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.     

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.     

Perceived dyadic coping,anxiety, depression and satisfaction with life of women diagnosed with fibromyalgia

Women diagnosed with fibromyalgia face a wide range of challenges impacting multiple aspects of their lives, such as their relationship with their partner. This study aims to examine how women diagnosed with fibromyalgia manage stress in their own couple and to investigate the role of dyadic coping in anxiety and depression symptoms, and in life satisfaction. Seventy-three women diagnosed with fibromyalgia and 73 matched women filled questionnaires to examine dyadic coping, anxiety and depression symptoms, and life satisfaction. Results show that women diagnosed with fibromyalgia perceived themselves and their partner as using more negative dyadic coping, more delegated dyadic coping and less common dyadic coping. Moreover, negative dyadic coping predicted higher anxiety symptoms and poorer life satisfaction. Overall, our findings highlight the importance of dyadic stress management in understanding psychological adjustment better in women diagnosed with fibromyalgia and the need to develop better-adapted interventions to support them effectively.     

A longitudinal examination of couples' coping strategies as predictors of adjustment to breast cancer

This study's goals were to examine coping strategies of women and their male partners as predictors of change in women's adjustment over the year following breast cancer treatment and to test whether partners' coping processes interact to predict adjustment. In a sample of women who had recently completed breast cancer treatment and were taking part in a psychoeducational intervention trial, the patients' and partners' cancer-specific coping strategies were assessed at study entry (average of 10 months after diagnosis). Assessed at study entry and 20 months after diagnosis (n = 139 couples), dependent variables were women's general (i.e., vitality, depressive symptoms, relationship satisfaction) and cancer-specific adjustment (i.e., cancer-specific distress, perceived benefits). Both patients' and partners' coping strategies at study entry predicted change in women's adjustment at 20 months. Women's use of approach-oriented coping strategies predicted improvement in their vitality and depressive symptoms, men's use of avoidant coping predicted declining marital satisfaction for wives, and men's approach-oriented strategies predicted an increase in women's perception of cancer-related benefits. Patients' and partners' coping strategies also interacted to predict adjustment, such that congruent coping strategy use generally predicted better adaptation than did dissimilar coping. Findings highlight the utility of examining patients' and partners' coping strategies simultaneously.     

Profiles of dyadic adjustment for advanced prostate cancer to inform couple-based intervention

Objective: The purpose of the study is to describe from a relational perspective, partners’ psychological adjustment, coping and support needs for advanced prostate cancer.

Design: A mixed methods design was adopted, employing triangulation of qualitative and quantitative data, to produce dyadic profiles of adjustment for six couples recruited from the urology clinics of local hospitals in Tasmania, Australia.

Methods: Dyads completed a video-taped communication task, semi-structured interview and standardised self-report questionnaires.

Results: Themes identified were associated with the dyadic challenges of the disease experience (e.g. relationship intimacy, disease progression and carer burden). Couples with poor psychological adjustment profiles had both clinical and global locus of distress, treatment side-effects, carer burden and poor general health. Resilient couples demonstrated relationship closeness and adaptive cognitive and behavioural coping strategies. The themes informed the adaption of an effective program for couples coping with women’s cancers (CanCOPE, to create a program for couples facing advanced prostate cancer (ProCOPE-Adv).

Conclusion: Mixed method results inform the development of psychological therapy components for couples coping with advanced prostate cancer. The concomitance of co-morbid health problems may have implications for access and engagement for older adult populations in face-to-face intervention.     

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.     

Love styles,coping, and relationship satisfaction: A dyadic approach

Romantic partners have different attitudes on what love is and what it means to be in a romantic relationship. These attitudes are conceptualized as love styles that relate to relationship‐maintenance behaviors and relationship satisfaction. Specifically, love styles could be associated with how partners cope with stress (dyadic coping), which in turn may be associated with relationship satisfaction. Using self‐report data from 92 heterosexual couples, findings showed that: (a) eros and agape love styles have positive direct effects on dyadic coping and relationship satisfaction, whereas ludus has a negative direct effect on dyadic coping and relationship satisfaction and (b) dyadic coping partially mediated the association between love styles and relationship satisfaction. Overall, associations were stronger for women than for men.     

Effects of coping style and BRCA1 and BRCA2 test results on anxiety among women participating in genetic counseling and testing for breast and ovarian cancer risk.

Using the monitoring process model (MPM), the authors examined the immediate effects of coping style and test results on the psychological distress of women at increased risk for breast and/or ovarian cancers. Cases selected for analysis were 107 probands and relatives of positive probands participating in genetic counseling and testing for heritable cancer risk. Specifically, the authors explored the relationships among coping style (high and low monitoring), test results (BRCA1 and BRCA2 mutation carrier and noncarrier status), and psychological distress (state anxiety). Consistent with the MPM, higher monitoring was associated with greater psychological distress while anticipating genetic test results. After test results were disclosed, greater distress was associated with testing positive for a mutation. The implications of the findings for breast and ovarian cancer patients are discussed.     

The Role of Optimism,Social Constraints,Coping, and Cognitive Processing in Psychosocial Adjustment Among Breast Cancer Survivors

The social-cognitive processing model suggests that a socially constrained environment may impede adjustment to a chronic illness. The present study primarily investigated the mediating psychological pathways through which social constraints on cancer-related disclosure, low optimism, disengagement-oriented coping, and brooding could be associated with low levels of psychosocial adjustment. One hundred twenty-five female breast cancer survivors participated in a cross-sectional study. Path analysis was used to examine the proposed model. Low optimism, increased social constraints, and higher levels of brooding appeared to be risk factors for poor psychosocial adjustment to breast cancer. Disengagement-oriented coping and brooding partially mediated the relationship between social constraints and adjustment. Brooding totally mediated the relationship between disengagement-oriented coping and adjustment. The current findings provide support for the value of the social-cognitive processing model among breast cancer survivors. The mapping of psychological pathways of adjustment to breast cancer may have useful clinical implications for better adjustment outcomes.     

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.     

A threshold model of social support, adjustment, and distress after breast cancer treatment

This study examined a threshold model that proposes that social support exhibits a curvilinear association with adjustment and distress, such that support in excess of a critical threshold level has decreasing incremental benefits. Women diagnosed with a first occurrence of breast cancer (N = 154) completed survey measures of perceived support (Social Provisions Scale), quality of life (Functional Living Index--Cancer), adjustment (Psychological Adjustment to Illness Scale) and psychological distress (Brief Symptom Inventory) approximately 3 weeks after surgical treatment and 8-16 months later. Consistent with a threshold model, multiple regression analyses suggested a significant curvilinear relationship between social support and distress at Time 1 and Time 2 and between social support and adjustment at Time 2. Consistent with this model, the significant bivariate correlations between social support and outcomes were accounted for almost entirely by women in the lowest quartile of support. Social support among women in the highest 3 quartiles was unrelated or only marginally related to adjustment and distress.     

Psychological Factors Associated with Emotional Responses to Receiving Genetic Risk Information

This study identified levels of distress, and predictors of levels of distress, in women undergoing assessment for genetic risk of breast/ovarian cancer based on their family history. It comprised a cohort study following 154 women who completed questionnaires at entry into a cancer genetic assessment programme and following risk provision. Independent significant associates of anxiety following risk provision were age, neuroticism, feeling hopeless about developing cancer, a perceived lack of control over developing cancer, lack of a social confidant, and a coping response involving acceptance/resignation. Depression was associated with age, neuroticism, feeling hopeless about developing cancer, lack of social confidant, and a coping response involving acceptance/resignation. To avoid high levels of psychological morbidity in future cohorts undergoing cancer genetic risk assessment, information should be given that emphasises that some degree of control over health outcomes through behaviour change or increased surveillance is possible.     

Long‐Term Adjustment of Infertile Couples Following Unsuccessful Medical Intervention

A 33‐month longitudinal study was conducted with 38 infertile couples making the transition to biological childlessness after unsuccessful fertility treatments. Changes in their levels of psychological distress; marital, sexual, and life satisfaction; and self‐esteem were examined. Increased self‐esteem and decreased sexual satisfaction were evident over time. Poorer adjustment was related to having none or few available options, little social support, poor emotional and physical health, and reliance on emotion‐focused coping. Participants who adopted demonstrated better adjustment.     

The Nature and Correlates of Psychological Adjustment in Gay Men with AIDS-Related Conditions1

This study assessed differences in the psychological adjustment of gay men who tested positive for the antibody to the human immunodeficiency virus (HIV). Twenty-one were symptomatic for AIDS, and 27 were asymptomatic. A group of 15 gay men who tested negative for the HIV was included as a comparison group. Men in the three groups were equivalent on demographic variables. Symptomatic men reported more health problems than either asymptomatic or seronegative men. Relative to men who were symptomatic, those who were asymptomatic reported more death anxiety, less optimism, and greater severity of psychological distress, and reported more frequent use of avoidance and distancing as coping strategies. The poor psychological functioning of asymptomatic subjects was attributed to the uncertainty regarding their future health status. Generally, positive psychological well-being of symptomatic and asymptomatic men was related to the infrequent use of avoidance coping strategies and high satisfaction with perceived social support.     

Relationship quality of partners in heterosexual married, heterosexual cohabiting, and gay and lesbian relationships

The relationship quality of partners in 44 married, 35 heterosexual cohabiting, 50 gay, and 56 lesbian monogamous couples was studied. Each couple lived together and did not have children living with them. Relationship quality was dimensionalized as love for partner, liking of partner, and relationship satisfaction. Cohabiting partners had the lowest Love for Partner and Relationship Satisfaction scores. Differences were also found among partner types on: barriers to leaving the relationship, alternatives to the relationship, a belief that mindreading is expected in the relationship, masculinity, femininity, androgyny, dyadic attachment, shared decision making, and perceived social support from family. The four partner groups did not differ in psychological adjustment. For each type of partner, love for partner was related to many barriers to leaving the relationship and high dyadic attachment; liking of partner was related to few alternatives to the relationship, high dyadic attachment, and high shared decision making; and relationship satisfaction was related to many attractions, few alternatives, few beliefs regarding disagreement is destructive to the relationship, high dyadic attachment, and high shared decision making. Stepwise multiple regression procedures were used to identify the best set of predictors for each partner type. Results are discussed in the context of existing models of relationship quality.     

Associations Between Sexual Orientation Discrimination and Depression Among Same-Sex Couples: Moderating Effects of Dyadic Coping

Drawing from minority stress theory and the systemic–transactional model, we examined whether perceptions of partner's dyadic coping behavior moderated the association between sexual orientation discrimination stress and symptoms of depression among individuals in a same-sex relationship. Data from 95 same-sex couples revealed that, overall, sexual orientation discrimination stress was positively associated with depressive symptoms; however, perceived partner emotion-focused supportive dyadic coping weakened this association. Specifically, higher sexual orientation discrimination stress was associated with greater depressive symptoms only for individuals perceiving low partner emotion-focused supportive dyadic coping. Implications for researchers and clinicians are presented.     

Identification of cognitive profiles among women considering BRCA1/2 testing through the utilisation of cluster analytic techniques

Based on the cognitive-social health information processing model, we identified cognitive profiles of women at risk for breast and ovarian cancer. Prior to genetic counselling, participants (N = 171) completed a study questionnaire concerning their cognitive and affective responses to being at genetic risk. Using cluster analysis, four cognitive profiles were generated: (a) high perceived risk/low coping; (b) low value of screening/high expectancy of cancer; (c) moderate perceived risk/moderate efficacy of prevention/low informativeness of test result; and (d) high efficacy of prevention/high coping. The majority of women in Clusters One, Two and Three had no personal history of cancer, whereas Cluster Four consisted almost entirely of women affected with cancer. Women in Cluster One had the highest number of affected relatives and experienced higher levels of distress than women in the other three clusters. These results highlight the need to consider the psychological profile of women undergoing genetic testing when designing counselling interventions and messages.     

The Role of Differentiation of Self and Dyadic Adjustment in Predicting Codependency

Working within the framework of the Bowen’s Family Systems Theory and using data from 318 non-clinical participants, the present study assessed a model in which codependent behaviors were predicted by dyadic adjustment in couple relationships and differentiation of self. Results indicated that the dimensions of differentiation of self (I-position, emotional reactivity, emotional cutoff, fusion with others) were more important in explaining the codependent behavior compared to the dimensions of dyadic adjustment (dyadic satisfaction, cohesion, consensus, affective expression). These results suggest the importance of considering the dynamics and outcomes of the process of differentiation of self both in research and in counselling and clinical practice with individuals, couples, and families.     

Identification of cognitive profiles among women considering BRCA1/2 testing through the utilisation of cluster analytic techniques

Based on the cognitive-social health information processing model, we identified cognitive profiles of women at risk for breast and ovarian cancer. Prior to genetic counselling, participants (N?=?171) completed a study questionnaire concerning their cognitive and affective responses to being at genetic risk. Using cluster analysis, four cognitive profiles were generated: (a) high perceived risk/low coping; (b) low value of screening/high expectancy of cancer; (c) moderate perceived risk/moderate efficacy of prevention/low informativeness of test result; and (d) high efficacy of prevention/high coping. The majority of women in Clusters One, Two and Three had no personal history of cancer, whereas Cluster Four consisted almost entirely of women affected with cancer. Women in Cluster One had the highest number of affected relatives and experienced higher levels of distress than women in the other three clusters. These results highlight the need to consider the psychological profile of women undergoing genetic testing when designing counselling interventions and messages.     

Body image issues in women with breast cancer

Diagnosis and treatment of breast cancer affects women physically as well as psychologically. There are many obvious and real factors that are related to psychological distress in women coping with breast cancer, such as facing a life-threatening illness, painful and impairing treatments, and significant role changes. Although these factors are clearly important, issues related to body image in women faced with breast cancer can also add to psychological distress. Women, in general, are concerned with their appearance, their weight, and their body, with recent studies suggesting 89% of women reported concerns with weight. Such premorbid concerns are often deeply ingrained and can contribute to psychological distress in women treated for breast cancer. The present article is a summary of the literature that has examined body image issues and related psychological adjustment in women with breast cancer. Implications for clinical practice and recommendations for future investigations are discussed.