Daily illness appraisal and collaboration in couples with type 1 diabetes.

OBJECTIVE: Dyadic coping theories posit that spousal involvement may benefit illness management through collaborative and supportive (C&S) strategies and shared illness appraisals. Illness appraisals have only been examined as individual differences rather than fluctuating daily as individuals manage the difficult Type 1 diabetes regimen. The study examined how daily illness appraisals of individuals with Type 1 diabetes and their spouses were linked to spouses' daily C&S strategies and whether C&S strategies were most beneficial for daily diabetes outcomes when they occurred in the context of shared illness appraisals. METHOD: Couples (N = 199) in which one person had Type 1 diabetes (M age patients = 46.81; 52.3% female; spouses = 46.40, 47.5% female) completed a 14-day diary assessing illness appraisals (ranging from nonshared through shared) and spouses' C&S strategies. Patients reported daily self-regulation failures, self-care behaviors, and perceived coping effectiveness. Daily blood glucose was gathered from glucometers. RESULTS: Multilevel models indicated both within-person and between-person effects of patients' and spouses' illness appraisals on C&S strategies with higher shared illness appraisals associated with greater C&S strategies. Greater shared illness appraisals were associated with fewer self-regulation failures and better self-care. C&S strategies were associated with lower self-care and higher blood glucose levels. Appraisal interacted with C&S strategies such that C&S strategies were associated with more self-regulation failures, lower self-care, and lower perceived coping effectiveness when patients reported lower shared appraisals. CONCLUSIONS: Results suggest that C&S strategies may be more detrimental for diabetes management when individuals view diabetes as less shared. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Diabetes stress and health: Is aging a strength or a vulnerability?

The purpose of this work was to examine (1) relations of diabetes stress to psychological well-being and health, (2) links of age to such outcomes and (3) the extent to which age moderated relations from diabetes stress to outcomes. These aims were addressed in a diverse community sample of 207 individuals recently diagnosed with type 2 diabetes, employing survey and daily diary methods. Participants reported age, diabetes distress, and psychological distress at baseline and 6 months later. Glycemic control also was assessed. Participants completed a 14-day daily diary protocol in which they reported daily diabetes stressors, mood, and self-care. Both cross-sectional and longitudinal results showed diabetes distress was associated with poorer outcomes. Daily diary data showed that individuals who reported more daily diabetes stressors reported poorer outcomes. Older age was linked to less psychological distress, but was unrelated to daily diabetes stressors. Older age attenuated relations of diabetes distress to outcomes.

An examination of the communal coping process in recently diagnosed diabetes.

Communal coping, which involves a shared illness appraisal and engaging in collaboration when illness-related problems arise, is likely beneficial for individuals with type 2 diabetes. The purpose of this work was to examine the process by which communal coping may lead to such benefits. First, we hypothesized that illness-related interactions characterized by more communal coping would involve greater spouse support provision and greater patient receptivity to support. Second, we hypothesized that such interactions would lead to greater perceived problem resolution and more positive perceptions of the interaction. Third, we expected communal coping to predict changes in long-term diabetes outcomes-increased self-efficacy, improved self-care, and reduced diabetes distress-6 months later. Finally, we predicted that these long-term links would be partially explained by the immediate interaction outcomes. We tested these hypotheses in a sample of 123 persons with recently diagnosed type 2 diabetes and their spouses. Patient and spouse communal coping was observed in the laboratory during a diabetes stressor discussion, and patients reported outcomes immediately after the discussion and 6 months later. Results were largely consistent with hypotheses, but spouse communal coping was more consistently linked to support outcomes, and only patient communal coping was linked to changes in long-term outcomes. This work contributes to the literature indicating communal coping is beneficial for individuals with chronic illness and provides insight into the process by which communal coping exerts these effects.

The importance of having fun: Daily play among adults with type 1 diabetes.

Although play has been linked to psychological and physical well-being in childhood, little work has examined benefits of play in adulthood. Play may be especially important in the context of coping with a chronic illness such as type 1 diabetes as self-care involves a difficult daily process. We hypothesized that daily play with one's romantic partner would be linked to better mood, greater diabetes disclosure, greater support receipt, greater perceived coping effectiveness with one's most important daily stressors, and better self-care regarding type 1 diabetes. We examined these hypotheses in a sample of 199 adults with type 1 diabetes. Participants completed daily diary measures of play with their partner and proposed outcomes for 14 days. Daily play was linked to better mood, greater diabetes disclosure to one's partner, greater support received from one's partner, and greater perceived coping effectiveness with the day's most important diabetes and general stressors. However, daily play was unrelated to self-care. Mediation analyses further indicated that positive mood explained links from daily play to perceived coping effectiveness, and diabetes disclosure explained links from daily play to support. These findings indicate that having fun with one's partner may have important psychological and relationship benefits for individuals with chronic illness. More work needs to be conducted to examine links from daily play to self-care. Implications are discussed.

I am a rock; I am an island: Implications of avoidant attachment for communal coping in adults with type 2 diabetes.

Accumulating evidence indicates that communal coping is beneficial for individuals with chronic illness. The current investigation examined attachment as a moderator of the effects of communal coping in a sample of persons with type 2 diabetes. We hypothesized that patient communal coping would be associated with higher relationship quality, lower distress, and better diabetes outcomes for patients low in avoidant attachment, but it would not be beneficial for patients high in avoidant attachment. Patient communal coping was coded from videotaped interactions in which 86 heterosexual couples discussed difficulties managing diabetes. The results indicated that patient communal coping was beneficial when avoidant attachment was low. When avoidant attachment was high, patient communal coping was related to lower relationship quality and higher distress and was unrelated to diabetes outcomes. This work sheds light on potential boundary conditions of communal coping's benefits, which will be important to consider in future communal coping interventions.

Short Report: Inclusion of Other in the Self Scale: An Adaptation and Exploration in a Diverse Community Sample.

We adapted the widely-used measure of relationship closeness, the Inclusion of Other in Self Scale (IOS; Aron, Aron, & Smollan, 1992), to assess communal coping (IOS-CC). Communal coping is a construct that reflects a shared appraisal of a stressor ('our problem' instead of 'my problem') and collaborative action to manage the stressor. We administered the IOS and the IOS-CC to a racially and economically diverse sample of persons with type 2 diabetes and their partners (n = 207 couples) and examined how a subset (n = 85 couples) interpreted the IOS-CC as well as the IOS. The IOS-CC was largely interpreted as intended. The IOS reflected interpersonal connection, as expected, but also a number of other relationship constructs. The IOS-CC and IOS were positively related, but empirically distinguished by stronger connections of the IOS-CC to communal coping and stronger connections of the IOS to relationship quality. Future researchers should consider using the IOS-CC to measure communal coping when a simple, visual, and less time-intensive measure is needed and consider the different ways the IOS is conceptualized by diverse populations.

Patient and partner illness appraisals and health among adults with type 1 diabetes.

In a study of 199 couples in which one person had type 1 diabetes, we examined how patient appraisal of the diabetes as shared versus individual was associated with collaborative, supportive and unsupportive behavior and whether patient shared illness appraisal was most beneficial for health when it occurred in the context of supportive behavior. We assessed illness appraisal among patients with type 1 diabetes and their partners and had patients complete relationship and health measures. Results showed partners were more likely than patients to hold shared illness appraisals. Patients' shared appraisals were associated with more collaborative and instrumental support, more emotional support, less protective buffering, and more overprotective behavior. When patients and partners were consistent in their shared appraisals, support was highest. Regression analysis showed collaborative and instrumental support, as well as emotional support, was related to better psychological and physical health when patients held shared compared to individual illness appraisals.

Daily sleep quality and daily stressors in couples coping with type 1 diabetes.

OBJECTIVE: To examine the influence of daily sleep quality in patients with Type 1 diabetes (T1D) on that of their spouses and to investigate the influence of couples' sleep quality on patients' diabetes-specific stressors and couples' general stressors the following day. METHODS: 199 patients with Type 1 diabetes (Mage = 46.82) and their spouses (Mage = 46.41) completed a 14-day diary where they reported on their own sleep quality, and the presence of general stressors. Patients reported the presence of diabetes-specific stressors. Multilevel modeling examined the effects of daily variability in (within-person effects) and average levels of (between-person effects) sleep quality on the number of next-day diabetes-specific stressors (controlling for prior day stressors). Furthermore, the actor-partner interdependence model was used to examine the effect of sleep quality on general stressors. RESULTS: Greater patients' daily sleep quality was related to their spouses' greater sleep quality. Increases in the patients' own daily- and average sleep quality were uniquely associated with fewer next day diabetes-specific stressors. Better own daily- and average sleep quality were associated with fewer general stressors for both partners. Spouses' increased daily sleep quality was associated with fewer general stressors of patients. CONCLUSIONS: The results support that sleep quality is a dyadic phenomenon among couples and suggest that better sleep quality may buffer diabetes specific and general stress in couples coping with T1D. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Communally coping with diabetes: An observational investigation using the actor-partner interdependence model.

Communal coping is a form of interpersonal coping that involves a shared illness appraisal and collaborating to address illness-related issues. We hypothesized that communal coping among couples in which one person is recently diagnosed with Type 2 diabetes would be related to better diabetes problem-solving, better mood, greater relationship quality, and less psychological distress for both partners. Communal coping was coded from videotaped interactions in which 119 heterosexual couples discussed difficulties in managing diabetes. Actor-partner interdependence models were performed to isolate associations of actor communal coping and partner communal coping with outcomes, and examined whether the couple-member had diabetes and sex as moderator variables. We expected that communal coping would be more beneficial for women than men, and that partner communal coping would be more strongly linked to outcomes than actor communal coping. Results were largely consistent with hypotheses, suggesting that communal coping is beneficial to couples coping with diabetes. (PsycINFO Database Record

Communal Coping and Adjustment to Chronic Illness: Theory Update and Evidence.

We present a theory of communal coping that describes an optimal pathway to patient adjustment among couples in which one person faces a chronic illness. Communal coping consists of a shared illness appraisal (i.e., person perceives illness as a joint rather than individual problem) and collaboration with a partner to manage the illness. We present a model of the communal coping process that links patient and partner shared illness appraisals to collaboration and a set of supportive interactions that might be reframed as collaboration in the presence of shared illness appraisals. We then outline a model that identifies potential antecedents of communal coping and mechanisms that link communal coping to patient illness adjustment (i.e., enhanced psychological well-being, improved health behaviors, better physical health) and partner psychological well-being. We review the empirical evidence for this model and conclude by identifying several moderator variables, noting potential limitations, and outlining future research directions.

Predicting the Pursuit and Support of Challenging Life Opportunities.

Deciding to embrace challenging opportunities may present one life context through which individuals may thrive, and these decisions may be influenced by one's significant relationships. Married couples were unobtrusively videotaped as one couple-member was presented with a challenging opportunity and decided whether to accept it. We assessed interpersonal predictors of the decision to accept or forgo the opportunity, predictors of the spouse's support during decision-making, and follow-up thriving outcomes 6 months later. Results indicated that specific support behaviors enacted by the spouse-relational catalyst (RC) support provision-encouraged decision-makers to accept the challenge and that this decision predicted long-term thriving outcomes for the decision-maker. Results also indicated that the spouse's support behavior was influenced by both chronic and experimentally manipulated motivations for providing support, and these motives provide pathways by which relationship satisfaction and attachment security predict the provision of RC support. Implications and directions for future research are discussed.

A Longitudinal Investigation of Relational Catalyst Support of Goal Strivings.

The goal of this work was to test a theoretical model of relational catalyst support provision that promotes thriving in non-adverse times. We tested a pathway proposed by Feeney and Collins (2014) that explains how relational catalyst support in the context of close relationships might lead to thriving. We proposed that once relational catalyst support has been received, it functions through the mechanisms of being perceived to be responsive to one's needs and promoting perceived capability. Perceived capability should promote indices of thriving including self-esteem, goal accomplishment, growth, and specific and general availability of support. This model was supported in two studies of married couples using observational and longitudinal methods surrounding the support of goal-strivings. Results indicate that (a) partner support of goal-strivings predicted important indicators of thriving over time, and (b) both received and perceived relational catalyst support work together and play important roles in predicting these outcomes.

Young at Heart: A Perspective for Advancing Research on Play in Adulthood.

Developmental and animal research has established play as important to well-being, yet little is known about implications of play by human adults, particularly within close relationships, where it is most likely to occur. Although this is an important emerging topic for psychology, several obstacles have impeded research in this area, including definitional issues and the lack of a guiding framework. In this article, we direct attention to this neglected research area and propose a perspective on play in adulthood that provides a definition of the construct (a behavior or activity that is carried out with the goal of amusement and fun, involves an enthusiastic and in-the-moment attitude or approach, and is highly interactive among play partners or with the activity itself) and identifies potential immediate outcomes (e.g., positive affect, feelings of being accepted and valued, reductions in daily stress) and long-term outcomes (e.g., psychological, physical, and relational health) of play in adulthood, with an emphasis on play occurring within the context of close relationships. In doing so, we elucidate important avenues for future research on this topic (e.g., development of standardized measures, examination of biological mechanisms), which is ripe for investigation.

Motivations for providing a secure base: links with attachment orientation and secure base support behavior.

This investigation examined the importance of underlying motivations in predicting secure base support behavior, as well as the extent to which support motivations are predicted by individual differences in attachment orientation. Participants were 189 married couples who participated in two laboratory sessions. During a questionnaire session, couples completed assessments of their underlying motivations for providing, and for not providing, support for their partner's exploration (i.e., goal-strivings), as well as assessments of their typical secure base support behavior. In an observational session, couples engaged in a discussion of one member's personal goals, during which the partner's secure base support was assessed. Results revealed a variety of distinct motivations for providing, and for not providing, secure base support to one's partner, as well as theoretically expected links between these motivations and both secure base behavior and attachment orientation. This work establishes motivations as important mechanisms that underlie the effective or ineffective provision of relational support.

Enacted support's links to negative affect and perceived support are more consistent with theory when social influences are isolated from trait influences.

Social support theory typically explains perceived support's link to mental health as reflecting the role of specific supportive actions (i.e., enacted support).Yet enacted support typically is not linked to mental health and perceived support as predicted by theory. The links are examined among enacted support, affect, and perceived support when links reflected (a) aspects of support and affect that generalized across relationship partners and time (i.e., trait influences) and (b) aspects that reflected specific relationship partners (i.e., social influences). Multivariate generalizability analyses indicated that enacted support was linked to low negative affect as predicted by theory only when correlations reflected social influences. When correlations reflected trait influences, enacted support was linked to high negative affect. Furthermore, perceived and enacted support were strongly linked when correlations reflected social influences but not trait influences. Thus, findings for enacted support fit social support theory better when social influences were isolated from trait influences.