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Prevention of Marital Distress: Current Issues in Programming and Research

Published online by Cambridge University Press:  06 October 2014

Brett C. Behrens*
Affiliation:
University of Queensland
Matthew R. Sanders*
Affiliation:
University of Queensland
*
Behaviour Research and Therapy Centre, Department of Psychiatry, Clinical Sciences Building, Royal Brisbane Hospital, Herston QLD 4029, Australia
Behaviour Research and Therapy Centre, Department of Psychiatry, Clinical Sciences Building, Royal Brisbane Hospital, Herston QLD 4029, Australia
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Abstract

Marital dissatisfaction is the most common presenting problem in adults seeking psychological services and is rated as the second most severe stress adults can experience after a death in the family. Almost every married couple is, at some time, at risk for marital distress, conflict, separation, and divorce and for the resulting stress on themselves and their children. Traditionally, theory and practice have focused on tertiary prevention of marital distress (i.e., marital therapies). However, marital therapy has limited efficacy and accesses only limited numbers of couples. Poor communication and dissatisfaction with interactions, assessed premaritally, are strong predictors of marital distress. Several marital distress prevention programs have been developed which generally or specifically target communication behaviour of pre- and early married couples. Outcome evaluations suggest such programs can lead to improved communication and problem-solving skills, improved relationship satisfaction, lower levels of marital violence, and diminished probability of marital dissolution. Suggestions for future research include a more fine-grained analysis of situation-specific cognition, affect, and psychophysiological responses during communication, incorporation of a self-regulatory model within prevention work, and the use of longitudinal research designs.

Type
Research Article
Copyright
Copyright © The Author(s) 1994

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References

REFERENCES

Arond, M.A., & Parker, S.L. (1987). The first year of marriage. New York: Warner Books.Google Scholar
Australian Institute of Family Studies (1993). Family Matters, 35, 2829.Google Scholar
Bachrach, L.L. (1975). Marital status and mental disorder: An analytical review. National Institute of Mental Health, DHEW Publication No. (ADM) 75-217. Washington, DC: U.S. Government Printing Office.Google Scholar
Baucom, D.H., & Lester, G.W. (1986). The usefulness of cognitive restructuring as an adjunct to behavioral marital therapy. Behavior Therapy, 17, 385403.CrossRefGoogle Scholar
Beach, S.R.H., & O'Leary, K.D. (1986). The treatment of depression occurring in the context of marital discord. Behavior Therapy, 17, 4349.Google Scholar
Bebbington, P. (1987). Marital status and depression: A study of English national admission statistics, Acta Psychiatrica Scandanavica, 75, 640650.CrossRefGoogle ScholarPubMed
Behrens, B.C., Halford, W.K., & Sanders, M.R. (1989). Behavioural marital therapy: An overview. Behaviour Change, 6, 112123.CrossRefGoogle Scholar
Behrens, B.C., Halford, W.K., & Sanders, M.R. (1990). Behavioral marital therapy: An evaluation of treatment effects across high and low risk settings. Behavior Therapy, 21, 423433.CrossRefGoogle Scholar
Behrens, B.C., Halford, W.K., & Sanders, M.R. (1992). Marital preparation program: A leaders' manual. Unpublished manuscript. University of Queensland.Google Scholar
Blampied, N.M. (1989). Behavioural marital therapy: Setting an agenda for the 1990's. Behaviour Change, 6, 187196.CrossRefGoogle Scholar
Blew, A. & Trapold, K. (1982, 11). Fixing what isn't broken: Methodology and ethical considerations in premarital interventions. Paper presented at the Annual Meeting of the Association for the Advancement of Behavior Therapy, Los Angeles, CA.Google Scholar
Bloom, B. (1985). Community mental health: A general introduction (2nd ed.). Monterey, CA: Brooks-Cole.Google Scholar
Bloom, B., Asher, S.J., & White, S.W. (1978). Marital disruption as a stressor: A review and analysis. Psychological Bulletin, 85, 867894.Google Scholar
Bradbury, T.N., & Fincham, F.D. (1990). Preventing marital dysfunction: Review and analysis. In Fincham, F.D., & Bradbury, T.N. (Eds.), The psychology of marriage (pp 374401). New York: Guilford.Google Scholar
Burman, B., & Margolin, G. (1992). Analysis of the association between marital relationships and health problems: An interactional perspective. Psychological Bulletin, 112, 3963.Google Scholar
Callan, V.J., & Noller, P. (1987). Marriage and the family. Sydney: Methuen.Google Scholar
Christensenn, A., & Shenk, J.L. (1991). Communication, conflict and psychological distance in nondistressed, clinic, and divorcing couples. Journal of Consulting and Clinical Psychology, 59, 458463.Google Scholar
Coie, J.D., Watt, N.F., West, S.G., Hawkins, D., Asarnow, J.R., Markman, J.H., Ramey, S.L., Shure, M.G., & Long, B. (1993). The science of prevention: A conceptual framework and some directions for a national research program. American Psychologist, 48, 10131022.Google Scholar
Cowen, C.P., & Cowen, P.A. (1992). When partners become parents. New York: Basic Books.Google Scholar
Coyne, J.C., Kahn, J., & Gotlib, I.H. (1987). Depression. In Jacob, T. (Ed.), Family interaction andpsychopathology (pp. 509534). New York: Plenum.CrossRefGoogle Scholar
D'Augelli, A., Deyss, C., Guerney, B., Hershenberg, B., & Sborofsky, S. (1974). Interpersonal skill training for dating couples: An evaluation of an educational mental health service. Journal of Counselling Psychology, 21, 385389.Google Scholar
Doherty, W.J. (1986). Marital therapy and family medicine. In Jacobson, N.S., & Gurman, A.S. (Eds.), Clinical handbook of marital therapy, (pp. 217236). New York: Guilford.Google Scholar
Emery, R.E. (1982). Interparental conflict and the children of discord and divorce. Psychological Bulletin, 92, 310330.Google Scholar
Emery, R.E., Joyce, S.A., & Fincham, F.D. (1987). The assessment of child and marital problems. In O'Leary, K.D. (Ed.), Assessment of marital discord. Hillsdale, NJ: Lawrence Erlbaum.Google Scholar
Filsinger, E.E., & Thoma, S.J. (1988). Behavioral antecedents of relationship stability and adjustment: A five-year longitudinal study. Journal of Marriage and the Family, 50, 785795.Google Scholar
Fincham, F.D., & Bradbury, T.N. (1988). The impact of attributions in marriage: An experimental analysis. Journal of Social and Clinical Psychology, 7, 122130.Google Scholar
Gallup, . (1989). Marriage satisfaction. Los Angeles, CA: Los Angeles Times Syndicate.Google Scholar
Giblin, P. (1986). Research and assessment in marriage and family enrichment: A meta-analysis study. Journal of Psychotherapy and the Family, 2, 7996.Google Scholar
Giblin, P., Sprenkle, D.H., & Sheehan, R. (1985). Enrichment outcome research: A meta-analysis of premarital, marital and family interventions. Journal of Marital and Family Therapy, 11, 257271.Google Scholar
Glick, P.C. (1989). Remarried families, stepfamilies and stepchildren: Brief demographic profile. Family Relations, 38, 2427.Google Scholar
Gore, S. (1978). The effect of social support in moderating the health consequences of unemployment. Journal of Health and Social Behavior, 19, 157165.Google Scholar
Gotlib, I.H., & McCabe, S.G. (1990). Marriage and psychopathology. In Fincham, F.D., & Bradbury, T.N. (Eds.), The psychology of marriage (pp. 227257). New York: Guilford.Google Scholar
Gottman, J.M. (1979). Marriage interaction: Experimental investigation. San Diego, CA: Academic Press.Google Scholar
Gottman, J.M. (1990). How marriages change. In Patterson, G.R. (Ed.), Depression and aggression in family interaction (pp. 75102). Hillsdale, NJ: Erlbaum.Google Scholar
Gottman, J.M., & Krokoff, L.J. (1989). Marital interaction and marital satisfaction: A longitudinal view. Journal of Consulting and Clinical Psychology, 57, 4752.Google Scholar
Gottman, J.M., & Levenson, R.W. (1988). The social psychophysiology of marriage. In Noller, P., & Kirkpatrick, M.A. (Eds.), Perspectives on marital interaction (pp. 82120). Philadelphia, PA: Multilingual Matters.Google Scholar
Gove, W.R., Hughes, M., & Styles, C.B. (1983). Does marriage have positive effects on the psychological well-being of the individual? Journal of Health and Social Behavior, 24, 122132.CrossRefGoogle ScholarPubMed
Greenberg, L.S., & Johnson, S.M. (188). Emotionally focused therapy for couples. New York: Guilford Press.Google Scholar
Grych, J.H., & Fincham, F.D. (1990). Marital conflict and children's adjustment: A cognitive-contextual framework. Psychological Bulletin, 108, 267290.Google Scholar
Guerney, B.G. (1977). Relationship enhancement. San Francisco, CA: Jossey Bass.Google Scholar
Guerney, B.G., Guerney, L., & Cooney, T. (1985). Marital and family problems prevention and enrichment programs. In L'Abate, L. (Ed.), The handbook of family psychology and therapy (Vol. 2, pp. 11791217). Homewood, IL: Dorsey.Google Scholar
Gurman, A.S., & Kniskern, D.P. (1977). Enriching research on marital enrichment programs. Journal of Marriage and Family Counselling, 3, 311.Google Scholar
Hahlweg, K., Baucom, D.H., & Markman, H. (1988). Recent advances in behavioral marital therapy and in preventing marital distress. In Falloon, R. (Ed.), Handbook of behavioral family therapy, (pp. 413448). New York: Guilford Press.Google Scholar
Hahlweg, K., & Markman, H. (1988). The effectiveness of behavioral marital therapy: Empirical status of behavior techniques in preventing and alleviating marital distress. Journal of Consulting and Clinical Psychology, 56, 440447.Google Scholar
Halford, W.K., & Sanders, M.R. (1989). Behavioural marital therapy in the treatment of psychological disorders. Behaviour Change, 6, 165177.Google Scholar
Halford, W.K., & Sanders, M.R. (1990). The relationship of cognition and behavior during marital interaction. Journal of Social and Clinical Psychology, 9, 489510.Google Scholar
Halford, W.K., Sanders, M.R., & Behrens, B.C. (1993). A comparison of the generalisation of behavioral marital therapy and enhanced behavioral marital therapy. Journal of Consulting and Clinical Psychology, 61, 5160.CrossRefGoogle ScholarPubMed
Halford, W.K., Sanders, M.R., & Behrens, B.C. (in press). Self-regulation in behavioral couples therapy. Behavior Therapy.Google Scholar
Heavey, H., Layne, C., & Christensen, A. (1993). Gender and conflict structure in marital interaction: A replication and extension. Journal of Consulting and Clinical Psychology 61, 1627.Google Scholar
Hooley, J.M., Orleay, J., & Teasdale, J.D. (1986). Levels of expressed emotion and relapse in depressed patients. British Journal of Psychiatry, 148, 642647.Google Scholar
Jacobson, N.S. (1989a). The maintenance of treatment gains following social learning-based marital therapy. Behaviour Therapy, 20, 325336.Google Scholar
Jacobson, N.S. (1989b). The politics of intimacy. The Behavior Therapist, 12, 2932.Google Scholar
Jacobson, N.S. (1992). Behavioral couple therapy: A new beginning. Behavior Therapy, 23, 493506.Google Scholar
Jacobson, N.S., & Addis, M.E. (1993). Research on couples and couple therapy: What do we know? Where are we going? Journal of Consulting and Clinical Psychology, 61, 8593.Google Scholar
Jacobson, N.S., Christensen, A., & Babcock, J. (in press). Integrative behavioral couple therapy. In Jacobson, N.S., & Gurman, A.S. (Eds.), Clinical handbook of couple therapy. New York: Guilford Press.Google Scholar
Jacobson, N.S., Follette, W.C., Revenstorf, D., Baucom, D.H., Hahlweg, K., & Margolin, G. (1984). Variability in outcome and clinical significance of behavioral marital therapy: A reanalysis of outcome data. Journal of Consulting and Clinical Psychology, 52, 497504.Google Scholar
Jacobson, N.S., Schmaling, K.B., & Holtzworth-Munroe, A. (1987). Component analysis of behavioral marital therapy: Two year follow-up and prediction of relapse. Journal of Marital and Family Therapy, 13, 187195.Google Scholar
Julian, D. (1992, 07). Expanding marital adjustment theories: What if marriage were fun? Paper delivered to the 4th World Congress on Behaviour Therapy, Gold Coast, Australia.Google Scholar
Keicolt-Glaser, J.K., Kennedy, S., Malkoff, S., Fisher, L., Speicher, C.E., & Glaser, R. (1988). Marital discord and immunity in males. Psychosomatic Medicine, 50, 213229.Google Scholar
L'Abate, L. (1983). Prevention as a profession: Toward a new conceptual frame of reference. In Mace, D.R. (Ed.), Prevention in family services (pp. 4962). Beverly Hills: Sage.Google Scholar
Levant, R.F. (1986). An overview of psychoeducational family programs. In Levant, R.F. (Ed.), Psychoeducational approaches to family therapy and counselling (pp. 151). New York: Springer-Verlag.Google Scholar
Levenson, R.W., & Gottman, J.M. (1985). Physiological and affective predictors of change in relationship satisfaction. Journal of Personality and Social Psychology, 49, 8594.Google Scholar
Mace, D.R. (1987). Three ways of helping married couples. Journal of Marital and Family Therapy, 13, 179185.Google Scholar
Mace, D.R., & Mace, V.C. (1976). Marriage enrichment: A preventive group approach for couples. In Olson, D.H.L. (Ed.), Treating relationships (pp. 321336). Lake Mills, IA: Graphic Publ.Google Scholar
Markman, H. (1981). The prediction of marital success: A five-year follow-up. Journal of Consulting and Clinical Psychology, 49, 760762.Google Scholar
Markman, H.J. (1984). The longitudinal study of couples' interactions: Implications for understanding and predicting the development of marital distress. In Hehlweg, K., & Jacobson, N.S. (Eds.), Marital interaction (pp. 253281). New York: Guilford Press.Google Scholar
Markman, H.J., Floyd, F., & Dickson-Markman, F. (1982). Towards a model for the prediction and primary prevention of marital and family distress and dissolution. In Duck, S. (Ed.), Personal relationships: Vol. 4. Dissolving personal relationships (pp. 223261). London: Academic Press.Google Scholar
Markman, H.J., Floyd, F., Stanley, S.M., & Lewis, H.C. (1986). Prevention. In Jacobson, N.S., & Gurman, A.S. (Eds.), Clinical handbook of marital therapy (pp. 173195). New York: Guilford.Google Scholar
Markman, H.J., Floyd, F., Stanley, S.M., & Storaasli, R.D. (1988). Prevention of marital distress: A longitudinal investigation. Journal of Consulting and Clinical Psychology, 56, 210217.Google Scholar
Markman, H.J., & Kraft, S.A. (1980). Men and women in marriage: Dealing with gender differences in marital therapy. The Behaviour Therapist, 12, 5156.Google Scholar
Markman, H.J., Lindahl, K., Balaguer, A., & Renick, M.J. (1992, 07). Impact of pre-marital and pre-birth constructive and destructive arguing on child development. Paper delivered to the 4th World Congress on Behaviour Therapy, Gold Coast, Australia.Google Scholar
Markman, H.J., Renick, M.J., Floyd, F.J., Stanley, S.M., & Clements, M. (1993). Preventing marital distress through communication and conflict management training. A 4- and 5-year follow-up. Journal of Consulting and Clinical Psychology, 61, 7077.Google Scholar
Medalie, J.H., & Goldbourt, U. (1976). Angina pectoris among 10,000: II. Psychosocial and other risk factors as evidenced by a multivariate analysis of a five year incidence study. American Journal of Medicine, 60, 910921.CrossRefGoogle Scholar
Miller, S., Nunnally, E.W., & Wackman, D. (1975). Alive and aware: Improving communication in relationships. Minneapolis, MN: Interpersonal Communication Program.Google Scholar
Murphy, C.M., & O'Leary, K.A. (1989). Psychological aggression predicts physical aggression in early marriage. Journal of Consulting and Clinical Psychology, 57, 579582.Google Scholar
Notarius, C., & Vanzetti, N. (1983). The marital agendas protocol. In Filsinger, E. (Ed.), Mariage and family assessment (pp. 209227). Beverly Hills, CA: Sage.Google Scholar
O'Farrell, T.J. (1989). Marital and family therapy in alcoholism treatment. Journal of Substance Abuse Treatment, 6, 2329.Google Scholar
O'Leary, K.D., Barling, J., Arias, I., Rosenbaum, A., Malone, J., & Tyree, A. (1989). Prevalence and stability of physical aggression between spouses: A longitudinal analysis. Journal of Consulting and Clinical Psychology, 57, 263268.Google Scholar
Olson, D.H. (1983). How effective is marriage preparation? In Mace, D. (Ed.), Prevention in family services (pp. 6575). Beverly Hills, CA: Sage.Google Scholar
Olson, D.H. (1990). Marriage in perspective. In Fincham, F.D., & Bradbury, T.N. (Eds.), The psychology of marriage, (pp. 402419). New York: Guilford.Google Scholar
Olson, D.H., & Fowers, B.J. (1986). Predicting marital success with PREPARE: A predictive validity study. Journal of Marital and Family Therapy, 12, 403413.Google Scholar
Olson, D.H., & Fowers, B.J. (1989). ENRICH marital inventory: The discriminant validity and cross validation assessment. Journal of Marital and Family Therapy, 15, 6579.Google Scholar
Olson, D.H., & Larsen, A.S. (1989). Predicting marital satisfaction using PREPARE: A replication study. Journal of Marital and Family Therapy, 15, 311322.Google Scholar
Otto, H.A. (Ed.). (1976). Marriage and family enrichment: New perspectives and programs. Nashville, TN: Parthenon Press.Google Scholar
Overall, J.E., Henry, B.W., & Woodward, J. (1974). Dependence of marital problems on parental family history. Journal of Abnormal Psychology, 83, 446450.CrossRefGoogle ScholarPubMed
Price, R.H., Cowen, E.L., Lorion, R.P., & Remos-Mckay, J. (1988). The search for effective prevention programs: What we learned along the way. American Journal of Orthopsychiatry, 59, 4958.Google Scholar
Raush, H.L., Barry, A., Hertel, R.K., & Swain, M.A. (1974). Communication, conflict, and marriage. San Francisco, CA: Jossey-Bass.Google Scholar
Reynolds, I., Rizzo, D., Gallagher, H., & Speedy, B. (1979). Psychosocial problems of Sydney adults. Sydney: Health Commission of New South Wales.Google Scholar
Ridley, C.A., & Bain, A.B. (1983). The effects of a premarital relationship enhancement program on self-disclosure. Family Therapy, 10, 1323.Google Scholar
Ridley, C.A., Jorgensen, S.R., Morgan, G., & Avery, A.W. (1982). Relationship enhancement with premarital couples: An assessment of effects on relationship quality. American Jounal of Family Therapy, 10, 4148.Google Scholar
Roberts, L.J., & Krokoff, L.J. (1990). A time-series analysis of withdrawal, hostility, and displeasure in satisfied and dissatisfied marriages. Journal of Marriage and the Family, 52, 95105.Google Scholar
Rosenbaum, A., & O'Leary, K.D. (1981). Marital violence: Characteristics of abusive couples. Journal of Consulting and Clinical Psychology, 49(1), 6371.Google Scholar
Rutledge, A.L. (1968). A systematic approach to premarital counseling. In Heston, J.C., & Frich, W.B. (Eds.), Counseling for the liberal arts campus. Yellow Springs, OH: Antioch Press.Google Scholar
Smith, M.L., Glass, G.V., & Miller, T.I. (1980). The benefits of psychotherapy. Baltimore, MD: Johns Hopkins University Press.Google Scholar
Snyder, D.K., Mangrum, L.F., & Wills, R.M. (1993). Predicting couples response to marital therapy: A comparison of short- and long-term predictors. Journal of Consulting and Clinical Psychology, 61, 6169.Google Scholar
Snyder, D.K., & Wills, R.M. (1989). Behavioral versus insight-oriented marital therapy: Effects on individual and interspousal functioning. Journal of Consulting and Clinical Psychology, 57, 3946.Google Scholar
Straus, M.A., & Gelles, R. (1986). Societal change and change in family violence from 1975 to 1985 as revealed by two national surveys. Journal of Marriage and the Family, 48, 465479.Google Scholar
Straus, M.A., Gelles, R., & Steinmetz, S.K. (1980). Behind closed doors: Violence in the American family. New York: Doubleday.Google Scholar
Van Widenfelt, B., Markman, H.J., Guerney, B., Behrens, B.D., Wilson, G., & Hosman, C. (in press). Promoting marital health. In Halford, W.K., & Markman, H.J. (Eds.), Clinical handbook of marriage and marital interventions. Chinchester: Wiley & Sons.Google Scholar
Vanicelli, M., Gingereich, S., & Ryback, R. (1983). Family problems related to the treatment and outcome of alcoholic patients. British Journal of Addiction, 78, 193204.Google Scholar
Veroff, J., Kulka, R.A., & Douvan, E. (1981). Mental health in America: Patterns of help-seeking from 1957–1976. New York: Basic Books.Google Scholar
Vincent, C.E. (1973). Sexual and marital health. New York: McGraw-Hill.Google Scholar
Wempler, K., & Sprenkle, D. (1980). The Minnesota Couple Communication Program: A follow-up study. Journal of Marriage and the Family, 42, 577580.Google Scholar
Widom, C.S. (1989a). Does violence beget violence? A critical examination of the literature. Psychological Bulletin, 106, 328.Google Scholar
Widom, C.S. (1989b). The cycle of violence. Science, 244, 160166.Google Scholar
Wolcott, I., & Glazer, H. (1989). Marriage counselling in Australia: An evaluation. Melbourne: Australian Institute of Family Studies.Google Scholar
Zimmer, D. (1983). Interaction patterns and communication skills in sexually distressed, maritally distressed, and normal couples: Two experimental studies. Journal of Sex and Marital Therapy, 9, 251266.Google Scholar