The Clinical Value of Couple and Family Case Conceptualizations

Clinicians who work primarily with individual clients and have developed competency with case conceptualizations can provide effective treatment. However, when they work with clients for whom couple and family dynamics are prominent, having an individual case conceptualization can be useful but limited. This chapter discusses the value of adding couple and family case conceptualizations. It describes how to incorporate couple interaction patterns and family interaction patterns in the case conceptualization process. A case example that captured and held national attention for more than 1 year is presented. It illustrates the pattern-focused approach for incorporating individual, couple, and family patterns into a composite case conceptualization.

Oxytocin and positive couple interaction affect the perception of wound pain in everyday life

A large body of animal and human laboratory research has linked social interaction and support to pain perception, with a possible role for the neuropeptide oxytocin as a neuroendocrine mediator. However so far, it has been unclear whether these effects translate to ecologically valid everyday life behavior and pain perception. In a randomized placebo-controlled study, a standard suction blister skin wound was induced to N = 80 romantic couples (N = 160 individuals). Couples then received intranasal oxytocin or placebo twice daily and were either instructed to perform a positive social interaction (partner appraisal task, PAT) once in the laboratory and two times during the following five days, or not. During these days, all participants reported their subjective pain levels multiple times a day using ecologically momentary assessment. Results from hierarchical linear modeling suggest that pain levels within the couples were inter-related. In men, but not in women, oxytocin reduced pain levels. Women reported lower pain levels in the group of positive social interaction, while this effect did not show in men. These results suggest that intranasal oxytocin might have sex-specific effects with pain reducing effects in men but the opposite effects in women. In contrast, especially women benefit from positive interaction in terms of dampened pain levels after positive interaction. The results add to the evidence for health-beneficial effects of positive couple interaction and point to underlying neuroendocrine mechanisms in everyday life pain specifically. The sex-specific effects, in particular, may have implications for psychopharmacological treatment of pain in men and women.

Interobserver agreement and the effects of ethnicity on observational coding of affect

Objectives: The Specific Affect Coding System (SPAFF) is a reliable system for coding observed affect but few studies have tested its generalizability and susceptibility to bias. Methods: The current study compared highly trained African American and Caucasian coders’ scores when coding the same videos of African American and Caucasian American couples. Results: While it was hypothesized that Caucasian Americans may code African America couples as being more aggressive and less positive based on stereotypes, results revealed a significant Ethnicity of Coder × Ethnicity of Couple interaction on the “neutral” code only. Both African American and Caucasian coders tended to rate out-group couples as being less neutral and showing less interest than in-group couples. No other emotion was identified as being over-coded in lieu of neutral, however. Conclusion: Results suggest a subtle bias in SPAFF coding. Adding a diversity component to the SPAFF training and recruiting diverse coders is recommended.

Interpersonal interactions within couples: Convergences and divergences between self-description and partner’s perception

Conjugality refers to the shared experience between partners characterized by an enduring bond. It is related to a high degree of intimacy, affective involvement, and different interpersonal strategies, and it is seen by partners as their most significant relationship. Such intensity makes couple interaction different from any other type of relationship. The objective of this study was to verify how interpersonal attitude of the participants toward their spouses are associated with their partners and the independent interviewer’s perception of their attitudes. The results showed that the participants had a perception of themselves that was, in general, congruent with their partners’ and the interviewer’s perception. However, the spouses agreed more about their relationship roles (dominant or submissive) and disagreed on the dedicated affection (friendly or hostile) between them. In contrast, the interviewer overestimated the subjects’ attempts to control but confirmed the presence of statements of affection. The results obtained also provided a realistic portrait of marital interactions, increasing the application spectrum of the Checklist de Relações Interpessoais (Check list of Interpersonal Transactions).