Alex J. Zautra

Spouse Criticism and Support: Their Association With Coping and Psychological Adjustment Among Women With Rheumatoid Arthritis

Examined whether psychological adjustment of women with rheumatoid arthritis would be related to the support and criticism the patient received from the husband. Interviews were conducted with the husbands of 103 women with rheumatoid arthritis. Spouse interviews were content coded for critical remarks. Wives completed a revised version of the Ways of Coping Scale and a scale of the perceived supportiveness of the spouse. Husbands completed rating scales assessing their perceived vulnerability to illness and the degree of burden they experienced in providing assistance to their wives. Path analyses revealed that patient adjustment was significantly related to the attitude of the spouse. Patients with a highly critical spouse engaged in more maladaptive coping behaviors and reported a poorer psychological adjustment. Independent of spousal criticism, patients who perceived their spouse as being supportive engaged in more adaptive coping. A path model was fit to the data that suggested that the spouse may affect adjustment indirectly through influencing the patients selection of adaptive or maladaptive coping responses.

Positive affect as a source of resilience for women in chronic pain

A sample of 124 women with osteoarthritis or fibromyalgia, or both, completed initial assessments for demographic data, health status, and personality traits and 10-12 weekly interviews regarding pain, stress, negative affect, and positive affect. Multilevel modeling analyses indicated that weekly elevations of pain and stress predicted increases in negative affect. Both higher weekly positive affect as well as greater positive affect on average resulted in lower negative affect both directly and in interaction with pain and stress. Finally, increases in weekly negative affect and higher average negative affect related to greater levels of pain in subsequent weeks. In contrast, higher levels of overall positive affect predicted lower levels of pain in subsequent weeks.

Are reports of childhood abuse related to the experience of chronic pain in adulthood? A meta-analytic review of the literature.

Background:Recent empirical evidence suggests that childhood abuse may be related to the experience of chronic pain in adulthood. To date, a systematic quantitative review of the literature has not been presented. Objectives:The purpose of this study was to use meta-analytic procedures to evaluate the strength of existing evidence of the association between self-reports of childhood abuse and the experience of chronic pain in adulthood. Methods:Analyses were designed to test the relationship across several relevant criteria with 4 separate meta-analyses. Results:Results of the analyses are as follows: 1) individuals who reported being abused or neglected in childhood also reported more pain symptoms and related conditions than those not abused or neglected in childhood; 2) patients with chronic pain were more likely to report having been abused or neglected in childhood than healthy controls; 3) patients with chronic pain were more likely to report having been abused or neglected in childhood than nonpatients with chronic pain identified from the community; and 4) individuals from the community reporting pain were more likely to report having been abused or neglected than individuals from the community not reporting pain. Conclusion:Results provide evidence that individuals who report abusive or neglectful childhood experiences are at increased risk of experiencing chronic pain in adulthood relative to individuals not reporting abuse or neglect in childhood.

Examinations of chronic pain and affect relationships : Applications of a dynamic model of affect

Two studies of the relationship between pain and negative affect are presented in this article: a study of weekly fluctuations in pain and negative affect among those with arthritis and a study of daily fluctuations in pain and negative affect for participants with fibromyalgia. The roles of positive affect and mood clarity (or the ability to distinguish between different emotions) in modifying the size of the relationship between pain and negative affect were examined in both studies as a means of testing the predictions of a dynamic model of affect regulation. In both studies, the presence of positive affect reduced the size of the relationship between pain and negative affect. Also, for arthritis participants with greater mood clarity, there was less overlap in ratings of negative and positive affective states.

Positive and negative social ties among older adults: Measurement models and the prediction of psychological distress and well-being

The factor structure of positive and negative social ties was studied among 246 older adults who were either recently physically disabled, recently conjugally bereaved, or matched controls. Covariance structure analyses were carried out on a network measure to determine whether positive and negative social ties represent independent domains of social experience, and to assess the degree to which their structure is invariant across groups undergoing major loss transitions. Positive and negative social ties were found to be independent and there was substantial similarity in their factor structure across the three groups. Hierarchical regression analyses revealed that, whereas positive social ties were related to psychological well-being, negative social ties were predictive of both psychological well-being and distress. These results demonstrate the importance of assessing both positive and negative ties in explaining the psychological adjustment of older adults.

Vulnerability to stress among women in chronic pain from fibromyalgia and osteoarthritis davis et al. stress vulnerability

In two investigations, we studied vulnerability to the negative effects of stress among women in chronic pain from 2 types of musculoskeletal illnesses, fibromyalgia syndrome (FMS) and osteoarthritis (OA). In Study 1, there were 101 female participants 50 to 78 years old: 50 had FMS, 29 had OA knee pain and were scheduled for knee surgery, and 22 had OA but were not planning surgery. Cross-sectional analyses showed that the three groups were comparable on demographic variables, personality attributes, negative affect, active coping, and perceived social support. As expected, FMS and OA surgery women reported similar levels of bodily pain, and both groups scored higher than OA nonsurgery women. However, women with FMS reported poorer emotional and physical health, lower positive affect, a poorer quality social milieu, and more frequent use of avoidant coping with pain than did both groups of women with OA. Moreover, the perception and use of social support were closely tied to perceived social stress only among the FMS group. In Study 2, we experimentally manipulated negative mood and stress in 41 women 37 to 74 years old: 20 women had FMS, and 21 women had OA. Participants from each group were randomly assigned to either a negative mood induction or a neutral mood (control) condition, and then all participants discussed a stressful interpersonal event for 30 min. Stress-related increases in pain were exacerbated by negative mood induction among women with FMS but not women with OA, and pain during stress was associated with decreases in positive affect in women with FMS but not women with OA. These findings suggest that among women with chronic pain, those with FMS may be particularly vulnerable to the negative effects of social stress. They have fewer positive affective resources, use less effective pain-coping strategies, and have more constrained social networks than their counterparts with OA, particularly those who experience similar levels of pain. They also seem to experience more prolonged stress-related increases in pain under certain circumstances, all of which may contribute to a lowering of positive affect and increased stress reactivity over time.

Life events and perceptions of life quality: Developments in a two-factor approach

This paper reviews research on how a two-factor model explains relationships between life events and perceptions of life quality. Positive life events were found to have different effects than negative life events. People rated their distress higher after experiencing negative events, but they did not always rate the quality of their daily lives lower. Positive events increased ratings of positive affect but were usually unrelated to psychological distress. While these data fit a two-factor model of psychological well-being best, such a model left some important exceptions to that model unexplained. To address such issues, the review focused on those occasions when the effects of events crossed affective domains. This fuller assessment promises to provide an integrative approach to understanding some of the affective and congnitive processes linking life events to quality of life.

Dimensions of Affect Relationships: Models and Their Integrative Implications

This article presents data from a number of areas of psychology that have dealt with the issue of whether positive and negative affects are independent—the bivariate view— or whether they operate inversely from each other—the unidimensional, bipolar view. Both models have extensive empirical support. A more integrative view, the Dynamic Model of Affect (DMA), specifies conditions under which both bivariate and bipolar models are valid. It is tailored to analyzing both affect systems functioning concurrently. The DMA is reviewed and then extended to show how 3 major areas of research can begin to incorporate the more integrative framework of analyzing co-occurring types of affect.

Measuring small life events

The development of an inventory to assess small events is described. In the construction of the inventory specific criteria were established and existing event inventories were screened for items and new items written to fit these criteria. The event had to denote an observable change in a persons everyday life, have a discrete beginning, be classifiable as either desirable or undesirable, and be scaled as having an average of 250 Life Change Units or less using B. S. Dohrenwend, Krasnoff, Askenasy, Dohrenwends (1978) magnitude estimation parameters. The inventory was constructed to cover events in major areas of life concern: family, work, leisure, household, financial, health/illness, nonfamily relations, crime/criminal activity, education, religion, and transportation. Two studies are reported that test the utility of the inventory.

Life events and personal causation: some relationships with satisfaction and distress.

The factors that generate happiness or distress in people are not well understood, nor are factors that change such states. This study attempted to show that accounting for peoples sense of personal causation could provide a clear understanding of the relationship between live events, personal activity, and measures of psychological well-being. After pretesting, three randomly selected groups of college students were given instructions either to (a) engage in 12 activities from a self-selected list of pleasurable activities, (b) engage in 2 activities from that list, or (c) return after 1 month for retesting only. Covariance analyses revealed that subjects instructed to engage in either 2 or 12 pleasurable activities reported greater pleasantness and a higher quality of life than controls; there were no differences between groups on reports of psychiatric distress. Prior negative life change was treated as a factor in the design and was found to interact with the activity instructions: Subjects reporting many prior negative changes exhibited less psychiatric distress along with greater pleasantness when instructed to engage in 12 activities rather than 2 or none. The results suggested that engaging in pleasant activities increases positive aspects of well-being in general, but may reduce distress only for subjects who are experiencing considerable life stress.