In response to the rising public and scholarly interest in understanding relational experiences in intercultural relationships, we propose a new concept-relational cultural intelligence (RCI)-to describe an individual's ability to learn and apply cultural knowledge in intimate relationships. In this article, we outline the theoretical foundation of RCI, introduce the RCI scale, and present initial results on its reliability and validity. We conceptualize RCI as a type of social intelligence with three dimensions: awareness, skills, and knowledge. This study surveyed 186 individuals in the United States who identified as being currently in an intercultural romantic relationship. The results provide evidence for the reliability and validity of the three-factor scale with 12 items. Results also showed that RCI was related to important aspects of relational experiences, such as relational stress and relationship satisfaction, and that it explained variance in relationship satisfaction above and beyond relational stress, commitment, and relationship duration.

IntroductionEarly detection and treatment of sepsis improves chances of survival; however, sepsis is often difficult to diagnose initially. This is especially true in the prehospital setting, where resources are scarce, yet time is of great significance. Early warning scores (EWS) based on vital signs were originally developed to guide medical practitioners in determining the degree of illness of a patient in the in-patient setting. These EWS were adapted for use in the prehospital setting to predict critical illness and sepsis. We performed a scoping review to evaluate the existing evidence for use of validated EWS to identify prehospital sepsis.MethodsWe performed a systematic search using the CINAHL, Embase, Ovid-MEDLINE, and PubMed databases on September 1, 2022. Articles that examined the use of EWS to identify prehospital sepsis were included and assessed.ResultsTwenty-three studies were included in this review: one validation study, two prospective studies, two systematic reviews, and 18 retrospective studies. Study characteristics, classification statistics, and primary conclusions of each article were extracted and tabulated. Classification statistics varied markedly for prehospital sepsis identification across all included EWS: sensitivities ranged from 0.02-1.00, specificities from 0.07-1.00, and PPV and NPV from 0.19-0.98 and 0.32-1.00, respectively.ConclusionsAll studies demonstrated inconsistency for the identification of prehospital sepsis. The variety of available EWS and study design heterogeneity suggest it is unlikely that new research can identify a single gold standard score. Based on our findings in this scoping review, we recommend future efforts focus on combining standardized prehospital care with clinical judgment to provide timely interventions for unstable patients where infection is considered a likely etiology, in addition to improving sepsis education for prehospital clinicians. At most, EWS can be used as an adjunct to these efforts, but they should not be relied on alone for prehospital sepsis identification.

Background: Depression is a common mental disorder that significantly contributes to the global burden of disease. Studies have consistently reported that migrant workers experience higher levels of depressive symptoms, especially women. Aims: This study aimed to examine the mediation role of sexual self-efficacy on the relationship between psychological wellbeing, and depressive symptoms among young female migrant workers in Vietnam's industrial zones. Methods: A cross-sectional study was conducted among 1061 female migrant workers aged 18 to 29 from January to November 2020 in Hanoi, Vietnam. Anonymous interview questionnaires were used to collect data on demographic characteristics, psychosocial wellbeing (PWB), sexual self-efficacy, and depressive symptoms. Mediation analysis was conducted to explore the mediation effect of sexual self-efficacy on the relationship between PWB and depressive symptoms. Results: Nearly 8% of the female migrant workers reported experiencing depressive symptoms. The final mediation model showed that the effect of overall psychological wellbeing on depressive symptoms was partially mediated by sexual self-efficacy. Specifically, 4.1% of the effect of overall PWB on depressive symptoms was mediated through sexual self-efficacy. In the PWB subdimension analyses, sexual self-efficacy mediated 14.3% of the effect of personal growth, 8.8% of the effect of purpose in life, 8.0% of the effect of autonomy, and 7.8% of the effect of environmental mastery on depressive symptoms, respectively. Conclusion: The study findings demonstrate that sexual self-efficacy plays an important role in the relationship between psychosocial wellbeing and depressive symptoms among female migrant workers in industrial zones in Vietnam. Improving psychosocial wellbeing and promoting sexual health including sexual self-efficacy should be prioritized when addressing depressive symptoms and mental health concerns among industrial zone female migrant workers in Vietnam, which may also be applicable in other low- and middle-income countries with similar socio-cultural settings.

After the rapid increase of the American divorce rate in the late 20th century, one of the most conspicuous efforts of the marriage movement in the 1990s that was used to increase marital stability was the legislation of the covenant marriage license, a more restricted marriage license issued in three different states of the U.S. To investigate the marital life of newlywed covenant versus standard couples, a large-scale 5-year couple study was conducted between 1998 and 2003 in Louisiana. The present study uses this large-sample, multiple-wave, multiple-group dyadic dataset to examine differences in co-development and divorce rates in 297 covenant and 380 standard mixed-sex couples using a multiple group growth curve modeling and survival analysis. We examined differences in marital trajectories between covenant and standard couples as well as between husbands and wives in each marital group. The results show (1) that the couples in both groups experienced, on average, declines in marital satisfaction, and such a decline was slower in covenant husbands than their wives as well as those in standard marriages, and (2) that co-development in marital satisfaction was more prominent in standard marriages than in covenant marriages, meaning standard couple's marital satisfaction declined at a more similar rate than that of covenant couples. We provide possible explanations and discuss practical implications.

Globalization has facilitated increasing cross-cultural interactions and the formation of intimate intercultural relationships. This study systemically screened and reviewed fifteen quantitative studies that included participants in a current intimate intercultural relationship, synthesizing their research methods and findings with a focus on investigating stressors and challenges. The results revealed that intercultural couples could face various external challenges like marginalization and family disapproval and internal challenges such as conflicting cultural values. When these challenges and stressors are present, couples are more likely to experience lower relationship satisfaction and more negative relational interactions. This study provides an overview of the state of quantitative research on intercultural relationships, highlighting its limitations and future directions. The findings of this critical analysis can also inform clinical practices with distressed intercultural couples.

Covenant marriage is a legally distinct marriage license available in Arizona, Louisiana, and Arkansas in the United States. This study revisited one of the largest longitudinal dyadic studies on covenant versus standard newlywed couples. Using this dataset of 677 different-sex couples, we explored whether being in a covenant marriage could predict how marital satisfaction developed over the first five marital years. We applied the Growth Mixture Modeling (GMM) method to identify groups that differed in their initial marital satisfaction and trajectory. The results revealed three different trajectory groups-one group showing high and stable marital satisfaction, which we named High Stable, and two groups showing declines in marital satisfaction, one being medium and the other one being low in satisfaction at the beginning of the marriage, and we named them Medium Declining and Low Declining respectively. Spouses with lower initial marital satisfaction experienced a faster decline and suffered the highest divorce rate. Actor-Partner Interdependence Model (APIM) analysis revealed that one's group membership was predicted by their partner's membership, suggesting a mutual influence on marital development. Being in a covenant marriage was able to predict husbands' membership as covenant husbands were found to be more likely in the high stable group.

This study examined how individual pretreatment symptoms (depression and anxiety) predicted longitudinal, relational processes in couples therapy (the therapeutic alliance and couple satisfaction). This study included 99 heterosexual couples receiving systemic couples therapy. Partners reported their individual pretreatment symptoms of depression and anxiety before intake. Each member reported their therapeutic alliance with the therapist at the end of sessions 2-8, as well as their couple satisfaction before intake and at the end of sessions 4 and 8. A Latent Profile Analysis revealed four profiles characterizing couples on their pretreatment psychological symptoms, namely both higher (where both members of the couple had higher depressive and anxiety symptoms), female higher, male higher, and both lower profiles. Furthermore, longitudinal, dyadic multilevel models revealed that men in male higher, female higher, and both higher profiles had higher initial alliance levels, compared to men in the both lower profile. In contrast, only female partners in the both higher profile had a higher initial therapeutic alliance than those in the both lower profile. Men in the both higher profile had faster reductions in their alliance, whereas other profiles did not predict changes in male or female alliance. Additionally, the male higher and both higher profiles predicted a lower initial level of couple satisfaction in males but not females. The profiles did not predict changes in couple satisfaction, which may be a result of lowered power due to missing data. Findings were discussed in the context of systemic family theory, with clinical implications for distressed couples.

Sexual intimacy is an essential experience to many romantic relationships, encompassing sexual identities, sexual desires, and sexual behaviors. Historically, people who identify as gay, lesbian, bisexual or questioning have been marginalized, tabooed, and illegalized in many societies, which have significantly shaped sexual minority (SM) couples’ views and experiences of sexual intimacy. When working with distressed SM couples, providing culturally sensitive and affirmative services is both necessary and effective considering the long-existing social stigma against sexual minorities and the imposed expectations by heterosexual norms. With the legalization of same-sex marriage in the U.S., working with SM couples is becoming an increasingly important practice in the U.S. However, many therapists receive little guidance in conceptualizing and treating SM couples and their experiences of sexual difficulties. The narrative therapy model has shown its theoretical advantages in working with couples with minority status, given its non-pathologizing stance in viewing minority experience. This paper proposes using a narrative couple therapy framework as a guide to help both therapists to explore sexual intimacy with SM couples. A case illustration is included.

To better understand the psychological well-being of Asian Americans living in the U.S., the present study focused on the experience of acculturative stress, family cohesion, and depression among Asian American immigrants (n = 1,641). Drawing data from the National Latino and Asian American Study (NLAAS), one of the first national epidemiological studies of Asian American's mental health, this study examined the associations between acculturative stress, family cohesion, and depression. In addition to correlation analyses, a logistic regression analysis was conducted to examine the potential buffering effect of family cohesion on the association between acculturative stress and depression. The results revealed that although family cohesion as a moderator was not found to be statistically significant, direct effects between acculturative stress and depression, and family cohesion and depression were both found to be significant. Both clinical and theoretical implications are discussed. What is the public significance of this article? This research reveals that Asian American immigrants with depression often experience a high level of acculturative stress and a low level of family cohesion. Researchers, practitioners, and educators need to be aware of the limited protective nature of a cohesive family relationship, and they are encouraged to explore alternative protective factors when working with Asian American immigrants who struggle with both depression and acculturation.

Cell phone use has become a mainstay in the lives of young adults, with 93% of Millennials owning a smartphone. With the increased accessibility of technology, individuals’ cell phone use may lead to personal distress in various facets of life. Specifically, problematic cell phone use may be the result of attempts to fulfill emotional needs or avoid connection with others. The present study used a systemic, attachment-based lens to investigate the roles of parental and romantic attachment in problematic cell phone use. A sample of 479 young adults (ages 18–26) completed an online survey gauging their cell phone use and attachment styles. Mediation analyzes were run to determine if adult attachment mediates the relationship from parental attachment to problematic cell phone use. The results found that attachment anxiety mediates the relationship between communication and alienation subscales for mother and alienation only for father to problematic cell phone use. Clinical implications are discussed with results informing assessment, prevention, and intervention efforts for individuals, families, and couples.