Background/Objective: Intimate partner relationship problems and intimate partner abuse and neglect — referred to in this paper as “relational problems and maltreatment” — have substantial and well-documented impact on both physical and mental health. However, classification guidelines, such as those found in the International Classification of Diseases (ICD-10), are vague and unlikely to support consistent application. Revised guidelines proposed for ICD-11 are much more operationalized. We used standardized clinical vignette conditions with an international panel of clinicians to test if ICD-11 changes resulted in improved classification accuracy. Method: English-speaking mental health professionals (N = 738) from 65 nations applied ICD-10 or ICD-11 (proposed) guidelines with experimentally manipulated case presentations of presence or absence of (a) individual mental health diagnoses and (b) relational problems or maltreatment. Results: ICD-11, compared with ICD-10, guidelines resulted in significantly better classification accuracy, although only in the presence of co-morbid mental health problems. Clinician factors (e. g., gender, language, world region) largely did not impact classification performance. Conclusions: Despite being considerably more explicated, raters’ performance with ICD-11 guidelines reveals training issues that should be addressed prior to the release of ICD-11 in 2018 (e. g., overriding the guidelines with pre-existing archetypes for relationship problems and physical and psychological abuse).
The COVID‐19 pandemic in the United States has changed many aspects of people's daily life, including increased time at home in response to shelter‐in‐place orders, heightened stress about health effects of COVID‐19, and shifts in other domains of life (e.g., employment). These lifestyle changes are likely to impact the well‐being of individuals and their romantic relationships. This investigation examined how COVID‐19 influenced couple and individual well‐being in real‐time during the early phase of the pandemic. Data were collected in early May 2020 during shelter‐in‐place orders in the United States. Participants in committed relationships (n = 332) completed an online survey assessing their experiences currently and before the pandemic. Results suggested that while couple functioning overall maintained or even improved, individual well‐being was more negatively impacted by the pandemic. Moreover, some groups who are at higher risk of a poor health outcome from COVID‐19 or experience unique challenges as a result of COVID‐19 reported worse outcomes (e.g., those whose employment changed) while others did not decline in their psychological and couple functioning (e.g., Black individuals and older individuals). These findings suggest that the pandemic has had varied impacts on couples and individuals, as well as across different virus‐related risk factors. Further research is needed to understand the nuanced effects of this pandemic on couples and individuals across time.
Historically, observational couple communication researchers have oscillated between splitting behaviors into narrowly defined discrete codes and grouping behaviors into broader codes—sometimes within the same study. We label this the “lump-versus-split dilemma.” Coding across a decade and 11 investigators were used to recommend the most meaningful number of codes to use when observing couples’ conflict. We combined data from 14 studies that used the Rapid Marital Interaction Coding System (RMICS) to score communication behavior during different-sex couples’ conflict interactions. In each study, couples completed at least one 10-min, video-recorded conflict discussion. Communication during these interactions was coded by trained research staff using RMICS; all codes were compiled into a single data set for descriptive analysis and exploratory factor analyses (EFAs). The final sample comprised N = 2,011 couples. Several RMICS codes were extremely infrequent—specifically, distress-maintaining attributions, psychological abuse, withdrawal, dysphoric affect, and relationship-enhancing attributions. By far, the most frequent code was constructive problem discussion. EFAs yielded two factors for both women and men. Factor 1 (Negative) contained two items: distress-maintaining attributions and hostility. Factor 2 (Nonnegative) contained constructive problem discussion and humor (and, for women only, acceptance). Results side heavily with the “lump” camp in the lump-versus-split dilemma in couple observational coding. These RMICS factor analysis results converge with those from other systems and imply that the microanalytic “splitting” era in couples coding should draw to a close, with future studies instead focused on negative, neutral, and positive codes.
Despite comparable levels of relationship satisfaction and intimacy, same-sex couples break up faster and more often than different-sex couples highlighting a need for quality couple therapy. Research suggests that culturally tailored services are desired by same-sex couples and may be more effective and better received. Although efficacious couple therapies exist to treat relationship distress, they have been overwhelmingly studied with different-sex couples. Sexual minority (SM) affirming couple therapies have not been systematically developed or evaluated. The current study involved developing and pilot testing a tailored couple therapy for distressed same-sex female couples. This treatment integrates the empirically-supported cognitive-behavioral couple therapy framework and SM stress model. Doctoral student therapists delivered the treatment in an open-trial format to a pilot sample of 11 same-sex female couples experiencing relationship distress and SM stress. Treatment was delivered with high adherence to the treatment manual. Participants reported high treatment satisfaction. As hypothesized, participants experienced significant decreases in relationship distress and improvements in couple coping with SM stress from pre-to post-treatment. The small sample size and floor effects precluded clear conclusions regarding anticipated improvements in individual mental health. Participants experienced comparable or stronger improvements in relationship functioning compared to couples in a similar benchmark study. Given this
The U.S. Preventive Services Task Force has recommended that clinicians screen patients for intimate partner violence (IPV). This article aims to develop and test the first screeners for clinically significant physical and psychological IPV (i.e., acts meeting criteria in the International Classification of Diseases (11th ed.; ICD-11; World Health Organization, 2019) and the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM–5; American Psychiatric Association, 2013). The goal was to derive screeners that (1) are maximally brief, while still achieving high sensitivity and specificity; (2) assess perpetration and victimization when either men or women are reporting; and (3) use ICD-11/DSM–5 criteria as the reference standard. Random samples of active duty service members at 82 installations worldwide were obtained via e-mail invitation (2006: N = 54,543; 2008: N = 48,909); their response rates were excellent for long general population surveys with no payment (2006: 44.7%, 2008: 49.0%). The population of spouses at the participating installation was invited by mailed postcard (2006: N = 19,722; 2008: N = 12,127; response rates—2006: 12.3%, 2008: 10.8%). Clinically significant physical intimate partner violence can be effectively screened with as few as four items, with sensitivities >90% and specificities >95%; clinically significant psychological intimate partner violence can be screened with two items. Men and women can be screened with equivalent accuracy, as can those committing the violence and those victimized by it.
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