@2024 Afarand., IRAN

---

ISSN: 2252-0805    The Horizon of Medical Sciences 2015;21(1):1-6

Background
… [1-5] Marital stress is defined as a situation in which couples experience problems with communication and problem solving while seeking solutions, live with each other and hardly accept each other differences [6 ]… [7, 8] Self-regulation was introduced as a method to improve the relationship between couples [9]. … [10] Couple therapy based on the self-regulation is that the couples themselves and not the therapist develop long-term changes in their marital relationship [11]. … [12]
Previous Studies
Short-term effectiveness of self-regulation approach has been investigated on marital satisfaction, reduction of depression, improvement of sexual relationship, improvement of love and intimacy [13], increase of marital intimacy of infertile couples [14], increase of psychological well-being of troubled couples [15] and the improvement of communication skills in couples [16] and the obtained results have been useful. Couple short-term self-regulation approach has led to reduction of marital conflict [17]. Short-term self-regulation approach to couple therapy, increases marital satisfaction, improves marital status and improves the depression, but it does not have any significant effect on anxiety [18]. Short-term self-regulation method increases the mental health of the couples and reduces their depression [19]. Couple therapy based on self-regulation has reduced the marital conflict and all its aspects, including conflict related to sexual relationship, emotional reactions, and personal relationship with relatives and better support of the children in experimental group compared to the observed group [20]. No Research was found investigating the impact of self-regulation approach on the marital stress.
Aim(s)
The aim of this study was to determine the effectiveness of short-term self-regulation approach in reducing the marital stress.
Research type
This is a quasi-experimental study using pretest- posttest design with unequal control group.
Research society, place and time
All couples with marital problems referred to Golha Health Center in the 6th District of Tehran (Iran) were studied in 2014.
Sampling method and number
16 couples were selected based on available sampling method and through random replacement, they were divided in control and experimental groups (each 8 couples). Inclusion criteria for the study were as follows: at least one year marriage duration, not being on the verge of divorce, no acute mental and personality disorders, participation of both members of the couple in the meetings, informed consent for the treatment, the commitment to attend all meetings until the end of the treatment, and no individual counseling and psychological services outside of treatment sessions. Exclusion criteria were consumption of psychiatric medication and drugs, taking any sedatives, alcohol, drugs, and formerly admitted in the psychiatric hospitals.
Used devices&materials
The tool of gathering data was Stockholm-Tehran Marital Stress Scale (STMSS). The main scale has 17 items that are scored zero or one. Minimum score of this scale is zero and the maximum score is 17. The higher the score of this scale, the greater is the stress on the relationship between the person and his/her spouse. Internal consistency of this scale as well as its construct validity has been described satisfactory using related scales [3]. The Persian version of this questionnaire has been translated and validated [21]. This form has 16 questions. Five options are very high, high, medium, low, and very low (with one to five scoring). Each subject is scored 24 (minimum) to 120 (maximum). (2 items of this questionnaire has five sections and totally, the sum of questions is 24). In order to assess test-retest reliability of the scale, the correlation coefficient between the scores obtained in two runs with a distance of two to four weeks, which was 0.78 [21]. Cronbach's alpha coefficient for internal consistency of this scale reported as 0.91that shows the high internal consistency of this test [21]. In the translated STMSS form, there is significant positive relationship between martial stress of subjects and their scores in marital problems and depression (0.53 and 0.41) based on the Pearson Correlation [3]. These correlations were statistically significant [21]. The internal consistency using Cronbach`s alpha was calculated 0.79. After pretest and completing the questionnaire, the couples in the experimental group were exposed to the intervention (short-term self-regulation couple treatment) for eight one-hour per week sessions in form of couple participation and individual participations without their couples. The controlled group did not receive any treatment. After the sessions, the posttest was administered. The package for the therapy sessions was based on Halford self-regulation couple therapy [12]. After the study, the therapy sessions of self-regulation was conducted for the couples. Data was analyzed using SPSS 20 in both descriptive level (mean and standard deviation) and analytic level (one-variable covariance analysis). To test the hypothesis according to pretest variable and possible primary difference between experimental and control groups, to reduce the primary difference and to compare the posttests, one-variable covariance analysis was used.
Findings by Text
The mean age of couples in experimental group was 35.00 ± 5.37 years and their marriage length was 12.22 ± 5.60. The mean age of couples in control group was 34.46 ± 4.26 years and their marriage length was 12.39 ± 3.70 years. The mean scores of marital stress in the pretest stage for experimental and control group were 71.25 ± 9.54 and 73.43± 8.13, respectively. In the post-test and post-intervention, mean scores of marital stress in the experimental and control groups were 44.93 ± 7.45 and 71.18 ± 10.8, respectively. Therefore, there was a significant decrease in the mean score for marital stress in experimental group compared control group. The effect of short-term self-regulation couple therapy in the test was 43%, which meant that 43% of individual differences in posttest scores of marital stress variable were related to the impact of intervention (group membership).
Main comparison to the similar studies
Based on the results of analysis of covariance, in the post-test, there was a significant reduction in marital stress in the experimental group compared with the control group and couple marital stress was improved by short-term self-regulation couple therapy. The results of this study are consistent with other studies [22-24]. There has been a higher marital satisfaction in couples who have been at high risk and have exposed to self-regulation therapy compared to the control group couples [22]. Self-regulation couple therapy increases the couple marital compatibility [23]. Couple therapy based on self-regulation is effective on the marital satisfaction, coping with spouse’s personality, communication, conflict resolution, satisfaction of leisure, improvement of sexual relationship and relationship with relatives and friends [24]. The results of this research on the effectiveness of self-regulation approach in couple therapy are in line with the results of other short-term self-regulation approaches to couple therapy [13, 17-19, 25-28]. …[29, 30].
Suggestions
To precise determination of the effects of short-term self-regulation approach to couple therapy, follow up should be included. The effectiveness of this approach on other variables such as marital commitment, marital strain, etc. must be examined. Other approaches to couple therapy should be used and their results should be compared with the results of the study.
Limitations
In generalizing the results to other cities and regions caution should be observed. Selecting available sample, self-reporting nature of the used tool, the lack of follow up and the existence of Hawthorne effect are other limitations of the current research.
Conclusions
Couple therapy based on short-term self-regulation model can affect the marital stress in the couples. Therefore, this approach can be used in family training centers and couple therapy groups for resolving the marital problems of the couples.
Acknowledgments
The researchers appreciate the authorities of Golha Health Center and all the participating couples.
Conflict of interest
There was no conflict of interest between the authors.
Ethical Permissions
The authors observed all ethical codes related to human subjects. All procedures were approved by the competent authorities.
Funding Sources
This study was carried out without any financial support of any certain institution.