Abstract
Although there is a body of evidence suggesting beneficial effects of premarital prevention, little research directly examines the mechanisms of effect. One study that examined changes in communication following training in the Prevention and Relationship Enhancement Program (PREP) found that, although couples made the expected communication gains pre to post PREP, female gains in positive communication were paradoxically associated with worse, not better, outcomes (Schilling et al., J. Fam. Psychol. 17(1):41–53, 2003). Using two samples, the current investigation did not yield evidence of such an association. We discuss issues related to replication studies (e.g., failure to reject null hypotheses), challenges in analyzing and interpreting dyadic data, and implications for prevention.
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Notes
We decided that missing data could not be imputed for couples who were excluded because they did not complete PREP or did not marry; these couples were excluded for conceptual reasons. These couples differ in meaningful ways from the sample we needed to focus on in the current investigation. Regarding those couples excluded because they did not complete POST and/or a later follow up, we elected not to impute their data because it is difficult to know for sure that they are missing at random and because the use of cut-off scores and changes scores calls for precision that imputed values would not allow. We were concerned that imputation would introduce too much noise into the analyses. Such unreliability seems to be a particularly salient problem in a study focused on replication because it would make finding significant results harder (i.e., statistical power would decrease).
To classify participants as distressed or not, Schilling et al. calculated reliable change in relationship adjustment from POST scores on the Dyadic Adjustment Scale. It seems more logical to assess changes from PRE, given the interest in knowing if couples improve or at least maintain levels of adjustment that were present prior to preventive intervention. We ran analyses both ways, using change in relationship adjustment over time from both PRE levels and POST levels. There were few differences. In an effort to be consistent with Schilling et al. (2003), we present results that are directly testing the same questions they addressed with the variables entered simultaneously (as done by Schilling et al.) based on change from POST scores. For analyses using one gender’s scores at a time (those we feel are both most parsimonious and most straightforward), we calculated distress based on declines from PRE (20 of 104 females and 20 of 103 males) which seemed more directly related to the assessment of prevention effects.
Schilling et al. explain in detail their use of a dichotomous outcome variable in assessing the impact of PRE to POST communication changes on marital outcomes. Participants’ outcomes were categorized as either non-distressed or distressed. Distressed was defined as either becoming divorced or demonstrating a reliable decline in relationship adjustment scores, into the distressed range of scores on the Dyadic Adjustment Scale (DAS; a measure highly similar to the MAT). Schilling et al. calculated the reliable change index as suggested by Jacobson and Truax (1991). Using the estimate of .96 for the reliability of the DAS, participants with a negative change of at least 7.7 at any follow-up point up to 5 years post intervention (compared to POST scores) and a DAS score <104 were classified as distressed (or if they became divorced). Because of a lower level of reliability for the MAT in our samples, we obtained a criterion for reliable change of 22.5. To be sure that we were not categorizing individuals as non-distressed that the method of Schilling et al. would have classified as distressed, we examined the logistic regression analyses for the FSP sample described below using both our criterion of 22.4 and their criterion of 7.7. The results were indistinguishable. All but two individuals were in the same category either way.
Survival analysis involves equations in which time is modeled in order to examine the timing and odds of onset. Typically, separate variables are used to indicate distinct assessment points. Schilling et al. (2003) modified survival analysis (i.e., using one variable to represent time rather than separate variables) that we were unable to find precedent for in the literature. This may, however, be of little consequence since timing was not a focus of their analyses or ours.
In addition to this alteration, we decided not to include the PRE interaction scores in these regressions. Schilling et al. included the PRE positive communication scores in addition to the residual scores. However, it seems redundant to enter both the PRE score and the residual score, because, as Lord (1967) indicates, entering either the PRE score and the POST score together or the residual score would essentially yield the same result. With the residual score, the PRE score is already being controlled for. We ran analyses both ways, and the results were essentially the same. Therefore, including both variables seems to do little more than unnecessarily reduce power by the effect on the degrees of freedom (also see Kenny 1998; also see Wainer 1991).
As noted earlier, we favor doing these analyses looking at change from PRE, rather than POST. However, we also examined the results with change in distress from POST, to be consistent with Table 1. The models were non-significant, and the odds ratios indicated that there was no hint of changes in positive communication predicting distress development (odds ratios ranged from 1.03 to 1.18).
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Acknowledgement
We thank the anonymous reviewers for their excellent questions and comments. This research was supported by two grants from The National Institutes of Health: 1RO1HD48780-1A1 from the National Institute of Child Health and Human Development and 5-RO1-MH35525-12 from The National Institute of Mental Health.
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Stanley, S.M., Rhoades, G.K., Olmos-Gallo, P.A. et al. Mechanisms of Change in a Cognitive Behavioral Couples Prevention Program: Does Being Naughty or Nice Matter?. Prev Sci 8, 227–239 (2007). https://doi.org/10.1007/s11121-007-0071-8
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DOI: https://doi.org/10.1007/s11121-007-0071-8