Marital Functioning and Physical Health: Implications for Social and Personality Psychology

Study on the relationship between depressive symptoms and Internet use in the older adults under the background of population aging-evidence based on CHARLS 2018 and 2020

BACKGROUND

Research has identified the effect of Internet use on depressive symptoms, where as the results remain controversial. Given the fact that both Internet use and depressive symptoms are in dynamic change, this paper focuses on the relationship between depressive symptoms and Internet use among Chinese elderly people in the context of population aging, which could generate targeted policy recommendations aimed at safeguarding the healthy development of older adults and provide an important basis for the government to build a more inclusive aging society.

METHODS

A total of 15,637 samples were extracted for analyses using CHARLS (China Health and Retirement Longitudinal Study) data after matching the 2018 and 2020 data by sample-identified correlation IDs (including ID, household ID, and community ID). The matching was intended to reduce the potential for confounding variables that could arise if the two datasets included different individuals, and make it easier to draw conclusions about the relationship between depressive symptoms and Internet use over time for the consistent people. Statistical analyses were performed using SPSS 28.0 and STATA software. Measurement data were expressed asx ¯ ± s and count data were expressed as frequency (%). Comparisons between groups were performed using t-test and ANOVA (The Analysis of Variance). Correlation analyses were performed using multiple linear regression and ordered probit regression analyses, and the test level was set at α = 0.05.

RESULTS

Older adults with greater device ownership had less severer depressive symptoms (P < 0.001) and those without Internet access (P < 0.05) had severer depressive symptoms. Older adults who didn't use mobile phones to pay (P < 0.001) and didn't use WeChat (P < 0.05) or post to their friends (P < 0.001) had severer depressive symptoms. The impact of Internet use was more evident among older adults who self-assessed health very good, were relatively younger, urban, and in marriage (P < 0.05).

CONCLUSIONS

Internet use might have a significant impact on depressive symptoms among older adults in the context of population aging.

Daily relationship satisfaction and markers of health: Findings from a smartphone-based assessment

Relationship satisfaction is associated consistently with better physical and mental health. Less is known about these associations in daily life, particularly the association between relationship satisfaction and cognitive health. This study examined the daily, within-person association between relationship satisfaction and subjective health markers, including cognitive health. Participants from the United States (N = 303; Mage = 51.71, SD = 7.32) in the Couples Healthy Aging Project (CHAP) completed assessments of relationship satisfaction and health markers every night for eight days. Multilevel modeling was performed by accounting for personal (sex, age, race, education), relational (relationship duration), and contextual (day in the study, weekend day) factors. Within-person, on days when participants were more satisfied with their relationship, they felt healthier, younger, more satisfied with their life, and more purposeful. They also reported a sharper mind, better memory, and clearer thinking; relationship satisfaction was unrelated to whether participants were bothered and disrupted by forgetting. Results indicated that a satisfying romantic relationship is closely associated with better physical, psychological, and cognitive health markers in daily life.

While You Are Sleeping: Marital Ambivalence and Blunted Nocturnal Blood Pressure

Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one's own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.

The health consequences of stress in couples: A review and new integrated Dyadic Biobehavioral Stress Model

Despite marriage's health benefits, all couples experience stress that can increase morbidity and mortality risks. Marital stress can alter endocrine, cardiovascular, and immune function-key pathways from troubled relationships to poor health. This review discusses how partners "get under each other's skin" to influence psychological, behavioral, and biological health. Then, I offer a comprehensive Dyadic Biobehavioral Stress Model to build on this foundational work and inspire transdisciplinary research integrating psychoneuroimmunological and relational lenses. This conceptual and empirically driven model provides promising new directions to investigate mechanisms linking individuals' relationships behaviors to their own and their partners' health, with particular emphasis on biological pathways. These mechanisms may impact each partner's physical health outcomes, such as disease development, illness severity, and accelerated biological aging. Risk and protective factors across developmental stages and diverse contexts are also discussed to help explain how, and under what conditions, partners influence each other's health. Research applying this model can push the boundaries of our current understanding on dyadic stress its far-reaching health effects on self-report and biological markers across the lifespan.

Effects of ePREP and OurRelationship on Low-Income Couples' Mental Health and Health Behaviors: a Randomized Controlled Trial

Relationship distress is a pervasive problem in the USA that disproportionally impacts couples with low-income levels. The goal of the present study was to evaluate the effectiveness of two online relationship interventions, OurRelationship and ePREP, both of which were supported by a paraprofessional coach, in improving mental health and physical health behaviors with low-income couples. Couples (N = 742) were randomized to either intervention or a 6-month waitlist control group and assessed pre-, mid-, and post-intervention as well at 4 and 6 months after randomization. Results from multilevel models indicated that during treatment, compared to couples in the waitlist group, couples in the intervention groups reported significantly greater improvements in mental health that were small to moderate in magnitude (psychological distress, anger, problematic alcohol use, and perceived stress) as well as improvements in physical health/health behaviors (perceived health, insomnia, and exercise) that were small in magnitude. Furthermore, the differences between intervention and waitlist groups were maintained over follow-up. Treatment gains in both mental health and physical health behaviors were generally stronger for those who began treatment with greater difficulties in those areas. Implications of these findings with regard to intervention and policy are discussed.

Optimism, pessimism, and health biomarkers in older couples

OBJECTIVE

Studies have demonstrated the importance of optimism in predicting perceived general health. However, the handful of studies focusing on cardiovascular biomarkers show inconsistent effects. Additionally, no study examined whether spousal levels of optimism and pessimism affect an individual's biological markers of cardiovascular health. Thus, our objectives were to examine whether partners' optimism and pessimism affect individual biological markers, differentiating between between-dyad associations and within-dyad predictive processes.

METHODS

Three waves of the Health and Retirement Study collected in 2006, 2010, and 2014 were used to test actor and partner effects of optimism and pessimism on C-reactive protein (CRP) and high-density lipoprotein. Multilevel longitudinal actor-partner models were used to examine the contribution of a partner's optimism and pessimism to each biomarker, adjusting for respondent's age, sex, depression, body mass index, daily activity levels, and a summary score of respondent's doctor-diagnosed chronic conditions.

RESULTS

Partners' pessimism and optimism levels were moderately associated. Results for within-person effects were all non-significant, both within and across waves. Associations at the between-person level were also non-significant, with the exception of a positive association between husbands' pessimism and their own CRP, and husbands' optimism and their wives' CRP.

CONCLUSIONS

Results suggest that optimism and pessimism may not play a pertinent role in within variability of biomarkers of cardiovascular diseases and have a minor role in predicting to between-person variability of biomarkers of cardiovascular diseases.

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

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

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

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

The Persian version of the revised dyadic adjustment scale (RDAS): a validation study in infertile patients

Background

Infertility can have a powerful impact on marital quality. The Revised Dyadic Adjustment Scale (RDAS) is a widely used measure of marital quality. This scale has not been validated in infertile patients. Therefore, this study aimed to evaluate the reliability and validity of the RDAS in a sample of infertile patients.

Methods

The sample of this methodological study consisted of 254 infertile patients referring to a referral infertility clinic in Tehran, Iran. A battery of questionnaires was administered to the participants, including a demographic/fertility questionnaire, the RDAS, the Relationship Assessment Scale (RAS), the Kansas Marital Satisfaction Scale (KMSS), the Couples Satisfaction Index- 4 Item (CSI-4), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale-4 Item (PSS-4). Internal consistency of the scale was assessed with Cronbach’s alpha, construct validity was investigated using confirmatory factor analysis (CFA), and convergent validity was examined by correlating the RDAS with RAS, KMSS, CSI-4, HADS, and PSS-4 instruments.

Results

The mean total RDAS score was 49.26 ± 9.34, and 100 patients (39.4%) had marital distress based on the cut-off value of < 48. The second-order three-factor model of the RDAS exhibited an excellent fit to the data, as indicated by χ²/df = 2.26; CFI = 0.96; GFI = 0.91; NFI = 0.93; IFI = 0.96; RMSEA = 0.071 and SRMR = 0.050. The RDAS and its subscales revealed satisfactory internal consistency that ranged from 0.664 to 0.847. Convergent validity was confirmed by strong correlations between RDAS scores and scores on the RAS, KMSS, and CSI-4. These correlations also tended to be larger than correlations with measures of HADS-anxiety, HADS-depression, and PSS-4. Among demographic/fertility variables, only infertility duration was found to be correlated to the RDAS.

Conclusion

The RDAS is a reliable and valid inventory for measuring marital quality in infertile patients. Further validation studies are needed to generalize the underlying structure of the scale in various populations.

The Quality of Marriage Index (QMI): a validation study in infertile patients

OBJECTIVE

Infertility can have a considerable effect on a person's marital satisfaction. The Quality of Marriage Index (QMI) is a self-report inventory to measure global perceptions of marital satisfaction. The current study examined the reliability and validity of the Persian language version of QMI in a sample of infertile patients.

RESULTS

The mean QMI total score was 36.54 ± 6.87. The internal consistency of the scale was good, with a Cronbach's alpha of 0.922. All inter-item correlations and item-total correlations were also in acceptable range. The confirmatory factor analysis results provided evidence for unidimensionality of the scale (χ²/df = 3.10; GFI = 0.97; CFI = 0.99; NFI = 0.99; RMSEA = 0.091 and SRMR = 0.020). The convergent validity of the QMI was demonstrated via significant correlations with measures of the Relationship Assessment Scale, Kansas Marital Satisfaction Scale, and Couples Satisfaction Index-4 Item. These correlations also tended to be larger than correlations with measures of Hospital Anxiety and Depression Scale and Perceived Stress Scale-4 Item. Among demographic/fertility variables, only infertility duration was negatively correlated to QMI scores. In sum, the QMI is a reliable and valid brief inventory for measuring overall marital satisfaction in infertile patients. Trial registration This was a cross-sectional study (NOT clinical trial); thus, the trail registration number is not required for the present study.

Perceived Partner Responsiveness, Daily Negative Affect Reactivity, and All-Cause Mortality: A 20-Year Longitudinal Study

OBJECTIVE

This study tested longitudinal associations between absolute levels of perceived partner responsiveness (PPR; how much people perceive that their romantic partners understand, care for, and appreciate them), daily negative affect reactivity and positive affect reactivity, and all-cause mortality in a sample of 1,208 adults for three waves of data collection spanning 20 years. We also tested whether longitudinal changes in PPR predicted mortality via affect reactivity.

METHODS

Data were taken from the National Survey of Midlife Development in the United States. PPR was assessed at waves 1 and 2, affect reactivity to stressors was assessed by daily diary reports at wave 2, and mortality status was obtained at wave 3.

RESULTS

Mediation analyses revealed absolute levels of PPR at wave 1 predicted wave 3 mortality via wave 2 affective reactivity in the predicted direction, but this did not remain robust when statistically accounting for covariates (e.g., marital risk, neuroticism), β = .004, 95% confidence interval = -.03 to .04. However, wave 1-2 PPR change predicted negative affect (but not positive affect) reactivity to daily stressors at wave 2, which then predicted mortality risk a decade later (wave 3); these results held when adjusting for relevant demographic, health, and psychosocial covariates, β = -.04, 95% confidence interval = -.09 to -.002.

CONCLUSIONS

These findings are among the first to provide direct evidence of psychological mechanisms underlying the links between intimate relationships and mortality and have implications for research aiming to develop interventions that increase or maintain responsiveness in relationships over time.

Marriage Dissatisfaction and the Risk of Sudden Cardiac Death Among Men

Conflicts in marriage have been associated with potential risk of cardiovascular disease; however, there is lack of prospective evidence on the association between marriage satisfaction and sudden cardiac death (SCD). We aimed to assess the association between perceived level of marriage satisfaction and risk of SCD. This study employed the Kuopio Ischemic Heart Disease study, an ongoing prospective population-based study in Finland. Perceived level of marriage satisfaction was assessed in 2,262 men using a well-structured self-administered questionnaire. Multivariable adjusted Cox regression models were used to estimate hazard ratios (95% confidence interval [CI]) for SCD. During a median follow-up period of 25.9 years, 239 SCDs were recorded. The mean age of participants was 53 (SD 5.2) years. On adjustment for several conventional cardiovascular risk factors, hazard ratio (95% CI) of SCD was 1.90 (CI 1.09 to 3.32; p = 0.02) for men who were dissatisfied with their marriage, compared with men who were satisfied with their marriage. The association remained consistent on further adjustment for preexisting coronary heart disease, socioeconomic status, and years of education 1.86 (CI 1.07 to 3.25; p = 0.03). In conclusion, dissatisfied marriage is associated with an increased risk of SCD among middle-aged Caucasian men, independent of conventional cardiovascular risk factors.

Stress spillover, African Americans' couple and health outcomes, and the stress-buffering effect of family-centered prevention

This study investigated (a) the stress spillover pathways linking contextual stressors, changes in couple relationship functioning and depressive symptoms, and changes in individuals' physical health, and (b) the stress-buffering effect of participation in an efficacious, family centered prevention program designed to protect couples from the deleterious effects of stressors. The sample consisted of 346 rural African American couples (63% married) who participated in a randomized controlled trial of the Protecting Strong African American Families (ProSAAF) program. Participants were assessed at three time points across 17 months. Results examining stress spillover within the control group indicated that elevated current, but not prior, financial hardship was associated with decreased effective communication, relationship satisfaction, and relationship confidence as well as increased depressive symptoms; current levels of racial discrimination also predicted greater depressive symptoms. Relationship confidence and relationship satisfaction, but not communication or depressive symptoms, in turn predicted declines in self-reported physical health. Results examining stress-buffering effects suggested that participation in ProSAAF protected individuals' relationship confidence from declines associated with elevated financial hardship. In addition, the indirect effect linking financial hardship to declines in physical health through relationship confidence that emerged among participants in the control group was no longer evident for ProSAAF couples. Results highlight the effect of contextual stressors on African Americans' couple and individual well-being and the potential for the ProSAAF program to provide a constructed resilience resource, protecting couple's confidence in their relationship from the negative effects of financial hardship and, consequently, promoting physical health. (PsycINFO Database Record

A Social Psychological Perspective on the Links between Close Relationships and Health

The association between the quality of people's close relationships and their physical health is well-established. But from a psychological perspective, how do close relationships impact physical health? This article summarizes recent work seeking to identify the relationship processes, psychological mediators and moderators of the links between close relationships and health, with an emphasis on studies of married and cohabitating couples. We begin with a brief review of a recent meta-analysis of the links between marital quality and health. We then describe our strength and strain model of marriage and health, homing in on one process-partner responsiveness-and one moderator-adult attachment style-to illustrate ways in which basic relationship science can inform our understanding of how relationships impact physical health. We conclude with a brief discussion of promising directions in the study of close relationships and health.

Protective Processes Underlying the Links between Marital Quality and Physical Health

Although the links between marital quality and physical health are now well established, the psychological processes through which marriage impacts health remain unclear. Additionally, prior research on the links between marriage and health has focused mainly on how negative aspects of relationships (e.g., conflict, hostility) can be damaging to one's physical health. In this article, we describe the strength and strain model of marital quality and health, which provides a roadmap for studying protective factors underlying marriage-health links. We home in one relationship process-partner responsiveness-and one broad class of psychological mechanisms-affective processes-to illustrate core aspects of the model. Our review suggests that future research will profit from a greater integration of theory from the social psychology of close relationships into studies of relationships and health.

Perceived Partner Responsiveness Predicts Better Sleep Quality Through Lower Anxiety

The present study investigated whether perceived partner responsiveness—the extent to which individuals feel cared for, understood, and validated by their partner—predicted subjective sleep problems and objective (actigraph-based) sleep efficiency through lower anxiety and depression symptoms. A life span sample of 698 married or cohabiting adults (35–86 years old) completed measures of perceived partner responsiveness and subjective sleep problems. A subset of the sample ( N = 219) completed a weeklong sleep study where actigraph-based measures of sleep efficiency were obtained. Perceived partner responsiveness predicted lower self-reported global sleep problems through lower anxiety and depression and greater actigraph-assessed sleep efficiency through lower anxiety. All indirect associations held after controlling for emotional support provision to the partner, agreeableness, and demographic and health covariates known to affect sleep quality. These findings are among the first to demonstrate how perceived partner responsiveness, a core aspect of romantic relationships, is linked to sleep behavior.

Perceived Partner Responsiveness Predicts Diurnal Cortisol Profiles 10 Years Later

Several decades of research have demonstrated that marital relationships have a powerful influence on physical health. However, surprisingly little is known about how marriage affects health--both in terms of psychological processes and biological ones. Over a 10-year period, we investigated the associations between perceived partner responsiveness--the extent to which people feel understood, cared for, and appreciated by their romantic partners--and diurnal cortisol in a large sample of married and cohabitating couples in the United States. Partner responsiveness predicted higher cortisol values at awakening and steeper (i.e., healthier) cortisol slopes at the 10-year follow-up. These associations remained strong after we controlled for demographic factors, depressive symptoms, agreeableness, and other positive and negative relationship factors. Furthermore, declines in negative affect over the 10-year period mediated the prospective association between responsiveness and cortisol slope. These findings suggest that diurnal cortisol may be a key biological pathway through which social relationships affect long-term health.

Marital quality and health: Implications for marriage in the 21st century

Being in a happy marriage is related to better psychological and physical health. This paper describes current approaches to conceptualizing and measuring marital quality and physical health, and results from a recent meta-analysis examining associations between marital quality and physical health outcomes. To illustrate the practical significance of these findings, this paper also illustrates how the magnitude of the marital quality - physical health association is similar in size to associations between health behaviors (diet, physical activity) and health outcomes, and briefly reviews the state of the science regarding plausible biobehavioral pathways that explain how marital functioning influences health. After describing the current state of research on factors that might modify the association between marital quality and health, particularly individual differences and gender, the paper concludes with implications of the past 50 years of research on marital quality and health for marriage in the 21^st century.

Implications of marital/partner relationship quality and perceived stress for blood pressure among older adults

OBJECTIVES

Although higher quality marriages are associated with better health outcomes, less is known about the mechanisms accounting for this association. This study examines links among marital/partner quality, stress, and blood pressure and considers both main and moderating effects.

METHOD

Participants from the National Social Life, Health, and Aging Project (N = 1,854; aged 57-85 years) completed in-person interviews regarding their marital/romantic partner relationships and perceived stress. Interviews included blood pressure assessments.

RESULTS

Linear regression models revealed no main effects of spousal/partner quality or stress on blood pressure. However, spousal/partner quality moderated the link between stress and blood pressure. Specifically, there were negative associations between stress and blood pressure among people reporting more confiding, less reliance, and greater demands from spouses/partners.

DISCUSSION

Findings highlight the complexity of relationship quality. Individuals appeared to benefit from aspects of both high- and low-quality spouse/partner relations but only under high levels of stress. Findings are inconsistent with traditional moderation hypotheses, which suggest that better quality ties buffer the stress-health link and lower quality ties exacerbate the stress-health link. Results offer preliminary evidence concerning how spousal ties "get under the skin" to influence physical health.

Attachment, skin deep? Relationships between adult attachment and skin barrier recovery

This study examined the relationship between individual differences in adult attachment and skin barrier recovery. Dating couples (N = 34) completed a self-report measure of attachment anxiety and avoidance, and during two separate laboratory visits, normal skin barrier function was disrupted using a tape-stripping procedure, followed by a 20 min discussion of personal concerns in one visit and relationship problems in the other, counterbalanced randomly across visits. Skin barrier recovery was assessed by measuring transepidermal water loss up to 2 h after skin disruption. Multilevel modeling showed that skin barrier recovery did not differ between the personal concern or relationship problem discussions. Among women, greater attachment anxiety predicted faster skin barrier recovery across the two visits, while greater attachment avoidance predicted slower skin barrier recovery. Among men, greater attachment anxiety predicted slower skin barrier recovery during the personal concern discussion only. The observed effects remained significant after controlling for transepidermal water loss in undisturbed skin, suggesting that the relationship between attachment security and skin barrier recovery was not due to other skin-related factors like sweating. Cortisol changes, self-reported emotions, stress appraisals, and supportiveness ratings were tested as potential mediators, and none explained the relationships between attachment and skin barrier recovery. These findings are the first to demonstrate associations between individual differences in attachment style and restorative biological processes in the skin, even in a sample of young dating couples in satisfied relationships.

Momentary work worries, marital disclosure, and salivary cortisol among parents of young children

OBJECTIVE

To investigate whether worries about work are linked to people's own cortisol levels and their spouses' cortisol levels in everyday life and whether marital factors may moderate these links. Although research has shown that satisfying marriages can buffer the physiological effects of everyday stress, the specific mechanisms through which marriage influences the processing and transmission of stress have not yet been identified.

METHODS

Thirty-seven healthy married couples completed baseline measures and then provided saliva samples and indicated their worries about work for six times a day from a Saturday morning through a Monday evening.

RESULTS

Wives' cortisol levels were associated positively with their own work worries (p = .008) and with their husbands' work worries (p = .006). Husbands' cortisol levels were associated positively only with their own work worries (p = .015). Wives low in both marital satisfaction and disclosure showed a stronger association between work worries and cortisol compared with wives reporting either high marital satisfaction and/or high marital disclosure.

CONCLUSIONS

These results suggest that momentary feelings of stress affect not only one's own cortisol levels but affect close others' cortisol levels as well. Furthermore, they suggest that, for women, the stress-buffering effects of a happy marriage may be partially explained by the extent to which they disclose their thoughts and feelings with their spouses.