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Journal ArticleDOI

Dynamics of Support Perceptions Among Couples Coping With Cardiac Illness: The Effect on Recovery Outcomes

01 Jul 2011-Health Psychology (Health Psychol)-Vol. 30, Iss: 4, pp 411-419
TL;DR: The effect of partners' perceptions of support provided on patients' recovery was moderated by patients' own perceptions of the support received, and the effect of this interaction was determined by the specific types ofSupport provided or received and by the Specific recovery outcome that was measured.
Abstract: Objective The current prospective study explored how male cardiac patients' perceptions of received support (i.e., active engagement, protective buffering, and overprotection) moderated the associations between female partners' perceptions of provided support and patients' recovery outcomes: psychological well-being, cholesterol levels, and smoking cessation. Methods Couples (N = 86) completed surveys at the initial hospitalization after patients' Acute Coronary Syndrome (ACS), and 1 and 6 months later. Partners' ways of providing support and patients' concurrent perceptions of these ways were measured using the Ways of Giving Support Questionnaire; patients' depressive and anxiety symptoms were measured using the Brief Symptom Inventory (BSI). Patients' cholesterol levels were assessed during hospitalization and 6 months later, and smoking habits were reported by the patients. Results Female partners' protective buffering was positively associated with male patients' depressive symptoms at follow-up only when male patients' own perceptions of partners' protective buffering were low. Female partners' active engagement was positively associated with better odds for male patients' cessation of smoking only when patients' own perceptions of partners' active engagement were high. Finally, female partners' overprotection was associated with higher levels of male patients' harmful blood lipids at follow-up, but only when patients' own perceptions of partners' overprotection were high. Conclusions As hypothesized, the effect of partners' perceptions of support provided on patients' recovery was moderated by patients' own perceptions of the support received. The effect of this interaction was determined by the specific types of support provided or received and by the specific recovery outcome that was measured. The clinical and theoretical implications of the findings are discussed.

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Journal ArticleDOI
TL;DR: A theoretical framework for studying health that is based in relationship science can accelerate progress by generating new research directions designed to pinpoint the mechanisms through which close relationships promote or undermine health.
Abstract: Supportive relationships are health protective (e.g., Berkman, Glass, Brissette, & Seeman, 2000; Cohen, 2004; Uchino, 2009). People who lack social ties or social integration experience higher mortality rates especially from cardiovascular disease but also from other diseases such as cancer (see Holt-Lunstad, Smith, & Layton, 2010). Although the connections between relationships and health are well-established, less is known about the interpersonal processes through which relationships influence health outcomes, despite a call for this type of research more than 20 years ago (e.g., House, Landis, & Umberson, 1988). Progress has been made on the biological mediators (e.g. Miller, Chen, & Cole, 2009), but cutting edge research in relationship science typically has not been integrated into health psychology. In this article, we draw on recent theory and research from the study of adult attachment theory in relationship science to develop an integrative framework for investigating how relationship constructs and processes influence health-related outcomes. The field of relationship science has expanded considerably in the past three decades, and it has yielded a number of rich theories of close relationships that have generated multiple innovative lines of research (for reviews, see Clark & Lemay, 2010 and Reis, in press). During approximately the same time period, health psychology also emerged as a distinct and rapidly expanding and developing subfield of psychology. Although many theories and empirical findings from relationship science are relevant for understanding a range of health-related issues, relationship science and health psychology have often progressed in parallel or independently with a few exceptions (e.g., Belcher et al., 2011; Kim, Carver, Deci, & Kasser, 2008; Manne et al., 2004a). Many specific ideas drawn from the social and personality literature on close relationships appear in the health literature, but overall, health psychology generally has not incorporated relationship science theories to generate hypotheses or integrated relationship science paradigms into research design and methodology. The goals of this article are threefold: To present one example of a theoretical model that integrates key relationship constructs and processes with biopsychosocial processes and health outcomes, to illustrate how the model can be applied to several specific health areas, and to offer recommendations to guide future relationship research designed to understand and promote health and well-being. Three major theoretical frameworks have guided most contemporary social and personality research on close personal relationships: attachment theory, interdependence theory, and theories based in evolutionary approaches (Reis, in press). In addition, relationships research has been informed by a variety of more specific theories such as the communal-exchange framework (Clark & Mills, 1979) and the intimacy process model (Reis & Shaver, 1988), and more recent approaches include the self-expansion model (Aron & Aron, 2001), the risk regulation model (Murray, Holmes, & Collins, 2006), and relationship goal approaches (Canevello & Crocker, 2011; Gable & Impett, in press). In this article, we selectively focus on one major theoretical perspective, adult attachment theory, because it is has driven a disproportionately large segment of research on relationship processes and outcomes over the past 25 years, has been shown to have wide explanatory power, and has clear relevance for health-related behavior and outcomes (see Mikulincer & Shaver, 2007). In the following sections, we first provide a brief overview of adult attachment theory. Second, we present a theoretical model incorporating components of attachment theory to specify how key relationship variables may predict health behavior and outcomes and highlight how this attachment-based model can generate novel lines of research to understand and promote health and well-being. Third, we discuss specific applications of the model to investigate connections between relationship processes and health (e.g., health behavior, coping with pain) in adults. Fourth, we offer examples of how the model might inform interventions. Finally, we provide a roadmap for future research. We focus on connections between close relationships and health and, because of space constraints as well as the centrality of close connections to our lives, we do not discuss other types of potentially relevant relationships such as broader social networks, buddy systems, or social connectivity (e.g., see Kawachi & Subramanian, 2008 and Smith & Christakis, 2008, all worthy of relationship science and health psychology integration as well.

295 citations


Cites background from "Dynamics of Support Perceptions Amo..."

  • ...…behavior (Paths f/g) in areas such as weight control (e.g., Dailey, Romo, & Thompson, 2011), diabetes (Stephens, Rook, Franks, Khan, & Iida, 2010), HIV prevention (e.g., Burton, Darbes, & Operario, 2010), and smoking (e.g., in couples including a male cardiac patient, Vilchinsky et al., 2011)....

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Journal ArticleDOI
TL;DR: Examination of estimates of internal consistency reliability, measurement invariance, and differential correlates of the Multidimensional Scale of Perceived Social Support in samples of undergraduate men and women found support for configural and metric invariance.
Abstract: In this study, we examined estimates of internal consistency reliability, measurement invariance, and differential correlates of the Multidimensional Scale of Perceived Social Support (MSPSS; Zimet, Dahlem, Zimet, & Farley, 1988) in samples of undergraduate men (n = 270) and women (n = 340). The MSPSS is designed to assess 3 sources of perceived social support: family, friends, and significant others. The participants ranged in age from 18 to 24 years (M age = 19.60, SD = 1.4 years). First, composite scale reliability and coefficient omega methods provided adequate estimates of internal consistency reliability for the original MSPSS total and subscale scores. Second, results of multiple-groups invariance confirmatory factor analysis provided support for configural and metric invariance. Partial measurement invariance was attained for scalar and strict measurement invariance across men and women. Additionally, given the high correlations among the first-order factors, we conducted multiple-groups bifactor ...

121 citations


Cites background from "Dynamics of Support Perceptions Amo..."

  • ...In the past decades, studies have linked the construct of social support with several areas of adaptive functioning, including mental health, interpersonal satisfaction, and physical well-being (Flannery, Wieman, & Wieman, 1989; Vilchinsky et al., 2011)....

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  • ...…a viable psychological construct, has been linked empirically to several state measures of psychological factors, including low levels of anxiety and depressive symptoms, and enhanced levels in areas of physical health and emotional well-being (e.g., Decker et al., 2007; Vilchinsky et al., 2011)....

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  • ...Social support, as a viable psychological construct, has been linked empirically to several state measures of psychological factors, including low levels of anxiety and depressive symptoms, and enhanced levels in areas of physical health and emotional well-being (e.g., Decker et al., 2007; Vilchinsky et al., 2011)....

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Journal ArticleDOI
TL;DR: Overall, the empirical review suggests that in Western couples, positive individual, and conjoint DC forms, taken together or separately, have individual and relational benefits for couples coping with stress in general and/or mental health or medical stressors.
Abstract: The present review on dyadic coping (DC) aims at providing a critical integration of both the conceptual and empirical DC literature and overcoming the limitations of past reviews by (a) describing, comparing, and integrating all the DC models, (b) presenting and integrating findings from studies based on DC models, and (c) suggesting directions for further research. The DC models identified and compared include: The congruence model (Revenson, 1994), the relationship-focused model (Coyne and Smith, 1991; O'Brien and DeLongis, 1996), the communal coping model (Lyons et al., 1998), the systemic-transactional model (Bodenmann, 1995, 1997), the relational-cultural model (Kayser et al., 2007), and the developmental-contextual coping model (Berg and Upchurch, 2007). After discussing each DC model, we advance a conceptual integration of all models, which serves as the framework to organize the review of the empirical literature. This integration includes the following DC dimensions: (a) Stress Communication, (b) Positive DC by One Partner (supportive DC, empathic responding, delegated DC, active engagement), (c) Positive Conjoint DC (common, collaborative, communal, mutual responsiveness); (d) Negative DC by One Partner (protective buffering, overprotection, and hostility/ambivalence), and (e) Negative Conjoint DC (common negative DC, disengaged avoidance). Developmental, relational, and contextual variables are included as factors shaping DC. To be included in the empirical review, articles had to be published in or a peer-reviewed journal in English and/or German before 2017 and include an original empirical study guided by one of the DC models. The review included 139 studies and, with the exception of the congruence model whose findings were discussed separately, findings were presented for overall DC and each of the dimensions identified in the conceptual integration. Findings were grouped also according to whether the stressor related or not to a medical or mental health condition. Demographic and cultural factors affecting DC were discussed. Overall, the empirical review suggests that in Western couples, positive individual, and conjoint DC forms, taken together or separately, have individual and relational benefits for couples coping with stress in general and/or mental health or medical stressors. Research on DC can be expanded to include other populations and stressors and use improved designs.

120 citations


Cites background from "Dynamics of Support Perceptions Amo..."

  • ..., 2011), heart problems (Joekes et al., 2007; Vilchinsky et al., 2011), CODP (Snippe et al....

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  • ..., 2009), (c) depression in men with heart disease (Hagedoorn et al., 2011; Vilchinsky et al., 2011), (d) distress in cancer patients (Manne et al....

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  • ...Israeli partners’ similarity in monitoring as an information seeking style predicted better adjustment in women with cancer; however, similarity in blunting as an information seeking style predicted better adjustment in men with cancer but predicted psychological distress in their caregivers (Barnoy et al., 2006)....

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  • ..., 2010), heart problems in Israeli (Vilchinsky et al., 2011), and Dutch couples (Joekes et al....

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  • ..., 2012), worse physical condition in cardiac patients (Joekes et al., 2007; Vilchinsky et al., 2011), and reduced dietary adherence and more diabetes distress in American diabetic patients (Johnson et al....

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Journal ArticleDOI
TL;DR: The effects of support provision and receipt on same-day physical activity, and the role of partners’ joint engagement in activities are examined, showing support provision is uniquely linked to goal implementation in everyday life.
Abstract: Little is known about how couples' social support facilitates the pursuit of important goals in daily life. Using an interpersonal perspective, we examined the effects of support provision and receipt on same-day physical activity, and studied the role of partners' joint engagement in activities. One hundred nineteen heterosexual couples reported on target persons' received and partners' provided support across 28 diary days, yielding 2,854 valid days. A dyadic report on couples' joint engagement was obtained from a subset of 88 couples. Target persons' daily activity was objectively assessed via accelerometers. On days with high versus low levels of provided support, target persons' activity was 25 min higher. Support receipt mediated 20% of this effect. Joint engagement accounted for around half of the effects of provided and received support. Support provision is uniquely linked to goal implementation in everyday life. Joint engagement in activities may be one explanation for how support is facilitated.

87 citations


Cites result from "Dynamics of Support Perceptions Amo..."

  • ...This stands in contrast with research ascribing the perceptions of recipients a critical role in how support relates to psychological and behavioral outcomes (e.g., Vilchinsky et al., 2011)....

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References
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Book
01 Jan 1974
TL;DR: In this paper, the authors present a detailed theory of psychological stress, building on the concepts of cognitive appraisal and coping, which have become major themes of theory and investigation in psychology.
Abstract: Here is a monumental work that continues in the tradition pioneered by co-author Richard Lazarus in his classic book Psychological Stress and the Coping Process. Dr. Lazarus and his collaborator, Dr. Susan Folkman, present here a detailed theory of psychological stress, building on the concepts of cognitive appraisal and coping which have become major themes of theory and investigation. As an integrative theoretical analysis, this volume pulls together two decades of research and thought on issues in behavioral medicine, emotion, stress management, treatment, and life span development. A selective review of the most pertinent literature is included in each chapter. The total reference listing for the book extends to 60 pages. This work is necessarily multidisciplinary, reflecting the many dimensions of stress-related problems and their situation within a complex social context. While the emphasis is on psychological aspects of stress, the book is oriented towards professionals in various disciplines, as well as advanced students and educated laypersons. The intended audience ranges from psychiatrists, clinical psychologists, nurses, and social workers to sociologists, anthropologists, medical researchers, and physiologists.

37,447 citations


Additional excerpts

  • ...Based on the cognitive appraisal theory of stress and coping (Lazarus & Folkman, 1984), we propose that the effects of the support provided by the partner on the patient’s recovery must be examined within the context of the patient’s own perceptions of the support received....

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Journal ArticleDOI
TL;DR: There is evidence consistent with both main effect and main effect models for social support, but each represents a different process through which social support may affect well-being.
Abstract: Examines whether the positive association between social support and well-being is attributable more to an overall beneficial effect of support (main- or direct-effect model) or to a process of support protecting persons from potentially adverse effects of stressful events (buffering model). The review of studies is organized according to (1) whether a measure assesses support structure (the existence of relationships) or function (the extent to which one's interpersonal relationships provide particular resources) and (2) the degree of specificity (vs globality) of the scale. Special attention is given to methodological characteristics that are requisite for a fair comparison of the models. It is concluded that there is evidence consistent with both models. Evidence for the buffering model is found when the social support measure assesses the perceived availability of interpersonal resources that are responsive to the needs elicited by stressful events. Evidence for a main effect model is found when the support measure assesses a person's degree of integration in a large social network. Both conceptualizations of social support are correct in some respects, but each represents a different process through which social support may affect well-being. Implications for theories of social support processes and for the design of preventive interventions are discussed.

14,570 citations


"Dynamics of Support Perceptions Amo..." refers background in this paper

  • ...Several explanations have been offered for this perplexing finding, including the idea that receiving support may undermine self-esteem and may make the recipient feel indebted to the provider (Buunk & Hoorens, 1992; Cohen & Willis, 1985; Dunbar, Ford, & Hunt, 1998)....

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Journal ArticleDOI
TL;DR: The BSI was developed from its longer parent instrument, the SCL-90-R, and psychometric evaluation reveals it to be an acceptable short alternative to the complete scale, and factor analytic studies of the internal structure of the scale contribute evidence of construct validity.
Abstract: This is an introductory report for the Brief Symptom Inventory (BSI), a brief psychological self-report symptom scale. The BSI was developed from its longer parent instrument, the SCL-90-R, and psychometric evaluation reveals it to be an acceptable short alternative to the complete scale. Both test--retest and internal consistency reliabilities are shown to be very good for the primary symptom dimensions of the BSI, and its correlations with the comparable dimensions of the SCL-90-R are quite high. In terms of validation, high convergence between BSI scales and like dimensions of the MMPI provide good evidence of convergent validity, and factor analytic studies of the internal structure of the scale contribute evidence of construct validity. Several criterion-oriented validity studies have also been completed with this instrument.

6,153 citations


"Dynamics of Support Perceptions Amo..." refers methods in this paper

  • ...Male patients’ depressive and anxiety symptoms were measured using the Brief Symptom Inventory (BSI; Derogatis & Melisaratos, 1983)....

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Journal ArticleDOI
TL;DR: The authors provides an overview of methods used to probe interaction effects and describes a unified collection offreely available online resources that researchers can use to obtain significance tests and confidence bands for simple slopes across the range of the moderator in the MLR, HLM, and LCA contexts.
Abstract: Simple slopes, regions of significance, and confidence bands are commonly used to evaluate interactions in multiple linear regression (MLR) models, and the use of these techniques has recently been extended to multilevel or hierarchical linear modeling (HLM) and latent curve analysis (LCA). However, conducting these tests andplotting the conditional relations is often a tedious and error-prone task. This article provides an overview of methods used to probe interaction effects and describes a unified collection offreely available online resources that researchers can use to obtain significance testsforsimple slopes, compute regions of significance, and obtain confidence bands for simple slopes across the range of the moderator in the MLR, HLM, and LCA contexts. Plotting capabilities are also provided.

4,505 citations


"Dynamics of Support Perceptions Amo..." refers methods in this paper

  • ...To test the simple slopes of this interaction, we used the procedures outlined by Preacher, Curran, and Bauer (2006), developed specifically for 2-way regression models....

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  • ...To test the simple slopes of this interaction, we used the procedures outlined by Preacher et al. (2006)....

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Journal ArticleDOI
TL;DR: Evidence linking social support to changes in cardiovascular, neuroendocrine, and immune function and related to more positive “biological profiles” across these disease-relevant systems is examined.
Abstract: Social support has been reliably related to lower rates of morbidity and mortality. An important issue concerns the physiological mechanisms by which support influences such health endpoints. In this review, I examine evidence linking social support to changes in cardiovascular, neuroendocrine, and immune function. Consistent with epidemiological evidence, social support appears to be related to more positive “biological profiles” across these disease-relevant systems. Recent research on immune-mediated inflammatory processes is also starting to provide data on more integrative physiological mechanisms potentially linking social support to health. The implications of these links, along with future research directions are discussed.

2,066 citations


"Dynamics of Support Perceptions Amo..." refers background in this paper

  • ...…has been found to facilitate healthier behaviors such as exercise, eating right, and not smoking, as well as greater adherence to medical regimens (Uchino, 2006), very few studies have assessed the associations between partners’ perceptions of support and actual acts of illness self-management or…...

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  • ...Partner support is considered health-promoting because it facilitates healthier behaviors such as exercise, maintaining a nutritious diet, and not smoking, as well as greater adherence to medical regimens (Uchino, 2006)....

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  • ...Although partner support has been found to facilitate healthier behaviors such as exercise, eating right, and not smoking, as well as greater adherence to medical regimens (Uchino, 2006), very few studies have assessed the associations between partners’ perceptions of support and actual acts of illness self-management or physiological outcomes (Franks, Stephens, Rook, Franklin, & Ketteyian, 2002; Joekes et al....

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