Features of Illness Versus Features of Romantic Relationships as Predictors of Cognitive and Behavioral Coping Among Individuals with Type 2 Diabetes.

For individuals with a chronic illness, such as type 2 diabetes, a multitude of factors may influence the ways people cope with their condition. This study compares characteristics of the illness and characteristics of a patient's romantic relationship as factors that predict coping behaviors for individuals with type 2 diabetes. Specifically, we identify illness uncertainty as a feature of chronic illness, as well as relational uncertainty and interference from partners as relationship characteristics that are associated with coping behaviors. Using Amazon Mechanical Turk, we recruited 500 participants who were diagnosed with type 2 diabetes and involved in a romantic relationship to complete an online survey about the ways they manage their illness in the context of their relationship. Structural equation model results showed that relational uncertainty and partner interference were both positively associated with the perceived threat of discussing the illness, whereas the effect for illness uncertainty was nonsignificant; thus, relationship characteristics were a more robust predictor of perceived threat than illness characteristics. In turn, the perceived threat of discussing the illness was negatively associated with treatment compliance and positively associated with topic avoidance about the illness. Treatment compliance was also negatively associated with topic avoidance. Implications for health and relationships are discussed.

Parent's alcoholism severity and family topic avoidance about alcohol as predictors of perceived stigma among adult children of alcoholics: Implications for emotional and psychological resilience.

Alcoholism is a highly stigmatized condition, with both alcohol-dependent individuals and family members of the afflicted experiencing stigmatization. This study examined the severity of a parent's alcoholism and family topic avoidance about alcohol as two factors that are associated with family members' perceptions of stigma. Three dimensions of stigma were considered: discrimination stigma, disclosure stigma, and positive aspect stigma. In addition, this study assessed associations between perceived stigmatization and individuals' experiences of depressive symptoms, self-esteem, and resilience. Adult children of alcoholics (N = 622) were surveyed about family conditions, perceived stigma, and their emotional and psychological well-being. Regression analyses revealed that the severity of a parent's alcoholism predicted all three types of stigma for females, but not for males. In addition, family topic avoidance about alcohol predicted all types of stigma for males and discrimination stigma and positive aspect stigma for females. With few exceptions, the three types of stigma predicted depressive symptoms, self-esteem, and resilience for both male and female adult children of alcoholics. The results are discussed in terms of their implications for promoting a family environment that mitigates stigma and encourages emotional and psychological well-being. In 2012, approximately 3.3 million deaths worldwide were due to the harmful use of alcohol (World Health Organization [WHO], 2014). Individuals who abuse alcohol are susceptible to a variety of negative health outcomes (Rehm et al., 2009) and display inappropriate social behaviors (Klingemann, 2001; Schomerus et al., 2011a). General societal perceptions tend to characterize alcohol-dependent individuals as irresponsible and lacking in self-control (Schomerus et al., 2011b). Research in the United Kingdom found that 54% of the population believes alcohol-dependent individuals are personally to blame for their own problems (Crisp, Gelder, Goddard, & Meltzer, 2005). In the United States, a person's own bad character or the way they were raised are more likely to be identified as reasons for alcoholism than they are for other types of mental illness (Schnittker, 2008). In addition, people prefer greater social distance between themselves and alcoholics than between themselves and people with mental illness (Crisp et al., 2005). The negative social perceptions of alcoholics likely contribute to feelings of stigma (Room, 2005). Not only does stigma affect the afflicted individual, but also members of his or her family (WHO, 2014). Children of parents with an alcohol dependency may be reluctant to discuss a parent's alcoholism with others if they feel pressured to keep it a secret or to avoid negative stereotypes (Afifi & Olson, 2005; Burk & Sher, 1990; Caughlin & Petronio, 2004; Lam & O'Farrell, 2011). Thus, the stigma of a parent's alcoholism may prevent children from addressing concerns and coping with their surroundings.

Partner Facilitation and Partner Interference in Individuals' Weight Loss Goals.

Drawing on the logic of the relational turbulence model, this study examined the ways in which romantic partners facilitate and interfere with individuals' weight loss goals. Participants (N = 122) described the ways in which their romantic partner had recently helped or hindered their weight loss at four times over the course of 2 months. We conducted a content analysis of responses to identify themes of partner facilitation (Research Question 1 [RQ1]) and partner interference (RQ2) in individuals' weight loss goals. Results revealed seven themes of partner facilitation: (a) partner enabling diet, (b) motivation and encouragement, (c) emotional support and positive reinforcement, (d) exercising together, (e) partner enabling exercise, (f) dieting together, and (g) relationship influence and priorities. Four themes of partner interference emerged in the data: (a) inability to plan for healthy meals, (b) inability to control the food environment, (c) preventing or discouraging exercise, and (d) emotional or relational discouragement.

Acid sphingomyelinase is required for protection of effector memory T cells against glucocorticoid-induced cell death.

The activity of acid sphingomyelinase (aSMase) was previously reported to be involved in glucocorticoid-induced cell death (GICD) of T lymphocytes. This mechanism in turn is believed to contribute to the therapeutic efficacy of glucocorticoids (GCs) in the treatment of inflammatory diseases. In this study, we reassessed the role of aSMase in GICD by using aSMase knockout mice. The absence of aSMase largely abolished the partial protection that effector memory CD4(+) T cells in wild-type mice possess against GICD. Reduced IL-2 secretion by aSMase-deficient CD4(+) T cells suggested that a lack of this important survival factor might be the cause of these cells' enhanced susceptibility to GICD. Indeed, addition of IL-2 restored the protection against GICD, whereas neutralization of IL-2 abrogated the otherwise protective effect seen in wild-type effector memory CD4(+) T cells. The therapeutic implications of the altered sensitivity of aSMase-deficient T cells to GICD were assessed in models of inflammatory disorders; namely, experimental autoimmune encephalomyelitis and acute graft-versus-host disease. Surprisingly, GC treatment was equally efficient in both models in terms of ameliorating the diseases, regardless of the genotype of the T cells. Thus, our data reveal a hitherto unrecognized contribution of aSMase to the sensitivity of effector memory CD4(+) T cells to GICD and call into question the traditionally attributed importance of GICD of T cells to the treatment of inflammatory diseases by GCs.

Depressive symptoms and mechanisms of relational turbulence as predictors of relationship satisfaction among returning service members.

In contrast to romanticized portrayals of reunion after deployment, U.S. military personnel may contend with the harsh reality of both depressive symptoms and upheaval in their romantic relationships during the postdeployment transition. This study employed the relational turbulence model to evaluate mechanisms linking depressive symptoms with relationship satisfaction. Cross-sectional, self-report data were collected from 220 service members living in 27 states who had returned home from deployment within the past six months. As hypothesized, the negative association between depressive symptoms and relationship satisfaction was mediated by relational uncertainty and interference from partners. These findings advance scholarship on depressive symptoms and relational turbulence, and they also suggest guidelines for helping service members with depressive symptoms maintain satisfying romantic relationships upon reentry.