Individual distress and dyadic adjustment over a three-year follow-up period in couple therapy: a bi-directional relationship?

This study examined the relationship between depressive symptoms and dyadic adjustment, as well as between interpersonal problems and dyadic adjustment, during residential couple therapy and at a three-year follow-up (N=106). Mixed models were used in the analyses. Significant improvement (p <.001) occurred on all measures from admission to discharge (effect sizes .27-.83) and from admission to three-year follow-up (effect sizes .52-.79). During the observation period, improvement in depressive symptoms at the first time point predicted improvement in dyadic adjustment at the subsequent time point. Furthermore, the dyadic adjustment level at discharge predicted improvement in depressive symptoms in the follow-up period. There were only modest associations between personality variables and dyadic adjustment. The clinical implication is that in couples suffering from co-existing relational and symptomatic distress, couple therapy should include the aim of lowering depressive symptoms.