Measures Of Relationship Quality Research Articles

175 A Dyadic Approach to Life-Threatening Illness in Older Adults and their Spouse Carers

Abstract Background Little research focuses on the older adult with life-threatening illness and their carer simultaneously, nor the role of the interpersonal and familial context around them. The purpose of this study was to identify factors associated with poor mental health and lack of shared appraisal of symptoms. Methods Multilevel modeling was used to examine cross-sectional data from 135 older adult-spouse carer dyads with life-threatening illness (59 with congestive heart failure and 76 with lung cancer). This was a secondary analysis of quantitative data from two studies. Data were gathered using established measures of symptoms (dyspnoea, fatigue, pain), depression, concealment, relationship quality and family support with in-person interviews conducted separately for older adults and their carers. Diagnosis and stage of disease were gathered from clinical records. Results Older adults with heart failure reported significantly more depressive symptoms than older adults with lung cancer, whereas spouses caring for someone with heart failure reported significantly less depressive symptoms than those caring for someone with lung cancer. Greater levels of spouse depressive symptoms were significantly associated with less shared appraisal of the older adult’s fatigue and pain interference, controlling for the quality of the relationship between them. Finally, risk factors for higher depressive symptoms of older adults included higher levels of concealing symptoms and worries from their spouse, advanced stage of disease, reporting low relationship quality and low levels of support from family. Risk factors for higher depressive symptoms of spouse carers included being younger and reporting low support from family. Conclusion Findings highlight the importance of taking a dyadic approach to life-threatening illness in older adults and the role of interpersonal and familial variables on the mental health of both members. Interventions to support and strengthen relationships and communication and address depressive symptoms of both members of the dyad are warranted.

A Longitudinal Hierarchical Examination of Smart Steps for Stepfamilies With Ethnically and Economically Diverse Couples

Over the past decade, relationship education has grown as a means of enhancing couple relationships. This longitudinal study was designed to examine the experiences and outcomes of 2,828 adults who participated in the Smart Steps for Stepfamilies: Embrace the Journey program. Self-report measures of relationship quality, commitment, and relationship instability were administered prior to participation, then immediately, 6 weeks, 6 months, and 1 year after participation. A three-level growth-curve analysis using hierarchical linear model suggested that stepfamily participants experienced small but statistically significant immediate increases in relationship quality and stability, but those gains diminished over time. The statistical analyses tested for moderating effects of individual and couple characteristics on programmatic outcomes over time. Application of these findings and implications for relationship education for stepfamilies are discussed.

Standardized assessment of relationship functioning in OEF/OIF Veterans with and without PTSD

ABSTRACT Posttraumatic Stress Disorder (PTSD) is associated with difficulties in intimate relationships, with most prior research examining associations with continuous, single-dimension, and often-unstandardized measures of general relationship quality or aggression. Standardized, well-normed assessments that include multiple couple problem areas could provide more precise information about the presence and specific nature of clinically significant concerns in patient care settings. This investigation aimed to replicate findings regarding increased difficulties in relationship functioning among Operations Enduring and Iraqi Freedom Veterans with PTSD and their romantic partners, specifically using a standardized assessment that permits identification of cases of clinically significant general couple distress and difficulties across multiple problem areas. We compared 32 male Veterans with PTSD and 33 without PTSD, and their romantic partners on reports of several problem areas using the revised Marital Satisfaction Inventory (MSI-R). All participants underwent structured diagnostic interviewing. PTSD couples reported clinically significant levels of relationship distress several times more frequently than comparison couples, both for general distress and across all specific problem areas (e.g., aggressive behavior, quality of leisure time together, sexual functioning, conflicts about finances and child rearing). The most notable problem areas for PTSD couples were affective and problem-solving communication. These results replicate associations of PTSD with general couple discord and multiple specific areas of couple difficulties and extend them by documenting the clinical severity of these problems. Mental health providers may consider incorporating standardized couple assessments into their evaluations of Veterans’ functioning. Couple therapies may consider using such measures to prioritize targets for treatment.

Parenting Interacts With Plasticity Genes in Predicting Behavioral Outcomes in Preschoolers.

Public health and pediatric nurses typically focus on supporting parenting to reduce the likelihood of children's behavioral problems. Studies have identified interactions between early exposures to stress in caregiving and child genotype in predicting children's behavioral problems, such that certain genotypes connote greater differential susceptibility or plasticity to environmental stressors. We sought to uncover the interaction between observational measures of parent-child relationship quality and genotype in predicting early-onset behavioral problems in 24-month-olds, using prospective methods. We conducted a secondary analysis of data collected on a subsample of 176 women and their infants enrolled during pregnancy in the ongoing Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study. Inclusion criteria required mothers to be ≥18 years of age, English speaking and ≤22 weeks gestational age at enrollment. Genetic data were obtained from blood leukocytes and buccal epithelial cell samples, collected from infants at three months of age. For each child, the presence of plasticity alleles was determined for BDNF, CNR1, DRD2/ANKK1, DRD4, DAT1, 5-HTTLPR, and MAOA and an overall index was calculated to summarize the number of plasticity alleles present. Observational assessments of parent-child relationship quality (sensitivity, controlling, and unresponsiveness) were conducted at six months of age. Children's internalizing (e.g., emotionally reactive, anxious/depressed, somatic complaint, withdrawn) and externalizing (e.g., aggression, inattention) behaviors were assessed at 24 months of age. After extracting genetic data, a maximum likelihood method for regressions was employed with Akaike Information Criterion (AIC) for model selection. When parents were less responsive and children possessed more plasticity alleles, children were more likely to be emotionally reactive, anxious/depressed, report somatic complaints, and withdrawn, while when parents were less responsive and children possessed fewer plasticity alleles, children were less likely to display these internalizing behaviors, in a differentially susceptible manner. Furthermore, when parents were more responsive, and children possessed more plasticity alleles, children were less likely to display internalizing behaviors (P = 0.034). Similarly, children who possessed either the CNR1-A plasticity allele (P = 0.010) or DAT1 9-repeat plasticity allele (P = 0.036) and experienced more/less parental control displayed more/fewer externalizing problems, respectively, in a differentially susceptible manner. The plasticity index score interacted with parental unresponsiveness in predicting anxiety and depressive behavioral problems in children, while individual genetic variants interacted with parental controlling behavior in predicting aggression and inattention in children, suggestive of differential susceptibility to caregiving. Especially in the context of nursing interventions designed to support childrearing and children's development, nurses need to be aware of the interactions between child genotype and parenting in understanding how well interventions will work in promoting optimal child behavior.

Transgender Youth and Social Support: A Survey Study on the Effects of Good Relationships on Well-being and Mental Health

Positive gender-supportive relationships have been found to promote well-being of transgender youth. The present study investigates how the quality of relationships to parents, friends and partners affects the mental well-being of transgender youth. An online survey was used for data collection. The sample consisted of 1,613 Finnish youth between 15 and 25 years of age. Youths who were identified as a transgender ( n = 370) were compared to cisgender (= no gender conflict, n = 1,243, mostly sexual minority youth) on measures of relationship quality and positive well-being. Transgender youth reported poorer well-being and relationships to parents than the control group did. Relationship quality predicted well-being of all participants, and there were no significant interactions between gender identity and relationship quality. Social support is important for transgender youth and has an impact on the well-being of youth regardless of gender identification.

A National Longitudinal Study of Partnered Sex, Relationship Quality, and Mental Health Among Older Adults.

We worked from a life course perspective to examine the relationship between partnered sex and older adults' trajectories of mental health as well as the potential mediating role of relationship quality in this association. We analyzed nationally representative data from three waves of the National Social Life, Health, and Aging Project (2005/2006 to 2015/2016). The sample included 1,911 married and cohabiting respondents aged 57 to 85 at the baseline survey. We examined four factors related to partnered sex: being sexually active, sexual frequency, feeling okay with sexual frequency, and sexual quality. Mental health was measured by self-rated poor mental health, unhappiness, and psychological distress. The relationship quality measures considered both relationship support and relationship strain. Results from mixed-effects models suggest that being sexually active, having sex more frequently, feeling okay with sexual frequency, and reporting better sexual quality were all related to better mental health outcomes. Relationship quality partially explained the effects of sex on mental health. This study highlights the importance of sex for mental health and relationship quality among older adults. The findings have implications for health policy and programs that seek to promote healthy aging.

Examining the Association Between Emotional Availability and Mindful Parenting

This study examined the associations between emotional availability (EA) and mindful parenting (MP), as well as their independent and combined associations with indicators of adolescent well-being. EA is a well-established measure of parent-child relationship quality and conceptualized to be a life-span measure of emotional connection in relationships. Thus far, the EA literature spans pregnancy to middle childhood. The current study extends the concept into the adolescence. MP is a construct shown to be associated with both positive parent-child relationships and adolescent well-being. The current study tests the association among EA, MP, and indicators of adolescent well-being in a sample of 30 mother-adolescent dyads (adolescent ages 10-14 years). EA and MP were assessed through observational coding of parent-adolescent interactions. Results indicated significant associations between EA and MP, and between each construct and adolescent outcomes. The strongest correlations were found between global scores of MP and EA (.53), and between MP subscales and the EA Scales of sensitivity (0.44-0.56) and structuring (0.48-0.59). One EA scale, adult nonhostility, and one MP scale, nonjudgmental acceptance of self and child, were significant predictors of parent-reported adolescent externalizing problems, independently and after accounting for the other (p < 0.05). These results indicate there are significant relations between EA and MP and both constructs are related to adolescent outcomes, with some specific contributions to indicators of adolescent well-being.

Quality Parent–Child Relationships: The Role of Parenting Style and Online Relational Maintenance Behaviors

This study examined the quality of parent–child relationships as a function of both parenting style and online relational maintenance behaviors. Five hundred and four parents completed measures of relationship quality (parental support, relational depth, parent–child conflict), parenting style (authoritarian, permissive, authoritative), and online relational maintenance behaviors (planning behaviors, comforting messages, material sharing); paired adolescents also assessed the quality of their parent–child relationships. A structural equation analysis evaluated a model in which parenting style predicted online relational maintenance behaviors that, in turn, predicted the quality of parent–child relationships. Results indicated partial support for our hypotheses.

Impact of a father-daughter physical activity program on girls' social-emotional well-being: A randomized controlled trial.

To increase girls' well-being, strategies are needed to optimize their social-emotional competence during childhood. Although positive fathering is important for girls, many fathers discount their unique influence and few participate in interventions. The Dads And Daughters Exercising and Empowered (DADEE) program was developed to engage fathers and their daughters through shared physical activity experiences. This study examined the program's impact on girls' well-being and the father-daughter relationship. Overall, 115 fathers (age range: 29-53 years) and 153 daughters (age range: 4-12 years) were randomized to (1) the DADEE program (9 weekly educational and practical sessions plus home-based challenges) or (2) a wait-list control. Assessments were baseline, 2 months (postintervention), and 9 months (94% retention). Daughters' social-emotional well-being was measured with the Devereux Student Strengths Assessment composite. Secondary outcomes included additional well-being indicators (e.g., global self-perception) plus validated measures of father involvement and father-daughter relationship quality. At 2 months, intervention daughters showed a medium-to-large improvement in overall well-being (+24.9 units, 95% CI [8.6, 41.1], d = 0.6), when compared with controls. Intervention daughters were also more likely to show clinically meaningful improvements in well-being (54%) than controls (18%). Medium-to-large effects were observed for: seven of eight social-emotional competencies (e.g., personal responsibility, d = 0.4-0.9), father-daughter relationship quality (d = 0.8, father-report; d = 0.5, daughter-report), daughters' prosocial behavior (d = 0.3) and several indicators of father involvement. Most outcomes had improved by 9 months. No effects were observed for daughters' emotional difficulties or global self-perception. This study provided the first experimental evidence that father-daughter physical activity programs may improve girls' well-being and the father-daughter relationship. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Black Intimacies Matter: the Role of Family Status, Gender, and Cumulative Risk on Relationship Quality Among Black Parents

Studies show that married families report higher levels of relationship quality relative to unmarried families; yet, limited attention has been given to differences in relationship quality between married and unmarried Black families. The authors examined the interplay between family status, gender, and cumulative risk exposure on relationship quality among Black parents. The results suggest that (a) differences between married and unmarried parents only emerged on two measures of relationship quality, (b) married mothers report higher levels of cohesiveness and lower levels of distress compared to married fathers and unmarried parents; (c) cumulative risk exposure was associated with each relationship quality measure; (d) cumulative risk mediated differences in relationship quality between married and unmarried mothers but not for married and unmarried fathers; and (e) cumulative risk exposure moderated the association between family status and gender whereby the effect of cumulative risk on relationship quality was more detrimental for married mothers.

Relationship Quality and Perceived Partner’s Body Appreciation Is Related to Women’s Own Body Appreciation and Sexual Functioning

Research on body appreciation is limited, especially when examining its relationship to sexual functioning. The aim of this study was to explore the relationship between body appreciation and sexual functioning, while measuring perceived partner’s body appreciation and general relationship quality. A sample of 244 women aged 18 to 30 completed measures of sexual functioning, relationship quality, and body image online. General relationship quality and perceived partner’s appreciation of one’s body predicted levels of sexual functioning. Levels of body appreciation did not predict sexual functioning over and above general relationship quality and perceived partner’s appreciation of one’s body. This study is the first to demonstrate the significance of general relationship quality and perceived partner’s body appreciation in relation to levels of body appreciation and sexual functioning. The findings highlight the importance of understanding body appreciation and its role in buffering the harmful impacts of viewing idealized images within the media.

Predicting Young Adults’ Romantic Relationship Quality: Sibling Ties and Adult Attachment Styles

Young adults’ romantic relationships have continually emerged as a significant area of study in psychological research. The authors examine possible associations between a measure of attitudes toward sibling relationships, a measure of adult attachment styles, and a measure of romantic relationship quality in a sample of 350 Italian university students (68.6% females, 31.4% males; age range 19-30 years, M age = 23.6 years, SD = 3.2). The authors tested the following hypotheses: that the perceived relationship quality between siblings was positively correlated with adult attachment styles and romantic relationship quality, that the frequent use of behaviors associated with adult attachment styles was negatively correlated with romantic relationship quality, and that attitudes toward sibling relationships and adult attachment styles predicted romantic relationship quality. Findings only partly supported the hypotheses, indicating that more positive attitudes toward sibling relationships and lower use of behaviors associated with avoidant attachment style influenced and predicted higher romantic relationship quality.

Remini-Sing: A Feasibility Study of Therapeutic Group Singing to Support Relationship Quality and Wellbeing for Community-Dwelling People Living With Dementia and Their Family Caregivers.

Background: Living at home following a diagnosis of dementia can be difficult for both the person living with dementia (PwD) and their family caregivers (FCG). Active group music participation may provide an avenue for emotional release, offer psychosocial support to caregivers and stimulate meaningful interaction between caregivers and loved ones with dementia. Therapeutic music interventions also have the capacity to facilitate reminiscence and social engagement and can help to manage challenging symptoms associated with dementia, such as anxiety, apathy, and agitation.Method: This feasibility study examined the acceptability of a 20-week therapeutic group singing intervention (Remini-Sing) and quantitative research assessments for PwD/FCG dyads living in the community. Quantitative measures for the following outcomes were tested for sensitivity and acceptability: relationship quality (PwD and FCG); life satisfaction, caregiver satisfaction, flourishing, and depression for FCGs; and anxiety, apathy, agitation, and quality of life for PwD. Quantitative assessments were conducted before, during (midway) and after 20 weeks of participation in a therapeutic singing group attended by the PwD and FCG together. The Remini-Sing intervention incorporated vocal warm ups, singing familiar songs, learning new songs, and opportunities for social interaction. Qualitative interviews were conducted with all dyads that completed the intervention.Results: Twelve PWD/FCG dyads were recruited and enrolled in the study. High participation and retention rates indicated that the intervention was received favorably by participants. There were no statistically significant changes on measures from pre to post intervention. However, favorable baseline scores on relationship quality and wellbeing measures were sustained over the 20-week intervention. The testing of these measures for feasibility also revealed that some were too difficult for PwD and thus yielded questionable results, some were potentially less relevant, and there were likely floor and ceiling effects on several of the measures utilized.Conclusions: This study demonstrated good feasibility for a research protocol and therapeutic group singing intervention for community-dwelling PwD and their FCGs. Participant reflections and researcher observations yielded useful information guiding the selection of quantitative outcome measures for future research in this area.

Correlates of anxiety and depression symptoms among patients and their family caregivers prior to allogeneic hematopoietic cell transplant for hematological malignancies.

Given the complexities and risks of allogeneic HCT, patients and their family caregivers may experience elevated psychological distress, including symptoms of anxiety and depression, in anticipation of the procedure. Patients and caregivers also bring with them their pre-HCT experiences of diagnosis, prior treatment, and associated burdens, thus potentially compounding their acute distress. Identification of clinical, psychosocial, and sociodemographic factors related to pre-HCT distress would allow targeting of patients and caregivers who may require assistance during the HCT process. Consecutive patients (n = 111) and their caregivers (n = 110) completed measures of anxiety, depression, cancer distress, perceived threat, perceived control, self-efficacy, relationship quality, and physical quality of life in the week before HCT. Multivariate linear regression analysis was used to identify factors associated with patient and caregiver anxiety or depression, including disease type, donor type, and patient and caregiver sociodemographic, health-related, and psychosocial factors. Family caregivers had higher levels of anxiety and depression symptoms than patients. Thirty percent of caregivers vs. 17% of patients met criteria for clinically significant anxiety and a lesser amount (5% for both) met criteria for clinically significant depression. Patient anxiety was related to younger age (b = - 0.22, p = 0.005) and greater cancer-related distress (b = 0.59, p < 0.001), while caregiver anxiety was related to lower self-efficacy (b = - 0.19, p = 0.011) and greater cancer-related distress (b = 0.58, p < 0.001). Similarly, patient depression was related to lower perceived control (b = - 0.17, p = 0.050), greater cancer-related distress (b = 0.34, p = 0.005), and lower physical functioning (b = - 0.26, p = 0.008), while caregiver depression was related to greater cancer-related distress (b = 0.46, p < 0.001). Family caregivers may be more emotionally vulnerable than patients before HCT and in need of additional assistance. Cancer-related distress was the strongest correlate of anxiety and depression in both patients and caregivers, suggesting that distress related to their cancer experience and its consequences plays a major role in their emotional functioning prior to HCT.

The Multiperspective Parent-Child Relationship Questionnaire (M-PCR)

The Multiperspective Parent-Child Relationship Questionnaire (M-PCR) Parent-child relationship quality may considerably impact child mental health. Yet many instruments apply effortful behavioral observation methods. In this paper we aim to develop a multiperspective questionnaire of parent-child relationships. Several experts in the field of parent-child interaction treatment generated 18 items to assess aspects of the parent-child relationship. Mothers, therapists and assistant therapists rated 129 mother-child dyads that were treated at the Child Psychiatric Family Day Hospital for preschool children in Münster, Germany at the beginning and again at the end of treatment. For validity purposes, a global measure of relationship quality (PIRGAS) and measures of maternal psychopathology (SCL-90-R) and child behavior problems (CBCL/1.5-5; C-TRF/1.5-5) completed the assessment.Six principal component analyses and subsequent oblique rotation revealed a stable patternof two interpretable factors labeled as "Affective Bond" and "Functional-Conflict" with highinternal consistency and retest-reliability. Validity of the MEK scales was supported by significant correlations with the global rating of relationship quality PIRGAS by experts (therapistsand assistant therapists) and measures of maternal and child psychopathology, particularlyexternalizing problems, and therapy outcome. The MEK appears as a valid, reliable and user-friendly instrument for assessing the quality of parent-child relationship in clinical contextsfrom different perspectives.

The Influence of Romantic Relationships on Substance Use in Emerging Adulthood

The current work built on prior research showing aspects of romantic relationships, including relationship quality and partner substance use, influence individual risk for substance use during emerging adulthood. Analyses were based on a sample of males from the Pathways to Desistance Project (PDP) data. Romantic relationships were quantified with an aggregate measure of relationship quality and specific measures of relationship satisfaction, monitoring, and partner antisocial behavior. With a focus on emerging adulthood, the current work was centered on Waves 8 and 9 of the PDP data. Regression models tested the association between the relationship measures and alcohol intoxication, marijuana use, and hard drug use in the past year. Models considered both contemporaneous and longitudinal effects. Across the aspects of romantic relationships, monitoring and partner antisocial behavior had the most consistent association with substance use. The association between monitoring and substance use was strongest when longitudinal effects were tested among those in a relationship at both Waves 8 and 9. Peer antisocial behavior and prior substance use were also associated with substance use. Results show that romantic relationships have an important influence on substance use within a criminal justice involved sample.

A typology of school-based mentoring relationship quality: Implications for recruiting and retaining volunteer mentors

A critical component of successful mentoring programs is the quality of relationships. In school-based settings, relationship quality measures tend to rely on single, unidimensional indicators reported by one informant. Using data from a school-based sample of both mentors and mentees enrolled in Big Brothers Big Sisters of the Greater Twin Cities (n = 244), we identified multidimensional profiles of mentoring relationships, factors associated with profiles, and associations between profiles and program-related mentor outcomes. Guided by Positive Youth Development concepts, a latent profile analysis identified three profiles based on multi-informant ratings of closeness, communication, engagement, and compatibility: Tough Matches, Tentative Mentors, and Tight Matches. Profile membership was associated with mentors' attitudes toward youth, match expectations, training received, and perceived program support. Profiles were also distinguished by match length and mentor commitment. Tentative mentors and those in tough matches could benefit from targeted practices to increase mentor capacity to connect and engage with mentees.

Dyadic analysis of siblings' relationship quality, behavioural responses, and pain experiences during experimental pain.

Research on family factors in paediatric pain has primarily focused on parents; the role of siblings has been largely ignored. This study examined whether sibling relationship quality was related to siblings' behaviours during experimental pain, and whether the behaviours of an observing sibling were related to children's pain outcomes. Ninety-two sibling dyads between 8 and 12 years old completed both observational and questionnaire measures of sibling relationship quality. Children took turns completing the cold-pressor task (CPT) in a counterbalanced order with their sibling present. Pain outcomes (intensity, fear, and tolerance) were recorded for each sibling, and the behaviour of the observing and participating siblings during the CPT were coded as attending, nonattending, and coping/encouragement. Structural equation modelling, using the actor-partner interdependence model, was conducted to analyse the dyadic data. While participating in the CPT with their sibling present, greater levels of warmth and positivity in the sibling relationship were related to children engaging in more nonattending behaviours and less attending behaviours. Greater levels of attending behaviours by the observing child was related to the sibling having a lower pain tolerance, and greater levels of coping/encouragement behaviours by the observing child was related to the sibling reporting greater pain intensity and fear during the CPT. Children with warmer/positive sibling relationships were more likely to respond to acute pain by shifting the focus away from their pain experience (eg, through distraction) when a sibling was present. Pain-focused behaviours by an observing sibling are related to greater child pain and fear during experimental pain.

Factor Structure of the Chinese Version of the Parent Adult-Child Relationship Questionnaire

The Parent Adult-Child Relationship Questionnaire (PACQ) included two identical versions of the 13-item scale, which were administered to each subject, one which referred to “relationship with mother” and the other to “relationship with father.” The PACQ, originally in English, is a self-report measure of the filial relationship. The present study aimed to develop a Chinese version of the PACQ and use it to explore Chinese parent adult-child relationships. A total of 454 Chinese adult-children completed the Chinese version of the PACQ. The structure of the questionnaire was analyzed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). We found that the Cronbach's α was 0.66–0.88 for fathers and 0.76–0.91 for mothers, which demonstrates high internal consistency reliabilities of the Chinese version of the PACQ. The Chinese version of the PACQ for father had similar constructs similar to with those of the original English version. However, a new factor for mothers, “attachment,” was derived from the original English version. The results suggested that the Chinese version of PACQ is a valid and reliable measure of relationship quality between Chinese adult-children and their parents.

Relationship quality and couples’ unhealthy behaviors predict body mass index in women

Research on the connection between relationship quality and body weight yields mixed results, suggesting the presence of a moderating variable. We tested whether the connection between four measures of relationship quality (conflict, ambivalence, maintenance, and love) and body mass index (BMI) was moderated by gender and couples’ unhealthy behaviors. The results showed that among women, those reporting good relationship quality had lower BMI than those with poor relationship quality, but only if they also showed little evidence of couples’ unhealthy behaviors. In other words, only the combination of high relationship quality and low prevalence of couples’ unhealthy behaviors was linked to lower BMI among women. In contrast, low relationship quality, regardless of couples’ unhealthy behaviors, and the combination of high relationship quality and high prevalence of couples’ unhealthy behaviors were all linked to higher BMI among women. These associations were not observed among men. The results suggest the presence of symptom-system fit—a relational pattern linking health detrimental behaviors and higher relationship quality.