A Developmental-Contextual Model of Couples Coping With Chronic Illness Across the Adult Life Span

Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA.
Psychological Bulletin (Impact Factor: 14.76). 12/2007; 133(6):920-54. DOI: 10.1037/0033-2909.133.6.920
Source: PubMed


A developmental-contextual model of couples coping with chronic illness is presented that views chronic illness as affecting the adjustment of both the patient and the spouse such that coping strategies enacted by the patient are examined in relation to those enacted by the spouse, and vice versa. The developmental model emphasizes that dyadic coping may be different at various phases of the life span, changing temporally at different stages of dealing with the illness as well as unfolding daily as spouses interact around dyadic stressors. In addition, couples engaged in dyadic coping are affected by broad sociocultural factors (culture and gender) as well as more proximal contextual factors (quality of the marital relationship and the specific demands of the chronic illness). The model provides a framework for understanding how couples coping with chronic illness may together appraise and cope with illness during adulthood and for determining when spousal involvement is beneficial or harmful to both patient and spousal adjustment. The developmental-contextual model to dyadic appraisal and coping has numerous research implications for the field, and the authors conclude with specific recommendations for future research.

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    • "Women, on the other hand, tend to gain intrinsic value and feelings of being loved from affectionate behaviors, even when sexual behaviors are avoided (Druley et al., 1997). Indeed, women are more likely to be interdependent in their self-representations (Acitelli & Antonucci, 1994), more aware and impacted by the quality of their relationship (Kiecolt-Glaser & Newton, 2001), and may benefit more from collaborative coping than men (Berg & Upchurch, 2007). As role and gender were confounded in the current sample, the disparate findings may well be a gender effect. "
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    ABSTRACT: Objective: The study examined whether couples coping with prostate cancer participating in a partnered exercise program-Exercising Together (ET)-experienced higher levels of physical intimacy (i.e., affectionate and sexual behavior) than couples in a usual care (UC) control group. Method: Men and their wives (n = 64 couples) were randomly assigned to either the ET or UC group. Couples in the ET group engaged in partnered strength-training twice weekly for 6 months. Multilevel modeling was used to explore the effects of ET on husband and wife engagement in both affectionate and sexual behaviors over time. Results: Controlling for relationship quality, wives in ET showed significant increases in engagement in affectionate behaviors compared to wives in UC. No intervention effects were found for husbands. Conclusion: Couple-based approaches to physical intimacy, after a cancer diagnosis, that facilitate collaborative engagement in nonsexual physical activities for the couple have potential to be effective for wives. More research is needed in this area to determine couples most amenable to such exercise strategies, optimal timing in the cancer trajectory, and the benefits of combining partnered exercise with more traditional relationship-focused strategies. (PsycINFO Database Record
    Health Psychology 10/2015; DOI:10.1037/hea0000287 · 3.59 Impact Factor
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    • "These results suggest that partner effects may become evident only in longer-term marriages, in which spouses are knowledgeable about and sensitive to fluctuations in one another's attitudes and feelings. A handful of studies have focused on crossover effects among older couples, yet most focus on small nonrepresentative samples or focus on crossover effects in the context of coping with chronic illness (e.g., Berg & Upchurch 2007). To evaluate whether partner effects are evident in long-term marriages among a nationally representative sample of older adults, we take advantage of the couple-based design of DUST and evaluate whether spousal marital appraisals are associated with one's E×WB, independent of one's own marital appraisals. "
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    ABSTRACT: 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. 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. 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. 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. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:
    The Journals of Gerontology Series B Psychological Sciences and Social Sciences 09/2015; DOI:10.1093/geronb/gbv073 · 3.21 Impact Factor
    • "Collaborative coping refers to the collaborative efforts made by both partners to manage the stressful situation together (e.g., discussing solutions). Controlling coping refers to situations in which the non-stressed partner " dominates the actions of the other spouse by taking charge and telling the other person what to do " (Berg & Upchurch, 2007, pp. 932-933). "
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    ABSTRACT: Meta-analytic methods were used to empirically determine the association between dyadic coping and relationship satisfaction. Dyadic coping is a systemic conceptualization of the processes partners use to cope with stressors, such as stress communication, individual strategies to assist the other partner cope with stress, and partners' strategies to cope together. A total of 72 independent samples from 57 reports with a combined sum of 17,856 participants were included. The aggregated standardized zero-order correlation (r) for total dyadic coping with relationship satisfaction was .45 (p=.000). Total dyadic coping strongly predicted relationship satisfaction regardless of gender, age, relationship length, education level, and nationality. Perceptions of overall dyadic coping by partner and by both partners together were stronger predictors of relationship satisfaction than perceptions of overall dyadic coping by self. Aggregated positive forms of dyadic coping were a stronger predictor of relationship satisfaction than aggregated negative forms of dyadic coping. Comparisons among dyadic coping dimensions indicated that collaborative common coping, supportive coping, and hostile/ambivalent coping were stronger predictors of relationship satisfaction than stress communication, delegated coping, protective buffering coping, and overprotection coping. Clinical implications and recommendations for future research are provided. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Clinical Psychology Review 08/2015; 42:28-46. DOI:10.1016/j.cpr.2015.07.002 · 7.18 Impact Factor
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