Patient and spouse perceptions of the patient's heart disease and their associations with received and provided social support and undermining

Numerous empirical studies have investigated the relationships between cardiovascular diseases (CVD) and patients’ psychological well-being, with a focus almost exclusively on its dark side. Very little is known on the impact of illness severity on both negative and positive indicators of patients’ well-being, as well as on the psychosocial variables that may mediate this association. Aim of the study was to investigate the impact of illness severity on depression as well as on health satisfaction and life satisfaction of patients undergoing a cardiovascular rehabilitation. It also aimed at testing the mediation of illness perception and self-efficacy beliefs in managing cardiac risk factors. The study involved 172 patients (mean age?=?66.43?years; SD?=?9.99?years; 76.2% men). Illness severity was measured in terms of left ventricular ejection fraction at discharge from the cardiology department, whereas all psychological dimensions were assessed one week later. Results showed significant relationships among illness severity, depression and health satisfaction that were fully mediated by illness perception and self-efficacy beliefs, but not significant relation between disease severity and life satisfaction (χ ²(1)?=?2.30, p?=?n.s.). Overall, findings underline the importance of working on illness perception and self-efficacy beliefs to contrast depression and to improve health and life satisfaction in patients with CVD.     

An investment model of sociosexuality,relationship satisfaction,and commitment: Evidence from dating,engaged, and newlywed couples

Using an investment model (Rusbult, 1980, 1983) of sociosexual attitudes (SOI-A), we examined SOI-A’s association with relationship outcomes using actor–partner interdependence models (APIMs) of over 400 dating, engaged, and newlywed couples. Men’s SOI-A negatively related to both men’s (actor effect) and women’s (partner effect) relationship satisfaction. This actor effect persisted after controlling for men’s and women’s relationship commitment, and was stronger (more negative) among dating couples (vs. engaged or newlywed couples) and couples with shorter relationship durations. Moderated-mediation APIMs suggested that (a) both actor-effect satisfaction–commitment associations were more positive in couples dating for 6 months and (b) men’s relationship satisfaction mediated the link between men’s SOI-A and men’s relationship commitment, but only in couples dating for 6 months.     

The association of idealization and intimacy factors with condom use in gay male couples

The purpose of this study was to assess the relationship of idealization and three specific intimacy factors (relationship satisfaction, excitement, and closeness) to reported condom use in gay male couples. It was expected that there would be negative associations of idealization and the intimacy factors with condom use. Both members of 45 gay male couples completed a questionnaire that assessed these factors. This study found (a) idealization to have a significant negative correlation with condom use, suggesting that the more the individuals idealized each other, the less likely that condoms were used during sex; (b) a significant negative association between relationship satisfaction and condom use, implying that as the couples experienced more satisfaction within their relationships, condom use decreased; (c) a significant negative correlation between excitement and condom use, suggesting that as excitement increased, condom use decreased; and (d) no significant association between closeness and condom use.     

Promoting resilience to depression among couples during pregnancy: The protective functions of intimate relationship satisfaction and self-compassion

Pregnancy, while often marked by joy, may pose considerable risk for depression among parents. Against a backdrop of adverse life events, expectant parents may be even more vulnerable to developing symptoms of depression during the prenatal period. Thus, it is critical to identify sources of resilience that might facilitate a successful transition to parenthood among couples who have a history of adversity. Prior work suggests that interpersonal and intrapersonal factors associated with resilience, such as intimate relationship satisfaction and self-compassion (i.e., self-kindness, common humanity, and mindfulness), have the potential to attenuate prenatal depression among couples with a history of stressful life experiences. We tested this possibility in a sample of 159 couples navigating pregnancy. As predicted, a greater number of prior stressful life experiences was associated with increased depression symptom severity for both mothers and fathers. However, moderation analyses revealed the positive link between cumulative stressful life experiences and depression symptom severity was attenuated among mothers who reported greater self-compassion in the form of feelings of common humanity, and fathers who reported higher levels of intimate relationship satisfaction and self-compassion in the form of mindfulness. Findings suggest enhancing intimate relationship satisfaction and self-compassion among expectant couples may be valuable in attenuating prenatal depression among those with a greater history of adversity.     

Relationship Patterns and Role of Religion in Elderly Couples with Chronic Illness

ABSTRACT

This study was designed to explore the various relationship patterns and the role religion plays as a coping resource for elderly couples in which at least one spouse has a chronic illness. Elderly couples were interviewed and also completed marital satisfaction and couple communication inventories. Five different relationship patterns emerged from the data: active couples, short-term caregivinjg couples, long-term caregiving couples, survival couples, and live-in caregiver couples. Various aspects of religion emerged as an important coping resource among the different relationship patterns. Ideas and questions for research and practice, generated by the study, are presented.     

The tendency to forgive in dating and married couples: The role of attachment and relationship satisfaction

Given the positive benefits associated with interpersonal forgiveness, the current investigation examined the tendency to forgive in romantic relationships. Two studies tested the hypothesis that the tendency to forgive mediates the association between attachment models of self and other and relationship satisfaction in dating (n = 184) and marital relationships (n = 96). In addition, the extent to which the tendency to forgive predicts forgiveness of an actual transgression was examined among married couples. The tendency to forgive partially mediated the relation between model of other (relationship partner) and satisfaction for those in dating relationships and for husbands. For those in marital relationships, the tendency to forgive partially mediated the relation between model of self and satisfaction. In addition, for wives, endorsing a greater tendency to forgive was related to forgiveness of an actual transgression, regardless of the severity of that transgression. For husbands, endorsing a greater tendency to forgive was related to forgiveness of an actual transgression, but only for more severe transgressions. Results are discussed in terms of who is more likely to forgive and the role that the tendency to forgive plays in romantic relationships.     

An Exploratory Study of Predictors of Relationship Commitment for Cisgender Female Partners of Transgender Individuals

The current exploratory study investigates which variables predict commitment among cisgender women currently in a relationship with a transgender-identified partner. This study includes variables specific to gender diverse couples such as years in the relationship, amount of prior knowledge about transgender identity, and gender role beliefs. Also included are the general relationship factors of satisfaction, quality of alternatives, investment size, and the outcome variable of commitment, as described in the Investment Model of Commitment. Using convenience sampling from online support groups, the sample was n = 138 cisgender female partners. The findings of the regression analyses indicate one's personal resilience and the number of years in the relationship prior to transition are significantly related to partner commitment, with satisfaction mediating both associations. The longer a participant was in the relationship at the time of a gender transition of a partner, the less satisfaction they report, thus reducing commitment to the relationship. Additionally the more personal resilience a partner endorses, the higher the relationship satisfaction, and in turn, more commitment is reported. The results offer information about the important factors related to staying in relationships during and after a gender transition.     

Impact of psychiatric illness upon asthma patients’ health care utilization and illness control. Are all psychiatric comorbidities created equal?

The impact of psychiatric illnesses upon asthma patients' functioning is not well understood. This study examined the impact of psychiatric comorbidity upon illness management in asthma patients using empirically-derived psychiatric comorbidity groups. Participants were a clinic sample of Greek-speaking asthma patients (N = 212) assessed using the Patient Health Questionnaire (PHQ) Somatoform, Depression, Panic Disorder (PD), Other Anxiety Disorder, Eating Disorder (ED) and Alcohol sub-scales. The associations between sub-scales were examined using multiway frequency analysis. The following groups were derived: Somatoform disorder and/or Any Depressive disorder (n = 63), Somatoform disorder and/or Other Anxiety disorder (n = 51), Somatoform disorder and/or Any ED (n = 60), and Any Anxiety group including PD and/or Other Anxiety disorder (n = 24). Across all groups, psychiatric illness was associated with significantly worse asthma control (p < .01). Participants in Any Anxiety group, OR = 4.61, 95% CI [1.90, 11.15], Somatoform and/or Any Depressive disorder, OR = 2.06, 95% CI [1.04, 4.09] and Somatoform and/or Other Anxiety disorder, OR = 2.75, 95% CI [1.35, 5.60] were at higher risk for asthma-related Emergency Room (ER) visits compared to controls. However only Somatoform and/or Any Depressive disorder, OR = 3.67, 95% CI [1.60, 8.72], Somatoform and/or Other Anxiety disorder, OR = 5.50, 95% CI [2.34, 12.74], and Somatoform and/or Any ED, OR = 4.98, 95% CI [2.14, 11.60] group membership were risk factors for asthma-related hospitalizations. Results suggest that while comorbid psychiatric disorders generally negatively impact asthma illness management, different psychiatric comorbidities appear to have disparate effects upon illness management outcomes.     

Dyadic Causal Sequencing of Depressive Symptoms and Relationship Satisfaction in Romantic Partners Across Four Years

Abstract

Causal sequencing between relationship satisfaction and depressive symptoms has important ramifications for couples therapy. Using dyadic data from the Pairfam study (N?=?1,876 German couples), an auto-regressive cross-lagged model was used to test the causal sequencing of these associations annually across four years. Although depressive symptoms had a significant bidirectional association with relationship satisfaction both within and between partners, depressive symptoms tended to serve as a stronger and more consistent predictor of relationship satisfaction than the reverse direction. Thus, clinically focusing on reducing depressive symptoms in couples’ therapy may serve to help prevent future deterioration in relationship quality.     

New dimensions of abnormal illness behaviour derived from the Illness Behaviour Questionnaire

The primary aim was to explore the factor structure of the Illness Behaviour Questionnaire (IBQ) and the generalisability of the derived dimensions to both general community members and four chronic illness groups. A questionnaire was administered to 675 participants, comprising 344 from the community, 80 with asthma, 95 with diabetes, 79 with chronic pain and 77 with chronic fatigue syndrome (CFS). Illness severity was calculated for all chronic illness participants (self-rated health for community members). Three IBQ scales were derived following an exploratory factor analysis for the whole sample: Affirmation of Illness (α = 0.71 (CFS)–0.79 (asthma, diabetes)), Concern for Health (α = 0.71 (asthma)–0.78 (pain)) and General Affective State (α = 0.70 (CFS)–0.80 (asthma)). Patterns of response across the five samples, and intercorrelations among the new scales and the original seven scales, were largely in accord with expectation. Long-standing criticisms of the IBQ were addressed by using systematic statistical principles to identify meaningful and psychometrically sound IBQ dimensions. The derived structure offers a more parsimonious account of possible illness responses, with the availability of a more concise yet informative index of abnormal illness behaviour having practical utility for researchers and clinicians alike.     

Daily stress,closeness, and satisfaction in gay and lesbian couples

A daily diary analysis of the associations among stress, closeness, and relationship and sexual satisfaction was conducted with a sample of 40 gay male and 55 lesbian couples. Using interdependence theory as a guide, both actor and partner effects of stress, closeness, and their interaction were investigated. As predicted, it was found that participants' own feelings of closeness toward their partners buffered the negative association between stress and satisfaction but that when participants' partners felt particularly close on a stressful day their closeness exacerbated associations between stress and reduced satisfaction. These contrasting effects of closeness underscore the importance of considering the daily processes of both partners contributing to relationship quality.     

RELATIONSHIP SATISFACTION, AFFECTIVITY, AND GAY-SPECIFIC STRESSORS IN SAME-SEX COUPLES JOINED IN CIVIL UNIONS

Relationship satisfaction, affect, and stress were examined in 313 same-sex couples who had had civil unions in Vermont during the first year of this legislation. Similarity between partners on age and on positive/negative affectivity was related to relationship satisfaction whereas there was no association with similarity in income, education, and outness. Lesbian couples ( n = 199), compared to gay male couples, reported experiencing more stress related to family reaction to their sexuality, whereas gay male couples ( n = 114) reported more stress surrounding the issues of HIV/AIDS and violence/harassment than did lesbian couples. This study is the first to examine within-couple factors among same-sex couples with legalized relationships.     

Minority Stress and Same‐Sex Relationship Satisfaction: The Role of Concealment Motivation

Most lesbian, gay, and bisexual (LGB) people want a stable, satisfying romantic relationship. Although many of the predictors of relationship outcomes are similar to those of heterosexual couples, same‐sex couples face some additional challenges associated with minority stress that also impact upon relationship quality. Here, we investigate the association between minority stressors and relationship quality in a sample of 363 adults (M age = 30.37, SD = 10.78) currently in a same‐sex romantic relationship. Internalized homophobia and difficulties accepting one's LGB identity were each negatively associated with relationship satisfaction via heightened concealment motivation. We also examined the protective role of identity affirmation on relationship quality, finding a direct positive relationship between the two variables. Minority stressors were negatively associated with couple relationship satisfaction via heightened concealment motivation. The finding that identity affirmation directly predicted increased couple satisfaction also highlights the important role of protective factors in same‐sex couple relationships.     

Gay males’ intimate relationship quality: The roles of attachment security,gay identity,social support,and income

Past research of relationship quality in same–sex couples has emphasized similarities with heterosexual couples. The present study examined both general and gay–specific intra– and interpersonal factors as predictors of gay men's relationship durability and relationship satisfaction. Our proposed path model postulated effects of contextual variables on self and relationships (i.e., social support/acceptance as context for attachment security, self–acceptance, and intimate relationships). The data, collected from an Israeli sample of gay men (N = 121), supported this model. All hypothesized paths were significant: Attachment security mediated the association of perceived friends’ support and self–acceptance with relationship quality, self–acceptance mediated the association of self–definition and perceived friends’ acceptance with relationship quality, and income had a direct association with relationship quality.     

Longitudinal associations between relationship problems,divorce, and life satisfaction: Findings from a 15-year population-based study

Relationship problems are negatively associated with life satisfaction. Bottom-up theories assume that relationship quality affects life satisfaction while top-down theories assume that global personality dispositions affect evaluations of relationship quality. Only bottom-up theories imply that the negative association between relationship problems and life satisfaction will be removed when the relationship is ended and that divorce thus may be a positive event for persons from troubled relationships. In this study associations between relationship problems, divorce, and life satisfaction were examined among 369 heterosexual couples. Relationship problems predicted life satisfaction 15 years later in both men and women. This association was significantly stronger among not-divorced than among divorced couples. Among couples with severe relationship problems those who divorced had higher life satisfaction at 15-year follow-up than those who remained together while the reverse was true among less troubled couples. The findings thus support bottom-up theories of life satisfaction.     

Escalation and Regulation of Emotional Arousal in Couples Predicts Relationship Satisfaction Concurrently and 25 Years Later

Relationship distress and divorce are major risk factors for the development or exacerbation of psychopathology and psychosocial impairments. Given that heightened negative emotions within couples’ interactions may portend negative relationship outcomes, it is critical to understand how emotions unfold across a conversation and how partners may influence each other’s immediate emotional experiences. This study examined whether these regulatory dynamics within one interaction predicted relationship satisfaction concurrently and 25 years later. Vocally‐encoded emotional arousal (f₀) was measured during couples’ (N = 25 couples) conversations about a relationship issue. Across different analytical strategies, results demonstrate that one partner’s f₀ dynamics had immediate and long‐term associations with the other partner’s satisfaction. Partners were less satisfied if the other partner (a) expressed higher f₀ overall and (b) escalated more in f₀ across the conversation. Yet, partners were more satisfied when their f₀ escalated across the conversation. Also, women specifically were more satisfied if their f₀ remained elevated longer before regulating back to their emotional baseline. Thus, higher f₀ was associated with higher satisfaction in the same partner, but associated with less satisfaction in the other partner—particularly when these emotions come from women. It may be that partners have to decide whether to prioritize expressing their emotions fully or limit expression in the service of their partner’s happiness. These findings challenge us to think of ways to address this “win–lose” scenario so that couples can balance both partners’ emotional needs and preserve relationship quality across the life span.     

Dysfunctional beliefs, self-monitoring, and marital conflict

Relationships among relationship beliefs, self-monitoring and conflict behavior were examined in 74 married couples. It was predicted that dysfunctional relationship beliefs would be negatively correlated with marital satisfaction and that high self-monitoring spouses would endorse more dysfunctional relationship beliefs and display more disagreeing and leadership conflict behavior. Dysfunctional beliefs were negatively correlated with satisfaction but low and high self-monitors did not differ in their conflict behavior. Discriminant analyses indicated that marital distress was a function of endorsement of dysfunctional relationship beliefs; decreased satisfaction with decisions; increased conflict relevance; and increased impression management reflected in high self-monitoring orientations among husbands and wives’ beliefs that their husbands were not behaving “normally.” The contribution of gender and impression management to marital distress is discussed. This study was funded by a University of Wisconsin-Madison faculty research grant awarded to the author.     

Couples treatment of agoraphobia: changes in marital satisfaction

Six agoraphobic women and their husbands participated in a group therapy program consisting of exposure and cognitive restructuring. The husbands acted as co-therapists. Ratings of marital satisfaction as well as severity of phobia were filled out independently by both clients and their husbands throughout the course of therapy and at follow-up. Two patterns of relationships among marital satisfaction and severity of phobia emerged. For four couples a parallel relationship was observed in that as phobia improved marital satisfaction increased. For two couples the inverse relationship was noted where improvements in phobia were correlated with decreases in marital satisfaction. The importance of the interpersonal context of agoraphobia and implications for treatment are suggested.     

Loving, liking, looking and sensation seeking in unmarried college couples

This study examined the relationships between sensation seeking or sensation seeking similarity and relationship satisfaction in college couples. Fifty-eight couples were tested with the Sensation Seeking Scale form V and the Loving and Liking Scales, and each couple was observed for eye gaze behavior. Eye gaze was found to be unrelated to the questionnaire measures of relationship involvement and a low but significant negative relationship was found between the female partner's love rating and mutual gaze and focus. As in previous research, couples' sensation seeking scores were significantly correlated, indicating tendencies toward assortative mating. However, only the women's relationship satisfaction scores were related to discrepancies in the couples' SSS scores. Individual sensation seeking scores correlated negatively with relationship satisfaction for both sexes. The latter effect was explained in terms of the high sensation seeker having a variety of interests outside of their primary relationships, and stronger tendencies for boredom and independence.     

Anxiety and Asthma Symptoms in Urban Adolescents with Asthma: The Mediating Role of Illness Perceptions

Twenty to 40% of adolescents with asthma experience significant symptoms of anxiety. This study examined the mediational role of illness perceptions in the relationship between anxiety and asthma symptoms in adolescents. One hundred fifty-one urban adolescents (ages 11–18) with asthma completed measures of illness perceptions, and anxiety and asthma symptoms. Using the Baron and Kenny approach and Sobel tests, we examined whether illness perceptions mediated the anxiety-asthma symptom relationship. Three illness perceptions significantly mediated the relationship between anxiety and asthma symptoms, z = 1.97–2.13, p < .05; adjusted R ² = 0.42–0.51, p < .05. Greater anxiety symptoms were associated with perceptions that asthma negatively impacted one’s life and emotions and was difficult to control. These negative illness perceptions were, in turn, related to greater asthma symptoms. Illness perceptions helped explain the anxiety-asthma symptoms link in adolescents. Results suggest that targeting illness perceptions in adolescents with asthma and anxiety may help reduce asthma symptoms.