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Published on: April 19, 2019
Better together: Relationship quality and mental health among cardiac patients and spouses
Karen Bouchard1,2, Alexandre Gareau3, Karolina Sztajerowska2
1University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Insights
Marital relationship quality impacts mental health in couples with cardiovascular disease (CVD). High relationship quality, especially mutual consensus and affection, is linked to fewer depression and anxiety symptoms for both patients and spouses.
Area of Science:
- Cardiology
- Psychology
- Sociology
Background:
- Marital relationship quality often declines after a cardiac event.
- The link between relationship quality and mental health in couples with cardiovascular disease (CVD) is understudied.
- Psychological distress is a known risk factor for CVD incidence, morbidity, and mortality.
Purpose of the Study:
- To assess the associations between relationship quality and mental health outcomes (depression, anxiety) in patients with CVD and their spouses.
- To investigate the role of dyadic interdependence in these associations.
Main Methods:
- Cross-sectional study of 181 couples (362 participants) where at least one partner had CVD.
- Utilized questionnaires to measure four dimensions of relationship quality and mental health.
- Employed an Actor-Partner Interdependence Model with hierarchical moderation analyses.
Main Results:
- Patients reported higher relationship satisfaction and fewer anxiety symptoms than spouses.
- Mutual high dyadic consensus and affectional expression were associated with fewer mental health symptoms for both partners.
- Low dyadic cohesion had actor effects on mental health, but these were mitigated when both partners perceived high cohesion.
Conclusions:
- Relationship quality is significantly associated with mental health symptoms in couples managing CVD.
- Reciprocal perceptions of relationship quality, particularly consensus and affection, are crucial for mental well-being.
- Further longitudinal and experimental research is needed to confirm these findings.
Abstract:
Reductions in marital relationship quality are pervasive post-cardiac event. It is not yet understood how relationship quality is linked to mental health outcomes in couples where one member has established cardiovascular disease (CVD) and the interdependence within dyads is seldom measured. This research is required as psychological distress has been independently linked to CVD incidence, morbidity, and mortality. This study assessed associations of relationship quality with depression and anxiety among patients with CVD and their spouses. Participants completed questionnaires measuring four dimensions of relationship quality and mental health. Data were analyzed using an Actor-Partner Interdependence Model with hierarchical moderation analyses. 181 dyads (N = 362 participants) comprised the study sample. Most patients had coronary artery disease (66.3%) and 25.9% were female. Patients reported higher relationship satisfaction and fewer anxiety symptoms than did spouses. Patients and spouses with high dyadic consensus and affectional expression reported fewer mental health symptoms, but only when the other partner also perceived high levels of consensus and affectional expression in the relationship. Patients and spouses with low dyadic cohesion reported worse mental health symptoms (actor effects), but those effects were no longer significant when both the patient and the spouse appraised the relationship as having high levels of dyadic cohesion. Taken together, relationship quality is linked to mental health symptoms in patients with CVD and their spouses. Longitudinal and experimental studies are now warranted to further substantiate the cross-sectional findings of this study.
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