Date of Award
Spring 5-1-2026
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Counselor Education and Counseling Psychology
First Advisor
Lynne Knobloch-Fedders
Second Advisor
Alexandra Kriofske Mainella
Third Advisor
Lisa Edwards
Abstract
Romantic relationship quality is central to people’s physical and mental health (Braithwaite and Holt-Lunstad, 2017; Proulx et al., 2007; Robles et al., 2014), and depression and generalized anxiety disorder (GAD) are negatively associated with the quality of couples’ relationships (Whisman et al., 2000). Using observational data coded using the Structural Analysis of Social Behavior model (SASB; Benjamin, 1979, 1987, 2000), this study compared the interactions of couples with depression (n = 23), couples with GAD (n = 27), and couples with co-occurring depression and GAD (n = 12). Multilevel models examined the associations between diagnostic status and couples’ interpersonal behaviors and employed relationship quality as a covariate. Results indicated that, compared to couples with GAD, couples with co-occurring depression and GAD exhibited more Self-Focused Autonomy, more Watching and Controlling behavior, and less Affirming and Understanding behavior. Compared to their partners, GAD patients displayed more Self-Focused Affiliation, Self-Focused Autonomy, Asserting and Separating behavior, and Disclosing and Expressing behavior; they also exhibited less Other-Focused Affiliation and Affirming and Understanding behavior. Compared to their partners, patients with depression enacted less Freeing and Forgetting behavior and Affirming and Understanding behavior. Finally, relationship quality was positively associated with Other-Focused Affiliation, Other-Focused Autonomy, and Nurturing and Protecting behavior; it was negatively associated with Watching and Controlling behavior and Belittling and Blaming behavior. These results suggest that, in line with previous research (Baucom et al., 2007; Knobloch-Fedders et al., 2013; Nelson and Beach, 1990; Schmaling and Jacobson, 1990), relationship quality explains more variance in couples’ interpersonal behavior than depression, GAD, and their co-occurrence do, and should be prioritized by clinicians as an important treatment target in the context of mental health disorders.