Romantic relationships and type 2 diabetes: The role of invisible social control.

OBJECTIVE: This study aimed to determine whether invisible social control provided by a romantic partner is associated with improved objective glucose outcomes for patients with Type 2 diabetes. Social control reflects a partner's attempt to modify or influence a patient's health behaviors. We hypothesized that the best outcome for all continuous glucose monitoring measures would be captured by an interaction condition reflecting invisible social control. METHOD: Patients with Type 2 diabetes and their partners (N = 63 couples) completed an 8-day daily diary period between 2016 and 2017. Self-report measures of social control receipt and provision were obtained each evening from patients and partners and patients wore a continuous glucose monitor throughout the diary period. Outcomes of daily glucose mean, standard deviation, time in range, and coefficient of variation were computed and two-way interactions between social control receipt and social control provision were probed and plotted. RESULTS: The two-way interaction significantly predicted daily glucose mean, standard deviation, and time in range, such that when patients reported no social control receipt, but partners reported social control provision, patients showed improvements in objective glucose measures. We found no significant effect for coefficient of variation. CONCLUSIONS: This study was the first to use an invisible social control framework to examine the daily dyadic associations between partner social control provision, patient social control receipt, and four objectively measured continuous glucose monitoring outcomes. Findings suggest that the visibility of social control provided by a romantic partner may be predictive of glycemic control in patients with Type 2 diabetes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Physiological synchrony in supportive discussions: An examination of co-rumination, relationship type, and heterogeneity.

During times of stress, we look to close others for support. Social support conversations are critical for relationship maintenance and well-being. Yet, certain ways of talking about problems-such as co-ruminating-can exacerbate stress. Since social support and co-rumination are both dyadic processes, it is important to examine physiological responses during these conversations in a dyadic manner. Little research has examined physiological synchrony of the sympathetic nervous system (SNS) during social support conversations or co-ruminative conversations. The current research capitalizes on an experimental manipulation of co-rumination using a sample of close friends (147 dyads) and romantic partners (113 dyads) to examine physiological covariation in the context of support. Across both samples, dyads exhibited significant physiological covariation in pre-ejection period reactivity (PEP). Contrary to our hypothesis, dyads in the co-rumination condition did not show more covariation. Close friend dyads did, however, exhibit more covariation as compared to romantic dyads. We also found significant variability in physiological covariation across dyads, with a minority of dyads exhibiting negative covariation of PEP reactivity. The homogeneity of the samples limits the generalizability of the findings and highlights the need for more diverse samples in future work. These findings underline the need for further exploration into the mechanisms that contribute to distinct patterns of physiological synchrony, the conditions in which negative synchrony occurs, and what predicts especially strong positive synchrony. This work extends our understanding of physiological synchrony of the sympathetic nervous system during support conversations and emphasizes the importance of considering heterogeneity in physiological processes.

How is companionship related to romantic partners' affect, relationship satisfaction, and health behavior? Using a longitudinal dyadic score model to understand daily and couple-level effects of a dyadic predictor.

Companionship is related to better affect and relationship satisfaction, but few studies have examined both partners' perspectives over time and the link between companionship and health. In three intensive longitudinal studies (Study 1: 57 community couples; Study 2: 99 smoker-nonsmoker couples; Study 3: 83 dual-smoker couples), both partners reported daily companionship, affect, relationship satisfaction, and a health behavior (smoking in Studies 2 and 3). We proposed a dyadic score model that focuses on the couple level for companionship as a dyadic predictor with considerable shared variance. On days with higher companionship, couples reported better affect and relationship satisfaction. When partners differed in companionship, they also differed in affect and relationship satisfaction. For smoking, a different picture emerged: Whereas smokers with nonsmoking partners smoked less on average with higher companionship, smokers with smoking partners smoked more on days with higher companionship. Findings show companionship as a consequential relationship construct deserving further study. Using the dyadic score model acknowledged both partners' perspectives on companionship. It demonstrated higher precision for detecting effects of partner averages in a dyadic predictor compared with traditional approaches, tests for effects of partner differences in a dyadic predictor and in outcome while maintaining the focus on the dyad.

Implementation of automated personalised breast radiotherapy planning techniques with scripting in Raystation.

OBJECTIVE: Implement scripted automatic breast planning (AP) for breast techniques within Raystation. METHODS: Manual plans (MPs) were re-planned and compared with AP plans for whole breast (WB), partial breast (PB), hybrid volumetric modulated arc therapy simultaneous integrated boost (VMAT SIB) and VMAT nodal plans. RESULTS: WB AP plans took 7 min comparing well to MP. One WB AP failed a mandatory dose constraint. Small statistically significant differences showed improved coverage for AP at expense of slightly hotter plans, however absolute differences were small (mean differences < 1% or D 0.5cc<0.2 Gy). PB AP plans took 9 min, showing improved coverage (V 24.7Gy97.6 vs 96.4 %). One PB AP case failed a mandatory constraint. Other dosimetric differences were non-significant. SIB AP plans took 14 min with one case failing a mandatory constraint with minor differences compared with MP except larger V 42.8Gy (3 vs 1.5 %) and more MU. VMAT AP plans took 12 min and were hotter for PTVp_4000 but had higher nodal coverage. Contra_Lung V 2.5Gy was higher (8.8 %) than MP plans (6.5 %). CONCLUSION: Automatic planning of modern breast techniques has been successfully introduced using a commercial planning system. AP plans are very similar to MP, requiring little manual interaction for most cases with significant timesaving potential. ADVANCES IN KNOWLEDGE: Scripted breast plans produced within minutes for WB, PB, SIB and VMAT. Successfully introduced into large busy department. Plans similar to manual plans, requiring little manual interaction.

Physiological coregulation during social support discussions.

Close relationships are proposed to function as dynamic regulatory systems, whereby partners jointly regulate each other's emotions and physiology to maintain an equilibrium level of responding--a process known as coregulation. Little is known, however, regarding when coregulation emerges. We hypothesized that because social support interactions involve explicit interpersonal emotion regulation attempts, they might be especially likely to engender stabilizing patterns of coregulation that entrain partners' responses toward an equilibrium level. We conducted a dyadic laboratory experiment in which romantic couples engaged in social support and control discussions as cardiovascular responses were measured. To assess dyadic coregulation, we used dynamical systems modeling with Bayesian estimation to capture the frequency of oscillations around an equilibrium level and changes in amplitudes over time. Results indicated there was coregulation across discussions as a whole, as well as differences in coregulation by discussion type and gender. Stabilizing coregulatory dynamics-indicated by patterns of oscillations around an equilibrium level and decreases in amplitudes as the discussions progressed-were more pronounced during social support (vs. control) discussions, especially when the male partner received support. There was also substantial between-dyad heterogeneity in couples' coregulation trajectories, whereby some couples showed pronounced coregulatory dynamics whereas other did not. Overall, this work suggests that social support interactions may be a key context when coregulation emerges and thereby offers novel insights into how relationships might contribute to well-being. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Decomposing variance in co-rumination using dyadic daily diary data.

It is unknown how co-rumination, or perseverating on problems or feelings with another person, unfolds in the daily lives of romantic couples. Using a variance decomposition procedure on data from a 14-day dyadic diary, we assessed how much variance in co-rumination was attributable to temporally stable and varying factors, as well as whether co-rumination is better measured as a couple-level or individual-level process. Within-person, within-couple fluctuations in co-rumination contributed most (~33%) to the total variance and summary scores based on these fluctuations were reliable. Stable between-couple differences accounted for ~14% of the total variance and could also be reliably assessed. However, within-couple agreement in co-rumination was low, such that the reliability at the level of within-couple change was inadequate. Research is needed to understand these divergent perceptions of co-rumination and potential downstream consequences. We conclude by considering how these results inform theory and can be applied to similar dyadic constructs.

Responsive social support serves important functions in clinical communication: Translating perspectives from relationship science to improve cancer clinical interactions.

Patient-clinician interactions are critical to patient-centered care, including in cancer care contexts which are often defined by multiple patient-clinician interactions over an extended period. Research on these dyadic interactions has been guided by perspectives in clinical communication science, but the study of clinical communication has not been fully integrated with perspectives on interpersonal interactions from relationship science research. An overlapping concept in both fields is the concept of responsive socialsupport. In this article, we discuss responsiveness as a concept that offers opportunities for connections between these two disciplines. Next, we focus on how relationship science can be applied to research in clinical settings. We discuss how three areas of relationship science define responsiveness and have potential for extension to clinical communication: (1) (in)visibility of social support, (2) attachment orientations, and (3) shared meaning systems. We also discuss how social biases can impede responsiveness and suggest research avenues to develop ideas and understand potential challenges in connecting these two fields. Many opportunities exist for interdisciplinary theory development that can generate momentum in understanding interpersonal processes in cancer care.

Within-person Changes in Co-rumination and Rumination in Adolescence: Examining Heterogeneity and the Moderating Roles of Gender and Time.

Although previous work has consistently identified positive associations between co-rumination and rumination during adolescence, little to no research has examined how this relationship operates on the person-specific level. The current study aimed to extend current developmental theories of co-rumination and rumination by examining within-person associations between these constructs. Survey data was collected from 1502 adolescents (Mage = 13.20; 52% girls; 52% non-Hispanic White) every six-months across the span of 3.5 years. The results showed that at time-points when adolescents reported co-ruminating more than their usual level, they reported concurrent increases in rumination. This association was stronger for boys and strengthened over time. Despite substantial between-person heterogeneity, 97% of adolescents showed positive associations between co-rumination and rumination. This research has important implications for mental health professionals, school systems, and parents who may look to teach adolescents about effective emotion-regulation.

Shared Reality Can Reduce Stressor Reactivity.

When a person faces a stressor alongside someone else, do they get more or less stressed when the other person agrees that the situation is stressful? While an equally stressed partner could plausibly amplify stress by making the situation seem more real and worthy of distress, we find that social validation during co-experienced stressors reduces reactivity. Specifically, the psychological experience of shared reality calms some people down. In Study 1, 70 undergraduate females who jointly faced a stressful event with someone else reported feeling less anxious when the other person felt the same way about the stressor, relative to when the other person appraised the situation in the opposite way or provided no indication of their appraisal. These findings were reflected in participants' physiological reactivity, especially in the parasympathetic nervous system. In Study 2, we generalize these findings to co-experienced stressors in the daily lives of 102 heteronormative romantic couples in the New York City area. In line with tend-and-befriend theory, we found that shared reality during co-experienced stressors reduced anxiety for almost all females (99% of the sample) and for a minority of males (42% of the sample). Together, these findings unify major theories in health and social psychology by implying that shared reality reduces stressor reactivity, and that this effect is partially moderated by sex.

Age-related change in task-evoked amygdala-prefrontal circuitry: A multiverse approach with an accelerated longitudinal cohort aged 4-22 years.

The amygdala and its connections with medial prefrontal cortex (mPFC) play central roles in the development of emotional processes. While several studies have suggested that this circuitry exhibits functional changes across the first two decades of life, findings have been mixed - perhaps resulting from differences in analytic choices across studies. Here we used multiverse analyses to examine the robustness of task-based amygdala-mPFC function findings to analytic choices within the context of an accelerated longitudinal design (4-22 years-old; N = 98; 183 scans; 1-3 scans/participant). Participants recruited from the greater Los Angeles area completed an event-related emotional face (fear, neutral) task. Parallel analyses varying in preprocessing and modeling choices found that age-related change estimates for amygdala reactivity were more robust than task-evoked amygdala-mPFC functional connectivity to varied analytical choices. Specification curves indicated evidence for age-related decreases in amygdala reactivity to faces, though within-participant changes in amygdala reactivity could not be differentiated from between-participant differences. In contrast, amygdala-mPFC functional connectivity results varied across methods much more, and evidence for age-related change in amygdala-mPFC connectivity was not consistent. Generalized psychophysiological interaction (gPPI) measurements of connectivity were especially sensitive to whether a deconvolution step was applied. Our findings demonstrate the importance of assessing the robustness of findings to analysis choices, although the age-related changes in our current work cannot be overinterpreted given low test-retest reliability. Together, these findings highlight both the challenges in estimating developmental change in longitudinal cohorts and the value of multiverse approaches in developmental neuroimaging for assessing robustness of results.

COVID-19 distress and interdependence of daily emotional intimacy, physical intimacy, and loneliness in cohabiting couples.

Introduction: COVID-19 has had a profound impact on relationship functioning, though effects have been heterogeneous. Reasons for divergent effects on relationship functioning remain unclear. Theoretical models suggest that it is not just stress exposure that leads to adverse relationships outcomes, but also subjective response to these stressors. Using data from a 14-day intensive longitudinal study of romantic dyads, we hypothesized that COVID-19-related distress would adversely impact one's own and one's partner's report of relationship functioning, on average. Interdependence at the between-couple and within-couple level was also examined. Methods: Participants were 104 female-male romantic couples cohabiting the New York metropolitan area (Mage = 28.86, SDage = 7.69) between August 2020 - April 2021. Couples reported COVID-19 distress during a baseline interview and daily relationship functioning for 14 days. Multilevel models were specified for six outcomes simultaneously: female and male partner daily physical intimacy, emotional intimacy, and loneliness. Interrelationships of the intercepts of the six outcomes were specified, reflecting between-couple associations of each partner's stable outcome tendencies. Interrelationships of the daily residuals of the six outcomes were also specified, reflecting within-couple associations at the daily level. Results: Female partner COVID-19 distress was inversely associated with her own emotional and physical intimacy and positively associated with her own and her partner's loneliness. Male COVID-19 distress was associated with his own loneliness only. There was significant interdependence at the between- and within-couple level, such that greater loneliness in either partner was associated with less intimacy in each member of the couple. Discussion: Only one partner effect for COVID-19 distress emerged, such that female partner distress was associated with male partner loneliness; however, interdependence at the between- and within-couple level suggested that distress may adversely impact relational well-being over time. Future studies should examine reciprocal relationships between COVID-19-related distress and relationship functioning.

Mood and judgment in a dyadic stress context.

The 1980s and 1990s witnessed a surge of psychological research addressing the role of affect in social judgments. Evaluations of others were shown to be shaped, at least in part, by a person's incidental mood in the moment of social evaluation; while negative moods instigated negative interpersonal evaluations, positive moods instigated positive interpersonal evaluations. Interestingly, these effects only emerged when the reason for the evaluator's mood was not obvious. Over 30 years later, we expand these findings to the dyadic domain. Rather than conceptualize interpersonal evaluations as occurring solely within an individual, we introduce the Dyadic Affect Infusion/Diffusion (DAID) model to suggest that interpersonal evaluations occur as fundamentally dyadic phenomena. Using 6 weeks of daily diary data from 311 couples in which one member approached a stressful event, we show that (a) mood influences relationship evaluations at both the intraindividual (i.e., affect infusion) and interindividual (i.e., affect diffusion) levels, (b) both affect infusion and affect diffusion are turned off by the availability of attributional information, and (c) these effects are better explained by affect infusion/diffusion rather than by several alternative mechanisms. Taken together, the DAID model bolsters the view that individualistic approaches to emotion and social cognition are insufficient and require theory and data at the dyadic and group levels of analysis. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The associations of COVID-19 percent positivity rate, relationship quality, and season with daily anxiety and depression in couples living in NYC.

Background: The COVID-19 pandemic changed nearly every aspect of daily life and had detrimental effects on mental health. Yet, impacts have been heterogeneous. We tested whether fluctuations in local COVID-19 percent positivity rates were associated with daily anxiety and depression in couples living in NYC, as well as whether these associations varied by relationship quality or season. We expected that adverse impacts of COVID-19 may be attenuated by high-quality relationships and during warmer months, or that people may habituate over time. Methods: Data on seven-day rolling average COVID-19 percent positive rate each day in NYC were merged with a 14-day dyadic diary study of cohabiting couples living in NYC between August 2020 through April 2021 (232 individuals from 116 couples; mean age 28.42 years, 52.59% female, 53.02% White). Dyadic multilevel models estimated the association COVID-19 positivity rate, season (sine and cosine of the calendar date), baseline relationship quality, and all two-and three-way interactions of these variables with daily anxiety and depression. Covariates included weekend and COVID-positive case within the couple. Results: Anxiety and depression mirrored COVID-19 positivity rates, and there was some evidence for habituation over time. Significant two-and three-way interactions suggested that being in a high-quality relationship buffered the association of COVID-19 positivity rate with both anxiety and depression during months when cases were low. Anxiety was elevated for individuals in high- (v. low-) quality relationships during the December-January surge. Conclusion: Seven-day rolling average COVID-19 percent positivity rate was associated with daily anxiety and depression among couples living in NYC. There was some evidence that individuals habituated to this stressor over time and that high-quality relationships were protective for mental well-being; however, there was some suggestion that couples in high-quality relationships may have engaged in processes such as co-rumination during surges, worsening their daily anxiety.

Modeling heterogeneity in the simultaneous emotional costs and social benefits of co-rumination.

Co-rumination is the act of perseverating on problems or negative emotions with another person. Past research has shown that co-rumination has tradeoffs, as it is related to more anxiety and depressive symptoms, yet also heightened feelings of closeness and better relationship quality. However, there has been little repeated measures work, leaving unknown the influence of within-person changes in co-rumination on individuals' functioning. Using data from 1,504 adolescents collected as part of a seven-wave study over 4 years, we hypothesized that at times when adolescents coruminated above their own average level of co-rumination, they would report more anxiety and depressive symptoms, as well as increased closeness with friends at concurrent timepoints. Moreover, we investigated heterogeneity in these effects, exploring whether there was variability in whether adolescents experienced simultaneous costs and benefits of increased co-rumination. The results reveal that the average adolescent reported associated increases in anxiety symptoms, depressive symptoms, and closeness with friends at times when they reported coruminating at higher-than-typical levels. Yet, there was significant heterogeneity in these effects, as some adolescents solely experienced costs of co-rumination and others experienced just benefits. Moreover, adolescents who experienced stronger-than-average effects of co-rumination on anxiety and depressive symptoms reported less of an increase in closeness with friends. These findings offer important insight into how co-rumination is associated with social-emotional functioning and have implications for recommending best practices for seeking support and discussing problems with close others. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Physical effects of daily stressors are psychologically mediated, heterogeneous, and bidirectional.

Prior research shows that daily stressors lead to greater psychological distress. A separate body of research links daily stressors to physical symptoms such as backaches and stomach problems. We integrate these literatures by positing an interconnected causal system, whereby stressors lead to psychological distress which, in turn, leads to physical symptoms. Our integrated approach also includes causal effects in the opposing directions: Psychological distress can increase physical symptoms and physical symptoms can increase psychological distress. Put simply, causal effects are bidirectional. This finding illuminates the concept of feedback loops, which have never been investigated in the stress literature until now. We find that reverberating feedback between stressors and distress equilibrates after just one and a half loops and that feedback between stressors and physical symptoms does not actually reach a full loop. Because of this, feedback loops have only minor consequences for physical symptoms by the end of the day. Finally, we discuss the aforementioned phenomena with between-person differences at the forefront, showing how some people are as much as four times as reactive as the average person, some people are not reactive at all, and other people are reactive in reverse directions (e.g., distress leads to fewer physical symptoms). We empirically support these claims using daily diary data from three separate studies that together represent diverse ages, geographic regions, relationship statuses, and racial identities. Once established, we consider the implications of our integrated causal feedback system in relation to existing knowledge and highlight critical areas for future study. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Physical activity after cardiac rehabilitation: Explicit and implicit attitudinal components and ambivalence.

OBJECTIVE: Physical activity is crucial in the treatment of cardiac disease. In addition to sociocognitive theories of behavior change, attitudinal ambivalence and nonconscious factors have also been demonstrated to predict physical activity. We propose an extension to the theory of planned behavior with a dual-systems approach including explicit and implicit attitudes, and different types of attitudinal ambivalence as moderators to predict the physical activity of patients after discharge from inpatient cardiac rehabilitation. METHOD: The sample comprised N = 111 cardiac patients who provided daily diary reports of intention, cognitive, affective, and implicit attitudes for 21 days after discharge (86% male, Mage = 62, SDage = 11, n = 2,017 days). Daily moderate-to-vigorous (MVPA) and light (LPA) physical activity were measured using accelerometers. Five types of ambivalence were calculated. Analyses included Bayesian multilevel modeling. RESULTS: Patients with more positive affective attitudes and more positive implicit attitudes had a higher intention. Higher ambivalence weakened the affective attitudes-intention relationship. On days with more positive implicit attitudes than usual, intention was lower, but only when ambivalence was low. Patients with higher ambivalence engaged in less MVPA. On days with extremely low ambivalence, implicit attitudes were negatively associated with tomorrow's MVPA. Patients with more positive affective attitudes engaged in more LPA, but only when their ambivalence was very low. On days with higher ambivalence than usual, the next day's LPA was shorter. However, another type of ambivalence showed the opposite effect. CONCLUSIONS: The results emphasize the importance of affective and implicit attitudes and ambivalence for the physical activity of cardiac patients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Longitudinal changes in amygdala, hippocampus and cortisol development following early caregiving adversity.

Although decades of research have shown associations between early caregiving adversity, stress physiology and limbic brain volume (e.g., amygdala, hippocampus), the developmental trajectories of these phenotypes are not well characterized. In the current study, we used an accelerated longitudinal design to assess the development of stress physiology, amygdala, and hippocampal volume following early institutional care. Previously Institutionalized (PI; N = 93) and comparison (COMP; N = 161) youth (ages 4-20 years old) completed 1-3 waves of data collection, each spaced approximately 2 years apart, for diurnal cortisol (N = 239) and structural MRI (N = 156). We observed a developmental shift in morning cortisol in the PI group, with blunted levels in childhood and heightened levels in late adolescence. PI history was associated with reduced hippocampal volume and reduced growth rate of the amygdala, resulting in smaller volumes by adolescence. Amygdala and hippocampal volumes were also prospectively associated with future morning cortisol in both groups. These results indicate that adversity-related physiological and neural phenotypes are not stationary during development but instead exhibit dynamic and interdependent changes from early childhood to early adulthood.

Social emotion regulation strategies are differentially helpful for anxiety and sadness.

Little is understood about how emotion regulation strategies typically used to regulate one's own emotions can be used to help others in distress, a process we refer to as social emotion regulation. We integrated research on social support, the self-regulation of emotion, and appraisal theories to hypothesize that different kinds of support and emotion regulation strategies should be differentially helpful for others, depending on the kind of emotion they are experiencing. Specifically, we predicted that helping others to actively modify their situation, as opposed to their appraisals and emotional responses, will be more effective for those experiencing anxiety as anxiety is a response to appraising threat in one's environment. However, helping others to modify their appraisals and emotions should be more effective for those experiencing sadness as sadness is a response to an irrevocable loss. To test this, we created a novel paradigm in which regulation targets were recruited online to write about personal events causing anxiety or sadness and regulation providers were recruited to provide written help to the targets. Study 1 supported the hypothesis using strategies drawn from the social support literature (advice vs. emotional support). Study 2 used strategies drawn from the literature on the self-regulation of emotion (situation modification vs. reappraisal) to demonstrate that as predicted, different strategies are believed to be differentially helpful depending on the target's emotion and when adjusting for individual differences in social and affective functioning, targets judge social emotion regulation strategies to be differentially helpful when implemented by providers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Couple Communication in Cancer: Protocol for a Multi-Method Examination.

Cancer and its treatment pose challenges that affect not only patients but also their significant others, including intimate partners. Accumulating evidence suggests that couples' ability to communicate effectively plays a major role in the psychological adjustment of both individuals and the quality of their relationship. Two key conceptual models have been proposed to account for how couple communication impacts psychological and relationship adjustment: the social-cognitive processing (SCP) model and the relationship intimacy (RI) model. These models posit different mechanisms and outcomes, and thus have different implications for intervention. The purpose of this project is to test and compare the utility of these models using comprehensive and methodologically rigorous methods. Aims are: (1) to examine the overall fit of the SCP and RI models in explaining patient and partner psychological and relationship adjustment as they occur on a day-to-day basis and over the course of 1 year; (2) to examine the fit of the models for different subgroups (males vs. females, and patients vs. partners); and (3) to examine the utility of various methods of assessing communication by examining the degree to which baseline indices from different measurement strategies predict self-reported adjustment at 1-year follow up. The study employs a longitudinal, multi-method approach to examining communication processes including: standard self-report questionnaires assessing process and outcome variables collected quarterly over the course of 1 year; smartphone-based ecological momentary assessments to sample participant reports in real time; and laboratory-based couple conversations from which we derive observational measures of communicative behavior and affective expression, as well as vocal indices of emotional arousal. Participants are patients with stage II-IV breast, colon, rectal, or lung cancer and their spouses/partners, recruited from two NCI-designated comprehensive cancer centers. Results will be published in scientific journals, presented at scientific conferences, and conveyed to a larger audience through infographics and social media outlets. Findings will inform theory, measurement, and the design and implementation of efficacious interventions aimed at optimizing both patient and partner well-being.