Predicting Improvement in Depression Across Therapies Using Indicators of Romantic Relationship Functioning: A Preliminary Investigation

Abstract

Depression is a common presenting problem, often affected by couple interactions in unique ways. However, research in the area of romantic relationship functioning and depression often replicates previous research or consists of literature reviews, limiting the clinical relevancy. The purpose of this preliminary study is to expand the research on the effects of relational processes on depression treatment outcomes. We tested whether initiator tendency, attachment anxiety, attachment avoidance, and marital satisfaction predicted improvement in depression for women with Major Depressive Disorder enrolled in a depression treatment clinical trial (n = 17). Women completed treatments of either pharmacotherapy or combined Emotionally Focused Therapy for couples and pharmacotherapy. We found that higher baseline levels of partner initiator tendency resulted in less change in depression (worse outcomes), regardless of treatment type and that higher baseline levels of attachment avoidance predicted better depression outcomes in treatment. Marital satisfaction, however, was not linked to change in depression. Initiator tendency is discussed as a critical romantic relationship factor for depression treatment outcomes.

Sexual and Relationship Satisfaction associated with Shifts in Dyadic Trajectories of Depressive Symptoms in German Couples across Four Years

“…Based on these findings, addressing issues involving relationship and sexual satisfaction may be a way in which clinicians can help clients assuage depression symptoms. This is consistent with evidence that treatment targeted toward improving the couple's relationship can also treat depression (Denton et al., ; Woods et al., ).…”

“…Particularly, relationship satisfaction was linked with depressive symptoms one year later (e.g., Hollist, Miller, Falceto, & Fernandes, 2007). In addition, preliminary studies of clinical interventions for couples as a way to treat depression suggest early evidence that enhancing a couple's relationship may be linked with positive treatment outcomes for depression (Denton et al, 2012;Woods, Priest, & Denton, 2015).…”

Explicit and implicit attachment and the outcomes of acceptance and commitment therapy and cognitive behavioral therapy for depression

“…However, other studies have produced similar results with regard to explicitly measured attachment anxiety. In the study by Woods and colleagues [35] attachment anxiety did not predict change in depression. McBride and colleagues [18] also found that attachment anxiety was not related to treatment outcome.…”

The Role of Attachment Behaviors in the Link between Relationship Satisfaction and Depression in Clinical Couples: Implications for Clinical Practice

“…Despite this, we were not able to find any research examining the relationship between all three variables—attachment style, relationship satisfaction, and depression—in the same model. This is concerning because common clinical approaches for treating depression in marriage are derived from an attachment framework (Anderson, Beach, & Kaslow, ; Woods, Priest, & Denton, ), yet research has failed to identify clear points of intervention that attempt to change or modify attachment styles in the context of depression. As such, the aim of this study is to use a measure of attachment that focuses more on behaviors—rather than styles—in an effort to explore the pathways between marital satisfaction and depression from an attachment framework.…”