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Family Process Sep 2020Infidelity occurs in approximately 25% of marriages and is associated with various negative consequences for individuals (e.g., depression, anxiety, and post-traumatic...
Infidelity occurs in approximately 25% of marriages and is associated with various negative consequences for individuals (e.g., depression, anxiety, and post-traumatic stress), the couple relationship (e.g., financial loss, increased conflict, and aggression), and the couple's children (e.g., internalizing and externalizing behaviors). Infidelity is also one of the most frequently cited reasons for divorce. The increased stress brought on by the pandemic may be putting couples at an increased risk for experiencing infidelity, and data collected during the pandemic have shown that people across the United States are engaging in behaviors that are associated with a high likelihood of experiencing infidelity. The negative consequences of infidelity are also likely to be exacerbated for couples during the pandemic due to the intersection with the social, emotional, and financial consequences of COVID-19. Furthermore, couples are likely to experience disruptions and delays to the affair recovery process during the pandemic, which can negatively impact their ability to heal. Therefore, recommendations for navigating affair recovery during the pandemic, including adaptations for therapy, are also discussed.
Topics: Betacoronavirus; COVID-19; Coronavirus Infections; Extramarital Relations; Female; Humans; Male; Marital Therapy; Pandemics; Pneumonia, Viral; Quarantine; SARS-CoV-2; United States
PubMed: 32621371
DOI: 10.1111/famp.12576 -
Current Psychiatry Reports Mar 2016Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders,... (Review)
Review
Infertility and perinatal loss are common, and associated with lower quality of life, marital discord, complicated grief, major depressive disorder, anxiety disorders, and post-traumatic stress disorder. Young women, who lack social supports, have experienced recurrent pregnancy loss or a history of trauma and / or preexisting psychiatric illness are at a higher risk of experiencing psychiatric illnesses or symptoms after a perinatal loss or during infertility. It is especially important to detect, assess, and treat depression, anxiety, or other psychiatric symptoms because infertility or perinatal loss may be caused or perpetuated by such symptoms. Screening, psychoeducation, provision of resources and referrals, and an opportunity to discuss their loss and plan for future pregnancies can facilitate addressing mental health concerns that arise. Women at risk of or who are currently experiencing psychiatric symptoms should receive a comprehensive treatment plan that includes the following: (1) proactive clinical monitoring, (2) evidence-based approaches to psychotherapy, and (3) discussion of risks, benefits, and alternatives of medication treatment during preconception and pregnancy.
Topics: Anxiety; Anxiety Disorders; Depression; Depressive Disorder, Major; Female; Grief; Humans; Infertility; Pregnancy; Quality of Life; Stillbirth; Stress Disorders, Post-Traumatic
PubMed: 26847216
DOI: 10.1007/s11920-016-0663-8 -
International Journal of Environmental... Feb 2022Few studies evaluating the relationship between depression and exercise consider peoples' socio-demographic characteristics. This cross-sectional study investigated the...
Few studies evaluating the relationship between depression and exercise consider peoples' socio-demographic characteristics. This cross-sectional study investigated the interaction between exercise and marital status and depression in Taiwanese adults. Data from the 2-item Patient Health Questionnaire (PHQ-2) was recruited from the Taiwan Biobank. Participants indicated their exercise status, showing 5015 no-exercise cases and 3407 exercise cases. Marital status, including unmarried, divorced or separated, and widowed, were all significant, especially among the no-exercise group. The relationship between exercise/no exercise and marital status was examined; no exercise and unmarried, divorced or separated, and widowed, as well as exercise and married were significant to PHQ-2. Gender was significant in both the married and unmarried groups. The association between exercise, marital status, gender, and education on PHQ-2 score was also significant. Married people, especially men, had lower depression scores. Additionally, exercise had a protective effect against depression for unmarried people, especially women.
Topics: Adult; Biological Specimen Banks; Cross-Sectional Studies; Depression; Female; Humans; Male; Marital Status; Taiwan
PubMed: 35162898
DOI: 10.3390/ijerph19031876 -
Archives of Women's Mental Health Oct 2021Perinatal depression is an important public health problem. Psychological interventions play an essential role in the treatment of depression. In the current paper, we... (Meta-Analysis)
Meta-Analysis Review
Perinatal depression is an important public health problem. Psychological interventions play an essential role in the treatment of depression. In the current paper, we will present the results of a series of meta-analyses on psychological treatments of perinatal depression. We report the results of a series of meta-analyses on psychological treatments of depression, including perinatal depression. The meta-analyses are based on a database of randomized trials on psychotherapies for depression that has been systematically developed and updated every year. Psychological interventions are effective in the treatment of perinatal depression with a moderate effect size of g = 0.67, corresponding with a NNT of about 4. These effects were still significant at 12 months after the start of the treatment. These interventions also have significant effects on social support, anxiety, functional impairment, parental stress, and marital stress. Possibly the effects are overestimated because of the use of waiting list control groups, the low quality of the majority of trials and publication bias. Research on psychotherapies for depression in general has shown that there are no significant differences between the major types of therapy, except for non-directive counseling that may have somewhat smaller effects. CBT can also be delivered in individual, group, telephone, and guided self-help format. Interventions in subthreshold depression are also effective and may prevent the onset of a full-blown depressive disorder, while therapies may be less effective in chronic depression. Psychological interventions are effective and deserve their place as first-line treatment of perinatal depression.
Topics: Anxiety Disorders; Cognitive Behavioral Therapy; Depression; Depressive Disorder; Humans; Psychotherapy
PubMed: 34228202
DOI: 10.1007/s00737-021-01159-8 -
The Oncologist Jun 2022Limited and conflicting findings have been reported regarding the association between social support and colorectal cancer (CRC) outcomes. We sought to assess the... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Limited and conflicting findings have been reported regarding the association between social support and colorectal cancer (CRC) outcomes. We sought to assess the influences of marital status and living arrangement on survival outcomes among patients with stage III colon cancer.
PATIENTS AND METHODS
We conducted a secondary analysis of 1082 patients with stage III colon cancer prospectively followed in the CALGB 89803 randomized adjuvant chemotherapy trial. Marital status and living arrangement were both self-reported at the time of enrollment as, respectively, married, divorced, separated, widowed, or never-married, and living alone, with a spouse or partner, with other family, in a nursing home, or other.
RESULTS
Over a median follow-up of 7.6 years, divorced/separated/widowed patients experienced worse outcomes relative to those married regarding disease free-survival (DFS) (hazards ratio (HR), 1.44 (95% CI, 1.14-1.81); P =.002), recurrence-free survival (RFS) (HR, 1.35 (95% CI, 1.05-1.73); P = .02), and overall survival (OS) (HR, 1.40 (95% CI, 1.08-1.82); P =.01); outcomes were not significantly different for never-married patients. Compared to patients living with a spouse/partner, those living with other family experienced a DFS of 1.47 (95% CI, 1.02-2.11; P = .04), RFS of 1.34 (95% CI, 0.91-1.98; P = .14), and OS of 1.50 (95% CI, 1.00-2.25; P =.05); patients living alone did not experience significantly different outcomes.
CONCLUSION
Among patients with stage III colon cancer who received uniform treatment and follow-up within a nationwide randomized clinical trial, being divorced/separated/widowed and living with other family were significantly associated with greater colon cancer mortality. Interventions enhancing social support services may be clinically relevant for this patient population.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT00003835.
Topics: Chemotherapy, Adjuvant; Colonic Neoplasms; Disease-Free Survival; Humans; Marital Status; Neoplasm Recurrence, Local
PubMed: 35641198
DOI: 10.1093/oncolo/oyab070 -
Cancer Medicine Jul 2023Distress is prevalent among lymphoma patients/survivors. Current processes of distress identification rely on self-reporting by patients/survivors, which may be limited... (Review)
Review
OBJECTIVE
Distress is prevalent among lymphoma patients/survivors. Current processes of distress identification rely on self-reporting by patients/survivors, which may be limited by their willingness to report symptoms. To help identify patients/survivors at greater risk, this systematic review aims to comprehensively review factors that may contribute to distress in lymphoma patients/survivors.
METHODS
PubMed was systematically searched for peer-reviewed primary articles (1997-2022) consisting of standardised keywords "lymphoma" and "distress." Information from 41 articles was integrated via narrative synthesis.
RESULTS
Consistent risk factors of distress include younger age, relapsed disease, and greater comorbidities and symptom burden. Active treatment and the transition from treatment to post-treatment could be challenging phases. Adequate social support, adaptive adjustment to cancer, engaging in work and healthcare professionals' support may mitigate distress. There is some evidence that older age may be associated with greater depression and life changes/experiences may shape how individuals cope with lymphoma. Gender and marital status were not robust predictors of distress. Other clinical, psychological and socioeconomic factors are understudied or have mixed findings.
CONCLUSIONS
While several factors of distress align with that of other cancers, more research is needed to identify significant factors of distress in lymphoma patients/survivors. The identified factors may support clinicians in identifying distressed lymphoma patients/survivors and providing interventions where necessary. The review also highlights avenues for future research and a need to routinely collect data on distress and its factors in registries.
Topics: Humans; Stress, Psychological; Quality of Life; Lymphoma; Neoplasms; Psychological Distress
PubMed: 37199079
DOI: 10.1002/cam4.6069 -
Current Oncology (Toronto, Ont.) Dec 2020Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting.
BACKGROUND
Evidence about the impact of marital status before hematopoietic cell transplantation (hct) on outcomes after hct is conflicting.
METHODS
We identified patients 40 years of age and older within the Center for International Blood and Marrow Transplant Research registry who underwent hct between January 2008 and December 2015. Marital status before hct was declared as one of: married or living with a partner, single (never married), separated or divorced, and widowed. We performed a multivariable analysis to determine the association of marital status with outcomes after hct.
RESULTS
We identified 10,226 allogeneic and 5714 autologous hct cases with, respectively, a median follow-up of 37 months (range: 1-102 months) and 40 months (range: 1-106 months). No association between marital status and overall survival was observed in either the allogeneic ( = 0.58) or autologous ( = 0.17) setting. However, marital status was associated with grades 2-4 acute graft-versus-host disease (gvhd), < 0.001, and chronic gvhd, = 0.04. The risk of grades 2-4 acute gvhd was increased in separated compared with married patients [hazard ratio (hr): 1.13; 95% confidence interval (ci): 1.03 to 1.24], and single patients had a reduced risk of grades 2-4 acute gvhd (hr: 0.87; 95% ci: 0.77 to 0.98). The risk of chronic gvhd was lower in widowed compared with married patients (hr: 0.82; 95% ci: 0.67 to 0.99).
CONCLUSIONS
Overall survival after hct is not influenced by marital status, but associations were evident between marital status and grades 2-4 acute and chronic gvhd. To better appreciate the effects of marital status and social support, future research should consider using validated scales to measure social support and patient and caregiver reports of caregiver commitment, and to assess health-related quality of life together with health care utilization.
Topics: Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Marital Status; Quality of Life
PubMed: 33380875
DOI: 10.3747/co.27.6327 -
European Review For Medical and... Dec 2019It has been reported that for obesity patients, improved problem-solving skills have a positive impact on losing weight and treatment adherence. The aims of our study,...
OBJECTIVE
It has been reported that for obesity patients, improved problem-solving skills have a positive impact on losing weight and treatment adherence. The aims of our study, by describing the problem-solving self-appraisal of obese patients applied to our center, were to provide data in enriching the obesity management, to facilitate weight loss and improve long-term goals for patients.
PATIENTS AND METHODS
The study design was cross-sectional and descriptive. There were no sampling methods, all patients registered to the center program and passed the health screening module were asked to be included. The data collection was performed via "Socio-demographic information form" and "Problem-Solving Inventory" (PSI) forms. Quantitative data were compared by Student's t-test, Mann-Whitney U test, One-way Anova, post-hoc test, and correlation analysis.
RESULTS
The total average of the PSI scores of 87 patients was 122.33±20.25. There was no statistical significance between the inventory scores and gender, marital status, financial state, smoking, and alcohol consumption (p>0.05). Physical activity and education were correlated with the PSI scores (p˂0.05).
CONCLUSIONS
The study showed that participants had low problem-solving self-appraisals. Providing an additional perspective on problem-solving skills may help to promote the psychological and physical well-being of obesity patients.
Topics: Adult; Cognitive Behavioral Therapy; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Obesity; Patient Compliance; Problem Solving; Self-Assessment; Treatment Outcome; Weight Loss; Weight Reduction Programs
PubMed: 31841204
DOI: 10.26355/eurrev_201912_19689 -
International Journal of Environmental... Sep 2022Raising and caring for a child with ASD is a challenge for the parents' marriage relationship. Caring for a disabled child changes the functioning of the family and...
Raising and caring for a child with ASD is a challenge for the parents' marriage relationship. Caring for a disabled child changes the functioning of the family and requires greater involvement in care and specialist therapy. The respondents' answers show that such parents experience higher levels of stress related to the upbringing and future of the child. However, parenting challenges need not be a negative experience if the parents support each other. The process of bringing up children in the family are related, inter alia, to the quality of their parents 'marriage, which is influenced by the partners' personal resources. The resilience of the partners and coping with this situation contribute to marital satisfaction. The aim of the study is to find out about the relationship between spouses' resilience and coping styles and their assessment of marriage satisfaction. In total, 50 married couples participated in the study-50 mothers of children with ASD and 50 fathers, the partners of these mothers (N = 100). The following tools were used: the Resilience Scale (SPP-25), the Coping Inventory for Stressful Situations (CISS) and the Well-Matched Marriage Questionnaire (KDM-2), as well as a survey questionnaire (data on respondents). The results show that the gender of the parent of a child with ASD does not differentiate the overall assessment of the quality of marriage (the overall score on the scale indicates a low level of satisfaction with the relationship). When analyzing in detail the dimensions of individual scales of satisfaction with the relationship, one statistically significant difference was noted for the sex of the respondents in the disappointment dimension, showing that the level of disappointment in the quality of the relationship is higher in wives than in husbands. In the other dimensions of satisfaction with marriage: intimacy, personal fulfillment, similarity, there were no statistically significant differences in terms of gender of the respondents. The resilience of the spouses positively correlates with their assessment of marriage satisfaction, and in particular, openness, perseverance and determination to act increase the level of Task-oriented coping (SSZ) with difficult situations. All resilience factors negatively correlate with the emotional coping style (SSE). In both the studied groups, openness is a significant predictor of intimacy, and persistence is a predictor of self-fulfilment in a relationship. A predictor of disappointment in women is managing using substitute activities (ACZ), while in men it is the Emotion-oriented coping (SSE) style. The results indicate the need to support married couples raising a child with ASD during the pandemic.
Topics: Adaptation, Psychological; Autism Spectrum Disorder; COVID-19; Child; Female; Humans; Male; Marriage; Pandemics; Parenting; Personal Satisfaction; Spouses
PubMed: 36231674
DOI: 10.3390/ijerph191912372 -
Clinical Journal of the American... Jul 2020Although some patients regret the decision to start dialysis, modifiable factors associated with regret have rarely been studied. We aimed to identify factors associated...
BACKGROUND AND OBJECTIVES
Although some patients regret the decision to start dialysis, modifiable factors associated with regret have rarely been studied. We aimed to identify factors associated with patients' regret to initiate dialysis.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
A 41-item questionnaire was administered to adult patients receiving maintenance dialysis in seven dialysis units located in Cleveland, Ohio, and its suburbs. Of the 450 patients asked to participate in the study, 423 agreed and 397 provided data on decisional regret. We used multivariable logistic regression to identify predictors of regret, which was assessed using a single item, "Do you regret your decision to start dialysis?" We report adjusted odd ratios (ORs) and 95% confidence intervals (95% CIs) for the following candidate predictors: knowledge of CKD, attitudes toward CKD treatment, and preference for end-of-life care.
RESULTS
Eighty-two of 397 respondents (21%) reported decisional regret. There were no significant demographic correlates of regret. Regret was more common when patients reported choosing dialysis to please doctors or family members (OR, 2.34; 95% CI, 1.27 to 4.31; <0.001). Patients who reported having a prognostic discussion about life expectancy with their doctors (OR, 0.42; 95% CI, 0.18 to 0.98; =0.03) and those who had completed a living will (OR, 0.48; 95% CI, 0.25 to 0.95; =0.03) were less likely to report regret with dialysis initiation.
CONCLUSIONS
Dialysis regret was common in this sample. Demographic factors (age, sex, marital status, race, or educational attainment) were not significantly associated with regret, but modifiable care processes were.
PODCAST
This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_06_09_CJN13781119.mp3.
Topics: Adult; Aged; Aged, 80 and over; Conservative Treatment; Decision Making; Emotions; Family Relations; Female; Health Knowledge, Attitudes, Practice; Humans; Living Wills; Male; Middle Aged; Patient Preference; Physician-Patient Relations; Prognosis; Renal Dialysis; Renal Insufficiency, Chronic; Surveys and Questionnaires; Terminal Care; Young Adult
PubMed: 32499230
DOI: 10.2215/CJN.13781119