Spousal Relationship Research Articles

Love and Care in the Lord’s Resistance Army (LRA) in Northern Uganda

Abstract Dominant storylines about armed conflicts and rebel groups, such as the Lord’s Resistance Army (LRA) rebel group in Uganda, typically focus on violence, suffering, harm, and abuse. Without a doubt, life within insurgency groups, including in the LRA, is characterized by immense social suffering, typically portrayed to be beyond the pale of humanity. Yet, what of the connections of compassion, joy, love, and care that emerged in the context of cohesion and alongside these aspects and experiences of violence, suffering, and abuse? Over the years, our interlocutors narrated to us what can be understood as meaningful forms of kinship, social connections, or intimacy during and after their time with the group; in the context of conjugal spousal relations, among fellow recruits, or between abductees and their families and communities. This article focuses on these practices of love and care within and in the wake of life in the LRA, and how they are entangled with and sit alongside experiences of violence. The simultaneities of care and suffering constitute a key aspect of this analysis; not intending to negate, downplay, ignore, or trivialize the detrimental impact of violence within rebel groups in general, nor to idealize the relations of compassion, love, or care that emerged within this context. This dual focus, we maintain, is important for unearthing the complexities, intricacies, and nuances of peoples’ lived realities in the context of insurgency movements, and in the context of armed conflict more broadly, holding important analytical and ethical implications.

Resilience and burden in family caregivers of patients with severe mental disorders

IntroductionFamily caregivers of patients suffering from severe psychiatric disorders may present with health problems, lower quality of life, and painful emotions, which can seriously compromise their well-being when they do not receive appropriate professional support.ObjectivesThe aims of this study were to assess the level of burden and resilience in family caregivers of patients with severe mental disorders and to determine associated factors.Methods We conducted a descriptive and analytical cross-sectional study among family caregivers of patients followed at the psychiatry outpatient clinic of the Hedi Chaker University Hospital in Sfax, during the period from February 2022 to July 2022. We used the Connor–Davidson Resilience Scale (CD-RISC) to assess resilience and the Zarit Burden Inventory to assess the level of burden. Higher scores indicate higher resilience and greater burden.ResultsThe sample included 90 family caregivers of patients with severe mental disorders. The average age was 50.68. They were the parents of patients in 40% of cases. Professionally active caregivers accounted for 57.8% of cases. Thirty family caregivers had a somatic disorder history (33.3%).The median age of patients was 42 years. Ten patients (11.1%) were financially independent. The diagnosis was schizophrenia in 68.9% of cases. The mean duration of illness was 16.23 years. Irregular follow-up was noted in 10 patients (11.1%).The mean scores of the Zarit Burden scale and the CD-RISC were 41.86± 10.33 and 58.46± 9.18 respectively.Unemployed caregivers and parents experienced a higher burden (p=0.001, p=0.03 respectively). The level of burden was higher in caregivers taking care of financially dependent patients (p=0.03), with a duration of the disease greater than 15 years (p=0.04), and with irregular follow-up (p=0.008).A low level of resilience in caregivers was correlated with spousal relationship (p=0.001), cohabitation with the patient (p=0.05), widowhood (p=0.01), low level of education (p=0.02), the presence of a somatic disorder history in the caregivers (p=0.04).A negative correlation was observed between CD-RISC and Zarit scores (p=0.04; r=-0.21).Conclusions Family caregivers of mentally ill patients experienced a significant level of caregiver burden, and it was lower in caregivers with higher levels of resilience. Psycho-educational programs directed toward family caregivers are highly recommended.Disclosure of InterestNone Declared

The interpersonal benefits of goal adjustment capacities: the sample case of coping with poor sleep in couples.

This study examined the role of goal adjustment capacities and coping in the association between spousal sleep efficiency and relationship satisfaction in romantic couples. A community lifespan sample of 113 heterosexual couples (age range = 21-82 years) was recruited using newspaper advertisements in the Greater Montreal Area from June 2011 to December 2012. Participants completed study measures (i.e., Goal Adjustment Scale, Brief Pittsburgh Sleep Quality Index, Relationship Assessment Scale, and the Brief Cope) at two time points, ~1 year apart. The results of actor-partner interdependence models with moderation (MIXED procedure in SPSS) reveal that goal disengagement buffered people from worsening relationship satisfaction associated with poor spousal sleep [95% CI B (-1.17, -0.12)], in part via increases in actor active coping [95% CI B (-0.32, -0.02)] and decreases in partner self-blame [95% CI B (-0.28, -0.01)]. Goal reengagement was related to diminished relationship satisfaction in response to poor own sleep [95% CI B (0.59, 1.79)], in part through increases in actor behavioral disengagement [95% CI B (0.05, 0.41)]. These findings point to a need for future studies to examine goal adjustment capacities and relationship-specific coping strategies as potential targets of intervention to maintain peoples' relationship satisfaction in the face of sleep problems.

Jurisprudential Analysis of Applicant Subordination in the Declaratory Death System

The system of declaration of death leads to a series of changes in civil legal relations, such as the annihilation of marital relations and the creation of inheritance. China's civil code stipulates that can apply for the declaration of natural person's death for the interested party, but have the right to apply for the declaration of death of the order of the interested party is still debated in the academic community, the controversy lies in the applicant should have the order of the applicant. This paper analyzes the jurisprudence on whether the applicant for the declaration of death should have the right of precedence, and finds that the focus of the debate on the right of precedence is on the protection of property rights and interests or identity rights and interests, and finally proposes that the identity relationship of spouses be separated from the property relationship in the declaration of death, and that the declaration of disappearance be made as a pre-procedure of the declaration of death, in order to protect the legitimate interests of the interested parties.

Influence of intimate partner violence and male involvement on maternal healthcare services utilisation in Nigeria.

Low maternal health care services utilisation, especially antenatal care attendance and skilled birth attendance, has been documented to be responsible for maternal mortality and morbidity in Nigeria. While available evidence suggests mixed findings on uptake of maternal health care services in the context of abusive spousal relationships, male involvement in household and health decision-making has been established to promote uptake of maternal health care services. Yet, studies which consider mediating influence of intimate partner violence on male involvement and maternal health care services uptake are sorely missing in Nigeria. We hypothesised that maternal health care services uptake in abusive marital unions has implications for male involvement in pregnancy care and this has been largely overlooked in Nigeria. This study extracted data from the 2018 Nigeria Demographic and Health Survey (NDHS). The 2018 NDHS is a nationally representative secondary data which collected population, demographic and health information on women, men and households in Nigeria. The secondary data used a two-stage stratified and multistage sampling technique to collect information from the respondents. In this study, data were extracted for women who were sexually active, within the reproductive age (15-49 years) and not pregnant in five years prior the survey (n = 7,847). The results indicated (77%) antenatal care attendance and (47%) skilled delivery. The mediating influence of IPV on male involvement resulted in women who experienced sexual violence more likely to use heath facility for antenatal care (OR = 3.20; C.I: 1.20-8.50). Women whose partners were involved in health decision making had lower odds of antenatal care attendance (OR = 0.64; C.I: 0.44-0.94). Also, women whose partners were involved in spending their earnings had lower probability of antenatal care attendance (OR = 0.72; C.I: 0.55-0.96). Yet, the mediating influence of intimate partner violence on male involvement resulted in a lower likelihood of use of skilled delivery for emotionally abused women (OR = 0.58; C.I: 0.39-0.85). Women whose partners were involved in spending their earnings had higher odds of using skilled delivery (OR = 2.15; C.I: 1.79-2.56). Yet, women whose partners were involved in their health decision-making had lower odds of using skilled delivery (OR = 0.46; C.I: 0.34-0.62). This study held the philosophical stance that intimate partner violence mediated the influence of male involvement on maternal health care uptake while intimate partner violence had an inconsistent influence on maternal health care uptake. Policies and interventions should aim at addressing deep-rooted gender norms which promote IPV and limit male involvement in pregnancy care in Nigeria. Programme and policy interventions should focus on enhancing socioeconomic status of women.

(265) Self-Image after Breast Cancer

Abstract Introduction Breast cancer is currently the first cancer diagnosed among women. The impact of its local treatments such as surgery and radiation and its systemic treatments such as chemotherapy, hormone-suppressant therapies and targeted therapies on women's bodies anatomically and physiologically and on their body image and body esteem are the major factors altering their sexual health and the quality of their spousal relationships. Objective We aim to evaluate the qualitative impact of breast cancer on its survivors' body-image. Methods We ran a prospective qualitative study using semi-structured interviews until saturation of findings. The patients included were women diagnosed, treated for breast cancer, and followed up in our institution. All participants were sexually active and no older than 55. The study enrolled 20 participants over a 6-month period (February 2022-July 2022). Results All participants had a history of breast surgery either lumpectomy or mastectomy (70%) with (one case) or without reconstructive surgery. All patients reported a history of radiation and chemotherapy. 60% had received hormone therapy with medically induced menopause. The majority of participants explained how their bodies had changed not only physically and anatomically on the outside but also on the inside especially in relation to the adverse effects of chemotherapy and hormone therapy. They also reported body emotional changes. This required an adaptation to their new body for them and their partners and entourage. The main themes emerging from their discourse were: physical and emotional adaptation to breast cancer per se and its local and systematic treatments, fear of others judgment and comments on their physical changes and loss or gain of self-esteem. Breast reconstruction was also an important theme it the participants verbatim. Conclusions The words and themes that characterized the participants' speeches highlighted the impact of cancer diagnosis and oncological therapies on breast cancer survivors. Being part of a psychological intervention focused on self-compassion and body acceptance helps breast cancer survivors develop a better perception and acceptance of their new bodies. Disclosure No.

The Image of the Married Woman in Portuguese, Spanish and Russian Proverbs in the Light of Medieval Christian Ethics

Purpose. To examine the portrayal of women in matrimonial contexts through an analysis of 437 proverbs originating from Portuguese, Spanish, and Russian traditions. This study aims to explore how these sayings mirror the cultural, societal, and religious beliefs surrounding women's roles in the institution of marriage.Results. The study found that the image of women in marriage within these proverbs is consistent across the cultures studied. It highlighted that while the Christian Church promotes chastity, it also endorses marriage to combat sexual promiscuity. Similarities were identified between Southern European and Russian proverbs regarding the spiritual foundation of Christian marriage, the nature of spousal relationships, and the expected qualities of a wife and mother.Conclusion. Proverbs serve as a cultural repository, mirroring traditions and values shaped by historical and literary influences. The proverbs perpetuate the religious and moral ideals of the Catholic and Orthodox Churches, particularly the patriarchal view of marriage. This view enforces a hierarchy within marriage, with the wife subordinated to the husband, who is seen as her spiritual guide and the determinant of roles and responsibilities in the family and the broader society.

Disentangling factors that influence the spousal relationship of people with young-onset dementia: starting points for person-centered care and support?

Disentangling factors that influence the spousal relationship of people with young-onset dementia: starting points for person-centered care and support?

Continuing Bonds in Marriage, Death and Divorce: Conceptual and Clinical Considerations in the Relationship to Self and Spouse.

The shift from the detachment model of mourning to the continuing bonds paradigm in bereavement placed relationships to the deceased alongside relationships to the living. This emphasis on the continuation of the connection to the other person after death paradoxically narrowed the gap between relationships in life and after death. We explore and expand the concept of continuing bonds as it is now used in the field of loss and bereavement by comparing spousal relationships in the living, deceased and divorced. The Two-Track Model of Loss and Bereavement is a framework and clinical paradigm that clarifies similarities and differences in these three pair-bond relationships. The focus on continuing bonds adds and deepens theory, clinical and research aspects of assessing spousal relationship for the living as well as the bereaved and divorced.

The Role of Spouses’ Relationships in Ensuring Family Well-being

There is an acute problem in the world of family relationships, their impact on human development, determining the dependence of social factors on the well-being of the family, and creating a socio-pedagogical mechanism aimed at increasing the level of happiness of families. One of the priority areas is to further improve the comprehensive education of children in the family, to ensure the stability of family relationships, and to expand pedagogical opportunities. Based on this, our study highlights the problems of family problems that affect the sustainability of today’s families and the implementation of mechanisms for eliminating stereotypes through pedagogical mechanisms through training seminars. The article mainly reveals the need to focus on improving the relationship of spouses’ by improving traditional and empathic mechanisms.

Perceptions of Barriers and Facilitators to Reducing Exposure to Secondhand Smoke in the Home: A Qualitative Study With Palestinian-Arab Women in Israel.

Smoking is a collective and complex problem in the Palestinian-Arab community in Israel, where women and children are particularly vulnerable to exposure to secondhand smoke (SHS), especially in the home. We undertook this study to better understand women's experiences with SHS exposure in the home and to identify pathways for intervention. Using the grounded theory approach, seven focus groups were conducted with 66 women in different localities across Israel. Purposive and snowball sampling techniques were applied to recruit women who have currently or previously been exposed to smoking in the home. Focus groups were audio-recorded and transcribed verbatim, and data were then coded and analyzed using the constant comparison analysis method to identify emergent themes and subthemes. Three core themes emerged from the discussions. These include women's perceptions of smoking among men and exposure to SHS in the home, the implications of smoking on spousal and social relationships, and the women's experiences in coping with this situation and their suggestions for interventions. We identified additional sub-themes, including the consequences to women's and children's health, as well as the complex interaction between smoking in the home and women's social position, agency, and home ownership. Women exposed to SHS in the home experience consequences that affect their health and their spousal and social relationships. They also face several personal and societal challenges in tackling this issue. Culturally tailored interventions targeting both communities and households can raise awareness and impact smoking behaviors in the home. The findings of this study demonstrate the far-reaching consequences of SHS exposure in the home among women who are exposed. The findings contribute to our understanding of smoking contingencies among men and smoking behaviors in the home. This study lays the groundwork for future community and household-based research and interventions. We suggest several critical junctures that may increase response to smoking cessation interventions and to reduce smoking in the home, such as at the time of marriage when the home policy is set, and the adverse effects of exposure on children and other family members, especially those with illness.

Interactive Pathology of the Spousal Relationship Before and After Husbands' Infidelity

The current research was conducted with the aim of examining the interactive pathology of the spousal relationship before and after the infidelity of husbands among affected women in Isfahan in the year it was carried out. The methodology of the present study was qualitative, employing thematic analysis. The population of this research consisted of women harmed by their husbands' infidelity in the city of Isfahan. For sample selection, purposive sampling was used, and ten women affected by their husbands' infidelity were chosen. The instrument of this research included semi-structured interviews, the questions of which were prepared based on the information obtained from the review of texts and sources to identify the interactive damages in the spousal relationship. The interviewing process with participants continued until thematic saturation was achieved. For data analysis, qualitative analysis was performed using thematic analysis method (Clarke & Braun, 2006). The findings of the research indicated that the interactive damages of spouses before and after infidelity encompass twenty-one main categories, which are situated in four domains: intrapersonal damages, interpersonal damages, extra-personal damages, and specific extra-personal damages. Given these results, it can be said that prior to infidelity, damages facilitate the prerequisites for betrayal, and afterwards, they lead to the weakening of the marital relationship.

AN EMPIRICAL EXAMINATION OF WORK LIFE BALANCE IN DUAL CAREER COUPLES IN PAKISTAN: A QUALITATIVE APPROACH

This study examine the issues of work life balance in dual career couples in the selected universities of Peshawar city of the Khyber Pakhtunkhwa Province of Pakistan. For this purpose, qualitative research protocol was used while interviewing 22 purposely selected dual career couples in the targeted locales. The selected participants were interviewed through Semi Structured Interviewed (SSI) in the participant setting, their narratives were documented, and thematic analysis were subsequently performed. The extracted themes were including role overload and role conflict, couples with children, spousal relations and interaction, and balancing work and family domain. The study reveals that dual career couples were experiencing role overload, role conflict and stressor while managing the multiple demands of occupational and family domain. Further, it was found that that the reported issues were heightened in the case of the couples with children. It is concluded from the study that dual career couples are experiencing significant role overload and stressor because of the lack of organizational support and absence of a viable public policy in the academic institutes of Pakistan. Keywords: Dual career couples, Family, Conflict, Role, Support

“I Hope my Partner Will Keep me up-to-date”: How Couples Navigate News Consumption and Avoidance

ABSTRACT In an era of information overload, understanding individuals’ news consumption and avoidance necessitates an examination of the specific contexts in which these practices occur. While research in journalism studies has mainly underscored consumption habits at the individual level, limited scholarly attention has been given to news avoidance within the structure of dyadic spousal relationships. This study shifts the focus from individual choices to the couple as a unit of analysis, exploring how each partner’s choice of media platform, content, and routines may be shaped by the context of being in a spousal relationship. Drawing on 82 interviews with Israelis, including 14 interviews with both partners of seven heterosexual couples, this study reveals three patterns of news avoidance within the context of a couple’s relationship: avoiding shared news consumption, gender-based news avoidance practices, and a division of media-related responsibilities. This study contributes to a more nuanced understanding of the contextual factors shaping news avoidance by elucidating how media use and non-use unfold within social relationships. It also demonstrates how news avoidance can be perceived as a liberating choice, enabled by partners’ negotiation of preferences, platforms, and routines.

The experiences of people living with dementia and their care partners participating in an online therapeutic songwriting program.

Despite the impact of dementia on close care relationships, accessible therapeutic services for people living with dementia and their care partners remain scarce. Further, there is an increasing demand for online services, highlighting the need for ongoing telehealth research. This study aimed to explore the experiences of people living with dementia and their informal and formal care partners following participation in a 10-week online therapeutic songwriting program. The songwriting program included four duo and six group sessions facilitated by a music therapist. Post-program semi-structured interviews were analysed using thematic analysis. Nine people with dementia and six care partners (nine duos) participated in the program. Five duos were in spousal relationships and four people with dementia participated with a formal care partner. Participants attended an average of four duo sessions and three group sessions. Six people with dementia and five care partners participated in post-program interviews. Four themes were developed: (1) No one else does this; (2) It's all about us as people; (3) After the sessions we'd come out buzzing; and (4) The journey was as important as the product. Participants highlighted songwriting as a unique opportunity to connect with music, experience welcomed challenges, and spend 'real time' together. The program drew on participants' lived experience and promoted connection with others, resulting in feelings of enjoyment, enhanced mood, and achievement. Participants valued both the songwriting process and song product, emphasising the importance of sensitive and skilful facilitation. Our findings suggest that these distinct benefits were not available through other support services. Further, online songwriting is a viable option for people living with dementia and their care partners where in-person sessions are not available or accessible.

A DYADIC ASSESSMENT OF COGNITIVE RESOURCES AND COGNITIVE FUNCTION AMONG OLDER KOREAN AMERICAN COUPLES

Abstract Individuals’ health and well-being are often shaped by significant others in their lives in that spousal relationships are particularly important. In dyadic studies among older couples, few studies have examined cognitive health as an outcome variable. Considering the lack of couple research on cognition especially among older immigrant population, the purpose of this study was to examine the cognitive function of community-dwelling older Korean American couples in the U.S. Data were drawn from a survey with older Korean Americans aged 60 and older, collected during 2017−2018 in multiple locations. Using a subset of 252 couples of the survey (individual N = 504), we examined the extent to which one’s cognitive function was associated with the cognitive resources (education, acculturation, friend network, and activity participation) of their own and of their spouse. The analyses with the Actor-Partner Interdependence Model showed the differences in the actor- and partner-effects between spouses. For husbands, acculturation was the only significant actor-level predictor to cognitive function. Wives’ cognitive function was associated with a wider array of their own cognitive resources, including education, friend network, and activity participation. The partner effect was only observed in education for husbands, indicating that wives’ higher education was beneficial for their husbands’ cognitive function. Further, the cognitive benefit of higher education was found to be maximized for husbands who also had greater levels of acculturation or activity participation. For practice implications, cognitive resources both in individual and spousal levels could help promote the cognitive health and well-being of older married couples.

PERCEIVED STRAIN ON THE SPOUSAL RELATIONSHIP AMONG MARRIED CUSTODIAL GRANDPARENTS WITHIN THE PARENTING ROLE

Abstract Providing primary care for grandchildren is known to have a significant impact on custodial grandparents’ well-being. For married custodial grandparents, although their caregiving burden may spill over to marriage which can lead to negative psychological outcomes, it has rarely been examined. We examined how custodial grandparents couples’ perceived stress in the spousal relationship due to parenting (PSSR) is associated with their psychological outcomes mutually using Actor Partner Interdependent Model. We further tested the moderating effect of coping strategies on the association between PSSR and psychological outcomes. Participants are grandparents couples providing full-time care to their grandchild in the absence of the grandchildren’s biological parents (N_dyad = 193). We found that one’s PSSR was associated with one’s higher depressive symptoms for both grandmothers and grandfathers. Regarding anxiety symptoms, only grandmothers’ PSSR was positively related to both their own and their spouses’ anxiety level.In terms of coping strategies, we found that a higher level of problem-focused coping was related to higher levels of anxiety for both grandmothers and grandfathers when grandmothers experienced higher PSSR. A higher level of emotional coping was related to higher level of depressive symptoms in both grandfathers and grandmothers when they experienced a higher level of PSSR. A higher level of emotional coping was related to both grandfathers and grandmothers’ higher level of anxiety when grandmother’s PSSR was higher. Our research adds to the existing body of literature by emphasizing how emotional and problem-focused coping can moderate the connection between increased PSSR and psychological outcomes among custodial grandparents.

Determinants of psychosocial factors amongst the oldest old: Longitudinal evidence based on the representative "survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia".

There are few studies investigating the determinants of psychosocial outcomes using data exclusively from the oldest old; and even fewer that use longitudinal data. Thus, our aim was to explore the determinants of psychosocial factors (in terms of life satisfaction, loneliness, and depressive symptoms) amongst the oldest old (also stratified by sex) based on representative, longitudinal data from Germany. Data from "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)" were used. This study includes community-dwelling and institutionalized individuals aged 80years and above (n=1760 observations in the analytical sample) located in North Rhine-Westphalia (the most populous state in Germany). The mean age was 86.6years (SD: 4.3years). Established instruments were used to quantify life satisfaction, loneliness, and depressive symptoms. Linear FE regressions were used in this study to mitigate the challenge of unobserved heterogeneity. Sex-stratified regressions were also conducted. Regressions showed that the loss of a spouse was significantly associated with worsening psychosocial factors (in terms of increases in depressive symptoms and loneliness). Furthermore, regressions revealed that increases in functional impairment were significantly associated with poorer psychosocial outcomes. This longitudinal study enhanced our understanding of the factors contributing to poorer psychosocial outcomes among the oldest old. Efforts to avoid or postpone functional impairment may contribute to more favorable psychosocial outcomes. Moreover, our current study underlines the importance of spousal relationships for psychosocial outcomes in the oldest age group.

Views of Men Regarding Not Availing Antenatal Care for Their Pregnant Partners in West Bengal

Antenatal care (ANC) is essential for the health of both the mother and the baby. Though females are the direct receivers of this care, yet the understanding of their husbands is crucial in determining the pregnant women’s access to ANC. NFHS–5 ( National Family Health Survey, 2019–2020 ) has reported that about 5.6% of women in West Bengal aged 15–49 who had a live birth in the five years preceding the survey had no ANC visit during their pregnancy. In this study, both qualitative and quantitative techniques have been used to understand the views of men whose female partners did not receive any ANC during their pregnancy in West Bengal. Data collection has been done from 130 respondents using a structured questionnaire, and then, statistical analysis has been performed using SPSS. Qualitative data have been collected from nine selected participants through telephonic interview. The result is that men’s views for their pregnant partners not availing ANC are influenced by the place of residence, educational qualification and number of children (statistically significant at p value < .05). However, lack of awareness, financial constraint, poor spousal relationship and inaccessibility to the maternity clinics are a few important reasons that have been focused in this study.

Impact of relationship status on psychological parameters in adults with congenital heart disease.

Adult congenital heart disease (ACHD) is a growing disease entity, posing questions concerning psychosocial outcomes across the lifespan. Spousal relationships were shown to benefit cardiovascular and mental health in the general population. We assessed the association of relationship status with anxiety and depression in ACHD patients and determined whether patients considered disease-related concerns potential mediators of relationship problems. N = 390 ACHD patients were included. Self-report questionnaires were used to assess relationship status, ACHD-related relationship problems, socio-demographic variables, and depression and anxiety scores. Further, clinical parameters concerning the heart condition were determined. N = 278 (71%) patients were currently in a relationship, while N = 112 (29%) were not in a relationship. Groups did not significantly differ regarding age, sex, and cardiovascular parameters. Two-way MANCOVA with relationship status and sex as independent variables, controlling for age, NYHA class, and NT-proBNP, showed an association of relationship status with depression, while sex was associated with anxiety. N = 97 (25%) patients reported disease-related adverse effects on a current or prior relationship. In detail, worries about body image (N = 57, 61%), own fears (N = 51, 54%), problems arising from wish to have children (N = 33, 35%), fears regarding a joint future (N = 29, 31%), partner's fears or lack of understanding (N = 28, 30%), and sexual problems (N = 21, 22%) were cited. Relationships status was associated with depression, while sex was associated with anxiety in ACHD patients. Relationship status as well as potential relationship problems, and the importance of social support for mental and physical well-being, should be considered when treating ACHD patients.