Couple Therapy for Posttraumatic Stress Disorder (PTSD)
Dr. Fredman is actively involved in efforts to develop and validate couple-based interventions for PTSD. She is the co-developer of Cognitive-Behavioral Conjoint Therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012), a couple-based therapy for PTSD that simultaneously treats PTSD symptoms and enhances intimate relationship functioning. Multiple studies support the efficacy of CBCT for PTSD in community, veteran, and military couples, and it is currently being disseminated nationally within the Department of Veterans Affairs.
Dr. Fredman is also interested in ways to increase the scalability of CBCT for PTSD. She was the Principal Investigator of a recently completed grant funded by the Departments of Defense and Veterans Affairs conducted as part of the work of the Consortium to Alleviate PTSD to study an abbreviated, intensive, multi-couple group version of CBCT for PTSD (AIM-CBCT for PTSD) to enhance treatment retention and efficiency . AIM-CBCT for PTSD was delivered during a single weekend retreat to 24 couples that included a service member or veteran with PTSD who had served in the post-9/11 conflicts. Results from this proof-of-concept pilot study are extremely promising. All couples completed treatment. Despite the brief format, there were significant improvements in patients' PTSD and comorbid symptoms (depression, anxiety, anger), partners' mental health, and partners' relationship satisfaction, relative to baseline levels. We are currently working on a grant to test the efficacy of AIM-CBCT for PTSD with a larger sample in the context of a randomized controlled trial. |
Couples' Emotion Regulation & Co-Regulation on Short Time Scales
Our lab is conducting multiple projects that focus on the regulation of emotion in a dyadic context and involves collaborative efforts with colleagues at Penn State, University of North Carolina-Chapel Hill, University of Heidelberg, and New York University. Collectively, these studies explore the regulation of emotion within and between partners in a dyad across a range of short time scales (second-by-second, within a day, across days), and they employ a variety of research methods (e.g., voice stress expressed during couples’ conversations, dyadic ecological momentary assessment and daily diary designs) and statistical techniques that capitalize on dyadic intensive longitudinal data (e.g., dynamical systems modeling).
Dr. Fredman is currently serving as an NIH-funded KL2 Scholar through Penn State's Clinical and Translational Science Institute (CTSI) to study how emotion is regulated intra- and interpersonally among couples with PTSD. In collaboration with Drs. Melanie Fischer (University of Heidelberg), Don Baucom (UNC-Chapel Hill), Sy-Miin Chow and Peter Molenaar (Penn State HDFS), Nilam Ram (Stanford University), and Amy Marshall (Penn State clinical psychology), we are studying how couples with PTSD regulate and co-regulate emotion encoded in the voice during couple-based discussions on a moment-by-moment basis and the extent to which these processes vary as a function of gender and PTSD symptom severity using dynamical systems modeling. Dr. Annie Le is also leading a project conducted in collaboration with Drs. Sy-Miin Chow and Zita Oravecz (PSU HDFS) and Drs. Rick Heyman and Amy Slep (NYU) to examine the second-by-second regulation and co-regulation of anger in aggressive and non-aggressive community couples. Using dynamical systems modeling, we are examining how individuals' and their partners' experiences of anger are coupled to their partners within and across emotion channels (self-reported and observed). |
Longitudinal Links between Relationship and Psychological Functioning among Black Americans
We are collaborating with Drs. Alyssa Gamaldo and David Almeida's labs to study the intersection between individual mental health and couple functioning among Black Americans, with consideration of how these linkages may depend on racially relevant socio-cultural factors and gender. Current projects include examining PTSD and other related mental health disorders in a dyadic and ecological context over time among Black couples during the Covid-19 pandemic.
Ms. August Jenkins is also leading a project focusing on the linkages between relationship adjustment and emotional well-being in Black Americans across timescales ranging from days to years. This work is support by her NIMHD-funded F31 Diversity Fellowship and investigates the role of discrimination, perceived neighborhood characteristics, and gender in these linkages among partnered Black-Americans. |
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Transition to Parenthood (TTP) and Early Parenting Years
The transition to parenthood (TTP) is a stressful period for many couples, frequently characterized by elevated levels of individual psychological stress and relationship distress. At the same time, it is also an ideal window of opportunity to foster family resilience given that families are still in the early stage of formation and expectant parents tend to be relatively more receptive to education and support. In light of these considerations, a number of Yunying (Annie) Le's studies have sought to elucidate risk and protective factors as well as malleable processes that may be targeted to optimize relationship functioning and parenting across the TTP and early parenting years. Our lab has has collaborated on a series of papers with Dr. Mark Feinberg (PSU Bennett Pierce Prevention Research Center), an expert on couples' adaptation during the transition to parenthood and the developer of Family Foundations, a couple-based psychoeducational transition to parenthood program.
In the context of this collaboration, Annie has led work examining the daily (Le, Fredman, McDaniel, Laurenceau, & Feinberg, 2019) and longitudinal (Le, McDaniel, Leavitt, & Feinberg, 2016) associations between coparenting and couple relationship quality within the first three years after the birth of a couple's first child. She also examined the mediating role of parenting stress in the prospective association between parental negative affectivity at 6 months postpartum and harsh parenting at three years postpartum (Le, Fredman, & Feinberg, 2017). Annie's current work focuses on couples' daily capitalization processes (i.e., sharing the best news of the day) during the postpartum period and how this is associated with daily feelings of closeness and coparenting support. Findings thus far are exciting and suggest that daily capitalization may be a low-cost, high yield strategy that couples can engage in to promote relational well-being during this important transitional period. We and Dr. Feinberg are also collaborating with Dr. Amy Marshall (PSU clinical psychology) on papers examining the association between PTSD symptoms and couple and family functioning during the transition to parenthood. We have shown that PTSD symptoms are associated with poorer perceived relationship quality and increased parenting stress for both individuals and their partners (Fredman, Le, Marshall, Brick, & Feinberg, 2017) and that PTSD symptoms are both directly associated with increased risk for the perpetration of child physical abuse, as well as indirectly through the coparents' romantic relationship dysfunction (Fredman et al., 2019). There are also prospective associations between PTSD symptoms and both partners' intimate partner aggression and parent to child aggression during the transition to parenthood (Marshall et al., in press). Collectively, findings suggest that intervening on parental PTSD symptoms and coparents' romantic relationship during the early parenting years may have important prevention implications for individual, couple, and family well-being among trauma survivors. |
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