Dyadic Analysis to Explain Distress in Couples

描述（由申请人提供）：现有的文献表明，性格、评价和应对构成了一个模型，可以解释乳腺癌患者及其伴侣的痛苦差异的重要比例。然而，许多差异仍然无法解释。研究病人和伴侣的文献表明，一方的痛苦和应对会影响另一方的痛苦和应对，尽管我们还不清楚是通过哪种机制。这项拟议中的研究预计将确定影响患者和伴侣痛苦的变量，并解释配偶一方如何影响另一方。在拟议的研究中，我们将确定在多大程度上，从一个认知压力模型的变量修改，包括一个二元成分提高模型的预测能力比传统的模型，不包括二元/配偶变量。我们将为患者和他们的伴侣确定这一点，以更好地了解乳腺癌的诊断如何导致夫妻之间潜在的长期心理困扰。为了实现这些目标，将招募60名已婚或有伴侣的女性，她们被诊断患有乳腺癌，正在接受辅助化疗，以及她们的伴侣。他们将通过邮件收到一份评估报告。对乳腺癌、乐观、应对策略（以问题为中心的应对、以情绪为中心的应对、以关系为中心的应对、以情绪表达和处理为中心的应对）和痛苦（情绪状态概况）进行初步评估。在控制了任何必要的人口统计学和疾病变量之后，使用SAS PROC MIXED多层建模的参与者伙伴相互依赖模型将用于确定模型中变量组之间的关系。我们期望在我们的分析中包括伴侣变量会比只包括个人变量产生更多统计上显著的差异。拟议研究的结果将为临床实践和更大的纵向研究提供信息，以确定干预措施的重要变量，以减少患者及其伴侣在整个癌症经历中的心理发病率。

DESCRIPTION (provided by applicant): Extant literature shows that personality, appraisals and coping comprise a model that explains a significant proportion of the variance in distress in patients with breast cancer and their partners. However, much of the variance remains unexplained. Literature that examines patients and partners together shows that the distress and coping of one influence the distress and coping of the other, although we have yet to understand through which mechanisms. The proposed research is expected to identify variables that affect distress in patients and partners and explain how one spouse impacts the other. In the proposed study, we will determine the extent to which the variables from a cognitive stress model modified to include a dyadic component improve the model's predictive ability over the traditional model that does not include dyadic/spouse variables. We will determine this for both for patients and for their partners in an effort to better understand how a diagnosis of breast cancer leads to potentially long-standing psychological distress in couples. In order to reach these goals, 60 married or partnered women, diagnosed with breast cancer and undergoing adjuvant chemotherapy treatment, and their partners will be recruited. They will be sent an assessment battery through mail. Primary appraisals of the breast cancer, optimism, coping strategies (problem-focused coping, emotion-focused coping, relationship-focused coping, and emotional expression and processing coping) and distress (Profile of Mood States) will be assessed. The Actor Partner Interdependence Model using multilevel modeling with SAS PROC MIXED will be used to determine relationships among groups of variables from the model after controlling for any necessary demographic and disease variables. We expect that including partner variables in our analyses will result in more statistically significant variance predicted in distress than including only the individual's variables. Findings from the proposed study will inform clinical practice and also a larger, longitudinal study to determine variables important for interventions to reduce psychological morbidity for patients and partners throughout the cancer experience.