Actor-partner Interdependence Model Research Articles

The Association Between Mutuality and Quality of Life in Adults With Chronic Illnesses and Their Nurses: Actor-Partner Interdependence Model Analysis.

To examine the association between mutuality and quality of life in nurse-patient dyads. A cross-sectional multi-centre study was conducted. The study was conducted in five tertiary hospitals in Italy. We enrol both inpatients and outpatients with chronic diseases and their nurses with a convenience sampling. One-hundred ninety-two dyads participated to the study. A self-assessment instrument including the Short-Form 12 Health Survey (SF-12), and the Nurse Patient Mutuality in Chronic Illness scale (NPM-CI scale), in the two versions-one for patients and one for nurses, was administered. The effects of nurse-patient mutuality on the physical and mental quality of life of nurses and patients were estimated with a series of actor-partner-interdependence models (APIM). Patients' and nurses' perceptions of their mutuality were positively correlated. For patient mental quality of life, there was a statistically significant actor effect both for patients, and for nurses. There was also a consistent statistically significant partner effect for patient mental quality of life. There were no statistically significant actor or partner effects for the nurses' and patients' physical quality of life. This construct may be influenced by additional components, further studies are needed. Mutuality between nurses and patients in chronic diseases influence both patient and nurse quality of life. Our results support the importance of taking a dyadic perspective when considering mutuality and quality of life in nurse-patient dyads. Nurse-patient mutuality is an indicator of a high-quality relationship, which allows shared goals and shared decision-making. Quality of life is one of the most important outcomes for chronic conditions patients and is an indicator of well-being. Quality of life is also an important variable in healthcare professionals' lives. Little is known about the association between mutuality and quality of life in nurse-patient dyads. Mutuality has an actor effect on patient's and nurse's quality of life and has a negative partner effect on patient's quality of life. The understanding of mutuality and interdependence within the dyad, could increase mental quality of life in nurse-patient dyads. STROBE checklist for cross-sectional studies was followed in this study. Patients were involved in the sample of the study.

Associations between school engagement and mental well-being among Finnish parent-child dyads

Abstract Background To understand how individual differences in mental well-being emerge for children and adolescents, it is important to understand the amenable factors in the context in which the development takes place - that is, for children, primarily in the family and in school. There is a notable gap in the research exploring the positive impacts of school factors on parent-child dyads and their mental well-being, and if there are any associations between school engagement and the mental well-being of parents and their children. Methods Data from 307 parent-child dyads were included in the study, the data stemming from a Finnish l research project (CONSENSUS) encompassing longitudinal survey data collection among both children in grades 4-6 and their parents. By exploring bivariate correlations and using the Actor-Partner Interdependence Model (APIM), the present study aims to investigate actor and partner effects of school engagement and mental well-being among parents and their child in grade 4-6. Results Preliminary results show that there are statistically significant correlations between parents’ and their children’s mental well-being, but that there are no significant correlations between children’s school engagement and parental school engagement. Further, statistically significant actor effects emerge between children’s school engagement and mental well-being, and between parental school engagement and mental well-being. Conclusions By clarifying the interaction between school engagement and mental well-being in parent-child dyads, this study not only contributes to the theoretical understanding of these constructs but also offers insights that can inform future development of mental well-being promotion interventions aimed at families and educational settings in Finland and elsewhere. Key messages • This study offers an innovative exploration of the links between mental well-being and school engagement among 274 Finnish parent-child dyads. • Results show various interactions between school engagement and mental well-being among the parent-child dyads, with implications for interventions intended to support well-being in families.

Shared care in heart failure management is linked with physical and mental health by perceived control in patient-caregiver dyads

Abstract Background Patients with heart failure (HF) and their family caregivers have interdependent relationships in managing HF. Shared care within dyads refers to interpersonal interactions characterized by exchanging care and support in chronic illness management. High levels of shared care improve patients’ health outcomes, but it is unclear if shared care is equally beneficial for caregivers. Also unknown is how shared care contributes to the outcomes of both dyad members. We propose that perceived control may be critical in the link between shared care and health status for dyads. Thus, the purpose of this study was to determine whether perceived control over one’s health mediates the association between shared care and physical and mental health in patients with HF and their caregivers. Method Patients with HF and their primary caregivers (N=151 dyads) completed questionnaires in this cross-sectional study. Shared care, perceived control over one’s own health, and health status were assessed using the three subscales of the Shared Care Instrument (i.e., communication, decision-making, and reciprocity), the Cardiac Attitudes Scale-Revised, and the Medical Outcomes Study Health Survey-36, physical and mental health scales, respectively. A series of actor-partner interdependence models with mediation dyadic analyses were conducted. Results Patients with HF (mean age 60.3 Years, 64% male) and their caregivers (mean age 56.6 years, 75% female) reported similar levels of communication and reciprocity in shared care, but patients reported higher scores of decision-making in shared care than their caregivers (P < .001). Perceived control over one’s own health significantly mediated the association between communication and physical health (indirect actor effect = .1487; 95% CI: 0.0478 to 0.2759) and between communication and mental health (indirect actor effect = .1650; 95% CI: 0.0454 to 0.3260) for patients, not caregivers (Figures A1 & A2). Similarly, perceived control significantly mediated the association between reciprocity and physical and mental health for patients, not caregivers (Figures B1 & B2). Perceived control mediated the association of decision-making with physical health and mental health for caregivers, not patients (Figures C1 & C2). Conclusion Higher levels of communication and reciprocity increased patients’ perceived control, ultimately improving their physical and mental health, whereas caregivers’ decision-making improved their health by enhancing their perceived control over their health. The different patterns of shared care are linked to the health of patients and caregivers by enhancing perceived control over one’s health.Figure A & BFigure C

The Relationship Between Dyadic Coping and Mental Health in Stroke Survivors and Their Spouse Caregivers: An Actor-Partner Interdependence Model.

To investigate the relationship among dyadic coping, mental health and the individual and mutual influences on stroke survivors and their spouse caregivers. A cross-sectional descriptive study was conducted in China from November 2019 to August 2020. The STROBE checklist was used to report the present study. The analysis included 224 dyads of stroke survivors and their spouse caregivers in China. Data on stroke survivors and their spouse caregivers were collected using the Dyadic Coping Inventory (DCI), the Patient Health Questionnaire nine-item scale (PHQ-9) and the Generalised Anxiety Disorder seven-item scale (GAD-7). The dyadic analysis was conducted based on the Actor-Partner Interdependence Model (APIM). Regarding actor effects, spouse caregivers' dyadic coping and perceived dyadic coping had a negative predictive effect on their own anxiety and depression. Stroke survivors' perceived dyadic coping had a negative effect on their own depression. Regarding partner effects, spouse caregivers' perceived dyadic coping also had a negative predictive effect on the depression of the patients. In contrast, stroke survivors' perceived dyadic coping was positively associated with spouse caregivers' anxiety and depression. These findings suggested that mental health of stroke survivors and their spouse caregivers was affected by various dyadic coping dimensions. Our research has the potential to contribute to the understanding dyadic coping and mental health of stroke survivor-spouse caregiver dyads. The findings reveal that the coping strategies employed by stroke couples are closely related to the mental health of both partners. This study provides evidence for the significant impact of dyadic coping on the psychological well-being of stroke survivors and their spouse caregivers. Therefore, dyadic interventions aiming at strengthening dyadic coping may have positive effects on their mental health. This study directly involved the patients and family caregivers in hospital settings.

Psychological Distress is Prevalent and Interdependent Among Patients with Decompensated Cirrhosis and Their Caregivers.

Little is known about the interdependence of psychological distress among patients with decompensated cirrhosis (DC) and their caregivers. In this cross-sectional study we examined the interdependence of psychological distress (Hospital Anxiety and Depression Scale) among 127 patient-caregiver dyads using Actor-Partner Interdependence Modeling. Among dyads, 26% had both partners reporting clinically significant anxiety and 18% reporting clinically significant depression. Caregiver anxiety significantly predicted patient depression (β=0.20, p=0.02). Psychological distress was prevalent and interdependent among dyads. These results underscore the need to develop interventions to reduce psychological distress in both patients with DC and their caregivers.

Alexithymia and illness perceptions in persons with multiple sclerosis and their partners

Illness perceptions (IPs) encompass opinions regarding the nature, severity and curability of a disease. The aim of this cross-sectional study was to investigate the association between alexithymia and IPs among persons with multiple sclerosis (PwMS) and their partners, as well as within the dyads composed of PwMS and partners. PwMS referred to the Multiple Sclerosis Center of the University Hospital “Policlinico-San Marco” from 11th August 2021 to 7th January 2022 and their partners completed a battery of questionnaires, including the Toronto Alexithymia Scale-20 and the Illness Perception Questionnaire Revised. A dyadic data analysis (Actor-Partner Interdependence Model) was performed to test the effect of alexithymic traits both on a person’s own illness perceptions (actor effect) and on the partner’s illness perceptions (partner effect). 100 PwMS (71 women; mean age 47.6 ± 10.4 years) and 100 partners (29 women; mean age 49.1 ± 10.8 years), with a mean partnership duration of 20.1 ± 11.7 years, were enrolled. At the dyadic analysis, statistically significant small-to-moderate actor and partner effects were found considering alexithymia (total score and alexithymic facets) and IPs, whereby higher alexithymic traits related to higher negative perceptions (i.e. consequences, emotional representations) and lower positive ones (i.e. coherence, treatment control). Our findings support the relationship between alexithymia and negative illness appraisals. This data may inform therapeutic interventions aimed at reducing alexithymic traits, which in turn may reduce negative, and potentially dysfunctional, illness perceptions.

The actor-partner interdependence model of fertility stress and marital quality among couples undergoing in vitro fertilization and embryo transfer: The mediating role of dyadic coping.

To explore the relationships among fertility stress, dyadic coping and marital quality in couples undergoing in vitro fertilization-embryo transfer (IVF-ET). Couples receiving IVF-ET treatment at the clinic of the reproductive medicine centre of a hospital in China from February 2023 to October 2023 were selected by convenience sampling. A general information questionnaire, the Infertility Fertility Stress Scale (COMP-FPSS-SF), the dyadic coping inventory, and the marital adjustment test were used to evaluate the results. AMOS24.0 software was used to construct an actor-partner interdependence model that extended to mediation to analyze the relationships among couples' fertility stress, dyadic coping, and marital quality. The fertility stress level of IVF-ET wives was significantly higher than that of their husbands (p<0.05). Wives' levels of dyadic coping and marital quality were significantly lower than those of husbands (p<0.05). Fertility stress, dyadic coping, and marital quality were positively correlated between IVF-ET couples (p<0.01). In terms of the actor effect, the fertility stress of IVF-ET couples had a significant impact on their marital quality through their dyadic coping (β=-0.188, p<0.05; β=-0.109, p<0.05). In terms of partner effects, wives' fertility stress significantly affected their husbands' marital quality through their own or their husbands' dyadic coping (β=-0.055, p<0.01; β=0.157, p<0.01). Dyadic coping mediates the relationship between fertility stress and marital quality in IVF-ET couples. Nurses can use husbands and wives as central individuals and dyadic coping as the starting point to formulate intervention measures to reduce fertility stress and improve marital quality.

Parents' perception of children's behaviors, self-compassion, and parenting stress: Actor-partner interdependence model.

This study explores how self-compassion mediates the relations between parents' perceptions of children's behaviors and parenting stress, as well as interactions between parents. We conducted a longitudinal actor-partner interdependence mediation model and assessed parents' perceptions of children's behaviors, self-compassion, and parenting stress. A total of 656 pairs of parents (fathers' Mage = 34.96 years, SDage = 5.62; mothers' Mage = 33.13 years, SDage = 5.77) participated in the study. Results revealed that parents' perceptions of children's problem behavior affected their own parenting stress through their self-compassion. Additionally, parents' perceptions of children's prosocial behavior directly influenced their own parenting stress and also affected it through self-compassion in both parents. Parents' perceptions of children's problem behavior directly influenced their partner's parenting stress and also indirectly through their own self-compassion. Similarly, parents' perceptions of children's prosocial behavior affected their partner's parenting stress via self-compassion in both parents. The findings highlighted the importance of parents recognizing and valuing their children's positive behaviors, thereby fostering a constructive "child effect" that improved the dynamics of the parental subsystem. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dyadic cannabis use, alcohol use and relationship satisfaction: A daily diary study

ObjectiveIntimate relationships are important contexts for understanding individuals’ substance use patterns and trajectories. Using a dyadic daily diary design reporting over 14 consecutive days, the present study examined the association between cannabis use, alcohol use, and momentary relationship satisfaction among adult couples MethodEligible individuals on Prolific were invited to participate. We identified 33 couples where both partners participated. Participants completed a baseline survey and a 14-day daily diary study assessing their daily cannabis use, alcohol use, and relationship satisfaction. Multilevel modeling was used, within an Actor-Partner Interdependence Model (APIM), to evaluate the individual and interactive effects of one’s own use and their partner’s use on relationship satisfaction ResultsSignificant actor and partner effects of alcohol and cannabis use were found using both baseline and daily report data. For individuals who use cannabis more heavily among sampled couples, cannabis and alcohol co-use was associated with reduction in their own next-day relationship satisfaction while alcohol-only use was significantly associated with increased next-day satisfaction. There were no significant effects of one’s own or their partner’s effects for individuals who use cannabis more lightly. ConclusionsFindings replicate and extend prior research by demonstrating the dynamic nature of dyadic substance use and highlighting the unique impact of alcohol and cannabis co-use on daily relationship functioning.

Bidirectional associations between parenting stress and coparenting: A longitudinal actor-partner interdependence analysis.

Although parents' parenting stress has been found to be related to coparenting, existing research has mostly focused only on one parent or examined the unidirectional effects between the two factors. The present study investigated the actor and partner effects as well as the bidirectional association between parents' parenting stress and coparenting in Chinese society. The study participants were 522 Chinese father-mother dyads with elementary school-aged children who followed for two measurement occasions (half a year apart). The cross-lagged actor-partner interdependence model (APIM) was used to examine the actor effects and partner effects in the bidirectional associations between both parents' parenting stress and coparenting. The findings revealed that both fathers' and mothers' parenting stress significantly negatively predicted their spouses' coparenting (partner effects), and mothers' coparenting significantly negatively predicted their spouses' parenting stress (partner effects). However, the actor effects between parents' parenting stress and coparenting were not significant. Furthermore, there were significant bidirectional associations between fathers' parenting stress and mothers' coparenting. Findings from the present study reveal the dynamic interaction between parenting stress and coparenting. The results point to the need for providing preventive interventions to parents with high levels of parenting stress and establishing a collaborative interaction framework between parents.

Problematic alcohol use, jealousy, and digital dating abuse: A dyadic analysis

Young adults engage in digital dating abuse (DDA), or threatening, monitoring, and controlling behavior towards a romantic partner through technology. Alcohol use and jealousy are well-established risk factors for in-person partner abuse but have not yet been investigated in couples in the context of DDA. Jealousy might be a relevant moderator in the digital context, potentially amplifying the negative associations between problematic alcohol use and DDA. Thus, we examine dyadic associations between young adults’ problematic alcohol use and DDA perpetration, with romantic jealousy as a moderator. Participants are young adult heterosexual couples ( N = 91 couples, M age = 21.03 years, 54.4% White, 19.2% Latino, 26.3% other). Results from actor-partner interdependence models suggest that men’s jealousy significantly moderates both the actor effect for men and the partner effect for women. In contrast, women’s jealousy significantly moderates the partner effects for both men and women. Men’s problematic alcohol use is a risk factor for their own DDA perpetration at high levels of jealousy and is a risk factor for their partner’s DDA perpetration across their own or their partner’s jealousy. Women’s problematic alcohol use is a risk factor for their partner’s DDA perpetration across levels of their jealousy. These findings underscore the importance of considering individual and relational factors in understanding DDA. The study highlights the need for dyadic interventions targeting problematic alcohol use and jealousy to prevent DDA. Future research should utilize longitudinal designs and diary studies to investigate in-the-moment processes and within-person variability.

A Sibling's Intuition: The Role of Sibling Approval for Romantic Relationships

Research has shown that family and peer relationships have an impact on the stability and quality of one's romantic relationships. According to family systems theory, family dyads are likely to impact the stability of romantic dyads within a system. Yet, little is known if and how one's sibling will impact the development and maintenance of that relationship. Therefore, the goal of this study is to understand how approval of a sibling's romantic relationship impacts the quality of that relationship. Participants ( N = 168) and their siblings ( N = 118) were recruited to participate in an online survey, which included questions regarding their current and previous romantic relationships, if applicable, their relationship with their sibling, and their approval of their sibling's previous and/or current relationship(s). Data was analyzed using moderation analyses and actor–partner interdependence models. Although regression results showed no effects of sibling approval for relationship quality for either current or past relationships, the path analyses revealed that when participants approved their siblings’ relationship, the satisfaction increased, but when the siblings approved of the participant's relationship, the satisfaction trended downward. Path analyses also showed that approval did not predict the satisfaction of either participant's or sibling's last relationship. In both models, sibling and participant approval significantly predicted each other. Last, sibling closeness was not found to moderate any of these relationships. These results show that sibling approval plays a role in romantic relationships, but the impacts vary depending on relationship context.

He Said, She Said: a Dyadic Perspective on Adolescent Conflict Management and Dating Violence.

Physical dating violence is a widespread problem in adolescence, which often occurs during conflict escalation. Given that individual reports may be subject to many biases, including data from both partners is essential to yield a more accurate portrait of adolescent dating relationships. This study sought to examine within-dyad agreement rates as well as dyadic associations between both partners' conflict behaviors and physical dating violence using actor-partner interdependence modeling. The sample consisted of 126 different-sex adolescent couples (n = 252, girls: Mage = 17.34, SD = 1.39, boys: Mage = 17.98, SD = 1.65). Each partner independently completed an online questionnaire. The results revealed that boys and girls mostly disagree about what is going on within their relationship, and that the use of destructive conflict behaviors equally contributed to both partner's physical dating violence perpetration and victimization. Increasing youth's awareness of their own and their partner's behaviors during conflict is key in preventing conflict escalation, and ultimately reducing the incidence of physical dating violence.

Assessing a Couples-Based, Digital HIV Serostatus-Neutral Intervention (Para Ti, Para Mí, Para Nosotros) for Adult Cisgender Sexual Minority Male Couples in Lima, Peru: Protocol for a 6-Month Pilot Randomized Controlled Trial.

HIV disproportionately affects sexual minority men (SMM; eg, gay, bisexual, and other men who have sex with men) in Lima, Peru; epidemiological data estimate that 32% to 39% of new HIV infections occur among adult cisgender SMM within primary partnerships (ie, male couples). Most HIV prevention-care research in Lima, Peru, has focused on SMM as individuals and not couples. To help address this critical gap in prevention care, we developed Para Ti, Para Mí, Para Nosotros (P3): a couples-based, digital HIV serostatus-neutral intervention (DHI) for adult cisgender SMM couples in Lima, Peru. The P3 DHI is designed to facilitate couples with skill-building, communication, decision-making, and working together to form and adhere to a detailed prevention care plan that aligns with their explicit sexual agreement. The P3 DHI is theoretically informed, self-guided, directed, sequential, and fully automated. This pilot randomized controlled trial (RCT) aims to examine the preliminary effects of P3 on couples' formation and adherence to a detailed prevention care plan containing evidence-based strategies that also aligns with their explicit sexual agreement over time. In addition, the feasibility of enrollment and retention and couples' acceptability of P3 will be assessed. The research implements a prospective, 6-month pilot RCT with a 3-month delayed control condition. After baseline, 60 enrolled SMM couples will be randomized to 1 of 2 conditions. Couples randomized to the unmatched, delayed control condition will receive access to the P3 DHI to use during the last 3 months of the trial after the 3-month assessment. Couples randomized to the immediate intervention condition will immediately receive access to the P3 DHI for 6 months. Study assessments will occur at baseline and months 3 and 6. Descriptive, comparative, qualitative, and longitudinal analyses using generalized linear mixed-effect, multilevel, and actor-partner interdependence models will be conducted to address the specific aims. The 6-month pilot RCT is ongoing. Recruitment, enrollment, and data collection began in January 2023 and ended in April 2024. A total of 74 adult cisgender SMM couples met all inclusion criteria, provided consent, and were enrolled in the pilot RCT. Retention was 92% (68/74) at month 6. Data are currently being analyzed to address the 3 specific aims regarding feasibility, acceptability, and preliminary efficacy. Findings from this research will reveal whether couples deemed the P3 DHI to be acceptable. Findings will also highlight the preliminary efficacy of the P3 DHI on couples managing their vulnerability to HIV and other sexually transmitted infections (STIs) over time via alignment of their prevention-care plan and sexual agreement. Trial findings will help shape the future direction of the P3 DHI while addressing the existing gap in prevention and care services for couples in the local context. ClinicalTrials.gov NCT05873855; https://clinicaltrials.gov/study/NCT05873855. DERR1-10.2196/63106.

Assessing Jealousy: Factor Analyses, Measurement Invariance, Nomological Validity, and Longitudinal APIM Analyses of the Multidimensional Jealousy Scale.

The Multidimensional Jealousy Scale is the standard instrument to assess cognitive, emotional, and behavioral jealousy. We examined competing factor models and external correlations with broad and narrow traits. Across two studies, we analyzed four samples (Ntotal = 2,117). Confirmatory factor analysis supported the measurement model of three correlated factors in comparison to unidimensional, second-order, and bifactor models. Thus, speaking against the use of a total score. Furthermore, we found measurement invariance between romantic partners. We extended the Multidimensional Jealousy Scale (MJS)' nomological net to personality pathology and replicated prior findings of associations with broad and narrow traits. Study 2 examined longitudinal data (5- to 9-month lag) from couples. Actor-Partner Interdependence Model analyses showed that the MJS predicts facets of relationship satisfaction in actors and partners. We discuss potential avenues for revising the MJS (e.g., heteronormative item wordings).

Sibling and best friend conflict resolution strategies among Mexican-origin youth

Sibling relationships evolve into a more egalitarian relationship dynamic resembling friendships during adolescence, potentially facilitating the transfer of interpersonal skills across relationships. This study investigates cross-relationship associations in conflict resolution strategies with siblings and friends. Research on family-peer linkages, largely focused on White populations, often overlook the role of siblings in other ethnoracial contexts. Drawing on social learning theory, we examined mean-level differences on conflict resolution strategy use with siblings versus friends and how conflict resolution strategies with siblings were related to those with friends. Participants were older ( M = 15.48; SD = 1.57) and younger siblings ( M = 12.55; SD = .60) in 246 Mexican-origin families. Adolescents reported on their use of solution-oriented, nonconfrontational, and controlling strategies with one another and their best friends, which reflect varying considerations for oneself, others, and their relationship. Multilevel ANOVAs suggest that adolescents typically use more adaptive strategies with friends than with siblings. Actor-Partner Interdependence Models revealed significant positive associations between actor-reported conflict resolution strategies with siblings and friends, even when accounting for relationship intimacy and conflict, expressive personality characteristics, and familism values, suggesting congruence across relationships. Cross-strategy analyses indicated that controlling strategies with siblings were correlated with all strategies with friends, while nonconfrontational strategies with siblings negatively related to solution-oriented strategies with friends. These findings highlight how sibling and friend experiences shape adolescents’ interpersonal skills and suggest avenues for future research on the enduring impact on social development.

Transactional models of depression via caregiver-child interactions: Evaluating conflict resolution as a source of resilience in adversity-exposed families

BackgroundYouth who experienced early life caregiving adversity (ECA) are at increased risk for developing depression, which may in part reflect a heightened vulnerability to the deleterious effects of later-life stressors, including poor caregiver mental health and interpersonal conflict. Transactional models posit bidirectional influences between caregivers and children that operate over development and more proximally across interactions. ObjectiveTo address gaps in knowledge of bidirectional influences between caregivers and children, and differences therein based on ECA exposure, we evaluated the effects of caregiver and child depressive symptoms on their own and each other’s emotion-related behavior during conflict resolution, and the effects of their behavior on their own and each other’s changes in affect expression from conflict resolution to a recovery task. Participants and setting161 caregiver-child dyads (child age 6–16 years; 49 % female youth; 45 % caregivers of ECA-exposed youth) participated in videorecorded conflict resolution and subsequent recovery tasks. MethodsCaregivers reported on their own and their child’s depressive symptoms. Trained coders rated caregiver and child positive and negative affect and supportive and unsupportive emotion-related behavior. ResultsContrary to expectations derived from models of stress-sensitization, results of actor-partner interdependence models demonstrated positive associations between caregiver depressive symptoms and supportive child behavior, among ECA-exposed families. Among these families, only, child supportive behavior was also associated with greater increases in subsequent caregiver positive affect during the recovery task. ConclusionsIn contrast to models of stress-sensitization, youth supportive reactions to caregiver distress may initiate positive spirals that transcend interactions. Implications for intervention efforts are discussed.

Predictors and Interdependence of Quality of Life in a Random Sample of Long-Term Young Breast Cancer Survivors and Their Biological Relatives.

Quality of life (QOL) among young breast cancer survivors (YBCS) is often worse than QOL of older breast cancer survivors or age-matched peers without a history of cancer. Families commonly support YBCS, particularly during treatment, but little is known about long-term YBCS and family member QOL. The purpose of this study was to identify demographic, clinical, and psychosocial predictors of physical and mental QOL in YBCS and biological relatives and investigate associations between their QOL (i.e., QOL interdependence). This secondary data analysis includes a random sample of long-term YBCS (≤ 45 years old at diagnosis) and up to two female relatives at baseline (post-treatment) and 18-month follow-up. The sample consists of 189 dyads (YBCS and one relative) and 121 triads (YBCS and two relatives). Actor-partner interdependence models (APIMs) were used to estimate the influence of YBCS's and relatives' demographic, clinical, and psychosocial factors on their own QOL (actor effects) and the other persons' QOL (partner effects). For YBCS and relatives, QOL at the baseline was associated with their QOL at 18-months. YBCS's perceived cancer risk was associated with their own and relatives' QOL. Older relatives' physical QOL at baseline was associated with younger relatives' physical QOL at follow-up. Age, race, marital status, years since diagnosis, education, out-of-pocket costs of care, routine sources of care, income, family support, fear of recurrence, anxiety, and depression were also significant predictors of QOL. Findings revealed independent and interdependent effects on QOL. These predictors point to potential targets of support for families. ClinicalTrials.gov ID: NCT01612338.

Gender, attachment, and demand/withdraw patterns in the context of moderate couple conflict in cisgender, heterosexual relationships.

A common pattern in couple relationships is demand/withdraw. Within this pattern, one partner seeks connection, change, and resolution of the issue, whereas the other seeks to end the discussion and limit closeness. We sought to further understand and update the literature by examining the relationship of gender and attachment (both self-report and narrative discourse) with demand/withdraw behaviors during moderate couple conflict. Using data from 63 cisgender, heterosexual couples, we used the actor-partner interdependence model within multilevel modeling, to explore the research questions. Findings revealed that during the woman's issue, men were more likely to withdraw. During the man's issue, preoccupied attachment in either partner was associated with more demand and women higher in attachment anxiety were more likely to demand. Demand behaviors in one partner were also associated with withdraw behaviors in the other (and vice versa). In this article, we discuss the research and clinical implications of these findings.

Discrepancies in perceptions of PTSD symptoms among veteran couples: Links to poorer relationship and individual functioning.

Veteran and intimate partner perceptions of posttraumatic stress disorder (PTSD) may differ, and little is known about how agreement or disagreement on symptom severity is related to relationship satisfaction. Veterans and their partners (N = 199 couples) completed a baseline assessment for a clinical trial evaluating two couple-based PTSD interventions. Veterans completed the PTSD Checklist for DSM-5 (PCL-5). Partners completed the collateral PCL-5 (PCL-5-C), which asked them to rate the severity of the veteran's PTSD symptoms. Both partner and veteran completed the Couples Satisfaction Index (CSI-32). Intraclass correlations (ICC) assessed agreement between PCL-5 and PCL-5-C total and subscale scores, which was low for total PCL and for all subscales (ICC = 0.15-0.46). Actor-Partner Interdependence Models (APIMs; actor-only pattern) tested associations between relationship satisfaction and PTSD symptom severity (total PCL and subscales), and the magnitude and direction of difference between PCL-5 and PCL-5-C (total and subscales). For veterans, more severetotal PTSD and negative cognition/mood scores were associated with lower relationship satisfaction, and the direction of discrepancy for negative cognition/mood (i.e., higher veteran-rated PTSD symptoms relative to partner's collateral report) was also associated with lower satisfaction. For partners, more severe collateral-reported symptoms for total PTSD and all four subscales were associated with lower relationship satisfaction; further, a larger discrepancy between veterans' and partners' reports of total PTSD, negative cognition/mood, and hyperarousal were associated with lower satisfaction. These results suggest that partners may have different perceptions of PTSD symptoms, and support the potential of fostering a shared understanding of PTSD symptom severity in couples.