Shared reality refers to the perception of sharing the same interpretation of the world with another, giving a sense of meaning to an otherwise complex and uncertain world. Despite its critical role in affective relationships, the notion of shared reality in romantic couples has been surprisingly overlooked. This critical review presents a unifying conceptualization in the burgeoning field of shared reality in romantic couples and provides a summary of its foundations and consequences, organizing it across three main areas of research: nonverbal coregulation, verbal communication, and couples' culture. To do so, we analyze the available literature on shared reality in romantic couples and link it with close literature within and outside relationship science to provide an extensive overview of the topic. Our critical review of the available literature reveals strong preliminary evidence for some positive outcomes of shared reality in couples, like increased relationship satisfaction and reduced life uncertainty. However, other potentially less positive outcomes, such as identity fusion and social isolation, have been largely neglected despite their theoretical and clinical importance. Overall, this review underscores the complex and nuanced links between shared reality and partners' well-being, which carry important indications for future research and clinical practice.
Sleep disorders-including insomnia and obstructive sleep apnea-have traditionally been studied and treated as individual conditions. However, accumulating evidence demonstrates that sleep is fundamentally a dyadic process for most adults, embedded within couple and family systems. This systematic review synthesizes findings from 38 studies published between 2000 and 2025 examining interventions that incorporate romantic partners or family members in the treatment of insomnia and obstructive sleep apnea. A comprehensive search identified studies meeting inclusion criteria: adult participants with diagnosed sleep disorders, partner/family involvement in >= 50% of treatment sessions, and validated sleep outcomes. Across reviewed studies, partner-involved interventions demonstrated advantages over individually delivered treatments. For insomnia, partner-assisted cognitive-behavioral therapy for insomnia showed enhanced treatment adherence and improved outcomes. For obstructive sleep apnea, spousal involvement predicted better continuous positive airway pressure adherence, with supportive collaborative involvement associated with increased nightly use while pressuring involvement predicted poorer adherence. Relationship quality, attachment security, and type of partner involvement consistently moderated treatment response. Meta-analytic evidence from a study of 62 independent samples confirms moderate associations between relationship quality and sleep quality (r = 0.34, 95% CI [0.09, 0.59]), with partner responsiveness emerging as particularly important. This review integrates empirical findings with systemic and interpersonal theories to articulate a relational framework for understanding and treating sleep disorders, with implications for clinical practice in couple and family psychology.
Anger is a significant problem for military veterans with posttraumatic stress disorder (PTSD). Interventions designed to treat PTSD have been shown to decrease anger, which may be associated with improvements in psychosocial functioning. Couple-based PTSD treatments, which target both PTSD and relationship functioning, may be particularly useful for improving anger and associated psychosocial functioning. Thus, the current study sought to examine whether decreases in veterans' and partners' anger following participation in a brief couple-based treatment for PTSD (brief Cognitive Behavioral Conjoint Therapy for PTSD) is associated with improvements in psychosocial impairment and relationship satisfaction, in addition to decreases in suicidal ideation. The sample included 184 veterans and their intimate partners (92 dyads). Each partner completed measures assessing several aspects of anger (angry temperament, angry reaction, and psychological aggression). Veterans also completed measures assessing their psychosocial impairment, relationship satisfaction, and suicidality. Latent growth curve models tested whether changes in anger over the course of treatment were associated with corresponding changes in veterans' functional outcomes at the within-person and between-person levels. Findings showed that improvements in veterans' anger were associated with improvements in their psychosocial impairment and relationship satisfaction over time. Partners' psychological aggression was also associated with improvements in veterans' psychosocial impairment over time. Neither veterans' nor partners' anger was associated with veterans' suicidality. Findings add to the literature demonstrating that improvements in anger for both veterans and their partners in the context of PTSD treatment may be associated with improvements in broader psychosocial functioning for veterans.
Veterans with posttraumatic stress disorder (PTSD) and their intimate partners often express a desire for partner involvement (e.g., communication with therapists) in veterans' trauma-focused treatment (TFT), which can enhance treatment engagement and response. Although relationship satisfaction and PTSD symptoms in both partners may impact their interest in treatment involvement, there is a dearth of literature investigating these influences dyadically. The current study is a secondary analysis of data from veterans and their partners who completed a mailed survey as the veteran was beginning TFT through the Veterans Affairs (n = 211 dyads). We conducted an actor-partner interdependence model to examine the influence of veterans' and partners' relationship satisfaction, PTSD symptoms, and their interactions on each of their interest in having the partner talk with the therapist. Veterans were more interested in therapists speaking with their intimate partners when they experienced greater relationship satisfaction (β = .23, SE = .07), and when their partner had less relationship satisfaction and lower PTSD symptoms (B = -0.38, SE = 0.13). Intimate partners were more interested in speaking with the therapist when their own PTSD symptom severity was higher (β = .19, SE = .07), and when they experienced less relationship satisfaction and the veterans' PTSD severity was high (B = -0.28, SE = 0.11). Results suggest the importance of considering interconnections between veterans' and their partners' PTSD symptoms and relationship satisfaction when determining when and how to encourage partner-therapist discussions during veterans' TFT.
While extensive research has examined maternal experiences in autistic families, fathers' perspectives remain substantially underexplored despite evidence suggesting qualitatively different experiences and support needs. This study explored the lived experiences of fathers raising autistic children, examining their adaptation processes, coping strategies, challenges, and sources of growth and resilience. Nine fathers of autistic adolescents (aged 12-19) participated in semistructured interviews. Data were analyzed using Braun and Clarke's thematic analysis within a social constructionist framework. Four interconnected themes emerged: (1) "From Father to Case Manager: The Evolution of Paternal Identity" captured fathers' transformation into multifaceted caregivers, (2) "Walking on Thin Ice: The Chronic Stress of Hypervigilant Parenting" described persistent emotional difficulties, (3) "Family Ecosystem Recalibration" revealed comprehensive family system reorganization, and (4) "Unexpected Gifts: Personal Growth and Profound Connection" highlighted paradoxical findings of significant personal growth despite substantial challenges. Fathers experience complex processes of identity evolution, chronic stress management, family system reorganization, and unexpected personal growth when raising autistic children. The findings challenge solely deficit-focused narratives while acknowledging genuine difficulties, providing foundation for developing father-inclusive support services.
Many studies have shown high rates of psychiatric comorbidity among post-9/11 veterans and highlighted the important role of intimate relationships in their functioning. However, none have identified (a) the degree of heterogeneity among profiles of veterans' comorbid psychopathology symptoms and relationship satisfaction or (b) the predictors of which profile the veterans ultimately express. To examine this question, we used self-report survey data from 485 U.S. veterans in committed relationships across two timepoints (at baseline and 10-year follow-up) as part of the Veterans Integrated Service Network 6 Post-Deployment Mental Health Study. We conducted a latent profile analysis to examine (a) concurrent symptoms of depression, posttraumatic stress disorder, and alcohol use and (b) relationship satisfaction at follow-up. Profiles were compared on military, psychological, physical, and contextual factors at each timepoint to determine which risk and protective factors predicted profile membership over time. A three-class solution identified a healthy group with minimal symptoms and higher relationship satisfaction (62.5%), a distressed group with clinically significant depression, posttraumatic stress disorder, and lower relationship satisfaction (31.75%), and a mixed group with clinically significant depression, posttraumatic stress disorder, and alcohol use and higher relationship satisfaction (6%). Veterans with higher levels of social support between baseline and the 10-year follow-up were more likely to be in the healthy group. Those in the mixed group were more likely to report higher lifetime trauma exposure and physical health symptoms over time. Ultimately, treatments for U.S. veterans should continue to consider comorbid symptom presentations, social support, and the integration of partners in health care as important clinical targets.
Family members can significantly impact recovery from opioid use disorder (OUD), but their role and the impact that OUD plays are understudied. Research often focuses on individual patient outcomes, neglecting the dynamic between family members. Understanding this crossover between individuals can inform family-level interventions to enhance OUD treatment. The present study examined the crossover between relationship quality and mental health among patients in OUD treatment and their support person (SP). We also examined how concordance within the dyad on perceived relationship quality affected mental health at baseline and over 3 months. Participants were 219 buprenorphine patients (58% male, 62% White) and their SPs (family [22%], partner [31%], friend [47%]; 72% female, 62% White) recruited from five community health centers providing outpatient OUD treatment. Each member of the dyad provided data on their perceived level of cohesion and conflict within the relationship and symptoms related to anxiety and depression at baseline and 3-month follow-up. High cohesion and low conflict in patient-SP dyads were linked to reduced mental health severity (p < .05) at baseline. Concordant dyads, even if reporting agreement on high conflict or low cohesion, showed even lower mental health symptoms at baseline (p < .001) and a greater rate of clinical improvement in mental health at follow-up (p < .05) than discordant dyads. This study emphasizes the influence that patients and SPs can have on each other's mental health and how concordance on their ratings of relationship quality can alleviate mental health symptoms. These findings offer insights into how the relationship can be leveraged to understand and tailor treatments that are supportive of both.
Same-gender couples face unique stressors that can impact relationship functioning, underscoring the need for culturally tailored, accessible interventions for this population. This study developed and tested a culturally adapted version of the evidence-based online OurRelationship program for relationally distressed same-gender couples. The tailored program included core activities from the OurRelationship program designed to address underlying relationship processes, enhanced with content addressing minority stressors, promoting relationship strengths unique to same-gender couples, and increasing representation of same-gender couples in program materials. The results showed significant within-group improvements over treatment in relationship satisfaction, emotional intimacy, communication during conflict, intimacy associated with lesbian, gay, bisexual, and transgender identity, and several mental health symptoms (Cohen's d = |0.41-1.07|), with a trend toward increased relationship confidence. No significant differences in treatment outcomes were found when compared to a matched subsample of mixed-gender couples who received the original, heteronormative version of the OurRelationship program in a previous study. Findings suggest that this adapted version is a promising and flexible intervention for distressed same-gender couples.
Parents of Black youth face numerous challenges when raising their children, such as promoting racial pride and preparing children for a racialized society. Racial socialization (RS) competency seeks to complement parents' messaging by examining three distinct areas: skills, confidence, and stress. The current cross-sectional study explores how discrimination experienced by parents influences child behavioral outcomes and whether the relationship is moderated by RS competency. A sample of 359 Black parents from across the United States (M-age = 37.8) were asked questions regarding their oldest child under the age of 18 (M-age = 9.5). Black parents completed an online questionnaire that assessed their competency in RS conversations, experiences with racial discrimination, and perception of their child's internalizing (i.e., feelings of sadness and unworthiness) and externalizing (i.e., aggression and combativeness) behaviors. Moderation analyses found that greater racial discrimination experienced by parents was associated with more child behavioral problems when parents' RS stress was high and when RS confidence was low. Further resources should be directed toward parents who have experienced more frequent racial encounters, especially those who lack confidence in conveying RS messages. Future studies should investigate whether clinical interventions could increase parental RS competency and protect against negative child behaviors.
Family caregiving is a major stressor that can compromise health and activate the HPA axis-one of the body's primary physiological stress systems. A multitude of past research shows that marital status and characteristics of the partnership can help buffer caregiving burden and enhance coping resources to mitigate negative physiological outcomes. However, there are numerous ways to measure the role of the spouse, and the conceptualization of these measures may have different implications for the links between stress and health. Moreover, many studies are limited by designs that specifically recruit both partners into a study, resulting in samples that may be skewed towards couples that already have higher relational quality or provide more support. In this study, parent caregivers of children (n=170) with rare genetic conditions and parent caregivers of typically developing children chose to participate alone or jointly as a couple. Information on caregiving burden, use of individual coping strategies, marital status, and caregiving-specific support by spouse/partner was collected via surveys. Blood samples were collected to assess serum arginine vasopression (AVP) levels-one biomarker of the HPA axis. Caregiving burden was positively associated with AVP, while greater use of individual coping resources was negatively associated with AVP. Marital status was directly linked to lower AVP, while caregiving-specific support and joint participation moderated some of the associations between caregiving burden, individual coping, and AVP. These findings highlight the need to consider multiple aspects of marriage and partnership as potential influences on the biological response to stress in parent caregivers.
OurRelationship (OR) is an 8-hr, web-based, primarily self-help program for distressed couples. It was developed to improve access to relationship interventions among populations who are traditionally hard to reach (e.g., couples with low income, living in remote areas, or from diverse backgrounds). While the effectiveness of the OR is well-established in these populations, less is known about its impact when made broadly accessible online, a context in which the typical self-referring client may be "easy-to-reach" (i.e., middle-class, well-educated). This pilot study examined the superiority of OR to bibliotherapy among 52 relationally distressed, opposite-sex, parenting couples characterized by high levels of education and low levels of stress and depression. Couples were recruited through broad, nonpaid announcements online (e.g., social media) and randomly assigned to either coach-guided OR self-guided bibliotherapy. Multilevel mixed-effects models assessed within- and between-group effects, and a benchmark analysis compared effects to those found in a previous harder-to-reach sample. The OR group showed small within-group effects on relationship functioning (d = .29-.32) and individual functioning (d = .16-.29). The bibliotherapy group demonstrated small-to-medium within-group effects on relationship functioning (d = .45-.56) and small effects (d = .01-.45) on individual functioning. No significant between-group differences emerged, except for greater increases in relationship confidence in the bibliotherapy group. Compared to a previous pilot study that recruited harder-to-reach distressed couples via paid online advertisements, the effects of OR were significantly lower. These findings suggest that the superiority of OR observed in harder-to-reach populations may diminish among more resourceful couples.
Social support is a known protective factor against opioid misuse. However, there is limited research focused on Black Americans, a population disproportionately impacted by the opioid epidemic. The current study examined whether emotional support mediated the relationship between family conflict and opioid misuse in a sample of 600 Black adults reporting opioid misuse. Following a screener and informed consent, participants completed a survey at two urban on-site study locations. Measures relevant to this study included socio-demographics, family conflict, opioid misuse, and emotional support. Data analysis employed univariate, bivariate, and multivariate methods, including mediation analysis using the SPSS PROCESS macro. Family conflict was associated with decreased emotional support and increased opioid misuse. Additionally, increased emotional support was associated with decreased opioid misuse. Mediation analysis revealed a significant indirect effect of family conflict on opioid misuse through emotional support. The findings highlight the influence of family dynamics on opioid misuse and suggests emotional support as a possible mechanism explaining these associations. Clinical implications for addressing family dynamics and support in treatment in a culturally congruent manner are discussed.
This study sought to understand the psychological and relational impact of infidelity in a sample of Colombian college students, their understanding of how this happened in their relationships, and how they coped with the aftermath. Participants were 16 women and five men (Mage = 21.5 years, SD = 2.0). The analytic method was thematic analysis, facilitating the identification of patterns (themes) within the data. Narratives about the relationship before the infidelity revealed patterns of conflict avoidance and gender-based inequality. In their explanations of the context of the infidelity, participants referred to relationship difficulties, gender-based social expectations, double standards about fidelity, and partners' individual characteristics. Coping responses included both proactive efforts to maintain their well-being (taking care of own needs, seeking friends' social support) and strategies to avoid dealing with emotions (drug abuse and casual sex). The implications of these findings for college-based relationship education programs are presented.
Research suggests that addressing sexual difficulties and concerns may enhance sexual satisfaction and, in turn, improve sexual and relationship outcomes among partnered individuals. This study examined whether perceived quality of sexual communication indirectly links insecure attachment (i.e., anxious and avoidant attachment) to sexual satisfaction among college students. Further, this study assesses sexual satisfaction by measuring both participants' own sexual satisfaction (i.e., self-sexual satisfaction) as well as their satisfaction derived from their partner's sexual experiences (i.e., partner-derived sexual satisfaction). This assessment of sexual satisfaction is relatively new within the literature. Participants (N = 352; 84.9% identified as female, 13.6% male, 1.4% gender diverse) were undergraduates from a southeastern university who identified as sexually active and were involved in a sexual relationship and/or romantic relationship. Participants were recruited via convenience sampling and were on average, 18.78 years old. Most participants identified as heterosexual (88.40%) and the remaining identified as bisexual (8.20%), queer (2.30%), gay (1.70%), lesbian (0.60%), and pansexual (0.60%). We collected cross-sectional survey data across three semester waves (Spring 2022, Fall 2022, and Spring 2023) and tested hypotheses using path analysis. Results revealed that both anxious and avoidant attachment were indirectly related to self-sexual satisfaction and partner-derived sexual satisfaction through perceptions of worse sexual communication. Clinicians could consider assessing and targeting attachment-related concerns and sexual communication skills when working with couples and individuals experiencing sexual dissatisfaction. Moreover, future research might explore and develop therapeutic interventions that improve sexual communication strategies, particularly among those high in attachment insecurity.
Recent research has focused on couple values, namely what the partners perceive as important for their couple as a whole. In Study 1, we investigated whether respondents' couple values, as perceived by each partner, when controlling for individual values, were related to coparenting among 546 individuals, all being parents (54.1% mothers; M-age = 41.52 years, SD = 7.19). Results showed the relevant role of both couple self-transcendence and self-enhancement values, over and above the respective individual values. In Study 2, we focused on the discrepancy between couple values of heterosexual parents (167 couples; M(age )of mothers = 42.14 years, SD = 6.78; M-age of fathers = 45.41 years, SD = 7.57), that is the extent to which partners have different perceptions of what is relevant for their couple, in relation to their coparenting. While couple values are more strongly related to coparenting compared to individual values, the couple value discrepancy between the two partners is not. It appears that each partner's perception of which values are relevant for the couple is more important for a supportive coparental relationship than the actual similarity in couple values between partners. Results are discussed in terms of their theoretical and practical implications.
Behavioral parent training (BPT) is the gold standard treatment for behavior problems, but not all families benefit. Furthermore, it remains unclear whether adaptations to BPT such as mindfulness lead to improved outcomes. Separately from BPT, mindful parenting programs (MPPs) have been implemented with parents of children with problem behaviors. However, research examining BPT and MPP together is limited. This comparative account detailed the conceptual basis for these treatments, including their purported mechanisms, and compared elements in BPT and MPP protocols to identify unique and shared elements. Four shared elements in BPT and MPP were identified, while three MPP elements and one BPT element were identified as unique. This review considered limitations in the literature and suggested future directions.
Depression is associated with decreased relationship satisfaction, and identifying what may moderate this association is important for informing clinical interventions for individuals in romantic relationships and suffering from depression. Dyadic coping, how couples manage stress together, has been demonstrated to have strong associations with relationship satisfaction. Most past research on dyadic coping, however, has been conducted with predominantly White samples. To extend these findings, we conducted a study examining the associations between depressive symptoms, dyadic coping, and relationship satisfaction among Asian American individuals. We hypothesized that dyadic coping from a partner, particularly in the form of supportive dyadic coping (i.e., providing emotional or problem-focused support) and joint dyadic coping (i.e., both partners trying to manage stress and cope together), would moderate the association between depressive symptoms and relationship satisfaction. We found that supportive dyadic coping attenuated the relationship between depressive symptoms and relationship satisfaction, such that the negative association between depressive symptoms and relationship satisfaction was stronger when supportive dyadic coping was low and weaker when supportive dyadic coping was high. Supportive dyadic coping may be particularly beneficial for Asian American adults in romantic relationships with elevated depressive symptoms. This is important insofar as Asian Americans may be less likely than their White counterparts to adopt supportive dyadic coping.
It is becoming more common for people to be in romantic interracial relationships (i.e., relationships in which romantic partners have different racial identities) in the United States. However, people in interracial relationships experience additional challenges that those in same-race relationships do not face. These additional challenges, such as having to navigate conflict due to cultural differences, may threaten the relationship's longevity. Ineffectively navigating cultural differences has the potential to negatively impact relationship quality (i.e., commitment and satisfaction). However, not all interracial relationships end, which suggests that how partners respond to conflict is important. That is, if people respond constructively to cultural conflict while inhibiting a destructive response, a process known as constructive accommodation, it may buffer against the negative effects of conflict on relationship quality. We predicted and found an interaction between perceptions of cultural conflict and constructive accommodation on relationship quality among people in interracial relationships. Such that, people who perceive greater constructive accommodation during high cultural conflict reported being more committed in their relationship compared to people engaging in low constructive accommodation.
