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Depression, Marital Satisfaction and Communication in Couples: Investigating

Gender Differences

Article  in  Behavior therapy · September 2010

DOI: 10.1016/j.beth.2009.09.001 · Source: PubMed

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Behavior Therapy 41 (2010) 306 – 316

www.elsevier.com/locate/bt

Depression, Marital Satisfaction and Communication in Couples:

Investigating Gender Differences
Barbara Gabriel
Steven R.H. Beach
University of Georgia

Guy Bodenmann
University of Zuerich

& Blalock, 1999). Several studies have identified

The correlation between depression and dysfunctional
marital interaction is well documented, but only a few
studies have examined gender-related differences in marital
interaction patterns of couples with a depressed partner. In
this paper we examined differences in observed marital
communication in a sample of 62 Swiss couples presenting
for treatment of depression. There were 16 maritally
distressed couples with a depressed wife, 21 maritally
nondistressed couples with a depressed wife, 18 maritally
distressed couples with a depressed husband, and 7
maritally nondistressed couples with a depressed husband.
Marital interaction behavior was found to depend on
gender, depression, marital distress, as well as gender of
the depressed partner. Our results suggest the need for a
gender-sensitive model of the link between marital interac-
tion and depression.
INTERPERSONAL PROBLEMS AND SOCIAL deficits, espe-
cially in the marital context, are strongly associated
with the development, intensity, and course of
depression (Backenstrass, 1998; Beach, Jones, &
Franklin, 2008; Bodenmann, 2006; Joiner, Coyne,
This study was supported by the Swiss National Science
Foundation SNF 610-062901 and 100013-109547/1.
Address correspondence to Barbara Gabriel, Institute for
Behavioral Research, 514 Boyd, GSRC, University of Georgia,
Athens, GA 30602; e-mail: bar.gabriel@yahoo.com.
0005-7894/10/306–316$1.00/0
© 2010 Association for Behavioral and Cognitive Therapies. Published by
Elsevier Ltd. All rights reserved.
lack of verbal and nonverbal positivity, asymmetry
in interaction patterns, a higher level of passivity/
withdraw, negative statements (e.g., complaints,
negative self-statements) as well as negative reci-
procity in couples with a depressed partner (e.g.,
Backenstrass, 1998; Biglan et al., 1985; Gotlib &
Whiffen, 1989; Hautzinger, Linden, & Hoffman,
1982; Jacob & Leonard, 1992; Johnson & Jacob,
1997; Sher, Baucom, & Larus, 1990). Couples with
a depressed member are, on average, more negative,
less positive and less congenial in their marital
interactions compared to couples without a de-
pressed partner (e.g., Johnson & Jacob, 1997;
McCabe & Gotlib, 1993). In keeping with this
pattern, depressed persons display in their marital
communication a higher frequency of interruption,
expression of negative feelings, criticism and
defensiveness, as well as a lower level of nonverbal
positivity. The partners of the depressed persons, on
the other hand, show enhanced criticism and
negativity directed toward the depressed partner
and the marital relationship (e.g., Benazon &
Coyne, 2000; Hautzinger et al., 1982).
One might wonder, however, whether gender of
the depressed partner is associated with differences
in the patterns of interaction observed among
couples with a depressed partner. Relatively few
studies have compared couples with depressed
wives to couples with depressed husbands (see
Johnson & Jacob, 1997, 2000, for an exception).
As a consequence, gender-linked patterns in this
context are not currently well-understood. There
 depression, marital satisfaction, and communication
are several reasons to expect that gender-linked
patterns may be important in depression. Some
studies have found a different time course in the
connection between marital satisfaction and de-
pression as a function of gender, with evidence of
an effect of history of marital distress on future
depression for wives and evidence of an effect of
history of depression on future marital distress for
husbands (e.g., Fincham, Beach, Harold, &
Osborne, 1997; but see Kurdek, 1998, and Davila,
Karney, Hall, & Bradbury, 2003, for evidence of
gender similarity in time course). There is also
evidence of a gender difference in response to
negative feelings (see also Nolen-Hoeksema, 1990),
and this gender difference may be intensified by
depression (Wilhelm, Roy, Mitchell, Brownhill, &
Parker, 2002). In particular, men may be more
likely to engage in behaviors that minimize, distract
from, or avoid interactions that potentially produce
negative emotions, whereas women may be more
likely to confront, ruminate, and engage such
interactions, resulting in greater arousal and greater
display of negative emotion for depressed women
during interaction tasks than for depressed men.
In addition, there is a broader literature on
gender-linked differences in marital interaction
that suggest the importance of attending to gen-
der-linked patterns. To the extent that women are
more relationship-oriented than men, for example,
they may feel more responsible for the resolution of
relationship difficulties (Baucom, Notarius, Burnett,
& Haefner, 1990; Culp & Beach, 1998), whereas
men may focus more on independence (Culp &
Beach, 1998; Gottman, 1994; Klinetob & Smith,
1996). Additionally, wives exhibit higher frequen-
cies of both positively and negatively valenced
behavior in marital interactions than husbands,
including greater nonverbal positivity and increased
levels of affect expression like self-disclosure,
criticism, and complaints. Husbands, on the other
hand, display higher levels of nonaffective, task-
oriented behavior and instrumental advice, but also
display anger and blame avoidance at higher rates
and may be more conflict averse on average
(Baucom et al., 1990; Christensen & Heavey,
1990; Dindia & Allen, 1992; Gottman, 1994;
Klinetob & Smith, 1996).
Gender-linked patterns have also been captured
in research on demand/withdraw patterns and are
particularly salient when couples are allowed to
select their own discussion topic. In these situations,
wives tend to display higher levels of demand and
criticizing behavior, and husbands are more likely to
display defensive, withdrawal, and stonewalling
behaviors (e.g., Christensen & Heavey, 1990;
Eldridge & Christensen, 2002; Gottman, 1994;
307
Rehmann & Holtzworth-Munroe, 2006). Because a
part of the gender difference in demand-withdraw
patterns observed in previous research is due to
wives more commonly selecting the topic for couple
discussion when the source of the topic is not
specified by the therapist or researcher (e.g.,
Christensen & Heavey, 1990; Klinetob & Smith,
1996), it is important to assess who selects the topic
of discussion in each interaction. This demand-
withdraw pattern is strongly related to other
escalating coercive negative behaviors (e.g., con-
tempt, belligerence, domineering) as well as marital
and psychological distress (e.g., Christensen &
Shenk, 1991; Gottman, 1994; Gottman & Notarius,
2000).
Another line of research suggesting the impor-
tance of examining gender in combination with
depression and marital interaction was provided by
Marchand and Hock (2000). In their investigation
of correlates of self-reported attacking and avoid-
ance behavior in a community sample, husbands'
lower self-reported marital satisfaction was the only
predictor of attacking and the strongest predictor of
avoidance behavior, explaining between 15 and 20
percent of the variance. For wives, on the other
hand, higher self-reported depression was the only
predictor of avoidance and the best predictor of
attacking behavior, explaining 26 to 57 percent of
the variance in self-reported behavior in these
domains. Conversely, recent work including behav-
ioral observation did not support a consistent
pattern of results linking gender, depression,
marital satisfaction, and wife demand/husband
withdraw behavior (e.g., Baucom et al., 2007).
Accordingly, this is an area in need of further
investigation.
Despite much interest in the topic of gender roles
and depression and compelling reasons to examine
the impact of gender on depression-linked interac-
tion behavior, little is currently known about
gender differences in marital interaction in the
context of depression. The few available studies
suggest that couples with depressed wives show less
positivity and a trend to a higher negativity than
couples with a depressed husband (Jacob &
Leonard, 1992; Johnson & Jacob, 1997, 2000).
Depressed husbands, compared to control hus-
bands, tend to display less problem solving, lower
negative reciprocity, more positive reactions, and
have less impact on their wives' subsequent
behavior. Wives of depressed husbands, on the
other hand, are less likely to engage in positive
reciprocity and display increased negativity (e.g.,
Jacob & Leonard, 1992; Johnson & Jacob, 2000).
Consistent with the broader literature on gender
differences, affect-relevant communication in
308 gabriel et al.
couples seems to be more strongly influenced by
wives. Thus, as for all gender differences, it is likely
that commonalities in the behavior in couples of
depressed wives and depressed husbands will be
greater than will differences (Johnson & Jacob,
1997). However, existing results indicate accentu-
ation of gender-typical interaction patterns associ-
ated with marital distress depending on the gender
of the depressed person.
It is also important to note that not all couples
with a depressed partner experience marital dis-
cord. Based on an extensive review of published
work, Whisman (2001) reported that the average
Dyadic Adjustment Scale (DAS) score of persons
diagnosed with depression (DAS = 93) was in the
distressed range and approximately 1 3/4 standard
deviations below the comparison sample. Since the
cutoff for marital discord on the DAS is 98, this
finding also indicates that many couples with a
depressed partner do not score in the discordant
range of the DAS. Coyne, Thompson, and Palmer
(2002) reported similar findings in their study of 38
depressed outpatients and 35 depressed inpatients
who they compared to a community sample.
Replicating and extending the Whisman (2001)
results, they found that approximately two thirds of
the outpatients and approximately one half of the
inpatients scored in the distressed range of the DAS.
Thus, marital relationships are often (but not
always) distressed among depressed men and
women.
Because some interaction behaviors may be more
tightly connected to level of marital distress in the
context of depression than others, it is necessary to
examine both maritally distressed and maritally
nondistressed couples with a depressed partner and
contrast their interaction patterns. In studies that
have examined this issue, relatively few problematic
interaction behaviors have been found to be tied
directly to level of depression (Schmaling &
Jacobson, 1990). Interaction behavior that is
more tightly connected to level of depression
includes more negative statements and less con-
flict-resolution-oriented behavior. In contrast,
greater marital distress is associated with a range
of negative or aggressive behavior during marital
interactions as well as less positive or facilitative
behavior (Hautzinger et al., 1982; Jackman-Cram,
Dobson, & Martin, 2006; Nelson & Beach, 1990;
Schmaling & Jacobson, 1990).
In the present paper we investigated differences in
the observed marital interaction between four
groups. Groups were distinguished on the basis of
marital satisfaction and the gender of the patient
(G1 = maritally distressed couples with a depressed
wife, G2 = maritally nondistressed couples with a
depressed wife, G3 = maritally distressed couples
with a depressed husband, G4 = maritally nondis-
tressed couples with a depressed husband). We
coded behavior using categories of the specific
affect coding system (SPAFF: Gottman, 1994) and
“Kategoriensystem fuer partnerschaftliche Interak-
tion” (KPI: Hahlweg et al., 1986). Based on the
literature reviewed above, the following results
were expected: (a) significant main effects of gender
(e.g., greater negativity and emotional expression in
wives) and index person (patient versus partner; see
Benazon & Coyne, 2000; Hautzinger et al., 1982);
(b) group differences for distressed versus nondis-
tressed groups (e.g., less positivity, higher negativity
in maritally distressed groups) and gender of
depressed person (e.g., higher negativity in de-
pressed women than depressed men) especially in
the sense of an exaggeration of gender-typical
demand/withdraw patterns among distressed cou-
ples with a depressed wife.
Method
procedure
Couples were recruited for participation in a
treatment study focusing on depression. Recruit-
ment methods included newspaper advertisements
and referals from medical facilities in Switzerland.
Criteria for participation in the study were (a)
meeting DSM criteria (DSM-IV; American Psychi-
atric Association, 1994) for unipolar depression
using the Structured Clinical Interview for DSM
(SKID; German version: Wittchen et al., 1990); (b)
BDI N 11 (German version: Hautzinger, Bailer,
Worall & Keller, 1995); (c) enduring romantic
relationship (duration at least 1 year); (d) sufficient
cognitive abilities (IQ N 80) to complete self-report
measures; and (e) agreement of the partner to
participate on the study. Exclusion criteria included
(a) bipolar disorder; (b) secondary depression with
additional comorbidities (e.g., psychosis, personal-
ity disorders, alcoholism); as well as (c) acute
suicidal tendencies.
Sixty-eight partners were successfully screened on
the phone by means of the BDI and SKID and the
list of inclusion and exclusion criteria. After this
procedure, an appointment for a detailed diagnosis
and videotaped marital interactions was set. Two or
three weeks before the home assessments, ques-
tionnaires were mailed to the home address and
were independently completed and returned at the
pre-assessment. The marital interactions were
videotaped in a standardized setting at the couple's
home after the diagnostic interview. The duration
of the conflict interaction was 15 minutes. The
couples discussed a stress-relevant topic concerning
 depression, marital satisfaction, and communication 309

their relationship determined prior the discussion
(see below).
participants
From the 68 screened couples, 62 heterosexual
couples (37 depressed wives, 25 depressed hus-
bands) seeking therapy for depression met the
inclusion criteria and completed the questionnaires
as well as the discussion task at the pre-assessment.
In keeping with prior research, an average score of
54 or more on the marital questionnaire (PFB;
Hahlweg, 1996) was used to categorize couples as
nondistressed. Those with an average score below
54 were categorized as distressed (see Table 1). The
groups contained 16 distressed couples with a
depressed wife (G1), 21 nondistressed couples
with a depressed wife (G2), 18 distressed couples
with a depressed husband (G3), and 7 nondis-
tressed couples with a depressed husband (G4).
There were no significant differences between
groups in the age of husbands and wives, duration
of the close relationships, or years since first
depression and BDI scores of the depressed persons
as well as the partners (see Table 1). However, there
were significantly fewer children in G2 compared to
G1, t(36) = 2.81, p b .01, and G3, t(35) = 3.58,
p b .001. Chi-square comparisons revealed no sig-
nificant group differences in the income, χ2 (3) =
2.66 (ns) or the education of wives, χ2 (3) = 3.25
(ns), or husbands, χ2 (3) = 5.91 (ns). Significantly
more couples in G1 were married than couples in
the other groups, χ2 (3) = 11.25, p b .01. Husbands
in G1, on the other hand, showed a significantly
higher percentage of employment than husbands in
the other groups, χ2(3) = 10.02, p b .05, whereas
wives in G1 tended toward lower employment than
wives in the two depressed husband groups, χ2(3) =
7.11, p b .1.
measures
Partnership Questionnaire (Partnerschaftsfragebogen,
PFB)
The PFB (Hahlweg, 1996) has 30 items and uses a
4-point scale for each item. It measures marital
quality and satisfaction and consists of three scales:
quarrelling (α = .93), tenderness (α = .95), and to-
getherness/communication (α = .86). A total score
below 54 points designates a low level of satisfac-
tion and discriminates reliably between distressed
and nondistressed couples (Hahlweg, 1996). The
PFB is a widely used self-report scale with good
internal consistency (α = .94) and has been exam-
ined with regard to validity (Hahlweg, 1996). The
PFB correlates significantly (r = .63) with the Mar-
ital Adjustment Test (Locke & Wallace, 1959;
Schindler, Hahlweg & Revenstorf, 1998).
Beck Depression Inventory (BDI)
The German version (Hautzinger et al., 1995) of the
BDI (Beck & Steer, 1987) is a 21-item self report
measure of the intensity (4-point scale) of affective,
cognitive, and somatic aspects of depression. The
reliability (α = .92) and validity are well-established,
and gender bias is low (e.g., Beck, Steer, & Garbin,
1988; Hautzinger et al., 1995).
Marital Interaction Task
The conflict discussions were coded using categories
of the SPAFF (Gottman, 1994) as well as of the KPI
(Hahlweg et al., 1986). Two coders independently

Table 1
Sample Means and Standard Deviations for Demographic Variables by Group
Variable G1 (n = 16) G2 (n = 21) G3 (n = 18) G4 (n = 7) F
(3,58)
M SD M SD M SD M SD
Age wife (year) 45.31 9.32 43.07 13.52 47.06 9.83 36.00 8.43 1.82
Age husband (year) 48.44 8.66 44.81 14.17 50.44 8.80 40.43 7.52 1.85
Number of children 1.91 1.13 0.95 0.93 2.00 0.85 1.07 1.54 4.42 ⁎
Years of relationship 18.98 9.95 14.94 12.75 20.13 10.9 10.32 6.93 1.76
PFB spouse's 41.80 9.80 69.14 9.79 42.90 10.42 64.05 7.92 35.07 ⁎
BDI spouse's 6.38 5.76 5.15 6.38 7.11 3.94 5.43 2.57 0.50
PFB patient's 39.36 13.48 67.61 11.39 41.79 10.30 65.43 11.31 26.46 ⁎
BDI patient's 25.89 7.46 24.55 7.29 26.50 8.22 21.36 6.81 0.87
Years since first 10.70 7.01 11.09 13.44 9.16 8.94 17.07 9.89 0.97
depression
PFB average a 40.58 10.61 68.37 9.47 42.34 7.83 64.74 8.50 40.68 ⁎
Note. G1 = distressed couples with a depressed wife. G2 = nondistressed couples with a depressed wife.
G3 = distressed couples with a depressed husband. G4 = nondistressed couples with a depressed husband.
BDI = Beck Depression Inventory. PFB = Partnership Questionnaire.
a
Average of wife's and husband's score.
⁎ p b .05.
310
coded the interactions in a five-minute time intervals
in a double-blind-administration. Interobserver reli-
abilities were assessed using the Kappa coefficient
(Cohen, 1960). Kappas for verbal categories ranged
from .80 to .97. Kappas for nonverbal categories
ranged from .66 to .85. The construct and predictive
validity of this observational system have been
demonstrated in prior research (Gottman, 1994;
Hahlweg et al., 1986).
To facilitate micro-analytic coding of the dura-
tion and frequency of specific interaction codes, a
computer-supported system (Computer Aided Ob-
servation System CAOS; Bourquard, Bodenmann
& Perrez, 1992–2005) was utilized.
Factor analysis (varimax rotation, principal
components) of scores for all 14 behavior codes,
across the entire sample, was used to aggregate rare
categories into coherent sets of behavior.1 This
procedure resulted in the following seven behav-
ioral categories: (1) eye contact, (2) interest/
curiosity, (3) nonverbal positivity, (4) emotional
self-disclosure, (5) interruption, (6) criticism-dom-
ineering (criticism, domineering), and (7) aggres-
sion-defensiveness (contempt, belligerence,
nonverbal negativity, stonewalling, defensiveness)
(see Gottman, 1994, for details). Although it is
more typical to treat defensiveness as a separate
code (e.g., Gottman, 1994), it was insufficiently
frequent in our data to do so. As a consequence, we
utilized the summary code described above and
found that it fit with our own factor analysis of the
observational data. Other rare behavior codes,
including “validation” or “affection,” could not
be combined with other categories on the basis of
factor analysis and so were excluded from the
current analyses.
Relative frequencies (rf) were calculated by
dividing the number of occurrences of a behavior
category by the total number of behaviors. For
relative duration (rd), we used total duration of a
behavior divided by the total duration of the
interaction (e.g., Bakeman & Gottman, 1997;
Johnson & Jacob, 1997). As a third measure,
dichotomous variables indicating the occurrence of
a behavior (0 = this person does not show a certain
behavior; 1 = this person shows a certain behavior)
were also used.
Since homogeneity of variance represents an
important precondition for analysis of variance
and related procedures (Bortz, 1993), we trans-
formed the data to stabilize variance across groups.
1
Results of the factor analysis are available from the first author
upon request.
gabriel et al.
This is particularly important for categories with
relatively few instances. We transformed the data
for relative frequency and relative duration by
converting the raw data into a 6-point Likert-type
scale (0 to 5). Specifically, nonoccurrence was
assigned zero, a category was assigned “1” if it
occurred but did so at a frequency less than
2 ⁎ (median/5), “2” if greater than “1” but less
than 4 ⁎ (median/5), “3” if greater than “2” but less
than 6 ⁎ (median/5), “4” if greater than “3” but
less than 8 ⁎ (median/5) and “5” for all values
greater than “4.” As a result of this transformation,
homogeneity of variance, as well as the stability of
the results, was markedly improved.2
Discussion topic and gender of initiator. Prior to
the discussion, both partners independently rated a
list of different topics indicating the intensity (4-
point scale) of the strain produced by the topic in
the context of their marital relationship. This list
contained the following subject areas: finances,
marital relationship (communication, sexuality,
jealousy, violence), family (children, parents-in-
law), leisure (friends, hobbies), consumption
(drugs, alcohol, television), and religion. After this
procedure, couples were instructed to discuss one of
the most stressful discussion topics. In addition to
interaction coding, two coders rated the videotaped
conflict discussion in terms of the gender of the
person initiating the issue and of the topic actually
discussed, assigning each discussion to one of the 6
categories.
Results
Analysis of variance of relative duration (rd) and
relative frequency (rf) were conducted. First, a two-
way mixed model multivariate/univariate analysis
of variance (MANOVA/ANOVA) design, with
group as between and gender as within (wife/
husband) factors, was calculated. Because the
depressed person could be either the husband or
the wife, we also examined the within-subject factor
of index person (i.e., patient vs. partner), in a
second set of two-way mixed MANOVA/ANOVA
analyses (between: four groups: within: patient/
partner) (see also Christensen & Shenk, 1991;
Kenny, Kashy, & Cook, 2006). Chi-square analy-
ses for the occurrence/nonoccurrence of the behav-
ior codes were conducted. In the case of directional
hypotheses, we utilized one-tailed significance tests.
Repeated analyses using number of children as a
2
More information about methodological aspects and results of
data transformation are available from the first author upon
request.
 depression, marital satisfaction, and communication 311

Table 2
Means/Standard Deviations for Interaction Behavior by Group
Behavior codes G1 G2 G3 G4
rd rf rd rf rd rf rd rf
Wives
Eye contact 2.81/1.28 3.06/1.06 3.05/1.50 2.95/1.16 2.78/1.17 3.17/1.10 3.71/0.95 2.86/0.69
Interest/curiosity 3.06/1.73 2.63/1.78 3.38/1.60 3.76/1.51 2.89/1.88 2.67/1.53 2.86/2.27 2.14/2.12
Nonverbal positivity 2.50/1.51 2.19/1.17 3.71/1.79 3.14/1.85 2.22/1.67 2.28/1.64 3.86/1.95 3.43/1.81
Emotional self-disclosure 3.56/1.71 3.38/1.46 3.43/1.36 3.57/1.25 3.39/1.46 3.06/1.51 3.14/1.35 3.14/1.46
Interruption 3.19/1.47 2.76/1.61 3.39/1.54 3.00/1.91
Aggression/defensiveness 2.19/2.01 2.50/2.10 0.48/0.98 0.52/1.21 1.83/1.76 2.00/1.75 1.71/2.36 1.86/2.41
Criticism/domineering 3.06/2.14 3.00/2.10 1.19/1.72 1.38/2.06 1.94/2.10 1.89/2.17 1.57/2.37 1.57/2.37

Husbands
Eye contact 2.88/1.36 2.69/1.20 2.86/1.15 3.33/1.20 2.61/1.15 2.83/1.20 3.14/1.57 2.86/1.68
Interest/curiosity 2.31/1.49 2.75/1.61 3.10/1.70 3.29/1.52 3.11/1.64 3.33/1.72 2.86/2.19 3.14/2.34
Nonverbal positivity 2.88/1.67 2.81/1.64 4.00/1.45 3.38/1.63 1.83/1.43 2.28/1.49 3.57/1.51 3.57/1.51
Emotional self-disclosure 2.19/1.64 2.31/1.70 2.43/1.69 2.48/1.50 3.33/1.78 3.00/1.37 2.71/1.98 3.14/1.68
Interruption 3.31/1.54 2.95/1.36 3.17/1.65 3.71/1.70
Aggression/defensiveness 3.19/2.26 2.81/2.20 1.14/1.98 1.14/1.98 1.67/2.25 1.72/2.14 1.43/2.44 1.43/2.44
Criticism/domineering 1.56/1.71 1.44/1.79 0.95/1.56 1.05/1.75 1.17/1.76 1.06/1.66 1.14/1.68 1.00/1.41
Notes. G1 = distressed couples with a depressed wife. G2 = nondistressed couples with a depressed wife. G3 = distressed couples with a
depressed husband. G4 = nondistressed couples with a depressed husband.
rd = relative duration. rf = relative frequencies.

covariate displayed the same pattern of significant
results, and so these results are not reported.
Further, there were no significant effects of initiator
or topic and so these factors were not included in
subsequent analyses.
gender and index person effects
For the relative duration (rd) data, there was a
significant multivariate effect (Hotteling's Trace) for
gender, F(1, 58) = 3.71, p b .01, as well as a signi-
ficant multivariate effect for index person, F(6, 53) =
2.10, p b .05. For relative frequency (rf) data, only
a significant multivariate effect for index person,
F(6, 53) = 1.86, p b .05, was found.
Follow-up ANOVAs revealed significant main
effects of gender for the relative duration of
emotional self-disclosure, F(1, 58) = 5.15, p b .05,
and for criticism/domineering, F(1, 58) = 6.77,
p b .01, with wives displaying higher levels than
husbands (see Tables 2, 3). Significant main effects
of index person versus partner were found indicat-
ing a lower relative frequency of interest/curiosity,
F(1, 58) = 3.93, p b .05, and higher values of aggres-
sion/defensiveness [rd: F(1, 58) = 4.29, p b .05; rf:
Fn=(1, 58) = 3.24, p b .05] among partners than
among depressed persons. Depressed persons, on
the other hand, showed a lower duration of
nonverbal positivity, F(1, 58) = 2.90, p b .05, and a

Table 3
MANOVAs and ANOVAs: F-Values for Group, Gender, Index Person, and Group x Index Person
Dependent variable group (3,58) gender (1,58) index person group × index
(1,58) person (3,58)
F F F F
rd rf rd rf rd rf rd rf
Multivariate effects 1.80 ⁎ 1.03 3.71 ⁎ 1.77 2.10 ⁎ 1.86 ⁎ 1.62 ⁎ 1.04
Eye contact 0.76 0.33 1.53 0.16 0.76 0.17 0.70 0.96
Interest/Curiosity 0.49 1.34 0.50 1.67 1.20 3.93 ⁎ 0.30 0.82
Nonverbal positivity 6.00 ⁎ 2.51 ⁎ 0.00 1.20 2.90 ⁎ 0.62 0.02 0.54
Emotional self-disclosure 0.66 0.19 5.15 ⁎ 3.37 ⁎ 2.25 3.04 ⁎ 1.82 1.33
Interruption 0.47 0.85 0.04 0.68
Aggression/defensiveness 3.63 ⁎ 3.24 ⁎ 2.02 0.17 4.29 ⁎ 3.24 ⁎ 0.65 0.17
Criticism/domineering 1.99 1.33 6.77 ⁎ 7.45 ⁎ 0.22 0.17 3.78 ⁎ 3.76 ⁎
Note. rd = relative duration. rf = relative frequency.
⁎ p b .05.
312 gabriel et al.

higher frequency of emotional self-disclosure, F(1,
58) = 3.04, p b .05, than their partners.
group effects
Significant multivariate group, F(18, 155) = 1.80,
p b .05 (Hotteling's Trace), and group-by-index
person, F(18, 155) = 1.62, p b .05, effects for relative
duration (rd) but not for relative frequency (rf) were
found. No significant multivariate effects were
revealed for group by gender [rd: F(18, 155) = 1.06,
ns; rf: F(21, 152) = 1.00, ns] (see Tables 2, 3).
ANOVAs with post hoc analyses to compare cells
of the design (Bonferroni, Dunnett's T3) were used
to explicate significant multivariate group differ-
ences. The nondistressed couples (G2 and G4)
displayed a significantly higher relative duration of
nonverbal positivity, F(3, 58) = 6.00, p b .001, than
distressed couples with a depressed husband (G3),
but were not significantly more positive than
distressed couples with a depressed wife. Further,
a higher relative duration for aggression/defensive-
ness for distressed (G1) than for nondistressed (G2)
couples with a depressed wife was revealed, F(3,
58) = 3.63, p b .01, but no such differences were
observed for couples with a depressed husband.
The significant interaction effect of group with
index person for criticism/domineering, F(1, 58) =
3.78, p b .01, was examined using univariate
ANOVAs to examine depressed persons and their
partners separately. There were no group differ-
ences in the relative duration of criticism/domineer-
ing for nondepressed partners, F(3, 58) = 0.95 (ns),
but there were significantly higher values, F(3, 58) =
4.15, p b .001, for distressed, depressed wives (G1)
compared to the other three groups.
Additional ANOVAs for gender effects within
each of the four groups were conducted. Only for
maritally distressed couples with a depressed wife
(G1) were there significant multivariate effects [rd:
F(6, 10) = 17.71, p b .001; rf: F(7, 9) = 4.47, p b .05]
indicating a gender difference in interaction behav-
ior between the depressed person and their partner.
For distressed couples with a depressed wife (G1),
significant effects were found indicating greater
emotional self-disclosure [rd: F(1, 15) = 7.59,
p b .01; rf: F(1,15) = 5.12, p b .05] and criticism/
domineering [rd: F(1, 15) = 11.25, p b .01; rf: F(1,
15) = 9.16, p b .01] for the depressed wives, whereas
husbands displayed a higher relative duration of
aggression/defensiveness than their wives [G1: F(1,
15) = 3.87, p b .05].
occurrence of behavior
Occurrence of behavior was examined using chi-
square tests for gender differences (Wilcoxon,
McNemar), which indicated a significantly higher
occurrence of emotional self-disclosure in wives than
husbands, χ2(1) = 2.45, p b .01. The chi-square test
for index patient vs. partner, on the other hand,
revealed significantly higher occurrence of aggres-
sion/defensiveness for partners than patients, χ2(1) =
2.89, p b .01.
Chi-square tests (H-test Kruskal-Wallis) were
used to compare occurrence of behavior between
the four groups (see Table 4). There were signifi-
cantly fewer persons displaying interest/curiosity in
G4 (nondistressed, with depressed husband) com-
pared to the other three groups, χ2 (3) = 7.09,
p b .05, there was a higher occurrence of criticism/
domineering, χ2 (3) = 8.12, p b .05, in G1 than in
either of the nondistressed groups, G2 (χ2 (1) =
7.82, p b .01) and G4 (χ2 (1) = 2.68, p b .05) as well
as of aggression/defensiveness in the two maritally
distressed groups, χ2 (1) = 16.63, p b .001.
Analysis for patients and partners separately re-
vealed significantly higher occurrence of criticism/

Table 4
Occurrence of Behavior by Group and Chi-square Value (df) for Group Differences
Behavior codes G1 (n = 16) G2 (n = 21) G3 (n = 18) G4 (n=7) group differences
overall depressed partner
d p d p d p d p χ2(3) 2
χ (3) χ2(3)
Eye contact 16 16 21 21 18 18 7 7 1.95 0.00 0.00
Interest/curiosity 15 15 20 21 18 17 6 5 7.90 ⁎ 2.30 7.03 ⁎
Nonverbal positivity 15 15 20 20 16 16 7 7 2.44 1.21 1.21
Emotional self-disclosure 15 14 21 18 17 18 6 7 1.29 2.47 3.65
Interruption 16 16 19 20 18 18 7 7 5.95 3.97 1.95
Aggression/defensiveness 11 12 5 7 8 14 2 3 0.00 7.99 ⁎ 10.53 ⁎
Criticism/domineering 13 9 8 7 8 10 3 3 8.12 ⁎ 7.62 ⁎ 2.66
Note. G1 = distressed couples with a depressed wife. G2 = nondistressed couples with a depressed wife. G3 = distressed couples with a
depressed husband. G4 = nondistressed couples with a depressed husband.
d = depressed person. p = partner.
⁎ p b .05.
 depression, marital satisfaction, and communication
domineering for depressed patients, χ2(3) = 7.63,
p b .05, in G1 than in the other groups and a lower
occurrence of interest/curiosity for partners in G4,
χ2(3) = 11.25, p b .01, relative to partners in other
groups. There was also more aggression/defensive-
ness for both partners in the maritally distressed
groups [patient: χ2(3) = 7.99, p b .05; partner: χ2(3) =
10.53, p b .010] than for those in the maritally
nondistressed groups (see Table 4).
discussion topic and initiator
The groups did not differ in terms of gender of the
initiator of the discussion, χ2 (3) = 2.29 (ns), as well
as of the topic, χ2 (3) = 0.42 (ns), actually discussed.
Topics discussed were 14.5 % finances, 37.7%
marital relationship, 21.3% family strain, 19.7%
leisure and 6.6% consumption (drugs, alcohol,
television). Fifty percent of topics were initiated by
wives.
As expected, strain due to the topic of “marital
problems” was rated higher in the two maritally
distressed groups, χ2 (3) = 33.19, p b .001. Addi-
tionally, the conflict topic of “family stress” for G1,
χ2 (3) = 6.53.19, p b .05, and the topic of “leisure
activity” for G3, χ2(3) = 9.33, p b .05, were rated as
conveying higher strain than in the other groups.
Discussion
In the present study we investigated gender
differences and patient vs. partner differences in
marital interaction in the context of depression and
marital distress by comparing distressed couples
with a depressed wife (G1), nondistressed couples
with a depressed wife (G2), distressed couples with
a depressed husband (G3) and nondistressed
couples with a depressed husband (G4). This set
of comparison groups allowed us to examine
patterns influenced by the intersection of gender,
depression, and marital distress. The most striking
result was that, in addition to substantial and
anticipated main effects of gender, index person
effects (patient versus partner), and effects of
marital distress, we also found group differences
due to the gender of the depressed person.
Depression was associated with different marital
interaction patterns depending on the gender of
depressed patient, and gender modified the effect of
marital distress in the context of depression.
Main effects of gender for higher emotional self-
disclosure and criticism/domineering in wives rep-
licated prior work (e.g., Baucom et al., 1990;
Dindia & Allen, 1992; Gottman, 1994), suggesting
robust gender differences on these behavioral
dimensions. Further, partners of depressed persons
displayed more aggression/defensiveness and a
313
higher duration of nonverbal positivity as well as
a lower frequency of emotional self-disclosure and
interest/curiosity than did depressed persons them-
selves, replicating prior work (Benazon & Coyne,
2000; Coyne, 1976; Hautzinger et al., 1982) and
suggesting asymmetry in the interaction of de-
pressed persons and their partners. The results also
confirmed gender- as well as depression-linked
patterns of marital interaction, in which emotional
self-disclosure seems to be associated with gender
(being female) as well as level of depression (being
depressed).
In keeping with our expectation that gender
differences would emerge in the context of marital
distress and depression, the maritally distressed
groups displayed the highest level of negative
behavior for depressed wives and the lowest level
of positive behaviors for depressed husbands. In line
with results from community samples (Christensen
& Heavey, 1990; Gottman, 1994), we found
gender-typical interaction behavior as well as an
effect of level of distress when distressed, depressed
wives were compared to nondistressed, depressed
wives. In particular, distressed couples with a
depressed wife compared to nondistressed couples
with a depressed wife demonstrated increased
gender-typical demanding/withdraw patterns
(Christensen & Heavey, 1990; Gottman, 1994).
Group differences in demanding/withdraw behav-
ior were not attributable to differences in the gender
of the person initiating the discussion nor to the
topic of discussion.
Whereas wives' depression was associated with
an exaggeration of gender differences in the context
of marital distress, husbands' depression was
associated with diminished gender differences.
Couples with a depressed husband showed a similar
level of demanding and emotional expression for
both partners regardless of level of marital distress,
replicating the findings of Johnson and Jacobs
(1997, 2000). Additionally, distressed couples in
the depressed husband group showed the lowest
nonverbal positivity. The lack of positive behaviors
in couples with a depressed husband may be as
noteworthy as the presence of negative behavior in
the couples with a depressed wife (see Beach et al.,
2008). Accordingly, the present results highlight the
possibility that depression may influence expression
of gender-typical patterns of interaction differently
depending on the gender of the depressed partner.
An important cautionary note is raised by group
comparison of demographic data on division of
household labor and employment. Across indices of
civil status, household labor and employment, the
marital structure in the distressed, wife depressed
group (G1) seems to be the most traditional.
314 gabriel et al.
However, whereas more traditional couples typi-
cally display lower wife-demand/husband-with-
draw patterns (Rehmann & Holtzworth-Munroe,
2006), in the current sample, the most traditional
couples were also those demonstrating the greatest
demand/withdraw patterns. Another potential cau-
tionary note is that both maritally distressed groups
(G1 and G3) had significantly more children, and
this may have contributed to greater stress for them.
These factors may partially explain group differ-
ences, as the association between marital problems
and depression in parents, especially wives, has
been shown to be related to a higher number of
children, traditional household labor as well as
lower partner engagement and support in parenting
(e.g., Brown & Harris, 1978; Feinberg, 2002;
Gabriel & Bodenmann, 2006).
Surprisingly, we observed very little stonewalling
or avoidance in the problem-solving discussions.
Given prior research on these behaviors we had
expected to see more (e.g., Gotlib & Whiffen, 1989;
Gottman, 1994). One possible explanation may be
that partners were particularly invested in their
relationships because they had volunteered to
participate in a treatment study (agreement of
both partners to participate in the intervention
study as well as the interaction task was required).
Accordingly, they might have been more open to
problem discussion and lower in avoidance than
couples drawn from the community who were not
seeking treatment. Alternatively, it may be that
there are cultural differences between American and
Swiss couples, leading to lower utilization of
escalation behavior sequences ending in stone-
walling in this sample. Or, it may be that there
were other, more subtle manifestations of avoid-
ance that we did not detect with our codes (e.g.,
Backenstrass, 1998; Benazon & Coyne, 2000).
Interestingly, it was relative duration and not
frequency of the behavior codes that revealed the
strongest differences between groups. The utiliza-
tion of relative duration increased the power of our
investigation without changing the patterning of
results and so should be considered for future
behavior observation studies as a way of potentially
decreasing inconsistency in results across studies
(Baucom et al., 2007). Also, our success in
standardizing variance seems to be a useful
methodological approach for dealing with more
specific and infrequently used behavior codes. This
has the potential to expand the specificity of
examination of interactive behavior in couples
and other family units. Additionally, the value of
using more specific interaction codes rather than
summary codes of “positive” and “negative” for a
more nuanced examination should be considered.
clinical implications
The current results suggest the importance of
gender-sensitive clinical models when intervening
with couples who have a depressed partner. In
particular, the current data suggest that the
patterning of couple interaction will differ for
distressed couples with a depressed partner depend-
ing on whether the depressed partner is male or
female. This suggests that it will not be sufficient to
generalize interventions designed for depressed
wives (e.g., Beach et al., 1990) when a depressed
husband is the identified patient. Rather, for
depressed husbands, it may be important in many
cases to focus on greater affective expression in
general as a way to increase expression of positive
affect. This appears to be a less common problem
when the identified patient is the depressed wife.
caveats
Despite our efforts to utilize comprehensive and
specific coding systems, it must be noted that the
categories utilized were still rather broad and coarse
relative to the nuances of dyadic interaction.
Obviously, it will always be possible to wonder if
some important nuances were overlooked in the
coding scheme utilized. It is also possible that sample
as well as culture-specific features may have influ-
enced the results. Finally, because of the small sample
size of the nondistressed, depressed husband group
(G4), it is also possible that some true differences
(e.g., the between partner effect of frequency of
interest/curiosity) may have been rendered nonsignif-
icant in this group due to lower power relative to
other groups rather than smaller effect size.
summary
Despite these concerns and caveats, however, in the
present study we were able to identify different
interaction patterns in couples with a depressed
partner associated with gender and marital distress.
In particular, the present study found a lack of
positivity in couples with a depressed husband,
suggesting this may be a particularly important
dimension for couples with a depressed husband.
We also found evidence of greater gender-based
asymmetry in the interaction of distressed, de-
pressed patients when the depressed patient is the
wife. These findings suggest the possible need for
different approaches to treatment depending on the
gender of the depressed patient.
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