Spousal health, marital satisfaction, and older Chinese adults' sleep: The moderating role of psychological resilience

PURPOSES

This study aims to examine the moderating role of psychological resilience in the association between two common marital relationship stressors (poor spousal health and low marital satisfaction) and sleep (sleep quality and sleep duration) among older adults in China.

METHODS

This study used four waves of data from the Chinese Longitudinal Healthy Longevity Survey (2008-2018) (N = 8769), and mixed-effects logistic models were used.

RESULTS

Poor spousal health and low marital satisfaction were independently associated with increased odds of poor sleep quality and short sleep duration, and decreased odds of long sleep duration. Greater psychological resilience was associated with increased odds of good sleep quality and decreased odds of short sleep duration, but had no significant effect on long sleep duration. In addition, psychological resilience moderated the odds of poor spousal health and low marital satisfaction on the risk of short sleep duration among older Chinese adults.

CONCLUSION

The findings provide novel evidence for the increased importance of marital stress and psychological resilience on sleep health in later life. Policy interventions are needed to support vulnerable older adults who experience poor spousal health and/or low marital satisfaction.

Gray Divorce During the COVID-19 Pandemic

OBJECTIVES

Drawing on emerging evidence that the pandemic appears to have impeded both the divorce process and actual divorces, we examined whether the gray divorce rate (i.e., divorce among adults aged 50+) declined following the onset of the COVID-19 pandemic.

METHODS

Data from the 2019 and 2021 American Community Survey (ACS) were used to track changes in gray divorce. With the 2021 ACS, we estimated pandemic-era gray divorce rates across sociodemographic subgroups for middle-aged and older adults. We then pooled the 2019 (N = 892,700) and 2021 (N = 898,828) data to examine whether the risk of divorce changed with the onset of the pandemic net of sociodemographic characteristics, distinguishing trends for middle-aged versus older adults.

RESULTS

The gray divorce rate dropped following the onset of the pandemic. This drop was more pronounced among middle-aged than older adults. For older adults, the divorce rate essentially stalled.

DISCUSSION

The gray divorce rate now mirrors the overall trend of modest decline in U.S. divorce patterns. Whether the gray divorce rate continues to shrink as society transitions to a postpandemic environment awaits future research.

Psychometric properties of dyadic data from the Marital Quality Scale of Indonesian Javanese couples

BACKGROUND

Researchers have demonstrated that various measurement concepts and dimensions depend on context and timing.

OBJECTIVES

The current study aimed to determine the psychometric properties of the Javanese couples' marital quality scale based on validity and reliability METHODS: In total 840 participants or 420 marital dyad from Java, Indonesia, were involved in this study. The psychometrics properties scale was analyzed using exploratory and confirmatory factor analysis, convergent and discriminant analysis, and composite reliability.

RESULTS

The exploratory factor analysis found relationship quality to consist of support, physical proximity, warmth, communication, acceptance and respect, role sharing, and responsibility factors. Well-being quality consists of happiness, harmony, and problem-solving. The fit of the measurement model was obtained using confirmatory factor analysis. The fit model was also found in the husband's and wife's groups, with no differences between them. The high correlations between wife-husband factors also proved the validity based on convergent and discriminant evidence. The reliability coefficient was high for each dimension and construct.

DISCUSSION

This analysis shows that the marital quality scale developed has information on psychometric properties that can be useful for researchers and the practicians using the marital quality instrument of Javanese couples in particular.

Marital quality and depression as mediators linking childhood maltreatment to adult physical health

BACKGROUND

Childhood maltreatment is known to influence adult physical health among midlife adults. Evidence suggests that depressive symptoms mediate the association. However, research has discounted the role of marital quality in understanding health outcomes among adults maltreated in childhood.

OBJECTIVE

To advance this line of inquiry, we examined the relationship between marital quality and depressive symptoms in a sequential mediation model linking childhood maltreatment to adult physical health over ten years.

PARTICIPANTS AND SETTING

Our sample consisted of midlife adults (n = 550) from three waves of the Midlife Development in the United States (MIDUS) study. The majority (n = 91.4 %) were white. At MIDUS 2, the mean age was 54.84 (SD = 10.78) and the mean age at MIDUS 3 was 63.96 (SD = 10.81).

METHODS

Structural equation modeling was used to examine the degree to which marital quality and depressive symptoms mediated the relationship between childhood maltreatment and adult physical outcomes. Bootstrapping procedures were used to estimate the indirect effects.

RESULTS

The serial mediation effects from maltreatment to adult physical health through marital quality and depressive symptoms were significant. Likewise, the simple indirect effects from maltreatment to subjective evaluations and the number of chronic health conditions through depressive symptoms were also significant.

CONCLUSIONS

Childhood maltreatment is linked to adult physical health problems through marital quality and depressive symptoms, suggesting that the quality of adult marriages may play a critical role in health outcomes. Improving the quality of marriages may reduce risk factors, such as depression, that potentate future physical health problems.

Mediating effect of mindfulness level on the relationship between marital quality and postpartum depression among primiparas

BACKGROUND

Postpartum depression refers to a depressive episode or depressive symptoms up to 12 mo after delivery. Trait mindfulness has presented a protective factor for postpartum depressive symptoms and proved efficient in improving relationship satisfaction among couples.

AIM

To investigate the correlations among mindfulness, marital quality, anxiety, and depression in a large city in western China during the post-corona virus infectious disease-2019 era and determine whether trait mindfulness mediates the relationship between marital quality and postpartum anxiety and depression among primiparas.

METHODS

A cross-sectional study was conducted. The self-administered questionnaire was submitted online through smartphones. The levels of mindfulness, anxiety, depression, and marital quality were respectively investigated by the mindful attention awareness scale (MAAS), the self-rating anxiety scale (SAS), the self-rating depression scale (SDS), and the marriage perception scale (MPS) in these enrolled Han and Tujia primiparas.

RESULTS

No statistical significance was observed in the prevalence of postpartum anxiety and depression, nor scores of MAAS and MPS-Total in different regions or ethnicities (P > 0.05). However, MPS-Marital interaction (P < 0.05), MPS-Family relationship (MPS-FR) (P < 0.01), and MPS-Marital conflict (MPS-MC) (P < 0.01) scores of urban primiparas were higher than those of rural primiparas. The MPS-MC score of Han primiparas was higher than that of Tujia primiparas (P < 0.05). Negative correlations were observed between MAAS and SAS (r = -0.457, P < 0.01), and MAAS and SDS (r = -0.439, P < 0.01). SAS has revealed a highly positive correlation with SDS (r = 0.720, P < 0.01) and a weak negative correlation with MPS (r = -0.200, P < 0.05). Besides, a weak negative correlation was observed between MAAS and MPS-MC (r = -0.184, P < 0.05), and a weak positive correlation was noticed between SAS and MPS-MC (r = -0.225, P < 0.01). Mediation analysis demonstrated a full mediation effect of mindfulness level on the relationship between MPS-FR and postpartum anxiety (P < 0.05, 95%CI: -0.384 to 0.033), MPS-MC and postpartum anxiety (P < 0.01, 95%CI: 0.027-0.193), MPS-FR and postpartum depression (P < 0.05, 95%CI: -0.365 to 0.031), and MPS-MC and postpartum depression (P < 0.01, 95%CI: 0.022-0.206).

CONCLUSION

Mindfulness demonstrates negative correlations with marital conflict, postpartum anxiety and depression, and it may have cross-ethnic and trans-regional characteristics. Although the mindfulness levels have revealed no significant mediating effect between the total score of marital quality and postpartum depression in this study, it demonstrates a full mediation effect on the relationships between family relationships, marital conflict, and postpartum anxiety and depression.

Intimate Relationships and Coronary Heart Disease: Implications for Risk, Prevention, and Patient Management

Purpose of Review

Research and clinical services addressing psychosocial aspects of coronary heart disease (CHD) typically emphasize individuals, focusing less on the context of intimate relationships such as marriage and similar partnerships. This review describes current evidence regarding the role of intimate relationships in the development, course, and management of CHD.

Recent Findings

Having an intimate partner is associated with reduced risk of incident CHD and a better prognosis among patients, but strain (e.g., conflict) and disruption (i.e., separation, divorce) in these relationships are associated with increased risk and poor outcomes. These associations likely reflect mechanisms involving health behavior and the physiological effects of emotion and stress. Importantly, many other well-established psychosocial risk and protective factors (e.g., low SES, job stress, depression, and optimism) are strongly related to the quality of intimate relationships, and these associations likely contribute to the effects of those other psychosocial factors. For better or worse, intimate partners can also affect the outcome of efforts to alter health behaviors (physical activity, diet, smoking, and medication adherence) central in the prevention and management CHD. Intimate partners also influence—and are influenced by—stressful aspects of acute coronary crises and longer-term patient adjustment and management.

Summary

Evidence on each of these roles of intimate relationships in CHD is considerable, but direct demonstrations of the value of couple assessments and interventions are limited, although preliminary research is promising. Research needed to close this gap must also address issues of diversity, disparities, and inequity that have strong parallels in CHD and intimate relationships.

The effects of a nurse-led couples intervention on marital quality of couples with gynecological cancer: A clinical randomized controlled trial

OBJECTIVE

To evaluate the effectiveness of a nurse-led couples intervention on the marital quality of couples coping with gynecological cancer.

METHODS

Couples coping with gynecological cancer were randomly allocated to the intervention (n = 51) and the control (n = 53) group. The intervention group received the nurse-led couples intervention developed based on the Preliminary Live with Love Conceptual Framework plus routine nursing care. The control group received only routine nursing care. Marital quality, including marital satisfaction, marital communication, and sexual life, were measured using Olson Marital Quality Questionnaire at 3 timepoints (baseline, 2- and 3-months following baseline). Generalized estimating equation was used to examine the effectiveness of the intervention in improving marital quality.

RESULTS

Patients and husbands in the intervention group had significantly improved marital satisfaction scores (Waldχ² = 11.109, P = 0.001; Waldχ² = 4.849, P = 0.028); the interaction between intervention and time had a significant effect on the marital communication of both patients and their husbands (Waldχ² = 6.214, P = 0.045; Waldχ² = 15.460, P < 0.001). Patient-reported and husband-reported sexual life was not significantly influenced by the intervention (Waldχ² = 0.167, P = 0.683; Waldχ² = 3.215, P = 0.073).

CONCLUSIONS

The nurse-led couples intervention based on the Preliminary Live with Love Conceptual Framework improved marital satisfaction and marital communication, but not sexual life, of couples coping with gynecological cancer. The provision of professional sexual health psychology training for nurses may be crucial if nurse-led models are to truly support the sexual health of couples coping with gynecological cancer.

REGISTRATION

Registered with www.chictr.org.cn (ChiCTR2000034232).

Alcohol Use and Blood Pressure Among Older Couples: The Moderating Role of Negative Marital Quality

OBJECTIVES

Spouses often have concordant drinking behaviors and important influences on one another's cardiovascular health. However, little is known about the implications of dyadic drinking patterns for blood pressure, and the marital factors that confer risk or resilience. This article examined links between alcohol use and blood pressure within individuals and opposite-sex couples over time, and whether those links vary by negative marital quality among older adults.

METHODS

Participants were from the nationally representative longitudinal Health and Retirement Study that included 4,619 respondents in 2,682 opposite-sex couples who participated in at least 2 of the waves from 2006 to 2016. Participants reported the number of drinks they typically consume per week, negative marital quality, and had their blood pressure measured via a cuff.

RESULTS

Analyses revealed that greater drinking was associated with increased systolic blood pressure among both husbands and wives. Furthermore, husbands who drank more had higher blood pressure when wives drank more alcohol, whereas there was no association between husbands' drinking and blood pressure when wives drank less alcohol. Interactions with negative marital quality showed that drinking concordance may be associated with increased blood pressure over time in more negative marriages.

DISCUSSION

Findings indicated that spousal drinking concordance, although often associated with positive marital quality, may have negative long-term health effects.

Couples' self-control and marital conflict: Does similarity, complementarity, or totality matter more?

Research that approached self-control as a dyad-level predictor of relationship outcomes is hitherto scarce. To address this research gap, this study investigates three configurations of couples' level of self-control on marital conflict. We test three competing hypotheses suggested in the literature: similarity hypothesis, complementarity hypothesis, and totality hypothesis. The data used to test these hypotheses is a unique couple data (N = 1698 individuals from 894 married couples) of husbands and wives from a representative sample in Hong Kong. Two-level random-intercept models were employed. Based on our analysis with the difference-score method and response surface analysis, we find evidence to support the similarity hypothesis. The similarity of self-control between husband and wife is important in predicting marital conflict. In contrast, the total level of self-control is not predictive of marital conflict. This study highlights that marital conflict is strongly associated with the mismatch of self-control between partners.

Gender Differences in the Link Between Marital Quality and Cognitive Decline Among Older Adults in Korea

OBJECTIVE

This study aimed to investigate the association between positive marital quality and cognitive health over time and to examine gender differences in this association.

METHODS

Drawing on 2006-2018 Korean Longitudinal Study of Aging data (n=7,427 respondents, 35,066 person-year observations), a series of hybrid mixed-effects models were used to estimate the effects of time-invariant (gender) and time-variant (marital quality) variables on within-person changes and on between-person differences in cognitive decline over the observation period.

RESULTS

The results showed that individuals' likelihood of having higher cognitive health grew when their spousal relationship became more positive and that, compared with those with lower levels of marital quality, people with higher levels of marital quality were more likely to have higher cognitive health. Interestingly, improvements in marital quality were more beneficial for men than for women, whereas level of marital quality had similar effects on men's and women's cognitive health.

CONCLUSION

Couple-based intervention programs aiming to improve marital quality should be encouraged, especially among older adults.

A national longitudinal study of marital quality and cognitive decline among older men and women

We provide one of the first national longitudinal studies of the association between trajectories of marital quality and cognitive functioning among older adults, with close attention paid to gender differences. Data were drawn from the Health and Retirement Study (HRS) 2006-2016. Marital quality trajectories were assessed at three waves: 2006/2008, 2010/2012, and 2014/2016. Cognitive trajectories were assessed at five waves: 2008, 2010, 2012, 2014, and 2016. The final analytic sample included 7901 respondents age 50 and older (4334 men and 3567 women) who were either married or cohabiting during the study period. Results from parallel linear growth curve models suggest that among older adults, initial positive marital quality was associated with better initial cognition, and initial negative marital quality was associated with worse initial cognition. Results from multiple group analysis further suggest that marital quality was significantly associated with men's cognitive trajectories but not women's. Among men, an increase in positive marital quality was associated with a slower rate of cognitive decline, whereas an increase in negative marital quality was associated with a faster rate of cognitive decline. These findings suggest that older men who experience a decline in marital quality may be vulnerable to cognitive decline and that reducing marital strain and improving marital quality may protect men's cognitive health in later life.

Giving or receiving spouse care and marital satisfaction among older Korean individuals

Health challenges are expected in later life, but they may place older married adults in Korea at greater risk than in the past due to increasing risks of extended morbidity associated with a longer lifespan, and limited availability of traditional long-term care provided by children in an extended family context. As spouse care has become more prevalent among older adults, the present study examined whether provision or receipt of spouse care might be differentially associated with marital quality for men and women, and whether availability of care from adult children (i.e., sons, daughters, or children-in-law) might moderate the association between receipt of spouse care and marital satisfaction. The analytic sample was drawn from five waves of the Korean Longitudinal Study of Ageing (2006-2014), consisting of married individuals, with both age 60 years or older at Wave 1. For analyses, multilevel models were estimated using SAS PROC MIXED. Findings showed that first, for men, becoming a caregiver for their wife was associated with a small increase in marital satisfaction; the transition to spouse caregiving was associated with a decline in marital satisfaction for women. Secondly, transitioning to receiving spouse care was associated with a decline in marital satisfaction among men, but an increase in marital satisfaction for women. Third, new care from daughters in the form of (I)ADL assistance was associated with a benefit to marital satisfaction among men and women who began to receive care from their spouses. Overall, findings highlighted Korean families in transition. Marriage might fare better in a more recent form of family care-husbands providing care for their wives. In addition, daughters might play a bigger role in family care now compared to daughters-in-law, the designated provider of family care under the Confucian patriarchal system.

Marital quality, gender, and later-life depressive symptom trajectories

We analyze six waves of data (2006-2016) from the Health and Retirement Study (n = 4,342) to examine how marital quality is associated with depressive symptom trajectories among a group of continuously married older adults. Results show gender parity in how own perceptions of positive and negative dimensions of marital quality are related to depressive symptom trajectories. In addition, spousal perceptions of negative marital quality are positively associated with growth in depressive symptomatology regardless of gender. Spousal perceptions of positive marital quality, however, are associated with lower depressive symptoms only for women.

Intraindividual reaction time variability as an index of attentional control acts as a moderator of the longitudinal relationships between marital quality and children's externalizing problems

The current study investigated whether trial-to-trial intraindividual reaction time variability (IIRTV), which serves as an index of attentional control fluctuations, moderates the effect of marital quality at 7 years of age on the development of children's externalizing problems from 7 to 9 years of age (N = 197). At the first assessment (T1), a flanker task was administered to children for assessing their IIRTV. The Chinese version of a marital quality questionnaire (Evaluating and Nurturing Relationship Issues, Communication, and Happiness [ENRICH]) and the Chinese version of the Child Behavior Checklist (CBCL) were completed by children's mothers to assess marital quality and children's externalizing problems. At the second and third assessments (T2 and T3), children's externalizing problems were reassessed by their mothers. Growth curve analyses showed that boys' externalizing problems were relatively high and significantly decreased over time, whereas girls' externalizing problems were relatively low and stable. Importantly, the results indicated that boys' IIRTV (but not girls' IIRTV) and parental marital quality interactively predict the concurrent and developmental trajectories of externalizing problems. Specifically, boys with greater IIRTV were found to exhibit a relatively persistent high level of externalizing problems in the context of poor parental marital quality, whereas boys with lower IIRTV were found to exhibit a relatively low level of externalizing problems over time regardless of their parental marital quality. The findings suggest that poorer attentional control indexed by greater IIRTV is a robust predictor of boys' externalizing problems and that better attentional control indexed by lower IIRTV may buffer the negative impact of adverse family environment on the development of boys' externalizing problems.

Relationship Quality Among Older Cohabitors: A Comparison to Remarrieds

OBJECTIVES

Later life marital patterns have undergone shifts over the past few decades, including a rapid growth of cohabiting unions. Despite the increase in older adult cohabitation, research on this population has been slow to keep up. Intimate relationships are linked to well-being and relationship quality is especially important because high-quality relationships offer a number of benefits for well-being, whereas poor-quality relationships often are detrimental. This study compares cohabiting and remarried individuals on two measures of relationship quality.

METHOD

Using data from the 2010 and 2012 Health and Retirement Study, I investigate the positive and negative relationship quality of cohabitors relative to their remarried counterparts and whether the association of union type and relationship quality varies by race.

RESULTS

Across both positive and negative relationship quality, I found few differences between cohabiting and remarried individuals. Black cohabitors report higher positive relationship quality than remarrieds, whereas White cohabitors and remarrieds do not differ.

DISCUSSION

These findings suggest that cohabiting unions and remarriages are comparable among White older adults, but that Black cohabitors may gain more in terms of positive relationship quality than their remarried counterparts.

Upward social comparison on mobile social media and depression: The mediating role of envy and the moderating role of marital quality

BACKGROUND

The use of mobile social media enables individuals to learn about others' lives, which may lead to upward social comparison. Evidence has shown that upward social comparison on mobile social media can have negative effect for individuals' mental health, such as a higher risk of depression. Previous studies on this issue have mainly focused on adolescents and college students, but less on married adults' well-being. Moreover, mechanisms underlying this association have not been well-documented.

METHODS

A total of 514 Chinese married adults (62% female) were recruited from 26 regions in China. They completed measures of upward social comparison on mobile social media, envy, marriage quality and depression.

RESULTS

The results showed a positive association between upward social comparison on mobile social media and depression, which was completely mediated by envy. The direct effect of upward social comparison on depression, and the relation between upward social comparison and envy, were both moderated by marital quality. More specifically that upward social comparison on mobile social media was more strongly associated with depression and envy in adults with lower marital quality.

LIMITATIONS

This study only focused on the interpersonal factor (i.e., marriage quality) as a moderating variable, not investigating the potential moderating roles of personality factors and other interpersonal factors. In addition, the cross-sectional in design could not examine the causal relationships among the variables.

CONCLUSIONS

High marriage quality can protect married adults from the adverse effects of upward social comparison on mobile social media.

The effectiveness of metacognition therapy on the marital quality of the women

INTRODUCTION

Marital quality is an important predictor of marital continuity, which can lead to mental health, well-being, and happiness for couples, and marital quality is equivalent to marital satisfaction and adjustment. This study was carried out to purpose the effectiveness of metacognition therapy on marital quality of women in the city of Isfahan.

MATERIALS AND METHODS

The research method was quasi-experimental with a pretest-posttest and control group design. The study population included all married women visiting consultation centers in the city of Isfahan during March 2018-March 2019. The sampling method was nonrandom voluntary sampling used to select 30 participants who were then randomly divided into experiment and control groups (15 individuals each). The research tool was the Revised Dyadic Adjustment Scale(RDAS). The experiment group participated in eight sessions of metacognition therapy, each lasting 90 min. Covariance analysis method was used to analyze the data via SPSS21.

RESULTS

The result of covariance analysis showed that metacognition therapy has been effective in improving the marital quality of the women in the city of Isfahan (P < 0.01).

CONCLUSION

The results of this study emphasize that metacognition therapy is effective on the marital quality of the women in the city of Isfahan. Using this treatment plan can result in improved marital quality and marital satisfaction and therefore improve the relationship of couples. Therefore, the results of the current study can provide empirical support for the use of metacognition therapy to improve marital quality.

Parents' Marital Quality and Children's Transition to Adulthood

Unique longitudinal measures from Nepal allow us to link both mothers' and fathers' reports of their marital relationships with a subsequent long-term record of their children's behaviors. We focus on children's educational attainment and marriage timing because these two dimensions of the transition to adulthood have wide-ranging, long-lasting consequences. We find that children whose parents report strong marital affection and less spousal conflict attain higher levels of education and marry later than children whose parents do not. Furthermore, these findings are independent of each other and of multiple factors known to influence children's educational attainment and marriage timing. These intriguing results support theories pointing toward the long-term intergenerational consequences of variations in multiple dimensions of parents' marriages.

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.

Religious Heterogamy and Partnership Quality in Later Life

OBJECTIVES

Prior research points to the importance of couple-level religious similarity for multiple dimensions of partnership quality and stability but few studies have investigated whether this association holds for older couples.

METHOD

The current article uses dyadic data from the National Social Life, Health, and Aging Project (NSHAP), a representative sample of 953 individuals age 62-91 plus their marital or cohabiting partners. We use modified actor-partner interdependence models.

RESULTS

Religious service heterogamy predicted lower relationship happiness and satisfaction. Both associations were partially explained by the fact that religiously dissimilar partners report relatively little free time in joint activity. Further, religiously heterogamous couples had less frequent sex and engaged in less nonsexual touch than their more similar counterparts.

CONCLUSIONS

Taken together, results attest to the ongoing importance of religious similarity-service attendance, in particular-for partnership quality in late life. Future research is needed to more fully examine which mechanisms account for these patterns.

Sex, race, and the role of relationships in diabetes health: intersectionality matters

Previous research has seldom used an intersectionality framework to consider how sex and race affect diabetes health, nor has it examined the role of sex and race in the well-established link between romantic relationship quality and health. This study targeted 200 adults with type 2 diabetes (46% Black; 45% female) and examined whether sex, race, and the interaction between sex and race predicted behavioral and psychological health, or moderated the link between relationship quality and health outcomes. Black women reported poorer diabetes self-care and lower self-efficacy compared to other groups. Relationship quality was associated with better self-care, increased self-efficacy, and lower depressive symptoms. The association between relationship quality and medication adherence was stronger for Black women, and the association between relationship quality and self-efficacy was stronger for both Black women and White men. Results suggest that Black women with diabetes experience more health disadvantages than other groups, but some of these disadvantages might be attenuated by supportive romantic relationships.

Marital quality, partner's engagement and continuous positive airway pressure adherence in obstructive sleep apnea

BACKGROUND

Continuous positive airway pressure (CPAP) is the first line therapy for obstructive sleep apnea (OSA) but its effectiveness requires high adherence. We aimed to assess the impacts of the spouse's/partner's involvement and the quality of the couple's relationship on CPAP adherence.

METHODS

In a multicenter prospective study conducted in France, patients reported their subjective views regarding their partner's engagement in their CPAP treatment and the quality of their marital relationship using the Quality of Marriage Index. A hierarchical linear model was built to assess the predictors of CPAP adherence at day 120. Structural equation modeling was performed to evaluate the direct and indirect effects of the spouse's/partner's engagement and the quality of the couple's relationship on CPAP adherence.

RESULTS

The 290 OSA patients were predominantly male (77%), with a median age of 53 years IQR: [46; 62], median BMI: 32 kg/m² [28.6; 35.9] and median apnea + hypopnea index: 43/per hour [33; 58]. Independent factors for CPAP adherence at day 120 were the partner's encouragement of CPAP usage and a stable relationship exceeding 30 years, although emotional support or collaboration were not associated with CPAP adherence. Structural equation modeling demonstrated that spouse's/partner's engagement is directly related to CPAP adherence and improvement of symptoms, and that CPAP adherence is a mediator of disease-specific health-related quality of life. Marital quality was a significant moderator of these interactions meaning that a spouse's/partner's engagement improved adherence only when the quality of marriage index was high.

CONCLUSION

Future research and integrated OSA management should systematically include and document the role of the spouse/partner in CPAP adherence.

Couple relationship education program "Living as Partners": evaluation of effects on marital quality and conflict

Relationship education programs are strategies that can favor better marital quality and conflict management between spouses. The relationship education program “Living as Partners: Turning Challenges into Opportunities” seeks to promote the couples’ learning of conflict resolution strategies and better quality levels in the relationship. This study evaluates the capacity of this program to produce results regarding marital quality and three dimensions of the couple’s conflict: frequency, intensity, and resolution strategies. Data from 41 couples were analyzed before and after the program, and a follow-up after 5 months (n = 33 couples) were conducted as well (single group, pre-test, post-test, and follow-up quasi-experimental design). Results show that the program produced immediate effects in all the outcome variables, which remained significant after 5 months, except for marital quality and for the strategy of compliance. These outcomes showed effect sizes ranging from low to high levels. The study presents evidence about the ability of the “Living as Partners” program to produce improvements in couple’s conflict indicators, addressing an unexplored field of research and intervention focused on Brazilian cultural specificities.

Gender Differences in the Structure of Marital Quality

Marriages consist of shared experiences and interactions between husbands and wives that may lead to different impressions of the quality of the relationship. Few studies, unfortunately, have tested gender differences in the structure of marital quality, and even fewer studies have evaluated whether genetic and environmental influences on marital quality differ across gender. In this study, we evaluated gender differences in the structure of marital quality using independent samples of married male (n = 2406) and married female (n = 2215) participants from the National Survey of Midlife Development in the United States who provided ratings on twenty-eight marital quality items encompassing six marital quality constructs. We further explored gender differences in genetic and environmental influences on marital quality constructs in a subsample of 491 pairs of twins. Results suggest partial metric invariance across gender but structural variability in marital quality constructs. Notably, correlations between constructs were stronger in women than men. Results also support gender differences in the genetic and environmental influences on different aspects of marital quality. We discuss that men and women may approach and react to marriage differently as the primary reason why we observed differences in the structure of marital quality.

Religiosity, Marital Quality and Couple Generativity in Italian Couples Belonging to a Catholic Spiritual Association: A Quali-Quantitative Study

The current studies aimed, firstly, at exploring the relationship between the level of religiosity and marital outcomes, in terms of relationship quality and couple generativity; secondly, at gaining insight into which strategies the couples use to ensure their marital quality/couple generativity, and understanding if religious practices have a positive influence on the development of such strategies. The studies focused on a specific aspect of religiosity, that is the active involvement in a Catholic association, and compared couples with a high level of religious involvement (HRI) belonging to a Catholic international association (New Families) and couples with a low level of religious involvement (LRI). Study 1 (N = 194) adopted a quantitative approach and analyzed data from questionnaires administered in two phases. Study 2 (N = 32) adopted a qualitative approach (grounded theory) and analyzed data from semi-structured interviews. Results of Study 1 showed that HRI men scored higher in relationship quality and couple generativity than LRI men, while HRI women scored higher in couple generativity than LRI women. In Study 2, no differences were found between HRI and LRI couples with respect to the factors that ensure marital quality and generativity (care of the relationship, dialogue, sharing, maintenance of the centrality of the relationship), but HRI and LRI couples used different strategies to achieve these goals.

Differentiating Between Attachment Styles and Behaviors and their Association with Marital Quality

The purpose of this study was to distinguish between the influence of attachment styles and behaviors on marital quality for couples. Data were gathered from 680 couples in a married relationship. Results showed attachment style and behaviors predicted marital quality for both men and women, with higher levels of attachment related to greater quality. Attachment behaviors predicted more of the variance in quality than did styles. Specific implications regarding how therapists may wish to foster behaviors that promote attachment security in marriages are discussed.

Does Viewing Pornography Reduce Marital Quality Over Time? Evidence from Longitudinal Data

Numerous studies have examined the connection between pornography viewing and marital quality, with findings most often revealing a negative association. Data limitations, however, have precluded establishing directionality with a representative sample. This study is the first to draw on nationally representative, longitudinal data (2006-2012 Portraits of American Life Study) to test whether more frequent pornography use influences marital quality later on and whether this effect is moderated by gender. In general, married persons who more frequently viewed pornography in 2006 reported significantly lower levels of marital quality in 2012, net of controls for earlier marital quality and relevant correlates. Pornography's effect was not simply a proxy for dissatisfaction with sex life or marital decision-making in 2006. In terms of substantive influence, frequency of pornography use in 2006 was the second strongest predictor of marital quality in 2012. Interaction effects revealed, however, that the negative effect of porn use on marital quality applied to husbands, but not wives. In fact, post-estimation predicted values indicated that wives who viewed pornography more frequently reported higher marital quality than those who viewed it less frequently or not at all. The implications and limitations of this study are discussed.

Marital Quality Buffers the Association Between Socioeconomic Status and Ambulatory Blood Pressure

BACKGROUND

Socioeconomic status is robustly associated with rates of death and disease. Psychophysiological stress processes are thought to account for a portion of this association.

PURPOSE

Although positive and supportive relationships can buffer psychophysiological stress responses, no studies have examined whether the quality of a primary adult relationship-marriage-may buffer the negative association between socioeconomic status and stress-related disease processes.

METHODS

The current study examines the interaction between income and marital quality (supportive vs. ambivalent) on individuals' daily ambulatory blood pressure, a valid and reliable indicator of cardiovascular risk.

RESULTS

Results revealed that supportive marital relationships buffered the otherwise higher ambulatory diastolic blood pressure associated with low income.

CONCLUSIONS

Results are consistent with the buffering hypothesis of social support and suggest that a supportive spouse may buffer stress-related autonomic processes linking low socioeconomic status to risk for cardiovascular disease.

Sexual dysfunction among women with Schizophrenia-A cross sectional study from India

Sexual dysfunction among women usually has a multifactorial etiology and is also difficult to study in cultures where open discussions about sexuality are not common. Not much is known about sexual function in women with schizophrenia even though it may have a significant impact on their quality of life and maybe influenced by several factors.

AIMS AND OBJECTIVES

This study aimed to assess the frequency and nature of sexual dysfunction in women with schizophrenia and study its association with marital quality, illness, treatment, and socio-demographic factors.

METHODOLOGY

This was a cross sectional, hospital-based study conducted among 63 women with schizophrenia attending the outpatient services of a tertiary care psychiatric hospital. Sexual dysfunction was assessed using the Female Sexual Function Index (FSFI). Side effects of medications, psychopathology, and marital quality were assessed using standard scales.

RESULTS

Among the 63 women assessed, 44 (70%) reported sexual dysfunction. Impaired desire was reported by all women, impaired arousal by 58 (92.1%), poor lubrication by 30 (47.6%), impaired orgasm by 48(76.2%) poor satisfaction by 44(69.8%) and pain by 23(36.5%). Poor Marital quality ('p' value-0.001), higher scores on general psychopathology of the Positive and Negative symptoms scale of schizophrenia (PANSS) ('p' value-0.049) and side effects such as weight gain, menstrual disturbances, galactorrohea and dry vagina were significantly associated with Female Sexual Dysfunction (FSD) in univariate analysis. However, multivariate analysis found marital quality alone to be significantly related to FSD.

Diabetes Risk and Disease Management in Later Life: A National Longitudinal Study of the Role of Marital Quality

OBJECTIVES

We assess the association between marital quality and both the risk of developing diabetes and the management of diabetes after its onset in later life.

METHOD

We use data from the first two waves of the National Social Life, Health, and Aging Project to estimate regression models with lagged dependent variables. The sample includes 1,228 married respondents, among whom 389 were diabetic. Those with either a reported diagnosis or with HbA1c ≥ 6.5% are identified diabetic. We categorize diabetic respondents into three groups: controlled, undiagnosed, and uncontrolled diabetes. We conduct factor analysis to construct positive and negative marital quality scales.

RESULTS

For women, an increase in positive marital quality between Waves 1 and 2 is related to a lower risk of being diabetic at Wave 2, net of diabetes status at Wave 1; surprisingly, for men, an increase in negative marital quality between Waves 1 and 2 is related to both a lower risk of being diabetic at Wave 2 and a higher chance of controlling diabetes at Wave 2 after its onset.

DISCUSSION

Our results challenge the traditional assumption that negative marital quality is always detrimental to health and encourage family scholars to distinguish different sources and types of negative marital quality.

Respite Care, Stress, Uplifts, and Marital Quality in Parents of Children with Down Syndrome

Parents of children with disabilities are at risk for high stress and low marital quality; therefore, this study surveyed couples (n = 112) of children with Down syndrome (n = 120), assessing whether respite hours, stress, and uplifts were related to marital quality. Structural equation modeling indicated that respite hours were negatively related to wife/husband stress, which was in turn negatively related to wife/husband marital quality. Also, wife uplifts were positively related to both wife and husband marital quality. Husband uplifts were positively related to husband marital quality. Therefore, it is important that respite care is provided and accessible to parents of children with Down syndrome.

Factors that influence in vitro fertilization treatment outcomes of Chinese men: A cross-sectional study

BACKGROUND

The thought of producing offspring has rooted in Chinese culture after thousands of years of feudal society. Infertility in men would bear significant psychological distress in this social environment.

PURPOSE

In this study, we explored the association between the outcomes of IVF treatment and anxiety, depression, marital satisfaction, communication, sexual relationship and social support.

METHODS

A cross-sectional study was conducted. A total of 202 Chinese men who received IVF treatment for the first time were investigated using socio-demographic questionnaire, Self-Rating Anxiety Scale, Self-Rating Depression Scale, ENRICH Marital Inventory and Social Support Rating Scale on the first day of IVF treatment.

RESULTS

The overall prevalence of depression and anxiety was 49.1% and 27.2%, respectively. Subjects with IVF failure had higher levels of depression and anxiety, lower levels of "Marital satisfaction", "communication" and "Sexual relationship" and social support. Logistic regression analysis indicated that depression, anxiety, marital satisfaction and sexual relationship were independent predictors of IVF failure.

CONCLUSION

The prevalence of depression and anxiety in Chinese men undergoing IVF was higher than that in other countries. These findings suggest that anxiety, depression, marital satisfaction, and sexual relationship are important factors leading to IVF failure. Therefore, it is important to provide psychological aid to male patients undergoing IVF treatment.

Does Partner Responsiveness Predict Hedonic and Eudaimonic Well-Being? A 10-Year Longitudinal Study

Motivated by attachment theory and recent conceptualizations of perceived partner responsiveness as a core feature of close relationships, the present study examined change in hedonic and eudaimonic well-being over a decade in a sample of more than 2,000 married adults across the United States. Longitudinal analyses revealed that perceived partner responsiveness- the extent to which individuals believe that their partner cares for, appreciates, and understands them-predicted increases in eudaimonic well-being a decade later. These results remained after controlling for initial hedonic and eudaimonic well-being, age, gender, extraversion, neuroticism, and perceived responsiveness of family and friends. Affective reactivity, measured via an 8-day diary protocol in a subset of the sample, partially mediated this longitudinal association. After controlling for covariates, perceived partner responsiveness did not prospectively predict hedonic well-being. These findings are the first to document the long-term benefits of perceived partner responsiveness on eudaimonic well-being.

The relations between marital quality, social support, social acceptance and coping strategies among the infertile Iranian couples

OBJECTIVE

Researchers aimed to assess marital quality among the infertile couples undergoing assistive reproductive treatments and their coping strategies, social support and social acceptance.

METHODS

In a cross-sectional study, 133 infertile couples undergoing assisted reproductive treatments were assessed for marital satisfaction, conflict resolution and marital communication, and coping strategies, using a self-report questionnaire. Also, the level of perceived social support and social acceptance as moderator variables were measured. Data were analyzed using independent t test, Pearson correlation coefficient, and linear regressions, after adjusting for age, cause of infertility and the duration of infertility.

RESULTS

No significant difference was found in the use of various coping strategies between couples. The correlation for marital satisfaction, marital communication and conflict resolution by using some coping strategy and the level of perceived social acceptance were significantly positive among women. Also, marital relationships had a positive and significant correlation with the level of perceived social support for men. But, unlike women, the couples' scales were significant for the perceived social support. The use of different coping strategies by men and women had a positive correlation with their perceived social support.

CONCLUSION

Coping strategies used by the infertile couples had an important role in different aspects of their married life in search of marital satisfaction, and intermediates by the perceived social acceptance for women and social support for men.

Marital Quality and Negative Experienced Well-Being: An Assessment of Actor and Partner Effects Among Older Married Persons

OBJECTIVES

We evaluate (a) associations between marital quality (emotional support, strain, and overall appraisal) and three negative aspects of experienced well-being (frustration, sadness, and worry) among older husbands and wives and (b) the relative importance of own versus spouse's marital quality assessments for understanding experienced well-being in later life.

METHOD

Data are from the 2009 Disability and Use of Time daily diary supplement to the Panel Study of Income Dynamics (N = 722). We estimate actor-partner interdependence models, using seemingly unrelated regression.

RESULTS

Own reports of marital strain are associated with own frustration, sadness, and worry among wives and are associated with frustration only among husbands. Own reports of marital support are associated with negative emotion among husbands only: higher levels of marital support are associated with less worry. Results from partner effects analyses also are mixed. Husbands' reports of marital strain are associated with wives' elevated frustration levels, whereas wives' reports of greater marital support are associated with their husbands' higher frustration levels.

DISCUSSION

One's own and spouse's marital appraisals play a complex role in shaping negative emotions among older adults. Findings suggest that frustration is a particularly complex emotion and a promising area for further study among older married couples.

Remarriage Beliefs as Predictors of Marital Quality and Positive Interaction in Stepcouples: An Actor-Partner Interdependence Model

Using an Actor-Partner Interdependence Model, we examined remarriage beliefs as predictors of marital quality and positive interaction in a sample of 179 stepcouples. Three beliefs were measured using subscales from the Remarriage Belief Inventory (RMBI) including success is slim, children are the priority, and finances should be pooled. Several significant actor and partner effects were found for both wives' and husbands' beliefs. Wives' marital quality was positively associated with their own beliefs that finances should be pooled and negatively associated with their own beliefs that success is slim. Wives' reports of their own and spouses' positive interaction were both positively associated with their beliefs that finances should be pooled. Their reports of spouses' positive interaction were also negatively associated with husbands' beliefs that success is slim. Husbands' marital quality was positively associated with wives' beliefs that children are the priority, positively associated with their own beliefs that finances should be pooled, and negatively with success is slim. Positive interaction for husbands was positively associated with wives' beliefs that finances should be pooled and negatively associated with their own beliefs that success is slim. Finally, husbands' reports of positive interaction for their spouses were positively associated with wives' beliefs that finances should be pooled. Implications for future research utilizing dyadic data analysis with stepcouples are addressed.

Understanding The Role of Mate Selection Processes in Couples' Pair-Bonding Behavior

Couples are similar in their pair-bonding behavior, yet the reasons for this similarity are often unclear. A common explanation is phenotypic assortment, whereby individuals select partners with similar heritable characteristics. Alternatively, social homogamy, whereby individuals passively select partners with similar characteristic due to shared social backgrounds, is rarely considered. We examined whether phenotypic assortment and/or social homogamy can contribute to mate similarity using a twin-partner design. The sample came from the Twin and Offspring Study in Sweden, which included 876 male and female monozygotic and same-sex dizygotic twins plus their married or cohabitating partners. Results showed that variance in pair-bonding behavior was attributable to genetic and nonshared environmental factors. Furthermore, phenotypic assortment accounted for couple similarity in pair-bonding behavior. This suggests that individuals' genetically based characteristics are involved in their selection of mates with similar pair-bonding behavior.

Marital Quality and Cognitive Limitations in Late Life

OBJECTIVES

Identifying factors associated with cognitive limitations among older adults has become a major public health objective. Given the importance of marital relationships for older adults' health, this study examines the association between marital quality and change in cognitive limitations in late life, directionality of the relationship between marital quality and cognitive limitations, and potential gender differences in these associations.

METHOD

Latent growth curve models were used to estimate the association of marital quality with change in cognitive limitations among older adults and the direction of the association between marital quality and cognitive limitations using 4 waves of the Americans' Changing Lives survey (N = 841).

RESULTS

Results indicate that more frequent negative (but not positive) marital experiences are associated with a slower increase in cognitive limitations over time, and the direction of this association does not operate in the reverse (i.e., cognitive limitations did not lead to change in marital quality over time). The association between negative marital experiences and cognitive limitations is similar for men and women.

DISCUSSION

The discussion highlights possible explanations for the apparent protective effect of negative marital experiences for older adults' cognitive health over time, regardless of gender.

"His" and "her" marriage? The role of positive and negative marital characteristics in global marital satisfaction among older adults

OBJECTIVES

We explore gender differences in older adults' appraisals of positive and negative aspects of their marriages, examine how these appraisals relate to global marital satisfaction, and identify distinctive marital profiles associated with global satisfaction in men and women.

METHOD

Data are from the Changing Lives of Older Couples Study (n = 1,110). We used a variant of principal components analysis to generate marital quality profiles, based on one's endorsement of positive and negative marital characteristics. OLS regression was used to detect associations between marital profiles and global marital satisfaction.

RESULTS

Men offered more positive marital assessments than women, particularly on items reflecting positive treatment by one's wife. Three marital quality profiles emerged: Positive, Positive-Negative, and Negative. Although marital satisfaction was best explained by positive appraisals in both genders, they were less important for men than for women. The negative profile showed a tendency for a stronger prediction in men.

DISCUSSION

Prior studies show small differences in men's and women's global marital satisfaction. Our work provides evidence that the presence and magnitude of such gender differences may vary based on the specific marital component considered. We discuss ways that gender shapes marital interactions, expectations, and perceptions, and the implications of our results for the well-being of married older adults.

Sexual activity and psychological health as mediators of the relationship between physical health and marital quality

OBJECTIVES

The pathways linking spousal health to marital quality in later life have been little examined at the population level. We develop a conceptual model that links married older adults' physical health and that of their spouse to positive and negative dimensions of marital quality via psychological well-being of both partners and their sexual activity.

METHODS

We use data from 1,464 older adults in 732 marital dyads in the 2010-2011 wave of the National Social Life Health and Aging Project.

RESULTS

We find that own fair or poor physical health is linked to lower positive and higher negative marital quality, spouse's health to positive quality, and that own and spouse's mental health and more frequent sex are associated with higher positive and lower negative marital quality. Further, we find that (a) sexual activity mediates the association between own and partner's physical health and positive marital quality, (b) own mental health mediates the association between one's own physical health and both positive and negative marital quality, and (c) partner's mental health mediates the associations of spouse's physical health with positive marital quality. These results are robust to alternative specifications of the model.

DISCUSSION

The results suggest ways to protect marital quality among older adults who are struggling with physical illness in themselves or their partners.

Stepparents and parenting stress: the roles of gender, marital quality, and views about gender roles

Previous research suggests that stepparenting can be stressful, although the mechanisms that contribute to the experience of parenting stress in stepfamilies are less clear. This study examines gender, marital quality, and views about gendered family roles as correlates of parenting stress among 310 stepmothers, stepfathers, and biological mothers and fathers. Findings suggest that stepparents, and especially stepmothers, experience higher levels of parenting stress than biological parents. Findings also suggest that less traditional views about gendered family roles and higher dyadic adjustment are associated with lower parenting stress for stepparents, particularly in combination. Stepparents reporting both of these protective factors were indistinguishable in terms of parenting stress from biological parents. These findings indicate potential pathways to mitigate the stress associated with stepparenting.

Widowhood, age heterogamy, and health: the role of selection, marital quality, and health behaviors

OBJECTIVE

Although the impact of widowhood on the surviving spouse's health has been widely documented, there is little empirical research examining whether certain spousal choice decisions and marital sorting patterns predispose individuals to be more vulnerable to the adverse consequences of widowhood for health.

DESIGN AND METHOD

We use data from the Wisconsin Longitudinal Study and employ ordinary least squares models to (a) document variations in mental and physical health between married and widowed persons, (b) determine whether widowed persons in age heterogamous unions are especially vulnerable to the adverse consequences of widowhood, and (c) investigate to what extent differential selection, marital quality, and health practices account for health disparities by marital status and the spousal age gap.

RESULTS

Widowed persons, especially those in age heterogamous unions, have worse mental health than married persons, but they do not seem to be more disadvantaged in terms of physical health. Differential selection, marital quality, and health behaviors partly account for some of the health disparities by marital status and spousal age gap.

DISCUSSION

Our findings suggest that marrying a spouse who is very dissimilar in age may enhance one's vulnerability to the adverse consequences of widowhood for health.

Bereavement-related regret trajectories among widowed older adults

OBJECTIVES

Although regrets and unfinished business with a deceased spouse are frequently discussed as crucial determinants of one's postloss adjustment, there have been few empirical investigations of bereavement-related regrets. This present study aimed to investigate the longitudinal course of these regrets and their correlates among widowed older adults.

METHODS

Drawing upon information from 201 widowed older adults in the Changing Lives of Older Couples study, this present study used latent class growth analysis to identify unique longitudinal trajectories of regret from 6 to 48 months postloss and examine differences between these trajectories with regard to grief and depressive symptomatology.

RESULTS

Three distinct bereavement-related regret trajectories were identified, characterized by Stable Low Regret, Stable High Regret, and Worsening High Regret. Results revealed that those in the Worsening High Regret group, whose bereavement-related regrets were exacerbated during the study, had the poorest grief outcomes. No differences were observed between these groups with regard to depressive symptoms, indicating that regret may be a unique marker of difficulties in the grieving process.

DISCUSSION

These findings highlight the importance of periodically reassessing bereavement-related regrets (and perhaps other aspects of the continued relationship with the deceased) over time and support the rationale behind interventions designed to facilitate resolution of these issues.