Tatiana Gray - Academia.edu (original) (raw)

Papers by Tatiana Gray

Research paper thumbnail of Are marital relationships a barrier to health care utilization in Southern Appalachia?: A dyadic examination of the link between marital quality and individual health care usage

Families, Systems, & Health, Sep 1, 2020

INTRODUCTION There are substantial health disparities in Appalachia partially due to the poor acc... more INTRODUCTION There are substantial health disparities in Appalachia partially due to the poor access and utilization of health care. Social support, especially in Appalachia, is consistently linked to the utilization of available health care. The present study aims to identify how on aspect of social support, relationship functioning, are associated with health care utilization for couples in Southern Appalachian. METHOD Individual and couple data (N = 147, individuals; n = 76, couples) were collected from participants interested in a brief couple interventions. Individuals and Dyadic Path analyses were conducted in Mplus using methods to account for the dependence in the data. RESULTS Relational aggression was the only marital factor linked to health care utilization in multivariate analyses while constructive communication was only linked to health care utilization in bivariate correlations, r = .24, p < .05. Dyadic results indicate that men's health care utilization may benefit from partner's relational aggression while women's utilization may be negatively influenced by her own self-reported relational aggression. DISCUSSION An individual's social context must be considered in order to completely understand barriers to health care utilization. Further, the inclusion of couple/dyadic level interventions should be considered in order to improve health care utilization in the Appalachian region and similarly rural regions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Research paper thumbnail of The Better Part of Valor: Developing a System for Studying How Couples Transition Out of Untimely Conflict Conversations

Journal of relationships research, 2015

This study employed a novel methodological design to explore how couples transition out of a disa... more This study employed a novel methodological design to explore how couples transition out of a disagreement that they do not have time to resolve. Thirty college-aged dating couples participated in a 20-minute interaction with their partner where they were required to transition from a conflict conversation to the story of how they met, in a time-limited paradigm. Independent coders coded transition styles and couples completed self-report measures of relationship satisfaction pre, post, and at 6-month follow-up. We identified four transition styles: Mutual Avoidant, Mutual Collaborative, Abrupt/Controlling, and Resign/Withdraw. Couples with a Resign/Withdraw style deteriorated over time compared to couples with the other three styles. Further, couples also varied in terms of transition qualities, including how easily they disengaged and how deeply meaningful the conversation was. Ease of transition was associated with increases in relationship satisfaction at 6 months, whereas depth was associated with decreases in relationship satisfaction both immediately after the interaction and at 6 months. Implications are discussed.

Research paper thumbnail of Dyadic latent profile analyses and multilevel modeling to examine differential response to couple relationship education

Journal of Family Psychology, Oct 1, 2020

There are mixed evaluations of couple relationship education indicating that these types of inter... more There are mixed evaluations of couple relationship education indicating that these types of interventions may be more or less effective depending on the couple type and demographic differences. However, this ambiguity requires more investigation with advanced statistical analyses that use a person-centered approach such as mixture modeling. We tested this hypothesis with a sample of different-sex couples (N ϭ 455 couples) who participated in a brief in-home couple intervention. We used dyadic latent profile analysis to determine possible relationship health typologies (RHTs) of presenting couples and multilevel models to examine differential intervention effectiveness between these RHTs. Results indicated there were 3 RHT: Partners Below Average with Wife Much Lower RHT (18%), Partners Below Average with Men Slightly Lower RHT (26%), and Partner Both Above Average RHT, (56%). RHTs did not differ by demographics. Below Average and Wife Lower RHTs responded the best to the brief couple intervention. In sum, we find that a brief intervention that targets the specific concerns of the couples may improve outcomes for multiple RHT.

Research paper thumbnail of Affirmative Adaptations of the Relationship Checkup to Meet the Needs of LGBTQ Couples

Journal of couple & relationship therapy, Nov 23, 2022

Research paper thumbnail of The Path of Emotional Least Resistance: Developing Theory Based on the Self-Reported Strengths of Happy and Distressed Couples in the Marriage Checkup

Journal of relationships research, 2018

This study examined the qualitative differences between the types of strengths identified by sati... more This study examined the qualitative differences between the types of strengths identified by satisfied versus distressed couples seeking a Marriage Checkup. We hypothesised that distressed couples would nominate less intimate strengths, while satisfied couples would nominate more intimate strengths. We found that distressed partners were significantly more likely to nominate items from a Parallel Support category, whereas satisfied women, but not men, were significantly more likely to nominate items from an Intimate/Affectionate category. These findings suggest that an indicator of developing couple distress is the point where couples begin to focus their attention on less emotionally vulnerable relationship aspects.

Research paper thumbnail of The Marriage Checkup: A randomized controlled trial of annual relationship health checkups

Journal of Consulting and Clinical Psychology, 2014

Objective-This study assessed the efficacy of the Marriage Checkup for improving relationship hea... more Objective-This study assessed the efficacy of the Marriage Checkup for improving relationship health and intimacy.

Research paper thumbnail of Affirmative Adaptations of the Relationship Checkup to Meet the Needs of LGBTQ Couples

Journal of Couple & Relationship Therapy

Research paper thumbnail of Marriage checkup in integrated primary care: A randomized controlled trial with active-duty military couples

Journal of Consulting and Clinical Psychology

Research paper thumbnail of Are marital relationships a barrier to health care utilization in Southern Appalachia?: A dyadic examination of the link between marital quality and individual health care usage

Families, Systems, & Health, 2020

INTRODUCTION There are substantial health disparities in Appalachia partially due to the poor acc... more INTRODUCTION There are substantial health disparities in Appalachia partially due to the poor access and utilization of health care. Social support, especially in Appalachia, is consistently linked to the utilization of available health care. The present study aims to identify how on aspect of social support, relationship functioning, are associated with health care utilization for couples in Southern Appalachian. METHOD Individual and couple data (N = 147, individuals; n = 76, couples) were collected from participants interested in a brief couple interventions. Individuals and Dyadic Path analyses were conducted in Mplus using methods to account for the dependence in the data. RESULTS Relational aggression was the only marital factor linked to health care utilization in multivariate analyses while constructive communication was only linked to health care utilization in bivariate correlations, r = .24, p < .05. Dyadic results indicate that men's health care utilization may benefit from partner's relational aggression while women's utilization may be negatively influenced by her own self-reported relational aggression. DISCUSSION An individual's social context must be considered in order to completely understand barriers to health care utilization. Further, the inclusion of couple/dyadic level interventions should be considered in order to improve health care utilization in the Appalachian region and similarly rural regions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Research paper thumbnail of Relationship Concerns

Principle-Based Stepped Care and Brief Psychotherapy for Integrated Care Settings, 2018

Research paper thumbnail of The Marriage Checkup: A public health approach to marital wellbeing

S:lnrfrc,rnt events also happened witliin .-: !r[.inizarion. As rr,e reported in the last j,. sq ... more S:lnrfrc,rnt events also happened witliin .-: !r[.inizarion. As rr,e reported in the last j,. sq lrircd e constrlring company lo :'.-:.luare our organization. The idea l-ras. , rq been floating in the air. During one of ',:r inancial committee meetings, Mike ,-rr ,nko nored thet. since our urganrzation * as rn excellent financial hcalth, it might be :Lmc to seriously look into hiring a consuit-:nc ilrm to address lingering questions :bout grolvth, membership, direction, op-.rations, structure, location, etc. Alter some-rreful cleliberatiofl, we quickly agreed that 1r might be time to ger serious about hiring .r consulting companf This was not indica-:ive of a crisis. To rhe conuar1,, hiring consuiting firms is goocl pracrice for any ,ru.rnizarion thlr wenrs to rem.rin rcsponsive to membership needs ancl to the current and future challenges ahead. Given the profound-and necessary-cl-ranges in health care our counrry is undergoing, r,,,e thought it rvas high rime to go ahead wit}r the organizational assessment. Thanks to the recommendarion of Lynn Br-rika, u,ho is u,orking for the American Psychological Association, we added McKinley Advisors to the possible consultants we considered. After interviewing McKinley Advisors (as well as a f-ev,,others), we knew that we founcl the right partner. McKinley Advisors are cxperienced cor-rsultants who speciaiize in nonprofit organizations and work rvith many relatecl health-care organizations, including the American Psychological Associatior-r. \7e \vere very satisfiecl rvith tl-reir work. Many people rvcre involved in tl-ris process and volunteered their llmg-166 many to acknon'ledge here. Instead, I rvanr to say 21 general and hearty thanks to all of you rvho spent countless hours or-r the pl-rone and in meetings with us and rvho helped develop an.i implement t1're report. The process through rvhich rl,e accomplished our goals made it crysral clear to ajl of us that our organization is in excellent heairh, not only financiali1,, Lrut trlso structurally and. .. *,e11, emotionallv. The consultants often commenteci on our exceptional commitment ro the organization, rvl-ricl'r is not just any profcssional organization br_rt our academic and professional l-rome and fhmilr,. I rvould like to thank the central office; the Board, and especially Denise Davis, Deb Hope, Bob Klepac, and Dean McKay, r.,n,ho u,ere closely involved in this data-gathering process. rVorking with you and many otl-rers has been a real privilege. You are an amazing bunch. I rvould also like to thank many of our Past Presidents fbr their guiclance and advice and to rhe many members who participated in the membership survey that rVcKinlel, conducted. \)7e s,'i11. of course, provicle upclates of our progrcss as u,e move ahead. ABCT is like a big tanker sailing in a rough end !onsrxnrJ) ,lt.rnging s(3i any change in direction requires careful maneuvering; and its effect \\,on'r be noticeable ir-r the immediate future. It looks like our slip is on course to a bright future, It's Lreen an amazing journer..

Research paper thumbnail of The Marriage Checkup: A randomized controlled trial of annual relationship health checkups

Journal of Consulting and Clinical Psychology, 2014

Objective-This study assessed the efficacy of the Marriage Checkup for improving relationship hea... more Objective-This study assessed the efficacy of the Marriage Checkup for improving relationship health and intimacy.

Research paper thumbnail of Marriage checkup in integrated primary care: A randomized controlled trial with active-duty military couples

Journal of Consulting and Clinical Psychology, May 1, 2022

Research paper thumbnail of The Before Baby Relationship Checkup: A Couples-Based Intervention to Reduce Relationship Risk Factors for Perinatal Mood and Anxiety Disorders

Journal of Clinical Psychology in Medical Settings

Research paper thumbnail of Attitudes toward relationship treatment among underserved couples

Couple and Family Psychology: Research and Practice

Research paper thumbnail of Dyadic latent profile analyses and multilevel modeling to examine differential response to couple relationship education

Journal of Family Psychology

Research paper thumbnail of Your place or mine?: Examining the accessibility and efficacy of a brief, home-based, couple intervention

Journal of Family Psychology

Research paper thumbnail of Randomized Controlled Trial of the Marriage Checkup: Depression Outcomes

Journal of Marital and Family Therapy

Research paper thumbnail of Consensus and relationship distress before and after a brief couples’ intervention

Journal of Family Psychology

Research paper thumbnail of The Path of Emotional Least Resistance: Developing Theory Based on the Self-Reported Strengths of Happy and Distressed Couples in the Marriage Checkup

Journal of Relationships Research

This study examined the qualitative differences between the types of strengths identified by sati... more This study examined the qualitative differences between the types of strengths identified by satisfied versus distressed couples seeking a Marriage Checkup. We hypothesised that distressed couples would nominate less intimate strengths, while satisfied couples would nominate more intimate strengths. We found that distressed partners were significantly more likely to nominate items from a Parallel Support category, whereas satisfied women, but not men, were significantly more likely to nominate items from an Intimate/Affectionate category. These findings suggest that an indicator of developing couple distress is the point where couples begin to focus their attention on less emotionally vulnerable relationship aspects.

Research paper thumbnail of Are marital relationships a barrier to health care utilization in Southern Appalachia?: A dyadic examination of the link between marital quality and individual health care usage

Families, Systems, & Health, Sep 1, 2020

INTRODUCTION There are substantial health disparities in Appalachia partially due to the poor acc... more INTRODUCTION There are substantial health disparities in Appalachia partially due to the poor access and utilization of health care. Social support, especially in Appalachia, is consistently linked to the utilization of available health care. The present study aims to identify how on aspect of social support, relationship functioning, are associated with health care utilization for couples in Southern Appalachian. METHOD Individual and couple data (N = 147, individuals; n = 76, couples) were collected from participants interested in a brief couple interventions. Individuals and Dyadic Path analyses were conducted in Mplus using methods to account for the dependence in the data. RESULTS Relational aggression was the only marital factor linked to health care utilization in multivariate analyses while constructive communication was only linked to health care utilization in bivariate correlations, r = .24, p < .05. Dyadic results indicate that men's health care utilization may benefit from partner's relational aggression while women's utilization may be negatively influenced by her own self-reported relational aggression. DISCUSSION An individual's social context must be considered in order to completely understand barriers to health care utilization. Further, the inclusion of couple/dyadic level interventions should be considered in order to improve health care utilization in the Appalachian region and similarly rural regions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Research paper thumbnail of The Better Part of Valor: Developing a System for Studying How Couples Transition Out of Untimely Conflict Conversations

Journal of relationships research, 2015

This study employed a novel methodological design to explore how couples transition out of a disa... more This study employed a novel methodological design to explore how couples transition out of a disagreement that they do not have time to resolve. Thirty college-aged dating couples participated in a 20-minute interaction with their partner where they were required to transition from a conflict conversation to the story of how they met, in a time-limited paradigm. Independent coders coded transition styles and couples completed self-report measures of relationship satisfaction pre, post, and at 6-month follow-up. We identified four transition styles: Mutual Avoidant, Mutual Collaborative, Abrupt/Controlling, and Resign/Withdraw. Couples with a Resign/Withdraw style deteriorated over time compared to couples with the other three styles. Further, couples also varied in terms of transition qualities, including how easily they disengaged and how deeply meaningful the conversation was. Ease of transition was associated with increases in relationship satisfaction at 6 months, whereas depth was associated with decreases in relationship satisfaction both immediately after the interaction and at 6 months. Implications are discussed.

Research paper thumbnail of Dyadic latent profile analyses and multilevel modeling to examine differential response to couple relationship education

Journal of Family Psychology, Oct 1, 2020

There are mixed evaluations of couple relationship education indicating that these types of inter... more There are mixed evaluations of couple relationship education indicating that these types of interventions may be more or less effective depending on the couple type and demographic differences. However, this ambiguity requires more investigation with advanced statistical analyses that use a person-centered approach such as mixture modeling. We tested this hypothesis with a sample of different-sex couples (N ϭ 455 couples) who participated in a brief in-home couple intervention. We used dyadic latent profile analysis to determine possible relationship health typologies (RHTs) of presenting couples and multilevel models to examine differential intervention effectiveness between these RHTs. Results indicated there were 3 RHT: Partners Below Average with Wife Much Lower RHT (18%), Partners Below Average with Men Slightly Lower RHT (26%), and Partner Both Above Average RHT, (56%). RHTs did not differ by demographics. Below Average and Wife Lower RHTs responded the best to the brief couple intervention. In sum, we find that a brief intervention that targets the specific concerns of the couples may improve outcomes for multiple RHT.

Research paper thumbnail of Affirmative Adaptations of the Relationship Checkup to Meet the Needs of LGBTQ Couples

Journal of couple & relationship therapy, Nov 23, 2022

Research paper thumbnail of The Path of Emotional Least Resistance: Developing Theory Based on the Self-Reported Strengths of Happy and Distressed Couples in the Marriage Checkup

Journal of relationships research, 2018

This study examined the qualitative differences between the types of strengths identified by sati... more This study examined the qualitative differences between the types of strengths identified by satisfied versus distressed couples seeking a Marriage Checkup. We hypothesised that distressed couples would nominate less intimate strengths, while satisfied couples would nominate more intimate strengths. We found that distressed partners were significantly more likely to nominate items from a Parallel Support category, whereas satisfied women, but not men, were significantly more likely to nominate items from an Intimate/Affectionate category. These findings suggest that an indicator of developing couple distress is the point where couples begin to focus their attention on less emotionally vulnerable relationship aspects.

Research paper thumbnail of The Marriage Checkup: A randomized controlled trial of annual relationship health checkups

Journal of Consulting and Clinical Psychology, 2014

Objective-This study assessed the efficacy of the Marriage Checkup for improving relationship hea... more Objective-This study assessed the efficacy of the Marriage Checkup for improving relationship health and intimacy.

Research paper thumbnail of Affirmative Adaptations of the Relationship Checkup to Meet the Needs of LGBTQ Couples

Journal of Couple & Relationship Therapy

Research paper thumbnail of Marriage checkup in integrated primary care: A randomized controlled trial with active-duty military couples

Journal of Consulting and Clinical Psychology

Research paper thumbnail of Are marital relationships a barrier to health care utilization in Southern Appalachia?: A dyadic examination of the link between marital quality and individual health care usage

Families, Systems, & Health, 2020

INTRODUCTION There are substantial health disparities in Appalachia partially due to the poor acc... more INTRODUCTION There are substantial health disparities in Appalachia partially due to the poor access and utilization of health care. Social support, especially in Appalachia, is consistently linked to the utilization of available health care. The present study aims to identify how on aspect of social support, relationship functioning, are associated with health care utilization for couples in Southern Appalachian. METHOD Individual and couple data (N = 147, individuals; n = 76, couples) were collected from participants interested in a brief couple interventions. Individuals and Dyadic Path analyses were conducted in Mplus using methods to account for the dependence in the data. RESULTS Relational aggression was the only marital factor linked to health care utilization in multivariate analyses while constructive communication was only linked to health care utilization in bivariate correlations, r = .24, p < .05. Dyadic results indicate that men's health care utilization may benefit from partner's relational aggression while women's utilization may be negatively influenced by her own self-reported relational aggression. DISCUSSION An individual's social context must be considered in order to completely understand barriers to health care utilization. Further, the inclusion of couple/dyadic level interventions should be considered in order to improve health care utilization in the Appalachian region and similarly rural regions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Research paper thumbnail of Relationship Concerns

Principle-Based Stepped Care and Brief Psychotherapy for Integrated Care Settings, 2018

Research paper thumbnail of The Marriage Checkup: A public health approach to marital wellbeing

S:lnrfrc,rnt events also happened witliin .-: !r[.inizarion. As rr,e reported in the last j,. sq ... more S:lnrfrc,rnt events also happened witliin .-: !r[.inizarion. As rr,e reported in the last j,. sq lrircd e constrlring company lo :'.-:.luare our organization. The idea l-ras. , rq been floating in the air. During one of ',:r inancial committee meetings, Mike ,-rr ,nko nored thet. since our urganrzation * as rn excellent financial hcalth, it might be :Lmc to seriously look into hiring a consuit-:nc ilrm to address lingering questions :bout grolvth, membership, direction, op-.rations, structure, location, etc. Alter some-rreful cleliberatiofl, we quickly agreed that 1r might be time to ger serious about hiring .r consulting companf This was not indica-:ive of a crisis. To rhe conuar1,, hiring consuiting firms is goocl pracrice for any ,ru.rnizarion thlr wenrs to rem.rin rcsponsive to membership needs ancl to the current and future challenges ahead. Given the profound-and necessary-cl-ranges in health care our counrry is undergoing, r,,,e thought it rvas high rime to go ahead wit}r the organizational assessment. Thanks to the recommendarion of Lynn Br-rika, u,ho is u,orking for the American Psychological Association, we added McKinley Advisors to the possible consultants we considered. After interviewing McKinley Advisors (as well as a f-ev,,others), we knew that we founcl the right partner. McKinley Advisors are cxperienced cor-rsultants who speciaiize in nonprofit organizations and work rvith many relatecl health-care organizations, including the American Psychological Associatior-r. \7e \vere very satisfiecl rvith tl-reir work. Many people rvcre involved in tl-ris process and volunteered their llmg-166 many to acknon'ledge here. Instead, I rvanr to say 21 general and hearty thanks to all of you rvho spent countless hours or-r the pl-rone and in meetings with us and rvho helped develop an.i implement t1're report. The process through rvhich rl,e accomplished our goals made it crysral clear to ajl of us that our organization is in excellent heairh, not only financiali1,, Lrut trlso structurally and. .. *,e11, emotionallv. The consultants often commenteci on our exceptional commitment ro the organization, rvl-ricl'r is not just any profcssional organization br_rt our academic and professional l-rome and fhmilr,. I rvould like to thank the central office; the Board, and especially Denise Davis, Deb Hope, Bob Klepac, and Dean McKay, r.,n,ho u,ere closely involved in this data-gathering process. rVorking with you and many otl-rers has been a real privilege. You are an amazing bunch. I rvould also like to thank many of our Past Presidents fbr their guiclance and advice and to rhe many members who participated in the membership survey that rVcKinlel, conducted. \)7e s,'i11. of course, provicle upclates of our progrcss as u,e move ahead. ABCT is like a big tanker sailing in a rough end !onsrxnrJ) ,lt.rnging s(3i any change in direction requires careful maneuvering; and its effect \\,on'r be noticeable ir-r the immediate future. It looks like our slip is on course to a bright future, It's Lreen an amazing journer..

Research paper thumbnail of The Marriage Checkup: A randomized controlled trial of annual relationship health checkups

Journal of Consulting and Clinical Psychology, 2014

Objective-This study assessed the efficacy of the Marriage Checkup for improving relationship hea... more Objective-This study assessed the efficacy of the Marriage Checkup for improving relationship health and intimacy.

Research paper thumbnail of Marriage checkup in integrated primary care: A randomized controlled trial with active-duty military couples

Journal of Consulting and Clinical Psychology, May 1, 2022

Research paper thumbnail of The Before Baby Relationship Checkup: A Couples-Based Intervention to Reduce Relationship Risk Factors for Perinatal Mood and Anxiety Disorders

Journal of Clinical Psychology in Medical Settings

Research paper thumbnail of Attitudes toward relationship treatment among underserved couples

Couple and Family Psychology: Research and Practice

Research paper thumbnail of Dyadic latent profile analyses and multilevel modeling to examine differential response to couple relationship education

Journal of Family Psychology

Research paper thumbnail of Your place or mine?: Examining the accessibility and efficacy of a brief, home-based, couple intervention

Journal of Family Psychology

Research paper thumbnail of Randomized Controlled Trial of the Marriage Checkup: Depression Outcomes

Journal of Marital and Family Therapy

Research paper thumbnail of Consensus and relationship distress before and after a brief couples’ intervention

Journal of Family Psychology

Research paper thumbnail of The Path of Emotional Least Resistance: Developing Theory Based on the Self-Reported Strengths of Happy and Distressed Couples in the Marriage Checkup

Journal of Relationships Research

This study examined the qualitative differences between the types of strengths identified by sati... more This study examined the qualitative differences between the types of strengths identified by satisfied versus distressed couples seeking a Marriage Checkup. We hypothesised that distressed couples would nominate less intimate strengths, while satisfied couples would nominate more intimate strengths. We found that distressed partners were significantly more likely to nominate items from a Parallel Support category, whereas satisfied women, but not men, were significantly more likely to nominate items from an Intimate/Affectionate category. These findings suggest that an indicator of developing couple distress is the point where couples begin to focus their attention on less emotionally vulnerable relationship aspects.