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PubMed1990

Identification of spouses at high risk during bereavement: a preliminary assessment of Parkes and Weiss' Risk Index.

The Risk Index developed by Parkes and Weiss (1983) is a brief structured assessment tool for identifying bereaved spouses who may be at high risk for developing complications during bereavement. The present study was undertaken to evaluate the utility of the Risk Index in predicting outcome during the first year of bereavement in spouses of deceased hospice patients. Professional staff at the hospice completed the Risk Index shortly after the spouse died and outcome was then assessed after 1, 3, 6, and 12 months. High-risk bereaved were younger than low-risk bereaved. Number of young children at home, existence of close relationships, and financial status were important predictors of outcome during the first year of bereavement. The findings suggest that the Risk Index may serve as a cost-effective means of assessing risk for complications during the first year of bereavement.

Abstracting and Indexing↗
PubMed2002

Adult attachment stance and spouses' marital perceptions during the transition to parenthood.

The relationship between adult attachment and marital perceptions was examined in couples making the transition to parenthood. The Adult Attachment Interview was administered to spouses prenatally, and marital perceptions were assessed prenatally and 3, 12, and 24 months postnatally. The couples were also observed during a marital interaction task. Spouses were assigned to groups based on their attachment security (secure/insecure) and mean level (low/high) of negative emotional escalation in their marital interactions. A series of two-way (attachment security by negative emotional escalation) repeated multivariate analyses of variance, followed by univariate analyses, revealed that insecure husbands and the wives of insecure husbands exhibited different patterns in their marital perceptions than secure husbands and the wives of secure husbands when in high negative escalation marriages. Insecure husbands and the wives of insecure husbands in high negative escalation marriages reported greater declines in positive marital perceptions or less positive marital perceptions overall across the two-year postnatal period than secure husbands and wives of secure husbands in similarly high conflict marriages. Such differences between secure and insecure husbands (and their wives) were not apparent in low negative escalation marriages. Findings are discussed in terms of the protective effect a secure attachment may convey upon spouses during stressful periods in their marriage.

Adult↗
PubMed1993

Quantification of the cardinal signs of parkinsonism and of associated disability in spouses of sufferers.

Work on the causation of idiopathic parkinsonism is limited by relying on gross clinical definition and lack of studies in the old. A prognostic index for parkinsonism, based on hypo/bradykinesia of gait, had considerably higher values in spouses of 20 aged suffers, who had been cohabiting for about half a century, than in 40 controls. Postural abnormality, measured by standing sway and foot separation during walking, was also greater in these spouses. Marked differences remained after correction for relevant covariates. A blinded rigidity rating was greater in the spouses of sufferers, tremor rating was not. The differences found are difficult to explain by selective mating, learned or reactive behaviour. This suggests that environmental causative influences operate in adult life.

Aged↗
PubMed1991

Assessment of quality of life by patient and spouse during antihypertensive therapy with atenolol and nifedipine gastrointestinal therapeutic system.

To evaluate differences in efficacy, safety, and quality of life, 394 male patients with mild-to-moderate hypertension were randomized to receive 20 weeks of either atenolol or nifedipine gastrointestinal therapeutic system (GITS) in a multicenter double-blind trial. A four-week placebo washout was followed by 8 weeks of titration and 12 weeks of maintenance therapy. Quality-of-life evaluation included clinical assessments by the patient and parallel take-home assessments by patient and spouse. Blood pressure was controlled equally in both groups. The total incidence of adverse reactions was similar in both groups, but a greater percentage of nifedipine GITS patients withdrew due to peripheral edema. Patients completing 20 weeks of therapy demonstrated a more favorable quality-of-life profile (P less than .05) for nifedipine GITS over atenolol in psychosocial (P less than .01), well-being (P less than .05), general affect (P less than .05), emotional ties (P less than .01), emotional control (P less than .05), vitality (P less than .05), and leisure (P less than .05) scores. Treatment differences were particularly pronounced for patients over 50 years of age and were not fully detectable until after 14 weeks of therapy. Deterioration in quality of life was associated with withdrawal. Spouses of younger patients receiving atenolol reported deterioration in sexual satisfaction as compared to spouses of patients taking nifedipine GITS (P less than .02). Thus age, length of trial, and third-party observation are important factors in quality-of-life assessment. Comparison of adverse reactions provides an incomplete measure of how well a drug is tolerated. In contrast, findings indicate that even subtle CNS-mediated effects on mood and well-being can be detected by quality-of-life evaluation.

Adult↗
PubMed1989

The health impact of living with a cognitively impaired elderly spouse: depressive symptoms and social functioning.

The purpose of this study was to identify the social and psychological consequences of living with a cognitively impaired spouse among community-dwelling elderly individuals. The study sample consisted of 318 spouse pairs drawn from a representative sample of noninstitutionalized elderly individuals. Our principal findings were that: (a) Cognitive impairment in wives is significantly (p less than .05) associated with depressive symptomatology in husbands, whereas cognitive impairment in husbands is only weakly (p greater than .20) associated with depressive symptomatology in wives; (b) Decreased participation in social/leisure activities is selectively related to spouses' level of cognitive functioning among both men and women; (c) The relationship between wives' cognitive impairment and husbands' depressive symptoms is influenced by perceived availability of financial support from friends and relatives, but not by ADL limitations in wives, lack of emotional or instrumental support from wives, household responsibilities among husbands, or lack of participation in social/leisure activities in husbands.

Activities of Daily Living↗
PubMed2000

Does type of disease matter? Gender differences among Alzheimer's and Parkinson's disease spouse caregivers.

PURPOSE OF STUDY: Mental health outcomes are widely reported among spouse caregivers, with wives generally faring worse than husbands. We hypothesized that gender differences would not be as strong in a cognitively intact group because caring for cognitively intact spouses may involve less severe reciprocity losses. We also examined gender differences in coping strategies within each group. DESIGN AND METHOD: 175 spouse caregivers for patients with Alzheimer's disease (AD; n = 88) and Parkinson's disease (PD; n = 87) were interviewed. Participants completed perceived stress (PSS), depression (CES-D), state anxiety (STAI, Form Y), and coping strategies (WCCL-R) measures. RESULTS: Wives in the AD group reported significantly worse mental health outcomes than husbands, while wives and husbands in the PD group showed no differences. AD caregiving wives were less likely than husbands to use problem-focused coping strategies. There were no significant gender differences in either group for social support or emotion-focused coping. IMPLICATIONS: Loss of reciprocity in marital relationships may affect women more negatively than men. Future studies that address underlying mechanisms of gender differences and focus on similar caregiving situations and contexts deserve attention.

Adaptation, Psychological↗
PubMed1976

Marital satisfaction as perceived by the medical student's spouse.

This is a report of student marriages as perceived by spouses of medical students at the Southwestern Medical School, University of Texas Health Science Center at Dallas. Between August and November 1974 a questionnaire was sent to all spouses (239) of sophomore, junior, and senior students and 1974 graduates. The questionnaire examined: areas of stress within marriage, congruence between expected and actual behavior in the marital partner's role performance, and the spouse's attitudes toward marital counseling and whether a marital counseling service should be made available. Stress factors frequently cited were student's preoccupation due to school pressures, limited finances for recreation and nonessentials, student's inaccessibility due to school and loneliness. Most respondents stated satisfaction with their marriage; however, 38 percent indicated that their marriage could have benefited from counseling some time during medical school.

Adult↗
PubMed1988

Stressors and psychological symptoms of family practice residents and spouses.

Fifty-nine family practice residents and their spouses from one university-based and three community-based residency programs were studied to assess the frequency of stressful events in their lives and to quantify adverse psychosocial effects associated with that stress. A modified version of a questionnaire produced and tested by the University of Minnesota and the widely used, standardized Symptom Checklist-90 (SCL-90) were used to assess stress and psychological symptoms. There was a high correlation between high numbers of stressful events in the residents' and spouses' lives and high ratings of psychological symptoms. This finding was particularly true for the female residents. Overall, the residents' responses were near the mean for a nonpatient group used as a normative comparison on each of the nine subscales of the SCL-90 and on the overall mean for the entire scale. This finding indicated that the residents, although their lives were quite stressful, were handling the stress without major problems. The residents and their spouses also answered questions about 10 therapeutic interventions concerning stress and indicated which interventions they preferred.

Family Practice↗
PubMedDate not supplied

Spouse-pair similarity on the California Psychological Inventory with reference to husband's coronary heart disease.

The present article reports on the results of several comparisons between 45 adult males with diagnosed coronary heart disease (cases) and their wives and 50 adult males without coronary heart disease (noncases) and their wives recruited from the Western Collaborative Group Study. The California Psychological Inventory and a life satisfaction inventory were administered to the couples in the two types of families. Results indicate that although both sets of husbands and wives fell within the well-functioning range on the CPI, wives of cases were significantly more dominant and less flexible than wives of noncase husbands. Case husbands were significantly more dominant than noncase husbands. No mean differences existed between case and noncase husbands and wives on a variety of life satisfaction measures. Computation of spouse-pair correlations revealed a pattern of overall dissimilarity across the CPI scales for case couples and overall similarity for the noncase couples. The only scale on which case spouse pairs were significantly similar was one measuring depression. Noncase couples were significantly more similar than case couples on scales measuring sociability, self-acceptance, and socialization. Previous findings from the research literature in the fields of personality, cardiac rehabilitation, and assortative mating are used to generate three competing hypotheses relating the present findings to cross spouse disease associations.

Achievement↗
PubMedDate not supplied

Exposure of heterosexuals to human immunodeficiency virus and viremia: evidence for continuing risks in spouses of hemophiliacs.

There is risk of transmission of human immunodeficiency virus (HIV) in sexually active couples, one of whom is seropositive. However, the frequency of such HIV transmission is not known. We have surveyed a population of monogamous hemophiliacs treated with potentially-infected coagulation factor concentrates during 1980-1984. We found high titers of antibodies to HIV in 24 of 30 hemophiliacs and in four of 30 spouses. The duration of HIV exposure from unprotected sexual intercourse ranged from greater than 12 to 78 months. The acquired immunodeficiency syndrome (AIDS) developed in six hemophiliac husbands, and one seropositive wife has lymphadenopathy. We were concerned that viremia with HIV might be the primary determinant of transmission to the men's wives. Circulating HIV was found in all of four hemophiliacs with AIDS, both of two with AIDS-related complex (ARC), four of 14 asymptomatic hemophiliacs, and two of four seropositive spouses. Isolation of HIV was less likely from asymptomatic hemophiliacs (29%) than from asymptomatic seropositive men (71%) in other high-risk groups. Our studies suggest that HIV was transmitted to 17% of the spouses of hemophiliacs. Efforts to educate all such couples about the risk of HIV infection remain imperative.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Cardiovascular reactivity and the presence of pets, friends, and spouses: the truth about cats and dogs.

OBJECTIVE: The purpose of this study was to examine the effects of the presence of friends, spouses, and pets on cardiovascular reactivity to psychological and physical stress. METHODS: Cardiovascular reactivity was examined among 240 married couples, half of whom owned a pet. Mental arithmetic and cold pressor were performed in one of four randomly assigned social support conditions: alone, with pet or friend (friend present for non-pet owners), with spouse, with spouse and pet/friend. RESULTS: Relative to people without pets, people with pets had significantly lower heart rate and blood pressure levels during a resting baseline, significantly smaller increases (ie, reactivity) from baseline levels during the mental arithmetic and cold pressor, and faster recovery. Among pet owners, the lowest reactivity and quickest recovery was observed in the pet-present conditions. CONCLUSIONS: People perceive pets as important, supportive parts of their lives, and significant cardiovascular and behavioral benefits are associated with those perceptions.

Adult↗
PubMed1998

Identifying causes of disagreement between self-reports and spouse ratings of personality.

Self-reports and spouse ratings of personality traits typically show less-than-perfect agreement, but powerful moderators of agreement have not yet been identified. In Study 1, 47 married couples completed the Revised NEO Personality Inventory to describe themselves and their spouses. Extent of agreement was not consistently moderated by response sets; the age, intelligence, or education of the respondent; or the length or quality of the relationship. In Study 2 these couples were interviewed about reasons for substantial disagreements, and an audiotape was content-analyzed. Sixteen reasons were reliably coded, including idiosyncratic understanding of items, reference to different time frames or roles, and unavailability of covert experience to the spouse. Faking good, assumed similarity, and other variables prominent in the psychometric literature were relatively unimportant. Findings (1) suggest that attempts to improve the validity of self-reports and ratings may need to be refocused and (2) underscore the desirability of routinely obtaining multiple sources of information on personality.

Adult↗
PubMed1993

Transmission of oral bacterial species between spouses.

The transmission of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and mutans streptococci was studied between 4 married couples who suffered from advanced periodontitis. Of the 20 couples investigated, the 4 in which both spouses harbored A. actinomycetemcomitans and P. gingivalis were chosen for the transmission study. Three of these couples also harbored mutans streptococci. A. actinomycetemcomitans isolates (8-24 per subject) and mutans streptococcal isolates (5-23 per subject) were serotyped by immunodiffusion technique. For ribotyping, chromosomal DNA from A. actinomycetemcomitans isolates (4-5 per subject) and mutans streptococcal isolates (4-11 per subject) was digested with restriction endonucleases ClaI or BglI and HindIII or SmaI, respectively. P. gingivalis isolates (2-15 per subject) were ribotyped by using ClaI, BglI and SmaI. The blotted restriction fragments were hybridized to the plasmid pKK3535, which contains the rRNA operon of the E. coli chromosome. The spouses in 2 couples shared the same sero- and ribotypes of A. actinomycetemcomitans and S. mutans. P. gingivalis ribotypes were identical in 2 couples. The result suggests transmission of oral bacteria between spouses.

Adult↗
PubMed1999

Sexual transmission and reinfection of group B streptococci between spouses.

OBJECTIVE: To study how GBS infection takes place between pregnant GBS-carriers and their husbands. METHODS: Pregnant women in whom GBS infections could be detected during 26 to 30 weeks of pregnancy and their husbands were studied during the two periods of August 1994 through May 1995 (Period A, 243 couples) and June through September 1997 (Period B, 141 couples). A urine sample was collected from a husband in the same morning when the vagina of his wife was tested for GBS. GBS were also classified according to their serotypes in 34 couples during Period A and B. RESULTS: In the two periods, GBS was detected in 18.1 and 19.3% of the wive's vaginal cultures, and in 19.1 and 17.0% of husbands' urinary cultures, respectively. There were no significant differences of the rate of GBS detection between the spouses, and also between the two trials. A high possibility of GBS infection was found in a couple when either of the spouses was possible to GBS. The serotypes of 31 of the 34 couples (91.2%) were identical. CONCLUSION: It is suggested that GBS can be sexually transmitted, and cause reinfection between spouses in spite of antepartum medication.

Adult↗
PubMed1993

Can spouse support be accurately and reliably rated? A generalizability study of families with disruptive boys.

The present study addressed two questions: Can support be accurately and reliably rated? What are the relative setting and subject effects on observed spouse support? From a sample of families with a disruptive boy, the supportive or stressing behaviors of the father towards the mother were rated by trained observers in four different standardized situations. A generalizability study was carried out to assess the relative contribution of variance due to subjects, situations, and raters on the support and stress scores. Results indicate a reliable inter-rater assessment of observed spouse support. Spouse support appears to be controlled both by personal and by situational characteristics.

Adult↗
PubMed1993

Personality characteristics of sisters and spouses of male alcoholics.

Sisters of alcoholics from high-density multigenerational families were assessed to determine personality characteristics. Spousal similarity was evaluated in proband/spouse pairs and in spouse pairs from the parental generation, allowing for comparisons of selection versus contagion as explanations for this similarity. Sisters were found to differ from control women with respect to Alienation and Social Closeness from the Multidimensional Personality Questionnaire, and Scale 6 (Paranoia) from the Minnesota Multiphasic Personality Inventory. Only spouses from the parental generation were similar on Alienation, suggesting that exposure over time (contagion) leads to greater similarity in parents from High-Risk families. Modest correlations in spouse pairs from both generations suggest that assortative mating for Social Closeness occurs among the parents of these individuals from High-Risk families, and further suggest that a diminished level of Social Closeness for sisters of alcoholics may be mediated in part by additive genetic variance. It is concluded that assortative mating for particular traits may contribute to increased risk for alcoholism. Also, failure to mate assortatively for other traits (e.g., Traditionalism, Harm Avoidance) may also contribute to increased rates in High-Risk families.

Adult↗
PubMed1993

Spouse concordance for alcohol dependence and heavy drinking: evidence from a community sample.

Using data from a community sample of 586 married couples, levels of spouse concordance for lifetime and current alcohol dependence and heavy drinking were estimated. In addition, marital quality ratings in concordant and discordant couples were compared. Spouse concordance was significant for lifetime alcohol dependence and for both lifetime and current heavy drinking. Marital quality varied as a function of current heavy drinking and alcohol dependence such that members of couples in which neither spouse drank heavily reported better marital quality than other couples. Furthermore, although marital quality did not differ significantly between concordant and discordant couples, couples concordant for current heavy drinking consistently reported poorer marital quality than other couples.

Adolescent↗
PubMed1983

Spouse-aided versus individual therapy in persisting psychiatric disorders: a systematic comparison.

Fifty-three married patients with a wide range of severe, persisting psychiatric disorders were randomly allocated to a form of couples therapy (spouse-aided therapy) or to individual therapy. Both were outpatient, goal-oriented therapies, with an overall mean duration of 9.5 hours. Before, during, immediately after, and three months after therapy, patients and spouses completed ratings of target and personal problems, sexual activity and attitudes, psychological symptoms, and marital satisfaction. Ratings were also conducted by independent assessors. Spouse-aided therapy proved superior to individual therapy at a statistically significant level on most outcome measures, with clinically worthwhile improvements in symptoms, problems, and marital satisfaction in both partners. Individual therapy was followed by improvement in some symptoms, but marital dissatisfaction increased and both partners were more depressed at three months follow-up than before treatment.

Adolescent↗