Long Term Effects of Premartial Intervention

描述(由申请人提供)：这项提案的总体目标是继续在宗教组织(ROS)向婚前伴侣提供的婚姻教育计划(准备、预防和加强关系计划)的大规模社区预防试验。这项计划旨在降低婚姻痛苦和相关心理健康问题的风险因素，并提高保护因素。鉴于婚姻痛苦和精神障碍之间的密切联系，预防因婚姻冲突而导致的精神障碍的努力比后来的、成本更高的治疗具有实质性的优势。将ROS作为一种提供系统的目标很重要，因为ROS已经成为许多不愿寻求心理健康专业人员服务的人预防和咨询的不那么耻辱的资源。这项工作评估了通过在关键的成年期过渡(即进入婚姻)期间最大限度地发挥功能来预防(与治疗)精神障碍的价值。这项工作建议跟踪217对夫妇的现有样本，进入痛苦和离婚的高危时期(结婚5-10年)，以评估婚前干预对婚姻痛苦和精神障碍症状的长期/持久预防效果。我们还将测试和完善我们的理论模型，即目标风险(例如，负面互动)和保护性因素(例如，处理冲突的信心)如何随着时间的推移与婚姻痛苦和精神障碍联系在一起。好处包括加强社区现有的“自然”干预措施(婚前咨询)，以及接触到可能不通过传统精神卫生系统寻求服务的人群(例如，男性、少数群体成员)。

DESCRIPTION (provided by applicant): The overarching aim of this proposal is to continue a large-scale community based prevention trial of a marriage education program (PREP, Prevention and Relationship Enhancement Program) delivered in Religious Organizations (ROs) to premarital couples. This program is designed to lower risk factors and raise protective factors for marital distress and associated mental health problems. Given the strong links between marital distress and mental disorders, efforts to prevent mental disorder due to marital conflict has substantial advantages over later and more costly treatment. Targeting ROs as a delivery system is important as ROs already serve as a less stigmatizing resource for prevention and counseling for many people who will not seek services from a mental health professional. This work assesses the value of preventing (vs. treating) mental disorders through maximizing functioning during a critical adulthood transition (i.e., entering marriage). This work proposes to follow an existing sample of 217 couples into a high risk period for distress and divorce (years 5-10 of marriage) in order to assess the long-term/durable preventative effects of premarital intervention on marital distress and symptoms of mental disorders. We will also test and refine our theoretical model of how targeted risk (e.g., negative interactions) and protective factors (e.g., confidence in handling conflicts) are linked over time to marital distress and mental disorder. Benefits include enhancing existing "natural" interventions in the community (premarital counseling) and of reaching a population who might not seek services through the traditional mental health system (e.g., men, minority group members).