Greater emotional arousal predicts poorer long-term memory of communication skills in couples

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Greater emotional arousal predicts poorer long-term memory of communication skills in couples Brian R. Baucom, University of Southern California Sarah Weusthoff, Technische Universitat, Braunschweig David Atkins, and University of Washington Kurt Hahlweg Technische Universitat, Braunschweig Abstract Many studies have examined the importance of learning skills in behaviorally based couple interventions but none have examined predictors of long-term memory for skills. Associations between emotional arousal and long-term recall of communication skills delivered to couples during a behaviorally based relationship distress prevention program were examined in a sample of 49 German couples. Fundamental frequency (f 0 ), a vocal measure of encoded emotional arousal, was measured during pre-treatment couple conflict. Higher levels of f 0 were linked to fewer skills remembered 11 years after completing the program, and women remembered more skills than men. Implications of results for behaviorally based couple interventions are discussed. Keywords emotional arousal; communication skills; long-term outcome; prediction; relationship education Virtually all behavioral couple interventions include communication training. Despite promising effects on communication skills in the short run (Blanchard, Hawkins, Baldwin, & Fawcett, 2009), Hahlweg and Richter (2010) found poor remembrance of communication skills 11 years after a preventive couple intervention: 55% of the participants remembered none of 5 speaker skills and 30% remembered none of 5 listener skills 1 , all of which were essential parts of the training. Because relationship conflict is an on-going, daily reality for many couples, including even those that benefit from couple interventions, understanding the factors related to long term learning of communication skills is vitally important. Very © 2012 Elsevier Ltd. All rights reserved. Corresponding author: Brian Baucom, Ph.D., Psychology Department, University of Southern California, 3620 South McClintock Ave., Los Angeles, CA 90089-1061, [email protected], Phone: 011-310-625-9267, Fax: 011- (213) 746-9082. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. 1 The specific skills included five speaker skills: 1) speaking for oneself, 2) speaking in terms of concrete situations, 3) speaking in terms of concrete behaviors, 4) expressing feelings, and 5) staying on topic, and five listener skills: 1) paraphrasing the partner’s point of view, 2) asking open-ended questions, 3) listen attentively to the speaker, 4) providing positive feedback, and 5) naming their own feelings/engaging in self-disclosure. NIH Public Access Author Manuscript Behav Res Ther. Author manuscript; available in PMC 2013 June 01. Published in final edited form as: Behav Res Ther. 2012 June ; 50(6): 442–447. doi:10.1016/j.brat.2012.03.010. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript

Transcript of Greater emotional arousal predicts poorer long-term memory of communication skills in couples

Greater emotional arousal predicts poorer long-term memory ofcommunication skills in couples

Brian R. Baucom,University of Southern California

Sarah Weusthoff,Technische Universitat, Braunschweig

David Atkins, andUniversity of Washington

Kurt HahlwegTechnische Universitat, Braunschweig

AbstractMany studies have examined the importance of learning skills in behaviorally based coupleinterventions but none have examined predictors of long-term memory for skills. Associationsbetween emotional arousal and long-term recall of communication skills delivered to couplesduring a behaviorally based relationship distress prevention program were examined in a sampleof 49 German couples. Fundamental frequency (f0), a vocal measure of encoded emotionalarousal, was measured during pre-treatment couple conflict. Higher levels of f0 were linked tofewer skills remembered 11 years after completing the program, and women remembered moreskills than men. Implications of results for behaviorally based couple interventions are discussed.

Keywordsemotional arousal; communication skills; long-term outcome; prediction; relationship education

Virtually all behavioral couple interventions include communication training. Despitepromising effects on communication skills in the short run (Blanchard, Hawkins, Baldwin,& Fawcett, 2009), Hahlweg and Richter (2010) found poor remembrance of communicationskills 11 years after a preventive couple intervention: 55% of the participants rememberednone of 5 speaker skills and 30% remembered none of 5 listener skills1, all of which wereessential parts of the training. Because relationship conflict is an on-going, daily reality formany couples, including even those that benefit from couple interventions, understandingthe factors related to long term learning of communication skills is vitally important. Very

© 2012 Elsevier Ltd. All rights reserved.

Corresponding author: Brian Baucom, Ph.D., Psychology Department, University of Southern California, 3620 South McClintockAve., Los Angeles, CA 90089-1061, [email protected], Phone: 011-310-625-9267, Fax: 011- (213) 746-9082.

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to ourcustomers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review ofthe resulting proof before it is published in its final citable form. Please note that during the production process errors may bediscovered which could affect the content, and all legal disclaimers that apply to the journal pertain.1The specific skills included five speaker skills: 1) speaking for oneself, 2) speaking in terms of concrete situations, 3) speaking interms of concrete behaviors, 4) expressing feelings, and 5) staying on topic, and five listener skills: 1) paraphrasing the partner’s pointof view, 2) asking open-ended questions, 3) listen attentively to the speaker, 4) providing positive feedback, and 5) naming their ownfeelings/engaging in self-disclosure.

NIH Public AccessAuthor ManuscriptBehav Res Ther. Author manuscript; available in PMC 2013 June 01.

Published in final edited form as:Behav Res Ther. 2012 June ; 50(6): 442–447. doi:10.1016/j.brat.2012.03.010.

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few studies have examined long-term retention of skills offered during couple intervention,and predictors of long-term memory of skills have yet to be established.

Dyadic material about communication skills is delivered through a variety of formatsincluding conjoint couple therapy, group-based intervention, bibliotherapy, andvideotherapy (i.e., Markman, Jamieson, & Floyd, 1983; Hahlweg, Markman, Thurmaier,Engl, & Eckert, 1998; Halford, Sanders, & Behrens, 2001). The goal of communicationtraining is to provide a foundation for couples to enhance effective problem-solving andintimacy-promoting communication and to alter dysfunctional interactions patterns (e.g.,Hahlweg et al., 1998). Indeed, substantial empirical evidence links gains in communicationskills to increased marital functioning and stability over time (e.g., Halford et al., 2001;Markman, Rhoades, Stanley, Ragan & Whitton, 2010). However, some studies have failedto find expected associations between communication skills acquisition and improvementsin marital functioning (e.g., Schilling, Baucom, D., Burnett, Sandin Allen, & Ragland,2003).

Despite the central role of communication skills, virtually no attention has been paid toidentifying predictors of information retention from preventative couple interventions. Asmall number of studies identify predictors of relationship satisfaction and marital status(i.e., married vs. divorced) in preventative couple interventions (e.g., Schilling et al., 2003;Baucom et al., 2006). The current study seeks to build on these valuable findings in threeprimary ways. First, the current study examines prediction of memory for skills rather thanof relationship satisfaction or marital status. Retention of information about communicationskills is an important outcome of preventative couple interventions in its own right. Second,the current study examines prediction over a longer time period, 11 years, than any existingstudy of predictors of response to couple intervention. Examining prediction over a longerperiod of time is important because differential treatment outcomes are frequently morepronounced over longer periods of time (i.e., there are typically a larger number of treatmentfailures farther out from treatment termination; Christensen, Atkins, Baucom, & Yi, 2010).Third, the current study examines a previously unexplored but conceptually importantpredictor of memory for communication skills: conflict-related emotional arousal.

Numerous studies have shown that higher levels of arousal during couple conflict areassociated with a range of negative couple outcomes. For example, higher levels ofemotional arousal (assessed via physiological indices like blood pressure, heart rate, skinconductance, or cortisol levels) have been linked to greater numbers of negative behaviorsand lower levels of concurrent relationship satisfaction, increased risk for longitudinaldeclines in relationship satisfaction, and increased risk for relationship dissolution (seeGottman & Notarius, 2002 for a review).

Recent findings show that higher levels of fundamental frequency (f0; an alternativemeasure of arousal based on the human voice) during couple conflict are linked to a numberof deleterious couple outcomes (e.g., poorer response to behaviorally based couple therapies[Baucom, Atkins, Simpson, & Christensen, 2009] and higher levels of the demand/withdrawinteraction pattern [Baucom, Atkins, Eldridge, McFarland, Sevier, & Christensen, 2011]). F0is a well-accepted measure of emotional arousal (see Juslin & Scherer, 2005 for a review)that refers to the lowest frequency harmonic of speech produced during phonation(measured in Hertz [Hz]). F0 is highly correlated with the perceived pitch of a person’svoice and with multiple physiological measures of arousal (e.g., r’s 0.27 to 0.55 for cortisoland blood pressure; Baucom, Weusthoff, & Hahlweg, 2010; Baucom, Spies, & Margolin,2010) as well as negative behavior during couple conflict (β = 0.22 for demand/withdrawbehavior; Baucom et al., 2011). Because it only requires a clear audio recording, it can becollected from videotaped interactions, is not a distraction for spouses during discussion,

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and can be analyzed using freely available software (e.g., Praat; Boersma & Weenink,2010). Yet, it is unclear whether arousal as measured by f0 is related to mechanisms oftherapy such as long-term memory for skills.

High levels of emotional arousal may interfere with partners’ abilities to learn, retain, andrecall the skills being delivered in the intervention. Couple conflict has often been describedas a chronic stressor and is one of the most commonly cited reasons why couples seektreatment (Doss, Simpson, & Christensen, 2004). Research has consistently linked higherlevels of emotional arousal to memory impairment when the arousal is associated with achronic stressor (see Wolf, 2008 for a review), and the negative impacts of chronicallyelevated emotional arousal on memory appears to increase over time (Tollenaar, Elzinga,Spinhoven, & Everaerd, 2008). For example, the deleterious effects of emotional arousalhave been found to emerge when subjects are retested after 1 week (Quevedo et al., 2003)and 5 weeks (Tollenaar et al., 2008) that frequently are not evident after short retest periodssuch as 1 hour (e.g., Quevedo et al., 2003) or 1 day (Tollenaar et al., 2008). Furthermore,clinical research on psychological disorders documents associations between dysregulatedemotional arousal and memory over very long-term periods of time such as years or decades(see Wolf, 2008 for a review). Therefore, assessing couples more than a decade aftercompleting the intervention is a sensitive test of differences that may not emergeimmediately after treatment termination.

Given the preventive focus of the intervention, couples in the current study varied widely intheir level of initial relationship satisfaction, ranging from distressed to non-distressed.Inclusion of distressed and non-distressed couples allows for a robust test of the linkagebetween conflict-related arousal and skills memory across the range of couples that typicallypresent for relationship distress prevention programs. We hypothesized that higher levels off0 exhibited prior to beginning the intervention would be associated with lower recall ofskills 11 years later for both male and female partners.

MethodsParticipants

Couples in the current study originally participated in a German-based, behavioralrelationship distress prevention program, Ein Partnerschaftliches Lernprogramm (EPL, ‘ALearning Program for Couples’; Kaiser, Hahlweg, Fehm-Wolfsdorf, & Groth, 1998). Thepresent analyses include 89 partners from 49 couples, out of the original 58 couples. Nine(18.4%) of the 49 couples had divorced by the 11-year follow-up. Details regarding theprocedure used for assignment to treatment and for follow-up assessments are described in[omitted for review]. Prior to intervention male partners were 40.0 years old (SD = 8.2,range = 25–64) and female partners were 37.1 years old (SD = 7.8, range = 23–64). Themajority of couples (80%) were married and mean duration of marriage was 9.4 years (SD =9.2, range = 0–34.5). About 65% of partners had at least high school education. Allparticipants self-identified as Caucasian.

ProcedureEPL, a behaviorally based relationship distress prevention program based on the Preventionand Relationship Enhancement Program (PREP; Markman Renick, Floyd, Stanley, &Clements, 1993), was offered in a weekend, group format to couples who wanted to improvetheir communication and solve relationship problems. EPL focuses on learning and applyingcommunication skills and a problem-solution scheme (for a detailed description please see[omitted for review]). Couples completed assessments before and after the EPL intervention

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including questionnaires and a 15-minute video-taped conflict discussion. All predictivemeasures in the current study are taken from the pre-treatment assessment.

Approximately eleven years after completing EPL, all partners were mailed a letter askingthem for permission to phone them and conduct an interview. Questions coveredrelationship status and quality, remembrance and application of EPL contents in everydaylife (open-ended question) and a subjective helpfulness rating of the training. If telephonecontact was not permitted, partners were asked for written information on marital status andquality. Of the 58 couples who completed EPL, 53 couples gave permission to be contactedby phone. One partner had died in four of the couples and these couples were thereforeexcluded from analyses in the current study. The remaining five couples did not respond toeither the first or second letter for unknown reasons. There were no significant differences indemographic or relationship variables between the subsamples included in and excludedfrom the current study.

MeasuresObservationally coded behavior—The Kategorien system fuer partnerschaftlicheInteraktion (KPI; Hahlweg, 2005), a micro-analytic coding system, was used to assess ninepositive and nine negative behaviors during conflict discussions. Summary scores werecalculated for verbal and nonverbal negative (4 and 5 items respectively) and positive (4 and5 items respectively) behaviors. Based on evidence highlighting the importance of the ratioof positive to negative behavior during conflict (e.g., Gottman, 1994), we also calculatedseparate indices of the ratio of positive to negative verbal and nonverbal behavior. Interraterreliability (Cohen’s Kappa) ranged from .64 (p < .001) to .78 (p < .001).

Relationship satisfaction—Relationship satisfaction at pre-treatment was measuredusing the Partnerschaftsfragebogen PFB [Partnership Questionnaire], (PFB; Hahlweg,1996), a 30-item instrument to measure marital quality. It consists of three subscales(Quarreling, Tenderness, and Togetherness/Communication) which were summed to yield aTotal PFB-score (Cronbach’s Alpha: .95). The PFBT correlates highly (r=0.85; Hahlweg,Klann, & Hank, 1992) with the total score of the Dyadic Adjustment Scale DAS (Spanier,1976), and higher PFBT scores indicate greater relationship satisfaction.

Skills remembered—The number of skills each partner remembered was assessed with asingle open-ended question, “Do you remember any of the specific skills which were taughtto you during the training?”. There were a total of 10 specific communication skills taught inEPL1 so the maximum number of skills that a partner could recall was 10.

Vocally encoded emotional arousal—Range of fundamental frequency (f0) was usedto measure vocally encoded emotional arousal. Several indices of f0 (including mean,maximum, standard deviation and range of f0) have been used as indices of encodedemotional arousal. Range of f0, calculated by subtracting the minimum value of f0 from themaximum value of f0, was used in the current study because it has been previously linked toresponse to couple therapy (Baucom et al., 2009) and because of recent recommendationsthat range of f0 is a cleaner measure of emotional arousal than the other indices of f0 (Juslin& Scherer, 2005), where wider range of f0 corresponds to greater emotional arousal. Rangeof f0 was estimated for each partner by analyzing audio recordings of each partner’s speechduring the pre-treatment problem-solving interaction using Praat, a freely available softwarepackage (Boersma & Weenick, 2010).

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Data AnalysesHierarchical generalized linear models (HGLMs; Raudenbush & Bryk, 2002) were used toanalyze the number of skills remembered. HGLMs are advantageous because they can adjustfor sources of non-independence (such as including both members of a couple), allow forunbalanced data, and can model non-normal outcomes. The number of remembered skills isa count variable, which is bounded at zero and positively skewed. Therefore, a PoissonHGLM was used with a log-link function, which guarantees that predictions from the modelare in the permissible range of the outcome (i.e., never negative). The following equationdescribes the two level HGLM:

where i indexes individuals and j indexes couples. The error term (i.e., u0j) controls for thenested data of individuals in couples. Pre-treatment relationship satisfaction and sex wereincluded as covariates to control for possible individual and couple differences in skillsknowledge prior to treatment (i.e., to rule out the alternative hypothesis that more satisfiedcouples already knew more skills). We also ran additional, exploratory models to investigatepotential sex differences in effects and to investigate the role of negative behavior2 duringthe conflict interactions. Due to the limitations of the sample size, sex differences and codedbehaviors were considered in separate models. Range of f0 and relationship satisfaction weregrand mean centered prior to creation of interactions and analysis. Sex was effect coded −.5for men and .5 for women. Analyses used the Hierarchical Linear Modeling program,version 6.04 (Raudenbush & Bryk, 2004).

ResultsMeans, standard deviations, and correlations for all variables are presented in Table 1.Couples were somewhat dissatisfied on average (mean PFB = 49.3), and women had agreater range of f0 than men (t(88) = 6.30, p < .001). No other significant associationsemerged between variables.

Based on the Poisson HGLM shown in Equation 1 and consistent with hypotheses, asignificant negative association emerged between skills remembered and range of f0 (B =−0.02, p < .01). Because Poisson regression models use a log link function, coefficients aretypically exponentiated (i.e., raised to base e) and interpreted as rate ratios (RR; Atkins &Gallop, 2007). Similar to odds ratios in logistic regression, a value of one signifies norelationship and the difference from one is interpreted as a percentage increase or decrease(if less than one) in the outcome. Thus, f0 has an RR of 0.98, indicating a 2% predicteddecrease in skills remembered for every one point increase in f0. For a one SD change in f0,the model predicts 26.2% fewer recalled skills. For example, spouses 1 SD below the meanof f0, at the mean of f0, and 1 SD above the mean of f0 are predicted to remember 3.15, 2.34,and 1.74 skills respectively. Additionally, a significant positive association emergedbetween skills remembered and sex (B = 0.51, RR = 1.66, p < .02), suggesting that whilecontrolling for pre-treatment relationship satisfaction, women relative to men remembered69.0% more skills. The effect of relationship satisfaction was non-significant.

In the exploratory analyses, none of the two- and three-way interactions between sex, f0 andPFB were significant, and none of the coded variables decreased the size of the effect

2Associations between higher levels of emotional arousal and higher levels of negative conflict behavior are well documented.Controlling for negative behavior ensures that the effect of f0 is not an artifact of larger skills deficits associated with higher levels ofnegative conflict behavior.

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between f0 and skills remembered. Results of these models are reported in Table 2. Allmodels were also run with 11-year marital status (0 = intact, 1= divorced) included as alevel-2 covariate. None of the main effects or interactions involving divorce was significantand results of these models are available from the first author.

DiscussionThis study’s central aim was to examine the ability of conflict-related, vocally encodedemotional arousal assessed using f0 to predict the number of communication skills thatpartners remembered from EPL 11 years after completing the intervention. Consistent withhypotheses, higher levels of f0 were associated with fewer skills remembered for both menand women, and women remembered more skills than did men. These findings are the firstthat we are aware of to identify long-term predictors of skills remembered from a coupleintervention and to link conflict-related f0 to long-term memory.

F0 and Skill RecallThe link between higher levels of conflict-related f0 and fewer skills remembered adds to thenascent literature on the factors involved in skills learning during couple intervention. Thisfinding is consistent with the rapidly growing literature linking higher physiological arousalassociated with chronic stress, most often measured with cortisol output (Wolf, 2008), toimpaired memory for new information. Cortisol output was not included in the current studyso it was not possible to investigate whether cortisol output mediates the associationbetween f0 and skills remembered. Recent evidence demonstrating that higher levels of f0are associated with higher levels of cortisol output (Baucom et al., 2010) suggests that thispossibility may be a fruitful avenue for future investigation.

Future work could furthermore clarify the association between f0 and long-term skillsmemory by examining different stages of memory. The current study examined the ability ofpartners to remember specific communication skills. This design is a test of uncued long-term recall for semantic information. It is possible that higher levels of conflict-relatedarousal also affect memory for skills by making it more difficult for spouses to encodeinformation. Higher levels of f0 are known to be associated with higher levels of conflictualbehaviors (Baucom, 2010). Additionally, evidence suggests that f0 is a salient aspect ofcommunication in and of itself and that spouses continually respond to one another’s f0.Spouses’ f0 values are typically positively and significantly correlated with one anotherduring conflict (r = 0.33, p = 0.013 in the complete sample), and numerous studiesdemonstrate that interactants’ f0 converges over the course of an interaction (e.g, Gregory,Dagan, & Webster, 1997). Engaging in arousing conflictual behaviors and responding to oneanother’s emotional expression may be distracting for partners and impair their ability toattend to new information presented during intervention sessions.

It is also possible that higher levels of conflict-related arousal impair spouse’s ability toconsolidate information about new skills. Emerging evidence suggests that even whenindividuals are able to attend to new information subsequent increases in emotional arousalnegatively impact their ability to consolidate that information (Andreano & Cahill, 2006).This finding suggests if spouses get into an argument while practicing a new skill, they mayhave difficulty retaining information about the skill.

Determining whether higher levels of emotional arousal are associated with encodingdeficits, consolidation deficits, and/or recall deficits would be valuable information forpractioners as it could identify whether it would likely be beneficial to spend additional timeon skills delivery in the same session to assist in encoding, to continue practicing the skillsin less volatile applications to assist in consolidation, and/or to repeat the delivery of skills

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across multiple sessions to assist in recall. The timing of spouses’ emotional arousal relativeto skills delivery within a session may indicate which of the first two options could be mosteffective. Emotional arousal that occurs prior to and that is sustained throughout skillsdelivery likely suggests that spouses are distracted and may need help downregulatingarousal before skills delivery. In contrast, emotional arousal that initiates during skillspractice likely suggests that spouses may benefit from additional skills practice in areas oftheir relationship that are less likely to lead to upset. Because f0 is so highly related toperceived pitch (r = .89; Standke, Kappas, & Scherer, 1984), clinicians do not need anyspecial training or equipment to assess vocally encoded emotional arousal duringpsychotherapy sessions and could likely monitor spouse’s encoded emotional arousal withrelative ease. Such information may be helpful in determining how to structure skillsdelivery and practice as sessions unfold.

Sex Differences in Skill RecallWomen were found to remember significantly more skills than men, and there are a numberof possible explanations for this effect. First, gender socialized behavior may havecontributed to women’s greater recall of skills because women may have been moremotivated to participate in the intervention than men. This heightened motivation may be aresult, at least in part, of the tendency for women to be socialized to pay greater attention torelationship relevant information and to place greater emphasis on relationship maintainingbehaviors and activities than men (e.g., Davies, & Lindsay, 2001). The majority ofparticipants indicated that the female spouse was the active partner to seek participation inthe program; such wives may have been more motivated than their husbands andparticipated more during training than their husbands. Second, emerging evidence suggeststhat men may be more sensitive to the effects of emotional arousal during social stressorssuch as couple conflict (Andreano & Cahill, 2006) and that men’s memory may be moreimpacted by emotional priming than women’s (Burton et al., 2004). Men may anticipategreater social evaluative threat during couple therapy than women and enter therapy moreprimed for negative emotional arousal than women as a result. In considering thispossibility, it is important to note that sex emerged as a main effect on skills rememberedbut did not moderate the association between f0 and skills remembered. A strict test ofmen’s greater sensitivity to arousal during social stressors would suggest that men’s f0should be more strongly associated with skills remembered than is women’s f0. The resultsof the current study are not consistent with such a strict test. However, it is possible thatmen’s heightened sensitivity to emotional priming and anticipation of threat is reflected ingreater arousal during the interaction. This admittedly speculative interpretation is in need ofdirect examination in future research. Third, men are likely to have engaged in higher levelsof emotional suppression during conflict than women, and greater engagement insuppression is associated with impaired memory (Richards & Gross, 2000). Malewithdrawal and emotional suppression during marital conflict is highly characteristic ofdistressed couples (e.g., Gottman, Levenson, & Woodin, 2001) similar to these participants.Consistent with this possibility, the KPI coding data indicated that men in this sampleexhibited somewhat less overall activity during conflict interactions (M = 67.74, SD =22.46) than did women (M = 71.86, SD = 23.49).

One important caveat to bear in mind while considering this finding is that while there is noindication that women knew more skills before beginning EPL than men, a pre-treatmentassessment of skills was not included in the current study. Concerns about this alternativehypothesis are lessened by the inclusion of relationship satisfaction and coded conflictbehaviors in the current study. It is well documented that more satisfied partners and spousestend to use more of the communication skills that were a part of the EPL intervention (e.g.,Hahlweg, 2005). Controlling for relationship satisfaction and coded conflict behaviors rules

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out the possibility that partners who may have used more of the skills prior to treatmentwere better able to remember the skills after treatment. Another factor that reduces thepotential impact of not assessing skills known prior to treatment is that even if couples usedmore of the skills prior to treatment, they are unlikely to have been aware that they weredoing so.

Summary, Limitations, and Directions for Future ResearchThe current study is the first that we are aware of to identify predictors of long-term memoryfor skills delivered during couple intervention as well as the first to predict response tocouple intervention more than four years after treatment termination. Both lower levels of f0and being female relative to being male were linked to remembering more skills. Identifyinga link between f0 and skill recall is particularly valuable given that the level of emotionalarousal experience during conflict is a potentially modifiable variable. Two limitations ofthe current study identify potentially valuable avenues for future research. The first of theselimitations is that treatment outcome was not included in the current study. Descriptiveanalyses show that there was very little variability in treatment response (82% of coupleswere at least moderately satisfied at the 11-year follow-up) so it was therefore not possibleto use f0 as a mediator of the association between skills remembered and treatment outcome.The second limitation is that skills remembered was tested solely in terms of declarativememory. It is possible that couples learned the skills in EPL initially through effortfulprocessing of information and deliberate behavioral practice but that with repetition overtime, using the skills became much less effortful and felt much more natural (Smith, 1994).The only way to access procedural learning of skills would be through observational data.The time lag between the initial assessment and 11-year follow-up made collectingobservational data prohibitively impractical. Despite these limitations, the findings of thecurrent study offer some of the first information about the factors involved in how muchinformation is retained from couple intervention, highlight the role of a malleable variable,emotional arousal, in this process, and identify a number of avenues for future research.

AcknowledgmentsThe project was supported by grants from the Deutsche Forschungsgemeinschaft DFG, Fe 263/5-1, Ha 1400/4-1,HA 1400/14-5 and HA 1400/16-1. [Omitted for review]

ReferencesAndreano JM, Cahill L. Glucocorticodi release and memory consolidation in men and women.

Psychological Science. 2006; 17:466–470.10.1111/j.1467-9280.2006.01729.x [PubMed: 16771794]

Atkins DC, Gallop RJ. Re-thinking how family researchers model infrequent outcomes: A tutorial oncount regression and zero-inflated models. Journal of Family Psychology. 2007; 21:726–735.10.1037/0893-3200.21.4.726 [PubMed: 18179344]

Baucom BR, Atkins D, Eldridge K, McFarland P, Sevier M, Christensen A. The language of demand/withdraw: Verbal and vocal expressions in dyadic interaction. Journal of Family Psychology. 2011;25:570–580.10.1037/a0024064 [PubMed: 21639632]

Baucom B, Atkins D, Simpson L, Christensen A. Prediction of response to treatment in a randomizedclinical trial of couple therapy: A 2-year follow-up. Journal of Consulting and Clinical Psychology.2009; 77:160–173.10.1037/a0014405 [PubMed: 19170462]

Baucom, B.; Spies, L.; Margolin, G. History of physical domestic aggression moderates theassociations between vocally encoded arousal during and cortisol reactivity to familial conflict.Poster presented at the triannual meeting of the World Congress of Behavioral and CognitiveTherapies; Boston, MA. 2010.

Baucom et al. Page 8

Behav Res Ther. Author manuscript; available in PMC 2013 June 01.

NIH

-PA Author Manuscript

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-PA Author Manuscript

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-PA Author Manuscript

Baucom, B.; Weusthoff, S.; Hahlweg, K. Construct validity of fundamental frequency during coupleconflict. Paper presented at the triannual meeting of the World Congress of Behavioral andCognitive Therapies; Boston, MA. 2010.

Blanchard VL, Hawkins AJ, Baldwin SA, Fawcett EB. Investigating the effects of marriage andrelationship education on couples’ communication skills: A meta-analytic study. Journal of FamilyPsychology. 2009; 23:203–214.10.1037/a0015211 [PubMed: 19364214]

Boersma, P.; Weenink, D. Praat: doing phonetics by computer (Version 5.1.41) [Computer program].2010. Retrieved July, 2010, from http://www.praat.org/

Burton LA, Rabin L, Bernstein Vardy S, Frohlich J, Wyatt G, Dimitri D, Guterman E. Genderdifferences in implicit and explicit memory for affective passages. Brain and Cognition. 2004;54:218–224.10.1016/j.bandc.2004.02.01 [PubMed: 15050778]

Christensen A, Atkins D, Baucom B, Yi J. Couple and individual adjustment for 5 years following arandomized clinical trial comparing traditional versus integrative behavioral couple therapy.Journal of Consulting and Clinical Psychology. 2010; 78:225–235.10.1037/a0018132 [PubMed:20350033]

Davies, P.; Lindsay, L. Does gender moderate the effects of marital conflict on children?. In: Grych, J.;Fincham, F., editors. Interpersonal Conflict and Child Development. New York, NY: CambridgeUniversity Press; 2001.

Doss B, Simpson L, Christensen A. Why do couples seek marital therapy? Professional Psychology:Research and Practice. 2004; 35:608–614.10.1037/0735-7028.35.6.608

Gottman, JM. What Predicts Divorce: The Relationship Between Marital Processes and MaritalOutcomes. New York: Lawrence Erlbaum; 1994.

Gottman JM, Notarius CI. Marital research in the 20th century and a research agenda for the 21st

century. Family Process. 2002; 41:159–197.10.1111/j.1545-5300.2002.41203.x [PubMed:12140959]

Gottman J, Levenson R, Woodin E. Facial expression during marital conflict. Journal of FamilyCommunication. 2001; 1:37–57.10.1207/S15327698JFC0101_06

Gregory SW, Dagan K, Webster S. Evaluating the relation between vocal accommodation inconversational partners’ fundamental frequencies to perceptions of communication quality. Journalof Nonverbal Behavior. 1997; 21:23–43.

Hahlweg, K. Fragebogen zur Partnerschaftsdiagnostik [Self report marital assessment: PartnershipQuestionnaire]. Göttingen: Hogrefe; 1996.

Hahlweg, K. Kategoriensystem für partnerschaftliche Interaktion (KPI): Interactional Coding system(ICS). In: Kerig, PK.; Baucom, DH., editors. Couple Observational Coding Systems. Mahwah NJ:Lawrence Erlbaum; 2005. p. 127-142.

Hahlweg K, Klann N, Hank G. Zur Erfassung der Ehequalität: Ein Vergleich der “Dyadic AdjustmentScale” (DAS) und des “Partnerschaftsfragebogens” (PFB). [Assessment of relationshipsatisfaction. A comparison of the “Dyadic Adjustment Scale” (DAS) and the“Partnerschaftsfragebogens” (PFB)]. Diagnostica. 1992; 38:312–327.

Hahlweg K, Markman HJ, Thurmaier F, Engl J, Eckert V. Relationship education of marital distress:Results of a German prospective–longitudinal study. Journal of Family Psychology. 1998; 12:543–556.10.1037/0893-3200.12.4.543

Hahlweg K, Richter D. Prevention of marital instability and distress. Results of an 11-year longitudinalfollow-up study. Behaviour Research and Therapy. 2010; 48:377–383.10.1016/j.brat.2009.12.010[PubMed: 20053393]

Halford WK, Sanders MR, Behrens BC. Can skills training prevent relationship problems in at-riskcouples? Four-year effects of a behavioral relationship education program. Journal of FamilyPsychology. 2001; 15:750–768.10.1037/0893-3200.15.4.750 [PubMed: 11770479]

Juslin, P.; Scherer, K. Vocal expression of affect. In: Harrigan, J.; Rosenthal, R.; Scherer, KR., editors.The new handbook of methods in nonverbal behavioral research. New York, NY: OxfordUniversity Press; 2005. p. 65-136.

Kaiser A, Hahlweg K, Fehm-Wolfsdorf G, Groth T. The efficacy of a compact psychoeducationalgroup training program for married couples. Journal of Consulting and Clinical Psychology. 1998;66:753–760.10.1037/0022-006X.66.5.753 [PubMed: 9803693]

Baucom et al. Page 9

Behav Res Ther. Author manuscript; available in PMC 2013 June 01.

NIH

-PA Author Manuscript

NIH

-PA Author Manuscript

NIH

-PA Author Manuscript

Markman HJ, Jamieson KJ, Floyd FJ. The assessment and modification of premarital relationships:Preliminary findings on the etiology and relationship education of marital and family distress.Advances in Family Intervention, Assessment and Theory. 1983; 3:41–90.

Markman HJ, Renick MJ, Floyd F, Stanley S, Clements M. Preventing marital distress throughcommunication and conflict management training: a 4- and 5-year follow-up. Journal ofConsulting and Clinical Psychology. 1993; 61:70–77.10.1037/0022-006X.61.1.70 [PubMed:8450110]

Markman HJ, Rhoades GK, Stanley SM, Ragan E, Whitton S. The premarital communication roots ofmarital distress: The first five years of marriage. Journal of Family Psychology. 2010; 24:289–298.10.1037/a0019481 [PubMed: 20545402]

Quevedo J, Saint Anna MK, Madruga M, Lovato I, de-Paris F, Kapczinski F, Cahill L. Differentialeffects of emotional arousal in short- and long-term memory in healthy adults. Neurobiology ofLearning and Memory. 2003; 79:132–135.10.1016/S1074-7427(02)00034-5 [PubMed: 12591221]

Raudenbush, SW.; Bryk, A.; Cheong, YF.; Congdon, R. HLM6: Hierarchical linear and nonlinearmodeling. Chicago: Scientific Software International; 2004.

Richards J, Gross JJ. Emotion regulation and memory: The cognitive costs of keeping one’s cool.Journal of Personality and Social Psychology. 2000; 79:410–424. doi: 1O.1037/70O22-3514.79.3.410. [PubMed: 10981843]

Schilling EA, Baucom DH, Burnett CK, Allen EA, Ragland L. Altering the course of marriage: Theeffect of PREP communication skills acquisition on couples’ risk of becoming maritallydistressed. Journal of Family Psychology. 2003; 17:41–53.10.1037/0893-3200.17.1.41 [PubMed:12666462]

Smith, E. Procedural knowledge and processing strategies in social cognition. In: Wyer, R.; Srull, T.,editors. Handbook of Social Cognition. Hillsdale, NJ: Lawrence Erlbaum Associates; 1994. p.144-152.

Spanier GB. Measuring dyadic adjustment: New scales for assessing the quality of marriage andsimilar dyads. Journal of Marriage and the Family. 1976; 38:15–28.10.2307/350547

Standke, R.; Kappas, A.; Scherer, KR. Die Attribution von Stimm- und Sprechermerkmalen inAbhängigkeit von Stimmqualität und Kontinuität des Sprechflusses. In: Schick, A.; Walcher, KP.,editors. Beiträge zur Bedeutungslehre des Schalls. Ergebnisse des 3. Oldenburger Symposions zurPsychologischen Akustik. Bern: Lang; 1984. p. 389-402.

Tollenaar M, Elzinga B, Spinhoven P, Everaerd W. The effects of cortisol increase on long-termmemory retrieval during and after acute psychosocial stress. Acta Psychologica. 2008; 127:542–552.10.1016/j.actpsy.2007.10.007 [PubMed: 18155678]

Wolf O. The influence of stress hormones on emotional memory: Relevance for psychopathology.Acta Psychologica. 2008; 127:513–531.10.1016/j.actpsy.2007.08.002 [PubMed: 17900515]

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• Vocal emotional arousal as a predictor of long-term memory for communicationskills

• Greater emotional arousal predicts remembering fewer skills

• Women remember more skills than men

• Sustained emotional arousal may impact memory through encoding, retrieval, orboth

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Tabl

e 1

Mea

ns, s

tand

ard

devi

atio

ns, a

nd c

orre

latio

ns o

f st

udy

vari

able

s

Var

iabl

e(M

ean,

SD

)C

orre

lati

ons

Ran

ge o

f f 0

Skill

s re

mem

bere

dR

elat

ions

hip

sati

sfac

tion

Ran

ge o

f f 0

(39.

90, 1

5.31

)

Skill

s re

mem

bere

d(2

.37,

1.8

1)−

0.18

Rel

atio

nshi

p sa

tisfa

ctio

n(4

9.28

, 12.

30)

0.07

0.05

Sex

(−0.

03, 0

.50)

0.57

***

0.12

0.11

Not

e:

* p <

.05,

**p

< .0

1,

*** p

< .0

01

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Baucom et al. Page 13

Tabl

e 2

Log

-lin

ear

mod

el f

or p

redi

ctin

g sk

ills

from

ran

ge o

f f 0

, rel

atio

nshi

p sa

tisfa

ctio

n, a

nd s

ex

Fix

ed E

ffec

tR

RL

ower

95%

for

RR

Upp

er 9

5% f

or R

R

Mai

n ef

fect

s m

odel

(A

IC =

267

.70)

Inte

rcep

t, γ 0

02.

34**

*1.

982.

77

Sex,

γ10

1.69

**1.

172.

45

Rel

atio

nshi

p sa

tisfa

ctio

n, γ

201.

000.

991.

01

Ran

ge o

f f0

, γ30

0.98

***

0.97

0.99

Exp

lora

tory

mod

el in

clud

ing

inte

ract

ions

(A

IC =

282

.92)

Inte

rcep

t, γ 0

02.

26**

*1.

132.

43

Sex,

γ10

1.66

*1.

132.

43

Rel

atio

nshi

p sa

tisfa

ctio

n, γ

201.

000.

991.

01

Ran

ge o

f f0

, γ30

0.98

**0.

970.

99

Sex

X r

ange

of

f0, γ

401.

010.

981.

03

Rel

atio

nshi

p sa

tisfa

ctio

n X

ran

ge o

f f0

, γ50

1.00

1.00

1.00

Sex

X r

elat

ions

hip

satis

fact

ion

X r

ange

of

f0, γ

601.

001.

001.

00

Exp

lora

tory

mod

els

incl

udin

g ne

gativ

e co

ded

beha

vior

(A

IC =

245

.87)

Inte

rcep

t, γ0

02.

13**

*1.

732.

63

Sex,

γ10

1.88

*1.

173.

02

Rel

atio

nshi

p sa

tisfa

ctio

n, γ

201.

000.

991.

01

Ran

ge o

f f0

, γ30

0.98

**0.

960.

99

Ver

bal n

egat

ivity

, γ40

0.99

0.98

1.01

Non

verb

al n

egat

ivity

, γ50

0.99

0.98

1.01

Exp

lora

tory

mod

els

incl

udin

g ra

tio o

f ne

gativ

e to

pos

itive

cod

ed b

ehav

ior

(AIC

= 2

37.7

8)

Inte

rcep

t, γ 0

02.

13**

*1.

712.

65

Sex,

γ10

2.02

**1.

253.

27

Rel

atio

nshi

p sa

tisfa

ctio

n, γ

201.

000.

991.

01

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Fix

ed E

ffec

tR

RL

ower

95%

for

RR

Upp

er 9

5% f

or R

R

Ran

ge o

f f0

, γ30

0.97

**0.

960.

99

Ver

bal r

atio

, γ40

1.13

†0.

991.

28

Non

verb

al r

atio

, γ50

0.99

0.94

1.04

Not

e:

† p <

.10,

* p <

.05,

**p

< .0

1,

*** p

< .0

01

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