Nearly 800,000 people in the US experience a stroke each year and many must adjust to living with chronic sequelae, including cognitive, language, and mobility impairments, and mood disturbance. The impact of stroke is shared between the stroke survivor and their romantic partner, as established roles and the ability to connect, participate in shared activities, communicate, and reciprocate may be altered due to impairments. An estimated 30-50% of stroke survivors and their partners experience depressive or anxiety symptoms that negatively affect rehabilitation outcomes and quality of life. Yet interventions to support couples post-stroke are largely insufficient or inaccessible. To address this need, our transdisciplinary team developed an 8-week remotely-delivered dyadic intervention to promote Resilience in Stroke survivor-care partner Dyads (ReStoreD), in which couples learn and practice goal-setting, communication strategies, and positive psychology-based activities like expressing gratitude, finding meaning, and fostering connections. Using a mixed methods design, our pilot study with 34 couples coping with stroke demonstrated feasibility, acceptability, and suggests ReStoreD may reduce depressive symptoms (eta-squared = .22) and increase resilience (eta-squared = .34) in stroke survivors, but not partners. Qualitative interviews indicate that survivors and partners reported the intervention positively impacted communication, meaningful activity engagement, and personal and dyadic coping. These findings are promising, but more research is needed. A national NIH NCMRR R01-funded trial of the intervention is ongoing (current n = 111 dyads of 200 planned).

Objective: Studies have found that cancer patients with dependent children exhibit high symptoms of anxiety, depression, and worry. Patients' parenting concerns can negatively impact their own and their family's adjustment to the cancer experience. However, relatively little is known about parenting concerns of partners of cancer patients, or associations between parenting concerns and couples' relationship adjustment. This longitudinal study investigated parenting concerns among both patients and partners, and their associations with psychological and relationship adjustment. Methods: One hundred thirty-four patients with cancer and their partners (67 couples) completed the Parenting Concerns Questionnaire at baseline and measures of psychological distress, communication, and relationship adjustment at four time points (baseline, 4-, 8-, and 12-month follow up). Results: Baseline parenting concerns did not differ by role, gender, cancer site or cancer stage (p > 0.05). Patients and partners who reported higher levels of parenting concerns at baseline reported significantly greater psychological distress and poorer communication concurrently and at each subsequent assessment. There were no significant associations between parenting concerns and relationship satisfaction either concurrently or over time. Conclusions: These findings reinforce the need for a dyadic perspective to assessing both patients' and partners' parenting concerns and a focus on processes such as communication as an avenue for managing and processing parenting concerns.

Given the bidirectional association between psychopathology and relationship distress, an in-depth understanding of couples’ interaction processes that contribute to psychopathology is needed. This study examined the interpersonal dynamics of vocally-encoded emotional arousal (fundamental frequency, f0) during couple conversations and their associations with depressive symptoms, anxiety symptoms, and relationship distress. Data from eight samples were pooled (N = 404 couples) to examine (a) overall trajectories of f0 across the interaction and (b) moment-by-moment intraindividual changes in and interpersonal reactivity to partners’ f0. Multilevel growth models and repeated-measures actor-partner interdependence models demonstrated that individuals with more severe depression showed more synchronizing reactivity to their partners’ f0 on a moment-by-moment basis, and their overall baseline level of f0 was lower. More severe relationship distress was associated with more steeply increasing trajectories of f0 and with greater synchronizing reactivity to partners’ f0. Relative differences in depressive symptoms between the two members of a couple were associated with interpersonal dynamics of f0 as well. There were no associations with anxiety symptoms. Thus, depressive symptoms were associated with characteristic interpersonal dynamics of vocally-encoded emotional arousal; yet, most consistent associations emerged for relationship distress, which future studies on individual psychopathology should take into account.

Abstract Introduction The goal of this study was to examine feasibility, acceptability, and preliminary efficacy of WePAP, a novel, couples-based treatment to promote positive airway pressure (PAP) adherence in patients with obstructive sleep apnea (OSA) and sleep quality in patients and partners. Methods Patients who were recently diagnosed with OSA and starting PAP and their partners completed pre- and post-treatment self-report measures of study constructs and actigraphy. Couples were randomly assigned to WePAP or information control (IC) groups. Post-PAP assessments and adherence downloads were completed at 1 and 3 months. The main outcomes were feasibility and acceptability ratings. Preliminary efficacy outcomes included: patient PAP adherence and subjective and actigraphy-assessed sleep in patients and partners. Secondary outcomes included depression, quality of life, relationship, and cognitive functioning. Results The study enrolled 37 couples (age m= 62.97; SD=9.04). All WePAP couples attended each of the three sessions. Compared to the IC group, patients and partners in WePAP rated the intervention more favorably and were more satisfied. Among the primary efficacy outcomes, PAP adherence was high in both groups (PAP use >4 h= 85% in WePAP and 77% in IC). There were significant within-group differences for subjective sleep, such that patients in both groups showed significant reductions in sleep disturbance at 3-months. In addition, patients in both groups and partners in WePAP showed significant reductions in sleep related impairment at 3-months. Among secondary outcomes, patients in both WePAP and IC showed significant improvements in depression and QOL. WePAP patients also showed small but significant improvements in a measure of processing speed and attention. There were no within- or between-group changes in relationship quality. Conclusion Results demonstrate that WePAP is feasible and well-liked by patients and partners, but did not demonstrate greater adherence or improved sleep quality in this sample of highly adherent patients. Future studies should examine longer-term outcomes and enroll patients at greater risk for non-adherence to PAP. Support (if any) The research reported in this publication was supported (in part or in full) by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers R21AG067183 (PIs: Baron and Troxel), 3R21AG067183-01A1S1 (Baron/DeVettori), UL1TR002538 and UM1TR004409.

Cancer poses a set of physical and emotional challenges to the patient, spouse, and their relationship. One challenge for couples is discussing cancer-related concerns in a manner that facilitates intimacy. Current couple-based interventions have been shown to have mixed efficacy, and little is known about how they bring about improvements. This study aims to expand our understanding of dyadic communication and intimacy to adapt and/or develop more effective interventions for couples coping with cancer. To accomplish this goal, the present study examined affective and behavioral processes associated with intimacy using the valence-affective-connection (VAC) framework and observational coding methods. Participants were 134 couples in which a patient was diagnosed with breast, colorectal, or lung cancer. Couples completed a battery of questionnaires, including a self-report measure of intimacy. Couples also completed a 15-min videotaped interaction about a cancer topic of their choosing, which was observationally coded for communication behavior and affective expression. Couples coping with cancer who reported higher versus lower intimacy engaged in qualitatively different levels, types, and patterns of communication behavior and affective expression. Specifically, couples who reported lower relationship intimacy used negative approach behavior and hard negative affect more frequently and for longer periods of time and were more likely to use avoidance-based communication. Higher intimacy couples were less likely to sustain the use of negative behavior and affect and displayed more reciprocity of positive joining affect. The study highlights important considerations for couple-based interventions and research in the context of cancer. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

BACKGROUND:Computational psychiatry has the potential to advance the diagnosis, mechanistic understanding, and treatment of mental health conditions. Promising results from clinical samples have led to calls to extend these methods to mental health risk assessment in the general public; however, data typically used with clinical samples are neither available nor scalable for research in the general population. Digital phenotyping addresses this by capitalizing on the multimodal and widely available data created by sensors embedded in personal digital devices (eg, smartphones) and is a promising approach to extending computational psychiatry methods to improve mental health risk assessment in the general population. OBJECTIVE:Building on recommendations from existing computational psychiatry and digital phenotyping work, we aim to create the first computational psychiatry data set that is tailored to studying mental health risk in the general population; includes multimodal, sensor-based behavioral features; and is designed to be widely shared across academia, industry, and government using gold standard methods for privacy, confidentiality, and data integrity. METHODS:We are using a stratified, random sampling design with 2 crossed factors (difficulties with emotion regulation and perceived life stress) to recruit a sample of 400 community-dwelling adults balanced across high- and low-risk for episodic mental health conditions. Participants first complete self-report questionnaires assessing current and lifetime psychiatric and medical diagnoses and treatment, and current psychosocial functioning. Participants then complete a 7-day in situ data collection phase that includes providing daily audio recordings, passive sensor data collected from smartphones, self-reports of daily mood and significant events, and a verbal description of the significant daily events during a nightly phone call. Participants complete the same baseline questionnaires 6 and 12 months after this phase. Self-report questionnaires will be scored using standard methods. Raw audio and passive sensor data will be processed to create a suite of daily summary features (eg, time spent at home). RESULTS:Data collection began in June 2022 and is expected to conclude by July 2024. To date, 310 participants have consented to the study; 149 have completed the baseline questionnaire and 7-day intensive data collection phase; and 61 and 31 have completed the 6- and 12-month follow-up questionnaires, respectively. Once completed, the proposed data set will be made available to academic researchers, industry, and the government using a stepped approach to maximize data privacy. CONCLUSIONS:This data set is designed as a complementary approach to current computational psychiatry and digital phenotyping research, with the goal of advancing mental health risk assessment within the general population. This data set aims to support the field's move away from siloed research laboratories collecting proprietary data and toward interdisciplinary collaborations that incorporate clinical, technical, and quantitative expertise at all stages of the research process. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR1-10.2196/53857.

Abstract Introduction Emerging research highlights the interdependence of sleep within couples and the impact of sleep and sleep disorders on couples’ relationship quality. The current study examines how adherence to positive airway pressure (PAP) as well as sleep duration and efficiency associates with both patient and partners’ relationship quality, among patients with obstructive sleep apnea (OSA) and their partners. Methods The sample included OSA patients initiating PAP treatment and their partners (N= 36 couples; mean age = 63.06, SD = 9.15). Mixed model analyses examined actor and partner effects of PAP adherence and actigraphy-assessed sleep duration and efficiency, on patient and partners’ self-reported relationship satisfaction and conflict. Results Greater patient PAP adherence (defined as > 4 hours use per night on average over 3 months of recording) was associated with higher levels of relationship satisfaction (B = 4.26; SE = 1.40; p = 0.01) and lower levels of relationship conflict (B = -5.24; SE = 2.51; p = 0.04) for patients and partners. Higher patient sleep efficiency was associated with higher levels of patient and partner reported relationship satisfaction (B = 0.12; SE = .06; p = 0.04). Associations involving sleep duration were significantly different for patients and partners. For patients, greater own total sleep time was significantly associated with higher levels of patients’ relationship satisfaction (B = 0.92; SE = 0.35; p = 0.01) whereas greater partner total sleep time was significantly associated with lower levels of patients’ relationship satisfaction (B = -1.35; SE = 0.67; p = 0.045). After adjusting for patient adherence, the magnitude and direction of these associations were similar but the p-values increased slightly (p = 0.085 for sleep efficiency; p = 0.054, 0.14, 0.12, respectively for sleep duration). Conclusion Results highlight how sleep and sleep disorders are implicated in couples’ relationship quality. Among couples in which one member has sleep apnea, adherence to PAP treatment and better sleep efficiency is associated with higher relationship satisfaction. Recognizing the dyadic implications of sleep and sleep disorders, including the potential impact on relationship quality, may be a powerful motivator to encourage adherence in sleep disorders populations. Support (if any) R21AG067183 (Baron and Troxel)

Preliminary evidence suggests different dimensions of subjective well-being (SWB) may be differentially associated with reduced suicide risk when measured at the person versus group level. In this longitudinal study, 2055 military personnel and civilian government employees completed self-report surveys administered 6 times from January 2020 to November 2021. Generalized estimating equation (GEE) models were used to examine associations among life satisfaction, perceptions of life being worthwhile, happiness, negative affect, and suicidal ideation. At the participant level, life satisfaction and worthwhile life were significantly correlated with reduced suicidal ideation whereas negative affect was significantly correlated with increased suicidal ideation. At the unit level, happiness was significantly correlated with reduced suicidal ideation. When covarying for participant-level depression and hopelessness, participant-level life satisfaction was no longer statistically significant. Results suggest eudaimonic SWB may be protective at the individual level whereas hedonic SWB may be protective at the group level.

In this study, we investigate using passive data, specifically heart rate and actigraphy, for individuals with binge-type eating disorders such as bulimia nervosa (BN) and binge-eating disorder (BED). By applying dynamical-system theory and incorporating advancements in technology-based health care, we explored the relationship between passive data patterns as potential indicators of binge-eating episodes. Over 30 days, 1,019 participants with BN or BED symptoms used the Recovery Record app on iPhone and Apple Watches for real-time eating-behavior logging. Apple Watches simultaneously recorded heart rate and actigraphy. Results show no marked difference in heart and step averages 2 hr before a binge versus a control period. However, significant momentum and stability differences emerged when examining the changing dynamics leading up to a binge event. These findings suggest that the stability of step, rather than their average value, may serve as a detectable indicator of approaching binge events.

Partialing correlated predictors to test independent effects is an essential tool in couple research. In actor-partner models, partners' parallel scores are partialed in tests of unique associations with outcomes. Correlated aspects of couple functioning are also often partialed within individuals to examine separate effects. Partialed versions of measures are typically interpreted as assessing the same construct as original unadjusted variables, but in fact their meaning can change. Extending a prior report on changes in construct validity resulting from partialing partners' parallel scores, the present analyses examined effects of partialing measures of positive and negative relationship variables within individuals, specifically perceived support from the partner and relationship conflict. In 300 middle-aged and older couples, we utilized participants' interpersonal circumplex ratings of their partner's typical behavior during marital interactions to compare interpersonal correlates of unadjusted and within-person partialed forms of the Quality of Relationships Inventory Support and Conflict scales. Compared to unadjusted scores, partialed support scores (i.e., adjusted for conflict) were substantially less closely associated with ratings of partner's warmth, and were associated with a less submissive (i.e., less agreeable, cooperative) form of warmth. Compared to unadjusted scores, partialed conflict scores (i.e., adjusted for support) were substantially less closely correlated with ratings of the partner's hostility, and were associated with a more controlling (i.e., critical, coercive) form of hostility. Results were nearly identical for wives and husbands. Partialing correlated scores within individuals can alter the construct validity of relationship measures, suggesting the need for careful reporting and interpretation in couple research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Interpersonal emotion dynamics in couples have implications for the interpersonal maintenance of psychopathology. That is, how individuals regulate their own emotions and respond to their partners' emotions is part of the interpersonal context of psychopathology and could influence treatment. The present study explored associations of (a) intrapersonal and interpersonal emotion dynamics in N = 18 couples with (b) obsessive-compulsive disorder (OCD) symptoms, partners' accommodation of OCD symptoms, and OCD treatment outcome, based on communicated emotional arousal (assessed as fundamental frequency) during couple interactions. Repeated-measures actor-partner-interdependence models suggested that the functional associations between obsessions and compulsions are reflected in patients' intrapersonal emotion dynamics prior to treatment, and partners' responses were associated with treatment outcome. Prior to treatment, patients with more severe obsessions needed longer to regulate their emotional arousal back to baseline after being perturbed. More severe compulsions were associated with patients' accelerated intrapersonal regulation. For partners, compulsions were associated with slowed regulation. Partners' heightened reactivity to patients' arousal and accelerated intrapersonal regulation were associated with smaller improvements in OCD and accommodation with treatment. Partners who show heightened reactivity might struggle tolerating the patients' emotional arousal, and might be less able to support exposure-based treatment of OCD.

Young men who have sex with men (YMSM) face the highest risk of HIV infection among adolescents, yet effective sexual health interventions for this population are limited. Parents and Adolescents Talking about Healthy Sexuality (PATHS) is an online intervention for parents designed to improve communication about HIV and increase behaviors supportive of YMSM sexual health. We conducted an RCT of PATHS with sixty-one parent-son dyads recruited online (sons were cisgender, gay or bisexual, ages 14–22). Assessments were completed at baseline, immediate post-intervention, and over the next 3 months. Per parent and son report, in the 3 months following the intervention, parents assigned to PATHS engaged in more HIV discussion, condom instruction, and facilitation of HIV testing. Parents also reported significant pre- to immediate-post intervention changes in attitudes, skills, and behavioral intentions relevant to engaging with their sons about sexual health. Parents are an untapped but promising resource in preventing HIV among YMSM. This trial was registered at ClinicalTrials.gov (Identifier: NCT04018573).

People who are happy with their romantic relationships report that their partners are particularly effective at meeting their everyday relational needs. However, the literature invites competing predictions about how people arrive at those evaluations. In pilot research, we validated a scale of concrete, specific relationship behaviors that can be performed by a romantic partner day-to-day. In Study 1, cross-lagged panel models examined how expectations of positive behaviors, perceptions of positive behaviors, and relationship quality predict changes in one another from week to week. People who expected more positive behaviors in turn perceived more positive behaviors from their partners 1 week later. Key effects extended to negative relationship behaviors (Study 2). In Study 3, the same pattern emerged in a dyadic sample, with expected behaviors predicting changes in perceived behaviors independent of the partner's own reports. Truth and bias analyses revealed that people with lower expectations had more negatively biased perceptions of their partners' behaviors, whereas high expectations were associated with better accuracy. We obtained these results in the context of specific, verifiable behaviors reported on over relatively short periods, underscoring how powerfully people's everyday relationship perceptions may be shaped by their more global perceptions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

OBJECTIVE The potential prognostic role of emotion regulation in the treatment of major depressive disorder (MDD) has been highlighted by transtheoretical literature and supported by promising empirical findings. The majority of the literature is based on self-report observations at a single snapshot, thus little is known about the prognostic value of moment-to-moment dynamic evolvement of emotion. The present study is the first to examine the prognostic value of both intra- and interpersonal, moment-to-moment emotion regulation dynamics, and the potential moderating effect of the type of treatment. METHOD To assess the prognostic value of emotion regulation dynamics, we focused on the first session, using 6,780 talk-turns within 52 patient-therapist dyads. Emotion regulation dynamics were measured using fundamental frequencies of the voice and were calculated using empirical Bayes residuals of the actor-partner interdependence model. Symptomatic change was measured using the Hamilton Rating Scale for Depression across 16 weeks of supportive treatment (ST) or supportive-expressive treatment (SET). RESULTS Findings suggest that patients who show less regulated intrapersonal dynamics during the first session show less reduction of symptoms throughout treatment (β = .26, p = .019). Findings further suggest that this association is mitigated when these patients receive SET, as opposed to ST (β = .72, p = .020). CONCLUSIONS The findings demonstrate the ability of first-session emotion regulation dynamics to serve as a prognostic variable. The findings further suggest that the adverse effect of emotion regulation dynamics on the patient's prognosis can be mitigated by explicit work on changing maladaptive emotional patterns. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prior research suggests that individual differences in aesthetic engagement-the propensity to be moved by art, nature, and beauty and a facet of the personality factor Openness to Experience-are associated with adaptive stress regulation. One hypothesis is that such individuals are more likely to view stressful circumstances as an opportunity for growth. The association between aesthetic engagement and stress-related growth orientation (SRGO) was investigated in two studies (total N = 463) using both behavioral coding and survey methods. Study 1 examined the association between aesthetic engagement and growth-oriented striving (self-improvement) in the context of an ecologically valid laboratory stressor. Results indicated that aesthetic engagement was significantly associated with observational behavior ratings of self-improvement across structured interviews regarding two recent stressors. Study 2 was a cross-sectional study that employed structural equation modeling to examine the hypothesized relationships between aesthetic engagement, including an expanded assessment of proneness to aesthetic chill, and measures assessing aspects of SRGO (COPE Positive Reinterpretation and Growth Subscale, Cognitive Flexibility Inventory, and Connor-Davidson Resilience Scale). Results demonstrated that individual differences in propensity to aesthetic chill experiences were associated with a SRGO latent construct. Taken together, converging evidence from these studies suggest that the tendency to view stressors as an opportunity for growth may be a characteristic adaptation of individuals high in aesthetic engagement and, in particular, proneness to aesthetic chill.

OBJECTIVE:To examine preliminary effects of ReStoreD (Resilience after Stroke in Dyads) on resilience in couples coping with stroke-related challenges. DESIGN:Supplemental analysis of prospective pilot trial with pre-/post-assessments and 3-month follow-up. SETTING:Community. PARTICIPANTS:Thirty-four cohabitating stroke-care partner dyads (N=34); at least 3 months post-stroke. INTERVENTIONS:8-week self-administered dyadic intervention (ReStoreD) consisting of activities completed individually and as a couple. MAIN OUTCOME MEASURES:10-item Connor-Davidson Resilience Scale. RESULTS:Care partner baseline resilience scores were significantly higher than persons with stroke scores. Repeated-measures analysis of variance suggest significant pre-post improvement in resilience for persons with stroke (mean difference [I - J]=-2.42, SE=.91, P=.04, 95% CI [-4.75, -0.08]) with a large effect size (η2=.34), which was maintained at 3-month follow-up. Care partners showed no significant change over time. CONCLUSIONS:This study provides preliminary evidence that ReStoreD improves resilience in persons with stroke. More research is needed to address resilience in care partners. These findings represent a promising first step to address the mental health needs in this population.

In smart computing, the labels of training samples for a specific task are not always abundant. However, the labels of samples in a relevant but different dataset are available. As a result, researchers have relied on unsupervised domain adaptation to leverage the labels in a dataset (the source domain) to perform better classification in a different, unlabeled dataset (target domain). Existing non-generative adversarial solutions for UDA aim at achieving domain confusion through adversarial training. The ideal scenario is that perfect domain confusion is achieved, but this is not guaranteed to be true. To further enforce domain confusion on top of the adversarial training, we propose a novel UDA algorithm, E-ADDA, which uses both a novel variation of the Mahalanobis distance loss and an out-of-distribution detection subroutine. The Mahalanobis distance loss minimizes the distribution-wise distance between the encoded target samples and the distribution of the source domain, thus enforcing additional domain confusion on top of adversarial training. Then, the OOD subroutine further eliminates samples on which the domain confusion is unsuccessful. We have performed extensive and comprehensive evaluations of E-ADDA in the acoustic and computer vision modalities. In the acoustic modality, E-ADDA outperforms several state-of-the-art UDA algorithms by up to 29.8%, measured in the f1 score. In the computer vision modality, the evaluation results suggest that we achieve new state-of-the-art performance on popular UDA benchmarks such as Office-31 and Office-Home, outperforming the second best-performing algorithms by up to 17.9%.