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Research has demonstrated a clear link between perceived emotional invalidation and increased psychological distress. However, available studies have predominantly focused on individual data, and leave the impact on relationship satisfaction largely unexplored. Considering the systemic-transactional model, our study aimed to examine the association between perceived emotional invalidation, psychological distress, and couple relationship satisfaction from a dyadic perspective. We conducted a cross-sectional study involving 240 mixed-gender couples from Portugal employing the Actor-Partner Interdependence Mediational Model to analyse the data to examine actor and partner direct and indirect effects. Results showed that, for both women and men, own perceived emotional invalidation was associated with own psychological distress but not with own relationship satisfaction. Also, own psychological distress was associated with own relationship satisfaction but only for women. Finally, one actor and one partner indirect effects were found. Women perceived emotional invalidation was associated with their own psychological distress which in turn contributed to lower levels of relationship satisfaction for both them and their partners. This study contributes to a deeper understanding of the dyadic effects of perceived emotional invalidation on psychological distress and relationship satisfaction within romantic relationships identifying interpersonal emotional dynamics as an important target of interventions.

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En la relación de pareja, el empleo del celular puede llegar a ocasionar conflictos, lo que afectaría la valoración de la unión conyugal. Objetivo: Determinar la asociación entre la satisfacción con la relación de pareja y los conflictos por el uso del celular en adultos peruanos. Materiales y Métodos. Estudio cuantitativo, de tipo no experimental, transversal y correlacional. La muestra fue constituida por 325 adultos peruanos mediante un muestreo no probabilístico. La información se recolectó mediante la técnica de la encuesta y como instrumento dos cuestionarios, la Escala de Valoración de la Relación propuesto por Hendrick y la Escala de Conflictos Relacionados al uso del celular de Roberts y David. Resultados. La satisfacción con la relación de pareja fue mayormente moderada para el 43,5%. Entre tanto, indicaron algún nivel de conflicto por el uso del celular el 72,9%. Además, no se encontró diferencias significativas en la satisfacción con la relación de pareja según el sexo. Conclusiones. Existe relación negativa moderada y significativa entre la satisfacción con la relación de pareja y los conflictos por el uso del celular en adultos peruanos (rs= -0.456), donde se alcanzó una p=0,000 (<0.05). De esta manera se sostiene que a mayor satisfacción, menores serán los conflictos percibidos por el uso del celular.

In the couple relationship, the use of cell phones can lead to conflicts, which would affect the assessment of the marital union. Objective: To determine the association between satisfaction with the couple relationship and conflicts due to cell phone use in Peruvian adults. Materials and Methods. Quantitative, non-experimental, cross-sectional and correlational study. The sample consisted of 325 Peruvian adults through non-probabilistic sampling. The information was collected using the survey technique and two questionnaires as instruments, the Relationship Assessment Scale proposed by Hendrick and the Conflicts Related to Cell Phone Use Scale by Roberts and David. Results. Satisfaction with the couple relationship was mostly moderate at 43.5%. Meanwhile, 72.9% indicated some level of conflict due to cell phone use. Furthermore, no significant differences were found in satisfaction with the couple relationship according to sex. Conclusions. There is a moderate and significant negative relationship between satisfaction with the couple relationship and conflicts due to cell phone use in Peruvian adults (rs= -0.456), where p=0.000 (<0.05) was reached. In this way, it is argued that the greater the satisfaction, the fewer the perceived conflicts due to cell phone use.

No relacionamento conjugal, o uso de celulares pode levar a conflitos, o que afetaria a avaliação da união conjugal. Objetivo: Determinar a associação entre a satisfação com o relacionamento conjugal e os conflitos devido ao uso de celular em adultos peruanos. Materiais e Métodos. Estudo quantitativo, não experimental, transversal e correlacional. A amostra foi constituída por 325 adultos peruanos através de amostragem não probabilística. As informações foram coletadas utilizando a técnica de survey e dois questionários como instrumentos, a Escala de Avaliação de Relacionamento proposta por Hendrick e a Escala de Conflitos Relacionados ao Uso de Celular de Roberts e David. Resultados. A satisfação com o relacionamento conjugal foi predominantemente moderada em 43,5%. Enquanto isso, 72,9% indicaram algum nível de conflito devido ao uso de celular. Além disso, não foram encontradas diferenças significativas na satisfação com o relacionamento conjugal de acordo com o sexo. Conclusões. Existe uma relação negativa moderada e significativa entre a satisfação com o relacionamento conjugal e os conflitos devido ao uso de celular em adultos peruanos (rs= -0,456), onde foi atingido p=0,000 (<0,05). Dessa forma, argumenta-se que quanto maior a satisfação, menores serão os conflitos percebidos devido ao uso de celular.

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Couple relationship education (CRE) has decades of research showing mixed results for participants. Various competing frameworks for CRE content have emerged in the development of the field, yet content has not been systematically investigated. Through an inductive content analysis of 15 different CRE programs, this study explored content themes and categories that are common across programs. Analysis found four themes throughout the programs: interactional skills, the self in the relationship, partner bonding, and relationship motivations. Categories for each theme were identified and are presented and discussed. Findings validate the primacy of teaching interactional skills within CRE including consistency in topics (e.g., communication training, conflict management). Other themes were also common (e.g., self in the relationship), though their categories were more diverse (e.g., self-care, expectations, personality). Several factors that have emerged as more significant in relationship theory and research were not well-represented in the content analysis (e.g., socioecological contexts, systemic patterns).

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Background: We aimed to examine the hypothesized negative associations between childbirth post-traumatic stress disorder (PTSD) symptoms (using the two-factor model of birth-related and general symptoms), social support, and a couple's relationship quality at 8-12 weeks postpartum. This analysis considered the longitudinal positive shared variance with acute stress disorder (ASD) symptoms measured shortly after birth, while accounting for obstetric and demographic variables. Methods: Participants included 246 mothers who gave birth at the maternity ward of a tertiary healthcare center. Self-report questionnaires were used 1-4 days postpartum (T1): Demographic information, the Birth Satisfaction Scale-Revised (BSS-R), and the National Stressful Events Survey Acute Stress Disorder Short Scale (NSESSS). At T2 (8-12 weeks postpartum), the Multidimensional Scale of Perceived Social Support (MSPSS), the Dyadic Adjustment Scale (DAS-7), and the City Birth Trauma Scale (BiTS). Results: In partial support of our hypotheses, three hierarchical regression analyses revealed a significant positive contribution of ASD symptoms to childbirth PTSD general symptoms (ß = .33, p <.001) and the total score (ß = .29, p <.001), but not to birth-related symptoms. Social support (ß = -.21, p = .003) and the quality of the couple's relationship (ß=-.20, p = .003) showed negative associations with the BiTS general symptoms. Conclusion: Our study enhances understanding of the shared variance between childbirth ASD and PTSD, supporting the factor structure of general and birth-related symptoms as different aspects of childbirth PTSD and highlighting the negative association of social support and the quality of a couple's relationship with PTSD general symptoms, suggesting potential avenues for targeted interventions.

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In couples dealing with health problems, we-disease appraisals can influence dyadic coping strategies to alleviate distress. This study describes the development and validation of a self-report scale to assess we-disease appraisals of health problems. The newly developed We-Disease Questionnaire (WDQ) was administered in three samples: parents of children with type 1 diabetes (n = 240) or cancer (n = 125) and individuals with visual impairment and their partners (n = 216). Reliability was measured by coefficient omega. To assess construct validity, correlations with other measures of individual and dyadic adjustment were examined. Descriptive statistics across all samples were compared. A 4-item version of the WDQ demonstrated good reliability and validity and showed meaningful associations with established scales. We-disease appraisals were highest among parents of children with cancer and lowest among couples with visual impairment. The WDQ is a reliable and valid measure that can be used across different health problems.

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Considerable evidence suggests couple relationship education (CRE) programs are effective in improving couples' relationship functioning, yet few studies have examined the implications of CRE programs on indicators of physical health despite substantial research supporting links between relational and physical health. This study utilized a sample of 308 couples randomly assigned to a CRE curriculum to explore the dyadic links between conflict management and self-care skills (emphasized in CRE), stress, and sleep dysfunction concurrently. We prospectively tested whether changes in skills drove changes in sleep dysfunction or vice versa, for both self and partner. Results from a series of structural equation models indicated indirect links for men and women between conflict management and self-care skills and sleep dysfunction through lower stress level at program start. Dyadically, men's and women's better conflict management skills were associated with partners' lower stress, which was in turn associated with partners' lower sleep dysfunction. Men's better self-care skills were linked with partners' lower stress levels, which were linked with partners' lower sleep dysfunction. Tests of dyadic prospective cross-lagged effects among changes in sleep and changes in skills indicated that initial improvements in both partners' sleep predicted improvements in their own conflict management skills 1 year later. Initial improvements in women's conflict management skills predicted reduced sleep dysfunction for themselves. Additionally, for both partners, early changes in self-care predicted later reductions in sleep dysfunction. Dyadically, immediate improvements in men's self-care predicted reduced sleep dysfunction for their partner a year later. Implications for research and practice are discussed.

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RATIONALE: HIV and cardiometabolic disorders including hypertension and diabetes pose a serious double threat in Malawi. Supportive couple relationships may be an important resource for managing these conditions. According to the theory of communal coping, couples will more effectively manage illness if they view the illness as "our problem" (shared illness appraisal) and are united in shared behavioral efforts. METHODS: This study qualitatively investigated communal coping of 25 couples living with HIV and hypertension or diabetes in Zomba, Malawi. Partners were interviewed separately regarding relationship quality, shared illness appraisal, communal coping, and dyadic management of illness. RESULTS: Most participants (80%) were living with HIV, and more than half were also living with hypertension. Most participants expressed high levels of unity and the view that illness was "our problem." In some couples, partners expected but did not extend help and support and reported little collaboration. Communal coping and dyadic management were strongly gendered. Some women reported a one-sided support relationship in which they gave but did not receive support. Women were also more likely to initiate support interactions and offered more varied support than men. In couples with poor relationship quality and weak communal coping, dyadic management of illness was also weak. Partner support was particularly crucial for dietary changes, as women typically prepared meals for the entire family. Other lifestyle changes that could be supported or hindered by a partner included exercise, stress reduction, and medication adherence. CONCLUSION: We conclude that gendered power imbalances may influence the extent to which couple-level ideals translate into actual communal coping and health behaviors. Given that spouses and families of patients are also at risk due to shared environments, we call for a shift from an illness management paradigm to a paradigm of optimizing health for spouses and families regardless of diabetes or hypertension diagnosis.

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ABSTRACT Introduction: A systemic instrument is presented to measure the socioemotional network in relation to the partner and the person's perception of the impact of this intimate network on his or her partner for his or her classification. It is based on the idea that a nurtured social network brings positive benefits to one's nuclear partner. In order to verify this assumption both in research and in clinical practice, it is necessary to construct a complex instrument that allows reaching different dimensions within and outside the couple. Objective: The study seeks the construction and validation of the Multidimensional Couple scale to measure seven dimensions in the couple: emotional, cognitive, physical interest, protection, trust, respect and power, as well as an additional dimension to classify the type of couple. Method: An Exploratory Factor Analysis (EFA) and Exploratory Factor Analysis (CFA) were carried out to test the psychometric properties and the adequacy to the theoretical model. A total of 1149 people (71.5% women and 28% men) living in Mexico participated. Result: The presence of a scale formed by 7 dimensions in the couple and a second order factor is confirmed, which can be applied both by adjusting the answers to the couple itself and to other people different from the couple. The goodness-of-fit and reliability indices are satisfactory. Conclusion: This scale provides a psychometric instrument that allows the study of the relationship between the couple.

RESUMEN Introducción: Se presenta un instrumento de origen sistémico para medir la red socioemocional en relación con la pareja y la percepción de la persona sobre el impacto de esta red íntima en su pareja para su clasificación. Se parte de la idea de que una red social nutrida aporta beneficios positivos en la propia pareja nuclear. Para la comprobación de este supuesto tanto investigación como en la práctica clínica, se hace necesaria la construcción de un instrumento complejo que permita alcanzar diferentes dimensiones dentro y fuera de la pareja. Objetivo: El estudio busca la construcción y validación de la escala La Pareja Multidimensional para medir siete dimensiones en la pareja: emocional, cognitiva, interés físico, protección confianza, respeto y poder, así como una dimensión adicional que permita clasificar el tipo de pareja. Método: Se ha llevado a cabo un Análisis Factorial Exploratorio (EFA) y Análisis Factorial Exploratorio (CFA) para comprobar las propiedades psicométricas y la adecuación al modelo teórico. Participó un total de 1149 personas (71.5% mujeres y 28% hombres) residentes en México. Resultados: Se confirma la presencia de una escala formada por 7 dimensiones en la pareja y un factor de segundo orden, que se puede aplicar tanto adecuando las respuestas a la propia pareja como a otras personas diferentes a esta. Los índices de bondad de ajuste y de fiabilidad son satisfactorios. Conclusión: Con esta escala se aporta un instrumento psicométrico que permite estudiar las diferentes dimensiones de la pareja y cómo estas se alimentan en base al establecimiento de relaciones con personas ajenas a la misma.

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PURPOSE: To investigate the impact of infertility in gender differences on psycho-traumatological, sexological, relational and emotional aspects and gender differences in couples requiring assisted reproductive treatment. METHODS: 151 couples were recruited with a mean age of 36.7 ± 4.8 years for women and 39.8 ± 6.6f or men. 43% of women and 34% of men had already received the diagnosis of infertility. To recruited subjects was administered the following psychometric tests: Sexological and Emotional in Infertility questionnaire (SEIq), Arizona Sexual Experience Scale (ASEX), the Orgasmomether and the International Trauma Questionnaire (ITQ). RESULTS: There was a significant difference in traumatic symptoms between men and women (t = 5,859, p < 0.05). Gender differences were found in the sexological dimension of the SEIq (t = 7,858, p < .001) and in the total ASEX score (t = 3,979, p < .001). Specifically, significant correlations emerged between the ASEX domains and the emotional and sexological aspects related to infertility only in women. The reaction to the diagnosis was negatively correlated with the emotional area of ​​the couple (r = -0.683, p < .001) and positively with the couple relationship (r = 0.815, p < .001). Multiple regression revealed that the overall functioning of the couple, rather than the single scales, is the main predictor of sexuality (R2 = 0.77). CONCLUSION: A clear impact of infertility on the couple's psycho-traumatological, psycho-sexological and relational aspects emerged. It could be useful to promote targeted support interventions on the most compromised areas of couple functioning in assisted reproductive centers.

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INTRODUCTION: Pregnant women who smoke are at a high risk of preterm birth (PTB) and have low partner-support. In a prospective cohort study, we aimed to examine the role of partner-support in gestational duration and PTB among pregnant women who smoke as well as the interaction with race/ethnicity. METHODS: We analyzed secondary data of 53 participants from the University at Buffalo Pregnancy and Smoking Cessation Study. Partner-support was measured with Turner's support scale where women reported how much they agreed with five statements about how supportive their partner was. Total partner-support was calculated and split into emotional support and accountability. We fit multivariable linear regression models and log-binomial regression models for gestational duration and PTB, respectively. RESULTS: Gestational duration significantly increased with partner-support (0.22 weeks longer per unit increment in partner-support score), emotional support (0.52 weeks), and accountability (0.35 weeks). This association tended to be stronger among Hispanics and women of other races than non-Hispanic Caucasians and African Americans. Women with a bed partner had 1.48 weeks longer gestational duration than women without a bed partner. DISCUSSION: Partner-support may increase gestational duration and reduce PTB risk among pregnant women who smoke, especially among Hispanic women. Sharing a bed with a partner was associated with a longer gestational duration. Our findings may be interpreted with caution due to limitations such as small sample size, recruitment within a single metropolitan area, and partner-support measurement via maternal reports only. A partner-support intervention to increase gestational duration is warranted.

Partner-support might help increase gestational duration and possibly reduce risk of preterm birth, and future research is needed to replicate our findings in larger samples. Pregnant women who smoke are at a high risk for short gestational duration and preterm birth (PTB) and have low partner-support. Previous research did not address the potential racial/ethnic differences in the influence of partner-support on PTB. We found partner-support might increase gestational duration and possibly reduce PTB risk among pregnant women who smoke. The association between partner-support and gestational duration tended to be stronger among Hispanics and women of other races than Non-Hispanic Caucasians and African Americans.

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OBJECTIVE: The aim was to synthesise the current qualitative literature on the impact of Parkinson's on the couple relationship, including individual and dyad studies. METHODS: Noblit and Hare's meta-ethnography approach was applied; 19 studies were included in the review following a systematic search of four electronic databases. The studies included experiences of 137 People with Parkinson's and 191 partners. FINDINGS: Analysis produced three themes: (1) Disruption of roles and responsibilities; (2) Challenges to communication and closeness; and (3) Grief, burden, and isolation. The themes are discussed with supporting extracts from the 19 included studies. CONCLUSION: The findings highlight the challenges that couples experience and the individual and relational resources that support coping. Support should be individually tailored to each couple as the impact on the couple may change in response to individual and contextual factors. This review adds further evidence to the case for relationally focused multidisciplinary team input at all stages of Parkinson's disease.

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BACKGROUND: This study examined how siblings and siblings-in-law of persons with intellectual disabilities experience the establishment of and processes within the couple relationship. METHOD: In-depth semi-structured interviews with 12 siblings and 12 siblings-in-law of persons with intellectual disabilities were analysed using thematic analysis. RESULTS: The participants did not perceive their special siblinghood as detrimental to their couple relationships. Siblings-in-law's prior acquaintance with persons with disabilities and professional support provided to the family of origin emerged as contributing factors. The effect of the siblinghood on the couple relationship was both positive and negative. CONCLUSIONS: The findings support the importance of the acceptance of others who are different, including in couple relationships when a sibling or sibling-in-law has intellectual disabilities, and underscore the role of professional therapists.

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Background: Childbirth is a major life event with expected positive outcomes, yet for some women postnatal psychopathological symptoms may harm women's interpersonal relationships. We hypothesized that higher levels of postnatal depression, post-traumatic stress (PTSD) symptoms, and fear of childbirth would be associated with mother-baby bond disorders and relationship dissatisfaction in couples.Method: A cross-sectional self-report online questionnaire was used to survey partnered women who had delivered in the year prior to the study. We used a convenience sample of 228 women recruited through purposive and snowball sampling. Childbirth experience, PTSD symptoms, attachment style, depression, mother-baby bond disorders, and couple relationship dissatisfaction were measured.Results: Women with higher PTSD and postnatal depression scores reported higher levels of mother-baby bond disorders-a relationship fully mediated by postnatal depression symptoms. Women who perceived childbirth as fearful or anxiety provoking had higher levels of PTSD and postnatal depression symptoms. Fearful and anxious birth perception was positively associated with mother-baby bond disorders-an association partly mediated by PTSD symptoms. Insecure attachment style was not found to be significantly associated with fearful or anxious perceptions of childbirth.Limitations: Women who have postnatal PTSD/depression are less inclined to participate in a study of this nature. Also, online surveys prevented the use of clinical diagnoses of PTSD and depression.Discussion and conclusions: Our results suggest that PTSD and postnatal depression affect women's mental health and family bonding. Women should be assessed for negative traumatic birth experiences, PTSD, and depression, to allow targeted observation for psychopathologies and therapeutic interventions.

Depression, not posttraumatic stress disorder (PTSD), is related to increased couple dissatisfaction.Both PTSD and depression are related to increased mother-baby bond disorders.Fear of childbirth increases as symptoms of PTSD and depression increase.

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Infertility and related treatments can negatively affect a couple's wellbeing. The aim of this study was to evaluate couples starting assisted reproductive treatment, differences in alexithymia and quality of life levels between partners, and the association of these psychological dimensions within the couple's members. Data was collected in two fertility centres in Rome; 47 couples completed the Fertility Quality of Life (FertiQoL), the 20-item Toronto Alexithymia Scale (TAS-20), and a socio-demographic questionnaire. Data analysis showed a worsened quality of life in women compared with their partners, as well as higher externally oriented thinking in men compared with their spouses. Associations between alexithymia and quality of life levels between women and men emerged. According to the regression analysis, a better quality of life in women was predicted by a greater partner's capabilities in identifying and describing emotion as well as by a better partner's quality of life, whereas for men, a better quality of life was predicted by their spouse's higher levels of quality of life. This study highlights the protective role that couples can play in the perception of the negative impact that infertility can have on their partner's quality of life. Further investigations are needed for the development of specific therapeutic interventions for the promotion of the couples' wellbeing.

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During the perinatal period, up to 25% of women experience difficulties in relating to their child. The mother-child bond promotes the transition to motherhood, protects the woman from depression, and protects the child from the intergenerational transmission of the disease. This study prospectively investigated if the relationship with the co-parent, the attachment style, and the bond that women had with their parents influenced the mother-fetus and then mother-child bond. We also explored the role of depression and anxiety. One hundred nineteen pregnant women were enrolled. We administered clinical interviews and psychometric tools. A telephone interview was conducted at 1, 3, and 6 months of follow-up. Maternal insecure attachment style (r = -0.253, p = 0.006) and women's dyadic adjustment in the couple's relationships (r = 0.182, p = 0.049) were correlated with lower maternal-fetal attachment. Insecure attachment styles and depression correlate with bottle-feeding rather than breastfeeding. The bond women had with their mothers, not their fathers, was associated with breastfeeding. Depression (OR = 0.243, p = 0.008) and anxiety (OR = 0.185, p = 0.004; OR = 0.304, p < 0.0001) were related to mother-infant bonding. Close relationships, past and present, affect the bond with the fetus and the child differently. Psychotherapy can provide reassuring and restorative intersubjective experiences.

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The literature has mainly focused on the impact of the negative aspects of the couple's relationship on the toddler's internalizing and externalizing problems. This study explored the impact of the positive and negative dimensions of the couple's relationship during the transition to parenthood on toddlers' psychological adjustment, considering the concurrent impact of the couple's relationship at 30 months postpartum. The sample comprised 115 mothers and fathers (N = 230) recruited during the 1st trimester of pregnancy. The mothers and fathers individually completed a measure of the couple's relationship (Relationship Questionnaire) during the first trimester of pregnancy, at 3 and 30 months postpartum, and the Child Behavior Checklist 1.5-5 at 30 months postpartum. Multiple linear regressions, cluster analyses, and univariate and multivariate analyses of variance were conducted. The positive dimension at the 1st trimester of pregnancy and the negative dimension of the couple's relationship at 3 months postpartum were the strongest predictors of the toddler's internalizing problems, while the negative dimension at 3 months postpartum and the positive dimension of the couple's relationship at 30 months postpartum were the strongest predictors of the toddler's externalizing problems. Two patterns of the couple's relationship (adjusted vs. non-adjusted) during the transition to parenthood were identified. Higher levels of internalizing and externalizing problems were found in toddlers from couples with a non-adjusted couple's relationship. Findings suggested the impact of both positive and negative dimensions of the couple's relationship during the transition to parenthood on the toddler's emotional and behavioral problems. Promoting the couple's relationship adjustment during the transition to parenthood can help to prevent toddlers' emotional and behavioral problems.

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Relationship standards are beliefs about what is important in a satisfying couple relationship, which vary considerably between cultures, and might mean that what couples seek from couple therapy differs across cultures. We assessed the standards of n = 49 Pakistani couples and whether those standards predicted couple satisfaction. To provide referents for the Pakistani standards, we also assessed selfreported relationship standards in n = 33 Western couples and n = 30 Chinese couples. Pakistani couples endorsed couple bond standards (e.g., expressions of love) as similarly important, and family responsibility (e.g., extended family relations) standards as more important, than Western or Chinese couples. In Pakistani couples, Couple Bond predicted couples' relationship satisfaction, but family responsibility and Religion predicted only wives' satisfaction. Modest sample sizes necessitate caution in interpreting results but suggest existing couple therapies might need modification to address the distinctive relationship standards of Pakistani couples.

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In recent years it has been discussed whether high-risk couples benefit more from Couple Relationship Education programs (CREs) than low-risk couples due to larger room for improvement, or profit less due to greater vulnerability. Pertinent response prediction studies yielded inconclusive results. Careful review suggests this may be due to: statistical handling (not disentangling room for improvement and vulnerability effects), time frame analyzed (not disentangling opposing effects during intervention and follow-up), sampling, and selection of risk factors. We used an analytic strategy that maximized odds for replicability and tested two hypotheses: (1) room for improvement: pre-intervention relationship dissatisfaction predicts gain in satisfaction during intervention, and decline during follow up, and (2) vulnerability: when adjusted for room for improvement (pre-intervention relationship dissatisfaction), risk factors show negative or negligible, but no positive associations with gain in satisfaction. Actor-Partner Interdependence Modeling (APIM) was employed in 79 self-referred (SR) couples and 50 clinician-referred (CR) couples who had completed the 'Hold me Tight' program, a CRE based on Emotionally Focused Couple Therapy. Our findings supported both the room for improvement hypothesis, with pre-intervention dissatisfaction predicting more gain during intervention (both samples) and decline during follow-up (SR sample, for the CR sample the effect was negligible), and the vulnerability hypothesis, as several negative, but no positive effects of risk factors were observed during intervention and follow-up. Specific risk factors did not replicate between samples. To promote replicable results in future research, we advocate disentangling room for improvement and vulnerability effects, separately testing effects during intervention and follow-up, purposeful sampling, and studying a large set of risk factors including partner variables.

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The loss of a child can impact maternal mental health and the emotional development of a subsequent baby. Couple relationship can help women to cope with this loss. This study investigates the association among child loss, maternal mental health (including prolonged grief), couple adjustment, and psycho-functional symptoms in the subsequent babies. 598 Brazilian mothers, recruited by convenience, took part in the study. Mothers with a baby loss (23%) presented greater age and religiosity, less income, a longer couple relationship, and better couple adjustment, and their baby presented a great number of symptoms. This population needs monitoring for early emotional assistance.

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Background: The diagnosis of epilepsy in a child often and understandably causes psychological adjustment difficulties in the parents. To help parents of children with epilepsy cope with stress, it is important to understand how parents cope with the sickness of their child. The objective of this study was to assess factors related to the state of anxiety and depression among parents of children with epilepsy. Methods: The present study was a cross-sectional study, and the data were collected through an anonymous, Internet-based survey platform between October 2018 and October 2019 from 250 participants aged 22-65 years. Participants were invited to fill questionnaires include socioeconomic questionnaire, anxiety, depression, and coping strategies scale. Result: Among the parents of children with epilepsy, 48.8% (122/250) had depressive symptoms (Patient Health Questionnaire-9 [PHQ-9] score >4) and 46.4% (116/250) had anxiety symptoms (7-item Generalized Anxiety Disorder [GAD-7] score >5). Depression among parents of children with epilepsy was significantly associated with comorbidity (odds ratio [OR] = 0.392, 95% CI = 0.182-0.846), a poor parental relationship (OR = 0.283, 95% CI = 0.130-0.614), positive coping (OR = 0.947, 95% CI = 0.903-0.992), and negative coping (OR = 1.287, 95% CI = 1.179-1.405). Anxiety among parents of children with epilepsy was significantly associated with a poor parental relationship (OR = 0.416, 95% CI = 0.207-0.835) and negative coping (OR = 1.155, 95% CI = 1.087-1.228). Conclusions: The present study indicates the importance of couple support and providing effective coping to make parents of children with epilepsy more resilient in the presence of negative life events, especially for parents of children with comorbidity with cognitive deficiency.