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Couple conflict during pregnancy: Do early family adversity and oxytocin play a role?

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Couple conflict during pregnancy: Do early family adversity and oxytocin play a role?

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Content Running head: COUPLE CONFLICT DURING PREGNANCY

Couple Conflict During Pregnancy: Do Early Family Adversity and Oxytocin Play a Role?
Mona Khaled
Clinical Science Program
Master of Arts
University of Southern California
December 2017

COUPLE CONFLICT DURING PREGNANCY 2
Table of Contents
Abstract ........................................................................................................................................... 3
Introduction ..................................................................................................................................... 4
Background and Significance ......................................................................................................... 5
Intimate Partner Conflict ............................................................................................................ 5
Is All Conflict Considered Equal? .............................................................................................. 7
Early Family Adversity ............................................................................................................... 9
Conflict During Pregnancy ....................................................................................................... 10
Oxytocin .................................................................................................................................... 12
Oxytocin and Interpersonal Distress ......................................................................................... 14
Oxytocin and Couple Conflict .................................................................................................. 16
Oxytocin and Early Family Adversity ...................................................................................... 17
Oxytocin During Pregnancy ..................................................................................................... 18
Current Study & Specific Aims ................................................................................................ 19
Methods......................................................................................................................................... 21
Participants ................................................................................................................................ 21
Procedure .................................................................................................................................. 21
Data Analysis ............................................................................................................................ 25
Results ........................................................................................................................................... 26
Discussion ..................................................................................................................................... 30
References ..................................................................................................................................... 36
Table 1 .......................................................................................................................................... 50
Table 2 .......................................................................................................................................... 52
COUPLE CONFLICT DURING PREGNANCY 3
Abstract
Intimate partner conflict is a strong predictor of individual physical and psychological health,
relationship outcomes, and children’s socioemotional development. Assessing maladaptive
couple dynamics during pregnancy, as well as potential contributing psychosocial and biological
correlates, is of clinical importance before these relational patterns shape the family environment
when the couple transitions to parenthood. In a sample of 49 first-time pregnant couples, we
examined how early adversity within the family of origin, relationship satisfaction, and plasma
oxytocin may relate to observed couple conflict behavior. We found that mothers’ early family
adversity was positively associated with mothers’ negative conflict behavior, yet no significant
results emerged for fathers. Fathers’ early family adversity moderated the relationship between
fathers’ oxytocin and mothers’ negative conflict behavior, such that among fathers who self-
reported greater early family adversity, higher levels of oxytocin were associated with mothers’
negative conflict behavior. Findings from the current study suggest that gender differences may
play a role in how harsh early family environments may impact adult relationship conflict.
Additionally, these results highlight how fathers’ early family experiences and biology may
affect their partner’s reactions to conflict. Understanding the effect of early life stress on couple
conflict and marital satisfaction, particularly during pregnancy, may help to understand how
partners contribute to detrimental couple conflict behavior while on the brink of starting their
own family.

COUPLE CONFLICT DURING PREGNANCY 4
Introduction
Couple conflict has significant implications for the quality and success of a relationship,
partners’ mental and physical health, and the well-being and development of the couple’s
offspring. Examining couple conflict during pregnancy is of particular importance, since the
transition to parenthood is often marked by increased conflict (Belsky & Kelly, 1994; Huston &
Holmes, 2004), and relatively abrupt and persistent declines in relationship satisfaction (Cowan
& Cowan, 2000; Lawrence, Rothman, Cobb, Rothman, & Bradbury, 2008; Moss, Bolland,
Foxman, & Owen, 1986; Pancer, Pratt, Hunsberger, & Gallant, 2000; Shapiro, Gottman, &
Carrère, 2000). Addressing harmful conflict behavior as the couple prepares to establish a new
family is necessary to promote positive psychological, physical, and relational health for the
parents, translating into a more harmonious environment for the child.
Couples’ conflict behaviors may originate from their own family interactions during
childhood (Noller, Feeney, Peterson, & Sheehan, 1995). Indeed, studies have found that family
of origin communication influences adult romantic relationship conflict (Benson, Larson,
Wilson, & Demo, 1993; Conger, Cui, Bryant, & Elder Jr, 2000; Koerner & Fitzpatrick, 2002;
Reese-Weber, & Bartle-Haring, 1998). Furthermore, adverse early family interactions, such as
experiences of physical and verbal aggression, or lack of warmth may shape interactions with
intimate partners in adulthood, and may contribute to higher rates of divorce (Colman & Widom,
2004), infidelity (Colman & Widom, 2004) and lower marital satisfaction (Colman & Widom,
2004; DiLillo et al., 2009). However, no studies have explored the effect of early life stress on
relationship quality during the transition to parenthood. When individuals create their own
families, they may mimic their early family environments, transmitting aggressive behaviors
they witnessed in childhood onto current romantic partners and offspring (Kalmuss, 1984).
COUPLE CONFLICT DURING PREGNANCY 5
Additionally, from these harsh family backgrounds, these individuals may have developed
difficulties with emotion regulation during childhood experiences of family adversity, impacting
ability to regulate interpersonal emotions in adult relationships (Berzenski & Yates, 2010).
Therefore, understanding the effect of early life stress on couple conflict and marital satisfaction,
particularly during pregnancy, may help to understand how partners contribute to detrimental
couple conflict behavior while on the brink of starting their own family.
The neuropeptide oxytocin plays a significant role in pregnancy and also has implications
for social relationships, making it an important consideration in couple conflict during
pregnancy. However, research on the effect of oxytocin on couple conflict behavior is limited,
complex, and inconsistent. Furthermore, no study has investigated the role of oxytocin on couple
conflict during pregnancy, a pivotal period for forming family dynamics.
To our knowledge, only two studies have experimentally observed couple conflict during
pregnancy. These studies examined the change in conflict behavior over the transition to
parenthood in order to evaluate its effect on marital satisfaction (Cox, Paley, Burchinal, & Payne,
1999) and assess a psychoeducation workshop (Shapiro & Gottman, 2005). While these are
important processes to understand, these studies did not investigate factors that potentially
contribute to problematic prenatal couple conflict behavior, such as early family experiences, and
did not identify the biological components that may impact these relationships.
Background and Significance
Intimate Partner Conflict
Marital conflict interactions can reflect the condition of the relationship, and particular
emotions expressed during conflict may reveal how a relationship will fare later on. For example,
negative emotion and positive emotion exchanged in just the first three minutes of a newlywed
COUPLE CONFLICT DURING PREGNANCY 6
conflict predicted couples’ divorce up to six years later (Carrère & Gottman, 1999). Distressed
couples’ conflicts are characterized not only by an exchange of negative emotionality, but by a
cyclical negative interaction style, whereby partners respond to hostile and dominant
communication with similar negative communication behavior (Billings, 1979). This model of
conflict engagement is termed the reciprocity hypothesis, a central theory in marital conflict
literature stating that distressed couples communicate with more reciprocal negative
communication exchanges and less reciprocity of positive exchanges as compared to non-
distressed couples (Azrin, Naster, & Jones, 1973; Lederer & Jackson, 1968; Patterson, Hops, &
Weiss, 1975; Stuart, 1969).
Intimate partner conflict not only affects the quality and trajectory of the relationship, but
may also impact each partner’s psychological and physical well-being. Marital conflict has been
linked to the onset and increase of depressive symptoms (Beach, Fincham, & Katz, 1998;
Fincham & Beach, 1999; O'Leary, Christian, & Mendell, 1994). When one partner receives an
illness diagnosis, marital conflict may exacerbate symptoms or hinder physical recovery (Coyne
& DeLongis, 1986). Furthermore, couples that engage in negative conflict behavior, such as
criticism, disagreement, denying responsibility, interrupting, noncompliance, disapproving, and
negative affect, tend to exhibit worse immune system functioning and higher blood pressure than
couples who do not display these behaviors (Kiecolt-Glaser et al., 1993).
In addition, marital conflict may have implications beyond the couple’s relationship,
spilling over into parenting style and children’s behavior. Couple conflict has been positively
correlated with disapproval of partners’ parenting (Margolin, Gordis, & John, 2001) as well as
negative parenting, such as inconsistent discipline and corporal punishment (Coln, Jordan, &
Mercer, 2012). Marital disputes also impact the parent-child relationship and increase negative
COUPLE CONFLICT DURING PREGNANCY 7
emotionality in the home (Schoppe-Sullivan, Schermerhorn, & Cummings, 2007). Additionally,
parents’ negative conflict behavior has been shown to predict externalizing and internalizing
problems in children, such as hyperactivity, antisocial behavior, negative engagement with peers,
hostility, and depression (Katz & Gottman, 1993; Davies, Harold, Goeke-Morey, & Cummings,
2002; El-Sheikh et al., 2009). Thus, intimate partner conflict has meaningful consequences, not
only for the marital relationship, but also for parenting and children’s well-being.
Is All Conflict Considered Equal?
Some researchers have asserted that the absence of disagreement or conflict,
characterized as a non-distressed relationship, is not equivalent to a satisfying relationship. In
other words, couples who do not argue aren’t necessarily content with their relationship. The
reverse contention is also supported: the presence of disagreement or conflict does not imply an
unsatisfying marriage (Bradbury, Fincham, Beach, 2000; Fincham, Beach, & Kemp-Fincham,
1997). Indeed, a relationship can be high in conflict but also high in warmth. Therefore, it is not
the existence of conflict within a relationship, but rather, the quality, or valence, of the conflict
that is most predictive of relationship outcomes. For instance, research indicates that higher
negative affectivity during conflict is related to poor relationship outcomes. Carrère and Gottman
(1999) examined negativity and positivity within couples’ 15 minute conflict discussions as
predictors of marital status six years later. Raters observed and coded the interactions. Positivity
was operationalized as any expression of joy, validation, interest or humor, while negativity was
coded as any expression of anger, contempt, belligerence, defensiveness, fear, sadness, or
stonewalling. They found that partners who later divorced had expressed more negativity and
less positivity during the conflict task than couples who stayed together. These findings
COUPLE CONFLICT DURING PREGNANCY 8
corroborate evidence that the valence of conflict behaviors are revealing of the trajectory of
marital relationships.
Although these results may suggest that during arguments, unstable and unsatisfied
marriages display more negative behaviors than positive ones, Gottman (1999) contends that
some negative interactions should be given more weight. He states that “not all negatives are
equally corrosive. Four behaviors, which [he] call[s] The Four Horsemen of the Apocalypse, are
most corrosive: criticism, defensiveness, contempt, and stonewalling” (Gottman, 1999, p.41).
The Four Horsemen are particularly good predictors of marital dissolution; however, stable and
satisfied marriages are not void of criticism, defensiveness, and stonewalling (Gottman, 1999).
Rather, these negative exchanges occur less frequently in successful marriages, and they are
often followed by effective resolution attempts, such as expressions of affection, interest, and
humor in the midst of conflict. Additionally, although the Four Horsemen may exist at times,
they are outnumbered by positive exchanges in successful relationships’ conflicts in a ratio of at
least five-to-one positive to negative interactions (Gottman, 1999). Contempt, on the other hand,
rarely occurs within stable, happy relationships. Gottman states that amount of contempt in these
types of marriages is “essentially zero” (Gottman, 1999, p.46). Contemptuous interactions can
extend beyond predicting divorce, and may affect partners’ physical health. Gottman (1993)
reports that husbands’ contemptuous facial expressions during a conflict task were predictive of
wives’ infectious illnesses up to four years later.
Despite Gottman’s (1999) distinction of The Four Horsemen of the Apocalypse from
other negative behavior, they have not been extensively studied as individual variables in the
marital literature. Instead, researchers consider the amount of negative and positive interactions
during a marital conflict (Carrère & Gottman, 1999; Gottman, 1993; Gottman, Coan, Carrère,
COUPLE CONFLICT DURING PREGNANCY 9
and Swanson, 1998). Thus, strong support exists for examining couple conflict behavior by
evaluating the amount of positive and negative affect.
Early Family Adversity
Conflict behavior within adult romantic relationships might be shaped in part by partners’
past relationship experiences, e.g. childhood interactions within the family of origin (Koerner &
Fitzpatrick, 2002). Not only might adverse early family environments, characterized by harsh,
conflictual, and cold parental behavior, impact adult relationships later on, but they are also
linked with mental and physical problems in childhood. Perhaps unsurprisingly, maltreated
children exhibit less prosocial and more disruptive, aggressive, and withdrawn behavior (Alink,
Cicchetti, Kim, & Rogosch, 2012). Growing up in an adversive family environment also
contributes to children’s susceptibility to mental health disorders later on in adulthood, including
depression, anxiety, and hostility (Herrenkohl, Hong, Klika, & Russo, 2013). Children who are
exposed to these environments are also at a higher risk for negative health behaviors as adults,
such as smoking, alcohol abuse, drug abuse, and unsafe sexual activity (Repetti, Taylor, &
Seeman, 2002), as well as chronic illnesses including cardiovascular disease and hypertension,
and even early death (Taylor, Lerner, Sage, Lehman, & Seeman, 2004; Umberson & Montez,
2010). Additionally, individuals who have experienced unsafe family environments report that
mental and physical health problems are more impairing and debilitating than individuals from
better-functioning households (Herrenkohl et al., 2013).
Early stressful family experiences can also have unfavorable effects on romantic
relationships in adulthood. Women who experienced maltreatment during childhood reported
less relationship quality (Colman & Widom, 2004), engaged in more infidelity (Colman &
Widom, 2004), and were more likely to divorce (Mullen, Martin, Anderson, Romans, &
COUPLE CONFLICT DURING PREGNANCY 10
Herbison, 1996). Additionally, husbands’ childhood physical and psychological maltreatment
and wives’ childhood neglect experiences, predicted decreased marital satisfaction in newlywed
couples (DiLillo et al., 2009).
Furthermore, individuals raised in high-conflict households may recreate their own early
family environments once they have children of their own, and therefore be more likely to be
aggressive in families they create as adults (Kalmuss, 1984; Cappell & Heiner, 1990; Berlin,
Appleyard, & Dodge, 2011; Ehrensaft et al., 2003), and even when their children have families
of their own (Doumas, Margolin, & John, 1994). This phenomenon is known as the
intergenerational transmission of aggression (Kalmuss, 1984). However, not all children who
have experienced family adversity go on to recreate these dynamics within their adult families.
Some studies have estimated that about two-thirds of individuals who were maltreated as during
childhood will not mistreat their own children and thus, their experiences of early family
aggression do not manifest into future aggressive behaviors towards their adult partners and
children (Egeland, Jacobvitz, & Papatola, 1987; Kaufman & Zigler, 1987). Exploring whether
early family of origin aggression manifests in couples’ conflicts, especially during pregnancy
and through the transition to parenthood, may clarify how the damaging cycle of family hostility
is maintained.
Conflict During Pregnancy
Research has demonstrated that frequency of conflict (Belsky & Kelly, 1994; Crohan,
1996; Kluwer & Johnson, 2007) and negative conflict behaviors (Crohan, 1996) tend to increase
during pregnancy and through the transition to parenthood, but not many studies have used
observational methods to measure the emotional dynamics expressed during prenatal marital
conflict. To our knowledge, only two research studies have observed couple conflict behavior
COUPLE CONFLICT DURING PREGNANCY 11
during pregnancy, and both examined change in conflict behavior over the transition to
parenthood.
The first study studied couple conflict behavior in relation to marital satisfaction from
pregnancy to two years postpartum (Cox, Paley, Burchinal, & Payne, 1999). Study visits were
during the prenatal period, and at 3, 12, and 24 months after birth. At each research visit, couples
discussed their current main source of disagreement for 15 minutes. Conflict conversations were
coded on dimensions of conflict, withdrawal, validation, communication skills, positive affect
and negative affect. Prenatal interaction style was associated with marital satisfaction, where
more positive problem-solving behavior was related to higher marital satisfaction during
pregnancy. Over the transition to parenthood, change in positive and negative conflict behavior
showed a non-linear trend. During the first year postpartum, positive conflict interactions
decreased, while negative interactions increased. The second year postpartum showed small
increases in positive conflict behavior and small decreases in negative conflict behavior. In
general, wives displayed more positive interactions during the conflicts compared to husbands.
Cox et al. (1999) found that, across the transition to parenthood, more positive conflict
interactions were associated with less of a decrease in marital satisfaction.
The second study assessed couple conflict as a measure of treatment efficacy for a
transition to parenthood psychoeducation intervention workshop (Shapiro & Gottman, 2005).
The Bringing Baby Home Workshop addressed a host of relational and family topics relevant to
the transition to parenthood, such as maintaining intimacy and romance, building meaning, and
respecting your partner’s life goals. Related to conflict, the workshop focused on conflict
management and regulation and “physiological self-soothing during conflict” (p. 8). Although
the data from this workshop shows no significant differences in overall negative conflict
COUPLE CONFLICT DURING PREGNANCY 12
behavior between the intervention group and controls (Shapiro, Gottman, and Fink, 2015), the
study demonstrates the intervention’s efficacy in reducing hostility (Shapiro & Gottman, 2005)
and contempt (Shapiro, Gottman & Fink, 2015), whereas controls exhibited increases in
contempt during conflict over the transition to parenthood. Additionally, husbands in the
intervention group showed an increase in positive affect, while the husbands in the control group
showed a significant decrease in positive affect from the prenatal to postpartum visits. The
Specific Affect Coding System (SPAFF; Gottman, McCoy, Coan, Collier, 1996), the same
approach used in the current study, was utilized to code the couples’ affective conflict behavior.
Oxytocin
Oxytocin is considered both a neuropeptide and hormone and believed to play an
important role in social relationships. Oxytocin is a nine amino acid neuropeptide centrally
synthesized in the hypothalamus, stored in the posterior pituitary gland, and then released into
the blood as a hormone (MacDonald & MacDonald, 2010). Central to reproductive functions in
mammals, peripheral oxytocin activates and strengthens uterine contractions during labor and
birth, as well as stimulates muscle contractions for the release of breast milk (Fuchs, Fuchs,
Husslein, & Soloff, 1984; MacDonald & MacDonald, 2010). Perhaps due to oxytocin’s essential
role in reproduction, research has investigated oxytocin’s function as a social affiliative
neuropeptide. Oxytocin has been associated with prosocial behavior and mother-infant bonding
in both non-human mammals and humans (Insel & Young, 2001); yet, oxytocin has also been
implicated as a marker of interpersonal distress (Tabak, McCullough, Szeto, Mendez, &
McCabe, 2011; Taylor, Saphire-Bernstein, & Seeman, 2010). Discrepant findings regarding
oxytocin as an affiliative peptide may be a result of inconsistent measurement methodologies
(Nave, Camerer, & McCullough, 2015). Studies examining oxytocin and social behaviors have
COUPLE CONFLICT DURING PREGNANCY 13
utilized plasma, salivary, urinary, and cerebrospinal oxytocin, basal and reactive oxytocin, as
well as artificially administered intranasal oxytocin and oxytocin receptor genes. Various
methods of measuring oxytocin display differing levels of the peptide, since, for example,
oxytocin is expressed in plasma in a shorter amount of time than in urine (Feldman, Gordon, &
Zagoory-Sharon, 2011). Thus, different biological systems of oxytocin do not tend to correlate
well with each other (McCullough, Churchland, & Mendez, 2013). Even among studies
measuring plasma oxytocin, extracted and unextracted methods are weakly correlated (Szeto et
al., 2011). Additionally, Nave et al. (2015) notes that questionable interpretation of study
outcomes, low replicability of findings, and lack of publication of null findings also contribute to
the inconsistent oxytocin literature. Therefore, due to varying measurement methodologies of
oxytocin and conflicting findings, the association between oxytocin and affiliative behavior
remains inconclusive.
Nevertheless, three prevailing psychosocial theories attempt to reconcile the inconsistent
research and clarify oxytocin’s complex function in social behavior. Taylor et al. (2006) asserts
one theory that in times of relational distress, increased oxytocin may be adaptive in motivating
individuals to seek out prosocial relationships. Therefore, from this perspective, one may expect
that individuals with greater interpersonal stress will show higher levels of oxytocin. A second
theory is the social-salience hypothesis, in which oxytocin is believed to facilitate the perceived
salience of interpersonal affect, regardless of emotional valence (Shamay-Tsoory et al., 2009).
Thus, oxytocin may serve to intensify relevant and existent social emotions, whether positive or
negative. Kemp and Guastella (2011) describe a third theory, the social-approach/withdrawal
hypothesis, whereby oxytocin may function to “increase approach-related social behaviors while
inhibiting withdrawal-related social behaviors” (p. 222). In other words, oxytocin increases
COUPLE CONFLICT DURING PREGNANCY 14
approach-oriented positive and negative emotions (i.e., happiness, trust, anger, aggression,
jealousy, etc.), and decreases withdrawal-oriented emotions (i.e., fear, disgust, anxiety).
Some studies on the association between oxytocin and couple conflict (Ditzen et al.,
2012) and early life stress (Bakermans-Kranenburg, van IJzendoorn, Riem, Tops, & Alink, 2011;
Pierrehumbert et al., 2010) provide evidence that may support the social-salience hypothesis of
oxytocin. We review the literature on oxytocin and social relationships with the aforementioned
limitations and theories in mind.
Oxytocin and Interpersonal Distress
In nonhuman mammals, oxytocin has been shown to promote affiliative behavior and
reduce stress (Carter, Devries, & Getz, 1995; Young & Wang, 2004). Similarly, in human
samples, oxytocin reduced cortisol and psychological responses to stress (Heinrichs,
Baumgartner, Kirschbaum, & Ehlert, 2003), increased trust (Kosfeld, Heinrichs, Zak,
Fischbacher & Fehr, 2005) and was associated with prosocial bonding and fewer depressive
symptoms (Gordon et al, 2008). Furthermore, experimentally-administered intranasal oxytocin
has been found to increase positive communication behavior during couple conflict and reduce
cortisol levels following conflict (Ditzen et al., 2009). In individuals with an insecure attachment
style, the oxytocin receptor gene showed a positive correlation with self-reported affectionate
communication (Floyd & Denes, 2015). Oxytocin has also been associated with mother-infant
attachment and bonding (Feldman, Weller, Zagoory-Sharon, & Levine, 2007; Galbally, Lewis,
IJzendoorn, & Permezel, 2011), as well as maternal affectionate parenting behavior and paternal
stimulating parenting behavior (Gordon, Zagoory-Sharon, Leckman, & Feldman, 2010).
Although oxytocin is generally believed to promote prosocial behavior, the research
findings on oxytocin and social affiliation are inconsistent. Several studies have found evidence
COUPLE CONFLICT DURING PREGNANCY 15
that oxytocin may actually serve as a marker of interpersonal distress. In a sample of 25 healthy
women, greater basal levels of oxytocin were linked with more interpersonal problems and stress
(Turner, Altemus, Enos, Cooper, & McGuinness, 1999). Among 45 men and women, higher
oxytocin concentration was associated with greater anxious attachment in close relationships
(Marazziti et al., 2006). In anxiously attached male adults, subjects who received intranasal
oxytocin had more negative mental representations of their mothers than subjects who received
the placebo (Bartz et al., 2010). Also, Cyranowski et al. (2008) found that in 17 depressed female
participants, plasma oxytocin levels were positively associated with symptoms of depression,
anxiety, and interpersonal dysfunction during a guided imagery task.
Additionally, Tabak, McCullough, Szeto, Mendez, and McCabe (2011) measured
oxytocin levels in a sample of 35 women who had experienced an interpersonal stressor five
days prior to a relational laboratory task. The majority of subjects indicated that the interpersonal
stressor was related to romantic infidelity, rejection by friend or potential partner, or termination
of a romantic relationship. The relational study task involved the participant giving a four-minute
speech in the lab about their feelings around the transgression. Tabak et al. (2011) found that
baseline levels of oxytocin were not associated with interpersonal anxiety or subjects’ self-
reported lack of forgiveness; however, task-related oxytocin reactivity was positively associated
with post-conflict anxiety and lack of forgiveness. Thus, the authors concluded that oxytocin
reactivity, but not basal oxytocin, may be linked with women’s relational distress.
Similarly, in post-menopausal women, higher concentrations of plasma oxytocin were
linked with poor relationship quality and less positive partner relations (Taylor et al., 2006).
Additionally, Taylor, Saphire-Bernstein, and Seeman (2010) found that elevated levels of
women’s plasma oxytocin was associated with more romantic relationship distress. Interestingly,
COUPLE CONFLICT DURING PREGNANCY 16
Tayor et al. (2010) reported that men’s higher oxytocin levels were not related to relational
distress, suggesting that gender-specific effects may play a role in the relationship between
oxytocin and interpersonal stress.
Expanding upon the evidence for gender effects on oxytocin, Feldman, Gordon and
Zagoory-Sharon (2011) examined plasma, salivary and urinary oxytocin levels in 112 mothers
and fathers interacting with their 4-6 month-old infants. Among mothers, but not fathers, urinary
oxytocin levels were positively correlated with interactive stress during infant play, parenting
stress, and anxious attachment style. However, mothers’ plasma and saliva oxytocin levels were
not correlated with urinary oxytocin or interpersonal distress. These conflicting associations are
not clearly understood. Feldman et al. (2011) surmise that one possibility could be due to the
delay in expression of oxytocin in urine. Further research is needed to elucidate the relationship
between these three biological systems of oxytocin.
Oxytocin and Couple Conflict
Previous research suggests that oxytocin may be associated with couple conflict, yet the
direction of effects is not conclusive. In one study, oxytocin was positively associated with
couples’ positive affect and affectionate touch during a dyadic interaction (Schneiderman,
Zagoory-Sharon, Leckman, & Feldman, 2012). Another study found that in marital couples,
higher oxytocin levels were associated with more positive communication behaviors, although
these couples were participating in a social support interaction task where they were “explicitly
instructed to avoid discussing topics that might lead to marital dissension” (Gouin et al., 2010).
Moreover, experimentally administered intranasal oxytocin increased the ratio of positive
to negative communication exchanges during a couple conflict task (Ditzen et al., 2009). A
follow-up study analysis of the data revealed that among subjects who received intranasal
COUPLE CONFLICT DURING PREGNANCY 17
oxytocin, men self-reported higher emotional arousal following the couple conflict task, while
women reported lower emotional arousal compared to controls (Ditzen et al., 2012). Emotional
arousal included self-ratings of anxiety, sadness, anger, and joy. These results suggest that
oxytocin may function to intensify the social and emotional salience of an experience, and point
to gender-specific effects of oxytocin on emotional reactivity to couple conflict.
To investigate the effect of oxytocin on a severe form of couple conflict, intimate partner
violence, DeWall et al. (2014) administered intranasal oxytocin or placebo to subjects with
varying levels of trait physical aggression, based on high ratings of two items (i.e., ‘‘Given
enough provocation right now, I might hit another person,’’ and ‘‘If I had to resort to violence to
protect my rights, I would right now”). Afterward, participants underwent two aggravation tasks,
which involved giving a speech to unsupportive viewers and applying an ice bandage to their
forehead, since negative criticism and physical pain have been shown to increase aggression
(Anderson & Bushman, 2002). Subjects then rated the likelihood that they would engage in five
aggressive behaviors toward a romantic partner (e.g., “throw something at my partner that could
hurt,” “slap my partner,” “twist my partner’s arm or hair,” “push or shove my partner,” and “grab
my partner”). Among individuals high in trait aggression, oxytocin increased self-ratings of the
probability to commit intimate partner violence. Therefore, among individuals with inclinations
toward aggressive behavior, oxytocin may increase the likelihood of inflicting harm on their
romantic partners.
Oxytocin and Early Family Adversity
The social-salience hypothesis argues that oxytocin intensifies relevant social emotions,
both positive and negative. In the case of early caregiving experiences, childhood adversity has
been shown to be associated with oxytocin levels. For individuals who have experienced adverse
COUPLE CONFLICT DURING PREGNANCY 18
early family environments, oxytocin may be linked with a propensity toward negative
interpretation of social cues (Bakermans-Kranenburg, van IJzendoorn, Riem, Tops, & Alink,
2011), although prior work reveals conflicting findings. In a sample of 90 males, higher levels of
early life stress in childhood were associated with lower plasma oxytocin concentration levels
(Opacka-Juffry & Mohiyeddini, 2012). However, children who had experienced early neglect did
not differ in basal oxytocin levels from the control children (Fries, Ziegler, Kurian, Jacoris, &
Pollak, 2005). One study found that women who had experienced childhood abuse displayed
lower levels of cerebrospinal fluid oxytocin (Heim et al., 2009), whereas another study reported
that women who suffered abuse as children had higher levels of oxytocin after a psychosocial
stress challenge (Pierrehumbert et al., 2010). Research suggests a link between early childhood
abuse and oxytocin, but the direction of the effect remains unclear, and additional research is
needed to clarify this relationship.
Oxytocin During Pregnancy
Across the course of pregnancy, oxytocin generally increases gradually and is positively
correlated with week of gestation, with oxytocin higher in the second half of pregnancy
(Claypool, McElin, & Reeves, 1974; Dawood, Ylikorkala, Trivedi, & Fuchs, 1979; De Geest,
Thiery, Piron-Possuyt, & Vanden Driessche, 1985). Although oxytocin displays a pattern of
steadily rising throughout pregnancy, oxytocin levels tend to vary widely between individuals
(Dawood et al., 1979). For example, within one sample of pregnant women, some showed low
oxytocin levels across pregnancy, whereas others showed high levels (Vasicka, Kumaresan, Han,
& Kumaresan, 1978). Furthermore, Leake, Weitzman, Glatz, and Fisher (1981) reported that
pregnant females showed low levels of oxytocin, such that they only differed from males and
non-pregnant females in oxytocin level when they entered labor. Similarly, Altemus et al. (2004)
COUPLE CONFLICT DURING PREGNANCY 19
observed that at 38-40 weeks of gestation, pregnant women had higher levels of oxytocin when
compared to non-pregnant women, while others reported significant increases in oxytocin at 36
weeks gestation for pregnant women compared to non-pregnant women (Silber, Larsson, &
Uynas-Moberg, 1991). However, Levine, Zagoory-Sharon, Feldman, and Weller (2007) found
that among one-third of their sample, pregnant women had consistent oxytocin levels throughout
gestation, while others had increasing or decreasing levels in late pregnancy. While oxytocin
concentration may be highly variable between individuals, oxytocin plays a significant functional
role in the activation and potentiation of uterine contractions during labor and birth (Fuchs,
Fuchs, Husslein, & Soloff, 1984), and therefore may increase preceding labor. In fact, artificial
oxytocin, or Pitocin, is often used to induce labor (Claypool, McElin, & Reeves, 1974).
Therefore, when analyzing oxytocin levels among pregnant women, statistically accounting for
week of gestation is necessary.
Current Study & Specific Aims
The current study examines couple conflict behavior during pregnancy, and the interplay
between conflict behavior and partners’ early family adversity, marital satisfaction, and basal
levels of plasma oxytocin. Elucidating how early family adversity and neuropeptide levels may
contribute to couples’ conflict can further the understanding of how problematic conflict
interactions are formed and expressed during the critical juncture of forming a family.
Furthermore, investigating the relationship between early life stress and marital satisfaction is
important to further identify factors that influence the quality of intimate relationships during
pregnancy.
COUPLE CONFLICT DURING PREGNANCY 20
The specific aims of this study are to examine how early family adversity predicts couple
conflict behavior and marital satisfaction during pregnancy, and to explore the effect of oxytocin
on these relationships.
Specific Aim 1: Investigate whether early family adversity is associated with 1a) prenatal couple
conflict behavior and 1b) marital satisfaction in first-time pregnant couples.
Hypothesis 1: More adverse early family experiences will be (1a) positively associated
with higher negative, lower positive, and lower neutral affect during prenatal couple
conflict and (1b) inversely associated with individual and partner marital satisfaction.
Specific Aim 2: Examine whether the association between early family adversity and individual
and partner marital satisfaction is best explained by the individual’s conflict behavior.
Hypothesis 2: Conflict behavior (e.g., negative, positive, and neutral affect) will mediate
the relationship between early life stress and individual and partner marital satisfaction,
such that an individual’s conflict behavior will be the mechanism linking experiences of
early family adversity to individual and partner marital satisfaction.
Specific Aim 3: Explore the relationship between basal plasma oxytocin and prenatal couple
conflict behavior.
Hypothesis 3: Basal plasma oxytocin will be associated with prenatal couple conflict
behavior.
Specific Aim 4: Examine whether the relationship between plasma oxytocin and prenatal couple
conflict behavior is moderated by early family adversity.
Hypothesis 4: From a social-salience hypothesis perspective, we expect that early family
adversity will moderate the association between plasma oxytocin and prenatal couple
conflict behavior, such that for individuals who have experienced early family adversity,
COUPLE CONFLICT DURING PREGNANCY 21
higher levels of oxytocin will be correlated with higher negative and lower positive
conflict behavior. Individuals who have not faced early family adversity will not show
this relationship.
Methods
Participants
The current study draws from the larger longitudinal HATCH (Hormones Across the
Transition to Childrearing) study, which investigates changes in hormones and behaviors across
the transition to parenthood within cohabitating couples expecting their first child. Study visits
take place during the prenatal, perinatal, and postpartum periods. The current study uses data
from the prenatal visit, conducted between 20-35 weeks of gestation. Questionnaire data was
available for 51 couples, but observational coding data for the conflict discussion were missing
for two of those couples (due to missing audio and a corrupted video file transfer), so these two
couples were excluded from analyses. Within the current sample of 49 couples, participants were
on average 28 weeks pregnant (sd = 3.48 weeks). Demographic characteristics, including
ethnicity, education level, relationship status, and age are reported in Table 1.
Procedure
During the prenatal visit, participants engage in several dyadic discussions of relationship
topics, complete questionnaires about their early childhood experiences and current relationship
satisfaction, and provide samples of blood for oxytocin assay. Approximately one hour into the
study visit, participants are each given a list of relational topics (e.g., sex and intimacy,
household chores, time spent together, time spent on electronics, etc.), and instructed to rate the
extent they would like to change each area in regard to their relationship. The experimenter
selects the three topics that appear to be the greatest source of conflict (e.g., topics that both
COUPLE CONFLICT DURING PREGNANCY 22
partners rated highly, and/or topics where partners’ ratings were particularly divergent). Couples
then discuss these topics for fifteen minutes and are video recorded. Instructions are as follows:
“Now, we’re going to have you sit together for 15 minutes and talk about areas of
concern in your relationship. Based on your responses to this questionnaire, it looks like
these [provide post-it note with topics] are the areas of greatest concern for you. We’re
going to ask you to start by talking about the first topic, and you may also talk about the
other topics if you have remaining time. These conversations sometimes get intense, and
that is OK. Try to discuss this topic as you would at home, and make sure you each get
your point across. You are also not restricted to the topics we have given you. If there are
other areas of concern in your relationship that you would like to discuss, feel free to go
over those as well.”
Following the conflict discussion, participants completed questionnaires and at the end of the
study visit, a licensed phlebotomist performs the blood draws.
Couple Conflict Behavior
Prenatal couple conflict behavior was assessed using the observational coding scheme,
The Specific Affect Coding System (SPAFF; Gottman, McCoy, Coan, & Collier, 1996). The
SPAFF identifies specific affective behavior based on verbal content, vocal tone, facial
expression, gestures, and body movement. The SPAFF includes five positive codes (affection,
enthusiasm, humor, interest, validation), 12 negative codes (anger, belligerence, contempt,
criticism, defensiveness, disgust, domineering, fear/tension, sadness, stonewalling, threats,
whining), and one neutral code. SPAFF has shown excellent construct and criterion validity and
has been widely used in studies of couple relationship behavior (Heyman, 2001).
COUPLE CONFLICT DURING PREGNANCY 23
Discussions were coded by four research assistants who were trained in using the SPAFF
coding system through a SPAFF coding manual, training meetings, and practice video coding.
Due to attrition of coders for various reasons, only two coders completed the entire sample of 49
couples. The third coder completed observational coding for the first 19 couple videos and the
fourth coder completed the first 12 videos. To assess inter-rater reliability among the four coders,
an intra-class correlation (ICC) was calculated (Bartko, 1966). ICC is widely used to assess inter-
rater reliability and is appropriate for studies involving two or more coders (Hallgren, 2012).
Inter-rater reliability for the 12 discussions, coded by all four raters, was .832. For the seven
videos coded by the three raters, ICC was .756. The remaining two raters had an ICC of .721 for
the rest of the 30 discussions.
Coders used the Noldus XT Observer system (Noldus, 1991) to enter observations, and
were instructed to code continuously throughout the video-taped conflict discussion. In other
words, each time an emotional behavior was expressed, a code was assigned until a different
emotional behavior was displayed. Thus, each second of the discussion was to be coded, and
coding data duration would be 15 minutes.
Coding data yielded total time in seconds for each affect code. For each participant, the
duration of all positive affect codes was summed to create a total duration of positive affect. The
same process was conducted for negative code duration and neutral code duration. Then, total
duration of each specific affect code (i.e., positive, negative, or neutral) was divided by total time
of coding, generating the proportion of time that each individual exhibited positive, negative, or
neutral affect during the entire discussion.

COUPLE CONFLICT DURING PREGNANCY 24
Questionnaire Measures
Early Family Adversity. The Risky Family Questionnaire (Taylor et al., 2004) was used
to assess the extent to which individuals experienced early family adversity, specifically harsh,
cold, conflictual, and chaotic family environments. The questionnaire instructs participants to
think about their family life during childhood and early adolescence (ages 5-15) in response to
13 items (e.g., “How often would you say there was quarreling, arguing, or shouting between
your parents?”). Items use a 5-point response scale (1 = not at all, 5 = very often). Higher scores
indicate more early family adversity.
Relationship Satisfaction. Relationship satisfaction was assessed using the Marital
Adjustment Test (MAT), a 15-item self-report scale that was originally designed by Locke and
Wallace (1959) to distinguish distressed and unsatisfied couples from well-adjusted and satisfied
ones. The scores for all 15 items are totaled and higher scores indicate higher levels of marital
satisfaction. A factor analysis using data from 149 wives and 157 husbands showed that the
MAT is an internally consistent measure of marital satisfaction (Kimmel & Van Der Veen,
1974). Typically, scores above 100 are interpreted to mean that the partner is satisfied with their
relationship (Abramowitz & Sewell, 1980), whereas scores ranging from 60 to 99 suggest
moderate relationship distress, and scores of 59 or lower indicate severe distress (Crane,
Allgood, Larson & Griffin, 1990); the mean score of 122 within this sample suggest generally
high levels of satisfaction.
Oxytocin Measurement
Blood for plasma oxytocin assay was drawn by a licensed phlebotomist into a sterile tube
into which 20 microliters of a protease inhibitor (Amastatin) has been added in order to limit the
degradation of oxytocin. Blood was then centrifuged for 15 minutes to separate plasma from
COUPLE CONFLICT DURING PREGNANCY 25
white blood cells and red blood cells. Plasma samples were then pipetted into 1 mL aliquot tubes
and frozen at -80 C. Plasma samples were shipped on dry ice to the University of Miami School
of Medicine where they were assayed within the Division of Endocrinology, Diabetes and
Metabolism (Armando Mendez, PI). Plasma samples were sent in batches of 5-10 couples
periodically throughout the course of data collection. The current data contains seven batches of
plasma samples. An examination of unextracted oxytocin revealed notable outliers (i.e., greater
than two standard deviations above the sample mean) for three mothers and four fathers. Thus,
unextracted oxytocin was truncated at two standard deviations above the mean, and these seven
participants’ oxytocin were removed from analyses. The first batch of the plasma samples
contained all seven of these outliers and, overall, comprised the highest values of oxytocin. We
communicated with the lab where the assays were performed, and discovered that this first batch
of plasma samples was assayed with a different dilution ratio (1:10) than was used for rest of the
six batches of samples (1:4). Thus, after the seven outliers were removed from analyses, we
controlled for this potential batch effect by creating a dummy variable with batch one coded as
“1” and all remaining batches coded as “0.” This dummy variable was entered as a covariate for
oxytocin data analyses to ensure that findings were not a result of batch effect.
Data Analysis
Associations between continuous variables were examined separately for male and
female partners using bivariate Pearson correlations. See Table 2 for a correlation matrix of all
bivariate associations. We used univariate statistics to explore sample characteristics of the
variables and behavioral measures. Variables were checked for outliers and log transformation of
predictor variables were considered. Multiple linear regression was used to test the relationships
between early family adversity, marital satisfaction, plasma oxytocin and couple conflict
COUPLE CONFLICT DURING PREGNANCY 26
behavior. Finally, bootstrapping tests of mediation were performed to test whether conflict
behavior (e.g., positive, negative, or neutral) mediated the association between early family
adversity and relationship satisfaction. We used bias-corrected bootstrapping tests of mediation
to estimate confidence intervals, utilizing the SPSS INDIRECT macro described by Preacher &
Hayes (2008). This approach uses bias-corrected bootstrapping techniques, a non-parametric
method based on resampling with replacement, to estimate confidence intervals. Confidence
intervals that do not contain zero indicate a mediation effect. Bootstrapping adjusts for uneven
sampling distribution of indirect effects (Preacher & Hayes, 2008) and is considered superior to
normal theory tests for estimation of indirect effects. Even in cases in which the predictor,
mediating variable, and outcome variable do not show statistically significant relationships,
mediation can be tested (Preacher & Hayes, 2008). Bias-correcting bootstrapping has been
consistently shown to be the most powerful test of mediation and required the smallest sample
size in order to detect effects as compared to other tests of mediation (e.g., the Sobel test and
Baron and Kenny’s Joint Casual-Steps Test) (Fritz & MacKinnon, 2007).
Results
Early Family Adversity and Couple Conflict Behavior
The first aim of this study was to investigate whether early family adversity is associated
with 1a) prenatal couple conflict behavior and 1b) marital satisfaction in first-time pregnant
couples. These associations were tested with linear regression models. The first model tested
whether an individual’s self-reported early family adversity predicts his/her positive, negative, or
neutral conflict behavior. The next model tested whether an individual’s self-reported early
family adversity predicts his/her partner’s positive, negative, or neutral conflict behavior. Since
partners are nested within couples, we split the file by gender and examined effects for male
COUPLE CONFLICT DURING PREGNANCY 27
partners and female partners separately. All associations are displayed in Table 2. Mothers’ early
family adversity was significantly associated with mothers’ negative conflict behavior (β = 0.30,
p = 0.04), such that mothers who reported more early family adversity exhibited more negative
behavior during the conflict discussion. Mothers’ early family adversity was not associated with
fathers’ positive, negative, or neutral conflict behavior. Additionally, fathers’ early family
adversity was not related to fathers’ or mothers’ positive, negative, or neutral conflict behavior.
Early Family Adversity and Relationship Satisfaction
The next model tested whether an individual’s early family adversity predicts his/her own
self-reported relationship satisfaction. The fourth model tested whether an individual’s early
family adversity predict his/her partner’s marital satisfaction. Early family adversity was not
significantly associated with self-reported or partner-reported relationship satisfaction (see Table
2). Mothers’ early family adversity was not significantly linked with self-reported relationship
satisfaction (β = -0.04, p = 0.81) or partner-reported relationship satisfaction (β = 0.04, p = 0.80).
Similarly, fathers’ early family adversity was not significantly linked with self-reported
relationship satisfaction (β = -0.21, p = 0.14) or partner-reported relationship satisfaction (β = -
0.02, p = 0.92).
We ran bootstrapping tests of mediation, controlling for pregnancy stage, to test whether
the association between early family adversity and prenatal relationship satisfaction was
mediated by conflict behavior (i.e., positive, negative, or neutral conflict behavior). We tested
whether mothers’ or fathers’ conflict behavior mediated the relationship between mothers’ early
family adversity and mothers’ relationship satisfaction. We also tested the same mediation (i.e.,
mothers’ or fathers’ conflict behavior) between fathers’ early family adversity and fathers’
relationship satisfaction. Results indicated no significant mediation effect.
COUPLE CONFLICT DURING PREGNANCY 28
Couple Conflict Behavior and Relationship Satisfaction
Individuals’ positive, negative, and neutral conflict behavior was tested as a predictor of
own or partner’s relationship satisfaction. Fathers’ negative conflict behavior was inversely
associated with fathers’ relationship satisfaction (β = -0.31, p = 0.03), and mothers’ relationship
satisfaction (β = -0.31, p = 0.03), such that when fathers expressed more negative affect during
the conflict discussion, fathers and mothers reported less relationship satisfaction. No other
significant associations emerged. When controlling for partners’ relationship satisfaction, both
associations became non-significant (i.e., when controlling for mothers’ relationship satisfaction,
the association between fathers’ negative conflict behavior and fathers’ relationship satisfaction
became non-significant; when controlling for fathers’ relationship satisfaction, the association
between fathers’ negative conflict and mothers’ relationship satisfaction became non-
significant).
Oxytocin and Couple Conflict Behavior
We explored the relationship between basal plasma oxytocin and prenatal couple conflict
behavior, testing males and females separately. First, associations were tested using bivariate
correlations (see Table 2). Mothers’ oxytocin was positively associated with mothers’ positive
conflict behavior (β = 0.34, p = 0.04). Mothers’ oxytocin was negatively associated with
mothers’ neutral conflict behavior (β = -0.42, p = 0.01) and fathers’ neutral behavior (β = -0.57,
p = 0.001). Mothers’ oxytocin was positively associated with fathers’ positive conflict behavior
(β = 0.51, p = 0.001). Fathers’ oxytocin was negatively associated with fathers’ neutral conflict
behavior (β = -0.40, p = 0.01). Fathers’ oxytocin was not significantly associated with mothers’
conflict behavior.
Significant bivariate associations were then entered into multiple linear regression
COUPLE CONFLICT DURING PREGNANCY 29
models, where basal plasma oxytocin level was entered as the predictor, and conflict behavior as
the outcome, along with the potentially relevant covariates of pregnancy stage, body mass index
(BMI), and oxytocin batch. When pregnancy stage and BMI were entered into the models, there
was no longer a significant association between mothers’ oxytocin and mothers’ positive conflict
behavior (β = 0.353, p = 0.079). All other bivariate associations remained significant when
controlling for pregnancy stage and BMI; however, when oxytocin batch was entered into the
model, all associations became non-significant.
Early Family Adversity as a Moderator of the Association between Oxytocin and Couple
Conflict Behavior
We examined whether the relationship between plasma oxytocin and prenatal couple
conflict behavior is moderated by early family adversity. To test this moderation hypothesis, we
created an interaction term (mean-centered oxytocin multiplied by mean-centered early family
adversity) and added this interaction term to a multiple regression model that also included
plasma oxytocin and early family adversity as predictors.
One moderation effect emerged. Fathers’ early family adversity moderated the
relationship between fathers’ oxytocin and mothers’ negative conflict behavior, such that when
oxytocin was higher among fathers who reported more early family adversity, mothers tended to
exhibit more negative conflict behavior (β = 0.53, p = 0.001). Results remain significant after
controlling for stage of pregnancy, BMI, and oxytocin batch (β = 0.56, p = 0.01). An additional
moderation effect was marginally significant (p < .10). After controlling for pregnancy stage,
BMI, and oxytocin batch, fathers’ early family adversity moderated the effect between fathers’
oxytocin and fathers’ negative conflict behavior (β = 0.38, p = 0.09). Similar to the prior
moderation effect, when oxytocin was higher among fathers who reported more early family
COUPLE CONFLICT DURING PREGNANCY 30
adversity, fathers exhibited more negative conflict behavior.
Discussion
The current study explored the role of adverse early family experiences and physiology
on couple’s relationship dynamics, particularly relationship satisfaction and relationship conflict.
As hypothesized, early family adversity was associated with greater negative affect during a
prenatal couple conflict discussion; however, this effect was only significant for mothers. These
findings indicate that pregnant first-time mothers who experienced childhood risky family
environments may tend to exhibit more negative affect during a partner couple discussion.
Fathers’ early family adversity was not significantly related to their behavior during the conflict
discussion. Therefore, females’ interpersonal experiences with their family of origin may be
influencing their interactions with their current romantic partner differently than for males. For
females, early family adversity may manifest in their adult intimate relationships through
negative affect and behavior expressed towards their partner. Perhaps it is not the case that
males’ history of harsh family environment does not impact their adult relationships, but rather
that it may manifest through other pathways not measured by the current study.
Several previous studies have reported that female victims of childhood family adversity
are more vulnerable to relationship dysfunction than males (Colman & Widom, 2004; DiLillo et
al., 2007). However, Paradis and Boucher (2010) found that males’ childhood maltreatment had
a greater impact on relational problems than females’ childhood maltreatment. In other words,
childhood maltreatment was a better predictor of relationship difficulties for males than females.
Paradis and Boucher (2010) measured interpersonal problems through nine self-report items in
which participants rated statements such as “I am too aggressive toward my partner” and “I try to
please my partner too much.” These self-reported relationship indices may not parallel with the
COUPLE CONFLICT DURING PREGNANCY 31
current study’s measure of observational conflict behavior, in which an independent coder rated
exhibited affect, thereby potentially reducing the subjectivity of interpersonal evaluation and
assessment.
Nevertheless, although these results seem contradictory to the current study findings,
similar to the present findings, Paradis and Boucher’s (2010) results signify a gender difference,
and support the notion that males’ and females’ childhood experiences of family adverse
environments manifest differently in their adult relationships. Thus, it is important to consider
how the effect of early family adversity on adult romantic relationships may differ by gender and
the implications for interventions prior to the transition to parenthood.
In regard to our second study aim, contrary to our stated hypothesis, early family
adversity was not associated with self-reported or partner-reported relationship satisfaction. This
finding is discordant from previous research indicating a link between adverse early family
experiences and lower relationship quality for women, but not men, (Colman & Widom, 2004),
and husbands’ childhood maltreatment, wives’ childhood neglect experiences and decreased
marital satisfaction (DiLillo et al., 2009). However, Colman and Widom (2004) measured
relationship quality through nine questions regarding the extent to which participants perceived
their partners as supportive, caring, and open to communication, which differs from the measure
of marital satisfaction used in the current study that assesses level of happiness, degree of
agreement on relational topics and extent to which they regret marrying their partner.
Taken together, the relationship between early family adversity and relationship quality
may differ by gender (Colman & Widom, 2004), and type of childhood maltreatment (DiLillo et
al., 2009) yet the current study did not find a significant relationship. To our knowledge, no
study has examined this relationship between early family adversity and relationship satisfaction
COUPLE CONFLICT DURING PREGNANCY 32
during pregnancy. Thus, there may be some unique factors about this period during the transition
to parenthood that contributes to relationship satisfaction above and beyond early family
experiences of maltreatment.
Another potential factor influencing relationship satisfaction is couple conflict behavior.
We found that fathers’ negative conflict behavior was inversely associated with fathers’ and
mothers’ relationship satisfaction, such that when fathers expressed more negative affect during
the conflict discussion, both fathers and mothers reported less relationship satisfaction. However,
when we controlled for partners’ relationship satisfaction, both associations became non-
significant. Therefore, mothers’ and fathers’ relationship satisfaction impacts one another
reciprocally more so than fathers’ expressed negative affect.
As an exploratory study aim, we examined the relationship between basal plasma
oxytocin and prenatal couple conflict behavior. Bivariate correlations between plasma oxytocin
and conflict behavior emerged. When controlling for pregnancy stage and BMI, the relationship
between mothers’ oxytocin and mothers’ positive conflict behavior became non-significant, yet
all other associations remained significant (e.g., mothers’ oxytocin was negatively associated
with mothers’ neutral conflict behavior and fathers’ neutral behavior. Mothers’ oxytocin was
positively associated with fathers’ positive conflict behavior. Fathers’ oxytocin was negatively
associated with fathers’ neutral conflict behavior.). However, when we added oxytocin batch as a
covariate into these models, all associations became non-significant. The first batch of oxytocin
samples assayed were processed using a different dilution ratio (1:10) than the other batches
(1:4), so this covariate was accounting for the relationship between oxytocin and conflict
behavior that the data originally revealed.
Lastly, we investigated our final study aim by testing whether early family adversity
COUPLE CONFLICT DURING PREGNANCY 33
moderated the relationship between oxytocin and conflict behavior. Results indicated that for
fathers who self-reported greater early family adversity, higher levels of oxytocin were
associated with mothers’ negative conflict behavior. Fathers’ early family adversity, when
combined with higher oxytocin, may elicit certain reactions or behaviors, such as negative affect,
from their partner during a discussion conflict. Moreover, results indicated a marginally
significant interaction in which fathers’ early family adversity moderated the relationship
between fathers’ oxytocin and fathers’ negative conflict behavior. Among fathers who reported
greater early family adversity, higher levels of oxytocin were associated with fathers’ likelihood
to exhibit negative conflict behavior with their partner. Although marginally significant, this
finding is consistent with the social salience hypothesis of oxytocin, such that higher levels of
oxytocin intensify socially relevant emotions. For these fathers, oxytocin may intensify adverse
early family interactions when engaging in conflict in their current romantic relationship, and
therefore may bring about negative emotions in the context of discussing interpersonal
disagreements. These moderation effects did not occur for females in our sample. No interaction
findings emerged between mothers’ early family adversity and mothers’ oxytocin for either
mothers’ or fathers’ conflict behavior. As stated above, there was a link between mothers’ early
family adversity and conflict behavior, but mothers’ oxytocin did not impact this relationship.
Conversely, fathers’ early family adversity was not associated with conflict behavior, yet fathers’
oxytocin levels moderated the role of early family adversity on conflict behavior. These results
may suggest that, during pregnancy, mothers’ adverse early family experiences and current
relationship conflict is less influenced by her oxytocin than for fathers. Perhaps since pregnant
mothers undergo numerous physiological changes over during the transition to parenthood, and
pregnant women’s oxytocin levels vary widely (Dawood et al., 1979), the link between mothers’
COUPLE CONFLICT DURING PREGNANCY 34
physiology and interpersonal relationships during pregnancy becomes less clear and more
complex. Previous research has not explored this link during the prenatal period. However, these
relationships may become elucidated after pregnancy, and over time. As Levine et al. (2007)
found, increases in oxytocin across pregnancy were associated with higher maternal-fetal
bonding postpartum.
To our knowledge, this was the first study to examine the effects of early family adversity
and oxytocin on couple conflict behavior and marital satisfaction in a sample of first-time
pregnant couples. Prior research has investigated the frequency and quality of conflict behavior
during pregnancy and the transition to parenthood, yet the majority of these studies used self-
report measures of relationship conflict. Only two studies have utilized observational coding to
measure expressed emotion during prenatal conflict discussions, yet both assessed change in
conflict behavior over the transition to parenthood. To address this gap in the literature, the
current study investigated potential contributing factors of the expression of conflict behavior
during pregnancy. Furthermore, this study integrates psychological, behavioral, and
physiological data to enhance understanding of how individual, interpersonal, and biological
contextual factors influence relationships.
Despite these strengths, the present study presents some limitations. We relied upon
individuals’ retrospective reports of early family adversity, which may impact the accuracy of
these accounts or recollections. As compared to documented case records of abuse, adults failed
to retrospectively report experiences of childhood abuse (Widom & Morris, 1997; Widom &
Shepard, 1996). Additionally, we analyzed risky family environments but did not measure
specific experiences of maltreatment. Berzenski and Yates (2010) found that overall, childhood
maltreatment predicted relationship violence, yet childhood emotional abuse was most predictive
COUPLE CONFLICT DURING PREGNANCY 35
of relationship violence, and childhood physical abuse did not predict relationship violence when
controlling for the other types of maltreatment. Thus, it is important to examine these
relationships by type of childhood family adversity. Lastly, the outliers within the first batch of
plasma oxytocin, which were processed differently than the other batches, accounted for the
main effects that initially emerged from the data.
Findings from the current study suggest that mothers’ early family adversity may impact
their negative conflict behavior during pregnancy and before the transition to parenthood.
Mothers who experienced more physical abuse, verbal aggression, or neglect within their family
of origin were more likely to exhibit negative affective behaviors when discussing contentious
relationship topics with their partner. However, this relationship was not significant for fathers.
Thus, early family adversity may impact males’ and females’ relationship conflict interactions
differently. Future research should examine gender differences in childhood maltreatment and
adult relationship function and conflict, particularly during the transition to parenthood. Finally,
fathers’ adverse family of origin experiences and fathers’ oxytocin were associated with an
increased tendency for mothers to exhibit negative emotion and behavior. Future research should
test mediators driving the interaction effect between early family adversity and physiology to
better understand the factors underlying partner conflict behavior. Clinical implications of this
study include considering the ways in which an adult’s experience of childhood maltreatment
may contribute to current relationship conflict behavior, how this experience manifests
differently for men and women, and the particular importance of addressing these phenomenon
during pregnancy before the couple dynamic evolves into a family environment.
COUPLE CONFLICT DURING PREGNANCY 36
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COUPLE CONFLICT DURING PREGNANCY 50
All Participants
(n = 98)
Males
(n = 49)
Females
(n = 49)
Participant / Couple Characteristics
n (%) n (%) n (%)
Education

High School Graduate/GED
2 (2.0%) 1 (2.0%) 1 (2.0%)
Some College
8 (8.2%) 6 (12.2%) 4 (8.2%)
Associate’s Degree
3 (3.1%) 1 (2.0%) 2 (4.1%)
Bachelor’s Degree
44 (44.9%) 28 (57.1%) 16 (32.7%)
Master’s Degree
27 (27.6%) 7 (14.3%) 20 (40.8%)
Professional or Doctoral Degree
11 (11.2%) 6 (12.2%) 5 (10.2%)
Unknown
1 (1.0%) 0 (0%) 1 (2.0%)
Race / Ethnicity

White 60 (61.2%) 32 (65.3%) 28 (57.1%)
Black or African American 5 (5.1%) 3 (6.1%) 2 (4.1%)
Hispanic or Latino 15 (15.3%) 7 (14.3%) 8 (16.3%)
Asian or Pacific Islander 12 (12.2%) 5 (10.2%) 7 (14.3%)
Other 6 (6.1%) 2 (4.1%) 4 (8.16%)
Declined to state 1 (1.0%) 0 (0%) 1 (2.0%)
Relationship Status
Married/ Domestic Partnership 80 (81.6%) 40 (81.6%) 40 (81.6%)
Dating/ Cohabiting 18 (18.4%) 9 (18.4%) 9 (18.4%)
M (SD)

M (SD)
Range
M (SD)
Range
Age
33.6 (5.34)

34.7 (6.24)
22-57
32.5 (4.43)
21-39
Early Family Adversity
23.6 (8.22)

22.4 (7.70)
12-45
24.8 (8.73)
13-45
Relationship Satisfaction
121.6 (20.06)

119.5 (21.26)
61-156
123.7 (18.86)
68-152
Table 1. Participant and Couple Characteristics
COUPLE CONFLICT DURING PREGNANCY 51

All Participants
(n = 98)
Males
(n = 49)
Females
(n = 49)
M (SD)

M (SD)
Range
M (SD)
Range

Oxytocin
220.9 (205)

201.2 (195.0)
5-773
240.5 (215.0)
27-935
Positive Conflict Behavior
.27 (.15)

.28 (.15)
.07-.75
.26 (.14)
.05-.66
Negative Conflict Behavior
.11 (.12)

.10 (.10)
0-.33
.12 (.13)
0-.45
Neutral Conflict Behavior
.63 (.17)

.63 (.16)
.16-.82
.62 (.17)
.21-.86
Table 1 Continued. Participant and Couple Characteristics
COUPLE CONFLICT DURING PREGNANCY 52
Table 2. Correlation matrix for continuous participant characteristics.

1 2 3 4 5 6 7 8 9 10 11 12
Mothers
1. Early Family Adversity -
2. Relationship Satisfaction -.04 -
3. Positive Conflict Behavior -.03 .20 -
4. Negative Conflict Behavior .30* -.28
^
-.28* -
5. Neutral Conflict Behavior -.17 .02 -.74** -.44** -
6. Oxytocin .36* .20 .34* .12 -.42** -
Fathers
7. Early Family Adversity -.28
^
-.02 .08 .15 -.18 .06 -
8. Relationship Satisfaction .04 .56** .25
^
-.27
^
-.03 .04 -.21 -
9. Positive Conflict Behavior .19 .03 .69** -.09 -.58** .51** -.04 .17 -
10. Negative Conflict Behavior .11 -.31* -.21 .69** -.29* .06 .14 -.31* -.26 -
11. Neutral Conflict Behavior -.21 .14 -.55** -.30* .73** -.57** -.11 .01 -.83** -.32* -
12. Oxytocin .33* -.09 -.12 .28 -.13 .29
^
-.04 -.10 .25 .27 -.40* -
Note: ** p < .01, * p < .05,
^
p < .10

Abstract (if available)

Abstract Intimate partner conflict is a strong predictor of individual physical and psychological health, relationship outcomes, and children’s socioemotional development. Assessing maladaptive couple dynamics during pregnancy, as well as potential contributing psychosocial and biological correlates, is of clinical importance before these relational patterns shape the family environment when the couple transitions to parenthood. In a sample of 49 first-time pregnant couples, we examined how early adversity within the family of origin, relationship satisfaction, and plasma oxytocin may relate to observed couple conflict behavior. We found that mothers’ early family adversity was positively associated with mothers’ negative conflict behavior, yet no significant results emerged for fathers. Fathers’ early family adversity moderated the relationship between fathers’ oxytocin and mothers’ negative conflict behavior, such that among fathers who self-reported greater early family adversity, higher levels of oxytocin were associated with mothers’ negative conflict behavior. Findings from the current study suggest that gender differences may play a role in how harsh early family environments may impact adult relationship conflict. Additionally, these results highlight how fathers’ early family experiences and biology may affect their partner’s reactions to conflict. Understanding the effect of early life stress on couple conflict and marital satisfaction, particularly during pregnancy, may help to understand how partners contribute to detrimental couple conflict behavior while on the brink of starting their own family.

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University of Southern California Dissertations and Theses

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Asset Metadata

Creator Khaled, Mona (author)

Core Title Couple conflict during pregnancy: Do early family adversity and oxytocin play a role?

School College of Letters, Arts and Sciences

Degree Master of Arts

Degree Program Psychology

Publication Date 10/03/2017

Defense Date 04/30/2017

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag couple conflict,early family adversity,OAI-PMH Harvest,oxytocin,Pregnancy,prenatal conflict

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Saxbe, Darby (committee chair), John, Richard (committee member), Manis, Frank (committee member), Margolin, Gayla (committee member)

Creator Email Mkhaled@usc.edu,Mona.mkhaled@gmail.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c40-441273

Unique identifier UC11264432

Identifier etd-KhaledMona-5806.pdf (filename),usctheses-c40-441273 (legacy record id)

Legacy Identifier etd-KhaledMona-5806.pdf

Dmrecord 441273

Document Type Thesis

Rights Khaled, Mona

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA