Partner Pronoun Use, Communal Coping, and Abstinence during Couple‐Focused Intervention for Problematic Alcohol Use

• Author: Kelly E. Rentscher,Varda Shoham,Emily C. Soriano,Matthias R. Mehl,Michael J. Rohrbaugh
• Published date: 01 June 2017
• Date: 01 June 2017
• DOI: http://doi.org/10.1111/famp.12202

Partner Pronoun Use, Communal Coping, and

Abstinence during Couple-Focused Intervention for

Problematic Alcohol Use

KELLY E. RENTSCHER*

EMILY C. SORIANO

†

MICHAEL J. ROHRBAUGH*

,‡

VARDA SHOHAM*

MATTHIAS R. MEHL*

Communal coping—a process in which romantic partners view a problem as ours rather

than yours or mine, and take collaborative action to address it —has emerged as an impor-

tant predictor of health and treatment outcomes. In a study of partners’ pronoun use prior

to and during couple-focused alcohol interventions, we examined first-person plural (we-

talk) and singular (I-talk) pronouns as linguistic markers of communal coping and behav-

ioral predictors of treatment outcome. Thirty-three couples in which one partner abused

alcohol were selected from a randomized control trial (N=63) of couple-focused Cognitive-

Behavioral or Family Systems Therapy if they had unambiguously successful or unsuccess-

ful treatment outcomes (i.e., patient maintained abstinence for 30 days prior to treatmen t

termination or had more than one heavy drinking day in the same period). Pronoun mea-

sures for each partner were obtained via computerized text analysis from transcripts of

partners’ speech, derived from a videotaped pretreatment interaction task and three subse-

quent therapy sessions. Spouse we-talk during the intervention (accounting for pretreat-

ment we-talk), as an index of communal orientation, uniquely predicted successful

treatment outcomes. In contrast, both patient and spouse I-talk during the intervention (ac-

counting for pretreatment I-talk), as a marker of individualistic orientation, uniquel y pre-

dicted unsuccessful outcomes, especially when distinguishing active and passive (Ivs. me/

my) pronoun forms. Results strengthen evidence for the prognostic significance of spouse

behavior for patient health outcomes and for communal coping (indexed via pronoun use)

as a potential mechanism of change in couple-focused interventions for health problems.

Keywords: Couples therapy; Alcohol use; Text analysis; LIWC; Close relationships

Fam Proc 56:348–363, 2017

Acommon objective of couple-focused interventions for health problems ranging from

depression to cancer and substance abuse is to increase partners’ collaboration in

addressing the problem (Bodenmann et al., 2008; Scott, Halford, & Ward, 2004; Shoham,

Rohrbaugh, Trost, & Muramoto, 2006). In particular, communal coping—a dyadic process

in which partners view a problem or stressor as ours rather than yours or mine, and take

*Department of Psychology, University of Arizona, Tucson, AZ.

†

Department of Psychological and Brain Sciences, University of Delaware, Newark, DE.

‡

Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC.

Correspondence concerning this article should be addressed to Kelly E. Rentscher, Department of

Psychology, University of Arizona, 1503 E. University Blvd., Tucson, AZ, 85721. E-mail: krentsch@email.

arizona.edu

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Family Process, Vol. 56, No. 2, 2017 ©2015 Family Process Institute

doi: 10.1111/famp.12202

we-based action to address it (Lyons, Mickelson, Sullivan, & Coyne, 1998)—has emerged

as an important predictor of individual health and treatment outcomes (Rohrbaugh, Mehl,

Shoham, Reilly, & Ewy, 2008; Rohrbaugh, Shoham, Skoyen, Jensen, & Mehl, 2012). The

present study investigated communal coping processes, indexed via partners’ pronoun

use, during two couple-focused interventions for problematic alcohol use. Specifically, we

examined partners’ use of first-person plural (we-talk) and singular (I-talk) pronouns dur-

ing a pretreatment alcohol discussion and subsequent therapy sessions as linguistic indi-

cators of a communal orientation to coping and behavioral predictors of treatment

outcome. We expected that partners would experience a shift in communal orientation

during the intervention that would be reflected in their pronoun use, such that partner

pronoun use during the therapy sessions (accounting for pretreatment pronoun levels)

would uniquely predict treatment outcomes.

A growing body of research on couples’ language use suggests that first-person plural

pronoun use (we-talk) is an implicit marker of shared identity and a communal orientation

to coping with health problems. Across interaction contexts, partner we-talk correlates

with positive emotional behaviors, lower physiological arousal, and effective problem-sol-

ving (Seider, Hirschberger, Nelson, & Levenson, 2009; Simmons, Gordon, & Chambless,

2005; Williams-Baucom, Atkins, Sevier, Eldridge, & Christensen, 2010). In the health

arena, we-talk by a patient’s spouse during a coping interview predicted a favorable symp-

tom course for heart failure patients (Rohrbaugh et al., 2008), and better adjustment for

patients with breast cancer and their spouses (Robbins, Mehl, Smith, & Weihs, 2013). In

the first study of pronoun use during couple-focused intervention, spouse we-talk during a

pretreatment conflict discussion and increases in we-talk by health-compromised smokers

and their spouses during couple-focused therapy sessions predicted patients’ post-treat-

ment cessation success (Rohrbaugh et al., 2012). Another recent study of pronoun use dur-

ing couple-based behavioral therapy for alcohol use disorders found that spouse we-talk

predicted patients’ percentage of days abstinent 6 months post-treatment (Hallgren &

McCrady, 2015); however, this study did not find evidence of change in we-talk over the

course of therapy predicting successful outcomes. Interestingly, each of these health-

related studies yielded asymmetrical findings, in which spouse we-talk predicted patient

health outcomes, in many cases over and above what the patient’s own we-talk predicted.

Many of these pronoun studies also investigated first-person singular pronoun use (I-

talk) during couple communication, although findings are less consistent. Some studies

find that I-talk during conflictual interaction correlates with negative emotional behavior

and marital dissatisfaction (Seider et al., 2009; Sillars, Shellen, McIntosh, & Pomegra-

nate, 1997), yet others find that I-talk associates with higher relationship quality for

women and couples that are clinically distressed but lower relationship quality for those

that are not (Simmons et al., 2005; Slatcher, Vazire, & Pennebaker , 2008; Williams-Bau-

com et al., 2010). When the topic of discussion was one partner’s health condition, greater

spouse I-talk during a coping interview predicted an improvement in general health func-

tioning for congestive heart failure patients. Greater I-talk by the patient relative to the

spouse during a health-related disagreement, however, was associated with problematic

demand–withdraw interaction patterns, suggesting patient defensiveness or resistance to

requests for behavior change (Rentscher, Rohrbaugh, Shoham, & Mehl, 2013). For exam-

ple, these spouse-demand/patient-withdraw patterns have been associated with low readi-

ness to change and decreased retention in treatment among individuals with alcohol use

disorders (Rohrbaugh & Shoham, 2005; Shoham, Rohrbaugh, Stickle, & Jacob, 1998).

Interestingly, recent studies have begun to explore active and passive elements of

first-person plural (we vs. us/our) and singular (Ivs. me/my) pronouns during marital

interaction as markers of potentially distinct psychological and relational processes. It is

important to note that although linguists subcategorize personal pronouns as subjective

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