Skip to main content

Patient and partner illness appraisals and health among adults with type 1 diabetes

Journal of Behavioral Medicine volume 42, pages 480–492 (2019)Cite this article

Abstract

In a study of 199 couples in which one person had type 1 diabetes, we examined how patient appraisal of the diabetes as shared versus individual was associated with collaborative, supportive and unsupportive behavior and whether patient shared illness appraisal was most beneficial for health when it occurred in the context of supportive behavior. We assessed illness appraisal among patients with type 1 diabetes and their partners and had patients complete relationship and health measures. Results showed partners were more likely than patients to hold shared illness appraisals. Patients’ shared appraisals were associated with more collaborative and instrumental support, more emotional support, less protective buffering, and more overprotective behavior. When patients and partners were consistent in their shared appraisals, support was highest. Regression analysis showed collaborative and instrumental support, as well as emotional support, was related to better psychological and physical health when patients held shared compared to individual illness appraisals.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

Notes

  1. We repeated these analyses and controlled for relationship quality. The interactions presented in the results section remained significant.

References

  • Afifi, T. D., Hutchinson, S., & Krouse, S. (2006). Toward a theoretical model of communal coping in postdivorce families and other naturally occurring groups. Communication Theory, 16, 378–409.

    Article  Google Scholar 

  • Association, A. D. (2017). 6 Glycemic targets: Standards of medical care in diabetes 2018. Diabetes Care, 41, S55–S64.

    Article  Google Scholar 

  • Berg, C. A., Butner, J. E., Butler, J. M., King, P. S., Hughes, A. E., & Wiebe, D. J. (2013). Parental persuasive strategies in the face of daily problems in adolescent type 1 diabetes management. Health Psychology, 32, 719–728.

    Article  PubMed  Google Scholar 

  • Berg, C. A., Schindler, I., & Maharajh, S. (2008a). Adolescents’ and mothers’ perceptions of the cognitive and relational functions of collaboration and adjustment in dealing with type 1 diabetes. Journal of Family Psychology, 22, 865–874.

    Article  PubMed  Google Scholar 

  • Berg, C. A., Schindler, I., Smith, T. W., Skinner, M., & Beveridge, R. M. (2011). Perceptions of the cognitive compensation and interpersonal enjoyment functions of collaboration among middle-aged and older married couples. Psychology and Aging, 26, 167–173.

    Article  PubMed  Google Scholar 

  • Berg, C. A., Skinner, M., Ko, K., Butler, J. M., Palmer, D. L., Butner, J., et al. (2009). The fit between stress appraisal and dyadic coping in understanding perceived coping effectiveness for adolescents with type 1 diabetes. Journal of Family Psychology, 23, 521–530.

    Article  PubMed  Google Scholar 

  • Berg, C. A., & Upchurch, R. (2007). A developmental-contextual model of couples coping with chronic illness across the adult life span. Psychological Bulletin, 133, 920–954.

    Article  PubMed  Google Scholar 

  • Berg, C. A., Wiebe, D. J., Butner, J., Bloor, L., Bradstreet, C., Upchurch, R., et al. (2008b). Collaborative coping and daily mood in couples dealing with prostate cancer. Psychology and Aging, 23, 505–516.

    Article  PubMed  Google Scholar 

  • Bodenmann, G. (1997). Dyadic coping: A systematic-transactional view of stress and coping among couples: Theory and empirical findings. European Review of Applied Psychology, 47, 137–140.

    Google Scholar 

  • Bodenmann, G., & Randall, A. K. (2012). Common factors in the enhancement of dyadic coping. Behavior Therapy, 43, 88–98.

    Article  PubMed  Google Scholar 

  • Bolger, N., & Amarel, D. (2007). Effects of social support visibility on adjustment to stress: Experimental evidence. Journal of Personality and Social Psychology, 92, 458–475.

    Article  PubMed  Google Scholar 

  • Carstensen, L. L., Isaacowitz, D. M., & Charles, S. T. (1999). Taking time seriously: A theory of socioemotional selectivity. American Psychologist, 54, 165–181.

    Article  CAS  PubMed  Google Scholar 

  • Diamantopoulos, A., Sarstedt, M., Fuchs, C., Wilczynski, P., & Kaiser, S. (2012). Guidelines for choosing between multi-item and single-item scales for construct measurement: A predictive validity perspective. Journal of the Academy of Marketing Science, 40, 434–449.

    Article  Google Scholar 

  • Falconier, M. K., Jackson, J. B., Hilpert, P., & Bodenmann, G. (2015). Dyadic coping and relationship satisfaction: A meta-analysis. Clinical Psychology Review, 42, 28–46.

    Article  PubMed  Google Scholar 

  • Funk, J. L., & Rogge, R. D. (2007). Testing the ruler with item response theory: Increasing precision of measurement for relationship satisfaction with the Couples Satisfaction Index. Journal of Family Psychology, 21, 572–583.

    Article  PubMed  Google Scholar 

  • Hagedoorn, M., Keers, J. C., Links, T. P., Bouma, J., Ter Maaten, J. C., & Sanderman, R. (2006). Improving self-management in insulin-treated adults participating in diabetes education. The role of the overprotection by the partner. Diabetic Medicine, 23, 271–277.

    Article  CAS  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 the most? Health Psychology, 19, 274–282.

    Article  CAS  PubMed  Google Scholar 

  • Helgeson, V. S., Jakubiak, B., Seltman, H., Hausmann, L. R. M., & Korytkowski, M. T. (2016). Implicit and explicit communal coping in couples with recently diagnosed type 2 diabetes. Journal of Social and Personal Relationships, 34, 1099–1121.

    Article  PubMed  PubMed Central  Google Scholar 

  • Helgeson, V. S., Jakubiak, B., Van Vleet, M., & Zajdel, M. (2018). Communal coping and adjustment to chronic illness: Theory update and evidence. Personality and Social Psychology Review, 22, 170–195.

    Article  PubMed  Google Scholar 

  • Helgeson, V. S., Novak, S. A., Lepore, S. J., & Eton, D. T. (2004). Spouse social control efforts: Relations to health behavior and well-being among men with prostate cancer. Journal of Social and Personal Relationships, 21, 53–68.

    Article  Google Scholar 

  • Johnson, M. D., Anderson, J. R., Walker, A., Wilcox, A., Lewis, V. L., & Robbins, D. C. (2013). Common dyadic coping is indirectly related to dietary and exercise adherence via patient and partner diabetes efficacy. Journal of Family Psychology, 27, 722–730.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kayser, K., Watson, L. E., & Andrade, J. T. (2007). Cancer as a “we-disease”: Examining the process of coping from a relational perspective. Families, Systems, and Health, 25, 404–418.

    Article  Google Scholar 

  • Lee, E., & Roberts, L. J. (2018). Between individual and family coping: A decade of theory and research on couples coping with health-related stress. Journal of Family Theory and Review, 10, 141–164.

    Article  Google Scholar 

  • Lewin, A. B., LaGreca, A. M., Geffken, G. R., Williams, L. B., Duke, D. C., Storch, E. A., et al. (2009). Validity and reliability of an adolescent and parent rating scale of type 1 diabetes adherence behaviors: The self-care inventory (SCI). Journal of Pediatric Psychology, 34, 999–1007.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lewis, M. A., & Rook, K. S. (1999). Social control in personal relationships: Impact on health behaviors and psychological distress. Health Psychology, 18, 63–71.

    Article  CAS  PubMed  Google Scholar 

  • Lyons, R. F., Mickelson, K. D., Sullivan, M. J. L., & Coyne, J. C. (1998). Coping as a communal process. Journal of Social and Personal Relationships, 15, 579–605.

    Article  Google Scholar 

  • Martire, L. M., Schulz, R., Helgeson, V. S., Small, B. J., & Saghafi, E. M. (2010). Review and meta-analysis of couple-oriented interventions for chronic illness. Annals of Behavioral Medicine, 40, 325–342.

    Article  PubMed  PubMed Central  Google Scholar 

  • McClure, M. J., Xu, J. H., Craw, J. P., Lane, S. P., Bolger, N., & Shrout, P. E. (2014). Understanding the costs of support transactions in daily life. Journal of Personality, 82, 563–574.

    Article  PubMed  Google Scholar 

  • Polonsky, W. H., Fisher, L., Earles, J., Dudl, R. J., Lees, J., Mullan, J., et al. (2005). Assessing psychosocial distress in diabetes: Development of the diabetes distress scale. Diabetes Care, 28, 626–631.

    Article  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.

    Article  Google Scholar 

  • Rafaeli, E., & Gleason, M. E. J. (2009). Skilled support within intimate relationships. Journal of Family Theory and Review, 1, 20–37.

    Article  Google Scholar 

  • Rentscher, K. E., Rohrbaugh, M. J., Shoham, V., & Mehl, M. R. (2013). Asymmetric partner pronoun use and demand-withdraw interaction in couples coping with health problems. Journal of Family Psychology, 27, 691–701.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rentscher, K. E., Soriano, E. C., Rohrbaugh, M. J., Shoham, V., & Mehl, M. R. (2017). Partner pronoun use, communal coping, and abstinence during couple-focused intervention for problematic alcohol use. Family Process, 56, 348–363.

    Article  PubMed  Google Scholar 

  • Revenson, T. A. (1994). Social support and marital coping with chronic illness. Annals of Behavioral Medicine, 16, 122–130.

    Google Scholar 

  • Rohrbaugh, M. J., Shoham, V., Skoyen, J. A., Jensen, M., & Mehl, M. R. (2012). We-talk, communal coping, and cessation success in a couple-focused intervention for health-compromised smokers. Family Process, 51, 107–121.

    Article  PubMed  Google Scholar 

  • Rottman, N., Hansen, D. G., Larsen, P. V., Nicolaisen, A., Flyger, H., Johansen, C., et al. (2015). Dyadic coping within couples dealing with breast cancer: A longitudinal, population-based study. Health Psychology, 34, 486–495.

    Article  Google Scholar 

  • Song, Y., Nam, S., Park, S., Shin, I.-S., & Ku, B. J. (2017). The impact of social support on self-care of patients with diabetes: What is the effect of diabetes type? Systematic review and meta-analysis. The Diabetes Educator, 43, 396–412.

    Article  PubMed  Google Scholar 

  • Stephens, M. A. P., Franks, M. M., Rook, K. S., Iida, M., Hemphill, R. C., & Salem, J. K. (2013). Spouses’ attempts to regulate day-to-day dietary adherence among patients with type 2 diabetes. Health Psychology, 32, 1029–1037.

    Article  PubMed  Google Scholar 

  • Thoits, P. A. (2011). Mechanisms linking social ties and support to physical and mental health. Journal of Health and Social Behavior, 52, 145–161.

    Article  PubMed  Google Scholar 

  • Tracy, E. L., Berg, C. A., Baucom, K. J. W., Turner, S. L., Kelly C. S., Van Vleet, M., et al. (in press). Daily sleep quality and duration and daily stressors in couples coping with Type 1 diabetes. Health Psychology. https://doi.org/10.1037/hea0000690.

  • Uchino, B. N. (2009). Understanding the links between social support and physical health. Perspectives on Psychological Science, 4, 236–255.

    Article  PubMed  Google Scholar 

  • Vangelisti, A. L. (2009). Challenges in conceptualizing social support. Journal of Social and Personal Relationships, 26, 39–51.

    Article  Google Scholar 

  • Ware, J., Kosinski, M., & Keller, S. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.

    Article  PubMed  Google Scholar 

  • Ware, J. E., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 Health Survey: Manual and interpretation guide. Boston: Nimrod.

    Google Scholar 

  • Zajdel, M., Helgeson, V. S., Seltman, H. J., Korytkowski, M. T., & Hausmann, L. R. M. (2016) Measuring communal coping in type 2 diabetes using a multi-method approach. In Poster presented at the 36th Annual Meeting of the Society of Behavioral Medicine, Washington, D.C.

Download references

Funding

The study was funded by the National Institutes of Health DP3 DK103999.

Author information

Authors and Affiliations

  1. Carnegie Mellon University, Pittsburgh, USA

    Vicki S. Helgeson, Meredith Van Vleet & Melissa Zajdel

  2. University of Utah, Salt Lake City, USA

    Cynthia A. Berg, Caitlin S. Kelly, Enjin Lee Tracy & Michelle L. Litchman

Authors
  1. Vicki S. Helgeson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cynthia A. Berg
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Caitlin S. Kelly
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Meredith Van Vleet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Melissa Zajdel
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Enjin Lee Tracy
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Michelle L. Litchman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Vicki S. Helgeson or Cynthia A. Berg.

Ethics declarations

Conflict of interest

Vicki S. Helgeson, Cynthia A. Berg, Caitlin S. Kelly, Meredith Van Vleet, Melissa Zajdel, Enjin Lee Tracy and Michelle L. Litchman declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all patients for being included in the study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Helgeson, V.S., Berg, C.A., Kelly, C.S. et al. Patient and partner illness appraisals and health among adults with type 1 diabetes. J Behav Med 42, 480–492 (2019). https://doi.org/10.1007/s10865-018-0001-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-018-0001-1

Keywords

  • Communal coping
  • Dyadic coping
  • Type 1 diabetes
  • Social support
  • Couples