Dissertations / Theses on the topic 'Couple relationship adjustment'

This thesis describes a program of research which aimed to identify the extent to which couple and stepfamily variables were associated with couple relationship adjustment and stability in stepfamily couples. Two studies were conducted. Study 1 consisted of 63 stepfamily couples who were in a committed relationship (married or cohabiting) and who had earlier taken part in an intervention program. It was hypothesised that positive couple relationship outcomes could be predicted by low couple aggression, high couple negativity, low couple withdrawal, high parenting disagreement, and high dysfunctional parenting over a 5-year period. The results did not support the hypotheses possibly due to low power in the design. In Study 2, 122 stepfamily couples who been living together (married or cohabiting) as a stepfamily were assessed on couple and stepfamily factors, and these were tested for their association with couple relationship adjustment and stability, using both self-report questionnaires and interview data. As predicted, stepfamily factors accounted for variance in couple stability above that accounted for by couple factors. Furthermore, stepfamily factors were associated with couple stability independent of couple adjustment. The influence of stepfamily couple relationship adjustment and stability seem distinctive from first-marriage couples. It was concluded that stepfamily relationship education programs for stepfamilies should address the unique needs of stepfamilies such as parenting education for inexperienced stepparents, the development of positive stepparent-stepchild relationships, and the building of stepfamily cohesion.

This thesis describes a program of research which aimed to identify the extent to which couple and stepfamily variables were associated with couple relationship adjustment and stability in stepfamily couples. Two studies were conducted. Study 1 consisted of 63 stepfamily couples who were in a committed relationship (married or cohabiting) and who had earlier taken part in an intervention program. It was hypothesised that positive couple relationship outcomes could be predicted by low couple aggression, high couple negativity, low couple withdrawal, high parenting disagreement, and high dysfunctional parenting over a 5-year period. The results did not support the hypotheses possibly due to low power in the design. In Study 2, 122 stepfamily couples who been living together (married or cohabiting) as a stepfamily were assessed on couple and stepfamily factors, and these were tested for their association with couple relationship adjustment and stability, using both self-report questionnaires and interview data. As predicted, stepfamily factors accounted for variance in couple stability above that accounted for by couple factors. Furthermore, stepfamily factors were associated with couple stability independent of couple adjustment. The influence of stepfamily couple relationship adjustment and stability seem distinctive from first-marriage couples. It was concluded that stepfamily relationship education programs for stepfamilies should address the unique needs of stepfamilies such as parenting education for inexperienced stepparents, the development of positive stepparent-stepchild relationships, and the building of stepfamily cohesion.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Psychology
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Although Prochaska and DiClemente (1984) considered the Transtheoretical Model of Change (TTM) to be relevant to couples therapy, there is a paucity of research in this area. Understanding how couples initiate change in their relationship still proves difficult due to barriers in the collection of couple level data and the fact that the majority of research on the TTM is individualistic in nature (Fowers, 2001; Schneider, 2003). Schneider (2003) reported that research suggests a relationship between change processes and relationship adjustment in couples. To my knowledge this study is the first test of the reliability and correlates of relationship change, beyond Schneider’s initial work. The purpose of the present study was to examine how individual adjustment and readiness to change affect relationship adjustment. Data were collected from a sample of 389 married and cohabitating individuals using a self-report survey. Readiness to change was found to partially mediate the relationship between individual well-being and relationship adjustment. This link underscores the concept of women as health gatekeepers of the family. The present study validates research on the TTM with individuals but draws further attention to the idea that changing a dyadic relationship is not an individual process.

Two studies were undertaken to explore how aspects of the couple relationship might play a role in women's experience of prenatal diagnosis (PND). Both studies involved women referred to the Children's Hospital of Eastern Ontario (CHEO) for prenatal genetic counseling due to advanced maternal age (AMA). The first study examined the role of the partner during the genetic counseling session by comparing 123 women who attended the session alone with 222 women accompanied by their partners, on the basis of self-report measures completed immediately prior to and following the session. Accompanied women reported somewhat higher levels of state anxiety and PND-related decisional conflict before the session than did those who attended alone (p < .05). The presence of the partner could thus reflect a support-seeking coping strategy employed by women to cope with feelings of indecision and anxiety surrounding the issue of prenatal diagnosis. Alternatively, it is possible that attendance by the partner contributed to anxiety and uncertainty among women. The second study sought to clarify the reasons for partner attendance or non-attendance at the genetic counseling and testing appointments, and to explore how certain relationship variables might relate to women's individual and marital adjustment following PND. Ninety-five women completed self-report measures prior to genetic counseling (Time 1), during the waiting period for PND test results (Time 2), and after normal results were known (Time 3). Many women reported that their partners attended the appointments on the basis of the couple's view of PND as a shared experience, or to provide emotional and decisional support for the women. The most common reason for partner non-attendance was work-related conflicts. At Time 2, distress was predicted by the degree to which women approached the PND decision jointly with their partners, and marital adjustment was predicted by women's satisfaction with the support received from their partners. Marital adjustment at Time 3 was predicted by earlier levels of partner agreement about PND-related issues. The association between pre-counseling partner agreement and Time 3 well-being was mediated by women's use of relationship-focused coping (partner support seeking and empathic responding) and moderated by women's satisfaction with their partners' support. Joint decision-making at Time 1 was linked to Time 3 adjustment indirectly, through women's satisfaction with their partners' support. Finally, women's use of avoidant coping strategies mediated the association between perceived partner support and Time 3 adjustment outcomes. Results suggest that aspects of the couple relationship have the potential to facilitate or hinder women's experience of PND counseling and testing, thus highlighting the potential benefits of focusing at least a portion of the genetic counseling session on couple-related issues.

Relationship separation is prevalent in Western society and ongoing problems for adults and children are common, resulting in high personal and social costs. A literature review revealed that no existing measure of separation adjustment assessed multiple domains of separation adjustment, and was psychometrically sound. Additionally, a literature review revealed that few studies have investigated change in separation adjustment over time using cognitive predictors. This thesis is a program of research investigating separation adjustment in recently separated adults. Five studies were conducted with three main aims: (1) to develop a multidimensional, psychometrically reliable and valid measure of separation adjustment; (2) to assess the trajectory of separation adjustment over time; and (3) to test the hypothesis that certain cognitive variables predict the trajectory of separation adjustment. A conceptualisation of separation adjustment was developed consisting of the following five domains: Connection to the former partner, loneliness and emotional negativity (referred to as lonely negativity), parenting negotiation, parent-child relationship and general psychological adjustment. The Problems After Separation Test (PAST) was developed to reflect the first four of the five domains. In Study 1, 268 participants separated for up to 18 months, were recruited to assess the factor structure and internal consistency of the PAST. In Study 2, 209 participants were recruited to assess the stability of the factor structure, and temporal stability. In Study 3, participants from Study 2 were used to obtain convergent and divergent validity. The results of the first three studies showed that separation adjustment is a multidimensional construct, and that the PAST is a reliable and valid measure of separation adjustment. Study 4 aimed to assess the trajectory of separation adjustment over a 6 month period using the PAST and another measure of general psychological adjustment. Participants from both Study 1 and 2 were used, and a longitudinal cohort sequential design was employed. The sample consisted of three cohorts: those separated for up to six months, those separated between 6 and 12 months, and those separated between 12 and 18 months. The results showed that connection to the former partner, lonely negativity, and general psychological adjustment improved over time, but parent-child relationships and parenting negotiation were stable, and chronic parenting problems were common. Men showed greater parent-child relationship problems than women, possibly because men were most likely to be the non-resident parent. Participants separating from a de facto relationship reported only slightly more problems on lonely negativity, general psychological distress and parent-child relationships than participants separating from a marriage. Study 4 also provides information on clinical and reliable change, suggested cut-offs that might be used to define normal, moderate and severe adjustment problems, and attrition analyses. Using participants from Study 2, Study 5 aimed to assess cognitive predictors of change on connection to the former partner, lonely negativity and psychological distress. The cognitions assessed at each data collection were dysfunctional attitudes, attachment style, causal attributions, threat appraisal, and self-efficacy. Causal attributions were obtained by asking participants "For three minutes tell my about the problems you had in your relationship and what lead to the separation". The responses were transcribed, a coding manual was devised, and inter-rater reliability of coding was good. Cross-sectionally, the majority of cognitions were associated with one or more domains of separation adjustment, however longitudinally, cognitions did not predict change in separation adjustment over a 6-month period. Cognitions themselves were found to be somewhat variable, which is not surprising given that stressful life events, such as relationship separation would alter cognitions. Other variables that might be responsible for changes in separation adjustment trajectory are discussed. The results of the combined 5 studies have both theoretical and practical implications. Theoretically, separation adjustment is a construct made up of distinct domains which have different trajectories. Connection, lonely negativity and psychological adjustment generally represent transient problems. Although the current research found that a non-trivial minority of participants continued to show distress on these domains two years post separation. On the other hand, parenting negotiation and the parent-child relationship was a chronic problem for many separated people, particularly men. Practically, the results of the current research suggests that most therapeutic attention should be directed towards improving parenting adjustment post separation. Limitations of the current research and suggestions for future research are discussed.

Relationship separation is prevalent in Western society and ongoing problems for adults and children are common, resulting in high personal and social costs. A literature review revealed that no existing measure of separation adjustment assessed multiple domains of separation adjustment, and was psychometrically sound. Additionally, a literature review revealed that few studies have investigated change in separation adjustment over time using cognitive predictors. This thesis is a program of research investigating separation adjustment in recently separated adults. Five studies were conducted with three main aims: (1) to develop a multidimensional, psychometrically reliable and valid measure of separation adjustment; (2) to assess the trajectory of separation adjustment over time; and (3) to test the hypothesis that certain cognitive variables predict the trajectory of separation adjustment. A conceptualisation of separation adjustment was developed consisting of the following five domains: Connection to the former partner, loneliness and emotional negativity (referred to as lonely negativity), parenting negotiation, parent-child relationship and general psychological adjustment. The Problems After Separation Test (PAST) was developed to reflect the first four of the five domains. In Study 1, 268 participants separated for up to 18 months, were recruited to assess the factor structure and internal consistency of the PAST. In Study 2, 209 participants were recruited to assess the stability of the factor structure, and temporal stability. In Study 3, participants from Study 2 were used to obtain convergent and divergent validity. The results of the first three studies showed that separation adjustment is a multidimensional construct, and that the PAST is a reliable and valid measure of separation adjustment. Study 4 aimed to assess the trajectory of separation adjustment over a 6 month period using the PAST and another measure of general psychological adjustment. Participants from both Study 1 and 2 were used, and a longitudinal cohort sequential design was employed. The sample consisted of three cohorts: those separated for up to six months, those separated between 6 and 12 months, and those separated between 12 and 18 months. The results showed that connection to the former partner, lonely negativity, and general psychological adjustment improved over time, but parent-child relationships and parenting negotiation were stable, and chronic parenting problems were common. Men showed greater parent-child relationship problems than women, possibly because men were most likely to be the non-resident parent. Participants separating from a de facto relationship reported only slightly more problems on lonely negativity, general psychological distress and parent-child relationships than participants separating from a marriage. Study 4 also provides information on clinical and reliable change, suggested cut-offs that might be used to define normal, moderate and severe adjustment problems, and attrition analyses. Using participants from Study 2, Study 5 aimed to assess cognitive predictors of change on connection to the former partner, lonely negativity and psychological distress. The cognitions assessed at each data collection were dysfunctional attitudes, attachment style, causal attributions, threat appraisal, and self-efficacy. Causal attributions were obtained by asking participants "For three minutes tell my about the problems you had in your relationship and what lead to the separation". The responses were transcribed, a coding manual was devised, and inter-rater reliability of coding was good. Cross-sectionally, the majority of cognitions were associated with one or more domains of separation adjustment, however longitudinally, cognitions did not predict change in separation adjustment over a 6-month period. Cognitions themselves were found to be somewhat variable, which is not surprising given that stressful life events, such as relationship separation would alter cognitions. Other variables that might be responsible for changes in separation adjustment trajectory are discussed. The results of the combined 5 studies have both theoretical and practical implications. Theoretically, separation adjustment is a construct made up of distinct domains which have different trajectories. Connection, lonely negativity and psychological adjustment generally represent transient problems. Although the current research found that a non-trivial minority of participants continued to show distress on these domains two years post separation. On the other hand, parenting negotiation and the parent-child relationship was a chronic problem for many separated people, particularly men. Practically, the results of the current research suggests that most therapeutic attention should be directed towards improving parenting adjustment post separation. Limitations of the current research and suggestions for future research are discussed.
Thesis (Professional Doctorate)
School of Applied Psychology
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The purpose of this study was to explore the marital adjustment of older adult couples with breast cancer, prostate cancer, and couples who have experienced neither. Participants were 64 couples in which at least one of the spouses was over 55 years of age, including 19 breast cancer couples, 20 prostate cancer couples, 25 couples who had experienced neither of these cancers. Most participants were young-old, Protestant, Caucasians from a high socioeconomic class. The breast cancer and prostate cancer participants had completed treatment an average of 39.5 months prior to participation. The methodology was a mail survey. Participants completed a demographic questionnaire, the Marital Satisfaction Questionnaire for Older Adults (MSQFOP) (Haynes et al., 1992), Primary Communication Inventory (PCI) (Navran, 1967), Miller Social Intimacy Scale (MSIS) (Miller & Lefcourt, 1982), and the Index of Sexual Satisfaction (ISS) (Hudson et al., 1981).There were no differences in the amount of discordance between the couples groups' level of marital satisfaction, communication, intimacy, and sexual satisfaction. In addition, there were no differences in the level of marital satisfaction, communication, intimacy, and sexual satisfaction between the participant groups. There was a significantly greater correlation between the prostate cancer couples' scores on the ISS than the correlation between the breast cancer couples' scores and the scores of the couples who had not experienced breast cancer or prostate cancer.The level of marital satisfaction, communication, intimacy, and sexual satisfaction reported was similar to that of the normative samples. There was no difference between the marital adjustment of the cancer couples and older couples who had experienced neither type of cancer. These results are good news for breast and prostate cancer survivors, and professionals. Older adults may be better able to incorporate the experience of cancer into their lives or are better prepared for chronic illness through anticipatory socialization. The high degree of agreement between the prostate cancer spouses on the ISS may be related to the sexual dysfunction that frequently accompanies treatment for this cancer. Future research should be qualitative and longitudinal and continue to explore the psychosocial implications of prostate cancer.
Center for Gerontology

Self-enhancement is a process by which individuals misperceive themselves by viewing themselves in a positively biased manner. Past research indicates that self-enhancement can have both positive and negative effects on romantic relationships. The purpose of this dissertation was to explore the role of self-enhancement in unmarried dating couples (N = 124 couples; 248 individuals) with respect to conflict, dyadic adjustment, causal and responsibility attributions, and possible moderators between self-enhancement and dyadic adjustment. The results are organized in four sections. First, I found a curvilinear relationship between participant self-enhancement and conflict. At very low and very high levels of self-enhancement there were increased levels of conflict. Second, participant self-enhancement was positively associated with positively associated with increased participant dyadic adjustment, but there was no relationship between participant self-enhancement and partner dyadic adjustment. Third, there was no relationship between participant self-enhancement and causal and responsibility attributions. Fourth, forgiveness and commitment did not moderate the relationship between self-enhancement and dyadic adjustment; however, there were main effects for both forgiveness and commitment - both forgiveness and commitment were positively associated with dyadic adjustment. I conclude by discussing limitations, areas of future research, and implications for counseling.

Thesis (M.S.)--University of Kentucky, 2008.
Title from document title page (viewed on October 30, 2008). Document formatted into pages; contains: viii, 48 p. : ill. Includes abstract and vita. Includes bibliographical references (p. 43-47).

Thesis (M.S.W.)--Smith College School for Social Work, Northampton, Mass., 2007
Thesis submitted in partial fulfillment for the degree of Master of Social Work. Includes bibliographical references (leaves 92-94).

Today’s military encompasses a wide variety of families who are affected by deployments in multiple and complex ways. Following deployments, families must reconnect in their relationships and reestablish their way of life. Appropriate and effective communication during this time is critical, yet many military couples struggle with this process. Moreover, student service members/veterans and their families are in a unique position. In addition to coping with changes in their marital relationship, student veterans may feel isolated or unsupported on college campuses, often experiencing anxiety, depression, posttraumatic stress, or suicidality. The current study seeks to bridge the gap between the military family literature and the student service member/veteran literature by examining how deployment experiences, mental health issues, and communication patterns influence post-deployment relationship adjustment among student veterans. Analyses tested whether communication style and/or current mental health concerns mediate associations between combat experiences and couples’ relationship adjustment, as well as between experiences in the aftermath of battle and relationship adjustment. Results suggest that although posttraumatic stress is significantly related to deployment experiences among student veterans, participants report no significant negative effects of deployment on relationship adjustment. Communication style, however, was significantly associated with relationship adjustment, and a lack of positive communication was found to correlate with PTSD diagnosis. Research and clinical implications are discussed.

Recent studies have shown that the experience of infertility is linked with emotional responses such as depression, anxiety, guilt, social isolation, and decreased self-esteem in both men and women. This study explored the impact of congruence between couples' infertility-related stress and its effects on depression and marital adjustment in infertile men and women. Study participants were comprised of 525 couples referred to a university-affiliated teaching hospital for assessment and treatment with advanced reproductive technologies. Participants completed the Fertility Problem Inventory (FPI), the Beck Depression Inventory (BDI), and the Dyadic Adjustment Scale (DAS) three months prior to their first treatment cycle. The impact of differences between couples' perceptions of infertility-related stress were examined in relation to their effect on individual levels of depression and marital adjustment in both men and women. Results showed that differences between couple's evaluations of infertility-related stress were predictive of female depression, but not male depression. Women in couples who reported high levels of congruence (e.g., agreement) concerning the impact of infertility-related stress had significantly lower levels of depression when compared to couples in which females experienced a greater amount of stress than their partners. In terms of marital adjustment, men and women in couples who reported high levels of congruence concerning the impact of infertility-related stress reported significantly higher levels of adjustment when compared to couples who differed in their appraisals of the stress. Treatment implications based on these findings and future research directions are discussed.
Master of Science

This study explored the individual and dyadic coping processes of men and women in infertile couples and their relationship to infertility stress, marital adjustment, and depression. Study participants were comprised of 1,026 men and women (420 of which were couples) who were referred to a university-affiliated teaching hospital for advanced reproductive treatments between the years of 1991 and 2001. Three months prior to treatment, participants completed the Ways of Coping Questionnaire (WCQ), the Fertility Problem Inventory (FPI), the Dyadic Adjustment Scale (DAS), and the Beck Depression Inventory (BDI). Findings from the study showed that escape avoidance, accepting responsibility, and self controlling were strongly related to increased stress, depression, and decreased marital adjustment for both men and women; while seeking social support was related to increased marital adjustment. Multivariate analyses of variance and covariance consistently showed that participants in four groups of couples who used high and low amounts of coping differed in their reports of infertility stress, marital adjustment, and depression. In addition, gender differences were found, with females consistently reporting greater levels of stress and depression than males. Several significant couple pairings among the four groups were found. Clinical implications linking study findings with marital and family therapies and ideas for future research are discussed.
Ph. D.

Contexte : les Plans Cancer 2 et 3 soulignent l'importance de la décision médicale partagée. Cependant, la littérature sur la reconstruction mammaire (RM) suite à un cancer du sein montre la place essentielle du médecin dans la prise de décision. Les proches apparaissent également comme peu pris en compte par les médecins dans le choix des traitements et en particulier le partenaire intime qui est le proche généralement le plus présent aux côtés de la patiente. À l'heure actuelle, aucune recherche n'a étudié les interactions conjugales dans le processus de décision d'une RM. Pourtant, plusieurs études ont montré l'interdépendance des deux membres du couple face à une maladie chronique et le rôle essentiel du partenaire dans l'ajustement des patientes au cancer du sein. Objectif : cette recherche a pour objectif principal d'étudier les interactions conjugales dans le processus de décision d'une RM suite au diagnostic d'un cancer du sein. Méthode : deux études ainsi qu'une revue systématique de la littérature ont été réalisées afin de répondre à cet objectif. Ces deux études étaient mixtes, comprenaient une partie quantitative (auto-questionnaires) et une partie qualitative (entretiens avec les femmes et leur partenaire). La première étude était rétrospective, en interrogeant des couples plusieurs années après le diagnostic du cancer. La seconde était prospective, en interrogeant des couples juste après le diagnostic du cancer. Les données quantitatives ont fait l'objet d'analyses non-paramétriques. Les données qualitatives ont fait l'objet d'une analyse de contenu thématique, d'une analyse lexicale (pour l'étude rétrospective) et d'une analyse phénoménologique interprétative (pour l'étude prospective). Résultats : les résultats de l'étude rétrospective montrent que l'ajustement émotionnel des femmes est le même quel que soit leur décision (RM immédiate, RM différée ou sans RM). Cependant, les femmes qui n'ont pas eu de RM recommanderaient moins leur décision comparées aux femmes qui ont eu une RM. Par ailleurs, les couples rapportent que la prise de décision de la RM est vécue et prise au sein du couple. Le partenaire y apparaît comme un soutien à la décision. La question de la temporalité apparaît différemment dans le discours des couples selon la décision. Les résultats de la revue systématique soulignent les différents rôles que les proches peuvent avoir dans la prise de décision d'un traitement pour une maladie chronique, notamment de manière directe (e.g., le partenaire communique ses préférences au patient) et indirecte (e.g., le choix du patient est guidé par sa perception de ses responsabilités familiales). Les résultats de l'étude prospective montrent qu'avant la mastectomie, les partenaires de femmes qui ne vont pas avoir de RMI expriment plus d'émotions négatives et un besoin d'information plus important que les partenaires de femmes qui vont avoir une RMI. De plus, les femmes et leurs partenaires pensent à la RM au moment de la mastectomie. Ces pensées leur permettent de se projeter dans le futur, où la RM est associée à une bonne santé. Penser à la RM pourrait alors permettre aux couples de s'ajuster face à la mastectomie et au diagnostic de cancer du sein. Conclusion : la prise de décision de la RM apparaît comme vécue au sein du couple, avec des spécificités en fonction de la décision prise (RM immédiate, RM différée ou pas de RM). Au niveau clinique, ce travail permet d'identifier les besoins des couples et de proposer des pistes d'interventions et d'outils à développer afin d'accompagner les femmes et leur partenaire. Au niveau de la recherche, il conviendrait d'investiguer plus largement comment la décision de la RM est prise entre la femme, son partenaire et les différents professionnels de santé impliqués dans la prise en charge médicale
Context: cancer Plans 2 and 3 emphasize the importance of a shared decision-making. However, the literature on breast reconstruction (BR) following breast cancer shows the physician essential place in this decision-making. Close others are also little included by physicians in this treatment choice and more specifically intimate partners. The latter is usually the most present near the women. To date, no research has studied couple interactions in the decision-making process of a BR. Yet, several studies have pointed out the interdependence of both members of a couple to face a chronic illness and partners' key role in women's adjustment facing breast cancer. Objective: the main objective of this research is to study couple interactions in the decision-making process of a BR following breast cancer diagnosis. Method: two studies as well as a systematic literature review were realized to meet this objective. These two studies were mixed, including a quantitative part (self-reported questionnaires) and a qualitative part (interviews with women and their partners). The first study was retrospective, interviewing couples several years after breast cancer diagnosis. The second study was prospective, interviewing couples just after breast cancer diagnosis. Quantitative data were subjected to non-parametric analysis. Qualitative data were subjected to a thematic content analysis, a lexical analysis and an interpretative phenomenological analysis. Results: the results of the retrospective study show that women's emotional adjustment is the same regardless their decision (immediate BR, delayed BR or no BR). However, women without BR would less recommend their decision compared to women with BR. In addition, couples report that BR decision was lived and taken within the couple. Partners were described as supportive in the decision-making process. The question of temporality emerged differently in couple's discourse according to the decision. The results of the systematic literature review highlight the different roles family members can have in treatment decision-making of a chronic illness, including direct (e.g., the partner says his/her preferences to the patient) and indirect influence (e.g., patient's choice is guided by his/her perception of his/her family responsibilities). The results of the prospective study shows that before the mastectomy, partners of women not having an immediate BR express more negative emotions and a greater need for information compared to partners of women having an immediate BR. Furthermore, women and their partners think to the BR at the time of the mastectomy. These thoughts allow couples to project themselves in the future, where BR is associated to a good health. Thinking to BR could allow couples to cope with the mastectomy and breast cancer diagnosis. Conclusion: BR decision-making appears as experienced within the couple, with specificities considering the decision (immediate BR, delayed BR or no BR). At the clinical level, this work allows to identify couples needs and to propose interventions and tools to develop in order to accompany women and their partners. At the research level, it should be distinguished more broadly how BR decision is made between the women, her partner and the health professionals involved in the medical care

This study evaluates the efficacy of a self-guided, low-intensity curriculum, Marriage Moments, based on Fowers' (2000) virtues model of marital quality that emphasizes friendship, generosity, justice and loyalty. The Marriage Moments program consists of a guidebook and a video that were designed to strengthen marriages during the transition to parenthood and is used in the context of a home visitation program for first-time parents. Participants in the study included 119 married couples who had recently given birth to their first child. They were assigned to either a treatment, comparison or control group. The treatment group received the Marriage Moments curriculum as well as the Welcome Baby home visitation curriculum, the comparison group only received the Welcome Baby curriculum and the control group received neither program. Data were gathered through a battery of self- and spouse-report measures given at 3-months, 4-months, and 9-months postpartum. Relationship outcome measures included in this study were the Marital Virtues Profile, Revised-Dyadic Adjustment Scale, RELATE Satisfaction subscale, Transition Adjustment Scale, Father Involvement Scale, Household Labor Scale, and Maternal Depression Scale. Despite positive evaluations of the program from participants, analyses revealed a lack of significant, positive effects for members of the treatment group. Further research is needed before reliable conclusions can be drawn about the value of a marital virtues model as a guide for low intensity intervention.

Le traitement d’un premier cancer de la prostate et les mois qui suivent, sont une période stressante pour les patients et leur conjointe. Les objectifs de cette étude sont, d’une part, de déterminer l’évolution de variables psychosociales (soutien social, qualité de la relation conjugale, ajustement dyadique et stratégies de coping) et du bien-être émotionnel et physique, et d’autre part, d’identifier les effets acteurs-partenaires, c'est-à-dire les effets des variables psychosociales d’un membre du couple sur son bien-être et sur celui de l’autre membre. Nous avons mené une étude longitudinale auprès de 132 patients atteints d’un cancer de la prostate et de 100 de leurs conjointes. Une évaluation psychologique leur a été proposée au début, au milieu, à la fin du traitement et quatre mois après. Les résultats montrent que les patients ont un état émotionnel et une qualité de vie satisfaisants et que les conjointes présentent une symptomatologie dépressive. Chez les patients, on observe des effets acteurs positifs du soutien social, de la relation conjugale et des stratégies de coping, centrées sur le problème ou sur la recherche de soutien social, sur leur bien-être, et des effets partenaires positifs de ces mêmes variables sur le bien-être de leur conjointe. Chez les conjointes, la relation conjugale a un effet acteur positif sur leur bien-être, mais le soutien social et les stratégies de coping centrées sur l’émotion ont des effets acteurs négatifs. De plus, l’effet partenaire soutien social des conjointes est positif sur le bien-être des patients, alors que celui des stratégies de coping centrées sur l’émotion est négatif. Celui de la relation conjugale est positif quand il s’agit de la disponibilité et de l’intensité du soutien, et négatif quand il s’agit de l’ajustement dyadique. De façon générale, le soutien social, la relation conjugale et les stratégies de coping sont de bons prédicteurs de la qualité de vie, directement ou par le biais du partenaire
The treatment of a first prostate cancer and the following months are a stressful period for the patients and their spouse. The first aim of this study was to determine the evolution of psychosocial variables (social support, quality of conjugal relationships, dyadic adjustment and coping strategies) and of emotional and physical well-being. The second aim was to identify actors-partners effects - that is the effect of one of partner’s psychosocial variables on his/her well-being and on that of the other. A longitudinal study was carried on 132 patients with prostate cancer and 100 of their spouses. A psychological evaluation was conducted at the beginning, half way through, at the end of the treatment and four months afterwards. Results showed that patients had a good emotional state and a good quality of life and, that the spouses developed a depressive symptomatology. For patients, positive actor effects of social support, conjugal relationships and coping strategies (problem-focused or seeking social support focused) on their well-being and, positive partner effects of the same variables on the spouses’ well-being were observed. For the spouses, conjugal relationships had a positive actor effect on their well-being, but social support and emotion-focused coping strategies had negative actor effects. Also, spouses’ social support had a positive partner effect on the patients’ well-being while emotion-focused coping strategies had a negative effect. Conjugal relationship effect was positive when referring to availability and intensity of support and, negative when referring to dyadic adjustment. Overall, social support, conjugal relationship and coping strategies were found to be good predictors of quality of life, directly or indirectly through the partner

M.Cur.
The death of a child is like none other. The impact shakes the world of parents in its entire being. This research tells the story of parents' experience of the couple relationship after child bereavement. The objectives of the research are to: • explore and describe a parent's experience of the couple relationship after child bereavement; and • describe guidelines for the advanced psychiatric nurse practitioner to provide support to parents who have experienced child bereavement in order to promote their mental health through the mobilisation of resources. The paradigmatic perspective of this study is guided by the Theory for Health Promotion in Nursing (Rand Afrikaans University, Department of Nursing Science, 2002:2-8). The focus is on the whole person. A functional approach was followed based on Botes's model (Botes in Rand Afrikaans University: Department of Nursing, 2002:9-15) for nursing research. The researcher utilised a qualitative, descriptive, exploratory and contextual design (Mouton, 1996: 102). An authoethnographic strategy was implemented, & Bochner in Denzin & Lincoln, 2001:739, 747). In-depth, semi-structured, phenomenological interviews were held with parents meeting the sampling criteria. Consent for the research was obtained from the Rand Afrikaans University and informed consent was obtained from the parents volunteering to participate in the research.

Doctoral thesis in Interuniversity Doctorate in Psychology, Specialty Clinical Psychology – Subject area: Family Psychology and Family Intervention, submitted to the Faculty of Psychology and Education Sciences of the University of Coimbra.
Background The death of a child impacts negatively several dimensions of parents’ lives and parental adjustment encompasses coping with individual grief and relational processes. When a child dies, parents are confronted with the need to address both the changes in themselves as individuals as well as in the relationship with their partners. Also, the adjustment to a child’s death impacts both parents, thus challenging them with the expectation of providing support to their partner while coping individually. Furthermore, the psychological adjustment of parents within a couple is not independent. Despite the interpersonal context in which parental grieving occurs, research with bereaved parents has been particularly focused on individual processes. A deep understanding of the phenomenon of parental bereavement and an approach that acknowledges the multidimensional (individual and relational) and dynamic complexity of bereaved parents’ grief after the loss of a child is essential. Hence, the general aims of our study were: to obtain a view of individual and relational processes inherent to parents’ adjustment (phase I); to identify the determinants and processes (individual, shared and relational) underlying parents’ individual and marital adjustment (phase II); and to examine the interdependence and interactive processes among bereaved couples (phase III). Methods This multi-method research project included three distinct research phases. In the first phase, a systematic review of empirical studies on the topic of marital adaptation of bereaved parents was conducted. This systematic review aimed to explore (1) the impact of the death of a child in the marital relationship, and (2) the influence of the marital relationship in the individual adjustment. The second phase focused on the cross-sectional examination of adjustment processes and outcomes in a sample of bereaved parents, including both quantitative (N = 197) and qualitative (N = 18) data purposely collected for this research project. Through self-report questionnaires and semi-structured interviews, information was gathered regarding: (1) sociodemographic characteristics and data regarding circumstances of death; (2) parents’ individual (grief, posttraumatic growth) and marital adjustment (dyadic adjustment); and (3) parents’ individual (continuing bonds, resilience) and marital (dyadic coping [DC] and interpersonal coping) resources, as well as parents’ perception of interactive processes. The third research phase focused on the analysis of interdependence among bereaved couples. We used dyadic longitudinal data of a previous research project collected from a sample of 227 bereaved couples (at 6, 13, and 20 months post-loss) on meaning-made and individual coping. Results Results from the systematic review of studies (phase I) indicated that a child’s death can have cohesive and detrimental effects on the couple’s relationship, depending on situational, dyad- and individual-level factors. Aspects such as marital quality and the couple’s interdependence were found to influence parents’ individual adjustment. Regarding the objectives in phase II, being a female, having lost a younger child, and having higher levels of resilience, internalized continuing bonds and stress communication by the partner were associated with higher levels of posttraumatic growth. Also, significant indirect effects of parents’ grief response on dyadic adjustment were found through stress communication by oneself and by the partner, positive DC by the partner; negative DC by the partner and joint DC. The timing of death (before vs. after birth) moderated the association between grief response and dyadic adjustment and between joint DC and dyadic adjustment. Finally, parents’ perceptions of positive interpersonal coping processes involved search for meaning, communication with the partner and behaviors with the function of protecting the partner and the relationship. In addition, parents perceived their individual grief and coping to influence the marital relationship, specifically communication, conflicts and support. On the other hand, support within the relationship was perceived to influence parents’ individual grief and coping. These interactive processes within bereaved parents functioned through interdependence between partners, and empathy and emotion contagion. Regarding the objective of phase III, we found that the combination of the parents’ own loss coping orientation and restoration coping orientation had a positive effect in parents’ meaning-made, whereas partners’ loss coping orientation had a negative effect. Conclusions The results from the present project highlight the need to: 1) account for the specific effect of the death of a child on marital relationships; 2) recognize the complex and bidirectional relationship between individual grief and the marital relationship, and how and when certain interpersonal interactions between bereaved partners impact the marital relationship; 3) acknowledge and optimize the potential protective effect of the interpersonal processes for parents individually and as couples; and 4) incorporate individual-level support in order to help bereaved partners to consider the consequences of their coping processes for themselves and their partners. Our results also enhance the relevance of emphasizing the wide-ranging types of factors contributing to salutogenic adjustment outcomes, namely posttraumatic growth and meaning-made.
Introdução A morte de um filho afeta negativamente várias dimensões da vida dos pais e o ajustamento parental envolve lidar com o luto individual e processos relacionais. Quando um filho morre, os pais são confrontados com a necessidade de lidar tanto com as mudanças em si mesmos como indivíduos, assim como na relação com o seu cônjuge. Ainda, o ajustamento à morte de um filho afeta ambos os pais, desafiando-os com a expectativa de apoiarem o companheiro ao mesmo tempo que lidam individualmente com a perda. Para além disso, o ajustamento psicológico dos pais enquanto casais não é independente. Apesar do contexto interpessoal em que o luto parental ocorre, a investigação com pais enlutados tem-se focado particularmente em processos individuais. Uma compreensão aprofundada do fenómeno do luto parental e uma abordagem que reconheça a complexidade multidimensional (individual e relacional) e dinâmica do luto dos pais após a perda de um filho é essencial. Neste sentido, os objetivos gerais do nosso estudo foram: obter uma visão dos processos individuais e relacionais inerentes ao ajustamento dos pais (fase I); identificar os determinantes e processos (individuais, compartilhados e relacionais) subjacentes ao ajustamento individual e conjugal dos pais (fase II); e examinar a interdependência e os processos interativos entre os casais enlutados (fase III). Metodologia O presente projeto de investigação incluiu três fases distintas. Na primeira fase, realizou-se uma revisão sistemática de estudos empíricos sobre a adaptação conjugal dos pais em luto. Esta revisão sistemática teve como objetivo explorar (1) o impacto da morte de um filho na relação conjugal e (2) a influência da relação conjugal no ajustamento individual. A segunda fase centrou-se no estudo transversal dos processos de ajustamento numa amostra de pais em luto pela morte de um filho, incluindo dados quantitativos (N = 197) e qualitativos (N = 18) recolhidos para este projeto de investigação. Através de questionários de autorrelato e entrevistas semiestruturadas, foi recolhida informação sobre: (1) dados sociodemográficos e dados relativos às circunstâncias da morte; (2) ajustamento individual dos pais (resposta de luto, crescimento pós-traumático) e conjugal (ajustamento diádico); e (3) recursos individuais (manutenção de vínculo, resiliência) e conjugais (coping diádico [CD] e coping interpessoal), bem como a perceção dos pais sobre os processos interativos. A terceira fase centrou-se na análise da interdependência entre os casais em luto. Utilizamos, nesta fase, dados diádicos longitudinais de um projeto de investigação anterior recolhidos de uma amostra de 227 casais em luto (6, 13 e 20 meses pós-morte) sobre o encontrar de um sentido na perda e o coping individual. Resultados Os resultados da revisão sistemática (fase I) indicaram que a morte de um filho pode ter efeitos coesivos ou prejudiciais na relação de casal, dependendo de fatores situacionais, diádicos e individuais. Aspetos como a qualidade conjugal e a interdependência do casal parecem influenciar o ajustamento individual dos pais. Em relação aos objetivos na fase II, ser mulher, ter perdido um filho mais novo, ter níveis mais elevados de resiliência, manutenção do vínculo de tipo internalizada e comunicação de stresse do cônjuge mostraram-se associados a maiores níveis de crescimento pós-traumático. Para além disso, foram encontrados efeitos indiretos significativos do luto parental no ajustamento diádico através da comunicação do stresse do próprio e do cônjuge, CD positivo do cônjuge; CD negativo do cônjuge e CD conjunto. O momento da morte (antes ou após o nascimento) moderou a associação entre o luto parental e o ajustamento diádico, e entre o CD conjunto e o ajustamento diádico. Finalmente, a perceção dos pais sobre os processos positivos de coping interpessoal envolveram a procura de um sentido na perda, comunicação com o cônjuge e comportamentos com a função de proteger o cônjuge e a relação. Os pais percecionaram que o luto e o coping individuais influenciaram a relação conjugal, especificamente a comunicação, os conflitos e o apoio no casal. Por outro lado, foi percecionado que o apoio no casal influenciava o luto e o coping individual dos pais. Esses processos interativos entre os pais operavam através da interdependência entre os cônjuges, e a empatia e contágio emocional. Em relação ao objetivo da fase III, a combinação do coping orientado para a perda com o coping orientado para a restauração teve um efeito positivo no encontrar um sentido na perda, mas o coping orientado para a perda (isoladamente) do companheiro teve um efeito negativo. Conclusões Os resultados do presente projeto de investigação destacam a necessidade de: 1) reconhecer o efeito específico da morte de um filho nas relações conjugais; 2) reconhecer a relação complexa e bidirecional entre o luto individual e a relação conjugal, e como e quando certas interações interpessoais entre os cônjuges afetam a relação conjugal; 3) reconhecer e otimizar o efeito potencialmente protetor dos processos interpessoais para os pais individualmente e como casais; e 4) incorporar apoio a nível individual para ajudar os pais a terem em conta as consequências dos seus processos de coping para si e para o cônjuge. Os nossos resultados salientam ainda a relevância de considerar a abrangência de tipos de fatores que contribuem para um ajustamento saudável à perda, nomeadamente o crescimento pós-traumático e o encontrar de um sentido na perda.

碩士
國立臺北教育大學
心理與諮商學系碩士班
102
The purpose of this research is to explore the relationship adjustment process of infertile couples, attempting to understand how infertile couples go through the process of wanting a child while still maintaining their marital relationship. This study used a semi-structured in-depth interview approach to interview three infertile couples, and used hermeneutic phenomenology to analyze the data. The research results are displayed below: 1.The relationship adjustment process of infertile couples can be divided into four stages: (1) Before wanting a child- fundamentals of the couple's relationship are formed (2) Preliminary stage of wanting a child- stress within the couple's relationship starts to accumulate (3) The cycle of treatment and failure- a shaky relationship and transformation (4) Giving up active treatment- the main stress dies away, entering a land of joy 2.The adjustment types can be divided into two categories: (1) Maintained relationship: conflict avoidance, self adjustment, miss catch of the intentions to become closer in relationship (2) Closer relationship: active communication, keeping each other company, compromising to satisfy each other's needs 3.The relationship adjustment process of infertile couples have four characteristics: (1) The strength of maintained relationships and closer relationships cancel out each other (2) The effort put into relationships can be continued (3) The adjustment process has an influence on the relationship and vice versa (4) Different ways of adjustment can appear simultaneously in different events and contexts of wanting a child 4.There are four dynamics in the relationship adjustment process of infertile couples: (1) There are differences in the starting point of each couple's relationship (2) Successful efforts to become closer: the couple's perception of each other has changed and it is the beginning of an improved relationship (3) Motivation to have a stable relationship (4) Unsuccessful attempts to have a closer relationship 5.The relationship adjustment process enhances the resilience of infertile couple's relationship. 6.Each adjustment of a conflict is a turning point for the improvement of an infertile couple's relationship. 7.Showing the vulnerability of self during the process of wanting a child can bring the other closer. 8.Increased quality and resilience of a couple's relationship can help them in confronting all kinds of challenges in their future relationship. 9.The movement of a couple's relationship is influenced by one another. 10.Avoiding conflict provides a buffer for the couple's relationship and helps to maintain their relationship 11.Three elements in practicing Christianity that facilitates a closer relationship in couples: (1) Interaction that enhances the relationship- acceptance, listening attentively, hugging (2) Buffering for the relationship- self adjustment (3) Hope for the future- handling matters stably and continuously 12.The belief of " having a son to carry on the family name" is mainly passed down from mother to daughter. 13.Infertile couples' stress of " having a son to carry on the family name" can be set down after the process of putting in effort to have a child. 14.The adjustment process of infertile couples have the three elements of "forbearance, patience and endurance"; these behavior have an effect on the couple's relationship. 15."Pursuing further education" can improve the relationship of infertile couples in three dimensions: (1) Increased understanding of each other- closer relationship (2) Changed attitude towards wanting a child- closer relationship (3) Decreased interaction between the couple- calmer relationship 16.The cost of infertile treatment in Taiwan is relatively cheaper than other countries, which helps the couple focus more on their marital relationship. Finally, according to the research results, suggestions for the research method and related practices are made, to provide reference for practitioners and future studies.

碩士
國立臺灣師範大學
教育心理與輔導學系
103
The main purpose of the present study was to explore the relationships among dyadic perfectionism, willingness and behavior of sacrifice, and love relationship adjustment of heterosexual college couples. A total of 272 completed self-reported questionnaires (136 college couples) were collected through purposive sampling and accidental sampling. Data was analyzed by one-way analysis of variance, Pearson product-term correlation, and hierarchical regression analysis. The major findings of the present study were as follows: 1. For both male and female, partner-oriented perfectionism and partner-prescribed perfectionism were negatively related to satisfaction/growth, positively related to conflict/paradox, and negatively related to autonomy. 2. Male’s willingness and behavior of active sacrifice and willingness and behavior of passive sacrifice” were positively related to satisfaction/growth, and negatively related to conflict/paradox. In addition, female students’ “willingness and behavior of active sacrifice and willingness and behavior of passive sacrifice were positively related to Satisfaction/Growth. Moreover, female students’ willingness and behavior of passive sacrifice” were negatively related to conflict/paradox and positively related to autonomy. 3. Female’s partner-oriented perfectionism were negatively related to male’s satisfaction/growth and positively related to male’s conflict/paradox. Moreover, both male’s and female’s partner-oriented perfectionism were negatively related to the opposite sex's satisfaction/growth, positively related to the opposite sex's conflict/paradox, negatively related to the opposite sex's autonomy. 4. Male’s partner-oriented perfectionism and partner-prescribed perfectionism negatively predicted their satisfaction/growth, and male’s willingness and behavior of active sacrifice” positively predicted their satisfaction/growth”. In addition, female’s partner-prescribed perfectionism negatively predicted their satisfaction/growth, and female’s willingness and behavior of passive sacrifice” positively predicted their satisfaction/growth”. For both male and female, partner-oriented perfectionism and partner-prescribed perfectionism positively predicted conflict/paradox. For both male and female, partner-prescribed perfectionism negatively predicted their autonomy. 5. Considering the effect from partner, male and female’s partner-prescribed perfectionism negatively predicted female’s satisfaction/growth. Male’s partner-oriented perfectionism, male and female’s partner-prescribed perfectionism positively predicted male’s conflict/paradox. 6. For both male and female, willingness and behavior of passive sacrifice had moderating effect between partner-prescribed perfectionism and satisfaction/growth. Male’s willingness and behavior of passive sacrifice had moderating effect between their partner-prescribed perfectionism and conflict/paradox. Female’s willingness and behavior of passive sacrifice had moderating effect between their partner-prescribed perfectionism and autonomy. Lastly, implications for counseling and future research were proposed based on the results. Key words: dyadic perfectionism, willingness and behavior of sacrifice, and love relationship adjustment

This autoethnography explores the phenomenon of marriage after traumatic brain injury (TBI). Capturing as its data, through a series of audio-recorded conversations and journal entries, the first-hand, co-constructed experiences of a married couple, it provides an ‘insider’ and as such, intimate perspective on life together following such an unexpected, disruptive and life-altering event. Situated within ‘a systemic constructionist’ epistemology, it spotlights, in particular, the relational aspects of the post-TBI marriage unfolding over time, rather than just the individual perspectives of each spouse at a single point in time - as most existing studies on the topic do. As a qualitative study, it made allowance for the collection and use of rich, nuanced data so as to do some justice to the complex nature of the topic being studied. David Reiss’ explanatory theory on ‘crisis and the development of the family paradigm’ was applied deductively during the carrying out of a thematic analysis of the data, with the intention of bringing new insights to the understanding of the phenomenon of the post-TBI marriage. Data were also analysed inductively, in that themes emerging from the data itself were also used. A discussion based on the findings of the data analysis was proffered. Based on these findings, recommendations on what issues therapists working from within a family-systems orientation might focus their attention on were made. A recommendation for TBI couples to receive support from early intervention and follow-up services was also made, along with identifying the consequent need for research first to be done on developing and implementing such a service
Psychology
M.A. (Psychology)

The purpose of this study is to explore the nature of dynamic relationships within families, and indicating how the decision to divorce may result from a family's difficulty in adjusting to new changes and stressors. Thus, divorce results in the redefinition of a nuclear system. This study made use of social constructionism as its epistemological framework. By means of in-depth one-on-one interviews, the researcher was able to hear the narratives of all six participants. Hermeneutics was used to analyze the data. The participants' stories were reencountered through the researcher's own frame of reference in which common themes of the divorce process were co-constructed. These themes were later elaborated on and a comparative analysis was undertaken to link them to the available literature. The information gained from the study could contribute to existing research on the impact of divorce, family reorganization following a divorce, and offer a new perspective in understanding family systems.
Clinical Psychology
M.A. (Clinical Psychology)