The Impact of Bipolar Disorder on Couple Functioning: Implications for Care and Treatment. A Systematic Review

If there is an abundant literature on the impact of bipolar illness on the family and/or caregivers of patients, few studies have addressed its impact on marital relationship and couple functioning. Uncovering information relating specifically to this topic may be particularly relevant due to the unusually high divorce rate among individuals with bipolar disorder. We therefore conducted a systematic literature search to evaluate the existing data on bipolar disorder and marital issues, with a special focus on the help and support that can be provided by mental health professionals in this regard. We identified quantitative studies with pre-defined outcomes as well as qualitative investigations trying to understand the experiences of partners. A total of 27 articles were included in the review. The literature was found to capture the impact of bipolar disorder on partners as well as on the marital relationship itself or the children. Bipolar illness has a negative impact on the lives of partners including self-sacrifice, caregiver burden, emotional impact, and health problems. This negative impact can be aggravated by a lack of care and a lack of information from health personnel. The negative impact on the relationship includes volatility in the relationship, stigmatization, dissatisfaction with sexual life, and lower rates of childbearing. Negative impacts are likely to favor disease relapses for the patient. Children may also be negatively impacted. However, the illness may sometimes have positive impacts such as personal evolution, strengthening relationship, or new hope and perspectives. Based on these findings, the interventions of mental health professionals should be aimed at minimizing the negative impacts while favoring the positive ones.

Factors Distinguishing Reciprocal Versus Nonreciprocal Intimate Partner Violence Across Time and Reporter

Although intimate partner violence (IPV) is often conceptualized as occurring unilaterally, reciprocal or bidirectional violence is actually the most prevalent form of IPV. The current study assessed physical IPV experiences in couples and evaluated risk and protective factors that may be differentially associated with reciprocal and nonreciprocal IPV concurrently and over time. As part of a multi-wave longitudinal study, women and men reported on the frequency of their IPV perpetration and victimization three times across the transition to parenthood. Participants also reported on risk factors related to personal adjustment, psychosocial resources, attitudes toward gender role egalitarianism, and sociodemographic characteristics at each wave. Participants were classified into one of four IPV groups (reciprocal violence, male perpetrators only, female perpetrators only, and no violence) based on their self-report and based on a combined report, which incorporated both partners’ reports of IPV for a maximum estimate of violence. Women and men were analyzed separately, as both can be perpetrators and/or victims of IPV. Cross-sectional analyses using self-reported IPV data indicated that IPV groups were most consistently distinguished by their levels of couple satisfaction, across gender; psychological distress also appeared to differentiate IPV groups, although somewhat less consistently. When combined reports of IPV were used, sociodemographic risk markers (i.e., age, income, and education) in addition to couple functioning were among the most robust factors differentiating IPV groups concurrently, across gender. In longitudinal analyses, sociodemographic vulnerabilities were again among the most consistent factors differentiating subsequent IPV groups over time. Several gender differences were also found, suggesting that different risk factors (e.g., women’s social support and men’s emotion regulation abilities) may need to be targeted in interventions to identify, prevent, and treat IPV among women and men.

Notes on working with divorcing and separating couples

Psychoanalytic couple psychotherapy has provided a rich body of work in relation to couple functioning. Simultaneously, the application of these principles to the field of separation and divorce has been underdeveloped. This article therefore briefly describes the work of a clinical service developed specifically for separating couples which adheres to the core psychoanalytic principles previously established. In doing so, important emphases emerge in relation to conceptualisation of the projective cycle, the therapist's internal setting, and the external setting and process of the clinical work itself.

Together We Can: Increase Couple Functioning for Low-SES Families

This study reviews how parenting efficacy and the coparenting relationship are influenced by a shortened and adapted Together We Can relationship program. Researchers were interested in determining how socioeconomic status and race impact parenting and coparenting outcomes. Participants included 26 White and African American individuals. Bronfenbrenner’s ecological theory and the spillover hypothesis assist with understanding how participant’s environments have impacted their current relationship and parenting practices. Statistically significant differences were found between pre- and posttests on both parenting and coparenting outcomes; further analyses showed racial and socioeconomic differences within these outcomes. As society continues to form increased romantic relationships and parenting systems, relationship education programs should be evaluated with varied populations.

Antisocial Traits, Negative Emotionality, and Trajectories of Relationship Quality in Mexican-Origin Couples

The symptoms of antisocial personality disorder (ASPD) and broader personality trait domains such as negative emotionality (NEM) may prove detrimental for marital quality. Previous research with European Americans has found that ASPD negatively predicts couple functioning, even when controlling for NEM. The current study extends previous work by testing whether ASPD (as well as a history of early conduct disorder) and NEM are related to marital quality trajectories in a sample of 450 Mexican-origin couples followed over 9 years. Consistent with other studies, there was a slight average decline in relationship quality over the course of the study along with differences between couples in the initial level of relationship quality and rate of change. Results indicated that NEM was a stronger correlate of initial levels of marital quality than ASPD. Findings underscore the relevance of NEM as a personality trait domain relevant for relationships.

The dyadic influences of mindfulness on relationship functioning

Using family stress and coping theory, the current study assessed dyadic influences of specific facets of mindfulness ( nonreactivity, acting with awareness, and nonjudgment), accounting for stress levels, on relationship quality and sexual satisfaction in an ethnically and economically diverse sample of 847 married and unmarried heterosexual couples. Results from actor–partner interdependence models indicated a positive association between one’s own report and partners’ report of nonreactivity and one’s own reports of relationship quality for both men and women. Men’s and women’s acting with awareness was associated with women’s sexual satisfaction. Nonjudgment was not uniquely associated with one’s own or one’s partner’s relationship quality or sexual satisfaction. Since the majority of research on mindfulness and relationship quality uses broad global measures of mindfulness, this study provides novel information on the comparative strength of dimensions of mindfulness on distinct areas of couple functioning using a dyadic approach. Suggestions for future work and implications for research and practice are discussed.

A Matter of the Heart: Daytime Relationship Functioning and Overnight Heart Rate in Young Dating Couples

Background Although past longitudinal research demonstrates that romantic partners affect one another’s health outcomes, considerably less is known about how romantic experiences “get under the skin” in everyday life. Purpose The current study investigated whether young couples’ naturally occurring feelings of closeness to and annoyance with each other during waking hours were associated with their overnight cardiovascular activity. Methods Participants were 63 heterosexual young adult dating couples (Mage = 23.07). Using ecological momentary assessments, couples reported their hourly feelings of closeness to and annoyance with their partners across 1 day; subsequent overnight heart rate was captured through wearable electrocardiogram biosensors. Actor–partner interdependence models tested whether individuals’ overnight heart rate varied as a function of (a) their own daytime feelings of closeness and annoyance (actor effects) and (b) their partner’s daytime feelings of closeness and annoyance (partner effects) while controlling for daytime heart rate. Results Although young adults’ feelings of romantic closeness and annoyance were unrelated to their own overnight heart rate (i.e., no actor effects), gender-specific partner effects emerged. Young men’s nocturnal heart rate was uniquely predicted by their female partner’s daytime relationship feelings. When women felt closer to their partners during the day, men exhibited lower overnight heart rate. When women felt more annoyed with their partners during the day, men exhibited heightened overnight heart rate. Conclusions The findings illustrate gender-specific links between couple functioning and physiological arousal in the everyday lives of young dating couples, implicating physiological sensitivity to partner experiences as one potential pathway through which relationships affect health.