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The interplay between partners’ responsiveness and patients’ need for emotional expression in couples coping with cancer

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Abstract

The central aim of this longitudinal observational study was to test whether patients with a high need for emotional expression are especially sensitive to their partners’ responsive behavior, and therefore at risk for depressive symptoms when responsiveness is withheld. Patients with colorectal cancer and their partners (n = 58) participated in a longitudinal study (3, 5 and 9 months after the diagnosis). Additionally to self-report measurements (i.e., patients’ need for emotional expression, patients’ depressive symptoms and patients’ relationship satisfaction) couples were videotaped discussing cancer-related concerns. External observers coded partners’ responsiveness (i.e., understanding, validation and caring) and patients’ self-disclosures. Partner responsiveness predicted lower levels of depressive symptoms over time in patients who had a relatively high need for emotional expression above and beyond the effect of relationship satisfaction. We demonstrated that partners’ understanding and validation are more important in explaining patients’ depressive symptoms than partners’ caring behavior. Our findings highlight the importance of the relational context in improving adaptation to cancer taking into account individual differences.

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Notes

  1. We also examined the models including gender, and morbidity as covariates because of their correlation with patients’ depressive symptoms. Patients’ were asked to indicate whether they had additional health complaints or not on a checklist of 26 chronic medical condition. Morbidity was coded as present if patients indicated one or more medical conditions other than cancer. Including these covariates did not change the results. Therefore, we excluded them from the final model to assure enough power for testing our hypotheses. We further examined the associations between depressive symptoms and several other demographic, and medical variables but none of these variables showed a significant correlation with depressive symptoms. Therefore they were not included in the final analysis. Finally, we have examined the association between several patient behaviors during the interaction (i.e., self-disclosure, frequency of speech turns, and total duration of patients’ speech) and other variables included in the models. Except for patient’s self-disclosure that was found to be related with patients’ need for emotional expression, none of the other behaviors were related to any of the predictors or outcome and therefore only patient’s self-disclosure was included in the final models.

  2. We also conducted one hierarchical regression analysis for the aggregated component of partners’ responsiveness (i.e., the average score of understanding, validation, and caring) and found similar results as for the models of understanding and validation R 2 = .34 for step 1; ∆R 2 = .10 for step 2 (p = .08); ∆R 2 = .06 for step 3 (p < .05).

References

  • Arrindell, W. A., Boelens, W., & Lambert, H. (1983). On the psychometric properties of the Maudsley Marital Questionnaire (MMQ): Evaluation of self-ratings in distressed and ‘normal’ volunteer couples based on the Dutch version. Personality and Individual Differences, 4, 293–306.

    Article  Google Scholar 

  • Bouma, J., Ranchor, A. V., Sanderman, R., & van Sonderen, E. (1995). Het meten van symptomen van depressie met de CES-D [the measurement of symptoms of depression with the CES-D]. Groningen, The Netherlands: Northern Centre for Healthcare Research, University of Groningen.

    Google Scholar 

  • Bradbury, T. N., & Pasch, L. A. (1994). The social support interaction coding system (SSICS) (unpublished coding manual). Los Angeles: University of California.

  • Canevello, A., & Crocker, J. (2010). Creating good relationships: Responsiveness, relationship quality, and interpersonal goals. Journal of Personality and Social Psychology, 99, 78–106. doi:10.1037/a0018186

    Article  PubMed Central  PubMed  Google Scholar 

  • Cho, S., Zunin, I. D., Chao, P. J., Heiby, E. M., & McKoy, J. (2012). Effects of pain controllability and discrepancy in social support on depressed mood among patients with chronic pain. International Journal of Behavioral Medicine, 19, 270–279. doi:10.1007/s12529-011-9175-4

    Article  PubMed  Google Scholar 

  • Cordova, M. J., Cunningham, L. L. C., Carlson, C. R., & Andrykowski, M. A. (2001). Social constraints, cognitive processing, and adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 69, 706–711. doi:10.1037/0022-006X.69.4.706

    Article  CAS  PubMed  Google Scholar 

  • Crowe, M. J. (1978). Conjoint marital therapy: A controlled outcome study. Psychological Medicine, 8, 623–636. doi:10.1017/S0033291700018833

    Article  CAS  PubMed  Google Scholar 

  • Cutrona, C. E. (1990). Stress and social support: In search of optimal matching. Journal of Social and Clinical Psychology, 9, 3–14.

    Article  Google Scholar 

  • Cutrona, C. E., Shaffer, P. A., Wesner, K. A., & Gardner, K. A. (2007). Optimally matching support and perceived spousal sensitivity. Journal of Family Psychology, 21, 754–758. doi:10.1037/0893-3200.21.4.754

    Article  PubMed  Google Scholar 

  • Dagan, M., & Hagedoorn, M. (in press). Response rates in studies of couples coping with cancer—A systematic review. Health Psychology.

  • Dagan, M., Sanderman, R., Schokker, M. C., Wiggers, T., Baas, P. C., van Haastert, M., et al. (2011). Spousal support and changes in distress over time in couples coping with cancer: The role of personal control. Journal of Family Psychology, 25, 310–318. doi:10.1037/a0022887

    Article  PubMed  Google Scholar 

  • Fekete, E. M., Stephens, M., Parris, A., Mickelson, K. D., & Druley, J. A. (2007). Couples’ support provision during illness: The role of perceived emotional responsiveness. Families, Systems, & Health, 25, 204–217. doi:10.1037/1091-7527.25.2.204

    Article  Google Scholar 

  • Figueiredo, M. I., Fries, E., & Ingram, K. M. (2004). The role of disclosure patterns and unsupportive social interactions in the well-being of breast cancer patients. Psycho-Oncology, 13, 96–105. doi:10.1002/pon.717

    Article  PubMed  Google Scholar 

  • Gottman, J. M., & Notarius, C. I. (2000). Decade review: Observing marital interaction. Journal of Marriage and Family, 62, 927–947. doi:10.1111/j.1741-3737.2000.00927

    Article  Google Scholar 

  • Hagedoorn, M., Dagan, M., Puterman, E., Hoff, C., Meijerink, W. J., Delongis, A., et al. (2011a). Relationship satisfaction in couples confronted with colorectal cancer: The interplay of past and current spousal support. Journal of Behavioral Medicine, 34, 288–297. doi:10.1007/s10865-010-9311-7

    Article  PubMed Central  PubMed  Google Scholar 

  • Hagedoorn, M., Kuijer, R. G., Buunk, B. P., DeJong, G. M., Wobbes, T., & Sanderman, R. (2000). Marital satisfaction in patients with cancer: Does support from intimate partners benefit those who need it most? Health Psychology, 19, 274–282. doi:10.1037/0278-6133.19.3.274

    Article  CAS  PubMed  Google Scholar 

  • Hagedoorn, M., Puterman, E., Sanderman, R., Wiggers, T., Baas, P. C., van Haastert, M., et al. (2011b). Is self-disclosure in couples coping with cancer associated with improvement in depressive symptoms? Health Psychology, 30, 753–762. doi:10.1037/a0024374

    Article  PubMed  Google Scholar 

  • Hagedoorn, M., Sanderman, R., Bolks, H. N., Tuinstra, J., & Coyne, J. C. (2008). Distress in couples coping with cancer: A meta-analysis and critical review of role and gender effects. Psychological Bulletin, 134(1), 1–30. doi:10.1037/0033-2909.134.1.1.

    Article  PubMed  Google Scholar 

  • Heyman, R. E., & Vivian, D. (1997). RMICS: Rapid marital interaction coding system: Training manual for coders (unpublished manuscript). State University of New York at Stony Brook.

  • Iwamitsu, Y., Shimoda, K., Abe, H., Tani, T., Kodama, M., & Okawa, M. (2003). Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression. Psychiatry and Clinical Neurosciences, 57, 289–294. doi:10.1046/j.1440-1819.2003.01119.x

    Article  PubMed  Google Scholar 

  • Khan, C. M., Iida, M., Stephens, M. A. P., Fekete, E. M., Druley, J. A., & Greene, K. A. (2009). Spousal support following knee surgery: Roles of self-efficacy and perceived emotional responsiveness. Rehabilitation Psychology, 54, 28–32. doi:10.1037/a0014753

    Article  PubMed  Google Scholar 

  • Kubacka, K. E., Finkenauer, C., Rusbult, C. E., & Keijsers, L. (2011). Maintaining close relationships: Gratitude as a motivator and a detector of maintenance behavior. Personality and Social Psychology Bulletin, 37, 1362–1375. doi:10.1177/0146167211412196

    Article  PubMed  Google Scholar 

  • Kuijer, R. G., Buunk, B. P., De Jong, G. M., Ybema, J. F., & Sanderman, R. (2004). Effects of a brief intervention program for patients with cancer and their partners on feelings of inequity, relationship quality and psychological distress. Psycho-Oncology, 13, 321–334. doi:10.1002/pon.749

    Article  PubMed  Google Scholar 

  • Laurenceau, J. P., Barrett, L. F., & Pietromonaco, P. R. (1998). Intimacy as an interpersonal process: The importance of self-disclosure, partner disclosure, and perceived partner responsiveness in interpersonal exchanges. Journal of Personality and Social Psychology, 74, 1238–1251. doi:10.1037/0022-3514.74.5.1238

    Article  CAS  PubMed  Google Scholar 

  • Laurenceau, J. P., Barrett, L. F., & Rovine, M. J. (2005). The interpersonal process model of intimacy in marriage: A daily-diary and multilevel modeling approach. Journal of Family Psychology, 19, 314–323. doi:10.1037/0893-3200.19.2.314

    Article  PubMed  Google Scholar 

  • Lepore, S. J. (2001). A social-cognitive processing model of emotional adjustment to cancer. In B. L. Andersen (Ed.), Psychosocial interventions for cancer (pp. 99–116). Washington, DC: American Psychological Association. doi:10.1037/10402-006

    Chapter  Google Scholar 

  • Maisel, N. C., Gable, S. L., & Strachman, A. (2008). Responsive behaviors in good times and in bad. Personal Relationships, 15, 317–338. doi:10.1111/j.1475-6811.2008.00201.x

    Article  Google Scholar 

  • Manne, S., Badr, H., Zaider, T., Nelson, C., & Kissane, D. (2010). Cancer-related communication, relationship intimacy, and psychological distress among couples coping with localized prostate cancer. Journal of Cancer Survivorship, 4, 74–85. doi:10.1007/s11764-009-0109-y

    Article  PubMed Central  PubMed  Google Scholar 

  • Manne, S., Ostroff, J., Rini, C., Fox, K., Goldstein, L., & Grana, G. (2004a). The interpersonal process model of intimacy: The role of self-disclosure, partner disclosure, and partner responsiveness in interactions between breast cancer patients and their partners. Journal of Family Psychology, 18, 589–599. doi:10.1037/0893-3200.18.4.589

    Article  PubMed  Google Scholar 

  • Manne, S., Sherman, M., Ross, S., Ostroff, J., Heyman, R. E., & Fox, K. (2004b). Couples’support-related communication, psychological distress, and relationship satisfaction among women with early stage breast cancer. Journal of Consulting and Clinical Psychology, 72, 660–670. doi:10.1037/0022-006X.72.4.660

    Article  PubMed  Google Scholar 

  • Manne, S. L., Winkel, G., Rubin, S., Edelson, M., Rosenblum, N., Bergman, C., et al. (2008). Mediators of a coping and communication-enhancing intervention and a supportive counseling intervention among women diagnosed with gynecological cancers. Journal of Consulting and Clinical Psychology, 76, 1034–1045. doi:10.1037/a0014071

    Article  PubMed Central  PubMed  Google Scholar 

  • Pasch, L. A., & Bradbury, T. N. (1998). Social support, conflict, and the development of marital dysfunction. Journal of Consulting and Clinical Psychology, 66, 219–230. doi:10.1037/0022-006X.66.2.219

    Article  CAS  PubMed  Google Scholar 

  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401. doi:10.1177/014662167700100306

    Article  Google Scholar 

  • Reis, H. T., & Shaver, P. (1988). Intimacy as an interpersonal process. In S. Duck, D. F. Hay, S. E. Hobfoll, W. Ickes, & B. M. Montgomery (Eds.), Handbook of personal relationships: Theory, research and interventions (pp. 367–389). Oxford, UK: Wiley.

    Google Scholar 

  • Roger, D., Garcia de la Banda, G., Lee, H. S., & Olason, D. T. (2001). A factor-analytic study of cross-cultural differences in emotional rumination and emotional inhibition. Personality and Individual Differences, 31, 227–238. doi:10.1016/S0191-8869(00)00131-8

    Article  Google Scholar 

  • Shelton, J. N., Trail, T. E., West, T. V., & Bergsieker, H. B. (2010). From strangers to friends: The interpersonal process model of intimacy in developing interracial friendships. Journal of Social and Personal Relationships, 27, 71–90. doi:10.1177/0265407509346422

    Article  Google Scholar 

  • Simpson, J. A., Winterheld, H. A., Rholes, W. S., & Oriña, M. M. (2007). Working models of attachment and reactions to different forms of caregiving from romantic partners. Journal of Personality and Social Psychology, 93, 466–477.

    Article  PubMed  Google Scholar 

  • Tamagawa, R., Garland, S., Vaska, M., & Carlson, L. E. (2012). Who benefits from psychosocial interventions in oncology? A systematic review of psychological moderators of treatment outcome. Journal of Behavioral Medicine, 35, 658–673. doi:10.1007/s10865-012-9398-0

    Article  PubMed  Google Scholar 

  • Tuinstra, J., Hagedoorn, M., Van Sonderen, E., Ranchor, A. V., Van den Bos, G. A. M., Nijboer, C., et al. (2004). Psychological distress in couples dealing with colorectal cancer: Gender and role differences and intracouple correspondence. British Journal of Health Psychology, 9, 465–478. doi:10.1348/1359107042304588

    Article  PubMed  Google Scholar 

  • Zech, E., & Rimé, B. (2005). Is talking about an emotional experience helpful? Effects on emotional recovery and perceived benefits. Clinical Psychology & Psychotherapy, 12, 270–287. doi:10.1002/cpp.460

    Article  Google Scholar 

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Acknowledgments

This research was supported by a grant from the Dutch Cancer Society (KWF); Contract grant number RUG 02-2581.

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Authors and Affiliations

  1. Health Psychology Section, Department of Health Sciences, University of Groningen, University Medical Center Groningen, P.O. Box 196, 9700 AD, Groningen, The Netherlands

    Meirav Dagan, Robbert Sanderman & Mariët Hagedoorn

  2. Department of Surgery, Medical Center Leeuwarden, P.O. Box 888, 8901 BR, Leeuwarden, The Netherlands

    Christiaan Hoff

  3. Department of Gastro Intestinal Surgery, Free University Medical Center, ZH 7 F 034 De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands

    W. J. H. Jeroen Meijerink

  4. Department of Surgery, Martini Hospital, P.O. Box 30033, 9700 RM, Groningen, The Netherlands

    Peter C. Baas

  5. Department of Gastroenterology, Martini Hospital, P.O. Box 30033, 9700 RM, Groningen, The Netherlands

    Michiel van Haastert

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  1. Meirav Dagan
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Correspondence to Meirav Dagan.

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Dagan, M., Sanderman, R., Hoff, C. et al. The interplay between partners’ responsiveness and patients’ need for emotional expression in couples coping with cancer. J Behav Med 37, 828–838 (2014). https://doi.org/10.1007/s10865-013-9543-4

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