Depression, marital satisfaction, and marital and personality measures of sex roles*

The present study examined the relationship between depression, marital satisfaction, and marital and personality measures of sex roles. Subjects included 50 couples in which the woman was clinically depressed (and of which 26 were maritally distressed), and 24 nondepressed, nondistressed control couples. Results indicated that compared to nondepressed couples, husbands and wives in relationships in which the wife was depressed showed greater inequality in decision making and dissatisfaction with the distribution of decision making and household tasks; wives additionally indicated greater dissatisfaction with distribution of childrearing responsibilities. The relationship between marital roles and depression was largely mediated by the impact of marital distress in the clinic couples. In addition, depressed wives were less masculine than nondepressed wives, and women with high levels of masculinity reported less depression than women with low levels.     

An exploratory investigation of marital functioning and order of spousal onset in couples concordant for psychopathology

Individuals with a psychiatric disorder are significantly more likely to have a spouse with a clinical diagnosis--marital concordance. We used a community sample of 304 couples concordant for either major depressive disorder (MDD) or substance use disorders (SUDs) to examine the relationship between marital functioning and gendered patterns of mental health diagnosis onset. For SUD concordance, couples in which wives onset before husbands--despite typical later onset for men--reported lower levels of marital satisfaction compared with couples in which the husband onset first. For MDD concordance, couples in which husbands onset with depression before wives--despite typical later onset for men--reported lower levels of marital satisfaction. These results suggest that for couples concordant for mental diagnoses, it is most problematic for marital functioning for one partner to have an atypically early onset. Implications for treatment targets in marital therapy are discussed.     

Treatment of narcissistic and borderline disorders in marital therapy: Suggestions toward an enhanced therapeutic approach

This paper examines a psychodynamic model of marital therapy that has been found to be useful when one or both partners suffer from disorders of the self. The theories of Heinz Kohut and recent self psychologists give insight into ways of understanding and treating each partner's narcissistic vulnerabilities. Some specific aspects of borderline and narcissistic disorders are described and discussed within the context of a marital relationship. This method of marital therapy not only helps couples to learn how to be selfobjects for each other, but also may facilitate rebuilding of damaged structures of the self. A case example is provided along with a discussion of why certain specific therapeutic interventions were made.I have no hesitation in claiming that there is no mature love in which the love object is not also a selfobject. Or, to put this depth-psychological formulation into a psychosocial context: There is no love relationship without mutual, self-esteem enhancing, mirroring and idealization (Kohut, 1977, p. 122).     

Preliminary estimates of cost-effectiveness for marital therapy

Cost‐effectiveness of marital therapy was examined beginning with a simple question: If government or health insurers paid for the screening and, where indicated, empirically supported treatment of 100,000 randomly selected married persons (i.e., 50,000 couples) from the general population, would the financial benefits outweigh costs? Two empirically supported forms of marital therapy, behavioral marital therapy and emotionally focused therapy, were considered in aggregate as possible treatments of choice. Marital therapy appears to be cost‐effective when paid for by government to reduce public costs of divorce or when paid for by insurers to offset the increased health‐care expenses associated with divorce. Implications and specific needs for future research to substantiate these conclusions are discussed.     

DEPRESSION IN MATURE MARRIAGES: IMPACT AND IMPLICATIONS FOR MARITAL THERAPY

Recent reviews of MFT literature have shown a failure to address mental health issues of the aging. Chief among these issues is depression, one of the most common psychological disorders found in older people. Although the relationship between depression and aging is a well-researched topic, few studies approach this common problem from a systemic perspective. Using data from a national survey of preretirement- and retirement-aged couples, this paper discusses the association between depression and marital quality in mature marriages as well the possibility of mediating variables such as the personality construct hardiness. Implications for marital therapy with older couples experiencing depression and future research are discussed.     

The treatment of sexual problems in marital and family therapy

With the proliferation of new research data and clinical practice techniques for dealing with sexual dysfunction, many family and marital therapists whose patients express sexual complaints experience the need to integrate this knowledge into their practice. For many couples and therapists, the rapid treatment approaches to sexual difficulties are inappropriate or ineffectual, yet the current literature addresses itself to either sex therapyper se or marital therapy and rarely deals with an integration of the two. This paper presents guidelines for assessing the sexual difficulties in the context of the relationship and outlines techniques for addressing the sexual difficulties directly while maintaining a more traditional marital therapy approach.     

Redirecting blaming in marital psychotherapy

This paper will address the methods utilized in encouraging the redirection of blaming in marital therapy. In this author's view, significant and lasting changes in marital interaction require that each spouse address his or her individual contributions to the conflictual relationship. Case material will be presented which illustrates the couple's shift from nonproductive blaming to greater self-understanding as the therapist orchestrates the shift from externalization to self-exploration.     

Antecedents and consequences of negative marital stressors

Many couples seeking therapy report the occurrence of severe, negative marital stressors (e.g., infidelity, threats of marital dissolution). In addition, existing research has demonstrated that these marital stressors precipitate Major Depressive Episodes and psychological symptoms. This longitudinal study examines the antecedents and consequences of negative marital stressors to help clinicians and researchers develop interventions that might prevent these stressors and their outcomes. Forty-one women completed a semistructured interview and measures of marital discord and depressive symptoms within one month after experiencing a marital stressor (baseline) and at a 16-month follow up. The results indicate that baseline marital discorded contributes to the occurrence of additional marital stressors during the follow-up period. Although baseline depressive symptoms do not predict additional marital stressors, depressive symptoms along with marital discord predict future depressive symptoms. Finally, baseline marital discord and additional marital stressors contribute to future marital dissolution. Clinical and research implications are discussed.     

Behavioral treatment of marital discord

Many techniques derived from various family therapies such as filial therapy (Stover & Guerney, 1967), conjugal therapy (Ely, 1970), conjoint parent/child therapy (Wertheim, 1959), conjoint marital therapy (Haley, 1963; Satir, 1964, 1965), and conjoint family therapy (Satir, 1964, 1965) have recently been incorporated into the practice skills repertory of clinical social workers. Of all of these approaches the behavioral view has a substantial pool of accumulated data to support its wide use in practice (Jacobson & Martin, 1976). However, virtually no detailed explanation of the behavioral view appears in the social work literature, thus hindering its application. To alleviate this deficiency this article reviews the following topics: basic philosophy; behavioral exchange and marital satisfaction; development of marital conflict; clinical implications; clinical assessment; tools for intervention; and procedural guidelines for the treatment process.     

Marital distress,co-occurring depression,and marital therapy: a review

This article reviews several factors that contribute to marital distress and co-occurring depression and also reviews empirically supported therapies. Gender contributes to marital distress and depression but does not appear to be the cause of either. Marital distress and depression appear to have bidirectional influence on each other. The depressed spouse's depression has a marked impact on the marital adjustment of the nondepressed spouse. Both marital distress and depression appear to be chronic. It is recommended that treatment be designed to help couples be supportive of each another, to adapt, and to cope with the depressive symptoms within the framework of their ongoing marital relations.     

Childhood parental loss and adult depression

Previous research demonstrates convincingly that childhood parental deaths and parental divorces have implications for adult well-being as defined by levels of depression, educational attainment, early age at marriage, and risk of divorce. What this research has failed to examine are the interconnections among these outcomes. Specifically, are the socioeconomic and marital outcomes of parental loss implicated in the observed higher levels of depression? This analysis takes a first step in answering this question. Using data from a sample of 1,755 married men and women, I estimated regression models which examine the extent to which adult socioeconomic status and current marital quality mediate and/or modify the loss-depression relationship. Parental divorce was strongly related to socioeconomic and marital outcomes. Furthermore, current marital quality contributed importantly to understanding the higher levels of depressed mood observed among persons from divorced homes. Parental death was much more weakly related to socioeconomic and marital outcomes, and these outcomes played little role in explaining its relationship to depression. Finally, all of these relationships were stronger among women than men. These findings support the utility of life-course approaches to understanding adult mental health.     

Relationship standards and marital satisfaction in Chinese and American couples

Samples of urban community couples in Shanghai, China, and suburban U.S. couples were administered measures of relationship adjustment and personal standards regarding characteristics of couple relationships. There were few gender differences in adherence to relationship standards but many differences between Chinese and U.S. couples. Fewer cultural differences existed in degree of couple consensus on relationship standards, but both adherence to standards and couple consensus on standards were associated with partners' levels of marital adjustment. Implications of the findings for clinical assessment and intervention with distressed couples, in particular for Western therapists working with Chinese couples whose standards may conflict with goals and methods of couple therapy, are discussed.     

DEPRESSION, BIOLOGY, MARRIAGE AND MARITAL THERAPY

Marital therapists have an, as yet, unrecognized contribution to make to the treatment of depression. It is incumbent upon them to keep abreast of the growing literatures concerning both biological and interpersonal aspects of depression, and to inform other mental health professionals, policy makers, and depressed persons and their families as to what marital therapy has to offer. Consistent with this goal, this article provides an introductory overview of recent findings concerning the biology of depression, the relative merits of medication versus psychotherapy, and the complex relationships between marriage and depression. While there is considerable evidence that many depressions have a biological component and that medication is an efficacious way of providing symptomatic relief, this in no way contradicts findings concerning the efficacy of psychotherapy and the importance of the marital relationship in the outcome of a depressive episode.     

Female marital mobility within Northern Ireland and the Republic of Ireland: a log-linear analysis

A series of log-linear models predicting the exchange marital experiences of Irish wives are prevented for the Irish Republic. The best explanatory model is one in which the relationship between a husband's occupational status and that of his father-in-law remains homogeneous across age levels, Women show a marked propensity to marry husbands at a similar occupational status as that of their fathers and long-range upward or downward mobility across the manual/nonmanual divide is unlikely. This tendency towards endogamy is particularly pronounced within the two upper non-manual categories and the manual strata generally the same general model of homogeneous association holds for Northern Ireland across age levels and religious affiliation. In the North, however, more short-range mobility occurs, particularly between the two upper non-manual groups. Despite this the norm for both the Irish Republic and Northern Ireland is marital immobility rather than marital mobility with no evidence of a fundamental trend towards increased marital mobility. Furthermore. The mobility through marriage that did occur does not result in an overall net advantage for women.     

Marital transitions, marital beliefs, and mental health.

In this paper, we examine whether people's beliefs about the permanence, desirability, and importance of marriage moderate the impact of marital transitions--including marital losses and gains--on depression, a disorder associated with both marital status and role transitions. Using two waves of panel data from the National Survey of Families and Households (N = 10,005), we find that a marital loss results in increased symptoms, whereas a marital gain results in decreased symptoms. We also find, however, that the negative effects of a marital loss are greater for people who believe in the permanence of marriage than they are for those who do not. Conversely, the positive effects of a marital gain are greater for people who believe in the desirability and importance of marriage than they are for those who do not. Our results highlight the potential utility of more systematically incorporating people's beliefs--and sociocultural factors more generally--into theory and research on the impact of stressors on mental health.     

Understanding variation in marital sexual pleasure: an impossible task?

Over the past twenty years, sociologists have begun to explore the social and cultural context within which sexual relationships are constructed and in Western society, given such importance. However, although it is commonly recognised that the contraceptive pill has changed the meaning of sexuality (Giddens, 1992; Ferguson, 1989) comparatively little attention has been paid to locating the level of pleasure married women derive from marital sex within the situational, structural and cultural parameters of their lives. The material in this paper is based on intensive interviews with 60 married women, aged 20–42 years old and randomly selected from the records of general medical practitioners in North London. The paper indicates that methodological squeamishness about the viability of a study of sexual pleasure is unwarranted. It shows that only just over one third of these respondents had a high level of sexual pleasure on the scale devised in the study (weighted kappa=.89). For the most part, such pleasure was not associated with other aspects of the marital relationship. Drawing on illustrative material, it locates such pleasure within the context of their marital and family situation and suggests future lines of enquiry.     

The ebb and flow of marital lust: a relational approach

This diary study examined daily fluctuation in marital lust over a 56-day period. The purposes of the study were to describe typical patterns of lust over time and to examine intrapersonal and interpersonal associations between relationship affect, relationship states, and marital lust. We also tested various daily moderational predictions. Four patterns of daily fluctuation in lust were identified. Typical patterns varied from almost no fluctuation to wide fluctuation over time. Our findings showed that daily affect was generally related to lust both within partners and between partners. Also, spouses relational states (closeness and equality of power) moderated several of these intrapersonal and interpersonal associations. In general, the affect-lust link was strengthened by closeness and equality of power, while the lust-lust link between spouses was often conditioned by both relationship affect and relational states. However, the role of negative affect toward spouses in interactions with other constructs was not as expected. We discuss possible explanations for the findings and implications for further research.     

Co-occurrence between marital aggression and parents' child abuse potential: the impact of cumulative stress

Evidence suggests that marital aggression and parent-to-child aggression sometimes occur within the same family, but little is known about why certain families are vulnerable to multiple forms of family aggression. According to family systems theory, negative affect in one family relationship can spread to other family relationships. According to family stress theory, aversive circumstances increase families' vulnerability to disruption and conflict. Based on these theories, the present study tests the hypothesis that cumulative family stresses potentiate the association between marital aggression and parents' child abuse potential. In a series of additive interactional models, husband-to-wife aggression was linked to husbands' and wives' child abuse potential in a context of both high financial stress and high parenting stress but was not linked in a context of low stress. Wife-to-husband aggression was linked to wives', but not husbands', child abuse potential in a context of high stress. These results highlight the potential role of contextual factors in the pervasiveness of aggressive exchanges across multiple family subsystems.     

Defining the psychomedical and systemic paradigms in marital and family therapy

A framework for defining paradigms within the field of marital and family therapy is presented. The term "paradigm" is critically analyzed as applied to mental health services. Paradigm crisis in marital and family therapy is described as resulting primarily from practical-theoretical, professional, andpolitical concerns rather than scientific anomaly. Subsequently, two paradigms are defined as related to marital and family therapy: the psychomedical and the social systems (systemic) paradigms. Both paradigms are defined according to basic propositions and methodological tenets. The need for, and the design of, critical paradigmatic experiments of the psychomedical paradigm against the systemic paradigm are addressed. Critical paradigmatic experiments are viewed as an offshoot of a postpositivistic empiricism in keeping with a contextual view of knowledge.     

The ebb and flow of marital lust: A relational approach

This diary study examined daily fluctuation in marital lust over a 56‐day period. The purposes of the study were to describe typical patterns of lust over time and to examine intrapersonal and interpersonal associations between relationship affect, relationship states, and marital lust. We also tested various daily moderational predictions. Four patterns of daily fluctuation in lust were identified. Typical patterns varied from almost no fluctuation to wide fluctuation over time. Our findings showed that daily affect was generally related to lust both within partners and between partners. Also, spouses’ relational states (closeness and equality of power) moderated several of these intrapersonal and interpersonal associations. In general, the affect‐lust link was strengthened by closeness and equality of power, while the lust‐lust link between spouses was often conditioned by both relationship affect and relational states. However, the role of negative affect toward spouses in interactions with other constructs was not as expected. We discuss possible explanations for the findings and implications for further research.