I am interested in social interactions - how behavioral exhanges unfold rapidly between persons. As current methods are not well suited to capture rapid reciprocal processes, I am developing, in collaboration with engineers and computer scientist, computational methods to understand better what happens when we talk with others and apply these methods in couple research and patient-therapist interactions.
Indicators of esteem
I was awarded a career grant and work for the University of Bern and Zurich.
- Modern Methods in Couples and Psychotherapy Research
Courses I teach on
Hilpert, P., † Xu, F. † Milek, A., Atkins, D. C., Bodenmann, G., & Bradbury, T. N. (in press). Redefining Social Support Mechanisms on the Between- and Within-Person Level. Journal of Family Psychology.
Burri, A., Hilpert, P., McNair, P., & Williams F. (2017). Exploring symptoms of somatization in chronic widespread pain: Latent class analysis and the role of personality. Journal of Pain Research.
Sorokowski, P., Randall, A., Groyecka, A., Frackowiak, T., Cantarero, K., Hilpert, P., Aghraibeh, A. M., Aryeetey, R., Bertoni, A., Bettache, K., Błazejewska, M., Bodenmann, G., Borders, J., Bortolini, T. S., Butovskaya, M., Castro, F. N., Cetinkaya, H., Cunha, D., David, O. A., DeLongis, A., Dileym, F. A., Domínguez Espinosa, A. D. C., Donato. S., Dronova, D., Dural, S., Fisher, M., Frackowiak, T., Gulbetekin, E., Hamamcıog, L., Akkaya, A., Hansen, K., Hattori, W. T., Hromatko, I., Iafrate, R., James, B. O., Jiang, F., Kimamo, C. O., King, D. B., Koç, F., Laar, A., Lopes, F. D. A., Martinez, R., Mesko, N., Molodovskaya, N., Moradi, K., Motahari, Z., Natividade, J. C., Ntayi, J., Ojedokun, O., Omar-Fauzee, M. S. B., Onyishi, I. E., Özener, B., Paluszak, A., Portugal, A., Relvas, A. P., Rizwan, M., Salkicevic, S., Sarmány-Schuller, I., Stamkou, E., Stoyanova, S., Šukolová, D., Sutresna, N., Tadinac, M., Teras, A., Tinoco Ponciano, E. L., Tripathi, R., Tripathi, N., Tripathi, M., Vilchinsky, N., Xu, F., Yamamoto, M. E., Yoo, G., & Sorokowska, A. (2017). Effects of Sex, Age, Marriage Duration, Religion, Number of Children, Economic Status, Education, and Collectivistic Values on Marital Satisfaction: Data from 33 Countries. Frontiers of Psychology
Sorokowska, A., Sorokowski, P., Hilpert, P., Aghraibeh, A. M., Aryeetey, R., Bertoni, A., Bettache, K., Błazejewska, M., Bodenmann, G., Borders, J., Bortolini, T. S., Butovskaya, M., Castro, F. N., Cetinkaya, H., Cunha, D., David, O. A., DeLongis, A., Dileym, F. A., Domínguez Espinosa, A. D. C., Donato. S., Dronova, D., Dural, S., Fisher, M., Frackowiak, T., Gulbetekin, E., Hamamcıog, L., Akkaya, A., Hansen, K., Hattori, W. T., Hromatko, I., Iafrate, R., James, B. O., Jiang, F., Kimamo, C. O., King, D. B., Koç, F., Laar, A., Lopes, F. D. A., Martinez, R., Mesko, N., Molodovskaya, N., Moradi, K., Motahari, Z., Natividade, J. C., Ntayi, J., Ojedokun, O., Omar-Fauzee, M. S. B., Onyishi, I. E., Özener, B., Paluszak, A., Portugal, A., Relvas, A. P., Rizwan, M., Salkicevic, S., Sarmány-Schuller, I., Stamkou, E., Stoyanova, S., Šukolová, D., Sutresna, N., Tadinac, M., Teras, A., Tinoco Ponciano, E. L., Tripathi, R., Tripathi, N., Tripathi, M., Vilchinsky, N., Xu, F., Yamamoto, M. E., & Yoo, G. (2017). Preferred interpersonal distance: A global comparison. Journal of Cross-Cultural Psychology. (IF=1.80; Rank 24 of 62 in Social Psychology)
Koranyi, N., Hilpert, P., Job, V., & Bodenmann, G. (2017). Automatic affective-motivational regulation processes underlying supportive dyadic coping: The role of increased implicit positive attitudes toward communal goals in response to a stressed relationship partner. Anxiety, Stress, & Coping.
Xu, F. Hilpert, P., Nussbeck, F W., & Bodenmann, G. (2016). Testing Stress and Dyadic Coping Processes in Chinese Couples. International Journal of Stress Management.
Hilpert, P., Randall, A. K., Sorokowski, P., Atkins, D. C., Sorokowska, A., Ahmadi, K., Aghraibeh, A. M., Aryeetey, R., Bertoni, A., Bettache, K., Błazejewska, M., Bodenmann, G., Borders, J., Bortolini, T. S., Butovskaya, M., Castro, F. N., Cetinkaya, H., Cunha, D., David, O. A., DeLongis, A., Dileym, F. A., Domínguez Espinosa, A. D. C., Donato. S., Dronova, D., Dural, S., Fisher, M., Frackowiak, T., Gulbetekin, E., Hamamcıog, L., Akkaya, A., Hansen, K., Hattori, W. T., Hromatko, I., Iafrate, R., James, B. O., Jiang, F., Kimamo, C. O., King, D. B., Koç, F., Laar, A., Lopes, F. D. A., Martinez, R., Mesko, N., Molodovskaya, N., Moradi, K., Motahari, Z., Natividade, J. C., Ntayi, J., Ojedokun, O., Omar-Fauzee, M. S. B., Onyishi, I. E., Özener, B., Paluszak, A., Portugal, A., Relvas, A. P., Rizwan, M., Salkicevic, S., Sarmány-Schuller, I., Stamkou, E., Stoyanova, S., Šukolová, D., Sutresna, N., Tadinac, M., Teras, A., Tinoco Ponciano, E. L., Tripathi, R., Tripathi, N., Tripathi, M., Vilchinsky, N., Xu, F., Yamamoto, M. E., & Yoo, G. (2016). The associations of dyadic coping and relationship satisfaction vary between and within nations: A 35-nation study. Frontiers of Psychology.
Xu, F. Hilpert, P., Nussbeck, F W., & Bodenmann, G. (2016). Dyadic coping and conflict interactions mediate the association between stress and relationship satisfaction in Chinese couples. International Journal of Stress Management.
Xu, F., Hilpert, P., Randall, A. K., Qiuping, L. & Bodenmann, G. (2016). Validation of the dyadic coping inventory with Chinese couples: Factorial structure, measurement invariance, and construct validity. Psychological Assessment.
Hilpert, P., Nussbeck, F. W., Bodenmann, G., & Bradbury, T. M. (2016). Improving personal happiness through couple intervention? A randomized controlled trial of a self-directed enhancement program. Journal of Happiness Studies.
Rusu, P., Hilpert, P., & Bodenmann, G. (2016). Dyadic coping in an eastern European context: Psychometric properties and validity of the Romanian version of the dyadic coping inventory. Measurement and Evaluation in Counseling and Development.
Vedes, A., Hilpert, P., Nussbeck, F. W., Randall, A.K., Bodenmann, G., & Lind, W. (2016). A dyadic approach to love styles, dyadic coping and relationship satisfaction. Personal Relationships.
Falconier, M., Jackson, J., Hilpert, P., & Bodenmann, G. (2015). Dyadic coping and relationship satisfaction: A meta-analysis. Clinical Psychological Review. Rusu, P., Hilpert, P., Beach, S. R. H., Turliuc, M. N., & Bodenmann, G. (2015). Dyadic coping mediates the association of sanctification with marital satisfaction and well-being. Journal of Family Psychology.
Maercker, A., Hilpert, P., & Burri, A. (2015). Childhood trauma and resilience in old age: applying a context model of resilience to a sample of former indentured child laborers. Aging & Mental Health.
Burri, A., Hilpert, P., & Spector, T. (2015). Longitudinal evaluation of sexual function in a cohort of pre- and postmenopausal women. Journal of Sexual Medicine.
Halford, W. K., Pepping, C., Hilpert, P., Bodenmann, G., Wilson, K. L., Busby, D., et al., (2015). Immediate effects of couple relationship education on low satisfaction couples. Behavior Therapy.
Hilpert, P., † Kuhn, R., † Anderegg, V., & Bodenmann, G. (2015). Comparing the effects of stressful and pleasant events on relationship behavior and satisfaction. Family Science.
Randall, A. K., * Hilpert, P., Jimenez-Arista, L., Walsh, K. J., & Bodenmann, G. (2015). Dyadic coping in the U.S.: Psychometric properties and validity for use of the English version of the dyadic coping inventory. Current Psychology.
Bodenmann, G., * Hilpert, P., Nussbeck, F. W., & Bradbury, T. M. (2014). Enhancement of couples' communication and dyadic coping by a self-directed approach: A randomized controlled study. Journal of Consulting and Clinical Psychology.
Hilpert, P., Bodenmann, G., Nussbeck, F. W., & Bradbury, T. M. (2013). Predicting relationship satisfaction in distressed and non-distressed couples based on a stratified sample: A matter of conflict, positivity, or support? Family Science, 4, 110-120.
Nussbeck, F. W., Hilpert, P. & Bodenmann, G. (2012). Der Zusammenhang von positivem und negativem Interaktionsverhalten in der Partnerschaft mit Partnerschafts¬zufriedenheit und Trennungsabsichten [The association of positive and negative interaction behavior in intimate relationships with relationship satisfaction and the intention to divorce]. Zeitschrift für Familienforschung, 24, 85-104.
Bona fide psychotherapy approaches are effective treatments for generalized anxiety disorder (GAD) compared to no-treatment conditions. Treatment manuals and protocols allow a relatively high degree of freedom for the way therapists implement these overall treatment packages and there is a systematic lack of knowledge on how therapists should customize these treatments. The present study experimentally examines two implementation strategies of customizing a bona fide psychotherapy approach based on a 16 session time-limited cognitive-behavioral therapy (CBT) protocol and their relation to the post-session and ultimate treatment outcomes.
This trial contrasts two different implementation strategies of how to customize the in-session structure of a manual-based CBT-protocol for GAD. The patients will be randomly assigned to two implementation conditions: (1) a systematic focus on subtle changes lasting from 7 to 20 min at the check-in phase of every psychotherapy session and (2) a state-of-the-art (SOTA) check-in phase lasting several minutes mainly focused on the session goals. Potential therapist effects will be examined based on an ABAB crossed-therapist design. Treatment outcomes will be assessed at the following times: post-session outcomes, treatment outcome at post assessment and 6- as well as 12-month follow-up.
The proposed randomized clinical implementation trial addresses the clinically relevant question of how to customize a bona fide psychotherapy protocol experimentally contrasting two implementation strategies. Through the development and testing of the proposed implementation design, this trial has the potential to inform therapists about efficacious implementation strategies of how to customize a manual-based treatment protocol in respect to the timing of the in-session structure.
This trial was registered at ClinicalTrials.gov (NCT03079336) at March 14, 2017.
evi? Svjetlana, Sarmány-Schuller Ivan, Schmehl Susanne, Senyk Oksana, Sinding Charlotte, Sorbring Emma, Stamkou Eftychia, Stoyanova Stanislava, `ukolová Denisa, Sutresna Nina, Tadinac Meri, Tapanya Sombat, Teras Andero, Tinoco Ponciano Edna Lúcia, Tripathi Ritu, Tripathi Nachiketa, Tripathi Mamta, Uhryn Olja, Yamamoto Maria Emília, Yoo Gyesook, Sorokowski Piotr (2018) Global Study of Social Odor Awareness, Chemical Senses 43 (7) pp. 503-513 Oxford University Press (OUP)
We examined the implicit affective mechanisms underlying provision of support in intimate dyads. Specifically, we hypothesized that in individuals with high relationship satisfaction, the perception that one?s partner is stressed leads to increased implicit positive attitudes toward communal goals. In turn, this change in implicit attitudes facilitates supportive behavior.
Design and methods:
In two studies, we induced partner stress by instructing participants to either recall a situation where their partner was highly stressed (Study 1; N = 47 university students) or imagine a specific stressful event (excessive workload; Study 2; N = 85 university students). Subsequently, implicit attitudes toward communal goals were assessed with an Implicit Association Test.
In both studies, we found that among participants with high relationship satisfaction partner stress increases preferences for communal goals. In addition, implicit preferences for communal goals predicted stronger inclinations to engage in supportive dyadic coping (Study 2).
The current findings provide important insights into the implicit cognitive-affective mechanics of dyadic coping. Moreover, they can explain how people manage to avoid experiencing motivational conflicts between partner-oriented and self-oriented goals in situations characterized by high partner stress.
evi? Svjetlana, Sarmány-Schuller Ivan, Schmehl Susanne, Senyk Oksana, Sinding Charlotte, Stamkou Eftychia, Stoyanova Stanislava, `ukolová Denisa, Sutresna Nina, Tadinac Meri, Teras Andero, Tinoco Ponciano Edna Lúcia, Tripathi Ritu, Tripathi Nachiketa, Tripathi Mamta, Uhryn Olja, Yamamoto Maria Emília, Yoo Gyesook, Pierce John D. (2017) Preferred Interpersonal Distances: A Global Comparison, Journal of Cross-Cultural Psychology 48 (4) pp. 577-592 SAGE Publications
evi? Svjetlana, Sarmány-Schuller Ivan, Stamkou Eftychia, Stoyanova Stanislava, `ukolová Denisa, Sutresna Nina, Tadinac Meri, Teras Andero, Ponciano Edna L. T., Tripathi Ritu, Tripathi Nachiketa, Tripathi Mamta, Yamamoto Maria E., Yoo Gyesook, Sorokowska Agnieszka (2017) Marital Satisfaction, Sex, Age, Marriage Duration, Religion, Number of Children, Economic Status, Education, and Collectivistic Values: Data from 33 Countries, Frontiers in Psychology 8 1199
well-being, while couples who avoid such discussions tend to report poorer well-being.
Inspired by the relationship intimacy model, the present study examined whether the
link between couples? sensory loss-related communication and well-being can be
explained by perceived spouse support and whether this mediation mechanism is stable
over time. Adults with sensory loss (AWSLs) and their spouses (N ¼ 206 individuals)
completed an online survey and were followed up 6 months later. A multi-group actor?
partner interdependence mediation model was used to test the mediation mechanism as
well as its stability over time. Results showed that the association between couples?
willingness to communicate about the sensory loss and psychological well-being was
mediated by perceived spouse support for AWSLs only. Furthermore, this mediation
effect remained stable over the 6-month period. These results support prior research that the manner in which couples communicate about the sensory loss is important for
their well-being. However, because perceived spouse support was not found to mediate
the association for spouses, future studies should investigate other factors as potential
mediating mechanisms among spouses of adults with sensory loss.
Self-Directed Approach: A Randomized Controlled Trial, Journal of Consulting and Clinical Psychology 82 (4) pp. 580-591 American Psychological Association
partners and any children they are raising, dissemination of prevention programs can be limited because
couples face many barriers to in-person participation. An alternative strategy, providing couples with an
instructional DVD, is tested in the present study, in which 330 Caucasian couples (N = 660 participants;
mean age: men 41.4 years, women 40.0 years) were randomly assigned to a DVD group without any
further support, a DVD group with technical telephone coaching, or a wait-list control group. Couples
completed questionnaires at pretest, posttest, and 3 and 6 months after completion of the intervention.
Self-report measures of dyadic coping, communication quality, ineffective arguing, and relationship
satisfaction were used to test whether the intervention groups improved in comparison with the control
group. Women in both intervention groups increased in dyadic coping, reduced conflict behavior, and
were more satisfied with their relationship 6 months after the intervention. Effects for men were mixed.
Participants with poorer skills reported stronger improvement. Intimate relationships can, within limits,
be positively influenced by a self-directed approach. Effective dissemination of principles underlying
successful relationships can be facilitated through the use of emerging low-cost tools and technologies.
European Context: Validity and
Measurement Invariance of the
Romanian Version of Dyadic
Coping Inventory, Measurement and Evaluation in Counseling and Development. 49 (4) pp. 274-285 SAGE Publications
Coping Inventory with data from 510 married couples. The results confirm the theoretical
factorial structure of the Dyadic Coping Inventory for both partners, indicating convergent
validity, discriminate validity, and measurement invariance (across genders and across cultures).
evi? Svjetlana, Sarmány-Schuller Ivan, Stamkou Eftychia, Stoyanova Stanislava, `ukolová Denisa, Sutresna Nina, Tadinac Meri, Teras Andero, Tinoco Ponciano Edna L., Tripathi Ritu, Tripathi Nachiketa, Tripathi Mamta, Vilchinsky Noa, Xu Feng, Yamamoto Maria E., Yoo Gyesook (2016) The Associations of Dyadic Coping and Relationship Satisfaction Vary between and within Nations: A 35-Nation Study, Frontiers in Psychology 7 1106 Frontiers Media
Theories about how couples help each other to cope with stress, such as the systemic transactional model of dyadic coping, suggest that the cultural context in which couples live influences how their coping behavior affects their relationship satisfaction. In contrast to the theoretical assumptions, a recent meta-analysis provides evidence that neither culture, nor gender, influences the association between dyadic coping and relationship satisfaction, at least based on their samples of couples living in North America and West Europe. Thus, it is an open questions whether the theoretical assumptions of cultural influences are false or whether cultural influences on couple behavior just occur in cultures outside of the Western world.
In order to examine the cultural influence, using a sample of married individuals (N = 7973) from 35 nations, we used multilevel modeling to test whether the positive association between dyadic coping and relationship satisfaction varies across nations and whether gender might moderate the association.
Results reveal that the association between dyadic coping and relationship satisfaction varies between nations. In addition, results show that in some nations the association is higher for men and in other nations it is higher for women.
Cultural and gender differences across the globe influence how couples' coping behavior affects relationship outcomes. This crucial finding indicates that couple relationship education programs and interventions need to be culturally adapted, as skill trainings such as dyadic coping lead to differential effects on relationship satisfaction based on the culture in which couples live.
Aspects of women's sexual functioning that have received relatively little attention are its stability and how changes in the different sexual response domains influence each other over time.
The aim of this study was to describe the changes and to evaluate the stability of self?reported sexual functioning over a 4?year period in a population sample of British women.
A 4?year follow?up study on N = 507 women, including 178 pre? and 329 postmenopausal women, was conducted. The validated Female Sexual Function Index (FSFI) was applied.
Main Outcome Measure
A multigroup path analytical model was used to examine autoregressive effects (the effect of a domain on itself at a later point in time) and cross?lag effects (one variable affecting another variable at a later point in time) across all FSFI domains of sexual functioning between pre? and postmenopausal women.
Overall, the proportion of postmenopausal women suffering from a sexual dysfunction at measurement point 1 (T1) was higher compared with premenopausal women (pre: 34.3% vs. post: 14.5%). However, both groups showed a comparable number of women developing a sexual problem (pre: 22.2% vs. post: 23.2%) or improving their sexual functioning (7.4% vs. 7.6%) after the 4 years. Furthermore, path model analyses revealed that each domain at T1 significantly predicted its level 4 years later (²s ranging from 0.33 for arousal to 0.57 for lubrication), with the exception of sexual satisfaction. In terms of cross?lag effects, the changes in all domains except for pain were predicted either by levels of desire, arousal, or orgasm at T1 (²s ranging from 0.18 to 0.36) in both groups.
Women's sexual functioning was moderately stable across the 4 years. The main predictors of changes in sexual functioning and satisfaction were desire and arousal, highlighting their role as possible key players in women's sexual health
Couples, International Journal of Stress Management 25 (1) pp. 84-95 American Psychological Association
(referred to as external stress) can spill over into couples? relationships, influencing
dyads? behaviors and their relationship satisfaction. There is substantial
evidence that the association between external stress and relationship satisfaction
is explained by 2 mediators: internal stress and dyadic coping. However, the
mediation processes of internal stress and dyadic coping have solely been
examined in Western couples. Accordingly, the current study aimed to test these
processes in a sample of 474 Chinese couples (N = 948) using the actor?partner
interdependence mediation model. Results reveal that internal stress and dyadic
coping can fully mediate the association between external stress and relationship
satisfaction in Chinese couples for men and women in a similar way. These
findings underscore the importance of moving beyond examining stress and
dyadic coping processes among couples in Eastern cultures.
Intervention: A Randomized Controlled Trial
of a Self-directed Couple Enhancement Program, Journal of Happiness Studies 17 (1) pp. 213-237 Springer Verlag
of former indentured child laborers, Aging & Mental Health 20 (6) pp. 616-626 Taylor & Francis
Psychological resilience has been rarely investigated in elderly populations. We applied a more comprehensive
model of trauma-specific coping and resilience, which included Ungar?s context model and included decentral factors of
resilience (i.e., environments that provide resources to build resilience).
We assessed resilience in a cohort of former Swiss indentured child laborers (N D 74; 59% males) at two time points;
first at the mean age of 80 years and then again 20 months later. At each time point, the following measures of resilience were
assessed: resilience indicators of life satisfaction and lack of depression. In addition, resilience predictors of trauma exposure,
perceived social support, dysfunctional disclosure of traumatic experiences, social acknowledgment as a victim, and selfefficacy;
and decentral resilience factors of education, income, number of children, and physical health were measured.
Using path-analysis, we found that life satisfaction and lack of depression were predicted by dysfunctional
disclosure, social support, and self-efficacy at various significance levels. Change scores of resilience were predicted by
higher trauma exposure, social acknowledgment as a victim, and an interaction between the two. The model for decentral
factors also fitted, with physical health and income predicting the resilience indicators.
Applying this comprehensive resilience model in a sample of older adults revealed meaningful findings in
predicting resilience at a single time point and over time. Atypical coping strategies, such as perceived social acknowledgment
as a victim and disclosure, may be particularly important for former victims who have suffered institutional abuse.
Factorial Structure, Measurement Invariance, and Construct Validity, Psychological Assessment 26 (8) pp. e127-e140 American Psychological Association
facing individual (e.g., workload) and common (e.g., parenting) stressors. Specifically, the DCI measures
partners? perceptions of their own (Self) and their partners? behaviors (Partner) when facing individual
stressors, and partners? common coping behaviors when facing common stressors (Common). To date,
the DCI has been validated in 6 different languages from individualistic Western cultures; however,
because culture can affect interpersonal interactions, it is unknown whether the DCI is a reliable measure
of coping behaviors for couples living in collectivistic Eastern cultures. Based on data from 474 Chinese
couples (N = 948 individuals), the current study examined the Chinese version of the DCI?s factorial
structure, measurement invariance (MI), and construct validity of test scores. Using 3 cultural groups
(China, Switzerland, and the United States [U.S.]), confirmatory factor analysis revealed a 5-factor
structure regarding Self and Partner and a 2-factor structure regarding Common dyadic coping (DC).
Results from analyses of MI indicated that the DCI subscales met the criteria for configural, metric, and
full/partial scalar invariance across cultures (Chinese-Swiss and Chinese-U.S.) and genders (Chinese men
and women). Results further revealed good construct validity of the DCI test scores. In all, the Chinese
version of the DCI can be used for measuring Chinese couples? coping behaviors, and is available for
cross-cultural studies examining DC behaviors between Western and Eastern cultures.
Public significance statement: The present study shows that within a transdiagnostic sample of 430 patients treated by 151 therapists, the alliance-outcome relation is dependent on the number of aggregated alliance assessments as well as on the type of outcome assessment (i.e. distress vs. subjective change measures). Aggregated early alliance assessments were shown to relate most strongly to retrospectively evaluated subjective change at post-treatment. Examining associations with subjective change measures provide additional clinical perspectives on process and outcomes when conducting clinical trials and routine outcome monitoring.
Public abstract: Despite ongoing encouragement to systematically consider patient-relevant outcomes in clinical trials of psychotherapy, subjective change measures (e.g., how patients evaluate the change during psychotherapy) are still neglected in guidelines of how to conduct trial research. The present analysis shows that these measures are able to detect strong process-outcome associations in comparison to distress measures and have the potential to substantially deepen our psychological knowledge of how to understand successful psychotherapies but also successful psychological treatments more generally.
Authors note: The present data set refers to Flückiger et al., 2013; preliminary results of the present analyses were presented at the Conference of the International Society of Psychotherapy Research (SPR) at June 2018 at Amsterdam.
Objective: Despite meta-analytic evidence showing that alliance is associated with post-treatment outcomes, several open questions still remain regarding this relation and its measurement. The current study sought to address three such questions simultaneously by investigating the alliance-outcome relation with two distress measures and four subjective change measures at post-treatment separately: First, we investigate whether (or not) the progressive aggregation of the early alliance assessments will increase the overall alliance-outcome relation across the six outcome measures. Second, we investigate whether the alliance-outcome relations using subjective change measures are independent from intake distress and early response. Third, we explore whether the progressive aggregation of the alliance on outcomes becomes particularly apparent between therapists or within therapists again investigating distress as well as subjective change measures.
Method: Data were drawn from n = 430 patients treated by n = 151 therapists. Patient ratings of early alliance were assessed after session 1 to 6. Six outcome measures were considered. Patients completed two commonly used distress measures at intake and at post-treatment and four measures of retrospectively evaluated subjective change at post-treatment. Multilevel models were used to predict treatment outcomes from alliance ratings aggregated across multiple sessions.
Results: The proportion of variance in outcome predicted by alliance scores varied considerably depending on the number of alliance assessments which were aggregated, as well as on the type of outcome assessment (distress vs. subjective change measures) explaining up to 15% of outcome variance. Improvements in the strength of prediction with aggregated alliance assessments were most pronounced for subjective change measures for between-therapist components of the alliance.
Conclusion: The strength of the alliance-outcome relation varies depending on the number of alliance observations that are aggregated, on how outcome is assessed (distress vs. subjective change measures), and whether scores are investigated at the between- or within-therapist level. Examining associations with subjective change measures provides an additional, person-centered metric of the relation between early alliance and treatment outcomes.
Objective: The investigation of session-to-session effects of working alliance on symptoms and coping experiences in patients diagnosed with GAD. Additionally, investigating these effects dependent on whether therapists are primed to work with patients strength (resource priming) or to adhere to the treatment manual (adherence priming).
Method: Data was drawn from a randomized controlled trial in which 57 patient were randomly assigned to either the resource priming condition or the adherence priming condition. Within- and between patient associations were disentangled using dynamic structural equation modeling.
Results: The total score of the working alliance as well as all its overlapping components (i.e., goal agreement, task consensus, bond) showed significant within-patient effects on next session coping experiences. More specifically, better alliance scores in one session were followed by more coping experiences in the subsequent session. With regard to anxiety symptoms, an association was found only with the working alliance total score as well as for the bonds component, but not for the goals and task components of the working alliance. The priming condition (resource priming vs adherence priming) had no influence on the within-patient alliance-outcome association. Between-patient alliance associations were only present with coping experiences, but not with anxiety symptoms.
Conclusion: The findings provide further empirical evidence for the hypothesis that the working alliance may be a robust facilitative factor for change in CBT treatments for GAD which evolves irrespective of the strictness with which therapists adhere to the treatment manual.
Objective: Close interpersonal relationships are fundamental to emotion regulation. Clinical theory suggests that one role of therapists in psychotherapy is to help clients regulate emotions, however, if and how clients and therapists serve to regulate each other?s emotions has not been empirically tested. Emotion coregulation ? the bidirectional emotional linkage of two people that promotes emotional stability ? is a specific, temporal process that provides a framework for testing the way in which therapists? and clients? emotions may be related on a moment to moment basis in clinically relevant ways.
Method: Utilizing 227 audio recordings from a relationally oriented treatment (Motivational Interviewing), we estimated continuous values of vocally encoded emotional arousal via mean fundamental frequency. We used dynamic systems models to examine emotional coregulation, and tested the hypothesis that each individual?s emotional arousal would be significantly associated with fluctuations in the other?s emotional state over the course of a psychotherapy session.
Results: Results indicated that when clients became more emotionally labile over the course of the session, therapists became less so. When changes in therapist arousal increased, the client?s tendency to become more aroused during session slowed. Alternatively, when changes in client arousal increased, the therapist?s tendency to become less aroused slowed.
Background. Painful sexual intercourse or dyspareunia is a common
complaint among women, affecting 12% - 21% of premenopausal
women. Recent studies have started focusing on the role of fear
avoidance and pain catastrophizing (PC) in genital pain and have
consistently highlighted the importance of psych-affective factors in
Aim. To establish the importance of PC, fear of pain, and depression for
the development and maintenance of female sexual pain.
Methods. A longitudinal study conducted in the UK assessing sexual pain
at two different time points in 2009 and 2013 in a convenience sample of
N = 979 British women.
Outcomes. Well validated questionnaires including the Pain
Catastrophizing Scale, the Pain Anxiety Symptom Scale, and the Female
Sexual Function Index (recent and lifelong version) were applied.
Results. Multilevel modeling showed a strong increase of short lived
sexual pain over the four years (À01 = -0.33, p Â .001). According to
the moderation analyses, only depression influenced the change in short
lived pain over the four years (À11 = 0.46, p = .016). Similarly, only
depression turned out to be independently associated with sexual pain
when entered into the multiple regression model, with women reporting
higher depression levels also reporting more sexual pain (p Â 0.05).
Clinical Translation. Clinicians should be aware that the mechanisms
influencing short lived sexual pain and changes in sexual pain seem to
be different from the more enduring psychological factors that lead to
the development and maintenance of ?chronic? sexual pain.
Strengths & Limitations. A very generic and unidimensional definition of
sexual pain was used without information on pain frequency or intensity
and no information on the possible underlying (medical or psychological
or both) causes was available. However, this represents the first study to
use repeated measure to assess how pain changes over a 4-year period
and to explore the role of potential psychoaffective risk factors.
Conclusion. Among the variables studied, symptoms of depression seem
to be the only independent predictor of lifelong sexual pain, over-riding
potential influences of pain catastrophizing or fear of pain.
Postcoital dysphoria (PCD) is a condition characterized by inexplicable feelings of tearfulness, sadness, and/or irritability. Previous research has mostly focused on these 3 symptoms, failing to explore other symptoms that can occur after sexual activity.
The aim of the present study was to get a more in-depth understanding of postcoital symptom variety, to compare the type and frequency of these symptoms in men and women, and to explore the context in which they manifest.
A convenience sample of 223 women and 76 men filled in an online survey consisting of a list of 21 symptoms and a set of additional questions.
Main Outcome Measure
The study outcomes were obtained using a study-specific questionnaire to assess postcoital symptoms, consisting of a list of 21 symptoms that form 4 domains and 2 additional questions that assess personal and interpersonal distress.
Of all participants, 91.9% reported any postcoital symptom over the past 4 weeks and 94.3% ever since they had been sexually active. The most common symptoms in women were mood swings and sadness, whereas in men, it was unhappiness and low energy. Men and women differed in the frequency of postcoital symptoms experienced ever since being sexually active, with women reporting more sadness, mood swings, frustration, and worthlessness. For 73.5% of individuals, the postcoital symptoms were present after consensual sexual intercourse, for 41.9%, after general sexual activity, and for 46.6% also, after masturbation. Of all participants, 33.9% said that they only experienced the symptoms after orgasm.
Postcoital symptoms are clearly more varied than previously suggested and are not related to classic ?dysphoria? only. Hence, we propose to cease calling the phenomenon ?postcoital dysphoria? and suggest to simply use the term ?postcoital symptoms.?
Strength & Limitations
This is the first study ever to provide a more in-depth exploration of postcoital symptom variety. The sample was relatively small, and the representativeness and, therefore, generalizability of the results was limited, given that a convenience sample was used.
Our results indicate that postcoital symptoms are a multifaceted phenomenon which shows similar expression in men and women. The symptoms are clearly more varied not related to classic ?dysphoria? only.
Objective: The present study provides an overview of the frequency, attitude, motivation and consequences of pornography consumption in heterosexual couples.
Methods: Participants aged between 18 and 60, living in Switzerland (N=1,091) and in a relationship for at least one year filled out an anonymous online survey.
Results: Women consume less pornography than man, mainly because of a lack of interest. Men consume because of relationship dissatisfaction and stress, in secret, with guilty feelings and to the displeasure of their partner. Women consume with good feelings and supported by their partners.
Conclusions: Gender differences in pornography consumption may lead to relationship conflicts. Thank to a coaching towards less negative attitudes, consumption can have positive effects for couples.