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OBJECTIVES To examine the associations between pleasant or reinforcing activities (as they relate to the behavioral theory of depression) and depressive symptoms across cultures. METHODS We tested for differences in the strength of association between pleasant events and depressive symptoms in probability samples of adults from the United States (N = 619) and Japan (N = 232). RESULTS Results indicate that frequency, enjoyment, and obtained pleasure from pleasant events were significantly and negatively associated with depressive symptoms for both American and Japanese adults, and these associations were significantly greater in magnitude for American adults relative to Japanese adults. CONCLUSIONS Findings suggest that there is a cross-sectional association between pleasant events and depressive symptoms in both the United States and Japan, and that this association is stronger in the United States.

Research with probability samples of civilians has found that marital distress is associated with incidence of several psychiatric disorders. However, there is little longitudinal research on marital distress and incidence of psychiatric disorders in military personnel. This study examined the prospective association between marital distress and incidence of major depressive episode (MDE), generalized anxiety disorder (GAD), panic disorder, posttraumatic stress disorder (PTSD), and substance use disorder in a probability sample of active-duty soldiers from the U.S. Army (N = 934). Results indicated that among individuals who did not meet diagnostic criteria for the associated disorder at baseline, marital distress at baseline was associated with 30-day incidence of MDE, GAD, and PTSD assessed 5 years later. These results support continued research on the role of marital distress and the onset and course of psychopathology in active-duty military personnel and suggest that couple-based interventions designed to prevent or reduce marital distress may be effective in the prevention and treatment of psychopathology in military personnel. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Background According to the Response Styles Theory, rumination maintains and exacerbates depression. This study was conducted to examine the bidirectional longitudinal associations between rumination and depressive symptoms in a probability sample of Australian adults, evaluate the degree to which the strength of these longitudinal associations was moderated by gender, and test whether these longitudinal associations remained statistically significant when adjusting for the influence of demographic characteristics and neuroticism. Methods A probability sample of Australian adults (N = 5891) completed self-report measures of rumination, neuroticism, and depressive symptoms at baseline and rumination and depressive symptoms at a four-year follow-up. Results Results from regression analyses indicated that rumination predicted residual change in depressive symptoms and depressive symptoms predicted residual change in rumination, suggesting that rumination and depressive symptoms influence one another in a bidirectional, recursive fashion. Gender was not a significant moderator of the longitudinal associations between rumination and depressive symptoms. Analyses including the covariates of age, gender, and neuroticism, a personality trait characterized by heightened negative emotionality, indicated that the bidirectional longitudinal associations between rumination and depressive symptoms were not explained by their shared association with demographic characteristics or neuroticism. Limitations Within-person analyses involving repeated assessments, shorter time intervals, and assessment of brooding rumination would provide a stronger test of the potential causal association between rumination and depressive symptoms. Conclusions Study findings suggest that rumination may be both a potential risk factor for and a consequence of depressive symptoms in adults.

Panel data from married adults (N = 1,853) in the General Social Survey, a probability sample of the adult household population of the United States, were used to evaluate (a) the longitudinal association between extramarital sex and marital dissolution 2 years later, (b) whether probability of marital dissolution differed as a function of the type of relationship people reported having with their extramarital sex partner, and (c) the degree to which these associations were incremental to participants' level of marital satisfaction at baseline. Compared to people who reported not engaging in extramarital sex, those who reported engaging in extramarital sex at baseline were significantly more likely to be separated or divorced 2 years later. Furthermore, the association between having extramarital sex with a close personal friend and marital dissolution was particularly strong. These associations remained statistically significant after adjusting for marital satisfaction. Results suggest that the identity of the extramarital sex partner and the type of relationship a person has with him or her has important implications for probability of marital dissolution above and beyond the contribution of marital satisfaction.Se utilizaron los datos de panel de adultos casados (N = 1,853) de la Encuesta Social General (General Social Survey), una muestra probabilística de la población de hogares de adultos de los Estados Unidos, para evaluar (a) la asociación longitudinal entre las relaciones sexuales extramatrimoniales y el divorcio dos años después, (b) si la probabilidad de divorcio difirió como una función del tipo de relación que las personas informaron tener con su pareja de relaciones sexuales extramatrimoniales y (c) el grado en el cual estas asociaciones aumentaron según el nivel de satisfacción matrimonial de los participantes al inicio del estudio. En comparación con las personas que informaron no tener relaciones sexuales extramatrimoniales, aquellos que sí informaron tener relaciones extramatrimoniales al comienzo del estudio tuvieron muchas más probabilidades de estar separados o divorciados dos años después. Además, la asociación entre tener relaciones sexuales extramatrimoniales con un amigo íntimo personal y el divorcio fue particularmente fuerte. Estas asociaciones continuaron siendo estadísticamente significativas después de ajustar teniendo en cuenta la satisfacción conyugal. Los resultados sugieren que la identidad de la pareja extramatrimonial y el tipo de relación que una persona tiene con ella repercuten considerablemente en la probabilidad de divorcio más allá del aporte de la satisfacción matrimonial.本论文的研究对象来自从美国的社会普查中提取的固定样本数据,他们有可能代表美国家庭成年人口的状况。具体而言所调查的人群是1853名已婚成年人,调查评估的内容涵盖以下几个方面:(a)婚外性和两年后婚姻解体之间的长期性关联,(b)婚姻解体的可能性是否会因为人们报告的与婚外性伴侣关系的类型的不同而有不同,(c)这些关联性导致被调查者的婚姻满意度的底线水平有所增加的程度。和那些没有报告婚外性行为的人们相比,那些报告了在婚姻底线有婚外性经历的人们有很大差别,他们更有可能分居或者两年后离婚。而且,在婚外与比较亲密的个人朋友发生性关系,这种婚外性与婚姻走向解体之间的关联性非常强。这些关联性在为了婚姻满意度进行调适之后仍然存在统计学上的显著性。研究表明,婚外性伴侣的身份和婚外出轨的一方与他或她的关系类型对婚姻是否可能走向解体有重要的影响, 其在促成婚姻满意度的能力之上和之外。.

Avoidance has long been viewed as an etiological mechanism of anxiety disorders. Of more recent focus within this literature is the distinction between avoidance that is trait-based (experiential avoidance) versus contextual (safety behaviors). Whereas both experiential avoidance and safety behaviors have been studied within anxiety research, no known studies have evaluated the direct and indirect relationships of these forms of avoidance in predicting critical outcomes, particularly in conjunction with symptom severity. To address this gap, the current study assessed social anxiety and panic symptoms, experiential avoidance, use of preventive and restorative safety behaviors, and quality of life to determine the direct and indirect contributions of trait-based and contextual avoidance in predicting clinically relevant outcomes via path analysis. U.S. adults with elevated social anxiety or panic symptoms (n = 254) were recruited online. Results from path analysis showed that, across groups, the relationship between symptoms and quality of life was indirectly accounted for by use of preventive safety behaviors. Further, for participants with panic symptoms (but not for those with social anxiety symptoms), experiential avoidance predicted quality of life even after accounting for use of preventive safety behaviors. The results of this study indicate that trait-based and contextual avoidance contribute significantly to clinically relevant outcomes.

OBJECTIVE The present study examined the association between marital satisfaction and all-cause mortality in a large, representative sample of American adults. Gender was evaluated as a potential moderator of this association. METHOD Ratings of marital satisfaction from married adults

Using the most recent nine waves of data from the General Social Survey, which consists of in-person interviews of independent probability samples of the adult household population of the United States, the purposes of this study were to (a) provide descriptive information on adults' attitudes toward extramarital sex, lifetime and annual prevalence of extramarital sex among ever-married adults, and the identity of the extramarital sex partner(s) of currently married adults; (b) evaluate temporal trends in attitudes toward and prevalence of extramarital sex from 2000 to 2016; and (c) test for gender differences in attitudes toward and prevalence of extramarital sex and descriptions of the extramarital partner. The percentages of Americans who reported that extramarital sex was always wrong significantly declined from 2000 to 2016, whereas the percentage who reported it was wrong only sometimes significantly increased. There was a statistically significant linear decline in reported lifetime prevalence of extramarital sex from 2000 (17.8%) to 2016 (16.3%), whereas there was no statistically significant change in reported annual prevalence of extramarital sex (3.0%). People most commonly reported having extramarital sex with a close personal friend (53.5%) or neighbor, coworker, or long-term acquaintance (29.4%). Compared with women, men were (a) less likely to report that extramarital sex was always wrong and more likely to view it as almost always wrong, wrong only sometimes, or not wrong at all; (b) more likely to report past-year and lifetime extramarital sex; and (c) more likely to report extramarital sex with someone they knew casually. (PsycINFO Database Record

Depression and alcohol use disorder (AUD) commonly co-occur, and this comorbidity is associated with greater impairment and higher likelihood of relapse compared to either disorder alone. Identifying shared vulnerability across depression and AUD may aid in developing more parsimonious treatment approaches. Low levels of positive reinforcement for healthy behaviors have been implicated as a shared vulnerability across both depression and AUD. However, prior research in this area has largely been conducted among college students and has rarely examined depression and AUD symptoms together. This study aims to extend prior literature by examining the association between both the frequency and enjoyment of activities and AUD symptoms in a national sample of adults (n = 609) while also accounting for depressive symptoms. Study results indicated that low levels of enjoyment were associated with greater alcohol-related problems and frequency of heavy episodic drinking, above and beyond depressive symptoms. The frequency of potentially pleasurable activities was unrelated to alcohol-related problems or heavy episodic drinking. Findings extend prior literature by providing evidence for the association between enjoyment of activities and alcohol use, above and beyond depressive symptoms, among a national sample of adults. These results suggest that prioritizing enjoyment of activities, rather than frequency, may be important for behavioral intervention efforts to address heavy drinking and associated problems. Future longitudinal research using observational methods of behavior is needed to identify causal relationships between activity enjoyment and AUD symptoms. (PsycINFO Database Record

Although distress in intimate relationships such as marriage is positively associated with psychiatric symptoms and disorders and suicidal ideation in probability samples of the civilian population in the United States, relatively little is known regarding these associations in probability samples of active-duty military personnel. The present study evaluated the association between marital distress and past-30-day prevalence of psychiatric disorders (i.e., mood, anxiety, and substance use disorders) and suicidal ideation in a sample of 8,669 married active-duty soldiers in the U.S. Army who participated in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Results indicated that marital distress was significantly and positively associated with past-30-day prevalence of major depressive disorder, generalized anxiety disorder, panic disorder, posttraumatic stress disorder, and substance use disorder, as well as past-30-day prevalence of suicidal ideation. These associations were incremental to shared associations with demographics and co-occurring psychiatric disorders. The findings support continued research on the association between relationship distress and psychopathology in active-duty service personnel, and suggest the potential utility of adapting existing, evidence-based couple interventions for the prevention and treatment of psychopathology or relationship distress, currently in use in veteran and civilian settings, for use with active-duty military personnel and their partners. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background Prior research has found a reliable and robust association between poor dyadic (e.g., marital) adjustment and depression and anxiety. However, it is possible that this association may be due, at least in part, to confounding variables (i.e., variables that are causally associated both with marital adjustment and psychopathology and could account for their covariation). The present study was conducted using a genetically informative sample of twins to examine the association between dyadic adjustment and symptoms of depression and anxiety, accounting for unmeasured genetic and shared environmental confounds. Methods A Swedish sample of monozygotic and dizygotic twins (218 female twin pairs and 321 male twin pairs) and their spouse or long-term partner completed self-report measures of dyadic adjustment, depressive symptoms, and anxiety symptoms. Results Results suggest that dyadic adjustment was significantly and negatively associated with depressive symptoms and anxiety symptoms in twins, and nonshared environmental influences largely accounted for this association. Furthermore, results obtained from partners’ reports of dyadic adjustment were largely consistent with those obtained from twins’ reports, suggesting that results were not a function of shared method variance. Limitations Longitudinal research in genetically informative samples would provide a stronger test of the causal association between dyadic adjustment and psychopathology. Conclusions The pattern of findings suggest that common nonshared environmental influences, such as partners’ characteristics, may lead to poorer dyadic adjustment and depression and anxiety. Therefore, couple-based interventions that improve dyadic adjustment may be effective in preventing and treating psychopathology in relationship partners.

This longitudinal study was conducted to evaluate actor and partner effects of marital discord on changes in symptoms of depression and generalized anxiety disorder (GAD) in a large population sample of Irish adults (N = 1,445 couples), adjusting for the potential confounds of quality of other social relationships and other psychopathology symptoms. The Actor-Partner Interdependence Model was used to examine actor and partner effects of marital discord on changes in symptoms of depression and GAD at a 2-year follow-up. Additional models examined these associations adjusting for family and friend discord and symptoms of the other type of psychopathology (depressive or GAD symptoms). Actor effects of marital discord on depressive and anxiety symptoms were greater for men than for women. There were significant, positive actor effects of marital discord on depressive symptoms for husbands and wives, which remained significant when adjusting for family and friend discord and GAD symptoms. There were significant, positive actor effects of marital discord on GAD symptoms for husbands, which remained significant when adjusting for family and friend discord and depressive symptoms. Results demonstrate that longitudinal associations between marital discord and depressive symptoms (for wives and husbands) and GAD symptoms (for husbands) are incremental to other rival explanations (family and friend discord and the other set of symptoms). Findings provide evidence for a potential causal association leading from marital discord to symptoms of depression and GAD.

Prior research has found that humiliating marital events are associated with depression. Building on this research, the current study investigated the association between one specific humiliating marital event-discovering that one's partner had an affair-and past-year major depressive episode (MDE) in a probability sample of married or cohabiting men and women who were at high risk for depression based on the criterion that they scored below the midpoint on a measure of marital satisfaction (N = 227). Results indicate that (i) women were more likely than men to report discovering their partner had an affair in the prior 12 months; (ii) discovering a partner affair was associated with a higher prevalence of past-year MDE and a lower level of marital adjustment; and (iii) the association between discovering a partner affair and MDE remained statistically significant when holding constant demographic variables and marital adjustment. These results support continued investigation into the impact that finding out about an affair has on the mental health of the person discovering a partner affair.

Over the past 40 years, a large body of literature has documented intimate partner relationship distress as a primary reason for seeking mental health services as well as an integral factor in the prognosis and treatment of a range of mental and physical health conditions. In recognition of its relevance to clinical care, the description of intimate partner relationship distress has been expanded in the DSM-5. Nonetheless, this is irrelevant if the DSM-5 code for intimate partner relationship distress is not reliably used in clinical practice and research settings. Thus, with the goal of dissemination in mind, the purpose of this paper was to provide clinicians and researchers with specific guidelines on how to reliably assess intimate partner relationship distress and how this information can be used to inform treatment planning. In addition to the implications for direct clinical care, we discuss the importance of reliable assessment and documentation of intimate partner relationship distress for future progress in epidemiology, etiology, and public health research.

Relationship functioning and individual mental health and well-being are strongly associated with one another. In this article, we first review the cross-sectional and longitudinal associations between relationship discord and various types of psychopathology, We then review findings suggesting that relationship discord is associated with poorer outcome for individual-based treatments for psychopathology and that, generally, relationship discord does not improve following individual-based treatments for psychopathology. Finally, we present a model for conceptualizing work with couples in which one partner has a psychiatric disorder and review the efficacy of couple-based interventions in the treatment for psychiatric disorders, with a focus on substance-related, mood, and anxiety disorders.

The associations between relationship adjustment and symptoms of depression and anxiety were evaluated in a sample of pregnant married or cohabiting women (N = 113) who were at risk for perinatal depression because of a prior history of major depression. Women completed self-report measures of relationship adjustment, depressive symptoms, and anxiety symptoms monthly during pregnancy and for the first six months following the birth of their child. Multilevel modeling was used to examine concurrent and time-lagged within-subjects effects for relationship adjustment and depressive and anxiety symptoms. Results revealed that (a) relationship adjustment was associated with both depressive symptoms and anxiety symptoms in concurrent analyses; (b) relationship adjustment was predictive of subsequent anxiety symptoms but not subsequent depressive symptoms in lagged analyses; and (c) depressive symptoms were predictive of subsequent relationship adjustment in lagged analyses with symptoms of depression and anxiety examined simultaneously. These results support the continued investigation into the cross-sectional and longitudinal associations between relationship functioning and depressive and anxiety symptoms in women during pregnancy and the postpartum period.

Objective This study evaluated the association between loneliness and the metabolic syndrome, which refers to a clustering of factors that have been shown to increase risk for cardiovascular disease, diabetes, stroke, and mortality. A secondary purpose was to evaluate whether age moderated the association between loneliness and the metabolic syndrome. Design Participants were 52 to 79 years old, and they were drawn from a population-based survey of people 50 years of age and older living in England (N = 3211). They completed a self-report measure of loneliness and a nurse visit that included collection of blood pressure, blood sample, and anthropometric measures. Main outcome measures Self-reported loneliness and the metabolic syndrome. Results After controlling for demographic variables and smoking status, loneliness was significantly associated with increasing likelihood of meeting criteria for the metabolic syndrome and with the individual criterion of central obesity. The association between loneliness and the metabolic syndrome was not moderated by age. Conclusion Results suggest that loneliness is associated with the metabolic syndrome. Therefore, the metabolic syndrome may be among the pathways by which loneliness increases risk of morbidity and mortality.

Associations between borderline personality disorder (BPD) symptoms and marital distress, perpetration of marital violence, and marital dissolution were evaluated in a population-based sample of married adults. The incremental association between BPD symptom severity and marital outcomes was also examined, controlling for the presence of Axis I disorders. Respondents from the National Comorbidity Survey Replication (NCS-R) who had been married at least once completed measures of BPD symptoms and provided information about their marital histories; a subset of participants completed measures of marital distress and marital violence. BPD symptom severity was positively associated with marital distress, perpetration of minor and severe marital violence, and marital disruption. Associations remained significant when controlling for presence of 12-month Axis I disorders. These findings underscore the importance of examining adverse social consequences of BPD.

Based on recent findings suggesting that marital discord is taxonic (i.e., that couples in discordant relationships differ qualitatively, and not just quantitatively, from couples in nondiscordant relationships), this study was designed to develop a brief screening measure for detecting the relationship discord taxon. A national, representative sample of 1,020 married couples completed the Marital Satisfaction Inventory--Revised. Data from this sample were used to create a 10-item screening measure. Using the cut scores from the original study that found evidence of taxonicity as a point of reference, the 10-item screen demonstrated good diagnostic performance in assessing the relationship discord taxon. Taxon classification based on the brief scale demonstrated good short-term stability. The scale is easily administered and scored, making it appropriate for use in clinical and research settings.

Addressing potential weaknesses in an earlier investigation, the authors examined the latent structure of marital discord using 4 product indicators from the Marital Satisfaction Inventory-Revised (Snyder, 1997) in a representative sample of community couples (N = 1,020). Results from 3 taxometric procedures suggested that marital discord is taxonic, with an estimated base rate of .31. Cut scores for classifying members of this marital discord taxon were identified. Additional analyses with several data sets of community and clinic couples provided evidence that the marital discord taxon classification demonstrated good (a) 6-week test-retest reliability, (b) criterion validity (i.e., differences in taxon prevalence in community vs. clinic couples), and (c) construct validity (i.e., correlations with therapist ratings of relationship quality). These results suggest that discordant couples differ qualitatively and not just quantitatively from nondiscordant couples and that user friendly methods, suitable for a range of research and clinical applications, can be used to identify marital discord.

The associations between DSM-IV personality disorders and probability of marriage, early marriage, and marital disruption were evaluated among people that participated in the National Epidemiologic Survey on Alcohol and Related Conditions, which is a nationally representative face-to-face survey of 43,093 respondents, 18 years and older. Participants completed a structured interview for the diagnosis of seven personality disorders, and provided information about the occurrence and timing of marriage and marital disruption. Results suggest that personality disorders were associated with decreased probability of marriage, increased probability of early marriage, and increased probability of marital disruption. These findings suggest that personality disorders have substantial consequences for the probability and timing of marriage and probability of marital disruption.

The purposes of this study were (a) to estimate the annual prevalence of, and to identify the predictors of, sexual infidelity in a population-based sample of married women (N = 4,884); and (b) to evaluate whether the prevalence and predictors of infidelity varied as a function of whether the assessment of infidelity was based on a face-to-face interview versus a computer-assisted self-interview. Annual prevalence of infidelity was much smaller on the basis of the face-to-face interview (1.08%) than on the computer-assisted self-interview (6.13%). Although many of the predictor variables replicated results from previous studies (e.g., demographic variables, religiosity, sexual experience), findings also indicated that childhood sexual abuse (i.e., forced sex) predicted greater probability of infidelity. Finally, the magnitude of the association with infidelity for 4 of the 9 predictor variables differed between the 2 methods for assessing infidelity. This study's findings underscore the importance of assessing infidelity with methods such as computer-assisted self-interviews that minimize the influence of social desirability and impression management.

Predictors of 12-month prevalence of sexual infidelity were examined in a population-based sample of married individuals (N = 2,291). Predictor variables were organized in terms of involved-partner (e.g., personality, religiosity), marital (e.g., marital dissatisfaction, partner affair), and extradyadic (e.g., parenting) variables. Annual prevalence of infidelity was 2.3%. Controlling for marital dissatisfaction and demographic variables, infidelity was predicted by greater neuroticism and lower religiosity; wives' pregnancy also increased the risk of infidelity for husbands. In comparison, self-esteem and partners' suspected affair were predictive of infidelity when controlling for demographic variables but were not uniquely predictive of infidelity when also controlling for marital dissatisfaction. Religiosity and wives' pregnancy moderated the association between marital dissatisfaction and infidelity.

This study was conducted to provide normative data on the Beck Depression Inventory--Second Edition (BDI-II) in college students.Data were obtained from 15,233 college students drawn from 17 universities in the United States, weighted to match the gender and race/ethnicity of enrollment in degree-granting institutions.Descriptive statistics, point prevalence of individuals exceeding cutoff scores, and mean differences by gender and race/ethnicity were provided. Because the distribution of BDI-II scores was not normal, percentile ranks for raw scores were provided for the total sample and separately by gender and race/ethnicity for the total sample and by race/ethnicity for men and women. Normative data were used to calculate the Reliable Change Index on the BDI-II for college students.Because the distribution of BDI-II scores demonstrated significant skewness and non-normal kurtosis, percentile ranks are important to consider in interpreting scores on the measure, in addition to descriptive statistics.

Although marital dissolution is associated with increased risk for poor mental and physical health outcomes, many people report improvements in functioning after divorce. To study the hypothesis that women in lower quality marriages would report the best outcomes upon separation/divorce, we investigated the combined effects of marital quality, gender, and marital status for predicting changes in life satisfaction (LS). Participants (N = 1,639; 50.3% men) were drawn from a nationally representative sample (Midlife in the United States Study), which included assessments of marital quality, marital status, and LS, at 2 time points (T1 and T2), roughly 10 years apart. Hierarchical linear regression analyses revealed an interaction between marital quality, marital status, and gender when predicting residual change in LS. Divorced women evidenced a negative association between marital quality and later LS, whereas continuously married women had a positive association between marital quality and later LS. In addition, women in higher quality marriages that become divorced showed the lowest LS, and women in lowest quality marriages show the highest LS among women with similar levels of marital quality. There was no association between marital quality and later LS for divorced or continuously married men. This work extends prior findings regarding gender differences in marital quality to postdivorce well-being, and suggests women in the lowest quality marriages may gain LS following divorce.

Although there is a well-documented association between relationship discord and depression, many individuals experience either discord or depression without experiencing the other. To understand this phenomenon, the authors evaluated moderators of the association between relationship discord and major depression among married or cohabiting individuals in the National Comorbidity Survey (N = 2,538; R. C. Kessler et al., 1994). Potential moderators included demographics, personality characteristics, parental depression, and childhood loss. Only one significant moderator was found: There was a stronger association between discord and depression for married people (vs. cohabiters). Among married individuals only, neuroticism also served as a moderator: Individuals higher in neuroticism showed a stronger association between discord and depression. In general, findings suggest that when a person or family presents with one problem (e.g., relationship discord), it is important to evaluate and potentially treat the other problem (e.g., depression) as well.

The prospective association between marital dissatisfaction and alcohol use disorders (abuse and/or dependence) was evaluated in a randomly selected community sample. Married individuals (N = 1,675) from the New Haven Epidemiologic Catchment Area project who did not have a current alcohol use disorder at baseline were followed prospectively for 12 months. Results indicated that baseline marital dissatisfaction was significantly associated with alcohol use disorder diagnosis during follow-up, with dissatisfied spouses being 3.7 times more likely than satisfied spouses to have a diagnosis of current alcohol use disorder at follow-up. The longitudinal association between baseline marital dissatisfaction and current alcohol use disorder diagnosis at follow-up remained significant when controlling for baseline demographic variables and history of alcohol use disorders.

Using path analysis and hierarchical linear modeling, the authors evaluated the associations between both partners' level of depression and anxiety, as measured by Minnesota Multiphasic Personality Inventory-2 (MMPI-2) content scales, and both partners' level of marital satisfaction among married couples (N = 774) that participated in the MMPI restandardization study (J. N. Butcher. W. G. Dahlstrom, J. R. Graham, A. Tellegen. & B. Kaemmer, 1989). Results indicated that marital satisfaction was predicted by the person's own level of anxiety and depression (i.e., actor effects) and by his or her spouse's level of depression only (i.e., partner effects). Findings also indicated that (a) there were no significant gender differences in the magnitude of effects, (b) depression effects were significantly stronger than anxiety effects, (c) actor effects were significantly stronger than partner effects, and (d) there were interactions between actor and partner effects for depression only.

The present study examined the association among marital satisfaction, marital power, and sexual desire in a sample of 60 community couples. We predicted that marital satisfaction would be positively correlated with sexual desire and that this association would be moderated by marital power, such that marital satisfaction would be more strongly correlated with sexual desire among individuals who perceive themselves as having less power in their relationship. Results indicated that marital satisfaction was significantly associated with sexual desire, but there was no evidence for the moderating effects of various forms of marital power.

Objective The purpose of this study is to examine the relation between sociotropy and bulimic symptoms. Studies of interpersonal functioning among individuals with bulimia nervosa consistently reveal issues of social dependency, need for approval, and fear of rejection. These themes are conceptually related to sociotropy, a cognitive-personality factor that has been implicated in the development and maintenance of depression. Individuals high in sociotropy are keenly invested in attaining others' approval and avoiding social rejection. Methods The relationship between sociotropy and bulimic symptoms was examined in two samples of women: undergraduate women and community women seeking treatment at a private eating disorder facility. Results In both samples, sociotropy was significantly associated with bulimic symptoms beyond the shared relation with depressed mood. Discussion Findings are discussed in terms of the maintenance and treatment of bulimia nervosa. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 34: 172–176, 2003.

This study examined the extent to which rumination and depression share genetic and environmental influences in a community sample of adult twins (N = 663). Twins completed multiple rumination questionnaires, a depressive symptoms questionnaire, and a diagnostic interview. Rumination was moderately heritable (h2=.37–.41 for the latent variable) and substantially influenced by nonshared environmental factors, and these results were consistent across different measures. Nonshared environmental influences on rumination were larger for women than men. Depressive symptoms and diagnosis were influenced by genetic and nonshared environmental factors (h2=.30–.45). The genetic correlations between rumination and depression were moderate to large (rA=.40–.82), suggesting that a substantial proportion of the genetic influences on rumination overlap with those on depression. Results were similar when examining self-reported depressive symptoms and interview-based diagnosis of major depressive disorder. These results highlight the importance of rumination in the integration of cognitive and genetic models of depression risk.

Relationship problems and depression often influence one another in a bidirectional, recursive fashion. Results from several clinical trials have demonstrated that couple therapy is effective in improving depression and reducing relationship problems. In this article, we describe an approach to working with depression in partnered individuals who are also unhappy in their relationship. This cognitive-behavior approach strives to (a) eliminate major stressors and reestablish positive activities in the relationship, (b) improve communication and problem solving in the relationship, and (c) solidify gains made in therapy and prevent relapse. The typical course of therapy is described and demonstrated in a case illustration. Couple therapy is a promising treatment for depressed individuals in distressed relationships.

Building on prior research that marital functioning is associated with a variety of health outcomes, we evaluated the association between marital adjustment and a marker of inflammation in a sample of married adults between the ages of 35 and 84 years old (N = 415) from the second wave of the population-based Survey of Midlife Development in the United States (MIDUS II). Specifically, we evaluated associations between positive (i.e., partner support) and negative (i.e., partner strain) dimensions of marital adjustment and interleukin-6 (IL-6) separately for men and women, and whether these associations were moderated by age. Results indicated that (a) marital adjustment was not associated with IL-6 in men, (b) age moderated the association between marital adjustment and IL-6 in women, (c) partner support and partner strain were associated with IL-6 in younger women, and (d) partner support but not partner strain was uniquely associated with IL-6 in younger women. The associations between marital adjustment and IL-6 in younger women were significant when controlling for demographic variables, health status indicators, health behaviors, depressive symptoms, and perceived stress. These findings suggest that IL-6 may be a useful biomarker for studying health-relevant biological responses within intimate relationships, and that young women, in particular, may exhibit increased inflammation when partner support is low.

The purpose of this study was to evaluate the association between marital functioning and binge eating disorder (BED).In a population-based survey of 2,084 married women, women with current (i.e., occurring in the past 12 months) BED were compared on three measures of marital functioning (marital satisfaction, negative interaction, and positive interaction) to women with (a) other current Axis I disorders and (b) no current disorder.Women with BED reported lower levels of marital satisfaction and higher levels of negative interaction than women with other disorders, who in turn reported poorer functioning than women with no disorder. Women with other disorders reported lower levels of positive interaction than women with BED, who in turn reported lower levels than women with no disorder.Findings suggest that marital functioning for women with BED is comparable to or worse than for women with other psychiatric disorders, which supports the need for continued investigation into the marital functioning of people with BED.

In this study, we explored whether the degree of temporal instability in relationship satisfaction might add to our understanding of the well-documented association between relationship quality and depression. We hypothesized that greater relationship satisfaction instability would be associated with higher depressive symptoms, controlling for mean satisfaction levels. We conducted 12 weekly assessments of relationship satisfaction and depressive symptoms in a sample of 131 cohabiting and married women, and used intraindividual standard deviations of scores over the 12 weeks as an index of instability. Results indicated that, as hypothesized, relationship satisfaction instability predicted variance in depressive symptoms beyond that predicted by mean satisfaction; women whose weekly relationship satisfaction fluctuated more widely tended to have higher depressive symptoms. In comparison, temporal instability in depressive symptoms did not predict variance in relationship satisfaction beyond that predicted by mean depressive symptoms. Prospective analyses tentatively suggested that satisfaction instability may precede rather than follow elevated depressive symptoms. Results suggest the utility of assessing relationship satisfaction instability in future studies exploring links between marital quality and depression.

Objective This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for specific sectors of treatment providers, including psychiatrist, other mental health provider, other medical provider, and religious services provider. Interviews were used to assess past-year service utilization and presence of anxiety, mood, and substance use disorders. Results Approximately 12% of married individuals sought help for problems with their emotions, nerves, or substance use during the 12 months preceding the interview. Marital distress was significantly associated with (a) overall mental health service utilization and service utilization provided by each of the sectors of providers when controlling for demographic variables and (b) overall mental health service utilization and receiving treatment from a psychiatrist when additionally controlling for past-year anxiety, mood, or substance use disorders. There was little evidence that the associations between marital distress and service utilization were moderated by gender or presence of psychiatric disorders. Conclusion The finding that marital distress is associated with greater mental health care service utilization suggests that clinicians should assess both individual and relationship factors among individuals presenting for treatment.

The clinical importance of relationship discord was examined through evaluating the association between relationship discord and multiple measures of impairment and psychological distress in a population-based sample of married and cohabiting adults (N=2,677). In comparison to people that were not in discordant relationships, individuals in discordant relationships reported greater social role impairment with relatives and friends and greater work role impairment. They also reported higher levels of general distress and poorer perceived health and were more likely to report suicide ideation. With the exception of suicide ideation, the associations between relationship discord and impairment and psychological distress remained significant when controlling for current mood, anxiety, and substance use disorders, suggesting that relationship discord is incrementally related to impairment and psychological distress over and above the effects of psychiatric disorders.

The revised integrative hierarchical model of depression and anxiety (S. Mineka, D. Watson, & L. A. Clark, 1998) proposes that high levels of neuroticism are shared between the depressive and anxiety disorders. This perspective was evaluated with data from the National Comorbidity Survey (N = 5,847), a population-based community sample. Analyses were based on both a broadband (i.e., diagnostic class) and a narrowband (i.e., specific disorder) approach. Results supported the model insofar as high neuroticism was shared across the depressive and anxiety disorders and was particularly elevated in people with comorbid depression and anxiety. Results are discussed in terms of their implications for understanding the association between personality and the depressive and anxiety disorders in a community sample and for the revised integrative hierarchical perspective.