Loneliness and Marital Quality as Predictors of Older Adults' Insomnia Symptoms

The current study examined associations between marital quality, loneliness, and sleep within a nationally representative sample of older adults who participated in Wave 2 of the National Social Life, Health, and Aging Project (NSHAP). Participants (N = 559) had a spouse or partner and completed a novel sleep module that included subjective (i.e., insomnia symptoms) and objective (i.e., wake after sleep onset;WASO) markers of sleep. Upon controlling for demographics and markers of mental and physical health, a distinct pattern of findings emerged for subjective versus objective markers of sleep. Regarding subjective sleep, older adults who experienced greater loneliness reported more insomnia symptoms, but only when spousal emotional support was low-moderate. Regarding objective sleep, older adults who reported more affectionate touch from their spouse experienced less WASO. Collectively, these findings identify specific aspects of marital quality that may have unique implications for partnered older adults' subjective and objective sleep quality.

Marital Quality and Loneliness Among Aging Vietnam-Era Combat Veterans: The Moderating Role of PTSD Symptom Severity

OBJECTIVES

We examined links between marital quality and loneliness among aging veterans and explored whether veterans' PTSD symptom severity moderated these associations.

METHODS

Data came from 269 Vietnam-Era combat veterans who had a spouse/partner (M age = 60.50). Utilizing two waves of data spanning six years, we estimated multiple regression models that included positive and negative marital quality, PTSD symptom severity, and loneliness in 2010 as predictors of loneliness in 2016.

RESULTS

Facets of positive (but not negative) marital quality were associated with veterans' loneliness. Companionship - spousal affection and understanding - was associated with lower subsequent loneliness among veterans with low/moderate - but not high - PTSD symptom severity. Conversely, sociability - the degree to which one's marriage promotes socializing with others - was associated with lower subsequent loneliness regardless of PTSD symptom severity.

CONCLUSIONS

Companionship and sociability were each associated with veterans' subsequent loneliness. Whereas benefits of companionship were attenuated at higher levels of PTSD symptom severity, benefits of sociability were not.

CLINICAL IMPLICATIONS

For veterans with higher PTSD symptoms, recommending mental health treatment to decrease symptom severity may help them to reap the benefits of close/intimate relationships. However, bolstering veterans' social participation more broadly may provide an additional means of reducing their loneliness.

Older Adults' Social Profiles and Links to Functional and Biological Aging in the United States and Mexico

OBJECTIVE

Social stress-loneliness, isolation, and low relationship quality-increase risks for aging-related diseases. However, the ways in which they intersect to undermine healthy aging remain poorly understood. We utilized latent class analysis to identify groups of older adults based on their social stress in both the United States and Mexico. Thereafter, we examined their cross-sectional associations with markers of functional and biological aging.

METHOD

Participants in the Health and Retirement Study (HRS, N = 8,316) and Mexican Health and Aging Study (MHAS, N = 15,001) reported their loneliness, isolation (i.e., living alone), and relationship quality with spouse, children, and friends. Outcomes included C-reactive protein (CRP), functional limitations, self-rated health, comorbidities, gait speed, and grip strength. Models controlled for demographics, health behaviors, and body mass index (BMI).

RESULTS

In both countries, five classes emerged, a Supported group and four with elevated social stress: (1) Strained, (2) Isolated, (3) Spousal Ambivalence, and (4) Unhappily Married. Compared to the others, Strained participants in both samples had greater functional limitations, poorer self-rated health, and more comorbidities, as well as slower gait in HRS and weaker grip in MHAS. Generally, Supported participants fared better than the other groups. In HRS, CRP levels differed between the Strained group and others, but these associations were explained by health behaviors and BMI.

CONCLUSIONS

Older adults in both countries with strained relationships fared worst in their aging-related outcomes, revealing new insights about the links between toxic social stress and unhealthy aging.

The Days Add Up: Daily Marital Discord and Depressive Reactivity Linked to Past-Month Depressed Mood and Marital Risk across 10 Years

Marital discord fuels depression, according to decades of research. Most prior studies in this area have focused on macro-longitudinal change in depression over the course of years, and on global ratings of marital satisfaction. Less work has examined fluctuations in depressed mood and marital discord in daily life, and none has investigated associations of short-term patterns with longer-term depressed mood and marital outcomes. Using data from participants in the Midlife in the U.S. (MIDUS) project, the current study examined daily associations between marital discord and depressed mood, as well as their links to concurrent and prospective patterns of past-month depressed mood and marital risk. Results showed that, on average, depressed mood rose on days when individuals had an argument or tension with their spouse (i.e., marital discord). More frequent daily marital discord was also associated with greater past-month depressed mood and marital risk, above and beyond prior levels. Those with larger depressive mood responses to discord in daily life (i.e., greater reactivity) exhibited higher concurrent past-month depressed mood and greater 10-year increases in depressed mood. As the first study to link daily marital patterns to concurrent and prospective changes in depressed mood and marital outcomes, this investigation uncovered two novel processes-daily marital discord and depressive reactivity-as important for understanding long-term patterns of marital risk and depression.

Military couples' experiences in the aftermath of a cancelled deployment

Deployment requires considerable preparation for military families and changes to these plans may create notable stress. The current study leveraged data from a sample of military couples who experienced the cancellation of an overseas deployment to learn more about their experiences as they adjusted to this change. Guided by family stress and anticipatory stress perspectives, we analyzed qualitative data from 28 service members and their significant others (i.e., spouses or cohabitating partners) to understand their overall reactions to the deployment cancellation. We identified three overall reactions (positive, negative, and ambivalent) that were based on participants' appraisals of-and preparations for-deployment, as well as ambiguity about family roles and relationships. Further, participants across groups experienced uncertainty about whether or not the deployment would occur, and altered timelines for other life events. Together, our findings highlight the post-cancellation period as a significant time of stress and transition for military families. However, our findings also signify the need to help all military families cope with uncertainty about when or if deployments will occur given that the military's priorities are often in flux. We therefore describe coping efforts that may be particularly adaptive for families to engage in as they prepare for uncertain, anticipated stressors.

The Social Context of Partnered Older Adults' Insomnia Symptoms

The current study included an examination of social factors that mitigate or exacerbate insomnia symptoms among older adults who are married or living with a partner. We first examined the unique effects of spousal support and strain on insomnia symptoms and then evaluated the degree to which extramarital social factors (e.g., friend support) moderated spousal influences. Data came from Waves 2 and 3 of the National Social Life, Health, and Aging Project. Our sample consisted of 495 participants who were either married or cohabitating with a partner (M age in years = 69.84, SD = 8.08). Spousal strain-but not support-predicted higher insomnia symptoms 5 years later. Spousal influences on sleep, however, were moderated by extramarital factors in nuanced ways. Findings highlight the importance of taking into account older adults' wider social context when examining the ways in which sleep is sensitive to positive and negative aspects of marital quality.

Dyadic Links Between Health Changes and Well-Being: The Role of Non-Spousal Confidants

Although the marital relationship is often the primary source of emotional support in adulthood, sole reliance on the spouse to discuss health-related issues may be harmful to the well-being of both partners. The first aim of this study was to examine whether declines in health during later life would be associated with poorer psychological well-being in self and partner. We further investigated whether declining health would have a stronger impact on own and partner psychological well-being in the absence of non-spousal health confidants. Longitudinal actor-partner interdependence models (APIMs) were used to test both hypotheses with dyadic data from Wave 2 (2010-2011) and Wave 3 (2015-2016) of the National Social Life, Health, and Aging Project (NSHAP). Contrary to prediction, increased anxiety following spousal declines in gait speed and cognitive function occurred for those whose spouse did (rather than did not) have additional health confidants. A much fuller understanding is needed in regard to whether close relationships provide resources or present unwanted complications to dyadic coping, and the processes by which effects occur.

Rumination and Sleep Quality Among Older Adults: Examining the Role of Social Support

OBJECTIVES

Although the adverse link between rumination and sleep quality is well established, much of the literature neglects the role of social factors. This study examined the role of older adults' perceived social support from spouses and from family/friends in modifying the association between trait rumination and sleep quality. Existing hypotheses suggest that social support may play 3 unique roles, each tested within the current study: (H1) support may act as a protective factor that buffers negative effects of rumination on sleep quality, (H2) support may curtail rumination and, in turn, promote sleep quality, and (H3) rumination may erode support and, in turn, undermine sleep quality.

METHOD

Data came from 86 partnered older adults in independent-living or retirement communities (Mage = 75.70 years). We utilized 3 waves of interview data collected annually between 2017 and 2019. The first hypothesis was tested using moderation in multilevel models; the second 2 hypotheses were evaluated with prospective associations using multilevel mediation.

RESULTS

Negative effects of high-trait rumination on time-varying sleep quality were attenuated among those who reported high, stable levels of support from their spouses. Perceived family/friend support did not yield the same protective effect. There was no evidence that support preempted, or was eroded by, rumination.

DISCUSSION

Perceived spousal support may act as a psychosocial resource that mitigates negative effects of trait rumination on older adults' sleep quality. Interventions aimed at mitigating maladaptive outcomes of rumination on sleep quality for older adults should consider spousal support as a key target.

Short- and Long-term Effects of Support Visibility on Support Providers' Negative Affect

OBJECTIVES

Seminal research with spouses of chronic pain patients indicates that providing patients with instrumental support can be either costly or beneficial for spouses' well-being. Drawing from the invisible support literature, this study evaluated the extent to which patients' recognition of spouses' support moderated daily and long-term associations between spouses' support provision and negative affect.

METHOD

Data came from a sample of spouses (N = 145) of knee osteoarthritis (OA) patients, and the patients themselves. Participants completed a baseline interview, 22 days of daily diaries, and two follow-up interviews 6 and 18 months after baseline. Multilevel models were estimated to test study hypotheses.

RESULTS

As expected, support visibility moderated daily and long-term associations between spouses' instrumental support provision and negative affect. Spouses reported elevated levels of negative affect in response to providing patients with extra care and attention, but only when their support was not recognized (i.e., reported) by patients.

DISCUSSION

Findings from the current study pinpoint support visibility as a protective factor that may mitigate negative short- and long-term effects of spousal instrumental support provision on spouses' negative affect. Promoting patients' awareness of their spouses' support may offset negative emotional consequences of caregiving in the context of chronic health stressors.

Aging veterans' mental health and well-being in the context of COVID-19: The importance of social ties during physical distancing

Prior wartime trauma likely acts as a double-edged sword that promotes both aging veterans' vulnerability and resilience in the context of the current COVID-19 pandemic. During this stressful time, aging veterans may benefit from having an array of socially supportive network ties. We therefore suggest that clinicians working with veterans encourage veterans to (a) create or sustain positive social connections while maintaining physical distance and (b) call upon coping strategies that helped them manage past difficulties. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Daily Links Between Sleep and Anger Among Spouses of Chronic Pain Patients

OBJECTIVES

This study identified daily associations between sleep, emotion, and marital functioning in the context of chronic pain. Because spouses' sleep is compromised on nights when patients experience more pain, we set out to identify implications of spouses' sleep for their own emotion (anger) upon waking and marital interaction (marital tension) throughout the rest of the day. We further considered whether spouses' critical attitudes about patients' pain-related coping exacerbated associations between their sleep, morning anger, and marital tension.

METHOD

Data came from a study of knee osteoarthritis patients (50+ years old) and spouses (N = 138 couples) who completed daily diaries across 22 days. Multilevel models were estimated to test hypotheses.

RESULTS

Spouses woke up angrier on mornings when they reported that their sleep was more unrefreshing than usual. This association was stronger among more critical spouses. Morning anger resulting from unrefreshing sleep, however, did not predict marital tension throughout the rest of the day.

DISCUSSION

Findings highlight the potential value of intervention efforts aimed at promoting spouses' sleep quality in an effort to offset negative emotional consequences that may undermine spouses' and patients' adjustment in the context of chronic pain.

Marital Quality, Loneliness, and Depressive Symptoms Later in Life: The Moderating Role of Own and Spousal Functional Limitations

Loneliness is a mechanism through which marital quality relates to older adults' mental health. Links between marital quality, loneliness, and depressive symptoms, however, are often examined independent of older adults' functional health. The current study therefore examines whether associations between marital quality, loneliness, and depressive symptoms are contextually dependent on individuals' own (or their spouse's) functional limitations, as well as on gender. Data came from couples (N = 1084) who participated in the Health and Retirement Study (HRS), a nationally representative dataset of older adults (age 50+). We utilized data from the 2014 leave-behind psychosocial questionnaire to measure spousal support/strain and loneliness, and interview data from 2014 to measure baseline depressive symptoms and demographic covariates (e.g., race and education). Depressive symptoms in 2016 served as the focal outcome variable. Findings from a series of path models estimated in MPLUS indicated that loneliness is a mechanism through which spousal support predicts older adults' depressive symptoms. Such linkages, however, were dependent on individuals' own functional limitations and gender. For functionally limited males in particular, spousal support was shown to reduce depressive symptoms insofar as it was associated with lower levels of loneliness; otherwise, it was associated with higher levels of depressive symptoms. Such findings reinforce the importance of taking a contextualized approach when examining associations between support and emotional well-being later in life.

RUMINATION, DEPRESSIVE SYMPTOMS, AND SLEEP QUALITY: SOCIAL SUPPORT AS A BUFFER

Rumination, the act of dwelling on negative, unwanted thoughts, can stoke depression and disrupt sleep, both of which may threaten older adults’ well-being. In line with a support buffering hypothesis, a previous study of younger and middle-aged adults found that social support mitigated the positive association between rumination and negative mood. To extend this research, we distinguished between spousal and family/friend support as moderators of rumination’s links both to depressive symptoms and sleep quality among older adults. Data came from a sample of 128 adults who were, on average, 77 years old at study onset. Rumination was measured via the Rumination-Reflection Questionnaire. Perceived support was measured by items utilized in multiple nationally representative studies of older adults. Depressive symptoms were measured via the NIH PROMIS measure, and sleep quality was measured via items from the Pittsburgh Sleep Quality Index. Results indicated that support from family/friends (but not spouses) buffered the positive association between rumination and depressive symptoms, even after controlling for depressive symptoms six months prior. Conversely, when sleep quality served as the outcome, support from spouses (but not family/friends) buffered the negative association between rumination and sleep quality, even after controlling for sleep quality six months prior. Findings highlight the potential for specific sources of social support to buffer different consequences of rumination on older adults’ health and well-being.

Military Spouses' Self- and Partner-Directed Minimization in the Context of Deployment

In light of technological advances enabling military couples to communicate throughout deployment, spouses of deployed service members often make decisions about what to share with service members, and how to respond to service members' concerns. In doing so, they manage an emotional boundary between service members and their families. This study focused on two behaviors military spouses may use when managing this boundary, namely their minimization of (1) their own concerns (i.e., self-directed minimization) and (2) service members' concerns (i.e., partner-directed minimization). The purpose of the current study was to identify correlates and consequences of these behaviors. Findings from a longitudinal structural equation model utilizing three waves of data from a sample of 154 married military couples in which the husband was a male National Guard soldier indicated that spouses were more likely to minimize both their own-and service members'-concerns when they themselves reported higher levels of depressive symptomology prior to deployment. Spouses' minimization of service members' concerns during deployment, in turn, predicted higher levels of service members' depressive symptomology at reintegration, even after accounting for their initial depressive symptomology and combat exposure. Implications for intervention efforts aimed at promoting individual and couple adjustment to deployment are discussed.

Psychological Adjustment of Aging Vietnam Veterans: The Role of Social Network Ties in Reengaging with Wartime Memories

It is projected that by 2020 there will be 8.7 million veterans over the age of 65 years, more than half (64%) of whom served during the Vietnam War. The effects of military service on mental health and well-being may be more pronounced later in life among those who served in Vietnam than prior cohorts of veterans. Many veterans confront and rework their wartime memories later in life in an attempt to find meaning and coherence, engaging in a process referred to as Later-Adulthood Trauma Reengagement (LATR). LATR often occurs in the context of other stressors that are a normative part of aging, such as role transitions (e.g., retirement), declines in physical health, and the death of close others (e.g., spouses), perhaps because these events trigger reminiscence. Importantly, LATR may result in either positive (e.g., acceptance) or negative (e.g., distress) psychological outcomes. It has been suggested that the presence of social/environmental resources, including socioemotional support, may aid veterans in successfully navigating LATR. We, therefore, review relevant areas of research to delineate the role that various layers of social context may play in -helping - or hindering - aging Vietnam veterans as they navigate LATR in the context of normative late-life stressors. We conclude by offering fruitful directions for future research and applied implications for intervention efforts.

Communication and connection during deployment: A daily-diary study from the perspective of at-home partners

In this study, 87 partners of deployed National Guard service members completed daily diaries in which they recorded for up to 7 consecutive days the channels (e.g., phone) by which they communicated with their service member, the communication activities (e.g., support provision) they and their service member engaged in, and how connected they felt to their service member. Multilevel modeling was used to explore two types of associations between couples' communication activities and partners' feelings of connection for partners who communicated with their service member via phone and/or video during the week. Findings indicated that, across the week, partners who reported that their service member provided them with higher levels of support and who made decisions together more often as a couple felt more connected to their service member (between-person associations). Additionally, on days when partners reported they provided support during phone calls more than they did on average, or their service member provided them support during video calls more than their service member did on average, they reported greater feelings of connection (within-person associations). Future research should explore how daily fluctuations in deployment communication may reinforce or challenge existing relationship processes, thus impacting how couples maintain their relationships after, as well as during, deployment. (PsycINFO Database Record