Psychological Distress In Partners Research Articles

Psychological distress in partners of patients with amyotrophic lateral sclerosis and progressive muscular atrophy: what’s the role of care demands and perceived control?

ABSTRACTCaregivers of Amyotrophic Lateral Sclerosis (ALS) and Progressive Muscular Atrophy (PMA) patients often experience psychological distress. Yet, it is unclear which factors explain the variance in psychological distress. This study seeks to evaluate how care demands and perceived control over caregiving influence psychological distress using moderation and mediation analysis. Data were collected as part of a RCT and 148 partners of patients with ALS or PMA were included. Psychological distress was assessed using the Hospital Anxiety and Depression Scale. Care demands were operationalized as physical functioning (Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised) and behavioural changes of the patient (Amyotrophic Lateral Sclerosis-Frontotemporal Dementia-Questionnaire). Perceived control over caregiving was assessed using items adapted from the Job Content Questionnaire. Results showed that more behavioural changes and lower perceived control over caregiving were associated with higher levels of psychological distress in caregivers. Patients’ physical functioning was not significantly related to caregivers’ psychological distress. No moderation or mediation effects were found of perceived control over caregiving on the relationship between demand and psychological distress. Monitoring, psychoeducation and caregiver support with regard to behavioural changes in patients, seem to be important for the wellbeing of caregivers. Caregivers’ perceived control might be a target for future interventions.

Risk of psychological distress in partners with functional disability among older Japanese adults.

The present cross-sectional study aimed to evaluate the association of psychological distress with a partner's disability in an older Japanese population, as well as the effect modification of social support on this association. The baseline survey was carried out between 1 December and 15 December 2006, and included 6809 participants from whom we collected data regarding functional disability and psychological distress. We defined functional disability as certification for long-term care insurance in Japan, and psychological distress as a Kessler 6 score of ≥10 out of 24. A multiple logistic regression analysis was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for increased psychological distress according to the categories of functional disability among partners. Stratified analyses were also carried out to investigate whether social support significantly affected the association between a partner's functional disability and psychological distress. The multiple-adjusted OR for psychological distress was 1.48 (95% CI 1.06-2.04) among participants whose partners had functional disabilities (vs those whose partners did not have functional disabilities). In the social support-stratified analysis, a significant association with psychological distress was observed among participants lacking social support for help with their daily housework (OR 2.47, 95% CI 1.23-4.83), but not among those with social support (OR 1.18, 95% CI 0.79-1.72); P for interaction = 0.03). A partner with functional disability conferred a significantly higher risk of psychological distress on older Japanese individuals, and this association was modified by social support. We conclude that social support might buffer psychological distress in this population. Geriatr Gerontol Int 2018; 18: 775-782.

Distress in partners of cardiac patients: relationship quality and social support

Introduction: While much research has focused on supporting patients' psychological recovery after an acute cardiac event, relatively little attention has been given to the psychological wellbeing of partners of patients. There are some indications that partners experience higher levels of anxiety and depression than cardiac patients. Previous studies have identified sociodemographic and behavioural predictors of distress in partners. The aim of this study was to investigate whether the quality of the marital relationship and the social support network impact on partner distress in the aftermath of a patient's cardiac event. Method: A mixed-method approach, including questionnaires and semistructured interviews, was used, with partners interviewed at the time of the event. Partner distress was measured at 12 months post event. Chi-square and t-tests were used to identify factors associated with partner distress, and logistic regression was used to identify unique predictors of partner distress. Results: One-hundred partners of cardiac patients consecutively admitted to the Royal Melbourne Hospital and the Melbourne Private Hospital over a 12-month period were recruited, with 73 participants retained at 12 months. Poor marital quality at the time of the cardiac event was the only unique predictor of partner distress. Thematic analysis of the qualitative data highlighted the ways marital quality impacts partners. Conclusion: Quantitative and qualitative findings illustrate the multi-dimensional impact of marital dysfunction on psychological distress in partners. Psycho-education and support for partners of cardiac patients appears warranted.

Partner accommodation in posttraumatic stress disorder: Initial testing of the Significant Others’ Responses to Trauma Scale (SORTS)

Posttraumatic stress disorder (PTSD) is associated with myriad relationship problems and psychological distress in partners of individuals with PTSD. This study sought to develop a self-report measure of partner accommodation to PTSD (i.e., ways in which partners alter their behavior in response to patient PTSD symptoms), the Significant Others’ Responses to Trauma Scale (SORTS), and to investigate its reliability and construct validity in 46 treatment-seeking couples. The SORTS demonstrated strong internal consistency and associations with individual and relationship distress. Accommodation was positively correlated with partners’ ratings of patients’ PTSD symptoms, patient self-reported depressive and trait anger severity, and partner self-reported depressive and state anger severity. Accommodation was negatively correlated with patient and partner relationship satisfaction and partners’ perceived social support received from patients. Findings suggest that accommodation may be an attempt to adapt to living with a partner with PTSD but may have negative implications for patient and partner well-being.

Emotional Distress in Partners of Patients with an Implantable Cardioverter Defibrillator: A Systematic Review and Recommendations for Future Research

Both patients with an implantable cardioverter defibrillator (ICD) and their partners face challenges when adapting to the ICD. Distress is a burden on its own for partners but may also affect well being and health of patients. This review provides a systematic overview of the literature on psychological distress in partners of ICD patients and recommendations for future research. PubMed and PsycInfo were searched in March 2010 using a priori defined search terms. This search and the additional hand search resulted in 22 studies, of which 13 were quantitative and eight qualitative. Sample sizes in quantitative studies varied considerably from 10 to 196 partners, with only six of 13 studies including >50 partners. Partner levels of distress were at least on par with patient levels. The majority of large-scale studies suggested that partner distress levels decrease in the first year postimplantation. Most studies reported no impact of ICD shocks on distress levels or quality of life in partners. ICD indication as well as comorbid conditions, age, and the psychological profile of the partner were related to distress and quality of life. Domains of concern emerging from qualitative studies were related to care of the ICD patient, helplessness and uncertainties related to shocks, role changes, sexual activities, overprotectiveness, and driving. Partner levels of distress may be as high as that of ICD patients. Research with large samples is needed to further investigate the course and determinants of partner distress and the influence that partner distress may have on patient health outcomes.

Distress in couples approached for genetic counseling and BRCA1/2 testing during adjuvant radiotherapy

Breast cancer patients mostly rely on their partners for support in dealing with their cancer diagnosis and treatment. Genetic counseling and BRCA1/2 testing during primary treatment may add to demands made on their partners. This study aimed to gain insight into the extent of psychological distress in partners of recently diagnosed patients and to find factors to help identify couples vulnerable to high psychological distress after an active approach for genetic counseling. Breast cancer patients and their partners (n=110) completed psychological distress measures (HADS and IES) prior to the approach for counseling (T0), after the approach (T1), and after leaving the genetic counseling protocol (T2). Couples not approached for counseling (n=85) completed similar questionnaires. Partners reported an equal or lower level of distress than patients, with a positive correlation between the two, although partners and patients differed in the course of their distress. Couples approached for genetic counseling did not differ in the level or course of either distress measure from not approached couples. A high baseline distress best predicts long-term high distress in patients and their partners. Younger patients were found to be particularly vulnerable. The approach for genetic counseling during adjuvant radiotherapy was not associated with extra psychological distress in partners or patients in the first year following the breast cancer diagnosis. A partner's long-term level of distress was significantly associated with that of the patient. Highly distressed patients with highly distressed partners were most likely to experience high distress in the long term.

The psychosocial impact of prostate cancer on patients and their partners

To assess the psychosocial impact of the diagnosis of either localised or metastatic prostate cancer (PCA) on patients and their female partners. Observational, prospective study at Time 1 and 6 months later at Time 2 of two groups of couples facing PCA. Time 1 was when patients were first diagnosed with histologically confirmed localised (potentially curable) PCA or metastatic (incurable) PCA. Depression and anxiety disorders according to the Diagnostic and statistical manual of mental disorders 4th edition (DSM-IV); psychological distress; marital satisfaction. At Time 1, partners had rates of DSM-IV major depression and generalised anxiety disorder twice those of women in the Australian community, and considerably higher than the patients' rates. At Time 2, psychological distress in partners had lessened but that in patients had increased. On the other hand, at Time 2, partners' marital satisfaction had deteriorated. To be fully effective, interventions aimed at reducing the psychosocial morbidity of PCA must involve both patient and partner, rather than the patient alone.

Goal disturbance, coping, and psychological distress in partners of myocardial infarction patients: Taking account of the dyad

This study aims to explore the relationship between goal disturbance and levels of psychological distress in partners of myocardial infarction (MI) patients. Furthermore, the role of partner and patient coping behaviour in the context of goal disturbance is explored. Forty dyads were interviewed and completed questionnaires 1 month (T1) and 4 months (T2) post MI. All patients were men. Patients and partners do not differ on anxiety or depression scores, however, patients experience significantly more higher order goal disturbance at T1. Partners reporting more goal disturbance also show increased distress at T1. More use of approach coping by partners contributes to explained variance in their goal disturbance. Partner avoidant coping is moderated by patient avoidant coping. Approaches to reduce distress in partners should thus take account of goal disturbance and coping behaviours within the dyad.

Caregiver burden and psychological distress in partners of veterans with chronic posttraumatic stress disorder.

Caregiver burden and psychological distress were examined in a sample of 71 partners of Vietnam War combat veterans. Partners of patients (n = 51) diagnosed with posttraumatic stress disorder (PTSD) experienced more caregiver burden and had poorer psychological adjustment than did partners of veterans without PTSD (n = 20). Among PTSD caregivers, patient PTSD symptom severity and level of interpersonal violence were associated with increased caregiver burden. When accounting for patient PTSD symptom severity, hostility, presence of major depression, level of interpersonal violence, and health complaints, only PTSD severity was uniquely associated with caregiver burden. Caregiver sociodemographic factors including age, race, education, and the availability of social support, did not moderate the relationship between PTSD symptom severity and caregiver burden. Caregiver burden was strongly related to spouse psychological adjustment.