Mutuality and Marital Adjustment, Well-Being, and Health in Military Couples

Welcome to the Spotlight on R&D column. This column showcases research activities and projects underway in many of the R&D Laboratories within the Department of Defense (DoD), partnering organizations, and the academic and practitioner community in military psychology. Research featured in the column includes a wide variety of studies and programs, ranging from preliminary findings on single studies to more substantive summaries of programmatic efforts on targeted research topics. Research described in the column is inclusive of all disciplines relevant to military psychology – spanning the entire spectrum of psychology including clinical and experimental, as well as basic and applied. If you would like your work to be showcased in this column, please contact Krista Ratwani at 202-552-6127.

This edition of the newsletter highlights work conducted to predict well-being and health in military couples. Specifically, conflict and mutuality were examined in relation to several important marital outcomes, such as depression, marital satisfaction, and somatic complaints. The research described here has important implications for helping military couples positively readjust upon soldier redeployment.

Research Overview

Reunion after deployment is a stressful event for military couples. Adaptive processes mediate the effects of personal characteristics and stressful events on marital adjustment (Karney & Crown, 2007). The current study evaluates the roles of conflict and mutuality as adaptive processes in military marriages. Expressive writing (EW) samples from active-duty soldiers and military spouses were coded for mutuality and conflict. Expressions of conflict were more frequent than expressions of mutuality; however, mutuality was generally a stronger predictor than conflict of marital adjustment and individual well-being and health. Results highlight the crucial role of mutuality in post-deployment adjustment.

Problem to Solve

Deploying into combat is a stressor for soldiers and their spouses. Reuniting brings additional stressors, such as divergent expectations for reunion and renegotiation of routines and responsibilities. Soldiers often return with psychological difficulties (Hoge et al., 2004), which can strain marriages. Relationship problems, in turn, may adversely affect partners' mental health and adjustment.

Despite these stressors, some military marriages remain resilient. Karney and Crown (2007) proposed a model of military marital adjustment, which states that enduring traits (e.g., neuroticism), emergent states (e.g., depression), resources (e.g., finances), and military and nonmilitary experiences (e.g., deployment-related separation; death in the family) impact marital adjustment via a mediating variable: adaptive processes. Adaptive processes in this context are “ways that spouses interact, communicate, resolve problems, provide support, and understand each other” (Karney & Crown, 2007, p. 24). Adaptive processes include couples' understandings of their relationship, not just observable behavior.

It is important to determine which adaptive processes are most critical to couple and individual health. Research on military couples has suggested that behaviors that promote marital resilience (e.g., communication during deployment; Wiens & Boss, 2006) are important. Yet, actions that make people feel supported and happy in their relationships differ broadly among couples (Lakey & Orehek, 2011). Research has increasingly recognized the importance of mutuality as an adaptive relational process (e.g., Buehlman, Gottman, & Katz, 1992). Singer, Labunko-Messier, Baddeley, and Alea (in press) have defined mutuality as the following:

An understanding within . . . partners that they exist within a larger entity that transcends . . . their individual selves, and entails feelings, cognitions, and behaviors that seek to promote the welfare . . . of the relationship while maintaining a simultaneous awareness of each partner's individual concerns . . . [T]he crucial aspect of mutuality is [that] both partners acknowledge the primacy of their relationship over individual and self-serving choices.

Studies in civilian populations show that mutuality protects marriages in the face of negative events; couples high in mutuality experience better adjustment to illness (Skerrett, 1998), greater marital satisfaction (Genero, Miller, Surrey, & Baldwin, 1992), and lower divorce rates (Buehlman et al., 1992). Wives in high-mutuality couples report less depression (Genero et al., 1992).

Singer et al. (in press) developed the Marital Engagement–Type of Union Scale (ME-ToUS) to measure mutuality. The ME-ToUS is a 10-item Likert scale that addresses mutuality in marital domains, including domestic chores, finances, and sex. The ME-ToUS predicts marital satisfaction incrementally over other measures of marital adjustment. For women, the ME-ToUS predicts self-reported somatic complaints, controlling for marital adjustment ( Singer & Labunko Messier, 2009 ).

Solution and Approach

To assess the impact of mutuality on marital satisfaction, depression, and somatic complaints, data were collected from soldiers and their spouses after the soldiers' most recent deployments had ended. There were three hypotheses:

• Hypothesis 1: Conflict is more frequently mentioned than mutuality across the domains of marital functioning.
• Hypothesis 2: Mutuality predicts marital satisfaction, depression, and somatic complaints concurrently and 1 month later, and mutuality is a better predictor than conflict because one might expect conflict to be inevitable in any difficult circumstance.
• Hypothesis 3: Mutuality has a greater influence on wives' emotional and physical well-being than on husbands' emotional and physical well-being.

Data for the current study were accounts of active duty military couples' reunions, written by soldiers and their spouses, as well as self-report measures collected at the time of the EW intervention (baseline) and 1 month later (follow-up). The following self-report measures were administered: the Relationship Assessment Scale (Hendrick, 1988) to assess marital satisfaction; the Patient Health Questionnaire (Spitzer, Kroenke, & Williams, 1999) to assess depression; and the Pennebaker Inventory of Limbic Languidness (Pennebaker, 1982) to assess somatic complaints.

These data were collected as part of a larger study testing the efficacy of an EW intervention aimed at improving relationship satisfaction and individual well-being in military couples (Baddeley & Pennebaker, 2011). In the EW intervention, individuals were asked to write about their deepest thoughts and feelings about transitioning from deployment to being reunited at home with their spouse. Participants in the current study were those in the EW condition who had left their writing with the researchers ( n = 102; 97.1% of the EW group). In 26 couples, both partners did EW. Twenty-six men and 24 women did EW while their spouses did control writing. Most couples (94.1%, n = 96) were composed of male soldiers and female spouses that had been married for an average of 7.5 years ( SD = 5.6) and reunited for an average of 9.4 months ( SD = 2.3) . Participants' mean age was 31.8 years ( SD = 6.6). Most were White, non-Hispanic (63.7%, n = 65), and 34.3% of participants ( n = 35) had completed college.

To assess the degree of mutuality and conflict within the EW accounts, a coding scheme was developed to rate the two constructs across nine domains of relationship functioning drawn from the ME-ToUS scale and adapted to better fit the experiences of the military population. These domains were (1) daily routine and chores, (2) finances, (3) childrearing, (4) physical intimacy, (5) communication during deployment, (6) communication and emotional intimacy at home, (7) future, (8) extended family, and (9) (in)fidelity. See Table 1 for examples.

Mutuality was coded if one or more of the following were present in a given domain: appreciation or affirmation of the partner and/or “we”-ness (agreement, teamwork, or give-and-take conflict resolution). Conflict was coded if one or more of the following were present: criticism or blaming of one partner by the other ; disagreements ; or dis approval of and/or disengagement from one's partner . Each essay's total score for mutuality and for conflict was the number of domains in which mutuality or conflict, respectively, was present. Two independent raters coded nine essays (κ > .8), and the remaining essays were coded by one rater.

Findings

Hypothesis 1 predicted that participants would express conflict more frequently than mutuality. Wilcoxon signed-ranks tests were used to compare the frequencies of mutuality versus conflict in each relationship domain. Both women and men mentioned conflict significantly more than mutuality regarding routine and chores, finances, and communication at home. Men mentioned conflict significantly more than mutuality regarding physical intimacy and infidelity; women mentioned conflict significantly more than mutuality regarding childrearing. In no domain did women or men mention mutuality more than conflict (see Table 1).

To test Hypotheses 2 and 3, the sample was divided into paired participants (couples in which both partners were included in the current study) and nonpaired participants (soldiers and spouses whose partner was not included in the current study). To account for nonindependence between partners in the paired sample, multilevel regressions with couple ID as a random intercept were conducted. Analyses for the nonpaired sample were ordinary least squares regressions. For each sample, three regressions examined effects on marital satisfaction, depression, and somatic complaints at baseline, and three examined effects on those same variables at follow-up.

Across two or more independent trials with binary outcomes, a binomial test can determine the likelihood of obtaining a particular number of “successes” across N trials given a known prior probability of success on each trial. In the current study, the trials in the paired sample and the nonpaired sample were statistically independent of each other. Binomial tests were used to assess the likelihood of obtaining either one or two significant results. Given a 5% probability of success ( p < .05) on one trial, the likelihood of obtaining one success was p = .098, or two successes, p = .003. Thus, when significant results emerge in only one sample, they should be interpreted with caution. When significant results emerge in both samples, they are likely robust.

Hypothesis 2 predicted that mutuality would be a stronger predictor than conflict of marital satisfaction, depression, and somatic complaints concurrently and at follow-up. Both conflict and mutuality were entered as predictors. As Table 2 shows, the results demonstrated mixed support for the hypothesis, as conflict was a stronger predictor of outcome variables in some cases compared to mutuality. However, higher mutuality was associated with significantly higher concurrent relationship satisfaction in both samples and with significantly (nonpaired sample) or marginally (paired sample) higher follow-up relationship satisfaction. Conflict was associated with lower relationship satisfaction at baseline and follow-up in the nonpaired sample only.

Higher mutuality (but not lower conflict) was associated with lower depression concurrently in both samples and in the nonpaired sample at follow-up. Lower conflict (but not higher mutuality) was associated with lower follow-up depression in the paired sample only.

Higher mutuality marginally predicted lower concurrent somatic complaints in both samples, and lower follow-up somatic complaints in the nonpaired sample. Binomial tests suggest that two results of p < .073 are not likely due to chance, p = .005. Mutuality was not significantly associated with follow-up somatic complaints in the paired sample; conflict was not significantly associated with somatic complaints concurrently or at follow-up in either sample.

Hypothesis 3 predicted a stronger relationship between mutuality and marital satisfaction, depression, and somatic symptoms for women than for men. Sex, mutuality, conflict, and the interaction of sex and mutuality were predictors. In the non-paired sample, the interaction was significant only for baseline depression, B = - 1.62, t = - 2.69, p = .010. In the paired sample, the interaction approached significance in predicting follow-up depression, B = - 1.52, t = - 2.03, p = .054, and reached significance in predicting follow-up somatic complaints, B = - 2.07, t = - 2.18, p = .041. In both samples, post hoc analyses assessed the relationship between mutuality and depression, controlling for conflict, separately for men and women. In the nonpaired sample, higher mutuality scores were associated with lower baseline depression for men, B = - 3.24, t = - 3.60, p = .001, but not for women, B = 0.20, t = 0.25, p = .81. In the paired sample, mutuality predicted lower follow-up depression, B = - 2.74, t = - 2.25, p = .035, and somatic complaints, B = - 2.85, t = - 2.06, p = .051, for women, but not for men: B = - .38, t = - 0.30, p = .77, and B = - 0.78, t = - 0.46, p = .65, respectively.

Implications

Results demonstrate support for Hypothesis 1 and provide preliminary support for Hypothesis 2. In support of Hypothesis 1, conflict was more frequent than mutuality across multiple relationship domains. Participants mentioned conflict more than mutuality regarding routine and chores, finances, and communication at home, suggesting that conflict is more salient than mutuality for military couples in these important domains. Consistent with gender role expectations, women perceived more conflict about childrearing and men perceived more conflict about physical intimacy and infidelity.

In support of Hypothesis 2, mutuality was a stronger predictor than conflict of marital and individual adjustment across 9 of 12 regression analyses. These findings support other research that has demonstrated the positive impact of mutuality on weathering stressful events (e.g., Skerrett, 1998).

There was mixed support for Hypothesis 3, that is, that mutuality would more strongly predict marital satisfaction and individual well-being in women versus men. The gender difference findings were present only for individual well-being, but not for marital satisfaction, and were inconsistent across the samples; they should therefore be interpreted with caution.

The current study had some limitations, including reliance on subjective accounts (vs. behavior). Additionally, EW may pull for individuals to write about problems rather than providing an objective assessment of events, leading to more frequent conflict expression. Nonetheless, mutuality's predictive value for well-being (above and beyond conflict) signals its potential buffering effect for couples after deployment.

Karney and Crown (2007) argued that adaptive processes are critical buffers in the face of the inevitable stress of post-deployment adjustment. The current study found that mutuality, an adaptive process, had greater importance than conflict for concurrent and prospective well-being in military couples. This first study of mutuality expression by members of military couples points to the potential of cultivating shared vision and sense of reciprocal responsibility as a means of coping with inevitable struggles and conflicts during marital reunion after deployment. Workshops to help couples strengthen their mutuality may enhance couples' connection and well-being post-deployment.

Author Note

For further information about this research effort, please contact Jenna L. Baddeley , who is now at the Ralph H. Johnson VA Medical Center, Charleston, SC, Mental Health Service. 

Data collection was supported by award W81XWH-08-1-0166 from the U.S. Army Medical Research and Materiel Command. Preparation of this manuscript was supported in part by award W91WAW-07-C-0029 from the Army Research Institute. We are grateful to Amy Adler, PhD, and Paul Bliese, PhD, for their help with this research.

References

Baddeley, J. L., & Pennebaker, J. W. (2011). A post-deployment expressive writing intervention for military couples: A randomized controlled trial. Journal of Traumatic Stress, 24, 581–585. doi:10.1002/jts.20679

Buehlman, K. T., Gottman, J. M., & Katz, L. F. (1992). How a couple views their past predicts their future: Predicting divorce from an oral history interview. Journal of Family Psychology, 5, 295–318. doi:10.1037//0893-3200.5.3-4.295

Genero, N. P., Miller, J. B., Surrey, J., & Baldwin, L. M. (1992). Measuring perceived mutuality in close relationships: Validation of the Mutual Psychological Development Questionnaire. Journal of Family Psychology, 6, 36–48. doi: 10.1037/0893-3200.6.1.36

Hendrick, S. (1988). A generic measure of relationship satisfaction. Journal of Marriage & the Family, 50, 93–98. doi:10.2307/352430

Hoge, C. W., Castro, C. A., Messer, S. C., Cotting, D. I., Koffman, R. L., & McGurk, D. (2004). Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. New England Journal of Medicine, 351, 13–22. doi:10.1056/NEJMoa040603

Karney, B. R., & Crown, J. S. (2007). Families under stress: An assessment of data, theory, and research on marriage and divorce in the military (RAND Corporation, MG-599-OSD). Retrieved from RAND website: http://www.rand.org/pubs/monographs/MG599.html

Lakey, B., & Orehek, E. (2011). Relational regulation theory: A new approach to explain the link between perceived social support and mental health. Psychological Review, 118, 482–495. doi:10.1037/a0023477

Pennebaker, J. W. (1982). The psychology of physical symptoms. New York, NY: Springer-Verlag.

Singer, J. A., & Labunko Messier, B. (2009). Marital Engagement–Type of Union Scale (ME-ToUS). New London: Connecticut College, Department of Psychology.

Singer, J. A., Labunko-Messier, B., Baddeley, J. L., & Alea, N. (in press). Mutuality and the use of the Marital Engagement–Type of Union Scale (ME-ToUS) in couples therapy. In K. Skerrett & K. Fergus (Eds.), Couple resilience across the lifespan: Emerging perspectives . New York, NY: Springer.

Skerrett, K. (1998). Couple adjustment to the experience of breast cancer. Family Systems and Health, 16, 281–298. doi:10.1037/h0089855

Spitzer, R. L., Kroenke, K., & Williams, J. B. (1999). Validation and utility of a self-report version of PRIME-MD: The PHQ primary care study. JAMA: Journal of the American Medical Association, 282, 1737–1744. doi:10.1001/jama.282.18.1737

Wiens, T. W., & Boss, P. (2006). Maintaining family resiliency before, during, and after separation. In T. W. Britt, A. B. Adler, & C. A. Castro (Series Eds.), Military life: The psychology of serving in peace and combat. Vol. 3: The military family (pp. 13–38). Columbus, OH: Praeger Security International.

Table 1

Frequencies of Mutuality and Conflict Reported by Men and Women Across Domains of Marital Life

Marital domain	Examples		Frequencies
			Mutuality		Conflict
	Mutuality	Conflict	Men ( n = 52)		Men ( n = 52)	Women ( n = 50)
				Women ( n = 50)
Routine and chores	“When he returns, it feels like he was never gone; we return to the same routine.”	“ Within days I started rearranging the house . . . it made me and my wife drift apart.”	16 (30.8%)	15 (30.0%)	27 (51.9%)*	29 (42.0%)*
Finances	“My wife does a great job [with finances] while I am gone.”	“Our finances are a shambles, and he blames me for it.”	6 (11.5%)	8 (16.0%)	16 (30.8%)*	19 (38.0%)*
Childrearing	“My wife kept the kids informed about where I was and what I was doing. This helped.”	“The kids come to me for everything and [he gets] angry.”	6 (11.5%)	5 (10.0%)	7 (13.5%)	16 ( 32.0%)*
Physical intimacy	“Almost immediately, we rekindled our physical intimacy.”	“When I got home I wasn't as attracted to her as before.”	3 (5.8%)	4 (8.0%)	13 ( 25.0%)*	7 (14.0%)
Communication during deployment	“My wife kept me informed . . . When I returned, I knew what was going on.”	“[The kids and I] spent days or weeks not knowing if [my husband] was alright.”	14 (26.9%)	10 (20.0%)	12 (23.1%)	11 (22.0%)
Communication, emotional intimacy at home	“He has finally started to open up to me.”	“We used to talk all the time . . . now, conversations are sporadic and unrewarding.”	16 (30.8%)	21 (42.0%)	36 (69.2%)*	37 (74.0%)*
Future	“We agreed I won't re-enlist.”	“After the last deployment we considered separating.”	10 (19.2%)	8 (16.0%)	13 (25.0%)	15 (30.0%)
Extended family	“We enjoy visiting her brother and sister-in-law.”	“I put my extended family's needs before my wife, which caused conflict.”	1 (1.9%)	2 (4.0%)	3 (5.8%)	2 (4.0%)
(In)fidelity	“I trust my wife. I know she would never cheat on me.”	“I know he was involved with someone else over there.”	2 (3.8%)	2 (4.0%)	10 (19.2%)*	5 (10.0%)

*Indicates significantly more conflict than mutuality for that gender in that domain, p < .05.

Note. Both the paired and nonpaired samples are included in the analyses. Numbers represent the number of participants reporting mutuality or conflict in each domain.

Table 2

Relationship Satisfaction, Depressive Symptoms, and Somatic Symptoms as a Function of Relationship Conflict and Mutuality

Variable	Time	Nonpaired sample ( n = 50)						Paired ( n = 52)
		Conflict			Mutuality			Conflict			Mutuality
		B	t	p	B	t	p	B	t	p	B	t	p
Relationship Satisfaction	Baseline	- 2.34	- 4.87	<.001	1.90	3.32	.002	- 0.39	- 0.60	.56	2.45	2.69	.013
	1-month follow-up	- 2.26	4.47	<.001	1.89	3.10	.003	- 0.71	- 1.10	.28	1.79	1.98	.060
Depressive symptoms	Baseline	0.79	1.51	.14	- 1.75	- 2.73	.009	0.57	0.89	.38	- 2.45	- 2.64	.014
	1-month follow-up	0.13	0.23	.82	- 1.75	- 2.58	.013	1.32	2.14	.042	- 1.19	- 1.36	.18
Somatic symptoms	Baseline	0.66	1.04	.30	- 1.43	- 1.84	.073	1.07	1.45	.16	- 2.05	- 1.95	.062
	1 month follow-up	0.05	0.07	.95	- 1.85	- 1.97	.056	1.02	1.28	.21	- 1.39	- 1.22	.23

Note. For each sample, results for conflict and mutuality are from regressions that included both as predictors. The df for the nonpaired sample is 47 for baseline analyses and 45 for follow-up analyses. The df for the paired sample is 24.