“Their intense problem solving-focused efforts were not helpful. They were falling apart, but [they were] doing it together and could see some positives,” Dr. Revenson said.
A second type of coping among couples was a type in which both partners used several strategies. The patients were using problem-solving skills, and their partners used more strategies involved escaping into fantasy and finding blame.
The third type of couple used few coping skills, and the fourth type included patients who coped alone with the spouse doing very little.
Spouses Affect Response to Pain
Another recent study conducted by Dr. Revenson and her colleagues has considered coping strategies within married couples and their responses to pain, as well as how spouses are integrated into the patient’s responses to chronic pain. Using the MPI, a personality inventory, the researchers looked at three spousal responses to pain: punishing responses through anger or frustration, solicitous responses through social support, and distancing responses.
In couples where patients felt their partners were using more punishing behavior than their partners said they were using, there was worse adjustment to pain.
There was also worse adjustment among couples where the partner rated himself high on helpfulness but where both he and his spouse agreed that he was doing a fair amount of punishing and distancing. These partners reported the most caregiver strain and the least marital satisfaction. “These couples agree with how the partner is acting, and it’s not good,” Dr. Revenson said. “It is apparent that we must study coping in its social context, and that for a patient with rheumatoid disease, the spouse and the family are the first step. How to do this still needs attention.”
“The next challenge for us is how to conceptualize and study coping beyond the individual and how to use a variety of methods to really get at the stories that people tell us and come up with general patterns,” she continued. “From this research, I hope that 10 years from now we will be able to talk about how to develop couple-based interventions and will be able to teach couples how to communicate.”
Kathy Holliman is a medical journalist based in New Jersey.
Reference
- Holtzman S, DeLongis A. One day at a time: The impact of daily satisfaction with spouse responses on pain, negative affect and catastrophizing among individuals with rheumatoid arthritis. Pain. 2007;131:202-213.
- Abraído-Lanza AF, Revenson TA. Illness intrusion and psychological adjustment to rheumatic diseases: a social identity framework. Arthritis Rheum. 2006;55:224-232.
