Marital Strain Research Articles

Marital Effects in Later Life: Dyadic Approaches and Gender Differences

Marriage is a dyadic system, within which the characteristics and experiences of each partner can have implications for both. Moreover, gender of both spouses may impact these dyadic influences. The five papers comprising this symposium all take a dyadic approach to studying midlife and older couples, and how their effects on one another may vary by gender. Donnelly examines the consequences of precarious work among midlife couples, finding heightened risks for marital strain and divorce, depending on which gender spouse is exposed to precarious work. Garcia also analyzes gender differences – in this case, how the gender of a woman’s spouse may affect associations between daily marital strain and sleep quality, with only women married to men showing adverse sleep outcomes. Polenick and colleagues study the long-term repercussions of chronic condition discordance, finding that both individual-level and couple-level discordance had impacts for husbands’ and wives’ physical activity. Gallagher and Stokes focus on cognitive functioning within dyads, revealing gendered effects: Wives’ poorer cognitive functioning was associated with their own (better) marital quality, while husbands’ poorer cognitive functioning was associated with wives’ (worse) marital quality. Lastly, Stokes and Barooah examine longitudinal dyadic associations between loneliness and vascular health, finding that own and partner’s baseline loneliness were associated with increased HbA1c levels only in the context of inferior marital support. Carr will assess the strengths and limitations of these papers, and discuss the contributions these studies can make to the field and to future research on marital effects and gender in later life.

Cognitive Functioning, Gender, and Marital Quality Among Older Married Couples: A Dyadic Approach

Older spouses influence one another in myriad ways, and dyadic effects of marital quality on health and well-being have been well-established. However, little attention has been paid to dyadic implications of cognitive functioning, including for spouses’ perceptions of the relationship itself. This study examines associations of older husbands’ and wives’ cognitive functioning with both partners’ reports of four marital quality outcomes. Structural equation modeling analyzed data from 1,414 opposite-sex couples drawn from the 2016 wave of the Health and Retirement Study. Findings revealed that (a) wives’ poorer cognitive functioning was associated with wives’ reporting greater closeness and higher ratings of enjoying time with a spouse, whereas (b) husbands’ poorer cognitive functioning was associated with wives’ reporting greater marital strain, lower marital support, lower closeness, and lower ratings of enjoying time with a spouse. This suggests that cognitive functioning/impairment has dyadic consequences for marital quality, which are highly gendered.

Loneliness trajectories and correlates of social connections among older adult married couples.

How loneliness manifests in older adult married couples is necessary to consider. Marriage partners may become more or less lonely based on shared circumstances with one another (i.e., the shared environment hypothesis). Moreover, individuals may pair off with a marriage partner who shares similar levels of loneliness (i.e., the homophily hypothesis; Cacioppo, Fowler, & Christakis, 2009), which can potentially lead to higher or lower levels of loneliness. Therefore, examining couples dyadically is beneficial in order to understand how loneliness operates over time. Three waves of the Health and Retirement Study were used and participants included 1,389 older adult couples. The current study uses growth-mixture modeling to examine older adult couples' joint loneliness trajectories. Multinomial logistic regressions were also used to examine social and demographic correlates of these trajectories. Three classes emerged, including classes characterized by high loneliness (N = 69), low loneliness (N = 998), and moderate loneliness (N = 322). Classes were distinguished at the first wave by husbands' and wives' marital support, husbands' marital strain, husbands' age, husbands' friendship strain, and wives' frequency of seeing friends. Overall, husbands' and wives' had relatively similar levels of loneliness over time and those who were in the low loneliness class tended to have more positive factors related to social connections. The present study provides insight into how loneliness functions over time among older adult couples, and has implications for practitioners who work with older adult couples. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

For Better or for Worse: Health and Marital Quality during Midlife.

Objective: To examine how changes in health are associated with marital quality over a 20-year period of midlife. Background: The health benefit associated with marriage (compared to non-marriage) is well established. Less work has explored how health and changes in a couple's health are associated with the marital relationship. Method: We used a sample of continuously married individuals who participated in three waves of the Midlife in the United States study (n = 1768). Multilevel modeling separated within-person changes and between-person differences in the effect of health on marital quality during midlife and older ages. Results: Marital support was lower and marital strain was higher for those with worse health relative to peers. Marital quality decreased when health decreased. Effects were particularly strong when spouses' health statuses became more discrepant. Conclusion: Health-of both self and partner-plays an important role in determining the marital quality of married persons during the midlife years.

The Implications of Providing Grandchild Care for Grandparents’ Marital Quality

This study distinguished among types of grandchild care (i.e., co-residence, high and low levels of babysitting, and no care), and examined their associations with grandparents’ marital quality. The sample consisted of 7,267 married grandparents aged 40 years and over from the 2008, 2010, and 2012 waves of the Health and Retirement Study. Providing grandchild care generally undermined grandparents’ marital quality; however, different types of grandchild care affected different aspects of marital quality. The negative effects of providing grandchild care were more pronounced among grandmothers than grandfathers. Grandmothers providing high-level babysitting care were at especially higher risk of experiencing marital strain among the caregiver groups. Findings suggest that providing grandchild care appears to be more of a stressor than a source of reward with respect to shaping grandparents’ marital quality. Sensitivity to such impact on marital quality may be usefully incorporated into developing supports and services meant for grandparent caregivers.

Sexual Knowledge in Post-Myocardial Infarction Patients: A Cross-Sectional Study.

BackgroundAdequate sexual knowledge is a key component of cardiac rehabilitation. Sexual knowledge in post-myocardial infarction (MI) patients is unknown. Thus, we conducted this study to investigate the sexual knowledge of post-myocardial infarction patients and their accessibility to sexual counseling.MethodologyBetween July and September 2018, a cross-sectional survey was carried out in 6six major hospitals in Karachi. The non-probability convenient sampling technique was used to include all patients meeting the inclusion criteria. To reduce biases, face-to-face interviews were conducted by investigators who were trained prior to the start of data collection. Knowledge was assessed using the Swedish version of the "Sex after MI Knowledge Test" questionnaire, where a higher score meant higher knowledge. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0 (IBM Corp., Armonk, NY) The t-test was applied to compare the knowledge score between males and females.ResultsThere was a total of 278 MI patients with a mean age of 54 years, of which 60% were men. The "Sex After MI Knowledge Test" scores varied between 37 and 67 (mean score 51 ± 5). None of the participants obtained the maximum possible test score of 75. The most frequently occurring score was 49 (16%). Around half of the participants (48%) incorrectly believed that sex cannot be safely resumed within a few weeks after the heart attack. Limited knowledge was found in questions pertaining to alcohol, viagra, and late evening being the best time to have sex. Medical knowledge was provided to only 27% (n=76) of the participants, of whom 77% (n=58) received it from the hospital staff itself. A significant difference existed in scores obtained by males and females, with males having a higher score and the mean difference in scores being 1.7 (p=0.015).ConclusionLack of sexual knowledge in MI patients due to the inadequacy of healthcare providers and the social stigma surrounding the topic causes marital strain leading to low quality of life.

Dyadic profiles of personality among older couples: Associations with marital quality

Understanding dyadic personality configurations and their associations with marital quality helps identify couples who are at high risk of marital strain. However, current research on personality similarity among spouses usually confounds couples with similarly positive and similarly negative personalities. This study aimed to (1) provide a clearer classification of dyadic personality profiles among older couples, (2) examine the associations between these profiles and both partners’ marital quality, and (3) explore gender differences in these associations. Data came from 3,178 older couples drawn from the 2010/2012 waves of the Health and Retirement Study. Latent profile analysis was used to identify dyadic personality profiles based on spouses’ standardized Big Five personality scores. Multilevel models examined associations between dyadic personality profiles and each partner’s marital quality, testing for gender differences as well. Six dyadic personality profiles were identified, including two opposite profiles (52%; positive wife–negative husband and positive husband–negative wife), two similar profiles (40%; similarly positive and similarly negative), and two extreme profiles (8%; extremely negative husband and extremely negative wife). Couples in the similarly positive profile reported the best marital quality, whereas couples in the similarly negative profile and the two extreme profiles reported the worst marital quality. The associations between profiles characterized by negative traits and marital quality were more pronounced among wives than husbands. This study advances the understanding of personality similarity and its consequences, suggesting heterogeneous subgroups of dyadic personalities among older couples and providing evidence of gender differences in the implications of personality similarity for relationship quality.

578 Childhood Burn Injuries: The Parent Perspective

Abstract Introduction Interventions for burn-injured children (BIC) largely focus on the child with the physical injury while consideration for family systems appears incidental. This study aimed to gain insight into the perspectives and needs of parents/caregivers of pediatric burn patients (PPBP). When considering BIC within the context of a family system, it is reasonable to expect the injury to engulf everyone. The literature emphasizes the acute and lasting physical and emotional impact of burns. Moreover, research suggests PPBP experience an emotional response to the incident that is often complicated by physical absence from their other uninjured children. Thus, this exploratory study fills a gap by engaging the unique perspective of the PPBP and posits direct implications for essential program enhancement/development. Methods PPBP attending a family program participated in semi-structured interviews (N=11) guided by the research question: What are the experiences of PPBP? Participants’ self-identified as African American (n=4), Caucasian (n=5), and Latino (n=2). Age ranged from 29 to 48 (M=38.36, SD=6.14). Interviews involved queries regarding the burn incident, from injury to present (M=7.12 years, SD=4.61), including support received, what they wish people understood about the experience, and ideas for programming. Interviews were recorded and transcribed. Data were analyzed using van Manen’s hermeneutic phenomenological approach. Results Findings supported PPBP’s unique experience coalescing into one theme—the never-ending trip from hell—conceptualized as, “I didn’t mean to get here—none of this is familiar and I can’t find anyone I know. What’s going on and when will it be over?” Mutual painful insights were parental guilt, sensory experiences related to the acute incident and aftercare, unknown prognosis and medical treatment expectations, physical/emotional health problems, family members insensitivity, managing the cruelty of others, isolation, marital strains, and sibling tensions. Families also reported positive outcomes: strength of informal support networks, empowerment through educating others, and creating new allies. PPBP emphasized the benefits associated with meeting other families who also endured a burn injury and the importance of mutual support. Conclusions Programs should address the needs of all family members, not just BIC. In order to mitigate the impact of burn trauma, the family system impact remains a critical primary consideration for research and interventions. Applicability of Research to Practice Findings can contribute to program planning with increased consideration of the family system. As a result of findings from this study, siblings are now included in a summer camp program historically serving only BIC.

Patterning of midlife marital trajectories in enduring marriages in a dyadic context: Physical and mental health outcomes in later years.

The current study, using prospective data over 25 years (1991-2015; N = 245 couples), investigates life course dyadic patterns of positive and negative marital trajectories (i.e., marital strength and strain, respectively) in middle-aged husbands and wives and an array of physical and mental health outcomes associated with these patterns. Spousal warmth, spouse's constructive conflict resolution, and couple's joint participation were used as indicators of marital strength, whereas spousal hostility, spouse's destructive conflict resolution, and marital instability were used as indicators of marital strain. Four dyadic latent classes with heterogeneous trajectory patterns were identified using husbands' and wives' concurrent strength and strain marital trajectories (1991-2001), including a couple stable and moderately favorable group, a couple stable and highly favorable group, a couple stable and husband more favorable than wife group, and a husband improving with wife slightly worsening group. The best health outcomes in 2015 were generally reported by members of the couple stable and highly favorable group, whereas the worst health outcomes were found, on average, for members of the husband improving with wife slightly worsening group. Based on these findings, interventions should promote and develop resiliency factors, thereby aiding in the redirection or improvement of middle-aged spouses' marital trajectories, which can reduce detrimental positive-negative imbalances in marital strength and strain.

Impact of stress on epidermal barrier function

The skin is made up of three layers. They are the epidermis, dermis and subcutaneous fat. The epidermis is the outermost layer which gives your skin its colour, regulates water loss through the skin and protects the body from bacteria and substances that irritate the skin. Plenty of research shows that stress that comes from crowding, isolation, cigarette smoke, lack of sleep, pain and marital strain can cause this layer to lose its function in both the short‐term and long‐term. This study aimed to review the relationship between stress and the loss of function of the epidermis. The results of 21 studies that looked into this relationship were analysed. They were all in English language and ranged from small to large‐scale studies. The stimulation of stress hormone release comes from a circuit in the brain. This study found that emotional stressors boost this circuit therefore increasing the amount of stress hormone released into the blood. This reduces production of the components that make up the epidermal layer, which leads to greater water loss. In conclusion, this review of 21 studies showed that there were negative effects of emotional stressors on the epidermal barrier function. It is recommended that future studies look into more real‐life stressors to further investigate the effect on skin. It also advises researching practical stress‐relieving therapies that can help minimise and restore the epidermal function, particularly in high‐risk people.

THE IMPORTANCE OF CREATING SHARED EXPECTATIONS FOLLOWING NURSING HOME DISCHARGE

Nursing home stays often represent a time of change for residents and their social networks (e.g., family, friends, and other social supports). Nursing home residents may be experiencing exacerbations of medical conditions, changes in physical functioning, and/or cognitive impairment. These changes often preclude the resident from returning to their pre-admission level of functioning, resulting in the need for adjustments for both residents and their social network. However, nursing home staff and residents/caregivers frequently have different expectations for post-discharge functioning. This may be the result of inadequate or unclear communication on the part of nursing home staff and/or residents and caregivers being unable or unwilling to internalize the information. The lack of shared expectations can leave residents and caregivers unprepared, creating unanticipated caregiving burdens for the social network and unwanted outcomes for the resident. We conducted interviews with 14 resident/caregiver dyads who experienced care transitions from VA nursing homes to examine expected and actual functioning and activities post-discharge. Using a qualitative content analysis approach, we identified several themes including marital strain related to mismatched expectations, impact of physical changes on Veterans’ social functioning, and differences between planned and actual post-discharge activities. We will discuss the importance of clear communication about expectations throughout the nursing home stay. We will also provide suggestions for improving discharge care planning to ensure creation of shared expectations and timely communication to allow residents and their social networks to adequately prepare for nursing home discharge.

ARE FAMILY RELATIONSHIPS A PROTECTIVE RESOURCE AMONG ADULTS WITH FUNCTIONAL IMPAIRMENT?

Health-related declines that affect physical functioning are a common stressor among older adults. Functional impairment can take a toll on older adults’ psychological well-being as it limits one’s capacities to independently carry out meaningful daily activities. The extent to which impairment affects mental health may vary based on the levels of support and strain in one’s personal relationships. Stress buffering perspectives suggest that support mitigates the detrimental psychological consequences of impairment, whereas stress amplification perspectives predict that strain will amplify these consequences. We use data from 2012 and 2016 waves of the Health and Retirement Study (N=3800) to explore: (a) the direct effects of functional limitation on depressive symptoms (CES-D); (b) the extent to which these associations are moderated by spouse, child, other relative, and friend support/strain; and (c) gender and marital status differences therein. Using lagged endogenous regression models, we find that impairment significantly increases depressive symptoms among men and women, and these effects are intensified by marital strain for both married men and women. However, buffering effects are found for women only, such that marital support mitigates against depressive symptoms in the face of current impairment. These results may reflect the gendered nature of marriage, where men with impairment uniformly benefit from marriage although women may experience protective effects of only in highly supportive unions. Results for other strain and support moderators also reveal gender differences, reflecting the distinctive ways that men and women interact with kin and friends over the life course.

Marital Strain, Support, and Alcohol Use: Results from a Twin Design Statistically Controlling for Genetic Confounding

Background: Marriage is one of the most frequently examined sources of social support and has been shown to protect against alcohol use and abuse. This study examines the relationship between perceived marital strain and support, and alcohol use controlling for additive genetic influence. Methods: Data from monozygotic (MZ) (n = 320) and dizygotic (DZ) (n = 464) twin pairs from the second wave of the National Survey of Midlife Development in the United States (MIDUS II) were used to test whether past year marital strain and support were associated with recent alcohol use. Generalized linear mixed models (GLMM) were estimated, allowing us to control for additive genetic and shared environmental influences as variance components. Results: Marital strain and support had positive, statistically significant associations with alcohol use. However, only the relationship between marital strain and alcohol use remained after controlling for variance in alcohol use attributed to genetics. Conclusions: After accounting for genetics, midlife adults still appear to cope with marital strain via alcohol use. However, this coping is unlikely to result in heavy episodic drinking or alcohol use disorder without other compounding factors.

Marital strain trajectories over a quarter century and spouses' loneliness: Couple-level and individual pathways.

Although research suggests that stressful marital experiences may lead to feelings of loneliness in later life, little is known about the influence of marital strain over an extended period of time on loneliness in later years. Thus, in the present study, drawing from family systems and cognitive theories along with common fate and actor-partner interdependence modeling approaches, we hypothesized a hybrid model comprised of two multilevel pathways explaining the persistent influence of marital strain on loneliness, including: (a) a couple-level pathway and (b) an individual pathway involving within-spouse and between-spouse effects. Specifically, we investigated the influences of individual- and couple-level trajectories of marital strain over a period of 25 years (from 1991 to 2015) on loneliness outcomes in later years with a sample of 257 couples in enduring, long-term (over 40 years) marriages. The results mostly supported both hypothesized pathways. Consistent with the pathway involving a couple-level process, couple-level trajectories of marital strain predicted couples' later-life loneliness as reflected by both spouses' reports of loneliness (shared perceptions). In addition, at the individual level, each spouses' unexplained variances (unique perception) in marital strain trajectories predicted his/her own later-life loneliness outcomes (within-spouse effect or actor effect). Findings are discussed as they relate to intervention and prevention programs focusing on the well-being of married couples in later life.

MARITAL STRAIN AND PSYCHOLOGICAL DISTRESS IN SAME-SEX AND DIFFERENT-SEX COUPLES.

This study examines the association of marital strain - as reported by each spouse - with psychological distress and considers whether the associations vary for men and women in gay, lesbian, and heterosexual marriages. Prior studies show that marital strain is associated with psychological distress. However, most studies rely on only one spouse's perspective and do not consider how appraisals of strain from both spouses may contribute to distress. Moreover, possible gender differences in these associations have been considered only for heterosexual couples. Analyses are based on 10 days of dyadic diary data from 756 midlife U.S. men and women in 378 gay, lesbian, and heterosexual marriages. Multilevel modeling is used to examine the association of self- and spouse-reported marital strain with psychological distress; actor-partner interdependence models (APIM) explore possible gender differences in these associations. Both self- and spousal-reports of marital strain are associated with psychological distress, with notable gender differences. The associations of self- and spouse-reported marital strain with distress are stronger for women in different-sex marriages when compared to men in same-sex and different-sex marriages. The association is also stronger for women in different-sex marriages compared to women in same-sex marriages, but for self-reported strain only. Marital appraisals by both spouses are important for psychological well-being and may be especially important for the well-being of women in different-sex marriages.

The impact of stress on epidermal barrier function: an evidence-based review.

The epidermal barrier functions to limit skin infection and inflammation by inhibiting irritant and immunogen invasion. Abundant evidence suggests that psychological stress stemming from crowding, isolation, nicotine smoking, insomnia, mental arithmetic tasks, physical pain, real-life stressors (examinations and marital strain) and lack of positive personality traits may impart both acute and chronic epidermal dysfunction. To review the relationship between stress and epidermal barrier dysfunction. A review of the PubMed and Embase databases was conducted to identify all English-language case-control, cross-sectional and randomized control trials that have reported the effect of stress on epidermal barrier function. The authors' conclusions are based on the available evidence from 21 studies that met the inclusion and exclusion criteria. Psychological stressors upregulate the hypothalamic-pituitary-adrenal axis to stimulate local and systemic stress hormone production. This ultimately leads to aberrant barrier dysfunction, characterized by decreased epidermal lipid and structural protein production, decreased stratum corneum hydration and increased transepidermal water loss. This evidence-based review explores the adverse effects of psychological stressors on epidermal barrier function. Future investigations using more real-life stressors are needed to elucidate further their impact on skin physiology and identify practical stress-relieving therapies that minimize and restore epidermal barrier dysfunction, particularly in at-risk populations. What's already known about this topic? The literature reports the negative effect of stress on prolonged wound healing. Less is known about the relationship between stress and epidermal barrier dysfunction, a chronic, superficial wound involving the upper epidermal layers. What does this study add? Psychological stressors impact epidermal barrier function by activating the hypothalamic-pituitary-adrenal axis to stimulate local and systemic stress hormone production. Stress hormones negatively affect the epidermal barrier by decreasing epidermal lipids and structural proteins, decreasing stratum corneum hydration and increasing transepidermal water loss. Identification of such stressors can promote stress-avoidance and stress-reduction behaviours that protect epidermal barrier function and prevent certain dermatological conditions.

Expanding the Conversation on Burnout Through Conceptions of Role Strain and Role Conflict.

Expanding the Conversation on Burnout Through Conceptions of Role Strain and Role Conflict.

Life Course Trajectories of Negative and Positive Marital Experiences and Loneliness in Later Years: Exploring Differential Associations

Loneliness is relatively common among older adults in the United States, and there can be significant physical, psychological, and cognitive impairments associated with feelings of loneliness. Consequently, this study seeks to uncover determinants of loneliness, particularly the impact of couples' negative and positive marital experiences (i.e., marital strain and strength) over the life course on loneliness in later adulthood. To accomplish this goal, an integrated analytical framework is utilized, incorporating growth curves within an actor-partner interdependence model, to capture the initial level and the rate of change in marital strain and strength over a period of 25years (from 1991 to 2015) with a sample of 257 couples in enduring, long-term marriages. Couples first participated in the Iowa Youth and Family Project in 1989 and most recently participated in the Later Adulthood Study in 2015. The confirmatory factor analyses showed that latent constructs of marital strain and marital strength are distinct constructs. The univariate growth curve analyses showed that there were significant interindividual variations in the initial level (1991) and rate of change (1991-2015) in marital strain and marital strength for both husbands and wives. While the initial level and rate of change in perceived marital strain from 1991 to 2015 was generally of consequence for both spouses' loneliness in 2015 (actor and partner effects), only actor effects were noted for marital strength. Findings are discussed as they relate to health policies and interventions focusing on the well-being of married couples in later life.

Osteopathic Manipulative Treatment as a Novel Way to Manage Postvasectomy Pain Syndrome.

Postvasectomy pain syndrome (PVPS) can be debilitating and is notoriously difficult to treat, often requiring a multidisciplinary approach. In this case report, osteopathic manipulative treatment (OMT) was used to treat a patient with PVPS. After vasectomy, an otherwise-healthy man experienced chronic right testicular pain, aggravated by exercise, touch, and sexual intercourse, resulting in marital strain and an inability to perform routine fitness activities. Symptoms persisted for 8 years, despite lifestyle modifications, orally administered pain regimens, pelvic floor physical therapy, nerve blocks, steroid injections, epididymectomy, spermatic cord denervation, and counseling. After the patient's urologist suggested orchiectomy, his family medicine physician referred him for OMT. The OMT interventions, applied over a 4-month period, were directed at the lumbar spine, pelvis, pelvic floor, and lower abdomen. After treatment, the patient reported absence of testicular pain most of the time and described his quality of life as "10 times better." Literature review revealed no reports of OMT used to manage PVPS.

Is relationship quality linked to diabetes risk and management?: It depends on what you look at.

Using nationally representative data (Midlife in the United States, N = 800), the present study therefore examines how aspects of marriage (e.g., strain, support, marital risk, and constructive communication) are linked to diabetes outcomes and whether these links vary as a function of sociodemographic characteristics related to health (e.g., gender, race, and income). Strain and marital risk were linked to an increased risk of developing diabetes and strain and poor communication were linked to an increased risk of poor diabetes management. Finally, marital support was linked to a lower risk of diabetes but only for those with lower income. These findings inform prevention and intervention programs focusing on social support mechanisms to potentially reduce the risk of developing diabetes (e.g., reduced marital strain and marital instability) and improving diabetes control (e.g., improved communication and reduced marital strain). (PsycINFO Database Record