Sex differences in testosterone reactivity during marital conflict.

When attempting to resolve relationship problems, individuals in close relationships sometimes challenge their partners with statements that oppose their partners' point of view. Such oppositional behaviors may undermine those partners' relational value and threaten their status within the relationship. We examined whether perceptions of opposition from a partner during a series of problem-solving interactions were associated with reactivity in testosterone levels and whether those associations were different for men and women. Fifty newlywed couples discussed four marital problems. Each member of the couple reported how much oppositional behavior they perceived from their partner during the discussions. Pre- and post-discussion saliva samples were assayed for testosterone. For men, but not for women, perceptions of oppositional behavior were associated with heightened testosterone reactivity, and this result replicated across three different measures of testosterone reactivity. Findings were specific to men's perceptions of oppositional behavior, and held controlling for objective measures of oppositional behavior coded from videos of the conversations. Results highlight the benefits of considering pair-bonded relationships as a novel context for investigating associations involving hormones and behavior. Findings also raise the possibility that sex differentiated hormonal reactions to opposition partly explain why conflict among heterosexual partners can be so divisive.

The partner's insecure attachment, depression and psychological well-being as predictors of diurnal cortisol patterns for breast cancer survivors and their spouses.

The purpose of this study was to explore whether stress from individual's and partner's depression, anxiety, sleep disturbances, insecure attachment and meaning in life were predictors of diurnal cortisol patterns in breast cancer survivors and their spouses. Thirty-four couple dyads participated in this eight-month follow-up study. The breast cancer survivors and their spouses completed the Medical Outcomes Study Sleep scale, the Beck Depression Inventory-II, the State Trait Anxiety Inventory, the Experiences in Close Relationships-Revised scale and the Meaning in Life Questionnaire, and they collected salivary cortisol at home at the time of awakening, 30 and 45 min after waking and at 1200 h, 1700 h and 2100 h. Diurnal cortisol slopes of survivors and spouses are positively correlated. But the factors associated with diurnal cortisol patterns are different between survivors and spouses. For survivors, neither survivor individuals' nor spouses' psychosocial factors were the predictors of survivors' diurnal cortisol patterns. For spouses, the survivors' higher anxious attachment style was the main predictor of spouses' flatter diurnal cortisol patterns. In conclusion, for spouses, psychophysiological stress responses are mainly influenced by breast cancer survivors' insecure attachment. Future couple supportive care interventions can address survivors' attachment styles in close relationships in order to improve neuroendocrine functions for both breast cancer survivors and their spouses.

"What's yours is mine": Partners' everyday emotional experiences and cortisol in older adult couples.

The existing literature consistently finds that emotional experiences and cortisol secretion are linked at the within-person level. Further, relationship partners tend to covary in emotional experience, and in cortisol secretion. However, we are only beginning to understand whether and how an individuals' emotions are linked to their relationship partners' cortisol secretion. In this project, we harmonized data from three intensive measurement studies originating from Canada and Germany to investigate the daily dynamics of emotions and cortisol within 321 older adult couples (age range=56-87 years). Three-level multilevel models accounted for the nested structure of the data (repeated assessments within individuals within couples). Actor-Partner Interdependence Models were used to examine the effect of own emotional experiences (actor effects) and partner emotional experiences (partner effects) on momentary and daily cortisol secretion. Adjusting for age, sex, education, comorbidities, assay version, diurnal cortisol rhythm, time spent together, medication, and time-varying behaviors that may increase cortisol secretion, results suggest that higher relationship partner's positive emotions are linked with lower momentary cortisol and total daily cortisol. Further, this association was stronger for older participants and those who reported higher relationship satisfaction. We did not find within-couple links between negative emotions and cortisol. Overall, our results suggest that one's relationship partner's positive emotional experience may be a protective factor for their physiological responding, and that these more fleeting and day-to-day fluctuations may accumulate over time, contributing to overall relationship satisfaction.

Attachment anxiety is linked to alterations in cortisol production and cellular immunity.

Although evidence suggests that attachment anxiety may increase risk for health problems, the mechanisms underlying these effects are not well understood. In the current study, married couples (N = 85) provided saliva samples over 3 days and blood samples on two occasions. Participants with higher attachment anxiety produced more cortisol and had fewer numbers of CD3(+) T cells, CD45(+) T cells, CD3(+)CD4(+) helper T cells, and CD3(+)CD8(+) cytotoxic T cells than participants with lower attachment anxiety. Higher cortisol levels were also related to fewer numbers of CD3(+), CD45(+), CD3(+)CD4(+), and CD3(+)CD8(+) cells, which is consistent with research showing that cortisol alters the cellular immune response. These data suggest that attachment anxiety may have physiological costs, and they provide a glimpse into the pathways through which social relationships affect health. The current study also extends attachment theory in an important new direction by demonstrating the utility of a psychoneuroimmunological approach to the study of attachment anxiety, stress, and health.

Autonomic reactivity and hypothalamic pituitary adrenal axis dysregulation in spouses of Oklahoma City bombing survivors 7 years after the attack.

OBJECTIVE: The objective of this exploratory pilot study was to examine autonomic reactivity and hypothalamic pituitary adrenal axis dysregulation in spouses of highly exposed survivors of the 1995 Oklahoma City bombing. METHODS: This study compared psychiatric diagnoses and biological stress markers (physiological reactivity and cortisol measures) in spouses of bombing survivors and matched community participants. Spouses were recruited through bombing survivors who participated in prior studies. Individuals with medical illnesses and those taking psychotropic medications that would confound biological stress measures were excluded. The final sample included 15 spouses and 15 community participants. The primary outcome measures were psychiatric diagnoses assessed with the Diagnostic Interview Schedule for DSM-IV (DIS-IV). Biological stress markers were physiological reactivity and recovery in heart rate and blood pressure responses to a trauma interview and cortisol (morning, afternoon, and diurnal variation). RESULTS: Compared to the community participants, spouses evidenced greater reactivity in heart rate, systolic blood pressure, and diastolic blood pressure; delayed recovery in systolic blood pressure; and higher afternoon salivary cortisol. CONCLUSIONS: The results support the need for further research in this area to clarify post-disaster effects on biological stress measures in the spouses of survivors and the potential significance of these effects and to address the needs of this important population which may be overlooked in recovery efforts.

You're under my skin: Long-term relationship and health correlates of cortisol synchrony in older couples.

Growing evidence points to systematic linkages in various physiological indices among romantic partners. This physiological synchrony may facilitate intimacy and connectedness in couples. However, synchronous increases in physiological arousal could also hamper the respective partners' health. To shed light on the consequences of physiological synchrony as well as their potential gender specificity, the current study examined associations between everyday cortisol synchrony and levels of and subsequent changes to relationship satisfaction and non-high-density lipoprotein (non-HDL) cholesterol levels over a 3-year period. Older couples (N = 85; age range = 60-87 years) provided saliva samples for cortisol estimation 5 times daily for 7 days. They further reported their relationship satisfaction and provided a blood sample that was analyzed for lipid levels up to three times in 1-year intervals. Data were analyzed using dyadic growth curve models. Among wives, higher cortisol synchrony was associated with stronger increases in relationship satisfaction over time (b = 1.61, p = .011) but also stronger increases in non-HDL cholesterol levels over time (b = 2.02, p = .042). For husbands, higher cortisol synchrony was not significantly associated with levels or changes of relationship satisfaction but with higher non-HDL cholesterol levels at Time 1 (b = 6.54, p = .015). Synchrony may be important for bonding and relationship maintenance. However, being strongly linked to a romantic partner's physiology may also have health costs due to the accumulative burden of repeated elevations in cortisol, possibly affecting husbands and wives in different ways. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Momentary work worries, marital disclosure, and salivary cortisol among parents of young children.

OBJECTIVE: To investigate whether worries about work are linked to people's own cortisol levels and their spouses' cortisol levels in everyday life and whether marital factors may moderate these links. Although research has shown that satisfying marriages can buffer the physiological effects of everyday stress, the specific mechanisms through which marriage influences the processing and transmission of stress have not yet been identified. METHODS: Thirty-seven healthy married couples completed baseline measures and then provided saliva samples and indicated their worries about work for six times a day from a Saturday morning through a Monday evening. RESULTS: Wives' cortisol levels were associated positively with their own work worries (p = .008) and with their husbands' work worries (p = .006). Husbands' cortisol levels were associated positively only with their own work worries (p = .015). Wives low in both marital satisfaction and disclosure showed a stronger association between work worries and cortisol compared with wives reporting either high marital satisfaction and/or high marital disclosure. CONCLUSIONS: These results suggest that momentary feelings of stress affect not only one's own cortisol levels but affect close others' cortisol levels as well. Furthermore, they suggest that, for women, the stress-buffering effects of a happy marriage may be partially explained by the extent to which they disclose their thoughts and feelings with their spouses.

Recovery of immune control over herpes simplex virus type 1 in female victims of intimate partner violence.

OBJECTIVES: To assess the course of immune control over Herpes simplex virus type 1 (HSV-1) through three salivary measures: neutralization of HSV-1, levels of specific antibody against HSV-1 (HSV-1-sIgA) and total immunoglobulin A (total sIgA), and to determine the factors that contribute to its recovery or deterioration. Several studies have demonstrated that intimate partner violence (IPV) affects immune responses in women, but none have investigated the impact longitudinally over time. METHODS: Women (n = 60), who participated in our previous cross-sectional study (T-1) and who had been either physically/psychologically (n = 22) or psychologically abused (n = 14) by their partners, were evaluated 3 years later (T-2). A control group of women (n = 24) was included for comparison. Saliva samples were collected twice a day (8 AM-9 AM, and 8 PM-9 PM) on 2 days spaced 2 weeks apart. Information about psychological and lifestyle variables was obtained by structured interviews. RESULTS: Physically/psychologically abused women had a significant improvement in both the capacity to neutralize HSV-1 and HSV-sIgA levels, and at T-2 the capacity of their saliva to inhibit virus was no longer different from the other two groups. Regression analysis indicated that the cessation of physical IPV was the main predictor of this recovery. CONCLUSIONS: This study shows that recovery of immune control over HSV-1 is possible in women who had been exposed to physical/psychological IPV despite an initially low antiviral capacity. Other longitudinal studies are needed to determine which factors best predict the restoration of physical and emotional well-being in order to design more effective intervention programs.

Couples' behavior during conflict in the lab and diurnal cortisol patterns in daily life.

The current study tested whether positive and negative behaviors exhibited by couples during conflict interactions assessed in the laboratory are associated with individuals' diurnal cortisol patterns (i.e., circadian rhythms in cortisol across the course of the day) outside of the lab. Participants (N = 82) provided a total of 18 salivary cortisol samples over a 3-day period and came into the lab with their spouse to engage in two ten-minute dyadic conflict discussions. These videotaped interactions were coded to assess the intensity with which couples displayed various positive behaviors (e.g., humor, affection) and negative behaviors (e.g., defensiveness, frustration) during the conflict discussions. Multi-level modeling was used to examine the associations between couples' positive and negative behavior during conflict discussions and diurnal cortisol patterns in daily life. Results showed links between overall positive, but not negative, behaviors and diurnal cortisol patterns. Individuals who experienced more positive behaviors with their partner during the conflict discussion showed a steeper ("healthier") cortisol slope across the day in their daily lives. Exploratory analyses investigating the association between specific positive and negative behaviors and diurnal cortisol revealed that affection and scorn were associated with diurnal cortisol patterns in daily life. This research advances our understanding of the impact of social relationships on physical health from a biopsychosocial perspective and has implications for understanding how the ways in which couples resolve conflict are linked to health-related biological processes in daily life.

Cortisol slopes and conflict: A spouse's perceived stress matters.

BACKGROUND: Perceived stress can lead to dysregulated cortisol patterns, including blunted peaks and flatter slopes, which are associated with increased morbidity and mortality risks. Couples' interdependence provides a prime opportunity for partners' stress to disrupt a healthy cortisol pattern. This study examined how individuals' own perceived stress and their partners' perceived stress shape cortisol levels and slopes across the day, as well as how positive and negative behaviors during conflict discussions impact associations between stress and cortisol. METHODS: Both partners of a married couple (n = 43 couples, 86 individuals) completed a full day in-person visit. Each partner completed the Perceived Stress Scale, and all couples engaged in a 20-min marital problem discussion which was recorded and later coded for positive and negative behaviors using the Rapid Marital Interaction Coding System (RMICS). Partners also provided five salivary cortisol samples across the day, two samples before the conflict and three after the conflict. The dyadic design and analyses provided a way to account for the interdependent nature of married couples' data, as well as to use the Actor-Partner Interdependence Model (APIM) to assess the mutual influence of spouses' stress on cortisol. RESULTS: Individuals with more stressed partners had flatter cortisol slopes than individuals with less stressed partners, who showed steeper and thus healthier declines across the day. Individuals' cortisol levels at the beginning of the day were similar regardless of their partners' perceived stress, but individuals with more stressed partners had higher cortisol levels 30-min, 1 h, and 4 h after the conflict discussion than those with less stressed partners. Couples' behavior during the conflict moderated the relationship between partner perceived stress and average cortisol; when couples used more negative and less positive behaviors, individuals with more stressed partners had higher average cortisol levels than those with less stressed partners. CONCLUSION: On a day couples experienced conflict, having a partner with higher perceived stress is associated with dysregulated cortisol patterns, including higher levels and flatter slopes, but having a partner with lower perceived stress is linked to steeper and thus healthier cortisol declines. A partner's stress was particularly consequential for one's own cortisol when couples used more negative and fewer positive behaviors during a conflict discussion. This research adds to the growing literature on pathways connecting marital interactions to important biorhythms and health.

Dyadic coping and the cortisol:CRP ratio: How marital stress influences physiological state.

Although previous data indicate that dyadic coping is associated with Hypothalamic-Pituitary-Adrenal (HPA-axis and C-reactive protein (CRP) separately, no study has reported on the ratio between these two systems and dyadic coping, despite this index of physiological homeostasis being associated with physical health and depression. Forty-eight community volunteers who were either married (n = 36) or cohabiting (n = 12) provided saliva and serum samples, and also completed a dyadic coping inventory. There was a significant inverse correlation between cortisol:CRP ratio and dyadic coping, but only for married participants. One of the six dyadic coping items, related to being able to calmly discuss something within a dyad, was the key factor in the association between dyadic coping and cortisol:CRP ratio. These findings provide some initial support for the influence of the way that spouses interact to solve problems and the balance between their HPA and immune systems.

Quality of life and psychiatric morbidity in patients successfully treated for oral cavity squamous cell cancer and their wives.

PURPOSE: To assess quality of life (QOL) and psychiatric morbidity in successfully treated oral cavity squamous cell cancer (OC-SCC) survivors and their wives. PATIENTS AND METHODS: Thirty-one men successfully treated for OC-SCC (mean, 3.7 years since diagnosis; UICC stages I to IV) together with their wives were assessed by questionnaires referring to QOL (WHOQOL-BREF), physical complaints (EORTC QOL-H&N35), and symptoms of anxiety and depression (HADS). Prevalence of psychiatric disorders was assessed by the Mini International Neuropsychiatric Interview (M.I.N.I.). RESULTS: Irrespective of tumor stage, a considerably high global QOL both in OC-SCC survivors and their wives could be detected when compared with an age-matched cancer-free population. No significant difference between the mean scores of 4 domains of the QOL (exception: environmental domain) was found between patients and their wives. In patients, lower QOL was associated with more physical complaints (social eating, swallowing, and pain) and higher levels of psychological distress (HADS); whereas in wives, QOL was found to be related to levels of psychological distress. In the M.I.N.I., a high prevalence of psychiatric disorders, particularly anxiety disorders, was found in wives (38.7%); but was lower in patients (16.2%). Patients and wives diagnosed with a psychiatric disorder reported significantly lower QOL. CONCLUSION: Both in OC-SCC patients and their wives a considerably high overall QOL can be found. "Social eating," "swallowing," and "sexuality" in patients and psychiatric disorders in wives seem to be strongly related to global QOL. The high prevalence of anxiety disorders in wives, however, should alert clinicians and the health care community. Thus, surgical improvement of somatic problems and treatment of psychiatric disorders should be addressed in individuals reporting an impaired global QOL.

Adult adiposity linked to relationship hostility for low-cortisol reactors.

Past research on the relation between hostility in intimate relationships and adiposity has yielded mixed findings. The present study investigated whether the association between relationship hostility and adiposity is moderated by people's biological reactions to couple conflict. Cohabiting adult couples (N = 117 couples) engaged in two conflict interactions, before and after which salivary cortisol levels were measured. Results revealed an association between relationship hostility and adiposity, but this association was concentrated among people with relatively low levels of cortisol reactivity to couple conflict. Results are interpreted in light of research demonstrating that cortisol reactivity can become blunted over time in response to repeated stressors. These results provide precision to etiological models of obesity by identifying cortisol reactivity as a factor that moderates the association between relationship hostility and adiposity. (PsycINFO Database Record

Ecologically salient stressors and supports and the coordination of cortisol and salivary alpha-amylase in mothers and infants.

This study examines the integration of the two main branches of the stress response system: the autonomic nervous system (via salivary alpha-amylase, sAA) and the hypothalamic-pituitary-adrenal axis (via cortisol). Mothers (n = 117) were randomized to have either a positive (n = 57) or conflictual (n = 60) discussion with their marital partner, after which mothers and infants (Mage = 5.9 months) engaged in free-play, followed by an infant-focused challenge task. Saliva samples were collected from the mother to assess physiological reactivity and recovery to the marital discussion, and from the infant to assess physiological reactivity and recovery to the challenge task. For both mothers and infants, sAA - cortisol coordination varied across the respective tasks. Further, findings suggest the sAA - cortisol connection is under social control, with stress response system coordination occurring only in supportive social relationships (i.e., mothers experiencing cohesive marital discussions, and in infants with sensitive and responsive mothers). Interestingly, however, it appears social support might function differently in mothers vs infants. Findings advance our understanding of the complex integration of stress physiology in the context of social relationships.

Thoughts after marital conflict and punch biopsy wounds: Age-graded pathways to healing.

Thoughts and emotions following marital conflict have received little attention but almost certainly contribute to marriage's long-term health effects. Consistent with emotion theories of aging, we expected the effects of post-conflict thoughts on important neuroendocrine and immune outcomes, cortisol levels and full-thickness wound healing, to differ by age. An age-diverse sample of married couples received a punch biopsy wound and discussed a marital problem, then privately recorded their thoughts and rated their mood. Salivary cortisol was sampled throughout the day, and wound healing was measured for 32days. Older adults reported more positive mood post-conflict than younger adults. Thoughts with more positive emotional content related to lower subsequent cortisol levels. Only older adults who expressed more positive thoughts after conflict experienced faster wound healing, not younger adults. These findings point to the increased physiological importance of regulatory post-stressor processes in older age, and broaden our understanding of social-emotional age differences in close relationships. These data also stimulate questions of whether marriage has more widespread health consequences for older partners, undetected in studies of short-term outcomes.

[Treatment of snoring by a Herbst-activator. Satisfaction of patient and bedfellow]. / Behandeling van snurken met een Herbst-activator. Tevredenheid van patiënten en partners.

Snoring is primarily a social problem which for instance brings considerable pressure on someone's conjugal relationship. Often treatment is demanded by the bedfellow. Patient as well as bedfellow needs to be involved in the treatment of the problem. In this study, twenty-three habitual snorers and their bedfellows completed a questionnaire concerning the effect of the treatment of snoring by a Herbst-activator before treatment and 3 and 6 months after treatment. Two-thirds of the patients and bedfellows were satisfied with the therapy results. The bedfellows exhibited an even more positive therapy effect than the patients.

A descriptive study on demographic and behavioral characteristics of males and their responses to a male involvement intervention in Blantyre, Malawi.

INTRODUCTION: Male involvement (MI) remains a key factor in the enrollment and retention of pregnant women in the Prevention of Mother to child transmission (PMTCT) of Human Immunodeficiency Virus (HIV) services. The objective of this study was to describe the characteristics of men who accompanied their partners for PMTCT services and secondly, describe the reported reasons for the non-reporting by men for the services in Blantyre, Malawi. METHODS: All men included in this analysis were partners of pregnant women enrolled in a MI in PMTCT randomized controlled trial (RCT), which took place in Blantyre, Malawi from 14 June 2013 to 24 February 2014. After randomization women were asked to invite their male partners for PMTCT services either through an invitation card or word of mouth invite. Descriptive statistics were tabulated using Stata. RESULTS: Of the 462 women randomized, 109 (23.59%) women came back to the clinic with their male partner following the intervention. The majority, 307 (66.5%) women returned to the clinic without their partners. Although most men accepted the intervention, some failed to accompany their partners because of work obligations, a lack of interest in accompanying their partners for the service, and others promised to report at the next clinic visit. CONCLUSION: The characteristics of men that reported were similar in the two groups, suggesting that demographic characteristics may not greatly influence their decision to be involved in PMTCT services. There is need to develop more flexible strategies to include men in PMTCT programmes.

Clinical audit of subjects with snoring & sleep apnoea/hypopnoea syndrome fitted with mandibular repositioning splint.

Snoring and obstructive sleep apnoea/hypopnoea syndrome (OSAHS) are often treated with mandibular repositioning splints (MRS), but the efficacy and satisfaction of them has not been comprehensively addressed. A survey on the use of and satisfaction with MRS was posted to 177 patients referred by a hospital orthodontic department for custom-fitting of a MRS. Data were analysed using non-parametric techniques. The response rate was 81% (n=144). Responders (30F, 114M) had mean (SD) age of 51 (11) years, apnoea+hypopnoea index (AHI) of 24 (21) per hr and Epworth Score of 10 (5) at diagnosis, and had been supplied with their MRS a median 7 (IQR 5-11) months previously. Fifty of the 144 patients (35%) had been offered continuous positive airway pressure (CPAP) treatment but had declined or abandoned this. Self-reported MRS use was 5 (2) h/night, with 74 of the 144 patients (51%) continuing to use MRS at least occasionally at a median 7 months after fitting. Survival analysis showed 12% still using MRS at 12 months. Epworth score fell slightly with MRS therapy [-2.4 (3.5); P=0.005] and 7 daytime and 2 nocturnal symptoms improved in MRS users (all P<0.05). Marital satisfaction did not change with MRS. Problems preventing MRS use in 70 non-users included: non-retention (n=12), sore mouth (n=13) or jaw (n=7), difficulties falling asleep (n=10) or breathing (n=7), excessive salivation (n=4), dental damage (n=4) and other problems (n=3). Continued use of MRS therapy was associated with a higher number of teeth, low marital satisfaction perceived by partners and greater improvement in symptoms reported by patients and partners. Continuance with MRS may be low and linked to tolerance problems.