Marital Adjustment, Depression and Myocardial Infarction

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DESCRIPTION (provided by applicant): Depression and Coronary Heart Disease (CHD) are each prevalent disorders, which frequently co-occur. Approximately 15-23% of individuals recovering from a heart attack (e.g., myocardial infarction; MI) will meet criteria for major depression and up to 65% will experience elevations in depressive symptoms. Yet, history of depression and disease severity are only moderately predictive of this co-morbidity. Importantly, depression is embedded within social context and, in particular, depression is strongly associated with marital adjustment. The primary goal of the current research is to examine if individuals with worse marital adjustment experience higher levels and a more persistent course of depressive symptoms following MI, in a 6-mo, 3-wave, prospective study of 150 men and women. Some research suggests that marital distress and depressive symptoms are more closely linked in women than in men. Therefore, the current research will examine if gender moderates the associations between marital adjustment and level and course of depression, with the hypothesis that associations will be stronger for women than for men. Previous research suggests that depression and possibly marital adjustment represent risk factors for negative physical health outcomes following MI. Further, when psychosocial risk factors occur in combination, the probability of negative outcomes is likely to increase substantially due to additive or synergistic effects. A secondary goal of the study will therefore be to examine the joint and independent effects of depression and marital adjustment on quality of life, functional status, and the probability of recurrent events following Ml. Women may experience worse outcomes following MI, and psychosocial factors could contribute to this trend. The proposed research will therefore examine if gender moderates the relationships between depression, marital adjustment, and health outcomes following CHD, with the hypothesis that effects will be stronger for women than for men. The broader goal of the proposed research is to identify aspects of social functioning that could represent potent, modifiable risk factors for CHD and depression co-morbidity, in the hopes of informing more effective prevention and intervention efforts.