Marital Factors Research Articles

Impotence: Organic factors and management approach

Abstract The multifactorial aetiology of impotence makes its diagnosis often difficult. Hormonal and vascular factors predominate among the organic etiologies and they can usually be diagnosed with currently available techniques. Neurological causes for impotence are more difficult to determine. Impotence of a psychogenic aetiology remains a difficult diagnosis to reach since there are no biological markers to establish with certainty the presence of such factors. The management approach frequently requires a comprehensive effort in order to solve the various causes. Currently available techniques usually permit the successful penile rigidity for vaginal penetration. It must be understood, however, that a rigid penis represents only a partial solution to the problem. Psychological, social, and marital factors must be dealt with simultaneously in order to reach what can be considered successful therapy.

The impact of family background and early marital factors on marital disruption.

Data from the National Survey of Families and Households for 1987-1988 are used to explore methodological and substantive issues concerning marital dissolution in the United States. "The analysis finds that marital disruptions are seriously underreported by males, making the analysis of male marital histories problematic. Also, the potential impact of reconciliations on the estimates of recent marital disruption based on separation is explored; no upward bias is likely to result from the inclusion of separations that may subsequently reconcile. The impact of a wide variety of factors on the risk of marital disruption is examined using proportional hazard techniques. Among them are included parental background factors, respondent's characteristics at the time of marriage, differences in spouses' characteristics, and joint activity statuses of marital partners in the first year of marriage. The risk of marital disruption is highest among women with young age at marriage, low education, a cohabitation history, and those whose spouse has been married previously. Parental family disruption affects marital stability primarily through age at marriage and cohabitation. Religious and educational heterogamy and male unemployment reduce marital stability."

Depression in spouses of chronic pain patients: the role of patient pain and anger, and marital satisfaction

Although several studies have shown that spouses of chronic pain patients may experience clinically significant depressive symptoms few studies have comprehensively examined the role of both patient and spouse-related factors in the development and maintenance of this emotional distress. Twenty-nine married male chronic benign low back pain patients and their spouses were recruited in order to examine the role of patient, spouse, and marital factors in spouse depressive symptomatology. The results indicated that 28% percent of the spouses in the sample reported significantly depressed mood. A 2-stage regression analysis was employed that revealed 3 significant predictors of spouse's depressed mood, namely patient's average pain, patient's reported levels of anger and hostility, and the spouse's level of marital satisfaction. These findings are discussed in terms of their implications for clinical interventions for pain patients and their families.

Research comparing the dyadic adjustment and sexual functioning concerns of diabetic and nondiabetic women.

The dyadic relationship and sexual functioning concerns of a group of diabetic women and a matched control group of nondiabetic women were compared. There was no statistically significant difference in overall dyadic adjustment between the two groups. Both diabetic and nondiabetic women were moderately well adjusted. However, diabetic women were significantly more concerned than nondiabetic women in the following six specific sexual functioning areas: (a) frequency of feeling sexual repulsion, (b) frequency of difficulty with vaginal lubrication, (c) frequency of difficulty reaching orgasm, (d) impact of genital discomfort, (e) frequency of performance anxiety, and (f) impact of performance anxiety. Therefore, health care professionals need to use the suggested holistic approaches in helping diabetic women overcome these sexual functioning concerns. Finally, the relationship between level of sexual functioning concerns and overall dyadic adjustment was not statistically significant for either group. This finding supports the belief that sexual and marital factors may operate independently.

Cognitive and marital factors in depression

The current investigation examines three groups of wives: (1) a group of nondepressed, nondiscordant community wives; (2) a group of nondepressed, discordant clinic wives; and (3) a group of depressed, discordant clinic wives. Groups were formed on the basis of structured interview responses and responses to a self-report inventory of depressive symptomatology. To be classified as depressed, wives were required to meet DSM III criteria for depression according to interview data and to exceed a Beck Depression Inventory score of 14. Both clinic groups showed equal levels of marital discord. Both nondepressed groups showed equally few cognitive errors. Accordingly, comparisons of these three groups allow us to test current interpersonal and cognitive theories of depression. The level of “closeness” in the marriage differentiated the depressed, discordant from the nondepressed, discordant wives despite their equal levels of overall marital discord. The level of depressive symptomatology was greater for the “nondepressed clinic wives than it was for the community wives despite their equal levels of cognitive errors. Both “closeness” in the marriage and cognitive errors accounted for the unique variance in level of depression. Implications for current interpersonal and cognitive accounts of depression are discussed.

Marriage and the psychological consequences of a heart attack: a longitudinal study of adaptation to chronic illness after 3 years.

As part of a larger study on recovery from myocardial infarction in a national sample of male cardiac patients, data was collected on slightly under 400 men and their wives over a 5-year period. This longitudinal data set was used to investigate the role of patient health cognitions and marital factors on long-term psychological response to the illness. Negative appraisals of threat and loss due to cardiac impairment/disability were found to be the best predictor of anxiety and depression at 3-4 years after hospitalisation. Patient cognitions appeared to be a chief mediator of medically-defined illness. Supportive marital environments were defined by scales measuring intimate attachment and spouse conflict. The latter was found associated with negative health cognitions and elevated anxiety. High intimacy marriages appeared to provide adequate social support, and the level of intimacy between the spouses was inversely related to the level of depressed mood. These findings were suggestive of a buffering effect of the patient's social support system. Other predictors, including the type A pattern, 'vital exhaustion', and social class were investigated as components of a multifactorial model for clinical screening purposes.

Migration, marital status and smoking as risk determinants of cancer.

To study the importance of migration to urban area, marital status and smoking as risk factors in cancer, a cohort of 4,475 Finnish men was followed up for the occurrence of cancer during the period 1964-1980. Of particular interest was the interaction of migration or marital status with smoking. For cancers at all sites, not married urbanized smoking men had the greatest risk, followed by not married native urban smokers. This pattern was mainly due to high risk of cancers of the lung and larynx among the urbanized men, with a risk peak among urbanized not married smokers. The pattern persisted even when the amount smoked was allowed for. The importance in lung cancer epidemiology of vitamin A deficiency, occupation and psychosocial stress was discussed, and some support was found for the role of psychosocial stress in both the migration and the marital status factors.

Effects of intoxication on alcoholics' marital communication and problem solving.

The effects of intoxication on the marital interactions of treatment-motivated alcoholics and their nonalcoholic spouses were studied in eight couples (two of which had an alcoholic wife). In half of the sessions, the alcoholics were given enough alcohol to reach a blood level of 10 mg/dl. Couples engaged in three 10-min conflict-resolution discussions of varying intensity counterbalanced for alcohol and no-alcohol sessions. Couples expressed significantly more positive verbalizations in the alcohol sessions than in the no-alcohol sessions. This was true especially for the nonalcoholic spouses, who doubled their rate of positive verbal behavior when interacting with an intoxicated partner. Alcoholics spoke more and tended to make more problem-describing statements while intoxicated than while sober. The alcoholics made a greater number of problem-solving statements than did their spouses. Alcoholics were significantly more negative and less positive in nonverbal behaviors than were their spouses, but neither self-report of marital satisfaction nor observations of verbal behavior reflected this. The models of both social-learning theory and systems theory for the relationship of marital factors to the etiology and maintenance of alcoholism are supported.

Resistance in directive sex therapy: recognition and management.

Resistance, in the form of marital conflict, may play an important role in mediating therapeutic efficacy with sexually dysfunctional couples. The concept of resistance is introduced with a social learning framework, and relevant research on the interface betwaeen marital factors, sexual dysfunction and treatment outcome is reviewed. Clinical guidelines for the recognition and management of resistance due to relationship discord are presented with particular emphasis on the importance of nonspeccific treatment factors.

Agoraphobia and marital relationship: Theory, treatment, and research

The present paper is a comprehensive review of the literature on the possible interactions between interpersonal, particularly marital factors on the one hand, and agoraphobic behavior on the other. First, some different theoretical formulations are described, followed by a discussion of reports and investigations concerning the agoraphobic's marital relationship. Then, attention is paid to those studies which examine the significance of marital factors in the outcome of exposure-treatment for agoraphobia. The remainder of this paper focuses on practical issues, suggestions, and warnings with respect to the different strategies for treating married agoraphobics. Finally, emphasis is given to methodological aspects of research needs in this area.

Predicting bereavement outcome: Marital factors.

Predicting bereavement outcome: Marital factors.

Sexuality in a 70-year-old urban population

Aspects of sexuality in 70-yr-old men and women were investigated as part of a population study in Gothenburg, Sweden. Seventy-six out of 166 men (46%), and 36 out of 266 women (16%) reported that they still had sexual intercourse. For married men the corresponding figure was 66 out of 128 (52%), and for married women 33 out of 91 (36%). The associations between continued sexual intercourse and marital factors, sexual factors, physical health, personality, mental health and some environmental factors were studied in married subjects and the results were as follows. Men who continued to have sexual intercourse had seldom suffered early parental death, seldom woke up during the night, had better mental health according to a global rating, and had a more positive attitude towards sexual activity among the aged. Women who continued to have sexual intercourse had comparatively young husbands, had no increase in emotional lability during recent years, had low levels of anxiety, had better mental health according to a global rating, had a general feeling of being healthy, judged their marriage to be happy and had positive experience of sexual intercourse and a positive attitude towards sexual activity among the aged.

Sex, Marital Status, and Mental Health: A Reappraisal

Previous research (cf. Gove) has suggested that the higher rates of mental illness among females may be due to the greater stress associated with the marital role for women in our society. Using data (N = 3674) gathered as part of a major epidemiologic study in the southeastern United States, the authors examine the relationships between Health Opinion Survey scores (a widely used psychiatric assessment instrument), marital status, marital history, length of marital status, and several sociodemographic variables. As anticipated, higher scores for females across race and in most marital statuses were found. But when data were analyzed via multiple regression which controlled for sociodemographic and marital status factors, it was found that low socioeconomic status (SES) was the strongest predictor of high scores. Being female was also significant. The only significant marital status variable in the equation was being separated. Persons who had been married more than once also had significantly elevated scores. Marital status, length of present status, and history of previous marital statuses were not powerful predictors of mental health problems: most of the explained variance was subsumed by sociodemographic variables. The authors conclude that the disproportionately high rates of mental illness among females cannot be accounted for by marital status and its incumbent stresses and suggest that other explanations need to be explored. The relationship between sex roles, marital status, and mental illness has received recently an increasing amount of attention in the social science and psychiatric literature (Brodsky: Clancy and Gove; Cooperstock; Gittleman-Klein and Klein: Gove; Gove and Tudor; Overall; Pokorny and Overall; Redick; Rosen et al.)1 Findings from these and other studies indicate that females in our society have higher rates of mental illness than males and/or that they more often seek treatment for problems related to psychiatric distress. The reasons for these differential rates have not been definitively established although a number of hypotheses have been offered. For example, Phillips and Segal have argued that the higher rates for females are due to methodological factors associated with response biases, e. g., naysaying and social desirability, a position refuted by Clancy and Gove. Gurin et al. have suggested the higher rates for females result from their finding marriage less satisfying than males. Others have contended that role strain, particularly as engendered by the changing status of females in industrial societies, produces ambiguous *This research was made possible by MH Grant No. 24740-01.

The Control of Human Fertility in Jamaica

This classic study of the early use of birth control in Jamaica was based on interviews conducted in 1956 with 1359 lower class women aged 14-40 who were currently in unions. 440 interviews were carried out in Kingston 215 in towns and 704 in rural areas. The questionnaires covered background demographic information on the respondents attitudes toward family size marital factors birth control fertility history and some control questions. The average respondent was 28 years old with 3.3 pregnancies and 2.5 living children. 29% were married 44% had common-law husbands and the remainder had regular sexual relations but did not reside with their partners. The average respondent had her 1st sexual union at age 16-17 but 1/4 started at 14. About 1/4 were working for pay and another 1/3 had done so in the past year. Close to 40% were in domestic work. 85% of the respondents mates were employed. Respondents on average had reached the 4th standard in elementary school. The analysis considered 3 problems: fertility control the influence of fertility on factors other than fertility control and an experimental program for fertility control. The analysis of fertility control focused on the degree of readiness of the population for contraception considering attitudes toward family size knowledge of birth control and attitudes toward birth control. Each aspect of fertility control was examined in relation to such demographic variables and to the other aspects. The analysis of differential fertility indicated that marital status and residence were the main factors responsible for the considerable variations in fertility levels. The experimental program for fertility control involved examining the degree of change in attitudes related to fertility control produced by pamphlets group meetings and case visits. A general conclusion of the work was that programs promoting the use of contraception are feasible in Jamaica and probably in similar countries.

Factors in Marital Adjustment

A comparison was made of 104 married couples rated by friends as well adjusted and 70 couples rated by friends as proorly adjusted. Little or no relationship was found between marital adjustment and factors such as family authority patterns of childhood, sex favoritism on the part of parents, sibling position, nativity of parents, and occupation of father. The evidence suggested relationships between material adjustment and factors such as unequal intimacy of women with their parents, excess or deficiency of friendships with the opposite sex on the part of men, similarity of mates as regard to schooling, and assortative mating with respect to age.