A Dyadic Perspective on Coping and its Effects on Relationship Quality and Psychological Distress in Couples Living with Chronic Pain: A Longitudinal Study

Manasi M Mittinty,Murthy N Mittinty,Sonia Bernardes,Lesley Verhofstadt,Liesbet Goubert,Annmarie Cano,Sara Kindt

doi:10.1093/pm/pnz267

Manasi M Mittinty, Murthy N Mittinty + Show 5 more

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https://doi.org/10.1093/pm/pnz267

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Abstract

Dyadic coping is a process of coping within couples that is intended not only to support the patient with chronic pain but also to maintain equilibrium in the relationship. This study aims to investigate the effect of patient-perceived and spouse-reported dyadic coping on both the patient and their partner's relationship quality and anxiety, stress, and depression over time. One hundred thirty-nine couples, with one partner experiencing chronic pain, participated in this study. Spanning three measurements over six months, couples reported on their anxiety, stress, depression, relationship quality, and dyadic coping. Patient-perceived supportive dyadic coping was positively associated with both partners' relationship quality but was negatively associated with spouses' stress over time. Patient-perceived negative dyadic coping was negatively associated with both partners' relationship quality and positively associated with patients' depression and spouses' depression and stress over time. Spouse-reported supportive dyadic coping showed a positive association with their own relationship quality and a negative association with spouses' depression at baseline and patients' depression at three-month follow-up. Spouse-reported negative dyadic coping was negatively associated with their relationship quality at baseline and positively associated with their partner's anxiety and stress at six-month and three-month follow-up, respectively. Similar inference was observed from the findings of growth curve model. As compared with spouse report, patient perception of dyadic coping is a better predictor of both partners' relationship quality and psychological outcomes over time. Both partners may benefit from early psychosocial intervention to improve their dyadic coping, relationship quality, and psychological outcomes.

Highlights

Chronic pain is a critical health condition which has deleterious effects on patients’ functional, psychological and social wellbeing [1,2,3]
Findings from Dyadic Growth Curve Model The findings suggested that patients who reported higher supportive dyadic coping, showed that on average patient’s stress was 18.16 on a scale of 0 to 63; depression was 16.47 on a scale of 0 to 63 and relationship quality was 79.78 on a scale of 0 to 100
Findings from this study showed that spouses’ own report of providing higher supportive dyadic coping was associated with their own relationship quality and depression at baseline but this association was lost over time

Summary

Introduction

Chronic pain is a critical health condition which has deleterious effects on patients’ functional, psychological and social wellbeing [1,2,3]. Given that partners are often an important source of support [5], understanding the role of partners’ coping efforts and support provision remains an important goal of current research. Research on partner support has demonstrated that volitionally provided spousal support (autonomous support provided by spouse out of commitment and affection) is perceived as more helpful by the patients than support provided under pressure (support provided out of guilt or criticism), and is associated with improved wellbeing, reduced stress [6], and better physical and psychological functioning [7,8,9]. Timing and motivation behind partner support has been investigated, very little is known about the bi-directional nature of dyadic coping which comprises of appraisal and response to pain from both partners [10]

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