-
Aging & Mental Health Apr 2023Research suggests that the death of a spouse has an adverse effect on a widow(er)'s cognition. However, little research has examined how the marital context before...
Research suggests that the death of a spouse has an adverse effect on a widow(er)'s cognition. However, little research has examined how the marital context before widowhood and gender influence this association. Guided by the social ambivalence and disease (SAD) model, this study examined the associations between spousal loss and cognition , with moderating effects of gender and pre-loss marital quality. We analyzed a national longitudinal data, Midlife in the United States (MIDUS), specifically MIDUS 2 (2004-2005) and MIDUS 3 (2013-2014). The analytic sample consisted of (1) 146 participants who experienced the death of their spouse between MIDUS 2 and MIDUS 3 and (2) 144 age- and gender-matched comparison participants who did not lose their spouse during the period. Adverse influence of widowhood on cognition was more pronounced among bereaved men than bereaved women. Widowed individuals whose relationships with their deceased spouse were ambivalent had poorer cognition than widowed individuals who had aversive relationships with their deceased spouse. Findings suggest that the influence of spousal death on cognitive functioning depends on gender and pre-loss marital quality, emphasizing the importance of considering pre-loss marital relationship and gender dynamics in developing efficient interventions for the widowed.
Topics: Male; Humans; Female; United States; Marriage; Cognition; Spouses; Affect; Gender Identity; Widowhood
PubMed: 35696361
DOI: 10.1080/13607863.2022.2084715 -
Child Abuse & Neglect Jun 2022Childhood maltreatment increases the risk of depression, especially after experiencing a stressful life event, such as bereavement. Employing emotion regulation...
BACKGROUND
Childhood maltreatment increases the risk of depression, especially after experiencing a stressful life event, such as bereavement. Employing emotion regulation strategies can mitigate the impact childhood maltreatment has on depression later in life following the loss of a spouse.
OBJECTIVE
We evaluated how cognitive reappraisal and expressive suppression moderated the impact of childhood maltreatment and depressive symptoms following spousal bereavement.
PARTICIPANTS AND SETTING
We examined 130 bereaved individuals 3 months after the death of a spouse, 4 months after the death of a spouse, and 6 months after the death of a spouse.
METHODS
We utilized a mixed model approach to test the interaction between childhood maltreatment and cognitive reappraisal and between childhood maltreatment and expressive suppression to predict depressive symptoms across 3 time points.
RESULTS
Cognitive reappraisal moderated the relationship between childhood maltreatment and depressive symptoms (b = - 0.17,p = .003); expressive suppression did not (b = 0.06,p = .452). Participants who used less cognitive reappraisal had a positive relationship between childhood maltreatment and depressive symptoms (b = 3.27,p < .001);participants who used more cognitive reappraisal did not (b = 1.09,p = .065).
CONCLUSIONS
Childhood maltreatment interacted with cognitive reappraisal, but not expressive suppression, to predict depressive symptoms following spousal bereavement. This study reveals how emotion regulation strategies can be utilized as a tool to buffer the impact of childhood maltreatment on mental health following a stressor later in life, which can serve as a target for future interventions for individuals experiencing a stressful life event.
Topics: Bereavement; Child; Child Abuse; Depression; Emotional Regulation; Humans; Spouses
PubMed: 35344805
DOI: 10.1016/j.chiabu.2022.105618 -
Supportive Care in Cancer : Official... May 2022In efforts to understand financial distress (FD) associated with advanced cancer care from the perspective of both patients with incurable disease and their spousal...
PURPOSE
In efforts to understand financial distress (FD) associated with advanced cancer care from the perspective of both patients with incurable disease and their spousal caregivers, we assessed FD in both members of the couple, identified symptom and quality of life (QOL) correlates, and examined the potential role of illness communication.
METHODS
Patients undergoing treatment for stage III/IV lung cancer or a grade III/IV primary brain tumor and their spousal caregivers (n = 76 dyads) completed measures of somatic and affective symptoms including FD, physical and mental QOL, and ease of engaging in illness communication. Patients and caregivers additionally rated their perception of each other's symptoms, including FD.
RESULTS
FD was endorsed by both patients (any FD 62.7%; high FD 24%) and spousal caregivers (any FD 64.7%; high FD 32.3%). Self-reported FD was significantly correlated (partial r = .52, p < .001) within couples. FD was associated with greater symptoms of anxiety (r = .29, p = .01; r = .31, p = .01), depression (r = 29, p = 01; r = .39, p = .001), and poorer physical QOL(r = - .25, p = .03; r = - .25, p = .001) for patients and caregivers, respectively. For patients, FD was additionally associated with poorer mental QOL(r = - .44, p < .001). Caregivers accurately perceived patient FD, yet patients tended to underreport their caregiver's FD by almost an entire point (t = 2.8, p = .007). A 3-way interaction (FD X role X illness communication) revealed (b = .40, p = .041) that illness communication moderated the association between FD and physical QOL for spouses so that spouses who reported less ease of illness communication demonstrated a stronger association between financial distress and physical QOL (b = - 2.08, p < .001) than those reporting greater ease of engaging in illness communication (b = .49, p = .508).
CONCLUSION
In the advanced cancer setting, FD is prevalent in both patients and their spousal caregivers and associated with psychological distress and poor physical QOL. Results suggest that optimal FD assessment should include patients and spouses, and spouse's ease of engaging with illness communication may be a potential target for future intervention studies.
Topics: Adaptation, Psychological; Caregivers; Humans; Lung Neoplasms; Quality of Life; Spouses
PubMed: 35112209
DOI: 10.1007/s00520-021-06758-w -
JAMA Psychiatry Mar 2018Although spouses strongly resemble one another in their risk for alcohol use disorder (AUD), the causes of this association remain unclear.
IMPORTANCE
Although spouses strongly resemble one another in their risk for alcohol use disorder (AUD), the causes of this association remain unclear.
OBJECTIVES
To examine longitudinally, in first marriages, the association of a first registration for AUD in one spouse with risk of registration in his or her partner and to explore changes in the risk for AUD registration in individuals with multiple marriages as they transition from a spouse with AUD to one without or vice versa.
DESIGN, SETTING, AND PARTICIPANTS
Population-wide Swedish registries were used to identify individuals born in Sweden between 1960 and 1990 who were married before the end of study follow-up on December 31, 2013. The study included 8562 marital pairs with no history of AUD registration prior to their first marriage and an AUD registration in 1 spouse during marriage and 4891 individuals with multiple marriages whose first spouse had no AUD registration and second spouse did or vice versa. Final statistical analyses were conducted from August 15 to September 1, 2017.
EXPOSURES
A spousal onset or history of AUD registration.
MAIN OUTCOMES AND MEASURES
Alcohol use disorder registration in national medical, criminal, or pharmacy registries.
RESULTS
Among the 8562 marital pairs (5883 female probands and 2679 male probands; mean [SD] age at marriage, 29.2 [5.7] years) in first marriages, the hazard ratio of AUD registration in wives immediately after the first AUD registration in their husbands was 13.82, which decreased 2 years later to 3.75. The hazard ratio of AUD registration in husbands after the first AUD registration in their wives was 9.21, which decreased 2 years later to 3.09. Among the 4891 individuals with multiple marriages (1439 women and 3452 men; mean [SD] age at first marriage, 25.5 [4.2] years), when individuals transitioned from a first marriage to a spouse with AUD to a second marriage to a spouse without AUD, the hazard ratio for AUD registration was 0.50 (95% CI, 0.42-0.59) in women and 0.51 (95% CI, 0.44-0.59) in men. After a first marriage to a spouse without AUD, the hazard ratio for AUD with a second marriage to a spouse with AUD was 7.02 (95% CI, 5.34-9.23) in women and 9.06 (95% CI, 7.55-10.86) in men. These patterns were modestly attenuated when moving from second to third marriages. Controlling for AUD registration prior to first marriage or between first and second marriages produced minimal changes in risk.
CONCLUSIONS AND RELEVANCE
The increase in risk for AUD registration in a married individual following a first AUD registration in the spouse is large and rapid. When an individual with serial spouses is married, in either order, to partners with vs without an AUD registration, the risk for AUD registration is substantially increased when the partner has an AUD registration and decreased when the partner does not have an AUD registration. These results suggest that a married individual's risk for AUD is directly and causally affected by the presence of AUD in his or her spouse.
Topics: Adult; Alcoholism; Causality; Female; Humans; Longitudinal Studies; Male; Marriage; Prevalence; Proportional Hazards Models; Registries; Risk; Spouses; Sweden
PubMed: 29417130
DOI: 10.1001/jamapsychiatry.2017.4457 -
Circulation. Heart Failure Oct 2017A diagnosis of heart failure (HF) often requires a comprehensive lifestyle change to maintain disease stability. When patients with HF are married, the spouse frequently...
BACKGROUND
A diagnosis of heart failure (HF) often requires a comprehensive lifestyle change to maintain disease stability. When patients with HF are married, the spouse frequently assumes the caregiving role. Our objectives were to describe the health of spouses of married patients with HF, and examine whether the health of a spouse impacts patient outcomes.
METHODS AND RESULTS
We identified 905 patients that were married at the time of incident HF diagnosis in Olmsted County, MN, from 2000 to 2012. Using Rochester Epidemiology Project resources, the patient and their spouse's comprehensive longitudinal health histories were linked. Spousal health at patient HF diagnosis was assessed by comorbidity burden, self-reported difficulty with activities of daily living and prior hospitalizations. The associations of spousal health with patient outcomes and patient death with spousal outcomes were examined using Cox and Andersen-Gill models. Spouses of patients with HF were elderly (mean age, 71 years), often had comorbid conditions, and 16% had difficulty with ≥1 activities of daily living. After adjustment for patient age, sex, and comorbidity, there were no independent associations of spousal health and patient risk of death or hospitalization after HF diagnosis. However, the risk of hospitalization (adjusted hazard ratio, 1.34; 95% confidence interval, 1.11-1.60; =0.002) and death (hazard ratio, 2.10; 95% confidence interval, 1.60-2.75; <0.001) increased in the surviving spouse after patient death.
CONCLUSIONS
We found no evidence that the health of a spouse impacts patient outcomes after HF diagnosis. However, after a patient with HF dies, their surviving spouse's risk of hospitalization and death increases.
Topics: Activities of Daily Living; Aged; Aged, 80 and over; Caregivers; Comorbidity; Cost of Illness; Female; Health Status; Heart Failure; Hospitalization; Humans; Longitudinal Studies; Male; Middle Aged; Minnesota; Proportional Hazards Models; Quality of Life; Risk Factors; Spouses
PubMed: 29030371
DOI: 10.1161/CIRCHEARTFAILURE.117.004088 -
Supportive Care in Cancer : Official... Nov 2022Due to population aging, the number of older adults with cancer will double in the next 20 years. There is a gap in research about older adults who are the caregiver of... (Review)
Review
PURPOSE
Due to population aging, the number of older adults with cancer will double in the next 20 years. There is a gap in research about older adults who are the caregiver of a spouse with cancer. Therefore, this review seeks to answer the overarching research question: What is known about the association of providing care on Health-Related Quality of Life (HRQOL), psychological distress, burden, and positive aspects of caregiving for an older adult caregiver to a spouse with cancer?
METHODS
This scoping review was guided by the framework of Arksey and O'Malley and refined by Levac et al. Comprehensive search strategies were conducted in Medline, Excerpta Medica Database (EMBASE), PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception until April 15, 2021. Two independent reviewers screened abstracts, full text, and completed data abstraction. A gray literature search and two stakeholder consultations were conducted.
RESULTS
A total of 8132 abstracts were screened, and 17 articles were included. All studies outlined caregivers provided preventive, instrumental, and protective care to a spouse in active cancer treatment. However, the time spent on caregiving was rarely examined (n = 4). Providing care had a negative association on HRQOL, perceived burden, and psychological distress outcomes. Five studies examined positive experiences of caregivers.
CONCLUSION
The scoping review findings highlight the informal care provided by older adult caregivers to a spouse with cancer and how the care provided is associated with HRQOL, burden, psychological distress, and the positive aspects of caregiving.
Topics: Humans; Aged; Caregivers; Spouses; Quality of Life; Neoplasms; Delivery of Health Care
PubMed: 35661256
DOI: 10.1007/s00520-022-07176-2 -
Journal of Family Psychology : JFP :... Aug 2022The objective of this study was to predict marital instability from a range of risk and protective factors in a large, representative cohort of military couples...
The objective of this study was to predict marital instability from a range of risk and protective factors in a large, representative cohort of military couples participating in the Millennium Cohort Family Study. Online and paper surveys were administered to service members and their spouses in 2011-2013, which captured couples' demographic and background characteristics, family stressors, military experiences, and mental health risk factors as well as protective factors including family communication, and military support and satisfaction. Approximately 3 years later, change in marital status was examined among participants who completed a follow-up survey ( = 6,494 couples). Hierarchical logistic regression models indicated that couples' younger age, lower education, childhood trauma, spouse employment status, mental health, and lower levels of communication contributed significant unique risk for marital instability. Moderation analyses by service member gender and spouse military status revealed that social isolation increased odds of marital instability for couples in which the service member was male but was not evidenced for couples in which the service member was female. Further, combat experience increased odds of marital instability for couples in which the service member was married to a veteran spouse but not for service members married to a dual-military or civilian spouse. Findings from this study can be used to target specific couple risk factors for marital instability and to tailor programs to at-risk subgroups. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Female; Humans; Male; Marriage; Military Personnel; Personal Satisfaction; Protective Factors; Spouses
PubMed: 34928627
DOI: 10.1037/fam0000949 -
Journal of Aging and Health Sep 2018The current study examined the mental health of couples living with and without sensory loss; compared the mental health of couples living with hearing, vision, or...
OBJECTIVES
The current study examined the mental health of couples living with and without sensory loss; compared the mental health of couples living with hearing, vision, or dual-sensory loss; and investigated the association between spouse support and the mental health of couples living with sensory loss.
METHOD
The study included 513 couples with sensory loss and 1,079 couples without sensory loss. Actor-Partner Interdependence Models were used to examine associations between spouse support and mental health.
RESULTS
Controlling for potential covariates, individuals with sensory loss and their spouses were at a greater risk of mental health problems. Sensory loss modality (hearing and/or vision) did not explain any differences. Both actor and partner effects of spouse support on anxiety and depression were found.
DISCUSSION
The findings highlight the need to support the mental health of couples living with sensory loss and indicate the importance of considering the intimate relationship in future studies.
Topics: Aged; Anxiety; Depression; Female; Humans; Interpersonal Relations; Male; Mental Health; Sensation Disorders; Sexual Partners; Spouses
PubMed: 28613091
DOI: 10.1177/0898264317713135 -
Aging & Mental Health Jun 2022The present study examines the moderating role of social connectedness (i.e. closeness, talk frequency, social network size, and neighborhood social ties) in the...
OBJECTIVES
The present study examines the moderating role of social connectedness (i.e. closeness, talk frequency, social network size, and neighborhood social ties) in the association between one's own and spouse's relationship strain and emotional well-being (i.e. depressive symptoms, happiness, and loneliness).
METHOD
Married couples ( = 865) were drawn from the second wave of the National Social, Health, and Aging Project. One Actor Partner Interdependence Model (APIM) and one Actor Partner Interdependence Model with Moderation (APIMoM) were conducted.
RESULTS
In terms of actor effects, relationship strain was associated with all emotional well-being outcomes. Wives' and husbands' greater relationship strain was associated with spouses' loneliness. Only wives' greater relationship strain was associated with her husbands' higher level of depressive symptoms and no partner effects were found for happiness. In six instances, social connectedness factors helped to ameliorate the association between self/spouse relationship strain, depressive symptoms, and happiness. However, wives' greater neighborhood social ties amplified the association between wives greater relationship strain and husbands' greater depressive symptoms. We did not find that social connectedness factors moderated the associations between self/spouse relationship strain and loneliness.
CONCLUSION
Even in late life marriages, marital strain is associated with less happiness and greater depressive symptoms and loneliness. Practitioners addressing emotional well-being may need to pay attention to spousal perceptions of relationship strain and social relationships external to the marital relationship when working with heterosexual couples. Efforts throughout the life course should be made to ensure connections with diverse types of social networks.Supplemental data for this article is available online at https://doi.org/10.1080/13607863.2021.1910786.
Topics: Aged; Depression; Emotions; Female; Humans; Interpersonal Relations; Marriage; Spouses
PubMed: 33870774
DOI: 10.1080/13607863.2021.1910786 -
Social Science & Medicine (1982) Jun 2023Drawing on the stress process, gender theory, and social roles theories, this study examines whether the associations between caregiving and mental health reflect the...
Drawing on the stress process, gender theory, and social roles theories, this study examines whether the associations between caregiving and mental health reflect the heterogeneity in caregiving experiences. It explores whether differences in care circumstances (location and intensity of care) and caregiver characteristics (gender and relation to care recipient) impact caregivers' health. While previous research has looked at these factors individually, this study uses longitudinal estimation methods to examine their combined associations with mental health. Using British data from the nationally representative panel survey Understanding Society (N = 366,907), fixed-effect models are used to assess the associations between the location and intensity of care, the caregiver's gender, and the relation to the care recipient and mental health. I report differences in mental health between non-caregivers and caregivers, as well as among caregivers across different care circumstances. While the results highlight the somewhat unique nature of each care circumstance and its relation to mental health, they uncover some general patterns. First, caregiving is a stressful social role. Second, care intensity is a crucial dimension of variation in the relationship between caregiving and mental health. Third, the location of care interacts with care relations only for less intensive caregivers. Fourth, there is a gradation in the negative association between caregiving activities and mental health by care relations. Finally, female caregivers are more susceptible to role overload and role captivity. When the care act is more expected and normative, such as when caring for a spouse, there is no difference by gender in mental health. Yet, differences by gender are evidenced when the intensive care act is less normative. This study unveils nuanced patterns in the joint and unique relations between care circumstances, caregiver characteristics, and mental health, and underscores the importance of effective care support especially for spousal and female parental caregivers.
Topics: Humans; Female; Mental Health; Stress, Psychological; Spouses; Parents; Surveys and Questionnaires
PubMed: 37121070
DOI: 10.1016/j.socscimed.2023.115922