"Not Now, I Am Too Stressed": Stress and Physical Intimacy in Early Marriage

Stressful events can disrupt couples' emotional connection, yet prior research is mixed regarding whether stress also disrupts couples' physical intimacy. This study considered whether stress must reach a critical threshold before hindering couples' sexual activity and physical affection (i.e., a curvilinear association). Couples (N = 144 couples plus four additional wives) completed two 14-day daily diary tasks during the early years of marriage. Multilevel modeling revealed a within-person curvilinear association between daily stress and sexual activity. Contrary to expectations, the likelihood of sexual activity declined as stress increased from low to moderate, then leveled off as stress continued to increase. For physical affection, a linear effect emerged. On days of greater stress, women, but not men, reported less affection. Further analyses suggested that women's stress is more influential than men's stress for couple's physical intimacy. Findings highlight the nuanced ways in which stress is linked to a vital component of satisfying relationships.

Blame the Pandemic: Buffering the Association Between Stress and Relationship Quality During the COVID-19 Pandemic

The COVID-19 pandemic created a unique climate for examining the links between stressful conditions and couples’ relationship well-being. According to theories of stress spillover, stressors originating outside the relationship, such as work stress and financial uncertainty, often undermine relationship quality. However, if individuals can easily attribute their problems to the stressful circumstances, their relationship may be more resilient. Given the salience of the pandemic, the current study used two waves of 14-day daily diary data collected from 191 participants to examine whether blaming the pandemic for problems may reduce stress spillover. We also expected the buffering effect of pandemic blaming attributions to wane as stressful conditions persisted and continued to tax partners’ coping resources. Multilevel modeling confirmed that women, but not men, who were more blaming of the pandemic exhibited reduced stress spillover during the COVID-19 outbreak; notably, this buffering effect did not weaken over time.

Respiratory sinus arrhythmia as a dyadic protective factor in the transition to parenthood

Considerable heterogeneity has been observed in couples' adjustment to the transition to parenthood (TTP). One potential yet understudied predictor of emotional adjustment to the TTP is the new parents' capacity for regulation. A widely accepted biological marker of this capacity is respiratory sinus arrhythmia (RSA), which is closely tied to parasympathetic activation. In the present work, we sought to examine the role of tonic RSA and RSA reactivity as possible protective dyadic factors in the TTP. As part of a larger study, we recruited a sample (N = 100) of TTP couples. At 15 weeks postpartum, the couples took part in a lab session during which their RSA was assessed both at rest (tonic RSA) and during four affiliative dyadic interactions (RSA reactivity). Following this session, couples completed daily diaries over a period of 3 weeks, reporting their daily levels of negative affect and stress. A Multivariate Actor Partner Interdependence Model was used to examine the extent to which each partner's RSA predicted their own and their partner's negative affect (NA) level, as well as NA stress-reactivity (i.e., the strength of the within-person stress-affect association). New mothers' tonic RSA predicted their own lower NA level and NA stress-reactivity; both their tonic RSA and RSA reactivity predicted their (male) partners' lower NA level; and finally, new fathers' tonic RSA and RSA reactivity predicted their (female) partners' lower NA stress-reactivity. These results suggest that RSA may serve as a personal and dyadic protective factor.

Acute salivary cortisol response among Mexican American adolescents in immigrant families

OBJECTIVES

Though previous research has indicated that language brokering can be stressful, the findings are mixed, pointing to potential moderators of the association. Guided by an ecological perspective, we examined the role of individual, family, and environmental factors in Mexican American adolescents' acute cortisol responses to language brokering.

METHOD

The study consisted of 46 Mexican American adolescents recruited around a metropolitan city in Central Texas. Participants translated a difficult medical document from English to Spanish for their parents, followed by an arithmetic task (modeled after the Trier Social Stress Test [TSST]). Participants' perceptions (perceived efficacy and parental dependence), parental hostility, and discrimination experiences were assessed via self-report and were examined as moderators of adolescents' responses to the task.

RESULTS

Results revealed differential responses to the task based on individual, family, and environmental factors. High efficacy and low dependence-parental hostility-discrimination related to stress responses characterized by low baselines, steeper reactivity, and faster recovery. Low efficacy and high dependence related to greater baseline stress and a slower recovery. High levels of parental hostility related to a slower recovery. High levels of discrimination related to greater baseline stress.

CONCLUSIONS

The study demonstrates that the modified TSST task can elicit an acute hypothalamic-pituitary-adrenal axis response, but the nature of this response is dependent upon participants' perceptions of language brokering (parental dependence and efficacy), parental hostility, and discrimination experiences. Adolescents' individual characteristics and contextual demands remain important considerations in understanding their acute stress responses. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Daily Support Equity in Romantic Couples

Receiving support may yield negative outcomes, although these can be offset by reciprocating support. Here, we argue that support receipt and reciprocation should be considered with reference to two separate needs, for relatedness/communion and competence/agency, which underlie differential effects of equity on affective versus relational outcomes. To test these, we go beyond earlier studies by (a) examining equity along a (daily) continuum, (b) using the novel analytic approach of polynomial regression with response surface analyses, and (c) indexing equity from both monadic and dyadic perspectives. Using dyadic daily diaries ( NDays = 35, NCouples = 80), we found personal outcomes (positive affect [PA] and negative affect [NA]) to be worst on inequitable days, particularly overbenefit ones. In contrast, equity did not play the same role with regard to relational outcomes (closeness/satisfaction), for which overbenefit proved more positive. Interestingly, the monadic and dyadic perspectives converged more with personal than with relational outcomes.

Reciprocal support and daily perceived control: Developing a better understanding of daily support transactions across a major life transition

A paradox of social support has been well documented: believing that support is available and perceiving high levels of it has well-established mental health benefits, but the actual receipt of support is often found to be ineffective and even detrimental (see Gleason & Iida, 2015). Researchers have suggested that support receipt may be associated with negative mood because it is linked with a lack of self-efficacy or perceived control (Bolger & Amarel, 2007). Research on daily support transactions found that reciprocal emotional support exchanges counteracted the negative effects associated with support receipt, but there was significant variation between individuals in their reactions to support exchanges suggesting that a potential moderating variable of the support pattern exists. Using a daily diary study of 78 couples approaching a shared stressor, the transition to parenthood, associations between control, self- and partner-reported support, and mood were investigated. Couples were asked to complete three weeks of daily diaries at three different time points. Previous support pattern effects on mood were replicated for partners, but whereas reciprocity was beneficial for mothers, support receipt alone was not negative. Perceived control was found to be a moderator of this process such that the greater an individual's sense of perceived control, the more one is buffered from any negative effects of support transactions. Exploratory analyses also suggest that overall patterns of supportive reciprocity influence marital satisfaction across the transition to parenthood. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Initial elevation bias in subjective reports

People's reports of their thoughts, feelings, and behaviors are used in many fields of biomedical and social science. When these states have been studied over time, researchers have often observed an unpredicted and puzzling decrease with repeated assessment. When noted, this pattern has been called an "attenuation effect," suggesting that the effect is due to bias in later reports. However, the pattern could also be consistent with an initial elevation bias. We present systematic, experimental investigations of this effect in four field studies (study 1: n = 870; study 2: n = 246; study 3: n = 870; study 4: n = 141). Findings show clear support for an initial elevation bias rather than a later decline. This bias is larger for reports of internal states than for behaviors and for negative mental states and physical symptoms than for positive states. We encourage increased awareness and investigation of this initial elevation bias in all research using subjective reports.

The role of emotional capital during the early years of marriage: Why everyday moments matter

Throughout a marriage couples will share countless ordinary moments together that may seem trivial, but which actually have potential to affirm and strengthen relational bonds. According to theories of emotional capital, the accumulation of shared positive moments in a relationship should serve as an essential resource for protecting the relationship against threats. To date, however, few empirical studies have explored the role emotional capital may play in shaping responses to negative relationship experiences. In the current study, newly married couples completed 3 14-day daily diary tasks assessing emotional capital, negative partner behaviors, and marital satisfaction over a 3-year period, for a total of 42 potential days of diary data. Contrary to predictions, emotional capital on a given day was not associated with reactivity to relationship threats on the following day. However, conceptually replicating prior work, individuals who accumulated more emotional capital on average across the diary tasks did exhibit lower reactivity to daily relationship threats; that is, on days of greater relationship threat (i.e., negative partner behaviors), those spouses who generally accrued more shared positive moments with their partner maintained greater feelings of marital satisfaction compared with spouses who accrued fewer positive moments. These findings contribute to a growing literature illustrating how positive shared activities between partners help sustain relationship quality over time. (PsycINFO Database Record

Daily Supportive Equity in Close Relationships

Receiving support in committed relationships has frequently been associated with negative psychological outcomes in the recipient, such as increased distress. The authors hypothesized that these negative effects could be offset by support recipients' reciprocation of support, that is, by creating a sense of supportive equity. To investigate this hypothesis, the authors obtained daily reports of mood and of received and given emotional support from both partners in 85 couples throughout a 4-week period. Reciprocity in support transactions was associated with higher levels of positive mood and lower levels of negative mood. In line with previous research, receiving support without reciprocation was associated with increases in negative mood. Giving support, regardless of receipt, was associated with a decrease in negative mood.

Symptoms of borderline personality disorder predict interpersonal (but not independent) stressful life events in a community sample of older adults

Individuals with borderline personality disorder (BPD) often experience stressful life events at a higher frequency than those without BPD. It is less clear what specific types of events are involved in this effect, and it has not been determined whether some features of BPD are more important than others in accounting for this effect. The latter issue is important in light of the heterogeneous nature of this diagnostic construct. These issues were examined in a large, representative community sample of men and women, ages 55-64. Ten Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR, Washington, DC, American Psychiatric Association, 2000) personality disorders were assessed at baseline using the Structured Interview for DSM-IV Personality: SIDP-IV (B. Pfohl, N. Blum, & M. Zimmerman, 1997, Washington, DC, American Psychiatric Press). Life events were measured at three sequential assessments following baseline at 6-month (N = 1,294), 12-month (N = 1,070), and 18-month (N = 837) follow-ups. Stressful life events were identified using a self-report questionnaire (LTE-Q; List of Threatening Experiences Questionnaire: A subset of prescribed life events with considerable long-term contextual threat by T. Brugha, C. Bebbington, P. Tennant, and J. Hurry, 1985, Psychological Medicine, Vol. 15, pp. 189-194.) followed by a telephone interview. Only borderline personality pathology was related to an increase in the frequency of interpersonal stressful life events. Three specific symptoms of BPD were largely responsible for this connection: unstable interpersonal relationships, impulsivity, and chronic feelings of emptiness (negative association). Symptoms of avoidant and schizoid personality disorders were associated with a reduced number of stressful life events that are considered to be outside a person's control (e.g., serious illness, injury, or death of a loved one). None of the personality disorders predicted an increase in the number of stressful financial events (e.g., major financial crisis). These findings suggest that, as individuals approach later life, certain features of BPD continue to serve as important risk factors for stressful life events of an interpersonal nature.

The enduring impact of maladaptive personality traits on relationship quality and health in later life

Over the past 5 years, the St. Louis Personality and Aging Network (SPAN) has been collecting data on personality in later life with an emphasis on maladaptive personality, social integration, and health outcomes in a representative sample of 1,630 adults aged 55-64 living in the St. Louis area. This program has confirmed the importance of considering both the normal range of personality and in particular the role of maladaptive traits in order to understand individuals' relationships, life events, and health outcomes. In the current article, we discuss the explanatory benefits of considering maladaptive traits or traits associated with personality disorders when discussing the role of personality in social and health outcomes, with an emphasis on adults in middle to later life, and integrate these findings into the greater literature.

Prevalence of Personality Disorders at Midlife in a Community Sample: Disorders and Symptoms Reflected in Interview, Self, and Informant Reports

This report is concerned with the prevalence of symptoms of specific personality disorders in a representative community sample and draws attention to the importance of different sources of diagnostic information. We recruited a sample of 1,630 people between the ages of 55 and 64 to participate in a study regarding personality and health. Using careful recruitment methods, our participation rate was 43 %. Participants completed the SIDP-IV interview as well as a questionnaire (self-report MAPP). Informants completed the same questionnaire (informant MAPP), describing the participant's maladaptive personality characteristics. According to the diagnostic interview, 7 % of participants met criteria for exactly one PD, 1 % met criteria for 2 or 3 PDs, and 2 % met criteria for PD NOS (defined as 10 or more miscellaneous criteria). Avoidant and obsessive compulsive PDs were the most common types. Correlations between the three sources of information indicated significant agreement among these measurement methods, but they are not redundant. In comparison to interview and self-report data, informants reported more symptoms of personality pathology (except for avoidant PD). Symptoms of personality pathology are continuously distributed, and subthreshold features may have an important impact on health and social adjustment. In this community sample, rates of co-morbidity among PDs and the proportion of PDNOS diagnoses are substantially lower than reported from clinical samples. Future research must evaluate the validity of diagnostic thresholds and competing sources of diagnostic information in relation to important life outcomes.

The role of locus of control in daily life

Conceived of as a stable trait, locus of control has been linked with psychological and physical health outcomes. We investigated whether locus of control operates as a state variable, whether variation in daily locus of control is associated with anxiety and stressful events, and whether it predicts daily health behaviors and symptoms. Using a daily diary study of pregnant couples, we found daily variation in locus of control was predicted by daily hassles and anxiety such that high same-day and previous-day anxiety and hassles were associated with reports of lower levels of control. Furthermore, daily locus of control was positively associated with positive health behaviors and predicted negative health symptoms. These results provide evidence for a social learning perspective on the development and maintenance of individuals' sense of control and suggest that locus of control should be considered both a state- and trait-level construct in future research.

Borderline but not antisocial personality disorder symptoms are related to self-reported partner aggression in late middle-age

We examined the relationship between personality pathology and the frequency of self-reported psychological and physical partner aggression in a community sample of 872 adults aged 55-64. Previous research suggests that antisocial and borderline personality disorder (PD) symptoms are associated with partner aggression. Controlling for gender, education, alcohol dependence, and other personality pathology, we found that borderline PD symptoms, which include abandonment fears, unstable identity, and affective instability, were significantly related to the frequency of self-reported aggression toward one's partner. This relationship was observed regardless of whether the participant's personality was described by a clinical interviewer, the participant themselves, or an informant chosen by the participant. Further, the relationship between borderline PD symptoms and self-reported partner aggression was moderated by gender such that women were driving the association. Conversely, antisocial PD symptoms, which include deceitfulness, irresponsibility, disregard for rules, and lack of remorse did not significantly account for variance in self-reported partner aggression.

The enduring impact of borderline personality pathology: risk for threatening life events in later middle-age

Both neuroticism and borderline personality disorder (BPD) are associated with increased frequency of stressful life events in young adults. It is not clear, however, whether this effect extends to later life because BPD is apparently diminished in frequency and severity when people reach middle adulthood. This issue was examined in a representative, community sample of men and women between the ages of 55 and 64 (N = 1,234). Ten DSM-IV PDs and neuroticism were assessed at baseline using a semistructured interview (SIDP-IV) and questionnaire (NEO-PI-R). Life events were measured 6 months later with a self-report questionnaire (LTE-Q) followed by a telephone interview. BPD features and neuroticism predicted increased frequency of life events, based on both self and interviewer-adjusted reports of negative life events. Avoidant and paranoid PD features predicted decreased frequency of negative life events. Approximately 42% of events reported on the LTE-Q were discounted following the telephone interview; higher scores on BPD symptoms were associated with more adjustments to self-report of threatening experiences. These findings indicate that symptoms of BPD and neuroticism continue to have a harmful impact on the lives of older adults.

Physicians' Use of Patients' Daily Reports of Quality of Life to Evaluate Treatment Response in Phase I Cancer Trials

For cancer patients on Phase I trials, one of the most important physician decisions is whether or not patients are deriving benefit from therapy. With an increasing number of cytostatic treatment agents, the criteria to determine patient response to Phase I treatment has become harder to define. Physicians are increasingly looking to patient-reported outcomes (PROs) such as quality of life (QOL) to help evaluate treatment response. Electronic daily diary (EDD) devices can be used by patients to report their QOL over extended periods of time, thereby providing a more accurate picture of how patients are affected by treatment on a daily basis. However, questions remain about how to integrate this patient-reported information into decisions about Phase I treatment. This study investigated how physicians use patients' daily QOL reports to evaluate patient response to Phase I treatment. Data were collected over a 4-month period from Phase I patients (N = 30) and physicians (N = 3) in an NCI-designated comprehensive cancer center. Patients completed daily QOL reports using EDD devices and physicians were provided with a summary of patients' QOL before each visit. After the visit, doctors recorded their treatment decision and also rated the importance of four biomedical factors (Toxicity, Imaging, Labs, and Performance Status) and QOL in their treatment decision for that visit. Although physicians rated QOL as being very important in evaluating treatment response, in practice, when predictors of their decisions were analyzed, results showed they relied exclusively on biomedical data (Toxicity, Imaging) to make Phase I treatment decisions. Questions remain about the utility and effective integration of QOL and biomedical data in clinical decision-making processes in Phase I clinical trials.

The influence of patient expectations regarding cure on treatment decisions

OBJECTIVE

To test whether cancer patients' expectations for cure prior to interacting with their oncologist influence their decisions to follow treatment recommendations. Further, to test whether patients' expectations for cure are affected by the strength of the oncologist-patient alliance or the extent to which companions (if present) share patients' expectations for cure.

METHODS

Interactions of 101 patients (and 114 companions) with oncologists about treatment were coded for the strength of the oncologist-patient alliance. Prior to the interaction, patients and companions reported expectations about whether the patient would be cured of cancer. After the interaction, patients reported whether they intended to follow the recommended treatment.

RESULTS

Patients who expected a cure were more likely to report an intention to follow oncologists' treatment recommendation when the strength of their alliance with their oncologist was weaker (B=-0.51, p<.05). Patients whose expectations for cure matched their companions' expectations were less likely to report intentions to follow treatment recommendations (B=-0.28, p<.05).

CONCLUSION

Patients who have an expectation of being cured of cancer prior to meeting with their oncologist are more likely to intend to follow recommended treatment when their alliance with the oncologist is weaker and their companions do not believe they will be cured.

PRACTICE IMPLICATIONS

To better understand patient treatment decisions and improve overall cancer care, oncologists should be aware of the complex ways that patients' expectations about cure influence treatment choices.

Receiving support as a mixed blessing: evidence for dual effects of support on psychological outcomes

Although social support is thought to boost feelings of closeness in dyadic relationships, recent findings have suggested that support receipt can increase distress in recipients. The authors investigated these apparently contrary findings in a large daily diary study of couples over 31 days leading up to a major stressor. Results confirm that daily support receipt was associated with greater feelings of closeness and greater negative mood. These average effects, however, masked substantial heterogeneity. In particular, those recipients showing greater benefits on closeness tended to show lesser cost on negative mood, and vice versa. Self-esteem was examined as a possible moderator of support effects, but its role was evident in only a subset of recipients. These results imply that models of dyadic support processes must accord a central role to between-individual heterogeneity.

Influence of clinical communication on patients' decision making on participation in clinical trials

PURPOSE

To investigate how communication among physicians, patients, and family/companions influences patients' decision making about participation in clinical trials.

PATIENTS AND METHODS

We video recorded 235 outpatient interactions occurring among oncologists, patients, and family/companions (if present) at two comprehensive cancer centers. We combined interaction analysis of the real-time video-recorded observations (collected at Time 1) with patient self-reports (Time 2) to determine how communication about trial offers influenced accrual decisions.

RESULTS

Clinical trials were explicitly offered in 20% of the interactions. When offers were made and patients perceived they were offered a trial, 75% of patients assented. Observed messages (at Time 1) directly related to patients' self-reports regarding their decisions (2 weeks later), and how they felt about their decisions and their physicians. Specifically, messages that help build a sense of an alliance (among all parties, including the family/companions), provide support (tangible assistance and reassurance about managing adverse effects), and provide medical content in language that patients and family/companions understand are associated with the patient's decision and decision-making process.

CONCLUSION

In two urban, National Cancer Institute-designated comprehensive cancer centers, a large percentage of patients are not offered trials. When offered a trial, most patients enroll. The quality and quantity of communication occurring among the oncologist, patient, and family/companion when trials are discussed matter in the patient's decision-making process. These findings can help increase physician awareness of the ways that messages and communication behaviors can be observed and evaluated to improve clinical practice and research.

Receiving support as a mixed blessing: evidence for dual effects of support on psychological outcomes

Although social support is thought to boost feelings of closeness in dyadic relationships, recent findings have suggested that support receipt can increase distress in recipients. The authors investigated these apparently contrary findings in a large daily diary study of couples over 31 days leading up to a major stressor. Results confirm that daily support receipt was associated with greater feelings of closeness and greater negative mood. These average effects, however, masked substantial heterogeneity. In particular, those recipients showing greater benefits on closeness tended to show lesser cost on negative mood, and vice versa. Self-esteem was examined as a possible moderator of support effects, but its role was evident in only a subset of recipients. These results imply that models of dyadic support processes must accord a central role to between-individual heterogeneity.

Overdiagnosis and underdiagnosis of personality disorders in older adults

OBJECTIVE

Recent evidence suggests that some of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition personality disorder (PD) criteria contain measurement bias across age groups. Specifically, this research showed that younger and older adults were differentially likely to endorse certain PD criteria, even when both groups were statistically matched using mechanisms of item response theory (IRT) for degree of PD pathology. For the analyses presented here, the authors used data from a large epidemiological study (N = 43,093), the National Epidemiologic Survey on Alcohol and Related Conditions, to examine the influence of this item-level measurement bias for reaching accurate algorithmic PD diagnoses of older adults.

METHODS

Joint probability analyses were used to determine the net effect of the item-level bias on the possible over- or underdiagnosis of six PDs in older adults.

RESULTS

When older adults were compared to younger adults at equivalent levels of PD pathology, they were more likely to receive diagnoses of obsessive-compulsive and schizoid PDs. In contrast, they were less likely to receive diagnoses of avoidant and dependent PDs. Younger and older adults were equally likely to receive diagnoses of histrionic and paranoid PDs. Of the seven PDs assessed in this dataset, only these six lend themselves to this type of analysis; antisocial PD differs because a diagnosis depends upon the presence of conduct disorder.

CONCLUSION

These findings raise concerns regarding the interpretation of existing older adult PD prevalence data.

An item response theory analysis of DSM-IV personality disorder criteria across younger and older age groups

Many of the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV; American Psychiatric Association, 1994) personality disorder (PD) diagnostic criteria focus on a younger social and occupational context. The absence of age-appropriate criteria for older adults forces researchers and clinicians to draw conclusions based on existing criteria, which are likely inadequate. To explore which DSM-IV PD criteria contain age group measurement bias, the authors report 2 analyses of data on nearly 37,000 participants, ages 18-98 years, taken from a public data set that includes 7 of the 10 PDs (antisocial, avoidant, dependent, histrionic, obsessive-compulsive, paranoid, and schizoid). The 1st analysis revealed that older age groups tend to endorse fewer PD criteria than younger age groups. The 2nd analysis revealed that 29% of the criteria contain measurement bias. Although the latent variable structure for each PD was quite similar across younger and older age groups, some individual criteria were differentially endorsed by younger and older adults with equivalent PD pathology. The presence of measurement bias for these criteria raises questions concerning the assessment of PDs in older adults and the interpretation of existing data.

Meta-perception for pathological personality traits: do we know when others think that we are difficult?

The self allows us to reflect on our own behavior and to imagine what others think of us. Clinical experience suggests that these abilities may be impaired in people with personality disorders. They do not recognize the impact that their behavior has on others, and they have difficulty understanding how they are seen by others. We collected information regarding pathological personality traits--using both self and peer report measures--from groups of people who knew each other well (at the end of basic military training). In previous papers, we have reported that agreement between self-report and peer-report is only modest. In this paper, we address the question: Do people know that others disagree with their own perceptions of themselves? We found that expected peer scores predicted variability in peer report over and above self-report for all 10 diagnostic traits. People do have some incremental knowledge of how they are viewed by others, but they do not tell you about it unless you ask them to do so; the knowledge is not reflected in ordinary self-report data. Among participants who expect their peers to describe them as narcissistic, those who agree with this assessment are viewed as being less narcissistic by their peers than those who deny being narcissistic. It therefore appears that insight into how one is viewed by others can moderate negative impressions fostered by PD traits.