Dr Peter Hilpert


Lecturer in Advanced Statistics
+44 (0)1483 682943
16 AC 05
Wednesday 1-3pm online during teaching times (email first please)

Research

Research interests

Indicators of esteem

  • I was awarded a career grant and work for the University of Bern and Zurich.

    My teaching

    Courses I teach on

    Postgraduate taught

    My publications

    Highlights

    Hilpert, P., Brick, T. R., Flückiger, C., *Vowels, M., Ceuleman, E., Kuppens, P, & Sels, L. (2020). What can be learned from couple research: Examining emotional co-regulation processes in face-to-face interactions. Journal of Counseling Psychology. (IF=4.82)

     

    Rubel, J. A., Hilpert, P., & *Wolfer, C., Held, J., Vîslă, A., & Flückiger, C. (2019). The working alliance in manualized CBT for generalized anxiety disorder Does it lead to change and does the effect vary depending on manual implementation flexibility? Journal of Consulting and Clinical Psychology. (IF=5.77)

     

    Flückiger, C., Hilpert, P., Goldberg, S., Caspar, F., Wolfer, C., Held, J., & Vîslă, A. (2019). Investigating the impact of early alliance on predicting subjective change at posttreatment: An evidence-based souvenir of overlooked clinical perspectives. Journal of Counseling Psychology. (IF=4.82)

    Publications

    Flückiger Christoph, Wolfer Christine, Held Judith, Hilpert Peter, Rubel Julian, Allemand Mathias, Zinbarg Richard E., Vîsl? Andreea (2018) How to customize a bona fide psychotherapy for generalized anxiety disorder? A two-arms, patient blinded, ABAB crossed-therapist randomized clinical implementation trial design [IMPLEMENT 2.0],BMC Psychiatry 18 (86) pp. 1-11 BMC Ltd. Part of Springer Nature

    Background

    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.

    Methods

    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.

    Discussion

    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.

    Trial registration

    This trial was registered at ClinicalTrials.gov (NCT03079336) at March 14, 2017.

    Hilpert Peter, Xu Feng, Milek Anne, Atkins David C., Bodenmann Guy, Bradbury Thomas N. (2018) Couples coping with stress: Between-person differences and within-person processes.,Journal of Family Psychology 32 (3) pp. 366-374 American Psychological Association
    In intimate relationships, spousal support (or dyadic coping) can directly benefit relationships (i.e., direct effect) and protect the relationship against the negative spillover effects of stress (i.e., buffer effect). As stress-coping theories suggest, both processes can vary between persons as well as within persons. However, empirically, this distinction is not always made explicit, resulting in potentially misleading conclusions about dyadic stress-coping processes. In the current study, we investigated stress and coping processes in couples at both between- and within-person levels. Participants were 84 Chinese dual-earning couples (N = 168 individuals) participated in a 7-day diary study. Between persons, our multilevel analyses replicated well-established buffering effects: The link between average stress and relationship outcomes was reduced if the partner provided more support on average. Within persons, results implied a significant buffer effect only in women; their relationship satisfaction was highest on days when they experienced higher levels of stress and higher levels of partner support. The present findings demonstrate how distinguishing between- and within-person effects can provide a better conceptual understanding of dyadic processes in intimate relationships while examining stress-coping associations in an understudied group. (PsycINFO Database Record (c) 2018 APA, all rights reserved)
    Sorokowska Agnieszka, Groyecka Agata, Karwowski Maciej, Frackowiak Tomasz, Lansford Jennifer E, Ahmadi Khodabakhsh, Alghraibeh Ahmad M, Aryeetey Richmond, Bertoni Anna, Bettache Karim, Blumen Sheyla, BBa|ejewska Marta, Bortolini Tiago, Butovskaya Marina, Cantarero Katarzyna, Castro Felipe Nalon, Cetinkaya Hakan, Chang Lei, Chen Bin-Bin, Cunha Diana, David Daniel, David Oana A, Dileym Fahd A, Domínguez Espinosa Alejandra del Carmen, Donato Silvia, Dronova Daria, Dural Seda, Fialová Jitka, Fisher Maryanne, Gulbetekin Evrim, Hamamc1o?lu Akkaya Asl1han, Hilpert Peter, Hromatko Ivana, Iafrate Raffaella, Iesyp Mariana, James Bawo, Jaranovic Jelena, Jiang Feng, Kimamo Charles Obadiah, Kjelvik Grete, Koç F1rat, Laar Amos, Lopes Fívia de Araújo, Macbeth Guillermo, Marcano Nicole M, Martinez Rocio, Mesko Norbert, Molodovskaya Natalya, Moradi Qezeli Khadijeh, Motahari Zahrasadat, Mühlhauser Alexandra, Natividade Jean Carlos, Ntayi Joseph, Oberzaucher Elisabeth, Ojedokun Oluyinka, Omar-Fauzee Mohd Sofian Bin, Onyishi Ike E, Paluszak Anna, Pierce John D, Pillay Urmila, Portugal Alda, Razumiejczyk Eugenia, Realo Anu, Relvas Ana Paula, Rivas Maria, Rizwan Muhammad, Salki
    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)
    Olfaction plays an important role in human social communication, including multiple domains in which people often rely on their sense of smell in the social context. The importance of the sense of smell and its role can however vary inter-individually and culturally. Despite the growing body of literature on differences in olfactory performance or hedonic preferences across the globe, the aspects of a given culture as well as culturally universal individual differences affecting odor awareness in human social life remain unknown. Here, we conducted a large-scale analysis of data collected from 10 794 participants from 52 study sites from 44 countries all over the world. The aim of our research was to explore the potential individual and country-level correlates of odor awareness in the social context. The results show that the individual characteristics were more strongly related than country-level factors to self-reported odor awareness in different social contexts. A model including individual-level predictors (gender, age, material situation, education, and preferred social distance) provided a relatively good fit to the data, but adding country-level predictors (Human Development Index, population density, and average temperature) did not improve model parameters. Although there were some cross-cultural differences in social odor awareness, the main differentiating role was played by the individual differences. This suggests that people living in different cultures and different climate conditions may still share some similar patterns of odor awareness if they share other individual-level characteristics.
    Background and objectives:

    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.

    Results:

    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).

    Conclusions:

    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.

    Burri Andrea, Hilpert Peter, McNair P, Williams Frances M (2017) Exploring symptoms of somatization in chronic widespread pain: Latent class analysis and the role of personality,Journal of Pain Research 10 pp. 1733-1740 Dove Medical Press
    Chronic widespread musculoskeletal pain (CWP) is a condition manifesting varied co-symptomatology and considerable heterogeneity in symptom profiles. This poses an obstacle for disease definition and effective treatment. Latent class analysis (LCA) provides an opportunity to find subtypes of cases in multivariate data. In this study, LCA was used to investigate whether and how individuals with CWP could be classified according to 12 additional somatic symptoms (migraine headaches, insomnia, stiffness, etc.). In a second step, the role of psychological and coping factors for the severity of these co-symptoms was investigated. Data were available for a total of N = 3,057 individuals (mean age = 56.6 years), with 15.4% suffering from CWP. In the latter group, LCA resulted in a three-class solution (ngroup1 = 123; ngroup2 = 306; ngroup3 = 43) with groups differing in a graded fashion (i.e., severity) rather than qualitatively for somatic co-symptom endorsements. A consistent picture emerged, with individuals in the first group reporting the lowest scores and individuals in group 3 reporting the highest. Additionally, more co-symptomatology was associated with higher rates of anxiety sensitivity and depression, as well as more extraversion and emotional instability. No group differences for any of the coping strategies could be identified. The findings suggest that CWP has several detectable subtypes with distinct psychological correlates. The identification of CWP subgroups is important for understanding disease mechanisms and refining prognosis as well as stratifying patients in clinical trials and targeting specific treatment at the subgroups most likely to respond.
    Sorokowska Agnieszka, Sorokowski Piotr, Hilpert Peter, Cantarero Katarzyna, Frackowiak Tomasz, Ahmadi Khodabakhsh, Alghraibeh Ahmad M., Aryeetey Richmond, Bertoni Anna, Bettache Karim, Blumen Sheyla, BBa|ejewska Marta, Bortolini Tiago, Butovskaya Marina, Castro Felipe Nalon, Cetinkaya Hakan, Cunha Diana, David Daniel, David Oana A., Dileym Fahd A., Domínguez Espinosa Alejandra del Carmen, Donato Silvia, Dronova Daria, Dural Seda, Fialová Jitka, Fisher Maryanne, Gulbetekin Evrim, Hamamc1o?lu Akkaya Asl1han, Hromatko Ivana, Iafrate Raffaella, Iesyp Mariana, James Bawo, Jaranovic Jelena, Jiang Feng, Kimamo Charles Obadiah, Kjelvik Grete, Koç F1rat, Laar Amos, de Araújo Lopes Fívia, Macbeth Guillermo, Marcano Nicole M., Martinez Rocio, Mesko Norbert, Molodovskaya Natalya, Moradi Khadijeh, Motahari Zahrasadat, Mühlhauser Alexandra, Natividade Jean Carlos, Ntayi Joseph, Oberzaucher Elisabeth, Ojedokun Oluyinka, Omar-Fauzee Mohd Sofian Bin, Onyishi Ike E., Paluszak Anna, Portugal Alda, Razumiejczyk Eugenia, Realo Anu, Relvas Ana Paula, Rivas Maria, Rizwan Muhammad, Salki
    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
    Human spatial behavior has been the focus of hundreds of previous research studies. However, the conclusions and generalizability of previous studies on interpersonal distance preferences were limited by some important methodological and sampling issues. The objective of the present study was to compare preferred interpersonal distances across the world and to overcome the problems observed in previous studies. We present an extensive analysis of interpersonal distances over a large data set (N = 8,943 participants from 42 countries). We attempted to relate the preferred social, personal, and intimate distances observed in each country to a set of individual characteristics of the participants, and some attributes of their cultures. Our study indicates that individual characteristics (age and gender) influence interpersonal space preferences and that some variation in results can be explained by temperature in a given region. We also present objective values of preferred interpersonal distances in different regions, which might be used as a reference data point in future studies.
    Rusu Petruta P, Hilpert Peter, Falconier Mariana, Bodenmann Guy (2017) Economic strain and support in couples: The mediating role of positive emotions,Stress and Health 34 (2) pp. 320-330 Wiley
    This study examined positive emotions as mediating mechanisms in the association between economic strain and spouses' supportive behaviour. Data were collected from 295 married couples living in Romania. Results from the Actor?Partner Mediator Model indicated that economic strain had a negative indirect effect on spouses' supportive dyadic coping due to its negative association with partners' positive emotions (joy, contentment, and pride). For both partners, positive emotions decreased when they experienced economic strain, which in turn reduced supportive dyadic coping in couples. These findings have theoretical implications in explaining the association of economic strain with partners' positive emotions and behaviours and also clinical implications for practitioners working with couples experiencing economic strain.
    Sorokowski Piotr, Randall Ashley K., Groyecka Agata, Frackowiak Tomasz, Cantarero Katarzyna, Hilpert Peter, Ahmadi Khodabakhsh, Alghraibeh Ahmad M., Aryeetey Richmond, Bertoni Anna, Bettache Karim, BBa|ejewska Marta, Bodenmann Guy, Bortolini Tiago S., Bosc Carla, Butovskaya Marina, Castro Felipe N., Cetinkaya Hakan, Cunha Diana, David Daniel, David Oana A., Espinosa Alejandra C. Domínguez, Donato Silvia, Dronova Daria, Dural Seda, Fisher Maryanne, Akkaya Asl1han Hamamc1o?lu, Hamamura Takeshi, Hansen Karolina, Hattori Wallisen T., Hromatko Ivana, Gulbetekin Evrim, Iafrate Raffaella, James Bawo, Jiang Feng, Kimamo Charles O., Koç F1rat, Krasnod?bska Anna, Laar Amos, Lopes Fívia A., Martinez Rocio, Mesko Norbert, Molodovskaya Natalya, Qezeli Khadijeh Moradi, Motahari Zahrasadat, Natividade Jean C., Ntayi Joseph, Ojedokun Oluyinka, Omar-Fauzee Mohd S. B., Onyishi Ike E., Özener Bar1_, Paluszak Anna, Portugal Alda, Realo Anu, Relvas Ana P., Rizwan Muhammad, Sabiniewicz Agnieszka L., Salki
    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
    Forms of committed relationships, including formal marriage arrangements between men and women, exist in almost every culture (Bell, 1997). Yet, similarly to many other psychological constructs (Henrich et al., 2010), marital satisfaction and its correlates have been investigated almost exclusively in Western countries (e.g., Bradbury et al., 2000). Meanwhile, marital relationships are heavily guided by culturally determined norms, customs, and expectations (for review see Berscheid, 1995; Fiske et al., 1998). While we acknowledge the differences existing both between- and within-cultures, we measured marital satisfaction and several factors that might potentially correlate with it based on self-report data from individuals across 33 countries. The purpose of this paper is to introduce the raw data available for anybody interested in further examining any relations between them and other country-level scores obtained elsewhere. Below, we review the central variables that are likely to be related to marital satisfaction
    Hofsoe Sofia Maria, Lehane Christine M, Wittich Walter, Hilpert Peter, Dammeyer Jesper (2018) Interpersonal communication and psychological well-being among couples coping with sensory loss. The mediating role of perceived spouse support.,Journal of Social and Personal Relationships 36 (8) pp. 2323-2344 SAGE Publications
    Couples who are willing to discuss sensory loss-related issues typically report better
    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.
    Bodenmann Guy, Hilpert Peter, Nussbeck Fridtjof W., Bradbury Thomas N. (2014) Enhancement of Couples? Communication and Dyadic Coping by a
    Self-Directed Approach: A Randomized Controlled Trial
    ,
    Journal of Consulting and Clinical Psychology 82 (4) pp. 580-591 American Psychological Association
    Although prevention of relationship distress and dissolution has potential to strengthen the well-being of
    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.
    Vedes Ana, Hilpert Peter, Nussbeck Fridtjof W, Randall Ashley K, Bodenmann Guy, Lind Wolfgang R (2016) Love styles, coping, and relationship satisfaction: A dyadic approach,Personal Relationships 23 (1) pp. 84-97 Wiley
    Romantic partners have different attitudes on what love is and what it means to be in a romantic relationship. These attitudes are conceptualized as love styles that relate to relationship?maintenance behaviors and relationship satisfaction. Specifically, love styles could be associated with how partners cope with stress (dyadic coping), which in turn may be associated with relationship satisfaction. Using self?report data from 92 heterosexual couples, findings showed that: (a) eros and agape love styles have positive direct effects on dyadic coping and relationship satisfaction, whereas ludus has a negative direct effect on dyadic coping and relationship satisfaction and (b) dyadic coping partially mediated the association between love styles and relationship satisfaction. Overall, associations were stronger for women than for men.
    Rusu Petruta P., Hilpert Peter, Turliuc Maria N., Bodenmann u (2017) Dyadic Coping in an Eastern
    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
    This study investigates the psychometric properties of the Romanian version of the Dyadic
    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).
    Hilpert Peter, Kuhn Rebekka, Anderegg Valentina, Bodenmann Guy (2015) Comparing simultaneously the effects of extra-dyadic and intra-dyadic experiences on relationship outcomes,Family Science 6 (1) pp. 129-142 Taylor & Francis
    This study simultaneously examines everyday negative and positive experiences that affect persons either outside of the intimate relationship (extra-dyadic) or within (intra-dyadic). In addition, we investigate whether the partner?s responses to each of these experiences mediate the link between experience and relationship outcomes. Altogether, 447 individuals who were currently in a relationship filled out an online questionnaire. Self-report measures included extra- and intra-dyadic everyday experiences of negative and positive events as well as corresponding partner responses and relationship satisfaction. Multigroup path analyses revealed that both negative and positive extra-dyadic experiences affect negative and positive intra-dyadic experiences of women, whereas the effects of positive extra-dyadic experiences had mixed effects for men. Furthermore, the perceived partner responses in each of the four experiences were found to be an important predictor with one exception for men?s intra-dyadic positive experiences.
    Hilpert Peter, Randall Ashley K., Sorokowski Piotr, Atkins David C, Sorokowska Agnieszka, Ahmadi Khodabakhsh, Aghraibeh Ahmad M., Aryeetey Richmond, Bertoni Anna, Bettache Karim, BBa|ejewska Marta, Bodenmann Guy, Borders Jessica, Bortolini Tiago S., Butovskaya Marina, Castro Felipe N., Cetinkaya Hakan, Cunha Diana, David Oana A., DeLongis Anita, Dileym Fahd A., Domínguez Espinosa Alejandra D. C., Donato Silvia, Dronova Daria, Dural Seda, Fisher Maryanne, Frackowiak Tomasz, Gulbetekin Evrim, Hamamc1o?lu Akkaya Asl1han, Hansen Karolina, Hattori Wallisen T., Hromatko Ivana, Iafrate Raffaella, James Bawo O., Jiang Feng, Kimamo Charles O., King David B., Koç F1rat, Laar Amos, Lopes Fívia De Araújo, Martinez Rocio, Mesko Norbert, Molodovskaya Natalya, Moradi Khadijeh, Motahari Zahrasadat, Natividade Jean C., Ntayi Joseph, Ojedokun Oluyinka, Omar-Fauzee Mohd S. B., Onyishi Ike E., Özener Bar1_, Paluszak Anna, Portugal Alda, Relvas Ana P., Rizwan Muhammad, Salki
    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
    Objective:

    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.

    Method:

    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:

    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.

    Conclusions:

    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.

    Kim Halford W., Pepping Christopher A., Hilpert Peter, Bodenmann Guy, Wilson Keithia L., Busby Dean, Larson Jeffry, Holman Thomas (2015) Immediate Effect of Couple Relationship Education on Low-Satisfaction Couples: A Randomized Clinical Trial Plus an Uncontrolled Trial Replication,Behavior Therapy 46 (3) pp. 409-421 Elsevier
    Couple relationship education (RE) usually is conceived of as relationship enhancement for currently satisfied couples, with a goal of helping couples sustain satisfaction. However, RE also might be useful as a brief, accessible intervention for couples with low satisfaction. Two studies were conducted that tested whether couples with low relationship satisfaction show meaningful gains after RE. Study 1 was a three-condition randomized controlled trial in which 182 couples were randomly assigned to RELATE with Couple CARE (RCC), a flexible delivery education program for couples, or one of two control conditions. Couples with initially low satisfaction receiving RCC showed a moderate increase in relationship satisfaction (d = 0.50) relative to the control. In contrast, couples initially high in satisfaction showed little change and there was no difference between RCC and the control conditions. Study 2 was an uncontrolled trial of the Couple Coping Enhancement Training (CCET) administered to 119 couples. Couples receiving CCET that had initially low satisfaction showed a moderate increase in satisfaction (g = .44), whereas initially highly satisfied couples showed no change. Brief relationship education can assist somewhat distressed couples to enhance satisfaction, and has potential as a cost-effective way of enhancing the reach of couple interventions
    Rusu Petruta P, Hilpert Peter, Beach Steven R. H, Turliuc Maria N, Bodenmann Guy (2015) Dyadic coping mediates the association of sanctification with marital satisfaction and well-being.,Journal of Family Psychology 29 (6) pp. 843-849 American Psychological Association
    Some studies suggest that the sanctification of marriage, or considering marriage sacred, is related to positive marital outcomes (e.g., marital satisfaction, conflict resolution). However, the mechanisms explaining this association have not been sufficiently investigated. In the current study, we analyzed supportive dyadic coping as a potential mediator of the relation between marriage sanctity and marital satisfaction, as well as between marriage sanctity and well-being. Self-reported data were collected from 215 Romanian couples (N = 430) belonging to the Christian Orthodox religion. Analyses using the common fate model indicate that supportive dyadic coping mediates both the relation between sanctification and marital satisfaction, as well as the relation between sanctification and well-being. These findings suggest that sanctification increases support provided to the partner, which in turn is positively related to marital satisfaction and well-being at the dyadic level.
    Burri Andrea, Hilpert Peter, Spector Timothy (2015) Longitudinal Evaluation of Sexual Function in a Cohort of Pre? and Postmenopausal Women,Journal of Sexual Medicine 12 (6) pp. 1427-1435 Wiley
    Introduction

    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.

    Aim

    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.

    Methods

    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.

    Results

    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.

    Conclusions

    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

    Xu Feng, Hilpert Peter, Nussbeck Fridtjof W., Bodenmann Guy (2018) Testing Stress and Dyadic Coping Processes in Chinese
    Couples
    ,
    International Journal of Stress Management 25 (1) pp. 84-95 American Psychological Association
    Previous empirical studies show that stress occurring outside of the relationship
    (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.
    Hilpert Peter, Bodenmann Guy, Nussbeck Fridtjof W., Bradbury Thomas N. (2016) Improving Personal Happiness Through Couple
    Intervention: A Randomized Controlled Trial
    of a Self-directed Couple Enhancement Program
    ,
    Journal of Happiness Studies 17 (1) pp. 213-237 Springer Verlag
    Although personal happiness is highly associated with social relationships, basic questions remain regarding the causal effect of improved social relationships on happiness. The main aim of this study was to test whether emotional and cognitive dimensions of personal happiness can be increased by means of a self-directed relationship enhancement program, which aims to increase relationship-relevant skills such as dyadic coping, communication, and conflict resolution. N = 220 couples were randomly assigned either to an intervention or to a waiting list control group (survey: pre-, post-, 3- and 6-month follow-ups). Multi-group latent change score models reveal that (1) personal happiness can be increased through a couple intervention; (2) change in personal happiness was predicted by an increase in skills and relationship satisfaction through the intervention; (3) the least happy participants benefited most from the intervention. Improving spousal interactions may help people become and stay happier. Participants in this study did not relapse to their set point of personal happiness as could be expected by adaptation theory. Thus, not treating individuals directly, but rather the dynamic system of spousal interactions as a whole, offers a potentially very powerful area for happiness research.
    Maercker Andreas, Hilpert Peter, Burri Andrea (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 20 (6) pp. 616-626 Taylor & Francis
    Objectives:

    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).

    Method:

    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.

    Results:

    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.

    Conclusion:

    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.

    Falconier Mariana K., Jackson Jeffrey B., Hilpert Peter, Bodenmann Guy (2015) Dyadic coping and relationship satisfaction: A meta-analysis,Clinical Psychology Review 42 pp. 28-46 Elsevier
    Meta-analytic methods were used to empirically determine the association between dyadic coping and relationship satisfaction. Dyadic coping is a systemic conceptualization of the processes partners use to cope with stressors, such as stress communication, individual strategies to assist the other partner cope with stress, and partners' strategies to cope together. A total of 72 independent samples from 57 reports with a combined sum of 17,856 participants were included. The aggregated standardized zero-order correlation (r) for total dyadic coping with relationship satisfaction was .45 (p = .000). Total dyadic coping strongly predicted relationship satisfaction regardless of gender, age, relationship length, education level, and nationality. Perceptions of overall dyadic coping by partner and by both partners together were stronger predictors of relationship satisfaction than perceptions of overall dyadic coping by self. Aggregated positive forms of dyadic coping were a stronger predictor of relationship satisfaction than aggregated negative forms of dyadic coping. Comparisons among dyadic coping dimensions indicated that collaborative common coping, supportive coping, and hostile/ambivalent coping were stronger predictors of relationship satisfaction than stress communication, delegated coping, protective buffering coping, and overprotection coping. Clinical implications and recommendations for future research are provided.
    Randall Ashley K, Hilpert Peter, Jimenez-Arista Laura E, Walsh Kelsey J, Bodenmann Guy (2015) Dyadic Coping in the U.S.: Psychometric Properties and Validity for Use of the English Version of the Dyadic Coping Inventory,Current Psychology 35 (4) pp. 570-582 Springer
    A majority of individuals living in the U.S. experience unhealthy levels of stress; however, romantic partners can help mitigate stress? deleterious effects by coping together (dyadic coping). The Dyadic Coping Inventory (DCI) measures coping behaviors when one or both partners experience stress. Specifically, the DCI measures a) partner?s self-report of his/her own (Self) and their partner?s (Partner) behavior, and b) Common DC during the experience of a common stressor. Despite its wide use, the DCI has not yet been validated for use in the United States (U.S.). The aim of this study was to address this gap in the literature. Using a sample of 938 individuals in the U.S. currently involved in a romantic relationship, we validated the English version of the DCI by analyzing its factorial structure and psychometric properties. Results supported the theoretically assumed factorial structure of the DCI. Convergent and discriminant validity, as well as measurement invariance across gender and culture using the original Swiss sample, was confirmed. The English version of the DCI is a valid self-report instrument for assessing couples' coping in the U.S.
    Xu Feng, Hilpert Peter, Randall Ashley K, Li Qiuping, Bodenmann Guy (2016) Validation of the Dyadic Coping Inventory With Chinese Couples:
    Factorial Structure, Measurement Invariance, and Construct Validity
    ,
    Psychological Assessment 26 (8) pp. e127-e140 American Psychological Association
    The Dyadic Coping Inventory (DCI, Bodenmann, 2008) assesses how couples support each other when
    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.
    Hilpert Peter (2018) Body Movement is Associated With Orgasm during Vaginal Intercourse in Women,The Journal of Sex Research 56 (3) pp. 356-366 Taylor & Francis (Routledge)
    Very few studies have investigated the relationship between women?s ability to experience an orgasm during vaginal intercourse and specific stimulation techniques. We examined two common techniques during vaginal intercourse both with and without simultaneous external clitoral stimulation: 1) body movement, in particular back-and-forth swinging movements of the pelvis and trunk; and 2) precise rubbing of the clitoris with an immobilized body. Structural equation modeling was used to compare the effects of the two stimulation techniques on women?s orgasm frequency (N = 1,239). As hypothesized, the frequency of orgasm during vaginal intercourse with simultaneous clitoral stimulation was positively associated with a preference for body movement during arousal. Body movement, as opposed to body immobilization, was also associated with a higher frequency of orgasm during vaginal intercourse without simultaneous clitoral stimulation. We conclude that body movement is associated with more orgasms during vaginal intercourse, whereas precise rubbing of the clitoris with an immobilized body is not associated with more orgasms. Teaching women to move their pelvis and trunk in a swinging back-and-forth movement during vaginal intercourse might therefore facilitate reaching an orgasm, whereas encouraging them to self-stimulate the clitoris might be less helpful if done with an immobilized body.
    Flückiger Christoph, Hilpert Peter, Goldberg Simon B., Caspar Franz, Wolfer Christine, Held Judith, Vîsl? Andreea (2018) Investigating the impact of early alliance on predicting subjective change at post-treatment ? An evidence-based souvenir of overlooked clinical perspectives,Journal of Counseling Psychology American Psychological Association

    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.

    ?

    Abstract

    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.

    Rubel Julian A., Hilpert Peter, Wolfer Christine, Held Judith, Vîsl? Andreea, Flückiger Christoph (2019) The working alliance in manualized CBT for generalized anxiety disorder Does it lead to change and does the effect vary depending on manual implementation flexibility?,Journal of Consulting and Clinical Psychology American Psychological Association

    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.

    Soma Christina S., Baucom Brian R. W., Xiao Bo, Butner Jonathan E., Hilpert Peter, Narayanan Shrikanth, Atkins David C., Imel Zac E. (2019) Coregulation of therapist and client emotion during psychotherapy,Psychotherapy Research pp. 1-13 Taylor & Francis (Routledge)

    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.

    This study aimed to investigate the impact of a 4-week online mindfulness-based intervention on work situation awareness and other measures of occupational health. A randomised wait-list control design was used, with three and six month follow up. Participants were UK-based employees of a large international insurance company (N=163). Participants who completed the intervention (n=18) reported a significantly greater positive change, comparing before and after the intervention, in levels of work situation awareness, mindful awareness, sleep quality, anxiety, fatigue (acute and chronic) and work-related rumination, when compared to the change reported by wait-list control participants (n=65). The groups were combined for follow up (3 months, n=22; 6 months, n=26) due to attrition. The effects held at three months for affective rumination and problem solving pondering (measures of work-related rumination), and at six months for work situation awareness and anxiety. Mindful awareness was not significantly higher at three months but levels were significantly higher at six months than baseline. Participants who had dropped out were contacted by email and their responses analysed using content analysis. Reasons given included time limitations and a stressful work environment. This study provides support for online mindfulness interventions in increasing occupational wellbeing when completed. The high rates of attrition highlighted areas for future research around who is best suited to these types of interventions to best target resources.
    Burri Andrea, Hilpert Peter, Williams Frances (2019) Pain catastrophizing, fear of pain, and depression and their association with female sexual pain,Journal of Sexual Medicine Elsevier

    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
    sexual pain.

    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  .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  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.

    Xu Feng, Hilpert Peter, Bodenmann Guy (2019) Daily and Long-Term Consequences of Support Seeking in Chinese Couples: Between-Person Differences and Within-Person Processes,International Journal of Psychology Psychology Press, Taylor & Francis
    It is widely accepted that support-seeking behavior is culture-specific, such that Asians are less likely to seek support when stressed compared with Westerners. However, mounting evidence is based on the vignette methodology or the cross-sectional survey and utilized students sample. Little is known about how such behavior manifests in real life and incurs relational consequences. Moreover, psychological theories predict both differences in support-seeking behavior between persons and the variability of such behavior within persons. The current study aims to explore between-and within-person associations between support seeking and relationship satisfaction in Chinese couples. Eighty-four Chinese couples reported their daily stressors, support seeking behavior, and relationship satisfaction every evening for 7 days and overall relationship satisfaction before the diary study and one year later. We found that support seeking matters in Asian couples: On days when couples sought more support, they would be more satisfied with their relationship. Notably, no negative associations between couples' own support seeking and partners' relationship satisfaction were found. This study advances our understanding of general and temporal support-seeking processes in Asian couples in the course of everyday life and over time. Results entail important theoretical and practical implications.
    Hilpert Peter, Brick Timothy R., Flueckiger Christoph, Vowels Matthew, Ceuleman Eva, Kuppens Peter, Sels Laura (2019) What Can Be Learned From Couple Research: Examining Emotional Co-Regulation Processes in Face-to-Face Interactions,Journal of Counseling Psychology American Psychological Association
    A crucial component of successful counseling and psychotherapy is the dyadic emotion co-regulation process between patient and therapist which unfolds moment-to-moment during therapy sessions. The major reason for the disappointing progress in understanding this process is the lack of appropriate methods to assess subjectively experienced emotions continuously during therapy sessions without disturbing the natural flow of the interaction. The resulting inability has forced the field to focus on patients? overall emotion ratings at the end of each session with limited predictive value of the dyadic interplay between patient and therapist?s emotional states within each session. The current tutorial demonstrates how couple research ? confronted with a comparable problem ? has overcome this issue by (i) developing a video-based retrospective self-report assessment method for individuals? continuous state emotions without undermining the dyadic interaction and (ii) using a validated statistical tool to analyze the dynamical process during a dyadic interaction. We show how to assess emotion data continuously, and how to unravel self-regulation and co-regulation processes using a Latent Differential Equation Modeling approach. Finally, we discuss how this approach can be applied in counseling psychology and psychotherapy to test basic theoretical assumptions about the co-creation of emotions despite the conceptual differences between couple dyads and therapist-patient dyads. The present method aims to inspire future research activities examining systematic real-time processes between patients and therapists.
    Hilpert Peter (2020) Triple P for Foster Parents with Young Foster Children: Results of a 1-year Randomized Clinical Trial,Journal of Interpersonal Violence SAGE Publications
    Background: Young children with a history of maltreatment or neglect in foster families often confront their caregivers with particularly challenging behaviors. This may lead to more parenting stress, an increased risk for the foster child to experience further maltreatment, and placement disruptions. Objective: We conducted a randomized controlled trial to investigate the efficacy of a parent group training tailored to the special needs of foster families. We hypothesized significant short- and long-term improvements regarding foster parents? parenting competencies, child mental health problems, and related outcomes. Participants and Setting: Eighty-one families with 87 foster children aged 2-7 years participated in the trial. For the intervention study, 44 randomly selected families (54%) were offered to participate in the parent group training. Intervention and control group families were reassessed three times over a period of one year. Results: Contrary to our expectations, we found no advantages of the intervention group compared to the usual care control group on any outcome measure. Instead, we found some significant changes in both groups across time. Discussion: Placement into foster care is associated with some favorable outcomes for foster children. Additional support for foster families beyond the services delivered in the youth welfare system to foster parents was not associated with more favorable outcomes. The present intervention is likely associated with a low risk of harm but also with a high likelihood of a lack of significant benefits for foster parents and their young foster children going beyond feeling satisfied about the delivered services. Participating foster families showed favorable baseline results on parenting measures which may have impeded intervention effects to unfold on these proximal variables.
    Burri Andrea, Hilpert Peter (2020) Postcoital Symptoms in a Convenience Sample of Men and Women,The Journal of Sexual Medicine Elsevier
    Abstract
    Introduction
    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.

    Aim
    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.

    Methods
    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.

    Results
    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.

    Clinical Implications
    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.

    Conclusion
    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.

    Brun del Re Ursina, Hilpert Peter, Spahni Stefanie, Bodenmann Guy (2020) Pornographiekonsum in der Partnerschaft: Häufigkeit, Motivation und Einstellung des Konsums und deren Geschlechtsunterschiede,Zeitschrift für Klinische Psychologie und Psychotherapie Hogrefe
    Background: To understand the effects of pornography consumption onto relationships we need to know how own and partner consumption is been experienced.
    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.

    Salinger J., Whisman M.A., Randall A.K., Hilpert P. (2020) Associations Between Marital Discord and Depressive Symptoms: A Cross-Cultural Analysis,Family Process Wiley
    The objectives of this study were to investigate actor and partner effects of the association between marital discord and depressive symptoms in a cross-cultural sample of 4,779 couples from 11 European countries that were divided into 3 groups (i.e., Northern, Central, Southern Europe), and evaluate the potential gender and cross-cultural invariance of this association. Actor-partner interdependence models were used to analyze the cross-sectional associations between self-reported perceived marital conflict and depressive symptoms. Marital conflict was significantly and positively associated with self-reported depressive symptoms for husbands and wives (actor effects), as well as with partner-reported depressive symptoms (partner effects). Pooling across cultural groups, no significant difference in the magnitude of actor or partner effects based on gender were found. The magnitude of the positive actor association varied across cultural groupings only for women: a significantly weaker association existed for women residing in North Europe relative to women in Central or Southern Europe. These results suggest that marital discord is a reliable correlate of depressive symptoms for European couples, and that the magnitude of the positive association varies by culture for women. Should these results be replicated longitudinally, couple-based interventions may be indicated to reduce marital discord and prevent and treat depression for discordant couples in Europe.
    Flückiger Christoph, Paul Jessica, Hilpert Peter, Vîsl? Andreea, Gómez Penedo Juan-Martin, Probst Greta Helene, Wampold Bruce E. (2020) Estimating the reproducibility of psychotherapy effects in mood and anxiety disorders: the possible utility of multicenter trials,World Psychiatry Wiley

    Estimating the reproducibility of psychotherapy effects is essential. This is particularly crucial for trials with large effects, as the inclusion of false-positive trials can lead to erroneous conclusions about treatment efficacy in research syntheses.

    Multicenter studies allow researchers to estimate the reproducibility of effects directly across centers under comparable study conditions (e.g., comparable enrollment procedures, inclusion/exclusion criteria, assessment plans). In an important sense, implementation of trials at various centers is close to a direct replication of findings. Accordingly, recent standards recognize the benefit of describing individual center effects in multicenter studies.

    Additional publications