Biomedical subjects

Donald H Baucom

Publications and source records attributed to Donald H Baucom.

17 recordsLinked to original sources

PubMed2006

Couple and individual adjustment for 2 years following a randomized clinical trial comparing traditional versus integrative behavioral couple therapy.

Follow-up data across 2 years were obtained on 130 of 134 couples who were originally part of a randomized clinical trial comparing traditional versus integrative behavioral couple therapy (TBCT vs. IBCT; A. Christensen et al., 2004). Both treatments produced similar levels of clinically significant improvement at 2 years posttreatment (69% of IBCT couples and 60% of TBCT couples). Both treatments showed a "hockey-stick" pattern of change in which satisfaction dropped immediately after treatment termination but then increased for most of follow-up. The break point when couples reversed courses and gained in satisfaction occurred sooner for IBCT than TBCT couples, and those couples who stayed together generally fared better in IBCT than in TBCT. Finally, there was evidence of greater stability during follow-up in IBCT than in TBCT couples. There was little change in individual functioning over follow-up, but when change occurred it was strongly related to change in marital satisfaction. Given that this sample was selected for its significant and chronic distress, the data are encouraging about the long-term impact of behavioral couple therapy.

Adaptation, Psychological↗

PubMed2006

Rated helpfulness and partner-reported smoking cessation support across the pregnancy-postpartum continuum.

Support interventions have not changed smoking cessation rates significantly. The pregnancy-postpartum continuum presents a unique opportunity to examine patterns of support. Expectant couples (N = 477) were surveyed twice during pregnancy and 3 times postpartum. Partners reported positive and negative smoking-specific support; women reported the helpfulness of partner support. Linear trends suggest that women viewed support as more helpful during pregnancy than during postpartum. Partners' provision of positive support across the continuum depended on their smoking; provision of negative support depended on women's smoking. Partners who smoked provided lower levels of both positive and negative support, especially postpartum. Women who smoked throughout the pregnancy perceived their partner's negative support as helpful. Implications are that partners who smoke may need help staying engaged in the support process. Partners may provide negative support in response to women's smoking cues. Women who are struggling with cessation may not view negative support as negative.

Adolescent↗

PubMed2006

Long-term prediction of marital quality following a relationship education program: being positive in a constructive way.

Relationship education programs such as Ehevorbereitung--Ein Partnerschaftliches Lernprogramm (Premarital Preparation--A Couples' Learning Program) and the Relationship Education and Relationship Enhancement Program (PREP) can help prevent marital distress among newlyweds. Thus, it is important to understand which couples respond best to the intervention and which couples respond less well. E. A. Schilling, D. H. Baucom, C. K. Burnett, E. A. Allen, and L. Ragland (2003) unexpectedly found that the more women increased positive communication in response to PREP, the more likely they were to become distressed in the subsequent 5 years. The current study explores similar issues, investigating a relationship education program in Germany. The current results indicate that couples are susceptible to future relationship distress if women demonstrate extreme increases in positive and decreases in negative communication after intervention. Implications are provided for adapting these relationship education programs in the future.

Adaptation, Psychological↗

PubMed2005

Treating couples recovering from infidelity: an integrative approach.

Infidelity is one of the most difficult problems to address in couple therapy, most likely because it involves a traumatic relationship event that alters the ways in which couples process information about each other and established behavioral patterns. We present a three-stage treatment designed to address the cognitive, behavioral, and emotional sequelae of affairs that integrates cognitive-behavioral and insight-oriented strategies with the literatures on traumatic response and forgiveness. A case study with pretreatment, posttreatment, and 6-month follow-up data is presented to illustrate the treatment methods.

Adaptation, Psychological↗

PubMed2005

Infidelity and behavioral couple therapy: optimism in the face of betrayal.

Infidelity is a common issue with which distressed couples and their therapists grapple. However, there are no data on the efficacy of commonly used therapies to treat couples in which there has been an affair. In the present exploratory study, the authors examined the therapy outcomes of a sample of infidelity couples (n=19) who had participated in a randomized clinical trial of marital therapy (N=134). Results show that infidelity couples began treatment more distressed than noninfidelity couples; however, evidence suggests that couples who had an affair and who revealed this affair prior to or during therapy showed greater improvement in satisfaction than noninfidelity couples. Implications for therapy with infidelity couples are discussed.

Adult↗

PubMed2005

Methodologically sound, cost-effective research on the outcome of couple therapy.

Because of its potential to answer pressing applied questions about what treatments to use with which couples as well as its potential to answer basic questions about couple functioning, outcome research on couple therapy is vital to the field. This article describes the primary methodological issues that an investigator faces in conducting outcome research during treatment development, efficacy testing, and effectiveness evaluation. Descriptions of what has been done in the past are integrated with recommendations about what should be done in the future. Mindful of the potential expense of outcome research, the authors suggest ways in which questions can be investigated cost effectively.

Behavioral Research↗

PubMed2005

Infidelity in couples seeking marital therapy.

The revelation of an affair is often an emotionally explosive event for a couple, yet little is known about specific individual and relationship factors that accompany infidelity. The present study examined the qualities of individuals and couples that differentiate couples with (n = 19) and without (n = 115) infidelity using couples from a randomized clinical trial of marital therapy. Findings indicated that couples with infidelity showed greater marital instability, dishonesty, arguments about trust, narcissism, and time spent apart. Gender also proved to be a significant moderator of several effects. Men who had participated in affairs showed increased substance use, were older, and were more sexually dissatisfied. Results offer initial clues to concomitants of affairs for couple therapists.

Age Factors↗

PubMed2005

Observational coding of relationship-schematic processing.

In this article, we introduce the construct Relationship-Schematic Processing (RSP), which is defined as the degree to which individuals process information in terms of their romantic relationship. We also present an observational coding system that was developed to assess the behavioral manifestations of RSP. The coding system was applied to videotaped problem-solving interactions completed by 55 maritally distressed couples. Findings indicated that wives engaged in more frequent and higher quality RSP than husbands did. Husbands reported greater relationship satisfaction when wives engaged in more frequent and higher quality RSP; wives reported greater satisfaction when husbands engaged in higher quality relationship processing. In addition, we assessed convergent validity with other measures of marital functioning.

Adult↗

PubMed2005

An investigation of unmet intimacy needs in marital relationships.

In this investigation we examined partners' responses to unmet intimacy needs in hopes of better understanding how these responses may affect intimacy satisfaction and overall relationship satisfaction. Eighty-four married couples, plus four additional husbands and 12 additional wives, were recruited from the community and completed measures of relationship satisfaction, intimacy need satisfaction, and attributional and communication responses to unmet intimacy needs. Consistent with the proposed mediational model, less negative attributional and communication responses to unmet intimacy needs were found to be beneficial for overall intimacy satisfaction and relationship satisfaction. In addition, more positive communication responses contributed to greater intimacy satisfaction. Limitations and clinical implications of the current study and directions for future work are discussed.

Adult↗

PubMed2004

Prenatal and postpartum smoking abstinence a partner-assisted approach.

BACKGROUND: A partner's provision of support and smoking status has been consistently associated with women's likelihood of smoking cessation during pregnancy and relapse in postpartum. DESIGN: A three-group randomized controlled intervention trial was conducted in 1996 to 2001, with 583 women and their partners randomized to usual care (UC), woman-only (WO), or partner-assisted (PA) intervention. Follow-ups occurred at 28 weeks of pregnancy, and 2-, 6-, and 12-months postpartum. SETTING: Womack Army Medical Center (WAMC) at Fort Bragg in Fayetteville, North Carolina. INTERVENTION: Women in the UC condition received provider advice to quit and a self-help guide. The WO condition received UC components plus a late-pregnancy relapse prevention kit (booklet and gift items) and six counseling calls (three in pregnancy and three postpartum) initiated by a health advisor. Women in the PA condition received the WO intervention, and their partners received telephone counseling and a support guide emphasizing skills to help the woman build and maintain her confidence to quit smoking. Partners who smoked also received cessation aids and related counseling. MAIN OUTCOME MEASURE: Seven-day self-reported abstinence from smoking at each follow-up. RESULTS: Intent-to-treat analyses showed no significant differences by condition in women's reports of abstinence at any follow-up. In late pregnancy, more partners were abstinent in the PA condition (15%) than in the UC condition (5%), p =0.02. CONCLUSIONS: Partner-assisted smoking-cessation interventions need further refinement. Influencing young couples' support patterns may require more intensive and conjoint intervention. Partners who smoke could benefit from support for their cessation efforts.

Adult↗

PubMed2004

Traditional versus integrative behavioral couple therapy for significantly and chronically distressed married couples.

A randomized clinical trial compared the effects of traditional behavioral couple therapy (TBCT) and integrative behavioral couple therapy (IBCT) on 134 seriously and chronically distressed married couples, stratified into moderately and severely distressed groups. Couples in IBCT made steady improvements in satisfaction throughout the course of treatment, whereas TBCT couples improved more quickly than IBCT couples early in treatment but then, in contrast to the IBCT group, plateaued later in treatment. Both treatments produced similar levels of clinically significant improvement by the end of treatment (71% of IBCT couples and 59% of TBCT couples were reliably improved or recovered on the Dyadic Adjustment Scale; G. B. Spanier, 1976). Measures of communication also showed improvement for both groups. Measures of individual functioning improved as marital satisfaction improved.

Adult↗

PubMed2004

Adult attachment and patterns of extradyadic involvement.

Relationships between patterns of extradyadic involvement (EDI) and adult attachment were examined separately with undergraduates and community adults reporting prior EDI. Those with fearful or preoccupied styles reported more intimacy motivations for EDI, and undergraduates with these styles also reported more self-esteem motivations. Conversely, those with a dismissive style reported more autonomy motivations for EDI. Those with a fearful attachment style reported ambivalence about intimacy in the EDI. Fearful and preoccupied undergraduates and community males reported a more obsessive extradyadic relationship. However, dismissive individuals did not report more casual EDI. Gender effects also emerged, with females reporting more intimacy motivations than males, and undergraduate males reporting more casual EDI than undergraduate females. In the undergraduate sample, dismissive males had the most extradyadic partners over the prior 2 years relative to all other groups, and preoccupied females reported more partners than secure females. Clinical implications of these findings are discussed.

Adolescent↗

PubMed2004

An integrative intervention for promoting recovery from extramarital affairs.

The discovery or disclosure of an extramarital affair can have a devastating impact on partners, both individually and on the relationships. Research suggests that affairs occur relatively frequently in relationships and are a common presenting problem in couple therapy. However, despite their prevalence, there is little empirical treatment research in this area, and most therapists describe this problem as one of the more difficult to treat. In this study, we used a replicated case-study design to explore the efficacy of an integrative treatment designed to help couples recover from an affair. Six couples entered and completed treatment. The majority of these couples were less emotionally or maritally distressed at the end of treatment, and the injured partners reported greater forgiveness regarding the affair. Details of the intervention, suggested adaptations of the treatment, and areas for future research are discussed.

Adaptation, Psychological↗

PubMed2003

The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life.

This preliminary study examined the self-efficacy of family caregivers with regard to helping cancer patients manage pain at end of life. A sample of 63 family caregivers of hospice-eligible cancer patients with pain provided ratings of their self-efficacy in assisting the patient in pain management and rated their own mood and level of caregiver strain. Patients completed measures of pain and quality of life. Data analyses revealed that caregivers who rated their self-efficacy as high reported much lower levels of caregiver strain as well as decreased negative mood and increased positive mood. Caregiver self-efficacy in managing the patient's pain was related to the patient's physical well-being. In dyads where the caregiver reported high self-efficacy, the patient reported having more energy, feeling less ill, and spending less time in bed. Considered overall, the results of this study suggest that caregiver self-efficacy in pain management is important in understanding how caregivers adjust to the demands of caring for cancer patients who have pain at the end of life.

Adult↗

PubMed2003

Altering the course of marriage: the effect of PREP communication skills acquisition on couples' risk of becoming maritally distressed.

This longitudinal study predicted marital outcome from communication skills gained from participation in the Prevention and Relationship Enhancement Program (PREP; H. J. Markman, S. L. Blumberg & S. M. Stanley, 1989; Stanley et al., 2001) by 39 women and 38 men. Results were in the expected direction for men but not for women. Men's pre- to posttest decrease in negative communication and increase in positive communication predicted decreased risk of marital distress onset in men. Women's pre- to posttest increase in positive communication, which was related to self-reported avoidance of problem solving, predicted an increased risk of male and female distress onset. Couples with men relatively high on premarital risk factors demonstrated a greater benefit from men's positive communication skills acquisition.

Adult↗

PubMedDate not supplied

Psychosocial issues confronting young women with breast cancer.

The current paper reviews the literature regarding psychosocial issues confronting young women with breast cancer. The findings indicate that younger women with breast cancer experience a lower quality of life after cancer compared to older women. In part, this lower quality of life results from the effects of medical treatment. The effects of surgery and removal of the breast result in more negative feelings regarding body image, particularly for young women. With systemic treatment, many younger women experience the sudden onset of menopause, with the attendant symptoms of hot flashes, decreased sexual desire, and vaginal dryness. These physical effects along with a variety of relationship issues contribute to a high level of sexual concerns for young women. From a psychosocial perspective, breast cancer affects both females and their male partners. Both partners experience psychological distress including depression and anxiety. Within the relationship, emotional support from the partner is important in women's adjustment. In terms of psychosocial interventions for breast cancer, findings suggest that the most frequently employed interventions, which treat the woman without her partner, are not optimal. Initial findings provide encouraging evidence that couple-based psychosocial interventions for women and their partners might be of particular assistance to both partners.

Adaptation, Psychological↗

PubMedDate not supplied

Couples' reports of support for smoking cessation predicting women's late pregnancy cessation.

PURPOSE: Although social support has been linked to smoking cessation, no studies have examined whether social support predicts women's late pregnancy cessation. Further, few have included reports from both support recipients and providers. DESIGN: Longitudinal. SUBJECTS: Pregnant couples (n = 394) reported support for cessation in early (13-20 weeks) and late (28 weeks) pregnancy. MEASURES: Different measures of couples' support were tested for predicting women's late pregnancy, cessation. Measures of couples' support that were calculated included: summative (added women's and male partners' support scores, possible range 2-10), difference (subtracted the lower score from the higher, possible range 0-4), strong link (used higher positive or lower negative score, possible range 1-5), weak link (lower positive or higher negative score, possible range 1-5), and female and male reports alone (possible ranges 1-5). Covariate-adjusted odds ratios for the association of these various measures of couples' support with women's late pregnancy cessation were calculated. RESULTS: Of the 12 scores (6 positive, 6 negative), only summative (p = .03) and weak link (p = .05) for positive support predicted women's quitting. CONCLUSION: Neither women's nor male partners' reports alone predicted women's cessation; only when both scores were considered, either by adding the scores or by taking the lower score, was the positive support score predictive. Future studies of social support should include support recipients' and providers' perspectives.

Adult↗