Spouse Ratings Research Articles

Optimism and pessimism in social context: An interpersonal perspective on resilience and risk

Using the interpersonal perspective, we examined social correlates of dispositional optimism. In Study 1, optimism and pessimism were associated with warm-dominant and hostile-submissive interpersonal styles, respectively, across four samples, and had expected associations with social support and interpersonal stressors. In 300 married couples, Study 2 replicated these findings regarding interpersonal styles, using self-reports and spouse ratings. Optimism–pessimism also had significant actor and partner associations with marital quality. In Study 3 (120 couples), husbands’ and wives’ optimism predicted increases in their own marital adjustment over time, and husbands’ optimism predicted increases in wives’ marital adjustment. Thus, the interpersonal perspective is a useful integrative framework for examining social processes that could contribute to associations of optimism–pessimism with physical health and emotional adjustment.

Similarity, agreement, and assumed similarity in proxy end-of-life decision making.

Medical decisions near the end of life are often made by proxies who can be inaccurate in their judgments of patient preferences. Given that accuracy in surrogate decision making is an important goal in end-of-life decision making, and in light of that previously seen levels of accuracy reflect substantial disagreement, error, or both, this study examined both relationship and individual factors that potentially affect surrogate accuracy. Specifically, this study examined similarity, agreement, and assumed similarity-a process whereby raters use their own traits and preferences to rate another person-in spousal ratings of end-of-life treatment. This study expands on previous research by examining the potential influence of relationship factors and assumed similarity on end-of-life decision making among a sample of newlyweds. Newly married couples (n = 197) completed self and spouse measures of hypothetical end-of-life preferences and scales assessing marital satisfaction, personality, and attitudes. Results indicate a moderate level of similarity on husband and wife self-rated end-of-life treatment preferences (rs = .18-.29) and a moderate level of agreement between self and proxy ratings (rs = .17-.41). The largest correlations were seen between self ratings and proxy ratings (e.g., husband self ratings and husband proxy ratings of wife preferences, rs = .46-.69), reflecting strong assumed similarity in proxy ratings. For wives, similarity with husbands on a few attitudinal variables (i.e., spirituality, moral strictness, and conservatism) influenced proxy accuracy. Recognizing the potential impact of personal preferences on proxy ratings, as well as the potential influence of relationship factors, may help improve proxy accuracy and end-of-life care for patients and families.

Incremental validity of spouse ratings versus self-reports of personality as predictors of marital quality and behavior during marital conflict.

The personality traits of neuroticism and agreeableness are consistently related to marital quality, influencing the individual's own (i.e., actor effect) and the spouse's marital quality (i.e., partner effect). However, this research has almost exclusively relied on self-reports of personality, despite the fact that spouse ratings have been found to have incremental validity over self-reports for a variety of other important outcomes. In a study of 300 middle-aged and older married couples, we examined the incremental validity of spouse ratings of neuroticism and agreeableness in predicting concurrent levels of self-reported marital quality, observations of behavior during a marital disagreement task, and depressive symptoms. Neuroticism and agreeableness had expected actor and partner effects on each of these outcomes. Spouse ratings of these traits demonstrated incremental validity in estimates of actor and partner effects on marital quality, marital behavior, and depressive symptoms. Results suggest that spouse ratings of personality may be important additions to the typical reliance on self-reports for research and clinical assessment in marriage.

Cohabitation Is No Longer Associated With Elevated Spousal Homicide Rates in the United States

Margo Wilson and collaborators discovered that cohabiting couples had very much higher spousal homicide rates than those in registered marriages, and cross-national research has shown this difference to be widespread. We now find that homicide rates in the two sorts of unions have converged in the United States, such that the previously large difference had completely vanished by 2005. Distinct age patterns whereby registered marriages are most lethal in youth and cohabitation is most lethal in middle age have nevertheless persisted. While their homicide rates were converging between 1990 and 2005, married and cohabiting couples were not growing more similar in their basic demographic attributes: age distributions and unemployment rates remained distinct, and differences in education and income actually increased. Why homicide rates in the two classes of unions have ceased to differ remains unknown. We suggest some lines of research that may help provide answers.

Interpersonal Circumplex Descriptions of Psychosocial Risk Factors for Physical Illness: Application to Hostility, Neuroticism, and Marital Adjustment

Personality risk factors for physical illness are typically studied individually and apart from risk factors reflecting the social environment, potentially fostering a piecemeal understanding of psychosocial influences on health. Because it can be used to describe both personality and social relationship processes, the interpersonal circumplex (IPC) provides an integrative approach to psychosocial risk. In 301 married couples we examined IPC correlates of 3 risk factor domains: anger, hostility, and aggressiveness; neuroticism; and marital adjustment. Risk factors displayed IPC locations ranging from hostile dominance (e.g., verbal aggressiveness, marital conflict) to hostility (e.g., anger) to hostile submissiveness (e.g., anxiety, depression); protective factors (marital satisfaction and support) reflected warmth or friendliness in the IPC. Similar descriptions were found using self-reports and spouse ratings of IPC dimensions, indicating that interpersonal styles associated with risk factors do not simply reflect common method variance. Findings identify interpersonal processes reflecting low affiliation or high hostility as a common component of risk and indicate distinctions among risk factors along the dominance dimension.

Spouse-Rated vs Self-rated Health as Predictors of Mortality

The Health and Retirement Study is a national sample of Americans older than 50 years and their spouses. The present study evaluated cross-sectional and longitudinal data from January 2000 through December 2006. The objective of the study was to evaluate the roles of spouse-rated vs self-rated health as predictors of all-cause mortality among adults older than 50 years. A total of 673 dyads of married couples were randomly selected to participate in a Health and Retirement Study module examining spouse-rated health. For each couple, one member was asked to rate his or her overall health status, and his or her spouse was asked to report the partner's overall health status. Mortality data were available through 2006. Our findings demonstrate that spouse-rated health (area under the curve, 0.75) is as strong a predictor of mortality as self-rated health (area under the curve, 0.73) (chi(2)(1) = 0.36, P = .54). Combining spouse-rated and self-rated health predicts mortality better than using self-rated health alone (area under the curve, 0.77) (chi(2)(1) = 6.72, P = .009). Spouse ratings of health are at least as strongly predictive of mortality as self-rated health. This suggests that, when self-rated health is elicited as a prognostic indicator, spouse ratings can be used when self-ratings are unavailable. Both measures together may be more informative than either measure alone.

Quality of life in end-stage renal disease patients: Differences in patient and spouse perceptions

Objectives: Spouses and other proxies consistently rate patient quality of life (QOL) lower than patients rate it themselves. This pattern has been observed in end-stage renal disease (ESRD), cancer, stroke and other chronic illnesses, but it has not been explained. The purpose of the current paper is to examine similarities and differences in spouse and patient ratings of the QOL of patients with ESRD. Method: Patients with ESRD and their spouses participated in baseline and one-year follow-up interviews. Both patients and spouses rated the patient's QOL, mood, functional ability, subjective health, and kidney disease symptoms. Spouses also rated their own QOL. Results: Spouses rated all patient characteristics, including QOL, as worse than did the patient. Change in perceptions of patient's mood and their subjective health predicted both patient and spouse ratings of patient QOL. Change in spouse's perceptions of patient's functional ability predicted spouse ratings of patient QOL, but not the patient's own ratings. Finally, change in the spouse's own QOL explained additional variance in their rating of the patient's QOL. Conclusion: Patients and spouses perceive patient QOL and predictors of patient QOL differently. Implications include the need to be aware of negative bias in spouse ratings of patients of QOL and other psychosocial variables, especially when spouse perceptions are considered by health care professionals. Discussing differences in patient and spouse perceptions in clinical settings with both patients and spouses will allow for a more comprehensive understanding of patient status.

Effects of Attending Phase II Cardiac Rehabilitation on Patient Versus Spouse (Proxy) Quality-of-Life Perceptions

Little has been published about the differences or similarities in patient and spouse views of the patient's health-related quality of life (HRQL) related to cardiac rehabilitation (CR) participation. This study described patient versus spouse (proxy) ratings of patient HRQL prior to (T1) and after 6 weeks (T2) of phase II CR. A nonprobability sample of patients referred to phase II CR and their spouses were recruited (42 pairs). The Short Form 36 v.2 (SF-36) instrument was used to measure HRQL. Differences between group means were tested with paired-samples t tests (P < .05). Improvements in patient self-report of HRQL from T1 to T2 were noted in physical functioning, role-physical, bodily pain, vitality, social functioning, role-emotional (all P <.001), mental health (P < .01), and both physical and mental component summary (P < .001). Spouse reports of patient HRQL improved in physical functioning, role-physical, bodily pain, vitality, social functioning, mental health (all P < .001), role-emotional (P < .01), and the physical (P < .001) and mental component summary (P < .01). Differences between patient and spouse were found at T1 in vitality and mental health (both P < .01). At T2, differences between patient and spouse were found in vitality (P < .001), physical functioning, mental health (both P < .05), and the mental component summary (P < .05). Improvement of patient HRQL is mirrored by spouse viewpoint of patient HRQL. This unique finding has not previously been reported in the literature.

Enabling Managers to Achieve Work-Family Balance: A Demands-Control Model of Housework Behavior and Family Satisfaction

The interplay between work and family has received a great deal of attention in the last two decades. We know very little, however, about the organizational factors that enable managers achieve a good balance between their work and family lives. Following Karasek (1979) demands-control model, we hypothesized that managerial workload will interact with time flexibility and task autonomy to predict the division of household labor, which in turn will influence family satisfaction. A sample of 103 managers reported their workload and their spouses reported the division of housework activities and their level of satisfaction with family life. Results show that time flexibility and task autonomy at work moderated the relationship between managers work demands and their spousal ratings of housework overload. As time demands increased, managers with low time flexibility contributed less than their spouses in household work (as reported by the spouse) than managers with high flexibility. A similar pattern emerges regarding travel and task autonomy. In turn, spousal housework overload had a negative impact on family satisfaction. Results are discussed in terms of their implications for managerial job redesign.

Associations of self-reports versus spouse ratings of negative affectivity, dominance, and affiliation with coronary artery disease: Where should we look and who should we ask when studying personality and health?

Aspects of negative affect and social behavior studied as risk factors for coronary heart disease are usually examined separately and through self-reports. Using structural models of these personality domains, we tested associations of self-reports and spouse ratings of anxiety, depressive symptoms, anger, affiliation and dominance with coronary artery disease (CAD). In 154 healthy older couples, the authors tested cross-sectional associations with CAD of three facets of negative affectivity and two dimensions of the Interpersonal Circumplex, (IPC) using scales derived from the NEO-PI-R. CAD was quantified as Agatston scores from CT scans of coronary artery calcification (CAC). Self-reports were generally unrelated to CAC, whereas spouse ratings were consistently associated, largely independent of potential confounds. When considered simultaneously, anxiety and anger were related to CAC but depression was not. When considered together, both dominance and (low) affiliation were related to CAC. Structural models of negative affectivity and social behavior can facilitate integrative study of psychosocial risk factors. Further, self-report measures of these traits might under-estimate related CHD risk.

Hostile Personality Traits and Coronary Artery Calcification in Middle-Aged and Older Married Couples: Different Effects for Self-Reports Versus Spouse Ratings

To examine the association between hostile personality traits and coronary artery disease (CAD) and the role of aspects of hostility, method of assessment, and age as influences on its magnitude, as prior studies of hostility and coronary artery calcification (CAC) have produced conflicting findings. Participants included 300 married couples (mean age = 54.4 years) free from diagnosed CAD. Participants completed four measures of hostility-self-reports and spouse ratings of angry hostility (i.e., tendency to experience anger) and antagonism (i.e., argumentative, mistrusting, and cold interpersonal behavior). In hierarchical random regression models accounting for dependency between husbands' and wives' observations, analyses of log-transformed Agatston scores indicated that self-reports of angry hostility and antagonism were not related to CAC. However, spouse ratings of both anger and antagonism were significantly associated with CAC severity. Interactions with age indicated that these associations occurred only among older participants. Control of behavioral and biomedical risk factors did not eliminate these effects. Antagonism but not anger was an independent predictor of CAC when considered simultaneously. Hostility is associated with concurrent asymptomatic CAD as assessed through CAC, but this effect is likely to be underestimated when hostility is assessed through self-reports rather than ratings by others and in samples with lower prevalence and severity of CAC.

Perceived Spouse Responses to Pain: The Level of Agreement in Couple Dyads and the Role of Catastrophizing, Marital Satisfaction, and Depression

The primary objective of this study was to examine whether individuals with chronic pain ("participants") and their spouses agree on perceptions of solicitous, distracting, and punishing spouse responses to pain. The second aim was to examine the role of participant catastrophizing (a negative mental set about pain), participant and spouse marital satisfaction, and participant and spouse depression in participant perceptions of spouse responses, spouse perceptions of their responses, and agreement between participants and spouses. Individuals with chronic musculoskeletal pain and their spouses (N=108 couples) completed questionnaire packets. Examination of overall group averages (participants vs. spouses) indicated little or no differences between participant and spouse ratings. Examination of individual agreement in participant and spouse ratings indicated substantial disagreement. The proposed moderators predicted both participant and spouse perceptions and jointly made minor contributions to dyad agreement. Although neither participant nor spouse perceptions of spouse responses are necessarily a reflection of actual behavior, the lack of agreement in this study suggests it may not be valid to use only patient perceptions in research related to spouse responses.

Personality development in emerging adulthood: Integrating evidence from self-ratings and spouse ratings.

The authors examined self-ratings and spouse ratings in a young adult newlywed sample across a 2-year interval. Rank-order stability correlations were consistently high and did not differ across the 2 types of ratings. As expected, self-ratings showed significant increases in conscientiousness and agreeableness--and declines in neuroticism/negative affectivity--over time. Spouse ratings yielded a very different pattern, however, showing significant decreases in conscientiousness, agreeableness, extraversion, and openness across the study interval. Spouse ratings also showed evidence of a "honeymoon effect," such that they tended to be more positive than self-ratings at Time 1. This effect had dissipated by the 2nd assessment; in fact, the spouse ratings tended to be more negative at Time 2. Analyses of individual-level change revealed little convergence between self- and spouse-rated change, using both raw change scores and reliable change index scores. Finally, correlational and regression analyses indicated that changes in spouse ratings were significantly associated with changes in marital satisfaction; in contrast, changes in self-ratings essentially were unrelated to marital satisfaction. These results highlight the value of collecting multimethod data in studies of adult personality development.

Factors Associated With Marital Satisfaction and Mood Among Spouses of Persons With Chronic Back Pain

Few studies have examined the impact of chronic pain on the spouse. In this study the impact of pain and disability as rated by both the patient and the spouse on spouse marital satisfaction and affective distress was examined in 110 couples. Zero-order correlations indicated that absolute ratings of perceived disability by the spouse, rather than discrepancies between spouse and patient ratings, were most highly associated with spouse marital dissatisfaction and affective distress. Predictors of spouse marital satisfaction and distress were examined by using simultaneous multiple regression. Spouse ratings of greater physical disability were significantly related to greater spouse affective distress. Spouse ratings of higher psychosocial disability, lower spouse marital satisfaction, and being a patient of male gender were marginally related to higher spouse affective distress. Spouse marital dissatisfaction was significantly associated with patient ratings of greater psychosocial disability and lower pain. Spouse-rated psychosocial disability and affective distress were also marginally related to spouse marital satisfaction. These findings highlight the importance of patient disability, particularly limitations in function as perceived by the spouse, on spouse adjustment. Perspective The impact of chronic pain on the spouse of the person with pain has received little empirical attention. The present study examines the relationship between patient and pain-related factors and psychosocial adjustment in the spouse.

Development and Validation of the Schedule of Compulsions, Obsessions, and Pathological Impulses (SCOPI)

This article describes a factor analytically derived, self-report instrument-the Schedule of Compulsions, Obsessions, and Pathological Impulses (SCOPI)-using data from college students, adults, psychiatric outpatients, and patients with obsessive-compulsive disorder (OCD). The five SCOPI scales all are internally consistent (with coefficient alphas of .80 and higher) and are strongly stable across a 2-month interval (with retest correlations ranging from .79 to .82). They also show good convergent and adequate discriminant validity (a) when correlated with other OCD measures and (b) in analyses of self-ratings versus spouse ratings. Additional analyses indicate that three scales-Obsessive Checking, Obsessive Cleanliness, and Compulsive Rituals-assess core symptoms of OCD. The two remaining scales-Hoarding and Pathological Impulses-appear to tap different (but related) constructs.

Randomized controlled trial of brief cognitive–behavioural interventions for insomnia in recovering alcoholics

To test the efficacy of a cognitive-behavioural approach to treating disturbed sleep in abstinent alcoholics. Sixty recovering alcoholics with insomnia were assigned randomly to individual therapy, self-help with telephone support or waiting-list control. Participants were volunteers recruited from out-patient treatment programs and through the media. Outcomes were assessed at post-treatment, 3-month and 6-month follow-ups using sleep diaries, the Pittsburgh Sleep Quality Index, wrist actigraphs and time-line follow-back interviews. Five sessions of out-patient cognitive-behavioural therapy for insomnia or a self-help manual with five telephone support calls. Treatment duration was 7 weeks. Treated participants were significantly more improved than control participants on diary measures of sleep quality, sleep efficiency, awakenings and time to fall asleep. No significant differences between the individual therapy and self-help treatment conditions on measures of insomnia severity were evident at post-treatment. Self-reported improvement in sleep was corroborated by clinician and spousal ratings of insomnia severity, but not by actigraph recordings of nocturnal activity. At 3- and 6-month follow-up assessments treatment gains were reasonably maintained in both treatment groups, although individual therapy was associated with a higher rate of clinically significant improvement. At the 6-month follow-up, 60% participants who were regular users of sedative medication at baseline discontinued the use of their medication. Treatment appeared to have little impact in preventing relapses to alcohol. Recovering alcoholics with insomnia can achieve better sleep by applying cognitive-behavioural strategies.

Spousal congruence on disability, pain, and spouse responses to pain

We examined congruence between chronic pain patients and their spouses on their reports of patient pain severity, patient disability, and spouse responses to pain. Patients reported that they were more physically and psychosocially disabled than their spouses reported them to be. However, spouses reported that the patients' pain was more severe than patients reported. Depressive disorders in the patient and gender interacted with patient–spouse ratings. For physical and psychosocial disability, depressed patient couples reported significantly larger differences in disability ratings than non-depressed patient couples. In addition, female patients' disability was rated as more severe by the female patients than by their husbands. Male patient couples did not report differences on physical disability. Findings relating to other forms of disability and to spouse responses are also described. The results are discussed in the context of an interpersonal perspective of chronic pain and have implications for the assessment of pain and disability.

Spousal congruence on disability, pain, and spouse responses to pain

We examined congruence between chronic pain patients and their spouses on their reports of patient pain severity, patient disability, and spouse responses to pain. Patients reported that they were more physically and psychosocially disabled than their spouses reported them to be. However, spouses reported that the patients' pain was more severe than patients reported. Depressive disorders in the patient and gender interacted with patient–spouse ratings. For physical and psychosocial disability, depressed patient couples reported significantly larger differences in disability ratings than non-depressed patient couples. In addition, female patients' disability was rated as more severe by the female patients than by their husbands. Male patient couples did not report differences on physical disability. Findings relating to other forms of disability and to spouse responses are also described. The results are discussed in the context of an interpersonal perspective of chronic pain and have implications for the assessment of pain and disability.

Individual and Crossover Effects of Work Schedule Fit: A Within‐Couple Analysis

A couple‐level analysis with a sample of 105 female reduced‐hours physicians and their full‐time–employed husbands found individual and spouse crossover effects: Each spouse's ratings of own schedule fit predict own job‐role quality; wives' ratings of partner/family schedule fit predict their marital‐role quality, with a similar trend for husbands; husbands' ratings of own schedule fit predict wives' marital‐role quality; and husbands' ratings of partner/family schedule fit and wives' ratings of own schedule fit predict husbands' psychological distress. These findings highlight the interdependence of couple members' experiences and illustrate potential costs of wives' trading off time at work for time at home.

Pragmatic communication skills in patients with Parkinson’s disease

Background. Pragmatic communication abilities may depend on intact frontal lobe systems. Independent evidence suggests that some persons with Parkinson’s disease (PD) are impaired on measures of frontal lobe function. Hypothesis. We therefore hypothesized in Study 1 that pragmatic communication skills would be impaired in some persons with PD and would be linked to frontal dysfunction in these patients. In Study 2 we hypothesized that PD patients would be unaware of their pragmatic communication deficits. Methods. In Study 1 we administered tests of pragmatic abilities and frontal lobe functioning to twenty-two persons with Parkinson’s disease (PD) and 10 healthy controls. In Study 2 we obtained self-ratings of pragmatic abilities from 11 PD patients and then checked these self-ratings against ratings of these same abilities by the patient’s spouses. Results. We found in Study 1 that patients with PD were: (a) significantly impaired on measures of pragmatic communication abilities, especially in the areas of conversational appropriateness, turn-taking, prosodics and proxemics, and that this impairment was significantly related to measures of frontal lobe function. In study 2 we found that PD patients overestimated their own abilities relative to spousal ratings of those abilities and thus were unaware of the extent of their problems with pragmatic social communication skills. Conclusion. We conclude that pragmatic social communication skills are impaired in PD and that this impairment may be related to frontal lobe dysfunction.