Couples and Childhood Adversity: A Prevention Science Approach to Exploring Resilience with Variable-Centered and Person-Centered Methods

Abstract

Contemporary research on couple relationship education (CRE) goes beyond testing the effectiveness of CRE for the average participant and assuming a “one size fits all” approach. Scholars acknowledge the complexity of the CRE field, and recent research questions center on exploring effectiveness of CRE for specific subpopulations, tests of demographic moderators of CRE outcomes, and prospective process of change models. Rooted in prevention science principles with a risk and resiliency emphasis, this dissertation combines this framework for recent CRE research with a trauma-informed lens. Although recent reports suggest that participants of federally funded CRE programs report higher rates of adverse childhood experiences (ACEs) than samples previously studied by the CDC, little attention has been given to the potential influence ACEs have on CRE participants’ individual and relational functioning before and after CRE. Even fewer studies have explored resiliency factors that may offset or outweigh risks due to ACEs while also assessing within-couple associations with an interdependence theory lens. The goals of this two-study dissertation were to (1) explore the concept of cumulative couple ACEs history, (2) advance the understanding of whether and how cumulative couple ACEs influence CRE program experiences for self and partner, (3) identify couple level risk and resiliency typologies in a diverse sample of couples using levels of two types of ACEs and two resiliency factors, and (4) determine how such typologies are linked to other sample characteristics including individual and relational functioning. The first study takes a trauma-informed approach to the growing body of literature on dyadic processes of change after CRE and the influence of ACEs on CRE participants’ experiences among diverse populations. With a sample of 409 couples, this study first tested whether improvements in couple relationship skills (self-care, conflict management, partner care) immediately after a CRE program predicted improvements in one’s own and one’s partner’s relationship quality one year later. Immediate post-program improvements in self-care, conflict management, and partner care predicted later improvements in relationship quality for oneself, but not one’s partner. Additionally, this study tested whether skills-related processes of change are the same regardless of cumulative couple ACEs. The only moderation evidence indicated that the association between improvements in conflict management and later improvements in relationship quality was weaker for participants with more cumulative couple ACEs. Process of change models used in the first study inform CRE practice by identifying specific program elements that underlie the promotion of healthy couple relationships. Self-care, conflict management, and partner care were validated as skills that are emphasized in CRE. Additionally, combining process of change models with moderation informs CRE efforts within populations with diverse levels of ACEs. The current dissertation’s findings suggest that couples with more ACEs experience benefits from CRE; however, they may need additional education and skills practice in conflict management. To further illuminate the diversity within CRE participants, the second study took an unprecedented, person-centered, couple-focused approach to investigating ACE-related risk and resiliency. Study 2 expanded on the concept of cumulative couple ACEs and explored latent risk and resiliency profiles in 921 couples as indicated by both partners’ ACEs, a novel measure of couple-focused mindfulness, and romantic self-efficacy. This study distinguished two types of ACEs - deprivation and threat dimensions - to offer new information about how the distinct dimensions may be differentially linked to individual and relational functioning. Six couple risk and resilience profiles were revealed and no one profile contained the majority of the sample, demonstrating the diversity of profiles. Two profiles were expected based on existing findings about the negative link between ACEs and relational functioning: Low Couple ACEs and Resilient and High Couple ACEs and Challenged. We also distinguished two couple profiles that are unmatched in their levels of ACEs. One such profile, High/Low ACEs and Resilient, was characterized by partners’ equally moderate levels of resiliency factors, despite one partner having high levels of ACEs while the other had low levels of ACEs. Participants in the other high/low ACEs profile, Incongruent: High/Low ACEs, Challenged/Resilient, reported expected levels of resiliency factors—the partner with more ACEs reported lower levels of resiliency factors, while the partner with fewer ACEs reported higher levels of resiliency factors. Lastly, two unexpected profiles emerged: Low Couple ACEs but Challenged and High Couple ACEs but Resilient. Study 2 also explored differences between couple risk and resiliency groups in demographic characteristics, relationship functioning, and mental health functioning. Exploring differences in demographic characteristics and functioning between the profiles allowed us to deepen the understanding of the types of people who comprise the profiles and what their needs may be in a CRE program. The highest functioning profile was unsurprisingly the Low Couple ACEs and Resilient profile. The following profiles reported moderate levels of functioning consistent with overall average levels of functioning: High/Low ACEs and Resilient, Incongruent: High/Low ACEs, Challenged/Resilient, and High Couple ACEs but Resilient. The Low Couple ACEs but Challenged and High Couple ACEs and Challenged profiles reported low levels of functioning, on average. Tests of demographic differences between risk and resiliency profiles also reveal information about the makeup of the profiles. For example, the Low Couple ACEs and Resilient profile had fewer parents, while the Low Couple ACEs but Challenged had the highest proportion of parents. Additionally, the majority of the High Couple ACEs but Resilient profile were African American/Black. Reasons for and implications of demographic differences among profiles are also discussed. This study adds to basic research on ACEs and resiliency and informs practice of community-based programming for couples.