This study tested associations among observed interaction patterns and dyadic adjustment in at-risk young adult couples (n = 47) from the Oregon Youth Study over the course of 7 years; each partner’s positive engagement, psychological aggression, and withdrawal within a particular conflict structure (his versus her topic) was used to predict adjustment over time at both within-couple (time-varying covariates) and between-couple (predictors of intercepts and slopes) levels of analysis. Women’s positive engagement during both topics and psychological aggression during men’s topics predicted higher or lower satisfaction, respectively, at both within- and between-couple levels. Increases in both men’s and women’s psychological aggression during their partner’s topic related to lower satisfaction over time within couples. Withdrawal during men’s topics predicted less decline in satisfaction, particularly for men. Results are discussed in terms of implications for future design of couples research.