This meta-analysis reviewed 126 published empirical articles over the past 50 years describing associations between marital relationship quality and physical health in more than 72,000 individuals. Health outcomes included clinical endpoints (objective assessments of function, disease severity, and mortality; subjective health assessments) and surrogate endpoints (biological markers that substitute for clinical endpoints, such as blood pressure). Biological mediators included cardiovascular reactivity and hypothalamic-pituitary-adrenal axis activity. Greater marital quality was related to better health, with mean effect sizes from r = .07 to .21, including lower risk of mortality (r = .11) and lower cardiovascular reactivity during marital conflict (r = -.13), but not daily cortisol slopes or cortisol reactivity during conflict. The small effect sizes were similar in magnitude to previously found associations between health behaviors (e.g., diet) and health outcomes. Effect sizes for a small subset of clinical outcomes were susceptible to publication bias. In some studies, effect sizes remained significant after accounting for confounds such as age and socioeconomic status. Studies with a higher proportion of women in the sample demonstrated larger effect sizes, but we found little evidence for gender differences in studies that explicitly tested gender moderation, with the exception of surrogate endpoint studies. Our conclusions are limited by small numbers of studies for specific health outcomes, unexplained heterogeneity, and designs that limit causal inferences. These findings highlight the need to explicitly test affective, health behavior, and biological mechanisms in future research, and focus on moderating factors that may alter the relationship between marital quality and health.

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Marital quality and health: A meta-analytic review.

Online dating sites frequently claim that they have fundamentally altered the dating landscape for the better. This article employs psychological science to examine (a) whether online dating is fundamentally different from conventional offline dating and (b) whether online dating promotes better romantic outcomes than conventional offline dating. The answer to the first question (uniqueness) is yes, and the answer to the second question (superiority) is yes and no. To understand how online dating fundamentally differs from conventional offline dating and the circumstances under which online dating promotes better romantic outcomes than conventional offline dating, we consider the three major services online dating sites offer: access, communication, and matching. Access refers to users' exposure to and opportunity to evaluate potential romantic partners they are otherwise unlikely to encounter. Communication refers to users' opportunity to use various forms of computer-mediated communication (CMC) to interact with specific potential partners through the dating site before meeting face-to-face. Matching refers to a site's use of a mathematical algorithm to select potential partners for users. Regarding the uniqueness question, the ways in which online dating sites implement these three services have indeed fundamentally altered the dating landscape. In particular, online dating, which has rapidly become a pervasive means of seeking potential partners, has altered both the romantic acquaintance process and the compatibility matching process. For example, rather than meeting potential partners, getting a snapshot impression of how well one interacts with them, and then slowly learning various facts about them, online dating typically involves learning a broad range of facts about potential partners before deciding whether one wants to meet them in person. Rather than relying on the intuition of village elders, family members, or friends or to select which pairs of unacquainted singles will be especially compatible, certain forms of online dating involve placing one's romantic fate in the hands of a mathematical matching algorithm. Turning to the superiority question, online dating has important advantages over conventional offline dating. For example, it offers unprecedented (and remarkably convenient) levels of access to potential partners, which is especially helpful for singles who might otherwise lack such access. It also allows online daters to use CMC to garner an initial sense of their compatibility with potential partners before deciding whether to meet them face-to-face. In addition, certain dating sites may be able to collect data that allow them to banish from the dating pool people who are likely …

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Online Dating A Critical Analysis From the Perspective of Psychological Science

The Case for Marriage: Why Married People are Happier, Healthier, and Better Off Financially. Linda J. Waite & Maggie Gallagher. New York: Doubleday. 2000. 260 pp. ISBN 0-38550085-8. $24.95 cloth. Marriage, our second oldest institution, has been controversial during most of its existence. In The Bankruptcy of Marriage, Calverton (1928) observed, "It is marriage as we know it... the marriage of modern monogamy, of the bindingcontract variety, our system of marriage, in other words, that has broken down, and to-day is bankrupt" (p. 62). Given its age and its undisputed importance, marriage has long been challenged and defended. The Case for Marriage offers a spirited and well-documented but flawed example of such a defense. First, its use of language is far from neutral. Its tone oozes with disrespect for those who deviate from lifelong marriage. Marriage throughout the text is referred to as a "bargain," a superior investment benefiting both those who participate and society at large. Cohabitation, on the other hand, is a "deal," something one picks up at a flea market. Cohabiting partners, regardless of their age, are referred to as "live-in" boy- or girlfriends and are described as "couples living together without commitment" (p. 190). Adult singles are treated as a residual category. As constructionists remind us, the use of language is not just a descriptive but a creative and frequently assertive activity. My second concern is conceptual. Marriage institutionalizes the legitimacy of offspring in human societies. Children born in it, regardless of its form, are considered "legitimate" and belong to a kinship network. The marriage institution, then, has a clear stake in its procreative consequences, as is exemplified by its sole universal rule, the "incest taboo." Its main "enemy" is promiscuous reproduction. Its "allies" are those other forms of "living together" that, regardless of their duration, counter random mating. "Family," the oldest human institution, traditionally is responsible for "caring" for the very young, and nowadays also for the aged. It seems impossible to imagine humanity's pilgrimage without these two institutions. It is quite possible, however, to imagine each one taking on a variety of forms. The core units of the marriage and family institutions are, respectively, married couples and family networks. The bulk of Waite's and Gallagher's book is not about the institutions of marriage and family, but rather about individuals who choose to participate in marital and familial units. They conceptualize marriage as more than a "private emotional relationship" and specify a "lifelong commitment to form a new family" (p. 187) as its raison d'etre. They use the words marriage and family interchangeably. This is confusing. For example, are voluntarily childless married couples to be considered deviants? Uncommitted? What about one-parent families? Are they a different legitimate family form or, as the authors seem to imply, simply an outcome of unwed motherhood, marital failure, or early spousal death? I agree with the authors that marriage's "larger public role must be acknowledged and supported by the larger society and its institutions" (p. 187). All social arrangements, whether sacred or profane, to use Durkheim's terminology, that combat reproductive promiscuity or inadequate family care deserve support from "society and its institutions." The authors' treatment of cohabitation is equally troublesome to me. Analytically, cohabitation, in its many manifestations, should not be contrasted or compared with marriage but rather with the equally diverse category of singlehood. I have no problem with the multitude of quantitative data amassed by the authors to show that enduring marriages and families, on the average, offer some distinct advantages over cohabitation. …

The Case for Marriage: Why Married People Are Happier, Healthier, and Better off Financially

We review research on families and health published between 2000 and 2009 and highlight key themes and findings from innovative, methodologically rigorous studies. Whereas research in prior decades focused primarily on whether family structure affects child and adult health, contemporary research examines the contextual and processual factors that shape for whom, for which outcomes, and under what conditions families affect mental and physical health. We discuss how family structure, transitions, and processes within families of origin affect children's health over the life course. We then examine the effects of marital status, transitions, and quality for adult health. We point out limitations in current research, discuss implications of recent findings for policy, and highlight theoretical and methodological directions for future research.

Advances in Families and Health Research in the 21st Century

A robust body of scientific evidence has indicated that being embedded in high-quality close relationships and feeling socially connected to the people in one's life is associated with decreased risk for all-cause mortality as well as a range of disease morbidities. Despite mounting evidence that the magnitude of these associations is comparable to that of many leading health determinants (that receive significant public health resources), government agencies, health care providers and associations, and public or private health care funders have been slow to recognize human social relationships as either a health determinant or health risk marker in a manner that is comparable to that of other public health priorities. This article evaluates current evidence (on social relationships and health) according to criteria commonly used in determining public health priorities. The article discusses challenges for reducing risk in this area and outlines an agenda for integrating social relationships into current public health priorities. (PsycINFO Database Record

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Advancing Social Connection as a Public Health Priority in the United States

Divorce is a relatively common stressful life event that is purported to increase risk for all-cause mortality. One problem in the literature on divorce and health is that it is fragmented and spread across many disciplines; most prospective studies of mortality are based in epidemiology and sociology, whereas most mechanistic studies are based in psychology. This review integrates research on divorce and death via meta-analysis and outlines a research agenda for better understanding the potential mechanisms linking marital dissolution and risk for all-cause mortality. Random effects meta-analysis with a sample of 32 prospective studies (involving more than 6.5 million people, 160,000 deaths, and over 755,000 divorces in 11 different countries) revealed a significant increase in risk for early death among separated/divorced adults in comparison to their married counterparts. Men and younger adults evidenced significantly greater risk for early death following marital separation/divorce than did women and older adults. Quantification of the overall effect size linking marital separation/divorce to risk for early death reveals a number of important research questions, and this article discusses what remains to be learned about four plausible mechanisms of action: social selection, resource disruptions, changes in health behaviors, and chronic psychological distress.

Divorce and Death A Meta-Analysis and Research Agenda for Clinical, Social, and Health Psychology

Objective:To assess blood pressure (BP) reactivity as recently separated adults completed a laboratory task asking to mentally reflect on their relationship experiences. Marital separations and the experience of divorce are associated with increased risk for early mortality and poor health outcomes.

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Marital dissolution and blood pressure reactivity: evidence for the specificity of emotional intrusion-hyperarousal and task-rated emotional difficulty.

Objective: The present study investigated the potential effects of church attendance and marital status on mood trajectories among older adults and whether these effects varied by gender. Method: Data from the Australian Longitudinal Study of Aging were used to examine the effects of church attendance and marital status on changes in depressed mood. Participants included 791 older adults (42.4% men; mean age at study entry = 75.62) who were interviewed at three time points over 8 years. Results: Using multilevel modeling to assess change, church attendance was found to have a protective effect against the emergence of mood problems among older adults. Also, although becoming married was associated with a decrease in depressed mood, becoming nonmarried was associated with an increase in depressed mood. Discussion: A sense of purpose as a potential explanation for the association between church attendance and changes in depressed mood in old age was discussed.

The effects of church attendance and marital status on the longitudinal trajectories of depressed mood among older adults.

Marital separation and divorce increase risk for all-cause morbidity and mortality. Using a laboratory analog paradigm, this study examined attachment anxiety, language use, and blood pressure (BP) reactivity among 119 (n = 43 men, 76 women) recently separated adults who were asked to mentally reflect on their relationship history and separation experience. A language use composite of verbal immediacy from participants’ stream-of-consciousness recordings about their separation experience as a behavioral index of attachment-related hyperactivation was created. Verbal immediacy moderated the association between attachment anxiety and BP at the beginning of a divorce-specific activation task. Participants reporting high attachment anxiety who discussed their separation in a first-person, present-oriented, and highly engaged manner evidenced the highest levels of BP at the start of the divorce-specific task. Results provide a deeper understanding of the association between marital dissolution and health and suggest that verbal immediacy may be a useful behavioral index of hyperactivating coping strategies.

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Attachment anxiety, verbal immediacy, and blood pressure: Results from a laboratory analog study following marital separation

Romantic breakups arouse fundamental questions about the self: Who am I without my partner? This study examined self-concept reorganization and psychological well-being over an 8-week period in the months following a breakup. Multilevel analyses revealed that poorer self-concept recovery preceded poorer well-being and was associated with love for an ex-partner, suggesting that failure to redefine the self contributes to post-breakup distress. Psychophysiological data revealed that greater activity in the corrugator supercilia facial muscle while thinking about an ex-partner predicted poorer self-concept recovery and strengthened the negative association between love for an ex-partner and self-concept recovery. Thus, the interaction between self-report and psychophysiological data provided information about the importance of self-concept recovery to post-breakup adjustment not tapped by either method alone.

Rita W. Law

Papers

Divorce and Death A Meta-Analysis and Research Agenda for Clinical, Social, and Health Psychology

Marital dissolution and blood pressure reactivity: evidence for the specificity of emotional intrusion-hyperarousal and task-rated emotional difficulty.

The effects of church attendance and marital status on the longitudinal trajectories of depressed mood among older adults.

Attachment anxiety, verbal immediacy, and blood pressure: Results from a laboratory analog study following marital separation

Facing a breakup: Electromyographic responses moderate self‐concept recovery following a romantic separation