Marital satisfaction in patients with cancer: does support from intimate partners benefit those who need it the most?

This cross-sectional study assessed 3 ways of providing spousal support. Active engagement means involving the patient in discussions and using constructive problem-solving methods; protective buffering means hiding one's concerns; and overprotection refers to underestimation of the patient's capabilities, resulting in unnecessary help and excessive praise for accomplishments. Ratings of received spousal support by 68 patients with cancer revealed findings similar to those of partners' ratings of provided support. The positive association between active engagement and the patient's marital satisfaction was stronger for patients with a rather poor psychological and physical condition than for those with a rather good condition. Furthermore, protective buffering and overprotection were negatively associated with marital satisfaction only when patients experienced relatively high levels of psychological distress or physical limitations.     

Everything Here is Fine: Protective Buffering by Military Spouses During a Deployment

To minimize potential distractions for deployed military service members (SMs), some nondeployed romantic partners have reported engaging in protective buffering, or intentionally withholding information or concerns to protect their deployed partner. This study assessed the associations of protective buffering and psychological distress and marital satisfaction for military couples during and after deployment. Additionally, the study explored whether protective buffering was related to SM reports of being distracted during deployment by family matters. A total of 54 couples provided data before, during, and after an Army deployment. In multilevel models, higher protective buffering by partners was associated with higher psychological distress and lower marital satisfaction for both SMs and partners during, but not after, deployment. Additionally, partners reported frequent use of protective buffering during deployment; however, protective buffering was not significantly correlated with family related distraction for SMs during deployment. Limitations and implications of these findings are discussed.     

Predictors of relationship adjustment among couples coping with a high risk of developing breast/ovarian cancer

This study investigated the association between supportive and collaborative processes and dyadic adjustment in 94 women at increased risk of breast/ovarian cancer and their partners. Participants were recruited through two familial cancer clinics. They completed mailed, self-report questionnaires that included measures of psychological distress, dyadic adjustment (consensus, cohesion and satisfaction) and couple predictor variables (perceived support and team approach). Most couples reported average-to-high levels of consensus, cohesion and satisfaction, with a small proportion of couples (6.4%) reporting scores that reached clinically significant levels of dyadic distress. Greater perceived support was associated with better dyadic consensus and satisfaction, and dyadic cohesion and satisfaction were higher among couples who reported greater use of a team approach. General distress did not moderate the association between dyadic coping and relationship quality. There were no significant relationships between intra-couple congruence on support or team approach, and dyadic adjustment. Most couples had a functional relationship in the face of the current health stressor, although a subgroup may be at elevated risk of negative psychological consequences, including further relationship strain. The results highlight that dyadic coping strategies are important factors involved in the quality of couples' relationship following genetic counselling for breast/ovarian cancer risk.     

Protective Buffering by Service Members During Military Deployments: Associations with Psychological Distress and Relationship Functioning

To shield a romantic partner from potential distress due to stressors occurring during deployment, service members (SMs) may engage in protective buffering, or withholding information or concerns from a romantic partner. This study utilized data from 54 couples collected before, during, and after a military deployment to assess whether SMs engaged in protective buffering while deployed and the possible associations between buffering and psychological, relationship, and contextual factors. Only 2% of SMs indicated never engaging in protective buffering during a deployment. In bivariate analyses, only partners’ psychological distress prior to deployment was significantly associated (negatively) with protective buffering. In multilevel models with time nested within individuals, and individuals nested within couples, higher buffering was associated with less partner distress during deployment, but was also associated with higher SM distress both during and after deployment. In these multilevel models, protective buffering was not significantly associated with SM or partner marital satisfaction.     

Psychological distress with relationship satisfaction is moderated by anticipatory relational savoring among non-deployed military partners

This study recruited participants whose partners were deployed for active-duty military service to examine whether anticipatory relational savoring moderated the association of psychological distress with relationship satisfaction. Two weeks prior to their partner's deployment (T1), participants (N = 73) completed a self-report measure of relationship satisfaction. Then, 2 weeks into their partner's deployment (T2), participants completed self-report measures of stress, loneliness, and depression (combined into a composite index of psychological distress), and relationship satisfaction. Participants also completed a stream-of-consciousness task at T2 in which they imagined and discussed their partner's return from deployment. We coded the stream-of-consciousness task for anticipatory relational savoring regarding their upcoming reunion with their deployed partner. We found that anticipatory relational savoring moderated the association of psychological distress with during-deployment relationship satisfaction after adjusting for demographics, interpersonal variables, and deployment-specific variables; the association did not hold after adjusting for pre-deployment relationship satisfaction, and thus was robust when considering the distress-satisfaction association during the deployment but was not when considering changes in relationship satisfaction from pre- to during-deployment. We discuss the potential importance of anticipatory relational savoring for this unique population.     

Relationship beliefs and illness appraisals are differentially associated with specific ways of coping in spouses of patients with type 2 diabetes

Using data from 117 spouses of patients diagnosed with type 2 diabetes and multiple-group path analysis, the current study explored the association of four relationship beliefs (satisfaction, sacrifice, confidence and instability) and four diabetes appraisals (consequences, distress, control and efficacy) with illness-specific coping behaviour: active engagement, protective buffering and overprotection. The potential moderating effect of gender was also tested. Results indicated gender did moderate the associations among the variables in the model, with the association of relationship satisfaction and active engagement being significantly stronger for men, while diabetes control was more strongly related to protective buffering for women. The only variables associated with active engagement were three relationship-specific cognitions: higher levels of relationship satisfaction (for men only), satisfaction with sacrifice and relationship confidence were all related to higher active engagement. The diabetes appraisals were the only variables associated with protective buffering and overprotection. Higher diabetes distress and diabetes control (for women only) and lower diabetes efficacy were predictive of greater protective buffering. Lower diabetes efficacy and higher diabetes control were associated with greater overprotection. Implications for theory, research and practice are discussed.     

The relational context of social support: Relationship satisfaction moderates the relations between enacted support and distress

In two studies of kidney transplant patients and their significant others, the authors examined whether the relations between enacted social support and patient distress were moderated by patients' satisfaction with their relationship with the support provider (i.e., their significant other). In Study 1 (n = 121 couples), unsupportive spousal behaviors were associated with more distress only among patients who were less satisfied with their marital relationship. In Study 2 (n = 112 couples), the relations between unsupportive behaviors and distress again varied as a function of the patient's relationship satisfaction, although the particular pattern of the interaction depended on the specific unsupportive behaviors offered to the patient. In both studies, relationship dissatisfaction was associated with higher levels of patient distress. Supportive behaviors were not related to distress and did not interact with relationship satisfaction. Implications for future research on social support in marriage are discussed.     

Couples coping with a myocardial infarction: a contextual perspective on wives' distress

Conventional models of stress and coping are highly individualistic and give little attention to circumstances and involvement with others. A more contextual perspective on wives of patients who had suffered myocardial infarctions was adopted in this study. Wives' distress was related to the character of the infarction, but initial contact with medical personnel and marital quality each had independent contributions. Other analyses related wives' distress to their and the patients' coping. Wives' protective buffering of patients had a positive relationship with their own distress, even though Smith & Coyne (1988) have shown it contributes to patients' self-efficacy. Results suggest the need to acknowledge the limitations on adaptation imposed by health and the health care system. Also, initial conditions set a trajectory for later adaptation and there may be tradeoffs between preserving one's own well-being and contributing to a partner's efficacy.     

A multilevel examination of interpartner intimate partner violence and psychological aggression reporting concordance

Low concordance of reports across partners has consistently been observed when partners report the frequency of intimate partner violence (IPV) and psychological aggression (PA) in their relationship. Researchers have been unsuccessful in the quest to discover systematic biases across reporters, perhaps due to examining constructs that are not the source of bias (e.g., gender, victim/perpetrator status) or examining potentially fruitful constructs using underpowered statistics or erroneous conceptualizations (e.g., examining variables at a dyadic, rather than an individual, level). We used multilevel modeling with two samples (Ns = 88 and 164 couples) to examine husbands' and wives' relationship satisfaction as individual-level correlates of husband- and wife-perpetrated IPV and PA reporting concordance. Consistent with prior literature, low to moderate levels of agreement were observed, and gender and victim/perpetrator status were not consistently associated with reporting concordance. In contrast, for both husbands and wives, relationship satisfaction was associated with reporting concordance such that high relationship satisfaction was related to reporting less of one's partner's PA than the partner reported, whereas low relationship satisfaction was related to reporting more of one's partner's PA than the partner reported. A similar pattern of results emerged for the reporting of IPV, but results did not cross validate between samples. These findings suggest that relationship satisfaction may lead to either reluctance, or increased willingness, to attribute negative relationship events to partner behavior, potentially due to partner blame and relationship schemas. In addition, the influence of individual-level factors may be occluded when aggregated across partners to examine correlates of interpartner reporting concordance.     

Goal disturbance,coping, and psychological distress in partners of myocardial infarction patients: Taking account of the dyad

Abstract

This study aims to explore the relationship between goal disturbance and levels of psychological distress in partners of myocardial infarction (MI) patients. Furthermore, the role of partner and patient coping behaviour in the context of goal disturbance is explored. Forty dyads were interviewed and completed questionnaires 1 month (T1) and 4 months (T2) post MI. All patients were men. Patients and partners do not differ on anxiety or depression scores, however, patients experience significantly more higher order goal disturbance at T1. Partners reporting more goal disturbance also show increased distress at T1. More use of approach coping by partners contributes to explained variance in their goal disturbance. Partner avoidant coping is moderated by patient avoidant coping. Approaches to reduce distress in partners should thus take account of goal disturbance and coping behaviours within the dyad.     

Social-cognitive processes as moderators of a couple-focused group intervention for women with early stage breast cancer.

OBJECTIVE: The purpose was to examine whether social-cognitive variables would moderate the efficacy of a couple-focused group intervention (CG) for women diagnosed with early stage breast cancer. DESIGN: Participants (N = 238) were randomly assigned to 6 sessions of a couple-focused group versus usual care. Intent to treat growth curve modeling analyses indicated that emotional expression and emotional processing moderated CG effects on depression. MAIN OUTCOME MEASURES: The primary outcome measures for this study were psychological distress and psychological well-being. RESULTS: Treatment attrition analyses separating out participants assigned to but not attending CG indicated that emotional expression, emotional processing, and protective buffering moderated the effects of CG among those who attended CG with the most consistent effects noted for emotional processing on indicators of distress and well-being. CONCLUSION: The CG intervention may be more effective for patients who begin the group experience using emotional approach coping strategies to deal with cancer.     

Partners' internal stress and well-being: The role of dyadic coping and problem resolution

Couples' experiences of daily stress can be detrimental for partners' individual and relational well-being, specifically their identity as a couple, their relational satisfaction, and their life satisfaction. Grounded in the Systemic Transactional Model, this study aimed at analyzing factors that may safeguard partners and their relationship from detrimental effects of internal stress (i.e., stress that originates inside the relationship). We examined the buffering effect of partners' positive dyadic coping and internal problem resolution. Daily diary data were collected across 7 days from 82 heterosexual couples. Multilevel dyadic analyses showed that internal stress was negatively associated with partners' individual and relational well-being. Positive dyadic coping moderated the association between partners' internal stress and couple satisfaction for both partners, but not life satisfaction and couple identity. Moreover, for partners who reported a resolution to the internal problem, the negative associations of internal stress with life satisfaction, couple satisfaction, and couple identity were significantly lower than for those who did not resolve the internal problem. This study confirms the negative role of internal stress on well-being, shows the associations between internal stress and couple identity, and highlights the protective role of dyadic coping and internal problem resolution in couples' daily lives.     

Ovarian cancer patients' psychological distress: the role of physical impairment, perceived unsupportive family and friend behaviors, perceived control, and self-esteem.

Although research has indicated that illness-related and interpersonal stress are associated with greater psychological distress among cancer patients, little empirical attention has been given to mechanisms that account for these relationships. In the present study, 2 mechanisms for the association between illness-related stress (physical impairment) and interpersonal stress (family and friend unsupportive responses) and psychological distress of 143 ovarian cancer patients were examined cross-sectionally. Separate structural equation models tested whether physical impairment impacted patients' distress via decrements in perceived control over their illness and whether unsupportive behaviors impacted patients' distress via decrements in patients' self-esteem. Results supported the proposed models and suggest that perceived control and self-esteem are 2 mechanisms for explaining how illness-related and interpersonal stress may be associated with psychological distress among women with ovarian cancer.     

Combat veterans' symptoms of PTSD and partners' distress: the role of partners' perceptions of veterans' deployment experiences

Romantic partners of combat veterans with posttraumatic stress disorder (PTSD) report elevated relationship and psychological distress. One recent study suggests that this association may be weaker when partners perceive that veterans experienced higher levels of traumatic deployment events, but such results have not yet been replicated. We replicated and extended these findings in a sample of 206 National Guard service members who deployed overseas since 2001 and their partners. We used multivariate structural equation models to explore whether partners' perceptions of service members' deployment experiences moderated the associations of severity of service members' overall PTSD and specific PTSD clusters with partners' psychological and relationship distress. The significant association of overall PTSD symptom severity with partners' distress was not moderated by partners' perceptions. When examining PTSD symptoms at the cluster level, only the numbing/withdrawal cluster was significantly associated with distress. However, this association was moderated by partners' perceptions of service members' deployment experiences, such that the associations weakened as these perceptions increased. These results are in line with research indicating that the avoidance cluster of PTSD symptoms is particularly detrimental for partners of those with PTSD. Furthermore, they indicate that such symptoms are associated with less distress in partners who perceive that service members experienced high levels of potentially traumatic deployment events. Such perceptions may be linked with external attributions for symptoms, which suggests that psychoeducation regarding the causes of PTSD and the totality of PTSD symptoms may be useful in intervening with such partners.     

Discrepancies between patients' and partners' perceptions of unsupportive behavior in chronic obstructive pulmonary disease

The literature on chronic diseases indicates that partner support, as perceived by patients, contributes to well-being of patients in either a positive or a negative way. Previous studies indicated that patients' and partners' perceptions of unsupportive partner behavior are only moderately related. Our aim was (1) to investigate whether discrepancies between patients' and partners' perceptions of two types of unsupportive partner behavior-overprotection and protective buffering-were associated with the level of distress reported by patients with chronic obstructive pulmonary disease (COPD) and (2) to evaluate whether the direction of the differences between patients' and partners' perceptions was associated with distress (i.e., whether patient distress was associated with greater patient or greater partner reports of unsupportive partner behavior). A cross-sectional study was performed using the data of a sample of 68 COPD patients and their spouses. Distress was assessed using the Hopkins Symptom Checklist-25. Patients' and partners' perceptions of unsupportive partner behavior were assessed with a questionnaire measuring overprotection and protective buffering. Distress was independently associated with patients' perceptions of protective buffering and discrepancies in spouses' perceptions of overprotection. Regarding the direction of the discrepancy, we found that greater partner reports of overprotection as compared with patient reports were related to more distress in COPD patients. Our study showed that patients' distress was associated not only with patients' perceptions, but also with discrepancies between patients' and partners' perceptions of unsupportive partner behavior.     

Distress in spouses of Vietnam veterans: associations with communication about deployment experiences

Emerging literature shows a consistent pattern of relationship and psychological distress in spouses or partners of combat veterans with symptoms of posttraumatic stress disorder (PTSD). One possible mechanism of partners' distress posited in clinical literature is that excessive discussion of traumatic events from deployment may have negative effects on partners. At the extreme, some partners are suggested to develop PTSD-like symptoms, or secondary traumatic stress. Despite these hypotheses, there have been few empirical tests of the effects of communicating about such events. In a sample of 465 combat veterans and their spouses who participated in the Family Interview Component of the National Vietnam Veterans Readjustment Study, we explored how the extent of couples' deployment-related communication was associated with partner relationships and psychological distress, and whether such associations were moderated by the severity of veterans' PTSD symptoms. Results showed that Vietnam-specific communication correlated negatively with relationship distress, but the effect was negligible after controlling for overall communication in the relationship. On the other hand, Vietnam-specific communication did not correlate with psychological distress, but the association was significantly moderated by veterans' PTSD symptom severity. Specifically, communication about Vietnam was increasingly and positively associated with partners' psychological distress as veterans' symptoms of PTSD rose into the clinical range, but nonsignificantly and negatively associated with such distress as PTSD symptoms decreased below this level. The findings support previous clinical recommendations that couples' discussions of potentially traumatic events be approached cautiously, and they suggest a need to attend to the content of couples' communications when conducting dyadic interventions for PTSD.     

When the heat is on: romantic partner responses influence distress in socially anxious women

This study provided a preliminary test of whether socially anxious women and their partners would show more negative social support behavior, especially among those with low relationship satisfaction, and whether this would increase the distress of the socially anxious women. Women with (n=22) and without (n=23) heightened social anxiety were observed interacting with their partners under a social-evaluative threat and support behaviors were coded. Unexpectedly, no differences were found between socially and non-socially anxious women and their partners. Although relationship satisfaction influenced this process, it was the more satisfied women who showed more negative behavior. Additionally, the more positive behaviors the partner exhibited, the greater was the distress reported by socially anxious women, particularly among women whose partners reported high relationship satisfaction. Implications for how these findings might expand theories on interpersonal processes in social anxiety are discussed.     

The psychosocial effects of rheumatoid arthritis on the patient and the well partner

Rheumatoid arthritis (RA) is a chronic disorder that can have a severe impact on patient's lives. This present study investigated four questions regarding the psychosocial effects on patients and their well partners. First we found that depression for both patients and partners were slightly elevated and 35.7% of patients and 23.3% of well partners had scores above the cut-off for possible clinical depression on the Center for Epidemiological Studies Depression Scale. Second, there was no significant difference between the patients' level of distress and that of the partners. Third, there were moderate positive correlations between patients' and partners' scores on measure of psychological functioning. Fourth, there were no differences in either the patients' or partners' well-being based on the gender of the patient. Finally, an exploratory analysis was conducted to examine the factors which influence the patients' and partners' depression and their view of the relationship.     

Direct and indirect pathways between adult attachment style and marital satisfaction

We explored direct, mediated, and moderated associations between adult attachment style and marital satisfaction using a community‐based sample of 73 married women. Continuous ratings of secure, avoidant, and ambivalent attachment styles were related to levels of marital satisfaction. However, psychological distress mediated the association between secure attachment and marital satisfaction, and social support mediated the relation between avoidant attachment and marital satisfaction. In addition, psychological distress moderated the relation between both secure and avoidant attachment styles and marital satisfaction.     

Partner–objectification in romantic relationships: A dyadic approach

The present study investigated the relationship between the objectification of one's romantic partner (partner–objectification) and relationship quality using 221 heterosexual couples. Controlling for relevant covariates, actor–partner interdependence models revealed no partner effects but multiple actor effects. First, men who objectified their partners more had lower levels of relationship commitment and relationship satisfaction, and perceived higher quality alternatives to the relationship. Second, women who objectified their partners more had lower levels of relationship satisfaction themselves. Third, relationship duration marginally moderated the association between partner–objectification and relationship commitment, with partner–objectification negatively linked to one's own relationship commitment in relationships of shorter durations, but not when relationship durations were longer. Implications for an investment model and romantic relationship objectification are discussed.