues as clinically significant RPM. Findings suggest that IPV-related training assists clinicians in making more accurate assessments of patients presenting with clinically significant relationship problems, including IPV. These data inform recommendations for IPV-related training programs and suggest that training should be repeated, multicomponent, and include experiential training exercises, and guidelines for distinguishing normative relationship problems from clinically significant RPM.
PMID: 33866857
ISSN: 1552-6518
CID: 4995742