A tale of two marital stressors: Comparing proinflammatory responses to partner distress and marital conflict.

Marital quality shares ties to inflammatory conditions like cardiovascular disease and diabetes. For decades, research has focused on marital conflict as a primary mechanism given its potential to trigger inflammatory responses. However, longitudinal evidence suggests that marital conflict declines over time, and little attention has been paid to the inflammatory aftermath of other types of marital exchanges. A spouse's emotional distress is an important but overlooked marital context, as partners are exposed to each other's upsetting emotions throughout adulthood. To directly compare reactivity in proinflammatory gene expression to these two marital stressors and to examine differences by age and marital satisfaction, 203 community adults ages 25-90 (N = 102 couples) provided blood samples and rated their negative mood before and after they 1) watched their partner relive an upsetting personal memory and, in a separate visit 1-2 weeks later, 2) discussed a conflictual topic in their relationship. Controlling for age, sex, race/ethnicity, BMI, alcohol use, smoking, and comorbidities, increases in proinflammatory gene expression were significantly larger after the partner's upsetting disclosure than after marital conflict (B = 0.073, SE = 0.031, p = .018). This pattern paralleled emotional reactivity to the tasks, wherein negative mood rose more in response to the partner's disclosure than to marital conflict (B = 4.305, SE = 1.468, p = .004). In sum, proinflammatory and mood reactivity to spousal distress exceeded reactivity to marital conflict, a well-established marital stressor. Findings reveal spousal distress as a novel mechanism that may link marriage to inflammation-related diseases, and even pose risks for both happy and unhappy couples across adulthood.

Longitudinal Links Between Parental Emotional Distress and Adolescent Delinquency: The Role of Marital Conflict and Parent-Child Conflict.

The mediating processes linking parental emotional distress and changes in adolescent delinquency over time are poorly understood. The current study examined this question using data from 457 adolescents (49.5% female; 89.5% White; assessed at ages 11, 12, and 15) and their parents, part of the national, longitudinal Study of Early Child Care and Youth Development (SECCYD). Maternal depression was only directly associated with changes in adolescent delinquency. Paternal depression was indirectly associated with changes in adolescent delinquency through a partner effect on mother-child conflict. The findings indicate the salience of parental depression and mother-child conflict for increases in adolescent delinquency and highlight the importance of including parental actor and partner effects for a more comprehensive understanding of the tested associations.

Marital Conflict and Healthy Dietary Habits Among Preschoolers: A Study of the Experience of Coupled Women in Urban Mexico.

In Mexico social dynamics are changing toward less traditional arrangements. With a qualitative interview study, we explore the link between marital conflict and mothers' ability to foster healthy dietary habits. Sample consisted of 21 middle-class cohabitating mothers of preschoolers. Results suggests that marital conflict leads women to experiences of tension, ambivalence, or inaction on fostering healthy eating habits. Parents' mismatch in gender beliefs, food preferences, time orientation, and risk aversion play a role in creating disagreements. When men participate, women feel "helped" and grateful, but the forms and extent of desired participation may vary among traditional, ambivalent and non-traditional women.

Parental Problem Drinking and Maladaptive Personality Features in Children: The Role of Marital Conflict.

The personality characteristics of children of exposed to parental problem drinking have been of interest to clinicians and researchers for several decades, but personality research on this population often focuses on identifying a unique cluster of adult personality traits. The current study adopts a cutting-edge dimensional approach to understanding personality pathology as extreme variants of the five factor model, and examines pathways of risk to personality pathology through marital conflict and emotional insecurity. Participants were 199 two-parent families with a child between the ages of 6 and 12 years. Parents completed questionnaire measures of their problem drinking, marital conflict, child emotional insecurity (i.e., emotional reactivity to conflict), and child maladaptive personality traits. Structural equation models found an indirect pathway from mother and father problem drinking to pathological child disagreeableness, introversion, emotional instability, and compulsivity via greater mother destructive marital conflict behavior and child emotional reactivity to conflict. There was also some evidence that this pathway of effects was stronger for girls than for boys. Findings support the use of a dimensional approach to understanding maladaptive personality among individuals exposed to parental problem drinking.

A Dyadic Investigation of Depressed Affect and Interspousal Behavior in Couples With Chronic Back Pain.

BACKGROUND: Depression and marital discord are characteristic not only of individuals with chronic low back pain (ICPs) but also of their spouses. PURPOSE: We examined actor-partner interdependence models to evaluate associations among depressed affect and criticism and support of partners at the same time point (concurrent effects) and 3 hr later (lagged effects). Fully dyadic models were used to account for both within-person and cross-spouse associations among depressed affect, criticism, and support for ICPs and spouses. We also examined the direction of the relationships (depressed affect predicting behavior and behavior predicting depressed affect) all while controlling for pain intensity, pain behavior, and the prior dependent variable. METHODS: ICPs (n = 105) and their spouses completed electronic diary measures of depressed affect and behavior (criticism and support) five times a day for 2 weeks. Hierarchical linear modeling with person-mean centering was used for data analysis. RESULTS: Within the same 3 hr epoch, more depressed affect was related to higher criticism and generally less support. Lagged analyses suggested bidirectional relationships between spouse's own depressed affect and spouse's own criticism of ICPs. Spouse depressed affect was also associated with decreased support received from ICPs. Pain behavior and pain intensity were also related to depressed affect, criticism, and support especially concurrently. CONCLUSIONS: Theories and interventions need to address not only ICP depressed affect but also spouse depressed affect, as spouse depressed affect may be a stress generating precursor to criticism and support.

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. 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 longitudinal links between marital conflict and Chinese children's internalizing problems in mainland China: Mediating role of maternal parenting styles.

The present study explored the role of parenting styles as mediating mechanisms in the link between marital conflict and Chinese children's internalizing problems. Participants were N = 1269 families (mothers, fathers, and children) from Shanghai, P. R. China. Multisource assessments were employed at three time points. Mothers and fathers reported their marital conflict and parenting styles (authoritative, authoritarian) and teachers and children reported on children's internalizing problems. Results from the Actor-Partner Interdependence Model (APIM) showed significant actor and partner effects for associations between marital conflict and parenting styles. After controlling for internalizing problems at Time 1, only maternal authoritarian parenting continued to mediate the relations between mothers' reported marital conflict and change in children's internalizing problems over time. This research provides valuable information about how important aspects of parenting influence the relations between marital conflict and internalizing problems among Chinese children.

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.

Couple relationship problems-a task for the general practitioner? A cross-sectional survey from Norway.

BACKGROUND: A healthy couple relationship is a predictor of good health. There is a lack of knowledge about what role family and couples counselling should have in general practice. OBJECTIVES: To identify the prevalence of patients who have talked, or want to talk, with their general practitioner (GP) about their couple relationship, to investigate what characterizes these patients and to explore whether they believe that couple relationship problems should be dealt with in general practice. METHODS: We conducted a cross-sectional survey in 70 general practices in Norway during spring 2019. A questionnaire was answered by 2178 consecutive patients (response rate 75%) in GP waiting rooms. Data were examined using frequencies and linear and logistic regression models. RESULTS: We included 2097 responses. Mean age was 49.0 years and 61.3% were women. One in four (25.0%) had already talked with their GP about couple relationship problems, while one in three (33.5%) wanted to talk with their GP about their couple relationship problems. These patients more frequently had experience of divorce, poor self-rated health, an opinion that their couple relationship had a significant impact on their health and lower couple relationship quality when adjusted for age, sex, present marital status and children living at home. We found that 46.4% of patients believed that GPs should be interested in their couple relationship problems. CONCLUSION: Relationship problems are frequently addressed in general practice. GPs should be prepared to discuss this issue to facilitate help for couples earlier than they might otherwise expect.

Informative title: Effects of social support, parenting stress and self-efficacy on postpartum depression among adolescent mothers in Jordan.

AIM AND OBJECTIVE: This study investigated the effects of social support, parenting stress and maternal self-efficacy on postpartum depression among adolescent mothers in Jordan. BACKGROUND: Adolescent pregnancy may have serious health, social and economic consequences for young women, families and communities. In Jordan, the incidence of adolescent pregnancy has increased from 5% in 2012 to 15% in 2018. Little attention has been given to postpartum depression among adolescent mothers in Arab and Middle Eastern countries. METHOD: In a cross-sectional design using convenience sampling, 200 women aged less than 20 years, six to eight weeks postpartum and who could speak and read Arabic were interviewed in a participating health clinic. The interview occurred before or after a woman's scheduled clinic appointment and included socio-demographic data, Edinburgh Postnatal Depression Scale (EPDS), Maternity Social Support Scale (MSSS), Parenting Stress Scale (PSS) and Perceived Self-efficacy Scale (PSES). Data collection took place between December of 2018 and April of 2019. Reporting followed the STROBE guidelines. RESULTS: Results revealed that 28.5% of adolescent mothers had probable postpartum depression. Mothers who reported high social support, high parenting stress, low self-efficacy, financial stress and marital conflict had significantly higher EPDS scores than those who did not report these stressors. CONCLUSION: Prevalence of postpartum depression reported in this study warrants immediate action on early assessment, detection and intervention. High levels of social support may feel overwhelming for young mothers and contribute to high parenting stress, low maternal self-efficacy and marital conflict. RELEVANCE TO CLINICAL PRACTICE: Adolescent mothers are at increased risk of PPD compared to mothers over 20 years of age. Perceived quality rather than availability of social support needs to be considered. Young mothers require education and early intervention prevention strategies to better prepared them for motherhood and manage stressors associated with their changing social role.

The Contribution of Stressful Marital Interactions to Loneliness and Health across Mid-life and Later Adulthood.

Although past research has noted longitudinal, and sometimes bi-directional, associations between marital interactions, loneliness, and physical health, previous work has not identified long-term associations and differential associations over life-course stages (i.e., mid-life and later adulthood). Utilizing a life-course stress process perspective and a sample of 250 couples in enduring marriages over 17 years (2001-2017), a structural equation model within a dyadic framework assessed the unique influences of stressful marital interactions on loneliness and physical health and the variation in bi-directional influences of loneliness and physical health over time. Marital interactions were relatively stable across life stages, yet marital interactions appear to influence loneliness and physical health. Notable distinctions were evident across life stages (from mid-life to later adulthood and then within later adulthood). Findings are discussed with an emphasis on the implications for health promotion and prevention programs targeting couples' quality of life in later years.

Honey, Do I Look Fat? Perceptions of Spouses' Weight and Weight Concerns Predict Marital Relationship Quality.

The majority of adults in the United States are overweight or obese, and yet Western ideals of beauty mean that low body fat composition is a component of physical attractiveness. In turn, perceived discrepancies between actual and ideal body shape and weight mean that many adults experience weight concerns-- and they also may be dissatisfied with their spouse's weight. This study examined whether weight concerns were linked to romantic relationship quality, an important domain of adult development. Specifically, we applied the Actor-Partner Interdependence Model to test how wives' and husbands' weight concerns and perceptions of their spouses' overweight contributed to their own and their spouse's reports of marital satisfaction and conflict over time. The sample was 197 heterosexual married couples (M age = 40.85 and 42.81 years for wives and husbands, respectively; M length of marriage = 18.6 years at Time 1) with children, who participated in a short-term longitudinal study of family relationships and adolescent development. Two-way interactions between partner perceptions of spouses' weight and gender indicated that husbands' perceptions that their wives were overweight predicted decreases in wives' marital satisfaction and increases in wives' reports of marital conflict across one year. In contrast, wives' perceptions of husbands' weight were not associated with changes in husbands' marital satisfaction or conflict. A two-way interaction between actor and partner weight concerns indicated that individuals reported more marital conflict when there was a discrepancy between their own and their spouse's weight concerns. Finally, a two-way interaction between actor and partner perceptions of spouse's weight indicated that, for individuals whose spouses rated them as below ideal weight, their perceptions of the spouse's overweight predicted their own lower marital satisfaction. Findings suggest that concerns about one's own and one's spouse's weight have negative ramifications for marital relationships.

The Mediator Role of Aggression in the Relationship between Marital Stress and Depression among Patients with Coronary Artery Disease.

BACKGROUND: Depression is one of the most important consequences of cardiovascular diseases (CVDs), and to control and treat it, it is necessary to identify its direct and indirect triggers and underlying factors. Therefore, the current study aims to evaluate and investigate the mediator role of aggression in the relationship between marital stress and depression. METHODS: The sample of current cross-sectional study includes 212 patients with coronary artery disease (CAD) in Iran evaluated from Jan to Jun 2017. The required data were gathered using Beck's Depression Inventory (BDI) questionnaire, Buss and Perry's Aggression Questionnaire (BPAQ), and Hudson's Marital Satisfaction Index (HMSI). The data were analysed using Pearson's correlation coefficient and structural equation modeling (SEM) using SPSS20 and AMOS software. RESULTS: The mean age of participants (68.4% male) was 58.5 ± 8.9. The results show that there is a significant positive relationship between all the variables (P < 0.05). The results of the model show that marital stress cannot directly predict depression (P = 0.586). However, through aggression, marital stress can significantly predict 18% of the variance of depression (P < 0.001). CONCLUSIONS: Not directly, but indirectly through aggression, marital stress can significantly predict increased depression among patients with CAD. The physiological and psychological pathways of the findings can be discussed.

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.

Cardiovascular Reactivity During Marital Conflict in Laboratory and Naturalistic Settings: Differential Associations with Relationship and Individual Functioning Across Contexts.

Cardiovascular reactivity during spousal conflict is considered to be one of the main pathways for relationship distress to impact physical, mental, and relationship health. However, the magnitude of association between cardiovascular reactivity during laboratory marital conflict and relationship functioning is small and inconsistent given the scope of its importance in theoretical models of intimate relationships. This study tests the possibility that cardiovascular data collected in laboratory settings downwardly bias the magnitude of these associations when compared to measures obtained in naturalistic settings. Ambulatory cardiovascular reactivity data were collected from 20 couples during two relationship conflicts in a research laboratory, two planned relationship conflicts at couples' homes, and two spontaneous relationship conflicts during couples' daily lives. Associations between self-report measures of relationship functioning, individual functioning, and cardiovascular reactivity across settings are tested using multilevel models. Cardiovascular reactivity was significantly larger during planned and spontaneous relationship conflicts in naturalistic settings than during planned relationship conflicts in the laboratory. Similarly, associations with relationship and individual functioning variables were statistically significantly larger for cardiovascular data collected in naturalistic settings than the same data collected in the laboratory. Our findings suggest that cardiovascular reactivity during spousal conflict in naturalistic settings is statistically significantly different from that elicited in laboratory settings both in magnitude and in the pattern of associations with a wide range of inter- and intrapersonal variables. These differences in findings across laboratory and naturalistic physiological responses highlight the value of testing physiological phenomena across interaction contexts in romantic relationships.

Marital Interactions, Family Intervention, and Disagreements: A Daily Diary Study in a Low-income Sample.

Little research has examined associations between low-income married couples' daily interactions and severity of disagreements. Similarly, few researchers have considered how family-strengthening interventions for low-income couples may affect the quality of daily interactions and associations between interactions and conflict experiences. This study aims to fill these gaps in the literature by leveraging daily diary data from a random assignment study of a family-strengthening intervention with low-income husbands and wives 30 months postenrollment. Married couples randomly assigned to the intervention participated in 10 weeks of relationship education services. Control group couples received no services. Thirty months postrandom assignment, participants reported on the severity of daily marital disagreements over a 15-day period, as well as their positive and negative emotions during inter-spousal interactions. Multi-level models demonstrated associations between reports of emotions in interactions and severity of disagreements. In addition, wives assigned to the family strengthening program reported fewer negative emotions during interactions at follow-up than wives in the control condition. Finally, negative associations between positive emotions in interactions and severity of disagreements were stronger for wives assigned to the intervention, while positive associations between negative emotions in interactions and severity of disagreements were weaker for wives assigned to the intervention. Implications for future research and intervention development are discussed.

Observed Relationship Behaviors and Sleep in Military Veterans and Their Partners.

BACKGROUND: Emerging research has begun to examine associations between relationship functioning and sleep. However, these studies have largely relied on self-reported evaluations of relationships and/or of sleep, which may be vulnerable to bias. PURPOSE: The purpose of the study was to examine associations between relationship functioning and sleep in military couples. This is the first research to examine associations between observed relationship behaviors and subjective and polysomnographically measured sleep in a sample at-risk for both sleep and relationship problems. METHODS: The sample included 35 military veterans and their spouses/partners. Marital functioning was coded from a videotaped conflict interaction. Analyses focused on behavioral codes of hostility and relationship-enhancing attributions. Sleep was assessed via self-report and in-home polysomnography. RESULTS: Greater hostility was associated with poorer sleep efficiency for oneself (b = -0.195, p = .013). In contrast, greater relationship-enhancing attributions were associated with higher percentages of stage N3 sleep (b = 0.239, p = .028). Partners' hostility was also positively associated with higher percentages of stage N3 sleep (b = 0.272, p = .010). Neither hostility nor relationship-enhancing attributions was associated with self-reported sleep quality, percentage of REM sleep, or total sleep time. CONCLUSIONS: Both partners' positive and negative behaviors during conflict interactions were related to sleep quality. These findings highlight the role that effective communication and conflict resolution skills may play in shaping not only the marital health of veterans and their spouses but also the physical health of both partners as well. Understanding the links between relationship functioning and sleep may be important targets of intervention in the aftermath of war.

Psychosocial Factors Related to the Intergenerational Transmission of Externalizing Behaviors in Early Midlife.

BACKGROUND: To study the intergenerational transmission of externalizing behaviors. METHODS: Participants came from a community-based random sample of residents in two upstate New York counties (N = 548). Data were collected from mothers at mean age 40 and from their children from adolescence (mean age = 14, SD = 2.8) to early midlife (mean age = 43, SD = 2.8) at seven time points. Structural equation modeling (SEM) was used to study the psychosocial factors as related to externalizing behaviors in early midlife. RESULTS: First, maternal externalizing behaviors were indirectly associated with the offspring's externalizing behaviors through the offspring's substance use in adolescence, the offspring's partner's smoking patterns, and the offspring's marital conflict. Second, maternal cigarette smoking was indirectly associated with the offspring's externalizing behaviors through the offspring's substance use in adolescence, the offspring's partner's cigarette smoking, and the offspring's marital conflict. Third, maternal marital conflict had an indirect effect on the offspring's externalizing behaviors, mediated by offspring marital conflict. CONCLUSIONS: The finding that externalizing behaviors can be transmitted from parent to child informs the need for family-based interventions that are appropriate to adolescents.

Child Characteristics, Parent Education and Depressive Symptoms, and Marital Conflict Predicting Trajectories of Parenting Behavior from Childhood Through Early Adolescence in Taiwan.

The study examined how child and parent characteristics, and contextual sources of stress, such as marital conflict predict initial status and trajectories of parent involvement, support, and harsh control, over a 4-year period in families in Taiwan (n = 4,754). Based on Belsky's (1984) ecological model of parenting, three domains predicting parenting were tested, child characteristics (age cohort and gender), father and mother characteristics (education and depressive symptoms), and contextual sources of stress (marital conflict). The study followed two cohorts of children; the younger cohort was followed from first to fourth grade and the older cohort from fourth to seventh grade. Initially, fourth graders reported more parental involvement, support, and harsh control than first graders. However, involvement, support, and harsh control decreased across the 4 years for the older cohort as they transitioned to early adolescence. In the first year, girls reported more parental involvement and support and less harsh control than boys. Across the 4 years, involvement and support increased, and harsh control decreased for boys; whereas involvement stayed the same, support slightly decreased, and harsh control slightly increased for girls. Children whose parents were more educated reported more parent involvement, support, and harsh control in the first year. Children whose fathers were chronically depressed and whose parents were experiencing marital conflict reported decreasing parent involvement and support over the years.

Neighborhood Collective Efficacy Moderates the Association between Maternal Adverse Childhood Experiences and Marital Conflict.

In a socio-demographically diverse sample of 501 caregivers participating in a longitudinal birth cohort study during the childbearing years, we examined whether neighborhood collective efficacy moderated the association between maternal adverse childhood experience (ACEs) and marital conflict. Maternal ACEs were assessed via retrospective reports. Neighborhood collective efficacy was measured via maternal and paternal reports at 2 months, and maternal reports of marital conflict were collected at infant age 2 and 18 months. Multiple linear regression analyses revealed that maternal ACEs were associated with increased marital conflict. Neighborhood collective efficacy moderated the association between early maternal ACEs and marital conflict, such that mothers experiencing ACEs had lower levels of marital conflict when exposed to high levels of neighborhood collective efficacy. Results suggest that extra-familial sources of social support and control, such as feelings of security, trust, order, and connectedness with others, may buffer the effects of early adversity on marital discord.