Content area
Full Text
J Behav Med (2012) 35:334346 DOI 10.1007/s10865-011-9349-1
A longitudinal analysis of intimacy processes and psychological distress among couples coping with head and neck or lung cancers
Sharon Manne Hoda Badr Deborah A. Kashy
Received: August 6, 2010 / Accepted: April 22, 2011 / Published online: May 10, 2011 Springer Science+Business Media, LLC 2011
Abstract Individuals diagnosed with lung and head and neck (HN) cancers and their spouses are at increased risk for distress. This study assessed whether the way couples communicate about cancer and their perceptions of relationship intimacy inuenced both partners adjustment. One-hundred thirty-nine patients and their spouses [For purposes of clarity, we refer to the patients intimate partner as the spouse, regardless of actual marital status and we reserve the term partner to refer to the other person in the couple (i.e., the patients partner is the spouse and the spouses partner is the patient)] completed measures of spousal communication, intimacy, and distress at three time points over 6 months. Using multilevel modeling, an over-time actor-partner interdependence model was specied that examined whether intimacy mediated associations between ones own and ones partners reports of communication at baseline and later distress. Patients and spouses who reported greater baseline distress reported more negative baseline communication as well as lower levels of intimacy and greater distress over time. Mediation analyses showed patients and spouses reports of positive spousal communication were associated with less subsequent distress largely through their effects on intimacy. Clinicians working with head and neck
or lung cancer patients should assess communication and intimacy because both impact couples distress.
Keywords Couple communication
Interpersonal processes Relationship intimacy
Psychological adaptation Cancer
Introduction
The diagnosis of lung or head and neck cancer can be very stressful for both patients and their spouses. Rates of distress among lung cancer (LC) patients have been reported to be as high as 43% for clinical depression (Hopwood & Stephens, 2000; Uchitomi et al., 2000), 17% for clinical anxiety (Montazeri et al., 2005; Rolke et al., 2009), and 60% for overall emotional distress (Graves et al., 2007; Steinberg et al., 2009). Between 15% (Sehlen et al., 2003) and 42% of patients diagnosed with head and neck cancers (HNC; Bergquist et al., 2007) report signicant depressive symptoms, and similar elevations in anxiety have...