abstract: Intercultural couples -partners from two different countries- may face increased levels of stress within their relationship (internal stress). Internal stress can negatively impact relationship satisfaction, whereas developing healthy ways to cope (dyadic coping; DC) can lower stress levels and improve relationship satisfaction (e.g., Bodenmann, 2005). Specifically, it may be important for partners to perceive that their partner as supporting them during times of stress through engaging in DC. This study examined whether intercultural couples experience internal stress and what effects, if any, perceived partner engagement in DC had on their reported relationship satisfaction. Cross-sectional data was gathered from 85 couples and was analyzed using Actor-Partner Interdependence Models (APIMs; Kenny & Cook, 1999). Separate APIMs were conducted to examine the association between the independent variables (perceived partner engagement in: positive DC, negative DC, delegated DC, and supportive DC) and the outcome variables of internal stress and relationship satisfaction, while controlling for years each partner lived in their country of birth, average and differences on identification with individualism-collectivism values and behaviors, and if partners did or did not identify as the same race and/or ethnicity. Additionally, APIMs of internal stress on relationship as moderated by perceived partner positive and negative DC were conducted. Results showed significant associations of all independent variables on internal stress and relationship satisfaction. There were no signification interactions between internal stress and DC on relationship satisfaction. Implications for relationship researchers and mental health professionals working with intercultural couples are discussed. / Dissertation/Thesis / Masters Thesis Counseling 2016

abstract: The prevalence of chronic illness among children in the United States is on the rise (CDC, 2014). Having a child with a chronic illness can be a substantial source of stress for a couple, including physical, emotional, and financial demands of caregiving as well as difficult decision-making regarding the child’s health (Mayo Clinic, 2015). Coping with such stressors can have a negative effect on the couple’s well-being, and, if not managed within the relationship, can lead to increased negative outcomes for both partners. Partners can, however, learn to cope with stress by engaging in the coping process together with dyadic coping (DC). Couples can engage in positive (i.e., supportive emotion-focused, supportive problem-focused, and delegated) or negative forms of DC. DC has been shown to mitigate stress for couples, while increasing reports of individual well-being (IWB) and relational well-being (RWB), but it has not been examined in the context of couples with a child with a chronic illness. To bridge this gap, the present study examined how couples cope with general stress as well as stress associated with their child’s diagnosis of a chronic illness (CI-related stress) and whether positive DC and negative DC moderate association between stress (general stress and CI-related stress) and well-being (IWB and RWB). Consistent with hypotheses, there were significant main effects of both types of stress (general and CI-related stress) on both types of well-being (IWB and RWB). Contrary to the hypotheses that DC (positive DC and negative DC) would moderate the associations between both types of stress and both types of well-being, only one significant interaction was found between CI-related stress and negative DC on IWB. Implications of these findings are discussed. / Dissertation/Thesis / Masters Thesis Counseling 2016

abstract: The demands and expectations of graduate school can be stressful for any student. Graduate students in a romantic relationship, in particular, contend with both individual and dyadic effects of graduate school stress, as stress has been found to be negatively associated with both individual and relational well-being. Asymmetrical graduate student couples, wherein one partner is in graduate school and the other is not, may be particularly vulnerable to relationship strain because of differences in their experience of graduate school. However, non-student partners can help the graduate student cope with stress through dyadic coping. This study sought to examine whether: a) there were associations between graduate school stress on individual (life satisfaction) and relational (relationship satisfaction) well-being, and b) whether these associations were moderated by positive and negative dyadic coping behaviors. Cross-sectional data from 62 asymmetrical graduate student couples were gathered using an online survey. Data were analyzed using Actor-Partner Interdependence Models (Kenny, Kashy, & Cook 2006). Separate models were conducted to examine overall associations between graduate stress and well-being, and additional analyses were conducted to examine potential moderation effects of perceptions of partner dyadic coping (actor effects) and partner self-reported dyadic coping (partner effects) on the overall associations between stress and life- and relationship satisfaction mentioned above. Results for the overall model suggested that graduate stress is associated with both individual- and relational well-being. Surprisingly, and against prior literature, positive dyadic coping did not buffer the negative association between graduate stress and well-being, and negative dyadic coping did not exacerbate the association. Implications of the findings for future research and for mental health counselors are discussed. / Dissertation/Thesis / Masters Thesis Counseling 2017

Il presente lavoro di tesi si colloca all'interno di un più ampio programma di intervento clinico per pazienti oncologici. Facendo riferimento ad una cornice teorica basata sul modello relationship-centered care, l'obiettivo di tale programma di intervento è quello di ricercare ed attivare modalità di coping diadico funzionali per fronteggiare la malattia oncologica attraverso i quali si articola questa ricerca, vogliono esplorare tre modalità di coping e caregiving: individuale, diadico e di gruppo. Nel primo studio verranno indagate le strategie di coping e di adattamento interpersonale di donne con cancro al seno, e se tali variabili sono in grado di predire l'adesione ad un trattamento clinico che implichi il paziente medesimo ed un caregiver da lui scelto. Il secondo studio sarà dedicato all'assesssment diadico, dove le coppie formate da paziente e caregiver saranno descritte in funzione di specifiche variabili quali la depressione, l'ottimismo e le caratteristiche di personalità; a questo proposito verrà indagato se tali tipologie di coppia sono in grado di predire lo stile di coping del paziente. Il terzo studio, di processo, è centrato sull'efficacia di un intervento clinico di gruppo in cui sono coinvolti i pazienti e i loro caregiver. / This dissertation examines the psychological assessment for women with breast cancer and their chosen caregivers. It will be wholly presented the longitudinal research design in which the three studies of this dissertation are included. The first study aims not only to standardize the sampling procedure, but it also has the clinical purpose to verify whether coping strategies and interpersonal adjustment preedict end moderate the acceptance to a Supportive-Expressive Group Therapy (SEGT). In the second study the unit of analysis is the couple, which allows for a more accurate description of dyadic coping processes. It will be described and examined specifics couple's typologies or couple matching depending on symptoms and psychological factors such as, life orientations, depression and personality traits. The third study is totally centred on the SEGT. It will be described the nature of intervention and the structure of each session, exploring how the contents and the styles of the therapeutic action change.

Die meisten Menschen sind daran interessiert, eine glückliche und befriedigende Partnerschaft zu führen. Die psychologische Forschung hat erbracht, dass vor allem die Kommunikation und das Problemlöseverhalten der Partner in Konfliktsituationen einen entscheidenden Einfluss darauf ausüben, ob eine Paarbeziehung gelingt oder nicht. Seit einiger Zeit werden auch Anpassungsprozesse an Belastungen als wichtige Einflussfaktoren gesehen. Mit dem Konzept des dyadischen Copings liegt ein elaborierter Ansatz zur Belastungsverarbeitung in Partnerschaften vor. Studien zum Effekt dyadischen Copings haben aufgezeigt, dass der partnerschaftliche Umgang mit Belastungen konkurrent und prospektiv mit der Beziehungsqualität zusammenhängt. Ein Manko der bisherigen Forschung zum dyadischen Coping ist die unzureichende Verknüpfung mit anderen Konzepten, die bedeutsam für die Qualität und die Entwicklung von Partnerschaften sind. In den letzten Jahren hat sich das Konzept der Bindung als ein fruchtbarer Ansatz für das Verständnis von Partnerschaften erwiesen. Bindung wird hier verstanden als die bewusst zugängliche kognitive Repräsentation zentraler Merkmale der Paarbeziehung. Der Bindungsstil steht mit zahlreichen partnerschaftsbezogenen Merkmalen in Verbindung, beispielsweise mit der Beziehungsqualität. Im Rahmen der vorliegenden Studie wurde die Hypothese untersucht, dass dyadisches Coping eine Mediatorvariable darstellt und den Effekt des Bindungsstils auf die Beziehungsqualität partiell vermittelt. Daneben wurde explorativ der Frage nachgegangen, ob soziodemographische Merkmale einen vorhandenen Mediationseffekt beeinflussen, d.h. ob moderierte Mediationseffekte bestehen. Hierzu wurde eine Querschnittuntersuchung durchgeführt. Bindungsstil, dyadisches Coping und Beziehungsqualität wurden mittels Selbstbeurteilungsinstrumenten erhoben. In die Regressionsanalysen gingen 192 Personen ein, die sich aktuell in einer Paarbeziehung befanden. Die Ergebnisse bestätigen weitgehend die Annahme, dass dyadisches Coping den Effekt des Bindungsstils auf die Beziehungsqualität partiell vermittelt. Dies gilt insbesondere für das positive dyadische Coping. Dieses wirkte sowohl bei der Bindungsdimension sicher-ängstlich als auch bei der Dimension abhängig-unabhängig als Mediatorvariable. Hingegen fungierte negatives dyadisches Coping nicht als Mediator. Neben diesen beiden wurde auch die neu konstruierte Variable Ratio negatives/positives dyadisches Coping als ein möglicher Mediator untersucht. Für diese Variable zeigten sich Ergebnisse, die denen zum positiven dyadischen Coping vergleichbar sind. Als ein wichtiges Ergebnis ist ferner anzumerken, dass Mediationseffekte fast ausschließlich zu beobachten waren, wenn die Beziehungsqualität im Sinne objektivierbarer, struktureller Merkmale als Kriterium betrachtet wurde. Wurde die Beziehungszufriedenheit, d.h. die subjektive, evaluative Komponente, als Kriterium herangezogen, ergaben sich direkte Effekte des Bindungsstils und nicht vermittelte. Daneben zeigte sich, dass soziodemographische Merkmale einige der erzielten Mediationseffekte moderierend beeinflussen. Trotz der bestehenden Einschränkungen der Studie, die vor allem in dem Querschnittdesign zu sehen sind, lässt sich anhand der erzielten Ergebnisse sagen, dass Bindung und dyadisches Coping bedeutsame Einflussfaktoren der Beziehungsqualität darstellen. Ferner zeigt die Studie erstmals auf, dass dyadisches Coping, welches in erheblichem Maße Prozesse des Helfens und Unterstützens umfasst, den Effekt des eigenen Bindungsstils auf die eigene erlebte partnerschaftliche Beziehungsqualität vermittelt. Als solches weist die Studie auf ein mögliches neues Themenfeld der Forschung zu Bindung, Bewältigung und Unterstützung im Kontext von Partnerschaften hin. / Most people are interested in a happy, satisfying intimate relationship. Psychological research has shown that a couple's communication and problem solving behavior are the most influential ingredients of a happy partner relationship. However, recent research has provided support that stressful events and adaptive processes also influence the quality of a couple's relationship. One well-developed concept for describing adaptation to stress in couples is dyadic coping. Research has shown that dyadic coping predicts relationship quality concurrently as well as longitudinally. One limitation of the available research on dyadic coping is the lack of associations with other relevant determinants and processes influencing the success of a relationship. One such concept is attachment, which has received much attention in the recent years. Attachment, as it is understood here, comprises the conscious mental representation of central characteristics of an intimate relationship. Many studies have shown that attachment style is related to diverse relationship characteristics, e.g. relationship quality. This study investigated the hypothesis that dyadic coping partially mediates the effect of attachment style on relationship quality. Additionally, moderated mediation effects were tested, i.e. it was investigated whether certain sociodemographic characteristics would moderate the mediation effect. The study employed a cross-sectional design. Attachment style, dyadic coping, and relationship quality were assessed using self-report questionnaires. The study sample comprised 192 persons living in a lasting, intimate relationship. Regression analyses were conducted to test for mediation effects. The results confirm the general hypothesis that dyadic coping partially mediates the effect of attachment style on relationship quality. This effect occurs when positive dyadic coping is regarded as a mediating variable. This variable partially mediates the effect of the attachment dimensions secure-fearful and dependent-independent. Negative dyadic coping did not act as a mediator. In addition, a relational index, ratio negative/positive dyadic coping, was constructed. The results for this variable paralleled those found for positive dyadic coping. Importantly, the mediating effect of the variables positive dyadic coping and ratio dyadic coping emerged almost exclusively when relationship quality, i.e. the observable and structural aspects of a relationship, was used as the criterion variable. Almost no mediation effects occurred when relationship satisfaction, i.e. the subjective evaluative component, was used as the criterion. Furthermore, sociodemographic characteristics moderated some of the mediation effects. Although the study has some limitations, most importantly the cross-sectional design, the results underline that attachment style and dyadic coping are relevant determinants of the quality of an intimate relationship. Further, it shows that dyadic coping mediates the effects of the personal attachment style on the personal evaluation of the partner relationship. Thus, this study underlines the importance of studying adaptation processes in couples from an attachment and coping framework.

Die meisten Menschen sind daran interessiert, eine glückliche und befriedigende Partnerschaft zu führen. Die psychologische Forschung hat erbracht, dass vor allem die Kommunikation und das Problemlöseverhalten der Partner in Konfliktsituationen einen entscheidenden Einfluss darauf ausüben, ob eine Paarbeziehung gelingt oder nicht. Seit einiger Zeit werden auch Anpassungsprozesse an Belastungen als wichtige Einflussfaktoren gesehen. Mit dem Konzept des dyadischen Copings liegt ein elaborierter Ansatz zur Belastungsverarbeitung in Partnerschaften vor. Studien zum Effekt dyadischen Copings haben aufgezeigt, dass der partnerschaftliche Umgang mit Belastungen konkurrent und prospektiv mit der Beziehungsqualität zusammenhängt. Ein Manko der bisherigen Forschung zum dyadischen Coping ist die unzureichende Verknüpfung mit anderen Konzepten, die bedeutsam für die Qualität und die Entwicklung von Partnerschaften sind. In den letzten Jahren hat sich das Konzept der Bindung als ein fruchtbarer Ansatz für das Verständnis von Partnerschaften erwiesen. Bindung wird hier verstanden als die bewusst zugängliche kognitive Repräsentation zentraler Merkmale der Paarbeziehung. Der Bindungsstil steht mit zahlreichen partnerschaftsbezogenen Merkmalen in Verbindung, beispielsweise mit der Beziehungsqualität. Im Rahmen der vorliegenden Studie wurde die Hypothese untersucht, dass dyadisches Coping eine Mediatorvariable darstellt und den Effekt des Bindungsstils auf die Beziehungsqualität partiell vermittelt. Daneben wurde explorativ der Frage nachgegangen, ob soziodemographische Merkmale einen vorhandenen Mediationseffekt beeinflussen, d.h. ob moderierte Mediationseffekte bestehen. Hierzu wurde eine Querschnittuntersuchung durchgeführt. Bindungsstil, dyadisches Coping und Beziehungsqualität wurden mittels Selbstbeurteilungsinstrumenten erhoben. In die Regressionsanalysen gingen 192 Personen ein, die sich aktuell in einer Paarbeziehung befanden. Die Ergebnisse bestätigen weitgehend die Annahme, dass dyadisches Coping den Effekt des Bindungsstils auf die Beziehungsqualität partiell vermittelt. Dies gilt insbesondere für das positive dyadische Coping. Dieses wirkte sowohl bei der Bindungsdimension sicher-ängstlich als auch bei der Dimension abhängig-unabhängig als Mediatorvariable. Hingegen fungierte negatives dyadisches Coping nicht als Mediator. Neben diesen beiden wurde auch die neu konstruierte Variable Ratio negatives/positives dyadisches Coping als ein möglicher Mediator untersucht. Für diese Variable zeigten sich Ergebnisse, die denen zum positiven dyadischen Coping vergleichbar sind. Als ein wichtiges Ergebnis ist ferner anzumerken, dass Mediationseffekte fast ausschließlich zu beobachten waren, wenn die Beziehungsqualität im Sinne objektivierbarer, struktureller Merkmale als Kriterium betrachtet wurde. Wurde die Beziehungszufriedenheit, d.h. die subjektive, evaluative Komponente, als Kriterium herangezogen, ergaben sich direkte Effekte des Bindungsstils und nicht vermittelte. Daneben zeigte sich, dass soziodemographische Merkmale einige der erzielten Mediationseffekte moderierend beeinflussen. Trotz der bestehenden Einschränkungen der Studie, die vor allem in dem Querschnittdesign zu sehen sind, lässt sich anhand der erzielten Ergebnisse sagen, dass Bindung und dyadisches Coping bedeutsame Einflussfaktoren der Beziehungsqualität darstellen. Ferner zeigt die Studie erstmals auf, dass dyadisches Coping, welches in erheblichem Maße Prozesse des Helfens und Unterstützens umfasst, den Effekt des eigenen Bindungsstils auf die eigene erlebte partnerschaftliche Beziehungsqualität vermittelt. Als solches weist die Studie auf ein mögliches neues Themenfeld der Forschung zu Bindung, Bewältigung und Unterstützung im Kontext von Partnerschaften hin. / Most people are interested in a happy, satisfying intimate relationship. Psychological research has shown that a couple's communication and problem solving behavior are the most influential ingredients of a happy partner relationship. However, recent research has provided support that stressful events and adaptive processes also influence the quality of a couple's relationship. One well-developed concept for describing adaptation to stress in couples is dyadic coping. Research has shown that dyadic coping predicts relationship quality concurrently as well as longitudinally. One limitation of the available research on dyadic coping is the lack of associations with other relevant determinants and processes influencing the success of a relationship. One such concept is attachment, which has received much attention in the recent years. Attachment, as it is understood here, comprises the conscious mental representation of central characteristics of an intimate relationship. Many studies have shown that attachment style is related to diverse relationship characteristics, e.g. relationship quality. This study investigated the hypothesis that dyadic coping partially mediates the effect of attachment style on relationship quality. Additionally, moderated mediation effects were tested, i.e. it was investigated whether certain sociodemographic characteristics would moderate the mediation effect. The study employed a cross-sectional design. Attachment style, dyadic coping, and relationship quality were assessed using self-report questionnaires. The study sample comprised 192 persons living in a lasting, intimate relationship. Regression analyses were conducted to test for mediation effects. The results confirm the general hypothesis that dyadic coping partially mediates the effect of attachment style on relationship quality. This effect occurs when positive dyadic coping is regarded as a mediating variable. This variable partially mediates the effect of the attachment dimensions secure-fearful and dependent-independent. Negative dyadic coping did not act as a mediator. In addition, a relational index, ratio negative/positive dyadic coping, was constructed. The results for this variable paralleled those found for positive dyadic coping. Importantly, the mediating effect of the variables positive dyadic coping and ratio dyadic coping emerged almost exclusively when relationship quality, i.e. the observable and structural aspects of a relationship, was used as the criterion variable. Almost no mediation effects occurred when relationship satisfaction, i.e. the subjective evaluative component, was used as the criterion. Furthermore, sociodemographic characteristics moderated some of the mediation effects. Although the study has some limitations, most importantly the cross-sectional design, the results underline that attachment style and dyadic coping are relevant determinants of the quality of an intimate relationship. Further, it shows that dyadic coping mediates the effects of the personal attachment style on the personal evaluation of the partner relationship. Thus, this study underlines the importance of studying adaptation processes in couples from an attachment and coping framework.

No description available.

No description available.

Chronic illness and invisible disability are impactful contexts during emerging adulthood and the launching stage of the family life cycle (Beatty, 2011; Capelle, Visser, and Vosman, 2016; Young et al., 2010). The parent-child relationship is important to both developmental and health outcomes in families coping with chronic illness during emerging adulthood (Crandell, Sandelowski, Leeman, Haville, and Knafle, 2018; Fenton, Ferries, Ko, Javalkar, and Hooper, 2015; Waldboth, Patch, Mahrer-Imhaf, and Metcalfe, 2016). While informed clinical competency in counseling families experiencing disablement is a diversity-affirmative ethical imperative among psychotherapists (Mona et al., 2017), little is known in family therapy about how parents and emerging adult children experience launching with chronic illness. This qualitative study explored the parent-child dyadic experience of living with a chronic illness called Postural Orthostatic Tachycardia Syndrome (POTS) during emerging adulthood. Seven dyads of parents and their emerging adult children with POTS were interviewed. Data analysis of in-depth interviews using Moustakas's (1994) transcendental phenomenology uncovered eight thematic clusters of meaning in the shared lived experience of POTS at the launching stage of the family life cycle. Clinical implications for family therapists were explored using Rolland's family system-illness (FSI) model of medical family therapy. Study limitations and future directions for further research were discussed. / Master of Science / More and more young adults are living with chronic illness. Postural Orthostatic Tachycardia Syndrome (POTS) is a little-known chronic illness that tends to begin during adolescence. Like many health problems that disproportionately affect women, POTS is often overlooked by doctors. POTS symptoms, such as dizziness and cognitive difficulty, impact a person's ability to engage in preferred activities and identities. Family therapists can play an impactful role in supporting parents and children with POTS through developmental tasks related to launching an emerging adult in the context of this complex and widely misunderstood chronic illness. This thesis presented the first qualitative study of parent-child dyadic experiences living with POTS. Clinical implications for medical family therapy were highlighted. To construct an interview framework, Rolland's Family Systems-Illness (FSI) clinical model for helping families cope with illness and disability was used in conjunction with Arnett's description of emerging adulthood as a developmental stage in life. Seven parent-child dyads were interviewed for 1-2 hours in fourteen separate interviews generating transcripts about 140,000 words long in total. Analysis of these interviews identified shared themes composing the essence of the parent-child experience living with POTS during emerging adulthood. Results were described through tables and narratives. Clinical implications for family therapists working with parents and children with POTS during emerging adulthood were proposed. Limitations and ideas for future studies were discussed.

Questa ricerca ha un approccio diadico che coinvolge sia i pazienti con malattie cardiovascolari che il loro partner durante l'ospedalizzazione. Il primo studio indaga l'effetto del coping diadico (DC) sulla soddisfazione coniugale dei partner considerando l'effetto moderatore del distress psicologico dei partner. I risultati mostrano che l'effetto benefico del DC positivo e comune sulla soddisfazione coniugale si verifica quando il distress psicologico dei partner è basso, al contrario il DC negativo diminuisce la soddisfazione coniugale tra coloro che hanno alti livelli di distress psicologico. Il secondo studio si propone di indagare la relazione tra DC, aderenza farmacologica e patient activation. La relazione è mediata dall'autoefficacia per la salute del paziente: il DC positivo e comune aumentano l'autoefficacia che a sua volta aumenta l'aderenza farmacologica e la patient activation; al contrario il DC negativo è dannoso durante il ricovero e anche dopo la dimissione. Il terzo studio indaga la relazione tra il distress psicologico e la qualità del supporto del partner (iperprotezione, ostilità e supporto al patient engagement) attraverso il ruolo moderatore del DC. I risultati mostrano che un alto distress psicologico è associato ad un peggior supporto del partner tra coloro che hanno basso DC positivo e alto DC negativo. / This research has a dyadic approach involving both patients with cardiovascular disease and their partner during the hospitalization. The first study investigates the effect of dyadic coping (DC) on partners’ marital satisfaction considering the moderating effect of the partners’ psychological distress. The results show that the beneficial effect of positive and common DC on marital satisfaction occurs when the partners’ psychological distress is low, on the contrary negative DC decreases marital satisfaction among those who have high levels of psychological distress. The second study aims to investigate the relationship between DC, adherence to medications and patient activation. The relationship is mediated by the patient health self-efficacy: positive and common DC increase patient health self-efficacy which in turn increases adherence to medication and patient activation; on the contrary, the negative DC is detrimental during hospitalization and also over time after discharge. The third study investigates the relationship between psychological distress and the quality of partner support (overprotection, hostility and support for patient engagement) through the moderating role of DC. The results show that high psychological distress increases worse partner support among those with low levels of positive DC and high negative DC.