Many children never receive treatment for their mental health symptoms-and those that do often receive it only after years of delay. Given that relationship and parenting conflict is an identified mechanism of child mental health symptoms, reducing distress in the parents' romantic relationship may help reduce this unmet need. In the current study, 213 couples with 1 or more children between the ages of 3 and 17 (inclusive) were randomized to receive the web-based OurRelationship program or to a 2-month waitlist condition. Intervention couples were also assessed in the year following the program. Couples in the OurRelationship program experienced a significant decrease in coparenting conflict during the intervention (Cohen's d ϭ Ϫ0.27) but also a significant increase in coparenting conflict in the following year, reducing the long-term effects of the intervention (within-group d ϭ Ϫ0.20 at 1-year follow-up compared with baseline). Additionally, parent-reported children's externalizing (within-group d ϭ Ϫ0.40) and internalizing (within-group d ϭ Ϫ0.27) symptoms significantly decreased from baseline to the 1-year follow-up. As hypothesized, improvement in relationship satisfaction during the program was significantly associated with a decrease in coparenting conflict which, in turn, was associated with reduction in both externalizing and internalizing symptoms in the children. These results indicate that online relationship-focused interventions offer an important, adjunctive approach to meet society's need for reducing children's mental health symptoms. Furthermore, the improvements in child functioning strengthen the evidence suggesting the cost-effectiveness of these relationship-focused interventions.
The current study sought to examine immediate and long-term consequences of college sexual assault (C-SA) among women with no prior sexual assault history. While much is known regarding the short-term negative impact of C-SA, the current study examines whether C-SA is associated with immediate academic and psychosocial consequences as well as long-term poorer mental health (depression, posttraumatic stress [PTS], anxiety) and interpersonal functioning (relationship quality, sexual and emotional intimacy). In addition, the current study explores potential moderators of these associations, including race, the nature of the assault, resulting injury, relation to perpetrator, and whether the assault was reported. A stratified design was used comparing women who experienced C-SA ( n = 201) to women with no C-SA history (n = 203) controlling for age, education, race, and ethnicity. Results from a series of repeated-measures analyses of variance (ANOVAs) demonstrated that across race and ethnicity, women with a history of C-SA reported lower grade-point averages, more missed classes, and fewer serious romantic relationships in college following the assault. Furthermore, results from a series of linear and logistic regression revealed that approximately 9 years later, women who experienced C-SA reported greater symptoms of depression, anxiety, and PTS as well as lower emotional and sexual intimacy. These associations differed by a number of assault variables (assault type, relation to perpetrator, amount of fear reported, physical injuries sustained, whether the assault was reported, whether medical treatment was sought). The current study further confirms the significant and pervasive impact of C-SA associated with women’s health and functioning, warranting further intervention to both reduce the incidence of C-SA and expand the reach of existing mental health interventions to survivors.
Objective: Military couples need and desire relationship interventions. Online interventions improve access; however, their effectiveness within the military population is untested. Using a subsample from a larger randomized controlled trial of OurRelationship and ePREP online relationship programs for low-income couples, this study examined baseline characteristics of military compared with civilian couples enrolled (Aim 1), treatment effects within military couples (Aim 2), and treatment differences between military and matched civilian participants (Aim 3). Method: Military couples (n ϭ 90 couples) in which 1 or both partners were active duty (11%) or veterans (89%) were selected from the larger randomized controlled trial along with a matched civilian sample selected using propensity scores. Results: No differences were found between military and civilian couples regarding baseline individual or relationship functioning. Program completion was lower among military couples (57%) compared with civilians (71%), whereas program satisfaction was equally positive. Among military couples, relationship satisfaction, conflict, emotional support, and breakup potential were significantly improved after treatment (between-groups d ϭ 0.31-0.46) and maintained at follow-up; intimate partner violence and individual functioning domains did not improve. When comparing military and civilian samples, there was a pattern of stronger treatment impacts on individual functioning for civilians, although only the impact on insomnia evidenced a significant difference. Conclusions: These online relationship interventions improved relationship functioning for military couples. More research is needed to test these interventions among clinically impaired military populations and to explore potential for improving program completion and effects on relationship violence and individual wellbeing. What is the public health significance of this article?Improving couple and family functioning is a major concern for active-duty and veteran couples. This study suggests that relationship-focused online programs-OurRelationship and ePREP-provide an effective and accessible method to improve the relationship functioning of military couples. Con-
Initial evidence suggests that gains in relationship functioning from brief, web‐based programs are maintained through one year following the intervention; however, whether these results generalize to a low‐income sample is unclear. Furthermore, previous research from in‐person couple therapy suggests there may be different shapes of maintenance slopes for behavioral versus acceptance‐based techniques. This study contacted 668 individuals who enrolled in online behavioral (ePREP) or acceptance‐based (OurRelationship) programs one year following completion of the program. Multilevel modeling was used to examine linear and quadratic rates of change in the year following the online intervention as well as total amount of change from pretreatment to 12‐month follow‐up for both relationship and individual functioning. The majority of couples who responded continued to be in a relationship with the same partner (68.3%). Examinations of relationship functioning indicated couples in both programs maintained their gains over follow‐up (i.e., no significant linear or quadratic changes), with medium‐to‐large within‐group effect sizes from pre‐ to one‐year follow‐up. There were no significant differences in relationship outcomes between OurRelationship and ePREP. Similarly, examinations of individual functioning outcomes indicated couples maintained their gains over follow‐up or continued to improve. In total, couples experienced small‐to‐medium within‐group effect sizes from pretreatment to one‐year follow‐up, with larger effects for individuals who were initially distressed. These results suggest that online programs create lasting change for low‐income couples in relationship and individual functioning, with minimal differences between behavioral and acceptance‐based orientations.
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