Prediction of response to treatment in a randomized clinical trial of marital therapy.

Abstract

This study investigated demographic, intrapersonal, and interpersonal predictors of treatment response in a randomized clinical trial of 134 distressed married couples, which examined traditional (N. S. Jacobson & G. Margolin, 1979) and integrative (N. S. Jacobson & A. Christensen, 1996) behavioral couple therapy. Results based on hierarchical linear modeling revealed that interpersonal variables were the strongest predictors, but their effects were largely limited to predicting initial marital dissatisfaction; greater individual mental health was also associated with less distress initially. Couples who were married longer demonstrated stronger treatment gains, and exploratory analyses suggested that sexually dissatisfied couples showed slower initial, but overall more consistent, gains in the integrative versus the traditional approach. Findings are considered in light of the previous literature on predicting response to marital therapy.

Partner Attachment as a Predictor of Long-Term Response to Treatment with Couples Therapy

“…In earlier research (Conradi et al, 2006), we found a correlation of 0.61 (p < .01). In contrast with neuroticism as examined by Atkins et al (2005) and B. R. Baucom et al (2009), we found model of self to be a significant predictor for treatment outcome. However, the sample on which Atkins et al's (2005) and B. R. Baucom et al's (2009) studies were based, was relatively functional, with only 16% having a current psychiatric diagnosis, whereas in our sample 76.5% had an ICD-10 diagnosis.…”

“…In contrast with neuroticism as examined by Atkins et al (2005) and B. R. Baucom et al (2009), we found model of self to be a significant predictor for treatment outcome. However, the sample on which Atkins et al's (2005) and B. R. Baucom et al's (2009) studies were based, was relatively functional, with only 16% having a current psychiatric diagnosis, whereas in our sample 76.5% had an ICD-10 diagnosis. Moreover, Atkins et al (2005) and B. R. Baucom et al (2009) applied marital satisfaction as an outcome measure, whereas in our study psychopathology (next to problem-solving capacity) served as a criterion measure.…”

“…To date, neuroticism is the only personality factor that has been studied as a predictor of response to couples therapy (Atkins et al, 2005; B. R. Baucom et al, 2009). These studies found that neuroticism was not significantly related to response to treatment.…”

“…A second limitation of existing studies on the response to treatment is that stable personality-related factors are almost never examined as a predictor of outcome (Atkins et al, 2005). Especially in combination with prediction of the long-term treatment outcome, examination of such stable factors is important.…”

“…Atkins et al, 2005;Gollan & Jacobson, 2002;Snyder, Castellani, & Whisman, 2006) have identified a great variety of predictors for marital satisfaction, the main outcome in most studies. These were (a) demographics (e.g., age, education, employment), (b) relationship factors (e.g., communication, commitment, marital distress, influence tactics), (c) individual characteristics (e.g., depression), and (d) the therapy process itself.…”