A longitudinal analysis of intimacy processes and psychological distress among couples coping with head and neck or lung cancers

Individuals diagnosed with lung and head and neck (HN) cancers and their spouses are at increased risk for distress. This study assessed whether the way couples communicate about cancer and their perceptions of relationship intimacy influenced both partners’ adjustment. One-hundred thirty-nine patients and their spouses [For purposes of clarity, we refer to the patients’ intimate partner as the spouse, regardless of actual marital status and we reserve the term partner to refer to the other person in the couple (i.e., the patient’s partner is the spouse and the spouse’s partner is the patient)] completed measures of spousal communication, intimacy, and distress at three time points over 6 months. Using multilevel modeling, an over-time actor-partner interdependence model was specified that examined whether intimacy mediated associations between one’s own and one’s partner’s reports of communication at baseline and later distress. Patients and spouses who reported greater baseline distress reported more negative baseline communication as well as lower levels of intimacy and greater distress over time. Mediation analyses showed patients’ and spouses’ reports of positive spousal communication were associated with less subsequent distress largely through their effects on intimacy. Clinicians working with head and neck or lung cancer patients should assess communication and intimacy because both impact couples’ distress.     

Assortative Mating for Cigarette Smoking and for Alcohol Consumption in Female Australian Twins and their Spouses

Background Non-random mating affects population variation for substance use and dependence. Developmentally, mate selection leading to positive spousal correlations for genetic similarity may result in increased risk for substance use and misuse in offspring. Mate selection varies by cohort and thus, assortative mating in one generation may produce marked changes in rates of substance use in the next. We aim to clarify the mechanisms contributing to spousal similarity for cigarette smoking and alcohol consumption.Methods Using data from female twins and their male spouses, we fit univariate and bivariate twin models to examine the contribution of primary assortative mating and reciprocal marital interaction to spousal resemblance for regular cigarette smoking and nicotine dependence, and for regular alcohol use and alcohol dependence.Results We found that assortative mating significantly influenced regular smoking, regular alcohol use, nicotine dependence and alcohol dependence. The bivariate models for cigarette smoking and alcohol consumption also highlighted the importance of primary assortative mating on all stages of cigarette smoking and alcohol consumption, with additional evidence for assortative mating across the two stages of alcohol consumption.Conclusions Women who regularly used, and subsequently were dependent on cigarettes or alcohol were more likely to marry men with similar behaviors. After mate selection had occurred, one partner’s cigarette or alcohol involvement did not significantly modify the other partner’s involvement with these psychoactive substances.An erratum to this article can be found at     

Reliability and validity of the chinese version of the job content questionnaire in Taiwanese workers

The reliability and validity of four selected scales—namely, job control, psychological demands, supervisor support, and coworker support—from the Chinese Version of the Job Content Questionnaire (C—JCL) were studied in 551 male and 648 female workers in Taiwan. Cronbach’s alpha coefficients for job control, supervisor support, and coworker support were all above .80. Whereas it was .55 for psychological demands, indicating insufficient internal consistency for this subscale. Participants responded to questionnaire items relatively consistently over a 3-month period. Exploratory factor analyses disclosed 4 empirical factors, which corresponded closely with theoretical constructsofthe JCL.As predicted by the model, lowest levels of job satisfaction were found in workers in “iso-strain” category (i.e., high demands combined with low control and low social support). These findings indicated that the C—JCL is reliable and valid for assessing psychosocial work conditions among Taiwanese workers, although further improvement is needed for the psychological demands subscale. This study was supported by grants from the National Science Council (NSC 89-2320-B006-088 and NSC 89-2314-B006-155), Taiwan. We thank Professor R. Karasek for permitting the development of the Chinese version of the JCL and providing suggestions regarding the Chinese translation     

The interplay between partners’ responsiveness and patients’ need for emotional expression in couples coping with cancer

The central aim of this longitudinal observational study was to test whether patients with a high need for emotional expression are especially sensitive to their partners’ responsive behavior, and therefore at risk for depressive symptoms when responsiveness is withheld. Patients with colorectal cancer and their partners (n = 58) participated in a longitudinal study (3, 5 and 9 months after the diagnosis). Additionally to self-report measurements (i.e., patients’ need for emotional expression, patients’ depressive symptoms and patients’ relationship satisfaction) couples were videotaped discussing cancer-related concerns. External observers coded partners’ responsiveness (i.e., understanding, validation and caring) and patients’ self-disclosures. Partner responsiveness predicted lower levels of depressive symptoms over time in patients who had a relatively high need for emotional expression above and beyond the effect of relationship satisfaction. We demonstrated that partners’ understanding and validation are more important in explaining patients’ depressive symptoms than partners’ caring behavior. Our findings highlight the importance of the relational context in improving adaptation to cancer taking into account individual differences.     

Unpacking the racial disparity in HIV rates: the effect of race on risky sexual behavior among Black young men who have sex with men (YMSM)

The purpose of this study is to evaluate the large disparity in HIV prevalence rates between young Black and White Americans, including young men who have sex with men (YMSM). Research focusing on individual behaviors has proven insufficient to explain the disproportionately high rate of HIV among Black YMSM. The purpose of the present study was to gain a greater understanding of the pronounced racial disparity in HIV by evaluating whether YMSM are more likely to engage in risky sexual behaviors as a function of their partner’s race. Participants included 117 YMSM from a longitudinal study evaluating lesbian, gay, bisexual, and transgender youth (ages 16–20 at baseline), who reported characteristics and risk behaviors of up to 9 sexual partners over an 18-month period. Results indicated that participants were less likely to have unprotected sex with Black partners, and this finding was not driven by a response bias (i.e., Black YMSM did not appear to be minimizing their reports of unprotected sex). Furthermore, there was support for the hypothesis that participants’ sexual networks were partially determined by their race insofar as sexual partnerships were much more likely to be intra-racial (as opposed to interracial). It is possible that dyad- and sexual network-level factors may be needed to understand racial disparities in HIV among YMSM.     

Patterns of pain-relevant social interactions

Past studies have focused on the individual effects of Solicitous, Distracting, and Negative spousal responses to pain on patient’s pain behavior and pain severity. Because spouses may emit any combination of these responses, this research examined the conjoint effects of marital satisfaction and these perceived spousal responses by using WISE “step-down” procedure as described by Kenny and Judd (1983). Ninety-six married male chronic-pain patients completed the West Haven-Yale Multidimensional Pain Inventory (WHYMPI), Locke Wallace Marital Adjustment Scale, and Pain Behavior Check List (PBCL). Final step-down models included significant 2-way and 3-way interactions on the PBCL measures of Distorted Ambulation and Seeking Help, significant main effects for Affective Distress, and a 4-way interaction on the WHYMPI Pain Severity scale. These trimmed models accounted for 23% to 33% of the variance in the criterion measures. These results show that higher order interactions make unique contributions to the variance and should be examined along with main effects.     

Hostility,conflict and cardiovascular responses in married couples: a focus on the dyad

This study examined the relations of one’s own total trait hostility and one’s spouse’s hostility as influences on cardiovascular (CV) responses to couple interactions (including conflict discussions) in 45 married couples aged 24—50. Systolic blood pressure and cardiac index (CI) reactivity to conflict discussion and recovery after conflict was greater in low hostile males if they were interacting with high hostile wives (p < .02). Vascular resistance index (VRI) reactivity to interactions was greater in high hostile husbands with high hostile wives (p < .05). Women showed no adverse CV effects of having a hostile spouse when their own hostility was low. Instead, seeming to anticipate the subsequent couple interactions, wives from duos in which both partners were high in hostility had higher baseline VRI levels and lower baseline CI compared to wives from duos in which both were low in hostility (ps < .05), and they simply maintained these group differences with no greater CV reactivity during the interactions. Findings suggest that CV responses before, during, and after marital discussions, particularly those characterized by conflict, may be influenced not only by one’s own hostility but by the hostility of one’s partner as well.     

Emotional support and gender in people living with HIV: effects on psychological well-being

Current research indicates that emotional support is strongly associated with physical and psychological adjustment in persons living with HIV/AIDS. While gender-differences in health and health behaviors of HIV positive patients are well studied, less is known about how men and women living with HIV/AIDS may differentially perceive and integrate support into their lives, and how it subsequently affects their psychological well-being. This cross-sectional study examines how emotional support received from partners and family/friends and gender explains psychological well-being (i.e., stress, depression, anxiety) in a sample of 409 partnered European HIV positive individuals. We hypothesized that gender would modify the associations between support and psychological well-being such that men would benefit more from partner support whereas women would benefit more from family/friend support. Results revealed that regardless of the source of support, men’s well-being was more positively influenced by support than was women’s well-being. Women’s difficulties in receiving emotional support may have deleterious effects on their psychological well-being.     

Intention to quit smoking: Is the partner’s smoking status associated with the smoker’s intention to quit?

Background: Smoking behavior among couples is often similar.Purpose: The aim of the study was to examine the relationship between the partner’s smoking status and the intention to stop smoking of the index person. Method: Cross-sectional data of 1,044 patients in a random sample of 34 general medical practices in northeastern Germany were analyzed.Results: Among smokers with a non-smoking partner (SNP), more intended to quit smoking in the next six months (37.0% vs. 31.4%), compared to smokers with a smoking partner (SSP). Also, more SNP intended to quit in the next four weeks (4.7% vs. 2.7%) compared to SSP. SNP were more active in the use of self-change strategies than SSP.Conclusion: The data confirm that the partner’s smoking status is related to the intention to quit smoking. Interventions should address the different needs of both smokers with a smoking partner and those with a non-smoking partner. This study is part of the Research Collaboration in Early Substance Use Intervention (EARLINT) funded by the German Federal Ministry of Education and Research (Grant No. 01EB0120, 01EB0420), the Social Ministry of the State of Mecklenburg-West Pomerania (Grant No. IX311 a 406.68.43.05), and the Krupp von Bohlen and Halbach foundation.     

The interplay of dyadic and individual planning of pelvic-floor exercise in prostate-cancer patients following radical prostatectomy

This study broadens the current understanding of the role of planning by focusing on the interplay between individual and dyadic planning (i.e. making plans about the target person’s behaviour together with a partner). Self-report data from N = 141 prostatectomy-patients and their partners were assessed at three times within 1 year post-surgery. Direct and indirect effects of dyadic and individual planning on patients’ pelvic-floor exercise (PFE) were tested. Proposed mediators were social support, social control, and action control. Cross-sectionally, the dyadic planning–PFE relationship was mediated by patients’ received support and partners’ provided social control. Longitudinally, mediators of dyadic planning were partners’ provided social control and support. Effects of individual planning on PFE were mediated by action control at baseline only. Also, at lower levels of individual planning, patients’ dyadic planning was more strongly associated with receipt of social control. Results underscore the importance of social factors in the planning process and its mechanisms in health-behaviour change.     

Spousal support in a behavior change intervention for cholesterol management

Objective

To evaluate spousal involvement in a nurse-led intervention for patients with high cholesterol in which patients set health goals and spouses learned support strategies.

Methods

Qualitative interviews were conducted with 29 patients and 26 spouses who received the intervention during a trial. Interviews were stratified by patient LDL-C change (better, same, worse). Coded text was content analyzed, and organized into thematic matrices, with columns indicating individuals (spouse or patient) and rows indicating dyads.

Results

Patients and spouses reported no drawbacks to spousal involvement; some patients whose LDL-C did not improve wanted more focus on spouse health. Spouses said that the nurse's expertise and interest were helpful and they were better able to communicate with patients about health. Although the program helped couples work together, spouses with better or same LDL-C talked more about functioning as a unit, whereas those whose partners had worse LDL-C talked more about functioning as individuals.

Conclusion

Although the spousal role was accepted, there were variations in level of involvement. More active spousal involvement might relate to better patient outcomes. For less involved spouses, more focus on their health may improve commitment or involvement.

Practice implications

These findings can inform ways to generate spousal support in future trials.     

Emotional support for men and women with cancer: Do patients receive what their partners provide?

Objectives: In the context of mainly gastrointestinal cancer surgery, the study examines the course of spousal support in 173 dyads over half a year to illuminate the function of gender in support transactions. Method: Provided and received emotional support were assessed in 108 male patient/female partner couples and 65 female patient/ male partner couples. Using the Berlin Social Support Scales, assessments took place during the week before cancer surgery, 1 month, and 6 months after cancer surgery. Results: Gender differences emerged for support received and provided. Support received from partners was initially high for all patients, remained high over time for men, but decreased for women. Provided support decreased for male partners, but remained high in female partners. The effects were of medium size. Patients’ received support was reflected by partners’ reports of support provided. Women who reported received support 6 months after surgery had partners who had reported support provision 5 months earlier. Conclusions: Alternative sources of support, in particular for women, such as their network of friends or professional help, may need to be identified. A couple-coping intervention could be implemented to help partners learn about each other’s needs in times of crisis and ways to cope with adversity.     

Perceived neighborhood disorder and psychological distress among Latino adults in the United States: Considering spousal/partner relationship

It has been well-established that neighborhood disorder and disadvantage are detrimental to mental health and psychological well-being. There has been growing research interest in minority stress issues, however, less is known about how perceived neighborhood disorder matters for psychological well-being among Latino adults in the United States. Analyzing data from National Latino Asian American Study, 2002–2003, the present study investigates the relationships among perceived neighborhood disorder, spousal/partner relationships (i.e., spousal/partner strain and support), and psychological distress. The findings indicated that perceived neighborhood disorder and spousal/partner strain were positively associated with increased psychological distress, whereas spousal/partner support had no protective effect against psychological distress. Moreover, mediation analysis showed that the association between perceived neighborhood disorder and psychological distress was partially mediated by spousal/partner strain (i.e., 15.13%), not spousal support. Finally, moderation analysis revealed that the presence of spousal/partner strain exacerbated the relationship between perceived neighborhood disorder and psychological distress. Conversely, the absence of spousal/partner strain appeared to buffer the adverse impact of neighborhood disorder on psychological distress. These findings highlighted the ill effect of problematic neighborhood environments on the quality of the spousal/partner relationship and subsequently Latino's psychological well-being.     

Relationship satisfaction in women: A longitudinal case‐control study about the role of breast cancer,personal assertiveness,and partners' relationship‐focused coping

Objective The aim of this study was to investigate whether a breast cancer diagnosis, personal assertiveness (i.e. frequency of assertive behaviour and tension associated with this behaviour), and partners' relationship‐focused coping (i.e. active engagement and protective buffering) were sources of variation in patients' relationship satisfaction, cross‐sectionally and over time. Design and method This longitudinal case‐control study assessed the two dimensions of personal assertiveness and relationship satisfaction in both women with cancer (N=72) and comparison controls (N=62). In addition, patients completed a measure assessing their partners' active engagement and protective buffering. Results Cases (i.e. women with breast cancer) were not found to report more relationship problems than controls. Women with breast cancer who tended not to express their concerns and feelings and who experienced much tension when they did, reported relatively low marital satisfaction. Moreover, partners' protective buffering was associated with less relationship satisfaction in especially more assertive (i.e. high frequency of assertive behaviour and low tension) women with cancer, while active engagement was associated with more relationship satisfaction, regardless of the women's personal assertiveness. Discussion The results of the present study indicate that a breast cancer diagnosis by itself may not be a risk factor for relationship problems. However, in the context of an illness such as cancer, personal assertiveness, and a partner's relationship‐focused coping strategies do seem to play a role in maintaining a satisfactory relationship with one's partner.     

The role of partner relationships in the young person’s adherence to the diabetes self-care regime

Background: This study investigated the role of partner relationships in the young person’s experience of diabetes. It was predicted that those people reporting a better quality relationship would report greater social support and better diabetes management. Method: Fifty young adults with diabetes and their spouse/partner completed web-based questionnaires. Results: A better quality relationship did not correlate with high reported levels of social support or with better diabetes management. Path analysis demonstrated, however, that for males with diabetes high reported quality of relationship predicted better diabetes management. Conclusions: Relationship quality does not generally predict better diabetes management; however, there may be a unique feature to good relationships that support men’s diabetes self-care.     

Spousal Support Satisfaction as a Modifier of Physiological Responses to Marital Conflict in Younger and Older Couples

We investigated linkages between spousal support satisfaction and affective, cortisol, and blood pressure responses to conflict in two samples, 85 newlyweds and 31 older couples, married an average of 42 years. Couples were admitted to a hospital research unit and provided self-reports regarding the support received from their spouses. After a baseline period, couples engaged in a 30-min conflict discussion during which time blood was drawn for cortisol assessment. After the conflict, newlyweds' blood pressure was measured. Among newlywed wives, greater spousal support satisfaction was associated with smaller changes in negative affect and cortisol responses to conflict. Notably, newlywed wives and husbands demonstrated lower blood pressure after conflict when spousal support satisfaction was higher. In contrast, older husbands (but not wives) exhibited greater cortisol responses when spousal support satisfaction was lower. These relationships provide a window on mechanisms linking marriage and health for men and women across the life span.     

Diving behavior reduces genera richness of lice (Insecta,Phthiraptera) of mammals

Lice of mammals spend the entire life cycle in the host hair, thus, the microclimate found near the mammal skin is likely to influence the structure of louse communities. Here we use a comparative approach to examine the effect of mammals’ diving behavior on the taxonomic richness of their lice. We compared the mean genera richness of lice, and — as potential confounding variables — the mean species richness of host, and the mean body mass of host between diving clades and their non-diving sister clades. Louse genera richness was significantly lower in clades of aquatic mammals than on their non-diving sister clades. Host species richness was not significantly different between these clades. Body mass was significantly higher in clades of aquatic mammals, however, the direction of this difference cannot explain the difference in parasite taxonomic richness. This study suggests that mammals’ diving behavior can effectively shape their ectoparasite communities.     

Spousal negative responses to cancer patients: the role of social restriction, spouse mood, and relationship satisfaction.

This cross-sectional study examined perceptions of spousal negative behaviors in 219 cancer patients. A mediational model was proposed to explain why a spouse might respond negatively to an ill partner because of greater restriction on activities as functional impairment increases. A moderating effect of the spouse's marital satisfaction assessed 3 months before other study measures was also proposed. Results provided support for the proposed model. The relationship between increasing patient functional impairment and spousal negative behaviors was medicated by greater restriction in spouse activities, as well as spousal negative mood. A marginally significant moderating effect for marital satisfaction was found. Although these results must be replicated with a prospective study, the findings begin to shed light on why spouses might respond in negative ways to an ill partner.     

Predictors of support provision: a study with couples adapting to incontinence following radical prostatectomy

Objectives. Four domains of predictors of support provision were tested in couples facing an illness‐related stress context. Predictor domains of partners' support provision to patients adapting to incontinence following prostatectomy included stress factors, recipient factors, provider factors, and relationship factors. Methods. Data from 109 patients and their female partners were analysed. Couples provided data on five measurement occasions from 2 weeks to 1 year postsurgery. Predictors included patient's incontinence (stress factor), patient's support mobilization, affect and general self‐efficacy (recipient factors), partner's affect and general self‐efficacy (provider factors), partners' average waking time spent together, both partners' relationship satisfaction and partner's received support from patient (as an indicator of reciprocal support; relationship factors). Results. Provider factors were not reliably associated with support provision, neither was patient negative affect. Stress and relationship factors accounted for outcome variance in the expected directions. Among recipient factors, mobilization of support and patient self‐efficacy were positively related with the outcome, whereas patient positive affect was negatively associated with support provision by partners. Conclusions. Findings on predictor domains are in line with other couple studies that used non‐illness‐related stress contexts. Resemblance of findings points to generalizability of predictions across stress contexts varying in content, controllability, and duration.