Unmitigated Communion and Adjustment to Breast Cancer: Associations and Explanations1

Responsiveness and Relationship Satisfaction in Couples Coping With Parkinson's Disease: A Pilot Study

Parkinson’s disease (PD) is a neurodegenerative disorder which impacts the person’s physical, psychological and relational well-being, and the well-being of their romantic partner, who is often in a caregiving role. People with PD may struggle to empathize with and respond to their partner’s emotional states, which can hinder relationship satisfaction for both partners. Care partners, who may feel burnt out from caring for their partner’s physical and cognitive needs, may be limited in their ability to be responsive to their spouse’s relational needs, which can hinder satisfaction. Despite the challenges faced by couples coping with PD, little work has considered the interpersonal factors associated with relationship satisfaction for affected couples. In the current study, we investigated individual differences in the motivation to be responsive to a partner’s needs (i.e., communal strength), as well as perceptions of a partner’s responsiveness (i.e., the extent to which a person perceives their partner to care for, validate, and understand them). We recruited 20 couples in which one partner was diagnosed with PD and their romantic partner self-identified as a full-time caregiver, in order to examine how responsiveness is associated with both partners’ relationship satisfaction. When partners with PD reported higher communal strength, they reported higher relationship satisfaction and so did their care partner. When partners with PD perceived their care partner to be more responsive, they reported higher relationship satisfaction. These findings provide some preliminary evidence for responsiveness as one interpersonal factor worthy of further consideration for helping couples cope with PD.

Depressive symptoms and unmitigated communion in support providers

In this research, we argue and demonstrate that the association between enacted (un)supportive behaviour and depressive symptoms is a function of the providers' levels of unmitigated communion (UC). UC is characterized by overinvolvement in others' problems, self‐neglect and externalized self‐evaluation. These characteristics appear to predispose individuals high in UC to experience depressive symptoms. As anticipated, we show that enacted supportive behaviour was negatively associated with depressive symptoms (Study 1 and 2), and enacted unsupportive behaviour was positively associated with depressive symptoms (Study 2), but only among individuals low in UC. Our findings are consistent with the idea that for high UC individuals, enacting supportive behaviour, or not enacting unsupportive behaviour, is insufficient to reduce their high levels of depressive symptoms. Copyright © 2009 John Wiley & Sons, Ltd.

Communal motivation in couples coping with vulvodynia: Sexual distress mediates associations with pain, depression, and anxiety

OBJECTIVE

To examine the role of a novel motivational perspective-sexual communal motivation-in women's pain during intercourse and both partners' distress in couples coping with vulvodynia, a prevalent gynecological pain condition. Our goal was to test whether sexual communal strength (i.e., motivation to meet a partner's sexual needs) and unmitigated sexual communion (i.e., prioritization of a partner's sexual needs in neglect of one's own needs) were indirectly associated with pain, depression, and anxiety via sexual distress.

METHODS

Couples (N=101) completed daily surveys about their sexual communal motivation, sexual distress, anxiety, depression, and women reported on their pain during intercourse. Using multilevel modeling, we examined how daily fluctuations in sexual communal motivation were directly and indirectly (via sexual distress) associated with pain and psychological distress.

RESULTS

On days when women with vulvodynia reported higher sexual communal strength, they reported less pain and anxiety, and on days when they reported higher unmitigated sexual communion, they reported more pain, more anxiety, and both partners reported more depressive symptoms. Daily associations between women's unmitigated sexual communion and greater pain, depression and anxiety were mediated by sexual distress.

CONCLUSIONS

Being motivated to meet a partner's sexual needs was associated with less pain and anxiety for women with vulvodynia, but when this motivation excluded a focus on one's own needs, there were detrimental consequences for women's pain and both partners' depressive symptoms. Interventions for improving women's pain and the psychological well-being of affected couples should target motivational factors and sexual distress.

Adjusting to Chronic Health Conditions

Research on adjustment to chronic disease is critical in today's world, in which people are living longer lives, but lives are increasingly likely to be characterized by one or more chronic illnesses. Chronic illnesses may deteriorate, enter remission, or fluctuate, but their defining characteristic is that they persist. In this review, we first examine the effects of chronic disease on one's sense of self. Then we review categories of factors that influence how one adjusts to chronic illness, with particular emphasis on the impact of these factors on functional status and psychosocial adjustment. We begin with contextual factors, including demographic variables such as sex and race, as well as illness dimensions such as stigma and illness identity. We then examine a set of dispositional factors that influence chronic illness adjustment, organizing these into resilience and vulnerability factors. Resilience factors include cognitive adaptation indicators, personality variables, and benefit-finding. Vulnerability factors include a pessimistic attributional style, negative gender-related traits, and rumination. We then turn to social environmental variables, including both supportive and unsupportive interactions. Finally, we review chronic illness adjustment within the context of dyadic coping. We conclude by examining potential interactions among these classes of variables and outlining a set of directions for future research.

Gender Roles and Mental Health in Women With and at Risk for HIV

Predominantly low-income and African American women from the same community, HIV-infected (n = 100; HIV+) and uninfected (n = 42; HIV-), were assessed on reported gender roles in sexual and other close relationships-including levels of self-silencing, unmitigated communion, and sexual relationship power-at a single recent study visit during 2008-2012. Recent gender roles were investigated in relation to depressive symptoms and health-related quality of life assessed both at a single visit during 2008-2012 and averaged over semiannual visits (for depressive symptoms) and annual visits (for quality of life) occurring between 1994 and 2012. Compared to HIV- women, HIV+ women reported significantly higher levels of several aspects of self-silencing, unmitigated communion, and multi-year averaged depressive symptoms as well as lower levels of sexual relationship power and recent and multi-year averaged quality of life. For both HIV+ and HIV- women, higher self-silencing and unmitigated communion significantly related to recent or multi-year averaged higher depressive symptoms and lower quality of life. Intervention strategies designed to increase self-care and self-advocacy in the context of relationships could potentially minimize depressive symptoms and enhance quality of life in women with and at risk for HIV.

Agentic and communal traits and health: adolescents with and without diabetes

The authors examined whether agentic and communal traits are associated with relationship and health outcomes among adolescents with and without diabetes. They interviewed 263 teens (average age 12; 132 Type 1 diabetes; 131 healthy) on an annual basis for 5 years. The authors measured agency, communion, unmitigated agency, and unmitigated communion as well as parent and peer relationship quality, psychological distress, and diabetes health. In concurrent and lagged multilevel models, unmitigated communion and unmitigated agency were associated with poor relationship outcomes and greater psychological distress for those with and without diabetes. In lagged analyses, unmitigated communion predicted deterioration in diabetes health. Communion and agency were associated with positive relationship and health outcomes, with the former being stronger than the latter. These results underscore the need to focus on unmitigated agency and unmitigated communion when studying the implications of personality for health during adolescence.

Gender-related traits, quality of life, and psychological adjustment among women with irritable bowel syndrome

OBJECTIVE

Irritable bowel syndrome (IBS) is a functional illness associated with significant impairment in quality of life. Compared to men, women are more likely to meet criteria for IBS, to seek treatment, and experience greater detriments in quality of life. In addition to physiological factors, psychosocial factors may contribute to such gender differences. We examined whether traits associated with masculine (agentic) and feminine (communal) gender roles were linked with adjustment to IBS.

METHODS

Women with IBS (N = 144) completed online self-report measures of gender-related traits (agency, communion, unmitigated agency, unmitigated communion, lack of agency, lack of communion), IBS-specific quality of life (IBS-QOL), and psychological adjustment (negative and positive affect).

RESULTS

Agency was positively associated with all dimensions of IBS-QOL and psychological adjustment. Select dimensions of IBS-QOL were lower among women higher in unmitigated agency (social reactions, body image) or unmitigated communion (interference with activity), and both traits were associated with increased negative affect. Lack of agency was associated with increased IBS-QOL (food avoidance) and decreased positive affect. Communion and lack of communion were not associated with either IBS-QOL or psychological adjustment.

CONCLUSIONS

Findings may help elucidate psychosocial factors contributing to quality of life among women with IBS.

Moderators of interventions designed to enhance physical and psychological functioning among younger women with early-stage breast cancer

PURPOSE

To identify factors that condition or moderate the impact of a previously described set of interventions on psychological and physical adjustment after diagnosis and treatment for early-stage breast cancer.

PATIENTS AND METHODS

Younger women (age < 51 years, N = 252) with early-stage breast cancer within 2 months of having completed active nonhormonal adjuvant therapy were randomly assigned to a three-arm clinical trial, consisting of a control arm, an education arm, and a nutrition arm. Primary end points, assessed before random assignment and 4 and 13 months later, included mental functioning, physical functioning, and depressive symptoms. Four types of moderator variables were identified, including two sets reflecting psychosocial resources, specifically personality factors and factors related to the person's social environment, a set reflecting demographic variables, and a set reflecting treatment and disease variables (including comorbidities).

RESULTS

Psychosocial factors were more likely to moderate treatment effects than were demographic and disease-related factors, but the moderating effects of these psychosocial factors were limited to patients receiving the nutrition intervention. Patients with lower psychosocial resources benefited from the nutrition intervention, whereas patients with a greater amount of psychosocial resources did not.

CONCLUSION

Future trials of this type should stratify by or select for the moderating variables identified here (ie, dispositional pessimism, unmitigated communion, and negative social interaction) to establish more firmly their role in responses to psychosocial interventions. Effort should also be made to collect data to inform the delivery of interventions to those who might benefit the most.

Unmitigated communion and health among adolescents with and without diabetes: the mediating role of eating disturbances

The authors examined the implications of unmitigated communion--a focus on others to the exclusion of the self--for psychological and physical health among adolescents with (n = 132) and without (n = 131) diabetes times/during a 1-year period. Unmitigated communion predicted greater psychological distress and lower levels of competence cross-sectionally and longitudinally, controlling for sex, pubertal status, and communion. Health status moderated some longitudinal relations, such that relations held only for adolescents with diabetes. In addition, unmitigated communion was associated with poor metabolic control and predicted a deterioration in metabolic control over the year for adolescents with diabetes. Unmitigated communion also was associated with disturbed eating behavior cross-sectionally and longitudinally, and disturbed eating behavior explained some of the relations of unmitigated communion to psychological but not physical health outcomes.

Übersetzung und Validierung der Skala zur Erfassung übermäßiger Communion von Helgeson und Fritz

Zusammenfassung. Übermäßige Communion (UC) ist durch Überinvolvierung in die Probleme anderer Menschen und Vernachlässigung eigener Bedürfnisse zu Gunsten der Bedürfnisse anderer gekennzeichnet. In der vorliegenden Arbeit wurde die UC-Skala von Helgeson und Fritz (1998) ins Deutsche übertragen und in drei Studien validiert. Die deutsche UC-Skala war zur Originalskala konvergent und vergleichbar konsistent, jedoch faktoriell komplexer. In der interpersonalen Konstruktanalyse wurde die vorherrschende thematische Qualität der UC-Skala im interpersonalen Eigenschafts- und Problem-Circumplex als submissiv-freundlich ausgewiesen. Überinvolvierung in die Probleme anderer und Vernachlässigung eigener Bedürfnisse ließen sich auf Item-Ebene im interpersonalen Eigenschafts-Circumplex differenzieren. Das Fünf-Faktoren-Modell klärte 22% der UC-Skalenvarianz auf und hing differenziell mit Überinvolvierung und Vernachlässigung eigener Bedürfnisse zusammen.

The effects of meritocracy beliefs on women's well-being after first-time gender discrimination

This study examined how meritocracy beliefs may buffer women from the negative psychological effects of an acute situation of gender discrimination. Although some research indirectly suggests that believing that meritocracy exists may increase wellbeing, group consciousness theories suggest that disbelieving that meritocracy exists will enhance psychological adjustment to gender discrimination. Women who reported little past experience with discrimination, and either believed or disbelieved that meritocracy exists, were exposed to either a laboratory situation of discrimination or a nondiscrimination failure (control) condition. Consistent with group consciousness theories, women experiencing discrimination reported greater well-being if they disbelieved that meritocracy exists than if they were believers. In contrast, women in the control condition reported greater wellbeing if they believed that meritocracy exists than if they were disbelievers. Implications for coping with discrimination are discussed.