Perceived control, coping efficacy, and avoidance coping as mediators between spouses' unsupportive behaviors and cancer patients' psychological distress.

This study examined whether avoidance, coping efficacy, and perceived control mediate the effects of spouses' unsupportive behaviors on patient psychological distress among 191 married individuals enrolled in cancer treatment. Results of the structural equation analyses suggested that avoidance and coping efficacy mediated the relationship between spouses' unsupportive behaviors and patient psychological distress. Perceived control of emotional aspects of the illness, including emotional responses and relationships with family and friends, and perceived control of the medical course of the cancer did not mediate the relationship between spouses' unsupportive behaviors and patient psychological distress. These findings suggest 2 mechanisms to explain why unsupportive responses from spouses may be associated with psychological distress among cancer patients.     

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.     

Responding to partners' expression of anger: the role of communal motivation

The effects of communal motivation on reactions to relationship partners' expressed anger were examined. In Study 1, married couples reported on the communal strength of their marriage, their expressions of anger to their spouse, and relationship satisfaction. In Study 2, college students reported on the communal strength of their best friendships, those friends' expressions of anger, and their evaluations of and provision of support to those friends. In Study 3, communal motivation toward a stranger who expressed mild anger was manipulated and evaluation of that stranger was measured. In all three studies, low communal motivation was associated with more negative evaluations of angry partners, lower relationship satisfaction, and, in Study 2, lower support provision. In contrast, when communal motivation was high, these decreases either did not occur (Studies 1 and 3) or were diminished (Study 2), and in Study 2, partners' anger was associated with increased provision of social support.     

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.     

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.     

The link between religion and spirituality and psychological adjustment: the mediating role of optimism and social support

Although optimism, social support, religiousness, and spirituality are important predictors of adjustment, rarely have studies examined these variables simultaneously. This study investigated whether optimism and social support mediated the relationship between religiousness and adjustment (distress and life satisfaction) and between spirituality and adjustment. Findings indicate that the relationship between intrinsic religiousness and life satisfaction and between prayer fulfillment and life satisfaction was mediated by optimism and social support. Furthermore, the relationship between religiousness and adjustment varied depending on how religiousness was operationalized and whether positive versus negative adjustment indicators were used. That is, intrinsic religiousness and prayer fulfillment were associated with greater life satisfaction, but extrinsic religiousness was not associated with life satisfaction. These findings were significant even after accounting for covariates (age, gender, ethnicity, social desirability). Results suggest religiousness and spirituality are related but distinct constructs and are associated with adjustment through factors such as social support and optimism.     

A dyadic investigation of exercise support between cardiac patients and their spouses.

The authors examined married partners' similarity in reported exercise behavior as a moderator of the association between social support for exercise provided and received by extending an actor-partner dyadic effects model. Participants were married cardiac rehabilitation patients and their spouses (N=99 couples). For couples similar in their reported exercise behavior, a significant association was found between both partners' independent reports of providing exercise support to and receiving exercise support from one another (n=49 couples). However, for couples differing in their reported exercise behavior (n=50 couples), no association was found between either partner's provision and receipt of support for exercise. Findings have the potential to inform practitioners of patients who may not be receiving adequate social support for their recommended exercise. Future interventions may consider implementing dyadic educational or motivational strategies with patients and their spouses.     

Perceived partner support in pregnancy predicts lower maternal and infant distress

Maternal postpartum emotional distress is quite common and can pose significant risk to mothers and infants. The current study investigated mothers' relationships with their partners during pregnancy and tested the hypotheses that perception of prenatal partner support is a significant predictor of changes in maternal emotional distress from midpregnancy to postpartum, and contributes to maternal ratings of infant distress to novelty. Using a prospective longitudinal design, 272 adult pregnant women were interviewed regarding their partner support, relationship satisfaction, and interpersonal security (attachment style and willingness to seek out support), and they completed standardized measures of prenatal symptoms of depression and anxiety (distress). At 6 to 8 weeks' postpartum, mothers reported these symptoms again and completed measures of their infants' temperament. Structural equation modeling (SEM) was used to test direct and indirect contributions of partner support, relationship satisfaction, and interpersonal security to maternal and infant postpartum distress. Mothers who perceived stronger social support from their partners midpregnancy had lower emotional distress postpartum after controlling for their distress in early pregnancy, and their infants were reported to be less distressed in response to novelty. Partner support mediated the effects of mothers' interpersonal security and relationship satisfaction on maternal and infant outcomes. A high-quality, supportive partner relationship during pregnancy may contribute to improved maternal and infant well-being postpartum, indicating a potential role for partner relationships in mental health interventions, with possible benefits for infants as well.     

Working models of attachment and attribution processes in intimate relationships

Two studies examined the link between working models of attachment and social construal processes in romantic relationships. In Study 1, individuals high in attachment-related anxiety responded to hypothetical partner transgressions by endorsing relationship-threatening attributions, experiencing emotional distress, and endorsing behavioral intentions that were likely to result in conflict. These effects emerged after controlling for pessimistic explanatory style, depressed mood, and self-esteem. In addition, the association between anxiety and emotional distress was mediated by attributions and attachment-related needs. In Study 2, anxious individuals endorsed relationship-threatening attributions for their partner's transgressions but less so for their partner's positive behaviors, and these effects occurred primarily among those in unhappy relationships. In contrast, avoidant individuals endorsed pessimistic attributions for their partner's positive behavior but less so for their partner's transgressions, and these effects occurred regardless of their level of relationship satisfaction.     

Relational self-construal moderates the effect of social support on life satisfaction

While social support is associated with a host of important physical and psychological benefits, these effects are not always straightforward. Still, the moderating factors that might underlie individual differences in reactions to social support are not well-understood. In the current studies, we examined individual differences in relational self-construal in the typically positive relationship between social support and life satisfaction. In Study 1 (N = 79) relational self-construal moderated the relationship between social support and life satisfaction such that social support was especially beneficial for those with high relational self-construal. We replicated this effect in Study 2 (N = 284), and also found that social support was especially important for individuals with high relational self-construal in the context of high feelings of stress. These studies suggest that social support has differently gauged effects on life satisfaction depending on an individual’s relational self-construal.     

Adult attachment style and partner choice: Correlational and experimental findings

Three studies were conducted to assess the role of attachment style in partner selection using both correlational and experimental methods. Study 1 (n = 83 couples) assessed correlations between partner ratings on attachment-style dimensions and the relations between own and partner attachment style and relationship satisfaction. In Study 2 (n = 226) and Study 3 (n = 146), participants who varied in terms of attachment style rated the desirability of potential partners who also differed in terms of attachment style. Results of all three studies generally suggested that individuals were most attracted to partners with similar attachment styles. For example, anxious individuals tended to be dating anxious partners in Study 1, and they preferred anxious partners over secure and avoidant partners in Studies 2 and 3 (combined data). Thus, not all individuals preferred secure partners. Second, unlike previous studies that looked primarily at partner correlations, there was no evidence of anxious/avoidant matching. In fact, anxious individuals seemed particularly averse to avoidant partners. Finally, ratings of parental caregiving styles (especially ratings of mothers) were associated with adult attachment dimensions and partner choices. For example, individuals who rated their mothers as more cold and ambivalent were less attracted to secure partners. Clinical and research implications are discussed.     

Communication behavior and relationship satisfaction among American and Chinese newlywed couples

Most research on couple communication patterns comes from North America and Europe and suggests cross-cultural universality in effects, but emerging studies suggest that couple communication takes different forms depending on the cultural context in which it occurs. The current study addressed this discrepancy by comparing the observed social support behaviors of 50 newlywed American couples and 41 newlywed Mainland Chinese couples, first on mean levels of positivity and negativity and second on behavior-satisfaction associations. Consistent with predictions derived from observational work by Tsai and Levenson (1997), Chinese couples were observed displaying significantly more negative behavior than American couples, even after controlling for relationship satisfaction; the 2 groups did not differ in observed positive behaviors. Tests of the moderating role of culture on behavior-satisfaction associations showed that positivity was significantly related to relationship satisfaction only for American husbands, whereas negativity was significantly associated with relationship satisfaction only for Chinese husbands. We speculate that cultural contexts may influence the display and evaluation of behavior in intimate relationships, suggesting the need for caution when generalizing models and associated interventions to non-Western couples.     

Partner support and marital satisfaction: Support amount,adequacy, provision,and solicitation

To compare the extent to which (a) amount versus adequacy of received support and (b) support provision versus solicitation behaviors predict marital satisfaction, married couples from the United States (N= 275) provided perceptions of received support and participated in 2 support transactions. Actor–partner interdependence modeling and structural equation modeling techniques were employed. Husbands’ perceptions of support adequacy predicted marital satisfaction more than their perceptions of support amount, whereas the results were generally the opposite for wives. Husbands’ provision and wives’ solicitation behaviors predicted marital satisfaction. Results suggest the need to move beyond simple counts of support received to examining support adequacy—and the various behaviors and roles involved in supportive transactions—to enhance theories of support and relationship functioning.     

Adjustment to Acute Leukemia: The Impact of Social Support and Marital Satisfaction on Distress and Quality of Life Among Newly Diagnosed Patients and Their Caregivers

Little is known about the specific patterns of adjustment among newly diagnosed acute leukemia patients and their caregivers. This study examined the trajectories of patient and caregiver distress over time as well as the extent to which marital satisfaction and social support moderated these trajectories among those with significant-other caregivers. Forty six patient-caregiver dyads provided ratings at four time points: within 1 week of diagnosis (T1), 2 week follow-up (T2), 6 week follow-up (T3) and 12 week follow-up (T4). As anticipated, patients and caregivers reported higher levels of distress around the time of diagnosis than they did during subsequent time points. Marital satisfaction was a significant predictor of distress among patients, whereas among caregivers, social support predicted distress and quality of life. Results support the inclusion of relational variables such as social support and relationship satisfaction in the assessment of newly diagnosed patients and families in order to best identify those at risk for distress over time.     

Moral outrage mediates the dampening effect of system justification on support for redistributive social policies

To understand how and why people tolerate ongoing social and economic inequality, we conducted two studies investigating the hypothesis that system justification is associated with reduced emotional distress and a lack of support for helping the disadvantaged. In Study 1, we found that the endorsement of a system-justifying ideology was negatively associated with moral outrage, existential guilt, and support for helping the disadvantaged. In Study 2, the induction of a system-justification mind-set through exposure to "rags-to-riches" narratives decreased moral outrage, negative affect, and therefore intentions to help the disadvantaged. In both studies, moral outrage (outward-focused distress) was found to mediate the dampening effect of system justification on support for redistribution, whereas existential guilt (Study 1) or negative affect in general (Study 2; inward-focused distress) did not. Thus, system-justifying ideology appears to undercut the redistribution of social and economic resources by alleviating moral outrage.     

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.     

Self‐concept clarity and relationship satisfaction at the dyadic level

Self‐concept clarity is an individual resource that is associated with couple relationship well‐being. In two dyadic studies, the authors investigated whether and how self‐concept clarity has implications for both partners' relationship satisfaction. Study 1 tested and supported the hypothesis that self‐concept clarity concurrently predicts own and partner's relationship satisfaction through couple identity in a sample of 202 dating couples. Study 2 tested and supported the hypothesis that self‐concept clarity predicts longitudinal change in own and partner's relationship satisfaction through positive (i.e., supportive and common) dyadic coping behaviors in a sample of 97 married couples. The findings clarify and expand the benefits of self‐concept clarity for partners' relational well‐being.     

Working models of attachment shape perceptions of social support: evidence from experimental and observational studies

Two studies examined the association between attachment style and perceptions of social support. Study 1 (N = 95 couples) used an experimental paradigm to manipulate social support in the context of a stressful task. Insecure participants (anxious and avoidant) who received low-support messages appraised these messages more negatively, rated a prior behavioral interaction with their partner as having been less supportive, and performed significantly worse at their task compared with secure participants. Study 2 (N = 153 couples) used a similar paradigm except that partners were allowed to send genuine support messages. Insecure participants (especially fearful) perceived their partners' messages as less supportive, even after controlling for independent ratings of the messages and relationship-specific expectations. These studies provide evidence that individuals are predisposed to appraise their support experiences in ways that are consistent with their chronic working models of attachment, especially when the support message is ambiguous.     

Impact of patient suffering on caregiver well-being: the case of amyotrophic lateral sclerosis patients and their caregivers

The impact of patient suffering on family caregivers is an understudied but important topic. This study of patients with amyotrophic lateral sclerosis (ALS) and their caregivers examined the associations of two components of patient suffering: patient physical symptoms, and mental distress, as well as the patient's support for the caregiver, with caregiver well-being. The sample consisted of 52 patients with ALS and their caregivers. Patients and caregivers each completed a structured survey assessing multiple domains including demographics, health, and well-being. Specifically, patients rated their own physical symptoms and mental distress. Caregivers rated their own daily affect, and the extent to which they perceived the patient as supportive. Caregivers also reported whether or not they had found any benefit in dealing with the patient's illness. Regression analyses yielded significant associations of patient distress with caregiver negative affect; patient support was associated with greater caregiver positive affect, and patient symptoms and support were associated with greater likelihood of caregiver benefit finding. There was a significant two-way interaction of patient symptoms by support, namely, benefit finding was not only more likely with greater physical suffering and patient support, but it was also the case that caregivers who perceived the care recipient as unsupportive could only find benefit when this person experienced intense physical suffering. Support interventions for ALS patients and their caregivers should devote particular attention to how caregivers may be affected by witnessing their loved one's sufferings, as well as identify and address challenges in support exchanges between caregivers and patients.     

Modeling support provision in intimate relationships

Whereas supportive interactions are usually studied from the perspective of recipients alone, the authors used a dyadic design to incorporate the perspectives of both provider and recipient. In 2 daily diary studies, the authors modeled provider reports of support provision in intimate dyads over several weeks. The 1st involved couples experiencing daily stressors (n = 79); the 2nd involved couples experiencing a major professional stressor (n = 196). The authors hypothesized that factors relating to (a) recipients (their requests for support, moods, and stressful events), (b) providers (their moods and stressful events), (c) the relationship (relationship emotions and history of support exchanges), and (d) the stressor (daily vs. major stressors) would each predict daily support provision. Across both studies, characteristics of providers, recipients, and their relationship emerged as key predictors. Implications for theoretical models of dyadic support processes are discussed.