Causes and consequences: individual distress in the context of couple interactions.

The covarying relationship between individual distress and couple interactions provides justification for developing a system to classify couple interactional behaviors. This system is proposed as an alternative to the Diagnostic and Statistical Manual of Mental Disorders (e.g., 4th ed.; DSM-IV; American Psychiatric Association, 1994) system, whose problems include reliance on linear models of causality, atheoretical classification of individual syndromes, and poor predictive validity and treatment utility. These difficulties may be resolved by using an alternative classification model of couple interactions, at least for many distressed individuals and couples. An example of a model for classifying couple interactions (including distressed individual behavior) is presented. The potential benefits of theoretical consistency, implied treatment-matching strategies, increased predictive validity and enhanced treatment utility of such an alternative classification system are discussed, along with guidelines for the further development and testing of couple interaction classification alternatives to the DSM nosology.