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. Author manuscript; available in PMC: 2020 Dec 1.
Published in final edited form as: Fam Process. 2018 Oct 25;58(4):891–907. doi: 10.1111/famp.12402

The dynamic interplay between satisfaction with intimate relationship functioning and daily mood in low-income outpatients

Rebecca Brock 1,*, Molly Franz 2, Jessica O’Bleness 3, Erika Lawrence 4
PMCID: PMC6483892  NIHMSID: NIHMS990543  PMID: 30357806

Abstract

Background:

Substantial research supports bidirectional links between intimate relationship discord and individual psychopathology, including depressive symptoms. However, few studies have utilized daily diary methods to capture the micro-level processes underlying the association between couple discord and depression, particularly among populations that are at elevated risk for both interpersonal and individual dysfunction. To address this gap, we examined whether daily changes in satisfaction with relationship functioning were associated with daily changes in negative affect and positive affect over the span of two weeks among mental health outpatients of low socioeconomic status.

Methods:

Participants were 53 low-income outpatients from community mental health clinics who completed a semi-structured interview about the quality of their intimate relationships followed by 14 daily reports of positive and negative mood and satisfaction with relationship functioning across several domains.

Results:

Growth curve analytic techniques revealed the hypothesized bidirectional relations. Decline in satisfaction with relationship functioning predicted escalation in negative affect and deterioration in positive affect over two weeks, and deterioration of mood predicted declining satisfaction with relationship functioning.

Conclusions:

This study extends existing knowledge about couple dysfunction and individual psychopathology by highlighting the immediate nature of this dynamic process as it unfolds over time.

Keywords: intimate relationship satisfaction, negative affect, positive affect, daily diary, low-income, outpatients

Depression is the leading cause of disability worldwide (World Health Organization, 2017) and is associated with notable distress and functional impairment (Löwe et al., 2008). A Couple and Family Discord Model of Depression (CFDM; Beach, 2014) recognizes the central role of intimate relationships in the onset and course of depressive disorders, and there is robust empirical support for this association (see Whisman & Baucom, 2012 and Pilkington, Milne, Cairns, Lewis, & Whelan, 2015 for reviews). However, few studies have conducted microscopic investigations of the dynamic link between intimate relationships and depression as it unfolds from one day to the next. The primary aim of the present study was to examine the association between changes in satisfaction with intimate relationship functioning over two weeks and changes in mood states closely tied to depression (negative affect and low positive affect; Watson, 2005). This aim was pursued in a sample of low-income individuals who were seeking mental health services, a population that tends to be underrepresented in research despite being at elevated risk for both interpersonal and individual distress and impairment (e.g., Conger, Conger, & Martin, 2010; Gurman, 2010; Unger et al., 2013). An in-depth analysis of intimate relationship functioning was conducted via semi-structured interviews and 14 consecutive daily reports of dyadic interactions and satisfaction across several relationship domains.

The Role of Intimate Relationships in Depression

Substantial research demonstrates that depression is robustly associated with intimate relationship maladjustment (e.g., Brock, Kroska, & Lawrence, 2016; Whisman, 2007). In a meta-analysis of 26 studies, researchers found that 44% of the variance in depressive symptoms is explained by concurrent intimate relationship dissatisfaction (Whisman, 2001). Further, several longitudinal studies demonstrate temporal precedence of intimate relationship discord as a predictor of later depression (Beach, Katz, Kim, & Brody, 2003; Giallo et al., 2017; Whisman & Bruce, 1999). Taken together, this research suggests that couple dysfunction may be a driving force in the onset and course of depressive disorders.

This link between intimate relationship discord and depression is consistent with Coyne’s (1976) interpersonal theory of depression, which identified excessive reassurance seeking and lowered social support as key contributors to depression. In an extension of this early work, Joiner and colleagues have found heightened rates of corumination, reassurance seeking, and negative feedback seeking occurring in relationships with one or more depressed partners (Joiner & Metalsky, 1995). For example, depressed individuals tend to seek confirmation from their partners that they are valued, loved, and worthy (Joiner, Metalsky, Katz, & Beach, 1999), but also solicit disapproval and criticism (Joiner, 1995). These behaviors contribute to increased hostility and stress (e.g., Pettit & Joiner, 2006; Timmons & Joiner, 2008) which ultimately increase symptoms (Starr, 2015). Partners of depressed individuals are more likely to demonstrate hostility directed toward the depressed person (e.g., blaming, attacking, ignoring), and research has demonstrated that such displays of expressed emotion by loved ones are associated with relapse in mood disorders (see Butzlaff & Hooley, 1998 for a meta-analysis). Thus, dyadic processes are central to understanding the complex link between intimate relationships and depression (Knobloch-Fedders, Knobloch, Durbin, Rosen, & Critchfield, 2013).

Focusing on low-income, treatment-seeking populations.

The bulk of research investigating processes contributing to depression has relied on student or community samples of higher functioning individuals (Tennen, Hall, & Afleck, 1995). Researchers have questioned whether college students endorsing symptoms of depression on self-report questionnaires are truly manifesting clinically significant levels of distress frequently seen among treatment-seeking populations (Tennen et al., 1995), an argument that extends to research with community samples. Further, treatment-seeking populations are at elevated risk for relationship dysfunction (Gurman, 2010) and could be more sensitive to the effects of interpersonal stress (Rounsaville, Weissman, & Prusoff, & Herceg-Baron, 1979). Alternatively, consistent with a kindling hypothesis, relatively severe and chronic cases of depression might be less reactive to environmental influences (e.g., Kendler & Gardner, 2016). Thus, basic research with individuals experiencing high enough levels of distress and impairment to motivate treatment-seeking behavior holds promise for further unraveling the complex link between intimate relationships and psychopathology.

Treatment-seeking individuals who are also of low SES are at even greater risk for relationship discord and individual distress due to higher rates of exposure to daily adversity and economic hardships (Conger et al., 2010; Hardie & Lucas, 2010; Lorant et al., 2003; Trail & Karney, 2012). Further, low SES couples not only experience more relationship discord (Karney, Garvan, & Thomas, 2003), but also greater relationship instability as indicated by higher divorce rates (Bramlett & Mosher, 2002; Conger et al., 2010) and rates of infidelity (Trail & Karney, 2012). Thus, low-income, treatment-seeking individuals appear to be especially vulnerable to experiencing intimate relationship dysfunction and instability, yet they have historically been underrepresented in research (e.g., Tennen et al., 1995; Unger et al., 2013).

Daily Diary Investigations of the Link between Intimate Relationships and Depression

Multi-wave research designs consisting of three or more repeated measures suggest that there is significant covariation between changes in relationship discord and depression over several years (Davila, Karney, Hall, & Bradbury, 2003; Karney, 2001; Whitton, Stanley, Markman, & Baucom, 2008). To build on this research, complementary designs using daily diary methods are needed to examine these processes as they unfold in real time, thus “capturing life as it is lived” (see Bolger, Davis, & Rafaeli, 2003 and Laurenceau & Bolger, 2005 for discussions). There are numerous advantages to implementing daily diary methods. First, they allow for fine-grained analyses of daily interactions, tapping into the micro-level processes (e.g., daily provision of support, daily negative affect) that underlie and reflect macro-level processes maintaining couple dysfunction and depression. Daily diary methods are particularly important for understanding associations between intimate relationships and mood, which are known to fluctuate over short periods of time (Arriaga, 2001; Gleason, Iida, Shrout, & Bolger, 2008; Merz & Roesch, 2011). Second, researchers can measure relationship events as they occur in their naturalistic environments, increasing external validity of findings beyond those obtained in contrived environments (e.g., laboratory). As such, these methods enhance our understanding of the ecosystem within which relationship dysfunction occurs. Finally, daily diary methods circumvent problems specific to retrospective reporting (e.g., recency and saliency heuristic biases), known to occur when asking respondents to recall global experiences of affect and relationship functioning over extended time periods (e.g., Bolger, Davis, & Rafaeli, 2003).

The implementation of daily diary methods requires adaptations to customary approaches to assessing depression. Most notably, long-term sampling methods utilize self-report surveys (e.g., Beck Depression Inventory-II; Beck, Steer, & Brown, 1996) or lengthy interview methods (e.g., Structured Clinical Interview for DSM-5; First, Williams, Karg, & Spitzer, 2015) to obtain information about symptoms and diagnosis. However, these measures are designed to assess global depressive symptoms, as opposed to daily features of depression, rendering them insensitive to short-term changes in mood. Consequently, the bulk of research examining depression on a daily basis examines fluctuation in mood states (e.g., Gleason et al., 2008; Overall & Hammond, 2013; Mehta, Walls, Scherer, Feldman, & Shrier, 2016). Research demonstrates that daily affective experiences contribute substantially to depressogenic cognitions, which ultimately underlie the experience of depression (e.g., Simonson, Sanchez, Arger, & Mezulis, 2012).

Importantly, instruments traditionally used to assess depression predominantly query about negative thoughts and emotions, and may not adequately capture the deficit of positive mood experienced by depressed individuals (Watson, Clark, & Tellegen, 1988). Assessing both negative and positive affective states provides a more valid picture of the daily experiences of depressed individuals (Watson et al., 1988). Such research has revealed that depressed individuals’ tendency to use strategies to dampen positive mood predicts the maintenance of depressive symptoms (Li, Starr, & Hershenberg, 2017; Starr & Hershenberg, 2017). Findings support the importance of examining daily mood states associated with depression (i.e., presence of negative affect and lack of positive affect; Watson, 2005), given that fluctuation in these mood states provides a sensitive measure of central features of depression.

Notably, the majority of daily diary studies examining the link between mood and intimate relationships have utilized relatively brief, narrowly-focused, self-report assessments of intimate relationship functioning (e.g., Mehta et al., 2016; Bolger, Zuckerman, & Kessler, 2000; Gleason et al., 2008; Overall & Hammond, 2013). For example, investigations have predominantly assessed relationship functioning using one or two items (e.g. “Did you provide emotional support to your partner today?”). In one of the few daily diary studies to use multiple items to assess intimate relationships, Mehta et al. (2016) assessed intimacy with three items (i.e., closeness, satisfaction, and affection). Virtually no daily diary research has assessed reciprocal relations between daily mood and relatively comprehensive assessments of intimate relationships.

Further, daily diary studies focused on clinical samples have largely investigated relationship processes among patients coping with physical rather than mental health problems. For example, findings demonstrate associations between daily relationship processes (e.g., support) and same-day mood among patients and partners with breast cancer and multiple sclerosis (Boeding et al., 2014; Kleiboer et al., 2007; Otto, Laurenceau, Siegel, & Belcher, 2015). To our knowledge, research has not yet examined these daily processes among low-income or mental health treatment seeking populations. However, given the importance of this work for informing interventions targeting underserved at-risk groups, investigations of these processes in these populations are sorely needed.

Present Study

The primary aim of the present study was to examine the reciprocal association between satisfaction with relationship functioning and daily mood (i.e., negative affect and low positive affect) in an at-risk sample of outpatients seeking services from community mental health centers. This population was not selected to evaluate treatment outcomes, but rather, was of interest given the elevated risk for clinically significant distress and impairment and high rates of diagnosable psychopathology. Outpatients completed a semi-structured interview about the quality of their intimate relationships during a laboratory visit, facilitating reflection about various aspects of the relationship (i.e., intimacy, support, respect, conflict). Subsequently, patients were asked to report, from home for 14 days, about interactions with their partners—parallel to the domains covered during the interview—and to rate their satisfaction with the interactions occurring within each domain. We implemented growth curve analytic (GCA; Bryk & Raudenbush, 1987) techniques within a multilevel modeling framework. We predicted that daily decrements in satisfaction with relationship functioning would be associated with escalation in negative affect and deterioration in positive affect above and beyond the typical course of daily mood. Further, we predicted that worsening mood over time (increasing negative affect and decreasing positive affect) would be significantly associated with decline in satisfaction with daily interactions in one’s intimate relationship.

Method

Participants and Procedures

Participants were recruited from community mental health clinics providing reduced fee services to low-income outpatients. Patients were approached by research assistants in the reception area and those who verbally consented to learn more about the study were given information. To be eligible, patients had to be: (a) in a committed relationship lasting at least 6 months and currently cohabiting with one’s partner to ensure sufficient daily interaction for informing reports, (b) over the age of 18, and (c) not actively psychotic. Note that eligible patients were not necessarily seeking treatment for couple discord; rather, they were required to be in a committed intimate relationship while seeking mental health services. Eligible patients were scheduled for a 2.5-hour, in-person appointment during which clinical interviews and questionnaires were administered. Participants then completed 10–15 minutes of questionnaires from home for 14 consecutive days following the laboratory appointment either on the internet (67.9%) or by mailing a paper version of the survey (if the participant did not have daily internet access). Participants were asked to record their experiences and perceptions at predetermined intervals (i.e., before bedtime). Participants were paid $50.

A total of 61 outpatients participated in the study. Data from two participants were omitted due to displays of active psychosis during the lab appointment; thus, a total of 59 participants (18 males and 42 females) met eligibility requirements. Participants were primarily White (84.5%), unemployed (56.9%), and had a modal income of less than $10,000. On average, participants were 41.81 years of age (SD=9.43). Over half of the sample were not engaged or married (51.8%), and the majority of participants had children (56.9%). Average length of current intimate relationship was 91.93 months (SD = 83.28), but almost half of the sample had separated from their partner at some point in the relationship (42.1%). Further, mean relationship satisfaction (M = 28.00, SD = 13.32) measured via the Quality of Marriage Index (Norton, 1983) was significantly lower than means derived from community samples. For example, compared to QMI scores of a community sample of 101 newlywed couples recruited through marriage licenses (M for women = 40.64, SD = 4.87; Brock & Lawrence, 2008), participants in the current sample had significantly lower QMI scores, t(157) = 8.60, p < .001. Thus, this represents an at-risk sample with regard to relationship dysfunction.

Almost all participants (91.5%) met either current or past diagnostic criteria for a mood, anxiety, or alcohol use disorder as measured by the Structured Clinical Interview for DSM-IV-TR Axis I Disorders (First, Spitzer, Gibbon, & Williams, 2002), and the majority of participants met current or past criteria for more than one diagnosis (72.9% comorbidity). The majority of the sample reported currently experiencing clinically significant distress or impairment (78%). Thus, this sample was comprised of individuals experiencing significant psychopathology relative to community or student populations. With regard to major depressive disorder (MDD), a total of 64.4% met full diagnostic criteria for MDD (current or past); 25.7% of those participants met criteria for a current major depressive episode (MDE), and 86% had experienced more than one episode in their lifetime.

Analyses in the present report were focused on the 53 participants who participated in the daily survey phase of the study. Notably, participants who complied with the daily survey procedures (N=53) did not differ significantly from the recruited sample (N=61) on any key demographic characteristics (i.e., gender, children, age, cohabitation length, past MDE, current MDE; χ2s ranged from .033 to .145; ts ranged from .151 to .407).

Measures

Daily mood.

The Positive and Negative Affect Schedule (PANAS; Watson et al., 1988) includes measures of two distinct, factor-analytically-derived dimensions of affective experience: Positive Affect and Negative Affect. Participants rated the extent to which they had felt each emotion “today” on a Likert-type scale ranging from 1 (very slightly or not at all) to 5 (extremely). Scores were summed across the 10 items on each scale (possible range: 10–50). The PANAS demonstrates strong reliability and validity (Watson et al., 1988), and has been used in prior daily diary research to examine mood states associated with depression (e.g., Mehta et al., 2016). Specifically, although the PANAS is not a diagnostic tool and does not enable us to determine whether someone meets full criteria for a major depressive episode on a given day, the Negative Affect scale reflects emotional experiences underlying both depression and anxiety whereas the Positive Affect subscale taps into the affective states uniquely underlying depression (e.g., Jolly, Dyck, Kramer, & Wherry, 1994; Mineka, Watson, & Clark, 1998; Watson et al., 1988; Watson, 2005). Cronbach’s alphas in this sample were .89 for positive affect and .90 for negative affect.

Daily satisfaction with intimate relationship functioning.

During the laboratory visit, participants completed the Relationship Quality Interview (RQI; Lawrence et al., 2008; Lawrence, Brock, Barry, Langer, & Bunde, 2009; Lawrence et al., 2011), which is a validated, 60–90 minute semi-structured interview. The RQI was administered by a team of undergraduate research assistants who had completed a workshop on the basics of clinical interviewing (e.g., directive and nondirective listening) and received detailed instruction in the administration of the RQI. Open-ended questions—followed by closed-ended questions—were asked to obtain contextual information about one’s intimate relationship across multiple domains including trust and intimacy, conflict management, balance of power and control, quality of sexual relationship, and support (see Lawrence et al., 2008 for more information). Participants were asked to consider the “past 6 months” when responding to questions. Interviewers independently rated each domain on scales ranging from 1 (poor functioning) to 9 (high functioning), which are specific to each domain. Accordingly, we obtained relatively objective scores of baseline dysfunction in the intimate relationship to account for the possibility that individuals experiencing more persistent relationship dysfunction would demonstrate a more robust association between daily reports of relationship satisfaction and mood. The RQI has demonstrated strong reliability, convergent validity, and divergent validity (Lawrence et al., 2008; 2009; 2011). Approximately 15% of the interviews were randomly selected and double-coded, and strong interrater reliability was established (average ICC = .93).

Interviewer scores for support, trust and intimacy, conflict management, and balance of power and control domains were highly interrelated (Cronbach’s α = .92); therefore, scores were averaged to obtain a single, objective score of overall relationship quality for each patient (subsequently referred to as “RQI”). On average, relationships were of moderate quality, M = 5.25 (SD = 2.08); however, the full range (1 to 9) of RQI ratings were observed. Ratings of sexual quality were correlated with the other domains (rs ranged from .43 to .66, p < .001) but were omitted from the aggregated score and subsequent analyses.1

Following the in-session interview, participants completed 14 days of home surveys (paper or online format). Participants were instructed to answer the questions before going to bed in the evening, thinking about interactions with their partners that had happened that day (since they woke up in the morning). The daily survey consisted of a series of questions about dyadic behaviors specific to each RQI domain (see Supplemental Material). The questions were parallel to those asked during the in-person interview, and served to prime participants to the details of interactions they had with their partners that day. Participants were then asked to make a global rating of satisfaction in each domain using a 9-point Likert scale ranging from 1 (I was not at all satisfied today...) to 9 (I was extremely satisfied today…). Similar to objective ratings obtained during the in-person interview, self-reports of satisfaction with support, trust and intimacy, conflict management, and balance of power and control were highly interrelated (Cronbach’s α = .94), and scores were averaged to obtain a single daily score of overall satisfaction with relationship functioning across multiple domains.

Data Analytic Plan

Growth curve modeling (GCM) techniques were implemented with HLM 7 software (Bryk & Raudenbush, 1987; Raudenbush & Bryk, 2002). GCM estimates within-person change for a variable (e.g., negative affect), and allows for the examination of time-varying covariates of repeated measures. Further, GCM allows for an examination of between-subject differences in the degree to which changes in daily satisfaction with relationship functioning are associated with changes in daily mood. There are multiple advantages of using GCM to analyze repeated assessments; most notably, repeated measures are nested within participants to account for interdependence, and cases are retained despite missing data across repeated assessments, which is customary in longitudinal research. Restricted likelihood estimation was used, and estimates are reported with robust standard errors to account for any violations of normality.

The following multilevel model was tested separately for each measure of mood (i.e., negative affect and positive affect):

Level-1 Model —

Mood = π0i + π1i(Time) + π2i(Relationship Satisfaction) + eti

Level-2 Model —

π0i = β00 + r0i

π1i = β10 + r1i

π2i = β20 + β21(Survey Method) + β22(Relationship Length) + r2i

The primary parameter of interest (β20) represents the degree to which daily fluctuation in satisfaction with relationship functioning is associated with daily fluctuation in mood, above and beyond change in mood explained by time. That is, this parameter tests whether there are significant deviations from the average trajectory of mood as a function of daily changes in satisfaction with the relationship. As is customary in GCA for daily diary data, Time (centered at Day 1) was included as a Level 1 covariate in all analyses.

Survey method (paper = 1, online = 0) was included as a Level 2 predictor of π2i to rule out the possibility that the association between changes in relationship satisfaction and changes in mood varies as a function of differences in method of survey administration. Relationship length was also included as a Level 2 predictor to account for the possibility that decreasing relationship satisfaction might be more strongly associated with escalating negative affect and declining positive affect for participants in more established relationships.

Next, the reverse model was tested to examine whether changes in daily mood were associated with changes in satisfaction with relationship functioning:

Level-1 Model —

Relationship Satisfaction = π0i + π1i(Time) + π2i(Mood) + eti

Level-2 Model —

π0i = β00 + r0i

π1i = β10 + r1i

π2i = β20 + β21(Survey Method) + β22(Relationship Length) + r2i

To examine whether the association between satisfaction with relationship functioning and daily mood varied as a function of preexisting intimate relationship quality, as measured during the laboratory visit with an objective semi-structured interview, RQI scores were included as a Level 2 predictor of π2i:

Level-1 Model —

Mood = π0i + π1i(Time) + π2i(Satisfaction with Relationship Functioning) + eti

Level-2 Model —

π0i = β00 + r0i

π1i = β10 + r1i

π2i = β20 + β21(Survey Method) + β22(Relationship Length) + β23(ROI) + r2i

Results

Descriptive information about satisfaction with relationship functioning, negative affect, and positive affect across the 14 days is reported in Table 1. To examine the nature of change in each outcome variable over the 14 days, we tested GCA models with time entered as a Level 1 covariate. Results indicated that, on average, satisfaction was relatively stable over time (i.e., no significant escalation or decline in satisfaction from one day to the next), t(52) = −0.93, p = .357; however, there was significant between-subject variability in the linear trajectories of satisfaction, χ2 (52) = 74.96, p = .020, suggesting that rates of daily change varied across individuals. Similarly, negative affect was relatively stable on average, t(52) = 0.49, p = .625, but there was significant between-subject variability in the linear trajectories of negative affect, χ2 (52) = 73.55, p = .026. On average, positive affect decreased at a significant daily rate, t(52) = −3.46, p < .001, and there was significant between-subject variability, χ2 (52) = 105.05, p < .001. The Intraclass Correlation Coefficients (ICCs) from the unconditional models excluding time were as follows: .576 for negative affect, .488 for positive affect, and .601 for relationship satisfaction. This indicates that a large proportion of the total variance was between subjects. It is customary to observe relatively high ICCs (often exceeding .40) when nesting repeated measures within person (Peugh, 2010).

Table 1.

Descriptive Statistics

M SD N
Satisfaction with Intimate Relationship
Quality (Possible Range: 1–9)
Day 1 5.95 2.48 41
Day 2 6.39 2.02 44
Day 3 6.45 2.29 38
Day 4 6.59 2.12 32
Day 5 5.93 2.50 39
Day 6 6.22 2.48 40
Day 7 6.09 2.57 35
Day 8 6.01 2.44 39
Day 9 6.00 2.57 34
Day 10 5.75 2.41 33
Day 11 5.54 2.65 40
Day 12 6.09 2.52 33
Day 13 5.63 2.79 35
Day 14 6.63 2.58 31
Negative Affect (Possible Range: 10–50)
Day 1 17.92 6.73 41
Day 2 15.92 5.70 44
Day 3 16.01 6.77 40
Day 4 16.14 6.22 38
Day 5 16.58 7.10 43
Day 6 16.57 7.92 42
Day 7 17.09 7.97 37
Day 8 16.51 6.93 41
Day 9 16.73 7.51 35
Day 10 16.09 7.56 37
Day 11 18.85 9.81 41
Day 12 16.98 7.88 36
Day 13 17.76 7.11 37
Day 14 17.00 7.55 34
Positive Affect (Possible Range: 10–50)
Day 1 25.52 7.75 41
Day 2 27.75 8.75 44
Day 3 24.63 8.04 40
Day 4 25.04 9.59 38
Day 5 25.10 9.14 43
Day 6 25.63 9.45 42
Day 7 24.40 8.29 37
Day 8 24.17 8.73 41
Day 9 23.83 9.18 35
Day 10 23.14 8.30 37
Day 11 23.40 9.81 41
Day 12 24.52 8.57 36
Day 13 21.41 8.94 37
Day 14 23.50 8.07 34
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Reciprocal Links Between Satisfaction with Relationship Functioning and Mood

Results are reported in Tables 2 and 3 and support our hypothesis that satisfaction across multiple domains of the intimate relationship and mood change in concert with one another over time for low-income outpatients seeking community mental health services. Greater daily decline in relationship satisfaction was associated with greater escalation in negative affect and decline in positive affect over the 14 days. Further, to the extent that negative affect increased and positive affect decreased across the 14 days, satisfaction declined at a faster rate. By controlling for time in the GCA models, we could test whether daily changes in one variable were associated with deviations from average trajectories of the other variable, providing evidence for the dynamic, reciprocal association between satisfaction with daily relationship functioning and mood. The associations between changes in satisfaction and mood did not vary as a function of survey method (paper versus online) or length of intimate relationship. Further, the reciprocal associations between relationship satisfaction and daily mood did not vary as a function of objective ratings of intimate relationship quality made by trained interviewers during the laboratory visit (i.e., RQI scores), ts ranged from −1.28 to 1.81, ps > .05.

Table 2.

GCA Results: Relationship Satisfaction Predicts Mood

Negative Affect Model (as Outcome)
Fixed Effect Coeff. SE t-ratio df p-value
Intercept, π0
 β00 16.55 0.72 23.03 52 <0.001
Time slope, π1
 β10 0.01 0.06 0.13 52 0.900
Relationship slope, π2
 β20 ‒1.07 0.27 ‒3.93 50 <0.001
 β21 (Survey Method) 0.30 0.31 0.98 50 0.332
 β22 (Length) 0.00 0.00 ‒0.61 50 0.546
Positive Affect Model (as Outcome)
Fixed Effect Coeff. SE t-ratio df p-value
Intercept, π0
 β00 26.26 0.92 28.49 52 <0.001
Time slope, π1
 β10 ‒0.30 0.09 ‒3.18 52 0.002
Relationship slope, π2
 β20 1.33 0.29 4.52 50 <0.001
 β21 (Survey Method) ‒0.06 0.44 ‒0.14 50 0.890
 β22 (Length) 0.00 0.00 ‒0.04 50 0.971
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Coeff. = unstandardized coefficients for all fixed parameters. The parameters of interest, representing the associations between daily levels of intimate relationship satisfaction and same-day mood, are bolded. The associations between daily relationship satisfaction and daily mood did not vary as a function of Survey Method (paper versus online) or relationship length (Length).

Table 3.

GCA Results: Mood Predicts Relationship Satisfaction

Negative Affect Model (as Predictor)
Fixed Effect Coeff. SE t-ratio df p-value
Intercept, π0
 β00 6.18 0.27 22.52 52 <0.001
Time slope, π1
 β10 ‒0.02 0.02 ‒0.95 52 0.348
Mood slope, π2
 β20 ‒0.15 0.03 ‒5.67 50 <0.001
 β21 (Survey Method) 0.04 0.04 1.03 50 0.309
 β22 (Length) 0.00 0.00 ‒0.50 50 0.620
Positive Affect Model (as Predictor)
Fixed Effect Coeff. SE t-ratio df p-value
Intercept, π0
 β00 5.97 0.30 19.88 52 <0.001
Time slope, π1
 β10 0.01 0.02 0.65 52 0.522
Mood slope, π2
 β20 0.07 0.02 3.80 50 <0.001
 β21 (Survey Method) 0.03 0.03 0.89 50 0.377
 β22 (Length) 0.00 0.00 0.35 50 0.730
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Coeff. = unstandardized coefficients for all fixed parameters. The parameters of interest, representing the associations between daily levels of mood and same-day intimate relationship satisfaction, are bolded. The associations between daily relationship satisfaction and daily mood did not vary as a function of Survey Method (paper versus online) or relationship length (Length).

Discussion

Results of the present study suggest that changes in satisfaction with daily interactions with one’s intimate partner significantly alter mood trajectories over two weeks. Further, the reverse effect was found such that deterioration of mood (decline in positive affect and increase in negative affect) was associated with less satisfying interactions in one’s intimate relationship over time. This reciprocal, bidirectional association was demonstrated in a sample of low SES outpatients seeking community mental health services, a population that tends to be underrepresented in research despite having an elevated risk for both interpersonal and individual distress (Conger et al., 2010; Gurman, 2010; Lorant et al., 2003). To our knowledge, this study represents one of the first investigations of the association between daily mood states and intimate relationship satisfaction in this at-risk population.

Results have implications for informing existing conceptual frameworks linking couple and family discord to individual distress and dysfunction, such as the CFDM (Beach, Sandeen, & O’Leary, 1990; Beach, 2014). The CFDM proposes that depressed mood and relationship discord reciprocally influence one another, and longitudinal studies have demonstrated that these processes covary over long periods of time (e.g., Davila et al., 2003), eventually contributing to both relationship dissolution and major depression (Breslau et al., 2011; Bruce & Kim 1992; Whisman & Bruce, 1999). Critically, our work points to the immediate nature of this dynamic process as it unfolds on a daily basis. Our findings, in combination with prior work, suggest that the daily processes maintaining relationship dissatisfaction and mood states closely tied to depression (Watson, 2005) are far from inconsequential; rather, they appear to compound over time and likely feed into the very processes that contribute to negative long-term outcomes. Further, given that study aims were pursued in a sample of low-income outpatients, results indicate that this process is generalizable to individuals experiencing considerable economic hardship, significant relationship distress and instability, and enough impairment to prompt treatment-seeking behavior.

Notably, this research did not test the efficacy of couple-based interventions for treating depression. Further, we focused on the daily experiences of individual outpatients in their intimate relationships rather than couples. Consequently, implications for couple-based interventions must be interpreted with caution. Nonetheless, we found evidence of the dynamic interplay between daily mood states associated with depression and dissatisfaction with daily interactions with one’s intimate partner. This points to the potential for interventions targeting intimate relationship dysfunction to not only enhance the quality of the relationship between partners but also promote positive and mitigate negative mood states (see Whisman, Johnson, Be, & Li, 2012 for a review).

Indeed, treatment studies demonstrate that depressed individuals in discordant relationships are less likely to experience improvements in mood symptoms following individual treatment for depression if interventions do not adequately address the interpersonal problems contributing to the symptoms (see Whisman & Baucom, 2012 for a review). Consequently, Whisman and Baucom (2012) advocate for referral to couple therapy, particularly if relationship dysfunction is relatively severe. For example, Behavioral Couple Therapy (BCT) and Cognitive-Behavioral Couples Therapy (CBCT) are empirically supported treatments that produce significant long-term improvements in individuals with depression, as well as reductions in marital dissatisfaction for distressed couples (Barbato & D’Avanzo, 2008; Nathan & Gorman, 2007; see Fischer, Baucom, & Cohen, 2016 and Whisman, Johnson, Be, & Li, 2012 for reviews). Further, Whisman and Baucom (2012) have suggested multiple ways of including partners in individual treatment (e.g., partner-assisted or disorder-specific interventions); this approach seems especially relevant for low-income patients who might lack the resources to afford couple counseling, especially given this form of treatment is not routinely covered by insurance or offered at community mental health clinics. Nonetheless, future research is necessary to demonstrate the efficacy of couple-based interventions in this population.

Limitations and Future Directions

Several limitations of the current study deserve mention. First, the sample was modest in size and a number of participants were missing daily diary data; however, this is not surprising given that (a) low-income, treatment-seeking populations are significantly more difficult to recruit and retain compared to community samples (e.g., Blumenthal, Sung, Coates, Williams, & Liff, 1995; Katz et al., 2001) and (b) study procedures were time intensive. Further, we utilized a well-established data analytic technique (GCA/MLM) that performs well in small samples and in the context of missing data, and we implemented robust measures of daily mood and satisfaction with relationship functioning. Nonetheless, it will be important to examine larger samples in future research. Relatedly, although we collected data from both males and females, our sample size prohibited us from examining whether effects varied by gender. Second, because our study inclusion criteria were relatively broad, producing a heterogeneous sample, this may have resulted in lowered internal validity. For example, although our sample was comprised of outpatients seeking services from community mental health centers, we did not collect information about the specific nature of the treatment being received or the length of time in which participants were in treatment. It is possible that the association between relationship satisfaction and mood varies across different treatment contexts. However, our findings are also likely to generalize more broadly to a representative sample of outpatients who are experiencing significant psychopathology (i.e., diagnosable, highly comorbid, and associated with functional impairment) regardless of their current treatment. Third, although we collected data from both female and male participants, we did not recruit couples, and were thus unable to obtain reports from both partners about the relationship. Dyadic data is particularly useful for examining the extent to which couples are affected by one another’s psychological symptoms and behaviors. This limitation is mitigated by the in-depth interviews and robust daily measures of satisfaction with relationship functioning obtained over 2 weeks; however, future research should include both partners to gather more complete information about the dyadic processes that influence depressive symptoms.

Although our daily diary design largely enabled us to circumvent problems specific to retrospective reporting, a small amount of retrospective recall bias exists because participants were asked to report on daily events before going to bed in the evening. However, this bias is considerably less than would be expected in studies with larger intervals between assessments (e.g., months, years; Bolger & Laurenceau, 2013). Further, it is possible that the significant association between daily satisfaction with relationship quality and daily mood could be an artifact of shared method variance (self-report surveys) or response bias. Finally, mood itself may have influenced ratings of satisfaction with relationship functioning, such that participants experiencing greater negative affect were more likely to perceive their relationship as dissatisfying. However, this limitation is offset by the fact that prior to making relationship satisfaction ratings across key domains, participants were primed to consider concrete behavioral indicators of interactions occurring that day, specific to each domain of our multifaceted measure of relationship quality.

Our study contributes to accumulating evidence of a reciprocal association between intimate relationships and mental health and demonstrates the immediate nature of this dynamic association as it evolves over time; however, future research should be conducted in more diverse samples to increase the generalizability of results. Most investigations of depression and intimate relationship functioning have been conducted with heterosexual, predominantly white, early adult relationships. Similarly, our sample was largely comprised of heterosexual, white women who reported being in a relationship with their current partner for over 7.5 years; however, almost half of participants reported separating from their current partner at some point in their relationship, suggesting a notable degree of relationship instability. Further, on average, relationship satisfaction in this sample (M = 28.00, SD = 13.32) was markedly lower than mean satisfaction reported in community samples of couples (e.g., M = 40.64, SD = 4.87; Brock & Lawrence, 2008); thus, as intended with our recruitment strategy, results are representative of a unique subsample of the population that is at particular risk for persistent and significant relationship dysfunction. Nonetheless, further research is needed to examine these processes among other underrepresented groups (e.g., same sex couples, racial/ethnic minorities).

Conclusion

A large body of research demonstrates a robust link between intimate relationship discord and depression. Results of the present study extend this work by demonstrating the dynamic, reciprocal association between satisfaction with daily experiences in one’s intimate relationship and daily mood states closely tied to depression in an at-risk sample of low-income outpatients. Participants completed semi-structured interviews that facilitated reflection about various aspects of the relationship prior to reporting about interactions with their partners unfolding on a daily basis; thus, we demonstrated this dynamic process using a relatively robust indicator of daily relationship satisfaction that was anchored in reports of specific dyadic behaviors (e.g., emotional disclosures, displays of love and affection, responses to help-seeking, decision-making efforts, behaviors during disagreements). Results have implications for informing existing conceptual frameworks linking couple discord to individual distress and dysfunction by demonstrating the immediate nature of this dynamic process as it unfolds on a daily basis.

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Footnotes

1

The quality of the sexual relationship has received limited attention in research aimed at explaining the link between intimate relationship quality and depression. Further, the omission of sexual functioning from the present study reduces potential confounds that would be introduced due to well-documented sexual side-effects of antidepressant medications (i.e., decreased libido, delayed orgasm; Montejo, Montejo, & Navarro-Cremades, 2015).

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