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PubMed2003

The social consequences of expressive suppression.

At times, people keep their emotions from showing during social interactions. The authors' analysis suggests that such expressive suppression should disrupt communication and increase stress levels. To test this hypothesis, the authors conducted 2 studies in which unacquainted pairs of women discussed an upsetting topic. In Study 1, one member of each pair was randomly assigned to (a) suppress her emotional behavior, (b) respond naturally, or (c) cognitively reappraise in a way that reduced emotional responding. Suppression alone disrupted communication and magnified blood pressure responses in the suppressors' partners. In Study 2, suppression had a negative impact on the regulators' emotional experience and increased blood pressure in both regulators and their partners. Suppression also reduced rapport and inhibited relationship formation.

Adaptation, Psychological↗
PubMed1997

Overt and covert coparenting processes in the family.

This article introduces a new self-report instrument designed to measure the frequency of parental behaviors thought to promote or undermine children's sense of family. Members of 103 married couples rated their behavior in both public (all family members present) and private (alone with child) contexts. Factor analyses of these data revealed four distinct factors indexing: behaviors in the service of promoting a sense of Family Integrity, largely covert parent-to-child communications undermining, or conveying Disparagement of, the coparental partner; overt interparental Conflict in the presence of the child; and coparental disciplinary activities (Reprimand). Significant husband-wife correlations were found on each of the four individual subscales. Construct-specific intercorrelations also obtained between like scales on the new measure and on the Family Environment Scale and Quality of Coparenting Scale. Cluster analyses of husbands' and wives' scores on the four Coparenting Scale factors suggested five "types" of coparenting families: Disconnected, Supportive, Average, Distressed-Conflicted, and Passionate. These clusters, along with the value of self-report instruments in assessing coparenting behaviors that may be largely clandestine in nature, are discussed.

Adult↗
PubMed1999

Approaching the locked dialogues of the body. Communicating symptoms through illness diaries.

OBJECTIVE: To describe and analyse communication following the use of an illness diary method in consultations with patients suffering from longstanding illness without clinical findings. DESIGN: Action research in own practice with qualitative formative evaluation of material provided by the use of the diary method. Analysis followed a procedure modified from phenomenologically-based methodology. SETTING: The practice of the main author. SUBJECTS: 36 consultations with 16 patients where the illness diary method was applied. RESULT: Communication following illness diary utilisation could be summarised as: 1) illness diaries as medical documentation, 2) making access to the insight of the patient, 3) exploring internal dialogues and locked voices, and 4) adding meaning to a spoken message through writing (creative distance). By changing the frames of conversation through illness diary utilisation towards one or more of these four levels of communication, the patient may become a more equal consultation partner. CONCLUSION: Illness diaries can provide clinically relevant information and may emphasise the patient's input and significance in medical dialogues on longstanding symptoms without clinical findings.

Adolescent↗
PubMed2004

Rehabilitation after coronary heart disease: spouses' views of support.

BACKGROUND: Family presence decreases mortality and improves psychosocial recovery after a coronary heart disease event. In this situation, spousal support seems important for the recovering partner's self-esteem and mastery. There is inadequate knowledge of how spouses view their supportive roles. AIM: The aim of this paper is to report a study investigating spouses' experiences of the rehabilitation phase of their partners' coronary heart disease and to gain their views about supporting them in lifestyle changes. METHOD: Eight male (mean age 61) and 17 female spouses (mean age 53), were interviewed 1 year after their partner's cardiac event. Of the partners, 18 had experienced myocardial infarction and 19 were revascularized. Interview transcripts were analysed qualitatively using a phenomenographic framework. FINDINGS: The analysis yielded five different views of the spouse's role. The participative role involved taking a practical part in lifestyle changes, communicating empathetically, and being positive about changes. The regulative role was characterized by being either positive or negative about changes, giving practical or cognitive support in order to control the partner's behaviour, and communicating authoritatively. In the observational role the spouse was passive, complied with suggestions, and communicated empathetically. The incapacitated role involved a positive attitude to changes, communicating without making demands, but being unable to provide support because of personal problems. Assuming a dissociative role entailed being negative about changes and authoritatively declaring a reluctance to be involved in the partner's change of lifestyle. Spouses adopted different roles depending on the support situation. CONCLUSION: Spouses' views of their roles in support varied considerably in terms of awareness of the benefits of behavioural changes, style of communication, pattern of co-operation and support situation. The findings favour the view that a family perspective is important in planning rehabilitation of patients following coronary heart disease.

Adult↗
PubMed2003

Using network analysis to understand community-based programs: a case study from highland Madagascar.

CONTEXT: Programs using community-based distribution (CBD) of family planning services have had mixed success in Sub-Saharan Africa. Knowledge about why these programs succeed or fail is limited. METHODS: In 1999, a total of 159 women and men of reproductive age were interviewed in a village in highland Madagascar with an active community-based family planning program. Network analysis informed by chi-square tests and multiple regression analysis was used to test whether respondents' communication with CBD agents and the location of their discussion partners were associated with their knowledge and use of family planning. RESULTS: The CBD agents were highly central in the village's family planning network; 35% of women and 19% of men directly communicated with a CBD agent about family planning or were indirectly linked to an agent. Knowledge of family planning was associated with having either a direct or an indirect link to a CBD agent; use of a modern method was associated with discussing family planning only with someone outside the village (odds ratio, 12.6) or with discussing it in the village and communicating directly with a CBD agent (10.8). CONCLUSIONS: Network analysis can improve the understanding of community-based program functioning by providing a way to examine who receives information from and is influenced by CBD agents.

Adolescent↗
PubMedDate not supplied

Partner influence on early discontinuation of the pill in a predominantly Hispanic population.

CONTEXT: Although studies have examined U.S. pill users' patterns of discontinuation, little is known about pill discontinuation, and the effects of partner influence, among Hispanics. METHODS: Follow-up data on pill use were collected from 213 predominantly Hispanic women who requested the pill in an urban family planning clinic in 2000. Logistic regression analyses were conducted to assess the association between a range of factors, including partner and relationship variables, and the odds of discontinuation within one month. RESULTS: The overall discontinuation rate within one month was 23%. Women who reported that their partner was unaware of their planned pill use had significantly elevated odds of discontinuing use (odds ratio, 3.4). Other variables that were independently associated with increased odds of early pill discontinuation were not taking the first pill during the clinic visit (3.0), feeling happy about the prospect of a pregnancy in the next six months (2.4) and intending to use the pill for one year or less (2.3). Age, which was assessed as a continuous variable, was negatively associated with the odds of early discontinuation (0.9). CONCLUSIONS: Male partners' awareness of planned pill use may be a marker for the level of communication and commitment in the relationship. Women may choose to disclose their planned pill use to supportive partners, and this may be beneficial to the relationship and the couple's contraceptive use. However, clinicians should take women's circumstances and needs into account before counseling them to tell a partner that they intend to use the pill.

Adolescent↗
PubMed1999

[Chronic somatic illness--illness diaries written at home give possibilities for communication about the body].

The article presents the development and qualitative evaluation of a clinical communicative method based on illness diaries used in consultations with patients suffering from long-standing illness without clinical findings. The article is based on action research in the authors' own practice. Data were collected from 36 consultations with 16 patients where the illness diary method was applied. Analysis followed a procedure modified from phenomenologically based methodology. The method has gradually been elaborated according to utilization experiences on an interactional level, leading to a more specific presentation of the method and its use. Communicative strategies arising from illness diary utilization could be summarized as: using illness diaries as medical documentation; getting access to the patient's insight; exploring internal dialogues and locked voices; and adding meaning to a spoken message through writing. When the framework of conversation is changed through illness diary utilization towards one or more of these four levels of communication, the patient may become a more equal consultation partner. Illness diaries can provide clinically relevant information and may emphasize the patient's input and significance in medical dialogues on long-standing symptoms without clinical findings.

Adolescent↗
PubMed2006

I thought we could be friends, but ...: systematic miscommunication and defensive distancing as obstacles to cross-group friendship formation.

This study examined the precursors and consequences of systematic miscommunications regarding relationship interest during intergroup interaction. Pairs of previously unacquainted same-sex students (White-White, White-Chinese, or Chinese-Chinese) engaged in a relatively intimate controlled interaction. White participants who had had little prior contact with Chinese persons were more apt to exhibit a signal-amplification bias (i.e., to perceive that their overtures had conveyed more interest than was actually the case) in intergroup as compared with intragroup exchanges. In contrast, White participants with high levels of prior contact with Chinese persons and Chinese participants did not show enhanced signal amplification in intergroup relative to intragroup exchanges. These results support our hypothesis that lack of intergroup contact experience sets the stage for miscommunications regarding friendship interest. White participants' tendency to feel that they had initially communicated more interest in being friends than their Chinese partner mediated a downward shift in their actual friendship interest over time, suggesting that signal amplification triggers defensive distancing and ultimately lowers the likelihood of cross-group friendship formation.

Adult↗
PubMed2004

Expression of emotion and quality of life after facial nerve paralysis.

OBJECTIVE: To investigate the facial expression of emotion and quality of life in patients after long-term facial nerve paralysis. STUDY DESIGN: Cross-sectional. SETTING: Facial nerve paralysis clinic. PATIENTS: Twenty-four patients with facial nerve paralysis and 24 significant others (partner, relative, friend). INTERVENTION: Patients were assessed using Sunnybrook, Sydney, and House-Brackmann grading scales and SF-36, Glasgow Benefit Inventory, and Facial Disability Index quality-of-life measures. RESULTS: When patients identified themselves as either effective or not effective at facially communicating each of Ekman's primary emotions (happiness, disgust, surprise, anger, sadness, and fear), 50% classified themselves as not effective at expressing one or more of the six emotions. Significant others of the not effective patients rated the emotions as more difficult for their partner-patients to communicate facially than did the significant others of effective patients. The SF-36 quality-of-life survey revealed lower social functioning relative to physical functioning for not effective patients. From the Sunnybrook Facial Grading System, more synkinesis was found for those patients not effective at expressing happiness, less brow and eye movement for patients not effective at expressing sadness, and less voluntary movement for those not effective with surprise. CONCLUSION: Movement deficits associated with expressing specific emotions and an association with quality-of-life measures were identified in patients with long-term facial nerve paralysis who saw themselves as not effective at facial expression of emotions. To improve management of emotional expression in patients with facial nerve paralysis, a broader approach is recommended, linking the practitioner's treatment goals with patient-driven outcome goals.

Adolescent↗
PubMed1995

Who's got the power? Gender differences in partners' perceptions of influence during marital problem-solving discussions.

Previous research on marital communication indicates that women have more influence in marital problem solving because they raise the issues and shape the discussion. Other studies suggest that men have the power in marital problem solving. This study re-examines power and influence from the partners' point of view. Twenty-seven couples-18 with a first child under 2, and 9 undecided about having children-were videotaped while working on a self-selected problem concerning their division of family labor. Data sources included: (a) transcribed audiotaped accounts given by each partner while viewing a videotape of their problem-solving discussion; (b) self-report questionnaires; and (c) ratings by a research team of the concordance between spouses' accounts. Husbands and wives were perceived as having a primary influence on different aspects of the discussion. Women tended to raise the issues and draw men out in the early phase of the discussion, while men controlled the content and emotional depth of the later discussion phases, and largely determined the outcome. The women's accounts emphasized that their influence in the early phase was often illusory: their behavior was shaped primarily by the effort to choose strategies that would avoid upsetting their husbands. In terms of overall satisfaction with marriage, wives had greater tolerance than their husbands for conflict in the area of division of domestic labor, but less tolerance for their husbands' domination of the discussion process. Women's marital satisfaction was higher when there was concordance between spouses in their accounts of their problem-solving discussion. This research highlights the importance of eliciting spouses' own perceptions and definitions in understanding the impact of gender-linked power differences in martial communication.

Adult↗
PubMed1999

Exploring young people's difficulties in talking about contraception: how can we encourage more discussion between partners?

Interviews were conducted with 56 young men and women aged 16-19 within the Southampton Community Health NHS Trust to explore difficulties in talking about contraception. Concern about a partner's hostile or negative reaction to any discussion about contraception was central to explaining why some people found it so difficult to initiate such discussions. Admitting the intention to have intercourse, together with a perceived association between condom use and disease prevention, were the main concerns. There was some indication of gender differences in these findings. Furthermore, this negative reaction is perceived to be exacerbated according to the partner's reputation, the potential for harming one's own reputation and whether there is a desire for a longer-term relationship with this partner. The most important outcome of the interviews was that these concerns about a partner's negative reaction were largely unjustified, with the vast majority of participants showing only positive responses to scenarios of future partners initiating discussions with them about contraception. In addition to the need to improve communication skills, the data suggest that greater awareness about the positive reactions towards such discussions should be encouraged.

Adolescent↗
PubMed2005

Communication and social skills in socially anxious and nonanxious individuals in the context of romantic relationships.

This study examined differences between socially anxious and nonanxious individuals' ability to use effective communication skills and social skills in the context of romantic relationships. Socially anxious (n = 13) and nonanxious (n = 14) individuals and their romantic partners were videotaped while participating in 10-minute neutral, negative, and pleasant conversations. Regardless of the type of conversation in which they were involved, socially anxious individuals demonstrated impairment in 10 of the 11 social skill variables assessed. In negative conversations, socially anxious individuals displayed more "very negative" behaviors than nonanxious individuals, and across all conversations they displayed fewer "positive" behaviors than nonanxious individuals. Partners of socially anxious and nonanxious individuals did not differ in their communication quality. The results suggest that social anxiety is associated with deficits in relationship maintenance behavior and call for the completion of a larger study examining the interpersonal consequences of social anxiety.

Adult↗
PubMed2003

Social and psychological influences on HIV preventive behaviors of youth in Haiti.

PURPOSE: To examine HIV/AIDS prevention-related sexual behaviors and identify potential predictors of those behaviors among youth living in Haiti. METHODS: Data were gathered from a cross-sectional survey conducted with 845 youth, aged 15-19 years, attending 12 primary and/or secondary schools. A subsample of the 491 students who were sexually active comprised the study sample. Data were collected using a theory-based, self-administered questionnaire. Data were analyzed by multiple logistic regression using SPSS for Windows. RESULTS: Only 18% of sexually active adolescents reported always or sometimes using condoms and 27% reported having used a condom the last time they had sex. Over 40% (43%) had had three or more lifetime sex partners. Findings from the multivariate logistic regression analyses indicate that consistent condom use, condom use at last sexual intercourse, and fewer lifetime sexual partners were significantly associated with high levels of self-efficacy to communicate about HIV/AIDS or use a condom. Significant negative associations were found among consistent condom use, condom use at last sex, and high barriers to condom use. Fewer lifetime sexual partners was significantly associated with high peer preventive norms and low traditional gender norms. CONCLUSION: These findings emphasize the importance of providing HIV prevention programs for young people in the study communities which enhance effective sexual communication and negotiation skills, target prevention-oriented social norms, and address how to overcome barriers to condom use.

Adolescent↗
PubMed1976

Spouses' understanding of the communication disabilities of aphasic patients.

The language skills of 11 aphasic patients were assessed through the use of the PICA. Spuses's understanding of the aphasic partner's language deficits was measured by rating the aphasic spouse on the Functional Communication Profile. Results indicate that spouses of aphasic patients view the patient's communication to be less impaired than it actually is. Implications for the counseling role of the speech pathologist in language therapy are discussed.

Adult↗
PubMed1982

Homologies between cell interaction molecular controlled by major histocompatibility complex- and Igh-V-linked genes that T cells use for communication. Tandem "adaptive" differentiation of producer and acceptor cells.

We have asked the question: how do partner cells in immunoregulatory interactions between T cell subsets acquire the ability to recognize and react appropriately with one another? In particular, we have asked whether these communication events are completely determined by the cell's genetic constitution, or whether the recognition events can be learned during ontogeny. We have found that the T cells of parent into F1 chimeras and homozygous nude mice with F1 thymus grafts not only learn to react with genetically disparate acceptor cells, but that the receptors on the acceptor cells themselves learn to react with genetically disparate producer cells. This learning process can overcome both major histocompatibility complex- and immunoglobulin heavy chain variable region-linked restricted communication between T cell subsets. We interpret these findings to indicate that thymic elements can start a cascade of differential events. The thymic elements, whether endogenous or passively acquired, select from a pool of producer cells those that will react appropriately with the thymic selecting cells, and these cells become expanded. Then, the private markers (idiotype) on the expanded pool of producer cells act as selecting and expanding elements that choose from a pool of acceptor cells those that recognize the producer cells idiotype as self. This second differentiational event, although apparently thymus evidence that this type of acceptor cell differentiation could also take place during the course of an immune response.

Animals↗
PubMed2004

How to cope with "noise" in social dilemmas: the benefits of communication.

Interactions in social life may be seriously affected by negative noise, whereby actual or perceived behavior is less cooperative than was intended (e.g., arriving late due to an unforeseen traffic jam). The present research examines whether negative noise exerts detrimental effects on impressions and cooperation and whether such effects could be reduced by communication. Consistent with hypotheses, Study 1 revealed that negative noise exerts detrimental effects on both impressions of partners' benign intent and cooperation and that these detrimental effects could be effectively reduced by communication about noise. Study 2 replicated both findings but only for individuals with low trust. Mediation analysis revealed that impressions of benign intent and prosocial interaction goals underlie the positive effects of communication on cooperation.

Adaptation, Psychological↗
PubMed2004

A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus.

OBJECTIVE: In a cross-sectional study, we previously identified 2 potentially modifiable risk factors for adverse outcomes in systemic lupus erythematosus (SLE): self-efficacy and social support. The goal of this study was to evaluate in a randomized controlled trial a theory-based intervention to improve patient self-efficacy and partner support to manage SLE. METHODS: Patients with SLE ages 18 years and older who met the American College of Rheumatology criteria and were able to identify a partner (spouse or family member) were recruited from 2 academic medical centers and randomized into an experimental group or a control group. Patients in the experimental group and their partners received an intervention designed to enhance self-efficacy, couples communication about lupus, social support, and problem solving, in the form of a 1-hour session with a nurse educator followed by monthly telephone counseling for 6 months. Patients in the control group and their partners received an attention placebo, including a 45-minute video presentation about lupus, and monthly telephone calls. Measures of physical and mental health status, disease activity, and psychosocial factors were collected at baseline, 6 months, and 12 months. The effect of the intervention on physical and mental health and disease activity at 6 and at 12 months was modeled with linear regression and adjusted for baseline health status, disease activity, sociodemographic factors, treatment change, and psychosocial factors. RESULTS: One hundred twenty-two patients (plus their partners) were enrolled and randomized as follows: 64 to the experimental intervention and 58 to the attention control group. The participants were predominantly white, approximately half were college educated, and the groups were balanced for sociodemographic factors. At 6 months, significantly higher scores for couples communication (P = 0.01) and problem-focused coping (P = 0.03) were seen in the experimental group compared with the control group. At 12 months (6 months after the intervention ended), social support was higher (4.4 versus 4.1; P = 0.03), self-efficacy was higher (7.2 versus 6.2; P = 0.02), couples communication was higher (3.5 versus 3.1; P = 0.03), and fatigue was lower (5.1 versus 6.3; P = 0.02) in the experimental group compared with the control group. Global mental health status at 12 months, as measured by the Short Form 36 survey, was 69 points in the experimental group compared with 58 points in the control group (P = 0.04). In multivariate models, adjusting for baseline covariates, scores for couple communication (P = 0.01) were significantly higher at 6 months, and scores for self-efficacy (P = 0.004) and global mental health status (P = 0.03) were significantly higher at 12 months in the experimental group compared with the control group, and the mean score for global physical function was higher by 7 points, which was a clinically meaningful change (P = 0.2). The mean score for fatigue was also significantly lower in the experimental group than in the control group (P = 0.05). SLE disease activity was unchanged by this intervention. CONCLUSION: This randomized, controlled trial of a theory-based educational intervention in SLE demonstrated significantly higher scores for couple communication, self-efficacy, and mental health status, and lower fatigue scores in the experimental group compared with the control group. Because couple communication and self-efficacy appear to be modifiable risk factors, they may also be potential targets in more disadvantaged populations.

Adult↗
PubMed1995

On organizing an international workshop on psychotherapeutic interventions in cancer patients. A virtual coffeebreak communication.

This paper is an unusual summary of my thoughts on the International Workshop on Psychotherapeutic Interventions in Cancer Patients in Flims, Switzerland, in 1995. Based upon virtual coffeebreak communications, I try to explain to my virtual partner how the idea of the workshop developed, how I came to select participants and experts, and why the workshop was structured in such a specific way. Concerning the workshop itself I shall quote personal feedback statements from participants, drawing upon the impressions they took with them from demonstration workshops prepared by the leading experts in the field. During the workshop the impact of psychosocial interventions upon survival was critically evaluated, whereas it was unanimously agreed that the most important target of psychosocial interventions in cancer patients is the improvement in quality of life. After the workshop I personally decided to enhance my professional engagement in the area of helping clinical oncologists and nurses to improve on the psychosocial skills they need in caring for cancer patients.

Congresses as Topic↗