Couples Adjusting to Multimorbidity: A Dyadic Study on Disclosure and Adjustment Disorder Symptoms.
Couples Adjusting to Multimorbidity: A Dyadic Study on Disclosure and Adjustment Disorder Symptoms.
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DOI：
10.3389/fpsyg.2019.02499
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发表时间：
2019-01-01
影响因子：
3.8
通讯作者：
Zimmerli, Lukas
中科院分区：
文献类型：
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作者：
Horn, Andrea B;Boettcher, Victoria S;Zimmerli, Lukas
背景：多重情感障碍不仅对患者而且对浪漫伴侣都具有挑战性。人际情绪调节的策略，如向伴侣透露，应该在多重创伤的心理社会适应中发挥重要作用。研究往往集中在疾病相关的披露，即使披露的想法和感受有关的世俗，日常生活中发生的事情也可能发挥作用，在coadjustment。目前的二元研究旨在调查这两种类型的人际调节策略和适应障碍症状之间的关联，遵循新的ICD 11标准，在多病患者及其伴侣中进行。在因急性健康危机住院后不久，N = 28例多病患者（平均年龄70岁）和他们的伴侣填写了关于夫妇中的披露、ICD 11的适应障碍标准的问卷。结果：患者和他们的伴侣都表现出类似的高水平的专注和适应失败，表明对复杂的健康状况的调整问题。两个合作伙伴的适应症状之间的相关性r = 0.22和0.45。回归的基础上的演员，合作伙伴的相互依赖模型显示，自己的世俗披露与较少的适应症状的患者。除此之外，还观察到了伴侣效应，揭示了伴侣的疾病相关披露与患者的专注水平之间的负相关。对于伴侣来说，伴侣的平凡披露与较少的关注，无法适应，以及超出自己披露报告的睡眠问题有关。此外，有一个演员的影响，疾病相关的披露对睡眠问题较少的partners.CONCLUSION：这些结果支持了人际关系的观点，身体疾病的调整过程。披露作为一种调节关系和情绪反应的方式可能在这里发挥相关作用，这似乎对患者及其伴侣来说是不同的。需要进一步的研究，以揭示更多的差异作用，疾病相关的和平凡的日常披露的心理社会调整面临健康挑战的夫妇。
BACKGROUND: Multimorbidity is challenging not only for the patient but also for the romantic partner. Strategies for interpersonal emotion regulation like disclosing to the partner are supposed to play a major role in the psychosocial adjustment to multimorbidity. Research has often focused on disease-related disclosure, even though disclosing thoughts and feelings related to mundane, everyday life occurrences might also play a role in coadjustment. The current dyadic study aimed at investigating the association between these two types of interpersonal regulation strategies and adjustment disorder symptoms, following the new ICD 11 criteria in multimorbid patients and their partners.METHODS: Shortly after being hospitalized due to an acute health crisis, N = 28 multimorbid patients (average age 70 years) and their partners filled in questionnaires on disclosure in the couple, adjustment disorder criteria of the ICD 11 ("preoccupation," "failure to adapt"), and sleep problems.RESULTS: Both patients and their partners did show similarly high levels of preoccupation and failure to adapt indicating adjustment problems to the complex health situation. The adjustment symptoms of both partners correlated between r = 0.22 and 0.45. Regression based on Actor-Partner Interdependence-Models revealed that own mundane disclosure was related to less adjustment symptoms in the patients. Beyond that, a partner effect was observed, revealing a negative association between partners' illness-related disclosure and the patients' level of preoccupation. For the partners, mundane disclosure of the partner was associated with less preoccupation, failure to adapt, and reported sleep problems above and beyond own disclosure reports. Furthermore, there was an actor effect of disease-related disclosure on less sleep problems for the partners.CONCLUSION: These results support an interpersonal view on adjustment processes to physical disease. Disclosure as a way of regulating the relationship and emotional responses might play a relevant role here, which seems to be different for patients and their partners. Further research is needed to shed more light on the differential role of disease-related and mundane everyday disclosure for psychosocial adjustment in couples confronted with health challenges.