Objective This study assessed the efficacy of the Marriage Checkup for improving relationship health and intimacy. Method Cohabiting married couples (N=215, Mage women=44.5 years, men=47 years, 93.1% Caucasian) recruited from a northeastern U.S. metropolitan area through print and electronic media were randomly assigned to MC treatment or wait-list control. Treatment but not control couples participated in assessment and feedback visits, at the beginning of the study and again one year later. All couples completed nine sets of questionnaires over two years. Outcome measures included the Quality of Marriage Index, the Global Distress subscale of the Marital Satisfaction Inventory-Revised, the Intimate Safety Questionnaire, and the Relational Acceptance Questionnaire. Results A latent growth curve model indicated significant between group differences in intimacy at every measurement point after baseline (d ranged from .20 to .55, Md = .37), significant between group differences in women’s felt acceptance for every measurement point after baseline (d ranged from .17 to .47, Md = .34), significant between group differences in men’s felt acceptance through the 1-year-2 week follow-up (d across follow-up ranged from .11 to .40, Md = .25), and significant between group differences in relationship distress through 1-year 6-month follow-up (d across follow-up ranged from .11 to .39, Md = .23). Conclusions Longitudinal analysis of the MC supports the hypothesis that the MC significantly improves intimacy, acceptance, and satisfaction. Implications for dissemination are discussed.

As family systems research has expanded, so have investigations into how marital partners coparent together. Although coparenting research has increasingly found support for the influential role of coparenting on both marital relationships and parenting practices, coparenting has traditionally been investigated as part of an indirect system which begins with marital health, is mediated by coparenting processes, and then culminates in each partner's parenting. The field has not tested how this traditional model compares to the equally plausible alternative model in which coparenting simultaneously predicts both marital relationships and parenting practices. Furthermore, statistical and practical limitations have typically resulted in only one parent being analyzed in these models. This study used model-fitting analyses to include both wives and husbands in a test of these two alternative models of the role of coparenting in the family system. Our data suggested that both the traditional indirect model (marital health to coparenting to parenting practices), and the alternative predictor model where coparenting alliance directly and simultaneously predicts marital health and parenting practices, fit for both spouses. This suggests that dynamic and multiple roles may be played by coparenting in the overall family system, and raises important practical implications for family clinicians.

Despite the ongoing prevalence of marital distress, very few couples seek therapy. Researchers and clinicians have increasingly been calling for innovative interventions that can reach a larger number of untreated couples. Based on a motivational marital health model, the Marriage Checkup (MC) was designed to attract couples who are unlikely to seek traditional tertiary therapy. The objective of the MC is to promote marital health for as broad of a population of couples as possible, much like regular physical health checkups. This first paper from the largest MC study to date examines whether the MC engaged previously unreached couples who might benefit from intervention. Interview and survey data suggested that the MC attracted couples across the distress continuum and was perceived by couples as more accessible than traditional therapy. Notably, the MC attracted a substantial number of couples who had not previously participated in marital interventions. The motivational health checkup model appeared to encourage a broad range of couples who might not have otherwise sought relationship services to deliberately take care of their marital health. Clinical implications are discussed.

Previous measures of childhood adversity have enabled the identification of powerful links with later-life wellbeing. The challenge for the next generation of childhood adversity assessment is to better characterize those links through comprehensive, fine-grained measurement strategies. The expanded, retrospective measure of childhood adversity presented here leveraged analytic and theoretical advances to examine multiple domains of childhood adversity at both the microlevel of siblings and the macrolevel of families. Despite the fact that childhood adversity most often occurs in the context of families, there is a dearth of studies that have validated childhood adversity measures on multiple members of the same families. Multilevel psychometric analyses of this childhood adversity measure administered to 1,194 siblings in 500 families indicated that the additional categories of childhood adversity were widely endorsed, and increased understanding of the sources and sequalae of childhood adversity when partitioned into within- and between-family levels. For example, multilevel confirmatory factor analyses (MCFAs) indicated that financial stress, unsafe neighborhood, and parental unemployment were often experienced similarly by siblings in the same families and stemmed primarily from family wide (between-family) sources. On the other hand, being bullied and school stressors were often experienced differently by siblings and derived primarily from individual (within-family) processes. Multilevel structural equation modeling (MSEM) further illuminated differential criterion validity correlations between these categories of childhood adversity with midlife psychological, social, and physical health. Expanded, multidomain, and multilevel measures of childhood adversity appear to hold promise for identifying layered causes and consequences of adverse childhood experiences.

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