Affiliation and control during marital disagreement, history of divorce, and asymptomatic coronary artery calcification in older couples.

OBJECTIVE: To examine behavioral observations of affiliation (ie, warmth versus hostility) and control (ie, dominance versus submissiveness) and prior divorce as predictors of coronary artery calcification (CAC) in older couples. In some but not all studies, marital disruption and low marital quality have been shown to confer risk of coronary artery disease (CAD). Inconsistencies might reflect limitations of self-reports of marital quality compared with behavioral observations. Also, aspects of marital quality related to CAD might differ for men and women. METHODS: Couples underwent computed tomography scans for CAC and marital assessments, including observations of laboratory-based disagreement. Participants were 154 couples (mean age, 63.5 years; mean length of marriage, 36.4 years) free of prior diagnosis of CAD. RESULTS: Controlling traditional risk factors, we found behavioral measures of affiliation (low warmth) accounted for 6.2% of variance in CAC for women, p < .01, but not for men. Controlling behavior (dominance) accounted for 6.0% of variance in CAC for men, p < .02, but not for women. Behavioral measures were related to self-reports of marital quality, but the latter were unrelated to CAC. History of divorce predicted CAC for men and women. CONCLUSIONS: History of divorce and behavioral--but not self-report--measures of marital quality were related to CAD, such that low warmth and high dominance conferred risk for women and men, respectively. Prior research might underestimate the role of marital quality in CAD by relying on global self-reports of this risk factor.

Perceptions of the cognitive compensation and interpersonal enjoyment functions of collaboration among middle-aged and older married couples.

Perceptions of cognitive compensation and interpersonal enjoyment of collaboration were examined in three hundred middle-aged and older couples who completed measures of perceptions of collaboration, cognitive ability, marital satisfaction, an errand task and judged their spouse's affiliation. Older adults (especially men) endorsed cognitive compensation and interpersonal enjoyment and reported using collaboration more frequently than middle-aged adults. Greater need for cognitive compensation was related to lower cognitive ability only for older wives. Greater marital satisfaction was associated with greater interpersonal enjoyment. These two functions related to reports of more frequent use of collaboration and perceptions of spousal affiliation in a collaborative task.

Conflict and collaboration in middle-aged and older couples: II. Cardiovascular reactivity during marital interaction.

Marital strain confers risk of cardiovascular disease (CVD), perhaps though cardiovascular reactivity (CVR) to stressful marital interactions. CVR to marital stressors may differ between middle-age and older adults, and types of marital interactions that evoke CVR may also differ across these age groups, as relationship contexts and stressors differ with age. The authors examined cardiovascular responses to a marital conflict discussion and collaborative problem solving in 300 middle-aged and older married couples. Marital conflict evoked greater increases in blood pressure, cardiac output, and cardiac sympathetic activation than did collaboration. Older couples displayed smaller heart rate responses to conflict than did middle-aged couples but larger blood pressure responses to collaboration-especially in older men. These effects were maintained during a posttask recovery period. Women did not display greater CVR than men on any measure or in either interaction context, though they did display greater parasympathetic withdrawal. CVR to marital conflict could contribute to the association of marital strain with CVD for middle-aged and older men and women, but other age-related marital contexts (e.g., collaboration among older couples) may also contribute to this mechanism.

Conflict and collaboration in middle-aged and older couples: I. Age differences in agency and communion during marital interaction.

Prior theory and research regarding age differences in marital interaction suggest that older couples display and experience more positivity and less negativity than middle-aged couples. However, studies of overt behavior in older couples are relatively rare and have emphasized disagreement, neglecting other important contexts for older couples such as collaboration during everyday problem solving. Further, the affiliation or communion dimension of social interaction (i.e., warmth vs. hostility) is commonly assessed but not the control or agency dimension (e.g., dominance vs. submissiveness). The present study examined affect, cognitive appraisals, and overt behavior during disagreement (i.e., discussing a current conflict) and collaboration (i.e., planning errands) in 300 middle-aged and older married couples. Older couples reported less negative affect during disagreement and rated spouses as warmer than did middle-aged couples. However, these effects were eliminated when older couples' greater marital satisfaction was controlled. For observed behavior, older couples displayed little evidence of greater positivity and reduced negativity-especially women. During collaboration, older couples displayed a unique blend of warmth and control, suggesting a greater focus on emotional and social concerns during problem solving.

Associations of self-reports versus spouse ratings of negative affectivity, dominance, and affiliation with coronary artery disease: where should we look and who should we ask when studying personality and health?

OBJECTIVE: Aspects of negative affect and social behavior studied as risk factors for coronary heart disease are usually examined separately and through self-reports. Using structural models of these personality domains, we tested associations of self-reports and spouse ratings of anxiety, depressive symptoms, anger, affiliation and dominance with coronary artery disease (CAD). DESIGN: In 154 healthy older couples, the authors tested cross-sectional associations with CAD of three facets of negative affectivity and two dimensions of the Interpersonal Circumplex, (IPC) using scales derived from the NEO-PI-R. MAIN OUTCOME MEASURES: CAD was quantified as Agatston scores from CT scans of coronary artery calcification (CAC). RESULTS: Self-reports were generally unrelated to CAC, whereas spouse ratings were consistently associated, largely independent of potential confounds. When considered simultaneously, anxiety and anger were related to CAC but depression was not. When considered together, both dominance and (low) affiliation were related to CAC. CONCLUSIONS: Structural models of negative affectivity and social behavior can facilitate integrative study of psychosocial risk factors. Further, self-report measures of these traits might under-estimate related CHD risk.

Task control and cognitive abilities of self and spouse in collaboration in middle-aged and older couples.

Collaborative problem solving may be used by older couples to optimize cognitive functioning, with some suggestion that older couples exhibit greater collaborative expertise. The study explored age differences in 2 aspects of collaborative expertise: spouses' knowledge of their own and their spouse's cognitive abilities and the ability to fit task control to these cognitive abilities. The participants were 300 middle-aged and older couples who completed a hypothetical errand task. The interactions were coded for control asserted by husbands and wives. Fluid intelligence was assessed, and spouses rated their own and their spouse's cognitive abilities. The results revealed no age differences in couple expertise, either in the ability to predict their own and their spouse's cognitive abilities or in the ability to fit task control to abilities. However, gender differences were found. Women fit task control to their own and their spouse's cognitive abilities; men only fit task control to their spouse's cognitive abilities. For women only, the fit between control and abilities was associated with better performance. The results indicate no age differences in couple expertise but point to gender as a factor in optimal collaboration.

Mother child appraised involvement in coping with diabetes stressors and emotional adjustment.

OBJECTIVE: To examine how children's and mother's appraisals of each other's involvement in coping with diabetes events are associated with emotional adjustment. METHODS: One hundred and twenty-seven children (ages 10-15 years) with type 1 diabetes and their mothers reported on their own emotional adjustment and how each other was involved in coping strategies surrounding diabetes stressful events. RESULTS: Appraisals that mothers and children were uninvolved with each other's stressors were associated with greater depressive symptoms and less positive mood; children's appraisals of mother's supportive involvement with children's less depressive symptoms, and appraisals of collaborative involvement with less depressive symptoms and more positive mood for both mothers and children. Appraised control was most detrimental for children for older females and for mothers of younger children. CONCLUSIONS: Collaborative involvement in coping efforts may be an important resource for addressing negative emotions that both children and mothers experience surrounding type 1 diabetes, especially across adolescence.

Parent-adolescent collaboration: an interpersonal model for understanding optimal interactions.

Current parent-adolescent behavioral interaction research highlights the importance of three elements of behavior in defining adaptive interactions: autonomy, control, and warmth vs. hostility. However, this research has largely addressed the developmental needs and psychosocial outcomes of adolescents, as opposed to parents, with a focus on how parent and adolescent behaviors influence adolescent adaptation. This paper utilizes both adolescent and mid-life developmental research, as well as parent-adolescent interaction research, to introduce a model for conceptualizing parent-adolescent interactions as a transactional process in which both parental and adolescent development are considered. Further, ideas are presented describing how adaptive parent-adolescent interactions may change across adolescence. The concept of collaboration is proposed as a conceptual tool for assessing one form of adaptive parent-adolescent interactions. The structural analysis of social behavior (SASB) is presented as a model for studying the complex reciprocal processes that occur in parent-adolescent interpersonal processes.

Mother and adolescent representations of illness ownership and stressful events surrounding diabetes.

OBJECTIVE: To assess the extent to which adolescents with diabetes and their mothers appraise diabetes as a shared entity across adolescence through (a) assessing appraisals of illness ownership and their relationship to joint responsibility for daily diabetes tasks, (b) exploring whether appraisals of shared illness ownership are associated with congruent views of what is stressful about diabetes, and (c) examining whether age-related declines occur in these shared appraisals across adolescence. METHODS: One hundred twenty-seven adolescents (ages 10-15 years, M = 12.8) and their mothers completed an interview that probed appraisals of illness ownership, the most stressful events surrounding diabetes in the past week, and a questionnaire regarding who was responsible for performing diabetes-related tasks. RESULTS: Dyads, most frequently, agreed that diabetes was a "shared" entity. Shared appraisals of illness ownership reflected the greater joint responsibility of mothers and children in daily diabetes tasks. Shared appraisals of illness ownership were not related to congruent reports of diabetes stressful events, and incongruence in appraisals of stressful events was common. With age adolescents reported less shared illness ownership and congruence regarding stressful events, age differences were not seen in mothers' reports. CONCLUSIONS: Although diabetes is often appraised as a social entity, adolescents and their mothers experience different aspects of the disease as stressful, especially as adolescents age, and become more independent in performing diabetes-related tasks.

Children's appraisals of maternal involvement in coping with diabetes: enhancing our understanding of adherence, metabolic control, and quality of life across adolescence.

OBJECTIVE: To examine how children's appraisals of maternal involvement in coping with diabetes are associated with adherence, metabolic control, and quality of life across adolescence. METHODS: Children (N = 127, ages 10-15 years) with type 1 diabetes completed measures of adherence, quality of life, and appraisals of mothers' involvement in dealing with diabetes problems (i.e., mother appraised as uninvolved, controlling, or collaborative). Metabolic control was indexed through medical records. RESULTS: Regardless of age or sex of child, appraised maternal uninvolvement was associated with poorer adherence and quality of life, while appraised collaboration was associated with better adherence and metabolic control. There was evidence that the association between appraised collaboration and metabolic control was partially mediated by adherence. Appraised control was associated with poorer adherence among older, but not younger, children and with poorer quality of life among older females but not among older males or younger children of either sex. CONCLUSIONS: Maintaining maternal involvement in diabetes care is important across ages 10 to 15, but the optimal form of this involvement may need to be adjusted to be consistent with the child's level of development. The present findings suggest that better adherence is seen across age when mothers are viewed as collaborating with, as opposed to controlling, their child when dealing with diabetes problems.

The role of autonomy and pubertal status in understanding age differences in maternal involvement in diabetes responsibility across adolescence.

OBJECTIVE: To examine how autonomy and pubertal status explain age decreases in maternal involvement in type 1 diabetes management across adolescence, how they relate to metabolic control, and the reasons that guide declines in maternal involvement. METHODS: One hundred twenty-seven children ages 10-15 years with type 1 diabetes and their mothers participated. Data included maternal and child report of diabetes management, child report of autonomy level, maternal report of pubertal status, maternal reports of reasons for transfer of diabetes responsibility, and glycosylated hemoglobin (Hba(1c)) values. RESULTS: Autonomy and pubertal status partially mediated age effects on reports of maternal involvement. Mothers' reasons for transferring responsibility included responding to the child's competence, promoting competence and maturity in their child, and minimizing hassles and conflict. The transfer of diabetes responsibility from mother to child without sufficient autonomy and when pubertal status was low was related to higher Hba(1c) values. CONCLUSIONS: The importance of chronological age for changes in maternal involvement suggests the need to examine mothers' and adolescents' developmental expectations for diabetes management. The reasons for transferring responsibility from mother to child suggest many avenues for intervention.