BACKGROUND: As non-face-to-face contact has become a daily routine owing to the development of science and technology and impact of the coronavirus disease (COVID-19) pandemic, online technology-based services (TBSSs) have been expanding. Consequently, in virtual metaverse exercise spaces, the number of participants using TBSS is increasing. This study aimed to examine the effects of TBSS characteristics on the quality of the relationship between service providers and users of metaverse exercise services.
METHODS: The participants were metaverse exercise service users in Korea, who were selected through purposive sampling (n = 254, 194 men, 61 women). A questionnaire survey was conducted to measure the participants\' TBSS characteristics (enjoyment, stability, usefulness, ease of use, and reliability) and relationship quality (satisfaction, trust, and commitment). We analyzed the frequency, validity, reliability, and descriptive statistics of the collected data. Moreover, correlation and multivariate multiple regression analyses were conducted.
RESULTS: Enjoyment, stability, usefulness, and reliability of TBSS had positive effects on satisfaction; however, ease of use did not have a significant effect. In addition, enjoyment, usefulness, ease of use, and reliability of TBSS had positive effects on trust; however, stability did not have a significant effect. Furthermore, enjoyment and reliability of TBSS had positive effects on commitment; however, usefulness, ease of use, and stability had no significant effects.
CONCLUSIONS: This study provides metaverse exercise service providers with management strategies for attracting and retaining members. The results of this study could help develop effective TBSS and aid metaverse service companies facing a fiercely competitive environment.

Little is known about the role of subjective sexual arousal within romantic relationships. The current paper addresses this limitation using a prospective study design that investigates the direct associations between subjective sexual arousal induced by a romantic partner (partner arousal) and arousal induced by pornography (porn arousal) on changes in relational outcomes. A total of 309 participants who were in a current romantic relationship completed measures of partner and porn arousal as well as relational outcomes (i.e., sexual satisfaction and relationship quality and stability) at baseline (T1) and completed a second assessment of relational outcomes 2 months later (T2). Partner arousal was found to have no significant associations with changes in relational outcomes; however, porn arousal was associated with significant declines in sexual satisfaction and relationship quality and stability over a 2-month period. This paper is the first to examine how feeling sexually aroused by porn may impact relational outcomes for those in romantic relationships.

This longitudinal study explored the impact of COVID-19 on individuals in romantic relationships. The sample spans three waves: first confinement (n = 52), deconfinement (n = 49), and second confinement (n = 26). The study tested sociodemographic factors, psychological adjustment (anxiety, depression, stress, well-being), COVID-19 threat perception, dyadic coping, and relationship quality. Results from repeated measures ANOVA and fuzzy set qualitative comparative analysis (fsQCA) models revealed a decline in anxiety, depression, and stress symptoms, coupled with improved relationship quality over time. Well-being and dyadic coping remained stable, while COVID-19 threat perception increased. QCA models emphasized the predictive power of initial mental states (anxiety, depression, stress, and well-being at W1) on subsequent adjustment. Notably, shorter relationship duration, healthcare worker status, and not having children, when combined with prior mental states, explained increased symptoms and diminished well-being. The study underscores the significance of addressing these factors in individuals navigating romantic relationships during the pandemic.

Background: Pregnancy loss (PL) is a common, yet rarely examined public health issue associated with an increased risk of impaired mental health, particularly depression.Objective: Previous research shows childlessness to be a correlate of depression after PL. First studies also indicate associations of the type of loss, multiple losses, relationship quality, and coping strategies with depression after the loss of a pregnancy. However, results are inconsistent and the few existing studies show methodological deficits. Therefore, we expect higher depression scores for women without living children, and we exploratively examine the associations between the type of loss, the number of losses, relationship quality, and coping strategies with depression scores for women who suffered a PL.Method: In an online setting, N = 172 women with miscarriage (n = 137) or stillbirth (n = 35) throughout the last 12 months completed the Patient Health Questionnaire (PHQ-D), Brief-COPE, and Partnerschaftsfragebogen (PFB), a German questionnaire measuring relationship quality.Results: In a multiple hierarchical regression analysis, stillbirth, β = 0.15, p = .035, presence of living children, β = -0.17, p = .022, and self-blame/emotional avoidance, β = 0.34, p < .001, are predictors of depression scores. However, there was no association between depression symptoms and other coping strategies, relationship quality, and multiple losses.Conclusions: Especially with regard to women who have no living children, have suffered a stillbirth, or are affected by self-blame/emotional avoidance, health care providers should monitor the presence of depressive symptoms. Our results indicate the need for specific instruments measuring coping style and relationship quality after PL, since the standard items of the PFB and the Brief-COPE seem inappropriate for this setting.
Stillbirth is associated with higher maternal depression scores than miscarriage.Women with living children show lower depression scores after pregnancy loss than childless women.Self-blame and emotional avoidance are associated with higher maternal depression scores after pregnancy loss.

Masturbation is common and generally accepted in Western society as a normal, healthy activity. In contrast, the Catholic Church holds that masturbation is immoral. Noting that the human person is a profound unity of body and spirit, if the Church is correct, masturbation should have negative effects on the human person. If the secular view is correct, masturbation should have conversely positive effects. This paper is divided into three parts. An in-depth literature survey was performed to evaluate the physical, medical, psychological, sociological and spiritual correlates of masturbation. The second part is a theological summary of the Catholic understanding of masturbation. The third part is an approach to therapy. Physically, masturbation was found to be less sexually satisfying than intercourse. Medical complications include penile injury and self-asphyxial behavior. Psychologically, masturbation was found to be associated with depression, anxiety, immature defenses, hypersexuality, guilt, poor body self-image and stress in the workplace. Sociologically most studies indicate a negative correlation between masturbation and relationship satisfaction, quality, intimacy, relational happiness, emotional satisfaction with the partner, trust, passion, and love. Spiritually, masturbation is highly positively correlated with pornography consumption and negatively with religion and religiosity. There is a higher rate of masturbation in homosexuals and bisexuals than in heterosexuals. Theologically, masturbation and pornography directly violate the religious virtue of chastity, undermining one\'s prayer life and the motivation to develop a spiritual life. Therapeutically, positive psychology, which emphasizes cultivating what it identifies as virtues, including justice, courage, temperance, wisdom (similar to prudence), transcendence (similar to hope) and humanity (similar to charity), can be used to counsel individuals struggling with masturbation. Once the harms are understood, a person can be counseled that this temptation represents a challenge, an opportunity to build self-control, and with self-control the capacity to develop character strengths and major virtues.

BACKGROUND: Caring for a person with dementia can be a challenging experience, often associated with chronic stress and a heavy burden on family caregivers. Dementia also impacts the relationship between the caregiver and the person with dementia. The quality of this relationship is, in turn, an important factor influencing the well-being of both dyad members. The psychoeducational intervention \"Learning to feel better . . . and help better\" has shown positive results regarding family caregivers\' subjective burden, psychological distress, and self-efficacy. However, relationship quality has not been addressed in the context of this intervention.
METHODS: A longitudinal constructivist grounded theory approach was used to explore relationship quality as perceived by caregivers, possible changes and intervention components facilitating or preventing such changes. Three qualitative, semi-structured interviews (before, during and after the intervention) were performed with 13 family caregivers from three different intervention groups. The resulting 39 interviews were analysed regarding individual caregiver trajectories, per time point for all caregivers and regarding specific caregiver subgroups.
RESULTS: A model focusing on sustaining relationship quality in dementia was developed. It shows strategies that family caregivers develop and apply to facilitate positive interactions and feelings of connectedness with their family members with dementia. It also indicates that mastering such strategies requires reflective skills based on specific knowledge of dementia and coping strategies, which can be enhanced through active skills training, in which caregivers are guided to work on their individual stressful situations. Factors hampering change included difficulties in accepting dementia-related changes.
CONCLUSIONS: Findings suggest that psychoeducation, with active skills training based on caregivers\' current daily life situations, providing systematic procedures to handle daily challenges and specific knowledge about the impact of the disease, could support them in developing and applying supportive strategies to sustain or improve their relationship to their family member with dementia.

Emotions are fundamental to social interaction and deeply intertwined with interpersonal dynamics, especially in romantic relationships. Although the neural basis of interaction processes in romance has been widely explored, the underlying emotions and the connection between relationship quality and neural synchronization remain less understood. Our study employed EEG hyperscanning during a non-interactive video-watching paradigm to compare the emotional coordination between romantic couples and close friends. Couples showed significantly greater behavioral and prefrontal alpha synchronization than friends. Notably, couples with low relationship quality required heightened neural synchronization to maintain robust behavioral synchronization. Further support vector machine analysis underscores the crucial role of prefrontal activity in differentiating couples from friends. In summary, our research addresses gaps concerning how intrinsic emotions linked to relationship quality influence neural and behavioral synchronization by investigating a natural non-interactive context, thereby advancing our understanding of the neural mechanisms underlying emotional coordination in romantic relationships.

Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one\'s own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.

The current study was designed to investigate the protective effects of gratitude in romantic relationships. Particular attention was given to differentiating the beneficial effects of perceived gratitude (i.e., gratitude from one\'s partner, or feeling appreciated) versus expressed gratitude (i.e., gratitude to one\'s partner, or being appreciative) in mitigating the negative effects of ineffective arguing and financial strain on multiple indicators of relationship quality, both concurrently and longitudinally. The sample comprised 316 African American couples with three waves of data spanning approximately 16 months. Results indicated higher levels of perceived gratitude - but not expressed gratitude - weakened the association between relationship stressors and worsened outcomes (i.e., less satisfaction and confidence, more instability) at both between-person and within-person levels. Concurrently, perceived gratitude exhibited protective effects with respect to ineffective arguing and financial strain; longitudinal protective effects were observed only with respect to ineffective arguing. Results highlight the ways in which perceiving gratitude from one\'s partner, both at a single instance and sustained over many months, can be protective for multiple facets of relationship quality. Collectively, findings underscore the importance of interpersonal gratitude for romantic relationships and its merit for increased attention in research and practice.

BACKGROUND: An important factor that has not been directly addressed very often in caregiver (CG) counseling to date is the quality of the relationship between the CG and the care recipient (CR). One reason is the lack of availability of a suitable assessment tool that is not strongly influenced by social desirability. Here, we present and evaluate a new item for the assessment of relationship quality (RQ) in the context of informal caregiving of older people.
METHODS: N = 962 informal caregivers of older people participated. Our item assessed RQ by providing three answer categories (positive, neutral, and negative) that were presented through the use of smiley faces. For evaluation, and to avoid bias due to social desirability, the neutral and negative categories were combined. We calculated a stepwise binary logistic regression.
RESULTS: Expected associations with the variables care burden, perceived positive aspects, and care motivation were found (all p values < 0.01). An exploratory analysis revealed that additional predictors of RQ consisted of the CR\'s age as well as whether the CR\'s diagnosis was dementia, CG\'s amount of dysfunctional coping, and whether the CG was caring for more than one CR.
CONCLUSIONS: We conclude that our item is well-suited for the assessment of RQ in the context of informal caregiving of older people. Because it uses language-free answer categories by means of smiley faces, our item can be applied easily. Bias due to social desirability can be minimized by dichotomization (i.e., combining the negative and neural answer categories). In future research, our tool should be evaluated in other contexts.