Spouse criticism and support: their association with coping and psychological adjustment among women with rheumatoid arthritis

Examined whether psychological adjustment of women with rheumatoid arthritis would be related to the support and criticism the patient received from the husband. Interviews were conducted with the husbands of 103 women with rheumatoid arthritis. Spouse interviews were content coded for critical remarks. Wives completed a revised version of the Ways of Coping Scale and a scale of the perceived supportiveness of the spouse. Husbands completed rating scales assessing their perceived vulnerability to illness and the degree of burden they experienced in providing assistance to their wives. Path analyses revealed that patient adjustment was significantly related to the attitude of the spouse. Patients with a highly critical spouse engaged in more maladaptive coping behaviors and reported a poorer psychological adjustment. Independent of spousal criticism, patients who perceived their spouse as being supportive engaged in more adaptive coping. A path model was fit to the data that suggested that the spouse may affect adjustment indirectly through influencing the patient's selection of adaptive or maladaptive coping responses.     

Effects of relationship maintenance on psychological distress and dyadic adjustment among couples coping with lung cancer

OBJECTIVE: Relationship maintenance strategies help to ensure the continuation of valued relationships by keeping them at a certain level of intimacy. This study evaluated how lung cancer patients' and spouses' efforts to maintain their relationships affected their psychological and marital adjustment over time. DESIGN: Psychosocial questionnaires were administered within 1 month of lung cancer treatment initiation (baseline) and 3 and 6 months later to 158 lung cancer patients and their spouses. MAIN OUTCOME MEASURES: Study outcomes were global severity index scores on the Brief Symptom Inventory, and total scores on the Dyadic Adjustment Scale. RESULTS: Multilevel modeling analyses using the Actor-Partner Interdependence Model showed that, regardless of gender or social role (i.e., patient or spouse), individuals who engaged in the strategies of positivity, networks, and shared tasks reported less distress at baseline than other participants. Over time, the effects of providing more assurances and experiencing a partner's increased reliance on social networks differed: patient distress was exacerbated, and spouse distress was alleviated. Couples where both partners engaged in more frequent maintenance behaviors reported greater dyadic adjustment at baseline and over time. CONCLUSION: For couples coping with lung cancer, the initial treatment period may be an important time that sets the tone for future spousal interactions. Engaging in relationship maintenance during this stressful time may help mold more resilient relationships and facilitate adjustment as the disease progresses.     

The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility

Infertility is a challenging experience, affecting individual and couples’ adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross‐sectional study, a total of 134 participants (67 couples with infertility) completed self‐report questionnaires assessing infertility‐related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes.     

Dyadic Coping Among Couples with COPD: A Pilot Study

COPD (chronic obstructive pulmonary disease) is associated with psychological distress for patients as well as their partners. Dyadic coping can be negatively impacted by stressors. This study's objective was to compare the dyadic coping of couples in which one partner suffered from COPD with healthy couples of the same age. A total of 43 complete couples with COPD and 138 healthy couples participated in this pilot study. The surveys were sent by mail. The response rate of the COPD sample was 24.3%. In order to analyze the effect of gender and role (patient vs. partner) on dyadic coping, linear mixed models were calculated. To analyze the effect of gender and group (COPD group vs. normative comparison group) on dyadic coping, two-way analyses of variance were calculated for independent samples. COPD patients and their partners indicated that the patients received more support and were less able to provide support to their partners. This difference was also evident in comparison with the normative comparison group. In addition, couples with COPD perceived higher levels of negative coping and provided a considerably lower assessment of their positive dyadic coping. The dyadic coping of couples with COPD is unbalanced and more negative when compared to that of healthy couples. Interventions aimed at supporting COPD couples should seek to improve couples' dyadic coping in addition to individual coping strategies.     

Predicting negative spousal attitudes toward depressed persons: a test of Coyne's interpersonal model

The utility of Coyne's (1976a) interactional model in predicting negative spousal attitudes toward depressed patients was examined. Eighty-nine couples with at least 1 member in treatment for depression were selected on the basis of semistructured diagnostic interviews. Overall, spouses living with a depressed patient reported significantly more distress than population norms. Consistent with prediction, patients' reassurance seeking and spouses' mood contributed to negative spousal attitudes. Additional analyses demonstrated that these effects persisted even after controlling for spouse marital adjustment, suggesting that negative spousal attitudes were more than a simple reflection of marital maladjustment.     

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.     

Dyadic coping and marital adjustment during pregnancy: A cross‐sectional study of Italian couples expecting their first child

Although the transition to parenthood is currently defined as a normative event, it can be potentially stressful for the couple relationship as it may contribute to psychological distress and reduced marital satisfaction. Using the systemic‐transactional conceptualisation of stress and coping as a theoretical framework, we claimed that the ability of the parents‐to‐be to adjust to their new roles and identity is influenced by dyadic coping strategies. This study examined the effects of dyadic coping on marital adjustment in a sample of 78 primiparous couples. Women and partners completed the Dyadic Adjustment Scale and the Dyadic Coping Questionnaire during late pregnancy. Data were analysed using the Actor‐Partner Interdependence Model. Results revealed that both women and partners' scores on positive dyadic coping behaviours contributed to higher marital adjustment, suggesting that risks for marital dissatisfaction may exist for couples not able to implement adaptive dyadic coping strategies, or for those unsatisfied with the implemented coping behaviours.     

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.     

The relationship of appraisal and coping to chronic illness adjustment

There is evidence that adaptation to chronic illness may be affected by psychological factors, especially how patients appraise and cope with the stress of their illness. The purpose of the present study was to examine the relationship of stress appraisal and coping responses to multiple behavioral indices of illness adjustment among patients with diverse chronic medical conditions. One hundred and one patients admitted to a multidisciplinary medicine/psychiatry unit completed measures of functional impairment, depression, symptom severity, and the Ways of Coping Checklist--Revised. Hierarchical regression analyses indicated that emotion-focused coping was positively related to poor psychosocial adjustment and depression after controlling for physician rated disease severity. Appraising chronic illness as holding one back predicted greater emotion-focused coping responses and poorer adjustment to illness. The use of problem-focused coping strategies was generally unrelated to illness adjustment. These findings suggest the presence of an emotion-focused coping triad consisting of wishful thinking, self blame, and avoidance, all of which appear to be maladaptive strategies when coping with chronic medical conditions. Implications for coping skills training and the need for longitudinal research is discussed.     

Couples and Diabetes: A 30-Year Narrative Review of Dyadic Relational Research

Diabetes is a chronic condition that affects both members of a couple. However, relatively few studies have focused on the entire couple system as the unit of observation when examining the psychosocial impact of this disease. This narrative review examines the literature between 1980 and 2010 that uses the couple as the unit of observation. A total of 49 articles were identified for review. Articles were grouped by their central themes or outcomes: (1) sexual functioning, (2) relationship adjustment and support, (3) culture and spirituality, (4) treatment/education programs, and (5) diabetes as a risk factor. Research and clinical implications such as increasing the utilization of dyadic analytical strategies and the importance of assessing illness burden from each partners’ perspective are discussed. Identified benefits of incorporating the couple dyad for future research and clinical practice included: (1) understanding the influence of variables such as a non-diabetic partner and gender have on diabetes adjustment and management, (2) the role disease severity and management of diabetes by the partner living with diabetes has on spousal support and non-diabetic partner emotional wellbeing, (3) the interdependent nature of couple outcomes in the areas of adjustment to sexual dysfunction, perceived illness burden, and couple satisfaction, as well as, (4) disease as both an individual and a shared experience among couples.     

Individual and Dyadic Coping and Fear of Progression in Mothers and Fathers of Children with Hematologic Cancer

This study investigated the association of individual and dyadic coping strategies with fear of progression (FoP) in mothers and fathers of children with hematologic cancer. Parental couples (N = 44) whose children had been diagnosed with hematologic cancer were recruited at a university hospital and a rehabilitation clinic in Germany between 03/2017 and 08/2017. Data included parents' self-report on FoP (Fear of Progression Questionnaire—parent version, FoP-Q-SF/PR), individual coping (Coping Health Inventory for Parents, CHIP-D), and dyadic coping (Dyadic Coping Inventory, DCI). Statistical analyses were carried out for mothers and fathers individually as well as for parental couples using dyadic data analyses (e.g., actor-partner interdependence model, APIM). Individual and dyadic coping strategies were significantly correlated with FoP in mothers, but not in fathers. Fathers' evaluation of the couple's dyadic coping significantly predicted mothers' FoP. The more frequent use of familial integration (CHIP-D FAM) and maintaining social support (CHIP-D SUP) as well as a better evaluation of their partners' dyadic coping was significantly associated with lower FoP in mothers. Differences in individual and dyadic coping in parental couples were not associated with FoP. Individual and dyadic coping strategies should be addressed in the psychosocial care of mothers and fathers of children with hematologic cancer. Study results support the benefits of involving fathers in psychosocial interventions, for example, in couple-based interventions that acknowledge interpersonal effects of coping on FoP. Future research should further explore coping strategies applied by fathers of children with hematologic cancer for the regulation of FoP.     

Spousal conflict resolution strategies and marital relations in late adulthood

In this study, we examined differences in the spousal conflict resolution strategies of husbands and wives in late adulthood among a sample of 76 married Israeli couples (N = 152). Using dyadic analysis (the actor–partner interdependence model), we examined the impacts of the strategies adopted by each spouse as well as their partner on evaluations of marital life as reflected in their assessments of positive and negative dimensions of marital life. The findings revealed that integration was the most prevalent strategy used by both spouses, whereas dominance and avoidance were the least prevalent strategies. Moreover, integration contributed most significantly to explaining assessments of marital life.     

Dyadic Coping in Couple Therapy Process: An Exploratory Study

This study aimed at moving beyond previous research on couple therapy efficacy by examining moment‐by‐moment proximal couple and therapist interactions as well as final treatment outcomes and their reciprocal association. Seven hundred four episodes of dyadic coping within 56 early therapy sessions, taken from 28 married couples in treatment, were intensively analyzed and processed using a mixed‐methods software (T‐LAB). Results showed that negative dyadic coping was self‐perpetuating, and therapists tended to passively observe the negative couple interaction; on the contrary, positive dyadic coping appeared to require a therapist's intervention to be maintained, and successful interventions mainly included information gathering as well as interpreting. Couples who dropped out of treatment were not actively engaged from the outset of therapy, and they used more negative dyadic coping, whereas couples who successfully completed treatment showed more positive dyadic coping very early in therapy. Results highlight the role of therapist action and control as critical to establishing rapport and credibility in couple therapy and suggest that dyadic coping patterns early in therapy may contribute to variable treatment response.     

Du modèle transactionnel à une approche dyadique en psychologie de la santé

In the context of chronic disease, models and studies in health psychology have first focused on the patients’ adjustment. Research conducted with the Transactional Model of Stress and Coping (Lazarus and Folkman, 1984) and the Transactional Integrative and Multifactorial Model (Bruchon-Schweitzer, 2002) have shown that individuals’ social relations, and especially family support, are associated to patients’ outcomes. Recently, studies have taken more attention to the “significant others”, most often the partners. In fact, relatives are also affected indirectly by the disease and its changes on daily life. Moreover, they often play a crucial role by helping the patient to face the disease. These models are focused on the individual and are not relevant to study dyads. An evolution of these models can be proposed by integrating a systemic and dyadic approach. In fact, the way the patient and the relative face the disease, the quality of their relation but also the way they face the disease together, as a dyad, have to be considered. The first part of this article presents the Transactional Model of Stress and Coping and the Transactional Integrative and Multifactorial Model and their evolutions. The second part shows how it is possible to develop a dyadic approach based on these models. It presents the Family System-Illness Model (Rolland, 1987), the Developmental-Contextual Model of couples coping with chronic illness across the adult life span (Berg and Upchurch, 2007) and a Systemic and Transactional Model of Dyads, which help to take more completely into account the adjustment processes of patients and relatives to a chronic illness.     

Applying the Transactional Stress and Coping Model to Sickle Cell Disorder and Insulin-Dependent Diabetes Mellitus: Identifying Psychosocial Variables Related to Adjustment and Intervention

This review paper examines the literature on psychosocial factors associated with adjustment to sickle cell disease and insulin-dependent diabetes mellitus in children through the framework of the transactional stress and coping (TSC) model. The transactional stress and coping model views adaptation to a childhood chronic illness as mediated by several psychosocial factors. This review examines the utility of the model in explaining adjustment in two different childhood diseases, identifies needed research and intervention targets, as well as highlights potential changes to the model. The major conclusions of this review suggest that, in addition to child-specific factors, family functioning is an area that interventions should address in sickle cell disease and insulin-dependent diabetes mellitus.     

Adjustment of caregivers to depressed older adults.

In this research, older adults (N = 150) hospitalized for major depression and their wife, husband, daughter, or son caregivers were interviewed. The primary purpose of the research was to evaluate the ability of caregiver background characteristics, patient illness characteristics, caregiver coping, and strategies for managing the patient at home to predict caregiver adjustment. Among the caregiver characteristics, being in functional health, being male, and being a spouse caregiver were associated with better adjustment. Husbands evidenced the best adaptation to caregiving and daughters the poorest. Patient illness characteristics were not related to caregiver adjustment. Coping with caregiving stresses by using tension reduction and deliberate effort behaviors and managing the patient with criticism and guidance were related to poorer caregiver adjustment.     

Attachment style,partner communication,and physical well‐being among couples coping with cancer

Attachment styles may influence interpersonal strategies used to cope with stress. We examined links between attachment style, communicative behaviors, and physical well‐being among 166 couples coping with cancer. Results of actor–partner interdependence mediation models indicated that insecure attachment styles were associated with greater self‐report of two different and seemingly contradictory communicative behaviors (disclosure and holding back), which in turn were associated with poorer physical well‐being. These effects were intrapersonal for both patients and spouses, with the exception of anxious attachment and holding back for spouses. They were also interpersonal in that spouse insecure attachment was associated with poorer patient physical well‐being through spouse communication (greater holding back and disclosure). Couple‐based communication interventions to support adjustment should consider attachment style.     

Attachment and spousal caregiving

A community sample of 362 married couples participated in a study of attachment and spousal caregiving, which combined qualitative and quantitative components. The qualitative component focused on actual experiences of caregiving, assessed by participants' semi‐structured accounts of a situation involving their role as caregiver for their spouse. Attachment styles and their underlying dimensions (comfort with closeness, anxiety over relationships) were related to the type of support provided, the coping strategies used in the situation, caregivers' feelings about the quality of their care, perceived effects on the couple bond, and the emotional tone of the accounts. The quantitative component tested a theoretical model of factors predicting willingness to provide care for the spouse if he or she should become dependent in later life. Measures of attachment and caregiving styles, attachment to spouse, and anticipated burden provided reliable prediction of willingness to care. The results support the conceptualization of attachment and caregiving as interrelated features of marital bonds, and they have important implications for patterns of family caregiving.     

Collaborative coping and daily mood in couples dealing with prostate cancer

Collaborative coping (i.e., spouses pooling resources and problem solving jointly) may be associated with better daily mood because of heightened perceptions of efficacy in coping with stressful events. The study examined the daily processes of collaborative coping (individuals' perceptions that the spouse collaborated), perceived coping effectiveness (ratings of how well they dealt with the event), and mood (i.e., Positive and Negative Affect Scale) across 14 days in 57 older couples coping with stressors involving the husband's prostate cancer and daily life in general. In hierarchical multivariate linear models, collaborative coping was associated with more positive same-day mood for both husbands and wives and less negative mood for wives only. These associations were partially mediated by heightened perceptions of coping effectiveness. Exploratory analyses revealed that collaborative coping was more frequent among wives who performed more poorly on cognitive tests and couples who reported greater marital satisfaction and more frequently using collaboration to make decisions. The results suggest that older couples may benefit from collaborative coping in dealing with problems surrounding illness.     

Everyday emotion word and personal pronoun use reflects dyadic adjustment among couples coping with breast cancer

Dyadic adjustment is integral for couples facing breast cancer; therefore, it is important to identify its everyday indicators. A total of 52 couples coping with breast cancer wore the Electronically Activated Recorder (EAR) for one weekend and completed the Dyadic Adjustment Scale to investigate how dyadic adjustment manifests in noncancer‐related word use. Multilevel models revealed that partners', rather than one's own, positive emotion words positively related to dyadic adjustment. Conversely, spouses' negative emotion words and patients' anger words were negatively related to dyadic adjustment. Furthermore, focus on spouses rather than patients (spouses “I” and patients “you”) positively related to dyadic adjustment. Results revealed that dyadic adjustment can be reflected in couples' everyday word use, serving as an objective indicator of marital quality.