PSYCHOLOGY OF RELATIONSHIPS
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PSYCHOLOGY OF RELATIONSHIPS
EMMA CUYLER AND
MICHAEL ACKHART EDITORS
Nova Science Publishers, Inc. New York
Copyright © 2009 by Nova Science Publishers, Inc.
All rights reserved. No part of this book may be reproduced, stored in a retrieval system or transmitted in any form or by any means: electronic, electrostatic, magnetic, tape, mechanical photocopying, recording or otherwise without the written permission of the Publisher. For permission to use material from this book please contact us: Telephone 631-231-7269; Fax 631-231-8175 Web Site: http://www.novapublishers.com NOTICE TO THE READER The Publisher has taken reasonable care in the preparation of this book, but makes no expressed or implied warranty of any kind and assumes no responsibility for any errors or omissions. No liability is assumed for incidental or consequential damages in connection with or arising out of information contained in this book. The Publisher shall not be liable for any special, consequential, or exemplary damages resulting, in whole or in part, from the readers’ use of, or reliance upon, this material. Any parts of this book based on government reports are so indicated and copyright is claimed for those parts to the extent applicable to compilations of such works. Independent verification should be sought for any data, advice or recommendations contained in this book. In addition, no responsibility is assumed by the publisher for any injury and/or damage to persons or property arising from any methods, products, instructions, ideas or otherwise contained in this publication. This publication is designed to provide accurate and authoritative information with regard to the subject matter covered herein. It is sold with the clear understanding that the Publisher is not engaged in rendering legal or any other professional services. If legal or any other expert assistance is required, the services of a competent person should be sought. FROM A DECLARATION OF PARTICIPANTS JOINTLY ADOPTED BY A COMMITTEE OF THE AMERICAN BAR ASSOCIATION AND A COMMITTEE OF PUBLISHERS.
LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA Cuyler, Emma. Psychology of relationships / Emma Cuyler and Michael Ackhart. p. cm. ISBN 978-1-60741-931-0 (E-Book) 1. Interpersonal relations. I. Ackhart, Michael. II. Title. HM1106.C89 2009 302.3'4--dc22 2008039628
Published by Nova Science Publishers, Inc.Ô New York
CONTENTS Preface
ix
Chapter 1
Communicating Empathies in Interpersonal Relationships Grace Anderson and Howard Giles
Chapter 2
Interpersonal Representations: Their Structure, Content, and Nature Shanhong Luo
Chapter 3
Generalized Anxiety Disorder and Interpersonal Relationships: The Case For a Systemic Intervention Danielle Black, Amanda Uliaszek, Alison Lewis and Richard Zinbarg
Chapter 4
Another Kind of “Interpersonal” Relationship: Humans, Companion Animals, and Attachment Theory Jeffrey D. Green, Maureen A. Mathews and Craig A. Foster
Chapter 5
The Role of Oxytocin in the Pathophysiology of Attachment Marazziti Donatella, Catena Dell’Osso Mari, Consoli Giorgio and Baroni Stefano
Chapter 6
Identity Exploration and Commitment Associations with Gender Differences in Emerging Adults’ Romantic Relationship Intimacy H. Durell Johnson, Kristen A. Loff, George Bell, Evelyn Brady, Erin A. Grogan, Elizabeth Yale, Robert J. Foley and Trishia A. Pilosi
Chapter 7
Development of an Interview for Assessing Relationship Quality: Preliminary Support for Reliability, Convergent and Divergent Validity, and Incremental Utility Erika Lawrence, Robin A. Barry, Rebecca L. Brock, Amie Langer, Eunyoe Ro, Mali Bunde, Emily Fazio, Lorin Mulryan,Sara Hunt, Lisa Madsen and Sandra Dzankovic
1 35
65
87 111
131
149
vi Chapter 8
Chapter 9
Chapter 10
Contents Assessing Relationship Quality: Development of an Interview and Implications for Couple Assessment and Intervention Erika Lawrence, Rebecca L. Brock, Robin A. Barry, Amie Langer and Mali Bunde The Tendency to Forgive in Premarital Couples: Reciprocating the Partner or Reproducing Parental Dispositions? F. Giorgia Paleari, Silvia Donato, Raffaella Iafrate and Camillo Regalia Is the Serotonergic System Altered in Romantic Love? A Literature Review and Research Suggestions Sandra J. E. Langeslag
173
191
213
Chapter 11
Update on Pheromone Research Donatella Marazziti, Irene Masala, Stefano Baroni, Michela Picchetti, Antonello Veltri and Mario Catena Dell’Osso
219
Chapter 12
Normal and Obsessional Jealousy: An Italian Study Donatella Marazziti, Marina Carlini, Francesca Golia, Stefano Baroni, Giorgio Consoli and Mario Catena Dell’Osso
229
Chapter 13
Jealousy, Serotonin and Subthreshold Psychopathology Donatella Marazziti, Francesca Golia, Marina Carlini, Stefano Baroni, Irene Masala, Mario Catena Dell’Osso, and Giorgio Consoli
237
Chapter 14
Advances in Dyadic and Social Network Analyses for Longitudinal Data: Developmental Implications and Applications William J.Burk,Danielle Popp, and Brett Laursen
Chapter 15
Chapter 16
Chapter 17
Chapter 18
Mother-Infant Interaction in Cultural Context: A Study of Nicaraguan and Italian Families Ughetta Moscardino, Sabrina Bonichini and Cristina Valduga “It’s Saturday…I’m Going out with My Friends”: Spending Time Together in Adolescent Stories Emanuela Rabaglietti and Silvia Ciairano Prevention of the Negative Effects of Marital Conflict: A Child-Oriented Program Patricia M. Mitchell, Kathleen P. McCoy, E. Mark Cummings, W. Brad Faircloth and Jennifer S. Cummings Mother-Infant Bonds: The Effects of Maternal Depression on the Maternal-Child Relationship Deana B. Davalos, Alana M. Campbell and Amanda L. Pala
245
259
281
303
319
Contents Chapter 19
Social Networks and Psychosocial Functioning among Children and Adolescents Coping with Sickle Cell Disease: An Overview of Barriers, Considerations, and Best Practices Rebecca H. Foster, HaNa Kim, Robbie Casper, Alma Morgan, Wanda Brice and Marilyn Stern
vii
339
Chapter 20
Parenting and Children’s Involvement in Bullying at School Ken Rigby
365
Chapter 21
Neurobiology of Social Bonding Donatella Marazziti, Alessandro Del Debbio, Isabella Roncaglia, Carolina Bianchi and Liliana Dell’Osso
369
Chapter 22
Cooperative and Non-cooperative Behavior in Pairs of Children: The Reciprocal Effects of Social Interaction in the Ongoing Construction of a Play Sequence Emanuela Rabaglietti, Fabrizia Giannotta, and Silvia Ciairano
Chapter 23
Chapter 24
Chapter 25
381
Social Relationships and Physical Health: Are We Better or Worse off because of Our Relationships? Julianne Holt-Lunstad and Briahna Bushman
399
Living in Discrepant Worlds: Exploring the Cultural Context of Sexuality among Turkish and Moroccan male Adolescents Barbara C. Schouten and Chana van der Velden
417
HIV/AIDS Prevention on Mexican Adolescents: The Synthesis of two Theories Considering the Interpersonal, Individual, and Psychological Influences Raquel A. Benavides-Torres, Georgina M. Núñez Rocha, Esther C. Gallegos Cabriales, Claude Bonazzo, Yolanda Flores-Peña, Francisco R. Guzmán Facudo, and Karla Selene López García
437
Chapter 26
Adolescents with Cancer: Adjustment and Supportive Care Needs Luisa M. Massimo
451
Chapter 27
The Quality of Caring Relationships Tineke A. Abma, Barth Oeseburg, Guy A. M. Widdershoven and Marian Verkerk
461
Chapter 28
An Attachment-Based Pathways Model Depicting the Psychology of Therapeutic Relationships Geoff Goodman
Chapter 29
A Study of the Relationship between Self-conscious Affects, Coping Styles, and Depressive Reaction after a Negative Life Event Masayo Uji, Toshinori Kitamura and Toshiaki Nagata
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493
viii Chapter 30 Index
Contents The Neuropsychology of Passionate Love Elaine Hatfield and Richard L. Rapson
519 545
PREFACE This book describes the various aspects of interpersonal relationships, which can be defined as the interactions between one group and another. How people represent their interpersonal relationships based on past experiences is explored, as well as the three main aspects of interpersonal representations- structure, content, and nature. Conflictive social interpersonal relationships and how they influence mental health are explored in this chapter, as well as the different coping styles people have. In addition, the various dimensions of empathy and how they relate to interpersonal relationships are reviewed and incorporated into a unified source of reference for future research. The role of the nonapeptide called oxytocin in the pathophysiology of attachment is described as well as the possible involvement of oxytocin in the onset of mental disorders. Differences in romantic relationship intimacy, resulting from identity exploration are discussed, as well as the differences in commitment based on gender. In addition, the correlation(s) between relationship adjustment, satisfaction, and quality are reviewed based on the Relationship Quality Interview (RQI), which assesses relationship quality across five dimensions, including trust, inter-partner support, quality of intimacy, respect, and communication. Furthermore, the association between social relationships and physical health is examined. The tendency to forgive in premarital couples is examined as well as the reasons behind forgiveness-possibly deriving from parental model behavior or reciprocation of the partner's behavior. In addition, a review of studies is done on the relationship between serotonin levels and romantic love, as well as how the thoughts of infatuated individuals mirror those who suffer from obsessive-compulsive disorder. Furthermore, generalized anxiety disorder (GAD), one of the more common anxiety disorders, is discussed and how it affects occupational, interpersonal and family functioning, as well as the different treatments for GAD. This book presents the most up-to-date information on pheromone research, including how pheromones may influence reproductive endocrinology and have a positive effect on one's mood. In addition, the differences between normal and obsessional jealousy is explored, as well as the role that neurotransmitters may play in the expression of jealousy. The neurobiological correlates of attachment in both animals and humans is examined, including infant-mother attachment, mother-infant attachment, adult-adult pair bonding formation, and human bonding. Human-pet relationships and their importance in the field of human psychology animal are also explained in this book. Furthermore, the relationships
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between cooperative and non-cooperative or competitive behavior in pairs of children in the ongoing process of interaction is reviewed. The social networking and psychosocial functioning among children and adolescents coping, in particular, with sickle cell disease is examined in this book, as well as the best practices for treatment. Furthermore, studies done on the adjustment and supportive care for adolescents that are dealing with high-risk diseases such as cancer are discussed. This book explores the major public health issue of HIV/AIDS in Mexican adolescents and Turkish and Moroccan male adolescents in the Netherlands. Three types of influences are discussed, including interpersonal influences, individual influences, and psychosocial influences. Finally, this book explores the psychology of therapist-patient relationships as well as the relationships between patients or disabled persons and professionals. The ways in which conflictive social interpersonal relationships may influence mental health is also discussed. Chapter 1 - Empathy is a concept that has been widely researched across the social sciences and, more importantly, is commonly used outside of academe as a method “to openup the channel of communication with the other” (Wikipedia, 2006). Although commonly employed colloquially, empathy is challenging to define explicitly and, hence, this chapter begins with some conceptual wood-clearing. Prior definitions reflect the specific contexts in which empathy was measured and studied. For instance, a study measuring empathy as a response to media defines empathy differently than a study that examines empathy as an interpersonal communication construct – and these definitions are not mutually exclusive or disparate. Instead, different definitions are a result of the various dimensions of empathy that researchers choose to highlight as a function of the particular empirical study’s focus. For this reason, many individuals may find empathy easier to enact than to describe its meaning in words. This chapter will examine the major definitional variations of empathy that have developed in research on interpersonal relationships, comparing and contrasting their implications. For instance, one major difference is whether empathy is a stable trait or a changing state; this definitional difference can lead to very different methods of research. An attempt is made to accomplish a more global definition of empathy by discussing the distinct ways in which it has been examined in the past, such as in terms of communicative competence, personal distress, and nonverbal expressions, and incorporating the many dimensions of empathy into a unified source of reference for future research. In so doing, this chapter will discuss how one individual may feel and express empathy and how that empathy may or may not be perceived as such by its recipients. The psychological origins of empathy will be identified and questions regarding motives underlying empathy will be raised, including whether it can be used as a form of impression management during social interactions. Empathy has been recognized as an important component of health communication. Research has shown that an empathic person holds more positive attitudes towards healthy behaviors regarding smoking and alcohol consumption (Kalliopuska, 1992). Moreover, an effective health campaign will evoke empathy among its target audience because it evokes greater cognitive and affective processing of the campaign message (Campbell & Babrow, 2004). Empathic communication with people with disabilities (particularly those inflicted by cancer) will be a continuous example used to help us understand the multidimensional implications of empathic communication. Empathy can ease tensions that may occur during
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this form of interaction and suggestions of appropriate empathic communication will be offered. Finally, a new communication model of the process of empathy will be introduced. Chapter 2 - How people represent their interpersonal relationships based on past experiences has great impact on their subsequent interactions with others. This chapter reviews previous theories and presents new propositions regarding three important aspects of interpersonal representations (IRs)—their structure, content, and nature. Specifically, the structure of IRs can be viewed as a three-level hierarchical organization, with general representations at the highest level, domain-specific representations at the midlevel, and relationship-specific representations at the lowest level. The content of IRs can be divided into three distinct yet interrelated components: self representations, other representations, and relationship representations. With regard to the nature, IRs can be conceptualized as consisting of accurate perceptions, systematic biases, and random errors. Chapter 3 - Generalized anxiety disorder (GAD), one of the more common anxiety disorders, is associated with significant impairment in occupational, interpersonal and family functioning. There is growing consensus that there is a need to improve the effectiveness of treatments for GAD given that even the most positive findings suggest that only 50% of patients treated with cognitive-behavior therapy (CBT) and/or medications experience what might be considered to be a cure. Whereas established treatments for GAD are individual modalities, there is evidence from several lines of research suggesting current treatments for that systemic therapy has promise to augment the effectiveness of therapy for GAD. These lines of research include (a) evidence that elevated marital dissatisfaction is associated with GAD; (b) evidence that marital and family problems are associated with other anxiety disorders including panic disorder with agoraphobia and obsessive compulsive disorder and are associated with poor outcome in the treatment of these other anxiety disorders; (c) evidence that marital and family problems are associated with major depression - another psychiatric condition closely related to GAD – and poor outcome in the treatment of major depression; (d) preliminary evidence that marital functioning and interpersonal problems predict outcome in the treatment of GAD; and (e) evidence that at least some forms of couples therapy are effective treatments for major depression and panic disorder with agoraphobia. Chapter 4 - Human-companion animal relationships provide an important but largely unexplored component of the human experience. Research examining these interspecies relationships may elucidate the depth and meaning of these relationships as well as provide unique insights into the fundamental nature of human psychology. Human-animal relationships offer a distinctive testing ground because pet choice is unilateral, whereas human friendships and romantic partner choices are mutual, and individuals may have reduced fear of rejection or evaluation from a pet than from a human relationship partner. This chapter reviews and applies to human-pet relationships key elements of attachment theory, including caregiving, exploration, the malleability of attachment styles, and the role of attachment anxiety and avoidance in choosing relationship partners. Potential future research directions using relationships theories in companion animal contexts is also covered. Chapter 5 - Oxytocin is a nonapeptide synthesized in the paraventricular and supraoptic nuclei of the hypothalamus. Although OT-like substances are present in all vertebrates, oxytocin has been identified only in mammals where it seems to be fundamental in the onset of typical mammalian behaviors, including labour and lactation. In the present chapter, the physiological role of oxytocin in the regulation of different functions and behaviors will be
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addressed: several data, mainly coming from animal models, have highlighted the role of this neuropeptide in the formation of caregiver-infant attachment, pair-bonding and, more generally, in linking social signals with cognition, behaviours and reward. In addition, recent evidences have demonstrated alterations of oxytocin system in several human neuropsychiatric disorders, leading to the hypothesis of a possible involvement of oxytocin in the onset of mental disorders. In this frame, the psychopathological implication of the disregulation of the oxytocin system and the possible use of oxytocin or its analogues and/or antagonists in the treatment of psychiatric disorders will be discussed. Chapter 6 - Emerging adulthood is considered a time when intimacy becomes an integral aspect of romantic relationships, and Arnett (2000) argues intimacy in emerging adults’ romantic relationships results from identity explorations. Previous research, however, suggests emerging adults’ romantic intimacy is associated not only with identity exploration, but also with identity commitments and gender. In an attempt to examine the theorized relationships among identity exploration, identity commitment, gender, and perceived romantic intimacy, the current study examined identity and romantic intimacy responses from a sample of 271 emerging adults (183 females, mean age = 19.22 years; and 88 males (mean age = 19.29 years). Findings indicated 1) both identity exploration and commitment predict emerging adults’ romantic relationship intimacy, 2) gender differences in romantic relationships differ according to emerging adults’ identity status, and 3) identity status differences in romantic relationship intimacy differs for emerging adult males and females. The current study’s test of Arnett’s (2000) hypothesis regarding identity exploration and romantic relationship intimacy development did not fully support his theorized association. Rather, findings suggest differences in emerging adults’ romantic intimacy are associated with their gender and identity commitments as well as identity exploration. As a result, Arnett’s (2000) proposal that identity exploration during emerging adulthood is a necessary precursor for intimate romantic relationships may not completely describe the association between identity and intimacy that emerges during this period, and this association may be more complex than originally theorized. Results are discussed in terms of understanding the moderating association of gender on identity exploration and commitment differences in emerging adults’ reports of romantic relationship intimacy. Chapter 7 - Historically, relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. In contrast, far less attention has been paid to the assessment of relationship quality. The first section of the chapter reviews the long-standing debate regarding – and clarify the distinctions among – relationship adjustment, satisfaction, and quality. Also discussed is the need for an empirically-supported, psychometrically strong measure of relationship quality. The second section presents the Relationship Quality Interview (RQI), a semi-structured, behaviorally anchored, individual interview that yields objectively coded ratings from the interviews. It was designed to assess relationship quality across five dimensions: (a) trust, closeness, and emotional intimacy; (b) inter-partner support; (c) quality of the sexual relationship; (c) respect, power, and control; and (e) communication and conflict management. The third section provides preliminary evidence of the reliability and validity of the interview. Across two samples, the RQI demonstrated strong reliability (internal consistency, inter-rater agreement, agreement across interviewers based on two members of the same couple, correlations among the scales) convergent validity (correlations between RQI scales and self-report questionnaires assessing similar relationship dimensions), and divergent validity (correlations between RQI scales and
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behavioral observations of related constructs, global measures of marital satisfaction, and individual difference measures of related constructs). A brief discussion of broader clinical issues relevant to couple assessment and prevention efforts concludes the chapter. Chapter 8 - Historically, relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. In contrast, far less attention has been paid to the assessment of relationship quality. In the first section of the chapter is a review of the long-standing debate regarding -- and clarify the distinctions among -relationship adjustment, satisfaction, and quality. Also discussed is the need for an empirically-supported, psychometrically strong measure of relationship quality. In the second section, the multidimensional nature of relationship quality, and review prior research relevant to each dimension. An introduction on the Relationship Quality Interview (RQI), a semi-structured, behaviorally anchored, individual interview that yields objectively coded ratings is covered. The RQI was designed to assess relationship quality across five dimensions: (a) trust, closeness, and emotional intimacy; (b) inter-partner support; (c) quality of the sexual relationship; (c) respect, power, and control; and (e) communication and conflict management. In the third section, preliminary evidence of the reliability and validity of the interview is provided. Across samples of dating and married couples, were examined reliability, convergent and divergent validity, and incremental validity of the RQI. A broader clinical issues relevant to couple assessment and intervention efforts is discussed in the fourth section. Chapter 9 - Although the tendency to forgive the partner has been shown to enhance personal and relational well-being, little is known about how this tendency originates. One possibility is that the tendency to forgive the partner develops as a function of the forgiveness exchanges people experience within their romantic relationships, thereby leading them to become more and more similar to the partner in their proneness to forgive. Another possible explanation is that social experiences people were exposed to within their own family of origin has led them to gradually internalize parental models and to become more and more similar to their parents in their willingness to forgive. These associations may be particularly evident during emerging adulthood, when engaged couples have to balance their family heritage and the forming of their new couple. The present work aimed at providing initial evidence in support of these hypotheses by investigating in a sample of premarital couples (N=165) and their parents the extent to which young adults’ tendency to forgive the partner was similar to the partner’s tendency to forgive them as well as to their mothers’ and fathers’ tendency to forgive one another. Dyads were the units of analysis and stereotype accuracy was controlled. Results indicate that young adults’ disposition to forgive the partner is similar to that of their partner and of their parents. Gender moderated these associations, as females were more similar to their parents than were males in their disposition to forgive. The findings are consistent with the idea that premarital couples, even though strongly involved in defining their own couple identity, are nonetheless affected by the forgiveness models to which they are exposed within their family of origin. Chapter 10 - Infatuated individuals think about their beloved a lot. The notions that these frequent thoughts resemble the obsessions of obsessive-compulsive disorder (OCD) patients and that those patients benefit from serotonin reuptake inhibitors (SSRIs), have led to the hypothesis that romantic love is associated with reduced central serotonin levels. In this chapter, the literature on this topic is reviewed and suggestions for future research are made.
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Previous studies have shown that romantic love is associated with lower blood serotonin levels and with lower serotonin transporter densities, the latter of which has also been observed in OCD patients. Further, SSRIs have been found to decrease feelings of romantic love and the serotonin 2 receptor gene has been associated with the love trait ‘mania’, which is a possessive and dependent form of love. Given that serotonin 2 receptors in the prefrontal cortex have also been implicated in impulsive aggression, this suggests that stalking behavior may be associated with these receptors. In short, the serotonergic system appears to be altered in romantic love indeed. Future research is needed to identify what parts of the serotonergic system, such as which serotonergic projections, brain areas, transmission stages and receptor types, are affected in romantic love and in what way they are altered. Furthermore, challenging the serotonergic system would be useful in determining the causal relationship between central serotonin levels and feelings of romantic love. In addition, future research should specifically investigate the different aspects of romantic love, such as state, trait, requited and unrequited love and its development in time. Chapter 11 - Pheromones are volatile compounds secreted into the environment (in sweat, urine) by one individual of a species and perceived by another individual of the same species, in which they trigger a behavioral response or physiological change. Besides insects, pheromones have been described in several invertebrate and vertebrate animals; moreover, they have been shown to modulate mating preferences, timing of weaning, learning ability to distinguish poisoning from not-poisoning food, social recognition and level of stress. Several studies suggest that pheromones might play an important role also in mammals, as it has been demonstrated that they can use chemical signals for mate attraction, territorial marking, dominance and probably other functions yet to be identified, amongst which, perhaps, some social behaviors. In humans, several studies have indicated that pheromones may influence reproductive endocrinology and have a positive effect on mood. Menstrual synchrony amongst women sharing the same environment is a long-recognized phenomenon related to pheromones produced in the armpits; these substances are not perceived as having any particolar odour, but nonetheless can influence the lenght of the mestrual cycle through the interference with different hormones. The aim of the present paper is to review the latest data on pheromones with a specific focus on humans and future developments. Chapter 12 - Background: Jealousy is a complex emotion spanning from normality to pathology. The present study aimed to define the boundaries between normal and obsessional jealousy by utilizing a specific self-report questionnaire. Methods: The so-called “Questionnaire of Affective Relationships (QAR)” was administered to 400 university students of both sexes, as well as to 14 outpatients affected by obsessive-compulsive disorder (OCD). The total scores and the responses to each of the 30 items were analyzed and compared. Results: Two hundred and forty-five (approximately 61 %) of the questionnaires given to the students were returned. Statistical analyses revealed that the OCD patients had higher total scores than the healthy students. Moreover, it is possible to identify an intermediate group of subjects, consisting of 10 % of the total, who exhibited thoughts of jealousy regarding their partner, but to a lesser degree than the OCD patients. These were labeled as “healthy jealous subjects” because no other psychopathological trait could be observed. in addition, significant intergroup differences in single items were observed.
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Conclusion: The present study showed that in the population of university students, 10 % of the subjects, although normal, had excessive jealous thoughts regarding their partner. In fact, this clearly distinguishes these subjects from the OCD patients and from the healthy subjects with no jealousy concerns by means of the specific questionnaire developed by us. Probably, they represent a subgroup of jealous , albeit normal, subjects. Chapter 13 - Background: Different studies have suggested that some neurotransmitters may play a role in the expression of jealousy. This study utilized the specific binding of 3Hparoxetine (3H-Par) as a peripheral tool to explore the serotonergic system in platelets of healthy subjects with and without jealousy concerns. Methods: Twenty-one subjects with thoughts of jealousy and 21 subjects without jealousy concerns, as revealed by their score at a specific questionnaire (“Questionnaire of Affective Relationships”, QAR), were included in the study. Subjects in the first group were administered a battery of self-report instruments designed to detect the presence of subthreshold psychopathology. The binding of 3H-Par was carried according to a standardized protocol. Results: The results showed a reduced density of 3H-Par binding in the “jealous” subjects, as compared with the “non-jealous” subjects. In addition, most of the subjects of the first group had one or moresubthreshold psychopathological conditions. Conclusion: In conclusion, jealousy may be considered an expression of subtle forms of psychopathology, and may provoke an alteration of the serotonergic system, as reflected by the lower density of the platelet serotonin transporter. Chapter 14 - Interdependence, a central feature of close relationships, presents contemporary scholars with theoretical and statistical challenges. Dyadic and social network analytic techniques have recently been formulated that offer several advantages over previous statistical methods by accounting for various forms of interdependence for longitudinal data collected from both relationship partners. Two of these methods are described: the ActorPartner Interdependence Model (APIM: Kenny, Kashy, & Cook, 2006) and actor-based models of network-behavioral dynamics (Snijders, Steglich, & Schweinberger, 2007). The APIM partitions variance into estimates of behavioral stability of both dyad members (actor effects), and interpersonal influence (partner effects), while adjusting for initial behavioral similarity between partners. The actor-based models describe dyadic relationships as embedded within a multitude of interconnected dyadic relationships (i.e., social networks). These dynamic models utilize computer simulations to partition variance into parameters that ascribe similarity based on network, dyadic and individual behavioral attributes. To illustrate the applicability of both methods, empirical examples from recent work using these models techniques are described. Chapter 15 - Although a common goal for parents is to promote their children’s successful development in a respective society, there is considerable cross-cultural variation in the beliefs parents hold about children, families, and themselves as parents. Previous research suggests that in traditional rural areas across the world, parents highly appreciate interrelatedness in their conceptions of relationships and competence, whereas in urban settings of Western industrialized societies, parents seem to promote independent parent– child relationships from early on. The main purpose of this study is to compare conceptions of parenting and mother-infant interactions in two cultural contexts that may be expected to hold different beliefs about parent-child relationships: Nicaraguan farmer families and middleclass Italian families. Fifty-six mothers from central Nicaragua (n = 26) and northern Italy (n
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= 30) and their infants aged 0-14 months participated in the study. Mothers were interviewed regarding their childrearing beliefs and behaviors, and were videotaped interacting with their infants during a free play session. Maternal responses were qualitatively analyzed using a thematic approach; maternal behaviors were coded into one of the following categories: social play, object play, motor stimulation, verbal stimulation, and face-to-face interaction. Findings indicated that: 1) Nicaraguan mothers emphasized interdependence and connectedness to other people in their socialization goals, whereas Italian mothers placed greater focus on childrearing strategies consistent with a more individualistic orientation; 2) Nicaraguan mothers exhibited a higher overall frequency of behaviors related to motor stimulation and face-to-face interaction, whereas Italian mothers were more likely to engage in social play, object play, and to emit a greater overall number of verbal behaviors towards their infants during the free-play session. The results suggest that parents’ conceptions of childcare reflect culturally regulated norms and customs that are instantiated in parental behavior and contribute to the structuring of parent-child interactions from the earliest months of life, thus shaping developmental pathways of infants and children. Implications for theory on the psychology of relationships as well as for clinical practice are discussed. Chapter 16 - During adolescence, peer relationships and friendships are relevant contexts for cognitive and social development [Bukowski, Newcomb and Hartup, 1996] and for future adult adjustment [Hartup and Stevens, 1999]. It is also known that people, and particularly adolescents, by way of narration and autobiographic construction, can define and attribute meaning to their self and their relationships with others. Bruner and colleagues [Amsterdam and Bruner, 2000; Bruner, 2002] pointed out that individuals construct stories to attribute meaning and order to daily life events. By narrating one’s own story it is possible to organise episodic memory, to shape the recollection of events, and to build reality [Smorti and Pagnucci, 2003]. Specifically in friendship relationships, narrative autobiographic experiences represent specific interpretative modalities used by adolescents to give meaning to the self and the others within these relationships. In this study, which is based on adolescent narrations, adolescent leisure-time behaviour in the company of friends, specifically on Saturday afternoons was explored. This study is also interested in identifying the self markers [Bruner, 1986; 1997], by which adolescents perceive themselves and others, and attribute meaning to their own experiences. Finally, investigating the relationship between the Self markers and some indicators of well-being (e.g. positive self-perception and expectations of success), social self-efficacy, adulthood (e.g. value of autonomy), and discomfort (e.g. feelings and sense of alienation). Participants included thirty adolescents (11 girls and 19 boys) aged 14 to 20 years (M= 15.8; D.S.= 1.4) attending two different types of high school (43% lyceum, 57% technical and vocational) in the northwest of Italy. The adolescents were asked to write a essay on the subject: “It’s Saturday…I’m going out with my friends”. The essays were analysed using thematic analysis of content as well as Bruner’s [1986; 1997] system of self markers. The following profiles summarise the findings. Most of the adolescents go out on Saturday and they have fun, talk, share convivial activities and sometimes also illegal activities (particularly boys) with their friends. Adolescents use frequently especially the Self markers of Agency (97%), Commitment (87%), Coherence (80%) and Social references (83%). Girls use the subjective aspects of Self markers, such as Qualia and Evaluation on the bases of expectations, more frequently than boys. Older adolescents use Agency and Resources more frequently than younger adolescents. Finally,
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Resources and Evaluation are related to positive self-perception and Social references is linked to Social self efficacy. This study has some limitations, such as the limited number of participants and the specificity of the essay, which make it impossible to generalise these findings to adolescent social life. Nevertheless, the findings can contribute to a better understanding of the meaning that peers and friends assume in adolescence. Chapter 17 - A psycho-educational program for advancing children’s coping skills and reactions to marital conflict was evaluated. Families with a child between the ages of 4 and 8 were randomly assigned to one of three groups: 1) parent program only; 2) parent and child program; or 3) self-study (control group). Parents in the parent-only and parent-child groups received the same psycho-educational program. Only children in the parent-child group received the child program which consisted of four visits in which children learned about marital conflict and family relationships; were taught about emotions and different levels of emotions; and were given tools for coping with conflict that would help them react in optimal ways for their development. Analyses suggested the promise of a child program for older children (ages 6-8) with regard to improved emotional security about marital conflict. However, consistent with other research, simply educating children about coping with marital conflict had minimal effects on outcomes associated with conflict between the parents. Chapter 18 - The mother infant bond has long been recognized as being crucial in multiple areas of infant development. The value that is placed on this relationship is recognized across the world and across groups of varying socioeconomic status. The multitudes of variables that are thought to be influenced by the mother infant relationship are impressive, even staggering. Research suggests that, depending on the level of bonding or lack thereof, infants may suffer outcomes as severe as irreversible neuropsychological deficits or development of long-standing psychopathology. However, others have argued that the effects are likely much more subtle, but certainly still important. During the last two decades there has been an increase in research focusing on the effects of maternal depression on the mother infant bond. Research in this field has apparently developed out of; a recognition of a relatively higher prevalence of postpartum maternal depression than once believed and recurring observations of differences in mother/infant relationships or infant behavior associated with maternal postpartum depression. The infant behaviors that have been implicated as resulting from this theoretically compromised mother infant relationship have included slight, transient effects on sociability and affective sharing to results suggesting significant increases in irritability, cognitive delays, behavioral problems, and difficulties with attachment, among others. Longitudinal data suggest that while some problems appear to resolve relatively quickly, there are some characteristics that endure long after infancy. Specifically, some researchers have argued that children and even adolescents who experienced problems bonding with their depressed mothers are at significantly greater risk of experiencing a variety of psychological symptoms, including depression, anxiety, and problems with addiction. Again, this view is controversial and others in the field link these increased risks to other factors such as low socioeconomic status or marital discord. While there appears to be consensus among most researchers in recognizing that there are likely effects of postpartum depression on mother infant bonding that affect early development, there is little consensus regarding the specific details of these effects. This review will systematically analyze research focusing on the effects of postpartum depression on the mother infant bond and those variables that are believed to be affected from potential difficulties in this bond.
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Chapter 19 - Over 70,000 individuals in the United States are diagnosed with sickle cell disease, yet relatively little attention has been paid to this group when compared to those diagnosed with other chronic illnesses such as asthma, cystic fibrosis, diabetes, or cancer. Like most major chronic illnesses, sickle cell disease influences familial and social relationships in numerous and ever-changing ways. Advances in sickle cell disease treatments and improved survival rates have resulted in dramatic shifts in relationship networks and psychosocial adaption for each child diagnosed. Several primary areas of concern have been identified for children and families facing sickle cell disease such as disruptions to educational and socialization processes, sudden changes in medical conditions including the persistent threat of pain crises, existential anxieties about death, the wide range of emotions that are often present in managing with the various stages of the disease and treatment, the overarching developmental trajectory of the child, and coping with having a serious illness or caring for a child with a serious illness. Literature has cited and research continues to find evidence of challenges faced by these children and adolescents including ways in which family functioning, social acceptance by peers, interactions with siblings, parenting style used in the home, and daily anxieties and pressures can play integrated roles in shaping life-long relationships and overall quality of life. Because sickle cell disease predominantly affects minority groups within the United States, families and medical professionals also must consider the cultural needs of each patient in order to promote best practices for treatment and the development of sustained, healthy relationships. While these noted challenges tend to be constant foci for all concerned with caring for and working to develop optimal relationships among individuals diagnosed with sickle cell disease, many individuals and families coping with a sickle cell disease diagnosis seem to function quite well when adaptive coping and supportive networks are present and persistent. This chapter will investigate how the many relationships that exist within the social context of a child’s world are impacted by sickle cell disease. An overview will be provided examining dynamics between parents, the children diagnosed with sickle cell disease, and their peers and siblings in terms of the challenges faced and the relationship strengths displayed. Cultural influences and means of improving life-long relationships will be explored. Lastly, currently implemented interventions promoting positive relationships will be discussed as well as future directions for research and intervention studies. Chapter 20 - Research into bullying amomg children has suggested that parents can play an important role in reducing the risk of their children becoming involved in bully/victim problems at achool .and can take steps to enable their children to cope more effectively (Smith and Myron-Wilson, 1998; Stelios, 2008; Rigby 2008). At the same time, it should be acknowledged that parental influence is limited by such factors as their child’s genetic endowment (Ball et al., 2008) peer pressure at school and unpredictable life events. (Harris, 1998). What parents can do to reduce the risk or impact of bullying on children can be considered under these headings: 1) Early childhood parenting 2) Parenting style with older children 3) Parents promoting skills that are helpful in reducing the risk of 4) Parents assisting children who are being bullied at school 5) Parents providing emotional and social support when children are bullied
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Chapter 21 - Social bonding development is fundamental for several animals, particularly for humans who are the most immature at birth, for its relevant impact upon survival and reproduction. Several neural and endocrine factors, most of which are still largely unknown, may modulate reproductive behaviors, mother-infant attachment and adult-adult bonding. Consequently, the aimed to review the neurobiological correlates of attachment in both animals and humans. MEDLINE and Pub-Med (1970-2008) databases were searched for English language articles using the keywords attachment, neuropeptides, neurotrophins, pair bonding, social behavior. Papers were reviewed that addressed the following aspects of attachment neurobiology: 1) Infant-mother attachment; 2) Mother-infant attachment; 3) Adult-adult pair bonding formation; 4) Human bonding. Oxytocin and vasopressin, two neurohypophyseal peptides, are known to be involved in the attachment process. Oxytocin is supposed to facilitate a rapid conditioned association to maternal odor cues, while linking environmental cues to the infant's memory of the mother. While oxytocin plays a role in the onset of maternal behavior in rats, vasopressin seems to influence paternal behavior in praire voles. Parental behavior development requires also gonadal steroids action. In adults, oxytocin and vasopressin may contribute to pair bonding process by modulating the neuroendocrine response, behaviors and emotions associated to preference formation and pair bonding. Recently, even neurotrophins have been suggested to play a role in social bonding. In conclusion, although the neurobiological basis of social attachment is mainly based on animal data, preliminary findings suggest that the same mechanisms may occur also in humans and would involve multi-sensory processing, complex motor responses and cognitive functions, such as attention, memory, recognition and motivation. The few data available in humans are intriguing and seem to open even more exciting perspectives to the treatment of a broad range of neuropsychiatric disorders. Chapter 22 – It is known that some social interactions begin and end cooperatively, while others start aggressively and end up even more so. It is also known that in some social interactions one of the partners might initially behave either cooperatively or competitively and aggressively towards the other partner, who may respond with the opposite type of behavior. However, over time, as the relationship evolves, behavioral patterns may change as each partner adapts to the behavior of the other. As social interactions evolve over time, it is possible to identify two phases: first, a reciprocal exploration phase, and second, an adjustment phase. Investigating very short term social interaction sequences of about ten minutes, concluded that these two phases last about five minutes each. The present study investigates the relationships between cooperative and non-cooperative or competitive behavior in pairs of children in the ongoing process of interaction during a tenminute play sequence. To reach the goal, it was necessary to first divide the time of the play sequence (10’) in two phases and looked at the differences between the first and second phase (5’ each). Second, divide the pairs of children in three groups: i) initially high in cooperation; ii) initially high in competition; iii) initially high in both. Third, look at the outcomes using both linear and logistic regression analyses. Hypothesised that: a) initially prevalent cooperative behavior is more likely to end in cooperation; b) initially prevalent competitive behavior is more likely to end in competition; c) initially mixed social interactions (both cooperative and competitive) are more likely to end in abandonment of the interaction and doing nothing.
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The sample is composed of 125 pairs of children. 69% (N=86) of the pairs were composed of same-sex children, while the remaining 31% (N=39) were mixed. The individuals within each pair were the same age. 35% of the pairs (N =44) were eight years old, 38% (N =48) were ten years old, and 27% (N=33) were twelve years old. The cooperative and competitive behavior of both the partners were observed.. The task was to finish a puzzle in ten minutes. The findings confirmed only the first two hypotheses. It was found that initially mixed situations were also more likely to end in cooperation. These findings underline the importance of intervention programs aimed at promoting social and cooperative skills in children to avoid starting negative social cycles or patterns. Chapter 23 - When asked, “What is necessary for your happiness?” or “What is it that makes your life meaningful?” most people mention before anything else-- satisfying close relationships with family, friends, or romantic partners. Relationships with others form a pervasive role in our everyday lives and are generally regarded as emotionally satisfying. Although it may not be surprising that social relationships are associated psychological benefits, there is also evidence to suggest that these relationships have beneficial effects on physical health and/or the lack of meaningful relationships may be detrimental. In fact, reviews of the literature indicate that a lack of meaningful relationships is associated with increased risk for morbidity and mortality from a variety of causes. Importantly, both the quantity and quality of social relationship can affect health and mortality. Overall, research suggests that having more and better quality relationships is associated with beneficial effects on health, while fewer and negative relationships are associated with detrimental effects on health. Therefore, a complete understanding of health-related consequences of social relationships requires simultaneous consideration of both the negative and the positive aspects of social experience. In this chapter, the health consequences of social relationships will be examined. This chapter will proceed by first, reviewing definitions of social support; second, a brief review of the substantial body of evidence that has linked social relationships with health benefits will be provided; third, the chapter will also include a brief review of the evidence showing the negative side of relationships (e.g., negativity and conflict within relationships is associated with negative health outcomes); and finally, the bulk of the chapter will focus on a relatively newer line of research that examines relationships that are characterized by both positive and negative aspects (ambivalent relationships). Because research has examined the positive and negative aspects of relationships separately, less is known about relationships that are not entirely positive or negative-but a mix of both negative and positive feelings. The remainder of this chapter will (1) define ambivalent relationships and provide theoretical and empirical justification for examination of ambivalent relationships; (2) summarize evidence linking ambivalent relationships to both mental and physical health outcomes; (3) provide evidence regarding maintenance of ambivalent relationships; and (4) propose future research. Thus, this chapter will summarize empirical research on the health impact of social relationships characterized by mixedfeelings (ambivalence). This data on ambivalent relationships will be presented in the context of the larger literature on social relationships and physical health and highlight the need for new directions in social relationships research. Chapter 24 - A high percentage of Turkish and Moroccan male adolescents in the Netherlands is sexually active. At the same time, they frequently engage in risky sexual
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behavior, which makes them vulnerable to HIV/STDs infection. To be able to design culturally appropriate health promoting interventions, more knowledge about the factors that influence their sexual behavior is needed. Therefore, this paper reports on a qualitative study that aims to increase our understanding of the influences on Turkish and Moroccan adolescent male sexuality within a broader interest in HIV/STD prevention. Seven focus groups with 29 Moroccan and 20 Turkish boys, aged between 14 and 18 years, were conducted. Analysis of the data highlighted several factors that may hinder condom use, such as lack of knowledge, lack of perceived risk, peer norms, lack of parent-adolescent communication about sexuality, and lack of self-efficacy toward buying condoms. Results also show some significant differences between the Turkish and Moroccan adolescents. Turkish adolescents are more conservative toward sexuality, they stick more strongly to cultural traditions and they have less knowledge about HIV/STDs than Moroccan adolescents. Moroccan adolescents experiment more frequently with sex. Therefore, they may be at higher risk of getting infected with HIV/STDs. The findings of this study provide a fertile starting point for designing culturally appropriate and effective health education programs in the field of safe sex promotion for ethnic minority adolescents. Chapter 25 - In Mexico, HIV/AIDS is a complex public health issue that carries significant psychosocial, socio-political, and economic repercussions. Adolescence is a period of development that not only encompasses physical and social changes, but also psychological. Adolescents engaging in unprotected sexual activities during this stage of development are at risk of contracting HIV infections. This paper posits that the Theory of Planned behavior has shown to be helpful in guiding research in HIV/AIDS prevention, but remains limited in the inclusion of ecological influences. Hence, this limitation is addressed using the Ecodevelopmental Theory. Therefore, this paper aims to develop a model based on the Theory of Planned Behavior and the Ecodevelopmental Theory that will explain HIV/AIDS prevention within the context of Mexican adolescents using concepts from both theories and the empirical evidence available. Three types of influences were identified during the process of theory synthesis: a) Interpersonal influences from the microsystem were parent communication about sex and peer influences; b) Individual influences included HIV/AIDS knowledge, gender (female), and age; and c) psychosocial influences consisted of perceived behavioral control for sexual health behaviors, subjective norms (gender roles), positive HIV attitudes, and sexual intentions. Results provide insight into the complex dynamics of the synthesis of the two aforementioned theories with respect to HIV/AIDS prevention. Communication about sex is positively related to sexual health behaviors for HIV/AIDS prevention, being female, and knowledge about HIV/AIDS. Peer influence is negatively correlated with sexual behaviors for HIV/AIDS prevention. It is unclear the relationship of HIV/AIDS knowledge and sexual behaviors and being female. Gender (female) is positively correlated with sexual behaviors and perceived behavioral control, but its relationship is unclear with subjective norms. Age is positively correlated with subjective norms, but negatively correlated with sexual health behaviors. Perceived behavioral control and positive attitudes are positively correlated to intentions and sexual health behaviors. In the case of subjective norms, it was positively correlated with intentions, but not with sexual behaviors. Finally, high intentions to use condoms influence sexual health behaviors. The final model allows for a better understanding of the connections among concepts related to sexual health behaviors in HIV/AIDS prevention. Future research is recommended regarding the unknown associations between gender, knowledge, subjective norms, and attitudes for
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future implementation of preventions programs against this fatal disease in the Mexican Adolescents. Chapter 26 - Adolescence is a difficult in-between age, even in good health, and any kind of illness can alter this situation. Living with a high risk disease for several years during adolescence requires the activation of psychological defense mechanisms, cognitive functions, perception, acceptance, memory, communication, judgment, and emotions, which taken together mean good coping. The successful evolution of the coping process ultimately leads to good quality of life and adaptation. Over the last few years, physicians and clinical psychologists have endeavored to provide a good psychosocial status to their patients, especially those with cancer and those undergoing painful and distressing treatments. This study chose to use the "narrative" approach with sick adolescents, since it would appear to be the most suitable in individual encounters. There is often the need to overcome an important barrier through a friendly approach. Narrative medicine, more than others, lends itself to the intimate knowledge of the person being examined. Listening and talking through a patient/doctor alliance are the first steps towards true psychological healing. Over the last few years this sort of dialogue with adolescent patients was chosen, since they turn to us both seeking the physicians who know them well and a space where they can talk openly. The narrative approach requires time, willingness and an appropriate setting. In addition, the supportive care needs of these youngsters with cancer are often brought up in these encounters and this suggests the extent to which these needs may remain unmet. The dialogue that takes place following the “narrative” approach allows us to obtain detailed personal information and insight into the values and abilities of each subject. Undoubtedly, some psychosocial disorders can be prevented. Nowadays, pediatricians, supported by psychologists and other specialists, can create an alliance with the parents and the sick adolescents in order to adequately face pitfalls that may become the source of disorders in their physical, cognitive, emotional and behavioral development, and especially with regards to post-traumatic stress. Four different situations of adolescents who were either suffering from or who were cured of cancer are reported in detail in this chapter, including information concerning their need for understanding, discrepancy in appearance and insight, crisis in quality of life and the identity process. Chapter 27 - In healthcare, relationships between patients or disabled persons and professionals are at least co-constitutive for the quality of care. Many patients complain about the contacts and communication with caregivers and other professionals. From a care-ethical perspective a good patient-professional relationship requires a process of negotiation and shared understanding about mutual normative expectations. Mismatches between these expectations will lead to misunderstandings or conflicts. If caregivers listen to the narratives of identity of patients, and engage in a deliberative dialogue, they will better be able to attune their care to the needs of patients. This is illustrated with the stories of three women with Multiple Sclerosis. Their narratives of identity differ from the narratives that caregivers and others use to understand and identify them. Since identities give rise to normative expectations in all three cases there is a conflict between what the women expect of their caregivers and vice-versa. These stories show that the quality of care, defined as doing the right thing, at the right time, in the right way, for the right person, is dependent on the quality of caring relationships. Chapter 28 - Throughout the history of psychotherapy, clinical theoreticians have evoked various metaphors to depict the therapist-patient relationship. With the advent of attachment
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theory and other advances in developmental psychology in the 1950s and 1960s, a new therapeutic metaphor was born: the caregiver-infant attachment relationship. This metaphor has yielded a number of insights into the process of psychotherapy and the nature of the interactions in which the therapist and patient engage. The first objective of this article is to illuminate both the advantages and disadvantages of using this metaphor to depict the psychology of therapeutic relationships. One distinction between this metaphor and the therapeutic relationship is the state of development of mental structures in the infant versus the patient. Whereas the caregiver is behaving in response to the infant’s emotional cues not contextualized by an interactional history of expectations to guide these cues, the patient enters into a therapeutic relationship with a complex and intricate interactional history of expectations. This asynchrony between the caregiver-infant attachment relationship and the therapist-patient relationship requires the therapist to behave in sometimes noncomplementary ways to challenge and interpret these transferential patterns rather than simply responding to emotional cues, as a caregiver would do. These interactional expectations, typically organized around definable patterns of behavior in the therapeutic relationship, are “often neither conscious and verbalizable nor repressed in the dynamic sense”, and thus pose challenges to traditional psychotherapy models that rely exclusively on symbolization to produce therapeutic change. This new understanding of therapeutic change forces therapists to focus more intensively on their own attitudes and behaviors vis-à-vis the patient as the quintessential instruments of change. Various aspects of the therapeutic relationship, in addition to verbalized interpretations of repressed conflict, have thus come under increased scrutiny. I present an attachment-based pathways model for understanding the interrelations among three relationship-based concepts used in contemporary psychotherapies: working alliance, patient attachment and therapist caregiving, and transference and countertransference. Thus, the second objective of this article is to sensitize therapists and psychotherapy process researchers to the structure and functioning of these interrelated concepts to increase therapeutic effectiveness. Chapter 29 - This study aimed to explore how the affects that result from conflictive social interpersonal relationships influence mental health, as well as to investigate how specific coping styles mediate between these affects and mental health. The Test of Self-Conscious Affect-3 assesses six self-conscious affects, namely guiltproneness, shame-proneness, externalization, detachment, alpha pride, and beta pride. In this study, selected for analysis were the four affects that originated from negative evaluations of the presented scenarios (guilt-proneness, shame-proneness, externalization, and detachment). This study used the Coping Inventory for Stressful Situations for estimating coping style, specifically task-oriented coping, emotion-oriented coping, and avoidance-oriented coping. A structural equation model that makes it possible to explore the causal relationship between self-conscious affects, coping styles, and mental health, was chosen as a statistical technique. Among the 394 Japanese university students who agreed to participate in this study, 298 experienced moderate to severe stressful negative life events during the fourmonth study. Of those 298 respondents, 268 completed every item of the TOSCA-3, the CISS, and the Self-rating Depressive Scale. These 268 were subjected to a structural equation model. Among the four affect categories which occur under stressful situations, only shameproneness directly contributed to a depressive reaction, whereas the other three (guiltproneness, externalization, and detachment) did not. Individuals with shame-proneness tended
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towards an emotional-oriented coping style, but this inhibited task-oriented coping. Guiltproneness induced task-oriented coping and avoidance-oriented coping. Externalization induced task-oriented coping and emotion-oriented coping. Detachment gave rise only to avoidance-oriented coping. Interestingly, among the three coping styles, only task-oriented coping induced a depressive reaction, whereas emotion-oriented coping and avoidanceoriented coping did not. These results were discussed primarily from the psychological perspective but also look briefly at how they might be applied to a clinical setting within psychiatry. Chapter 30 - Throughout history, artists, poets, and writers have been interested in the nature of passionate love, sexual desire, and sexual behavior. In the 1960s, social psychologists and sexologists began the systematic investigation of these complex phenomena. Yet, only recently have neuroscientists and biochemists begun to explore these complex phenomena. In this entry will review what these distinguished theorists and researchers have learned about these processes.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 1
COMMUNICATING EMPATHIES IN INTERPERSONAL RELATIONSHIPS Grace Anderson* and Howard Giles Department of Communication University of California, Santa Barbara, California 93106, USA
ABSTRACT Empathy is a concept that has been widely researched across the social sciences and, more importantly, is commonly used outside of academe as a method “to open-up the channel of communication with the other” (Wikipedia, 2006). Although commonly employed colloquially, empathy is challenging to define explicitly and, hence, we shall need to begin this chapter with some conceptual wood-clearing. Prior definitions reflect the specific contexts in which empathy was measured and studied. For instance, a study measuring empathy as a response to media defines empathy differently than a study that examines empathy as an interpersonal communication construct – and these definitions are not mutually exclusive or disparate. Instead, different definitions are a result of the various dimensions of empathy that researchers choose to highlight as a function of the particular empirical study’s focus. For this reason, many individuals may find empathy easier to enact than to describe its meaning in words. This chapter will examine the major definitional variations of empathy that have developed in research on interpersonal relationships, comparing and contrasting their implications. For instance, one major difference is whether empathy is a stable trait or a changing state; this definitional difference can lead to very different methods of research. We seek to accomplish a more global definition of empathy by discussing the distinct ways in which it has been examined in the past, such as in terms of communicative competence, personal distress, and nonverbal expressions, and incorporating the many dimensions of empathy into a unified source of reference for future research. In so doing, we will discuss how one individual may feel and express empathy and how that empathy may or may not be perceived as such by its recipients. The psychological origins of empathy will be identified and questions regarding motives underlying empathy will be *
Contact: Grace L. Anderson. Department of Communication, University of California, Santa Barbara, Santa Barbara, CA 93106-4020, USA.
[email protected]; Fax: 805-893-7102
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Grace Anderson and Howard Giles raised, including whether it can be used as a form of impression management during social interactions. Empathy has been recognized as an important component of health communication. Research has shown that an empathic person holds more positive attitudes towards healthy behaviors regarding smoking and alcohol consumption (Kalliopuska, 1992). Moreover, an effective health campaign will evoke empathy among its target audience because it evokes greater cognitive and affective processing of the campaign message (Campbell & Babrow, 2004). Empathic communication with people with disabilities (particularly those inflicted by cancer) will be a continuous example used to help us understand the multidimensional implications of empathic communication. Empathy can ease tensions that may occur during this form of interaction and suggestions of appropriate empathic communication will be offered. Finally, a new communication model of the process of empathy will be introduced.
HOW IS EMPATHY CONCEPTUALIZED? Empathy has been recognized as a multidimensional concept, consisting of both cognitive and emotional components (Duan & Hill, 1996). Researchers consider the cognitive component to be characterized as the ability to take another’s perspective in a social encounter (Coke, Batson, & McDavis, 1978; Smith, 2006; Smither, 1977; Wilson & Cantor, 1985). Yet, this distinct form of perspective-taking requires the individual to imagine what the other person is experiencing rather than what the individual him/herself would experience under similar circumstances (Batson, Early, & Salvarani, 1997; Jackson, Brunet, Meltzoff, & Decety, 2006). Bennett (1979) distinguished between the perspective-taking of the self and other by contrasting sympathy and empathy. More specifically, sympathy involves a form of perspective-taking based upon the notion that all individuals perceive a common reality and, therefore, react to stimuli in a similar manner. As a result, an individual will take another’s perspective by envisioning how him/herself will react to circumstances in a uniform reality. Conversely, empathy is based upon the assumption that all individuals experience different realities. As a result, perspective-taking must incorporate the possibility that another individual may react differently to similar circumstances. Ritter (1979) found this differentiation between sympathy and empathy apparent during the maturation of adolescents. More specifically, younger adolescents engage in more generalized perspective-taking strategies, failing to differentiate between the needs of others and the needs of themselves. In comparison, older adolescents engage in more complex perspective-taking because they “simply have a greater range of interpersonal constructs available, particularly those relevant to understanding others’ psychological characteristics, upon which to base communication strategies” (Ritter, 1979, p. 50). Listener-adapted communication was exhibited by older adolescents as a result of their increased communicative strategy repertoire. As a consequence of their interpersonal experience, older adolescents have a greater ability to understand the specific perspective of another. In sum, perspective-taking gives the empathizer knowledge regarding another individual’s affective state, but the communicator must develop an understanding of others’ psyche through accumulated life experiences. The empathizer can understand how others may feel and possibly identify the causes for their emotions. Consequently, this has been labeled
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cognitive empathy. Yet, empathy entails an intimate form of communication that goes beyond cognitive understanding and an empathizer can adopt the emotions of others in order to vicariously feel their sentiments (Smith, 2006; Smither, 1977; Warner, 1997). This second dimension of empathy has been labeled emotional empathy. As an illustration, imagine an empathic person communicating with a young investment banker who smokes cigarettes and has just been diagnosed with lung cancer. Cognitive empathy allows the empathizer to take the specific perspective of the investment banker. Although smoking may be the direct cause of the investment banker’s cancer diagnosis, an empathizer would also realize that such a stressful job with long hours may have driven the banker to use nicotine as a stimulant in order to increase job productivity. As a result, the banker is not directly to blame for his cancer diagnosis and an empathizer realizes that a number of complex factors - in addition to smoking - may have contributed to the presence of cancer in the body. In addition, empathy is emotional because the empathizer also shares in the emotions of the investment banker. The empathizer would be able to vicariously feel the stress of the investment banker’s career and his subsequent anguish because the banker’s future is threatened by a potentially fatal illness. It is the sharing of emotions that makes empathy a unique concept. In order to share an affective state with another individual, some scholars assert that the empathizer must suspend his/her own emotions in order to better feel the emotions of another individual. On the other hand, the empathizer should refrain from complete integration of identity with the other individual (Greenberg & Elliott, 1997; Vanaerschot, 1997; Warner, 1997). In this respect, the empathizer is aware of the other’s emotions yet, retains his/her distinct identity from the other individual. For example, when empathizing with a jealous individual “one does not become jealous himself but merely experiences what it must be like [for the other individual] to feel jealously” (Smither, 1977, p. 257). This identity distinction can help the empathizer validate the other individual’s emotions in relation to his/her own experiences (Bohart & Greenberg, 1997). This disagreement may not have to be resolved immediately. Instead, individuals can possess different forms of empathy depending upon the degree to which they retain a distinct identity. In other words, there is a spectrum of identity suspension. The empathizer can experience complete emotional contagion with another communicator or understand the other communicator’s emotion without intensely experiencing the specific emotions him/herself. This may vary as a function of communication context, the communicator’s ability to take the other’s perspective, and/or distracting communicative noise. But as yet, this phenomenon needs empirical examination. Some researchers have clarified the debate over identity suspension by further subdividing emotional empathy into emotional contagion and empathic concern (Stiff, Dillard, Somera, Kim, & Sleight, 1988). The former occurs when the empathizer adopts the affective state of the other individual, as discussed previously. The latter can be characterized as a general concern and regard for the welfare of others. Empathizers who experience empathic concern will exhibit prosocial behaviors, such as helping and communicative responsiveness, because they are motivated by a concern for the other’s welfare. However, empathizers who also experience emotional contagion will vicariously feel the other’s distress and become less communicatively responsive. They are egotistically motivated to reduce their own unpleasant feelings instead of comforting the distressed other. Taken together, empathic concern is positively associated with emotional contagion such that empathizers must first feel concerned for the other’s welfare in order to vicariously feel the other’s emotions. These
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findings suggest that empathizers should suspend their identities from complete integration with the other individual in order to behave altruistically. But, complete identity suspension during empathy may deny the empathizer the more visceral experiences of empathy which may be more intrinsically and extrinsically rewarding (for an intercultural perspective on empathy, see Arnett & Nakagawa, 1983; Broome, 1991; & DeTurk, 2001). Empathy, therefore, has been conceptualized as a multidimensional concept that consists of two forms of empathy with corresponding functions. Cognitive empathy describes the perspective-taking function that enables the empathizer to understand and anticipate the thoughts, reactions, urges of the recipient of empathic communication. This allows the empathizer to best tailor a message specifically towards the recipient and consequently communicate a message that empathically incorporates the recipient’s specific needs. The second form of empathy is emotional empathy. This form of empathy serves the function of emotional sharing where the empathizer can feel the emotions of the other individual. This function validates another’s emotions because they are justified by an empathizer who legitimately feels similar emotions as result of their communicative interaction. When combined, the two functions of empathy leads the recipient of empathic communication to feel increased perceived support and personal control as a consequence of such an interactive experience (Williams, Giles, Coupland, Dalby, & Manasse, 1990). Future research could illuminate exactly how such a communicative context is created and maintained by the empathizer. Ritter (1979) found that the general ability to take another’s perspective develops as an individual matures and gains life experiences to become knowledgeable about the possible perspectives of another (see section below for further elaboration). It would be interesting to discover which immediate contextual circumstances alter this perspective-taking ability. What is the degree to which perspective-taking ability can be weakened by contextual noise? Additionally, empirical analysis could study the degree to which individuals suspend their identity when sharing emotions during empathic communication with another individual. Which kind of empathizer retains a distinct identity when sharing in the emotions of another individual? Is there a difference between these empathizers and other empathizers that completely integrate their identities with other individuals when sharing in their emotions? This could be related to the attributions the empathizer assigns to the other individual and his/her distress. For instance, an empathizer may empathize with a speaker who has acquired lung cancer. However, the empathizer does not fully integrate his/her identity with the other when sharing the in the other’s emotions, because the empathizer feels that the other is partially to blame for contracting lung cancer as a result of heavy smoking. The degree to which a communicator suspends his/her own identity when sharing in another’s emotions may be a way in which communicators can vary the degree of empathy they communicate. In the next section, we will discuss variation in empathic communication in more depth and related methodological considerations.
EMPATHY: TRAIT VERSUS STATE Variation in empathy is most pronounced when it is defined as an emotional state. In this case, an individual’s empathy fluctuates as a function of differing social interactions and their level of respect for and affiliation with another (Duan & Hill, 1996). For instance, a single
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individual can experience varying degrees of empathy, depending upon how the context evokes empathy. Conversely, empathy can be considered similar to a personality trait whereby empathy is tantamount to a stable ability that an individual develops through maturation (Smither, 1977; Wilson & Cantor, 1985). In this case, trait empathy varies from individual to individual as some have greater capacity to empathize compared to others. The investigation of trait empathy would lend itself well to a between-subjects design where personality differences between individuals could be observed. On the other hand, investigation of state empathy lends itself to a within-subjects design where changes in empathy could be observed within the individual as context changes. Methodological difference between state empathy and trait empathy can be demonstrated by considering the degree of identity suspension during emotional empathy. For instance, one individual may experience complete emotional contagion while other empathizers may maintain a distinct identity. In this way, there are inter-individual differences of identity suspension during emotional empathy (Duan & Hill, 1996). Imagine a young child in day care who observes another child start to cry and, as a result, the initial child offers his/her security blanket as solace. However, observing another peer in distress proves to be too overwhelming and this child starts to cry as well. In comparison, an older adolescent may have a better sense of personal identity and, consequently, suspends his/her identity during empathic communication. This exemplifies that emotional contagion differs between individuals as a function of developmental ability. In addition, one individual may experience varying degrees of identity suspension during emotional empathy. In this case, empathy is a fluctuating state where a single individual may experience different forms of empathy over a relatively short period of time (Duan & Hill, 1996). For instance, picture a female teenager waiting by the telephone for a call from her love interest. Her little brother approaches her seeking attention because he has cut his finger while playing and wants comfort. The sister acknowledges her brother’s hurt finger, covers it with a Band-Aid and tells him to play with more caution. The telephone rings and the teenager excitedly greets her love interest on the other end, but swoons when the love interest informs her that he has injured himself during a touch football game. Her response over the telephone is emotional and she feels weak at the knees. The same individual has exhibited fluctuating state empathy as a consequence of a change in context. In this case, a change of interactants during empathic communication causes the individual’s state empathy to vary. It is important to remember that each empathizer exhibits both trait empathy and state empathy, as in Figure 1. Each individual has a general empathic ability (trait empathy) that is a function of their life experiences and cognitive complexity. Yet each individual experiences variations of empathy (state empathy) that fluctuates around their general empathic ability level (trait empathy) as a consequence of context and other temporary situational variables (Duan & Hill, 1996). Individuals’ state empathy fluctuates around their general ability level of trait empathy.
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Figure 1. Model exhibiting the inter-individual differences of trait empathy in addition to the intraindividual and inter-individual differences of state empathy.
As above, it may be useful to measure trait empathy with a between-subjects design and state empathy with a within-subjects design, but this may not always be the case. Sometimes it may be useful to measure state empathy with a between-subjects design when the frequency of and size of fluctuations around each individual’s trait empathy differs between individuals. For example, some individuals may experience more rapid fluctuations of state empathy in comparison to others and/or they may experience greater extremes of empathy as their state empathy fluctuates dramatically from their general trait empathy level. This may be the case when an individual is more behaviorally sensitive to contextual cues and, consequently, experiences greater fluctuations of state empathy more frequently than other individuals who may be better able to ignore contextual distractions or communicative noise. In this manner, state empathy varies on an inter- as well as intra-individual basis. Additionally, trait empathy may be measured with a within-subjects design if one were interested in investigating how life-altering events may influence an individual’s general empathy level overall. For instance, experiencing the death of a loved one may boost an individual’s trait empathy to a higher level by gaining the experiential knowledge of that event so that perspective-taking is easier to enact when empathizing with others also experiencing devastating life events. In sum, the difference between state empathy and trait empathy lies in the manner in which empathy is conceptualized. Research that treats empathy as a state is concerned with the manner in which individuals empathically respond to specific stimuli that evoke empathy. In this way, state empathy is usually considered an outcome variable where individuals react to contextual cues. On the other hand, research examining trait empathy focuses on the maturational or experiential differences between individuals and how this affects their stable empathic patterns. In this case, trait empathy is generally treated as a pre-existing variable where individuals respond to particular stimuli as a function of their previous experiences and maturity.
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A DEVELOPMENTAL PERSPECTIVE ON EMPATHY A developmental perspective on empathy considers it an artifact of an individual’s maturity. Empathy is developed as one gains life experiences with which to use as cognitive reference tools when taking the other’s perspective during communicative interactions. In other words, an empathic individual must first understand his/her own identity to use as a reference with which to compare to another’s identity (Smither, 1977). In fact, the components of empathy may be evolutionary in nature. Perspective-taking may have evolved as a result of a complex social environment in which individuals must predict the behaviors of others in order to manipulate social circumstances to their advantage. In addition, emotional sharing may have evolved in order for individuals to facilitate group cohesion, such as kin and sexual selections (Smith, 2006). Not only is empathy a construct that has evolved with the growth of general society, but empathy and perspective-taking, in particular, are skills that develop as one matures (Ritter, 1979). Wilson and Cantor (1985) measured the self-reports and physiological responses of children of differing ages to television programming and found that younger children became less emotionally aroused by a television character’s fear than older children who experienced the same treatment. Wilson and Cantor believe that the lack of empathy exhibited by the younger children did not result from a failure to recognize the nature of the character’s emotion, but a failure to take the character’s perspective when compared to older children. Conflicting research, however, suggests that children as young as preschoolers exhibit affective perspective-taking towards each other in the sense that they infer each others’ feelings in a non-egocentric manner and engage in cognitive perspective-taking (Denham, 1986). In addition, there is evidence that perspective-taking abilities can be fostered among relatively young children by allowing them to work cooperatively together. Bridgeman (1981) found that fifth grade students when learning in a cooperative peer-initiated classroom environment engaged in increased role-taking when compared to fifth grade students in a more formal teacher-centered classroom and other innovative classroom environments. She concludes that role-taking is critical to the development of a child’s conscious self as described by George Herbert Mead. An individual’s identity can only be conceived in relation to others. The important conclusion to be drawn from this contrary evidence of younger children regards the peer interactivity of these methodological designs. Young children are able to relate to other children of similar age in a manner that best fosters an environment for the acquisition of empathic skills. It seems as though interactions among young peers stimulates empathic behaviors at an earlier age than would unfettered maturation. In addition, this peer interactivity has been found to increase empathy among older children (fourth and fifth graders) with below age norm performance on empathy, in the absence of explicit training (Silvern et. al., 1979). It would seem that peers can teach each other empathic behaviors in the place of trained professionals when another peer needs to be caught-up to an age-appropriate empathic skill level. Empirical research that takes a developmental perspective on empathy tends to treat empathy as a stable trait of research participants. Less research has been conducted that measures empathy as a fluctuating dispositional state. Yet, dispositional state empathy suggests that “empathic disposition can be trained” and, therefore, raises important empirical questions for future research (Greif & Hogan, 1973, p. 284). This implies that state empathy
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and trait empathy are not mutually exclusive. Over time, state empathy can become less variable and more stable with the recurrence of a certain context and emotional state and, accordingly, more closely resemble trait empathy. As a certain form of state empathy becomes engrained into an individual’s normal behavioral patterns, this particular form of empathy becomes trait empathy. Previous research has examined this process by measuring children’s state empathy as a function of the common environment of television viewing. Zillmann and Cantor (1977) measured children’s dispositional reactions to a television character’s emotions. This study, however, did not fully support empathy as the impetus for the children’s reaction to the television character. Instead, these researchers found state empathy to be a partial mediator in the relationship between a television show and children’s reactions to the programming. When the television character behaved benevolently and neutrally, the children’s affective responses conformed to the character’s emotional reaction. When the benevolent character expressed triumph, the children also responded with triumph. Alternatively, when the character behaved malevolently the children’s affective responses were discordant with the character’s emotional reaction. When the malevolent character expressed triumph, the children may express disappointment. In this case, the children could not have behaved empathically because they would have conformed to the malevolent character’s emotions as well. Instead, Zillmann and Cantor concluded that children’s affective reactions conformed when they held positive sentiments towards the television character and exhibited discordant affective reactions when they had negative sentiments towards the television character. This is also known as the affective-dispositional rationale. This study demonstrates that state empathy has precursors during interpersonal interactions. In this case, children only exhibit state empathy when positive sentiment is felt for the target individual. This behavior will be cultivated as these children mature and continue to view television as a common pastime. State empathy towards well-liked characters becomes less variable and more established as a trait form of empathy. In addition, this empathic reaction to television characters may also become a reaction to target individuals in reality according to the cultivation hypothesis. More specifically, there may be precursors to empathy towards people with disabilities and the disease of cancer. Will the affective-dispositional rationale be supported among research subjects empathizing with a target individual diagnosed with cancer? This implies that individuals would only express empathy towards another with cancer if the individual harbors positive sentiment towards the latter. This requires that the two individuals have a personal relationship where positive sentiment has been developed and harbored between them. Consequently, the affective-dispositional rationale may only be a fragment of the entire picture because empathy can be expressed between individuals who do not have a close personal relationship with each other. What if a personal relationship has not developed? An important factor to consider would be the attributions an individual assigns without much personal knowledge about the interactant. For example, different attributions are typically assigned to individuals with lung cancer when compared to individuals with leukemia. Individuals may assign blame and believe that an adult with lung cancer caused this infliction to occur to him/herself when compared to an individual with a type of cancer that is less preventable, such as leukemia. This train of thought is supported by previous research where it was found that “cancer patients held less firm convictions about causative factors in the etiology of cancer than did
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non-cancer patients” (Linn et al., 1982, p. 838). The researchers suggest that cancer patients are not necessarily avoiding reality, instead they are more aware of the complexities of the disease and its multitude of possible causes. Individuals without cancer, however, are not so acutely aware of the disease and its causes and, consequently, use heuristics in order to assign attributions to the cancer patient. The assignment of attributions is not contingent upon a personal relationship between the individuals. In addition, the assignment of attributions is more commonplace during everyday communication and may serve as a more universal and explanatory precursor to the expression of empathy towards individuals with cancer. The predictive influence of attributions can be investigated by measuring empathic reactions to individuals with diverse forms of cancer diagnoses. Different cancer diagnoses may affect the empathic reactions individuals with cancer receive from others because attributions influence this relationship.
FROM WHERE DOES EMPATHY COME? Aside from the precursors and the communicative context, empathy is an innately human response to observing another human in distress. This section takes a step back in order to best examine the fundamental derivation of empathy. The field of psychoanalysis considers the origins of empathy to arise from human identity itself. More specifically, individuals each possess a dual identity that consists of an articulate self and an organic self. The articulate self is an individual’s responsible agent with values, goals, and intentions. This is an individual’s conscious identity that is manifested when the individual refers to him/herself as ‘I’. In contrast, the human identity also consists of an organic self, where the interdependence of bodily functions allows for the existence of the articulate self to exist and function (BarrettLennard, 1997). The most fundamental form of empathy is ‘self empathy’ and this occurs when an individual’s organic self and articulate self are in equilibrium. This can be conceived as a form of inner listening where the needs of the organic self are realized by the articulate self (Barrett-Lennard, 1997). Self-empathy can be conceptualized as the articulate self’s recognition of the organic self’s limitations. For instance, an individual may consciously desire to attend a university but may experience health limitations resulting from cancer and the corresponding treatment. The equilibrium of the articulate self with the organic can be represented by the individual’s recognition of the specific implications that cancer will have on his/her academic performance. This equilibrium may be maintained over time if the individual enrolled in a university with a large medical facility where he/she would have more immediately convenient access to treatment. The internal empathic process has been documented in the form of a magnetic resonance imaging experiment (Jackson, Brunet, Meltzoff, & Decety, 2006). Researchers found that respondents activated different portions of their brains when imagining themselves in pain compared to imagining another individual in pain. More specifically, brain activation was restricted to the affective components such as the anterior cingulate cortex, the insula, and the right temporo-parietal region associated with perspective-taking tasks when the research subject was asked to imagine another individual in pain. In comparison, further activation was detected when the research participant was asked to imagine him/herself in pain. The sites of
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the brain already activated by imagining another in pain were accompanied by further activation of the medial prefrontal cortex and the neural circuit, which has been associated with self-identification. The researchers associated the overlapped difference in brain activation to Batson’s (1983) distinction between empathy and personal distress. Empathy may be represented by the perspective-taking and affective activation of the brain when the research subject imagines another in pain. However, the greater activation when research subjects imagining themselves in pain may be an indication of the egocentric characteristic of personal distress. “Focusing on our own thoughts and feelings reduces empathy, whereas focusing on those of distressed Others increases empathy” (Jackson et al., 2006, p. 759). These researchers further speculate that experiencing another’s pain to the same degree as one experiences his/her own pain would result in over-arousal of empathy where every individual’s distress would become distressing to the observer as well. The fact that there is not a complete overlap in brain activity between the self and other conditions suggests support for the above distinction between the articulate and the organic self. The brain activity stimulated by imagining another individual in pain may be an indication of the activation of the articulate self. The research subject is consciously processing the pain of another individual as an outside observer. In comparison, the increased brain activity stimulated by imagining oneself in pain may represent the simultaneous activation of the articulate and the organic self. The research subject can imagine exactly how the pain would feel him/herself through the organic self. In addition, research subjects use their articulate selves to imagine how they would appear to others observing their pain. Problems arise for the individual when the organic and articulate self internally conflict. For example, people with invisible inflictions, such as many forms of cancer in early stages, may appear to be healthy externally, yet are ailing internally. In other words, the organic self is unhealthy, however, the articulate self may seem healthy to other individuals because a person with cancer may function and communicatively appear as a healthy individual. In fact, some people in the early stages of cancer may strive to keep their cancer diagnosis concealed during casual interactions and may experience anxiety as a result. In this manner, a person with cancer is motivated to avoid being labeled as disabled and unhealthy (Harwood & Sparks, 2003; Matthews & Harrington, 2000). Matthews and Harrington (2000) believe, however, that people with cancer may be susceptible to feelings of shame during communicative encounters because these people are aware that they are externally representing a healthy person when they are not internally healthy. In other words, the person with cancer is consciously withholding information regarding their diagnoses during interpersonal interactions in order to maintain group membership in a dominant social group of healthy people. In this respect, shame may increase because there is potential for a negative discovery of the cancer diagnosis. More specifically, shame may increase with time when a person harbors a clandestine cancer diagnosis during relationships with others. Additionally, shame may dramatically amplify when this furtive diagnosis is abruptly discovered by another. In this case, shame can be considered an outcome of a discord between the articulate and organic self when one is not self-empathic. Although empathy is typically considered a behavior that requires the interaction of two or more individuals, the origins of empathy arise from the identity and the self. At the most basic level, an individual empathizes with him/herself when the individual strikes a compromise between his/her organic self and articulate self. This form of intrapersonal
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empathy gives the individual a balanced identity and the foundation with which to feel and express empathy with others in the interpersonal setting.
FELT AND PERCEIVED EMPATHIES Just as there may be inconsistencies between a single individual’s organic and articulate selves, there can be inconsistencies where some may try to communicate empathy, yet the recipient does not interpret their communication as such. Braithwaite and Eckstein (2003) have documented such empathic discrepancies by interviewing people with disabilities regarding their management of instrumental help from other individuals. For instance, a person with a disability may want and/or need assistance, yet the manner in which the assistance is offered and enacted may not respect the needs of the disabled person. The individual’s initial motivation may have been empathic, yet the recipient of the assistance will not likely interpret the help as empathic because it was unwanted or conducted in an inappropriate manner. This suggests that an individual with a disability may seek or need a form of empathy that a healthy individual is unable to enact as a result of a lack of awareness or an inappropriate perspective. Previous research supports this claim by finding that observers’ judgments of individuals’ illnesses are more highly correlated with the actual severity of illness when compared to individuals’ self-rating of their illnesses. Brissette, Leventhal, and Leventhal (2003) conducted a 9-year longitudinal study and attributed the observers’ greater accuracy of illness severity to their reliance on objective manifestations of illness, such as appearance and visible symptoms. In comparison, the individual with the illness harbors more hopeful judgments about themselves stemming from their positive affect and optimism which can cause them to underestimate their own illness severity. This divergence in judgments may be the root of the discrepancy between the observer’s perceived empathy and how that empathy is interpreted by the person with the illness. An observer may empathically offer unwanted assistance because the noticeable symptoms of the illness are compelling to the observer. However, the person with the illness may be too optimistic to believe that such help is necessary and, therefore, the offer of assistance is not perceived as empathic. Not unrelatedly, Williams et al. (1990) argue that the motivation to seek support and or provide support is a consequence of an individual’s personal goals. Accordingly, an inconsistency between an individual’s communicated empathy and how that empathy is perceived by the recipient can be a consequence of conflicting goals. For instance, individuals may express empathic support in order to communicate their altruism. Yet, the recipient of the empathic communication may wish to remain autonomous and not desire support or the manner in which the empathic support was offered violated the recipient’s autonomy. Consistent with the development perspective, empathy may take practice in order to accurately and affectively share in another’s emotions. To facilitate this form of empathy, the empathizer must learn to distinguish the appropriate cues. More specifically, the communicator must perceive and recognize behaviors of the other individual that reveals their internal emotional state. This recognition includes gestures that are intentionally enacted to communicate an internal emotional state and natural expressions which are non-intentional symptoms of the individual’s internal emotional turmoil (Smither, 1977). In this case, a
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discrepancy between felt empathy and perceived empathy would occur if the empathizer does not effectively recognize these emotional manifestations or if the individual seeking empathy does not effectively communicate their emotional gestures to the empathizer. At the very least, both individuals need to recognize the importance of communicating internal emotional states. In order to avoid a discrepancy between felt and perceived empathy, observers should first be confident that they are taking the perspective of the specific target of their empathic efforts. Many times someone with a disability prefers to seek assistance from acquaintances and friends in order to ensure that his/her perspective is in mind (Braithwaite & Eckstein, 2003). However, even family members of cancer patients experience difficulties in this regard (Lobchuk & Vorauer, 2003). This suggests that family members need to be consciously reminded to refrain from taking their own self-oriented viewpoint and take the cancer patient’s instead. Once accomplished, however, the assistance will appeal to the needs of the ill individual, not to the philanthropic needs of the observer. Family members’ difficulty with empathizing and visualizing the needs of another family member diagnosed with cancer may stem from unawareness. The health consequences of cancer and chemotherapy are experiences that many people have not encountered and this may make empathy difficult to effectively enact. Family members of a person with cancer can overcome this difficulty by first acknowledging that the cancer experience is different that their own healthy experiences. This will combat the family members’ tendency to consider their own self-oriented viewpoint as similar to the viewpoint of the individual diagnosed with cancer. In addition, it will help the healthy family member to harbor a more appropriate estimation of the specific perspective of the person with cancer. The second component of empathy, affective contagion, may be difficult as well for family members. They have not likely experienced the emotions and sensations associated with cancer and chemotherapy and, therefore, cannot fully comprehend the discomfort and pain associated with the condition of the actual diagnosis. In this case, it is important to listen attentively to the individual’s requests for help and accomplish exactly what was requested (Braithwaite & Eckstein, 2003). A common mistake family members make when assisting a cancer patient is to foresee and predict assisting duties that the cancer patient may need in the future. For example, family members may commonly help loved ones with cancer by assisting them to the restroom when they are too weak. These family members may believe that they can further assist their loved ones by purchasing and placing a chamber pot next to the bed in order to eliminate the trek to the restroom and the need for assistance. Yet, this chamber pot may represent a loss of autonomy and control for people with cancer. The loved ones with cancer may feel ashamed by the negative associations of the chamber pot and regret asking for assistance from family members. Healthy family members do not always have the specific knowledge regarding the emotions associated with a cancer diagnosis to make such assumptions. Many times people with a disability prefer to ask for assistance before being offered assistance in order to maintain control of their daily routine. In addition, general offers of assistance may be better received than specific suggestions of assistance (Braithwaite & Eckstein, 2003). For example, “May I help you?” is a better offer of assistance than “Do you need help opening the cabinet door?”. The increased specificity of the second offer of assistance may make the person’s disability overly salient. In this way, the observer’s empathy is drawing too much attention towards the individual’s inability to open the cabinet
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door instead of the individual’s personal identity (Merrigan, 2000). Empathy should be exclusively directed towards target individuals’ emotional state instead of characteristics of the target individuals, such as their disabilities or general health conditions. General messages of assistance are better than specific messages because the individual without the disability does not likely have sufficient knowledge to make specific assumptions about the emotional state of the individual with a disability. Hence, the individual without a disability must become comfortable with the emotional uncertainty involved in an interaction with an individual with a disability. The latter will reduce this uncertainty for the individual without the disability by asking for assistance when it is desired and needed. In this case, the individual without the disability can exhibit empathy by recognizing that the perspective of the individual with the disability may be too different for the individual without the disability to accurately imagine on his/her own. “If incompetence, paradoxically, is necessary along the road to competent, enmeshed intercultural relationships [between disabled culture and nondisabled culture], perhaps short-term, local risks in each individual interaction are exchanged for long-term attitudinal change and development” (Merrigan, 2000, p. 233). The Communication Predicament of Disability Model displays communication between cultures and may lend insight to this discussion (Ryan, Bajorek, Beaman, & Anas, 2005). This model is cyclical and describes how non-disabled individuals allow stereotypes to dictate the manner in which they address disabled individuals. The cyclical characteristic of this model demonstrates how stereotypes can be continuously confirmed and stray further and further from reality. In this case, an individual may express empathy in an inappropriate manner because it is stemming from a faulty stereotype that has been internalized. The solution to this predicament empowers the people with disabilities by suggesting that they exhibit selective assertiveness. In this manner, the stereotype may be weakened and the individual with the disability is not labeled as a constant dissenter. Interestingly, experienced empathy discrepancy does not always occur on an interpersonal level. This discrepancy is observable during intrapersonal communication as well. Loewenstein (2005) labels these discrepancies as hot-cold empathy gaps. He believes that individuals can misjudge their own behaviors and tendencies across different affective states. Individuals who are in affectively ‘cold’ states - or are not affectively aroused - will fail to recognize how they will behave when they become affectively aroused or when they are in a ‘hot’ state. For example, an individual who has a benign cancer tumor may wish to undergo surgery in order to remove the tumor. Yet, this individual may regret this decision when he/she is experiencing anxiety directly before the surgery. Conversely, individuals who are experiencing affectively ‘hot’ states may underestimate the influence of their emotional state and overestimate the resolution of their decision. For instance, individuals who have just been diagnosed with life-threatening cancer may feel especially vulnerable and choose to undergo aggressive chemotherapy treatment. Yet, these individuals may come to regret this decision when the side-effects of chemotherapy dramatically reduce their quality of life. In order to combat the effects of hot-cold empathy gaps, individuals must exhibit a presence of mind where individuals may feel affectively hot or cold, yet are able to foresee their emotions when the affective state has changed. To summarize, individuals exhibit helping behaviors stemming from empathic altruism even when the needs of the other are different from the needs of the empathizer (Denham, 1986; Litvack-Miller, McDougall, & Romney, 1997). Empathy springing from good intentions may fall short and not be interpreted reciprocally as empathic by the receiver. This
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problem can be combated by accurate perspective-taking and emotional awareness of the other’s affective state. However, accuracy becomes increasingly difficult when the other individual is experiencing something that empathizers have not experienced themselves, such as cancer and corresponding treatments. In this case, the empathizer must tolerate a level of uncertainty during the preliminary stages of the interaction or relationship in order to allow the other individual to seek the specific empathy or assistance that is truly needed. A “conservative” form of empathic communication is more appropriate when unsure of the correct application of empathy during unfamiliar social encounters.
EMPATHY AS AN IMPRESSION MANAGEMENT TOOL Can a person strategically communicate empathy without actually feeling it? In others words, can an individual express a manufactured or even deceitful version of empathy in order to favorably manipulate an interpersonal relationship? There is evidence that people may avoid feeling empathy when they anticipate that they will be asked to help - and when such helping could be considered costly for the empathizer (Shaw, Batson, & Todd, 1994). But what if the communicator still wants to be perceived as empathic in order to maintain a positive social identity? This is a circumstance where an individual intends to maintain a division between experienced empathy and expressed empathy in order to communicate a form of so-called Machiavellian empathy. This section will discuss how empathy can be used for impression management when the communicators vary in the degree to which they enact perspective-taking and emotional contagion, respectively. Smith (2006) believes that the answer lies in the very conceptualization of empathy. More specifically, all individuals may not have the capacity to enact both components of empathy, perspective-taking and affective sharing. An individual may possess greater perspective-taking abilities and lack the affective ability to share in another’s emotions. This kind of individual may be a skilled manipulator of social circumstances because these individuals will not become overwhelmed with the emotions of others around them. A lack of sensitivity to others’ affective states combined with a skilled sense of others’ perspectives will give these individuals the capacity to manipulate social relationships to their advantage. Yet, this individual’s Machiavellian empathy may incur personal costs, such as social isolation, because others may become aware that they are being manipulated or, intuitively, sense that this manipulator is not sincere. There is evidence that this egocentrism is common because taking another’s perspective does not automatically lead to empathic behaviors. After considering the other’s perspective, individuals will have less egotistic judgments concerning resource allocation and fairness (Epley, Caruso, & Bazerman, 2006). However, these judgments of fairness are not reflected in the behaviors of these individuals. Egotistic or self serving behaviors did not reduce as a consequence as taking the other’s perspective. In this manner, an individual may engage in perspective-taking of the other and realize the fair and just manner in which to treat the other, yet still behave egotistically in order to gain an advantage over another or accomplish a personal goal (as above, see Stiff et al., 1988). On the other hand, Smith (2006) contends that an individual may easily share in another’s emotions, yet neglect to take that person’s perspective. These individuals are likely to be
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easily influenced by empathic emotion and this affective contagion will cause them to have a fluctuating sense of self. In addition, such individuals will neglect to imagine how others perceive their behavior and, therefore, lack the ability to purposely tailor communicative messages. This type of empathic ability, consisting of low perspective-taking and high affective sensitivity, may lend the individual to being susceptible to Machiavellian empathy because they would be captive to the emotional surges of an interpersonal encounter. However, to lack the ability of affective sensitivity or perspective-taking is an extreme condition that would not frequently manifest itself in many individuals. It is more likely that individuals possess both components of empathy and, instead, exhibit moderate fluctuations in both perspective-taking and affective sensitivity in order to adhere to social expectations, as shown in Figures 2 and 3. “One could be empathic (i.e., enter the other’s frame of reference) but then use one’s sense of the other’s experience to manipulate the person” (Mahrer, 1997, p. 168). For example, an individual may momentarily engage in increased perspective-taking in order to gain the approval of another communicator. Or an individual may feign emotional contagion in order to emphasize similarity and affective connection with another. This discussion re-conceptualizes empathy to have a looser definition whereby individuals differentially engage in perspective-taking or emotional contagion for an egocentric advantage during interpersonal relationships. In this manner, empathic communication can differ in degree and intensity such that only the “purest” form of empathy can be communicated when both perspective-taking and emotional contagion are authentically enacted.
Figure 2. Diagram of empathy and impression management.
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Figure 3a. The components of empathy and an individual’s ability to manage another’s impressions of him/herself.
Figure 3b. The components of empathy and an individual’s susceptibility to impression management from another.
Again, the distinction between state and trait empathy is an important one. The individual who lacks the ability to take another’s perspective or share in another’s emotions will exhibit a different form of trait empathy than another who possesses both components of empathy. Conversely, individuals’ who have the capacity to change their perspective-taking and affective sharing abilities in order to match social appropriateness exhibit a fluctuating state empathy that changes within the individual according to specific contexts. Either way, empathy, without compassion, can be dangerously manipulative - and empathy without perspective-taking can be foolhardy (Bohart & Greenberg, 1997). It would be interesting to study variations in perspective-taking and affective sharing abilities using the theoretical framework of communication accommodation theory.
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Following this, individuals would vary the empathy that they express to another in order to explicitly communicate their intergroup attitudes (Gallois, Ogay, & Giles, 2005; Giles, Coupland, & Coupland, 1991; Hecht, Jackson, & Pitts, 2005). For example, communicators that wish to distinguish themselves from a member of an outgroup might underaccommodate their speech style when interacting with them. In terms of empathy, these communicators would take the other’s perspective only to determine their outgroup status, yet neglect to communicate any emotional response that they may or may not feel as a consequence of interacting with the other individual. In other words, the communicators are intentionally withholding their emotional empathy in order to make group boundaries explicit and seemingly impermeable during the interaction. On the other hand, communicators can use empathy to linguistically converge towards another in order to reduce intergroup dissimilarity and soften the emphasis of group boundaries with communication accommodation. In this case, communicators would take the other’s perspective more intensely in order to determine the individual’s group membership and better tailor a message towards the listener. In addition, these communicators would emphasize that they are sharing in the emotions of the other and consequently verbally accentuate emotional similarity. Future research that supports this approach would imply that empathy can be used as an impression management tool during interpersonal interactions when individuals behave vis-à-vis their intergroup beliefs (see Harwood & Giles, 2005).
OPERATIONALIZATIONS OF EMPATHY Empathy may seem difficult to measure, yet previous researchers have already belabored the arduous task of creating operational measures that capture the multidimensional nature of it. Valid and reliable measurement tools, such as the Hogan Empathy Scale (EM) and the Mehrabian and Epstein Questionnaire Measure of Emotional Empathy (QMEE), have been developed and they measure two distinct aspects of empathy (Chlopan, McCain, Carbonell, & Hagen, 1985; Duan & Hill, 1996). Although some research has found both measures to be reliable and valid, the QMEE seems to be measuring vicarious emotional arousal and, possibly, an individual’s general tendency to become emotionally aroused in various contexts. Alternatively, EM more closely measures the perspective-taking component of empathy (Hogan, 1969). But some have questioned its validity because EM has been found to be multidimensional at both the first- and second-order factor levels, suggesting that EM’s subscales are more informative than its composite score (Dillard & Hunter, 1989). “Taken together, these two scales, the QMEE and Hogan’s EM scale measure empathy as the ability (a) to become emotionally aroused to the distress of another and (b) to take the other person’s point of view, in order to have true empathy” (Chlopan et. al., 1985, p. 650). In fact, Davis (1983) has integrated these components of empathy into one scale entitled the Interpersonal Reactivity Scale (IRI). “Rather than treating empathy as a single unipolar construct (i.e., as either cognitive or emotional), the rationale underlying the IRI is that empathy can best be considered as a set of constructs, related in that they all concern responsivity to others but are also clearly discriminable from each other” (Davis, 1983, p. 113). More specifically, the IRI consists of four subscales that each measure perspectivetaking, empathic concern, fantasy, and personal distress. The perspective-taking and empathic
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concern subscales attempt to measure the components of empathy previously discussed. However, Davis also considered fantasy tendencies and personal distress as additional components. Davis’ fantasy subscale measures an individual’s ability to imagine the feelings of fictitious characters in books and movies, for example. Fantasy tendencies are expected to have a positive relationship to an individual’s emotionality. The personal distress subscale measures the egocentric feelings of personal anxiety during interpersonal interactions. The association between empathy and personal distress will be discussed in greater detail in an ensuring section. Davis found a positive correlation between the perspective-taking and the empathic concern subscales which support the previous discussion indicating that perspective-taking and affective contagion are important components of empathy (Coke et al., 1978). In addition, Davis found that the perspective-taking subscale was highly correlated with the EM and the fantasy tendencies and empathic concern subscales were highly correlated with the QMEE. This confirms the claims made by Chlopan et al. regarding the distinct measurements of the EM and the QMEE. In sum, the EM measures the perspective-taking component of empathy and the QMEE measures vicarious emotional arousal in various contexts. In general, the fantasy subscale resembles the empathic concern subscale in that both subscales have a relationship with emotional reactivity and selfless concern. However when compared to the empathic concern scale, the fantasy subscale has a weaker relationship with other-oriented sensitivity and a stronger relationship with verbal intelligence measures (Davis, 1983). Other-oriented sensitivity is integral to the concept of empathy and its weak relationship with the fantasy subscale may indicate that an empathic individual with fantasy tendencies has trouble tailoring a message that incorporates another individual’s specific needs. Overall, research has shown that an individual with fantasy tendencies will react emotionally to another in distress and have selfless concern for the other individual; however this concern may not be communicated with other-oriented sensitivity. In other words, the receiver of the empathic communication may not interpret the message as empathic because it was communicated in an inappropriate manner. The fantasy aspect of empathy has been the target of intriguing investigations in media communication where fantasy involvement (i.e., perspective-taking of fictional characters) has led to some interesting reactions to film (Tamborini, Salomonson, & Bahk, 1993; Tamborini, Stiff, & Heidel, 1990). Davis’ personal distress subscale was important because it exhibited a negative correlation with the EM. This indicates that individuals with high personal distress will be less able to take another’s perspective and, therefore, less likely to feel empathy. In other words, personal distress is an opposite reaction to another in distress and a reaction that is separate and distinct from empathy. This is consistent with the research conducted by Batson, O’Quin, Fultz, and Vanderplas, (1983) where a distinction was invoked between empathy and personal distress as separate reactions to the same stimulus of viewing another individual’s suffering. Personal distress is an egocentric reaction to another’s distress because individuals are focused on their own negative feelings as a consequence of the other’s distress. Empathy, on the other hand, is an altruistic reaction in the sense that the individual’s focus is on the other’s distress. Taken as a whole, these correlations further confirm that researchers are sharpening empathy measures towards increased validity. Smither (1977) offers the researcher a word of caution regarding the measurement of empathy. ‘Pseudo-empathy’ must be controlled for during measurement. More specifically, ‘pseudo-empathy’ is an individual’s normative reactions to another in order to adhere to
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implicit social expectations. “The concern here is an important one: empathy is a response to the particular feeling-states of another individual, and cannot be a response to a generalizedother or to the situation itself” (emphasis in text; p. 258). In order to prevent the measurement of ‘pseudo-empathy,’ the individual or research participant must have information regarding the specific emotions and relational context in which the individual is embedded. Many times individuals respond to a situation in a generic manner because they prefer to be careful and cautious during interpersonal interactions or because they have experienced similar situations in the past. It is important for future research to have poignant stimuli that actually evoke empathy instead of a cautious normative response. Another way to combat the measurement of ‘pseudo-empathy’ would be to confront research participants with unfamiliar situations and individuals during experimental treatments. Consequently, research participants would be forced to specifically scrutinize the current research condition because they do not have a similar past experience to rely upon. However, Duan and Hill (1996) call for a dramatic change in the manner by which empathy is measured. They believe the previous measures of empathy do not adequately evaluate intra-individual fluctuations of empathy (state empathy) and, instead, suggest that an indirect measurement of empathy is superior. These researchers believe a better calculation of the perspective-taking function of empathy would be to measure the attributions that empathizers assign to the behaviors of recipients in addition to the attributions recipients assign to their own behaviors. Empathy has occurred when both the empathizer and the recipient identify the same attributions for the recipient’s behavior. “The validity of the method can be theoretically inferred, because the accuracy of the match [of assigned attributions] should reflect the degree to which one person is taking another’s perspective” (Duan & Hill, 1996, p. 267). Similarly, the emotional contagion function of empathy can be measured by the degree of match between the empathizer’s and the recipient’s emotions or affective state. In sum, the unit of analysis when measuring the perspective-taking component of empathy is attribution congruence and the unit of analysis when measuring the emotional contagion component of empathy is affective congruence. Duan and Hill’s second-order manner of assessing empathy has the benefit of using the empathic recipient’s perspective and emotions as the comparison baseline to which an empathizer must conform in order to exhibit a true form of empathy. In other words, this is a subjective measure of empathy that is more adaptable to personal and contextual differences. This is to be compared to objective measures where an individual’s empathy is compared to a pure and superior form of empathy that independently exists outside of the particular interaction. However, Duan and Hill’s measurement of empathy was intended for counseling psychology and psychotherapy and, consequently, has methodological drawbacks when their conclusions are applied to the empirical context of social science. In order for a match of perspectives and emotions to occur, both an empathizer and a recipient of empathy must be present in a controlled environment in order for researchers to measure their congruence. This limits the measurement of empathy to the experimental setting with at least two interacting research participants. This rules out the measurement of empathy in response to media forms, for example, and limits the possibility of surveys and content analyses of empathic content. In fact, different methods of empathy measurement result in varying associations between empathy and prosocial behavior. For instance, positive associations between empathy and prosocial behavior are strongest when empathy is measured with physiological indices (i.e. heart rate), when similarity is experimentally manipulated, and by self-report measures during
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experimental situations (Eisenberg & Miller, 1987). Interestingly, picture/story procedures measuring empathy among children were not associated with prosocial behavior. This suggests that some methods can better detect altruistic behavior associated with empathic communication than others. A global construct such as empathy needs an amalgamated analysis in order to accurately measure the multidimensional nature of the variable during empirical research. Although pitfalls such as pseudo-empathy have been identified, there are subtle ways to combat these pitfalls during the empirical process that reduce the chances of measuring normative responses instead of empathy. In addition to the methods of measurement identified above, the strength of empirical research investigating empathy lies in the treatment stimuli that in fact evoke empathy from research participants.
RELATED CONSTRUCTS Empathy is an important construct to measure empirically because it primarily leads to positive behaviors, such as assistance and helping behaviors towards others in distress. However, it is important to make a distinction between empathy and other reactions individuals have when observing another in distress. The relationship between empathy and personal distress confirmed by Batson et al. (1983) is one of many findings that purport empathy and personal distress to result in distinct motivations to help another individual. More specifically, empathy motivates an individual to help another out of altruistic desire. On the other hand, personal distress leads to an egocentric form of helping behavior where individuals will help another in order to calm down their own state of mind (Batson, Fultz, & Schoenrade, 1987; Batson et al., 1983; Coke et al., 1978). In sum, both empathy and personal distress can be reactions to the same stimulus of witnessing another individual experiencing distress. However, empathy and personal distress are distinct reactions because they trigger divergent motivations to help. Unfortunately, empathic altruistic desires to help diminish as the cost of helping the other individual increases (Batson et al., 1983). For instance, the treatment of cancer can be financially costly especially when considered at an aggregate level where hospital administrators have to consider the costs and rewards of treating a number of cancer patients without health coverage. On a case-by-case basis, administrators empathize with each cancer patient and their families and are altruistically motivated to help. However, the costs dramatically accrue when all cancer patients without health coverage are considered on a budgetary basis. In this case, the financial costs increase hospital administrators’ personal distress and egotistic concern for their job security because it is their responsibility to adhere to a manageable budget. This egotistic desire will eventually override an empathic administrator’s altruistic motivation to help. The altruistic alternative would sacrifice resources at the cost of the collective good. Hospital funds would be allocated to a few individuals and less total resources would be available for general upkeep of the hospital facilities that would benefit all patients indiscriminately. There is evidence documenting how egotistic and altruistic allocations of resources change as a consequence of empathy. Individuals’ are primarily motivated to benefit oneself and secondarily motivated to allocate resources that benefit their social group as a whole
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(Batson et al., 1995). But if individuals feel empathy for a particular other, then they are motivated to benefit the other individual even when it costs the group, as a whole. Interestingly, there are times when the altruistic motivations of empathy may conflict with the collective good. An egotistic motivation to help oneself and one’s social group can lead to greater long-term self-benefit because resource allocation to the collective good would solidify a positive social standing for oneself within the social group and would benefit the group in relation to other groups also competing for resources in a society. In this case, an altruistic motivation to help a particular other at the expense of the group would not lead to long-term self benefit. Perhaps this illustrates why empathy is so intriguing to examine. Empathic communication is a common human behavior of altruism that paradoxically occurs at the expense of the collective good and long-term self-benefit. Perhaps the two distinct forms of motivation produced by empathy and personal distress are the cause of ambiguous empirical results concerning attitudes and stereotypes about individuals diagnosed with cancer. For instance, Gray and Rodrigue (2001) found that young adolescents with high trait empathy had stronger desire to participate in academic, social and general activities with a hypothetical new peer with cancer. In fact, this stronger desire remained when empathic young adolescents considered participating in activities with a healthy hypothetical new peer. This indicates an absence of a cancer stigma. And all adolescents (empathic and non-empathic) intended to exhibit positive behaviors towards the peer with cancer when compared to a hypothetical peer without cancer. These encouraging results may have been a result of the researchers’ ability to successfully evoke an altruistic desire to help and, subsequently, measure empathy towards a peer with cancer. Conversely, Sherman, Smith, and Cooper (1982-83) found that individuals had less positive affect towards contact with a cancer patient when compared to contact with a patient with a broken leg. More specifically, positive affect increased with the patients’ attractiveness and decreased when the individuals perceived the patient to be in greater pain. In this case, the researchers may have evoked personal distress among their research respondents. Interacting with an unattractive patient in great pain may be personally distressing. These findings have unfortunate implications. Cancer patients who may, arguably, be considered less attractive under certain conditions tend to be individuals who have undergone intense chemotherapy and have consequently experienced hair and weight loss. These individuals also tend to be in great pain from the treatment itself in addition to an aggressive form of cancer. This is a ripe opportunity for empathy to be expressed in order to quell cancer patients’ physical and emotional distress. However, Sherman et al. has shown that empathy is not healthy individuals’ common reaction under these circumstances. In fact, this finding remains consistent with Gray and Rodrigue because their research participants were asked to imagine a hypothetical peer with cancer. These research participants were children who probably would not imagine a new peer who is unattractive and in constant pain. It can be suggested that Gray and Rodrigue would have encountered different results if their research participants were actually confronted with a new peer who was observably experiencing pain and other physical indications of an aggressive cancer diagnosis. As above, the empathizer experiences increased emotional contagion and vicariously feels the distress of the peer, the empathizer is more likely to become communicatively unresponsive in order to reduce one’s own distress (Stiff et al., 1988). Future research is needed in order to specifically identify aspects of the cancer experience that evoke empathy among healthy observers instead of personal distress. Or which
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individuals tend to express empathy more often towards others with cancer? Can increased contact cultivate empathy towards individuals-with-cancer and reduce personal distress? Increased contact could help a healthy individual realize and appreciate another individual’s distinct personality and how a cancer diagnosis inhibits the other’s persona (Pettigrew & Tropp, 2000; Wright, Broday, & Aron, 2005). This would imply that individuals who have had a relative with cancer or experienced cancer themselves would be more likely to express empathy in this context. Medical personnel of oncology may also express increased empathy according to this contact hypothesis, however their increased knowledge about treatment and medical practice may be a covariate. A common aim for future research could be focused on discovering the aspects of the cancer experience that bring out the best responses in healthy observers in addition to individuals-with-cancer. Another construct related to empathy is communication competence (Greif & Hogan, 1973; Ritter, 1979). Wiemann (1977) considered competent communicators as empathic, affiliative, supportive, relaxed while interacting, and able to adapt their behavior according to the specifics of the interaction and between interactions. Individuals have greater competence as they possess more of these qualities and the degree to which they exhibit these qualities. Redmond (1985) found the concepts of communication competence and empathy very closely related (r = .98). Communication competence and empathy may be composed of the same set of skills and behaviors. In fact, Redmond believes that such a strong correlation may methodologically hinder effective research and indicate that the concept of empathy is being treated too globally. It is possible that one factor, empathy/the competent communication of empathy, is being measured twice when researchers treat empathy and communicator competence as separate and distinct concepts. Empathy may be an internal skill and communication competence may be the behavioral manifestation of empathy. It may be possible for an individual to feel empathy yet not be able to effectively communicative his/her empathic state. This internal empathy, unfortunately, would not be recognized as empathy because it was not effectively communicated. This is consistent with Redmond’s findings because research subjects were required to take the third person perspective and assess empathy and communicative competence as an outsider to an auditory interaction. Research participants listened to an auditory interaction and, accordingly, did not have visual cues and personal knowledge regarding the communicator’s internal affective state. These research participants will not be able to detect the communicator’s empathy unless it is competently verbalized. Any empathy that was detected by research participants was detected only because the communicator was competently able to express empathy. Therefore, the strong correlation between empathy and communication competence existed because auditory manifestations of communicator competence were required in order for research participants to perceive the presence of empathy in the target individual during the auditory interaction. In sum, empathy has to be competently communicated in order for another individual to recognize it as empathy. Thompson (1981) found that children with handicaps had lower communication competence in that they were less able to adapt their communication towards the listener. In addition, children without handicaps were less able to adapt their communication toward children with handicaps as well. This effect persisted even when children with and without handicaps shared classes together. The authors find these results an indication that children with handicaps are not receiving empathic communication from their peers and, therefore, not able to model empathic communication themselves because they are not being exposed to it.
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However, another possibility could be a circumstance where the children are experiencing a form of intergroup conflict and children with and without handicaps are each avoiding any consideration of the other’s perspective. Either way, empathic communication can often be problematic between children with and without handicaps. According to communication accommodation theory, this behavioral pattern can be considered reciprocal underaccommodation where handicapped and non-handicapped children are maintaining a division between social groups within the classroom. Although there are other factors influencing the communicative competence of handicapped children, this discussion implies that the environment in which children communicate with disabled children is already unstable and not naturally fostering reciprocal empathic communication. Interestingly, however, siblings of children with cancer experience fewer difficulties in psychological adjustment when they also experience high empathy (Labay & Walco, 2004). Empathy may help them emotionally reconcile discrepancies in family resources that are focused away from the siblings. Conversely, siblings who are less empathic and less able to understand others’ emotional states may have difficulty communicating their needs and act impulsively. It would seem that the empathizer has increased communicative competence during the distress following cancer diagnoses in the family. Empathy was also found to be correlated with age, further suggesting that empathy is a developmental ability that may develop in tandem with communicative competence during maturation. Can nonverbal cues effectively communicate empathy? Recently, researchers have focused on the combination of person-centered messages and nonverbal immediacy cues in comforting messages (Jones, 2004, 2005; Jones & Burleson, 1997, 2003; Jones & Guerrero, 2001; Jones & Wirtz, 2006). Comforting messages could be considered a way for individuals to express their empathy and altruistic desire to help another individual. Person-centered comforting messages validate and acknowledge another individual’s specific emotional distress and Jones (2004) found that individuals who receive person-centered messages feel reduced emotional distress and perceive the communicator of person-centered messages as supportive and caring. On the other hand, nonverbal immediacy conveys liking, interpersonal warmth and connection, and stimulates psychological arousal which helps the individual to recognize the prior emotions of warmth, liking and connectedness. In addition, Jones found that individuals who communicate nonverbal immediacy are perceived as more competent communicators. It would seem that communicators who express nonverbal immediacy and person-centered supportive messages are more competent communicators of empathic warmth and connection. However, Jones and Guerrero (2001) maintain that nonverbal immediacy and personcenteredness facilitate different functions during the emotional support process and may be distinct concepts. Nonverbal immediacy communicates a warm and open context for comforting, but person-centeredness incorporates explicit statements which encourages disclosure of distressing emotions. Consequently, person-centered comforting messages overtly provide an opportunity for emotional distress to be verbalized and allows for the reappraisal of these emotions in an interpersonal context. Jones and Wirtz (2006) further suggest that the comforting process consists of a reappraisal of distressing emotions which can lead to emotional improvement. In other words, emotional reappraisal was a mediating variable between person-centeredness and affective improvement. Individuals who use person-centered messages in order to comfort distressed individuals will explicitly encourage other individuals to verbalize their feelings. This
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verbalization will help determine the cause of distress and spur other sense-making cognitive reappraisals that will eventually reduce the initial distress. However, reappraisal was found to be only a partial moderator because there was a direct decrease in emotional distress resulting from person-centered comforting messages. More specifically, an individual’s emotional distress will reduce simply as a result of another individual validating and acknowledging his/her distress with person-centered comforting messages, as in Figure 4. In sum, person-centered comforting messages communicate empathy in two ways. First, an individual is acknowledging another’s distress by tailoring a message towards the particular distress of the other individual. Second, person-centered messages explicitly allow the distressed individual to verbalize emotional distress and commence a reappraisal process towards distress reduction (Bohart & Greenberg, 1997; Jones & Wirtz, 2007; Warner, 1997). Both functions of person-centered messages manifest a unique form of perspective-taking required of the empathizer. An individual can take another’s perspective by simply acknowledging the other individual’s emotional distress. On the other hand, the reappraisal process can be considered a more dynamic form of perspective-taking where each individual shares his/her perspective regarding the emotional distress of one individual and, thus, negotiate a more balanced interpretation of the distressing emotions. In this manner, a mutual perspective of all members of the interaction is achieved and this leads to emotional distress reduction. There are a number of constructs related to empathy as the latter is not an isolated orthogonal entity. Instead, empathic communication is part of a process where another’s distress is recognized by an individual and that individual’s empathic response may or may not be competently communicated. However, the presence of empathy in the individual’s psyche can trigger an altruistic motivation to help another individual in distress which can be manifested by the comforting behaviors of nonverbal immediacy and person-centered messages.
Figure 4. Model of outcomes resulting from comforting behaviors.
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In further examining the process of empathic communication, the following came to mind. What circumstances or events in everyday life commonly trigger individuals’ egotistic motivation of personal distress to override their empathic altruistic motivation to help another? What strategies can individuals use to combat personal distress and restrain egotistic motivation in order to uphold an altruistic desire to help in the face of adversity or personal hardship? Are there other helping behaviors that better manifest an empathic individual’s altruistic desire to help? Is there a way to measure empathy that an individual legitimately harbors, yet is not able to competently communicate? These questions only seek to further illuminate an empathic process that has been diligently documented by previous research.
OUTCOMES OF EMPATHY As just discussed, messages of empathy and their underlying altruistic motivations to help can be manifest by comforting behaviors such as nonverbal immediacy and personcentered messages. In many respects, the emotional distress reduction resulting from the reappraisal process spurred by person-centered messages can be considered an outcome of empathic communication. This is supported by cancer research where supportive conversations consisting of the mutual sharing of personal cancer experiences lead to greater perceptions of effective helping among interactants (Pistrang, Solomons, & Barker, 1999). In this case, the self-disclosure regarding cancer was more positively evaluated when empathy was first communicated during the relationship. Consequently, one positive outcome of empathy is the perceived emotional assistance resulting from the mutual sharing of experiences. Other, more global, outcomes of empathy have been explored as well. For instance, international conflicts may be resolved through the proper enactment of collective empathy (Nadler, 2003; Nadler & Liviatan, 2004, 2006; Nadler & Saguy, 2005). Researchers have analyzed the international conflict between the Palestinians and the Israelis to discover the role of empathy in the achievement of conflict resolution. They have found that empathy leads towards conflict resolution only when the conflicting parties maintain a preliminary level of trust. If trust is not present between the conflicting parties, expressions of empathy may sometimes lead to increased conflict. In this case, an expression of empathy is perceived as an empty offer of reconciliation and possibly perceived as intentionally deceptive. In this manner, trust has been found to moderate the relationship between empathy and conflict resolution. Trust can be engendered when the opposing groups participate in successive interactions towards a common goal that fulfills the needs of all groups involved. The researchers use social identity theory for support by asserting that groups engaging in collective action will embrace a larger group identity that overrides their separate identities and lead to cooperative interaction. Likewise, trust may be an important moderator during interpersonal conflict and two individuals in disagreement can engender trust by working towards a common goal. Over time, trust will develop once cooperative interaction becomes more frequent. Similar intergroup conflict can be observed between healthy individuals and individualswith-cancer. Individuals may avoid others who have been diagnosed with cancer or individuals may exhibit overly intrusive behaviors that can strain the interpersonal
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relationship (Flanagan & Holmes, 2000). Moreover, this conflict may lack trust. Cancer is a disease that can remain invisible to an observer some days and, yet, produce noticeable symptoms other days. Healthy individuals may harbor doubts about the severity of the disease when the observable signs of the illness are ambiguous (Matthews & Harrington, 2000). These doubts may spring from a wishful desire for the cancer diagnosis of their friend or family member to be bogus. In order for empathy to reconcile the strained relationship, trust must be re-established. Trust may be restored by educating healthy individuals about the fluctuating symptoms of cancer, especially if this education is collectively achieved through a partnership between the healthy individual and the individual-with-cancer. If these individuals collectively work towards the goal of cancer education together, they both will have increased knowledge in addition to a larger shared identity between them. Increased trust will further increase the likelihood of a positive relationship between empathy and conflict resolution. These possible outcomes demonstrate that the effects of empathic communication resonate from the interpersonal to the international level. However, it is important to remember that positive outcomes from empathy will only occur when empathy is communicated in the context of a trusting relationship.
A MODEL OF INTERPERSONAL AND INTERGROUP EMPATHY AS A COMMUNICATIVE PROCESS The empirical findings discussed in the previous sections have been mapped-out into a model in order to display the process of empathic communication. For simplicity, this model of empathy displays the communication between an empathizer and a receiver. The communicator has just witnessed or become aware that another individual is experiencing some form of distress and, consequently, this communicator feels personal distress and/or the beginnings of empathy: perspective-taking and emotional contagion, as in Figure 5. Picture this model as a set of three concentric circles that start at the upper left-hand section of the model and each circle represents a different process related to empathy. As depicted, two processes commence when communicators observe another in distress. These communicators can experience personal distress themselves as a result of witnessing another endure a painful experience or emotional turmoil. The outmost circle represents the process of personal distress where egotistic motivation compels communicators to reduce their own distress by comforting the other individual. This particular process is represented by personal distress appearing twice on the processional model in order to reflect both the empathizer’s and the recipient’s distress. The empathic process is represented by the next concentric circle where individuals can respond to others’ distress by taking their perspective and sharing in their emotions because empathizers have an altruistic desire to help the other individuals. Lastly, the innermost circle represents the process of conflict resolution where empathy is fundamental to the resolution of conflict between two parties. Empathy is integral to the two inner circles and consequently there is overlap of the empathic process and the process of conflict resolution.
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Figure 5. Empathic communication process model.
Parsimony notwithstanding at this stage of model development, there are a number of possible additions and potential changes to this model that future research can implement. One improvement entails the identification of specific helping behaviors individuals enact when exhibiting empathy. The current dialog box signifying ‘helping behaviors’ is perhaps generic and needs elaboration in future theorizing. It would be interesting to assess whether individuals experiencing personal distress resort to different helping behaviors as a consequence of their egotistic motivation to help in comparison to the altruistically motivated helping behavior commonly chosen by individuals who exhibit empathy. Any differences would have direct implications for the empathy as a communicative process model. Instead of one ‘helping behaviors’ dialog box, personal distress and empathy would have relationships with two separate ‘helping behaviors’ dialog boxes, each representing the differing helping behaviors that personally distressed individuals and empathic individuals typically enact. Additionally, it would be interesting to discover if helping behavior springing from personal distress results in as much emotional improvement in the target individual as helping behavior exhibited by an empathic individual.
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EPILOGUE Empathy’s multidimensional nature has been reflected by the diverse manner in which it has been examined in previous research in addition to this present analysis. Although a mainly interpersonal construct, historically, empathy research has been expanded to embrace the dynamics of media communication, intergroup, and intrapersonal communication. However, empathy has not been explicitly examined in organizational settings. Boggs and Giles (1999) scrutinize the communication accommodation that occurs in the workplace as a consequence of gender social groups. Could the observed accommodative patterns be a corollary of empathy (or lack thereof) in the workplace? Can an empathic workplace be intentionally fostered? In addition, empathy research has yet to investigate the effect of intercultural differences. Duan and Hill (1996) report that collectivistic values are positively related to dispositional empathy. However, they question whether this tendency would remain when an individual with collectivistic values is confronted with another’s distress about a decidedly individualistic issue. Other questions regarding empathy in collectivistic cultures remain. For instance, will empathy communicated in a collectivistic culture be more broadly directed to the family of the distressed individual? How does empathy change when comparing cultures that typically communicate with high vs. low contexts? More specifically, is empathy more likely to be implicitly communicated in a high context culture when compared to a low context culture? Overall, research has focused on the role of the empathizer as opposed to the receiver of empathic communication. However, the research which incorporates empathy into the context of disability and cancer better focuses the attention on the receiver of empathic communication. The experience of a cancer diagnosis and treatment is embedded within the social relationships of people with cancer which contributes to their social identity (Harwood & Sparks, 2003; Sparks & Harwood, 2008). This highlights the importance of social relationships when facing the health threat of cancer. Yet, empirical findings indicate that friends and family have difficulty taking the perspective of the person-with-cancer. In consideration, friends and family members should recognize that the cancer experience may be beyond their perspective-taking abilities. Although this can be psychologically uncomfortable as a result of uncertainty, empathy can be best expressed by its availability. It might be helpful to allow people with cancer to ask for assistance and emotional support when needed and in the manner that they desire. The cancer experience changes as a consequence of different stages from diagnosis to chemotherapy to remission and social relationships of support need to adapt accordingly (Sparks & Harwood, 2008). Fortunately, empathy is a common reaction when observing another in distress and contributes to comforting behaviors in addition to a variety of other prosocial behaviors (Litvack-Miller, McDougall, & Romney, 1997). It can be the manner in which empathy is expressed during sensitive communicative interactions that heightens or dampens its positive effect on the social relationship. Needless to say, there is an array of other viable theories we could have fruitfully invoked (e.g. uncertainty reduction theory) however, space and parsimony precludes such a luxury. For instance, the dual identity proposed as the origin of empathy in this chapter may be similar to the dual identity proposed by the theory of Symbolic Interactionism. Do the
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articulate self and the organic self correspond with the ‘I’ and the ‘me’? In addition, social identity theory has been used to examine the intergroup relationships between individualswith-cancer and other social groups (Harwood, & Sparks, 2003). It would be interesting to further study how empathy may change intergroup communication. Does empathy change the manner in which group identity is achieved and maintained via social comparison? Can empathy soften the perceived boundaries between social groups? Moreover, communication accommodation theory (as above) may explain the linguistic manifestations of empathic intergroup interaction. Do the linguistic strategies of communication accommodation theory provide a better framework with which to examine empathic communication? Can a communicator linguistically diverge from another while still expressing empathy; or is empathy solely a form of communication convergence? Almost finally and returning to our starting point, empathy still deserves more conceptual scrutiny. More specifically, empathy has been regarded as an individual’s response to observing another experiencing distress. This implies that empathy only occurs when an individual observes another’s negative emotion(s). However, empathy can be a response to another’s positive emotion(s) such as a wedding engagement, a pregnancy announcement, graduation, etc. It would be interesting to discover if there is a difference between positive emotions and negative emotions in the manner in which empathy is elicited. Duan and Hill (1996) believe that “empathizing with someone with positive emotions can be emotionally rewarding and empathizing with someone with negative emotions can be morally rewarding” (p. 268). Future research could empirically explore this assumption in order to determine if empathizers responding to another’s positive emotions experience a different empathic process than communicators responding to another’s negative emotions. Empathic communication in response to another’s positive emotions is outside of the framework of this chapter, yet it is an important manner in which empathy can vary and, therefore, an area in need of further development A global concept such as empathy requires a global method of examination. However, analysis of such a ubiquitous concept is needed in order to better understand interpersonal relationships. Previous research has met this demand and has proven to be both enlightening and enigmatic. Most importantly, empathy is not simply a reification of academia, but a concept pragmatically used by the general population in a fairly reliable manner (Hogan, 1969).
REFERENCES Arnett, R. C., & Nakagawa, G. (1983). The assumptive roots of empathic listening: A critique. Communication Education, 32, 368-378. Barrett-Lennard, G. T. (1997). The recovery of empathy – Towards others and self. In A. C Bohart & L. S. Greenberg (Eds.), Empathy reconsidered: New directions in psychotherapy (pp. 103-123). Washington, DC: American Psychological Association. Batson, C. D., Batson, J. G., Todd, M., Brummett, B. H., Shaw, L. L., Aldeguer, C. M. R. (1995). Empathy and the collective good: Caring for one of the others in a social dilemma. Journal of Personality and Social Psychology, 68, 619-631.
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Batson, D. C., Early, S., & Salvarani, G. (1997). Perspective taking: Imagining how another feels versus imagining how you would feel. Personality and Social Psychology Bulletin, 23, 751-758. Batson, D. C., Fultz, J., & Schoenrade, P. A. (1987). Distress and empathy: Two qualitatively distinct vicarious emotions with different motivational consequences. Journal of Personality, 55, 19-39. Batson, D. C., O’Quin, K., Fultz, J., & Vanderplas, M. (1983). Influence of self-reported distress and empathy on egoistic versus altruistic motivation to help. Journal of Personality and Social Psychology, 45, 706-718. Bennett, M. J. (1979). Overcoming the golden rule: Sympathy and empathy. Communication Yearbook, 3, 407-422. Boggs, C., & Giles, H. (1999). “The canary in the coalmine”: The nonaccommodation cycle in the gendered workplace. International Journal of Applied Linguistics, 9, 223-245. Bohart, A. C., & Greenberg, L. S. (1997). Empathy: Where are we and where do we go from here?. In A. C Bohart & L. S. Greenberg (Eds.), Empathy reconsidered, New directions in psychotherapy (pp. 419-450). Washington, DC: American Psychological Association. Bohart, A. C., & Tallman, K. (1997). Empathy and the active client: An integrative, cognitive-experimental approach. In A. C Bohart & L. S. Greenberg (Eds.), Empathy reconsidered, New directions in psychotherapy (pp. 393-417). Washington, DC: American Psychological Association. Braithwaite, D. O., & Eckstein, N. J. (2003). How people with disabilities communicatively manage assistance: Helping as instrumental social support. Journal of Applied Communication Research, 31, 1-26. Brissette, I., Leventhal, H., & Levethal, E. A. (2003). Observer ratings of health and sickness: Can other people tell us anything about our health that we don’t already know?. Health Psychology, 22, 471-478. Bridgeman, D. L. (1981). Enhanced role taking through cooperative interdependence: A field study. Child Development, 52, 1231-1238. Broome, B. J. (1991). Building shared meaning: Implications of a relational approach to empathy for teaching intercultural communication. Communication Education, 40, 235249. Campbell, R. G., & Babrow, A. S. (2004). The role of empathy in responses to persuasive risk communication: overcoming resistance to HIV prevention messages. Health Communication, 16, 159-182. Chlopan, B. E., McCain, M. L., Carbonell, J. L., & Hagen, R. L. (1985). Empathy: Review of available measures. Journal of Personality and Social Psychology, 48, 635-653. Coke, J. S., Batson, C. D., & McDavis, K. (1978). Empathic mediation of helping: A twostage model. Journal of Personality and Social Psychology, 36, 752-766. Davis, M. H. (1983). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44, 113-126. DeTurk, S. (2001). Intercultural empathy: Myth, competency, or possibility for alliance building? Communication Education, 50, 374-384. Denham, S. A. (1986). Social cognition, prosocial behavior, and emotion in preschoolers: Contextual validation. Child Development, 57, 194-201.
Communicating Empathies in Interpersonal Relationships
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Dillard, J. P., Hunter, J. E. (1989). On the use and interpretation of the emotional empathy scale, the self-consciousness scales, and the self-monitoring scale. Communication Research, 16, 104-129. Duan, C., & Hill, C. E. (1996). The current state of empathy research. Journal of Counseling Psychology, 43, 261-274. Eisenberg, N., & Miller, P. A. (1987). The relation of empathy to prosocial and related behaviors. Psychological Bulletin, 101, 91-119. Epley, N., Caruso, E. M., & Bazerman, M. H. (2006). When perspective taking increases taking: Reactive egoism in social interaction. Journal of Personality and Social Psychology, 91, 872-889. Gallois, C., Ogay, T., & Giles, H. (2005). Communication accommodation theory: A look back and a look ahead. In W. Gudykunst (Ed.), Theorizing about intercultural communication (pp. 121-148). Thousand Oaks, CA: Sage. Giles, H., Coupland, J., & Coupland, N. (1991). Accommodating theory: Communication, context, and consequence. In H. Giles, J. Coupland, & N. Coupland (Eds.), Contexts of accommodation: Developments in applied sociolinguistics (pp. 1-68). Cambridge: Cambridge University Press. Gray, C. C., & Rodrigue, J. R. (2001). Brief report: Perceptions of young adolescents about a hypothetical new peer with caner: An analog study. Journal of Pediatric Psychology, 26, 247-252. Greenberg, L. S., & Elliott, R. (1997). Varieties of empathic responding. In A. C Bohart & L. S. Greenberg (Eds.), Empathy reconsidered, New directions in psychotherapy (pp. 167186). Washington, DC: American Psychological Association. Greif, E. B., & Hogan, R. (1973). The theory and measurement of empathy. Journal of Counseling Psychology, 20, 280-284. Flanagan, J., & Holmes, S. (2000). Social perceptions of cancer and their impacts: Implications for nursing practice arising from the literature. Journal of Advanced Nursing, 32, 740-749. Harwood, J., & Giles, H. (Eds.) (2005). Intergroup communication: Multiple perspectives. New York: Peter Lang. Harwood, J., & Sparks, L. S. (2003). An intergroup communication approach to cancer. Health Communication, 15, 145-160. Hecht, M. J., Jackson, R. L. II, & Pitts, M. J. (2005). Culture: Intersections of intergroup and identity theories. In J. Harwood, & H. Giles (Eds.), Intergroup communication: Multiple perspectives (pp. 117-137). New York: Peter Lang Publishing, Inc. Hogan, R. (1969). Development of an empathy scale. Journal of Consulting and Clinical Psychology, 33, 307-316. Jackson, P. L., Brunet, E., Meltzoff, A. N., & Decety J. (2006). Empathy examined through the neural mechanisms involved in imagining how I feel versus how you feel pain. Neuropsychologia, 44, 752-761. Jones, S. M. (2004). Putting the person into person-centered and immediate emotional support. Communication Research, 31, 338-360. Jones, S. M. (2005). Attachment style differences and similarities in evaluations of affective communication skills and person-centered comforting messages. Western Journal of Communication, 69, 233-249.
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Jones, S. M., & Burleson, B. R. (2003). Effects of helper and recipient sex on the experience and outcomes of comforting messages: An experimental investigation. Sex Roles, 48, 119. Jones, S. M., & Burleson, B. R. (1997). The impact of situational variables on helpers’ perceptions of comforting messages. Communication Research, 24, 530-555. Jones, S. M., & Guerrero, L. K. (2001). The effects of nonverbal immediacy and verbal person-centeredness in the emotional support process. Human Communication Research, 27, 567-596. Jones, S. M., & Wirtz, J. G. (2006). How does the comforting process work?: An empirical test of an appraisal-based model of comforting. Human Communication Research, 32, 217-243. Jones, S. M., & Wirtz, J. G. (2007). “Sad monkey see, monkey do:” Nonverbal matching in emotional support encounters. Communication Studies, 57, 71-86. Kalliopuska, M. (1992). Attitudes towards health, health behavior, and personality factors among school students very high on empathy. Psychological Reports, 70, 1119-1122. Labay, L. E., & Walco, G. A. (2004). Brief report: Empathy and psychological adjustment in siblings of children with cancer. Journal of Pediatric Psychology, 29, 309-314. Linn, M. W., Linn, B. S., & Stein, S. R. (1982). Beliefs about causes of cancer in cancer patients. Social Science and Medicine, 16, 835-839. Litvack-Miller, W., McDougall, D., & Romney, D. M. (1997). The structure of empathy during middle childhood and its relationship to prosocial behavior. Genetic, Social, and General Psychological Monographs, 123, 303-322. Lobchuk, M. M., & Vorauer, J. D. (2003). Family caregiver perspective-taking and accuracy in estimating cancer patient symptom experiences. Social Science and Medicine, 57, 2379-2384. Loewenstein, G. (2005). Hot-cold empathy gaps and medical decision making. Health Psychology, 24, S49-S56. Mahrer, A. R. (1997). Empathy as therapist-client alignment. In A. C Bohart & L. S. Greenberg (Eds.), Empathy reconsidered, New directions in psychotherapy (pp. 187215). Washington, DC: American Psychological Association. Matthews, C. K., & Harrington, N. G. (2000). Invisible disability. In D. O. Braithwaite & T. L. Thompson (Eds.), Handbook of communication and people with disability (pp. 405422). Mahwah, New Jersey: Lawrence Erlbaum. Mehrabian, A., & Epstein, N. (1972). A measure of emotional empathy. Journal of Personality, 40(4), 525-543. Merrigan, G. (2000). Negotiating personal identities among people with and without identified disabilities: The role of identity management. In D. O. Braithwaite & T. L. Thompson (Eds.), Handbook of communication and people with disability (pp. 223-238). Mahwah, New Jersey: Lawrence Erlbaum. Nadler, A. (2003). Post resolution process: An instrumental and socio-emotional routes to reconciliation. In G. Salomon & B. Nevo, (Eds.) Peace education worldwide: The concept, underlying principles, the research. Mahwah, N.J.: Erlbaum. Nadler, A., & Liviatan, I. (2004). Intergroup reconciliation process in Israel: Theoretical analysis and empirical findings. In N. R. Branscombe & Doosje (Eds.), Collective guilt: International perspectives (pp. 216-235). New York: Cambridge University Press.
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Nadler, A., & Liviatan, I. (2006). Intergroup reconciliation: Effects of adversary’s expressions of empathy, responsibility, and recipient’s trust. Personality and Social Psychology Bulletin, 32, 459-470. Nadler, A., & Saguy, T. (2005). Reconciliation between nations: Overcoming emotional deterrents to ending conflicts between groups. In. H. Langholtz & C. E. Stout (Eds.), The psychology of diplomacy (pp. 29-46). New York: Praeger. Pettigrew, T. F., & Tropp, L. (2000). Does intergroup contact reduce prejudice? Recent metaanalytical findings. In S. Oskamp (Ed.), Reducing prejudice and discrimination: Social psychological perspectives (pp. 93-113). Mahwah, NJ: Erlbaum. Pistrang, N., Solomons, W., & Barker, C. (1999). Peer support for women with breast cancer: The role of empathy and self-disclosure. The Journal of Community and Applied Social Psychology, 9, 217-229. Redmond, M. V. (1985). The relationship between perceived communication competence and perceived empathy. Communication Monographs, 52, 377-382. Ritter, E. M. (1979). Social perspective-taking ability, cognitive complexity and listeneradapted communication in early and late adolescence. Communication Monographs, 46, 40-51. Ryan, E. B., Bajorek, S., Beaman, A., & Anas, A. P. (2005). “I just want you to know that ‘them’ is me”: Intergroup perspectives on communication and disability. In J. Harwood & H. Giles (Eds.), Intergroup communication: Multiple perspectives (pp. 117-137). New York: Peter Lang. Shaw, L. L., Batson, D., & Todd, R. M. (1994). Empathy avoidance: Forestalling feeling for another in order to escape the motivational consequences. Journal of Personality and Social Psychology, 67, 879-887. Sherman, M. F., Smith, R. J., & Cooper, R. (1982-83). Reactions towards the dying: The effects of a patient’s illness and respondents’ beliefs in a just world. OMEGA, 13, 173189. Silvern, L. E., Waterman, J. L., Sobesky, W., & Ryan, V. L. (1979). Effects of a developmental model of perspective taking training. Child Development, 50, 243-246. Smith, A. (2006). Cognitive empathy and emotional empathy in human behavior and evolution. The Psychological Record, 56, 3-21. Smither, S. (1977). A reconsideration of the developmental study of empathy. Human Development, 20, 235-276. Sparks, L., & Harwood, J. (2008). Cancer, aging, and social identity: Development of an integrated model of social identity theory and health communication. In L. Sparks, H. D. O'Hair, & G. L. Kreps, (Eds.), Cancer communication and aging. (pp. 77-95). Cresskill, NJ: Hampton Press. Stiff, J. B, Dillard, J. P., Somera, L., Kim, H., & Sleight, A. C., (1988). Empathy, communication, and prosocial behavior. Communicaiton Monographs, 55, 198-213. Tamborini, R., Salomonson, K., & Bahk, C. (1993). The relationship of empathy of comforting behavior following film exposure. Communication Research, 20, 723-738. Tamborini, R., Stiff, J., & Heidel, C. (1990). Reacting to graphic horror: A model of empathy and emotional behavior. Communication Research, 17, 616-640. Thompson, T. L. (1997). Interpersonal communication and health care. In M. L. Knapp & G. R. Miller (Eds.), Handbook of interpersonal communication (2nd ed., pp. 696-725). Thousand Oaks, CA: Sage.
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Thompson, T. L. (1981). The development of communication skills in physically handicapped children. Human Communication Research, 7, 312-324. Vanaerschot, G. (1997). Empathic resonance as a source of experience-enhancing interventions. In A. C Bohart & L. S. Greenberg (Eds.), Empathy reconsidered, New directions in psychotherapy (pp. 141-166). Washington, DC: American Psychological Association. Warner, M. S. (1997). Does empathy cure? A theoretical consideration of empathy, processing, and personal narrative. In A. C Bohart & L. S. Greenberg (Eds.), Empathy reconsidered, New directions in psychotherapy (pp. 125-140). Washington, DC: American Psychological Association. Wiemann, J. M., (1977). Explication and test of a model of communicative competence. Health Communication Research, 3, 195-213. Wikipedia [online]. 2006 [8/25/06]. Empathy (keyword). Available from: URL: http://en.wikipedia.org/wiki/Empathy. Williams, A., Giles, H., Coupland, N., Dalby, M., & Manasse, H., (1990). The communicative contexts of elderly social support and health: A theoretical model. Health Communication, 2, 123-143. Wilson, B. J., & Cantor, J. (1985). Developmental differences in empathy with a television protagonist’s fear. Journal of Experimental Child Psychology, 39, 284- 299. Wright, S. C., Broday, S. M., & Aron, A. (2005). Intergroup contact: Still our best hope for improving intergroup relations. In C. S. Crandall & M. Schaller (Eds.), Social psychology of prejudice: Historical and contemporary issues (pp. 143- 164). Seattle, WA: Lewinian Press. Zillmann, D. & Cantor, J. R. (1977). Affective responses to the emotions of a protagonist. Journal of experimental social psychology, 13, 155-165.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 2
INTERPERSONAL REPRESENTATIONS: THEIR STRUCTURE, CONTENT, AND NATURE Shanhong Luo* Department of Psychology, University of North Carolina at Wilmington, North Carolina, USA
ABSTRACT How people represent their interpersonal relationships based on past experiences has great impact on their subsequent interactions with others. This chapter reviews previous theories and presents new propositions regarding three important aspects of interpersonal representations (IRs)—their structure, content, and nature. Specifically, the structure of IRs can be viewed as a three-level hierarchical organization, with general representations at the highest level, domain-specific representations at the midlevel, and relationshipspecific representations at the lowest level. The content of IRs can be divided into three distinct yet interrelated components: self representations, other representations, and relationship representations. With regard to the nature, IRs can be conceptualized as consisting of accurate perceptions, systematic biases, and random errors.
Keywords: Interpersonal representations, working models, relational schema, general representations, domain-specific representations, relationship-specific representations, self representations, other representations, relationship representations, accuracy, bias
One of the most important ideas in the area of close relationships is that individuals’ past relationship experiences exert powerful influences on their subsequent interactions with others. It has been theorized that the mechanism by which past experiences influence current behaviors is through internal representations. That is, people internalize repeated experiences and develop mental representations that capture regularities in patterns of the self in relation *
Correspondence should be sent to Shanhong Luo, Department of Psychology, Social Behavioral Science Building, University of North Carolina at Wilmington, Wilmington, NC, 28403. Email:
[email protected].
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to others; these interpersonal representations guide how people process, interpret, and respond to incoming information (see Bowlby, 1973, 1980; Baldwin, 1992; Safran, 1990a, 1990b). Given the central role these representations play in interpersonal behaviors, it is of particular importance to understand three key aspects of interpersonal representations (IRs)—their structure, content, and nature. Over the past two decades, researchers have made great strides in understanding the structure and content of IRs. However, little attention has been given to the nature of IRs until recently. This chapter has two primary goals. The first goal is to provide an integration of theoretical propositions and a review of empirical evidence regarding the structure and the content of IRs. The second goal is to introduce a conceptualization to help understand the nature of IRs. More specifically, I discuss the following three propositions: First, with regard to structure, IRs are hypothesized to be organized in a hierarchical fashion, including general representations at the highest level, domain-specific representations at the midlevel, and relationship-specific representations at the lowest level. Second, with regard to content, IRs can be thought of as having three distinct yet interrelated components: representations of the self, others, and the relationship between the two. Finally, with regard to the nature of IRs, it is suggested that IRs can be conceptualized as consisting of accurate perceptions, systematic biases, and random errors. In discussions of these propositions, I draw heavily on attachment literature, particularly theory and research regarding internal working models, because working models of attachment are central elements of IRs. However, I also review theories and empirical work in other fields that are not necessarily within the attachment framework, such as relational schema theory and person perception research. The term “interpersonal representations” is selected because of its broad applicability and inclusiveness.
THE STRUCTURE OF INTERPERSONAL REPRESENTATIONS General and Specific Representations Typically individuals are involved in more than one relationship. For example, most people have relationships with parents, romantic partners, friends, colleagues, and etc. Consequently, it is likely that individuals do not hold a single set of representations but have a family of representations. Early attachment theorists have suggested that internal working models should include both overarching, general representations and more contextualized representations that correspond to specific relationships (Bowlby, 1973, 1980; Bretherton, 1985; Main, Kaplan, & Cassidy, 1985). This idea of multiple representations has been widely accepted by relationship researchers (e.g., Baldwin, 1992; Collins & Read, 1994; Pietromonaco & Feldman Barrett, 2000; Shaver, Collins, & Clark, 1996). The hypothesis of multiple representations has received little empirical examination until recently. Several studies have been designed to explicitly test this hypothesis (e.g., Baldwin, Keelan, Fehr, Enns, & Koh-Rangarajoo, 1996; Cozzarelli, Hoekstra, & Bylsma, 2000; Klohnen, Weller, Luo, & 2005; Pierce & Lydon, 2001; Ross & Spinner, 2001). These studies show that individuals indeed hold both general representations as well as specific representations that correspond to different types of relationships. Moreover, specific
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representations tend to be positively associated with each other, suggesting that individuals tend to hold similar models across different relationships. However, the size of these correlations ranged only from small to moderate (Furman et al., 2002; Pierce & Lydon, 2001; Ross & Spinner, 2001; Klohnen et al., 2005), indicating that representations that correspond to various relationships are not identical. General representations are also positively associated with specific representations; once again these associations tend to have modest magnitude, suggesting that general representations are not simply a composite of specific representations (Pierce & Lydon, 2001; Cozzarelli et al., 2000; Klohnen et al., 2005). Overall, these findings show that individuals have distinct, yet interrelated representations for different relationships, and that these specific representations are also linked to general representations.
A Hierarchical Model of Interpersonal Representations To date, research designed to test the structure of representations has typically assessed IRs on two levels—general and specific representations. However, it is important to differentiate between two types of specific representations that differ in their level of abstractness. Specifically, adults are not only involved in many different types of relationships (e.g., parental, friendships, romantic relationships), but within each type of relationship they also typically interact with many different individuals. Therefore it is very likely that in addition to holding the more general representations corresponding to each type of relationship, individuals also hold distinct, concrete representations for each person whom they are interacting with. Consistent with these ideas, Collins and colleagues suggested that the structure of IRs can be conceptualized as a three-level hierarchical organization (Collins & Read, 1994; Collins, Guichard, Ford, & Feeney, 2004). Figure 1 provides a hypothetical example of this hierarchy. General representations, the most abstract representations, are at the top of the hierarchy. At the midlevel are domain-specific representations—representations corresponding to different types of relationships, such as relationships with parents, romantic partners, and friends. Relationship-specific representations are at the lowest level of the hierarchy. These are the most concrete representations corresponding to specific individuals, such as mother and father, previous and current romantic partners, and different friends. Due to space limitation, Figure 1 only provides two examples of specific individuals under each type of relationship. However, it is very likely that several different persons are nested within each type of relationship in real life. Overall, Fletcher, & Friesen (2003) has tested the validity of this hierarchical conceptualization of interpersonal representations. The researchers took a confirmatory factor analysis (CFA) approach to examine the hierarchical structure of attachment working models. They assessed working models at both domain-specific level (i.e., how people view themselves and others in different types of relationships including familial, friendship, and romantic relationships) and relationship-specific level (i.e., how people view themselves and specific others in each relationship, for example, relationship with one’s mother and father, specific friends, and current romantic partner). CFA results from both sets of data showed that the manifest indicators at the relationship-specific level could be modeled as forming domainbased latent variables, which in turn formed one overarching, second-order latent factor. This higher-order factor can be thought of as representing individuals’ most general attachment
Figure 1. A hypothetical example of the hierarchical model of interpersonal representations. Note. Ptn1 = partner 1. Ptn 2 = partner 2. Frd 1 = friend 1. Frd 2 = friend 2.
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representations. These findings suggest that manifest indicators of relationship-specific representations measured for different relationships can be successfully modeled as forming a hierarchical structure similar to the model in Figure 1. A limitation of this research was that it treated domain-specific and general representations as latent factors which in theory cannot be directly assessed. However, the studies reviewed earlier have shown that individuals do have access to these more generalized representations (e.g., Baldwin et al., 1996; Klohnen et al., 2005). It thus will be important for future research to examine the proposed three-level hierarchical model more directly by assessing all three levels of the hierarchy (rather than treating the more general levels as latent factors) and modeling all of the levels simultaneously.
Implications of a Hierarchical Organization of Interpersonal Representations Differential Predictive Power of General and Specific Representations General and specific representations are likely to have differential power when it comes to prediction of intra- and interpersonal functioning. For example, representations at the higher levels of the hierarchy should be stronger predictors of broader constructs such as general well-being and psychological adjustment, whereas representations at the lower levels should be better predictors of narrower outcomes such as quality of specific relationships. Several studies provide evidence that general and specific representations are differentially associated with different outcomes (Cozarelli et al., 2000; Crowell, Fraley, & Shaver, 1999; Klohnen et al., 2005; Pierce & Lydon, 2001). For example, Klohnen et al. (2005) found that general attachment models were the strongest and most reliable predictors of personal wellbeing variables such as emotional stability, self-esteem, and ego-resiliency, whereas domainspecific models best predicted relationship outcomes (e.g., satisfaction, conflict, closeness) within different types of relationships. Although these studies did not investigate the predictive validity of relationship-specific representations, it is expected that relationshipspecific representations should be the best predictor of quality of relationships with specific individuals. Which Lower-level Representations are Most Important to Higher-level Ones? Given that individuals hold multiple sets of specific representations, it is important to test which specific representations make the most contributions to the more abstract representations. It is likely that representations of the most important relationships (such as relationships with significant others) at a lower level will have the strongest influence on representations at the next higher-level of abstraction. In Figure 1, this proposition is illustrated by showing the links between the most influential representations and next higherlevel representations in bold. Klohnen et al. (2005) provide some support for this proposition. In a sample of college students, they found that romantic partner and friend models made the strongest and independent contributions to the prediction of general models than models of mother and father. This pattern of results is consistent with the proposal that most young adults have shifted their focus from parents to peers as their primary source of fulfillment of their attachment needs (see Fraley & Davis, 1997; Trinke & Bartholomew, 1997).
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A related proposition is that the relative importance of lower-level representations to higher-level representations may change over time. Children may base their general representations primarily on their relationship experiences with their major caregivers, usually their parents. As individuals reach adulthood, peers, particularly romantic partners, play an increasingly important role in individuals’ lives. Klohnen et al. (2005) found that the longer individuals had been involved in their romantic relationships, the more strongly their romantic attachment models were predictive of their general attachment models. As individuals take on new roles and responsibilities (e.g., moving away from parents, getting married, starting a career, having children, taking care of aging parents), the relative importance of representations of each relationship type as well as of each person may change drastically. Thus, it is extremely important that researchers who pursue these types of questions to take a developmental perspective and examine how lower-level representations contribute to higher-level representations at different life stages.
What Is Adaptive, More Consistent or More Variable Representations? Given that individuals hold fairly distinct representations under different relationship contexts (e.g., La Guardia et al., 2000), it is important to examine whether some people show greater variation in their representations across relationships than others. If individual differences in variability do exist, what implications does this have for psychological wellbeing and relationship functioning? Klohnen and Weller (2006) assessed working models that participants held for the self in relation to romantic partners, friends, their father, and their mother. They indexed working model variability by computing the standard deviation of the ratings across the four relationships for each participant; that is, each participant obtained a variability index that indicated how much his or her self-representations varied across the four relationships. They indeed found substantial individual differences in the variability of working models. Moreover, differences in variability were systematically associated with attachment security. Specifically, more insecure individuals tended to hold more variable working models than more securely attached individuals. Individuals who held more variable working models were also lower in self-esteem, less emotionally stable and ego-resilient, and had lower self-concept clarity. With regard to relationship outcomes, variability was associated with less adaptive relationship functioning, including lower satisfaction, less involvement, and more conflict. Most importantly, this pattern of results held when attachment insecurity was controlled, suggesting that variability had negative consequences for intra- and interpersonal functioning above and beyond effects due to attachment insecurity. These findings are quite consistent with self-concept differentiation theory, which suggests that variability of internal self representations across roles may indicate a maladaptive fragmentation of the self (Donahue, Robins, Roberts, & John, 1993). The findings go against attachment researchers’ idea that having a singular, rigid representation of self in different relationships is likely to be maladaptive given that different relationship partners will, in fact, behave differently and therefore should be interacted with differently (e.g., Linville, 1987; Pierce & Lydon, 2001). However, given the lack of research on variability of representations across relationships, it is important to test the robustness of these findings and to examine the causal direction of these effects as well as the underlying processes.
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Accuracy of Representations Varying in Specificity Specificity of representations is likely to play a role in the extent to which these representations are accurate and biased. Neff and Karney (2002, 2005) reasoned that for more specific representations, it should be relatively easy to find objective standards to evaluate the accuracy of these representations and thus more difficult to hold biased perceptions that have little basis in reality. As representations become more general and abstract, fewer objective standards exist, making it more necessary and more likely to develop biases. It is predicted that more general representations are likely to be more biased and less accurate, whereas the opposite should be true for more specific representations. It is important to note that this proposed pattern should also hold for representations that are within the same level of the hierarchy but differ in their extent of abstractness. For example, perceiving a partner as “loving” is more global than perceiving him or her as “taking care of me when I’m sick.” Global partner perceptions are likely to be less accurate than perceptions of the partner’s specific attributes (Neff & Karney, 2005).
THE CONTENT OF INTERPERSONAL REPRESENTATIONS Because IRs develop on the basis of repeated interactions primarily within dyadic relationships, the content of these representations should involve representations of the self, of others, and of the relationship between the self and others.1 As Figure 1 shows, representations at every level of the hierarchy are hypothesized to have all of these three components. Specifically, at the lowest, relationship-specific level, people hold representations of themselves and each specific interaction partner, and representations of the relationship between themselves and the partner. At the domain-specific level, they hold a more generalized representations of the self and others involved in each type of relationship, and representations of every type of relationship. At the highest level, individuals hold the most general representations of the self, others, and relationships. Thus, IRs are not only vertically connected within the hierarchy (i.e., across different levels), but also horizontally connected (i.e., across representations of the self, others, and relationships).
Representations of the Self and Others Relationship researchers have long-standing interests in mental representations of the self and others. Attachment theory, one of the classical theories in relationship literature, suggests 1
Different authors have conceptualized content of interpersonal representations from slightly different perspectives. Some researchers think of content components in terms of the target of representation (Pietromonaco & Feldman Barrett, 2000); that is, the content of IRs includes how people represent about the self (e.g., am I lovable?) and about others (e.g., are others trustworthy?). Other researchers conceptualize the content of representations from a more cognitive perspective (Collins & Read, 1994; Collins et al., 2004); that is, the content of IRs is likely to include several different types of cognitions such as memories, beliefs and expectations, goals and needs, plans and action tendencies. Each of these two conceptualizations has their own merits and is not mutually exclusive. I chose to take the “target” approach because the focus of the entire article is on schema-like representations that are abstracted from past experiences and are consciously accessible. It seems most appropriate to think of the content of these representations as including self representations, other representations, and relationship representations.
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that individuals develop internal working models of self and other on the basis of repeated interactions with primary attachment figures. Whereas models of self capture the generalized beliefs about how acceptable and worthwhile the self is, models of others capture the generalized beliefs about how available and responsive others are (e.g., Bowlby, 1973; Bartholomew & Horowitz, 1991; Hazan & Shaver, 1987; Pietromonaco & Feldman Barrett, 2000). Models of self and others can be viewed as representations of self and others at the general level. According to relational schema theory (Baldwin, 1992), self schemas and other schemas are two of the three key elements of relational schemas. Baldwin (1992) defined self schemas and other schemas as “generalizations about the self and others in specific relational contexts that are used to guide the processing of social information.” (pp. 468) Self and other schemas thus are highly contextualized constructs and quite similar to relationship-specific representations of the self and others in the three-level hierarchical model. The current conceptualization of IRs is able to integrate the essence of both working models of attachment and relational schemas and expand it into a broader framework. In particular, I propose that the content of self representations should not limit to the worthiness of the self; similarly, the content of other representations should not restrict to the availability and responsiveness of others. Both self and other representations should contain multiple dimensions including the more intrapersonal (e.g., competent, worrying) and the more interpersonal dimensions (e.g., sociable, distant). I will illustrate this point further below.
Are Self Representations and Other Representations Independent or Interdependent? Because IRs develop on the basis of repeated interactions between the self and others, self representations and other representations are likely to be related to each other. According to Bowlby’s (1973) original attachment theory, children’s models of self and models of others are hypothesized to be mutually confirming. For example, a child with a consistently rejecting mother may come to think of the self as worthless and of others as undependable. This interdependence between self and other representations should also hold for adults. For example, a person with loving and responsive romantic partner may perceive the self as lovable and of the partner as trustworthy. More recently several authors have argued that individuals who are involved in close relationships are motivated to represent the self and close others in a collective rather than in an individualistic manner (e.g., Agnew, Van Lange, Rusbult, & Langston, 1998; Aron, Aron, Tudor, & Nelson, 1991; Cross, Morris, & Gore, 2002). Empirical research provides strong evidence for this hypothesis. For example, individuals tend to perceive their romantic partners and their close friends as being similar to themselves even though there is little actual similarity between them (Kenny & Acitelli, 2001; Klohnen & Luo, 2006; Watson, Hubbard, & Wiese, 2000b; Murray, Holmes, Bellavia, Griffin, & Dolderman, 2002; Cross et al., 2002); they also tend to show greater spontaneous usage of plural pronouns (e.g., we, us, ours, Agnew et al., 1998) and have more difficulty differentiating between characteristics of the self and of close others (Aron et al., 1991); finally, individuals view partners’ successes as shared glories rather than threats to self-esteem as the classical social comparison theory would expect (Gardner, Gabriel, & Hochschild, 2002; Beach et al., 1998). These findings suggest that representations of the self and of others are highly interdependent rather than independent.
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However, attachment studies tend to show that self models and other models are largely independent of each other (e.g., Cozzarelli et al., 2000; Griffin & Bartholomew, 1994; Pierce & Lydon, 2001). How do we reconcile this seeming inconsistency? I argue that the independence between self models and other models based on attachment research should not be interpreted as evidence for the relation between representations of self and others, because (1) these studies actually only measured self representations and did not explicitly measure individuals’ representations of others (i.e., they did not ask participants to rate how they view others); (2) essentially these studies assessed two dimensions of self representations—a more intrapersonal dimension (which was named “self model”) captures a sense of competence and confidence, whereas the other dimension is more interpersonal in nature (which was named “other model”) and captures how individuals perceive themselves in relation to others (e.g., do individuals perceive themselves as trusting and loving, or cold and distant?) (e.g., Griffin & Bartholomew, 1994). The interpersonal dimension (i.e., other model) is expected to be relatively independent from the intrapersonal dimension (i.e., self model) because they capture quite different domains of self representations. In other words, the finding that self and other models tend to be independent only reflects the association between the two dimensions—the intrapersonal dimension and the interpersonal dimension, rather than the true association between self- and other representations. In order to test whether self- and other representations are truly interdependent, particularly whether this interdependence holds at more general levels as most evidence for the interdependence has been obtained from studies of relationship-specific representations, future research will need to independently assess these two representations and systematically test their associations.
Individual Differences in Self and Other Representations Important individual differences seem to underlie representations of the self and others. Attachment researchers have theorized that individuals with different attachment styles are likely to hold systematically different models of self and other: Whereas primarily secure individuals have positive beliefs about the self and others, fearful individuals are typically characterized by low self-worth and negative expectations about others. Dismissing individuals tend to hold negative models of others and highly positive models of the self, whereas preoccupied individuals show the opposite pattern—they have negative beliefs about the self and positive models of others (see Bartholomew & Horowitz, 1991; Griffin & Bartholomew, 1994). Pietromonaco and Feldman Barrett (2000) provided a comprehensive review regarding the evidence for these hypothesized patterns associated with different attachment styles. They concluded that whereas there is robust evidence for the theoretically predicted patterns of models of self, evidence is less consistent for models of others. Part of the inconsistency observed for other models is likely to be due to the fact that some studies examined self and other representations in general terms (e.g., Collins & Read, 1990; Hazan & Shaver, 1987), whereas others tested them in specific relationships (e.g., Pietromonaco & Feldman Barrett, 1997). Since every specific interaction partner is different from each other, accordingly, one’s representations of others should show reasonable variability. In general, most previous studies have only examined individual differences on either general representations or a specific type of representations and thus failed to take into consideration the fact that individuals hold multiple representations at different levels. Thus, it will be important for future research to clarify (1) for each level in the hierarchy of IRs, how different individuals represent the self
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and others and (2) to what extent these individual differences in self representations and other representations hold across different levels of abstractness.
Importance of Self and Other Representations to Relationship Functioning Self- and other representations have strong associations with relationship satisfaction. Previous research has shown that individuals who perceive themselves as low in self-esteem, highly neurotic, or insecurely attached tend to be less satisfied with their relationship; their relationships also tend to be less stable (e.g., Karney & Bradbury, 1995; Murray, Holmes, & Griffin, 2000; Campbell, Simpson, Boldry, & Kashy, 2005; Watson, Hubbard, & Wiese, 2000a). Individuals tend to be happier in their relationships if they perceive their partner as more extraverted, agreeable, conscientious, and less neurotic, and if they view their partner as less avoidant and anxious (e.g., Kosek, 1996; Watson et al., 2000a; Watson et al., 2004). Watson et al. (2000a, 2004) used both individuals’ self-ratings and partner-ratings on a range of individual difference domains (e.g., Big Five, affectivity) to predict relationship satisfaction in dating and married samples. Their findings showed that in spite of their interdependence, self and other ratings made independent, substantial contributions to the prediction of relationship satisfaction. However, partner ratings tended to contribute more than self ratings did, suggesting that self and partner representations may play different roles in relationship maintenance and that partner representations may be the more proximal predictors of relationship satisfaction than self representations.
Relationship Representations In their interactions with others, individuals form representations of many aspects of their interpersonal experiences. Self- and other representations are two subsets of these representations. In addition to holding representations of the self and others, individuals may also develop representations of the relationship between themselves and others. Relationship representations can be conceptualized as organized knowledge, perceptions, and evaluations of the relationship between the self and others. The content of relationship representations may include perceptions of various aspects of the relationship such as relationship closeness, mutual trust, control in relationship, optimism about future of relationship, severity of relationship conflict, and quality of communication. To date, there has been sporadic discussion about relationship representations in the relationship literature. For example, attachment theorists propose that internal working models have two primary components—models of the self and models of others. Although some authors have suggested that working models may also include models of the relationship between the self and others (e.g., Pietromonaco & Feldman Barrett, 2000), there is no systematic conceptualization of relationship representations as a unique component of working models. Other theorists tend to focus on representations of specific interactions or events between the self and others rather than on representations of the relationship between the two (Baldwin, 1992; Stern, 1985; Mitchell, 1988; Safran, 1990a, 1990b). For instance, in addition to proposing that self schemas and other schemas are important components of relational schema, Baldwin (1992) defined a third component, interpersonal scripts, as schemas for the typical “if-then” interaction sequences between self and other in a particular situation. Example interpersonal scripts are “if I come home late, my girlfriend will suspect
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that I am with some other girl and will complain for hours.” Because interpersonal scripts are schemas of “if-then” interaction sequences between the self and specific others, whereas relationship representations are expected to consist of generalized expectations regarding the relationship between the self and others, interpersonal scripts can be thought of as forming the basis of relationship representations. It is very important for researchers to start to consider relationship representations as a unique component of IRs and as an equally important component as self- and other representations. Although relationship representations are likely to be closely associated with representations of self and others, they may contain unique perceptions of the relationship and reflect the interactive nature of the relationship that is not likely to be fully captured by self and other representations. Thus including relationship representations in the study of IRs should greatly improve our understanding of IRs. Empirical research regarding relationship representations is scarce. However, some initial findings shed important light on the link between relationship representations and self representations. Helgeson (1994) found that positive self-beliefs and positive relationship beliefs showed differential predictive power to general psychological wellbeing (i.e., anxiety, depression, hostility) and relationship outcomes (i.e., breakup or not, adjustment to physical separation, adjustment to breakup). More specifically, positive self-beliefs were associated with better wellbeing but not with relationship outcomes, whereas relationship beliefs predicted all three relationship outcomes. Fowers, Lydons, and Montel (1996) tested whether positive illusions about marriage are primarily outgrowths of the self-enhancing illusions or an integral part of a satisfaction maintenance mechanism. Their results supported that positive illusions about marriage are more closely associated with marriage quality than with selfenhancement tendencies. Finally, Endo, Heine and Lehman (2000) found that relationshipserving biases were largely unrelated to self-esteem and self-serving biases. Overall, it seems that relationship representations are quite distinct from self representations and may serve very different functions. As Van Lange and Rusbult (1995) pointed out, “compared to selfenhancement processes, relationship enhancement may be more complex… and may be multifaceted.” However, these pioneering studies have focused on one particular aspect of relationship representations—enhancement perceptions and have only examined the links between relationship representations and self representations. It thus will be important to test (1) how relationship representations and other representations are associated and (2) whether these two components independently predict relationship outcomes.
THE NATURE OF INTERPERSONAL REPRESENTATIONS To date, theorizing about the nature of IRs has been limited to the notion that IRs are internalized, general beliefs about the self in relation to others that develop from past interpersonal experiences. For example, attachment theorists have suggested that working models include general beliefs about self and others (e.g., Bowlby, 1973; Collins & Read, 1994). According to Baldwin’s (1992) conceptualization, relational schemas primarily consist of generalizations about self and other as well as expectations of behavior sequences involved in their interactions. However, what is exactly the nature of these “general beliefs” about self, others, and the relationship? These theories did not provide further hypotheses. One important
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purpose of this chapter is to provide a useful conceptualization of the nature of IRs. Although IRs are likely to include other components such as past memories and future goals (see Collins & Read, 1994; Collins et al., 2004), the focus here is on the nature of “working” representations that are expected to have the most direct and powerful influence on individuals’ current thoughts, feelings, and behaviors. In particular, I focus on consciously accessible representations that can be assessed by self-report methods. One way to conceptualize the nature of IRs is to think from the perspective of accuracy and inaccuracy of these representations. Individuals are able to obtain reasonable accuracy when they are motivated to be accurate and have sufficient cognitive resources to do so (see Gagne & Lydon, 2004). At the same time, representations may be systematically biased in one way or another due to cognitive (e.g., Watson et al., 2000b) and motivational factors (e.g., Klohnen & Luo, 2006; Murray, Holmes, & Griffin, 1996a; Murray et al., 2002). Finally, random perceptual errors occur due to temporary, situational factors (see Funder, 1995; Murray et al., 1996a). Therefore, the nature of IRs should necessarily reflect reality to some degree and should also contain misperceptions. Some misperceptions are systematic biases and some are purely erroneous perceptions (see Figure 2). Accordingly, it is useful to conceptualize IRs as a composite of accurate perceptions, systematic biases, and random errors (see Klohnen & Luo, 2006; Murray et al., 1996a). This three-component conceptualization can be readily incorporated in the proposed hierarchical model of IRs. We can think of the three components as being nested within self, other, and relationship representations at each level of the hierarchy. That is, general, domain-specific, and relationship-specific representations of self, others, and relationships, should all contain accurate perceptions, systematic biases, and random errors.
Interpersonal Representations
=
Accurate Perceptions
+
Inaccurate Perceptions
Systematic Biases
Random Errors
Figure 2. A conceptualization of the nature of interpersonal representations.
In the following sections of the article, my focus is on the systematic components of representations—accurate and biased perceptions since these two components are expected to have systematic and most meaningful influences on personal and relational outcomes. I first discuss the methodological approaches to studying accuracy and bias, followed by a review of research regarding accuracy and bias in representations of the self, the partner and the relationship in the romantic context. I choose to focus on accuracy and bias in romantic representations because romantic relationship is usually the most influential relationship in adulthood and thus romantic representations should have the greatest impact on individuals’ intra- and interpersonal functioning.
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Approaches to Conceptualizing and Measuring Accuracy and Bias There are two major approaches to conceptualizing and assessing accuracy and bias: the logical impossibility approach and the accuracy benchmark approach (see Funder, 1995; Taylor & Brown, 1988).
The Logical Impossibility Approach This approach has been widely used to examine social comparison processes. In a typical paradigm of this approach, participants are asked to rate themselves relative to average others. Results show the majority rate desirable attributes as more descriptive of themselves than of average others (the “above-average effect”) and undesirable attributes as less descriptive of themselves than of the average others (the “below-average effect”) (e.g., Brown, 1986; Kruger, 1999). Because most attributes have a statistically normal distribution, it is logically impossible for the majority to be truly better than the average; that is, some people must be exaggerating. This self-serving tendency is considered to be a bias. The “better than average effect” is seen not only in self perceptions, but also in perceptions of one’s close others, including romantic partners (e.g., Murray & Holmes, 1997), friends (e.g., Brown, 1986; Suls, Lemos, & Stuart, 2002), and family members (e.g., Endo et al., 2000). Although this approach clearly shows that some people in the population must be biased, it does not allow us to pinpoint who are biased and to what extent these individuals are biased. The Accuracy Benchmark Approach Researchers who take this approach first need to define an accuracy benchmark, which then allows them to show to what extent individuals’ perceptions deviate from that benchmark. Any systematic differences between individuals’ perceptions and the accuracy benchmark are then considered a bias. This approach is popular among psychologists who are interested in self perceptions and other perceptions. The basic assumption behind this approach is that individuals’ perceptions contain both accurate perceptions and biases, and it is possible to separate accurate perceptions and biases as long as there is an accuracy benchmark. However, unlike object perception, for which we are able to find some objective criteria to judge whether the perceptions are accurate or not, there is no perfect “objective truth” or accuracy benchmark in person perception. In fact, various accuracy benchmarks have been used and justified depending on the particular research purposes (e.g., Funder, 1995). In the study of intimates’ perceptions, one possible accuracy benchmark is ratings provided by an outside observer of the couple, for example, a common friend to both partners. Self-friend agreement on ratings of the same attributes is then considered as an index of accuracy. If intimates’ ratings significantly and systematically deviate from the ratings made by outsiders, the deviations are considered as indicators of perceptual bias (e.g., John & Robins, 1994; Murray, Holmes, Dolderman, & Griffin, 2000). Self-ratings provided by the partners can be another accuracy benchmark for individuals’ perceptions of their partners. Deviations in participants’ partner perceptions from the partners’ self-perceptions are then be considered as evidence of bias (e.g., Murray et al., 1996a, 1996b; Kenny & Acitelli, 2001; Klohnen & Luo, 2006; Watson et al., 2000b; see Gagne & Lydon, 2004 for a more detailed review).
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Accuracy and Bias in Self Representations Overall, people seem to hold fairly accurate self representations because (1) there is substantial agreement between participants’ self ratings and their partner’s ratings of them (e.g., Klohnen & Luo, 2006; Watson et al., 2000b; Murray et al., 1996a), (2) the agreement between participants’ self-ratings and friends’ ratings of them is reasonable (e.g., John & Robins, 1994; Murray et al., 2000), and (3) self-evaluations of performance show considerable convergence with evaluations from unacquainted peers and observers (John & Robins, 1994). Despite this accuracy, there is also robust evidence that individuals’ self representations are biased. Taylor and Brown (1988) published an influential review of the enhancement bias in self-concepts. They suggest that self-enhancement biases are a rule rather than an exception and that these biases can be observed in three domains: (a) overly positive views of the self, (b) exaggerated perceptions of personal control, (c) unrealistic optimism about one’s future. How do romantic relationships influence individuals’ self representations? Important changes in self views seem to take place when people start to have romantic feelings for somebody. Aron, Paris and Aron (1995) followed their participants five times over 10 weeks and found that those who had just fallen in love during this period showed significant selfconcept changes: participants discovered new aspects of self, and their self-efficacy and selfesteem increased. These findings indicate that falling in love has a powerful, positive influence modifying self representations. However, because the researchers only obtained self-report measures of the representations, it is not clear to what extent the changes in selfconcepts reported by those who fell in love would be evident to outside observers; that is, we are not sure how accurate these changes are. We also do not know whether these changes in self representations are permanent. For example, would individuals lose the changes in selfconcepts when they do not have feelings for the person any more? Would they show negative changes in self representations when they experience relationship break-ups? Longitudinal studies following individuals throughout their relationships are needed to answer these questions. Research on dating and married couples suggests that people in relationships may rely on their partners’ feedback to construct their self views. Murray et al. (1996b) followed dating individuals over a year and found that partners’ initial perceptions of participants were a significant predictor of participants’ self-perceptions one year later when participants’ initial self perceptions were controlled. This finding suggests that intimates tend to incorporate partners’ perceptions into their self views. Drigotas and his colleagues (Drigotas, 2002; Drigotas, Rusbult, Wieselquist, & Whitton, 1999) found that the more individuals believed that their partner perceive them in line with what they ideally would like to become, the more individuals indeed became so over time. It seems that partners’ perceptual confirmation of individuals’ ideal self motivates them to move further toward their ideal self, thus bringing their actual self representations closer to their ideal self over time. In summary, romantic partners’ feedback plays an important role in shaping individuals’ self representations.
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Accuracy and Bias in Romantic Partner Representations Partner representations have been extensively studied in the past decade. Overall, research suggests that there is substantial accuracy in individuals’ partner representations. For instance, individuals’ ratings of their partners show moderate agreement with partners’ selfratings (Kenny & Acitelli, 2001; Klohnen & Luo, 2006; Klohnen & Mendelsohn, 1998; Watson, et al., 2000b; Murray et al., 1996a, 1996b). Individuals also share considerable agreement with their friends regarding perceptions of their partners (Murray et al., 2000). Finally, married and dating couples are relatively accurate in inferring each other’s ongoing thoughts and feelings (Thomas, Fletcher, & Lange, 1997; Thomas & Fletcher, 2003). On the other hand, as the old saying “beauty is in the eyes of the beholder” illustrates, partners’ perceptions of each other are nevertheless biased even though they are able to perceive their partners fairly accurately. In order to test how people form perceptions of their partners, researchers have examined possible ways by which individuals’ perceptions of their partners systematically deviate from the partners’ self-perceptions. Perceiving Actual Partner as Being Similar to One’s Ideal Partner Everybody has his or her own ideas about what their ideal partner is like. However, in real life very few people end up with a partner who fits their ideal images perfectly. Rather than being constrained by the less-than-perfect reality of what partners are actually like, individuals may be motivated to view their partners in an idealized fashion. For example, research has consistently shown that individuals perceive their partner as being similar to their ideal partner standards to a degree that goes beyond the actual resemblance between their partner’s self-ratings and their ideal partner images (Murray et al., 1996a, 1996b). More importantly, individuals tend to be happier and stay longer in their relationships when they perceive partners close to their own ideal partner images (Fletcher, Simpson, & Thomas, 2000; Fletcher, Simpson, Thomas, & Giles, 1999). Therefore, distorting partner perceptions in the direction of one’s ideal partner images may have beneficial rather than detrimental effects. Perceiving the Partner as Being Similar to One’s Ideal Self The motivation that underlies this process is similar to the previous one. Individuals seek in partners what they value in themselves and what they ideally want to be but are not able to achieve; in short, individuals are motivated to fulfill their own “ideal self” in their partners (Klohnen & Mendelsohn, 1998; Klohnen & Luo, 2003). However, because people do not always secure a partner who resembles their ideal self, they might bias their partner perceptions toward their ideal self. There is empirical evidence for this hypothesized perceptual pattern. At the initial attraction stage, the more similar the potential partner is perceived to be to one’s ideal self, the more attractive the partner appears to be (Klohnen & Luo, 2003; LaPrelle, Hoyle, Insko, & Bernthal, 1990). Dating and married individuals tend to perceive their partners as being more similar to their ideal selves than they actually are (Murstein, 1971; Klohnen & Mendelsohn, 1998). It seems that people wish to be with somebody who has the potential to fulfill their ideal self and are motivated to perceive their current partners in line with their ideal selves.
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Perceiving the Partner in An Overly Positive Way Individuals may also be motivated to simply perceive their partner in a generally positive light or in a socially desirable way—not necessarily in line with their ideal self or ideal partner images. There are good reasons for people to do so because positive biases allow them to maintain their conviction that their partner is the “right” one and that their relationship is worth keeping, particularly when the relationship is threatened by feelings of doubt and uncertainty (Murray, 1999). Indeed, recent research provides robust evidence for positive biases in partner perceptions. Research taking the logical impossibility paradigm has well documented the “(partner) better than average effect” among dating and married individuals; that is, the majority of individuals believe their own partners are more virtuous than average or typical partners (e.g., Murray & Holmes, 1997; Endo et al., 2000) and better than their friends’ partners (e.g., Murray et al., 2000). Research based on the accuracy benchmark approach also shows that intimates tend to perceive their partners more positively than the partners view themselves or their friends perceive the partner (e.g., Murray et al., 1996a, 1996b, 2000). Moreover, individuals who hold these positive biases tend to be happier and their relationships are more likely to persist over time (e.g., Murray et al., 1996a, 1996b; Rusbult, Van Lange, Wildschut, Yovetich, & Verette, 2000). Perceiving the Partner as Being Similar to One’s Actual Self From a motivational perspective, it is psychologically rewarding to perceive partners similar to the self because the perceived similarity may validate one’s self views, increase familiarity between intimates, and result in fewer disagreements and conflicts (Aron et al., 1991; Klohnen & Luo, 2003; Murray et al., 2002). In fact, the more individuals perceive a potential partner as similar to themselves, the more attracted they are to him or her (Klohnen & Luo, 2003). People in dating and married relationships also exaggerate the similarity between themselves and their partner on a variety of dimensions such as interpersonal qualities, values, and feelings (Murray et al., 2002; Kenny & Acitelli, 2001), general personality and affectivity (Klohnen & Luo, 2006; Watson et al., 2000b), adaptive and nonadaptive personality characteristics (Ready, Clark, Watson, & Westerhouse, 2000), and attachment dimensions (Klohnen & Luo, 2006; Ruvolo & Fabin, 1999). It is important to note that different labels have been applied to this general phenomenon, including “egocentrism” (Murray et al., 2002), “similarity bias” (Klohnen & Luo, 2006), “assumed similarity” (Watson et al., 2000b), “self-based heuristic” (Ready et al., 2000), and “social projection” (Ruvolo & Fabin, 1999). Irrespective of the label, the underlying idea is the same—intimates tend to perceive more similarity between themselves and their partners than their actual similarity. Furthermore, this similarity bias is positively associated with feelings of being understood and relationship satisfaction (Klohnen & Luo, 2006; Murray et al., 2002). In summary, individuals’ partner representations include both accurate and biased perceptions. There appears to be several processes leading to biases in partner representations: perceiving partners as similar to one’s actual self, ideal self, ideal partner, as well as perceiving partners in an overly positive way. There is at least one other process in partner perceptions—perceiving partners as highly secure in terms of attachment (Klohnen & Luo, 2003). It is likely that these processes may be partly overlapping, or that one or several of these processes may be more influential than others. So far no study has investigated all of these processes in the same context. Klohnen and Luo (2003) examined three processes in participants’ perceptions of hypothetical dating partners: perceiving the partner as similar to
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(a) participants’ actual self, (b) their ideal self, and (c) the secure attachment prototype. Results showed that the effect of perceptual security on attraction to the partner was subsumed by the effect of perceptual ideal self similarity. However, both actual and ideal self similarity made significant and independent contributions to the prediction of attraction. Future research should examine all of these processes simultaneously to determine which of these processes has the strongest influence on partner representations, and to what extent these processes make independent contributions to attraction and subsequent relationship development.
Accuracy and Bias in Romantic Relationship Representations Although relationship representations have received less attention compared to self- and partner representations, several studies have shown that accuracy and bias coexist in romantic relationship representations. Evidence for accuracy in relationship representations mainly comes from two types of research: First, representations are considered accurate if dyadic partners’ ratings of the relationship are correlated. For example, couples’ perceptions of improvement in their relationship, optimism about the relationship, perceptions of joint control over events in the relationship were moderately correlated (Murray & Holmes, 1997; Spretcher, 1999). Second, individuals’ thoughts and feelings about their relationship (e.g., their self-reported love, satisfaction, commitment, and closeness) are valid predictors of the future status of their relationships (see Gagne & Lydon, 2004 for a review). Individuals’ predictions of their own relationship length are also moderately correlated with how long their relationships last six months later (MacDonald & Ross, 1999). On the other hand, recent research also shows robust evidence for relationship enhancement bias. Parallel to Taylor and Brown’s (1988) typology of self enhancement bias, relationship enhancement bias can be categorized into three domains: perceived superiority of one’s own relationships, exaggerated control over relationships, and unrealistic optimism about the relationship development. Perceived Superiority of One’s Own Relationships Individuals take it for granted that their own relationships are much better than those of others. For example, intimates perceive the quality of their own relationships or marriages as better than that of average others’ in terms of closeness, mutual understanding, supportiveness, happiness, and the importance of the relationship (Endo et al, 2000; Fowers, Lyons, Montel, & Shaked, 2001). Individuals also tend to rate their relationships as better than those of their friends (Helgeson, 1994; Van Lange & Rusbult, 1995; Rusbult et al., 2000; Agnew, Loving, & Drigotas, 2001; Martz et al., 1998). Compared to outside observers, such as friends, intimates egocentrically view their own relationships more positively (MacDonald & Ross, 1999; Murray et al., 2000). Exaggerated Control Over One’s Own Relationships Murray and Holmes (1997) asked dating and married individuals to rate the amount of joint control they possessed over positive and negative events within their relationships; that is, their ability to increase the probability of good outcomes and decrease the probability of bad outcomes. Results showed that participants believed that they had much more control
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than other couples had. Using a similar procedure, Martz et al. (1998) found that intimates also believed that they had better control over their relationships than their friends had. Unrealistic Optimism about Romantic Relationship Development People tend to egocentrically believe their relationships are getting better over time. Sprecher (1999) conducted a longitudinal study that followed couples over four years. When asked to make a global comparison between their current relationship quality and the relationship quality measured last time, participants believed that their relationships were becoming more enjoyable and satisfactory. However, their actual ratings of relationship satisfaction obtained each time showed that their satisfaction, in fact, decreased over time. Another longitudinal study conducted by Karney and Frye (2002) corroborated this finding. They followed newlyweds over 10 years and found that intimates’ actual ratings of marital satisfaction were getting lower as time went by; however, when thinking in retrospective, they believed that their relationships were becoming better. Individuals also tend to overestimate how long their own relationships will last, whereas their roommates, friends and parents make more accurate predictions (Drigotas et al., 1999; MacDonald & Ross, 1999). When it comes to prediction of the likelihood of divorce, the majority of married respondents believed that they were unlikely to divorce, while the national divorce rate is nearly 50% (e.g., Fowers et al., 2001; Heaton & Albright, 1991). In summary, partners tend to show reasonable agreement with each other in their views and predictions of the relationship. On the other hand, they egocentrically believe that their own relationships are better than others, that they have more control over their own relationships, and that their relationships are becoming better. These relationshipenhancement biases are associated with better concurrent relationship outcomes, such as greater satisfaction and less conflict; these biases are also associated with greater relationship stability (Murray & Holmes, 1997). Given that representations of the self, partners, and relationships all contain enhancement biases, one important next step is to examine the how self-, partner-, and relationship-enhancement biases are related to each other and whether these biases play independent roles in relational functioning.
Revisiting Several Key Questions about Accuracy and Bias Over the last decade, an increasing number of researchers have become interested in accuracy and bias in perceptions of romantic partners (Gagne & Lydon, 2004; Kenny & Acitelli, 2001; Klohnen & Luo, 2006, 2005b; Klohnen & Mendelsohn, 1998; Murray et al., 1996a, 1996b, 2002; Neff & Karney, 2002, 2005). However, theorizing and research on this topic to date are quite limited because (1) most research and theory have primarily been concerned with understanding “when and how people are accurate as well as when and how they are mistaken” (pp. 652, Funder, 1995) rather than systematically considering accuracy and bias in the same context, and (2) previous research has not vigorously related accuracy and bias to other variables such as individual differences and relationship outcomes. I hope that conceptualizing the nature of IRs as containing accurate and biased perceptions (as well as random errors) will provide helpful insights for addressing the following questions about accuracy and bias.
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How Should We Conceptualize the Relation between Accuracy and Bias? The above review of romantic representations provides robust evidence that accuracy and bias coexist in representations people hold about themselves, their partners, and their relationships. In fact, this has become a consensus among relationship researchers (Gagne & Lydon, 2004; Kenny & Acitelli, 2001; Klohnen & Luo, 2006; Neff & Karney, 2002, 2005). However, little research has examined how being accurate is associated with being biased. A common, naïve assumption is that accuracy and bias are mutually exclusive; that is, the more accurate one’s perceptions are, the less biased these perceptions must be. Klohnen and Luo (2006) explicitly proposed that accuracy and bias do not have to be inversely associated. Because IRs are conceptualized to consist of accurate perceptions, systematic biases, and random errors, it is possible that when one of the three components changes, it does not necessarily translate into direct, one-to-one change in the other components. The association between perceptual accuracy and bias is likely to depend on the specific context in which these perceptions develop, such as the nature of the relationship and the degree of acquaintanceship. In the context of committed romantic relationships, Klohnen and Luo (2006) reasoned that accuracy and bias in partner perceptions are independent because the motivational factors that are likely to foster accuracy and those likely to foster biases are quite distinct in nature. Indeed, their results showed that accuracy was unrelated to the similarity or positivity bias. It is interesting to reflect on what these findings really mean. They suggest that knowing how accurate a person’s perceptions of his partner are, does not necessarily inform us about how biased he is—he may be very biased, moderately biased, or not at all biased. These findings thus fundamentally challenge the common assumption that greater accuracy in our perceptions of others must necessarily entail becoming less biased. I hope that this new perspective will stimulate more research on the nature of the association between accuracy and bias. For example, it will be important to examine how type of relationship and acquaintanceship may moderate the relation between accuracy and bias (see Klohnen & Luo, 2006). Is Everybody Equally Accurate and Biased? Although on average, individuals tend to be both accurate and biased when perceiving their partners, there appears to be considerable variability in the degree to which they are accurate and biased. Luo and Klohnen (2006) found that more ego-resilient and more securely attached individuals tend to show greater accuracy, similarity bias, and positivity bias in partner perceptions. Murray et al. (1996a, 1996b) showed that individuals with more positive self-views tend to see their partners more consistent with their ideals, whereas those who have more negative self-views engage in less idealization of their partners. John and Robins (1994) found that there was substantial variation in the extent to which individuals enhance their self evaluations; in particular, people whose self-evaluations were the most unrealistically positive tended to be narcissistic. It appears that individuals’ tendency to be accurate and biased are at least in part a function of who they are (see also Gagne & Lydon, 2004). However, the processes underlying the link between individual differences and perceptual accuracy or bias have not been fully explored.
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Which is More Adaptive: Accuracy or Bias? Another interesting question is to what extent accuracy and bias in IRs are beneficial. There has been a long debate regarding whether accuracy or positive bias is more adaptive. Some researchers argue that positivity or enhancement bias is adaptive (e.g., Endo et al., 2000; Martz et al., 1998; Murray et al., 1996a, 1996b; Murray & Holmes, 1997; Taylor & Brown, 1986), whereas others argue that accurate perceptions are beneficial (Colvin, Block, & Funder, 1995; Kobak & Hazan, 1991; Swann, Hixon, & De La Ronde, 1992; Swann, De La Ronde, & Hixon, 1994). It is suggested that these seemingly contradictory perspectives may both be true to some extent and can be reconciled if we conceptualize the relationship between accuracy and bias not as mutually exclusive but as relatively independent. Based on this conceptualization, it is possible for accuracy and bias to both have adaptive effects. Klohnen and Luo (2006) provided the most direct evidence for this proposition. They created an accuracy index and a positivity index for each individual in their newlywed sample; results suggested that accuracy and positivity bias contributed independently to the prediction of marital satisfaction. Neff and Karney (2005) also found that accuracy and positivity bias can operate simultaneously at different levels: Although most newlyweds enhanced their partners at the level of global perceptions, those who held more accurate perceptions of partners’ specific qualities were more supportive and less likely to divorce. Finally, Katz and her colleagues (Katz & Joiner, 2002; Katz, Anderson, & Beach, 1997) found that the association between positivity bias and relationship satisfaction was curvilinear, indicating that even though people tend to idealize their partners, their perceptions are also constrained by reality; perceptions that are too positive and have no basis in reality tend to have negative effects on relationships. These results consistently show that both accurate perceptions and positive bias are important to relationships. With regard to the adaptive value of similarity bias, researchers have found that similarity bias is associated with better marital satisfaction (Murray et al., 2002). More importantly, Klohnen and Luo (2006) showed that accuracy and similarity bias made independent contributions to the prediction of satisfaction. In summary, these findings suggest that both accuracy and bias are beneficial and important to a happy, satisfactory relationship or marriage. It is likely that a combination of moderate accuracy and bias may be most adaptive for relationship functioning; that is, accuracy without bias or bias without accuracy can both have negative implications for relationships (see also Gagne & Lydon, 2004; Neff & Karney, 2005).
FURTHER CONSIDERATIONS The primary aim of this chapter was to review, discuss, and propose theories and research relevant to how people represent their interpersonal relationships based on past experiences, with a particular emphasis on romantic contexts. Specifically, I have discussed three important aspects of IRs: their structure, content, and nature. Although the discussion has mainly focused on these aspects of IRs, I would like to draw attention to several additional questions that are broader in scope.
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Do Interpersonal Representations Contain Both Implicit and Explicit Components? I have been mainly discussing consciously accessible (i.e., explicit) representations that can be obtained from self-report measures. However, IRs are likely to include more than just explicit components. Research on attitudes, self-esteem, and stereotypes suggests that these psychological processes contain both implicit and explicit components that independently influence perceptions, judgments and behaviors (for a review see Greenwald & Banaji, 1995). Recent empirical evidence suggests that personality also includes implicit and explicit components (Asendorpf, Banse, & Mucke, 2002). Although little direct evidence indicates that IRs contain both explicit and implicit components, relationship researchers have reflected on this possibility. For example, attachment theorists have suggested that conscious and unconscious working models may be inconsistent and that the more conscious side may serve self-defensive functions (Bowlby, 1980; Collins & Read, 1994; Collins et al., 2004; Mikulincer, 1995; Pietromonaco & Feldman Barrett, 2000; Simpson & Rholes, 2002). In particular, Bartholomew (1997) elaborated on this issue in light of the observation that dismissing individuals tend to hold positive self models and that preoccupied individuals tend to hold positive other models when assessed with explicit measures. She noted that at some unconscious level dismissing individuals may feel negatively about themselves, yet they manage to maintain a positive self-image as a way to defend a “fragile” sense of self. Similarly, preoccupied individuals may unconsciously hold negative models of others, and their conscious positive other models are a defense against the fact that their significant others are at times unavailable and unsupportive. In order to get a comprehensive understanding of IRs, it is extremely important for researchers to use more implicit measures (e.g., the Implicit Association Test) in addition to explicit measures to examine representations that are less masked by conscious self-defense or self-presentation motives. Specific questions to be addressed include: (1) Are there systematic discrepancies between responses obtained from explicit and implicit measures of IRs? (2) If there are systematic discrepancies, does the nature of these discrepancies differ across individuals? (3) How do explicit and implicit representations jointly influence the processing of information? (4) Are explicit and implicit representations differentially associated with personal and relationship well-being?
How Do Interpersonal Representations Influence Perceptions, Feelings, and Behaviors? The main purpose of this chapter is to review theories and research regarding the more static aspects of IRs—their structure, content, and nature. However, one of the most important tasks that relationship researchers face is to understand the dynamic aspects of IRs—how representations affect individuals’ perceptions, feelings, and behaviors. Social cognition research has provided important insights in this regard. Representations can be largely categorized into two types in terms of their accessibility. Most frequently used representations become chronically accessible and they influence information processing in an automatic manner, whereas representations that are less accessible can be temporarily activated (e.g.,
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Bargh, Bond, Lombardi, & Tota, 1986); which specific representations that are activated and used to guide perceptions and behaviors will likely depend on the extent to which it applies to the specific situation (see Higgins, & Brendl, 1995). IRs, just like other mental representations, include both chronically and temporarily accessible representations. Different individuals are likely to hold different chronically accessible representations that have automatic and systematic influence on their perceptions, feelings, and behaviors. For example, individuals with low self-esteem may hold chronic negative self representations that may lead them to perceive others’ positive feedback as sarcastic. With chronic positive other representations, securely attached individuals may interpret their partner’s absence as temporary and unintentional. For individuals who hold chronic negative relationship representations, they may be hesitant to get involved in committed relationships because they believe that relationships are difficult and frustrating. Research designed to examine temporarily accessible IRs is still at its earliest stage; however, initial findings shed important light on how these representations are activated and applied to subsequent information processing. For example, Mikulincer, Gillath, and Shaver (2002) found that subliminal priming of threat led to increased accessibility of representations of attachment figures, suggesting that situation plays an important role in the activation of representations. Baldwin, Carrell, and Lopez (1990) found that participants gave less positive self-evaluations after the subliminal presentation of a disapproving significant other, whereas subliminally priming a disapproving non-significant other did not have any effect. Mikulincer, Hirschberger, Nachmias, and Gillath (2001) subliminally primed attachmentsecure representations or non-attachment representations and found that the primed secure representations led to more positive reactions to neutral stimuli than non-attachment priming did. Pierce and Lydon (2001b) showed that subliminal activation of positive interpersonal expectations increased reports of seeking emotional support and decreased the use of selfdenigrating coping, whereas activation of negative interpersonal expectations decreased experiences of positive affect and tended to impede constructive coping. In summary, it seems that both chronic accessible and temporarily activated representations strongly influence the processing of incoming information. Given that social cognition research has shown that chronically and temporarily accessible representations have additive influences on social perception (Bargh et al., 1986), it will be useful for relationship researchers to explore the nature of the joint influence of these two types of representations in relationship contexts—whether their effects are independent, overlapping, or interactive.
Stability and Change in Interpersonal Representations Most theorists acknowledge that IRs are quite stable over time but also changeable when life circumstances change (e.g., Bowlby, 1969; Pietromonaco, Laurenceau, & Feldman Barrett, 2003). Indeed, previous research has provided robust evidence that individuals’ representations of themselves and others are remarkably stable over time (e.g., Kirkpatrick & Hazan, 1994; Klohnen & Bera, 1998; Murray et al., 1996b; Scharfe & Bartholomew, 1994). In spite of this high stability, IRs also show interesting changes over time in response to new experiences. For example, when individuals fall in love with somebody, their self concepts are expanded and their self-esteem increases (Aron et al., 1995). Dating and married individuals come to adopt partners’ perceptions of them into their self representations
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(Murray et al., 1996b; Drigotas et al., 1999). They also tend to represent the self and close others as a unit over time (e.g., Aron et al., 1991; Agnew et al., 1998). The marital intervention literature suggests that it is possible and useful to induce changes in people’s representations of the self, the spouse, and the relationship; these changes provide alternatives to maladaptive representations (see Pietromonaco et al., 2003 for a review). To date, research investigating the question of representational stability has primarily focused on individuals who are involved in well-established relationships. Only a few studies have examined IRs at earliest stages of relationship development (Aron et al., 1995; Fletcher et al., 2000). Even less research has been conducted to examine how individuals represent themselves, their ex-partners, and previous relationships after the relationship has dissolved (but see Felmlee, 2001 for an exception). Given that individuals tend to hold “positive illusions” for themselves, their partner, and their romantic relationship while they are involved in an ongoing relationship, would they become more objective or more negatively biased after they break up with their partner? It is very important to examine IRs throughout the entire course of relationship development, including initial crush or attraction, consolidation, and dissolution. This type of longitudinal research is extremely valuable because they not only inform us regarding the stability of IRs, but also help to address questions regarding the direction of causality between representations and relationship outcomes, for example, do positive partner representations lead to attraction or does attraction to someone make people biased?
CONCLUSIONS A good understanding of how people represent themselves in relation to others is of enormous importance to relationship research because what we think about ourselves, others, and our relationship is likely to greatly influence how we attend to new information and how we interpret new facts; moreover, our representations guide what we feel and how we act in relationships. The structure, content, and nature are the three most fundamental aspects of these representations. Understanding these aspects of IRs as well as of the links between IRs and individuals’ feelings and behaviors in relationships also has important practical implications because such knowledge helps us design interventions that will hopefully promote healthy relationship patterns and prevent maladaptive ones from developing in the first place. The study of IRs is therefore both theoretically rich and practically valuable. It nicely bridges social cognition and relationship research, and cuts across different areas of psychology, including social, personality, developmental, and clinical psychology. This challenging work will likely require creative methodologies that combine techniques typically employed by social psychologists (e.g., priming, response latencies) and research designs typically used by relationship researchers (e.g., dyadic design, longitudinal studies). As an effort to accomplish this goal, this chapter provides an extensive review and discussion of theories and research regarding the structure, content, and nature of IRs. I hope that this chapter will provide a useful beginning of a more comprehensive theoretical framework that can help shape future research on IRs.
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ACKNOWLEDGEMENT The author wishes to thank Eva Klohnen for her helpful comments on earlier drafts of this chapter.
REFERENCES Agnew, C. R., Loving, T. J., & Drigotas, S. M. (2001). Substituting the forest for the trees: Social networks and the prediction of romantic relationship state and fate. Journal of Personality & Social Psychology, 81, 1042-1057. Agnew, C. R., Van Lange, P. A. M., Rusbult, C. E., & Langston, C. A. (1998). Cognitive interdependence: Commitment and the mental representation of close relationships. Journal of Personality & Social Psychology, 74, 939-954. Aron, A., Aron, E. N., Tudor, M., & Nelson, G. (1991). Close relationships as including other in the self. Journal of Personality and Social Psychology, 60, 241-253. Aron, A., Paris, M., & Aron, E. N. (1995). Falling in love: Prospective studies of self-concept change. Journal of Personality and Social Psychology, 69, 1102-1112. Asendorpf, J. B., Banse, R., & Mucke, D. (2002). Double dissociation between implicit and explicit personality self-concept: The case of shy behavior. Journal of Personality & Social Psychology, 83, 380-393. Baldwin, M. W. (1992). Relational schemas and the processing of social information. Psychological Bulletin, 112, 461-484. Baldwin, M. W., Keelan, J. P. R., Fehr, B., Enns, V. E., & Koh-Rangarajoo, E. (1996). Social-cognitive conceptualization of attachment working models: Availability and accessibility effects. Journal of Personality and Social Psychology, 71, 94-109. Baldwin, M. W., Carrell, S. E., Lopez, D. F. (1990). Priming relationship schemas: My advisor and the Pope are watching me from the back of my mind. Journal of Experimental Social Psychology, 26, 435-454. Bargh, J. A., Bond, R. N., Lombardi, W. J., & Tota, M. E. (1986). The additive nature of chronic and temporary sources of construct accessibility. Journal of Personality & Social Psychology, 50, 869-878. Bartholomew, K. (1997). Adult attachment processes: Individual and couple perspective. British Journal of Medical Psychology, 70, 249-263. Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61, 226-244. Beach, S. R. H., Tesser, A., Fincham, F. D., Jones, D. J., Johnson, D., & Whitaker, D. J. (1998). Pleasure and pain in doing well, together: An investigation of performancerelated affect in close relationships. Journal of Personality and Social Psychology, 74, 923-938. Bowlby, J. (1973). Attachment and loss: Vol. 2. Separation: Anxiety and anger. NY: Basic. Bowlby, J. (1980). Attachment and loss: Vol. 3. Loss: Sadness and depression. New York: Basic.
Interpersonal Representations: Their Structure, Content, and Nature
59
Bretherton, I. (1985). Attachment theory: Retrospect and prospect. In I. Bretherton & E. Waters (Eds.) Growing points of attachment theory and research. Monographs of the Society for Research in Child Development, 50, (1-2, Serial No. 209), 3-35. Brown, J. D. (1986). Evaluations of self and others: Self-enhancement biases in social judgments. Social Cognition, 4, 353-376. Campbell, L., Simpson, J. A., Boldry, J., & Kashy, D. A. (2005). Perceptions of Conflict and Support in Romantic Relationships: The Role of Attachment Anxiety. Journal of Personality & Social Psychology, 88, 510-531. Collins, N. L., Guichard, A., Ford, M. B., & Feeney, B. C. (2004). Working models of attachment: New developments and emerging themes. In W. S. Rholes & J. A. Simpson (Eds) Adult Attachment: Theory, Research, and Clinical Implications. New York: Guilford Press. Collins, N., & Read, S. J. (1994). Adult attachment, working models, and relationship quality in dating couples. Journal of Personality and Social Psychology, 58, 644-663. Collins, N., & Read, S. J. (1994). Cognitive representations of attachment: The structure and function of working models. In D. Perlman & K. Bartholomew (Eds.) Advances in Personal Relationships (Vol. 5, 53-90). London: Jessica Kingsley. Colvin, C. R., Block, J., & Funder, D. C. (1995). Overly positive self-evaluations and personality: Negative implications for mental health. Journal of Personality and Social Psychology, 68, 1152-1162. Cozzarelli, C., Hoekstra, & Bylsma, W. (2000). General versus specific mental models of attachment: Are they associated with different outcomes? Personality and Social Psychology Bulletin, 26, 605-618. Cross, S. E., Morris, M. L., & Gore, J. S. (2002). Thinking about oneself and others: The relational-interdependent self-construal and social cognition. Journal of Personality & Social Psychology, 82, 399-418. Crowell, J. A., Fraley, R. C., & Shaver, P. R. (1999). Measurement of individual differences in adolescent and adult attachment. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 434-465). New York: Guilford Press. Donahue, E. M., Robins, R. W., Roberts, B. W., & John, O. P. (1993). The divided self: Concurrent and longitudinal effects of psychological adjustment and social roles on selfconcept differentiation. Journal of Personality & Social Psychology, 64, 834-846. Drigotas, S. M. (1999). The Michelangelo phenomenon and personal well-being. Journal of Personality, 70, 59-77. Drigotas, S. M., Rusbult, C. E., Wieselquist, J., & Whitton, S. (1999). Close partner as sculptor of the ideal self: Behavioral affirmation and the Michelangelo phenomenon. Journal of Personality and Social Psychology, 77, 293-323. Endo, Y., Heine, S. J., Lehman, D. R. (2000). Culture and positive illusions in close relationships: How my relationships are better than yours. Personality and Social Psychology Bulletin, 26, 1571-1586. Felmlee, D. H. (2001). From appealing to appalling: Disenchantment with a romantic partner. Sociological Perspectives, 44, 263-280. Fletcher, G. J. O., & Fincham, F. D. (1991). Attribution processes in close relationships. In G. J. O. Fletcher & G. D. Fincham (Eds.), Cognition in close relationships (pp. 7-35). Hillsdale, NJ: Erlbaum.
60
Shanhong Luo
Fletcher, G. J. O., Simpson, J. A., & Thomas, G. (2000). Ideals, perceptions, and evaluations in early relationship development. Journal of Personality and Social Psychology,79, 933940. Fletcher, G. J. O., Simpson, J. A., Thomas, G., & Giles, L. (1999). Ideals in intimate relationships. Journal of Personality and Social Psychology, 76, 72-89. Fowers, B. J., Lyons, E. M., & Montel, K. H. (1996). Positive marital illusions: Selfenhancement or relationship enhancement? Journal of Family Psychology, 10, 192-208. Fowers, B. J., Lyons, E., Montel, K. H., & Shaked, N. (2001). Positive illusions about marriage among married and single individuals. Journal of Family Psychology, 15, 95109. Fraley, R. C., & Davis, K. E. (1997). Attachment formation and transfer in young adults' close friendships and romantic relationships. Personal Relationships, 4, 131-144. Funder, D. C. (1995). On the accuracy of personality judgment: A realistic approach. Psychological Review, 102, 652-670. Furman, W., Simon, V.A., Shaffer, L., & Bouchey, H.A. (2002). Adolescents' working models and styles with parents, friends, and romantic partners. Child Development, 73, 241-255. Gagne, F. M., & Lydon, J. E. (2004). Bias and Accuracy in Close Relationships: An Integrative Review. Personality & Social Psychology Review, 8, 322-338. Gardner, W. L., Gabriel, S., & Hochschild, L. (2002). When you and I are “We”, you are not threatening: The role of self-expansion in social comparison. Journal of Personality and Social Psychology, 82, 239-251. Greenwald, A. G., & Banaji, M. R. (1995). Implicit social cognition: Attitudes, self-esteem, and stereotypes. Psychological Review, 102, 1-27. Griffin, D., & Bartholomew, K. (1994). Models of self and other: Fundamental dimensions underlying models of adult attachment. Journal of Personality and Social Psychology, 67, 430-445. Hazan, C., & Shaver, P. R. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511-524. Heaton, T. B., & Albright, S. L. (1991). Stable unhappy marriages. Journal of Marriage and the Family, 53, 747-758. Helgeson, V. S. (1994). The effects of self-beliefs and relationship beliefs on adjustment to a relationship stressor. Personal Relationships, 1, 241-258. Higgins, E. T., & Brendl, C. (1995). Accessibility and applicability: Some "activation rules" influencing judgment. Journal of Experimental Social Psychology, 31, 218-243. John, O. P., & Robins, R. W. (1994). Accuracy and bias in self-perception: Individual differences in self-enhancement and the role of narcissism. Journal of Personality & Social Psychology, 66, 206-219. Karney, B. R., & Bradbury, T. N. (1995). The longitudinal course of marital quality and stability: A review of theory, method, and research. Psychology Bulletin, 118, 3-34. Karney, B. R., & Frye, N. E. (2002). “But we’ve been getting better lately”: Comparing prospective and retrospective views of relationship development. Journal of Personality and Social Psychology, 82, 222-238. Katz, J., & Joiner, T. E. J. (2002). Being known, intimate, and valued: Global self-verification and dyadic adjustment in couples and roommates. Journal of Personality, 70, 33-58.
Interpersonal Representations: Their Structure, Content, and Nature
61
Katz, J., Anderson, P., & Beach, S. R. H. (1997). Dating relationship quality: Effects of global self-verification and self-enhancement. Journal of Social and Personal Relationships, 14, 829-842. Kenny, D. A., & Acitelli, L. K. (2001) Accuracy and bias in the perception of the partner in a close relationship. Journal of Personality & Social Psychology, 80, 439-448. Kirkpatrick, L. A., & Hazan, C. (1994). Attachment styles and close relationships: A fouryear prospective study. Personal Relationships, 1, 123-142. Klohnen, E. C. (2005). A circumplex measure of working models of adult attachment. Manuscript under review. Klohnen, E. C., & Bera, S. (1998). Behavioral and experiential patterns of avoidantly and securely attached women across adulthood: A 31-year longitudinal perspective. Journal of Personality & Social Psychology, 74, 211-223. Klohnen, E. C., & Luo, S. (2003). Interpersonal attraction and personality: What is attractive—Self similarity, ideal similarity, complementarity, or attachment security? Journal of Personality and Social Psychology. Klohnen, E. C., & Luo, S. (2005). Accuracy and bias in newlyweds' partner perceptions: Not mutually exclusive but mutually beneficial. Manuscript under revision. Klohnen, E. C., & Mendelsohn, G. A. (1998). Partner selection for personality characteristics: A couple-centered approach. Personality and Social Psychology Bulletin, 24, 268-278. Klohnen, E. C., & Weller, J. A. (2005). Variation in attachment organization across relationships. Manuscript in preparation. Klohnen, E. C., Weller, J. A., Luo, S., & Choe, M. (in press). Organization and predictive power of general and relationship-specific attachment models: One for all, and all for one? Personality and Social Psychology Bulletin. Kobak, R., & Hazan, C. (1991). Attachment in marriage: Effects of security and accuracy of working models. Journal of Personality and Social Psychology, 60, 861-869. Kosek, R. B. (1996). The quest for a perfect spouse: Spousal ratings and marital satisfaction. Psychological Reports, 79, 731-735. Kruger, J. (1999). Lake Wobegon be gone! The “Below-Average Effect” and the egocentric nature of comparative ability judgments. Journal of Personality and Social Psychology, 77, 221-232. La Guardia, J. G., Ryan, R. M., Couchman, C. E., & Deci, E. L. (2000). Within-person variation in security of attachment: A self-determination theory perspective on attachment, need fulfillment, and well-being. Journal of Personality and Social Psychology, 79, 367-384. LaPrelle, J., Hoyle, R. H., Insko, C. A., & Bernthal, P. (1990). Interpersonal attraction and descriptions of the traits of others: Ideal similarity, self similarity and liking. Journal of Research in Personality, 24, 216-240. Linville, P. W. (1987). Self-complexity as a cognitive buffer against stress-related illness and depression. Journal of Personality & Social Psychology, 52, 663-676. Luo, S., & Klohnen, E. C. (2005). Partner perceptions in newlyweds: Who are accurate and who are biased? Manuscript in preparation. MacDonald, T. K., & Ross, M. (1999). Assessing the accuracy of predictions about dating relationships: How and why do lovers' predictions differ from those made by observers? Personality and Social Psychology Bulletin, 25, 1417-1429.
62
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Main, M., Kaplan, K., & Cassidy, J. (1985). Security in infancy, childhood, and adulthood: A move to the level of representation. Monographs of the Society for Research in Child Development, 50 (1-2, Serial No. 209), 66-104. Martz, J. M., Verette, J., Arriaga, X. B., Slovik, L. F., Cox, C. L., & Rusbult, C. E. (1998). Positive illusion in close relationships. Personal Relationships, 5, 159-181. Mikulincer, M. (1995). Attachment style and the mental representation of the self. Journal of Personality and Social Psychology, 69, 1203-1215. Mikulincer, M., Gillath, O., & Shaver, P. R. (2002). Activation of the attachment system in adulthood: Threat-related primes increase the accessibility of mental representations of attachment figures. Journal of Personality & Social Psychology, 83, 881-895. Mikulincer, M., Hirschberger, G., Nachmias, O., & Gillath, O. (2001). The affective component of the secure base schema: Affective priming with representations of attachment security. Journal of Personality and Social Psychology, 81, 305-321. Mitchell, S. A. (1988). Relational concepts in psychoanalysis. Cambridge, MA: Harvard University Press. Murray, S. L. (1999). The quest for conviction: Motivated cognition in romantic relationships. Psychological Inquiry, 10, 23-34. Murray, S. L., & Holmes, J. G. (1997). A leap of faith? Positive illusions in romantic relationships. Personality and Social Psychology Bulletin, 23, 586-604. Murray, S. L., Holmes, J. G., & Griffin, D. W. (1996a). The benefits of positive illusions: Idealization and the construction of satisfaction in close relationships. Journal of Personality and Social Psychology, 70, 79-98. Murray, S. L., Holmes, J. G., & Griffin, D. W. (1996b). The self-fulfilling nature of positive illusions in romantic relationships: Love is not blind, but prescient. Journal of Personality and Social Psychology, 71, 1155-1180. Murray, S. L., Holmes, J. G., & Griffin, D. W. (2000). Self-esteem and the quest for felt security: How perceived regard regulates attachment processes. Journal of Personality & Social Psychology, 78, 478-498. Murray, S. L., Holmes, J. G., Bellavia, G., Griffin, D. W., & Dolderman, D. (2002). Kindred spirits? The benefits of egocentrism in close relationships. Journal of Personality and Social Psychology, 82, 563-581. Murray, S. L., Holmes, J. G., Dolderman, D., & Griffin, D. W. (2000). What the motivated mind sees: Comparing friends' perspectives to married partners' views of each other. Journal of Experimental Social Psychology, 36, 600-620. Murstein, B. I. (1971). Self-ideal-self discrepancy and the choice of marital partner. Journal of Consulting and Counseling Psychology, 37, 47-52. Neff, L. A., & Karney, B. R. (2002). Judgments of a relationship partner: Specific accuracy but global enhancement. Journal of Personality, 70, 1079-1112. Neff, L. A., & Karney, B. R. (2005). To know you is to love you: The implications of global adoration and specific accuracy for marital relationships. Journal of Personality & Social Psychology, 88, 480-497. Overall, N.C, Fletcher, G. J., & Friesen, M.D. (2003). Mapping the intimate relationship mind: Comparisons between three models of attachment representations. Personality & Social Psychology Bulletin, 29, 1479-1493. Pierce, T., & Lydon, J. E. (2001a). Global and specific relational models in the experience of social interactions. Journal of Personality and Social Psychology, 80, 613-631.
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Pierce, T., & Lydon, J. E. (2001b). Priming relational schemas: Effects of contextually activated and chronically accessible interpersonal expectations on responses to a stressful event. Journal of Personality and Social Psychology, 75, 1441-1448. Pietromonaco, P. R., & Feldman Barrett, L. (1997). Working models of attachment and daily social interactions. Journal of Personality and Social Psychology, 73, 1409-1423. Pietromonaco, P. R., & Feldman Barrett, L. (2000). The internal working models concept: What do we really know about the self in relation to others? Review of General Psychology, 4, 155-175. Pietromonaco, P. R., Laurenceau, J., & Feldman Barrett, L. (2003). Change in relationship knowledge representations. In H. Reis, M. S. Fitzpatrick, & A. Vangelisti (Eds.) Advances in Personal Relationships: Stability and Change in Relationships. NY: Cambridge University Press. Ready, R. E., Clark, L. A., Watson, D., & Westerhouse, K. (2000). Self- and peer-related personality: agreement, trait ratability, and the “self-based heuristic.” Journal of Research in Personality, 34, 208-224. Ross, L. R., & Spinner, B. (2001). General and specific attachment representations in adulthood: Is there a relationship? Journal of Social and Personal Relationships, 18, 747766. Rusbult, C. E., Van Lange, P. A. M., Wildschut, T., Yovetich, N. A., & Verette, J. (2000). Perceived superiority in close relationships: Why it exists and persists. Journal of Personality and Social Psychology, 79, 521-545. Ruvolo, A. P., & Fabin, L. A. (1999). Two of a kind: Perceptions of own and partner's attachment characteristics. Personal Relationships, 6, 57-79. Safran, J. D. (1990a). Towards a refinement of cognitive therapy in light of interpersonal theory: I. Theory. Clinical Psychology Review, 10, 87-105. Safran, J. D. (1990a). Towards a refinement of cognitive therapy in light of interpersonal theory: II. Practice. Clinical Psychology Review, 10, 107-121. Scharfe, E, & Bartholomew, K. (1998). Do you remember?: Recollections of adult attachment patterns. Personal Relationships, 5, 219-234. Shaver, P.R., Collins, N., & Clark, C.L.(1996). Attachment styles and internal working models of self and relationship partners. In G. Fletcher & J. Fitness (Eds.), Knowledge structures in close relationships: A social psychological approach (pp. 25-61). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc. Simpson, J. A & Rholes, W. S. (2002). Fearful-avoidance, disorganization, and multiple working models: Some directions for future theory and research. Attachment and Human Development, 4, 223-229. Sprecher, S. (1999). “I love you today more than yesterday”: Romantic partners’ perceptions of change in love and related affect over time. Journal of Personality and Social Psychology, 76, 46-53. Stern, D. N. (1985). The interpersonal world of the infant. New York: Basic Books. Suls, J., Lemos, K., & Stewart, H. L. (2002). Self-esteem, construal, and comparisons with the self, friends, and peers. Journal of Personality and Social Psychology, 82, 252-261. Swann, W. B., De La Ronde, C., & Hixon, J. G. (1994). Authenticity and positivity strivings in marriage and courtship. Journal of Personality and Social Psychology, 66, 857-869. Swann, W. B., Hixon, J. G., & De La Ronde, C. (1992). Embracing the bitter “truth”: Negative self-concepts and marital commitment. Psychological Science, 3, 118-121.
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Taylor, S. E., & Brown, J. D. (1988). Illusion and well-being: A social psychological perspective on mental health. Psychological Bulletin, 103, 193-210. Thomas, G., & Fletcher, G. J. O. (2003). Mind-reading accuracy in intimate relationships: Assessing the roles of the relationship, the target, and the judge. Journal of Personality & Social Psychology, 85, 1079-1094. Thomas, G., Fletcher, G. J. O., & Lange, C. (1997). On-line empathic accuracy in marital interaction. Journal of Personality & Social Psychology, 72, 839-850. Trinke, S. J., & Bartholomew, K. (1997). Hierarchies of attachment relationships in young adulthood. Journal of Social and Personal Relationships, 14, 603-625. Van Lange, P. A. M., & Rusbult, C. E. (1995). My relationship is better than—and not as bad as—yours: The perception of superiority in close relationships. Personality and Social Psychology Bulletin, 21, 32-44. Watson, D., Hubbard, B., & Wiese, D. (2000a). General traits of personality and affectivity as predictors of satisfaction in intimate relationships: Evidence from self- and partnerratings. Journal of Personality, 68, 413-449. Watson, D., Hubbard, B., & Wiese, D. (2000b). Self-other agreement in personality and affectivity: The role of acquaintanceship, trait visibility, and assumed similarity. Journal of Personality and Social Psychology, 78, 546-558. Watson, D., Klohnen, E. C., Casillas, A., Simms, E. N., Haig, J., & Berry, D. S. (2004). Match makers and deal breakers: Analyses of assortative mating in newlywed couples. Journal of Personality, 72, 1029-1068.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 3
GENERALIZED ANXIETY DISORDER AND INTERPERSONAL RELATIONSHIPS: THE CASE FOR A SYSTEMIC INTERVENTION Danielle Black The Family Institute at Northwestern University, Evanston, Illinois 60201, USA
Amanda Uliaszek, Alison Lewis Northwestern University, Evanston, Illinois 60208, USA
Richard Zinbarg Northwestern University, Evanston, Illinois 60208, USA The Family Institute at Northwestern University, Evanston, Illinois 60201, USA
ABSTRACT Generalized anxiety disorder (GAD), one of the more common anxiety disorders, is associated with significant impairment in occupational, interpersonal and family functioning. There is growing consensus that we need to improve the effectiveness of our treatments for GAD given that even the most positive findings suggest that only 50% of patients treated with cognitive-behavior therapy (CBT) and/or medications experience what might be considered to be a cure. Whereas established treatments for GAD are individual modalities, there is evidence from several lines of research suggesting current treatments for that systemic therapy has promise to augment the effectiveness of therapy for GAD. These lines of research include (a) evidence that elevated marital dissatisfaction is associated with GAD; (b) evidence that marital and family problems are associated with other anxiety disorders including panic disorder with agoraphobia and obsessive compulsive disorder and are associated with poor outcome in the treatment of these other anxiety disorders; (c) evidence that marital and family problems are associated with major depression - another psychiatric condition closely related to GAD – and poor outcome in the treatment of major depression; (d) preliminary evidence that marital functioning and interpersonal problems predict outcome in the treatment of GAD; and (e) evidence that at least some forms of couples therapy are effective treatments for major depression and panic disorder with agoraphobia.
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INTRODUCTION Generalized Anxiety Disorder (GAD) is an impairing psychological problem in which an individual experiences worry and anxiety over a number of different things most of the day, nearly every day, for a period of at least six months (DSM-IV-TR, 2000). In order to meet diagnostic criteria for GAD, worries must be accompanied by a number of physical and psychological symptoms including restlessness, muscle tension, sleeplessness, difficulty concentrating, frequent fatigue, and irritability. Subjective distress over symptoms is often quite severe, with feelings of loss of control over worry serving as another diagnostic criterion (DSM-IV-TR, 2000). GAD is very common; epidemiological results from the National Cormorbidity Survey (NCS) found lifetime prevalence rates of GAD to be nearly seven percent for females and four percent for males (Kessler et al., 1994). Further, according to this study, more than three percent of the population suffers from GAD within any given year. The more recent National Comorbidity Survey Replication found very similar prevalence rates (Kessler, Berglund, Demler, Jin, et al., 2005; Kessler, Chiu, Demler & Walters, 2005). Within the NCS, regardless of whether lifetime or one year prevalence rates were examined, among suffers of GAD, women outnumbered men by a rate of two to one (Wittchen, Zhao, Kessler, & Eaton, 1994). GAD typically begins early in life and has a relatively chronic course. Fifty percent of cases report onset by age 18 and 75 percent report onset by age 26 (Campbell, Brown & Grisham, 2003). Further, in DSM-IV, the former diagnosis of Overanxious Disorder (OAD) in children was subsumed under GAD. According to Albano, Chorpita, and Barlow (2003), data collected using DSM-III and DSM-III-R diagnoses, suggest that GAD may typically begin in childhood between 10.8 and 13.4 years of age. Among patients with GAD, rates of full remission are low (Kessler, Keller, & Wittchen, 2001). Although epidemiological studies have not yet looked at the longitudinal course of this disorder in a non-treatment seeking population, based on comparisons of point prevalence rates and lifetime prevalence rates in these studies, researchers have estimated that 40 to 60 percent of individuals with a lifetime history of GAD are experiencing an episode at any given point (Kessler, Keller, & Wittchen, 2001). This suggests that individuals with a history of GAD are symptomatic for much of their lifetimes and that the course of GAD is relatively chronic. Symptoms of this disorder appear to wax and wane, getting worse during times of stress (DSM-IV-TR, 2000). Research indicates that GAD has considerable costs, both for individuals who suffer from this disorder and for society as a whole. GAD can severely impair physical, psychological, and social functioning as well as quality of life (e.g. Ninan, 2001; Roy-Byrne & Katon, 1997; Wittchen, Carter, Pfister, Montgomery, & Kessler, 2000). Within the National Commorbidity Survey, individuals with GAD were 2.5 times more likely than others to report high levels of social impairment and 3.5 times more likely to report high levels of work impairment (Wittchen, 2002). Studies suggest that GAD has a significant financial impact, with the primary costs relating to nonpsychiatric healthcare expenses. GAD is the most common anxiety disorder in primary care medical settings and primary care physicians often order expensive tests to try to find end-organ dysfunction rather than diagnosing GAD (Ninan, 2001; Wittchen, 2002). Patients with GAD report a two-fold higher average number of visits to primary care
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physicians than individuals with depression and significantly more visits to non-mental health doctors even after entering the presence of physical illness as a covariate (Wittchen, 2002). Workplace costs are also significant (Ninan, 2001; Wittchen, 2002). In one study, 34 percent of individuals who experienced pure GAD within a 12-month period year and 48 percent of individuals who experience GAD and comorbid depression exhibited reductions of ten percent or more in work productivity over the course of a month (Wittchen, 2002).
LIMITATIONS IN THE EFFECTIVENESS OF CURRENT TREATMENTS FOR GAD To date, two types of treatments for GAD, pharmacotherapy and Cognitive Behavioral Therapy (CBT), have received extensive empirical support. However, there is reason to believe that both of these forms of treatment are limited in their effectiveness. Many individuals with GAD do not show any improvement following treatment, and among those who do improve, a number remain symptomatic (Borkovic & Whisman, 1996; Gould, Otto, Pollack, & Yap, 1997). Medications that are commonly used to treat GAD include benzodiazepines, azapirones, tricyclic anti-depressents, selective-serotonin reuptake inhibitors, and serotonin norepinephrine reuptake inhibitors (Wittchen, 2002). A recent meta-analysis suggested that pharmacotherapy is superior to placebo in producing short-term reductions in symptoms of generalized anxiety disorder (Mitte, Noack, Steil, & Hautzinger, 2005). Empirically supported CBT packages for GAD target the physiological, cognitive, and behavioral components of this disorder using a number of different techniques. Techniques utilized in CBT for GAD include psychoeducation, relaxation training, cognitive restructuring, worry imagery exposure, in-vivo situational exposure, and time management (e.g., Brown, O’Leary, & Barlow, 1994; Craske & Barlow, 2005Craske, Barlow & O’Leary, 1992; Zinbarg, Craske & Barlow, 19932006). Chambless and Gillis (1993) meta-analyzed 9 trials of CBT for GAD and reported that the mean effect size for CBT compared with either wait-list, pill placebo or nondirective therapy was 1.54. This mean effect size was significantly greater than zero, indicating that CBT is an effective treatment for GAD. Gould, Otto, Pollack and Yap (1997) reported a more modest mean effect size of .70 on symptoms of anxiety based on 22 trials of CBT for GAD. However, this more modest effect size was still significantly greater than zero, again indicating that CBT is an effective treatment for GAD. In addition, Gould et al. found that CBT was just as effective as pharmacotherapy for symptoms of anxiety and was significantly more effective than pharmacotherapy for symptoms of depression that commonly co-occur with GAD. Looking at the clinical significance of these treatments, however, paints a more sobering picture. Borkovec & Whisman’s (1996) meta-analysis of CBT trials examined the percentage of patients in these studies who were classified as high on end state (HES) functioning at post-treatment, defining HES as falling within the normal range of scores on the majority of outcome measures given at the end of each study. They reported an average HES figure of 50 percent. Though pharmacotherapy trials have tended not to report HES statistics, given that CBT produces at least as large an effect size as medications on symptoms of anxiety in GAD
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trials (Gould, Otto, Pollack, & Yap, 1997), it seems reasonable to assume that medications produce no more impressive outcomes than CBT for GAD in terms of HES. Borkovec, Newman, Pincus and Lytle (2002) attempted to improve on the effectiveness of CBT for GAD in several ways, increasing therapy time by 50 percent and refining previously included treatment components. Despite these modifications, HES rates of treatment effectiveness were comparable to rates found in previous studies, leading Borkovec and colleagues to conclude that other methods are needed to improve upon the results produced by CBT techniques. Within this study, higher levels of interpersonal difficulties as measured by the Inventory of Interpersonal Problems–Circumplex Scales (Alden, Wiggins & Pincus, 1990; Horowitz, Alden, Wiggins & Pincus, 2000) at both pre- and post-treatment, were associated with poorer outcome at 6 month follow-up. Hence, one potential method for improving treatment efficacy would be to incorporate treatment components targeting patient interpersonal functioning. Preliminary results from the current trial just being completed by the Borkovec laboratory, in which individual interpersonal therapy techniques were added to their CBT package, have yielded a post-treatment effect size that is 17.5% to 78.8% larger than the posttreatment effect sizes from their previous trials of pure CBT packages (Borkovec & Sharpless, 2003). Clearly, these preliminary results are promising. At the same time, it is important to consider that for most people marriage is the relationship that is the greatest source of both social support (e.g., Argyle, 1999; Argyle & Furnham, 1983; Denoff, 1982;) and conflict (e.g., Argyle, 1999; Argyle & Furnham, 1983; Whisman, Sheldon & Goering, 2000). Thus, couples therapy may also have promise in the treatment of GAD. Indded, As we discuss below, there are several indirect lines of evidence that suggest that couples therapy may be at least as promising an interpersonal therapy as individual interpersonal therapy to add to the CBT package for GAD patients with partners. We begin by reviewing the evidence on GAD and problematic interpersonal functioning in general. We then proceed to focus more specifically on difficulties in marital and family functioning in GAD and disorders closely related to GAD.
GAD AND PROBLEMATIC INTERPERSONAL STYLES Several studies have shown that people with GAD experience significant interpersonal problems with peers, family, and romantic partners (Borkovec, Newman, Pincus, & Lytle, 2002; Whisman et al., 2000). Perhaps not surprisingly, therefore, the content of worry experienced by people with GAD is often interpersonal in nature (Breitholtz, Johansson, & Ost, 1995; Roemer, Molina, & Borkevec, 1997). More specifically, people with GAD appear to exhibit interpersonal styles that may impact their experience of interpersonal problems and worry. Using the Inventory of Interpersonal Problems (IIP; Horowitz, Alden, Wiggins, & Pincus, 2000), several studies have found that GAD is related to specific problematic interpersonal styles, specifically behaviors associated with being overly nurturant, nonassertive, overly accommodating, self-sacrificing, and intrusive/needy (Crits-Christoph, Gibbons, Narducci, Schamberger, & Gallop, 2005; Eng & Heimberg, 2006). There is also evidence that people with GAD have perceptual biases during interpersonal interactions which impact their interpersonal problems and experiences. Studies on
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information processing have shown that people with high anxiety (as opposed to normal controls or people with depression) show an attentional bias toward social threat cues, which depressed and normal controls tended to direct their attention away from the same threatening stimuli (MacLeod, Matthews, & Tata, 1986; Mathews & MacLeod, 1985; Mogg, Matthews, & Eysenck, 1992). GAD is also associated with a greater vigilance and orientation toward threatening faces (Bradley, Mogg, White, Groom, & de Bono, 1999;; Mogg, Millar, & Bradley, 2000). One study also found adolescent’s perception of parental rejection, overcontrol, and attachment was correlated with adolescent GAD, with perceived parental rejection and alienation uniquely predicting GAD (Hale, Engels, & Meeus, 2006). Some research has speculated that people with GAD lack awareness of their negative interpersonal impact on others (Erikson & Newman, 2007; Newman, Castonguay, Borkevec, & Molnar, 2004). Research has examined both overestimation of negative impact or catastrophizing bias (a belief that the GAD participant had a much more negative impact on the confederate than the confederate believed) and underestimation of negative impact or naivety bias (a lack of awareness on the part of the GAD participant concerning their negative impact as perceived by the confederate). In a study where those with GAD and control participants interacted with a confederate in a self-disclosure task, results showed that GAD was associated with a greater discrepancy between how the participant believed they impacted confederates and how the confederates actually reported feeling (Erikson & Newman, 2007). This finding was most pronounced in the Hostile-Submissive domain of interpersonal impact. This domain refers to a sense that one’s partner feels inadequate and nervous in the interaction, which exerts an interpersonal “pull” for one to put the other at ease or otherwise contain their discomfort. This behavioral style is therefore submissive in its unassertive aspects and hostile in the passive sense of expecting ridicule and coldly withdrawing from full social engagement. This study also found a U-shaped relationship between the amount of worry and degree of discrepancy in estimation in the HostileSubmissive area. In other words, high worry was associated with both over- and underestimating the degree of hostility-submissiveness, illustrating both a catastrophizing and naivety bias. Those demonstrating the naivety bias (those who underestimated their impact on others) were the least liked by the confederates, possibly because they were unable to read social cues concerning their interpersonal behaviors (Erikson & Newman, 2007). For patients with GAD, problematic interpersonal styles tend to change in the more desirable direction over the course of therapy (Borkevec et al., 2002; Crits-Christoph et al., 2005). Crits-Christoph and colleagues (2005) found a significant change in social avoidance, nonassertive, exploitable, overly nurturant, and intrusive interpersonal styles, as well as a change in a total score of all problematic styles combined. Borkevec and colleagues (2002) also found a change in all IIP categories from pre- to post-treatment.
MARITAL FUNCTIONING AND GAD There are several lines of evidence to suggest that GAD is associated with poor marital functioning. McLeod (1994) investigated marital distress and GAD among couples in which one member had a diagnosis of GAD (wives with GAD only and husband with GAD only) as well as couples in which both members had GAD. Wives with GAD reported significantly
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higher levels of marital distress than wives without GAD. However, husbands with GAD did not significantly differ on their report of marital distress compared to husbands without GAD. Couples who both had GAD did not report significantly higher levels of marital distress than couples with only one spouse diagnosed with GAD. Whisman (1999) replicated these results in a randomized national sample. That is, GAD was significantly associated with marital distress for woman but not for men with GAD. Whisman et al. (2000) extended this finding by examining nine diagnoses and found that the strongest diagnostic correlate of marital dissatisfaction was GAD. However, this study did not replicate the findings with regard to gender; gender did not moderate the relationship between GAD and marital distress. This study also compared the relationship between GAD and dissatisfaction among different social relationship including spouse, relatives, and friends. Individuals suffering with GAD reported significantly more dissatisfaction with their marital relationship compared with their dissatisfaction with other social relationships such as relatives and friends. In the most recent national sample investigating the relationship between GAD and marital distress, marital distress was significantly associated with elevated risk of GAD (Whisman, 2007). Among all of the anxiety disorders, marital distress had the strongest association with GAD. Further, GAD had one of the strongest associations with marital distress than any other psychiatric disorder excluding bi-polar disorder and alcohol dependence. Finally, gender did not moderate the relationship between GAD and marital distress. Overall, the association between marital distress and GAD is robust across several large national samples. Further, GAD appears to have a higher association with marital distress compared to other psychiatric disorders across these studies. Marital distress is one of the most robust predictors of divorce (see Bradbury & Karney, 1995 for a review). The previous research suggests GAD should also be associated with a higher risk for divorce. Only one study has investigated this association. In a national random survey, GAD was associated with a significantly elevated risk of divorce for both men and woman (Kessler, Walters, & Forthofer, 1998). Men with GAD had a higher risk of divorcing than men with any other disorder excluding mania. For women, GAD was significantly associated with an elevated risk for divorce; however, the odds ratio for elevated risk of divorce was equal to or lower than most of the other psychiatric disorders. Interestingly, whereas GAD is associated with an elevated risk of divorce, one study has shown that GAD is also associated with a higher likelihood of entering into marriage or a marriage-like relationship (Yoon & Zinbarg, 2007). Negative marital interaction appears to be one of the main factors that contribute to increased marital distress and divorce (see Karney and Bradbury, 1995; Weis & Heyman, 1990 for reviews). Thus, the previous evidence from the GAD marital functioning research would indicate GAD most likely would be associated with negative marital interaction. Only one study, conducted by our laboratory, has investigated the observed marital interaction of GAD couples (Zinbarg, Lee & Yoon, 2007). However, this study did not compare observed marital interaction between GAD, normal controls, and other psychiatric disorders but rather studied associations between marital interaction and treatment outcome within a GAD sample. We have since recruited a normal control sample and are currently working on analyses comparing the GAD couples and the normal control couples. By extension of the previous marital interaction research with normal and distressed couples, we expect GAD couples to have higher levels of negative marital interaction compared to other psychiatric diagnoses and normal controls. Given that GAD shares core features in common with the other anxiety disorders and depression (e.g., Zinbarg & Barlow, 1996; Kendler, Gardner,
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Gatz, & Pederson, 2007; Krueger, Caspi, Moffitt, Silva, & McGee, 1996), we next turn to the evidence regarding associations of marital and family functioning with anxiety disorders other than GAD and with depression.
MARITAL AND FAMILY FUNCTIONING AND ANXIETY DISORDERS OTHER THAN GAD Dysfunctional family functioning (e.g., marital and extended family members) relates to anxiety disorders other than GAD. The majority of research between family functioning focuses on Panic Disorder with Agoraphobia (PDA). A growing number of studies focus on the relationship between dysfunctional family functioning and Post Traumatic Stress Disorder (PTSD). Finally, there exist a small number of studies investigating the relationship between family functioning and Obsessive Compulsive Disorder (OCD) and Social Anxiety Disorder (SAD). PDA is sometimes associated with dysfunctional marital functioning. Bryne, Carr, and Clark (2004) reviewed 24 studies investigating the relationship between marital distress and PDA. Ten of these studies investigated the relationship between marital distress and PDA retrospectively. The majority of these studies (n = 9) found an association between marital distress and PDA (Fry, 1962; Goldstein and Chambless, 1978; Goodstein and Swift, 1977; Holmes, 1982; Kleiner & Marshall, 1987; Quadrio, 1984; Roberts, 1964; Symonds, 1971; Webster, 1953). Only one study did not find a significant relationship between marital distress and PDA. However, retrospective studies have many methodological flaws such as response biases. Fourteen studies investigated the relationship between marital distress and PDA prospectively (Arrindell & Emmelkamp, 1986; Buglass et al., 1977; Emmelkamp et al., 1992; Fisher and Wilson, 1985; Friedman, 1990; Hafner, 1977a, 1983; Hand and Lamontagne, 1976; Kleiner et al., 1987; Lange and van Dyck, 1992; McLeod, 1994; Markowitz et al., 1989; Massion et al., 1993; Torpy and Measey, 1974). In six studies, PDA was significantly associated with marital distress. In seven of the prospective studies, marital distress was not significantly associated with PDA (Arrindell & Emmelkamp, 1986; Buglass et al., 1977; Emmelkamp et al., 1992; Fisher and Wilson, 1985; Friedman, 1990; Hafner, 1977a; Lange and van Dyck, 1992). Finally, one study (Massion et al., 1993) found that couples in which one member had PDA reported similar levels of marital distress compared to couples in which member had GAD. Thus, whereas the association between PDA and marital distress may not be as strong when measured prospectively as when assessed retrospectively, the prospective studies do converge with the retrospective ones in demonstrating that PDA is associated with marital distress. There is a growing body of research investigating the relationship between family functioning and PTSD. In a series of studies, PTSD has been significantly associated with marital distress (Forbes, et al, 2003; Whisman, 1999; Whisman, 2007). In one national study, PTSD was even found to be more highly associated with martial distress than any other psychiatric disorder (Whisman, 1999). Further, across different PTSD populations (e.g., veterans, POWs, etc.), individuals with PTSD, compared to their non affected counterparts (those experiencing the same trauma without PTSD), reported higher levels of marital distress (Carroll, Rueger, Foy, & Donahoe, 1985; Cook et al., 2004; Dekel & Solomon, 2006).
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PTSD has been linked to other forms of marital dysfunction such as marital violence and divorce. PTSD symptoms are significantly associated with the use of physical aggression with intimate partners (O’Donnell et al., 2006; Hughes, 2007) and an elevated risk for divorce (Kessler, Walters, & Forthofer, 1998). Individuals with PTSD have higher rates of divorce and marital violence compared to their counterparts without PTSD. Men diagnosed with PTSD, compared with men without PTSD, are more likely to be physically aggressive toward their relationship partners (Carroll, Rueger, Foy, & Donahoe, 1985; Sherman, Fred, Jackson, Lyons, & Han, 2006) and are twice as likely to divorce and three times as likely to experience multiple divorces (Jordan et al., 1992). Less is known about the relationship between marital functioning and OCD. For example, whereas Whisman (1999, 2000, 2007) investigated the relationship between several psychiatric diagnoses and marital distress, OCD was not included in any of these three studies. Similarly, Kessler, Walters, and Forthofer (1998) investigated the likelihood of divorce associated with several different psychiatric diagnoses; however, OCD was not included in the study. To date, only one small sample study has investigated the relationship between marital distress and OCD symptoms (Riggs, Hiss, & Foa, 1992). This study did not find a significant relationship between OCD symptoms and marital distress. Little is also known with regards to social phobia and marital functioning. Whisman (1999) found a significant relationship between social phobia and marital distress and this relationship was replicated in a separate national sample by Whisman (2007). It should be noted, however, that once the presence of other psychiatric diagnoses were entered as covariates in Whisman (1999), social phobia was no longer significantly correlated with marital distress. Further, social phobia is not related to an increased risk of divorce (Kessler, Walters, & Forthofer, 1998).
MARITAL AND FAMILY FUNCTIONING AND MAJOR DEPRESSION Several lines of empirical research support a close link between GAD and major depressive disorder (MDD). First, GAD and MDD co-occur at a rate greater than what would be expected by chance (Kessler, Nelson, McGonagle, Liu, Schwartz, & Blazer, 1996; Mineka, Watson, & Clark, 1998). Second, similar phenotypic patterns have emerged suggesting that GAD is more closely related to MDD than to other anxiety disorders (e.g., Zinbarg and Barlow, 1996). Third, GAD and MDD have a genetic correlation of 1.0, indicating that they are not genetically distinguishable from one another (Kendler, Gardner, Gatz, & Pederson, 2007; Kendler, 1996, Kendler, Neale, Kessler, Heath, & Eaves, 1992). Fourth, according to personality studies, GAD and MDD share the common vulnerability trait of neuroticism or negative emotionality (Krueger, Caspi, Moffitt, Silva, & McGee, 1996; Barlow & Campbell, 2000; Watson, Gamez, & Simms, 2005). Therefore, the literature on marital and family functioning in MDD might be relevant to similar topics in GAD. Epidemiological research indicates the MDD is significantly related to not getting along with one’s spouse and not having any close friends (Whisman, Sheldon, & Goering, 2000). Other studies have documented elevated rates of insecure adult romantic attachment in depressed patients and their partners, with the likelihood of insecure attachment in partners covarying with the chronicity of the patient’s depressive symptoms (e.g., Roberts, Gotlib &
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Kassel, 1996; Whiffen, Kallos-Lilly & MacDonald, 2001; Whisman & McGarvey, 1995). Several lines of research offer an explanation for the interpersonal difficulties found in those with MDD. One literature review summarized four major areas of interactional problems among depressed dyads (Beach, Sandeen & O'Leary, 1990). First, depressed patients engage in more “depressive” behaviors with their spouses than do non-depressed spouses and these behaviors suppress spousal aggression (Beach & Nelson, 1989; Biglan, et al., 1985, 1989; Hops et al., 1987; Nelson & Beach, 1990). Second, depressed and discordant couples experience low levels of relationship cohesion, even when compared to discordant, nondepressed dyads (Beach et al., 1988; Monroe, Bromet, Connell, & Steiner, 1986). Third, the interactions of depressed persons and their spouses lack symmetry, such that depressed individuals are more likely to be passive and let decision making be done for them. Fourth, even though they suppress the expression of hostility, depressed discordant dyads are likely to reciprocate negative partner behavior when it occurs (Biglan, et al., 1985). Another possible explanation for the interpersonal problems found in those with MDD concerns reassurance seeking behavior (e.g., Joiner & Metalsky, 1995, 2001; Joiner & Schmidt, 1998; Potthoff, Holahan & Joiner, 1995). This research has been done in the context of peer/roommate relationships, as well as with married and dating couples. Findings suggest that reassurance seeking predicts negative attitudes and contagious depression in partners, as well as depression in response to partner devaluation (e.g., Benazon, 2000; Katz, Beach & Joiner, 1998, 1999). While some studies have reported that reassurance seeking is specific to depression, at least two analyses have supported a link between anxiety and reassurance seeking (e.g., Joiner, 1994; Joiner, Katz and Lew, 1999). In addition to the problematic interpersonal styles evidenced by people with MDD, there is also growing evidence that depressed individuals play a role in generating interpersonal stressors in their lives (e.g., Hammen, 1991; Hammen, Davila, Brown, Ellicott, & Gitlin, 1992; Uliaszek, Zinbarg, Mineka, Craske, & Griffith, 2008). Research has shown that depressed women subsequently experience more dependent (i.e., at least party due to the woman’s behavior), interpersonal stressful life events compared with others, but not on stressful life events that were judged to be independent or outside the woman’s control. The types of interpersonal stress experienced included marital problems (including divorce or separation) and social dysfunction.
MARITAL AND FAMILY FUNCTIONING AND PREDICTION OF TREATMENT RESPONSE IN DEPRESSION AND ANXIETY DISORDERS OTHER THAN GAD Marital, familial, and peer interpersonal difficulties have relevance for response to treatment of depression. There is a large body of research on expressed emotion (EE) and treatment response in depression. EE is conceptualized as consisting of three factors: criticism and hostility, emotional overinvolvement (EOI), and positivity (Chambless, Steketee, Bryan, Aiken, & Hooley, 1999). The evidence suggests that the expression of hostility toward the depressed patient by family members (most of whom are spouses) and patient perceived criticism predict poor treatment response (e.g., Addis & Jacobson, 1996; Hooley & Teasdale, 1989; Rounsaville, Weissman, Prusoff & Herceg-Baron, 1979). It is also noteworthy that the
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severity of expressions of hostility toward the patient correlates with the chronicity of the symptoms among depressed patients (Hayhurst, Cooper, Paykel, Vearnals & Ramana, 1997). Dysfunctional family interactions also influence response to treatment for a variety of anxiety disorders. EE has been linked to treatment outcome across a variety of anxiety disorders. Peter and Hand (1998) found that higher criticism expressed by a spouse toward the patient with PDA predicted better long – term outcome in CBT for PDA. However, Tarrier, Sommerfield and Pilgrim (1999) found that greater levels of relative hostility expressed toward the patient predicted poorer treatment outcome in PTSD patients treated with either cognitive therapy or imaginal exposure therapy for PTSD. Although these results seem contradictory, other researchers have found differential relationships between the different facets of the EE construct and treatment outcome for anxiety disorders. In a sample of OCD and PDA patient completing CBT, Chambless and Steketee (1999) found that greater levels of hostility expressed toward the patient by relatives predicted higher rates of dropout and poorer treatment outcome. On the other hand, they also found that higher rates of nonhostile criticism predicted better treatment outcome. Fogler, Tompson, Stektee, and Hofmann (2007) investigated the impact of EE on treatment outcome for social phobia. These researchers found lower levels of perceived criticism were associated with a greater likelihood of treatment dropout; whereas, hostile EE and emotional overinvolvement were not associated with treatment dropout.
INTERPERSONAL PREDICTORS OF GAD TREATMENT RESPONSE Results from studies utilizing the IIP have found that interpersonal problems can predict of the patient’s response to treatment. One GAD treatment study found that greater interpersonal problems (as assessed by the IIP) predicted worse outcome at 6-month followup (Borkevec et al., 2002). Another study demonstrated that being overly nurturant was associated with less change in anxiety and worry symptomatology at post-treatment (CritsChristoph et al., 2005). Overall, improvement in interpersonal problems, especially of the overly nurturant variety, was associated with improvement in symptomatology (CritsChristoph et al., 2005). The results of a study examined interpersonal interactions between GAD patients and their partners also suggests that interpersonal problems are predictors of treatment response just as the IIP studies do (Zinbarg, Lee, & Yoon, 2007). This study found that partner hostility when discussing the GAD patients’ worries predicted worse functioning at the end of treatment. Non-hostile criticism by the partner during the worry discussion predicted better end-state functioning.
EFFICACY OF COUPLES THERAPY FOR DEPRESSION ND ANXIETY DISORDERS OTHER THAN GAD The efficacy of couples therapy for GAD has yet to be investigated. Several studies have investigated the efficacy of couples therapy or spouse assisted therapy for depression and
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other anxiety disorders. For the reasons discussed above, these studies may have relevance for GAD and so we review them below. Given the dyadic problems of many depressed individuals and the effects of marital functioning on treatment response in depression, it should perhaps not be surprising that several studies have tested the efficacy of couples therapy for depression. Across these studies, couples therapy improved both depressive symptoms and marital functioning. Jacobson et al. (1991) randomly assigned married women diagnosed with depression to Behavioral Marital Therapy (BMT), individual cognitive therapy (CT), or a treatment combining BMT and CT. BMT was as effective as the other conditions at reducing depressive symptoms, but only BMT significantly improved marital distress. Beach and O’Leary (1992) replicated and extended these findings in a sample of distressed couples in which the wife was depressed. The couples were randomized to three different conditions: BMT, CT, or a 15 week waiting list condition. BMT and CT both significantly reduced depressive symptoms. Similarly to the Jacbson et al. (1991) study, only BMT provided significant improvements in marital distress. These previous studies focused on depressed wives. Emanuels-Zuurveen and Emmelkamp (1996) extended and replicated these previous findings by including depressed husband and depressed wives in their sample. Couples were randomly assigned to either individual cognitive/behavioral therapy or communication-focused marital therapy. In both conditions depressive symptomotology improved post treatment; however, only the marital therapy condition exhibited significant reductions in marital distress. Finally, Foley et al. (1989) extended these findings using a different theoretical intervention than CBT. Depressed patients (including men and woman) were randomized to either individual interpersonal psychotherapy (IPT) or a couple format version of IPT. Similar to past findings, both conditions improved depression, but only the couple IPT intervention improved marital functioning. Overall, these studies provide evidence that couples therapy is an efficacious treatment for depression. Further, couples treatment has the extra benefit of improving marital functioning; whereas, individual treatment only reduces depressive symptoms. Several treatment outcome studies have investigated the efficacy of involving relationship partners in the treatment of Agoraphobia. Interventions involving partners in the treatment of Agoraphobia differ in the focus of treatment. These interventions can be divided into two main foci. One group of interventions target the patient’s avoidance through partner assisted exposure therapy. The second group target relationship functioning through interpersonal skills training for both the patient and partner. Daiuto, Baucom, Epstein and Dutton (1998) conducted a meta analysis that distinguished outcomes based on these two types of interventions. The first set of analyses compared individual exposure therapy to partner assisted exposure therapy. Across six treatment outcome studies, individual exposure therapy, if anything, outperformed partner assisted exposure therapy; however, the two types of treatment were not significantly different from one another. The second group of analyses compared interventions targeting couple functioning to interventions targeting general interpersonal problems. Interventions targeting couple functioning led to significantly better outcomes at follow-up than exposure alone. In contrast, interventions targeting general interpersonal problems led to significantly worse outcomes at both post-treatment and followup than exposure alone. Thus, it appears that including the partner in treatment is most effective when interventions are included that are aimed at the partners’ interaction patterns. Indeed, some forms of involving the partner in treatment (i.e., partner-assisted exposure) may even be counter-productive.
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Despite the large body of literature establishing a relationship between PTSD and marital functioning and the fact that several treatment developers have developed clinical interventions for PTSD incorporating couple therapy (e.g., Johnson, 2002), there exists only one randomized clinical trial of family therapy for PTSD.. Monson et al. (2004) investigated a Cognitive –Behavioral Couples’ treatment for PTSD. The PTSD patients improved significantly on PTSD symptoms from pre-test to post-test; however, this study did not include a control sample. Thus, it is difficult to attribute the results to the intervention. Glynn et al. (1999) conducted the first randomized clinical control trial of couples therapy with a PTSD population. Veterans and a family member were randomly assigned to three different conditions: waiting list, 18 sessions of twice-weekly exposure therapy, or 18 sessions of twice-weekly exposure therapy followed by 16 sessions of behavioral family therapy (BFT). Both active treatments performed better than the wait-list control group. However, BFT was not significantly different than individual exposure therapy at reducing PTSD symptoms. Despite evidence showing that family functioning may influence OCD response to treatment and the fact that some therapists have developed systemic treatments for OCD (e.g., MacFarlene, 2001), there has yet to be a randomized clinical trial investigating the efficacy of family or couple therapy for OCD. Some research has investigated family therapy for children suffering from social phobia (e.g., Barrett, Dadds, & Rapee, 1996); however, an empirical evaluation of a systemic intervention for adults has not yet been investigated.
CONCLUSION GAD is not only common but is also associated with significant impairment in occupational, interpersonal and family functioning. Unfortunately, there is also growing consensus that our current treatments for GAD are not effective enough and we need to improve them. Whereas established treatments for GAD are individual modalities, we have reviewed evidence from several lines of research suggesting current treatments for that systemic therapy has promise to augment the effectiveness of therapy for GAD. One of the important lessons from the literature on the inclusion of the patient’s partner in the treatment of PDA, is that one needs to choose one’s intervention targets carefully when including a family member in treatment as some forms of couples interventions so appear to augment the effectiveness of CBT for PDA whereas others show a trend toward worse outcomes compared with individual CBT (Daiuto, Baucom, Epstein & Dutton, 1998). We are currently beginning a study designed to assist in the process of selecting systemic targets. One aim of this study is to replicate the findings from Zinbarg, Lee & Yoon (2007) showing that pre-treatment levels of partner hostility predict worse response to individual CBT whereas pre-treatment levels of partner non-hostile criticism predicts better treatment response. A second aim of this study is to extend our earlier findings by testing whether similar patterns hold for interactions with other relatives for those patients with GAD who are not married or in a marriage-like relationship as well as testing whether these systemic variables predict treatment response above and beyond the effects of potential third-variables such as chronicity of GAD, axis II pathology in the patient, and axis I or axis II pathology in the partner/relative. If our earlier results are replicated and found to be not entirely attributable to plausible third-variables, it
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would suggest that systemic interventions designed to reduce hostility and increase nonhostile criticism would hold great promise for increasing the efficacy of treatment for GAD.
REFERENCES Addis, M. E., & Jacobson, N. S. (1996). Reasons for depression and the process and outcome of cognitive-behavioral psychotherapies. Journal of Consulting and Clinical Psychology,64, 1417–1 424. Albano, A. M., Chorpita, B. F., & Barlow, D. H. (2003). Childhood anxiety disorders. In E. J. Mash, & R. A. Barkley (Eds.), Child psychopathology (pp. 279–329). New York: Guilford Press. Alden, L. E., Wiggins, J. S., & Pincus, A. L. (1990). Construction of circumplex scales for the Inventory of Interpersonal Problems. Journal of Personality Assessment, 55, 521– 536. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author. Argyle, M. (1999). Causes and correlates of happiness. In D. Kahneman, E. Diener, & N. Schwarz (Eds.), Well-being: The foundations of hedonic psychology (pp. 353–373). New York: Russell Sage Foundation. Argyle, M., & Furnham, A. (1983). Sources of satisfaction and conflict in long-term relationships. Journal of Marriage & the Family, 45, 481–493. Arnow, B. A., Taylor, C. B., Agras, W. S., & Telch, M. J. (1985). Enhancing agoraphobia treatment outcome by changing couple communication patterns. Behavior Therapy, 16, 452–467. Arrindell, W. A., & Emmelkamp, P. M. (1986). Marital adjustment, intimacy and needs in female agoraphobics and their partners: a controlled study. British Journal of Psychiatry, 149, 592–602. Arrindell, W. A., Emmelkamp, P. M., & Sanderman, R. (1986). Marital quality and general life adjustment in relation to treatment outcome in agoraphobia. Advances in Behavior Research and Therapy, 8, 139–185. Barlow, D. H., & Campbell, L. A. (2000). Mixed anxiety-depression and its implications for models and anxiety disorders. Comprehensive Psychiatry, 41 (1), 55–60. Barlow, D. H., O’Brian, G. T., & Last, C. G. (1984). Couples treatment of agoraphobia. Behavior Therapy, 15, 41–58. Barrett, P. M., Dadds, M. R., & Rapee, R. M. (1996). Family treatment of childhood anxiety: A controlled trial. Journal of Consulting and Clinical Psychology, 64, 333–342. Beach, S. R., Nelson, G. M., & O'Leary, K. D. (1988). Cognitive and marital factors in depression. Journal of Psychopathology & Behavioral Assessment, 10, 93–105. Beach, S. R., & O'Leary, K. D. (1986). The treatment of depression occurring in the context of marital discord. Behavior Therapy, 17, 43–49. Beach, S. R., & O'Leary, K. D. (1992). Treating depression in the context of marital discord: Outcome and predictors of response of marital therapy versus cognitive therapy. Behavior Therapy, 23, 507–528.
78
Danielle Black, Amanda Uliaszek, Alison Lewis et al.
Beach, S. R., Sandeen, E., & O’Leary, K. D. (1990). Depression in Marriage: A Model for Etiology and Treatment. New York: Guilford Press. Benazon, N. R. (2000). Predicting negative spousal attitudes toward depressed persons: A test of Coyne's Interpersonal Model. Journal of Abnormal Psychology, 109, 550–554. Biglan, A., Hops, H., Sherman, L., Friedman, L. S., Arthur, J., & Osteen, V. (1985). Problemsolving interactions of depressed women and their husbands. Behavior Therapy, 16, 431– 451. Biglan, A., Rothlind, J., Hops, H., & Sherman, L. (1989). Impact of distressed and aggressive behavior. Journal of Abnormal Psychology, 98, 218–228. Borkovec, T. D., Newman, M. G., Pincus, A. L., & Lytle, R. (2002). A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. Journal of Consulting & Clinical Psychology, 70, 288–298. Borkovec, T. D. & Sharpless, B. (2004). Generalized anxiety disorder: Bringing cognitive behavioral therapy into the valued present. In: S.C. Hayes, V.M. Follette and M.M. Linehan, Editors, Mindfulness and relationship: Expanding the cognitive-behavioral tradition, The Guilford Press, New York (pp. 209–242). Borkovec, T. D., & Whisman, M. A. (1996). Psychosocial treatment for generalized anxiety disorder. In M. R. Mavissakalian & R. F. Prien (Eds.), Long-term tratments of anxiety disorders (pp. 171–199). Washington, DC: American Psychiatric Press. Bradley, B. P., Mogg, K., White, J., Groom, C., & De Bono, J. (1999). Attentional bias for emotional faces in generalized anxiety disorder. British Journal of Clinical Psychology, 38, 267–278. Breitholtz, E., Johansson, B., & Ost, L. G. (1995). Cognitions in generalized anxiety disorder and panic disorder patients: A prospective approach. Behaviour Research and Therapy, 37, 533–544. Brown, T., O'Leary, T., & Barlow, D. H. (1994). Generalized anxiety disorder. In D. H. Barlow (Ed.), Clinical handbook of psychological disorders (pp. 154-208). New York: Guilford. Bryne, M., Carr, A., & Clark, M. (2004). The efficacy of couple-based interventions for panic disorder with agoraphobia. Journal of Family Therapy, 26, 105–125. Buglass, D., Clarke, J., Henderson, A., Kreitman, N. and Presley, A. (1977). A study of agoraphobic housewives. Psychological Medicine, 7, 73–86. Carroll, E. M., Rueger, D. B.,Foy, D. W. & Donahoe, C. P. (1985). Vietnam combat veterans with Posttraumatic Stress Disorder: Analysis of marital and cohabitating adjustment. Journal of Abnormal Psychology, 94, 329–337. Cerny, J. A., Barlow, D. H., Craske, M. G., & Himadi, W. G. (1987). Couples treatment of agoraphobia: A two-year follow-up. Behavior Therapy, 18, 401–415. Chambless, D. L., & Gillis, M. M. (1993). Cognitive therapy of anxiety disorders. Journal of Consulting & Clinical Psychology, 61, 248–260. Chambless, D. L., & Steketee, G. (1999). Expressed emotion and behavior therapy outcome: A prospective study with obsessive-compulsive and agoraphobic outpatients, Journal of Consulting and Clinical Psychology, 67, 658–665. Chambless, D. L., Steketee, G., Bryan, A. D., Aiken, L. S., & Hooley, J. M. (1999). The structure of expressed emotion: A three-construct representation, Psychological Assessment, 11, 67–76.
Generalized Anxiety Disorder and Interpersonal Relationships
79
Cook, J. M., Riggs, D. S., Thompson, R., Coyne, J. C., & Sheikh, J. I. (2004). Posttraumatic stress disorder and current relationship functioning among World War II ex-prisoners of war. Journal of Family Psychology, 18, 36–45. Craske, M. G., Barlow, D. H., & O’Leary, T. A. (1992). Mastery of your anxiety and worry. San Antonio, TX: The Psychological Corporation. Crits-Christoph, P., Gibbons, M. B. C., Narducci, J., Schamberger, M., & Gallop, R. (2005). Interpersonal problems and the outcome of interpersonally oriented psychodynamic treatment of GAD. Psychotherapy: Theory, Research, Practice, Training, 42(2), 211224. Denoff, M. S. (1982). The differentiation of supportive functions among network members: An empirical inquiry. Journal of Social Service Research, 5, 45–59. Emanuels-Zuurveen, L., & Emmelkamp, P. M. G. (1996). Individual behavioral-cognitive therapy v. marital therapy for depression in maritally distressed couples, British Journal of Psychiatry, 169,181–188. Emanuels-Zuurveen, L., & Emmelkamp, P. M. G. (1997). Spouse-aided therapy with depressed patients, Behavior Modification, 21, 62–77. Emmelkamp, P. (1980). Agoraphobics’ interpersonal problems: their role in the effects of exposure in vivo therapy. Archives of General Psychiatry, 37, 1303–1306. Emmelkamp, P., & Gerlsma, C. (1994). Marital functioning and the anxiety disorders. Behavior Therapy, 25, 407–429. Emmelkamp, P., van Dyck, R., Bitter, M., Heins, R., Onstein, E. J. and Eisen, B. (1992). Spouse-aided therapy with agoraphobics. British Journal of Psychiatry,160, 51–56. Eng, W., & Heimberg, R. G. (2006). Interpersonal correlates of generalized anxiety disorder: Self versus other perception. Anxiety Disorders, 20, 380–387. Erikson, T. M., & Newman, M. G. (2007). Interpersonal and emotional processes in generalize anxiety disorder analogues during social interaction tasks. Behavior Therapy, 38, 364 – 377. Fisher, L. M. and Wilson, G. T. (1985). A study of the psychology of agoraphobia. Behavior Research and Therapy, 23, 97–107. Fogler, J., Tompson, M. C., Steketee, G., & Hofmann, S. G. (2007). Influence of expressed emotion and perceived criticism on cognitive-behavioral therapy for social phobia. Behaviour Research and Therapy, 45, 235–249. Foley, S. H., Rounsaville, B. J., Weissman, D. S., & Cheveron, E. (1989). Individual versus conjoint interpersonal therapy for depressed patients with marital disputes, International Journal of Family Psychiatry, 10, 29–42. Forbes, D., Creamer, M., Allen, N., McHugh, T., Debenham, P., Hopwood, M. (2003). MMPI-2 as a predictor of change in PTSD symptom clusters: A further analysis of the Forbes et al. (2002) data set. Journal of Personality Assessment, 81, 183–186. Friedman, S. (1990). Assessing the marital environment of agoraphobics. Journal of Anxiety Disorders, 4, 335–340. Fry, W. F. (1962) The marital context of anxiety syndrome. Family Process, 1, 245 – 252. Glynn, S. M., Eth, S., Randolph, E. T., Foy, D. W., Urbaitis, M., Boxer, L., Paz, G., Leong, G. B., Firman, G., Salk, J. D., Katzman, J. W., & Crothers, J. (1999). A test of behavioral family therapy to augment exposure for combat-related posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 67, 243–251.
80
Danielle Black, Amanda Uliaszek, Alison Lewis et al.
Goldstein, A. and Chambless, D. (1978) A reanalysis of agoraphobia. Behavior Therapy, 9, 47–59. Goodstein, R. K. and Swift, K. (1977) Psychotherapy with phobic patients: the marriage relationship as the source of symptoms and focus of treatment. American Journal of Psychotherapy, 31, 284–293. Gould, R. A., Otto, M. W., Pollack, M. H., & Yap, L. (1997). Cognitive behavioral and pharmacological treatment of generalized anxiety disorder: A preliminary meta-analysis. Behavior Therapy, 28, 285–305. Hafner, R. J. (1976). Fresh symptom emergence after intensive behaviour therapy. British Journal of Psychiatry, 129, 378–383. Hafner, R. J. (1977a). The husbands of agoraphobic women: assortative mating or pathogenic interaction? British Journal of Psychiatry, 130, 233–239. Hafner, R. J. (1977b). The husbands of agoraphobic women and their influence on treatment outcome. British Journal of Psychiatry, 131, 289–294. Hafner, R. J. (1979). Agoraphobic women married to abnormally jealous men. British Journal of Medical Psychology, 52, 99–104. Hafner, R. J. (1983). Marital systems of agoraphobic women: contributions of husband’s denial and projection. Journal of Family Therapy, 5, 379–396. Hale, W. W., Engels, R., & Meeus, W. (2006). Adolescent’s perception of parenting behaviours and its relationship to adolescent generalize anxiety disorder symptoms. Journal of Adolescence, 29, 407–417. Hammen, C. (1991). Generation of stress in the course of unipolar depression. Journal of Abnormal Psychology, 100, 555–561. Hammen, C., Davila, J., Brown, G., Ellicott, A., & Gitlin, M. (1992). Psychiatric history and stress: Predictors of severity of unipolar depression. Journal of Abnormal Psychology, 101, 45–52. Hand, I., & Lamontagne, Y. (1976). The exacerbation of interpersonal problems after rapid phobia removal. Psychotherapy: Theory, Research & Practice, 13, 405–411. Hayhurst, H., Cooper, Z., Paykel, E. S., Vearnals, S., & Ramana, R. (1997). Depressed emotion and depression. British Journal of Psychiatry, 171, 439–443. Holmes, J. (1982) Phobia and counterphobia: family aspects of agoraphobia. Journal of Family Therapy, 4, 133–152. Hooley, J. M., & Teasdale, J. D. (1989). Predictors of relapse in unipolar depressives: Expressed emotion, marital distress, and perceived criticism. Journal of Abnormal Psychology, 98, 229–235. Hops, H., Biglan, A., Sherman, L., Arthur, J., et al. (1987). Home observations of family interactions of depressed women. Journal of Consulting & Clinical Psychology, 55, 341– 346. Horowitz, L. M., Alden, L. E., Wiggins, J. S., & Pincus, A. L. (2000). IIP–64/IIP–32 professional manual. San Antonio, TX: The Psychological Corporation. Hughes, F. (2007). Predicting the use of aggressive conflict tactics in a sample of women arrested for domestic violence. Journal of Social and Personal Relationships, 24, 155– 176. Jacobson, N. S., Dobson, K., Fruzzetti, A. E., Schmaling, K. B. & Salusky, S.. (1991). Marital therapy as a treatment for depression. Journal of Consulting and Clinical Psychology, 59, 547–557.
Generalized Anxiety Disorder and Interpersonal Relationships
81
Joiner, T. E. (1994). Contagious depression: Existence, specificity to depressed symptoms, and the role of reassurance seeking. Journal of Personality and Social Psychology, 67, 287–296. Joiner, T. E., Jr., Katz, J., & Lew, A. (1999). Harbingers of depressotypic reassurance seeking: Negative life events, increased anxiety, and decreased self-esteem. Personality and Social Psychology Bulletin, 25, 630–637. Joiner, T. E., Jr., & Metalsky, G. I. (1995). A prospective test of an integrative interpersonal theory of depression: A naturalistic study of college roommates. Journal of Personality & Social Psychology, 69, 778–788. Joiner, T. E., Jr., & Metalsky, G. I. (2001). Excessive reassurance seeking: Delineating a risk factor involved in the development of depressive symptoms. Psychological Science, 12, 371–378. Joiner, T. E., Jr., & Schmidt, N. B. (1998). Excessive reassurance-seeking predicts depressive but not anxious reactions to acute stress. Journal of Abnormal Psychology, 107, 533–537. Johnson, S. M. (2002). Emotionally focused couple therapy with trauma survivors: Strengthening attachment bonds. New York, NY: Guilford Press. Jordan, B. K., Marmar, C. R., Fairbank, J. A., Schlenger, W. E., Kulka, R. A., Hough, R. L., & Weiss, D. S. (1992). Problems in families of male Vietnam veterans with posttraumatic stress disorders. Journal of Consulting and Clinical Psychology, 60, 916–926. Karney, B. R., & Bradbury, T. N. (1995). The longitudinal course of marital quality and stability: A review of theory, method, and research. Psychological Bulletin, 118, 3–34. Katz, J., Beach, S. R. H., & Joiner, T. E., Jr. (1998). When does partner devaluation predict emotional distress? Prospective moderating effects of reassurance-seeking and selfesteem. Personal Relationships, 5, 1–13, 409–421. Katz, J., Beach, S. R. H., & Joiner, T. E., Jr. (1999). Contagious depression in dating couples. Journal of Social & Clinical Psychology, 18, 1–13. Kendler, K. S. (1996). Major depression and generalised anxiety disorder. Same genes, (partly) different environments revisited. British Journal of Psychiatry, 30, 68–75. Kendler, K. S., Gardner, C. O., Gatz, M., & Pederson, N. L. (2007). The sources of comorbidity between major depression and generalized anxiety disorder in a Swedish national twin sample. Psychological Medicine, 37(3), 453–462. Kendler, K. S., Neale, M. C., Kessler, R. C., Heath, A. C. & Eaves, L. J. (1992). Major depression and generalized anxiety disorder. Same genes, (partly) different environments? Archives of General Psychiatry 49, 716–722. Kessler, R. C., Keller, M.B., & Wittchen, H.-U. (2001). The epidemiology of generalized anxiety disorder. Psychiatric Clinics of North America, 24, 19–39. Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshleman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Survey. Archives of General Psychiatry, 51, 8–19. Kessler, R. C., Nelson, C. B., McGonagle, K. A., Liu, J., Swartz, M. S. & Blazer, D. G. (1996). Comorbidity of DSM-III-R major depressive disorder in the general population: results from the US National Comorbidity Survey. British Journal of Psychiatry, 168, 17–30.
82
Danielle Black, Amanda Uliaszek, Alison Lewis et al.
Kessler, R. C., Walters, E. E., & Forthofer, M. S. (1998). The social consequences of psychiatric disorders, III: Probability of marital stability. American Journal of Psychiatry, 155, 1092–1096. Kleiner, L., & Marshall, W. L. (1985). Relationship difficulties and agoraphobia. Clinical Psychology Review, 5, 581–595. Kleiner, L., & Marshall, W. L. (1987). The role of interpersonal problems in the development of agoraphobia with panic attacks. Journal of Anxiety Disorders, 1, 313–323. Kleiner, L., Marshall, W. L. & Spevack, M. (1987). Training in problem-solving and exposure treatment for agoraphobics with panic attacks. Journal of Anxiety Disorders, 1, 219–238. Krueger, R. F., Caspi, A., Moffitt, T. E., Silva, P. A., & McGee, R. (1996). Personality traits are differentially linked to mental disorders: A multi-trait/multi-diagnosis study of an adolescent birth cohort. Journal of Abnormal Psychology, 105, 299–312. Lange, A., & van Dyck, R. (1992). The function of agoraphobia in the marital relationship. Acta Psychiatrica Scandinavica, 85, 89–93. Leff, J., Vearnals, S., Brewin, C. R., Wolff, G., Alexander, B., Asen, E., et al. (2000). The London Depression Intervention Trial: Randomised controlled trial of antidepressants v. couple therapy in the treatment and maintenance of people with depression living with a partner: Clinical outcome and costs. British Journal of Psychiatry, 177, 95–100. MacFarlene, M. M. (2001). Systemic treatment of obsessive-compulsive disorder in a rural community mental health center: An integrative approach. In MacFarlane, M. M. (Ed.), Family therapy and mental health: Innovations in theory and practice, (pp. 155–183). Binghamton, NY, US: Haworth Clinical Practice Press. MacLeod, C., Mathews, A., & Tata, P. (1986). Attentional bias in emotional disorders. Journal of Abnormal Psychology, 95, 15–20. Markowitz, J. S., Weissman, M. M., Quellette, R., Lish, J. D., & Klerman, G. L. (1989). Quality of life in panic disorder. Archives of General Psychiatry, 46, 984–992. Massion, A. O., Warshaw, M. G. and Keller, M. B. (1993). Quality of life and psychiatric morbidity in panic disorder and generalised anxiety disorder. American Journal of Psychiatry, 150, 600–607. Mathews, A. M., & MacLeod, C. (1985). Selective processing of threat cues in anxiety states. Behaviour Research and Therapy, 23, 563–569. McLeod, J. D. (1994). Anxiety disorders and marital quality. Journal of Abnormal Psychology, 103, 767–776. Mineka, S., Watson, D., & Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377– 412. Mitte K., Noack P., Steil R., & Hautzinger M. A. (2005). A meta-analytic review of the efficacy of drug treatment in generalized anxiety disorder. Journal of Clinical Psychopharmacology, 25, 141–50. Mogg, K., Mathews, A., & Eysenck, M. (1992). Attentional bias to threat in clinical anxiety states. Cognition and Emotion, 6, 149–159. Mogg, K., Millar, N., & Bradley, B. P. (2000). Biases in eye movements to threatening facial expressions in generalized anxiety disorder and depressive disorder. Journal of Abnormal Psychology, 109, 695–704.
Generalized Anxiety Disorder and Interpersonal Relationships
83
Monroe, S. M., Bromet, E. J., Connell, M. M., & Steiner, S. C. (1986). Social support, life events, and depressive symptoms: A 1-year prospective study. Journal of Consulting & Clinical Psychology, 54, 424–431. Monson, C.M, Schnurr, P. P, Stevens, S.P., & Guthrie, K. A. (2004). Cognitive-behavioral couple's treatment for posttraumatic stress disorder: Initial findings. Journal of Traumatic Stress, 17, 341–344. Nelson, G. M., & Beach, S. R. (1990). Sequential interaction in depression: Effects of depressive behavior on spousal aggression. Behavior Therapy, 21, 167–182. Newman, M. G., Castonguay, L. G., Borkevec, T. D., & Molnar, C. (2004). Integrative therapy. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 320–350). New York: Guilford Press. Ninan, P. T. (2001). Dissolving the burden of generalized anxiety disorder. Journal of Clinical Psychiatry, 62, 5–10. O'Donnell, C., Cook, J. M., Thompson, R., Riley, K., & Neria, Y. (2006). Verbal and physical aggression in World War II former prisoners of war: Role of posttraumatic stress disorder and depression. Journal of Traumatic Stress, 19, 859–866. O'Leary, K. D., & Beach, S. R. (1990). Marital therapy: A viable treatment for depression and marital discord. American Journal of Psychiatry, 147, 183–186. Peter, H., & Hand, I. (1988). Patterns of patient-spouse interaction in agoraphobics: Assessment by Camberwell Family Interview (CFI) and impact on outcome of selfexposure treatment. In: I. Hand, & H.-U. Wittchen (Eds.), Panic and phobias: 2. Treatments and variables affecting course and outcome. Berlin: Springer. Potthoff, J. G., Holahan, C. J., & Joiner, T. E. (1995). Reassurance seeking, stress generation, and depressive symptoms: An integrative model. Journal of Personality and Social Psychology, 68, 664–670. Quadrio, C. (1984) Families of agoraphobic women. Australian and New Zealand Journal of Psychiatry, 18, 164–170 Riggs, D. S., Hiss, H., & Foa, E. B. (1992). Marital distress and the treatment of obsessive compulsive disorder. Behavior Therapy, 23, 585–597. Roberts, A. (1964) Housebound housewives: a follow-up study of phobic-anxiety state. British Journal of Psychiatry, 110, 191–197. Roberts, J. E., Gotlib, I. H., & Kassel, J. D. (1996). Adult attachment security and symptoms of depression: The mediating roles of dysfunctional attitudes and low self-esteem. Journal of Personality and Social Psychology, 70(2), 310–320. Roemer, L., Molina, S., & Borkevec, T. D. (1997). An investigation of worry content among generally anxious individuals. Journal of Nervous and Mental Disease,185, 314–319. Rounsaville, B. J., Weissman, M. M., Prusoff, B. A., & Herceg-Baron, R. L. (1979). Marital disputes and treatment outcome in depressed women. Comprehensive Psychiatry, 20, 483–490. Roy-Byrne, P. P., & Katon, W. (1997). Generalized anxiety disorder in primary care: The precursor/modifier pathway to increased health care utilization. Journal of Clinical Psychiatry, 58, 34–40. Sherman, M. D., Sautter, F., Jackson, M. H., Lyons, J. A, & Han, X. (2006). Domestic violence in veterans with posttraumatic stress disorder who seek couples therapy. Journal of Marital & Family Therapy, 32, 479–490.
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Symonds, A. (1971) Phobias after marriage: women’s declaration of dependence. American Journal of Psychoanalysis, 31, 144–152. Tarrier, N., Sommerfield, C., & Pilgrim, H. (1999). Relatives’ expressed emotion (EE) and PTSD treatment outcome. Psychological Medicine, 29, 801–811. Torpy, D. M. and Measey, L. G. (1974). Marital interaction in agoraphobia. Journal of Clinical Psychology, 30, 351–354. Uliaszek, A. A., Zinbarg, R. E., Mineka, S., Craske, M. G., & Griffith, J. (2008). A longitudinal examination of the stress generation model of emotional disorders and personality. Manuscript in Preparation. Watson, D., Gamez, W., & Simms, L. J. (2005). Basic dimensions of temperament and their relation to anxiety and depression: A symptom-based perspective. Journal of Research in Personality, 39, 46–66. Webster, J. (1953) The development of phobias in married women. Psychological Monographs: General and Applied, 67, 1–18. Weiss, R. L., & Heyman, R. E. (1990). Observation of marital interaction. In F. D. Fincham & T. N. Bradbury (Eds.), The psychology of marriage: Basic issues and applications (pp. 87–117). New York: Guilford Press. Whiffen, V. E., Kallos-Lilly, A. V., & MacDonald, B. J. (2001). Depression and attachment in couples. Cognitive Therapy and Research, 25(5), 577–590. Whisman, M. A. (1999). Marital dissatisfaction and psychiatric disorders: Results from the national comorbidity survey. Journal of Abnormal Psychology, 108, 701–706. Whisman, M. A. (2007). Marital Distress and DSM–IV Psychiatric Disorders in a PopulationBased National Survey. Journal of Abnormal Psychology, 116, 638–643. Whisman, M. A., & McGarvey, A. L. (1995). Attachment, depressotypic cognitions, and dysphoria. Cognitive Therapy and Research, 19(6), 633–650. Whisman, M. A., Sheldon, C. T., & Goering, P. (2000). Psychiatric disorders and dissatisfaction with social relationships: Does type of relationship matter? Journal of Abnormal Psychology, 109, 803–808. Wittchen, H.U. (2001). Generalized anxiety disorder: Prevalence, burden, and cost to society. Depression and Anxiety, 16, 162–171. Wittchen, H. U., Carter, R. M., Pfister, H., Montgomery, S. A., & Kessler, R. C. (2000). Disabilities and quality of life in pure and comorbid generalized anxiety disorder and major depression in a national survey. International Clinical Psychopharmacology, 15, 319–328. Wittchen, H. U., Zhao, S., Kessler R. C. , & Eaton W. W. (1994). DSM-III-R generalized anxiety disorder in the National Comorbidity Survey. Archives of General Psychiatry, 51, 355–364. Yoon, L. & Zinbarg, R. (2007). Generalized anxiety disorder and entry into marriage or a marriage-like relationship. Journal of Anxiety Disorders, 21, 955 – 965 Zinbarg, R.E., Craske, M. & Barlow, D. H. (1994). Therapist's Guide for the Mastery of Your Anxiety and Worry Program. Albany, NY: Graywind Publishing Co. Zinbarg, R. E., & Barlow, D. H. (1996). Structure of anxiety and the anxiety disorders: A hierarchical model. Journal of Abnormal Psychology, 105, 181–193.
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Zinbarg, R. E., Lee, J. E., & Yoon, L. (2007). Dyadic predictors of outcome in a cognitivebehavioral program for patients with generalized anxiety disorder in committed relationships: A “spoonful of sugar” and a dose of non-hostile criticism may help. Behaviour Research and Therapy, 45, 699–713.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 4
ANOTHER KIND OF “INTERPERSONAL” RELATIONSHIP: HUMANS, COMPANION ANIMALS, AND ATTACHMENT THEORY
Jeffrey D. Green, Maureen A. Mathews Virginia Commonwealth University, USA
Craig A. Foster United States Air Force Academy, USA
ABSTRACT Human-companion animal relationships provide a important but largely unexplored component of the human experience. Research examining these interspecies relationships may elucidate the depth and meaning of these relationships as well as provide unique insights into the fundamental nature of human psychology. Human-animal relationships offer a distinctive testing ground because pet choice is unilateral, whereas human friendships and romantic partner choices are mutual, and individuals may have reduced fear of rejection or evaluation from a pet than from a human relationship partner. We review and apply to human-pet relationships key elements of attachment theory, including caregiving, exploration, the malleability of attachment styles, and the role of attachment anxiety and avoidance in choosing relationship partners. We also discuss potential future research directions using relationships theories in companion animal contexts.
Human beings are social creatures, and as such have a fundamental need to belong (Baumeister & Tice, 1990; Leary, Tambor, Terdal, & Downs, 1995). We seek the security, support, and comfort of friends and family. It is therefore not surprising that the field of close relationships has been a central and burgeoning area within psychology. However, most close relationships theory and research overlooks the important fact that “interpersonal” needs can be met without other people per se. Individuals commonly attach themselves to objects, concepts, and abstractions to serve attachment and belonging functions. One particularly
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prevalent and compelling type of attachment involves the one that humans have with nonhuman animals. Individuals go to great lengths to form or maintain social connection. Gardner, Pickett, and Knowles (2005) proposed that individuals use one-sided (“parasocial”) attachments to maintain belongingness when necessary. In two recent studies, Knowles and Gardner (2008) found that writing about or viewing a picture of one’s favorite TV character (i.e., characters from the NBC show “Friends”) buffered individuals from the negative emotional consequences of social rejection. Similarly, researchers have studied God as a “substitute attachment figure” (e.g., Kirkpatrick, 1998), including possible psychological and physical health benefits of feeling interdependent with a deity. Connection to nature in general also may foster a sense of belongingness. Frantz, Winter, and Mayer (2008) found that individuals who felt a strong connection to nature reported a higher sense of belongingness as a result of interaction with the natural world and were psychologically shielded from the effects of social rejection. If individuals feel a connection to and appear to benefit from a relationship with intangible or invisible characters, it stands to reason that significant benefits may accrue from relationships with animal companions. Though relationships with some animals (e.g., fish) may be relatively parasocial or onesided, relationships with other common pets, such as cats and dogs, clearly provide companionship, physical contact, and comfort. Human-animal relationships are profoundly important ones, and pets frequently are treated as family members. Though the influence of pets on human well-being has been investigated, little theoretically based work has been conducted to fully explicate the psychology of these relationships. Human-animal relationships are different from interpersonal relationships in many ways. Unique characteristics of the human-animal relationship (e.g., ability of humans to unilaterally choose their animal companions, reduced fear of evaluation by animal companions) provide an opportunity to examine human psychology in contexts unavailable to traditional humanhuman relationships. That is, a closer investigation of human relationships with animals may extend our understanding of human cognition, emotion, and behavior. In this chapter, we provide a selective review of some research on human-animal relationships to demonstrate that these relationships have a significant impact on the human experience. At the same time, we argue that researchers have just scratched the surface of this potentially rich field and should investigate human-animal relationships using available interpersonal relationship theories and methods. Our review will draw primarily upon the important theory of attachment (Bowlby, 1969) as one example of an appropriate theory to extend to human-animal relationships. Finally, we propose ways in which human-animal relationships can be used to both examine and extend traditional psychological theory, and suggest new avenues of research in order to advance our understanding of human-animal relationships. We begin by providing some background on the evolution of the most common pets (i.e., cats and dogs) as an intial basis for explaining the prevalence and depth of humananimal relationships.
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CO-EVOLUTION OF HUMANS AND ANIMALS The dog-human relationship is arguably the closest we humans can ever get to establishing a dialogue with another sentient life-form, so it is not surprising that people tend to emerge from such encounters with a special sense of affinity with ‘man’s best friend.’ James Serpell (1995), p. 2
Companion animals vary widely from fish to birds to several species of mammals, but canine-human relationships have a particularly long evolutionary history. Descended from the grey wolf (Vila et al., 1997), modern domestic dogs (Canis familiaris) were the first animals that humans domesticated at the end of the last Ice Age, approximately 15,000 years ago (Serpell, 1995). One account suggests that this domestication accompanied the hunting shift to early archery; domesticated dogs facilitated successful hunting by helping track herds and subdue wounded prey (Serpell, 1995). However, a more radical view by Schleidt and Shalter (2003) argues that humans and wolves, both omnivores and both relatively cooperative, group-oriented species, started following herds in Eurasia around the same time, and thus coevolved as joint partners in obtaining food. In either case, it is notable that humans domesticated dogs before domesticating the animals that have provided them with their most common sources of animal protein (e.g., cattle, goats, pigs), animals whose domestication requires less nomadic living. Whether through domestication or co-evolution, the long history of dogs living with humans has led dogs to understand verbal and non-verbal communication from humans. Scientific views about the abilities of non-human animals to use language and, more broadly, engage in symbolic thought, have ebbed and flowed in recent decades, but the latest research suggests that humans have underestimated the abilities of canines and other animals such as orangutans, parrots, and dolphins (Morell, 2008). Some dogs have learned to understand hundreds of words, and recent research suggests that they may engage in other types of symbolic cognition such as connecting an object to its two-dimensional picture (Morell, 2008). A series of studies (Hare, Brown, Williamson, & Tomasello, 2002), found that dogs were superior to chimpanzees (our closest existing relative biologically) and wolves in reading nonverbal human cues. In these studies, humans pointed to, tapped, or gazed at the location of hidden food; even puppies (but not wolf pups) were relatively successful at decoding these human behaviors, suggesting that this ability is not the result of learning but the result of the evolution of dogs living with humans. Thus, it appears that dogs are able to communicate with humans on a level that even humans’ closest relatives (i.e., chimpanzees) cannot. The domesticated cat (Felis catus) also has a storied history with human beings. The modern-day house cat descends from Felis silvestris lybica in the Far East. The development of agriculture is thought to have spurred the relationship between cats and humans; cats eradicated vermin from grain storage, and humans, in return, provided basic shelter and food (Driscoll et al., 2007). A recent archeological excursion uncovered 9,500 year-old cat remains buried with human remains on the island of Cyprus (Vigne, Guilaine, Debue, Haye, & Gérard, 2004). In addition, the ancient Egyptian culture had a high reverence toward cats, and even had gods (e.g., Bastet) that took feline form. Cats were considered to be intelligent but mysterious, and thus were treated with wonder and respect.
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SIGNIFICANCE OF ANIMAL COMPANIONS TO HUMANS The rich history between humans and dogs or cats helps to explain the lavish interdependence that can occur between humans and animals today. The American Pet Products Manufacturers Association (APPMA) reports in the 2007-2008 National Pet Owners Survey that 63% of U.S. households include a pet. It is estimated that in 2008, the total U.S. expenditures within the pet industry will exceed $43.3 billion, nearly double the 1998 figure. It may be the case that more people own pets, but it is also appears that individuals are spending increasing amounts of time and money on their pets. Many types of brand-name or luxury pet products and services have been developed and marketed in recent years, including products analogous to those for humans. Companies such as Paul Mitchell and Omaha Steaks are marketing new designer pet products, such as dog shampoo and gourmet steak dog treats (APPMA, 2007), and massage, acupuncture, and yoga for pets are now readily available. Many hotel chains have adopted increasingly pet-friendly policies, and insurance companies offer accident and life insurance for pets. As of 2007, 39 states allow for the establishment of trusts to take care of pets in case of the owner’s or guardian’s death (Bennett, 2007). Some owners also spend vast sums of money on ceremonies to celebrate milestones such as pet birthdays and pet weddings, complete with wedding outfits, cakes, and (human) officiants. State courts have recognized that animals represent far more than mere possessions. In two notable cases, owners have been awarded upwards of $30,000 when their pets were deemed to have been killed wrongfully (Tanick, 1998). In short, pets are ubiquitous. Individuals go to great lengths to care for them, and illustrate their deep attachment by traveling with them, celebrating milestones with them, and (as we will revisit later) mourning their loss. Psychologists appear to have underestimated the similarities to interpersonal relationships, but they also largely have ignored characteristics of human-animal relationships that are unique. Such characteristics may provide new insights into human psychology.
HUMAN-ANIMAL RELATIONSHIPS AND PSYCHOLOGICAL INQUIRY Unique facets of the human-animal relationship might provide elegant and compelling tests of traditional psychological theory. We will summarize a few ways in which the development and maintenance of interpersonal relationships differs from human-animal relationships.
Risk of Rejection One critical issue is that the decision to acquire an animal companion can be a unilateral choice, whereas the choice of a romantic partner or friend is almost inevitably a mutual one. This issue is most clearly revealed in unrequited love, where a suitor experiences love for someone who does not love in return (Baumeister, Wotman, & Stillwell, 1993). Although interpersonal rejection commonly is associated with romantic relationships, social exclusion also occurs between friends and acquaintances and has powerful psychological consequences,
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including aggressive and self-defeating behaviors (Twenge, Baumeister, Tice, & Stucke, 2001; Twenge, Catanese, & Baumeister, 2002). Some individuals may hesitate to initiate friendship or romantic relationships due to fear of rejection, but when it comes to relationships with animals, individuals experience virtually no risk of partner rejection.
Fear of Evaluation A related aspect of human-animal relationships is the reduced fear of evaluation. According to George Eliot, “we long for an affection altogether ignorant of our faults. Heaven has accorded this to us in the uncritical canine attachment.” There are many implications for this reduced fear of evaluation by an animal companion. For example, owning a pet could be particularly beneficial for the socially anxious. Social anxiety is the distress felt when one perceives that she will be negatively evaluated by another person (Fenigstein, Scheier, & Buss, 1975; Leary, 1983), and is associated with hypersensitivity to social situations and presenting oneself as non-confrontational (Schlenker & Leary, 1985). Social anxiety, loneliness, and feeling that one has poor social skills often co-occur (Bruch, Kaflowitz, & Pearl, 1988; Solano & Koester, 1989). Companion animals may provide the socially anxious with relatively non-evaluative and therefore non-threatening social interaction experiences both at relationship initiation and during relationship maintenance. The socially anxious person’s fears of possessing poor social skills are unlikely to be activated in interactions with animals. The presence of an animal companion may reduce feelings of loneliness in some circumstances (e.g., Banks & Banks, 2005, but see Gilbey, McNicholas, & Collis, 2007). Having a pet may even increase one’s confidence in social interactions with other people, including but not limited to opportunities to meet likeminded individuals via one’s pet (such as behavioral training classes or pet playdates), situations that also may be relatively less threatening since the focus often is on the animals.
Choice and the Selection of Partner Characteristics Humans have an unprecedented amount of choice in choosing whether to obtain a pet and the corresponding nature of that animal companion. The process of selecting pets may be limited by individuals’ living arrangements or finances. Nevertheless, the choice of a pet is a relatively unconstrained, particularly when compared to mutually negotiated human relationships. Mail-order brides notwithstanding, one cannot simply unilaterally choose to enter into a romantic relationship, but one can wake up intending to initiate a relationship with a pet, go to a shelter or pet store, and begin a close relationship that very day. Moreover, individuals can choose the species that they prefer based on the amount of care required, and can even choose the specific characteristics they desire in an animal companion. In fact, some animals, particularly different breeds of dog, have been bred selectively to possess certain temperaments and characteristics. Thus, animals generally are more predictable than humans (Leary et al., 1994). Animals (even cats) do not plot how to put their best paw forward, selectively disclose information, or engage in outright deception in order to be viewed more favorably. A relationship with a pet is “what you see is what you get” relative to the unpredictability of a human relationship.
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In summary, companion animals offer qualitatively different types of supportive relationships, especially compared to romantic relationships, by providing a great deal of choice in a relatively non-evaluative context. We revisit these and other aspects of humananimal relationships in the context of attachment theory.
ATTACHMENT THEORY AND THE HUMAN-ANIMAL RELATIONSHIP Introduction to Attachment Theory Attachment theory describes interlocking behavioral systems centered on the formation of close interpersonal bonds. Bowlby (1969; 1980) asserted that the attachment system evolved due to prolonged helplessness on the part of human offspring. Behaviors such as the crying of infants serve to maintain or increase proximity between infant and caregiver. Infants and children use their caregivers as a safe haven, where they can seek refuge and support when afraid. Caregivers also serve as a secure base from which children can explore their environments. Ainsworth and colleagues (e.g., Ainsworth, Blehar, Waters, & Wall, 1978) employed the “Strange Situation,” a laboratory procedure in which children and caregivers experience separation and reunion, to systematically test some of the tenets of Bowlby’s theory. They identified specific ways in which children reacted to the reappearance of their mother, which led to theory and research on different attachment styles. Ainsworth and colleagues (1978) found three primary attachment styles based on her Strange Situation research: secure, anxious-ambivalent, and avoidant. A secure style presumably develops when the caregiver is consistently responsive and affectionate. Secure individuals are comfortable with closeness, and approach relationships with confidence and trust. An anxious-ambivalent style presumably develops when the caregiver is inconsistently responsive. The unpredictability leads anxious-ambivalent individuals to be more uncertain of and preoccupied with the status of their relationships. An avoidant attachment style presumably develops when the caregiver is cool and emotionally unresponsive. Avoidant individuals tend to be more emotionally distant, reluctant to express physical expression or emotional need, and more independent. In recent decades, social psychologists have appropriated the attachment framework to explore issues of intimacy, support seeking, caregiving, and emotion regulation in adult relationships, particularly romantic relationships. Hazan and Shaver (1987) led this expansion of attachment theory, and adapted and validated the secure, anxious-ambivalent, and avoidant styles for adult romantic relationships. Bartholomew and Horowitz (1991) provided a revised but complementary framework by conceptualizing attachment as two dimensions on a positive-negative continuum: view of self and view of others, yielding four different styles. A positive view of both self and others corresponds to Hazan and Shaver’s secure attachment. A negative view of self and positive view of others corresponds to Hazan and Shaver’s anxious ambivalent attachment, which Bartholomew and Horowitz refer to as preoccupied. The Hazan and Shaver avoidant category describes a negative view of others, but Bartholomew and Horowitz characterize a positive view of self and negative view of others as dismissingavoidant and a negative view of self and negative view of others as fearful-avoidant.
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Subsequent research has proposed moving beyond a typology or style approach, instead characterizing attachment along two dimensions: attachment avoidance and attachment anxiety (Fraley & Waller, 1998). However, the four Bartholomew and Horowitz styles have heuristic value when considered as mapping avoidance and anxiety in two-dimensional space (e.g., low avoidance and high anxiety corresponds to preoccupied attachment; high avoidance and low anxiety corresponds to dismissing-avoidant attachment).
Attachment to Pets The emotional depth of the human-companion animal bond suggests that attachment theory can be applied to human-animal relationships. Many researchers agree with this informal view (Beck & Madresh, 2008). Moreover, humans frequently treat companion animals similarly to children or domestic partners; attachment theory has demonstrated that it is versatile enough to apply both to parent-child and romantic relationships. However, we mention a few important caveats. First, the word attachment is commonly used by researchers when they are referring to general bonding with animals but does not necessarily refer to Bowlby’s attachment theory in particular (Crawford, Worsham, & Swineheart, 2006). Several scales purportedly measure human attachment to pets, but are not based on attachment theory (e.g., the Lexington Attachment to Pets Scale; Johnson, Garrity, & Stallones, 1992). Second, human-pet relationships are inherently unequal: the animal is dependent on its human companion for virtually all of its major needs. (However, it is worth noting that this power differential is characteristic of many interpersonal relationships, from parent-child to supervisor-worker to romantic relationships, where one member of the dyad possesses more control in the relationship.) Third, some debate exists over the quality of attachment to animals. For example, Endenburg (1995) conducted a large survey study in the Netherlands and described the attachment relationships assessed between humans and their animals as “weak,” though the strongest attachments were felt to dogs and cats relative to other animals. Indeed, many animals are owned for work-related reasons (e.g., herding) or are otherwise seen as instrumental (e.g., for protection of the home); owners do not necessarily feel psychologically attached to such animals. Put another way, some pet owners consider their pet merely to be their property, whereas others consider their pet to be a valued member of the family deserving of the rights and privileges as such (Carlisle-Frank & Frank, 2006). Fourth and most important, much of the recent research involving attachment theory and human-animal relationships is theoretically or methodologically problematic. Researchers need to develop or adapt (Beck & Madresh, 2008) more valid measures of attachment to pets and study a wider variety of pet-related behaviors and cognitions. Much of the extant humanpet work is correlational, bringing into question some of the conclusions that may be drawn. Experimental methods often are challenging (e.g., it is difficult to randomly assign people to be cat owners or dog owners), but are essential for advancing our understanding of these relationships. In addition, the research has been limited because its focus primarily has been the influence of pets on humans, rather than the psychology of the human-animal relationship more broadly. An enhanced application of traditional interpersonal relationships theory and methods to the companion animal arena can demonstrate the significance of these relationships and use these unique relationships to further understand people. In short, this research area would benefit from a superior integration of established theory and
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methodology. Nevertheless, researchers have begun to explore this profoundly important component of human relationships.
Can Humans be Attached to Animals? What Defines an “Attachment”? Bowlby (1969) hypothesized that the attachment system is activated automatically by threatening situations. Recent research has found that peers (i.e., close friends and romantic partners) replace parents as serving the functions of safe haven (to whom do you turn when you feel vulnerable?), proximity maintenance (with whom do you want to spend time?), and secure base (whom do you count on to support you when you really need it?), and that separation from close others, particularly romantic partners, is both subjectively distressing (e.g., Fraley & Shaver, 1998) and physiologically arousing (Fraley & Shaver, 1997). These functions may be identified in cognition, emotion, physiology, and behavior (Hazan, GurYaish, & Campa, 2006). The attachment process appears to take time to develop, and these behavioral systems may be transferred from parent to romantic partner or best friend in progressive stages (i.e., proximity seeking followed by safe haven and then secure base; Fraley & Davis, 1997). It takes about six or seven months for infants to direct the various attachment behaviors to a particular caregiver (Ainsworth, Bell, & Stayton, 1973; Bowlby, 1969). Adults appear to take months or years to transfer these systems to their romantic partner (Hazan & Zeifman, 1994). Most types of strong attachment bonds are marked by high degrees of physical contact, though the type of contact varies according to relationship type (e.g., sexuality for romantic partners). In short, attachment relationships are qualitatively different from the relationships between acquaintances and are marked by a particular pattern of cognition, emotion, and behavior. How might one assess the degree to which humans are attached to animals? The tools of cognitive-social psychologists might be harnessed to test attachment to animals. In a series of lab studies, Mikulincer, Gillath, and Shaver (2002) subliminally primed threat and found that the names of attachment figures were more accessible. Participants first provided several lists of names, including individuals who served attachment functions for them, individuals they were close to but who were not attachment figures, and acquaintances. Participants were presented with a string of letters that was either a word or not, and tasked with deciding as quickly as possible whether the string of letters was a word. Prior to the presentation of the letter string, participants were subliminally exposed to either a threat word (failure, separation) or neutral word (hat). Individuals were quicker to recognize the names of attachment figures after the threat word but not after the neutral word; this difference was not significant for the names of other close persons, acquaintances, unknown persons, or nonwords. This research also revealed differences in individual attachment style. Those high in anxiety showed heightened accessibility of the names of attachment figures even without the subliminal threat word prime, and individuals high in avoidance appeared to inhibit the activation of attachment figure names when the threat prime word was separation. This is consistent with other research (e.g., Simpson, Rholes, & Nelligan, 1992); these investigators brought couples into the lab and told the female member of the couple that she was going to experience an anxiety-provoking experimental procedure, showing her a room filled with psychophysiological equipment. Unbeknownst to them, the couples were filmed while
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waiting for this ostensible procedure, and their caregiving and support-seeking behaviors were observed and coded. Securely attached women, relative to anxious or avoidant women, were more likely to seek support and reassurance from their romantic partner when facing a stressful situation. The paradigm developed by Mikulincer and colleagues (2002) could be modified to test whether individuals form attachment bonds to their pets. Although the variety and distinctiveness of pet names may need to be accounted for, adding pet names to the lists of names provided by participants and engaging in the same lexical decision task would assess whether this heightened accessibility exists for close pets. We suggest that a significant percentage of individuals, those who report a longer and closer relationship with their pets, will identify their pets’ names more quickly when exposed to a subliminal threat. The method employed by Simpson and colleagues (1992) also could be applied to pets, by observing how individuals seek support from their pets during stressful and non-stressful situations (also see following discussion of Allen, Blascovich, Tomaka, & Kelsey, 1991). More broadly, research in the lab or in the field could assess the extent to which individuals perceive their pets as serving proximity maintenance, safe haven, and secure base functions. For example, individual preferences for animal companions when under stress, either in a diary-type study or manipulated directly in the lab, could be investigated. Presumably, these functions, though different in their manifestations from human relationships, should be present in many human-animal relationships. Like human relationships, human-animal companion relationships likely take months or years to develop, and the proximity seeking, safe haven, and secure base functions likely transfer at different stages as they do from parents to peers. Examining individuals who lack a primary human attachment (e.g., single adults living alone but with a pet) would be a particularly interesting test of these processes. The strong attachment that many humans form with their companion animals is revealed in the bereavement that humans endure after losing their non-human friends (Hunt & Padilla, 2006). The significance of losing an animal companion has been characterized as “disenfranchised,” meaning that the depth of this loss is underestimated and social support often is lacking (Stewart, Thrush, & Paulus, 1989), but scholars have observed a significant animal-related bereavement process. Over half of participants in one study reported believing in an afterlife for their deceased pet (Davis, Irwin, Richardson, & O’Brien-Malone, 2003). One researcher has developed a social work bereavement model based on traditional human grief therapy, but specifically designed for animal loss (Turner, 2003). Attachment theory should be harnessed to further research pertaining to pet bereavement; reactions to the death of a spouse as well as the death of a pet proceed through similar stages as the distress of separation from an attachment figure: protest, despair, and detachment (Parks, 1972). In short, some evidence for the viability of the notion that humans may be as attached to their pets as they are to humans is manifest in similar and profound emotional reaction to their loss.
Safe Haven, Caregiving, and Support Seeking Many safe haven and secure base functions of the attachment system may be subsumed under the notion of caregiving (Feeney & Collins, 2006); a caregiver provides felt security. Caregivers typically regulate their behavior in response to the needs and expressions of infants. Cries of hunger and cries of pain elicit different responses by parents to restore
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closeness and meet the infant’s needs. However, attachment style differences exist regarding how effectively the caregiver notices and interprets the needs of the infant, and the extent to which the caregiver appropriately regulates behavior. More distressing events elicit a stronger desire to restore proximity to an attachment figure (e.g., people often seek physical contact with a romantic partner or parent when distressed or ill). Unfortunately, individuals often give the type of support that they themselves have received (e.g., abused individuals often are insensitive to the needs of others). Avoidant individuals are more likely to use indirect support-seeking strategies, which often lead to unhelpful forms of support (Collins & Feeney, 2004). Avoidant men overall provide less support and are more insensitive to their partners’ needs, failing to regulate the amount of support given as a function of distress that the partner feels. There is some evidence that the more stressful the situation, the less support provided by avoidant men to their partners, the opposite of the pattern typically desired by their partners (Simpson et al., 1992). Avoidant individuals are less likely to provide the physical proximity and contact that their distressed partners desire. Research on the relationship between avoidant individuals and their animal companions could further reveal the dimensions and causes of this pattern of support giving. Do avoidant individuals turn to their pets when stressed? Are they more likely to engage in physical contact with animals but not human romantic partners in such circumstances? Do they provide comfort to their distressed animal companions better than they do to their distressed human companions? Anxious individuals provide less effective support and exhibit more compulsive or overinvolved caregiving (Kunce & Shaver, 1994). That is, the care they offer may be more focused on their own needs (and their perceptions of non-fulfillment) and not well coordinated with their partners’ preferences. We suspect that compulsive caregiving by anxious individuals extends to treatment of pets. This may lead to animals that are unruly and poorly trained. We also suspect that patterns of support-seeking directed at pets might differ from the pattern directed at humans by anxious individuals. Feeney and Collins (2006) took attachment-related support-seeking and caregiving research a step further by investigating motivations for caregiving. Avoidant caregivers are more likely to help their partners for selfish reasons, such as feeling a sense of obligation or assuming that the help will be reciprocated later. Anxious caregivers show a mixture of these motivations and more selfless motivations, including concern for their partners and intrinsic enjoyment of helping their loved ones. Secure individuals appear to be motivated more by love and concern for their partners. Thus, these different motivations suggest reasons why insecurely attached (i.e., avoidant or anxious) individuals provide less effective support or more compulsive support. The motivations for caregiving potentially could be assessed even more powerfully by comparing motivations for the selection of different animals as pets, such as by modifying Kunce and Shaver’s (1994) adult caregiving questionnaire. Such research also would have implications for animal welfare (e.g., if there is a link between owner attachment style and pets that are overfed or more likely to develop separation anxiety).
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Secure Base and Exploration Exploration is a fundamental need that is active when the attachment system is quiescent. Bowlby (1969, 1988) discussed the notion of the secure base as a central one in attachment theory. Infants and children use their primary caregivers as launching pads from which to explore. As they get older, children typically operate in ever-increasing orbits around their caregivers. The attachment and exploration systems are connected because exploration potentially exposes explorers to dangers as they increase distance from caregivers. When the threat of danger is perceived, the attachment system is activated and individuals seek to reestablish greater proximity to attachment figures. Research on exploration and especially the concept of the secure base have been virtually ignored by researchers. One of the few direct investigations of the secure base found that when individuals felt that they had a reliable secure base in their partners (i.e., their partners were sensitive to their needs when they were stressed), they felt that their goals were more attainable and had higher goal-related self-efficacy (Feeney, 2003). Mikulincer (1997) found that curiosity or information search, a cognitive precursor to exploration, was greater for secure individuals relative to avoidant individuals, and that secure individuals also had reduced need for cognitive closure relative to anxious and avoidant individuals. Hazan and Shaver (1990) operationalized exploration as orientation to work, and found that secure individuals were more confident about work, enjoyed work for its own sake, and were not preoccupied by fears of failure. Anxious individuals, in contrast, feared negative evaluation and appeared to be motivated to gain the approval of others. Avoidant individuals often used work to replace social interactions. Elliot and Reis (2003) identified a link between attachment and exploration-related motivation, specifically effectance motivation—the desire to have successful interactions with one’s environment. Effectance motivation, and the desire for exploration in general, should be a default motivation unless other motives temporarily establish primacy (e.g., individuals who believe that their safety is threatened will cease exploring their environment). Anxiously attached individuals, for example, may therefore have chronic interference with explorationbased motivation because they feel threatened (Elliot & Reis, 2003; White, 1959). Elliot and Reis found that secure attachment was associated with a high need for achievement (and a low fear of failure) in academic settings. Security also was associated with more approach goals (how can I get better at this?) than avoidance goals (how do I prevent failing?). Green and Campbell (2000) developed an index to measure exploration in the social (e.g., meet new people), intellectual (e.g., visit a modern art museum), and environmental (e.g., travel overseas) domains, and found that attachment avoidance and anxiety both were negatively correlated with exploration. That is, less anxiety and greater comfort with closeness correlated with the desire to engage in activities such as joining a new social group, visiting a strange place, or thinking about unusual ideas. A second study activated one of the three attachment relational schemas (cf. Baldwin, 1992; Baldwin, Carrel, & Lopez, 1990) to assess experimentally the link between attachment and adult exploration. Individuals were primed with a secure, anxious, or avoidant relational schema via an ostensible sentence memorization task in which key words in the sentences related to attachment constructs (e.g., dependence, unpredictability, trust, disclosure, uncertainty). Individuals primed with one of the two insecure styles were less interested in exploration and expressed reduced preference
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for novel stimuli (e.g., unusual Escher prints such as a dragon biting its own tail) relative to those primed with the secure style. Future research could investigate how couples affect each other’s exploration. Perhaps securely attached couples foster more exploration as each partner serves as a secure base for the other from which to try new activities. In a similar vein, animal companions might provide the emotional resources (i.e., the secure base) for an individual to engage in greater social or environmental exploration, or even change an owner’s dispositional levels of anxiety or avoidance, preparing him or her for more secure human relationships. Perhaps simply having a pet might open the door to pet-related activities that facilitate the development of human relationships (e.g., volunteering at the ASPCA, online chats with fellow cat lovers). On the other hand, some types of exploration might be inhibited by the attachment to an animal companion. For example, Mikulincer (1997) found that avoidant individuals read more about consumer products (i.e., acted more curious) when that choice competed with social interaction. That is, avoidant individuals may choose a less threatening relationship with a pet over a human relationship. In addition to possible moderation by attachment anxiety or avoidance, the type of animal companion or the quality of the human-animal relationship might moderate this relationship. In short, examining exploration from the perspective of pet-human relationships may provide valuable insights about human attachments and exploration in various domains.
Pet Choice and Attachment Style A great deal of social psychological theory has addressed how individuals choose their friends and romantic partners, and these concepts may be applied to research on choosing pets. Attachment theory provides a particularly fascinating approach to this issue. Research suggests that the pairing of individuals according to attachment style is not random. Some research has found that individuals are most attracted to those who share their attachment style (Frazier, Byer, Fischer, Wright, & DeBord, 1996). However, these preferences may not become reality. Kirkpatrick and Davis (1994) found no avoidant-avoidant or anxious-anxious pairs in a sample of 354 heterosexual dating couples. They also found that couples composed of an avoidant man and an anxious woman were fairly stable over three years, in spite of the fact that these relationships were relatively unhappy. It may be that individuals find themselves with partners who confirm their (often negative) attachment-related expectations (e.g., an avoidant man expects his partner to be clingy and demanding, which characterizes anxious-ambivalence). What is the relevance of this research for human-animal pairings? First, do humans view different pets along attachment-related dimensions? We have obtained suggestive evidence that they do. We asked individuals to provide open-ended descriptions of dogs and cats, and used content analysis to examine the attachment-related words. Dogs were described with more security-related words, whereas cats were described with more avoidance-related words. (These results were not qualified by individual levels of avoidance and anxiety—similar perceptions of cats and dogs existed for everyone.) These findings were replicated when we adapted the Experiences in Close Relationships (ECR-R) scales (Fraley, Waller, & Brennan, 2000; Sibley, Fischer, & Liu, 2005), the most commonly used and validated measure of attachment avoidance and anxiety, to dogs and cats separately. That is, we asked individuals
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to imagine owning a particular animal and to report how they would feel in the context of a relationship with that animal (“it is easy for me to be affectionate with my dog”). If dogs and cats are perceived to vary along attachment-related dimensions, does their desirability as pets depend in part on the level of avoidance or anxiety of potential owners? We collected some preliminary data on this question as well. Not surprisingly, the more avoidant individuals reported themselves to be, the less interested they were in owning a pet. The more anxious individuals reported themselves to be, the more interested they were in wanting to own a pet. However, findings for specific animals varied somewhat: anxiety was positively correlated with wanting to own a cat, but not correlated with wanting to own a dog. Our tentative conclusion is therefore consistent with the Kirkpatrick and Davis (1994) findings and their interpretation of attachment pairing: individuals may end up choosing a pet that confirms their expectations (e.g., an anxious person is more likely to choose a cat, who is perceived to be relatively avoidant). More direct research is needed to assess if attachment avoidance and anxiety predict the type of pet that individuals actually choose.
Do Attachment Styles Change? Another fascinating theoretical question involves the malleability of attachment styles or dimensions. Attachment usually is conceptualized as a stable individual difference developed during childhood as a result of the pattern of behavior by one’s primary caregiver. Reports of the stability of attachment styles have varied widely in the literature, but the best conclusion at this time is that these styles are only moderately stable over the long-term (Fraley, 2002). Individuals likely have different attachment styles with different individuals (Kamenov & Jelic, 2005). Put another way, individuals have schemas or working models of different attachment styles in memory. Even though there likely is a primary (or chronically activated) style, the other styles can be activated under different circumstances or in different relationships (Green & Campbell, 2000). For example, one may feel securely attached to many friends, but feel anxious when considering a particular friend who rarely returns calls. Attachment stability is affected by the beginning or ending of a romantic relationship (Kirkpatrick & Hazan, 1994) and non-romantic relationships (i.e., those with family members and friends) tend to be more secure than romantic relationships (Kamenov & Jelic, 2005). When we directly compared individuals’ attachment anxiety and avoidance (as assessed by the ECR-R) with their reports on the same measure adapted for different animals, we found that individuals reported significantly more attachment security to dogs than to people (with cats falling in between). Similar results of strongly felt security associated with pets were recently reported by Beck and Madresh (2008), supporting our previous contention that human-pet relationships are characterized by reduced evaluation concerns. Research shows that experiences with family members, friends, and romantic partners may buffer and possibly even alter attachment anxiety and avoidance; however, whether pets may help individuals change on attachment dimensions (i.e., become less avoidant or less anxious) is a currently unaddressed but fascinating question. That is, will the felt security from a long-term relationship with a pet change one’s predominant attachment style from an insecure to a secure one? If so, how might that affect the individual’s human relationships? In summary, attachment anxiety and avoidance can be measured at the general level or at the partnerspecific level. Relationships with many animals may be associated with less anxiety than
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relationships with humans. Future research should investigate whether pet-human relationships affect more general attachment orientations, and thus possibly affect future human relationships. More broadly, research on both humans and animals as third parties to dyadic relationships is needed (Green, Burnette, & Davis, 2008), because third parties can profoundly influence those relationships. This area is woefully underresearched, in part due to methodological and statistical challenges. Balance theory (Heider, 1958) provides a particularly useful framework for investigating the role of third parties in dyadic relationships. Being overly attached to one’s pet (one’s first love?) may have deleterious consequences for a romantic relationship if the partner feels he or she is competing against the pet. Stammbach and Turner (1999) found that attachment to cats correlated negatively with the number of close others who provided social support. On the other hand, as mentioned previously, pets may provide a secure base or buffer for some individuals, or provide a training ground for learning caregiving and support-seeking, leading to better human relationships longer-term.
COMPANION ANIMALS AND HEALTH Physical Contact, Ownership, and Health Attachment theory can also be seen in the considerable literature (of which we discuss only representative examples) investigating the influence of animals on human well-being. Such research generally has found that companion animals improve physical and mental wellbeing for human owners (Crawford, Worsham, & Swinehart, 2006). Proximity to a variety of pets (e.g., watching aquarium fish; Katcher, Segal, & Beck, 1984) or petting an animal (even snakes, Eddy, 1996) can reduce blood pressure or heart rate, although the evidence is somewhat mixed. Other work has confirmed that touching pets can attenuate cardiovascular responses (Vormbrock & Grossberg, 1988), but some research has found no significant benefits or even come to the opposite conclusion (i.e., raised physiological markers in the presence of an animal). However, some of these studies have used unfamiliar animals, highlighting the differences between the potential calming presence of any animal and the unique bond with one’s own animal. The attachment system is activated under stressful conditions, so attachment-related concerns will be more pronounced in stressful situations than in non-stressful situations. Though they did not assess attachment style, which may have qualified their results, Allen and colleagues (1991) had female dog owners perform a stressful mental arithmetic task in the lab as well as at home. Autonomic responses (e.g., skin conductance, pulse rate) were assessed on both occasions. Participants completed the task at home either alone (only the experimenter present), with their dog present (but no touching of the pet occurred), or with a close friend. Compared to the alone condition, participants had significantly less physiological reactivity when their pets were present, but more reactivity when their friends were present. Participants apparently were concerned about being evaluated by their friends even though the friends intended to be supportive; participants tried to perform the arithmetic tasks more quickly but made more errors when their friends were present. The dogs in this
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case appear to have provided non-evaluative social support, consistent with our previous assumptions. These more controlled experiments are complemented by research focusing on the influence of animals on longer-term physical and psychological health. Research confirms that companion animals usually provide health benefits, though this evidence is also sometimes conflicting (for reviews see Podberscek, Paul, & Serpell, 2000; Wilson & Turner, 1998). For example, a longitudinal study demonstrated that individuals who had recently acquired pets, as opposed to non-pet owners, showed significant decreases in the number of subsequent physician visits (Headey & Grabka, 2007). Researchers found lower rates of depression among humans highly attached to their pets (Garrity et al., 1989). The limitations of correlational research are particularly noteworthy in these situations. It is possible that the presence of a pet reduces depressive symptoms, but it is also possible that non-depressed individuals are more likely to seek out a pet for companionship, and that additional variables may moderate this association.
Special Populations Much of the companion animal and health research has focused on special populations such as the elderly, likely due to potential increases in loneliness and health-related issues associated with this demographic group (Siegel, 1990; Tucker, Friedman, Tsai, & Martin, 1995). Elderly animal owners, relative to non-owners, showed less deterioration in general health (Raina, Waltner-Toews, Bonnett, Woodward, & Abernathy, 1999), engaged in healthier behaviors such as exercise and diet (Dembrecki & Anderson, 1996), and had significantly fewer visits to the doctor (Siegel, 1990). However, the influence of companion animals on elderly health has not been entirely consistent (Parslow, Jorm, Christensen, Rodgers, & Jacomb, 2005; Siegel, 1990) likely due to the considerable methodological challenges associated with studying pet ownership in this population (Pachana, Ford, Andrew, & Dobson, 2005). Another special population that has received attention is individuals recovering from serious illness. For example, dog ownership (but not cat ownership) was associated with a higher survival rate from heart episodes over one year (Friedman & Thomas, 1995). A parallel study examined the role of pet ownership in lung transplant recipients (Irani, Mahler, Goetzmann, Russi, & Boehler, 2005). Lung transplant recipients who owned pets showed subsequently greater quality of life but no significant physical health differences when compared to lung-transplant recipients who did not own pets. The absence of any significant health differences is compelling when considering that health centers sometimes warn against pets because of the possibility for zoonotic disease transmission. At least in this intriguing study, any physical health-related risks associated with having pets appear to be negligible or offset by the psychological boosts associated with owning a pet. The influence of pets on human health dovetails nicely with growing utilization of animals in pet-facilitated therapy. Pet-facilitated therapy (PFT) refers to the use of animals as catalysts in several forms of therapeutic intervention (Brodie & Biley, 1999; Hines & Fredrickson, 1998). “Therapy” in this context may carry some degree of ambiguity; it often is unclear whether PFTs are tied to a specific therapeutic goal or the more general goals of personal development and well-being. To illustrate the former, Levinson (1969), in a seminal
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paper, had his dog (described as a co-therapist) attend therapy sessions with child psychiatric patients and found that withdrawn children often opened up after interacting with the dog. To illustrate more general well-being or skill goals, pets have been used to facilitate reading development in children: the presence of a pet helped children increase their reading skill and their confidence in reading (Philips, 2006). The most common applications of PFT involve elderly populations who frequently lack social support (Hooker, Freeman & Stewart, 2002) or children and adults with clinical or related disorders. For example, PFT has been utilized for hospitalized children (Kaminski, Pellino, & Wish, 2002), autistic children (Prothmann et al., 2005; Redefer & Goodman, 1989), children with eating and anxiety disorders (Prothmann et al., 2005), and adult incarcerated felons (Moneymaker & Strimple, 1991). The fact that animals can assist in the recovery or increased well-being of individuals with a variety of physical or psychological problems provides further evidence that the human-animal bond can be a close and vital one.
Explanations for Health Benefits: Direct and Indirect Effects Several explanations have been proffered for why animals confer health benefits to their human companions. One obvious direct effect involves the affection that individuals receive from pets and the fact that individuals can affiliate with pets during stressful times (Collis & McNicholas, 1998). In addition, some researchers have investigated the idea that animals provide humans with greater meaning or purpose because they are responsible for the care of their pets (e.g., Collis & McNicholas, 1998). One indirect explanation for the association between pet ownership and health is that companion animals can increase social support by facilitating interactions between humans (e.g., Chinner & Dalziel, 1991). Another indirect explanation is that pet owners may exhibit increased physical activity, such as dog owners going for walks more often than non-dog owners.
Connections to Attachment Theory Much less work has approached these questions from an attachment theory (or other theoretical) perspective. Indirectly related to attachment theory and its emphasis on close emotional bonds, unmarried dog owners who reported feeling close to their pet had fewer doctor visits than unmarried dog owners who reported not feeling close to their pet, as well as fewer doctor visits than unmarried non-owners (Headey, 1999). Colby and Sherman (2002) incorporated attachment style directly into an examination of pet visitation and subjective well-being in an institutionalized elderly population. They demonstrated that attachment styles play an important role in the effectiveness of pet visitation; whereas individuals with secure or anxious/ambivalent attachment styles responded positively to dog visitation, those with avoidant attachment styles responded negatively. This pattern is consistent with research on humans. Carpenter and Kirkpatrick (1996) found the following attachment style differences regarding stress and physiological reactivity: Securely attached women did not show different reactivity to a psychological stressor when alone than when with their romantic partner, but avoidant women showed higher blood pressure when their partner was with them compared to when they were by themselves. As queried previously, do avoidant
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individuals inhibit contact with pets when highly stressed, or is the lack of evaluation going to make them just as likely to turn to a pet, rather than a human, for comfort? In summary, the majority of research suggests that companion animals provide physical and psychological health benefits. Nevertheless, researchers should continue to incorporate attachment theory and other relationship theories and methods to investigate the connection between animals and health.
SUMMARY One of the most popular textbooks on the psychology of interpersonal relations (Berscheid & Regan, 2005) includes a section on “relationships with companion animals.” This brief synopsis includes wonderful anecdotes about the bonds between individuals and animals as well as examples in which an animal beloved by one person increases the stress felt by that person’s spouse. However, no scientific research is cited, which emphasizes (a) the poor integration of the human-animal relationship into the broader notion of “interpersonal relationships” and (b) the opportunity for additional research. We hope that our selective review of the relevant literature helps spur researchers to venture into these largely uncharted waters, so that future textbooks on relationships have a surfeit of sources from which to draw. We have touched on only a few of the myriad applications to both human and animal welfare. Bowlby’s attachment theory and his insights about human emotional bonds were in part inspired by research on animals, including the Harlow studies (e.g., Harlow, 1958) of rhesus monkey babies who attached to artificial cloth mothers that did not provide milk over wire mothers that provided milk (highlighting the importance of physical touch in an emotional bond), as well as animal imprinting studies that demonstrated the tendency of many baby animals such as goslings to follow the first animal they see after they are born or hatched. Therefore, it is gratifying to see that attachment theory may come full circle and be fruitfully applied to relationships between humans and their animal companions. We deliberately focused on this one theoretical perspective, but other theories of human relationships also may be applied to relationships between humans and animal companions. For example, interdependence theory (Kelley & Thibaut, 1978; Rusbult & Arriaga, 2000) may help to illuminate issues of power and dependence and the variety of interdependent situations in which humans and animals find themselves enmeshed. As psychologists and pet owners, we are excited about what the future holds for research on human-animal relationships. These close relationships are worthy of study in their right, but we also are confident that a theoretically and methodologically rigorous approach to studying them will expand our understanding of interpersonal human bonds.
ACKNOWLEDGEMENTS We thank Jeni Burnette, Jennifer Clarke, and Jody Davis and for their constructive feedback on earlier drafts. We also thank our beloved pets Indy, Maggie, Mini, Durango, Jupiter, and Emily for their inspiration and support during this project. Correspondence
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concerning this article should be addressed to Jeffrey D. Green, Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, P. O. Box 842018, Richmond, Virginia 23284-2018; E-mail:
[email protected] REFERENCES Ainsworth, M.D.S., Bell, S.M.V., & Stayton, D. J. (1973). Individual differences in the strange-situation behavior of one-year-olds. In L. S. Stone, H. T. Smith, & L. B. Murphy (Eds.), The competent infant. New York: Basic Books. Ainsworth, M.D.S., Blehar, M. C.,Waters, E., & Wall, S. (1978). Patterns of attachment: A psychological study of the strange situation. Hillsdale, NJ: Lawrence Erlbaum. Allen, K. M., Blascovich, J., Tomaka, J., & Kelsey, R. M. (1991). Presence of human friends and pet dogs as moderators of autonomic responses to stress in women. Journal of Personality and Social Psychology, 61, 582-589. American Pet Products Manufacturers Association (2007). 2007/2008 National Pet Owners Survey, 11th ed. Byrum, CT: APPMA. Baldwin, M.W. (1992). Relational schemas and the processing of social information. Psychological Bulletin, 112, 461-484. Baldwin, M. W., Carrel, S. E., & Lopez, D. F. (1990). Priming relationship schemas: My advisor and the pope are watching me from the back of my mind. Journal of Experimental Social Psychology, 26, 435-454. Banks, M. R., & Banks, W. A. (2005). The effects of group and individual animal-assisted therapy on loneliness in residents of long-term care facilities. Anthrozoös, 18, 396-408. Bartholomew, K., & Horowitz, L. M. (1991). Attachment styles among young adults: A test of a four-category model. Journal of Personality and Social Psychology, 61, 226-244. Baumeister, R. F., & Tice, D. M. (1990). Anxiety and social exclusion. Journal of Social and Clinical Psychology, 9, 165-195. Baumeister, R. F., Wotman, S. R., & Stillwell, A. M. (1993). Unrequited love: On heartbreak, anger, guilt, scriptlessness, and humiliation. Journal of Personality and Social Psychology, 64, 377-394. Beck, L., & Madresh, E. A. (2008). Romantic partners and four-legged friends: An extension of attachment theory to relationships with pets. Anthrozoös, 21, 43-56. Bennett, L. (2007, December 10). Pet industry trends for 2008. Retrieved March 4, 2008, from http://www.smallbiztrends.com/2007/12/pet-industry-trends-for-2008.html/ Berscheid, E., & Regan, P. (2005). The psychology of interpersonal relationships. Upper Saddle River, NJ: Pearson Education. Bodsworth, W., & Coleman, G. J. (2001). Child-companion animal attachment bonds in single and two-parent families. Anthrozoös, 14, 216-223. Bowlby, J. (1969). Attachment and loss: Volume 1. Attachment. New York: Basic Books. Bowlby, J. (1980). Attachment and loss: Volume 3. Loss: Sadness and depression. New York: Basic Books. Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York: Basic Books.
Another Kind of “Interpersonal” Relationship
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Brodie, S. J., & Biley, F. C. (1999). An exploration of the potential benefits of pet-facilitated therapy. Journal of Clinical Nursing, 8, 329-337. Bruch, M. A., Kaflowitz, N. G., & Pearl, L. (1988). Mediated and nonmediated relationships of personality components to loneliness. Journal of Social & Clinical Psychology, 6, 346355. Carlisle-Frank, P., & Frank, J. M. (2006). Owners, guardians, and owner-guardians: Differing relationships with pets. Anthrozoös, 19, 225-242. Carpenter, E. M., & Kirkpatrick, L. A. (1996). Attachment style and presence of a romantic partner as moderators of psychophysiological responses to a stressful laboratory situation. Personal Relationships, 3, 351-367. Colby, P. M., & Sherman, A. (2002). Attachment styles impact on pet visitation effectiveness. Anthrozoös, 15, 150-164. Collins, N. L., & Feeney, B. C. (2004). Working models of attachment shape perceptions of social support: Evidence from experimental and observational studies. Journal of Personality and Social Psychology, 87, 363-383. Collis, G. M., McNicholas (1998). A theoretical basis for health benefits of pet ownership. In C. C. Wilson & D. C. Turner (Eds.), Companion animals in human health (pp. 105-122). Thousand Oaks, CA, USA: Sage Publications. Chinner, T. L., & Dalziel, F. R. (1991). An exploratory study on the viability and efficacy of a pet-facilitated therapy project within a hospice. Journal of Palliative Care, 7, 13-20. Crawford, E. K., Worsham, N. L., & Swinehart, R. (2006). Benefits derived from companion animals, and the use of the term “attachment.” Anthrozoös, 19, 98-112. Davis, H., Irwin, P., Richardson, M., & O’Brien-Malone, A. (2003). When a pet dies: Religious issues, euthanasia and strategies for coping with bereavement. Anthrozoös, 16, 57-74. Dembrecki, D., & Anderson, J. (1996). Pet ownership may be a factor in improved health of the elderly. Journal of Nutrition for the Elderly, 15, 1531. Driscoll et al. (2007). The Near Eastern origin of cat domestication. Science, 317, 519-523. Eddy, T. J. (1996). RM and beaux: Reductions in cardiac activity in response to a pet snake. Journal of Nervous and Mental Disease, 184, 573-575. Elliot, A. J., & Reis, H. T. (2003). Attachment and exploration in adulthood. Journal of Personality and Social Psychology, 85, 317-331. Endenburg, N. (1995). The attachment of people to companion animals. Anthrozoös, 8, 83-89. Feeney, B. C. (2003). Adult romantic attachment and couple relationships. In M. Mikulincer & P. R. Shaver (Eds.), Attachment in adulthood: Structure, dynamics, and change (pp. 355-377). New York, NY: Guilford Press. Feeney, B. C., & Collins, N. L. (2006). Interpersonal safe haven and secure base caregiving processes in adulthood. In J. Simpson (Ed.), Adult Attachment: Theory, Research, and Clinical Implications (pp. 300-338). New York, NY: Guilford Press. Fenigstein, A., Scheier, M. F., & Buss, A. H. (1975). Public and private self-consciousness: Assessment and theory. Journal of Consulting and Clinical Psychology, 43, 522-527. Fraley, C. R. (2002). Attachment stability from infancy to adulthood: Meta-analysis and dynamic modeling of developmental mechanisms. Personality and Social Psychology Review, 6, 123-151. Fraley & Davis, 1997). Attachment formation and transfer in young adults’ close relationships and romantic relationships. Personal Relationships, 4, 131-144.
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Fraley, R. C., & Shaver, P. R. (1997). Adult attachment and the suppression of unwanted thoughts. Journal of Personality and Social Psychology, 73, 1080-1091. Fraley, R. C., & Shaver, P. R. (1998). Airport separations: A naturalistic study of adult attachment dynamics in separating couples. Journal of Personality and Social Psychology, 75, 1198-1212. Fraley, R. C., & Waller, N. G. (1998). Adult attachment patterns: A test of the typological model. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 77-114). New York, NY: Guilford Press. Fraley, R. C., Waller, N. G., & Brennan, K. A. (2000). An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology, 78, 350-365. Frazier, F. A., Byer, A. L., Fischer, A. R., Wright, D. M., & DeBord, K. A. (1996). Adult attachment style and partner choice: Correlational and experimental findings. Personal Relationships, 3, 117-136. Friedman, E., & Thomas, S. A. (1995). Pet ownership, social support, and one-year survival after acute myocardial infarction in the cardiac arrhythmia suppression trial (CAST). American Journal of Cardiology, 76, 1213-1217. Gardner, W. L., Pickett, C. L., & Knowles, M. L. (2005). Social snacking and shielding: Using social symbols, selves, and surrogates in the service of belonging needs. In K. D. Williams, J. P. Forgas, & W. Von Hippel (Eds.), The social outcast: Ostracism, social exclusion, rejection, and bullying (pp. 227-241). New York, NY: Psychology Press. Garrity, T. F., Stallones, L., & Marx, M. B. (1989). Per ownership and attachment as supportive factors in health of the elderly. Anthrozoös, 3, 35-44. Gilbey, A., McNicholas, J., & Collis, G. M. (2007). A longitudinal test of the belief that companion animal ownership can reduce loneliness. Anthrozoös, 20, 345-353. Green, J. D., Burnette, J., & Davis, J. L. (2008). Third-party forgiveness: (Not) forgiving your close other's betrayer. Personality and Social Psychology Bulletin, 34, 407-418. Green, J. D., & Campbell, W. K. (2000). Attachment and exploration: Chronic and contextual accessibility. Personality and Social Psychology Bulletin, 26, 452-461. Hare, B., Brown, M., Williamson, C., & Tomasello, M. (2002). The domestication of social cognition in dogs. Science, 298, 1634-1636. Harlow, H. F. (1958). The nature of love. American Psychologist, 13, 673-685. Hazan, C., Gur-Yaish, N., & Campa, M. (2006). What does it mean to be attached? In J. Simpson (Ed.), Adult Attachment: Theory, Research, and Clinical Implications (pp. 5585). New York, NY: Guilford Press. Hazan, C., & Shaver, P. R. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52, 511-524. Hazan, C., & Shaver, P. R. (1990). Love and work: An attachment-theoretical perspective. Journal of Personality and Social Psychology, 59, 270-280. Hazan, C., & Zeifman, D. (1994). Sex and the psychological tether. In K. Bartholomew & D. Pearlman (Eds.), Advances in personal relationships: Vol. 5. Attachment processes in adulthood (pp. 151-178). London: Jessica Kingsley. Headey, B. (1999). Health benefits and health costs savings due to pets: Preliminary estimates from an Australian national survey. Social Indicators Research, 47, 233-243. Headey, B., & Grabka, M. M. (2007). Pets and human health in Germany and Australia: National longitudinal results. Social Indicators Research, 80, 297-311.
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Heider, F. (1958). The psychology of interpersonal relations. New York, NY: Wiley. Hines, L., & Fredrickson, M. (1998). Perspective on animal-assisted activities and therapy. In C. C. Wilson & D. C. Turner (Eds.), Companion animals in human health (pp. 232-239). Thousand Oaks, CA: Sage Publications. Hooker, S. D., Freeman, L. H., & Stewart, P. (2002). Pet therapy research: A historical review. Holistic Nursing Practice, 17, 17-23. Hunt, M., & Padilla, Y. (2006). Development of the pet bereavement questionnaire. Anthrozoös, 19, 308-324. Irani, S., Mahler, C., Goetzmann, L., Russi, E. W., & Boehler, A. (2006). Lung transplant recipients holding companion animals: Impact on physical health and quality of life. American Journal of Transplantation, 6, 404-411. Johnson, T. P., Garrity, T. F., & Stallones, L. (1992). Psychometric evaluation of the Lexington Attachment to Pets Scale. Anthrozoös, 5, 160-175. Kamenov, Z., & Jelic, M. (2005). Stability of attachment styles across students’ romantic relationships, friendships and family relations. Review of Psychology, 12, 115-123. Kaminski, M., Pellino, T., & Wish, J. (2002). Play and pets: the physical and emotional impact of child-life and pet therapy on hospitalized children. Children’s Health Care, 31, 321-335 Katcher, A., Segal, H., & Beck, A. (1984). Comparison of contemplation and hypnosis for the reduction of anxiety and discomfort during dental surgery. American Journal of Clinical Hypnosis, 27, 14-21. Kelley, H. H., & Thibaut, J. W. (1978). Interpersonal relations: A theory of interdependence. New York, NY: Wiley. Kirkpatrick, L. A. (1998). God as a substitute attachment figure: A longitudinal study of adult attachment style and religious change in college students. Personality and Social Psychology Bulletin, 24, 961-973. Kirkpatrick, L. A., & Davis, K. E. (1994). Journal of Personality and Social Psychology, 66, 502-512. Kirkpatrick, L. A., & Hazan, C. (1994). Attachment styles and close relationships: A fouryear prospective study. Personal Relationships, 1, 123-142. Knowles, M. L., & Gardner, W. L. (2008, February). “Ill be there for you…”: Favorite television characters as social surrogates. Paper presented at the Society for Personality and Social Psychology conference, Albuquerque, New Mexico. Kunce, L. J., & Shaver, P. R. (1994). An attachment-theoretical approach to caregiving in romantic relationships. In K. Bartholomew & D. Pearlman (Eds.), Advances in personal relationships: Vol. 5. Attachment processes in adulthood (pp. 205-237). London: Jessica Kingsley. Leary, M. R. (1983). A brief version of the Fear of Negative Evaluation Scale. Personality and Social Psychology Bulletin, 9, 371-375. Leary, M. R., Nezlek, J. B., Downs, D., Radford-Davenport, J., Martin, J., & McMullen, A. (1994). Self-presentation in everyday interactions: Effects of target familiarity and gender composition. Journal of Personality and Social Psychology, 67, 664-673. Leary, M. R., Tambor, E. S., Terdal, S. K., & Downs, D. L. (1995). Self-esteem as an interpersonal monitor: The sociometer hypothesis. Journal of Personality and Social Psychology, 68, 518-530.
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Levinson, B. M. (1969). Pet-Oriented Child Psychotherapy. Springfield, IL, USA: Charles C. Thomas. Frantz, C. M., Winter, O., & Mayer, S. (2008, February). Meeting the need to belong through connection to nature. Paper presented at the meeting of the Society for Personality and Social Psychology, Albuquerque, New Mexico. Mikulincer, M. (1997). Adult attachment style and information processing: Individual differences in curiosity and cognitive closure. Journal of Personality and Social Psychology, 72, 1217-1230. Mikulincer, M., Gillath, O., & Shaver, P. R. (2002) Activation of the attachment system in adulthood: Threat-related primes increase the accessibility of mental representations of attachment figures. Journal of Personality and Social Psychology, 83, 881-895. Moneymaker, J. M., & Strimple, E. O. (1991). Animals and inmates: A sharing companionship behind bars. Journal of Offender Rehabilitation, 16(3-4), 133-152. Morell, J. (2008, March). Minds of their own: Animals are smarter than you think. National Geographic, 36-61. Pachana, N. A., Ford, J. H., Andrew, B., & Dobson, A. J. (2005). Relations between companion animals and self-reported health in older women: Cause, effect, or artifact? International Journal of Behavioral Medicine, 12, 103-110. Parkes, C. M. (1972). Bereavement: Studies of grief in adult life. New York, NY: International University Press. Parslow, R. A., Jorm, A. F., Christensen, H., Rodgers, B., & Jacomb, P. (2005). Pet ownership and health in older adults: Findings from a survey of 2,551 community-based Australians aged 60-64. Gerontology, 51, 40-47. Philips, M. (2006, December 11). A reader’s best friend. Newsweek, 14. Podberscek, A. L., Paul, E. S., & Serpell, J. A. (2000). Companion animals and us: Exploring the relationships between people and pets. New York: Cambridge University Press. Prothmann, A., Albrecht, K., Dietrich, S., Hornfeck, U., Stieber, S., & Ettrich, C. (2005). Analysis of child-dog play behavior in child psychiatry. Anthrozoös, 18, 43-58. Raina, P., Waltner-Toews, D., Bonnett, B., Woodward, C., & Abernathy, T. (1999). Influence of companion animals on the physical and psychology health of older people: An analysis of a one-year longitudinal study. Journal of the American Geriatrics Society, 47, 323329. Redefer, L. A., & Goodman, J. F. (1989). Brief report: Pet-facilitated therapy with autistic children. Journal of Autism and Developmental Disorders, 19, 461-467. Rusbult, C. E., & Arriaga, X. B. (2000). Interdependence in personal relationships. In W. Ickes & S. Duck (Eds.), The social psychology of personal relationships (pp. 79-108). Chichester, UK: Wiley. Schleidt, W. M., & Shalter, M. D. (2003). Co-evolution of human and canids. Evolution and Cognition, 9, 57-72. Schlenker, B. R. & Leary, M. R. (1985). Social anxiety and communication about the self. Journal of Language and Social Psychology, 16, 171-192. Sibley, C. G., Fischer, R., & Liu, J. H. (2005). Reliability and validity of the revised experiences in close relationships (ECR-R) self-report measure of adult romantic attachment. Personality and Social Psychology Bulletin, 31, 1524-1536. Siegel, J. M. (1990). Stressful life events and the use of physician services among the elderly. Journal of Personality and Social Psychology, 58, 1081-1086.
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Serpell, J. (1995). The domestic dog: Its evolution, behaviour, and interactions with people. Cambridge, UK: Cambridge University Press. Siegel, J. M. (1990). Stressful life events and use of physician services among the elderly: The moderating role of pet ownership. Journal of Personality and Social Psychology, 58, 1081-1086. Simpson, J., Rholes, W., & Nelligan, J. S. (1992). Support seeking and support giving within couples in an anxiety provoking situation: The role of attachment styles. Journal of Personality and Social Psychology, 62, 434-446. Solano, C. H., & Koester, N. H. (1989). Loneliness and communication problems: Subjective anxiety or objective skills? Personality and Social Psychology Bulletin, 15, 126-133. Sprecher, S., & Felmlee, D. (1992). The influence of parents and friends on the quality and stability of romantic relationships: A three-wave longitudinal investigation. Journal of Marriage and the Family, 54, 888-900. Stammbach, K., B., & Turner, D. C. (1999). Understanding the human-cat relationship: Human social support or attachment. Anthrozoös, 12, 162-168. Stewart, C. S., Thrush, J. C., & Paulus, G. (1989). Disenfranchised bereavement and loss of a companion animal: Implications for caring communities. In K. J. Doka (Ed.), Disenfranchised grief: Recognizing hidden sorrow (pp. 147-159). Lexington, MA, USA: Lexington Books. Tanick, M. H. (1998, December). Pets must have more legal worth than replacement costs. Dog World, 83(12), 78-80. Tucker, J. S., Friedman, H. S., Tsai, C. M., & Martin, L. R. (1995). Playing with pets and longevity among older people. Psychology and Aging, 10, 3-7. Turner, W. G. (2003). Bereavement counseling: Using a social work model for pet loss. Journal of Family Social Work, 7(1), 69-81. Twenge, J. M., Baumeister, R. F., Tice, D. M., & Stucke, T. S. (2001). If you can’t join them, beat them: Effects of social exclusion on aggressive behavior. Journal of Personality and Social Psychology, 81, 1058-1069. Twenge, J. M., Catanese, K. R., & Baumeister, R. F. (2002). Social exclusion causes selfdefeating behavior. Journal of Personality and Social Psychology, 83, 606-615. Vigne, J., Guilaine, J., Debue, K., Haye, L., & Gérard, P. (2004). Early taming of the cat in Cyprus. Science, 304, 259. Vilà, C., Savolainen, P., Maldonado, J. W., Amorim, I. R., Rice, J. E., Honeycutt, R. L., Crandall, K. A., Lundeberg, J., & Wayne, R. K. (1997). Multiple and ancient origins of the domestic dog. Science, 276, 1687–1689. Vormbrock, J. K., & Grossberg, J. M. (1988). Cardiovascular effects of human-pet dog interactions. Journal of Behavioral Medicine, 11, 509-517. White, R. W. (1959). Motivation reconsidered: The concept of competence. Psychological Review, 66, 297-333. Wilson, C. C., & Turner, D. C. (1998). Companion animals in human health. Thousand Oaks, CA: Sage Publications.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 5
THE ROLE OF OXYTOCIN IN THE PATHOPHYSIOLOGY OF ATTACHMENT Marazziti Donatella1,*, Catena Dell’Osso Mari2, Consoli Giorgio1, and Baroni Stefano1 1
Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Italy 2 Dipartimento di Psicologia, University of Florence, Italy
ABSTRACT Oxytocin is a nonapeptide synthesized in the paraventricular and supraoptic nuclei of the hypothalamus. Although OT-like substances are present in all vertebrates, oxytocin has been identified only in mammals where it seems to be fundamental in the onset of typical mammalian behaviors, including labour and lactation. In the present chapter, the physiological role of oxytocin in the regulation of different functions and behaviors will be addressed: several data, mainly coming from animal models, have highlighted the role of this neuropeptide in the formation of caregiver-infant attachment, pair-bonding and, more generally, in linking social signals with cognition, behaviours and reward. In addition, recent evidences have demonstrated alterations of oxytocin system in several human neuropsychiatric disorders, leading to the hypothesis of a possible involvement of oxytocin in the onset of mental disorders. In this frame, the psychopathological implication of the disregulation of the oxytocin system and the possible use of oxytocin or its analogues and/or antagonists in the treatment of psychiatric disorders will be discussed.
*
Author to whom correspondence and reprint requests should be sent: Dr. Donatella Marazziti. Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, via Roma, 67, I-56100 Pisa, Italy; Telephone: +39 050 835412; Fax: +39 050 21581; E-mail address:
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INTRODUCTION The first evidence of the existence of a neural pathway from the supraoptic (SON) nucleus of the hypothalamus to the posterior pituitary dates back to the end of the 19th century [1]. Subsequently, Scharrer (1928) discovered, in the fish hypothalamus, the existence of neurons which could secrete substances via exocytosis of cytoplasmic vesicles, the so-called “glandular cells” [2]. Two decades later, oxytocin (OT) was isolated in pituitary extracts and became the first peptide hormone to have its amino acid sequence identified and to be synthesized in its active form [3]. This chapter aimed to provide a comprehensive review of the OT system and of its role in the formation of social bonds, as well as its possible involvement in the onset of psychopathology.
SYNTHESIS AND LOCALIZATION OT is a small peptide characterized by a six amino acid ring and a three amino acid tail. It differ from vasopressin (AVP) in terms of two amino acids: Ile vs Phe at position 3 and Leu vs Arg at position 8, respectively. The presence at the position 8 of the chain of a neutral amino acid enables OT to bind to its receptors [4]. All vertebrates possess at least a OT-like and a AVP-like peptide, while suggesting the existence of two evolutionary molecular lineages: the isotocin-mesotocin-OT line, implicated in reproductive functions, and the vasotocin-vasopressin line, involved in the water homeostasis. On the contrary, OT and AVP have been found only in mammals and probably have developed in parallel with typical mammalian behaviors, such as uterine contraction during labour and milk ejection essential for lactation. Magnocellular neurons of the SON and paraventricular (PVN) nuclei of the hypothalamus OT and AVP are the major source of OT [5]. OT and AVP are assembled as precursors which are subsequently processed in the neurosecretory vesicles. The largest precursor of OT is preprooxytocin, that comprises three components: a signal sequence of about 16–30 amino acid residues at the neuropeptide terminal, the neuropeptide sequence and the space parts [6]. During the intravescicular post-translational processing, OT precursor undergoes sequential proteolytic cleavage and other enzimatic modifications, such as glycosylation, phosphorylation, acetylation and amidation, that lead to the three final products: OT, neurophysin and a carboxy-terminal glycoprotein. Once synthetized, OT is targeted along the axon to the posterior pituitary [7] where each axon produces several nerve terminals that constitute about 50% of the total volume of the neural lobe. At this level OT and its transporting proteins may be released into the blood, so that they can stimulate their receptors located in distant target organs, such as mammary gland and kidney. Several other biologically active substances, including AVP, neuropeptide Y, tyrosine hydroxylase, dynorphin, thyrotropin-releasing hormone, atrial natriuretic factor, galanin and nitric oxide (NO) synthase, are co-released with OT, even if the reciprocal effects between them and OT are still unknown [8, 9]. Oxytonergic magnocellular projections do not reach only the posterior pituitary, but also terminate in the arcuate nucleus, the lateral septum, the medial amygdaloid nucleus and the
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median eminence [10]. In the magnocellular SON and PVN nuclei, OT is also locally released from dendrites and can act as self-neuromodulators: the somatodendritic release occurs in response to several stimuli, including suckling, parturition, dehydration, hemorrhage, fever, physical restraint, pain, mating and territorial marking behaviors, administration of hypertonic solutions or pharmacological challenges [11]. OT, through the hypothalamic-pituitary portal vascular system, can also reach the adenohypophysis where it seems to be involved in the regulation of the release of different adenohypophysial hormones, including prolactin, adrenocorticotropic hormone (ACTH) and gonadotropins. OT is supposed to act as a prolactin-releasing factor but only when the dopamine levels are low, like during periods of dopamine withdrawal that characterize the onset of prolactin secretion. Moreover, since pituitary OT receptor gene expression is restricted to lactotrophs and increases at the end of gestation [12], it seems that OT function as a prolactin-releasing factor only around the end of gestation. OT may play a role in the endocrine response to stress: in rats, OT seems to potentiate the release of ACTH induced by CRH. In fact, if CRH is responsible for the immediate secretion of ACTH following an acute stress, when CRH levels begin to decrease during prolonged stress, the persistent level of OT in the median eminence seems to be related to the delayed ACTH response and the generation of ACTH pulsatile secretory bursts [13]. However data are controversial: in humans, OT infusion inhibited the plasma ACTH responses to CRH, and suckling and breast stimulation increased and decreased, respectively, plasma OT and ACTH levels; these evidences would indicate an inhibitory influence of OT on ACTH secretion. OT has also been demonstrated to stimulate LH release: an advancement of the LH surge with earlier ovulation has been described after OT administration to proestrous rats. However, the physiological relationships between OT and LH has yet to be clarified [14]. OT is also released from neurons localized in the dorsal-caudal part of PVN and called parvicellular given their smaller size, as compared with that of the magnocellular neurons. Their axons are part of the descending tract directed to the sympathetic centers of the spinal cord and to the parasympathetic caudal autonomic centers, such as the dorsal motor nucleus of the nervus vagus and the nucleus of tractus solitarii [15, 16]. A peripheral synthesis of OT has also been demonstrated in placenta, uterus, corpus luteum, amnion, testis and heart.
OXYTOCIN RECEPTORS There is a single population of OT receptors which can be found in the brain and peripheral organs. They belong to the class I of G protein-coupled receptor family and are coupled to phospholipase C-beta which, once activated, leads to the generation of 1,2-diacylglycerol and inositol trisphosphate. The final increase of intracellular Ca2+ may trigger several cellular events, such as smooth cell contraction, changes of cellular excitability, modifications of gene trascription and protein synthesis [17]. The brain distribution of OT receptors show a large interspecies variability. In rats, OT binding sites have been found in the olfactory system, basal ganglia, thalamus, lymbic system (bed nucleus of the stria terminalis, central amygdaloid nucleus, ventral subiculum), hypothalamus (ventromedial nucleus), brain stem and spinal cord. In the rabbit, no receptors have been detected in the ventral subiculum of the hippocampus or in the hypothalamic
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ventromedial nucleus. In human brain, they are mainly distributed in the pars compacta of substantia nigra and globus pallidus, areas which have been linked to attachment, as well as in the anterior cingulate and medial insula [18]. Conversely, OT binding sites were absent in hippocampus, amygdala, entorinal cortex and olfactory bulb. Theoretically, the different distribution of OT receptors in the brain of individuals belonging to different species might be related to the variety of functions potentially regulating by them. The density and distribution of OT receptors in the brain also varies across development and can be influenced by steroids, such as estrogen, progesterone, androgens and glucocorticoids. At peripheral level they have been demonstrated to be localized in kidney, heart, thymus, pancreas and adipocytes. These receptors are stimulated by the OT released into the blood by the neurohypophisis and carry on several important physiological function.
SOCIAL ATTACHMENT AND OXYTOCIN Most of the data on the neurobiological mechanisms that subtend the formation of social bonds came from animal models. In fact, the methods of science (invasive, rigorously controlled) are difficult to apply to personal experiences associated with social attachment in humans. Neuropeptides, particularly OT, seem to play a critical role in the initiation and maintenance of complex social behaviors [19-21]. They would act trough the inhibition of defensive behaviours associated with fear and anxiety and trough the promotion of positive social behaviours which may lead to social bonds formation. The most relevant data on this issue will be reviewed, according to Harlow’s classification of social bonds (parental attachment, infant attachment, pair attachment) [22]. The hormonal effects of specific physiological states, which are known to encourage positive social behaviours, will also be reported.
Parental Attachment The most stable and long-lasting form of social bond is maternal attachment, which is critical for the survival of mammals. Most of the data on the biochemical and neurobiological mechanisms that subtend maternal bonding came from precocial ungulates, especially sheep, who develop selective filial attachment. In fact, as in humans, in these animals maternal attachment is usually developed only towards the ewe’s own lamb. The hormones regulating birth and lactation have been implicated in the genesis of caregiver – infant attachment [23, 24]. OT, the mammalian hormone with the predominant role in both birth and lactation, has been obviously considered the main candidate for the onset of caregiver – infant attachment and about 30 years ago was proposed as the hormone of the mother love [25, 26]. Vaginal stimulation and sukling may lead to maternal bonding trough a release of OT and endogenous opioids [24]. In sheep, it has been demonstrated that OT injection can lead ewes to get attached to unfamiliar lamb, while OT antagonists may block the maternal bond formation [27]. Rats represent another ideal subject for studying the maternal care: nulliparous female rats do not show any interest in infants until the parturition, when a drastic change in
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motivation occurs and typical maternal behaviours became established [28]. OT injection in the lateral ventricles of nulliparous ovariectomized rats may induce maternal behaviors [29], while the central injection of OT antagonists or lesions of OT-producing magnocellular neurons in the hypothalamus inhibit the onset of maternal behaviors. These data, coupled with the fact that, once a female has become maternal, OT antagonists have no effect, might indicate that OT is foundamental for the onset, but not for the maintenance of maternal attachment [30]. In humans, little is known on the influence of OT in maternal behaviors: in a old study it was reported that breast-feeding within 1 h of birth, when OT levels are high, could contribute to a long-lasting mother-infant bond with beneficial effects on the development of the child [31]. Although the neurobiological mechanisms underlying OT-related onset of maternal behaviors are still unclear, the increase of OT receptors in the bed nucleus of the stria terminalis and the ventromedial nucleus of the hypothalamus, that occurs just before parturition, may represent crucial steps of this process [32].
Infant Attachment Infant attachment has been often studied on the basis of behavioural and hormonal changes associated to the separation from the attachment figure. In primates, the attachment object represent the safe and secure base which can protect the infant from threats and provide him with food. During the early development, the mother-infant interaction and the early social experiences may produce long-lasting changes in the brain of the infant with profound behavioural and emotional effects throughout the whole life. OT seems to be critical in the genesis of infant attachment: infants are exposed to the high levels of maternal OT during both labor and lactation. In animals, infants do not develop preferences for the mother if they are pretreated with OT antagonists, while OT administration was demonstrated to facilitate a rapid conditioned association to maternal odor cues [33]. Therefore, the increased blood levels of this hormone may induce positive social interactions, including the formation of social bonds and of their memories, as well as of selective infant–parent attachments. OT administration reduces the separation response of the rat pups, consistently with the role of this peptide in either attachment or separation response [34, 35]. Interestingly, OT receptors have been found in the developing brain with a transient but marked “overproduction” (as compared to the adult) in the limbic areas in the first two postnatal weeks [36, 37]. In addition, OT receptors are present in the reward circuit that includes the nucleus accumbens, the cortex, the talamus and the pallidus, and which, during infant development, has been implicated in the regulation of that sense of ssafety and protection which makes social and parental interactions highly rewarding. OT is considered to be one of the potential candidates involved in the transduction of early experiences (birth process, breast-feeding and other aspects of parent-infant interactions) into physio- (patho-) logical changes, including brain growth, later stress reactivity and ovarian disorders [38]. In humans, the deprivation of the normal parental cares has been recently shown to produce long-lasting changes in the sensitivity to OT during adulthood [39] and to alter the development of children’s OT and AVP systems, which interfere with the comforting effects that typically emerge between children and familial adults who take care of them; in fact, OT
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and AVP levels are increased by socially pleasant experiences, including comforting touches and smells [40].
Adult Pair Bonds A natural animal model for studying the neurobiological substrates of pair bond formation is provided by the prairie voles, small arvicoline rodents that live in pairs and develop adult heterosexual pair bonds that resemble those of humans [41]. In fact, the prairie vole, that are usually found in multigenerational family, shows the classic features of monogamy: a breeding pair lives in the same nest and territory, males, too, take care of infants and intruders of either sex are refused [42]. On the contrary, montane voles are not monogamous and live in isolated conditions showing little interest in social contact. The two species show a different neural distribution of OT receptors: the prairie voles show OT receptors in the nucleus accumbens and prelimbic cortex, brain regions associated with the reward system, while suggesting that OT might have reinforcing properties. In the montane voles the OT receptors are mainly distributed in the lateral septum and seem to be responsible for the effects of OT on self-grooming behavior observed only in this species. Similar differences in receptor distribution have also been observed in pine and meadow voles which are characterized by different social organization (i.e., monogamous versus nonmonogamous) [43]. In prairie voles, period of non-sexual cohabitation can lead to pair bond formation, however, if mating is allowed, they are developed more quikly [44]; mating is known to lead to a release of OT which, therefore, has been hypothesized to be involved in pair bonding [21]. The hypothesis of the involvement of OT in pair bonding seemed to be confirmed by the evidence that, in female prairie voles, central OT treatments increase social contact and facilitate partner preference formation which, on the contrary, seem to be inhibited by the use of OT antagonists [45, 46]. In any case, OT seems to produce different effects in male and female prairie voles: central OT administration in females, but not in males, facilitates the development of a partner preference in the absence of mating [34]. However, the role of OT in males remain unclear, possibly because males are more dependent on AVP. In humans, OT administration seem to increase the trust towards the others, possibly through the involvement of the amygdala, the main component of the circuit of fear and social cognition which highly expresses OT receptors [47]. OT seem to be able to modulate some functions of human amygdala: a neuroimaging study (functional magnetic resonance) showed that OT reduced significantly the activation of amygdala and its coupling to brain regions implicated in autonomic and behavioral responses to fear [48]. The property of OT to facilitate the formation of social bonds has been related to the improvement of the inference of the affective mental state of the other subjects, which, in turn, would lead to a reduction of the ambiguity experienced during a social interaction with subsequent decreases of anxiety levels [49]. This theory is in line with the previous result of a reduction of the autonomic response to aversive pictures after OT treatment [50]. OT administration, however, did not affect self-report scales of psychological state regarding anxiety and mood [51]; it seems that the presence of a social interaction is necessary to elicit the OT effect, since it would become evident only in the social context, but not when subjects rate themselves in isolation. Moreover, it has been demonstrated that the decrease of amigdala activation after OT
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administration was more significant for social stimuli, such as faces, than for non social ones, suggesting that different neural systems may mediate social and non-social fear [51]. A critical requirement for the formation of pair bonds is the ability to identify conspecifics [52]. OT seem to be involved in social learning and recognition, the so-called social memory. In fact, OT knock-out mices are not able to recognize previously encountered conspecifics and do not show any attachment behaviour; however, central OT administration before the first contact can restore normal attachment behaviors [53]. Therfore, OT seems to be involved in acquisition rather than in consolidation of social bonds and, in rats, OT can lead to the onset of partner preference [54]. The likelihood of a social encounter is also important for pair bond formation: for example, anxiety and novelty avoidance may reduce the likelihood of approaching a conspecific. While OT has been demonstrated to decrease anxiety-like behaviors, AVP seems to increase them [55]. The opposite effects on behaviors produced by OT and AVP may be explained by the need of a gender-specific modulation of different behaviors. Although OT influences sexual behaviors and social interactions in both males and females, the onset of maternal behaviors is fundamental in females [16] and require the inhibition of novelty avoidance, the suppression of prior social avoidance learning and a decrease of aggression. On the contrary, AVP promotes behavioral modifications leading to the establishment of territories and dominance hierarchies characteristic of male social behavior.
Sexual Behavior and Attachment There is a strong relationship between neuropeptides and sexual behaviour. In those species that form heterosexual pair bonds, such as prairie voles, sexual contacts are followed by the formation of stable bonds [42]. In humans, plasma OT levels increase during sexual arousal and are significantly higher during orgasm than at baseline in both males and females [20, 21]. Moreover, the level of muscular contractions during orgasm has been positively related to OT plasma levels [56], suggesting that some OT effects may depend on its ability to stimulate smooth muscles contraction in the genital area. In addition, intranasal OT administration seems to enhance the sexual arousal and orgasm intensity: interestingly, a woman who had used a synthetic OT spray, experienced an increased sexual desire associated with intense vaginal transudate [57, 58]. Overall, during sexual arousal OT seems to act peripherally on reproductive organs and activates the sexual functions in both women and men. Beyond its peripheral effects on reproductive organs, OT might also sensitize the neurons responsible for the cognitive feelings of orgasm, while representing a physiological substrate for both sexual behavior and performances. In men, AVP concentrations increased significantly during arousal and returned to basal levels at the time of ejaculation, while plasma OT rose about five-fold during ejaculation and returned to basal concentrations within about 30 minutes [59].
Stress and Attachment It is well known that threatening situations might strengthen and facilitate the onset of social bonds [60]. In prairie voles, stress and corticosterone injection have been demonstrated
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to facilitate pair bond formation. The underlying hypothesized mechanism is that glucocorticoids modulate social bonds by influencing synthesis and release of OT and/or OT receptors [61]. OT may be released from the pituitary gland in response to different stressful stimuli, such as pain, conditioned fear and exposure to novel environments [62]. In rats, the acute exposure to immobilization stress resulted in increased OT-mRNA levels, while both forced swimming and shaker stress provoked a raise of central and plasma OT concentrations. OT would facilitate the activation of the hypothalamic-pituitary-adrenal axis by increasing the glucocorticoid release. Along this line, it is supposed that the stressinduced central release of OT can ameliorate some stress-related disorders, such as depression and anxiety: in mice and in rats, OT showed anxiolytic properties in estrogen-treated females possibly mediated by its influence on dopaminergic neurotransmission in the limbic areas. Since stress and anxiety impair maternal caretaking, a reduced stress responsiveness during lactation appear to be adaptive for both mother and infant. In line with these observations, lactating women showed reduced hormonal responses to exercise stress, as compared with postpartum women who bottle-feed their infants [63]. Furthermore, women with panic disorder have been demonstrated to experience, during lactation, a reduction of their anxiety symptoms [64].
OXYTOCIN AND NEUROPSYCHIATRIC DISORDERS Only a few data exist on a possible involvement of OT in the pathophysiology of neuropsychiatric disorders. Although most of them should be considered as suggestions, nevertheless they are intriguing and would indicate the need of further research in this promising area.
Depression Since OT has been shown to decrease stress response and anxiety levels, to modulate cognitive functions and promote positive social relationships, some symptoms of depression, including social withdrawal, cognitive impairment, appetite modifications and stress reactivity [65], have been related to alteration of the OT system [66]. In a postmortem study, increased density of AVP- and OT-expressing neurons was detected in the PVN nucleus of depressed patients [67]; on the contrary, no difference in OT levels was found in cerebrospinal fluid (CSF) of depressed patients and control subjects [68]. As far as OT plasma levels, although in a first study decreased levels of the neuropetide have been reported in depressed patients [69], no difference in a larger group of patients, as compared with healthy subjects was also found [70]. More recently, a negative correlation correlation was found between plasma OT and symptoms of depression and anxiety in 25 patients affected by major depression [71]. The OT abnormalities reported in depression, although requiring further support, may be linked to the dysregulation of the HPA axis reported in this condition, together with the multiple neurotransmitters and modulators acting at this level.
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Anxiety Disorders Obsessive-compulsive disorder (OCD) is characterized by obsessions and/or compulsions. OT may influence physiological activities, including memory acquisition, maintenance and retrieval, as well as grooming, maternal and sexual behaviors, which may be related to some OCD features. OT receptors have been identified in some brain areas, which have also been implicated in the pathophysiology of OCD [72-75]. In animals, the central OT injection produce a significant increase of grooming behavior [76, 77] which is considered a model of compulsions, as cleaning behaviors are prototypical symptoms in OCD patients [78, 79] and parallel the OT-induced grooming behaviors observed in animals [80]. The hypothesis of an involvement of the OT system in the pathophysiology of OCD is supported by the evidence that pregnancy and the postpartum period are characterized by an increased risk for the onset of contamination obsessions [81-84]. It is possible that a subgroup of women are vulnerable to the induction or exacerbation of OCD after the exposure to the elevated OT levels, such as those occurring during the pregnancy [85, 86]. Moreover, increased OT levels in the CSF of adults with OCD and Tourette’syndrome, as compared with healthy control subjects, have been reported and they seem to correlate with the current severity of OCD [87]. The attempts to administer OT to OCD patients led to controversial results [88-92], so that further data are necessary to understand the potentiality of OT or its analogues as antiobsessional treatment. OT seems to have anxiolytic properties. In mothers, OT levels have been demonstrated to positively relate with a reduction of the incidence of stress and anxiety disorders [63]; pregnancy, a period characterized by increased OT levels, seems to be protective for some anxiety disorders, including panic disorder. OT, which is released during stress, seems to be an important modulator of anxiety and fear response, with a final reduction of anxiety [9395]. Dysfunctions of the amygdala, which is implicated in the biological response to danger signals in social interaction, have been reported in anxiety disorders; however, it is known that amygdala activity is modulated by OT, since its intranasal administration reduce amygdala activation and its coupling to the brain regions involved in the autonomic and behavioral response to fear [48]. Recently, a downregulation of OT receptors has been related to the pathophysiology of social anxiety disorder that might explain the cognitive misappraisals typical of the patients affected by this condition [48]. In patients with post-traumatic stress disorder (PTSD), the intranasal OT administration was able to decrease the memory retrieval and conditioned response [50]. In fact, OT attenuates memory consolidation and retrieval, facilitates the extinctions of an activated avoidance response and attenuates passive avoidance behavior [96, 97]. Alterations of the OT system following severe early stress and trauma may interfere with the normal brain devolpment while increasing the subsequent risk of developing PTSD and, more in general, any kind of psychopathology [98].
Eating Disorders OT and AVP, which have been demonstrated to influence feeding behavior [99], have been eating disorders where inconclusive results have been reported [100-103]. The serum activity of the prolyl endopeptidase (PEP), an enzyme that cleavages many active
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neuropeptides, such as OT, AVP, thyrotropin releasing hormone, substance P, bradykinin, neurotensin and angiotensin [104], was decreased in both bulimic and anorectic patients [105]. The CSF OT levels were found to be low in restricting anorectic partients [103], but, since they tend to normalize after weight restoration, they were interpreted as secondary to malnutrition and abnormalities in fluid balance [105, 106]. Autoantibodies against OT were reported in both anorexia and bulimia nervosa and seem to indicate that immune dysfunctions may also be involved in the pathophysiology of these disorders [107].
Addiction A crucial drug-sensitive component of the reward circuit, which is enhanced by abuse drugs, is represented by the mesolimbic dopaminergic system which is under the modulatory control of several neurotransmitters and hormones [108]. OT could be involved in the development of tolerance and dependence towards abuse substances including opiates and cocaine [109]. Given that adaptation and learning are likely to be implicated in the neural events leading to drug tolerance and dependence [110], OT is supposed to modulate dopamine in the reward circuit. In mice, OT seems to inhibit the onset of tolerance to morphine [111] and to attenuate the symptoms of morphine withdrawal [109]. OT attenuated also the cocaine-induced hyperactivity and inhibited the behavioral tolerance to the effect of this drug, while facilitating the development of behavioral sensitization [112-114]. As far as ethanol is concerned, OT was shown to inhibit the development of tolerance to ethanol in mice [115]; acute alcohol administration inhibits OT secretions [116], while its chronic use stimulates it [117]. It has also been hypothesized that OT might be involved in the cognitive dysfunctions observed in alcoholics [117, 118].
Schizophrenia Only a few data are available on the relationship between OT system and psychoses. OT levels were increased in schizophrenic patients, as compared with healthy controls, particularly in those taking neuroleptics [119]. In addition, in the brain of untreated schizophrenic patients, a morphometric evaluation of neurophysin-immunoreactivity suggested the presence of alterated OT function [120].
Autism and Related Disorders OT and AVP seem to be implicated in social skills [19-21, 121, 122] and abnormalities of their neural pathways may underlie several aspects of autism, such as repetitive behaviors, cognitive and social deficits, early onset, and genetic loading [123, 124]. The central regulation and expression of OT and AVP may help to explain the higher prevalence of the disorder in male subjects: in fact, centrally active AVP has been related to increased vigilance, anxiety, arousal and activation, while OT seems to have opposite effects including reduced anxiety, relaxation, growth and restoration. Therfore, higher activity of AVP, due to
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an increased exposure to androgens, might contribute to the male vulnerability to autism, while OT, which is estrogen-dependent and is higher in female subjects, especially during early development, may be a protective factor [125]. There are only a few data on the relationships between OT and autism: plasma OT levels have been reported to be decreased in 29 autistic children, as compared with healthy control subjects, and to negatively relate to the reported scores on social and developmental measures [126]. Moreover, in the blood of autistic children, an altered, extended form of OT, which is normally detected only during the fetal life, has been found at higher levels than in normal subjects [127]; this fetal form less active than the adult OT and may interfere with the functioning of the OT system. In addition, it has been suggested that the OT receptor gene may be an excellent candidate for the susceptibility to autism [123, 128-130]: two specific nucleotide polymorphisms of OT receptors, rs2254298 and rs53576, seem to characterized autistic subjects in a Chinese Han population [131]; this association has been replicated in a Caucasian sample of United States but only for the rs2254298 polymorphism [132]. Another association study has recently confirmed that specific haplotypes in the OT receptor gene may confer the risk to develop autism [133].
Prader-Willy Syndrome The Prader Willy syndrome (PWS) is a genetic disorder characterized by mental retardation, hypogonadism, short stature and distinctive dysmorphic features. A 42% reduction of OT-expressing neurons was described, post-mortem, in the PVN nucleus of PWS subjects, as compared with healthy controls [134]. Similarly to what described in OCD patients, increased OT CSF levels have been found in PWS subjects [81].
CONCLUSION OT and the OT system are currently attracting an increasing interest and have become one of the main topics of several research lines. Several data, mainly coming from animals, suggest that OT plays a major role in the modulation of a broad range of functions and of complex behaviours including its role in the formation of caregiver-infant attachment, pairbonding and, more generally, in linking social signals with cognition, behaviours and reward. Recently OT has been implicated in the pathophysiology of different neuropsychiatric disorders, even if data are scattered and the abnormalities described in patients are quite meagre and, therefore, should be considered preliminary.
REFERENCES [1] [2]
Ramon, Cajal (1894). La fine structure des centres nerveux. Procedings of the royal society, London.. Scharrer, E., Scharrer, B. (1940). Secretory cells within the hypothalamus. Res. Publ. A. Nerv. Ment. Dis. 20, 170-174.
122 [3] [4] [5]
[6] [7] [8] [9]
[10]
[11]
[12]
[13]
[14] [15]
[16]
[17] [18]
Erika Lawrence, Robin A. Barry, Rebecca L. Brock et al. Du Vigneaud, V., Ressler, C., Trippet, S. (1953). The sequence of amino acids in oxytocin, with a proposal for the structure of oxytocin. J. Biol. Chem. 205(2), 949-57. Barberis, C., Movillac, B., Durroux, T. (1998). Structural bases of vasopressin/oxytocin receptor function. J. Endocrinol. 156(2), 223-9. Swaab, D. F., Pool, C. W., Nijveldt, F. (1975). Immunofluorescence of vasopressin and oxytocin in the rat hypothalamo-neurohypophyseal system. J. Neural Transmission 36, 195-215. Holmgren, S. & Jensen, J. (2001). Evolution of the nervous system, evolution of vertebrate neuropeptides. Brain Res. Bull. 55, 723– 735. Arvan, P. & Castle, D. (1998). Sorting and storage during secretory granules biogenesis: looking backward and looking forward. Biochem. J. 332, 593–610. Pretel, S. & Piekut, D. (1990). Coexistence of corticotropin-releasing factor and enkephalin in the paraventricular nucleus of the rat. J. Comp. Neurol. 294, 192-201. Xiao, M., Ding, J., Wu, L., Han, Q., Wang, H., Zuo, G., Hu, G. (2005). The distribution of neural nitric oxide symthose-positive cerebrospinal fluid-contacting neurons in the third ventricular wall of male rats and coexistence whith vasopressin or oxytocin. Brain Res. 1038, 150-62. Pittman, Q. T., Blume, H. W., Renaud, L. P. (1981). Connections of the hypotholamic paraventricular nucleus with the neurohypophisis, median eminence, amigdale, lateral septum and midbrain perioqueductal gray : an electrophysiological study in the brain. Brain Res. 215, 15-28. Neumann, I., Douglas, A. J., Pittman, Q. J., Russell, J. A., Landgraf, R. (1996). Oxytocin released within the supraoptic nucleus of the rat brain by positive feedback action in involved in parturition-related events. J. Neuroendocrinol. 8, 227-233. Breton, C., Pechoux, C., Morel, G., Zingg, H. H. (1995). Oxytocin receptor messenger ribonucleic acid: characterization, regulation, and cellular localization in the rat pituitary gland. Endocrinology 136, 2928–2936. Boyle, L. L., Brownfield, M. S., Lent, S. J., Goodman, B., Vo Hill, H., Litwin, J., Carnes, M. (1997). Intensive venous sampling of adrenocorticotropic hormone in rats with sham or paraventricular nucleus lesions. The Journal of endocrinology 153, 159– 167. Evans, J. J. (1996). Oxytocin and the control of LH. Journal of Endocrinology 151, 169–174. Amico, J. A., Challinor, S. M., Comeron, J. L. (1990). Pattern of oxytocin concentrations in the plasma and cerebrospinal fluid of lactating rhesus monkeys (Macaca Mulatta): evidence for funtionally independent oxytocinergic pathways in primates. J. Clin. Endocrinol. Metab. 71(6), 1531-5. Palkovits, M., Toth, Z. E., Gallatz, K., Fodor, M. (1999). Decussations of the descending paraventricular pathways to the brainstein and spinal cord autonomic centers. J. Comp. neurol. 414, 255-66. Gimpl, G., Fahrenholz, F. (2001). The oxytocin receptor system: structure, function, and regulation. Physiol. Rev. 81, 629-683. Brown, C. H., Stern, J. E., Jackson, K. L., Bull, P. M., Leng, G., Russell, J. A. (2005). Morphine withdrawal increases intrinsic excitability of oxytocin neurons in morphinedependent rats. Eur. J. Neurosci. 21(2), 501-12.
Development of an Interview for Assessing Relationship Quality
123
[19] Wakerley, J. B., Lincoln, D. W. (1973). The milk-ejection reflex of the rat: a 20- to 40fold acceleration in the firing of paraventricular neurones during oxytocin release. J. Endocrinol. 57, 477-93. [20] Carmichael, M. S., Humbert, R., Dixen, J., Palmisano, G., Greenleaf, W., Davidson, J. M. (1987). Plasma oxytocin increases in the human sexual response. The Journal of clinical endocrinology and metabolism 64, 27–31. [21] Carter, C. S. (1992). Oxytocin and sexual behavior. Neuroscience and Biobehavioral Reviews 16, 131–144. [22] Harlow, H. F. & Mears, C. (1979). The Human Model: Primate Perspectives. John Wiley & Sons, New York. [23] Keverne, E. B. (1995). Neurochemical changes accompanying the reproductive process: their significance for maternal care in primates and other mammals. In: C. R. Pryce, R. D. Martin & D. Skuse (Eds). Motherhood in human and non-human primates. Karger, Basel, pp. 69-77. [24] Keverne, E. B., Nevison, C. M., Martel, F. L.(1997). Early learning and the social bond. Annals of the New York Academy of science. 807, 329-339. [25] Klopfer, P. H. (1971). Mother love: what turns it on? American Scientist 59, 404-407. [26] Newton, N. (1973). Interrelationships between sexual responsiveness, birth and breast feeding. In: J. Zubin & J. Money (Eds). Contemporary sexual behaviour: critical issues in the 1970s. Johns Hopkins University Press, Baltimore, pp. 77-98. [27] Carter, C. S. (1998). Neuroendocrine perspectives on social attachment and love. Psychoneuroendocrinology 23, 779-818. [28] Numan, M. (1994). A neural circuitry analysis of maternal behavior in the rat. Acta Paediatr. Suppl. 397, 19-28. [29] Pedersen, C. A., Prange, A. J. (1979). Induction of maternal behavior in virgin rats after intracerebroventricular administration of oxytocin. Proceedings of the National Academy of Sciences of the United States of America 76, 6661–6665. [30] Skutella, T., Weber, T., Jirkowski, G. F. (1993). Coexistence of oxytocin and tyrosine hydroxylase in the rat hypothalamus, an immunocytochemical study. J. Neural. Transm. Gen. Sect. 94, 55-61. [31] Kennell, J. H., Jerauld, R., Wolfe, H., Chesler, D., Kreger, N. C., Mcalpine, W. (1974). Maternal behavior one year after early and extended post-partum contact. Developmental medicine and child neurology 16, 172–179. [32] Caldwell JD, Walker CH, Pedersen CA, Barakat AS, Mason GA (1994). Estrogen increases affinity of oxytocin receptors in the medial preoptic area-anterior hypothalamus. Peptides 15, 1079–1084. [33] Nelson, E. & Panksepp, J. (1996). Oxytocin mediates acquisition of maternally associated odor preferences in preweanling rat pups. Behav. Neurosci. 110, 583-92. [34] Winslow, J. T., Hastings, N., Carter, C. S., Harbaugh, C. R., Insel, T. R. (1993). A role for central vasopressin in pair bonding in monogamous prairie voles. Nature 7, 365, 545-8. [35] Tribollet, E., Goumaz, M., Raggenbass, M., Dreifuss, J. J. (1991). Appearance and transient expression of vasopressin and oxytocin receptors in the rat brain. J. Recept. Res. 11, 333-46. [36] Shapiro, L. E., Insel, T. R. (1989). Ontogeny of oxytocin receptors in rat forebrain: a quantitative study. Synapse 4, 259-66.
124
Erika Lawrence, Robin A. Barry, Rebecca L. Brock et al.
[37] Insel, T. R. & Winslow, J. T. (1991). Central administration of oxytocin modulates the infant rat's response to social isolation. Eur. J. Pharmacol. 2;203(1),149-52. [38] Carter, C. S. (2003). Developmental consequences of oxytocin. Physiology & Behavior 79, 383-397. [39] Meinlschmidt, G., Heim, C. (2007). Sensitivity to intranasal oxytocin in adult men with early parental separation. Biol. Psychiatry 1;61(9), 1109-11. [40] Fries, A. B., Ziegler, T. E., Kurian, J. R., Jacoris, S., Pollak, S. D. (2005). Early experience in humans is associated with changes in neuropeptides critical for regulating social behavior. Proc. Natl. Acad. Sci. USA 102 (47), 17237-40. [41] Insel, T. R. (1997). A neurobiological basis of social attachment. Am. J. Psychiatry 154, 727-35. [42] Carter, C. S., DeVries, A. C., Getz, L. L. (1995). Physiological substrates of mammalian monogamy: the prairie vole model. Neurosci. Biobehav. Rev. 19(2), 30314. [43] Insel, T. R., Wang, Z. X., Ferris, C. F. (1994). Patterns of brain vasopressin receptor distribution associated with social organization in microtine rodents. J. Neurosci. 14(9), 5381-92. [44] Williams, J. R., Catania, K. C., Carter, C. S. (1992). Development of partner preferences in female prairie voles (Microtus Ochrogaster): the role of social and sexual experience. Hormones and Behavior 26, 339-349. [45] Williams, J. R., Insel, T. R., Harbaugh, C. R., Carter, C.S. (1994). Oxytocin administered centrally facilitates formation of a partner preference in female prairie voles (Microtus ochrogaster). J. Neuroendocrinol. 6(3):247-50. [46] Insel, T. R., Winslow, J. T., Wang, Z. X., Young, L., Hulihan, T. J. (1995). Oxytocin and the molecular basis of monogamy. Advances in experimental medicine and biology 395, 227–234. [47] Kosfeld, M., Heinrichs, M., Zack, P. J., Fischbacher, U., Fehr, E. (2005). Oxytocin increases trust in humans. Nature 435, 673-676. [48] Kirsch, P., Esslinger, C., Chen, Q., Mier, D., Lis, S., Siddhanti, S., Gruppe, H., Mattay, V. S., Gallhofer, B., Meyer-Linderberg, A. (2005). Oxytocin modulates neural circuitry for Social Cognition and Fear in Humans. J. Neurosci. 25, 11489-11493. [49] Domes, G., Heinrichs, M., Gläscher, J., Büchel, C., Braus, D. F., Herpertz, S. C. (2007). Oxytocin attenuates amygdala responses to emotional faces regardless of valence. Biol. Psychiatry 15;62(10), 1187-90. [50] Pittman, R. K., Orr, S. P., Lasko, N. B. (1993). Effects of intranasal vasopressin and oxytocin on physiologic responding during personal combat imagry in Vietnam veterans with posttraumatic stress disorder. Psychiatry Res. 48, 107-17. [51] Meyer-Lindenberg, A., Hariri, A. R., Munoz, K. E., Mervis, C. B., Mattay, V. S., Morris, C. A., Berman, K. F. (2005). Neural correlates of genetically abnormal social cognition in Williams syndrome. Nat. Neurosci. 8, 991-3. [52] Insel, T. R., Frenald, R. D. (2004). How the brain processes social information: searching for the social brain. Annu. Rev. Neurosci. 27, 697-722. [53] Dantzer, R., Bluthe, R. M., Koob, G. F., Le Moal, M. (1987). Modulation of social memory in male rats by neurohypophysial peptides. Psychopharmacology 91, 363– 368.
Development of an Interview for Assessing Relationship Quality
125
[54] Popik, P. & Van Ree, J. M. (1993). Social transmission of flavored tea preferences: facilitation by a vasopressin analog and oxytocin. Behav. Neural Biol. 59, 63-8. [55] Bielsky, I. F., Young, L. J. (2004). Oxytocin, vasopressin, and social recognition in mammals. Peptides 25(9), 1565-74. [56] Carmichael, M. S., Warburton, V. L., Dixen, J., Davidson, J. M. (1994). Relationships among cardiovascular, muscular, and oxytocin responses during human sexual activity. Archives of Sexual Behavior 23, 59–79. [57] Anderson, H. M. & Dennerstein, L. (1994). Increased female sexual response after oxytocin. B.M.J. 309, 929. [58] Anderson, H. M., Dennerstein, L. (1995). Oxytocin and female sexuality. Gynecologic and obstetric investigation 40(4), 217-211. [59] Murphy, C. R., Dwarte, D. M. (1987). Increase in cholesterol in the apical plasma membrane of uterine epithelial cells during early pregnancy in the rat. Acta Anatomica 128, 76–79. [60] Bowlby, J. (1980). Attachment and Loss. New York: Basic Books. [61] DeVries, A. C., DeVries, M. B., Taymans, S. E., Carter, C. S. (1996). The effects of stress on social preferences are sexually dimorphic in prairie voles. Proceedings of the National Academy of Science 93, 11980-11984. [62] Onaka, T. (2004). Neural pathways controlling central and peripheral oxytocin release during stress. J Neuroendocrinol. 16(4), 308-12. [63] Altemus, M. (1995). Neuropeptides in anxiety disorders. Effects of lactation. Ann. N.Y. Acad. Sci. 771, 697-707. [64] Klein, D. F., Skrobola, A. M., Garfinkel, R. (1995). Preliminary look at the effects of pregnancy on the course of panic disorder. Anxiety 1, 227–232. [65] Pariante, C. M., Miller, A. H. (2001). Glucocorticoid receptors in major depression: relevance to pathophysiology and treatment. Biol. Psychiatry 49, 391–404. [66] Bell, C. J., Nicholson, H., Mulder, R. T., Luty, S. E., Joyce, P. R. (2006). Plasma oxytocin levels in depression and their correlation with the temperament dimension of reward dependence. J. Psychopharmacol. 20(5), 656-60. [67] Purba, J. S., Hoogendijk, W. J., Hofman, M. A., Swaab, D. F. (1996). Increased number of vasopressin- and oxytocin-expressing neurons in the paraventricular nucleus of the hypothalamus in depression. Arch. Gen. Psychiatry 53, 137-43. [68] Newport, D. J., Heim, C., Owens, M. J., Ritchie, J. C., Ramsey, C. H., Bonsall, R., Miller, A. H., Nemeroff, C. B. (2003). Cerebrospinal fluid corticotropin-releasing factor (CRF) and vasopressin concentrations predict pituitary response in the CRF stimulation test: a multiple regression analysis. Neuropsychopharmacology 28, 569– 576. [69] Frasch, A., Zetzsche, T., Steiger, A., Jirikowski, G. F. (1995). Reduction of plasma oxytocin levels in patients suffering from major depression. Adv. Exp. Med. Biol. 395, 257-8. [70] van Londen, L., Goekoop, J. G., van Kempen, G. M., Frankhuijzen-Sierevogel, A. C., Wiegant, V. M., van der Velde, E. A., De Wied, D. (1997). Plasma levels of arginine vasopressin elevated in patients with major depression. Neuropsychopharmacology 17(4), 284-92.
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[71] Scantamburlo, G., Hansenne, M., Fuchs, S., Pitchot, W., Maréchal, P., Pequeux, C., Ansseau, M., Legros, J. J. (2007). Plasma oxytocin levels and anxiety in patients with major depression. Psychoneuroendocrinology 32(4), 407-10. [72] Rapoport, J. L.& Wise, S. P. (1988). Obsessive–compulsive disorder: evidence for basal ganglia dysfunction. Psychopharmacology Bulletin 24, 380–384. [73] Stahl, S. M. (1988). Basal ganglia neuropharmacology and obsessive–compulsive disorder: the obsessive–compulsive disorder hypothesis of basal ganglia dysfunction. Psychopharmacology Bulletin 24, 370–374. [74] Modell, J. G., Mountz, J. M., Curtis, G. C., Greden, J. F. (1989). Neurophysiologic dysfunction in basal ganglia:limbic striatal and thalamocortical circuits as a pathogenetic mechanism of obsessive compulsive disorder. Journal of Neuropsychiatry 1, 27–36. [75] Insel, T. R. (1992). Toward a neuroanatomy of obsessive–compulsive disorder. Archives of General Psychiatry 49, 739–744. [76] Van Wimersma Greidanus, T. B., Kroodsma, J. M., Pot, M. L. H., Stevens, M., Maigret, C. (1990). Neurohypophyseal hormones and excessive grooming behavior. European Journal of Pharmacology 187, 1–8. [77] Marroni, S. S., Nakano, F. N., Gati, C. D., Oliveira, J. A., Antunes-Rodrigues, J., Garcia-Cairasco, N. (2007). Neuroanatomical and cellular substrates of hypergrooming induced by microinjection of oxytocin in central nucleus of amygdala, an experimental model of compulsive behavior. Mol. Psychiatry 12(12):1103-17. [78] Holzer, J. C., Goodman, W. K., McDougle, C. J., Baer, L., Boyarsky, B. K., Leckman, J. F., Price, L. H. (1994). Obsessive compulsive disorder with and without a chronic tic disorder: a comparison of symptoms in 70 patients. British Journal of Psychiatry 164, 469–473. [79] Leckman, J. F., Grice, D.E., Barr, L.C., de Vries, A. L. C., Martin, C., Cohen, D. J., McDougle, C. J., Goodman, W. K., Rasmussen, S. A. (1995). Tic-related vs. non-ticrelated obsessive compulsive disorder. Anxiety 1, 208–215. [80] McDougle, C. J. (1999). Possible role of neuropeptides in obsessive compulsive disorder. Psychoneuroendocrinology 24, 1-24. [81] Jenike, M. A. (1990). Obsessive–compulsive disorders in pregnancy and childbirth. Year Book Medical Littleton. [82] Neziroglu, F., Anemone, R., Yaryura-Tobias, J. A. (1992). Onset of obsessive compulsive disorder in pregnancy. American Journal of Psychiatry 149, 947–950. [83] Sichel, D. A., Cohen, L. S., Dimmock, J. A., Rosenbaum, J. F. (1993). Postpartum obsessive compulsive disorder: a case series. Journal of Clinical Psychiatry 54, 156– 159. [84] Epperson, C. N., McDougle, C. J., Brown, R. M., Leckman, J. F., Goodman, W. K., Price, L. H. (1995). OCD during pregnancy and the puerperium. American Psychiatric Association New Research Abstract #NR 112: 84. [85] Leckman, J. F. & Mayes, L. C. (1999). Preoccupations and behaviors associated with romantic and parental love—the origin of obsessive-compulsive disorder? Child. Adolesc. Psychiatry Clin. North Am. 8, 635 665. [86] Albert, U., Maina, G., Bogetto, F., Ravizza, L. (2000). The role of recent life events in the onset of obsessive-compulsive disorder. CNS Spectr. 5(12), 44-50.
Development of an Interview for Assessing Relationship Quality
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[87] Leckman, J. F., Goodman, W. K., North, W. G. (1994). Elevated cerebrospinal fluid levels of oxytocin in obsessive-compulsive disorder. Comparison with Tourette’s syndrome and healty controls. Arch. Gen. Psychiatry 51, 782-792. [88] Ansseau, M., Legros, J. J., Mormont, C., Cerfontaine, J. L., Papart, P., Geenen, V., Adam, F., Franck, G. (1987). Intranasal oxytocin in obsessive–compulsive disorder. Psychoneuroendocrinology 12, 231–236. [89] Charles, G., Guillaume, R., Schittecatte, M., Pholien, P., Van Wettere, J. P., Wilmotte, J. (1989). Oxytocin in the treatment of obsessive–compulsive disorder: a report on two cases. Psychiatry and Psychobiology 4, 111–115. [90] Den Boer, J. A., Westenberg, G. M. (1992). Oxytocin in obsessive compulsive disorder. Peptides 13, 1083–1085. [91] Salzberg, A. D. & Swedo, S. E. (1992). Oxytocin and vasopressin in obsessive– compulsive disorder. American Journal of Psychiatry 149, 713–714. [92] Epperson, C. N., McDougle, C. J., Price, L. H. (1996). Intranasal oxytocin in obsessive compulsive disorder. Biological Psychiatry 40, 547–549. [93] Jezova, D., Skultetyova, I., Tokarev, D. I., Bakos, P., Vigas, M. (1995). Vasopressin and oxytocin in stress. Ann. N. Y. Acad. Sci. 29;771, 192-203. [94] McCarthy, M. M., McDonald, C.H., Brooks, P. J., Goldman, D. (1996). An anxiolytic action of oxytocin is enhanced by estrogen in the mouse. Physiol. Behav. 60(5):120915. [95] Marazziti, D., Dell'Osso, B., Baroni, S., Mungai, F., Catena, M., Rucci, P., Albanese, F., Giannaccini, G., Betti, L., Fabbrini, L., Italiani, P., Del Debbio, A., Lucacchini, A., Dell'Osso, L. (2006). A relationship between oxytocin and anxiety of romantic attachment. Clin. Pract. Epidemol. Ment. Health 11;2, 28. [96] Bohus, B., Kovacs, G. L., de Wied, D. (1978). Oxytocin, vasopression and memory: opposite effects on consolidation and retrieval processes. Brain Research 157, 414-417. [97] Amico, J. A., Robinson, G. (1985). Oxytocin: Clinical and Laboratory Studies. Elsevier, New York. [98] Teicher, M. H., Andersen, S. L., Polcari, A., Anderson, C. M., Navata, C. P. (2002). Developmental neurobiology of childwood stress and trauma. Psychiatr. Clin. North Am. 25, 397-426. [99] Olson, B. R., Drutarosky, M. D., Stricker, E. M., Verbalis, J. G. (1991). Brain oxytocin receptor antagonism blunts the effects of anorexigenic treatments in rats: evidence for central oxytocin inhibition of food intake. Endocrinology 129, 785–791. [100] Baranowska, B. (1990). Are disturbance in opioid and adrenergic sytems involved in the hormonal dysfunctions of anorexia nervosa? Psychoneuroendocrinology 15, 371379. [101] Gold, P. W., Gwirtsman, H., Avgerinos, P. C., Nieman, L. K., Gallucci, W. T., Kaye, W., Jimerson, D., Ebert, M., Rittmaster, R., Loriaux, D. L., Chrousos, A. (1986). Abnormal hypotalamic-pituitary-adrenal function in anorexia nervosa: pathophysiology mechanisms in underweight and wieght-corrected patients. N. Engl. J. Med. 314, 13351342. [102] Kaye, W. H. (1996). Neuropeptide abnormalities in anorexia nervosa. Psychiatry research 62, 65-74.
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Erika Lawrence, Robin A. Barry, Rebecca L. Brock et al.
[103] Demitrack, M. A., Lesem, M. D., Listwak, S. J., Brandt, H. A., Jimerson, D. C., Gold, P. W. (1990). CSFf oxytocin in anorexia nervosa:clinical and pathophysiologic considerations. Am. J. Psychiatry 147, 882-886. [104] Welches, W. R., Brosnihan, K. B., Ferrario, C. M. (1993). A comparison of the properties and enzymatic activities of three angiotensin processing enzymes: angiotensin converting enzyme, prlyl endopeptidase and neutral endopeptidase. Life Sci. 52, 1461-1480. [105] Maes, M., Lin, A., Bonaccorso, S., Goossens, F., Van Gastel, A., Pioli, R., Delmeire, L., Scharpe, S. (1999). Higher serum prolyl endopeptidase activity in patients with post-traumatic stress disorder. J. Affect. Disorders 53, 27-34. [106] Chiodera, P., Volpi, R., Capretti, L., Marchesi, C., D’Amato, L., De Ferri, A., Bianconi, L., Coiro, V. (1991). Effect of estrogen or insulin-induced hypoglicemia on plasma oxitocin levels in bulimia and anorexia nervosa. Methabolism 40, 1226-1230. [107] Fetissov, S. O., Harro, J., Jaanisk, M., Jarv, A., Podar, I., Allik, J., Nilsson, I., Sakthivel, P., Lefvert, A. K., Hokfelt, T. (2005). Autoantibodies against neuropeptides are associated with psychological traits in eating disorders. PNAS 102 (41), 1486514870. [108] Koob, G. F. (1992). Neuronal mechanisms of drug reinforcement. Annals of the New York Academy Science 654, 171-191. [109] Kovacs, G. L., Sarnyai, Z., Szabo, G. (1998). Oxytocin and addiction: a review. Psychoneuroendocrinology 23, 945-62. [110] De Wied, D., Gispen, W. H., Van Wimersma Greidanus, T. J. B. (1986). Neuropeptides and Behavior. Pergamon Press, Oxford. [111] Kovacs, G. L. & Telegdy, G. (1987). Endorphin tolerance is inhibited by oxytocin. Pharmacology and Biochemical Behavior 26, 57-60. [112] Kovacs, G. L., Sarnyai, Z., Babarczy, E., Szabò, G., Teledgy, G. (1990). The role of oxytocin –dopamine interactions in cocaine-induced locomotor hyperactivity. Neuropharmacology 29, 365-368. [113] Sarnay, Z., Birò, E., Babarczy, E., Vecsernyes, M., Laczi, F., Szabò, G., Krivan, M., Kovacs, G. L., Telegdy, G. (1992a). Oxytocin modulates behaviouraladaptation to repeated treatment with cocaine in rats. Neuropharmacology 31, 593-598. [114] Sarnay, Z., Szabò, G., Kovacs, G. L., Telegdy, G. (1992b). Opposite actions of oxytocin and vasopressin in the development of cocaine-induced behavioral sensitization in mice. Pharmacology and Biochemical Behavior 43, 491-494. [115] Szabò, G., Kovacs, G. L., Telegdy, G. (1989). Intraventricular administration of neurohypophyseal hormones interferes with the development of tolerance to ethanol. Acta Physiologia Hungaricae 73, 97-103. [116] Nemeroff , C. B. & Loosen, P. T. (1987). Handbook of Clinical Endocrinology. Guilford Press, New York. [117] Marchesi, C., Chiodera, P., Brusamonti, E., Volpi, R., Coiro, V. (1997). Abnormal plasma oxytocin and beta-endorphin levels in alcoholics after short and long term abstinence. Prog. Neuropsychopharmacol. Biol. Psychiatry 21, 797-807. [118] Holden, J. J., McLaughlin, E. J., Reilly, E. L., Overall, J. E. (1988). Accelerated mental aging in alcoholics patients. J. Clin. Psychiatry 44, 286-292.
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[119] Beckmann, H., Lang, R. E., Gattaz, W. F. (1985). Vasopressin-Oxytocin in cerebrospinal fluid of schizofrenic patients and normal controls. Psychoneuroendocrinology 10 (2), 187-91. [120] Mai, J. K., Berger, K., Sofroniew, M. V. (1993). Morphometric evaluation of neurophysin-immunoreactivity in the human brain: pronounced inter-individual variability and evidence for altered staining patterns in schizophrenia. J. Hirnforsh 34, 133-54. [121] Insel, T. R. (1992). Oxytocin, a neuropeptide for affiliation: evidence from behavioral, receptor autoradiographic, and comparative studies. Psychoneuroendocrinology 17, 335. [122] Panskepp, J. (1992). Oxytocin effects on emotional processes: separation distress, social bonding and relationships to psychiatric disorders. Ann. N. Y. Acad. Sci. 652, 243-252. [123] Insel, T. R., O’Brien, D. J., Leckman, J. F. (1999). Oxytocin, vasopressin, and autism: is there a connection? Biol. Psychiatry 45 (2), 145-57. [124] Insel, T. R., Young, L. J. (2001). The neurobiology of attachment. Nat. Rev. Neorosci. 2,129-136. [125] Carter, C. S. (2007). Sex differences in oxytocin and vasopressin: implications for autism spectrum disorders? Behav. Brain Res. 10;176(1), 170-86. [126] Modahl, C., Green, L., Fein, D., Morris, M., Waterhouse, L., Feinstein, C., Levin, H. (1998). Plasma oxytocin levels in autistic children. Biol. Psychiatry 15;43(4), 270-7. [127] Green, L., Fein, D., Modhal, C., Feinstein, C., Waterhouse, L., Morris, M. (2001). Oxytocin and autistic disorder: alterations in peptide forms. Biol. Psychiatry 50 (8), 609-13. [128] Young, L. J. (2001). Oxytocin and vasopressin as candidate genes for psychiatric disorders: Lessons from animal models. Am. J. Med. Genet. 105, 53-54. [129] Young, L. J., Pitkow, L. J., Ferguson, J. N. (2002). Neuropeptides and social behavior: animal models relevant to autism. Mol. Psychiatry 7, 538-39. [130] Ylisaukko-oja, T., Alarcon, M., Cantor, R. M., Auranen, M., Vanhala, R., Kempas, E., von Wendt, L., Jarvela, I., Geschwind, D. H., Peltonen, L. (2006). Search for autism loci by combined analysis of Autism Genetic Resource Exchange and Finnish families. Ann. Neurol. 59, 145-55. [131] Wu, S., Jia, M., Ruan, Y., Liu, J., Guo, Y., Shuang, M., Gong, X., Zhang, Y., Yang, X., Zhang, D. (2005). Positive associations of the Oxytocin Receptor Gene (OXTR) with Autism in the Chinese Han Population. Biol. Psychiatry 58, 74-77. [132] Jacob, S., Brune, C. W., Carter, C. S., Leventhal, B. L., Lord, C., Cook, E. H. (2007). Association of the oxytocin receptor gene (OXTR) in Caucasian children and adolescents with autism. Neurosci. Lett. 24;417(1), 6-9. [133] Lerer, E., Levi, S., Salomon, S., Darvasi, A., Yirmiya, N., Ebstein, R. P. (2007). Association between the oxytocin receptor (OXTR) gene and autism: relationship to Vineland Adaptive Behavior Scales and cognition. Mol. Psychiatry Sep 25. [Epub ahead of print] [134] Swaab, D. F., Purba, J. S., Hofman, M. A. (1995). Alterations in the hypothalamic paraventricular nucleus and its oxytocin neurons (putative satiety cells) in Prader-Willy syndrome: A study of five cases. J. Clin. Endocrinol. Metab. 80, 573-579.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 6
IDENTITY EXPLORATION AND COMMITMENT ASSOCIATIONS WITH GENDER DIFFERENCES IN EMERGING ADULTS’ ROMANTIC RELATIONSHIP INTIMACY H. Durell Johnson*, Kristen A. Loff, George Bell, Evelyn Brady, Erin A. Grogan, Elizabeth Yale, Robert J. Foley, and Trishia A. Pilosi Pennsylvania State University, Pennsylvania, USA
ABSTRACT Emerging adulthood is considered a time when intimacy becomes an integral aspect of romantic relationships, and Arnett (2000) argues intimacy in emerging adults’ romantic relationships results from identity explorations. Previous research, however, suggests emerging adults’ romantic intimacy is associated not only with identity exploration, but also with identity commitments and gender. In an attempt to examine the theorized relationships among identity exploration, identity commitment, gender, and perceived romantic intimacy, the current study examined identity and romantic intimacy responses from a sample of 271 emerging adults (183 females, mean age = 19.22 years; and 88 males (mean age = 19.29 years). Findings indicated 1) both identity exploration and commitment predict emerging adults’ romantic relationship intimacy, 2) gender differences in romantic relationships differ according to emerging adults’ identity status, and 3) identity status differences in romantic relationship intimacy differs for emerging adult males and females. The current study’s test of Arnett’s (2000) hypothesis regarding identity exploration and romantic relationship intimacy development did not fully support his theorized association. Rather, findings suggest differences in emerging adults’ romantic intimacy are associated with their gender and identity commitments as well as *
Correspondence concerning this article should be addressed to H. Durell Johnson, Human Development and Family Studies, Pennsylvania State University, 120 Ridge View Drive, Dunmore, PA 18512-1699, Phone: 570-963-2672, Fax: 570-963-2535, E-mail:
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Erika Lawrence, Robin A. Barry, Rebecca L. Brock et al. identity exploration. As a result, Arnett’s (2000) proposal that identity exploration during emerging adulthood is a necessary precursor for intimate romantic relationships may not completely describe the association between identity and intimacy that emerges during this period, and this association may be more complex than originally theorized. Results are discussed in terms of understanding the moderating association of gender on identity exploration and commitment differences in emerging adults’ reports of romantic relationship intimacy.
INTRODUCTION Early romantic relationships act as a “training ground” for social development by allowing adolescents to experiment with intimacy and sexual activity within a secure context (Davies & Windle, 2000; Furman & Shaffer, 2003), and this secure context is beneficial to the members of the relationship. For example, involvement in a romantic relationship increases one’s status within the peer group (Furman & Simon, 1999; Miller & Benson, 1999; Davies & Windle, 2000) and serves as an additional friendship context (Furman & Shaffer, 2003). Further, the secure context of romantic relationships provides both members with a feeling of connectedness to the other member as well as a sense of companionship. The connectedness and companionship associated with romantic relationships are associated with increased positive affect (Furman & Shaffer, 2003; Joyner & Udry, 2000), increased positive self-concept (Davies & Windle, 2000; Brendgen, Vitaro, Doyle, Markiewicz, & Bukowski, 2002), and lower levels of loneliness and anxiety (Collins & Sroufe, 1999; Davies & Windle, 2000). Higher levels of self-esteem are associated with adolescent feeling of being understood and cared for within their romantic relationship (Collins & Sroufe, 1999). By providing companionship that is beneficial for its members (Furman & Simon, 1999; Miller & Benson, 1999), involvement in romantic relationships can lead to positive social adjustment (Brengden et al., 2002; Davies & Windle, 2000). The transition to intimate romantic relationships is considered a normative developmental process. However, individuals vary in their capacity for developing and maintaining these relationships. One factor associated with the capacity for developing intimate romantic relationships is each member’s personal identity development. Previous research suggests that identity and intimacy progress concurrently during adolescence and emerging adulthood (Craig-Bray, Adams, Dobson, 1988; Dyk & Adams, 1987; Franz & White, 1985; Mellor, 1989; Paul & White, 1990). According to Erikson (1968), it is possible to share oneself with another through the formation of intimate relationships after the development of identity. Before the formation of identity, however, the person is not able to share and commit a self that is not fully differentiated and not fully understood. Sullivan (1953), however, states that the development of intimacy and emotional closeness is an important milestone for the development of identity during adolescence. Research supports the association between identity and intimacy formation as well as similar patterns of identity development during later periods of adolescence for males and females (Schiedel & Marcia, 1985). Although males and females display similar patterns of identity development, research by Schiedel and Marcia (1985) indicates that 1) females generally score higher than males in relationship intimacy when identity development is low and 2) females typically report higher levels of intimacy when compared to males with
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similar identity characteristics. These findings suggest that males and females take different pathways towards intimacy development, and intimacy is contingent upon identity for males but not for females. By adolescence, boys focus on developing an independent identity. In contrast, females organize and develop the self in the context of important relationships which serves as the basis of their identity process (Gilligan, 1982; Josselson, 1987; Patterson, Sochting, & Marcia, 1992; Surrey, 1991). Therefore, “identity and intimacy issues may be merged for females” (Dyk & Adams, 1990, p. 93), and “identity [development] precedes the emergence of … intimacy for males” (Dyk & Adams, 1987, p. 232). As a result, female reports of relationship intimacy may not be as strongly related to their identity development as are male reports of relationship intimacy, and this pattern of intimacy and identity development is likely to continue until adulthood (Josselson, 1987). Although Erikson (1968) and Sullivan (1953) appear to argue contradictory roles of intimacy and identity in development, both agree that the later period of adolescence is characterized by the development and integration of intimacy and identity. Establishing emotional closeness is important for relationship development and assists in establishing a safe context (i.e., a close relationship) for identity exploration (Mclean & Thorne, 2003). Further, commitment to an interpersonal identity is associated with higher intimacy for females than males in same- as well as opposite-sexed relationships (Craig-Bray et al., 1988). Possessing a more advanced identity status promotes the development of emotional closeness and intimacy in adolescent friendships which further promotes identity development. As a result, individuals with “more advanced identity statuses are typically in more advanced intimacy statuses” (Dyk & Adams, 1987, p.232).
INTIMACY AND IDENTITY ASSOCIATIONS DURING EMERGING ADULTHOOD Despite the established association between intimacy and identity in the literature, the relationship between these constructs during emerging adulthood is not as well known (Montgomery, 2005). New theories of adolescent and adult development (i.e., Arnett, 2000) have proposed that identity exploration is a process characteristic of late adolescent and adult development, and exploration seen during early and middle adolescence is not associated with identity development. Only in late adolescence and young adulthood does one see the examination and exploration processes necessary for identity achievement. According to Arnett’s (2000) conceptualization of emerging adulthood (i.e., 18 to roughly 25 years of age), identity exploration during this period involves “trying out various life possibilities and gradually moving toward making enduring decisions”, and emerging adulthood is “the period that offers the most opportunity for identity explorations of romantic relationships” (p. 473). Further, emerging adults who engage in identity exploration increasingly focus on long-term factors in their romantic relationships than emerging adults who have not engaged in identity exploration or have limited explorations. As a result, emerging adults’ decisions regarding their romantic relationships increasingly focus on relationship intimacy as they engage in identity explorations (Arnett, 2000; Nelson & Barry, 2005). Arnett’s (2000) argument regarding identity exploration as a component of romantic relationship intimacy development is supported by previous research (e.g., Dyk & Adams,
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1987, 1990). However, he proposes identity exploration as leading to romantic intimacy commitments. In his description of emerging adults’ romantic intimacy development, Arnett (2000) implies that emerging adults who engage in identity explorations develop more intimate romantic relations than individuals not exploring their identity. Although identity exploration may lead to identity commitments, identity commitment is not considered an end result of identity exploration (Waterman, 1993, 1999). Rather, Marcia (1980) and Bilsker and Marcia (1991) state that identity commitment and exploration are separate but interrelated processes of identity development. As a result, 1) emerging adults can commit to intimacy beliefs without exploring these beliefs, 2) emerging adults can explore intimacy beliefs without making a commitment, or 3) emerging adults can neither explore nor commit to intimacy beliefs. Rather than viewing identity exploration as the primary process to intimacy commitments and viewing identity commitment as an end result of identity exploration, the joint role of identity commitment and exploration may serve as a better predictor of emerging adults’ romantic relationship intimacy. Research examining the joint role of identity commitment and exploration associations with relationship intimacy suggests identity commitment (separate from identity exploration) predicts relationships intimacy. For example, findings by Loff, Bell, Grogan, Foley, Pilosi, and Johnson (2005) and Loff and Johnson (2006) indicate that individuals characterized as having made identity commitments have more intimate romantic relationships than those characterized as having not made identity commitments regardless of their reported identity explorations. Further, Meeus, Iedema, Helsen, and Vollebergh (1999) state that individuals may find decisions made without exploration an “acceptable end-point of identity development” because identity exploration is not a necessarily needed component of “progressive development” (p. 429). Waterman (1993) also argues that individuals who have made commitments without exploring these commitments may be as satisfied with their life choices as those who have explored their commitments, and these decisions should not be disrupted unless they interfere with one’s ability to function effectively. An additional limitation concerning Arnett’s (2000) argued association between identity exploration and romantic intimacy concerns gender differences in identity and intimacy development. Several researchers (i.e., Markstrom & Kalmanir, 2001) propose that males and females take different identity pathways towards developing relationship closeness and intimacy. According to Dyk and Adams (1987, 1990) and Surrey (1991), female identity and intimacy development may unfold simultaneously while male identity development may precede intimacy development. As a result, females who have made identity commitments may report higher levels of intimacy than females who have not made commitments, regardless of their explorations. Males, however, who have not made commitments or who have made commitments without exploration may not report intimacy levels as high as those males who have both explored and committed to their identity decisions. Although identity exploration may serve as a precursor for more advanced intimacy development in romantic relationships, previous research 1) does not suggest identity exploration as the definitive pathway to more intimate relationships and 2) suggests the identity – intimacy association possibly differs for males and females. To test Arnett’s (2000) proposed association between identity exploration and romantic intimacy in relation to these previous findings, the associations among gender, identity status, and perceived romantic relationship intimacy were examined in the current study. First, results were hypothesized to indicate significant identity status differences in romantic relationship intimacy for female
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and male participants. As previously stated, female relationship intimacy often coincides with their identity development. As a result, females low in identity exploration and commitment were expected to report the lowest levels of romantic relationship intimacy. Females high in identity commitment, however, were expected to report higher levels of intimacy than females who had not reported identity commitments. Further, males typically do not report high levels of relationship intimacy until they have resolved identity-related issues. Therefore, males high in both identity exploration and commitment were expected to report higher intimacy levels than males low in identity commitment and/or exploration. Second, results were hypothesized to indicate significant gender differences in intimacy across identity statuses. Because females generally report more intimate relationships than males regardless of identity status, female participants were hypothesized to report higher levels of romantic relationship intimacy than males regardless of identity status.
METHOD Participants A total of 437 emerging adults from a commuter campus of a large Northeastern university were recruited to participate in the current study. Given the focus on emerging adults who were “exploring” romantic relationships, only unengaged and unmarried participants were included in the current study. Based on this criteria, the preliminary sample consisted of 292 participants (93 males, mean age = 19.27 years; Range = 18 to 21 years, and 199 females, mean age = 19.17 years; Range = 18 to 21 years). Examination of missing data resulted in two additional participants being removed from the study. Analysis of the remaining participants indicated a final sample of 88 males (mean age = 19.29 years; Range = 18 to 21 years), and 183 females (mean age = 19.22 years; Range = 18 to 21 years). The final sample did not significantly different in age from participants not reporting a romantic relationship, t (271) = < -1, p = .49. In order to reduce potential selection and response bias associated with recruiting from introductory social science classes, requests for participation were directed to the general student body through the posting of fliers on campus and speaking to undergraduate courses across disciplines. Participants were given a small gift and course extra-credit for their participation.
Demographic and Relationship Description Measures Personal data (i.e., age and gender) were obtained from each participant. Participants were then asked to think of their romantic partner, report on the length of time they have known their friend (years and months), and indicate the average amount of time per day that they typically spent with that person (hours and minutes).
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Females Males
Diffuse 32 26
Foreclosed 51 28
Moratorium 56 23
Achieved 44 11
Identity Status Measure The Ego Identity Process Questionnaire (EIPQ: Balistreri, Busch-Rossnagel, & Geisinger, 1995) was used to assess participant perceptions of their current identity process characteristics. The EIPQ is a 32-item scale that measures dimensions of commitment (e.g., “I have definitely decided on the occupation I want to pursue.”) and exploration (e.g., “I have considered adopting different kinds of religious beliefs.”) on a six point scale that ranges from 1 - Strongly disagree to 6 - Strongly agree. Commitment and exploration responses are measured on eight different areas of identity development (e.g., Occupation, Religion, Politics, Values, Family, Friendship, Dating, and Sex-Roles). Reliability of the overall commitment and exploration scales was α = .81 and .79, respectively. Using median split procedures (Mdn = 61.00 for commitment and Mdn = 64.00 for exploration), individuals were categorized as either high or low in identity commitment and exploration. Identity commitment and exploration categories were then combined to categorize individuals according to a specific identity status: diffuse (low commitment and exploration), foreclosed (high commitment and low exploration), moratorium (low commitment and high exploration), or achieved (high commitment and exploration). Frequencies for each identity category are presented in Table 1.
Romantic Relationship Intimacy Measures General Friendship Intimacy General same- and cross-sex friendship intimacy was assessed using the intimacy component subscale of Triangular Love Scale Sternberg (1997). The intimacy component sub-scale is a 15-item scale that measures perceived closeness in relationships (e.g., “I am able to count on ____________ in times of need.”). Responses are measured according to a nine point Likert scale ranging from 1 – Not at all to 9 – Extremely. Scale reliability in the current study was α = .91. Intimacy Intensity and Frequency The Miller Social Intimacy Scale (MSIS) is a 17-item scale that measures dimensions of intimacy frequency and intensity (Miller & Lefcourt, 1982). Six questions are used to assess intimacy frequency (e.g., “How often do you show your friend affection.”), and responses are recorded on a ten point scale that ranges from 1- Very rarely to 10 – Almost always. Eleven questions are used to assess intimacy intensity (e.g., “How close do you feel to your friend most of the time.”), and responses are recorded on a ten point scale ranging from 1 – Not
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much to 10 – A great deal. Reliability of the overall frequency and intensity scales was α = .83 and .84.
Positive and Negative Intimacy The positive intimacy subscale of the Personal Assessment of Intimacy in RelationshipModified inventory (PAIR-M; Theriault, 1998) was used to assess participant perceptions of their capacity for closeness. The positive intimacy subscale consists of 5-items that measure participant perceptions of positive intimacy behaviors. (e.g., “I can tell my feelings to my friend.”) and 7-items that measure negative intimacy (“I have the tendency to neglect my romantic partner’s needs.”). Responses to the PAIR-M are recorded on a five point Likert scale that ranges from 1 – Very rarely to 5 – Very often. Scale reliabilities in the current study were α = .83 for positive intimacy and α = .79 for negative intimacy. Relationship Closeness The Inclusion of Other in the Self (IOS) Scale developed by Aron, Aron, and Smollar (1992) was used to measure participant perceptions of relationship closeness. The IOS Scale consists of two circles that signify the participant and a designated other (e.g., same-sex friend). Participants were asked to choose one of the seven sets of circles, ranging from no overlap between the two circles (scored as 1 - Not a close relationship) to nearly complete overlap between the two circles (scored as 7 - Very close relationship) that best describes the closeness of the relationship. The IOS shows good convergent validity with other measures in the current study measuring relationship closeness (See Table 1), and reliability measures of the IOS Scale as reported by Aron et al. (1992) show satisfactory measurement test-retest reliability for friendships, α = .92. Relationship Commitment Commitment level in participant friendships was measured using the commitment subscale from the Rusbult Investment Model Scale (Rusbult, Drigotas, & Verette, 1994). This seven-item Likert-scale assesses four domains of personal relationships. Each item in the commitment scale asked the participant to indicate such features as the strength of commitment, stability, and the likely duration of a specified relationship on a scale from 1 Not very; quite short to 5- Completely committed/Very long duration. Rusbult et al. (1994) report commitment subscale reliabilities of α =.91 to .95. Scale reliability in the current study was α = .81.
Data Collection Procedures Data used in the current study were part of larger study examining interpersonal and intrapersonal factors associated with college students’ friendship and romantic relationship intimacy. Data collection occurred during a one and a half-hour session. Participants were informed by the researchers that the study was examining relationship intimacy and closeness. Participants were then administered one of a series of booklets asking them to report their demographic information and to think of either a same-sex friend, cross-sex friend or romantic partner. Participants were then asked to read the instructions very carefully before
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beginning, and instructed to describe the length of time they have know their friend and the amount of time spent with the friend daily, as well as the intimacy and emotional closeness experienced with their same-sex or cross-sex friend. Questionnaires were collected after participants completed the first friendship description, and participants were administered the identity questionnaire (as well as several others not used in the current study). After completing the identity measurements, participants were then administered a second booklet asking them to describe another of their relationships (depending upon which relationship was described previously) and report on the same relationship characteristics. On completion of the second relationship booklet, participants were administered a series of questionnaires that assessed social adjustment. Finally, participants were administered the final relationship questionnaire and requested to follow the same instructions. Once participants completed the third relationship rating, they were debriefed and compensated for participating. Table 2. Participant Demographics, Relationship Demographics, Identity Component, and Romantic Relationship Intimacy Correlations
1. Gender Identity Components 2. Exploration 3. Commitment Relationship Demographics 4. Months Known 5. Minutes Spent w/ Daily Intimacy Measures 6. Closeness 7. General Intimacy 8. Commitment 9. Positive Intimacy 10. Negative Intimacy 11. Intimacy Frequency 12. Intimacy Intensity
1 2 3 --- -.25** -.17**
---
-.15 ---
4 -.12*
5 -.11
6 .02
7 -.19**
8 -.10
9 -.15*
10 .20**
11 -.40**
12 -.25**
-.01 .11
-.07 .17**
-.20** .12*
-.11 .39**
-.12* .36**
-.07 .37**
-.14* -.47**
-.03 .27**
-.06 .31**
---
.18**
.18**
.14*
.17**
.11
-.02
.18**
.02
---
.08
.13*
.12
.18**
-.07
.27**
.19**
---
.61**
.40**
.39**
-.19**
.42**
.33**
---
.59** ---
.65** .46**
-.45** -.43**
.60** .27**
.63** .31**
---
-.49**
.49**
.53**
---
-.37** -.40-** ---
.66** ---
Note: Spearman’s Rho presented for Gender correlations (-1 = Female and 1 = Male). *p < .05. **p < .01.
RESULTS Data Transformations and Preliminary Correlation Analysis Prior to testing the hypothesized associations between gender, identity status, and romantic relationship intimacy, identity and intimacy scores were transformed to standardized
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Z-scores. In addition, correlations were conducted to examine relationships 1) among predictor variables, 2) between relationship descriptive variables (i.e., minutes spent with daily and months known) and friendship intimacy variables, and 3) among intimacy measures. As shown in Table 2, correlations among predictor variables (i.e., gender and identity status) indicated females reported higher levels of identity exploration and commitment than did males. The pattern of correlations indicates differential reporting of the predictor variables according to participants’ gender. Examination of relationship descriptive variables and romantic relationship intimacy variable correlations indicated the number of months participants have known their romantic partner was significantly associated with each intimacy measure except positive intimacy, negative intimacy, and intimacy intensity. Further, the number of minutes participants spent daily with their romantic partner was positively associated general intimacy, positive intimacy, intimacy intensity, and intimacy frequency (see Table 2). Given the consistent correlation patterns, both the number of months participants have known their friend and the amount of time spent with their friend daily were used as covairates when examining the gender, identity, and intimacy associations. Finally, as shown in Table 2, examination of intimacy correlations indicated significant correlations among all measures and supports the use of multivariate analysis of variance in the examination of the hypothesized intimacy differences.
Examination of Proposed Intimacy Differences Multivariate analysis of covariance (MANCOVA) was conducted to examine differences in romantic relationship intimacy. Because the number of months participants have known their romantic partner and the amount of time participants spend weekly with their romantic partner was correlated with the intimacy measures (see Table 2), both relationship descriptive variables were used as covariates. A 2 (Gender) X 4 (Identity Status) MANCOVA failed to indicate either months know, Wilk’s λ= .93, F(7, 255) = 2.10, p = .06, or minutes spent with daily Wilk’s λ= .95, F(7, 255) = 1.97, p = .07, as significant covariates of intimacy reports. As a result, the relationship demographic variables were dropped from further analysis, and a 2 (Gender) X 4 (Identity Status) multivariate analysis of variance (MANOVA) was used to test the proposed hypotheses. The 2 (Gender) X 4 (Identity Status) MANOVA indicated a significant Gender X Identity Status interaction associated with reports of romantic relationship intimacy, Wilk’s λ= .73, F(21, 744) = 4.00, p < .001. Examination of the interaction’s identity status simple-effects indicated significant gender differences for participants classified as diffuse, Wilk’s λ= .46, F(7, 50) = 8.25, p < .001, foreclosed, Wilk’s λ= .49, F(7, 71) = 10.37, p < .001, moratorium, Wilk’s λ= .65, F(7, 73) = 5.61, p < .001, or achieved, Wilk’s λ= .65, F(7, 47) = 3.59, p < .01. Further, gender simple-effects indicated significant identity status differences for females, Wilk’s λ= .42, F(21, 503) = 8.34, p < .001, and males, Wilk’s λ= .54, F(21, 225) = 2.51, p < .001.
Identity Status Simple-effects Multiple Comparisons As shown in Table 3, Tukey’s-b examination of gender differences across identity statuses revealed diffuse females reported higher levels of romantic relationship intimacy than males except on reports of closeness and negative intimacy. Foreclosed females reported
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higher levels of intimacy than males except on reports of negative intimacy. Moratorium females differed from moratorium males on reports of negative intimacy and intimacy frequency. Achieved females differed from achieved males on reports of closeness and commitment. No other significant differences were indicated between moratorium and achieved females and males. Table 3. Gender and Identity Status Differences in Romantic Relationship Intimacy Identity Status Intimacy Variable
Diffuse
Foreclosed
Moratorium
Achieved
Female
.08a
.48b
-.51c
.12a
Male
-.04
-.03
-.04
.42
Female
-.33a
.76b
-.69c
.33a
Male
-.64a
-.40a
-.16a
.55b
Female
.03a
.69b
-.67c
.21a
Male
-.41a
-.08a
-.40a
.79b
Female
.29a
.56b
-.51c
.32a
Male
-.69a
.02a
-.58a
.32b
Female
.40a
-.57b
.11a
-.36b
Male
.67a
-.12b
.69a
-.38b
Female
.23a
.86b
-.26c
.38a
Male
-.62a
-.82a
-.65a
.24b
.13a
.69b
-.41c
.45a
a
.79b
Closeness
General Intimacy
Commitment
Positive Intimacy
Negative Intimacy
Intimacy Frequency
Intimacy Intensity Female Male
-.55a
-.39a
-.66
Note: Intimacy variable row means with different superscripts significantly different, p < .05. Intimacy variable column means in bold significantly different, p < .05.
Female Identity Status Differences As shown in Table 3, Tukey’s-b examination of female intimacy scores indicated several identity status differences. First, foreclosed females reported higher levels of closeness, general intimacy, commitment, positive intimacy, intimacy frequency, and intimacy intensity than did achieved, moratorium, and diffuse females. Further, achieved and diffuse females reported higher scores on each of these intimacy measures than did moratorium females. Achieved and diffuse females did not differ on their reports of these measures. Second, foreclosed and achieved females did not differ in their reports of negative intimacy and
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reported lower levels of negative intimacy than did diffuse and moratorium females. Diffuse and moratorium females did not differ in their reports of negative intimacy.
Male Identity Status Differences Tukey’s-b examination of male identity status differences revealed achieved males reported more intimate romantic relationships than did diffuse, foreclosed, and moratorium males across each intimacy measure except negative intimacy and closeness. Achieved and foreclosed males reported lower levels of negative intimacy than did diffuse and moratorium males, and no significant differences were indicated for romantic relationship closeness (see Table 3).
CONCLUSION As previously stated, Arnett (2000) argues emerging adults’ identity explorations allow them to make long-term commitments regarding intimacy decisions in their romantic relationships. Although identity exploration is often considered an integral part of identity development, theorist and researchers do not necessarily view exploration as a necessary process when making identity commitments (Meeus et al., 1999; Waterman, 1993). Further, Arnett’s (2000) argument stating identity exploration is a distinct and necessary process for intimacy development during emerging adulthood minimizes the role of identity commitment and gender in the formation of romantic relationship intimacy. As evidenced in the current study, identity exploration explained certain specific differences in emerging adult intimacy reports. However, several instances are evident where identity exploration was not an effective predictor of intimacy. As a result, the proposal that identity explorations occurring during emerging adulthood are necessary for intimacy development may not apply equally to all emerging adults. The conceptualization of the identity exploration and intimacy relationship during emerging adulthood fails to recognize the differential approach to relationship intimacy taken by females and males. Because the identity development process varies for each individual and does not follow one developmental sequence (Grotevant, 1986), Arnett’s (2000) theoretical position concerning qualitative differences in the identity process during adolescence and adulthood overlooks the importance of gender and identity commitments associated with exploration when attempting to explain emerging adults’ capacity for romantic relationship intimacy. The current study’s test of Arnett’s (2000) hypothesis regarding identity exploration and romantic relationship intimacy development did not fully support his theorized association. Rather, findings indicate 1) both identity exploration and commitment predict emerging adults’ romantic relationship intimacy, 2) gender differences in romantic relationships differ according to emerging adults’ identity status, and 3) identity status differences in romantic relationship intimacy differs for emerging adult males and females. As a result, Arnett’s (2000) proposal that identity exploration during emerging adulthood is a necessary precursor for intimate romantic relationships may not completely describe the association between identity and intimacy that emerges during this period, and this association may be more complex than originally theorized.
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Gender Differences in Romantic Relationship Intimacy across Identity Statuses As mentioned previously, research indicates females report more intimate relationships than males. Results, however, qualify this finding in that gender differences in intimacy are moderated by emerging adults’ identity status. Gender comparison of emerging adults who reported low exploration scores and either low or high commitment scores (i.e., diffuse and foreclosed identity statuses) indicated females reported more romantic intimacy than did males. Although gender differences were evident for moratorium and achieved emerging adults, the number of variables in which females and males differed was relatively small when compared to genders differences for diffuse and foreclosed emerging adults. This finding was not expected, and it possibly provides further insight into previously reported gender differences in relationship intimacy, as well as provides support for Arnett’s (2000) argument concerning the association between identity exploration and romantic intimacy. Adolescents have generally not engaged in identity explorations concerning romantic intimacy (Arnett, 2000). Although male and female adolescents are similar in their identity explorations and romantic intimacy, females report closer and more intimate relationships than males (Clark-Lempers, Lempers, & Ho, 1991; Fischer, Munsch, & Greene, 1996; Johnson, 2005). Findings from the current study suggest similar gender differences in romantic intimacy reports for emerging adults who report low levels of identity exploration. Emerging adults who reported low levels of identity explorations reported romantic intimacy patterns similar to that of adolescents. Romantic intimacy differences present during adolescence likely continue into emerging adulthood for those individuals who have not engaged in identity exploration. However, this difference in emerging adults’ intimacy reports appears to decrease as males and females begin their identity explorations.
Female and Male Identity Status Differences in Romantic Relationship Intimacy The current study’s general pattern of findings does not fully support Arnett’s (2000) position regarding the association between emerging adults’ identity exploration and romantic relationship intimacy. Findings do, however, suggest that Arnett’s proposal may describe male experiences of romantic intimacy. In the current study, males who were classified as achieved (i.e., reported high levels of exploration and commitment) reported higher levels intimacy than did males classified as diffuse, foreclosed, or moratorium (and lower levels of identity exploration and/or commitment). These findings support the notion that increased romantic intimacy and relationship commitment emerges out of explored identity commitments. Further, this finding supports previous research examining the association between identity and intimacy that suggests 1) males place a greater importance on identity relative to intimacy (Surrey, 1991), and 2) males are likely to develop intimate relationships as identity issues are resolved through exploration and commitment (Dyk & Adams, 1990). As a result, associations suggest emerging adult males may be more committed to their romantic relationships and view these relationships as more intimate after identity commitments are made through exploration. Further the identity status difference evident in
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male reports of intimacy does provide support for Arnett’s (2000) argument that emerging adult identity explorations are necessary for the formation of intimate romantic relationships. Associations between male emerging adults’ identity and intimacy reports support Arnett’s (2000) theory regarding identity exploration and romantic intimacy. However, responses from female emerging adults suggest a very different set of associations between identity and intimacy. Females who reported high levels of identity commitment and low levels of exploration reported more intimate romantic relationships than did females with other identity commitment and exploration patterns (Females who reported low levels of commitment and high levels of exploration reported the lowest levels of relationship intimacy.). As stated previously, Arnett (2000) argues that explored identities are a necessary component of romantic relationship intimacy. However, Erikson (1968) states that individuals with formed identities are more likely to form and maintain intimate romantic relationships relative to those without an established identity. Based on the current findings, it is possible the commitment to an identity (regardless of exploring these identity decisions) constitutes an established identity for emerging adult females. For example, one can be satisfied with their identity beliefs without having explored these beliefs (Waterman, 1993). Further, Patterson et al. (1992) state that previous studies examining female identity patterns suggest foreclosed females “looked more similar to those in identity achievement” (p. 18). As a result, females who have made identity commitments but are not currently questioning or exploring these decisions may have clear romantic relationship expectations that are associated with an increased focus on the formation, maintenance, and development of romantic relationships. Further, these relationship expectations and increased relationship focus likely lead to more committed, intimate, and emotionally close romantic relationships relative to females with different identity patterns. A second pattern of findings somewhat contradictory to Arnett’s argument regarding the necessity of identity exploration concerns the similar intimacy reports of identity diffuse (i.e., low commitment and exploration) and achieved (i.e. high commitment and exploration) females. Although these two groups did not report the same intimacy levels as foreclosed females, previous research, suggests achieved females would have more intimate relationships than diffuse females. The higher than expected intimacy levels can possibly be explained by the interpersonal approach taken by females who have not explored or committed to a set of identity beliefs. Muuss (1996) argues that females who are low in identity exploration and commitment may become “overly receptive” to their relationship experiences (p. 63). These females may become “distracted by the pleasures” of the relationship (Waterman, 1993; p. 153) which leads to the perceptions of a committed and intimate romantic relationship. However, as evidenced by the higher negative intimacy score for diffuse females, diffuse females appear to view their romantic relationships more negatively than achieved and foreclosed females. As a result, the similar romantic relationship intimacy scores between diffuse and achieved females indicated in the current study is likely qualitatively different despite the quantitative similarities and warrants further investigation. Arnett (2000) argues identity exploration during emerging adulthood is a necessary precursor for the development of romantic intimacy. The position that identity exploration is isolated to late adolescence and young adulthood is misrepresentative of the identity process must be interpreted with caution. Identity development is a fluid process that does not necessarily begin or end in any specific developmental stage, and previous research shows identity exploration is not limited to one developmental trajectory or developmental period.
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As a result, identity research that follows the theory that identity exploration is a specific late adolescent and young adult process will overlook the importance of the superficial and transient decisions made during early adolescence that provide the foundation for later identity explorations. Although previous findings provide moderate support for this position, the current study indicates identity commitment associations with romantic relationship intimacy as well as gender differences in the relationship among identity commitment, exploration, and romantic relationships intimacy. Use of a college sample possibly limits generalization of the current study. However, findings may provide a better understanding of the identity process associated with romantic intimacy development for male and female emerging adults by indicating that identity exploration is only a part of the larger process that leads to the development of intimate romantic relationships.
AUTHOR NOTES H. Durell Johnson, Kristen A. Loff, George Bell, Evelyn Brady, Erin A. Grogan, Elizabeth Yale, Robert J. Foley, and Trishia A. Pilosi, Department of Human Development and Family Studies, Penn State Worthington Scranton. Elizabeth Yale and George Bell are currently pursuing graduate degrees at Marywood University, Scranton, PA. Portions of this research were funded by the Pennsylvania State University Matthew’s Research Award and Research Development Grant awarded to the first author and the Pennsylvania State University’s Undergraduate Research Grant awarded to Kristen A. Loff, George Bell, Erin A. Grogan, Robert J. Foley, and Trishia A. Pilosi. Portions of this study were presented at the 2005 Annual Meting of the Society for Research on Identity Formation, Miami, FL and the 2007 Biennial Meeting of the Society for Research on Adolescence, Boston, MA.
REFERENCES Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the early twenties. American Psychologist, 55, 469 – 480. Aron, A., Aron, E. M., & Smollar, D. (1992). Inclusion of other in the self-scale and the structure of interpersonal closeness. Journal of Personality and Social Psychology, 63, 596-612. Balistereri, E., Busch-Rossnagel, N. A., & Geisinger, K. F. (1995). Development and preliminary validation of the Ego Identity Process Questionnaire, Journal of Adolescence, 18, 179-192. Bilsker, D., & Marcia, J. E. (1991). Adaptive regression and ego identity. Journal of Adolescence, 14, 75 – 84. Brendgen, M., Vitaro, F., Doyle, A. B., Markiewicz, D., Bukowski, W. M. (2002). Same-sex peer relations and romantic relationships during early adolescence: Interactive links to emotional, behavioral, and academic adjustment. Merrill-Palmer Quarterly, 48, 77-103.
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Clark-Lempers, D. S., Lempers, J. D., & Ho, C. (1991). Early, middle, and late adolescents’ perceptions of their relationships with significant others. Journal of Adolescent Research, 6, 296 – 315. Collins, W. A., & Sroufe, L. A. (1999). Capacity for intimate relationships: A developmental construction. In W. Furman, B. B. Brown, & C. Feiring (Eds.), The development of romantic relationships in adolescence. Cambridge studies in social and emotional development (pp.125-147). New York: Cambridge University Press. Craig-Bray, L., Adams, G. R., & Dobson, W. R. (1988). Identity formation and social relationships during late adolescence. Journal of Youth and Adolescence, 17, 173-187. Davies, P. T., & Windle, M. (2000). Middle adolescents’ dating pathways and psychosocial adjustment. Merrill-Palmer Quarterly, 46, 90-118. Dyk, P. A., & Adams, G. R. (1987). The association between identity development and intimacy during adolescence: A theoretical treatise. Journal of Adolescent Research, 2, 223-235. Dyk, P. A., & Adams, G. R. (1990). Identity and intimacy: An initial investigation of three theoretical models using cross-lag panel correlations. Journal of Youth and Adolescence, 19, 91-110. Erikson, E. H. (1968). Identity: Youth and crisis. New York: Norton Fischer, J. L., Munsch, J., & Greene, S. M. (1996). Adolescence and intimacy. In G. R. Adams, R. Montemayor, & T. P. Gullotta (Eds.), Psychosocial development during adolescence (pp. 95-129). Newbury Park, California: Sage Publications. Furman, W., & Shaffer, L. (2003). The role of romantic relationships in adolescent development. In P. Florsheim (Ed.), Adolescent romantic relationships and sexual behavior: Theory, research, and practical implications (pp. 3-22). Mahwah, New Jersey: Lawrence Erlbaum. Furman, W., & Simon, V. A. (1999). Cognitive representations of adolescent romantic relationships. In W. Furman, B. B. Brown, & C. Feiring (Eds.), The development of romantic relationships in adolescence. Cambridge studies in social and emotional development (pp.75-98). New York: Cambridge University Press. Franz, C. E., & White, K. M. (1985). Individuation and attachment in personality development: Extending Erikson’s theory [Special Issue: Conceptualizing gender in personality theory and research]. Journal of Personality, 53, 224-256. Gilligan, C. In a different voice: Psychological theory and women’s development. Cambridge: Harvard University. Grotevant, H. D. (1986). Assessment of identity development: Current issues and future directions. Journal of Adolescent Research, 1, 175-181. Johnson, H. D. (2004). Grade, gender, and relationship differences in emotional closeness within adolescent friendships. Adolescence, 39, 243-256. Josselson, R. (1987). Finding herself: Pathways to identity development in women. San Francisco: Jossey-Bass. Joyner, K., & Udry, J. R. (2000). You don’t bring me anything but down: Adolescent romance and depression. Journal of Health and Social Behavior, 41, 369-391. Loff, K. A., Bell, G., Grogan, E. A., Foley, R. J., Pilosi, T. A., & Johnson, H. D. (2005,
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February). Identity status associations with sex differences in the emotional closeness of college students’ friendships and romantic relationships. Poster presented at the Annual Conference of the Society for Research on Identity Formation. Miami. Loff, K. A., & Johnson, H. D. (2006, March). Identity and sex-role associations with gender differences in emerging adults’ same- and cross-sex friendship intimacy. Poster presented at the Annual Conference of the Society for Research on Identity Formation. San Francisco. Marcia, J. E. (1980). Identity in adolescence. In J. Adelson (Ed.), Handbook of adolescent psychology. New York: Wiley Press. Markstrom, C. A., & Kalmanir, H. M. (2001). Linkages between the psychosocial states of identity and intimacy and the ego strengths of fidelity and love. Identity, 1, 179-296. McLean, K. C., & Thorne, A. (2003). Late adolescents’ self-defining memories about relationships. Developmental Psychology, 39, 635-645. Meeus, W., Iedema, J., Helsen, M., & Vollebergh, W. (1999). Patterns of adolescent identity development: Review of literature and longitudinal analysis. Developmental Review, 19, 419-461. Mellor, S. (1989). Gender differences in identity formation as a function of self-other relationships. Journal of Youth and Adolescence, 18, 361-375. Miller, B. C., & Benson, B. (1999). Romantic and sexual relationships during adolescence. In W. Furman, B. B. Brown, & C. Feiring (Eds.), The development of romantic relationships in adolescence. Cambridge studies in social and emotional development (pp.99-121). New York: Cambridge University Press. Miller, R. S., & Lefcourt, H. M. (1982). The assessment of social intimacy. Journal of Personality Assessment, 46, 514-518. Montgomery, M. J. (2005). Psychosocial intimacy and identity: From early adolescence to emerging adulthood. Journal of Adolescent Research, 20, 346-374. Muuss, R. E. (1996). Theories of adolescence (6th ed.). New York: McGraw-Hill. Nelson, L. J., & Barry, C. N. (2005). Distinguishing features of emerging adulthood: The role of self-classification as an adult. Journal of Adolescent Research, 20, 242-262. Patterson, S. J., Sochting, I., & Marcia, J. E. (1992). The inner space and beyond: Women and identity. In G. R. Adams, T. P. Gullotta, & R. Montemayor (Eds.), Adolescent identity formation. Advances in adolescent development (Vol 4., pp. 9-24). Thousand Oaks, California: Sage. Paul, E. L., & White, K. M. (1990). The development of intimate relationships in late adolescence. Adolescence, 25, 375-400. Rusbult, C. E., Drigotas, S. M., & Verette, J. (1994). The investment model: An interdependence analysis of commitment processes and relationship maintenance phenomena. In D. Canary & L. Stafford (Eds.), Communication and relational maintenance (pp. 115-139). New York: Academic Press. Schiedel, D. G., & Marcia, J. E. (1985). Ego identity, intimacy, sex-role orientation, and gender. Developmental Psychology, 21, 149-160. Sternberg, R. J. (1997). Construct validation of a triangular love scale. European Journal of Social Psychology, 27, 313-335. Sullivan, H. S. (1953). The interpersonal theory of psychiatry. New York: Norton.
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Surrey, J. L. (1991). The “self-in-relation”: A theory of women’s development. In J. Jordan, A. Kaplan, J. Miller, I. Stiver, and J. Surrey (Eds.), Women’s growth in connection: Writings from the Stone Center. New York: Guilford Press. Theriault, J. (1998). Assessing intimacy with the best friend and sexual partner during adolescence: The PAIR-M inventory. The Journal of Psychology, 5, 493-506. Waterman, A. S. (1993). Finding something to do or someone to be: A Eudaimonsit perspective on identity formation. In J. Kroger (Ed.), Discussions on ego identity. Hillsdale, NJ: Erlbaum. Waterman, A. S. (1999). Identity, the identity statuses, and identity status development: A contemporary statement. Developmental Review, 19, 591-621.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 7
DEVELOPMENT OF AN INTERVIEW FOR ASSESSING RELATIONSHIP QUALITY: PRELIMINARY SUPPORT FOR RELIABILITY, CONVERGENT AND DIVERGENT VALIDITY, AND INCREMENTAL UTILITY Erika Lawrence, Robin A. Barry, Rebecca L. Brock, Amie Langer, Eunyoe Ro University of Iowa, Iowa City, Iowa, USA
Mali Bunde CIGNA Behavioral Health Care, Minnesota, USA
Emily Fazio University of Denver, Denver, Colorado, USA
Lorin Mulryan University of Loyola,Chicago, Illinois, USA
Sara Hunt Utah State University, Logan, Utah, USA
Lisa Madsen Emory University, Atlanta, Georgia, USA
Sandra Dzankovic Des Moines University, Des Moines, Iowa, USA
ABSTRACT Historically, relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. In contrast, far less attention have been paid to the assessment of relationship quality. In the first section of our paper, we
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Erika Lawrence, Robin A. Barry, Rebecca L. Brock et al. review the long-standing debate regarding – and clarify the distinctions among – relationship adjustment, satisfaction, and quality. We also discuss the need for an empirically-supported, psychometrically strong measure of relationship quality. In the second section, we present the Relationship Quality Interview (RQI), a semi-structured, behaviorally anchored, individual interview that yields objectively coded ratings from the interviews. It was designed to assess relationship quality across five dimensions: (a) trust, closeness, and emotional intimacy; (b) inter-partner support; (c) quality of the sexual relationship; (c) respect, power, and control; and (e) communication and conflict management. In the third section, we provide preliminary evidence of the reliability and validity of the interview. Across two samples, the RQI demonstrated strong reliability (internal consistency, inter-rater agreement, agreement across interviewers based on two members of the same couple, correlations among the scales) convergent validity (correlations between RQI scales and self-report questionnaires assessing similar relationship dimensions), and divergent validity (correlations between RQI scales and behavioral observations of related constructs, global measures of marital satisfaction, and individual difference measures of related constructs). We conclude with a brief discussion of broader clinical issues relevant to couple assessment and prevention efforts.
INTRODUCTION Historically, relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. In contrast, far less attention have been paid to the assessment of relationship quality. In the first section of our paper, we review the long-standing debate regarding – and clarify the distinctions among – relationship adjustment, satisfaction, and quality. We also discuss the need for an empirically-supported, psychometrically strong measure of relationship quality. In the second section, we present the Relationship Quality Interview (RQI), a semi-structured, behaviorally anchored, individual interview that yields objectively coded ratings from the interviews. It was designed to assess relationship quality across five dimensions: (a) trust, closeness, and emotional intimacy; (b) inter-partner support; (c) quality of the sexual relationship; (c) respect, power, and control; and (e) communication and conflict management. We describe the development of the interview, our justification for the dimensions of relationship quality included, and the microanalytic and macro-analytic coding systems we developed. In the third section, we provide preliminary evidence of the reliability and validity of the interview. Our goal is for the RQI to be used as an assessment tool prior to the implementation of prevention programs with young couples. Therefore, we administered the RQI to 101 newlywed couples 91 dating individuals. To assess reliability, we analyzed internal consistency, inter-rater agreement, agreement across interviewers based on two members of the same couple, and correlations among the scales. To examine convergent validity, we analyzed correlations between RQI scales and self-report questionnaires assessing similar relationship dimensions. To examine divergent validity, we computed correlations between RQI scales and: (a) behavioral observations of related constructs, (b) global measures of relationship satisfaction, and (c) individual difference measures of related constructs. In the fourth section, we discuss broader clinical issues relevant to couple assessment and prevention efforts. First, we discuss the importance of standardizing empirically-supported couple assessments, and review ongoing efforts to achieve this goal. Second, we make
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specific recommendations for enhancing couple prevention programs. Third, we discuss the possible utility of interviews as motivational tools to increase participation in prevention programs among couples at high risk for longitudinal distress and dissolution, and review ongoing efforts to achieve this goal.
SECTION 1: RELATIONSHIP SATISFACTION, ADJUSTMENT, AND QUALITY For as long as relationship satisfaction has been assessed, there has also been considerable confusion and controversy over the differences among the terms relationship satisfaction, relationship adjustment, and relationship quality (See Snyder, Heyman, & Haynes, 2005, and Heyman, Sayers, and Bellack, 1994 for detailed discussions of these issues.) Relationship satisfaction refers to global sentiment or happiness as a unitary construct. Relationship adjustment is broader in scope, and includes a consideration of dyadic processes such as conflict management skills and relationship outcomes such as satisfaction. Relationship quality refers to dyadic processes alone, such as the quality of a couple’s conflict management skills, supportive transactions, sexual relations, or emotional intimacy. Additionally, several terms have been used to describe low satisfaction or adjustment, including relationship discord, dissatisfaction, distress, and dysfunction. Low relationship satisfaction is also distinguished from dissolution, which refers to separation or divorce. Over the last 60 years, relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. They have been assessed via epidemiological research, treatment outcome research, and basic close relationships research. They are the field’s measures of whether couples are happy and whether our couple therapies are working. Relationship satisfaction and adjustment are strongly associated with the 50% divorce rate in the U.S., individual distress (e.g., depression, anxiety, and alcohol abuse), physical health, and children’s well-being. Far less attention has been paid to the assessment of relationship quality. Some dimensions of relationship quality have received a lot of attention, such as communication and conflict management processes. Others have received almost no attention, such as emotional intimacy and balance of decision-making and interpersonal control within a couple. Still others have received attention in other disciplines but have not been integrated into couple research or couple therapy, such as investigations of the quality of a couple’s sexual relationship. Among the measures that do exist for assessing relationship quality, several conceptual and methodological limitations hinder their utility. First, these measures are typically specific to one dimension such as conflict management skills, rather than capturing the multidimensional construct of relationship quality. Second, existing measures of relationship quality are often confounded with measures of satisfaction or adjustment. Specifically, these measures include items that tap into both relational processes and satisfaction. The purpose of this study is to introduce and provide preliminary evidence for a new instrument designed to assess relationship quality as a multidimensional phenomenon. Historically, relationship satisfaction and adjustment have been assessed by administering questionnaires to partners and then calculating sum scores based on their responses. Scores
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are typically placed on a continuum from low to high satisfaction. Starting in the 1950s, relationship adjustment was assessed with omnibus measures in which partners evaluated multiple aspects of their relationships, such as the amount of disagreement across different areas of conflict, global evaluations of the relationship, and frequency of sexual relations. The Marital Adjustment Test (MAT; Locke & Wallace, 1959) and Dyadic Adjustment Scale (DAS; Spanier, 1976) are two widely used measures of dyadic adjustment. In the 1980s, researchers and clinicians also began assessing relationship satisfaction with shorter, unidimensional measures of global sentiment toward one’s relationship. The Quality of Marriage Index (QMI; Norton, 1983) and Kansas Marital Satisfaction Scale (KMS; Schumm et al., 1986) are widely used measures of global relationship satisfaction. Researchers and clinicians also began to assess relationship satisfaction using a semantic differential approach, a way of quantifying partners’ evaluations of their relationships by having them rate their perceptions on scales between two opposite adjectives (e.g., satisfied to dissatisfied, good to bad; Osgood, Suci, & Tannenbaum, 1957; Huston & Vangelisti, 1991). Since the mid-1990s, there has been a move toward assessing relationship satisfaction and adjustment with multidimensional approaches. For example, the Positive and Negative Quality in Marriage Scale (PANQIMS; Fincham & Linfield, 1997), on which partners evaluate the positive and negative qualities of their partner and relationship, yields scores for two distinct aspects of relationship satisfaction. Other measures collapse these two domains, making it impossible to determine whether it is lack of positive or high levels of negative evaluation that reduces relationship happiness. In contrast, the PANQIMS allows partners to be categorized as happy (high positive and low negative), distressed (low positive and high negative), ambivalent (high on both positive and negative), or indifferent (low on both positive and negative). The Marital Satisfaction Inventory (MSI-R; Snyder & Aikman, 1999) is a multidimensional measure of relationship adjustment that differentiates among levels and sources of distress. Dimensions include assessments of family of origin conflict, sexual satisfaction, and problem-solving communication strategies. Three other multidimensional inventories have been used in the last decade or two (PREPARE, Olsen, Fournier, & Druckman, 1996; FOCCUS, Markey & Micheletto, 1997; RELATE, Busby, Holman, & Taniguchi, 2001). Each of these inventories provide scores on dimensions such as realistic relationship expectations, effective communication, emotional health, exposure to negative family-of-origin experiences, and personal stress management (Larson, Newell, Topham, & Nichols, 2002). Thus, like the MSI-R, these measures are multidimensional in nature, yet they capture a variety of factors that may influence dyadic functioning and were not intended to measure relationship quality specifically. Couple researchers and clinicians have long used self-report questionnaires to quantify dyadic processes in basic research and to guide interventions. Unfortunately, self-report questionnaires are vulnerable to biases including social desirability (Godoy et al., 2008; Kluemper, 2008), depressed mood and depressive cognitions (e.g., Cohen, Towbest, & Flocco, 1988; Raselli & Broderick, 2007), memory biases in retrospective reports (Karney & Frye, 2002), and cognitive dissonance (e.g., newlyweds may be more likely to present couple processes in a positive light because they have just gotten married and do not want to consider the possibility that their marriage already has difficulties; McNulty, O’Mara, & Karney, 2008; Miller, Niehuis, & Huston, 2006). Behavioral observation tasks were developed to deal with these problems, and our ability to understand couple processes across domains became much stronger. However, observational methods are costly and time-consuming, and as such are
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less likely to be widely adopted by clinicians in the near future. Moreover, although standardized, psychometrically sound interaction protocols exist to assess couples’ transactions with established coding systems, there is no network at present that can readily and conveniently code these interactions and provide results in a timely manner. In sum, although an important methodological development in couple research methodology, behavioral observation tasks are not going to become a standardized assessment tool for couple therapists. In addition to self-report questionnaires and behavioral observation tasks, clinical interviews are often used to gather reliable and valid information during an assessment. Outside of the close relationships literature, The Structured Clinical Interview for the Diagnostic Statistical Manual (DSM-IV; First et al., 1995) is a standardized interview for assessing Axis I disorders. The Adult Attachment Interview (AAI; George, Kaplan, & Main, 1985) is routinely used by researchers studying attachment processes. There is also emerging interest in developing semi-structured interviews to assess relationship satisfaction and quality. There are several advantages to using clinical interviews rather than behavioral observation data in couple research. First, clinical interviews allow the objective coder to consider partners’ perceptions when evaluating the relationship; however, the biases of self report are still omitted (e.g., Morrison & Hunt, 1996). Second, interviews allow for a more global perception of dyadic processes as opposed to behavioral observation data that provide a snapshot of a particular type of interaction. Third, once an interviewer is trained to reliability, administering and coding clinical interviews is typically faster and less expensive than coding behavioral observation data. Fourth, clinical interviews are more likely to be embraced by clinicians compared to behavioral observation methods, affording us the opportunities to move toward standardization of couple assessments and bridge the gap between couple researchers and clinicians. There have been isolated efforts to develop and validate structured interviews for couple research and therapy. For example, the Structured Diagnostic Interview for Marital Distress and Partner Aggression (Heyman et al., 2001) allows researchers and clinicians to reliably and validly diagnose couples in terms of relationship distress and physical aggression. The content of the interview is similar to that of the Dyadic Adjustment Scale (Spanier, 1976) and the Conflict Tactics Scales (Straus et al., 1996), and the format is similar to that of the SCID. However, no interview exists to assess the construct of relationship quality. The purpose of the present study was to develop a semi-structured interview to assess relationship quality and to provide preliminary support of its reliability and validity.
SECTION 2: THE RELATIONSHIP QUALITY INTERVIEW AND DIMENSIONS OF RELATIONSHIP QUALITY The Relationship Quality Interview (RQI) was designed to provide an interview-based approach to quantifying important dimensions of relationship quality. It is a multidimensional interview to assess relationship quality across five key relationship domains, including emotional intimacy, inter-partner support, sexual relations, inter-partner respect and control, and communication and conflict management. We use objective interviewer ratings of couple functioning on each domain based on semi-structured, behaviorally anchored, individual
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interviews with both partners to control for the possibility that self-reports of relationship functioning might be influenced by factors such as global relationship satisfaction, depression or social desirability. The use of objective ratings also allowed us to control for the possibility that couples married only 3-6 months might experience cognitive dissonance when discussing potential weaknesses or problems in their relationships, which might influence their selfreports of the quality of their relationship.
Domains of Relationship Quality Our aim in the present study was to be comprehensive in our examination of dimensions of relationship quality that would influence the longitudinal course of relationship satisfaction and stability. As such, after an exhaustive review of the close relationships literature across multiple disciplines (e.g., social and clinical psychology, communication studies, family studies, sociology), we identified five dimensions of relationship quality as potential risk or protective factors. Communication and conflict management was operationalized as comprising frequency and length of arguments, verbal, psychological and physical aggression during arguments, withdrawal during arguments, emotions and behaviors before, during and after arguments, and conflict resolution strategies. In accord with Cutrona and colleagues’ work (e.g., Cutrona, Russell, & Gardner, 2005), inter-partner support was operationalized as comprising four types of support when one partner has had a bad day, is feeling down, or has a problem: emotional support (talking and listening to each other, holding hands, hugging, letting partner know s/he understands), direct or indirect tangible support (direct support: when one’s partner helps to solve the problem or make the situation better; indirect support: providing time or resources so that one’s partner is better able to solve the problem him- or herself, e.g., providing childcare), informational support (giving advice, providing partner with information, helping partner think about a problem in a new way), and esteem support (expressing confidence in one’s ability to handle things, telling partner s/he is not at fault for a problem). Match between types of support desired and types of support provided, and whether support is offered in a positive or negative manner, were also assessed. Level of dyadic emotional closeness and intimacy was operationalized as comprising emotional closeness (an overall mutual sense of closeness, warmth, affection, and interdependence), quality of the couple’s friendship, and demonstrations of love and affection (quantity and quality of love and affection expressed in the relationship, including verbal and physical expressions of love). Sensuality and sexuality was operationalized as comprising the quality of the sexual relationship (frequency of sexual activity, symmetry in initiation of sexual activity, satisfaction, negative emotions, sexual difficulties, concerns) and sensuality (touching, hugging, cuddling, massage, the extent to which sensuality exists separate from sexual activity in the relationship). Respect and control was operationalized as comprising mutual acknowledgement of competence and independence; acceptance and positive regard for the other even when one disagrees with him or her, a/symmetry in decision-making across a variety of areas, partners’ satisfaction with that division of responsibilities, and a couple’s ability to negotiate control across a variety of areas (e.g., scheduling one’s own day, controlling money). The overwhelming majority of research in the close relationships field has been focused on the quality of a couple’s ability to solve problems and conflicts. Theories of intimate
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relationships and of the determinants of relationship outcomes (e.g., Christensen & Walczynski, 1997; Gottman, Swanson, & Murray, 1999), a great deal of the empirical research on intimate relationships, most observational research on intimate relationships, reviews on dyadic interactions (e.g., Karney & Bradbury, 1995; Weiss & Heyman, 1997), and most existing psychological interventions for couple distress (e.g., Behavioral Marital Therapy; Jacobson & Holtzworth-Munroe, 1986; Prevention and Relationship Enhancement Program; Floyd, Markman, Kelly, Blumberg, & Stanley, 1995) have targeted relationship conflict. Within the last decade or so, there has been a tremendous increase in attention to the role of spousal support as an adaptive dyadic skill (e.g., Gable, Gonzaga, & Strachman, 2006; Neff & Karney, 2005; Pasch & Bradbury, 1998). Other researchers have focused specifically on emotional intimacy (e.g., Barnes & Sternberg, 1997; Barry, Lawrence, & Langer, in press; Cordova, Gee, & Warren, 2005; Laurenceau et al., 2005), the quality of a couple’s sexual relationship (e.g., Henderson-King & Veroff, 1994; LoPiccolo, Heiman, Hogan, & Roberts, 1985), and respect and control (e.g., Gray-Little & Burks, 1983; Ehrensaft, LanghinrichsenRohling, Heyman, & Lawrence, 1999; Huston, 1983; Whisman & Jacobson, 1990). We know of only one study in which multiple dimensions of relationship quality were examined (Schramm, Marshall, Harris, & Lee, 2005). (See Lawrence et al., in press for a detailed review of the literature relevant to our decisions to include each of these five dimensions of relationship quality.) In sum, the existing literature suggests that there are multiple aspects of relationship quality. However, when relationship quality is examined, researchers typically examine only one or two domains of dyadic processes per sample, which presumably grossly underestimates the complexity of relationship quality. Moreover, many of these studies did not statistically examine sex differences in relationship quality, which may lead to an incomplete, skewed, or inaccurate conceptualization of intimate relationships and, consequently, to interventions that are limited in their effectiveness. This literature has also suffered from methodological limitations, including measurement issues such as the use of self-report measures of relational behaviors which may be influenced by social desirability and cognitive dissonance (particularly among newlyweds), shared method variance, retrospective data, heterogeneous samples and cross-sectional designs. By developing the RQI, we sought to begin to overcome these limitations and provide a novel way to assess the dimensions of relationship quality. Our goal was to develop a semistructured interview that can be administered individually to partners to assess their relationship quality or functioning across multiple relationship domains and yield objective ratings. The goal of the RQI is to serve as an assessment tool prior to disseminating intervention programs for couples.
The Relationship Quality Inventory (RQI) The RQI is a 60-minute semi-structured interview yielding objective ratings of the quality of couples’ relationships across five dimensions. Partners are administered the interview individually. After obtaining information on relationship history, participants are asked to describe the quality of their relationship across five dimensions over the past six months; Open ended questions – followed by a series of closed ended questions – are asked to allow novel contextual information to be obtained. During the spouse’s description of each
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dimension of relationship quality, the interviewers probe using detailed behavioral indicators and exemplars of each area to establish veridicality of report (see Prescott et al., 2000). Answers are coded into nominal or ordinal categories; responses also guide decisions about which subsequent questions are asked. Thus, the interview is branch-structured to facilitate conditional questions. Broad dimensions and specific items originally were selected following a multidisciplinary review of the close relationships literature. Following the compilation of a pool of potential domain-specific items, a team of six psychology pre-doctoral and doctoral students specializing in couple relationships sorted the pool into the domain categories. Items were deleted if there was less than 80% agreement among raters on their dimension classification. To get at the domain of Emotional Closeness and Intimacy, items were included that aimed to measure a couple’s ability to create mutual emotional closeness and intimacy in their relationship. Sample items include “How close do you feel to your partner?” and “Are there any specific personal (i.e., non-relationship) topics that either of you avoid talking about with the other?” Items in the Support section of the interview measured the level of support provided in the relationship, the type of support (emotional, tangible, etc), whether the support is given in a variety of situations and the mutuality of the support in the couple. Sample items include “Does your partner try to support you by spending a lot of time talking with you when you have a problem?” and “Can your partner tell when you are feeling down or need support, even if you don’t say anything?” In the section on the domain of Sensuality and Quality of the Sexual Relationship, items were included that asked about the frequency of sexual and sensual behaviors, the partner’s satisfaction, negative emotions, and difficulties in this area. Examples of items include “How satisfied are you with your sexual relationship?” and “Do you engage in sensual behaviors together, such as touching, cuddling, hugging or massage?” Items in the Respect and Control domain ask about dyadic decisionmaking across a variety of topics, and the balance of control in the relationship. Sample items include “Does one of you tend to make most of the decisions in your relationship?” and “How is money managed in your relationship?” Items included to assess the domain of Communication and Conflict Management looked at negative affect in the relationship, verbal, psychological, and physical aggression, and conflict resolution strategies. Sample items include “Do you feel comfortable expressing your own opinions during a discussion with your partner?” and “Do either of you ever threaten to leave the relationship during an argument?” Interviewers independently rated the relationship on each domain using five-point scales. Ratings may range from 1-5 and scores of .5 (e.g., 3.5) are permissible. For example, in the domain of Spousal Support, a rating of 1 indicates that the couple “blames, challenges, gives advice when not requested; neither partner gives much/any support, or amount of support is extremely skewed in favor of one partner over the other.” A rating of 3 is assigned if “some support is provided, but skewed in favor of one partner over the other or provided in only certain situations. Variety of support is limited.” A rating of 5 indicates “a high level and quality of support from both partners; large variety of types of support spanning a variety of situations.” Interviewers made objective ratings to eliminate the possibility that associations between poor functioning in a key domain and other factors (e.g., marital distress) were due to reporting biases. All interviews were audio-taped, and inter-rater reliability was assessed using a random sample of 20% of the interviews. Coders were considered to be in agreement if two independent raters were within .5 on the 5-point scale.
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SECTION 3: PRELIMINARY EVIDENCE FOR THE RELIABILITY AND VALIDITY OF THE RELATIONSHIP QUALITY INVENTORY (RQI) In this section we provide preliminary evidence for the reliability and validity of the RQI in our target populations of young relationships – dating and newlywed couples. First, we assessed reliability, convergent validity, and divergent validity. Second, we examined the generalizability of the RQI across dating and marital relationships and across men and women. Third, we examined the utility of the RQI to assess risk of relationship distress over and above existing self-report measures and behavioral observation methods.
Samples Recruited to Assess Reliability and Validity of the RQI Sample 1 comprised 101 married couples recruited through marriage license records from suburban communities and small towns in Iowa. Couples dated an average of 48 months (SD = 27.79) prior to marriage and 77% of them cohabited. Average estimated annual joint income of couples was between $30,001- $40,000. Husbands’ average age was 25.91 (SD = 3.09) and their modal years of education were 14 years. Wives’ average age was 24.5 (SD = 3.46) and their modal years of education were also 14 years. For 15% of the couples, at least one member of the couple identified him or herself as a member of an ethnic minority group. (The proportion of non-Caucasian individuals in Iowa is 9%; US Census, 2007.) Sample 2 comprised 91 individuals in heterosexual romantic relationships lasting at least two months. Participants were enrolled in an introductory psychology course at The University of Iowa. They ranged in age from 18 to 27 (M = 18.27 years, SD = 1.03 years) and were predominantly Caucasian/Non-Hispanic (96.7%). Most participants defined their relationships as “seriously dating” (96%). Only 1.1% were cohabiting, and relationship duration ranged from 2 months to 5 years (M = 17.16 months, SD = 13.26). Objective codes for all five RQI scales are presented in Table 1. On a 1-5 scale, interviewers’ mean ratings ranged from 3.35 to 4.20 across all five RQI scales. On average, couples’ relationship quality in these five domains was good to very good, which would be expected in samples of dating or newlywed couples. Moreover, scores on all domains yielded normal distributions, suggesting that there was adequate range in relationship quality across participants in each of the five domains.
Reliability Analyses To assess reliability of the RQI, we analyzed inter-rater reliability, agreement of interviewers’ scores across husbands’ and wives’ interviews, and correlations among RQI scales; see Table 1 for all of the results.
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RQI Scales
Trust, Closeness & Emotional Intimacy Inter-partner Support
Descriptives and Agreement across Husband and Wife Interviews Marital Sample Dating Sample t(102) Mean Husbands Wives (SD) Mean Mean (SD) (SD) 4.13 4.20 1.06 3.40 (.53) (.39) (.65)
Intraclass Correlations Marital Sample
Dating Sample ICC
Husbands ICC
Wives ICC
.82
.71
.82
3.97 (.49)
3.94 (.50)
-.41
3.63 (.50)
.78
.88
.87
Sexual Relations
3.92 (.65)
3.87 (.64)
-.79
3.36 (.66)
.94
.76
.77
Respect, Acceptance, Decision-Making & Control Communication & Conflict Management
3.97 (.55)
4.01 (.47)
.51
3.36 (.69)
.82
.84
.91
3.69 (.75)
3.78 (.67)
1.17
3.35 (.83)
.93
.84
.92
Inter-Rater Reliability To assess inter-rater reliability, 20% of the audio-taped interviews were randomly assigned to a second coder. Intra-class correlations were computed by averaging across correlations for each pair of objective codes. Correlations were above .70 across all five RQI scales for husbands’ and wives’ interviews in the marital sample and for participants in the dating sample. See Table 1 for all intra-class correlations. Agreement Based on Husband versus Wife Interviews Cross-spouse correlations on RQI ratings were low to moderate in magnitude (rs ranged from .25 to .54), suggesting that husbands and wives were providing somewhat different (but related) information and perspectives on their relationship functioning. Even though ratings were objective and generated based on behavioral indicators of relationship functioning, spouses may be giving at least somewhat different behavioral indicators, which then guide those objective ratings. However, the magnitude of the majority of the inter-spousal associations suggested the potential utility of aggregating across RQI ratings based on husbands’ and wives’ interviews to create a more reliable rating for each domain. Moreover, the t-tests revealed that ratings based on husbands’ and wives’ individual interviews were not significantly different (ts(100) ranged from .51 to 1.17, all ns).
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Correlations among RQI Scales It was important to first determine that the RQI scales were sufficiently interrelated to justify conceptualizing them as components of a higher-order measure of relationship quality. Within-subject correlations across RQI scales are presented in Table 2. Pairs of RQI scales within wives and within husbands in the marital sample correlated .38 to .65. In the dating sample, pairs of RQI scales correlated .24 to .63. This level of inter-correlation is appropriate for sub-factors of a more general construct (Clark & Watson, 1995) and indicates that the different scales are moderately inter-correlated but not redundant. There was one exception to this pattern, however. Inter-partner Support and Respect and Control were strongly correlated within subjects in the marital sample, with correlations of .65 and .70 for husbands and wives, respectively.
Convergent/Divergent Validity Analyses To assess convergent/divergent validity, we examined the extent to which RQI interview scales correlated with data on these same dyadic processes collected via self-report questionnaires and behavioral observations. Self-report measures included: (a) the Problem Solving Communication (PSC) and Affective Communication (AFC) subscales from The Marital Satisfaction Inventory-Revised (MSI-R; Snyder & Aikman, 1999) to measure negative communication and conflict management patterns, and (b) a modified version of The Support in Intimate Relationships Rating Scale (SIRRS; Dehle et al., 2001; see Barry et al., 2008 for details and psychometric properties of the revised SIRRS) to assess perceptions of support amount from one’s partner and support adequacy. Behavioral observation indices of relationship quality included: (a) an inter-partner support interaction task and the Social Support Interaction Coding System (SSICS; Pasch, Harris, Sullivan, & Bradbury, 2002), a coding system that assesses the behaviors exchanged by partners during a supportive discussion, and (b) a problem-solving interaction task and the Specific Affect Coding System – Revised (SPAFF-R; Gottman McCoy, & Coan, 1996), designed to measure positive and negative affect expressed during a problem-solving discussion.
Correlations between RQI Subscales and Self-report Measures of Related Constructs First we examined the correlations between the RQI subscales and self-report measures of relationship function in the relevant domains. Thus the constructs were somewhat related and the methods of assessment differed (objective interview versus self-report questionnaires). For the Emotional Closeness and Intimacy subscale we used the Affective Communication subscale of the Marital Status Inventory-Revised. For the Inter-partner Support subscale we used the adequacy scale from the Support in Intimate Relationships Rating Scale. For the Communication and Conflict Management subscale we used the Problem-Solving Communication scale of the MSI-R. (Self-report measures of the quality of the sexual relationship and of respect and control were not available in the present sample to compare to the RQI Sexual Relations and Respect and Control subscales, respectively.) As shown in Table 3, the RQI scales were weakly to moderately correlated with the self-report questionnaires. Correlations ranged from .24 to .56 in the marital sample, and from .03 to .23 in the dating sample.
Table 2. Correlations among RQI Scales Marital Sample
Dating Sample
Husbands Respect & Control
Comm. & Conflict
.65****
.46****
.25*
.38****
.24*
-----
-----
.35**
.26****
-----
-----
-----
-----
.63**
-----
-----
-----
-----
-----
Wives
Trust & Closeness
Support
Sex
Respect & Control
Comm. & Conflict
Trust & Closeness
Support
Trust & Closeness
.32**
.56**
.38**
.54**
.49**
-----
.59****
.59**
.27**
.51**
.65**
.44**
-----
-----
.49**
.52**
.54**
.38**
.44**
-----
.52**
.70**
.47**
.25**
.54**
.46**
.57**
.40**
.63**
.51**
Inter-partner Support Sexual Relations Respect & Control Communication & Conflict Mgmt.
Sex .56****
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Table 3. Convergent and Divergent Validity Analyses Range of Correlations with other RQI Scales
Correlations with Questionnaires of Correlations with Similar Relationship Constructs a Behavioral Data of Similar Constructs
Correlations with Global Relationship Satisfaction c
Correlations with Individual Differences in Similar Constructs d
b
Trust & Closeness Support Sexual Relations Respect & Control Comm. & Conflict a
Marital Husb. Wife .38-.56 .48-.59
Dating .56-.65
Husb. .37**
.44-.65 .38-.51
.52-.70 .40-.52
.24-.56 .25-.56
.28** -----
.38-.65
.47-.70
.35-.65
.44-.54
.40-.63
.24-.63
Marital Wife .42**
Dating
Marital Wife -----
Husb. .41**
Marital Wife .41**
Dating
-.23*
Husb. -----
.24* -----
.03 -----
.18+ -----
-.05 -----
.46** .35**
.39** .37**
.002 -.05
-----
-----
-----
-.17+
-.05
.43**
.39**
-.01
.56****
.44****
-.08
.25**
.14+
.36**
.38**
.22*
.09
Marital Husb. Wife -(.07-(.20.29**) .22) -----------------(.19.34**) -(.34.51)***
-(.004.12) -(.26.31)*
Dating -(.05-.07) ---------.08-.12 -(.08-.12)
Self-report questionnaires of similar constructs for each RQI scale were: for Trust and Closeness, the AFC Scale of the MSI-R; for Support, the Adequacy scale of the SIRRS; for Communication and Conflict, the PSC Scale of the MSI-R. Of note, the Trust and Closeness RQI scale was also compared to the Intimacy and Passion Scales from the Sternberg Love, Passion, and Intimacy Scale, and the pattern of correlations remained the same (rs = -.01 and .02, respectively). b Behavioral observation data of similar constructs for each RQI scale were: for Support, the Social Support Interaction Task and the SSICS; for Respect and Control, the Problem-Solving Interaction Task and the Contempt, Disgust, Domineering, and Belligerence codes from the SPAFF-R; for Communication and Conflict, the Problem-Solving Interaction Task and the remaining 12 positive and negative affect codes from the SPAFF-R. Of note, SPAFF data were analyzed multiple ways using to examine correlations with Communication and Conflict Management, and the pattern of results remained the same. c The Quality of Marriage Index (QMI) was analyzed for all correlations with global relationship satisfaction. Of note, in the sample of dating couples, this pattern of findings was replicated using the Perceived Relationship Quality Components (PRQC); rs ranged from .00 to .13. d Self-report questionnaires of individual differences were identical in both samples unless otherwise noted here. Measures of individual differences in similar constructs for each RQI scale were: for Trust and Closeness, the SNAP Detachment and Mistrust Scales, the Relationship Scales Questionnaires (in the marital sample), and the ECR-R Avoidance Scale (in the dating sample); for Respect and Control, the SNAP Manipulativeness Scale and the Hostility Scale from the Buss-Perry Aggression Questionnaire; for Communication and Conflict Management, the SNAP Negative Temperament Scale and the Anger Scale from the Buss-Perry Aggression Questionnaire.
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Correlations between RQI Subscales and Behavioral Observations of Related Constructs Next we examined the correlations between the RQI subscales and behavioral observations of measures of relationship functioning in the relevant domains. (Behavioral observation data were only available in the marital sample.) Thus the constructs were related but the methods of assessment differed (objective interview versus behavioral observations of couple functioning). For the Inter-partner Support subscale we used behavioral observations from two support interaction tasks that were later coded via the Social Support Interaction Coding system. For the Communication and Conflict Management subscale we used behavioral observations from two problem-solving interaction tasks that were later coded via the Specific Affect Coding System – Revised. As shown in Table 2, conclusions about marital processes yielded based on the RQI did not correlate with data collected via behavioral observations of these marital processes. Correlations ranged from .05 to .25.
Divergent Validity Analyses To assess divergent validity, we examined the associations between RQI subscales and measures of individual differences in related constructs. For example, we examined associations between the Emotional Closeness and Intimacy domain to measures of detachment and mistrust as personality traits, and to avoidant attachment as an attachment style. We measured individual differences by administering: (a) the Negative Temperament, Detachment, Mistrust, and Manipulativeness scales from The Schedule for Nonadaptive and Adaptive Personality - 2nd Edition (SNAP-2; Clark, Simms, Wu, & Casillas, in press); (b) the Anger and Hostility Scales from The Buss-Perry Aggression Questionnaire (Buss & Perry, 1992); and the Relationship Scales Questionnaire (RSQ; Griffin & Bartholomew, 1994) and the Experiences in Close Relationships – Revised scale (ECR-R; Fraley, Waller, & Brennan, 2000). We also assessed divergent validity by examining the associations between RQI subscales and a global measure of relationship satisfaction, The Quality of Marriage Index (QMI; Norton, 1983), to determine whether our purported assessment of domain-specific relationship quality was distinct from global relationship satisfaction. Three aspects of discriminant validity were considered. First, Campbell and Fiske (1959) state that a good convergent/discriminant validity pattern exists when matched variables correlate more highly with each other than with any other variable. Thus we examined whether the inter-correlations among RQI scales were higher than the correlations between RQI scales and measures of similar constructs via different methods. Second, the associations between the RQI scales and related traits were examined to determine whether RQI subscale scores discriminated between functioning within one’s marriage on a given domain and individual differences in interpersonal functioning on that domain across relationships. Third, we examined associations between RQI scales and a measure of global marital satisfaction to determine whether the RQI is simply assessing global marital satisfaction rather than relationship quality across multiple domains. Results are presented in Table 3.
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Campbell and Fiske’s Test of Convergent/divergent Validity We examined whether the inter-correlations among RQI scales were higher than the correlations between RQI scales and measures of similar constructs via different methods. Results are presented in Table 3. In general, this target pattern was clearly obtained for all five RQI scales in both samples. For each RQI scale, the correlations with other RQI scales (convergent validity) were generally larger than correlations with questionnaire or behavioral observation data. This support was evident for husbands and wives, and across marital and dating participants. Three of the four RQI Scales – Emotional Closeness and Intimacy, Interpartner Support, and Respect and Control – clearly meet the Campbell and Fiske test for excellent convergent and discriminant validity at the scale level. In contrast, there is mixed but generally strong evidence regarding the RQI Communication and Conflict Management Scales. The scale does meet Campbell and Fiske’s criteria when compared to self-report questionnaires in the dating sample and when compared to behavioral observation data in the marital sample. Moreover, the RQI Communication and Conflict Management Scale is only moderately correlated with the corresponding self-report questionnaire. However, this moderate correlation is similar to the moderate correlations between the RQI Communication and Conflict Management scale and the other RQI scales (which range from .40 to .63); thus, it does meet the Campbell and Fiske criteria in that regard. Correlations between RQI Subscales and Relevant Traits Zero-order correlations between the RQI subscales and trait-level constructs related to each domain assessed were examined. (Trait questionnaires to measure sexual relations across relationships and global social support were not available in the present samples to compare to the RQI Sexual Relations and Inter-Partner Support subscales, respectively.) For the Emotional Closeness and Intimacy subscale we used the (a) SNAP Detachment scale, (b) SNAP Mistrust scale, and (c) ECR-R Attachment Avoidance scale. All of the associations relevant to the Emotional Closeness and Intimacy subscale were small across husbands and wives and across dating and marital participants (rs ranged from .05 to .29). These findings support our contention that the RQI Emotional Closeness and Intimacy subscale is not simply measuring individual differences such as global detachment or mistrust as personality traits or an avoidant attachment style but rather measures a construct that is specific to the intimate relationship. For the Respect and Control subscale we used the SNAP Manipulation scale and the AQ Hostility Scale. All of the associations were small across husbands and wives and across dating and married participants (rs ranged from .004 to .34). Therefore, the Respect and Control subscale is not simply measuring individual differences such as manipulative or hostile personality traits but rather measures a construct that is specific to the intimate relationship. For the Communication and Conflict Management subscale we used (a) the Anger Scale from the Buss-Perry Anger Questionnaire and (b) the SNAP Negative Temperament scale. With one exception, the correlations were small, with rs ranging from .08 to .34. (The correlation between this scale and Negative Temperament for husbands was moderate (.51), although this association was small among wives and dating participants. Thus, the quality of a couple’s communication and conflict management strategies is clearly distinct from both trait anger and global negative temperament; however, for husbands, quality of conflict management is also clearly related to husband negative temperament.
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Correlations between RQI Subscales and Global Relationship Satisfaction Correlations between ratings of domain-specific relationship quality and global relationship satisfaction were low to moderate for husbands and wives (rs ranged from .35 to .46) and low for dating participants (rs ranged from .002 to .22), indicating that the domainspecific assessments of relationship quality did not simply represent indicators of an underlying latent variable of marital satisfaction. Moreover, the associations between relationship quality and satisfaction are clearly stronger for married couples compared to dating couples, which we expected given the longer duration and stronger commitment of married couples.
Incremental Validity Analyses We examined the utility of the RQI to assess risk of relationship distress over and above existing self-report measures and behavioral observation methods. In addition to our assertions that a clinical interview will be more user-friendly for clinicians and that the interview provides a better measure of the constructs of interest (compared to existing selfreport questionnaires and behavioral observational data), we also expected the RQI scales to predict global relationship satisfaction over and above these existing measures. We examined the incremental utility of each RQI scale when predicting cross-sectional and longitudinal (three-year) satisfaction for men and women. In the marital sample, we examined the extent to which each RQI scale provided incremental predictive validity in accounting for global marital satisfaction. For four of the five RQI scales – Emotional Closeness and Intimacy, Inter-partner Support, Respect and Control, and Communication and Conflict – we analyzed the incremental predictive power of the RQI scale over and above self-report questionnaires of these marital processes and, when available, behavioral observation data of these marital processes. We did not have any selfreport questionnaire data for the quality of the couple’s sexual relations. Incremental validity was examined when predicting both concurrent and longitudinal marital satisfaction. Results for all regression analyses are presented in Table 4.
Cross-sectional Analyses In the marital sample, three of the four RQI scales – Emotional Closeness and Intimacy, Inter-partner Support, and Respect and Control – demonstrated incremental predictive power. Interestingly, in the dating sample, only the RQI Communication and Conflict Management scale demonstrated incremental predictive power. The RQI Emotional Closeness and Intimacy Scale predicted concurrent marital satisfaction for husbands and wives over and above our self-report measure of this construct (Affective Communication Scale of the MSIR; Snyder & Aikman). The RQI Inter-Partner Support Scale predicted concurrent marital satisfaction for husbands and wives over and above both our self-report measure (SIRRS; Dehle et al.) and our behavioral observation data (SS interaction task coded via the SSICS coding system; Pasch et al.). The RQI Respect and Control Scale predicted concurrent marital satisfaction for husbands – but not for wives – over and above both our self-report measure (Problem-Solving Communication Scale of the MSI-R; Snyder & Aikman) and our behavioral observation data (problem-solving interaction task coded for belligerence,
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dominance, contempt, and disgust via the SPAFF coding system; Gottman et al.). The RQI Communication and Conflict Management Scale predicted concurrent relationship satisfaction for dating participants (but not for husbands or wives) over and over and above our self-report measure (Problem-Solving Communication Scale of the MSI-R; Snyder & Aikman). Thus, the RQI appears to provide incremental utility to explaining global marital satisfaction compared to existing self-report questionnaires and behavioral observation data for Emotional Closeness and Intimacy, Inter-partner Support, and Respect and Control, but not for Communication and Conflict Management. Table 4. Incremental Predictive Validity
MSI-R: AFC Scale RQI Trust & Closeness SIRRS Adequacy Scale RQI Support Scale SIRRS Adequacy Scale SSICS Support Codes RQI Support Scale MSI-R: PSC Scale SPAFF Behaviors a RQI Respect & Control MSI-R: PSC Scale SPAFF Behaviors b RQI Commun./Conflict a
Predicting Time 1 Relationship Satisfaction Marital Sample Dating Sample Husbands Wives
Husbands
Wives
b (SE) / Adjusted R2
b (SE) / Adjusted R2 Δ
b (SE) / Adjusted R2 Δ
b (SE) / Adjusted R2
b (SE) / Adjusted R2
Predicting Time 4 Satisfaction Marital Sample
Δ
Δ
1.29**** (.19) 1.46* (.72) / .02*
1.07**** (.13) 1.91* (.98) / .02*
-1.59**** (.24) -.26**** (.43) / .33
1.02** (.33)
.45+ (.28)
3.02* (1.21) / .06*
.15 (1.95) /.00
.12+ (.05)
.14 *** (.04)
.28 (.09) **
.08 (.07)
.09 + (.05)
3.20**** (.87) / .22 .14** (.05)
2.72** (.92) / .26 .07 (.05)
-.01 (.48) / .09
.42 (1.28) / .001 .10 (.09)
1.21 (1.19) / .04 .07 (.06)
.01 (.02) 1 .82+ (1.07) / .192 -.63**** (.09) -.00 (.02) 1.51* (.69) / .03* 1.05**** (.15) .001 (.003) -.09 (.60) / .41
-.02 (.03) 3.30** (1.12) / .15 -.72**** (.09) .01 (.02) 1.45* (.74) / .02* 1.04**** (.14) .001 (.003) .70 (.60) / .46
.03 (.04) .91 (2.05) / .02 -.30 (.17)+
-.02 (.03) 1.28 (1.39) / .002 -.39* (.19)
-.02 (.03) 2.47* (1.23) / .04* .19 (.27)
.03 (.03) 1.13 (1.43) / .02 .34 (.21)
.003 (.005) 1.40 (1.10) / .03
-.001 (.004) 1.14 (.92) / .04
-------------.65**** -----.04/.41 -.91 (.12) **** ----.64* (.30) / .41*
Δ
SPAFF behaviors: Disgust, Contempt, Domineering, Belligerence. All other positive and negative SPAFF codes. Of note, SPAFF data were analyzed multiple ways to examine corr.s with Commun. & Conflict. Pattern of results remained the same. + p < .10; * p < .05; ** p < .01; *** p < .001; **** p < .0001. b
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Longitudinal Analyses Next we examined the incremental predictive utility of these same RQI scales when predicting longitudinal marital satisfaction – at three years of marriage. Two of the four RQI scales – Emotional Closeness and Intimacy and Respect and Control – demonstrated incremental utility in predicting husbands – but not wives – longitudinal marital satisfaction. The RQI Emotional Closeness and Intimacy Scale predicted husbands’ longitudinal marital satisfaction over and above our self-report measure of this construct (Affective Communication Scale of the MSI-R; Snyder & Aikman). The RQI Respect and Control Scale also predicted husbands’ longitudinal marital satisfaction over and over and above both our self-report measure (Problem-Solving Communication Scale of the MSI-R; Snyder & Aikman) and our behavioral observation data (problem-solving interaction task coded for belligerence, dominance, contempt, and disgust via the SPAFF coding system; Gottman et al.). The RQI Inter-partner Support Scale and Communication and Conflict Scales did not incrementally predict longitudinal marital satisfaction for either husbands or wives over and above our self-report measure or our behavioral observation data Thus, the RQI appears to provide incremental utility to explaining husbands’ – but not wives’ – longitudinal global marital satisfaction compared to existing self-report questionnaires and behavioral observation data for Emotional Closeness and Intimacy and Respect and Control, but not for Inter-partner Support or Communication and Conflict Management.
Conclusion The RQI demonstrated strong reliability, with inter-rater agreement consistently above .7, no significant differences among interviewer ratings based on whether the male or female partner was interviewed in a given couple. Correlations among RQI subscales ranged from .2 to .6 (with one exception), supporting our contention that the subscales are best conceptualized as related dimensions of the underlying construct of relationship quality, yet these subscales capture conceptually distinct (albeit related) dimensions of relationship quality. The RQI also demonstrated good convergent validity, with correlations ranging from .2 to .6 between the subscales and self-report measures of related relationship constructs (emotional intimacy, communication and conflict management, inter-partner support). Divergent validity was assessed four ways. First, correlations between RQI scales and behavioral observations of related constructs were weak, ranging from .05 to .25, supporting our contention that the RQI captures markedly distinct constructs from what is captured via behavioral observation interaction tasks. Second, correlations between RQI scales and measure of global relationship satisfaction were weak, ranging from .002 to .46, supporting our contention that the RQI is not simply a measure of global relationship satisfaction. Third, correlations between RQI subscales and individual difference measures of related constructs (e.g., avoidant attachment, mistrust, detachment, negative temperament, hostility) were weak, ranging from .004 to .3 (with one exception at .5), supporting our contention that the RQI scales capture constructs that are unique to one’s current intimate relationship rather than being indicative of individual differences that might be present across multiple types of relationships (e.g., friends, acquaintances, co-workers). Fourth, convergent validity analyses generally yielded stronger correlations then divergent validity analyses, lending partial support to the Campbell-Fiske (1959) test of construct validity.
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SECTION 4: CLINICAL IMPLICATIONS OF THE RQI FOR COUPLE ASSESSMENT AND PREVENTION EFFORTS In this section we discuss clinical implications at two levels. First, we discuss the generalizability of the RQI itself based on the data presented in Section 3. Second, we discuss the broader clinical implications of the RQI for improving couple assessment and prevention efforts.
Generalizability of the RQI We examined the generalizability of the RQI in two ways. First we examined its generalizability across men and women. The RQI yielded strong psychometric data for men and women. Second, we found that the RQI demonstrated reliability, validity, and incremental utility across dating and marital relationships. As the proportion of couples who cohabit and/or date for many years prior to marriage increases, greater attention is being given to the study of pre-marital relationships (e.g., Brown & Booth, 1996; Stanley, Rhoades, & Markman, 2006). Additionally, it has been suggested that patterns that develop early in relationships (i.e., even before marriage) are important for individual and dyadic outcomes (Cutrona et al., 2005). Thus, patterns of relationship quality that emerge during courtship likely impact individual and relationship functioning. Despite this potential importance, little work has addressed whether relationship quality functions similarly in dating and marital relationships. As expected, the pattern of findings was stronger in the analyses of the marital sample compared to the dating sample. The longer duration and stronger commitment of the married participants would presumably lead to greater utility of the RQI in such a sample. The next step is to examine the psychometric properties of the RQI in distressed samples of couples, such as in a sample of couples seeking couple therapy. We would expect the pattern of results to be similar, if not stronger, to that found with the marital sample. More generally, as the intimate relationship becomes more solidified and more central to one’s life, we would expect the RQI to have greater utility and for the interview to demonstrate stronger convergent and divergent validity when administered. There are several ways in which the generalizability of the RQI can be expanded in future research. First, although the RQI was developed as an assessment tool for young couples and to be administered in accord with prevention programs, it seems just as likely that it could be used as part of a standardized assessment protocol for treatment-seeking and/or distressed couples and to guide treatment for those couples. Before we can recommend that the RQI be used in this way, we must first assess the reliability and validity of the RQI in distressed, established, and/or treatment-seeking couples. Second, the reliability and validity of the RQI should be examined with same-sex couples and couples at other stages of their relationships (e.g., cohabiting couples, engaged couples, couples experiencing the transition to parenthood). Finally, other dimensions of relationship quality might be worth incorporated into the RQI, such as fun and leisure time and quality of the couple’s friendship.
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Implications for Couple Assessment and Prevention Efforts There are several implications of the present study for couple assessment and intervention efforts. First, the RQI is intended to be used as part of a standardized assessment battery for couple interventions. For example, it can be administered to couples and then incorporated into a feedback session in which relationship strengths/protective factors and relationship risk factors/ vulnerabilities are emphasized. By quantifying relative strengths and weaknesses across multiple dimensions of a relationship, feedback may be more palatable to couples. Second, the RQI might function as a motivational tool to get couples to participate in couple prevention programs or treatments. Cordova and colleagues (Cordova et al., 2005; Gee, Scott, Castellani, & Cordova, 2002) developed an indicated intervention program called the Marriage Checkup based on the principles of motivational interviewing. As they describe, prior to dissolution, it is likely that couples that become severely distressed first pass through an at-risk stage in which they experience early symptoms of marital deterioration but have not yet suffered irreversible damage to their marriage. It is during this at risk stage when couples might benefit most from early intervention. To date, they have found evidence for the attractiveness, tolerability, efficacy, and mechanisms of change produced by this interview, as well as its ability to predict marital satisfaction two years later. In line with this important work, it is possible that the RQI could be modified and tested as a motivational interview for at risk couples as well. Third, because the RQI can be used to identify domains of strength and weakness in couples’ relationships, it might be useful as a tool to identify at risk couples. To date, studies of leading preventive interventions have not fared well at recruiting couples at risk for adverse marital outcomes. Published samples have been disproportionately Caucasian, well educated, and middle class (see Carroll & Doherty, 2003, for a review). However, divorce rates are markedly higher among African American couples (70% vs. 47% in Caucasian couples), among couples who did not finish high school (60% vs. 36% for college graduates), and among couples who start marriage with children (rates are twice as high as couples who marry without children; Raley & Bumpass, 2003). Despite their omission from prevention programs, couples in these high-risk populations report high levels of interest in participating in these interventions (Johnson et al., 2002). In sum, relationship enhancing interventions appear to have failed to test their programs in the populations at greatest risk for distress and divorce. Administering the RQI prior to implementing a prevention program might allow at risk couples to be identified, while simultaneously being used as a motivational tool to encourage these at risk couples to participate in these prevention interventions. Fourth, intervention programs can be better tailored to the needs of specific couples, rather than implementing a one-size fits all approach. For example, a couple’s RQI may indicate strong quality of communication and conflict management skills but poor quality of inter-partner support. In this case, intervention techniques specific to improving the quality of support in that relationship is more appropriate and intervention techniques targeting conflict management skills are unnecessary. This approach seems more beneficial for treating couples and more cost-effective from a health care perspective.
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REFERENCES Barry, R.A., Bunde, M., Brock, R.L., & Lawrence, E. (2008). Examining the validity and utility of distinguishing among types of support in intimate relationships. Manuscript submitted for publication. Barry, R.A., Lawrence, E., & Langer, A. (in press). Conceptualization and assessment of disengagement in romantic relationships. Personal Relationships. Brown, S. L., & Booth, A. (1996). Cohabitation versus marriage: A comparison of relationship quality. Journal of Marriage and Family, 58, 668-678. Busby, D.M., Holman, T.B., Taniguchi, N. (2001). RELATE: Relationship evaluation of the individual, family, cultural, and couple contexts. Family Relations, 50, 308-316. Buss, A. H., & Perry, M. P. (1992). The aggression questionnaire. Journal of Personality and Social Psychology, 63, 452-459. Campbell, D.T., & Fiske, D.W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, 81-105. Carroll, J.S., & Doherty, W.J. (2003). Evaluating the effectiveness of premarital prevention programs: A meta-analytic review of outcome research. Family Relations, 52, 105-118. Christensen, A., & Walczynski, P. T. (1997). Conflict and satisfaction in couples. In R. J. Sternberg & M. Hojjat (Eds.), Satisfaction in close relationships (pp. 249–274). NY: Guilford. Clark, L. (1993). Manual for the Schedule for Nonadaptive and Adaptive Personality. MN: University of Minnesota Press. Clark, L.A., Simms, L.J., Wu, K.D., & Casillas, A. (in press). Schedule for Nonadaptive and Adaptive Personality (2nd ed.). MN: University of Minnesota. Cohen, L.H., Towbes, L.C., & Flocco, R. (1988). Effects of induced mood on self-reported life events and perceived and received social support. Journal of Personality and Social Psychology, 55, 669-674. Cordova, J. V., Gee, C. B., Warren, L. Z. (2005). Emotional skillfulness in marriage: Intimacy as a mediator of the relationship between emotional skillfulness and marital satisfaction. Journal of Social and Clinical Psychology, 24, 218-235. Cutrona, C.E., Russell, D.W., & Gardner, K.A. (2005). The relationship enhancement model of social support. In T.A. Revenson, K. Kayser & G. Bodenmann (Eds.), Couples coping with stress (pp. 3-23). DC: APA. Cutrona, C.E., & Suhr, J.A. (1992). Controllability of stressful events and satisfaction with spouse support behaviors. Communication Research, 19, 154-174. Cutrona, C.E., & Suhr, J.A. (1994). Social support communication in the context of marriage: An analysis of couples’ supportive interactions. In B.R. Burleson, T.L. Albrecht & I.G. Sarason (Eds.), Communication of social support: Messages, interactions, relationships, and community (pp. 113-135). CA: Sage. Dehle, C., Larsen, D., & Landers, J.E. (2001). Social support in marriage. American Journal of Family Therapy, 29, 307–324. Ehrensaft, M.K., Langhinrichsen-Rohling, J., Heyman, R.E., O’Leary, K.D., & Lawrence, E. (1999). Feeling controlled in marriage: A phenomenon specific to physically aggressive couples? Journal of Family Psychology, 13, 20-32.
170
Erika Lawrence, Robin A. Barry, Rebecca L. Brock et al.
Fincham, F.D., & Linfield, K.J. (1997). A new look at marital quality: Can spouses feel positive and negative about their marriage? Journal of Family Psychology, 11, 489-502. First, M.B., Gibbon, M., Spitzer, R.L., & Williams, J.B.W. (1997). Structured Clinical Interview for DSM–IV Axis I Disorders—Clinician version. Washington, DC: American Psychiatric Association. Floyd, F.J., Markman, H.J., Kelly, S., Blumberg, S.L., & Stanley, S.M. (1995). Preventive intervention and relationship enhancement. In N. S. Jacobson & A. S. Gurman (Eds.), Clinical handbook of couple therapy (pp. 212-226). NY: Guilford. Fraley, R.C., Waller, N.G., & Brennan, K.A. (2000). An item response theory analysis of selfreport measures of adult attachment. Journal of Personality and Social Psychology, 78, 350-365. Gable, S.L., Gonzaga, G.C., & Strachman, A. (2006). Will you be there for me when things go right? Supportive responses to positive event disclosures. Journal of Personality and Social Psychology, 91, 904-917. Gee, C.B., Scott, R.L., Castellani, A.M., & Cordova, J.V. (2002). Predicting 2-year marital satisfaction from partners’ discussion of their marriage checkup. Journal of Marital and Family Therapy, 28, 399-407. Geiss, S., & O’Leary, K. (1981). Therapist ratings of frequency and severity of marital problems: Implications for research. Journal of Marital & Family Therapy, 7, 515-520. George, C., Kaplan, N., & Main, M. (1985). The Berkeley adult attachment interview. Unpublished protocol. University of California, Berkeley. Godoy, R., Reyes-Garcia, V., Tanner, S., Leonard, W.R., McDade, T.W., & Huanca, T. (2008). Can we trust an adult's estimate of parental school attainment? Disentangling social desirability bias and random measurement error. Field Methods, 20, 26-45. Gottman, J., McCoy, K., & Coan J. (1996). The Specific Affect Coding System. In J. Gottman (Ed.) What predicts divorce? The measures (pp. 561). NJ: Erlbaum. Gottman, J.M., Swanson, C., & Murray, J. (1999). The mathematics of marital conflict: Dynamic mathematical nonlinear modeling of newlywed marital interaction. Journal of Family Psychology, 13, 3-19. Gray-Little, B., & Burks, N. (1983). Power and satisfaction in marriage: A review and critique. Psychological Bulletin, 93, 513– 538. Griffin, D.W., & Bartholomew, K. (1994). The metaphysics of measurement: The case of adult attachment. In K. Bartholomew & D. Perlman (Eds.), Attachment processes in adulthood: Henderson-King, D.H., & Veroff, J. (1994). Sexual satisfaction and marital well-being in the first years of marriages. Journal of Social and Personal Relationships, 11, 509–534. Heyman, R.E., Feldbau-Kohn, S.R., Ehrensaft, M.K., Langhinrichsen-Rohling, J., & O’Leary, K.D. (2001). Can questionnaire reports correctly classify relationship distress and partner physical abuse? Journal of Family Psychology, 15, 334–346. Heyman, R.E., Sayers, S.L., & Bellack. A.S. (1994). Global marital satisfaction versus marital adjustment: An empirical comparison of three measures. Journal of Family Psychology, 8, 432-446. Huston, T.L. (1983). Power. In H.H. Kelley, E. Berscheid, A. Christensen, J.H. Harvey, T.L. Huston, G. Levinger, E. McClintock, L.A. Peplau, & D.R. Peterson (Eds.), Close relationships (pp. 169-219). NY: Freeman.
Development of an Interview for Assessing Relationship Quality
171
Huston, T.L., & Vangelisti, A.L. (1991). Socioemotional behavior and satisfaction in marital relationships: A longitudinal study. Journal of Personality and Social Psychology, 61, 721-733. Jacobson, N.S., & Holtzworth-Munroe, A. (1986). Marital therapy: A social learning/cognitive perspective. In N. S. Jacobson & A. S. Gurman (Eds.), Clinical handbook of marital therapy (pp. 29-70). NY: Guilford. Karney, B. R., & Bradbury, T. N. (1995). The longitudinal course of marital quality and stability: A review of theory, method, and research. Psychological Bulletin, 118, 3-34. Karney, B.R., & Frye, N.E. (2002). "But we've been getting better lately": Comparing prospective and retrospective views of relationship development. Journal of Personality and Social Psychology, 82, 222-238. Kluemper, D.H. (2008). Trait emotional intelligence: The impact of core-self evaluations and social desirability. Personality and Individual Differences, 44, 1402-1412. Kurdek, L. A. (2002). On being insecure about the assessment of attachment styles. Journal of Social and Personal Relationships, 19, 811-834. Larson, J.H., Newell, K., Topham, G., & Nichols, S. (2002). A review of three comprehensive premarital assessment questionnaires. Journal of Marital and Family Therapy, 28, 233-239. Laurenceau, J., Barrett, L.F., & Rovine, M.J. (2005). The interpersonal process model of intimacy in marriage: A daily-diary and multilevel modeling approach. Journal of Family Psychology, 19, 314-323. Locke, H.J., & Wallace, K.M. (1959). Short marital adjustment and prediction tests: Their reliability and validity. Marriage and Family Living, 21, 251–255. LoPiccolo, J., Heiman, J.R., Hogan, D.R., & Roberts, C.W. (1985). Effectiveness of single therapists versus cotherapy teams in sex therapy. Journal of Consulting and Clinical Psychology, 53, 287-294. Markey, B., & Micheletto, M. (1997). Instructor manual for FOCCUS. Omaha, NE: Archdiocese of Omaha. McNulty, J.K., O'Mara, E.M., & Karney, B.R. (2008). Benevolent cognitions as a strategy of relationship maintenance: "Don't sweat the small stuff"....But it is not all small stuff. Journal of Personality and Social Psychology, 94, 631-646. Miller, P.J. E., Niehuis, S., & Huston, T.L. (2006). Positive illusions in marital relationships: A 13-year longitudinal study. Personality and Social Psychology Bulletin, 32, 1579-1594. Morrison, A.T., & Hunt, H.T. (1996). "Reals", "roles", and demand features: A critical look at interview versus questionnaire measures of subjective states. Canadian Psychology, 37, 112-119. Neff, L.A., & Karney, B.R. (2005). Gender differences in social support: A question of skills or responsiveness? Journal of Personality and Social Psychology, 88, 79-90. Norton, R. (1983). Measuring marital quality: A critical look at the dependent variable. Journal of Marriage and the Family, 45, 141-151. Olsen, D. H., Fournier, D. H., & Druckman, J. M. ( 1996). PREPARE. Minneapolis, MN: Life Innovations. Osgood, C.E., Suci, G.J., & Tannenbaum, P.H. (1957). The measurement of meaning. Urbana, IL: University of Illinois Press. Pasch, L.A., & Bradbury, T.N. (1998). Social support, conflict, and the development of marital dysfunction. Journal of Consulting and Clinical Psychology, 66, 219-230.
172
Erika Lawrence, Robin A. Barry, Rebecca L. Brock et al.
Pasch, L.A., Harris, K.M., Sullivan, K.T., & Bradbury, T.N. (2002). The social support interaction coding system. In P. Kerig & D. Baucom (Eds.), Couple observational coding systems. Mahwah, NJ: Lawrence Erlbaum & Associates. Prescott, A., Bank, L., Reid, J. B., Knutson, J. F., Burraston, B. O., & Eddy, J. M. (2000). The veridicality of retrospective reports of punitive childhood experiences. Child Abuse and Neglect, 24, 411-423. Raley, R.K. (2003). The topography of the divorce plateau: Levels and trends in union stability in the United States after 1980. Demographic Research, 8, 245-260. Raselli, C., & Broderick, J.E. (2007). The association of depression and neuroticism with pain reports: A comparison of momentary and recalled pain assessment. Journal of Psychosomatic Research, 62, 313-320. Reynolds, S. K., & Clark, L. A. (2001). Predicting personality disorder dimensions from domains and facets of the five factor model. Journal of Personality, 69, 199–222. Schramm, D.G., Marshall, J.P. Harris, V.W., & Lee, T.R. (2005). After "I do": The newlywed transition. Marriage and Family Review, 38, 45-67. Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., & Bugaighis, M.A. (1986). Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage and the Family, 48, 381–387. Simpson, J.A., Rholes, W.S., & Nelligan, J.S. (1992). Support seeking and support giving within couples in an anxiety-provoking situation: The role of attachment styles. Journal of Personality and Social Psychology, 62, 434-446. Snyder, D.K., & Aikman, G.G. (1999). Marital Satisfaction Inventory-Revised. In M.E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment. (2nd ed., pp. 1173-1210). Mahwah, NJ: Erlbaum. Snyder, D.K., Heyman, R.E., & Haynes, S.N. (2005). Evidence-based approaches to assessing couple distress. Psychological Assessment, 17, 288-307. Spanier, G.B. (1979). The measurement of marital quality. Journal of Sex and Marital Therapy, 5, 288-300. Stanley, S.M., Rhoades, G.H., & Markman, H.J. (2006). Sliding vs. deciding: Inertia and the premarital cohabitation effect. Family Relations, 55, 499-509. Straus, M., Hamby, S., Boney-McCoy, & Sugarman, D. (1996). Revised Conflict Tactics Scales: Development and preliminary psychometric data. Journal of Family Issues, 17, 283-316. US Census Bureau Population Division (2007) Race and Hispanic or Latino origin in Iowa’s counties: 2006. Weiss, R.L., & Heyman, R.E. (1990). Marital distress. In A.S. Bellack, M. Hersen, & A.E. Kazdin (Eds.), International handbook of behavior modification and therapy (2nd ed.; pp. 475-501). NY: Plenum. Whisman, M.A., & Jacobson, N.S. (1990). Power, marital satisfaction, and response to marital therapy. Journal of Family Psychology, 4, 202-212. Xu, Y., & Burleson, B.R. (2001). Effects of sex, culture, and support type on perceptions of spousal social support: An assessment of the “support gap” hypothesis in early marriage. Human Communication Research, 27, 535-566.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 8
ASSESSING RELATIONSHIP QUALITY: DEVELOPMENT OF AN INTERVIEW AND IMPLICATIONS FOR COUPLE ASSESSMENT AND INTERVENTION Erika Lawrence, Rebecca L. Brock, Robin A. Barry, Amie Langer University of Iowa, Iowa City, Iowa, USA
Mali Bunde CIGNA Health Solutions, Eden Prairie, Minnesota, USA
ABSTRACT Historically, relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. In contrast, far less attention has been paid to the assessment of relationship quality. In the first section of our paper, we review the long-standing debate regarding -- and clarify the distinctions among -relationship adjustment, satisfaction, and quality. We also discuss the need for an empirically-supported, psychometrically strong measure of relationship quality. In the second section, we discuss the multidimensional nature of relationship quality, and review prior research relevant to each dimension. We also introduce the Relationship Quality Interview (RQI), a semi-structured, behaviorally anchored, individual interview that yields objectively coded ratings. The RQI was designed to assess relationship quality across five dimensions: (a) trust, closeness, and emotional intimacy; (b) inter-partner support; (c) quality of the sexual relationship; (c) respect, power, and control; and (e) communication and conflict management. In the third section, we provide preliminary evidence of the reliability and validity of the interview. Across samples of dating and married couples, we examined reliability, convergent and divergent validity, and incremental validity of the RQI. In the fourth section, we discuss broader clinical issues relevant to couple assessment and intervention efforts.
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INTRODUCTION Historically, relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. In contrast, far less attention has been paid to the assessment of relationship quality. In the first section of our paper, we review the long-standing debate regarding -- and clarify the distinctions among -- relationship adjustment, satisfaction, and quality. We also discuss the need for an empirically-supported, psychometrically strong measure of relationship quality. In the second section, we introduce the Relationship Quality Interview (RQI), a semi-structured, behaviorally anchored, individual interview that yields objectively coded ratings. It was designed to assess relationship quality across five dimensions: (a) trust, closeness, and emotional intimacy; (b) inter-partner support; (c) quality of the sexual relationship; (c) respect, power, and control; and (e) communication and conflict management. We describe the development of the interview, our justification for the dimensions of relationship quality included, and the coding system employed. In the third section, we provide preliminary evidence of the reliability and validity of the interview. Our goal is for the RQI to be used as an assessment tool prior to the implementation of prevention programs with young couples. Therefore, we administered the RQI to 101 newlywed couples and 91 dating individuals. To assess reliability, we analyzed internal consistency, inter-rater agreement, agreement across interviewers based on two members of the same couple, and correlations among the scales. To examine convergent validity, we analyzed correlations between RQI scales and self-report questionnaires assessing similar relationship dimensions. To examine divergent validity, we computed correlations between RQI scales and (a) behavioral observations of related constructs, (b) global measures of relationship satisfaction, and (c) individual difference measures of related constructs. We also examined the incremental utility of the RQI to explain cross-sectional and longitudinal relationship satisfaction over and above existing measures of these same dimensions of relationship quality. In the fourth section, we discuss broader clinical issues relevant to couple assessment and prevention efforts. First, we discuss the importance of identifying a standardized couple assessment strategy, and review ongoing efforts to achieve this goal. Second, we make specific recommendations for enhancing couple prevention programs. Third, we discuss the possible utility of interviews as motivational tools to increase participation in prevention programs among couples at high risk for longitudinal distress and dissolution, and review ongoing efforts to achieve this goal.
SECTION 1: RELATIONSHIP SATISFACTION, ADJUSTMENT, AND QUALITY Over the last 60 years, relationship satisfaction and adjustment have been the target outcome variables for almost all couple research and therapies. Nevertheless, there has also been considerable debate over the differences among the terms relationship satisfaction, relationship adjustment, and relationship quality. Relationship satisfaction refers to global sentiment or happiness as a unitary construct. Relationship adjustment is broader in scope,
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and includes a consideration of dyadic processes such as conflict management skills and relationship outcomes such as satisfaction. Relationship quality refers to dyadic processes alone, such as the quality of a couple’s conflict management skills, supportive transactions, sexual relations, or emotional intimacy (Lawrence, Barry, Brock, & Langer, in press; see Snyder, Heyman, & Haynes, 2005, and Heyman, Sayers, and Bellack, 1994 for detailed discussions of these issues). In this section, we provide a brief overview of the ways in which relationship adjustment, satisfaction, and quality have been assessed to date, followed by a discussion of the strengths and weaknesses of different methods of relationship assessment (e.g., self-report questionnaires vs. clinical interviews).
Assessments of Relationship Adjustment, Satisfaction and Quality Relationship adjustment is typically assessed with omnibus measures in which partners evaluate multiple aspects of their relationships, such as the amount of disagreement across different areas of conflict, global evaluations of the relationship, and frequency of sexual relations (cf. Dyadic Adjustment Scale, Spanier, 1976; Marital Adjustment Test, Locke & Wallace, 1959). Others have employed multidimensional approaches that distinguish among sources of distress. For example, dimensions of the Marital Satisfaction Inventory (MSI-R; Snyder & Aikman, 1999) include family of origin conflict, sexual satisfaction, and problemsolving communication. Other questionnaires include dimensions such as relationship expectations, emotional health, and personal stress management, as well as communication strategies and family of origin conflict (FOCCUS, Markey & Micheletto, 1997; Larson, Newell, Topham, & Nichols, 2002: PREPARE, Olsen, Fournier, & Druckman, 1996; RELATE, Busby, Holman, & Taniguchi, 2001). We contend that the multidimensional nature of these questionnaires represents an improvement over the omnibus measures that yield a single aggregated score for marital adjustment. However, the dimensions included in these newer questionnaires seem to confound predictors of dyadic functioning (e.g., family of origin conflict) with assessment of dyadic functioning (e.g., problem-solving communication) and, in some cases, with individual functioning (e.g., emotional health). Relationship satisfaction is often assessed with shorter, unidimensional measures of global sentiment toward one’s relationship (e.g., Kansas Marital Satisfaction Scale, Schumm et al., 1986; Quality of Marriage Index, Norton, 1983). Others have employed a semantic differential approach, a way of quantifying partners’ evaluations of their relationships by having them rate their perceptions on scales between two opposite adjectives (e.g., satisfied to dissatisfied, good to bad; Huston & Vangelisti, 1991; Osgood, Suci, & Tannenbaum, 1957). Still others have developed multidimensional approaches. For example, on the Positive and Negative Quality in Marriage Scale (PANQIMS; Fincham & Linfield, 1997), partners evaluate the positive and negative qualities of their partner and relationship, and are subsequently categorized as happy (high positive and low negative), distressed (low positive and high negative), ambivalent (high on both positive and negative), or indifferent (low on both positive and negative). In contrast to the wealth of attention paid to assessing relationship satisfaction and adjustment, far less attention has been paid to the assessment of relationship quality. Some dimensions of relationship quality have received a lot of attention, such as communication and conflict management processes. Others have received almost no attention, such as
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emotional intimacy or decision-making/interpersonal control processes. Still others have received attention in other disciplines but have not been integrated into couple research or therapy, such as investigations of the quality of a couple’s sexual relationship. Among the measures designed to assess relationship quality, several conceptual and methodological limitations hinder their utility. First, these measures are typically specific to one dimension such as conflict management, rather than capturing the multidimensional nature of relationship quality. Second, existing measures of relationship quality are often confounded with the constructs of satisfaction or adjustment. Specifically, these measures include items that tap into both relational processes and satisfaction.
Method of Assessment: Questionnaires, Behavioral Observations, and Clinical Interviews Couple researchers and clinicians have long used self-report questionnaires to quantify dyadic processes in basic research and to guide couple interventions. Unfortunately, selfreport questionnaires are vulnerable to biases including social desirability (Godoy et al., 2008; Kluemper, 2008), depressed mood and depressive cognitions (e.g., Cohen, Towbest, & Flocco, 1988; Raselli & Broderick, 2007), memory biases in retrospective reports (Karney & Frye, 2002), and cognitive dissonance (e.g., newlyweds may be more likely to present couple processes in a positive light because they have just gotten married and do not want to consider the possibility that their marriage already has difficulties; McNulty, O’Mara, & Karney, 2008; Miller, Niehuis, & Huston, 2006). Behavioral observation tasks were developed to deal with these problems, and our ability to understand couple processes across domains improved. However, observational methods are costly and time-consuming, and as such are less likely to be widely adopted by clinicians in the near future. Moreover, although standardized, psychometrically sound interaction protocols exist to assess couples’ transactions with established coding systems, there is no network at present that can readily and conveniently code these interactions and provide results in a timely manner. In sum, although an important methodological development in couple research methodology, behavioral observation tasks are unlikely to become standardized assessment tools for couple therapists. In addition to self-report questionnaires and behavioral observation tasks, clinical interviews are often used to gather information during an assessment. Outside of the close relationships field, The Structured Clinical Interview for the Diagnostic Statistical Manual (SCID; First et al., 1995), a standardized interview for assessing Axis I DSM disorders, is often used. The Adult Attachment Interview (AAI; George, Kaplan, & Main, 1985) is also routinely used by researchers studying attachment processes. There are several advantages to employing clinical interviews rather than behavioral observation data in couple research. First, clinical interviews allow the objective coder to consider partners’ perceptions when evaluating the relationship; however, the biases of selfreport are still omitted (e.g., Morrison & Hunt, 1996). Second, interviews allow for a more global perception of dyadic processes as opposed to behavioral observation data that provide a snapshot of a particular type of interaction. Third, once an interviewer is trained to reliability, administering and coding clinical interviews is typically faster and less expensive than coding behavioral observation data. Fourth, clinical interviews are more likely to be embraced by clinicians compared to behavioral observation methods. This latter advantage
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could have important implications for the future of couple assessment and intervention, including helping to facilitate a move toward the standardization of couple assessments, and bridging the gap between couple researchers and clinicians. (See Section 4 of this chapter for a detailed discussion of clinical implications.) There have been isolated efforts to develop and validate structured interviews for couple research and therapy. For example, the Structured Diagnostic Interview for Marital Distress and Partner Aggression (Heyman et al., 2001) allows researchers and clinicians to reliably and validly diagnose couples in terms of relationship distress and physical aggression. The content of the interview is similar to that of the Dyadic Adjustment Scale (Spanier, 1976) and the Conflict Tactics Scales (Straus et al., 1996), and the format is similar to that of the SCID. However, no interview exists to assess the construct of relationship quality. Therefore, as we describe in the next section, we sought to develop an interview-based approach to quantifying important dimensions of relationship quality.
SECTION 2: DIMENSIONS OF RELATIONSHIP QUALITY AND THE RELATIONSHIP QUALITY INTERVIEW As we began to develop our interview, we sought to be comprehensive in our examination of the dimensions of relationship quality that would influence the longitudinal course of relationship satisfaction and stability. Therefore, we first conducted an exhaustive review of the close relationships literature across multiple disciplines (e.g., social and clinical psychology, communication studies, family studies, sociology). In this section, we summarize our review and describe how it guided the development of the interview.
Dimensions of Relationship Quality The overwhelming majority of research in the close relationships field has been focused on the quality of a couple’s ability to solve problems and conflicts. Theories of intimate relationships and of the determinants of relationship outcomes (e.g., Christensen & Walczynski, 1997; Gottman, Swanson, & Murray, 1999), a great deal of the empirical research on intimate relationships, most observational research on intimate relationships, reviews on dyadic interactions (e.g., Karney & Bradbury, 1995; Weiss & Heyman, 1997), and most existing psychological interventions for couple distress (e.g., Behavioral Marital Therapy; Jacobson & Holtzworth-Munroe, 1986; Prevention and Relationship Enhancement Program; Floyd, Markman, Kelly, Blumberg, & Stanley, 1995) have targeted relationship conflict. Within the last decade or so, there has been a tremendous increase in attention to the role of partner support as an adaptive dyadic skill (e.g., Gable, Gonzaga, & Strachman, 2006; Neff & Karney, 2005; Pasch & Bradbury, 1998). Other researchers have focused specifically on emotional intimacy (e.g., Barnes & Sternberg, 1997; Barry, Lawrence, & Langer, 2008; Cordova, Gee, & Warren, 2005; Laurenceau et al., 2005), the quality of a couple’s sexual relationship (e.g., Henderson-King & Veroff, 1994; LoPiccolo, Heiman, Hogan, & Roberts, 1985), and respect or control (e.g., Gray-Little & Burks, 1983; Ehrensaft, Langhinrichsen-
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Rohling, Heyman, & Lawrence, 1999; Huston, 1983; Whisman & Jacobson, 1990). (See Lawrence et al., 2008 for a detailed review of the literature.) Across these studies of relationship quality, researchers typically examine only one or two domains of dyadic processes per sample, which presumably grossly underestimates the complexity of relationship quality. Moreover, many of these studies did not statistically examine sex differences in relationship quality, which may lead to an incomplete, skewed, or inaccurate conceptualization of intimate relationships and, consequently, to interventions that are limited in their effectiveness. This literature has also suffered from methodological limitations, including measurement issues (such as the use of self-report measures of relational behaviors that may be influenced by social desirability and cognitive dissonance, particularly among couples in new relationships), shared method variance, retrospective data, heterogeneous samples and cross-sectional designs. Consequently, we sought to begin to overcome these limitations and provide a novel way to assess the dimensions of relationship quality.
Dimensions of Relationship Quality Included in the Relationship Quality Interview (RQI) Based on our review, we identified five dimensions of relationship quality: (1) communication and conflict management, (2) inter-partner support, (3) emotional closeness and intimacy, (4) quality of the sexual relationship, and (5) respect, power, and control. We operationalized communication and conflict management as comprising frequency and length of arguments, verbal, psychological and physical aggression during arguments, withdrawal during arguments, emotions experienced and behaviors expressed before, during and after arguments, and conflict resolution strategies. In accord with Cutrona and colleagues’ work (e.g., Cutrona, Russell, & Gardner, 2005), inter-partner support was operationalized as comprising four types of support when one partner has had a bad day, is feeling down, or has a problem: emotional support (talking and listening to each other, holding hands, hugging, letting one’s partner know s/he understands), direct or indirect tangible support (direct support: helping one’s partner solve the problem or make the situation better; indirect support: providing time or resources so that one’s partner is better able to solve the problem him- or herself, e.g., providing childcare), informational support (giving advice, providing one’s partner with information, helping one’s partner think about a problem in a new way), and esteem support (expressing confidence in the partner’s ability to handle things, telling one’s partner s/he is not to blame for a problem). Match between types of support desired and types of support provided, and the extent to which support is offered in a positive or negative manner, are also assessed. Emotional closeness and intimacy was operationalized as comprising emotional closeness (an overall mutual sense of closeness, warmth, affection, and interdependence), quality of the couple’s friendship, and demonstrations of love and affection (quantity and quality of love and affection expressed in the relationship, including verbal and physical expressions of love). We operationalized quality of the sexual relationship as comprising the quality of the sexual relationship (frequency of sexual activity, symmetry in initiation of sexual activity, satisfaction, negative emotions, sexual difficulties, concerns) and sensuality (touching, hugging, cuddling, massage, the extent to which sensuality exists separate from sexual activity in the relationship). Finally, respect, power, and control was
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operationalized as comprising mutual acknowledgement of competence and independence; acceptance and positive regard for the other even when one disagrees with him or her, a/symmetry in decision-making across a variety of areas, partners’ satisfaction with that division of responsibility, and a couple’s ability to negotiate control across a variety of areas (e.g., scheduling one’s own day, controlling money).
The Relationship Quality Interview (RQI) Once we converged upon and operationalized our dimensions of relationship quality, we generated a pool of potential items. A team of six psychology pre-doctoral and doctoral students specializing in couple relationships sorted the items into the different relationship categories. Items were deleted if there was less than 80% agreement among raters on their classification. Next we conducted three pilot studies in which we administered the interview to dating, cohabiting, and married couples; the RQI was revised after each pilot study. The final version of the RQI is described herein. The RQI is a 60-minute semi-structured interview administered indvidually to each partner. After obtaining information on relationship history, participants are asked to describe the quality of their relationship across the five different dimensions over the past six months. Open-ended questions -- followed by a series of closed-ended questions -- are asked to allow novel contextual information to be obtained. During the individual’s description of each dimension of relationship quality, the interviewers probe using detailed behavioral indicators and exemplars of each area. Participants’ responses also guide decisions about which subsequent questions are asked. Interviewers independently rate the relationship on each domain. Ratings may range from 1-5 and scores of .5 (e.g., 3.5) are permissible. We use objective interviewer ratings to control for the possibility that self-reports of relationship functioning might be influenced by factors such as global relationship satisfaction, depression or social desirability. The use of objective ratings also allows us to control for the possibility that couples in the early stages of a relationship (e.g., dating for only a few months, newly married) might experience cognitive dissonance when discussing potential weaknesses or problems in their relationships, which might influence their selfreports of the quality of their relationship.
SECTION 3: RELIABILITY AND VALIDITY OF THE RELATIONSHIP QUALITY INTERVIEW (RQI) In this section we provide preliminary evidence for the reliability and validity of the RQI in dating and newlywed couples. First, we assessed reliability, convergent validity, and divergent validity. Second, we examined the generalizability of the RQI across dating and marital relationships and across men and women. Third, we examined the utility of the RQI to assess risk of relationship distress over and above existing self-report measures and behavioral observation methods. (Please see Lawrence et al., 2008 for a detailed presentation of these analyses.)
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Samples Recruited to Assess Reliability and Validity of the RQI Sample 1 comprised 101 married couples recruited through marriage license records from suburban communities and small towns in Iowa. Couples dated an average of 48 months (SD = 27.79) prior to marriage and 77% of them cohabited. Average estimated annual joint income of couples was between $30,001- $40,000. Husbands’ average age was 25.91 (SD = 3.09) and their modal years of education were 14 years. Wives’ average age was 24.5 (SD = 3.46) and their modal years of education were also 14 years. For 15% of the couples, at least one member of the couple identified him or herself as a member of an ethnic minority group. Sample 2 comprised 91 individuals in heterosexual romantic relationships lasting at least two months. Participants were enrolled in an introductory psychology course at The University of Iowa. They ranged in age from 18 to 27 (M = 18.27 years, SD = 1.03 years) and were predominantly Caucasian/Non-Hispanic (96.7%). Most participants defined their relationships as “seriously dating” (96%). Only 1.1% were cohabiting, and relationship duration ranged from 2 months to 5 years (M = 17.16 months, SD = 13.26). On a 1-5 scale, interviewers’ mean ratings ranged from 3.35 to 4.20 across the two samples and across all five RQI scales. On average, couples’ relationship quality ranged from “good” to “very good,” as expected in samples of dating or newlywed couples. Moreover, scores on all domains yielded normal distributions, suggesting that there was adequate range in relationship quality across participants in each of the five domains.
Reliability Analyses We examined the reliability of the RQI in three ways. First, to assess inter-rater reliability, 20% of the audio-taped interviews were randomly assigned to a second coder. Intra-class correlations were above .70 across all five RQI scales for husbands’ and wives’ interviews in the marital sample and for participants in the dating sample. Second, we examined whether interviewers’ ratings on the RQI scales differed as a function of whether the interviewer was speaking to the husband or the wife of a given couple. There were no significant differences among interviewer ratings based on whether the male or female partner was interviewed (ts(100) ranged from .51 to 1.17, all ns). Third, we examined within-subject associations among RQI scales. Correlations among RQI subscales ranged from .25 to .65, supporting our contention that the subscales are best conceptualized as related dimensions of the underlying construct of relationship quality, yet these subscales capture conceptually distinct (albeit related) dimensions of relationship quality. (There was one exception to this pattern: in the marital sample, Inter-Partner Support and Respect, Power, and Control were strongly correlated, with correlations of .65 and .70 for husbands and wives, respectively.)
Agreement with Self-Report Questionnaires and Behavioral Observations We examined the extent to which RQI interview scales correlated with existing measures -- self-report questionnaires and behavioral observations -- of these same relationship dimensions. We expected correlations between RQI scales and self-report questionnaires, and between RQI scales and behaviorally observed data, to generally be low for two reasons.
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First, our assertion is that the RQI interview provides a more valid measure of relationship quality in each of the assessed domains. Thus we did not operationalize our constructs in the same way as they were operationalized in the existing measures. Second, the RQI is the first interview of relationship quality. Therefore, we cannot examine convergent validity of the RQI by comparing it to an existing interview. Instead we are comparing RQI scales to measures of similar constructs assessed with different methods. This method variance is expected to generate lower correlations than if our method was the same but our constructs differed. First we examined the correlations between the RQI subscales and self-report measures of relationship quality in the relevant domains. Self-report measures included: (a) the Problem Solving Communication (PSC) and Affective Communication (AFC) subscales from The Marital Satisfaction Inventory-Revised (MSI-R; Snyder & Aikman, 1999) to measure negative communication and conflict management patterns, and (b) a modified version of The Support in Intimate Relationships Rating Scale (SIRRS; Dehle et al., 2001) to assess perceptions of support amount from one’s partner and support adequacy (see Barry et al., in press for details and psychometric properties of the revised SIRRS). The RQI scales were weakly to moderately correlated with the self-report questionnaires. Correlations ranged from .24 to .56 in the marital sample, and from .03 to .23 in the dating sample. Next we examined the correlations between the RQI subscales and behavioral observations of relationship quality in the relevant domains. (Behavioral observation data were only available in the marital sample.) Behavioral observation indices of relationship quality included: (a) an inter-partner support interaction task and the Social Support Interaction Coding System (SSICS; Pasch, Harris, Sullivan, & Bradbury, 2002), a system that assesses the behaviors exchanged by partners during a supportive discussion, and (b) a problem-solving interaction task and the Specific Affect Coding System – Revised (SPAFFR; Gottman McCoy, & Coan, 1996), designed to measure positive and negative affect expressed during a problem-solving discussion. Correlations between RQI scales and behavioral observations of related constructs were weak, ranging from .05 to .25, supporting our contention that the RQI captures markedly distinct constructs from what is captured via behavioral observation interaction tasks.
Discriminant Validity Three aspects of discriminant validity were considered. First, Campbell and Fiske (1959) stated that a good convergent/discriminant validity pattern exists when matched variables correlate more highly with each other than with any other variable. Thus we examined whether the inter-correlations among RQI scales were higher than the correlations between RQI scales and measures of similar constructs collected via different methods. In general, this target pattern was clearly obtained for all five RQI scales in both samples. For each RQI scale, the correlations with other RQI scales (convergent validity) were generally larger than correlations with questionnaire or behavioral observation data. This support was evident for husbands and wives, and across marital and dating participants. Three of the four RQI Scales – Emotional Closeness and Intimacy, Inter-Partner Support, and Respect, Power, and Control – clearly met the Campbell and Fiske test for excellent convergent and discriminant validity. In contrast, there was mixed but generally strong evidence regarding the RQI Communication
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and Conflict Management Scale. The scale did not meet Campbell and Fiske’s criteria when compared to self-report questionnaires in the dating sample, nor when compared to behavioral observation data in the marital sample. Moreover, the RQI Communication and Conflict Management Scale was only moderately correlated with the corresponding self-report questionnaires. However, this moderate correlation was similar to the moderate correlations between the RQI Communication and Conflict Management scale and the other RQI scales (which range from .40 to .63); thus, it does meet the Campbell and Fiske criteria in that regard. Second, we examined associations between RQI scales and a measure of global relationship satisfaction (Quality of Marriage Index; Norton, 1983) to determine whether the RQI simply captures satisfaction rather than relationship quality across multiple domains. Correlations were low to moderate for husbands and wives (rs ranged from .35 to .46) and low for dating participants (rs ranged from .002 to .22), supporting our contention that the RQI is not simply a measure of global relationship satisfaction. Third, the associations between the RQI scales and related traits were examined to determine whether RQI scores discriminated between (a) functioning within one’s relationship on a given dimension and (b) individual differences in interpersonal functioning across relationships. For example, we compared the Emotional Closeness and Intimacy scale to measures of global detachment, mistrust, and avoidant attachment. We measured individual differences by administering: (a) the Negative Temperament, Detachment, Mistrust, and Manipulativeness scales from The Schedule for Nonadaptive and Adaptive Personality - 2nd Edition (SNAP-2; Clark, Simms, Wu, & Casillas, in press); (b) the Anger and Hostility Scales from The Buss-Perry Aggression Questionnaire (Buss & Perry, 1992); and the Relationship Scales Questionnaire (RSQ; Griffin & Bartholomew, 1994) and the Experiences in Close Relationships – Revised scale (ECR-R; Fraley, Waller, & Brennan, 2000). Correlations between RQI subscales and individual difference measures of related constructs (e.g., avoidant attachment, mistrust, detachment, negative temperament, hostility) were weak, ranging from .004 to .3 (with one exception at .5), supporting our contention that the RQI scales capture constructs that are unique to one’s current intimate relationship rather than being indicative of individual differences that might be present across multiple types of relationships (e.g., friends, acquaintances, co-workers).
Incremental Validity Analyses Finally, we gathered preliminary evidence for the utility of the RQI to assess risk of relationship distress over and above existing self-report measures and behavioral observation methods. In addition to our assertions that (a) a clinical interview will be more user-friendly for clinicians, and (b) our interview provides a better measure of the constructs of interest (compared to existing self-report questionnaires and behavioral observational data), we also expected the RQI scales to predict global relationship satisfaction over and above these existing measures. We examined the incremental utility of each RQI scale when predicting cross-sectional and longitudinal (three-year) satisfaction for men and women. First we examined the incremental utility of the RQI in explaining cross-sectional relationship satisfaction. In the marital sample, three of the four RQI scales – Emotional Closeness and Intimacy, Inter-partner Support, and Respect, Power, and Control –
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demonstrated incremental explanatory power (bs > 1.44, ps < .05). In the dating sample, two scales -- Emotional Closeness and Intimacy, and Communication and Conflict Management -demonstrated incremental predictive power (bs > .25, ps < .05). Next we examined the RQI’s incremental utility in predicting longitudinal (3-year) relationship satisfaction in the marital sample. Two of the four RQI scales – Emotional Closeness and Intimacy and Respect, Power, and Control – demonstrated incremental utility in predicting husbands’ – but not wives’ – longitudinal marital satisfaction (bs > 2.46, ps < .05).
SECTION 4: CLINICAL IMPLICATIONS OF THE RQI FOR COUPLE ASSESSMENT AND PREVENTION EFFORTS In this section we discuss clinical implications at two levels. First, we discuss the generalizability of the RQI itself based on the data presented in Section 3. Second, we discuss the broader clinical implications of the RQI for improving couple assessment and prevention efforts.
Generalizability of the RQI We examined the generalizability of the RQI in two ways. First we examined its generalizability across men and women. The RQI yielded strong psychometric data for men and women. Second, we found that the RQI demonstrated reliability, validity, and incremental utility across dating and marital relationships. As the proportion of couples who cohabit and/or date for many years prior to marriage increases, greater attention is being given to the study of pre-marital relationships (e.g., Brown & Booth, 1996; Stanley, Rhoades, & Markman, 2006). Additionally, it has been suggested that patterns that develop early in relationships (i.e., even before marriage) are important for individual and dyadic outcomes (Cutrona et al., 2005). Thus, patterns of relationship quality that emerge during courtship likely impact individual and relationship functioning. Despite this potential importance, little work has addressed whether relationship quality functions similarly in dating and marital relationships. As expected, the pattern of findings was stronger in the analyses of the marital sample compared to the dating sample. The longer duration and stronger commitment of the married participants would presumably lead to greater utility of the RQI in such a sample. The next step is to examine the psychometric properties of the RQI in distressed samples of couples, such as in a sample of couples seeking therapy. We would expect the pattern of results to be similar, if not stronger, to those found in the marital sample. More generally, as the intimate relationship becomes more solidified and more central to one’s life, we would expect the RQI to have greater utility and for the interview to demonstrate stronger convergent and divergent validity when administered. There are several ways in which the generalizability of the RQI can be expanded in future research. First, although the RQI was developed as an assessment tool for young couples and to be administered in accord with prevention programs, it seems just as likely that it could be used as part of a standardized assessment protocol for treatment-seeking and/or distressed couples and to guide treatment for those couples. Before we can recommend that the RQI be
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used in this way, we must first assess the reliability and validity of the RQI in distressed, established, and/or treatment-seeking couples. Second, the reliability and validity of the RQI should be examined with same-sex couples and couples at other stages of their relationships (e.g., cohabiting couples, engaged couples, couples experiencing the transition to parenthood). Finally, other dimensions of relationship quality might be worth incorporating more fully into the RQI, such as fun and leisure time and quality of the couple’s friendship.
Implications for Couple Assessment and Prevention Efforts There are several implications of the RQI for couple assessment and intervention efforts. First, the RQI is intended to be used as part of a standardized assessment battery for couple interventions. For example, it can be administered to couples and then incorporated into a feedback session in which relationship strengths/protective factors and relationship risk factors/vulnerabilities are emphasized. By quantifying relative strengths and weaknesses across multiple dimensions of a relationship, feedback may be more palatable to couples. Second, the RQI might function as a motivational tool to increase couples’ participation in prevention programs or treatments. Cordova and colleagues (Cordova et al., 2005; Gee, Scott, Castellani, & Cordova, 2002) developed an indicated intervention program called the Marriage Checkup based on the principles of motivational interviewing. As they describe, prior to dissolution, it is likely that couples that become severely distressed first pass through an at-risk stage in which they experience early symptoms of marital deterioration but have not yet suffered irreversible damage to their marriage. It is during this at risk stage that couples might benefit most from early intervention. To date, they have found evidence for the attractiveness, tolerability, efficacy, and mechanisms of change produced by the Marriage Checkup, as well as its ability to predict marital satisfaction two years later. In line with this important work, it is possible that the RQI could be modified and tested as a motivational interview for at risk couples as well. Third, because the RQI can be used to identify domains of strength and weakness in couples’ relationships, it might be useful as a tool to identify at risk couples for prevention programs. To date, studies of leading preventive interventions have not fared well at recruiting couples at risk for adverse marital outcomes. Published samples have been disproportionately Caucasian, well educated, and middle class (see Carroll & Doherty, 2003, for a review). However, divorce rates are markedly higher among African American couples (70% vs. 47% in Caucasian couples), among couples who do not finish high school (60% vs. 36% for college graduates), and among couples who start marriage with children (rates of divorce are twice as high as couples who marry without children; Raley & Bumpass, 2003). Despite their omission from prevention programs, couples in these high-risk populations report high levels of interest in participating in these interventions (Johnson et al., 2002). In sum, relationship enhancing interventions appear to have failed to test their programs in the populations at greatest risk for distress and divorce. Administering the RQI prior to implementing a prevention program might allow at risk couples to be identified, while simultaneously being used as a motivational tool to encourage these at risk couples to participate in these prevention interventions. Fourth, intervention programs can be better tailored to the needs of specific couples, rather than implementing a “one size fits all” approach. For example, a couple’s RQI data
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may indicate strong quality of communication and conflict management skills but poor quality of inter-partner support. In this case, intervention techniques specific to improving the quality of support in that relationship would presumably be more appropriate, whereas intervention techniques targeting conflict management skills would be unnecessary. This approach seems more beneficial for treating couples and more cost-effective from a health care perspective.
REFERENCES Barry, R.A., Bunde, M., Brock, R.L., & Lawrence, E. (in press). Validity and utility of a multidimensional model of received support in intimate relationships. Journal of Family Psychology. Barry, R.A., Lawrence, E., & Langer, A. (2008). Conceptualization and assessment of disengagement in romantic relationships. Personal Relationships, 15, 297-315. Brown, S. L., & Booth, A. (1996). Cohabitation versus marriage: A comparison of relationship quality. Journal of Marriage and Family, 58, 668-678. Busby, D.M., Holman, T.B., Taniguchi, N. (2001). RELATE: Relationship evaluation of the individual, family, cultural, and couple contexts. Family Relations, 50, 308-316. Buss, A. H., & Perry, M. P. (1992). The aggression questionnaire. Journal of Personality and Social Psychology, 63, 452-459. Campbell, D.T., & Fiske, D.W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, 81-105. Carroll, J.S., & Doherty, W.J. (2003). Evaluating the effectiveness of premarital prevention programs: A meta-analytic review of outcome research. Family Relations, 52, 105-118. Christensen, A., & Walczynski, P. T. (1997). Conflict and satisfaction in couples. In R. J. Sternberg & M. Hojjat (Eds.), Satisfaction in close relationships (pp. 249–274). NY: Guilford. Clark, L. (1993). Manual for the Schedule for Nonadaptive and Adaptive Personality. MN: University of Minnesota Press. Clark, L.A., Simms, L.J., Wu, K.D., & Casillas, A. (in press). Schedule for Nonadaptive and Adaptive Personality (2nd ed.). MN: University of Minnesota. Cohen, L.H., Towbes, L.C., & Flocco, R. (1988). Effects of induced mood on self-reported life events and perceived and received social support. Journal of Personality and Social Psychology, 55, 669-674. Cordova, J. V., Gee, C. B., Warren, L. Z. (2005). Emotional skillfulness in marriage: Intimacy as a mediator of the relationship between emotional skillfulness and marital satisfaction. Journal of Social and Clinical Psychology, 24, 218-235. Cutrona, C.E., Russell, D.W., & Gardner, K.A. (2005). The relationship enhancement model of social support. In T.A. Revenson, K. Kayser & G. Bodenmann (Eds.), Couples coping with stress (pp. 3-23). DC: APA. Cutrona, C.E., & Suhr, J.A. (1992). Controllability of stressful events and satisfaction with spouse support behaviors. Communication Research, 19, 154-174. Cutrona, C.E., & Suhr, J.A. (1994). Social support communication in the context of marriage: An analysis of couples’ supportive interactions. In B.R. Burleson, T.L. Albrecht & I.G.
186
Erika Lawrence, Robin A. Barry, Rebecca L. Brock et al.
Sarason (Eds.), Communication of social support: Messages, interactions, relationships, and community (pp. 113-135). CA: Sage. Dehle, C., Larsen, D., & Landers, J.E. (2001). Social support in marriage. American Journal of Family Therapy, 29, 307–324. Ehrensaft, M.K., Langhinrichsen-Rohling, J., Heyman, R.E., O’Leary, K.D., & Lawrence, E. (1999). Feeling controlled in marriage: A phenomenon specific to physically aggressive couples? Journal of Family Psychology, 13, 20-32. Fincham, F.D., & Linfield, K.J. (1997). A new look at marital quality: Can spouses feel positive and negative about their marriage? Journal of Family Psychology, 11, 489-502. First, M.B., Gibbon, M., Spitzer, R.L., & Williams, J.B.W. (1997). Structured Clinical Interview for DSM–IV Axis I Disorders—Clinician version. Washington, DC: American Psychiatric Association. Floyd, F.J., Markman, H.J., Kelly, S., Blumberg, S.L., & Stanley, S.M. (1995). Preventive intervention and relationship enhancement. In N. S. Jacobson & A. S. Gurman (Eds.), Clinical handbook of couple therapy (pp. 212-226). NY: Guilford. Fraley, R.C., Waller, N.G., & Brennan, K.A. (2000). An item response theory analysis of selfreport measures of adult attachment. Journal of Personality and Social Psychology, 78, 350-365. Gable, S.L., Gonzaga, G.C., & Strachman, A. (2006). Will you be there for me when things go right? Supportive responses to positive event disclosures. Journal of Personality and Social Psychology, 91, 904-917. Gee, C.B., Scott, R.L., Castellani, A.M., & Cordova, J.V. (2002). Predicting 2-year marital satisfaction from partners’ discussion of their marriage checkup. Journal of Marital and Family Therapy, 28, 399-407. Geiss, S., & O’Leary, K. (1981). Therapist ratings of frequency and severity of marital problems: Implications for research. Journal of Marital & Family Therapy, 7, 515-520. George, C., Kaplan, N., & Main, M. (1985). The Berkeley adult attachment interview. Unpublished protocol. University of California, Berkeley. Godoy, R., Reyes-Garcia, V., Tanner, S., Leonard, W.R., McDade, T.W., & Huanca, T. (2008). Can we trust an adult's estimate of parental school attainment? Disentangling social desirability bias and random measurement error. Field Methods, 20, 26-45. Gottman, J., McCoy, K., & Coan J. (1996). The Specific Affect Coding System. In J. Gottman (Ed.) What predicts divorce? The measures (pp. 561). NJ: Erlbaum. Gottman, J.M., Swanson, C., & Murray, J. (1999). The mathematics of marital conflict: Dynamic mathematical nonlinear modeling of newlywed marital interaction. Journal of Family Psychology, 13, 3-19. Gray-Little, B., & Burks, N. (1983). Power and satisfaction in marriage: A review and critique. Psychological Bulletin, 93, 513– 538. Griffin, D.W., & Bartholomew, K. (1994). The metaphysics of measurement: The case of adult attachment. In K. Bartholomew & D. Perlman (Eds.), Attachment processes in adulthood: Henderson-King, D.H., & Veroff, J. (1994). Sexual satisfaction and marital well-being in the first years of marriages. Journal of Social and Personal Relationships, 11, 509–534. Heyman, R.E., Feldbau-Kohn, S.R., Ehrensaft, M.K., Langhinrichsen-Rohling, J., & O’Leary, K.D. (2001). Can questionnaire reports correctly classify relationship distress and partner physical abuse? Journal of Family Psychology, 15, 334–346.
Assessing Relationship Quality
187
Heyman, R.E., Sayers, S.L., & Bellack. A.S. (1994). Global marital satisfaction versus marital adjustment: An empirical comparison of three measures. Journal of Family Psychology, 8, 432-446. Huston, T.L. (1983). Power. In H.H. Kelley, E. Berscheid, A. Christensen, J.H. Harvey, T.L. Huston, G. Levinger, E. McClintock, L.A. Peplau, & D.R. Peterson (Eds.), Close relationships (pp. 169-219). NY: Freeman. Huston, T.L., & Vangelisti, A.L. (1991). Socioemotional behavior and satisfaction in marital relationships: A longitudinal study. Journal of Personality and Social Psychology, 61, 721-733. Jacobson, N.S., & Holtzworth-Munroe, A. (1986). Marital therapy: A social learning/ cognitive perspective. In N. S. Jacobson & A. S. Gurman (Eds.), Clinical handbook of marital therapy (pp. 29-70). NY: Guilford. Karney, B. R., & Bradbury, T. N. (1995). The longitudinal course of marital quality and stability: A review of theory, method, and research. Psychological Bulletin, 118, 3-34. Karney, B.R., & Frye, N.E. (2002). "But we've been getting better lately": Comparing prospective and retrospective views of relationship development. Journal of Personality and Social Psychology, 82, 222-238. Kluemper, D.H. (2008). Trait emotional intelligence: The impact of core-self evaluations and social desirability. Personality and Individual Differences, 44, 1402-1412. Kurdek, L. A. (2002). On being insecure about the assessment of attachment styles. Journal of Social and Personal Relationships, 19, 811-834. Larson, J.H., Newell, K., Topham, G., & Nichols, S. (2002). A review of three comprehensive premarital assessment questionnaires. Journal of Marital and Family Therapy, 28, 233-239. Laurenceau, J., Barrett, L.F., & Rovine, M.J. (2005). The interpersonal process model of intimacy in marriage: A daily-diary and multilevel modeling approach. Journal of Family Psychology, 19, 314-323. Lawrence, E., Barry, R.A., Brock, R.L., & Langer, A. (in press). Assessment of marital satisfaction. In H. Reis & S. Sprecher (Eds.), Encyclopedia of Human Relationships. Thousand Oaks, CA: Sage. Lawrence, E., Barry, R.A., Brock, R.L., Bunde, M., Ro, E., Fazio, E., Mulryan, L., Hunt, S., Madsen, L., & Dzankovic, S. (2008). An interview to assess couple functioning across multiple domains: Preliminary support for reliability, convergent and divergent validity, and incremental and predictive validity. Manuscript submitted for publication. Locke, H.J., & Wallace, K.M. (1959). Short marital adjustment and prediction tests: Their reliability and validity. Marriage and Family Living, 21, 251–255. LoPiccolo, J., Heiman, J.R., Hogan, D.R., & Roberts, C.W. (1985). Effectiveness of single therapists versus cotherapy teams in sex therapy. Journal of Consulting and Clinical Psychology, 53, 287-294. Markey, B., & Micheletto, M. (1997). Instructor manual for FOCCUS. Omaha, NE: Archdiocese of Omaha. McNulty, J.K., O'Mara, E.M., & Karney, B.R. (2008). Benevolent cognitions as a strategy of relationship maintenance: "Don't sweat the small stuff"....But it is not all small stuff. Journal of Personality and Social Psychology, 94, 631-646. Miller, P.J. E., Niehuis, S., & Huston, T.L. (2006). Positive illusions in marital relationships: A 13-year longitudinal study. Personality and Social Psychology Bulletin, 32, 1579-1594.
188
Erika Lawrence, Robin A. Barry, Rebecca L. Brock et al.
Morrison, A.T., & Hunt, H.T. (1996). "Reals", "roles", and demand features: A critical look at interview versus questionnaire measures of subjective states. Canadian Psychology, 37, 112-119. Neff, L.A., & Karney, B.R. (2005). Gender differences in social support: A question of skills or responsiveness? Journal of Personality and Social Psychology, 88, 79-90. Norton, R. (1983). Measuring marital quality: A critical look at the dependent variable. Journal of Marriage and the Family, 45, 141-151. Olsen, D. H., Fournier, D. H., & Druckman, J. M. ( 1996). PREPARE. Minneapolis, MN: Life Innovations. Osgood, C.E., Suci, G.J., & Tannenbaum, P.H. (1957). The measurement of meaning. Urbana, IL: University of Illinois Press. Pasch, L.A., & Bradbury, T.N. (1998). Social support, conflict, and the development of marital dysfunction. Journal of Consulting and Clinical Psychology, 66, 219-230. Pasch, L.A., Harris, K.M., Sullivan, K.T., & Bradbury, T.N. (2002). The social support interaction coding system. In P. Kerig & D. Baucom (Eds.), Couple observational coding systems. Mahwah, NJ: Lawrence Erlbaum & Associates. Prescott, A., Bank, L., Reid, J. B., Knutson, J. F., Burraston, B. O., & Eddy, J. M. (2000). The veridicality of retrospective reports of punitive childhood experiences. Child Abuse and Neglect, 24, 411-423. Raley, R.K. (2003). The topography of the divorce plateau: Levels and trends in union stability in the United States after 1980. Demographic Research, 8, 245-260. Raselli, C., & Broderick, J.E. (2007). The association of depression and neuroticism with pain reports: A comparison of momentary and recalled pain assessment. Journal of Psychosomatic Research, 62, 313-320. Reynolds, S. K., & Clark, L. A. (2001). Predicting personality disorder dimensions from domains and facets of the five factor model. Journal of Personality, 69, 199–222. Schramm, D.G., Marshall, J.P. Harris, V.W., & Lee, T.R. (2005). After "I do": The newlywed transition. Marriage and Family Review, 38, 45-67. Schumm, W.R., Paff-Bergen, L.A., Hatch, R.C., Obiorah, F.C., Copeland, J.M., Meens, L.D., & Bugaighis, M.A. (1986). Concurrent and discriminant validity of the Kansas Marital Satisfaction Scale. Journal of Marriage and the Family, 48, 381–387. Simpson, J.A., Rholes, W.S., & Nelligan, J.S. (1992). Support seeking and support giving within couples in an anxiety-provoking situation: The role of attachment styles. Journal of Personality and Social Psychology, 62, 434-446. Snyder, D.K., & Aikman, G.G. (1999). Marital Satisfaction Inventory-Revised. In M.E. Maruish (Ed.), The use of psychological testing for treatment planning and outcomes assessment. (2nd ed., pp. 1173-1210). Mahwah, NJ: Erlbaum. Snyder, D.K., Heyman, R.E., & Haynes, S.N. (2005). Evidence-based approaches to assessing couple distress. Psychological Assessment, 17, 288-307. Spanier, G.B. (1979). The measurement of marital quality. Journal of Sex and Marital Therapy, 5, 288-300. Stanley, S.M., Rhoades, G.H., & Markman, H.J. (2006). Sliding vs. deciding: Inertia and the premarital cohabitation effect. Family Relations, 55, 499-509. Straus, M., Hamby, S., Boney-McCoy, & Sugarman, D. (1996). Revised Conflict Tactics Scales: Development and preliminary psychometric data. Journal of Family Issues, 17, 283-316.
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US Census Bureau Population Division (2007) Race and Hispanic or Latino origin in Iowa’s counties: 2006. Weiss, R.L., & Heyman, R.E. (1990). Marital distress. In A.S. Bellack, M. Hersen, & A.E. Kazdin (Eds.), International handbook of behavior modification and therapy (2nd ed.; pp. 475-501). NY: Plenum. Whisman, M.A., & Jacobson, N.S. (1990). Power, marital satisfaction, and response to marital therapy. Journal of Family Psychology, 4, 202-212. Xu, Y., & Burleson, B.R. (2001). Effects of sex, culture, and support type on perceptions of spousal social support: An assessment of the “support gap” hypothesis in early marriage. Human Communication Research, 27, 535-566.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 9
THE TENDENCY TO FORGIVE IN PREMARITAL COUPLES: RECIPROCATING THE PARTNER OR REPRODUCING PARENTAL DISPOSITIONS? F. Giorgia Paleari University of Bergamo, Italy
Silvia Donato, Raffaella Iafrate and Camillo Regalia Catholic University of Milan, Italy
ABSTRACT Although the tendency to forgive the partner has been shown to enhance personal and relational well-being, little is known about how this tendency originates. One possibility is that the tendency to forgive the partner develops as a function of the forgiveness exchanges people experience within their romantic relationships, thereby leading them to become more and more similar to the partner in their proneness to forgive. Another possible explanation is that social experiences people were exposed to within their own family of origin has led them to gradually internalize parental models and to become more and more similar to their parents in their willingness to forgive. These associations may be particularly evident during emerging adulthood, when engaged couples have to balance their family heritage and the forming of their new couple. The present work aimed at providing initial evidence in support of these hypotheses by investigating in a sample of premarital couples (N=165) and their parents the extent to which young adults’ tendency to forgive the partner was similar to the partner’s tendency to forgive them as well as to their mothers’ and fathers’ tendency to forgive one another. Dyads were the units of analysis and stereotype accuracy was controlled. Results indicate that young adults’ disposition to forgive the partner is similar to that of their partner and of their parents. Gender moderated these associations, as females were more similar to their parents than were males in their disposition to forgive. The findings are consistent with the idea that premarital couples, even though strongly involved in defining their own couple identity, are nonetheless affected by the forgiveness models to which they are exposed within their family of origin.
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INTRODUCTION Within the literature on close relationships, a body of evidence attests that forgiving a romantic partner has potential benefits for the well-being of the relationship and of the victim. In particular, there is evidence that in community couples forgiving the partner reduces psychological aggression, enhances intimacy and commitment in the relationship, promotes constructive communication, and has a positive influence on marital quality over time (Eaton & Struthers, 2006; Fincham & Beach, 2002, 2007; Paleari, Regalia & Fincham, 2005; Tsang, McCullough, & Fincham, 2006). Forgiveness toward the partner has also proven to enhance the victim’s overall mental and physical health (Berry & Worthington, 2001; Karremans, Van Lange, Ouwerkerk, & Kluwer, 2003; see also, Bono, McCullough, & Root, 2008), thereby helping the individual to maintain and restore a valuable close relationship, crucial to the victim’s human need of connectedness. Considering the great amount of attention that has been devoted to partner forgiveness as a predictor of relational and personal well-being, surprisingly little is known about how the tendency to forgive the partner originates. The purpose of the present research is to fill this gap in the literature, focusing particularly on the degree to which the tendency to forgive emerges from an individual’s relationship with an intimate partner and from his or her experiences in the family of origin. The tendency to forgive the partner can be defined as a general propensity to overcome avoidant, resentful or revengeful reactions (i.e., thoughts, feelings, intentions, and behaviors), and to develop benevolent and conciliatory ones, when facing the partner’s offences (e.g., Fincham, Hall, & Beach, 2005; Rye, Loiacono, Folck, Olszewski, Heim, & Madia, 2001; McCullough, Pargament, & Thoresen, 2000). Empirical support for this notion has been found by studies showing that the tendency to forgive the partner entails two correlated dimensions, a positive one, reflecting benevolent and conciliatory dispositions, and a negative one, involving resentful, vengeful, and/or avoidant inclinations (Fincham & Beach, 2002). Evidence of one single factor underlying the two dimensions has also recently been found (Maio, Thomas, Fincham, & Carnelley, 2008). The tendency to forgive the partner is more general than specific acts of forgiveness as it is assumed to be stable across multiple offences occurring within a romantic relationship. At the same time the tendency to forgive the partner is more specific than “forgivingness” (Berry, Worthington, Parrott, O’Connor, & Wade, 2001). Forgivingness is understood as the global disposition to forgive across multiple offences occurring in a variety of relationships and interpersonal situations, thus serving as a basis for more specific responses of forgiveness (Roberts, 1995), whereas the tendency to forgive the partner is linked more tightly to the particular history with the romantic partner (see also McCullough & Witvliet, 2002; Kachadourian, Fincham, & Davila, 2004). The tendency to forgive the partner and “forgivingness” have been shown to be related to personality dimensions such as trait empathy, emotional stability and agreeableness (McCullough & Witvliet, 2002; Mullet, Neto, & Rivière, 2005; Maio et al., 2008) which are known to be influenced by genetic factors (Tsuang, Eaves, Nir, Jerskey, & Lyons, 2005; Flint, 2004). This finding is sometimes used to support the argument that the tendency to forgive may have a biological root, which explains its relative stability across situations. Despite these possible genetic influences, the tendency to forgive the partner is likely to be affected by relationships experienced within one’s social network. In particular we
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maintain that two types of social experiences will be linked to one’s tendency to forgive the partner, namely those shared with the partner himself/herself and those shared within one’s own family of origin. This association may be particularly evident during “emerging adulthood” (Arnett, 2000), a distinct developmental period corresponding to the third decade of life (i.e., ages 20 to 30). During this period dating relationships are generally transformed into more serious romantic relationships (Furman, 2002) and engaged couples, more then ever before, have to acknowledge and balance the different heritage partners received from their families and the forming of their new couple (Cigoli & Scabini, 2006). A first possibility is that the tendency to forgive the partner emerges from partners’ shared experiences with one another, and especially from their forgiveness transactions, with each partner sometimes in the role of offender and other times in the role of victim (Hoyt et al., 2005). The norm of reciprocity suggests that the partner’s typical forgiving or unforgiving responses to one’s own relational transgressions are likely to be important determinants of one’s propensity to forgive future partner offences. Studies on negative reciprocity (e.g., Capaldi, Kim, & Shott, 2007; Cordova, Jacobson, Gottman, Rushe, & Cox, 1993) demonstrate that this norm may be particularly strong in couple relationships. In other words, given that partners’ interdependence is the defining feature of close relationships (Kelley et al., 1983), one’s willingness to forgive the partner is likely to be progressively modulated as a function of the disposition to forgive that the partner shows in the context of ongoing interactions. In this regard, a study by Hoyt and colleagues (2005) found tentative evidence indicating that the propensity to forgive the partner tends to be reciprocated in long term married couples. This evidence suggests that over time an individual’s proneness to forgive the partner may become similar to the partner’s. Another possible explanation for the development of the tendency to forgive the partner involves social experiences within one’s own family of origin. The disposition to forgive the partner may be transmitted across generations not only because of its potential heritable component, but also because of the parents’ role in socialization, a process that clearly continues throughout emerging adulthood (Arnett, 2007). According to Grusec (2002), parental socialization involves three specific goals - a) the development of self-regulation of emotion, thinking, and behavior¸ b) the acquisition of a culture’s standards, attitudes, and values, and c) the development of role-taking skills, strategies for resolving conflicts, and ways of viewing relationships - all of which are closely linked to forgiveness. Forgiveness has been judged of critical importance in strengthening self-regulatory processes through empowering powerless victims (e.g., Ahmed & Braithwaite, 2006) and has been repeatedly conceptualized and empirically examined as a crucial strategy to effectively cope with interpersonal and intergroup conflicts and to restore social relationships (e.g., Fincham, Beach, & Davila, 2004; Hoyt et al., 2005; Roe, 2007). Furthermore, given the high moral value that many religions place on it, forgiveness is viewed as a moral virtue and as a human strength across many cultures (e.g., Friesen & Fletcher, 2007; Rye et al., 2000). Thus, for a variety of reasons, parents may include forgiveness in their socialization practices. The transmission of values and behavioral patterns across generations has often been described in terms of internalization, a process whereby parental and societal values and behaviors are gradually integrated into the child’s self system, resulting in intergenerational similarity. As reviewed by Zentner and Renaud (2007), internalization concepts can be found within different theoretical approaches such as symbolic interactionism (Cooley, 1902; Mead, 1934), psychoanalysis (Freud, 1923/1961; Sandler & Rosenblatt, 1962; Meissner, 1981), and
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social learning (Aronfreed, 1968; Bandura, 1971). Even though parent-child similarity (or congruence) does not necessarily imply internalization, in the traditional sense of accurately perceiving parents’ positions and behaviors and integrating them into a coherent sense of self (Grusec & Goodnow, 1994; Zentner & Renaud, 2007), verifying the existence of such a similarity is undoubtedly the first step to examine whether internalization actually occurs across generations. Extant research provides evidence that parents and children are similar across a wide range of domains, including attitudes (e.g., Cashmore & Goodnow, 1985), values (e.g., Knafo & Schwartz, in press), ideal selves (Zentner & Renaud, 2007), perfectionism (Soenens et al., 2005) and empathy (Soenens, Duriez, Vansteenkiste, & Goossens, 2007). Research based on married offspring also indicates that parent and children are similar in the risk of marital instability (Amato & DeBoer, 2001), in their level of marital conflict, intimacy and individuation (Harvey, Curry, & Bray, 1991; Story, Karney, Lawrence & Bradbury, 2004). To our knowledge, only two studies provide data relevant to the hypothesis that the tendency to forgive is transmitted across generations. These studies, by Mullet and colleagues, show that parents and their adult children tend to be similar both in the conceptualization of forgiveness (Mullet, Girard, & Bakshi, 2004) and in the tendency to grant it (Mullet, Rivière, & Munoz Sastre, 2006). In particular, by distinguishing between different dimensions underlying “forgivingness,” Mullet and colleagues found that mother’s tendency to be resentful as well as fathers’ tendency to avenge or to grant forgiveness depending on contingent circumstances were linked to their children’s corresponding dispositions. Our main goal in the present study was to provide further evidence on forgiveness similarity across generations and across partners, by investigating the extent to which premarital engaged adult children’s tendency to forgive the partner was congruent a) with their parents’ tendency to forgive one another, thereby suggesting a possible internalization process by the children, and b) with their romantic partners’ tendency to forgive them, thereby indicating reciprocity within the premarital couple. We focused on adult children prior to marriage because, as previously observed, they were living a life transition during which they have to balance their family heritage and the forming of their new couple. A significant degree of similarity in the tendency to forgive the partner was expected both across offspring and their parents and across partners. In fact, although premarital partners are still influenced by the culture they inherited from their family of origin, during this period they are deeply involved in defining their couple identity as a separate entity from their familial belonging (Aquilino, 1997; Crespi & Sabatelli, 1997; Cigoli & Scabini, 2006). Along with these considerations, in this particular phase of the family life cycle, we can hypothesise a greater similarity to the partner’s tendency to forgive than to the parents’ ones. A secondary goal was to verify whether intergenerational similarity in the tendency to forgive the partner was moderated by child and parent gender, and by children’s perception of parents as positive models for their lives. A substantial literature suggests that child and parent gender may affect the degree of intergenerational similarity. Compared to males, females tend to develop values, aspirations, behaviors and relationship outcomes more similar to their parents’ ones (e.g., Caspi & Elder, 1998; Zentner & Renaud, 2007), probably because they spend more time in close proximity to their family than males do and are more accurate perceivers of parental positions, owing to their higher ability in adopting others’ points of view (e.g., Cotterell, 1993; Eisenberg, Carlo, Murphy, & van Court, 1995; Eisenberg, Miller,
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Shell, McNalley, & Shea, 1991). Moreover, children are more likely to be similar to their mothers than to their fathers, because mothers, by virtue of spending more time with children and having more intimate relationships with them, tend to have more opportunities to share with them their ideals, attitudes and feelings (e.g., Harach & Kuczynski, 2005). Consistent with these gender patterns, we assumed that the parent-child similarity would be higher for female children than for male ones and for mothers than for fathers. Furthermore, there are reasons to suppose that intergenerational similarity would increase the extent to which children hold a positive view of parents and of what they have transmitted to them. For example, research on racial attitudes demonstrated that racial attitudes parents are willing to express influence their children’s implicit prejudice, depending on children’s level of identification with their parents (Sinclair, Dunn, & Lowery, 2005). Similarly, maternal gender-role beliefs and attitudes are stronger predictors of daughters’ beliefs and attitudes when daughters identify with their mothers (Steele & Barling, 1996). To address the above questions we decided to adopt a dyad-centered or idiographic approach when evaluating similarity (see Luo & Klohnen, 2005; Kenny, Kashy, & Cook, 2006). Much research on partners and parent-child similarity has taken a variable-centered or nomothetic approach, focusing on variables as the unit of analysis. This approach assesses similarity by computing a correlation between the members of a dyad’s scores on the same domain across all dyads in a particular sample (e.g., between mothers’ and children’s scores on the tendency to forgive across all mother-child dyads). This correlation reflects the degree to which members of a dyad tend to be similar in a given sample, but it does not tell us the extent to which any specific dyad is similar or not. Conversely, the dyad-centered approach computes a profile similarity index for every dyad in the sample by correlating each member of a dyad’s scores across all items on a given domain. Thus, the profile similarity index is a characteristic of each dyad, not of the whole sample. Adopting the dyad-centered approach allowed us to treat the profile similarity index as a variable in itself, for example to examine whether it differs across child gender or types of dyads considered (i.e., mother-child, fatherchild, and partner-child) or whether it is related to other variables (e.g., children’s perception of parents as models). More importantly, adopting the dyad-centered approach allowed us to control for the so-called stereotype accuracy 1. Members of a dyad might appear to be similar in their tendency to forgive the partner not only because they are really similar to each other but also because they respond stereotypically, matching the profile of responses of other people in the same cultural group (e.g., Cronbach, 1955; Kenny & Acitelly, 1994). In other words, because both members of a dyad are part of a larger group, in which some responses to forgiveness issues are more typical or normative than others, as a result of shared cultural values, social desirability, and social biases (e.g., Klohnen & Mendelsohn, 1998), their responses are expected to be similar not only because of their own relationship but also because of this stereotype effect. For example, given that forgiveness is an highly desirable value for the Catholic church, which is strongly rooted within the Italian society, people who give stereotypic responses may tend to say that they are forgiving in their relationship. According to Kenny and colleagues (Kenny et al., 2006; Kenny & Acitelli, 1994), stereotype accuracy needs to be removed to uncover the degree of unique similarity between the dyad members. As Kenny and colleagues pointed out, however, both stereotype accuracy and 1
This concept has been referred to also as “stereotype” (Cronbach, 1955; and Kenrick and Funder,1988) and as “stereotype effect” (Kenny and Acitelly,1994).
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uniqueness are sources of dyadic similarity, though they refer to two different aspects of it. As for the purpose of our study, the absence of a unique similarity might not mean the absence of reciprocation or internalization, but a different mechanism through which these processes may take place, namely through partners’ socialization of the broader forgiveness culture in which their relationships are embedded. Moreover, because fathers, mothers and children may hold different views about forgiveness-related issues, we can expect different stereotype effects for these three different groups (Kenny & Acitelli, 1994). Relying upon these considerations, we also verified whether forgiveness responses in the present sample were affected by one single or by multiple stereotype effects and whether controlling for them substantially altered any of the findings related to similarity. With this respect, we expected that, when controlling for stereotype accuracy, the level of similarity across partners and across generations would be still significant, but substantially reduced. On the one hand, we had theoretical reasons to expect that across partners and generations the similarity in the tendency to forgive would not be simply an artefact of stereotype accuracy. On the other hand, previous evidence suggests that controlling for stereotype effects could substantially reduce the level of similarity (see for example Deal, Halverson, & Wampler, 1999). Owing to the lack of literature on the issue, we were not able to predict whether the strength of this expected reduction in similarity would be different in mother-child, father-child, and partnerchild dyads nor whether and how controlling for stereotype accuracy would alter any of the postulated moderating effects of parent/child gender and of child’s perceptions of parents upon similarity. In sum, our review of the existing literature has led us to investigate the following hypotheses. Hypothesis 1: There is a significant similarity in the tendency to forgive the partner between engaged young adult partners and between these partners and their parents. This similarity remains significant, even though reduced, when controlling for stereotype accuracy. Hypothesis 2: Similarity between engaged partners is higher than similarity between partners and their parents. Hypothesis 3: Mother-child similarity is higher than father-child similarity. Hypothesis 4: Parent-daughter similarity is higher than parent-son similarity. Hypothesis 5: Parent-child similarity is positively related to children’s views of parents as models for their life. Specifically, children are more similar to their parents in the tendency to forgive the partner when they perceive parents as positive models for their lives. We also examined whether forgiveness responses were affected by one single or by multiple stereotype effects and whether corrections for it/them would affect the different types of similarity or would change any of the moderating effects described from hypothesis 2 to hypothesis 5.
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METHOD Participants One hundred and sixty-five premarital heterosexual couples and their parents living in the North of Italy participated in the study. Specifically in 135 couples both of the woman’s parents completed their questionnaires (overall 540 participants); in 106 couples both of the man’s parents completed their questionnaires (overall 424 participants) and in 76 couples both parental couples filled in the materials. Among the engaged partners, the average duration of the relationship was 6 years (SD = 3.6). Women’s mean age was 29 (SD = 3.7) and men’s age was 31 (SD = 4.3). Thirty-four percent of the couples were cohabiting; among non-cohabiting partners 60.5% of women and 54.9% of men were living with their parents. The form of household was not significantly related to any of the investigated variables. Although a few offspring ended their formal education with elementary school (6.7% of the women, 15.3% of the men), most reached a terminal high school degree (49.1% women, 60.2% of the men) or a college or university degree (44.2% women, 24.5% men). As for household income, 21% of women and 13.5% of men earned below 1.500 € per month, 61% of women and 64% of men earned between 1.500 and 3.000 €, 13.5% of women and 19% of men earned between 3.000 € and 5.000 €, 4.5% of women and 3.5% of men earned over 5.000 €. Among the parents, the average duration of the marriage was 33.3 years (SD = 5.2). Mothers’ mean age was 57 (SD = 6.7) and fathers’ mean age was 60 (SD = 6.8). Parents’ number of children ranged from 1 to 7 (M = 2, SD = 0.8). Twenty-seven point seven percent of mothers and 25.4% of fathers reached up to elementary school, 65.7% of mothers and 68.2% of fathers reached up to high school degree, and 4.6% of mothers and 6.4% of fathers reached college or university degree. As for household income, 26.5% of parents earned below 1.500 € per month, 55.3% of parents earned between 1.500 and 3.000 €, 15.7% of parents earned between 3.000 € and 5.000 €, and 2.5% of parents earned over 5.000 €. More than the 95% of subjects defined themselves as affiliated with the Catholic Church. However, their degree of religiousness was modestly related to their tendency to forgive (r healthy jealous subjects OCD patients > healthy controls Healthy jealous subjects > healthy subjects OCD patients > healthy jealous subjects > healthy subjects
CONCLUSION There is a main bias in the present study, that should be acknowledged: it was carried out in a sample of university students and local residents, which, as has already been pointed out (Mullen & Martin, 1994), is not representative of the general population; however, most of the published papers on jealousy report results based on samples consisting of students (Mathes, 1986; Micheal et al., 1995; Pines & Friedman, 1997). Notwithstanding this limitation, our study showed some intriguing results. About 10% of the students had a tendency to harbor excessive thoughts of jealousy concerning their partner. This is not a finding which can be easily compared to those of previous studies, since we specifically directed the subjects to focus only on current relationships and the feelings associated with it, without referring to any past experiences. When past experiences were taken into consideration, the percentage of jealous subjects rose, but the level of jealousy was not as extreme (Mathes et al., 1982; Buunk et al., 1985; Mathes, 1986; Paul et al., 1993).
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More important, our questionnaire enabled us to quite clearly distinguish three groups of subjects: the normal subjects, those who were excessively jealous and whom we labeled “normal jealous”, and those patients affected by obsessional jealousy. The results for a number of the items on the questionnaire were significantly different in the three groups, such as the time spent in jealous thoughts/concerns (between 1 and 4 hours a day amongst the normal jealous subjects, and between 4 and 8 hours a day amongst the OCD patients), the ability to remove jealous thoughts out of the mind, the degree to which the relationship was impaired, the degree to which there was an attempt to limit the partner’s freedom, and the checking up on a partner’s behavior. Noteworthy is the fact that healthy jealous subjects were no different from the OCD patients in terms of egodystonia, which may represent a specific index of obsessional preoccupation. The OCD patients did, however, show higher scores than both the normal jealous subjects and the healthy controls with regard to the frequency of preoccupation, suspicion, interference with daily activities, strategies to avoid jealous thoughts/concerns, and the checking for traces of sexual intercourse. It might be concluded that “normal jealous subjects” suffered from a moderate form of OCD, or had an obsessive-compulsive personality or a positive family history of OCD: but we excluded all such possibilities by means of a detailed psychiatric interview and the YBOCS total score that was within the normal range. In addition, the percentage of those “normal jealous” subjects is different from that reported for OCD, which is present in the 2.5 % of the general population (Karno et al., 1988). We believe that, at least in young subjects, our questionnaire is effective in distinguishing three different forms of jealousy, and that even normal jealousy is heterogeneous (Mullen & Martin, 1994; Micheal et al., 1995; Stein et al., 1994). We recently proposed a dimensional model along the “uncertainty/certainty” and “insight/no insight” dimensions, possibly related to the 5-HT system (Marazziti et al., 1999, 2003a, b), spanning from the pole of normality to the opposite pole of delusional severity, where a number of different conditions can be located. It is our opinion that the phenomenon of jealousy may also fit well in this model.
REFERENCES American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Press. Buss, D. M. (1989). Sex differences in human mate preferences: Evolutionary hypotheses tested in 37 cultures. Behavioural and Brain Science, 12, 1-49. Buss, D. M., Larsen, R. J., Westen, D., Semmelroth, J. (1992). Sex differences in jealousy: Evolution, physiology, and psychology. Psychological Science, 3, 251-255. Buunk, B. P., Angleitner, A., Oubaid, V., Buss, D. M. (1996). Sex differences in jealousy in evolutionary and cultural perspective: Tests From the Nederlands, Germany and the United States. Psychological Science, 7, 359-363. Cobb, J. P., Marks, I. M. (1979). Morbid jealousy featuring as obsessive-compulsive neurosis; treatment by behavioral psychoterapy. British Journal of Psychiatry, 34, 301305. Docherty, J., Ellis, J. (1979). A new concept and finding in morbid jealousy. American Journal of Psychiatry, 133, 679-683.
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First, M. B., Spitzer, R. L., Gibbon, M., Williams, J. B. V. (1997). Structured Clinical Interview for DSM-IV Axis I disorder-Patient Edition (SCID-I/P, Version 2.0, 4/97 revision). Biometrics Research Department, New York State Psychiatric Institute. Goodman, W. K., Price, L. H., Rasmussen, S. A. (1986) The Yale Brown Obsessivecompulsive Scale I: development, use and reliability. Archives of General Psychiatry, 46, 1006-1011. Gross, M. D. (1991). Treatment of pathological jealousy by fluoxetine. American Journal of Psychiatry, 148, 683-684. Insel, T. R., Shapiro, L. E. (1992). Oxytocin receptor distribution reflects social organization in monogamous and polygamous voles. Proceedings of the National Academy of Sciences, USA, 89, 5981-5985. Insel, T. R., Winslow, J. T. (1998). Serotonin and neuropeptides in affiliative behaviors. Biological Psychiatry, 44, 207-219. Karno, M., Golding, J. M., Sorenson, S. B. (1988). The epidemiology of obsessivecompulsive disorder in five US Communities. Archives of General Psychiatry, 45, 10941099. Kraepelin, E. (1910). Ein Lehrbuch fur Studierende und Aertze. 8th ed. Leipzig, Germany: Johann Ambrosius Barth. Kraft-Ebbing, R. (1982). Ueber Eifersuchtswahn beim Männe. Journal of Psychiatry and Neurology, 10, 212-231. Lane, R. D. (1990). Successful fluoxetine treatment of pathological jealousy. Journal of Clinical Psychiatry, 51, 345-346. Marazziti, D., Akiskal, H. S., Rossi, A., Cassano, G. B. (1999). Alteration of the platelet serotonin transporter in romantic love. Psychological Medicine, 29, 741-745. Marazziti, D., Di Nasso, E., Masala, I., Baroni, S., Abelli, M., Mengali, F., Mungai, F., Rucci, P. (2003b). Normal and obsessional jealousy: a study of a population of young adults. European Psychiatry, 18, 106-111. Marazziti, D., Rucci, P., Di Nasso, E., Masala, I., Baroni, S., Rossi, A., Giannaccini, G., Mengali, F., Lucacchini, A. (2003a). Jealousy and subthreshold psychopathology: a serotonergic link. Neuropsychobiology, 47, 12-16.Mathes, E. W., Roterr, M. P., Joerger, S. M. (1982). A convergence validity study of six jealousy scales. Psychological Reports, 50, 1143-1147. Mathes, E. V. (1986). Jealousy and romantic love: a longitudinal study. Psychological Reports, 58, 885-886. Michael, A., Mirza, S., Mirza, K. A. H. (1995). Morbid jealousy in alcoholism. British Journal of Psychiatry, 167, 668-672. Mullen, P. E. (1991). Jealousy: The pathology of passion. British Journal of Psychiatry, 158, 593-601. Mullen, P. E., Martin, J. (1994). Jealousy: A community study. British Journal of Psychiatry, 164, 35-43. Newman, J. D. (1998). The physiologic control of mammalian vocalization. New York: Plenum Press. Nie, N. H., Hull, C. H., Steinbrenner, K., Bent, D. H. (1998). Statistical Package for the Social Science (SPSS), (4nd edn), New York: Mc Graw-Hill Company. Parker, G., Barrett, E. (1997). Morbid jealousy as a variant of obsessive-compulsive disorder. Australian and New Zealand Journal of Psychiatry, 31, 133-138.
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Paul, L., Foss, M. A., Galloway, J. (1993). Sexual jealousy in young men and women. Aggressive Behaviour, 19, 401-420. Pines, A. M., Friedman, A. (1997). Gender differences in romantic jealousy. The Journal of Social Psychology, 138, 54-71. Shrestha, K., Reeds, D. W., Rix, K. J. B. (1985). Sexual jealousy in alcoholics. Acta Psychiatrica Scandinavica, 72, 283-290. Stein, D. J., Hollander, M. D., Josephson, S. C. (1994). Serotonin reuptake blockers for the treatment of obsessional jealousy. Journal of Clinical Psychiatry, 55, 30-33. Tarrier, N., Beckett, R., Harwood, S., Bishay, N. (1990). Morbid jealousy: a review and cognitive-behavioural formulation. British Journal of Psychiatry, 157, 319-326.
In: Psychology of Relationships Editors: Emma Cuyler and Michael Ackhart
ISBN 978-1-60692-265-1 © 2009 Nova Science Publishers, Inc.
Chapter 13
JEALOUSY, SEROTONIN AND SUBTHRESHOLD PSYCHOPATHOLOGY Donatella Marazziti*, Francesca Golia, Marina Carlini, Stefano Baroni, Irene Masala, Mario Catena Dell’Osso, Giorgio Consoli Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, Italy
ABSTRACT Background: Different studies have suggested that some neurotransmitters may play a role in the expression of jealousy. In our study, we utilized the specific binding of 3Hparoxetine (3H-Par) as a peripheral tool to explore the serotonergic system in platelets of healthy subjects with and without jealousy concerns. Methods: Twenty-one subjects with thoughts of jealousy and 21 subjects without jealousy concerns, as revealed by their score at a specific questionnaire (“Questionnaire of Affective Relationships”, QAR), were included in our study. Subjects in the first group were administered a battery of self-report instruments designed to detect the presence of subthreshold psychopathology. The binding of 3H-Par was carried according to a standardized protocol. Results: The results showed a reduced density of 3H-Par binding in the “jealous” subjects, as compared with the “non-jealous” subjects. In addition, most of the subjects of the first group had one or moresubthreshold psychopathological conditions. Conclusion: We concluded that jealousy may be considered an expression of subtle forms of psychopathology, and may provoke an alteration of the serotonergic system, as reflected by the lower density of the platelet serotonin transporter.
Keywords: Jealousy, Serotonin System, Serotonin transporter, Platelets, Subthreshold Psychopathology
*
Author to whom correspondence and reprint request are to be sent: Dr. Donatella Marazziti. Dipartimento di Psichiatria, Neurobiologia, Farmacologia e Biotecnologie, University of Pisa, via Roma, 67, I-56100 Pisa, Italy. Telephone: +39 050 835412; Fax: +39 050 21581. E-mail address:
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INTRODUCTION Romantic jealousy is a heterogeneous emotion, ranging from normality to pathology, with different degrees of intensity, persistence and insight (Parker and Barrett, 1997), and can be defined as a complex emotional state in which a suspicion, or even conviction, of a partner’s infidelity is the main concern. How to define exactly the boundaries between “normal” and “pathological” jealousy represents “a formidable problem” for clinicians (Mullen, 1991), because recognizing pathological jealousy seems to be easier than defining it (Tarrier et al., 1990). Pathological jealousy may be an extreme reaction to an abnormally-perceived threat to a relationship, or a symptom of an underlying organic/toxic condition, such as alcoholism (Shresta et al., 1985; Michael et al., 1995), or of a psychiatric disorder, such as obsessive-compulsive disorder, mood disorders, separation anxiety and paranoia (Tarrier et al., 1990). Most researchers have focussed their efforts on delusional jealousy, while the other forms of pathological jealousy have received much less attention. From the evolutionary point of view, jealousy is an experience and a response which is both universal and innate with different significance in the two sexes: in men it is driven by the certainty of paternity, while in women by the need of a stable and long-lasting support for childrearing (Buss et al., 1989; 1992). For this reason, it has been suggested that neurobiological mechanisms might regulate the development, expression and degree of jealousy. Early in the last century, Kraepelin (1910) proposed that jealousy has its roots in the brain, while noting its presence in both neurological and substance abuse disorders. The literature on the biology of jealousy is quite meager and, perhaps, involves the attachment system (oxytocin) (Insel and Shapiro, 1992) and different neurotransmitters, such as norepinephrine, opioid peptides, dopamine and serotonin (5-HT), which play a role in pairbonding formation, sexual behavior and the establishment of long-lasting relationships (Newman, 1998). We recently proposed a dimensional model along the “uncertainty/certainty” and “insight/no insight” dimensions, which had permitted the detection of similar reductions in platelet 5-HT transporter proteins in both patients with different psychiatric disorders and normal conditions, such as the early phase of a love relationship (Marazziti et al., 1999). In the current study we applied the same theoretical model to jealousy Therefore, we measured and compared the platelet 5-HT transporter, by means of the 3Hparoxetine binding (3H-Par), in both jealous and non-jealous subjects,who were distinguished on the basis of their scores at a specific self-administered questionnaire (“Questionnaire ofAffective Relationships”, QAR).
METHODS Subjects Our study sample consisted of: a) 21 subjects (14 female and 7 male, mean age +SD: 24.9+4.0 years) who had jealous thoughts; and b) 21 subjects matched by age and gender with group a), selected from a larger group of medical students and residents who completed
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the QAR and were included in a previous study (Marazziti et al., 2003). These were 14 females and 7 males, with a mean age of 25.1+5 years,and were not jealous. A psychiatric interview excluded the presence of a personal or family history of major psychiatric disorders. We then categorized the subjects as “jealous” or “non-jealous” according to how much time the subject spent on thoughts/concerns regard their partner’s fidelity: we considered more than 1 hour a day to be a specific hallmark, based on a similar item in the Yale Brown Obsessive-Compulsive Scale (Y-BOCS) (Goodman et al., 1986). The subjects in group a) were administered a battery of spectrum questionnaires with the aim of detecting the presence of a subthreshold psychopathology (Rucci & Maser, 2000). Furthermore, measurements were repeated in two different years in order to check the stability of the binding parameters. None of the subjects was suffering from a physical illness. All gave their informed written consent to participate in the study, which was approved by the Ethical Committee of the University of Pisa.
Instruments: Questionnaire of Affective Relationships (QAR) The QARis composed by 30 items, and all responses to the questions are assigned a number on a Likert scale from 1 (least severe) to 4 (most severe). The items were specifically designed to permit an evaluation concerning behaviors arising from thoughts of jealousy, such as checking a partner’s explanations, friends, or clothes, or limiting a partner’s freedom (Marazziti et al., 2003). No specific cut-off score has yet been established to discrimate between “jealous” and “nonjealous” subjects because this questionnaire was not yet validated . Therefore, for the purposes of the present study we decided to use just a single item, specifically “time spent on thoughts/ concerns regarding a partner’s fidelity”, to characterize jealous subjects.
Spectrum Instruments We used the following four instruments to better characterize jealous subjects: the mood spectrum self-report (MOODS-SR), the social anxiety spectrum self-report (SHY-SR), the panic-agoraphobia spectrum self-report (PAS-SR) and the obsessive-compulsive spectrum self-report (OBS-SR), which were designed to assess the spectrum of 4 psychiatric disorders, namely mood disorders (unipolar and bipolar disorder), social anxiety disorder, panic disorder and obsessive-compulsive disorder. Excellent psychometric properties were demonstrated by these spectrum instruments, amongst which were high test-retest reliability, good discriminant validity and, for the PASSR, clinical validity in predicting time to response to treatment (Frank et al., 2000; 2002; Shear et al., 2001; Dell’Osso et al., 2002). Following a method described in Frank et al. (2001), we employed Receiver Operating Characteristic Curve (ROC) analysis in determining a cut-off score for these instruments. Subjects meeting at least one of the four spectrum conditions were identified using these cut-off scores. The expert clinical judgment of one of the authors was also used to determine the presence of the spectrum. To define a clinically significant spectrum condition, we
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utilized a combined criterion, defined by exceeding at least one threshold score on the four instruments and being rated clinically positive for the spectrum.
Preparation of Platelet Membranes Venous blood (20 ml) was collected between 8 and 9 a.m. during the months of MarchJune (to avoid the possible interference of circadian and seasonal rhythms, respectively) from subjects who had fasted. The sample was then mixed with 1 ml of anticoagulant 0.15 M EDTA. The biologists who analyzed the blood samples had no knowledge of the subjects’ conditions. We used low-speed centrifugation (200 x g, for 20 min, at 22°C) to obtain platelet-rich plasma. Platelets were precipitated from PRP by centrifugation at 10,000 x g for 10 min at 4°C, and then washed with 8 ml buffer (150 mM NaCl, 20 mM EDTA, 50 mM Tris-HCl, pH 7.5, 4°C). We lysed and homogenized the pellets in 8 ml buffer (5 mM Tris-HCl, 5mM EDTA, pH 7.5, 4°C) with an ultrathurrax homogenizer, which were then centrifuged twice at 30,000 x g for 15 min at 4°C. The ensuing pellet was then stored at -80°C until the assay, which was performed within a week.
3
H-Par Binding
Platelet membranes were suspended in an assay buffer 50 mM Tris, 120 mM NaCl, 5 mM KCl (pH 7.4), and homogenized. The 3H-Par binding was carried out following the method of Marazziti et al. (1996). The incubation mixture consisted of 100 µl of platelet membranes (50-100 µg protein/tube), 50 µl of 3H-Par at six concentrations ranging from 0.01 to 1 nM, and 1850 µl of assay buffer. Specific binding was obtained as the binding remaining in the presence of 10 µM fluoxetine (a gift from Eli-Lilly Co., Indianapolis, USA) as a displacer. All samples were assayed in duplicate and incubated at 22°C for 1 hour. The incubation was halted by adding 5 ml of cold assay buffer. The content of the tubes was immediately filtered under vacuum through glass fibre filters GF/C (Whatman) 2.5 cm in diameter, and washed 3 times with 5 ml of assay buffer. Equilibrium-saturation binding data, the maximum binding capacity (Bmax, fmol/mg) and the dissociation constant (Kd, nM) were analyzed by means of iterative curve-fitting computer programs EBDA (McPherson, 1985). Proteins were measured following Peterson’s method (1977).
Statistics Independent-sample t-test analysis was used to compare the Bmax mean values between the two study groups. We performed analysis of covariance (ANCOVA) to check for the effect of gender and age on differences in mean Bmax values between the groups. All analyses were carried out using SPSS, version 10.
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RESULTS The mean+SD of the QAR total score was 40+11 and 53+12 in the non-jealous and the jealous subjects, respectively, significantly lower in the first than in the second group. Jealous subjects had Bmax values significanly lower than those without jealousy concerns (833+232 vs 1518+229, t-test= -10, df=38, p
