child in the family, including effects on the child’s mental or other medical disorders.
Other Problems Related to  Primary Support Group
V61.10 (Z63.0) Relationship Distress With Spouse or Intimate Partner
This category should be used when the major fo cus of the clinical contact is to address the
quality of the intimate (spouse or partner) relationship or when the quality of that rela-
tionship is affecting the course, prognosis, or  treatment of a mental or other medical dis-
order. Partners can be of the same or differ ent genders. Typically, the relationship distress
is associated with impaired functioning in beha vioral, cognitive, or affective domains. Ex-
amples of behavioral proble ms include conflict resolution difficulty, withdrawal, and
overinvolvement. Cognit ive problems can manifest as chronic negative attributions of the
other’s intentions or dismissals of the part ner’s positive behaviors. Affective problems
would include chronic sadness, apathy, and/or anger about the other partner.
Note:  This category excludes clinical encounte rs for V61.1x (Z69.1x) mental health ser-
vices for spousal or partner abuse prob lems and V65.49 (Z70.9) sex counseling.
V61.03 (Z63.5) Disruption of Family by  Separation or Divorce
This category should be used when partners in  an intimate adult couple are living apart
due to relationship problems or are in the process of divorce.
V61.8 (Z63.8) High Expressed Emotion Level Within Family
Expressed emotion  is a construct used as a qualitat ive measure of the “amount” of emo-
tion—in particular, hostility, emotional overin volvement, and criticism directed toward a