Couple Communication in Cancer: Protocol for a Multi-Method Examination

Cancer and its treatment pose challenges that affect not only patients but also their significant others, including intimate partners. Accumulating evidence suggests that couples’ ability to communicate effectively plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models have been proposed to account for how couple communication impacts psychological and relationship adjustment: the social-cognitive processing (SCP) model and the relationship intimacy (RI) model. These models posit different mechanisms and outcomes, and thus have different implications for intervention. The purpose of this project is to test and compare the utility of these models using comprehensive and methodologically rigorous methods. Aims are: (1) to examine the overall fit of the SCP and RI models in explaining patient and partner psychological and relationship adjustment as they occur on a day-to-day basis and over the course of 1 year; (2) to examine the fit of the models for different subgroups (males vs. females, and patients vs. partners); and (3) to examine the utility of various methods of assessing communication by examining the degree to which baseline indices from different measurement strategies predict self-reported adjustment at 1-year follow up. The study employs a longitudinal, multi-method approach to examining communication processes including: standard self-report questionnaires assessing process and outcome variables collected quarterly over the course of 1 year; smartphone-based ecological momentary assessments to sample participant reports in real time; and laboratory-based couple conversations from which we derive observational measures of communicative behavior and affective expression, as well as vocal indices of emotional arousal. Participants are patients with stage II-IV breast, colon, rectal, or lung cancer and their spouses/partners, recruited from two NCI-designated comprehensive cancer centers. Results will be published in scientific journals, presented at scientific conferences, and conveyed to a larger audience through infographics and social media outlets. Findings will inform theory, measurement, and the design and implementation of efficacious interventions aimed at optimizing both patient and partner well-being

Prediction of treatment response at 5-year follow-up in a randomized clinical trial of behaviorally based couple therapies.

OBJECTIVE: Building on earlier work examining predictors of short- and moderate-term treatment response, demographic, intrapersonal, communication, and interpersonal variables were examined as predictors of clinically significant outcomes five years after couples completed one of two behaviorally based couple therapies. METHOD: One hundred and thirty-four couples were randomly assigned to Integrative Behavioral Couple Therapy (IBCT; Jacobson & Christensen, 1998) or Traditional Behavioral Couple Therapy (TBCT; Jacobson & Margolin, 1979) and followed for 5 years after treatment. Outcomes include clinically significant change categories of relationship satisfaction and marital status at 5-year follow-up. Optimal subsets of predictors were selected using an automated, bootstrapped selection procedure based on Bayesian Information Criterion. RESULTS: Higher levels of commitment and being married for a longer period of time were associated with decreased likelihood of divorce/separation (Odds Ratio [OR] = 1.39, p = .004; OR = 0.91, p = .015). Being married for a longer period of time was also associated with increased likelihood of positive, clinically significant change (OR = 1.12, p = .029). Finally, higher levels of wife desired closeness were associated with increased odds of positive, clinically significant change and decreased odds of divorce for moderately distressed, IBCT couples (OR = 1.16, p = 0.002; OR = 0.85, p = 0.007, respectively) whereas the opposite was true for moderately distressed, TBCT couples (OR = 0.77, p < 0.001; OR = 1.17, p = 0.002, respectively). CONCLUSIONS: Commitment-related variables are associated with clinically significant outcomes at 5-year follow-up as well as at termination and moderate-term follow-up. PUBLIC HEALTH SIGNIFICANCE: This study indicates that couples who begin marital therapy with higher levels of commitment are least likely to get divorced and most likely to report improvements in relationship satisfaction five years after ending treatment. In addition, it appears that the impact of wives’ desired closeness depended on the type of treatment moderately distressed couple received

Effects of a Parent-Focused HIV Prevention Intervention for Young Men Who have Sex with Men: A Pilot Randomized Clinical Trial

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)

Ghost hunting in the nonlinear dynamic machine.

Integrating dynamic systems modeling and machine learning generates an exploratory nonlinear solution for analyzing dynamical systems-based data. Applying dynamical systems theory to the machine learning solution further provides a pathway to interpret the results. Using random forest models as an illustrative example, these models were able to recover the temporal dynamics of time series data simulated using a modified Cusp Catastrophe Monte Carlo. By extracting the points of no change (set points) and the predicted changes surrounding the set points, it is possible to characterize the topology of the system, both for systems governed by global equation forms and complex adaptive systems. RESULTS: The model for the simulation was able to recover the cusp catastrophe (i.e. the qualitative changes in the dynamics of the system) even when applied to data that have a significant amount of error variance. To further illustrate the approach, a real-world accelerometer example was examined, where the model differentiated between movement dynamics patterns by identifying set points related to cyclic motion during walking and attraction during stair climbing. These example findings suggest that integrating machine learning with dynamical systems modeling provides a viable means for classifying distinct temporal patterns, even when there is no governing equation for the nonlinear dynamics. Results of these integrated models yield solutions with both a prediction of where the system is going next and a decomposition of the topological features implied by the temporal dynamics

An analysis of pca-based vocal entrainment measures in married couples’ affective spoken interactions

Abstract Entrainment has played a crucial role in analyzing marital couples interactions. In this work, we introduce a novel technique for quantifying vocal entrainment based on Principal Component Analysis (PCA). The entrainment measure, as we define in this work, is the amount of preserved variability of one interlocutor&apos;s speaking characteristic when projected onto representing space of the other&apos;s speaking characteristics. Our analysis on real couples interactions shows that when a spouse is rated as having positive emotion, he/she has a higher value of vocal entrainment compared when rated as having negative emotion. We further performed various statistical analyses on the strength and the directionality of vocal entrainment under different affective interaction conditions to bring quantitative insights into the entrainment phenomenon. These analyses along with a baseline prediction model demonstrate the validity and utility of the proposed PCA-based vocal entrainment measure