Abstract
Cancer and its treatment pose challenges that affect not only patients but also their significant others, including intimate partners. Accumulating evidence suggests that couples’ ability to communicate effectively plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models have been proposed to account for how couple communication impacts psychological and relationship adjustment: the social-cognitive processing (SCP) model and the relationship intimacy (RI) model. These models posit different mechanisms and outcomes, and thus have different implications for intervention. The purpose of this project is to test and compare the utility of these models using comprehensive and methodologically rigorous methods. Aims are: (1) to examine the overall fit of the SCP and RI models in explaining patient and partner psychological and relationship adjustment as they occur on a day-to-day basis and over the course of 1 year; (2) to examine the fit of the models for different subgroups (males vs. females, and patients vs. partners); and (3) to examine the utility of various methods of assessing communication by examining the degree to which baseline indices from different measurement strategies predict self-reported adjustment at 1-year follow up. The study employs a longitudinal, multi-method approach to examining communication processes including: standard self-report questionnaires assessing process and outcome variables collected quarterly over the course of 1 year; smartphone-based ecological momentary assessments to sample participant reports in real time; and laboratory-based couple conversations from which we derive observational measures of communicative behavior and affective expression, as well as vocal indices of emotional arousal. Participants are patients with stage II-IV breast, colon, rectal, or lung cancer and their spouses/partners, recruited from two NCI-designated comprehensive cancer centers. Results will be published in scientific journals, presented at scientific conferences, and conveyed to a larger audience through infographics and social media outlets. Findings will inform theory, measurement, and the design and implementation of efficacious interventions aimed at optimizing both patient and partner well-being.
Highlights
Patients with cancer often report disease- and treatmentrelated side effects including fatigue, pain, and cognitive impairment (Bower, 2008; IOM, 2008)
Findings indicated that: (a) women with a higher f0 overall displayed more behaviors likely to elicit positive support, and (b) women displayed fewer adaptive support-eliciting behaviors when their partners exhibited higher overall f0. These findings suggest that it may be adaptive for female patients to experience and express emotional arousal during conversations of cancerrelated concerns, but that high emotional arousal on the part of their partners may interfere with this process
Empirical support for the SCP model would indicate that interventions should focus on strategies that enhance cognitive processing
Summary
Patients with cancer often report disease- and treatmentrelated side effects including fatigue, pain, and cognitive impairment (Bower, 2008; IOM, 2008). Communication behaviors that are associated with better adjustment include open discussion of cancer-related concerns (often referred to as disclosure), and the ability to listen and respond supportively to one’s partner. Maladaptive communication behaviors include holding back from disclosure, and avoiding or responding negatively to one’s partner’s disclosure. A variety of self-report measures have been utilized to assess adaptive and maladaptive communication behavior, including those assessing disclosure and holding back from disclosure; protective buffering which is hiding concerns and/or negative emotions from one’s partner (Hagedoorn et al, 2000); and social constraints which are perceptions that the partner’s responses to one’s own disclosures are avoidant, discouraging or disapproving (Lepore and Revenson, 2007). Individuals who hold back from expressing cancerrelated concerns to their partner, or perceive their partner as non-responsive, avoidant, or critical of their expressions have poorer individual and relationship functioning (Porter et al, 2005; Hinnen et al, 2009; Langer et al, 2009; Traa et al, 2015)
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