It is estimated that the divorce rate for marriages in which at least one party is a physician is 10-20% higher than the general population. Predicting the variables that contribute to marital satisfaction, identifying the skills associated with those behaviors and developing a residency curriculum to teach the skills to resident physicians is the focus of this study. Intimacy, conflict resolution and emotional expressiveness have all been identified as important aspects of marital satisfaction. We will determine how each of these variables contributes to marital satisfaction using multilevel logistic regression. The results will be used to develop a skills based training curriculum for residency to improve the lives and well-being of physicians and their families.

Healthy sexuality includes relational, emotional, and physical elements (Busby et al., 2021). However, there are gaps in what is known about the physical aspects of sexual relationships. Genital acceptance and physical sexual knowledge are two areas of physical relationships that may have an effect on the satisfaction of sexual relationships. Attachment, namely levels of anxious and avoidant attachment, is another factor that has been related to sexual relationships (Allsop et al., 2021; Bennett et al., 2019; Busby et al., 2020). Results from a dyadic sample of 515 couples who had been in a relationship for at least two years were studied. Structural equation modeling was used to estimate the direct and indirect actor and partner effects of physical sexual knowledge and genital acceptance on sexual satisfaction, working through mechanisms of anxious and avoidant attachment. Findings indicate the importance of considering genital acceptance and physical sexual knowledge, especially in regard to female bodies, to help move couples toward lower levels of insecure attachment and improved sexual relationships. Findings also denote the specific influence of avoidant attachment on sexual satisfaction in couple relationships as well as the importance of examining genital acceptance for men and women in a partnered context.

Current literature focusing on those exposed to disaster includes calls for more studies with populations who have regular exposure to extreme weather events. The current study reported on a secondary data analysis with a sample of 240 heterosexual couples living in or near coastal regions in the southeast US, who were at risk of experiencing disaster events during the 2019 hurricane season (June-December). An actor-partner interdependence model was fit to the dyadic data via path analysis to test the mediating effect of grit on the relationship dyadic coping (mental health and attachment behaviors) and disaster-related losses, accounting for trauma history. Negative, indirect actor effects suggested women's trauma history is associated with their own attachment behaviors, through lower levels of grit. Direct effects were also found, women's higher levels of trauma history were associated with lower levels of grit for themselves and their husbands. Lastly, male and female partner's higher grit levels were associated with lower levels of male's mental health outcomes (e.g., post-traumatic stress symptoms). Clinical implications were provided for how couple and marriage therapists can best serve couples facing trauma history and disaster-related loss.

Research indicates that having high sexual satisfaction during pregnancy is difficult for couples. This negative trend is important considering that low sexual satisfaction can negatively affect both relationship satisfaction, psychological health, and child outcomes. However, there is evidence that this trend does not apply to all and different groups of couples exist in terms of their sexual satisfaction in pregnancy. Guided by family systems theory and the biopsychosocial model, the current study explored if different subsets of couples, composed of pregnant wives and husbands, exist in terms of their sexual satisfaction during pregnancy and what factors distinguish potential subsets. Using U.S. nationally representative data from 523 pregnant married couples and latent profile analysis adjusting for pregnancy-related biological factors, two subsets of pregnant couples were identified—a larger subset of couples where wives and husbands were satisfied with sex overall (79%) and a smaller subset where wives and husbands were neutral about satisfaction with sex (21%). Having lower depressive symptoms among wives was associated with a greater likelihood of being in the more satisfied subset over the less satisfied subset—the only significant predictor among a variety of biological, psychological, and relational factors, including sexual frequency. Implications include the notion that most U.S. couples do well in navigating the sexual challenges in their control during pregnancy and the importance for medical professionals, practitioners, and educators to help women maintain good mental health during pregnancy in order to better sexual, relational, and psychological outcomes for expectant couples and improve early childhood outcomes.

Individuals with LGBTQ+ identities face discrimination and bigotry, components of their minority status stress, often on a daily basis (Meyer, 2003). Elevated levels of minority stress have been negatively associated with relationship satisfaction (e.g. Rostosky, 2007), such that as minority stress increases, relationship satisfaction often decreases as well. This is an examination of the relationship between general stress, identity-related stress, minority stress, and relationship satisfaction for sexual/gender minority and heterosexual, cisgender individuals who were currently in couple relationships lasting 6 months or longer. All participants completed the Romantic Perceptions Survey, Gender Relations Scale, and Daily Hassles Scale – Short Form. The LGBTQ+ participants also completed the LGBT Minority Stress Measure. I conducted t-test comparisons to examine group differences between heterosexual, cisgender participants and LGBTQ+ participants on relationship satisfaction, identity-related stress, and general stress. The LGBTQ+ and participants exhibited significantly higher levels of relationship satisfaction, general stress, and self-rated identity-related stress than did heterosexual, cisgender participants. I also conducted two hierarchical linear regressions to determine how general stress and identity related stress impacted relationship satisfaction for heterosexual, cisgender participants, and how general stress, identity related stress, and minority stress impacted relationship satisfaction for LGBTQ+ couples. Results of the hierarchical linear regressions were interpreted and found that general and self-rated identity-related stressors in combination predicted relationship satisfaction for LGBTQ+ participants, and general stress alone best predicted relationship satisfaction for heterosexual, cisgender participants. Specific minority status stress did not further contribute to the explanation of relationship satisfaction for LGBTQ+ participants. Results are discussed in terms of implications for research and practice.

Substance Use Disorder (SUD) is a chronic relapsing disease that afflicts 10% of the US population. Recidivism rates for SUD treatment in the United States (US) remain high. Couple therapy has be shown to be an effective treatment modality for SUD, and research consistently indicates that couple therapy is more effective than individual therapy in treating SUD. Still, most US treatment centers do not use couple therapy as a primary treatment modality. To explore the underuse of couple therapy and the barriers that prevent its use, individual, semi-structured interviews were conducted with twenty (N = 20) clinical directors of SUD treatment centers across the US. A theoretical thematic analysis was used incorporating Everett Rogers’ diffusion of innovations theory to assess barriers that hinder the use of couple therapy to treat SUD in addiction treatment centers. Issues related to observability, compatibility, and complexity of couple treatment were found to severely impede the implementation of couple therapy in addiction treatment centers. Recommendations include ongoing research to determine influences on agency programming, fostering pro-research environments in universities and agencies, removing barriers to access to evidence-based practice information, and promoting the federal initiative of technology transfer in SUD treatment. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2020. / FAU Electronic Theses and Dissertations Collection

This study is a two part study of the experiences of women participating in conjoint treatment for domestic violence. The participants in the first part of the study included 11 clients, from whom information was gathered in 25 interviews. The second part of the study focused on three women. Their opinions were garnered in five interviews. Five of the women were in multi-couple group therapy and nine participated in from four to twelve sessions of conjoint couple therapy with their partners. This study focused on how female partners of male batterers experienced strength-based focused couples therapy as part of a research and development project for couples treatment of domestic violence. The concepts of safety, responsibility for the violence, power and control, validation and empowerment guided the researcher. The women related that having two therapists and pre- and post-session check-ins contributed to their sense of safety. Although the women reported that their mate taking responsibility for the violence was important, they thought the therapy's focus on their strengths kept their mates committed to attending therapy sessions. Women, who reported that their mates were taking more responsibility for their actions, attributed the change to their therapists being persistent in discussing the various forms of abusive behavior and in stressing accountability for individual behavior. Most of the women indicated that talking about what they had experienced and that gaining support from therapists and group members increased their power and ability to focus on their own needs. Women in the study stressed the importance of having some form of follow-up support to be able to practicing new skills with their partners. Based on the recommendations of the women in this study, the treatment of domestic violence should provide women safe outlets for expressing their feelings, acknowledgment of their experience and tools for resolving the conflicts in their relationship. / Master of Science

The increase in new human immunodeficiency virus (HIV) infections among heterosexual couples in Africa may reverse the gains made by HIV prevention programs. HIV screening among such couples remains low and understudied.This qualitative study focused on the motivations for HIV screening among heterosexual couples. The primary research goal was to examine the lived experiences of heterosexual couples who were screened for HIV and received their results in Nakuru-Kenya. The health belief model (HBM) served as the theoretical framework and as a basis for the secondary questions which sought to explore the participants' perceptions on HIV based on the constructs of the HBM. Semi-structured interviews were conducted with a purposively selected sample of 14 heterosexual couples. Data were collected through face-to-face audio-recorded interviews, which were coded and analyzed using Moustakas's phenomenological data analysis method. Six major themes emerged from the clustered responses of the participants. Couples recognized that they may be susceptible to HIV infection because HIV is transmitted primarily through sexual contact. Some couples perceived HIV as a severe, life-threatening condition in their lives; others perceived HIV as chronic disease that could be managed through treatment and good health care. The fear of negative consequences was cited as a barrier to couples' willingness to receive HIV counselling and testing. Couples perceived HIV testing as having multiple benefits, including freedom from worries and as a motivation to plan their lives. Health messages and partner dialogue were major cues that encouraged couples to undergo HIV testing. Testimonials from other couples who had been tested and chose to talk about their experiences contributed to a strong feeling of self-efficacy. These study findings may help to improve HIV prevention interventions for heterosexual couples.

Marital quality is a broad measurement of perceptions of satisfaction, happiness, and stability by partners in an established relationship. Marital quality has been relatively understudied among Mexican Americans, a population that warrants the inclusion of cultural constructs in any model concerning relationship outcomes. Therefore, acculturation differences between Mexican American couples were conceptualized as a distal context for understanding marital quality. Traditional gender role values and communication style (warmth and hostility) were included as proximal contexts. Data from Conger’s California Families Project were utilized; results indicated that while most measures of acculturation did not impact marital quality, language use interacted with gender roles values and communication style to influence husbands’ marital quality. Warmth, hostility, and traditional gender role values all exhibited a significant direct influence on marital quality for both husbands and wives. Potential explanations and recommendations for future directions are discussed.

Dual-earner couples raising children face stress that can interfere with marital happiness. Some of these couples seek help from marriage and family therapists, but many therapists claim they are not well trained in the issues facing these couples. In order to determine what might help therapists. researchers in the past have traveled two scholarly paths: (a) studying dual-income couples who still have children at home and are dealing with the stressors of this lifestyle with varying degrees of success, and (b) asking long-term, happily married couples what helped them stay together successfully. This study combined both approaches. Dual-earner couples whose chi ldren were grown and who identified themselves as having great marriages refl ected on strategies that helped them develop and maintain successful and satisfying marriages. Implications for marital therapy are discussed.