Marital Interactions and the Duration of Alcoholic Husbands′ Sobriety

Recent studies of the family interactions of alcoholics have suggested that the alcoholic's general drinking adjustment may influence marital interactions. The present investigation examined the marital interactions of 30 male alcoholics who had maintained continuous sobriety for various lengths of time ranging from a few days to over 7 years. It was predicted that longer periods of sobriety would be associated with less conflict and fewer struggles for control between husbands and wives. The findings supported the hypothesis, in that the duration of the husbands′ sobriety was significantly negatively correlated with the number of statements of disagreement emitted by husbands and wives. Also, there were trends for duration of sobriety to be negatively associated with the frequencies of question-asking and aggressive behaviors by husbands, and positively associated with the amount of talk time by husbands. Contrasts of 11 high sobriety couples (duration of sobriety: 2 years or longer) and 11 low sobriety couples (duration of sobriety: less than 4 months) revealed that high sobriety husbands asked fewer questions, stated fewer disagreements, and emitted fewer aggressive behaviors than husbands in the low sobriety group. In addition, high sobriety husbands displayed a trend toward more active talk time, and their wives showed a trend toward asking fewer questions than their low sobriety counterparts. The results suggest that marital functioning is superior in couples with longer periods of sobriety. The need for examining possible causal links in this relationship is emphasized.     

Differences between alcoholic couples accepting and rejecting an offer of outpatient marital therapy

Following an extensive initial evaluation, 35 couples with alcoholic husbands decided to participate in couples therapy (acceptors) and 28 couples did not (rejectors). A significant discriminant function indicated that acceptors were characterized by husbands with more education, better marital adjustment, full-time employment, and larger number of alcohol-related arrests. Acceptors also had sought more outpatient help in the past year. Rejectors were characterized by wives with better marital adjustment, greater living distance from clinic, and husbands with more alcohol-related hospitalizations. Rejector husbands also tended to be older. Practical implications for recruiting alcoholics and spouses into marital therapy are discussed.     

Marital aggression. Impact, injury, and health correlates for husbands and wives.

The overall aim of the current study was to comprehensively evaluate the prevalence, impact, and health correlates of marital aggression in a clinical sample of maritally discordant couples seeking psychological treatment. Participants were 93 consecutively presenting clinic couples and 16 maritally satisfied matched control couples from the community. Overall, 71% of clinic couples reported at least one act of marital aggression during the past year. Although 86% of the aggression reported was reciprocal between husbands and wives, impact and injuries sustained as a function of this aggression differed between husbands and wives. Specifically, wives were more likely than husbands to be negatively affected and to sustain severe injuries (eg, broken bones, broken teeth, or injury to sensory organs). Additionally, wives who experienced marital aggression reported clinical levels of depressive symptomatology. Recommendations are offered and risk markers are identified to improve detection by physicians of patients who may be involved in violent marriages.     

Marital relationship in late adulthood: synchronous versus asynchronous couples

The article presents a study on marital relations in late adulthood, conducted among a sample of 469 Israeli couples, who were divided into four groups based on occupational status and spousal timing of retirement. Two of the groups were categorized as synchronous: pre-retired couples (both partners are close to retirement); and retired couples (both partners are retired), and two of the groups were categorized as asynchronous: employed husband/retired wife and retired husband wife/employed husband. Differences between the groups were examined in three areas: Division of tasks in the home; marital power relations; and quality of marriage. Regarding division of tasks in the home, feminine tasks were usually more egalitarian among retired couples and retired husbands/employed wives than among pre-retired couples and employed husbands/retired wives. In addition, synchronous-retired couples were found to be more egalitarian than synchronous-pre-retired and asynchronous employed husbands/retired wives with regard to general tasks, while masculine tasks were usually carried out by husbands in all four groups. With respect to quality of marriage, the pre-retired couples expressed more marital complaints than did the retired couples, while no differences were found between either of the asynchronous groups. Nonetheless, marital power relations were generally egalitarian in all four groups.     

Family Interactions of Alcoholics as Related to Alcoholism Type and Drinking Condition

BACKGROUND: Several studies have reported that the marital interactions of antisocial and aggressive, versus nonantisocial and nonaggressive, alcoholics exhibit higher rates of aversive-defensive communications and higher levels of negative reciprocity. To extend these findings, we examined the effect of alcoholism type (high- versus low-antisocial alcoholics: HAS, LAS) and drinking condition on family communication patterns. METHODS: Marital and parent-child dyads from 100 alcoholic families were videotaped while they discussed personally relevant issues during drinking and no-drinking sessions (no children were offered any alcohol). All interactions were coded with the Marital Interaction Coding System, and the data were assessed for differences in rate of positive, negative, and problem-solving behaviors, as well as sequential structures. RESULTS: HAS couples were more negative during the drink versus no-drink condition, whereas drinking did not affect negativity for LAS couples. In addition, the negative communications of HAS versus LAS alcoholics were more likely to increase spouse negativity during the drink versus no-drink condition. Group differences for parent-child interactions were few. CONCLUSIONS: The nature of family interactions was related to both alcoholism type and alcohol consumption, and the marital interactions of alcoholism types could be differentiated on the basis of the frequency and sequential structure of negative exchanges. It is most important to note that it is the interactions of the HAS alcoholic that undergo the most change as a function of drinking condition, with little support for the "adaptive consequences" hypothesis that alcohol consumption leads to more effective problem-solving for couples in which the alcoholic exhibits fewer antisocial and more internalizing characteristics. Study limitations and directions for future research are discussed.     

Personal, family and social functioning among older couples concordant and discordant for high-risk alcohol consumption

Aims This study compares the personal, family and social functioning of older husbands and wives concordant or discordant for high‐risk alcohol consumption and identifies predictors of changes in concordance and high‐risk consumption. Design, Participants, Measurements Three groups of couples were identified at baseline and followed 10 years later: (i) concordant couples in which husbands and wives engaged in low‐risk alcohol consumption (n = 54); (ii) concordant couples in which husbands and wives engaged in high‐risk alcohol consumption (n = 38); and (iii) discordant couples in which one partner engaged in high‐risk alcohol consumption and the other partner did not (n = 75). At each follow‐up, husbands and wives completed an inventory that assessed their personal, family and social functioning. Findings Compared to the low‐risk concordant group, husbands and wives in the high‐risk concordant group were more likely to rely on tension‐reduction coping, reported more friend approval of drinking, and were less involved in religious activities; however, they did not differ in the quality of the spousal relationship. The frequency of alcohol consumption declined among husbands in discordant couples, but not among husbands in concordant couples. Predictors of high‐risk drinking included tension‐reduction coping, friend approval of drinking and, for husbands, their wives' level of drinking. Conclusions High‐risk and discordant alcohol consumption do not seem to be linked to decrements in family functioning among older couples in long‐term stable marriages. The predictors of heavy alcohol consumption among older husbands and wives identify points of intervention that may help to reduce their high‐risk drinking.     

Spousal characteristics as predictors of well-being in older couples.

This study examined the relations between spousal variables and the psychological well-being of husbands and wives in older couples to determine if spousal characteristics were more important determinants of well-being for wives than for husbands. One hundred-twenty older married men and women completed standardized self-report measures and a short interview. The variables investigated included education, verbal intelligence, personality, physical health, marital adjustment, psychological well-being, as well as response bias to marital defensiveness. Spousal variables significantly predicted wives' well-being (R2 = 29%) with the three most influential predictor variables being the husbands' perception of the marriage, positive dimension of well-being and physical health. In contrast, spousal variables did not significantly predict husbands' well-being. The study supported the hypothesis of differential responsiveness of men and women to spousal variables and highlighted the importance of marital adjustment for the psychological well-being of older wives.     

Condom use within marriage: an assessment of changes in South Africa and Uganda

The aim of the study is to measure trends in condom use in marital and cohabiting relationships in South Africa and Uganda. The data for the study come from two cross sectional surveys conducted in 1998 and 2008 among adult men and women and their partners in KwaZulu-Natal, South Africa and the Jinja district, Uganda. The findings suggest that consistent condom use has risen substantially in both countries. The percentage reporting consistent condom use in the South African sample of husbands increased from 2.5% in 1998 to 12% in 2008 and from 5.5 to 12.5% among wives. In Uganda, the corresponding trends are 1.1-8.3% for husbands and 4-8.6% for wives. In both countries, condom use was considerably higher among the minority of couples where one or both partners were thought to be HIV positive. Increasingly, in both countries condoms are also used for contraceptive purposes. Condoms play a role in preventing HIV infection but the challenge is for prevention programs to broaden their focus toward meeting the needs of married and cohabiting couples.     

Marital Functioning in Early Versus Late-Onset Alcoholic Couples

Current knowledge about alcohol and marital functioning is limited by restrictive sample selection, inattention to the literature on individual-based alcoholic subtypes, and lack of research linking individual differences among alcoholics to marital functioning. The present study was designed to study marital functioning of alcoholics in light of current alcohol typologies. Subjects were part of a larger study on conjoint treatment of alcoholic males and their female partners. Four typologies—including Type 1/2, In-Home/Out-of-home, SteadyIEpisodic, and EarlyILate Onset—were tested for replicability and discriminant validity before linking them to marital functioning. Discriminant validity was found only for the Early (59%)-versus Late (41 %)-Onset typology; thus, further analyses linked only this typology with marital functioning. At baseline, Early-Onset couples reported more marital instability, and the females in these couples were more distressed. During treatment, Early-Onset couples reported higher daily marital satisfaction than Late-Onset couples. Regardless of age of onset, males reported higher marital satisfaction than their spouses during treatment, but their satisfaction did not increase during treatment. Female partners' marital satisfaction increased during treatment. Female partners of Late-Onset males reported particularly low marital satisfaction during treatment. Parsing the sample according to the early-/late-onset typology yielded different predictors of marital satisfaction for males and females within each subtype. For female partners of Early-Onset alcoholics, psychological distress unrelated to her pattner's drinking severity was most associated with her own marital satisfaction, whereas marital adjustment of female partners of Late-Onset alcoholics was most associated with the male's level of perceptual accuracy regarding her needs. This pattern was reversed for the males; marital adjustment of Early-Onset alcoholics was most associated with his partner's perceptual accuracy of his needs, whereas marital functioning of Late-Onset alcoholics was best accounted for by his own psychological distress.     

Marital Satisfaction and Personality Traits in Long-Term Marriages: An Exploratory Study

This study explored personality dimensions that contribute to marital satisfaction in older couples in long-term marriages (M = 49.2 years). Each spouse completed the Comprehensive Marital Satisfaction Scale, the Horney-Coolidge Tridimensional Inventory (HCTI), and the NEO-Five Factor Inventory (NEO-FFI). There was a moderate correlation between the marital satisfaction scores for husbands and wives. Husbands' marital satisfaction was significantly higher when their self-reported HCTI Detachment scores were lower and their HCTI Aggression scores were higher. Wives' marital satisfaction was higher when their Detachment scores and their husbands' Detachment scores were lower. On the NEO-FFI, only wives' marital satisfaction was significantly related to the more Extraverted and the less Conscientious the husbands reported themselves to be. Clinical implications and research directions are discussed.     

Hepatitis B seromarkers, hepatitis C antibody, and risk behaviors in married couples, a bordered province of western Thailand: Hepatitis B seromarkers, hepatitis C antibody, and risk behaviors

Background

Married couples constitute a target group for reducing the risk of infections with hepatitis B virus (HBV) and hepatitis C virus (HCV).

Objectives

This study attempted to assess HBV seromarkers, anti-HCV-positive rates, and risk behaviors among married couples in a bordered province of western Thailand.

Materials and Methods

A cross-sectional study of 114 married couples aged 15-44 years was performed. Approximately 25-30 married couples were randomly selected from 4 districts in a province of western Thailand. All study participants who participated voluntarily were interviewed using structured questionnaires. Their blood specimens were collected to screen for HBV seromarkers (HBsAg, anti-HBs, and anti-HBc) and anti-HCV.

Results

Approximately 21.1% of husbands and 2.6% of wives had a history of extramarital sex without using a condom; 18.4% of husbands and 4.4% of wives had tattoos; and 18.4% and 3.5%, respectively, consumed alcohol regularly. Additionally, 4.4% of husbands and 2.6% of wives had a history of sexual contact before marriage. In the serological study, 10.5% of husbands and 5.3% of wives were HBsAg-positive, and 1.8% of husbands and 0.9% of wives were anti-HCV-positive. Among HBsAg-positive subjects, 15/18 had spouses who were positive for any HBV marker, and 1 had a spouse who was HBsAg- and anti-HBc positive. Three participants were positive for anti-HCV (2 males and 1 female). One anti-HCV-positive male had a history of regular alcohol consumption and extramarital sex without a condom, and another had a history of intravenous drug use. The anti-HCV-positive female had a history of sexual contact before marriage.

Conclusions

This study found high percentages of risk behaviors and HBsAg positivity among married couples in a bordered province of western Thailand, especially in husbands. These findings support the evidence of HCV transmission via sexual contact and intravenous drug use.     

Gender inequality and the risk of HIV among married couples in North India

This study investigated the distribution and determinants of HIV risks among married couples in North India. Gender inequality emerged as a potential driver of HIV risks in this region. Data collection took place in 2003 in a probability survey of 3385 couples living in India's most populous state – Uttar Pradesh – and Uttaranchal. Couples' analyses utilizing generalized estimating equations showed that compared with husbands, wives were less knowledgeable about HIV (OR = 0.31, 95% CI = 0.27–0.36), more likely to consider themselves at risk for infection (OR = 6.86, 95% CI = 4.65–10.13), and less likely to feel that a wife had the right to refuse sex with her husband (OR = 0.50, 95% CI = 0.44–0.58). The proportion of husbands reporting non-marital sex in the past year was 7.1% and transactional sex in the past year, 2.2%. Among their wives, 73.4% were unaware of their husbands' non-marital sexual behaviors and only 28.9% of husbands reported condom use during their last non-marital sexual encounter. Logistic regression analyses showed that husbands' alcohol use, husbands' mobility, and urban residence were positively associated with husbands' non-marital sexual behaviors adjusting for other covariates. The data demonstrate that HIV prevention programs among couples in North India should consider both sexual risks and gender inequalities which potentially fuel HIV spread in this region.     

Middle-aged couples' exchanges of support with aging parents: patterns and association with marital satisfaction

We examined the context of intergenerational support exchanges with aging parents and its association with middle-aged couples' marital satisfaction. A sample of 197 middle-aged couples reported support they gave to and received from their parents (n = 440). Results indicated that couples provided more total support to and received more from their parents as a function of number of living parents, but the amount of support each parent received ('parent-adjusted support') was lower when there were more living parents. The amount of support given to and received from parents had no association with the couple's marital satisfaction, but discrepancies in support given to and received from parents did have a significant association with marital satisfaction. Husbands who gave more support to their living parent(s) than their wives reported lower marital satisfaction. A similar effect on marital satisfaction was found for wives who gave more support to their living parents than their husbands. These findings contrast with caregiving studies where amount of support affected marital satisfaction and suggest that inequalities in involvement with parents may be a critical dimension in marriages of midlife adults.     

HIV-1夫妻间传播的回顾性队列研究

目的研究艾滋病病毒Ⅰ型（HIV-1）的夫妻间传播率,为预防控制性传播提供科学依据。方法在某农村地区,2000—2007年陆续发现的110对配偶-方为HIV-1感染者,均为1990—1997年间-次性输血而感染,无其他感染因素,感染后与配偶无保护性生活7．51年,感染者的配偶否认除夫妻无保护性传播以外的艾滋病传播因素。对感染者配偶用酶联免疫吸附试验和免疫印迹试验（Western—blot）检测HIV抗体。结果HIV-1的夫妻间传播率为17．3％,年均传播率为2．3％。其中妻子传给丈夫的概率为19．1％,平均年感染机率2．7％;丈夫传给妻子的概率为9．5％,平均年感染机率1．1％。无保护性生活时间越长、妻子感染时丈夫的年龄越小感染率越高,测算夫妻间每次无保护性交的感染机率为0．024％～0．032％。HIV阳性妻子每次无保护性交传染给丈夫的机率是0．028％～0．037％;HIV阳性丈夫每次无保护性交传染给妻子的机率是0．011％～0．015％。结论在夫妻-方感染日期明确、夫妻无保护性生活年限明确的情况下,得到的HIV-1的夫妻传播率,对预防控制艾滋病性传播具有重要的指导意义。     

A Relational Approach to Counseling Women with Alcohol and Other Drug Problems

Examination of the change strategies associated with successful long-term sobriety remains an understudied area in addiction research. The following study recruited individuals with long-term sobriety (range 16–25 years continuous abstinence). Subjects (n = 11) were surveyed on demographic information, problem history, Alcoholics Anonymous (AA) affiliation, and helping behaviors within several life domains over the course of sobriety. General helping behaviors increased from lower levels in the month prior to getting sober, to moderate levels at 1 year of sobriety, but did not continue to increase with additional years of sobriety. Levels of general help to others at home, work, and 12-step programs were similar at varying lengths of sobriety. Whereas overall levels of general help given to others were similar across settings, helping other alcoholics, as opposed to helping others at home or work, was rated as contributing the most to staying sober. Across time, alcoholics increased participation in helping behaviors specific to 12-step programs. The utility of helping others as a behavioral strategy to maintain successful addictive behavioral change is discussed.     

Individual and Interpersonal Characteristics that Influence Male-Dominated Sexual Decision-Making and Inconsistent Condom Use Among Married HIV Serodiscordant Couples in Gujarat,India: Results from the Positive Jeevan Saathi Study

Approximately 40 % of new infections occur among married women. No studies have examined the factors that may contribute to HIV transmission among HIV-negative wives in HIV serodiscordant relationships in Gujarat, India. In 2010, a cross-sectional survey with 185 HIV serodiscordant, married couples (i.e. 185 HIV-positive husbands and their 185 HIV-negative wives) in Gujarat was conducted. Socio-demographic, individual, and interpersonal characteristics of HIV-positive husbands and their HIV negative wives were examined. The association of these characteristics with inconsistent condom use and male-dominated sexual decision-making, were examined using multivariate logistic regression analyses. Approximately 10 % of couples reported inconsistent condom use in the past 3 months and 20 % reported intimate partner violence (IPV). Reports of IPV were associated with a higher odds of inconsistent condom use among HIV-positive husbands (aOR = 6.281). Husbands who reported having received couples counseling had a lower odds of male-dominated decision making about condom use (aOR = 0.372). HIV-negative wives who reported sex communication had a lower odds of male-dominated decision making about condom use (aOR = 0.322) with their HIV-positive husbands. Although condom use is a traditional measure of risk behavior, other factors that facilitate risk, such as male-dominated sexual decision-making need to be considered in analyses of risk.     

Toward a Model for Counseling the Wives of Alcoholics

Earlier literature on the wives of alcoholics confused the causes with the effects of alcoholism. Wives of alcoholics were thought to be highly neurotic contributors to their husbands' illness. Furthermore, sexist biases influenced opinion and research with the result that while wives were blamed for their spouses' illness, husbands of alcoholic wives were considered blameless victims. Despite recent gains in the understanding of alcoholism and its effects on family dynamics, treatment of alcoholic marriages continues to reflect subtle sexist attitudes and values. For example, wives are often viewed as little more than adjuncts to their husbands' treatment. Such approaches undermine reality-centered and effective treatment. A model for counseling wives of alcoholics is proposed which addresses her special and separate concerns.     

Does type of disease matter? Gender differences among Alzheimer's and Parkinson's disease spouse caregivers

PURPOSE OF STUDY: Mental health outcomes are widely reported among spouse caregivers, with wives generally faring worse than husbands. We hypothesized that gender differences would not be as strong in a cognitively intact group because caring for cognitively intact spouses may involve less severe reciprocity losses. We also examined gender differences in coping strategies within each group. DESIGN AND METHOD: 175 spouse caregivers for patients with Alzheimer's disease (AD; n = 88) and Parkinson's disease (PD; n = 87) were interviewed. Participants completed perceived stress (PSS), depression (CES-D), state anxiety (STAI, Form Y), and coping strategies (WCCL-R) measures. RESULTS: Wives in the AD group reported significantly worse mental health outcomes than husbands, while wives and husbands in the PD group showed no differences. AD caregiving wives were less likely than husbands to use problem-focused coping strategies. There were no significant gender differences in either group for social support or emotion-focused coping. IMPLICATIONS: Loss of reciprocity in marital relationships may affect women more negatively than men. Future studies that address underlying mechanisms of gender differences and focus on similar caregiving situations and contexts deserve attention.     

A comparison of marital interaction patterns between couples in which the husband does or does not have Alzheimer's disease

Objectives. Our main purpose was to examine similarities and differences in patterns of interpersonal interaction between Alzheimer's disease (AD) caregiving and noncaregiving couples (n = 54). Methods. Twenty-seven wives caring for moderately impaired husbands with probable AD and 27 noncaregiving wives from comparable sociodemographic backgrounds were videotaped in their homes during both mealtime and a future event planning task. In addition, they completed self-report questionnaires to assess depression, stress, relationship mutuality, and perceived hope. Results. Compared with their counterparts, caregiving wives reported higher levels of depression and stress, but similar shared values and closeness. For the three factors developed from the Marital Interaction Coding System (MICS, version IV; Supportive Facilitative, and Rapport Building), a complex pattern of results was found in which disease status, type of task, and gender interacted significantly. Noncaregiving couples were more interactive overall and expressed more support to each other. Caregiving wives were found to be most facilitative during the planning task, whereas AD husbands were highest on interactions that built rapport (e.g., smiling) during that same task. Caregiving wives actually increased their facilitative behavior from the mealtime to planning task, probably reflecting the increased demand characteristics of the latter. DISCUSSION: This study is one of a small body of literature to describe the negative impact of AD on spousal communication as observed and coded in two videotaped interaction situations in the home. Suggestions are made for future research, including the inclusion of longitudinal designs and non-Caucasian couples.     

Transmission of HIV from injecting drug users to their wives in India

We aimed to identify factors associated with transmission of human immunodeficiency virus (HIV) from injecting drug users (IDUs) to their wives in Manipur, northeast India, where the prevalence of HIV among IDUs is 80% via a case-control study. One hundred and sixty-one HIV-infected IDUs and their wives were recruited from September 1996 to August 1997 inclusive. HIV status was determined by enzyme-linked immunosorbent assay (ELISA) plus Western blot, Interviews were administered anonymously. Regression analysis identified factors associated with transmission of HIV from IDU husbands to their non-injecting wives. Seventy-two wives (45%) were HIV-positive. Only 15% of the couples reported regular usage of condoms during intercourse. On multivariate analysis, a sexually transmitted disease (STD) in either member, reported by the husband, estimated duration of HIV in the husband for >8 years, and a history of blood transfusions were associated with infection in the wife. In conclusion, STDs are associated with transmission of HIV from husband to wife. Improved control of STDs, condom promotion, and improved blood screening are urgently needed in Manipur.