Coexisting difficulties and couple therapy outcomes: psychopathology and intimate partner violence

Couples presenting for treatment of relationship distress often experience additional problems, including individual psychopathology and intimate partner violence (IPV). Both issues are associated with current and future poor relationship functioning in nontreatment samples, but relatively little is understood about their association with initial presentation and outcomes in couple therapy. The current study examined these associations in a sample of 177 heterosexual couples who received therapy at two Veteran's Affairs clinics. Unlike most studies of couple therapy outcomes, couples were not excluded from treatment specifically because of high levels of psychopathology or IPV. Results of Actor Partner Interdependence Model (APIM) analyses revealed actor and partner effects of depression, actor effects of anxiety, and partner effects of IPV on initial relationship satisfaction, such that greater coexisting difficulties were associated with poorer initial satisfaction. However, improvement in relationship satisfaction over the course of therapy was not associated with psychopathology, and, contrary to hypothesis, was positively associated with men's IPV prior to treatment, even when initial level of satisfaction was controlled. The results suggest that coexisting symptoms of psychopathology or IPV may not necessarily interfere with therapy outcomes and, indeed, therapy may have positive effects for couples with these problems.