Intimate Partner Support Research Articles

Sources of Social Support and Trauma Recovery: Evidence for Bidirectional Associations from a Recently Trauma-Exposed Community Sample.

Although the association between post-traumatic stress disorder (PTSD) and social support is well documented, few studies have tested the causal pathways explaining this association at several points in the acute post-trauma recovery period or examined whether the association varies for different sources of social support. To address these gaps, 151 community individuals (mean age = 37.20 years, 69.5% women) exposed to trauma within the previous 6 months were recruited to complete measures of PTSD and social support from intimate partners, friends, and relatives four times in 1 year. In line with recent recommendations for research on social support and PTSD symptoms, random intercept cross-lagged panel modeling (RI-CLPM) was used to examine dynamic changes between PTSD severity and social support over time. The pattern of RI-CLPM cross-lagged coefficients indicated that positive deviations from one's expected stable level of total social support (across all sources) sped up the recovery of PTSD symptoms at the end of the post-trauma year, and more severe PTSD symptoms than expected based on one's expected stable level of PTSD started eroding social support midway through the assessment year. When specific sources of social support were analyzed separately, the association between within-person increases in social support from friends at any given time point accelerated the recovery from PTSD across the entire year. Among participants with intimate partners (n = 53), intimate partner support did not predict PTSD symptoms, but more severe PTSD symptoms at any given time point predicted less support at the following time point. Results from this longitudinal study provide additional support for the bidirectional relationship between PTSD and social support over time and suggest that perceived social support from friends may be especially helpful during trauma recovery.

Help-seeking experiences and intimate partner support in vulvodynia: A qualitative exploration.

Vulvodynia is a poorly understood chronic pain condition characterized by persistent and unexplained pain in the vulva. Given the intimate nature of the pain, partners may play an important role in promoting self-management and help-seeking behaviours among women with vulvodynia. The current study aimed to explore the role of partner support in pain experiences and help-seeking behaviours among women with vulvodynia. A qualitative interpretive design was used. Ten women with vulvodynia (M age = 37.9 years) were interviewed using a semi-structured non-directive topic guide. Data were analysed using reflexive thematic analysis. Three themes around help-seeking experiences were constructed from the data: (1) 'It's Been a Battle' - Failed by the Healthcare System; (2) 'It's Just the Vulva' - Dismissed by Healthcare Professionals; and (3) 'I Diagnosed Myself' - The Patient Becomes the Expert. Participants described negative help-seeking experiences characterized by long delays to diagnosis, lack of awareness and understanding from healthcare professionals, minimization of symptoms, and having to advocate for and demand care. A further three themes pertaining to partner support were also developed: (1) 'That Person to Listen to You' - Source of Emotional Support; (2) 'Why Don't You Try This?' - Finding Solutions Together; and (3) 'He Forgets that it's Still There' - Vulvodynia is a Foreign Concept. Partners provided emotional support and showed empathy and understanding, and practical support by accompanying women to medical appointments and help with pain management. However, participants felt partners' understanding of vulvodynia was limited and that this impacted their relationships. Findings highlight a lack of continuity of care and multidisciplinary approach to treatment, with help-seeking experiences being mainly negative in this sample. Increasing public awareness of vulvodynia and improving healthcare access is crucial to improving physical and psychological outcomes for this group. Partners can play an important role in supporting people with vulvodynia; however, other outlets of support should be further explored.

Trauma symptoms contribute to daily experiential avoidance: Does partner support mitigate risk?

Objective: The present study examined the protective role of partner support in reducing daily experiential avoidance (EA) associated with trauma symptoms in a sample of 154 couples during pregnancy. Background: Although psychological distress during pregnancy may hinder the developing bond between parents and infants after birth, high quality intimate partner support has the potential to enhance psychological wellbeing during pregnancy, particularly in the context of trauma. Specifically, partner support might mitigate the impact of trauma symptoms on maladaptive coping strategies such as EA by enabling individuals to safely encounter their distress. Method: Participants completed a semi-structured clinical interview of support and a PTSD symptom inventory, followed by home surveys of EA over 14 days. We examined growth trajectories of EA over 14 days using latent trajectory modeling within a dyadic framework. Results: Trauma symptom severity was associated with higher levels of EA across the 2 weeks; however, among women, the impact of trauma symptoms on EA was no longer significant when support from a partner was above average quality or higher. Findings also revealed partner effects; to the extent that women reported higher levels of trauma symptoms, their partners had higher levels of EA. Conclusion: Findings highlight the protective role of high quality support from intimate partners and suggest that trauma-related interventions targeting partner support processes, especially those implemented during pregnancy, might enhance recovery and prevent further distress and dysfunction among pregnant women experiencing trauma symptoms.

The dark side of helping behaviors: Partner support increases daily alcohol use in outpatients with a history of alcohol dependence

The primary goal of the present study was to systematically investigate the role of intimate partner support in alcohol use and to examine whether partner support serves a maladaptive function among individuals with a history of alcohol dependence. This goal was pursued in a sample of low-income outpatients because of increased risk for chronic stress and alcohol use disorders among this population. We implemented a comprehensive, multi-method assessment of partner support and ecological momentary assessments of alcohol use over 14 consecutive days. Results demonstrate the potential “dark side” of helping behaviors that has been proposed in recent literature. Specifically, in a sample of low-income outpatients, we found that receiving more frequent and higher quality support from one’s partner put individuals meeting criteria for alcohol dependence at greater risk for consuming alcohol. Findings converge with research suggesting that helping behaviors might function to enable maladaptive coping mechanisms in the context of alcohol use disorders.

You Don’t Get It Babe: Intimate Partner Support Coupled with Racialized Discrimination among Intra-Racial and Inter-Racial Couples

This article explores intimate partner support between inter-racial couples in which both partners have a minoritized racial identity (or identities); inter-racial couples in which one partner is White/Caucasian identified; and intra-racial couples in which both partners identify as the same minoritized racial identity. Utilizing qualitative survey research methodology, (n = 48) participants shared their experiences with race-related discrimination, stress, and intimate partner support. The results of the study indicated that dating, partnering, coupling or marrying intra-racially serves as a major protective factor for receiving support within an intimate relationship when coping with racial discrimination, stress and traumatic microaggressions. The article highlights the importance of critical self-awareness and consciousness utilizing Critical Race Theory (CRT) when providing clinical services to couples that include at least one partner of a minoritized racial/ethnic identity group. Finally, clinical practice recommendations will also be included for couples’ therapist working with interracial couples utilizing an antiracist and Critical Race Theoretical approach.

Can Social Support Overcome the Individual and Structural Challenges of Being a Sex Offender? Assessing the Social Support-Recidivism Link.

Social support is important for individual's successful reentry; however, little is known about how it operates or is influenced by individual and structural factors. Understanding how social support matters for individuals convicted of a sex offense is especially important as they may have a different reentry experience due to the nature of their crime and post-conviction restrictions. This study examines the nature and effects of instrumental and expressive social support from family, friends, intimate partners, and parole officers on recidivism for a sample of men convicted of sex offenses using mixed methods. Results show that family, friend, and intimate partner support had no effects on recidivism, however participants reporting a positive relationship with their parole officer were more likely to return to prison. Qualitative analysis of in-depth interviews sheds light on how the nature of these relationships might explain the social support-recidivism link in a high stakes population.

Intimate partner support: A comparison of gay, lesbian, and heterosexual relationships

AbstractIn this investigation, intimate partner support, relationship satisfaction, and separation proneness were assessed for four types of people: men in a relationship with a woman (MRW), men in a relationship with a man (MRM), women in a relationship with a man (WRM), and women in a relationship with a woman (WRW). Men and women in same‐sex relationships received more support, were more satisfied, and reported fewer thoughts of separating than their counterparts in opposite‐sex relationships. The effect of relationship type on satisfaction was not significant once the amount of received support was controlled. The implications of these findings for understanding the support process in same‐sex relationships are discussed.

Breast cancer survivors' experiences of partner support and physical activity participation.

To examine women's experiences of enablers and constraints to physical activity participation after being diagnosed with breast cancer while mothers of dependent children. In-depth, semi-structured interviews were conducted with 36 Australian women diagnosed with breast cancer while mothers of dependent children. Social, structural and individual enablers and constraints to women's participation in physical activity included level of intimate partner support, daily household and childcare responsibilities, post-treatment pain and fatigue and level of priority for and pleasure derived from physical activity participation. The study concludes that social enablers and constraints, particularly partner support and gendered identity, were powerful in framing women's participation. Implications for those working in survivorship care include the need to consider ways to address women's gendered identities and their associated social roles, relationships and responsibilities when designing strategies to increase breast cancer survivors' physical activity participation. Further research is needed to understand the prevalence of the effects of perceived partner support on breast cancer survivors' physical activity participation.

Social Undermining and Intimate Partner Support Predict Depression in Cancer Patients

Title: This paper describes a cross-sectional analysis of a population of cancer patients in Quito, Ecuador, using surveys to assess depression levels and correlate depression with social support and social undermining. Background: Rates of depression among cancer patients are higher than in the general population. In Latin America, social support and social undermining are important, though understudied, factors in a patient’s mental health status. We assessed depression levels in a population of patients at a cancer hospital in Quito, Ecuador, and examined the association between depression, social support and social undermining. We hypothesized that depression was inversely related to social support levels and directly correlated with levels of social undermining. Methods and Findings: A total of 298 patients was approached in the waiting rooms of the Sociedad de Lucha Contra el Cancer (SOLCA) hospital in Quito, Ecuador over a two-month period. Surveys assessing depression, distress level, social support and social undermining were administered using an electronic tablet (iPad) based platform. High depression scores were associated with low levels of social support (p<0.0001) and high levels of social undermining (p<0.0001). Higher depression scores were associated with female gender, low education status and unemployment. Conclusions: Results of this study indicate that social support and social undermining are important factors in a cancer patient’s depression status and that computer-tablet based screening is a cost-effective, rapid, and efficient method to identify patients with major depression who should be targeted for therapy.

Using a life course model to examine racial disparities in low birth weight during adolescence and young adulthood.

This study examined relationships between health, social, environmental, and economic factors during adolescence and the subsequent risk of giving birth to a low-birth-weight (LBW) infant, to inform strategies for reducing racial disparities in LBW. Data were derived from the National Longitudinal Study of Adolescent Health. A sample of 1213 adolescents, reporting on first pregnancies, was created with 35% black, non-Hispanic (black) and 65% white, non-Hispanic (white) participants. Independent variables were from the domains of individual characteristics, health status, access to care, and social environment. The dependent variable was low birth weight. Overall and race-specific logistic regression models were estimated. Black women had 1.9times the odds of giving birth to an LBW infant as white women. Factors associated with LBW differed between black women and white women. Black women with a history of hypertension were 6 times more likely to have an LBW infant. Intimate partner support during prenatal care was protective for black women. Factors associated with an increased risk of giving birth to an LBW infant for white women included an intergenerational pattern of LBW, low body mass index during adolescence, and smoking during pregnancy. Socioeconomic factors during adolescence did not predict the odds of having an LBW infant for either group, except for white women whose parents had less than a high school education and black women living in medium-poverty neighborhoods. Findings suggest that strategies to reduce racial disparities should address the specific needs of the population being served over the life course.

Combat disclosure in intimate relationships: Mediating the impact of partner support on posttraumatic stress.

Although previous research has shown a negative relation between partner support and posttraumatic stress disorder (PTSD) symptom severity among military service members following deployment, the mediating mechanisms of this effect remain poorly understood. This study examined willingness to disclose deployment- and combat-related experiences as a mediating mechanism underlying the linkage between intimate partner support and PTSD symptom severity in a sample of 76 U.S. Air Force service members deployed to Iraq in a year-long, high-risk mission. Airmen's reports of overall social support, and partner support specifically, significantly predicted concurrent postdeployment PTSD symptom severity. Subsequent mediation analyses demonstrated that level of disclosure of deployment- and combat-related experiences by service members to their intimate partners accounted for a significant portion of the relation between partner support and postdeployment PTSD symptom severity. The level of Airmen's disclosure was also inversely related to levels of relationship distress. Implications of these findings for prevention and intervention strategies and for further research are discussed.

More than re-establishing the partner relationship: Intimate aftercare for Somali parents in diaspora

Objectiveto explore the sexual relationship and couples' perceptions about intimate partner support following childbirth. Designa hermeneutic design using a naturalistic inquiry framework as a qualitative proxy for medical anthropology. Data were collected using a fictional and culturally-specific narrative during focus group discussions (FGDs) in early 2011. Analysis was conducted by ‘functional narrative analysis’ and interpreted for conceptual constructions. Recruitment was by snowball and purposive sampling. Settinga diasporic context among participants living in six urban centres across Sweden. Participantssuccessful recruitment included 16 Somali-Swedish fathers and 27 mothers. Three FDGs were conducted with fathers (3–7 participants) and seven with mothers (3–6 participants). Findingswithin day 40 post partum, parents learn to rely on each other in the absence of traditional support networks. After the first 40 days, the re-introduction of sexual intimacy is likely to occur. Of the fathers experiencing postpartum sexual aversion, these seemed to experience ‘existential angst’ resulting from a combination of profound remorse over having put the partner into what they perceived as a life-threatening situation during childbirth and their perceived moral and ethical obligations to provide support in this setting. Mothers in general did not directly discuss their own sexuality. Women could imagine men's sexual aversion after witnessing childbirth. However, they seemed unaware of men's potential for angst. Mothers are situated between the loss of traditional postpartum support networks, comprised of close female kin, and their own newly-defined responsibilities in the host setting. Fathers embrace their new role. Both partners articulated the mother's new role as enhancing autonomy and independence in the host setting. However, women held mixed attitudes about fathers replacing traditional kin support. Implications for practiceto date, late postpartum aftercare for immigrant African parents is anecdotally linked to evidence-based recommendations, which have been identified for parents who are ethnically-congruent to a western study setting. Our findings suggest that aftercare meant for Somali parents living in these settings requires an understanding of how traditional intimate support and the postpartum sexual relationship are re-negotiated in the diasporic context. This includes recognition of the father as a willing and supportive partner.

“The Body Gives Way, Things Happen”: Older women describe breast cancer with a non-supportive intimate partner

PurposeMany women identify their intimate partner as important source of support during cancer diagnosis and recovery, but little is known about how women deal with breast cancer while in a relationship self-described as difficult. The purpose of this article is to describe the aging-related experiences of older women who were diagnosed with breast cancer while in a non-supportive, difficult intimate relationship. MethodSemi-structured qualitative interviews were conducted with a convenience sample of 16 women aged 55–84 years (mean 68.1 years) in community settings in the mid-Atlantic United States. Data were analyzed using hermeneutic phenomenological analysis. ResultsParticipants self-identified as being in a difficult intimate relationship (relationship length range: 1 year- 60 years, mean 35.6 years). Reasons for relationship difficulty ranged from intimate partner abuse to terminal illness. The findings included the themes: “At my Age”: participants reflect on aging and breast cancer; breast cancer, sexuality, and aging; and silence. ConclusionsIssues related to aging such as changes in sexual relationships, comorbidities, and partner illness complicated the women’s breast cancer experience. Despite relationship difficulties, these women coped effectively with breast cancer in various ways. Study findings will increase awareness about the unique, complex needs of older women facing breast cancer with non-supportive intimate partners. Nurses should assess older breast cancer patients keeping in mind physical functioning, comorbidities, social support network, and quality of intimate partner support.

“If Looks Would Kill Then I Would Be Dead”: Intimate Partner Abuse and Breast Cancer in Older Women

The objective of this study was to describe the experiences of older women diagnosed with breast cancer while experiencing intimate partner abuse (IPA), determined by scores on the Women's Experience With Battering (WEB) Scale. Semi-structured qualitative interviews were conducted with a convenience sample of 11 women ages 51 to 84 (mean age = 64.8). Data were analyzed using hermeneutic phenomenological analysis. Themes that emerged were Cancer and Control, Negative Relationship Changes, Changes in Intimacy, and Moving On. Older women simultaneously experiencing IPA and breast cancer have unique needs due to the complex interplay among three factors: age, IPA, and breast cancer. Gerontological nurses should be aware of issues surrounding older women with breast cancer and older women experiencing IPA. Assessment of older breast cancer patients should take into consideration patients' social support network and quality of intimate partner support.

'My husband would not help me, so I was driving over there': older rural women experiencing breast cancer with a non-supportive intimate partner

This article describes the experiences of older rural women diagnosed with breast cancer while in a non-supportive, and sometimes abusive, intimate relationship. Breast cancer is primarily a disease of older women, and in the USA, a higher percentage of rural women are more than 65 years of age compared with other geographical areas. Many women identify their intimate partner as an important source of support during cancer diagnosis and recovery, but little is known about how women deal with breast cancer while in a relationship self-described as difficult. Semi-structured qualitative interviews were conducted with a convenience sample of nine rural women from community settings in western Virginia and West Virginia. Participants ranged in age from 55 to 84 years at the time of interview (mean 69 years). Age at diagnosis ranged from 53 to 71 years (mean 59.2). Relationship length ranged from 1 to 55 years (mean 28.5). Time between interview and diagnosis ranged from 1 to 31 years (mean 9.8). All were in heterosexual relationships. Breast cancer stage ranged from I to III. Data were analyzed using hermeneutic phenomenological analysis. Several themes emerged related to the experience of breast cancer with a non-supportive intimate partner in a rural setting. The themes were: driving, gossip, rural location as therapeutic, and community support. Older rural women operating without the support of their intimate partner present to oncology treatment with unique challenges, particularly related to distance, financial stress, and sometimes heightened relationship stress. Rural women also reported rural strengths that aided them in their recovery. These findings indicate a need for complete assessments of social network and quality of intimate partner support in the rural oncology care setting.

Stigma and the Sexual Isolation of People with Serious Mental Illness

Sociologists have long recognized the importance of spousal or intimate partner support for individuals' mental and physical well-being. Numerous studies, however, suggest that people with serious mental illness have considerable difficulties in finding and maintaining intimate partner relationships. Using qualitative data collected from a large sample of people with serious mental illness as part of an HIV prevention research study, this paper explores the narrative explanations of sexual isolation for the sub-sample of individuals who reported no current sexual activity (N = 261). The analysis revealed an array of eight, interrelated explanations of sexual inactivity, including poor access to sexual partners; experiencing sexual dysfunction; psychosocial difficulties forming relationships; fearing disease or pregnancy; moral and quality of relationship concerns; sexually restrictive treatment cultures and settings; everyday life with mental illness gets in the way; and feeling devalued and withdrawing from others. More generally, these findings offer empirical insights into the multiple ways through which the stigma of mental illness influences the daily lives of people, including individual experiences of social rejection, structural forms of discrimination, as well as important social-psychological processes that reshape the self and behavior.