Health and Health Behavior Concordance between Spouses in Same-Sex and Different-Sex Marriages

Dyadic perspectives on loneliness and social isolation among people with dementia and spousal carers: findings from the IDEAL programme

OBJECTIVES

This study aims to investigate the impact of self and partner experiences of loneliness and social isolation on life satisfaction in people with dementia and their spousal carers.

METHODS

We used data from 1042 dementia caregiving dyads in the Improving the experience of Dementia and Enhancing Active Life (IDEAL) programme cohort. Loneliness was measured using the six-item De Jong Gierveld loneliness scale and social isolation using the six-item Lubben Social Network Scale. Data were analysed using the Actor-Partner Interdependence Model framework.

RESULTS

Self-rated loneliness was associated with poorer life satisfaction for both people with dementia and carers. The initial partner effects observed between the loneliness of the carer and the life satisfaction of the person with dementia and between social isolation reported by the person with dementia and life satisfaction of the carer were reduced to nonsignificance once the quality of the relationship between them was considered.

DISCUSSION

Experiencing greater loneliness and social isolation is linked with reduced life satisfaction for people with dementia and carers. However, having a positive view of the quality of the relationship between them reduced the impact of loneliness and social isolation on life satisfaction. Findings suggest the need to consider the experiences of both the person with dementia and the carer when investigating the impact of loneliness and social isolation. Individual interventions to mitigate loneliness or isolation may enhance life satisfaction for both partners and not simply the intervention recipient.

Let's Enjoy an Evening on the Couch? A Daily Life Investigation of Shared Problematic Behaviors in Three Couple Studies

Symptom-system fit theory proposes that problematic behaviors are maintained by the social system (e.g., the couple relationship) in which they occur because they help promote positive relationship functioning in the short-term. Across three daily life studies, we examined whether mixed-gender couples reported more positive relationship functioning on days in which they engaged in more shared problematic behaviors. In two studies (Study 1: 82 couples who smoke; Study 2: 117 couples who are inactive), days of more shared problematic behavior were accompanied by higher daily closeness and relationship satisfaction. A third study with 79 couples post-stroke investigating unhealthy eating failed to provide evidence for symptom-system fit. In exploratory lagged analyses, we found more support for prior-day problematic behavior being associated with next-day daily relationship functioning than vice-versa. Together, findings point to the importance of a systems perspective when studying interpersonal dynamics that might be involved in the maintenance of problematic behaviors.

Alcohol Use and Mortality Among Older Couples in the United States: Evidence of Individual and Partner Effects

BACKGROUND AND OBJECTIVES

Spouses with concordant (i.e., similar) drinking behaviors often report better quality marriages and are married longer compared with those who report discordant drinking behaviors. Less is known regarding whether concordant or discordant patterns have implications for health, as couples grow older. The present study examined whether drinking patterns among older couples are associated with mortality over time.

RESEARCH DESIGN AND METHODS

The Health and Retirement Study (HRS) is a nationally representative sample of individuals and their partners (married/cohabiting) over age 50 in the United States, in which participants completed surveys every 2 years. Participants included 4,656 married/cohabiting different-sex couples (9,312 individuals) who completed at least 3 waves of the HRS from 1996 to 2016. Participants reported whether they drank alcohol at all in the last 3 months, and if so, the average amount they drank per week. Mortality data were from 2016.

RESULTS

Analyses revealed concordant drinking spouses (both indicated they drank in the last 3 months) survived longer than discordant drinking spouses (1 partner drinks and the other does not) and concordant nondrinking spouses. Analysis of average drinks per week showed a quadratic association with mortality such that light drinking predicted better survival rates among individuals and their partners compared with abstaining and heavy drinking. Further, similar levels of drinking in terms of the amount of drinking were associated with greater survival, particularly among wives.

DISCUSSION AND IMPLICATIONS

This study moves the field forward by showing that survival varies as a function of one's own and one's partner's drinking.

Evidence of correlations between human partners based on systematic reviews and meta-analyses of 22 traits and UK Biobank analysis of 133 traits

Positive correlations between mates can increase trait variation and prevalence, as well as bias estimates from genetically informed study designs. While past studies of similarity between human mating partners have largely found evidence of positive correlations, to our knowledge, no formal meta-analysis has examined human partner correlations across multiple categories of traits. Thus, we conducted systematic reviews and random-effects meta-analyses of human male-female partner correlations across 22 traits commonly studied by psychologists, economists, sociologists, anthropologists, epidemiologists and geneticists. Using ScienceDirect, PubMed and Google Scholar, we incorporated 480 partner correlations from 199 peer-reviewed studies of co-parents, engaged pairs, married pairs and/or cohabitating pairs that were published on or before 16 August 2022. We also calculated 133 trait correlations using up to 79,074 male-female couples in the UK Biobank (UKB). Estimates of the 22 mean meta-analysed correlations ranged from rmeta = 0.08 (adjusted 95% CI = 0.03, 0.13) for extraversion to rmeta = 0.58 (adjusted 95% CI = 0.50, 0.64) for political values, with funnel plots showing little evidence of publication bias across traits. The 133 UKB correlations ranged from rUKB = -0.18 (adjusted 95% CI = -0.20, -0.16) for chronotype (being a 'morning' or 'evening' person) to rUKB = 0.87 (adjusted 95% CI = 0.86, 0.87) for birth year. Across analyses, political and religious attitudes, educational attainment and some substance use traits showed the highest correlations, while psychological (that is, psychiatric/personality) and anthropometric traits generally yielded lower but positive correlations. We observed high levels of between-sample heterogeneity for most meta-analysed traits, probably because of both systematic differences between samples and true differences in partner correlations across populations.

In it Together: Relationship Transitions and Couple Concordance in Health and Well-Being

Events that change the family system have the potential to impact couple dynamics such as concordance, that is, partner similarity in health and well-being. This project analyzes longitudinal data (≥ two decades) from both partners of up to 3,501 German and 1,842 Australian couples to investigate how couple concordance in life satisfaction, self-rated health, mental health, and physical health might change with transitioning to parenthood and an empty nest. Results revealed couple concordance in intercepts (averaged r = .52), linear trajectories (averaged r = .55), and wave-specific fluctuations around trajectories (averaged r = .21). Concordance in linear trajectories was stronger after transitions (averaged r = .81) than before transitions (averaged r = .43), whereas no systematic transition-related change in concordance of wave-specific fluctuations was found. Findings emphasize that shared transitions represent windows of change capable of sending couples onto mutual upward or downward trajectories in health and well-being.

Substance Use and Relationship Functioning Among Young Male Couples

Research shows that, for different sex couples, individual levels of substance use are deleterious for relationship quality (e.g., satisfaction, intimate partner aggression), whereas dyadic concordance is usually protective. However, there has been no research on these effects among male couples, even though they show increased risk for substance use and certain indices of relationship distress (e.g., intimate partner aggression) compared to different sex couples. Male partners also display distinct similarity patterns and norms surrounding substance use, suggesting that there might be unique effects of substance use on relationship quality among this population. We conducted actor-partner interdependence models of substance use on relationship quality (intimate partner aggression, satisfaction) among a large sample of male dyads (N = 934 individuals, N = 467 dyads). Results suggested that there are novel actor, partner, and similarity effects that imply unique pathways to relationship well-being for male couples. These results are discussed in light of future clinical and empirical efforts. [NCT03186534 - 6/12/2017; NCT03284541 - 6/23/2017].

Relationship Support and Strain among Sexual Minority Women: Changes across Cohorts from 1995 to 2013

Sexual minority women are granted more rights today than ever before. However, it is unclear how the relationships of sexual minority women have changed compared to previous decades. Additionally, a large body of work has focused on women's same-sex (e.g., lesbian) relationships without accounting for the unique experiences of bisexual women in their relationships. The current study utilizes two national samples of heterosexual, lesbian, and bisexual women to address these gaps, one cohort from 1995 and a second from 2013. We performed analyses of variance (ANOVAs) to examine the effects of sexual orientation, cohort, and their interaction on relationship support and strain. On average, relationships exhibited higher quality in 2013 than in 1995. When considered together, lesbian and bisexual women exhibited higher relationship support than heterosexual women in 1995, but not 2013. Importantly, examining lesbian and bisexual women as separate groups revealed that bisexual women's relationships were on average characterized by lower support and higher strain than lesbian women. Simple effects indicated that bisexual women in 2013 were at the highest risk for diminished relationship quality, while lesbian and heterosexual women's relationships were either stable or improved in this more recent cohort. Implications for clinical practice as well as future research on sexual minority women is discussed.

Partner Gender and Binegativity Uniquely Impact Relationship Quality among Bisexual Men

Romantic relationships both buffer and exacerbate adverse health outcomes among bisexual individuals, so understanding determinants of their functioning may be key to correcting health inequities affecting this population. Binegativity (i.e., prejudiced attitudes about bisexuality) expressed from one's intimate partner has the potential to be uniquely impactful for bisexuals, but it is presently unknown how this experience might impact the quality (and therefore potential health promotive effects) of their romantic relationships. In addition, gender of one's current romantic partner may shape experiences of binegativity and relationship quality in important ways. The purpose of this report was to examine how binegativity from intimate partners impacts relationship functioning (i.e., relationship satisfaction and intimate partner aggression) among bisexual men (N = 113), and how the gender of one's partner might moderate this effect. Results suggested that binegativity is detrimentally associated with relationship satisfaction, and that bisexual men in relationships with women report more frequent intimate partner aggression. Furthermore, partner gender and binegativity showed novel interactive associations with intimate partner aggression, such that bisexual men in relationships with women tended to perpetrate less intimate partner aggression when experiencing more binegativity. These results are discussed with regard to future avenues for research into the health promotive benefits of relationships for bisexual individuals.

Motivating Weight Loss Among Black Adults in Relationships: Recommendations for Weight Loss Interventions

BACKGROUND

Black men and women have the highest rates of obesity in the United States. Behavioral weight loss programs incorporating intimate partners may be effective in combating obesity among this population. Yet, current participation in these programs is low. Identifying motivations and triggers to weight loss may provide insight in designing programs to increase participation.

AIM

To determine triggers and motivations for weight loss among Black men and women in committed relationships to inform development of weight loss interventions.

METHOD

Twenty semi-structured interviews, based on an integrated theoretical framework of interdependence and communal coping and the social cognitive theory, were conducted among Black heterosexual couples where one or both individuals intentionally lost ≥5% of their body weight in the last 6 months in a metropolitan region in a southern state. Interviews were transcribed and coded. Themes were identified following multi-rater coding and direct and conventional content analysis. Recommendations were developed from emergent themes.

RESULTS

Among individuals with recent weight loss, personal relevancy and awareness (health awareness and self-awareness) were identified as personal triggers for weight loss initiation. Health concerns and appearance were general motivations among the total sample.

CONCLUSION

Emphasizing the impact of weight on daily functioning and quality of life, and increasing awareness of personal weight status and health consequences, may increase weight loss initiation and participation in weight loss programs among Black men and women in committed relationships. Findings also highlight strategies to improve recruitment and retention and guide intervention development and implementation for this population.

Exploring typologies of appraisals, involvement, and distress in type 2 diabetes family members

The present study conducted a latent profile analysis from a US national sample of 446 family members to identify and predict unique clusters of family members' PWD illness appraisals, involvement, and psychological distress. Time since diagnosis, diabetes adherence, the relationship with the PWD, age, gender, race/ethnicity, income, and economic pressure were included as predictors. Class membership was used to predict the family members' own health behaviors (sleep quality, days of physical activity, and diet quality). Results revealed four distinct classes: Moderately Concerned, Involved, and Distressed (32.51%), Least Concerned, Distressed, and Involved (27.13%), Less Concerned and Distressed, Moderately Involved (23.77%), and Most Concerned, Involved, and Distressed (16.82%). The significant predictors and outcomes of class membership revealed interesting patterns in associations with class membership. Consequently, in addition to involving family members, health promotion and intervention efforts must consider the psychological health and illness appraisals of family members rather than a one-size-fits-all approach.

Mealtime Behavior and Depressive Symptoms in Late-Life Marriage

This study examined whether one spouse's mealtime behaviors were associated with their own and their partner's depressive symptoms among older, married couples. We examined gender differences in these associations and tested marital satisfaction as a mediator of these associations. 101 couples self-reported mealtime behavior (number of meals, snacks, fast-food meals, and meals eaten alone), depressive symptoms, and marital satisfaction. Results of the Actor Partner Interdependence Model revealed a statistically significant actor effect of number of fast-food meals on depressive symptoms and a significant partner effect of number of fast-food meals and number of meals eaten alone on depressive symptoms. There were gender differences. Husbands' marital satisfaction mediated the effect of meals eaten alone on depressive symptoms. Wife's marital satisfaction mediated the effect of the husband's meals eaten alone, and wife's number of fast-food meals on the wife's depressive symptoms. Findings have implications for dyadic interventions to improve depressive symptoms.

The role of partner support for health behaviours in people living with and beyond cancer: A qualitative study

OBJECTIVE

This study aimed to qualitatively explore how partner support for health behaviours is perceived, received, and utilised in people living with and beyond cancer (LWBC).

METHODS

Semi-structured audio interviews were conducted with 24 participants, 15 men and nine women, living with and beyond breast, prostate, and colorectal cancer. Inductive and deductive Thematic Analysis was used to analyse the data.

RESULTS

Three key themes with six subthemes were identified relating to partner support for health behaviours: (1) Interdependence (Reciprocity, Overt Control, Influence & Motivation) (2) Concordance (Shared Attitudes & Health Beliefs, Shared Health Behaviour) and (3) Communal Coping (Communal Orientation towards Health and Decision Making, Co-operative Action in Health Behaviour).

CONCLUSIONS

Partner support plays a unique and significant role in the health behaviours of people LWBC. Partners play a collaborative role in managing health and facilitating health behaviours, while the high level of concordance in couples may represent a potential barrier to change via the reinforcement of maladaptive health beliefs and behaviours.

IMPLICATIONS FOR CANCER SURVIVORS

Overall, findings demonstrate that partners should be considered and included where possible when designing future behaviour change interventions for people LWBC.

Examining foodwork and eating behaviors among heterosexual and gay male couples

OBJECTIVES

Spouses play an important role in their partner's eating behaviors, including both promoting and impeding healthy eating. The division of foodwork in the relationship (i.e., if there is individual or shared responsibility for food roles) may vary as a function of gender or sexual orientation and may be important in understanding eating behaviors.

METHOD

Using cross-sectional, dyadic data from 462 heterosexual and gay married couples (N = 921 individuals) residing in the United States, we accordingly sought to examine which partner was most responsible for two food roles, food shopping and meal preparation (Aim 1); whether these roles differed by gender (Aim 1a) and sexual orientation (Aim 1b); whether these food roles were related to the frequency of eating healthy and unhealthy foods (Aim 2); and whether these associations differed by gender (Aim 2a) and sexual orientation (Aim 2b).

RESULTS

We found that one individual was responsible for these roles in a majority of couples, although meal preparation was more likely to be shared in gay than in heterosexual couples. We also found that, in general, the person responsible for these food roles ate healthy more frequently compared to when their partner was responsible; findings for shared responsibility were more equivocal. These associations did not differ, however as a function of gender or sexual orientation.

CONCLUSION

Our findings contribute to a further understanding of food dynamics among heterosexual and gay male couples and have important implications for health promotion and intervention efforts.

The health consequences of stress in couples: A review and new integrated Dyadic Biobehavioral Stress Model

Despite marriage's health benefits, all couples experience stress that can increase morbidity and mortality risks. Marital stress can alter endocrine, cardiovascular, and immune function-key pathways from troubled relationships to poor health. This review discusses how partners "get under each other's skin" to influence psychological, behavioral, and biological health. Then, I offer a comprehensive Dyadic Biobehavioral Stress Model to build on this foundational work and inspire transdisciplinary research integrating psychoneuroimmunological and relational lenses. This conceptual and empirically driven model provides promising new directions to investigate mechanisms linking individuals' relationships behaviors to their own and their partners' health, with particular emphasis on biological pathways. These mechanisms may impact each partner's physical health outcomes, such as disease development, illness severity, and accelerated biological aging. Risk and protective factors across developmental stages and diverse contexts are also discussed to help explain how, and under what conditions, partners influence each other's health. Research applying this model can push the boundaries of our current understanding on dyadic stress its far-reaching health effects on self-report and biological markers across the lifespan.

Investigating differential protective effects of marriage on substance use by sexual identity status

BACKGROUND

Research suggests that marriage is protective against substance use. However, few studies have examined whether this protective effect differs for sexual minorities, a population at increased risk for substance use. Using data from four waves of the cross-sectional U.S. National Alcohol Survey (NAS; 2000, 2005, 2010, and 2015), we investigated whether the protective effects of marriage varied by sexual identity.

METHODS

Sex-stratified logistic regression models were used to examine independent and interactive effects of current marital status (being married vs. not) and sexual minority status (lesbian/gay/bisexual vs. heterosexual) on high-intensity drinking, alcohol use disorder, and marijuana use in the past year.

RESULTS

Among both women and men, sexual minority status was generally associated with higher odds of these outcomes and marriage was consistently associated with lower odds. Differential effects of marriage by sexual identity with respect to marijuana use were found only among men; marriage was significantly associated with decreased odds of marijuana use among heterosexual men but increased odds among sexual minority men.

CONCLUSIONS

Marriage may be less consistently protective against hazardous drinking and marijuana use among sexual minorities than heterosexuals. Findings underscore the importance of both quantitative and qualitative studies designed to better understand disparities in substance use across both sexual identity and relationship statuses.

Differences in how spouses influence each other's alcohol use in same- and different-sex marriages: A daily diary study

RATIONALE

Different-sex spouses influence each other's alcohol consumption, with women having more influence on their spouses than men. Because women drink less than men, this long-term influence partly explains why married men and women consume less alcohol than their unmarried peers. However, much less is known about possible gender differences in the ways spouses influence each other's alcohol use on a day-to-day basis in same-compared to different-sex marriages. Because sexual minority people are at higher risk for alcohol use disorders compared to their heterosexual counterparts, such knowledge could shed light on ways to reduce this risk and alcohol use disparities between sexual minority and heterosexual people.

METHOD

We use 10 days of diary data collected in 2014-2015 in the United States from 157 female same-sex, 106 male same-sex, and 115 different-sex married couples in midlife (ages 35-65) to examine how one spouse's drinking influences how much the other spouse drinks on the following day.

RESULTS

Men reported higher levels of daily drinking than women; after including covariates, men in different-sex marriages reported drinking at the highest levels. Results from actor-partner interdependence models show that men in same- and different-sex marriages drink more, and women in different-sex marriages drink less when their spouse drinks more the previous day. Female same-sex spouses did not change their drinking behaviors in response to their spouse's drinking.

CONCLUSIONS

Overall higher rates of drinking among men in same-sex marriages suggest an accumulation effect of drinking that may contribute to sexual minority health disparities. Women and men in different-sex marriages may be engaging in social control or navigating masculinity norms. Women in same-sex marriages may not feel the need to adjust to low levels of drinking by their spouses. Findings suggest that spousal influence over alcohol consumption unfolds differently in same-sex compared to different-sex marriages.

Associations between partner's diet undermining and poor diet in mixed-weight, older gay married couples: a dyadic mediation model

BACKGROUND

Prior studies have examined how individuals may undermine their partner's efforts to maintain a healthy diet, but gay couples have not been represented in this work. Additionally, research has not accounted for mixed-weight status [lighter partner (LP) and heavier partner] nor investigated the mechanisms through which undermining is associated with dietary outcomes.

OBJECTIVE/DESIGN/MEASURES

Utilising dyadic data from 224 gay married couples across the United States, we tested associations between perceptions of partner's diet undermining strategies and diet quality with couple food disagreements and depressive symptoms as putative, serial mediators in an actor-partner interdependence mediation model.

RESULTS

Results revealed that more severe diet undermining was associated with both partners' poorer diet quality, which was explained by more frequent couple food disagreements and higher depressive symptoms for both heavier and LPs.

CONCLUSION

These findings suggest that undermining strategies are detrimental to both partners' relational health (increased conflict), emotional health (depressive symptoms) and physical health (diet)-regardless of weight status-and provide valuable targets for prevention and intervention. Our study underscores the interdependence of couple relations in lifestyle changes and specifically highlight the need for health professionals to discuss the partner's indirect or unintended disruptions to the patient's plan.

Self-perceptions of aging and domain-specific health outcomes among midlife and later-life couples

Objectives: This study places the self-perceptions of aging (SPA)-health link in the couple context and examines how changes in one’s own and spouse’s SPA influence multiple health domains and how such associations differ by gender. Methods: Fixed-effects regression models were estimated. Data were drawn from the Health and Retirement Survey ( N = 5972). Results: For both husbands and wives, almost all health domains declined when their own SPA became more negative. The spouse’s SPA were associated with one’s self-rated health, regardless of gender. Gender differences existed in some cross-spousal health effects; while the husband’s SPA were associated with his wife’s depressive symptoms, the wife’s SPA were associated with her husband’s physical disability, functional limitations, and chronic diseases. Discussion: The SPA–health association extends beyond the individual in married persons, demonstrating intertwined health trajectories in older couples. The detrimental effects of ageism might be underestimated if the spillover effects were not considered.

The Gender-as-Relational Approach for Theorizing About Romantic Relationships of Sexual and Gender Minority Mid- to Later-Life Adults

We deploy the "gender-as-relational" (GAR) approach to enhance the study of the long-term romantic relationships of sexual and gender minority mid- to later-life adults. The GAR approach states that gender within relationships is shaped by three key factors: own gender, partner's gender, and the gendered relational context. This approach highlights that the relationship dynamics of men, women, and gender nonconforming people are highly diverse, reflecting that gender is a social construct formed within interactions and institutions. We explicate how GAR can reorganize the study of sexual and gender diversity in three research areas related to aging and relationships-caregiving, marital health benefits, and intimacy-and discuss theory-driven methods appropriate for a GAR research agenda. A GAR framework reorients research by complicating taken-for-granted assumptions about how gender operates within mid- to later-life romantic relationships and queering understandings of aging and romantic relationships to include experiences outside of heteronormative and cisnormative categories.

Sexual- and Gender-Minority Families: A 2010 to 2020 Decade in Review

OBJECTIVE

To review research on sexual and gender minority (SGM) families-including lesbian, gay, bisexual, transgender, queer, asexual, and intersex (LGBTQAI+) families- from 2010-2020.

BACKGROUND

Research on the SGM population has increased and diversified in the past decade.

RESULTS

This paper reviews three subareas that make up the majority of research on SGM families today: (1) SGM family of origin relationships, (2) SGM intimate relationships, and (3) SGM-parent families. This review also highlights three main gaps in the existing literature: (1) a focus on same-sex and gay and lesbian families (and to a lesser extent bisexual and transgender families) and a lack of attention to the families of single SGM people as well as intersex, asexual, queer, polyamorous, and other SGM families; (2) an emphasis on white, socioeconomically advantaged SGM people and a failure to account for the significant racial-ethnic and socioeconomic diversity in the SGM population; and (3) a lack of integration of SGM experiences across the life course, from childhood to old age.

CONCLUSION

The next decade should aim to examine the full range of SGM family ties, include more vigorous examinations of race-ethnicity and socioeconomic status, and develop more robust accounts of family across the life course with novel theory and data sources across the methodological spectrum.

Marriage, divorce, and the immune system

This article reviews evidence from several lines of work to describe how marriage and divorce can provoke health-relevant immune alterations, including ways that marital closeness can be perilous for health and divorce can be beneficial. The multiple stresses of a troubled relationship are depressogenic, and the development of a mood disorder sets the stage for psychological and biological vulnerability. Depression provides a central pathway to immune dysregulation, inflammation, and poor health; gender-related differences in depression and inflammation can heighten risk for women compared to men. Sleep and obesity can simultaneously feed off depression as they promote it. In addition, spousal similarities in health behaviors, gene expression, immune profiles and the gut microbiota offer new ways to consider the health advantages and risks of marriage and divorce, providing new perspectives on couples' interdependence, as well as new directions for research. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Marriage, Social Control, and Health Behavior: A Dyadic Analysis of Same-sex and Different-sex Couples

Prior research based on studies of heterosexual populations suggests that men's health benefits more from marriage than women's, in part because women do more than men to influence the health habits of their spouse. We extend this work by using dyadic survey data from 838 spouses in 419 gay, lesbian, and heterosexual marriages to consider differences in social control tactics across same-sex and different-sex couples-that is, how spouses monitor and regulate each other's health habits. Results suggest that although gender differences in social control are common, gendered patterns sometimes differ depending on whether one is in a same-sex or different-sex marriage. Results also point to the importance of health habits as strong drivers of relationship dynamics across gay and lesbian as well as heterosexual marriages.