Katherine Péloquin

Self-perceived burden in chronic pain: Relevance, prevalence, and predictors

Summary Self‐perceived burden, that is, patients’ perception of being a burden to others, is a clinically relevant and commonly reported experience in patients with chronic pain. Abstract Chronic pain is a debilitating condition that can have an impact on various facets of interpersonal functioning. Although some studies have examined the extent to which family members are affected by an individual’s chronic pain, none have examined patients’ perceptions of feeling that they have become a burden to others. Research on self‐perceived burden in different medical populations, such as cancer, amyotrophic lateral sclerosis, and stroke, has shown that it is associated with physical symptoms and, more robustly, with psychological difficulties and concerns. The present study examined the prevalence and predictors of self‐perceived burden in a tertiary chronic pain sample. Participants were consecutive patients (N = 238) admitted to an outpatient, interdisciplinary, chronic pain management program at a rehabilitation hospital. At admission, participants completed a battery of psychometric questionnaires assessing self‐perceived burden, as well as a number of clinically relevant constructs. Their significant others (n = 80) also completed a measure of caregiver burden. Self‐perceived burden was a commonly reported experience among chronic pain patients, with more than 70% of participants endorsing clinically elevated levels. It was significantly correlated with pain intensity ratings, functional limitations, depressive symptoms, attachment anxiety, pain self‐efficacy, and caregiver burden. Self‐perceived burden was also correlated with an item assessing suicidal ideation. In a hierarchical regression model, depressive symptoms, pain self‐efficacy, and adult attachment significantly predicted self‐perceived burden after controlling for demographic and pain‐related variables. In conclusion, self‐perceived burden is a clinically relevant and commonly reported interpersonal experience in patients with longstanding pain.

Measuring Empathy in Couples: Validity and Reliability of the Interpersonal Reactivity Index for Couples

This article includes three studies aimed at adapting the Interpersonal Reactivity Index (Davis, 1980), a measure of general cognitive and emotional empathy, to assess empathy expressed within a romantic relationship. We examined the factorial structure of the Interpersonal Reactivity Index for Couples (IRIC). Results supported the use of the 2-factor measure (Dyadic Perspective Taking and Dyadic Empathic Concern) in 3 independent samples (individuals in heterosexual relationships, individuals in same-sex relationships, and partners of heterosexual couples). The IRIC also demonstrated good convergent, discriminant, concurrent, predictive, and incremental validity as well as adequate internal consistency and stability over 18 months.

Chronic pain and the interpersonal theory of suicide.

OBJECTIVE Chronic pain is a known risk factor for suicide. To date, however, few studies of people with chronic pain have tested specific predictions about suicidal ideation that are derived from theory. The interpersonal theory of suicide proposes that the psychological constructs of thwarted belongingness and perceived burdensomeness are unique and independent precursors to suicidal ideation. We tested this hypothesis in a clinical sample of patients with chronic pain. METHOD A total of 303 patients of a chronic pain rehabilitation program completed measures of pain severity, duration, and disability; cognitive-affective measures of depression and catastrophizing; and interpersonal measures of relationship distress and self-perceived burden to others. The latter measures were included as indices of the belongingness and burdensomeness constructs. Participants also rated two items pertaining to suicidal ideation. RESULTS In a multiple regression analysis, both distress in interpersonal relations (β = 0.12, p = .037) and self-perceived burden to others (β = 0.25, p < .001) were significant predictors of suicidal ideation, even after adjusting statistically for demographic characteristics, pain severity and duration, functional limitations, catastrophizing, and depression. CONCLUSIONS These findings suggest that the interpersonal theory is relevant to understanding elevated rates of suicidal ideation among people with chronic pain, and may have broader applicability to other populations with chronic illness or disability.

A dyadic approach to the study of romantic attachment, dyadic empathy, and psychological partner aggression:

This study examined the intrapersonal, dyadic, and mediational relationships underlying romantic attachment (Experiences in Close Relationships), dyadic empathy (Interpersonal Reactivity Index for Couples), and psychological partner aggression (Revised Conflict Tactics Scales) in 193 community-based couples. In women, attachment insecurity predicted lower dyadic empathy and greater psychological aggression. In men, attachment insecurity predicted lower perspective taking, higher empathic concern, and greater psychological aggression. Partner effects were found for men, with their attachment predicting their female partner’s dyadic empathy and psychological aggression. In women, low perspective taking mediated the relationship between: (1) their anxiety over abandonment and their psychological aggression; and (2) their avoidance of intimacy and their psychological aggression. Findings are consistent with the attachment theory and clinical implications are discussed.

Romantic Attachment Insecurity Predicts Sexual Dissatisfaction in Couples Seeking Marital Therapy

Researchers and practitioners have noted the importance of considering individual characteristics as well as couple dynamics when attempting to understand couples and sexual difficulties. Using a dyadic approach, this study examined the links between 2 forms of romantic attachment insecurity (anxiety and avoidance) and sexual dissatisfaction among members of couples seeking couple therapy. A large clinical sample of 242 French-speaking couples completed the Experiences in Close Relationships Scale and the Index of Sexual Satisfaction. Analyses based on the actor–partner interdependence model revealed that both attachment anxiety and avoidance predicted individuals’ own sexual dissatisfaction (actor effects). The authors also observed 2 partner effects: (a) anxiety in men predicted female partners’ sexual dissatisfaction and (b) avoidance in women predicted male partners’ sexual dissatisfaction. The results support attachment theory and have clinical implications for emotion-focused couple therapy and other approaches to couple therapy.

Sexuality Examined Through the Lens of Attachment Theory: Attachment, Caregiving, and Sexual Satisfaction

Attachment researchers have proposed that the attachment, caregiving, and sexual behavioral systems are interrelated in adult love relationships (Mikulincer & Shaver, 2007). This study examined whether aspects of partners’ caregiving (proximity, sensitivity, control, compulsive caregiving) mediated the association between their attachment insecurities (anxiety and avoidance) and each others sexual satisfaction in two samples of committed couples (Study 1: 126 cohabiting or married couples from the general community; Study 2: 55 clinically distressed couples). Partners completed the Experiences in Close Relationships measure (Brennan, Clark, & Shaver, 1998), the Caregiving Questionnaire (Kunce & Shaver, 1994), and the Global Measure of Sexual Satisfaction (Lawrance & Byers, 1998). Path analyses based on the actor-partner interdependence model (APIM) revealed that caregiving proximity mediated the association between low attachment avoidance and partners’ sexual satisfaction in distressed and nondistressed couples. Sensitivity mediated this association in nondistressed couples only. Control mediated the association between mens insecurities (attachment-related avoidance and anxiety) and their partners’ low sexual satisfaction in nondistressed couples. Attachment anxiety predicted compulsive caregiving, but this caregiving dimension was not a significant mediator. These results are discussed in light of attachment theory and their implications for treating distressed couples.

Curvilinear associations between neuroticism and dyadic adjustment in treatment-seeking couples.

Among personality traits, neuroticism has been shown to be the most significant predictor of dyadic adjustment. Despite some propositions arguing that low, as well as high levels of personality traits are maladaptive tendencies, only the negative linear relationship between neuroticism and couple satisfaction has been addressed in past research. The aim of this study was to examine the nonlinear association between neuroticism and dyadic adjustment for both partners of a clinically distressed sample of couples. The sample included 472 couples seeking couple therapy who completed the NEO-FFI (P. T. Costa & R. R. McCrae, 1992, NEO PI-R professional manual, Odessa, FL, Psychological Assessment Resources) and the Dyadic Adjustment Scale (G. B. Spanier, 1976, Measuring dyadic adjustment: New scales for assessing the quality of marriage and similar dyads, Journal of Marriage and the Family, 38, pp. 15-28). Results showed, for actor and partner effects, a significant nonlinear, inverted U-shaped relationship between neuroticism and dyadic adjustment. In particular, both very low levels and high levels of neuroticism were associated with lower dyadic adjustment for both the individual and his or her partner. This finding is in contrast with the traditional negative linear association between neuroticism and dyadic adjustment observed in previous research. Openness and agreeableness also positively predicted self and partner dyadic adjustment. Findings bear important clinical implications for therapists assessing and working with distressed couples.

Childhood Sexual Abuse and Intimate Partner Violence in a Clinical Sample of Men: The Mediating Roles of Adult Attachment and Anger Management

This study examined the association between men’s experience of childhood sexual abuse and later perpetration of intimate partner violence, considering the roles of attachment insecurity and poor anger regulation. The sample was 302 Canadian men undergoing counseling for relationship difficulties or aggression. They completed questionnaires assessing childhood sexual abuse, the two dimensions of attachment insecurity (anxiety and avoidance), anger regulation processes, physical and psychological aggression, and social desirability bias. Path analyses showed that men who experienced childhood sexual abuse scored higher on attachment anxiety, which in turn was associated with aggressive behaviors directly and through four anger-related variables (trait anger, anger-in, anger-out, and low anger control). Attachment-related avoidance predicted psychological aggression, but not physical aggression, through men’s trait anger and anger-in.

Whose fault is it? Blame predicting psychological adjustment and couple satisfaction in couples seeking fertility treatment

Abstract Infertility bears psychological and relational consequences for couples who face this problem. Few studies have examined the role of self- and partner blaming to explain psychological and relationship adjustment in couple presenting with a fertility problem. This study used a dyadic approach to explore the links between blaming oneself and one’s partner and both partners’ symptoms of depression and anxiety, and couple satisfaction in 279 couples enrolled in fertility treatments. Partners were questioned about the extent to which they blamed themselves and their partner for the fertility problem. They also completed the Dyadic Adjustment Scale and the Index of Psychological Symptoms. Path analyses based on the Actor–Partner Interdependence Model showed that self-blame predicted anxiety and depression symptoms in both men and women. Men’s self-blame also predicted their own lower relationship satisfaction, whereas women’s self-blame predicted more depression and anxiety in their partner. Partner blame in women predicted their own and their partner lower relationship satisfaction. Women’s tendency to blame their partner also predicted their own depression symptoms. Clinical implications of these findings are discussed.

Systemic aspects of conjugal resilience in couples with a child facing cancer and marrow transplantation

Introduction The negative impact of paediatric cancer on parents is well known and is even greater when intensive treatments are used. This study aimed to describe how couples whose child has received a transplant for the treatment of leukaemia view conjugal resilience and to evaluate the role of we-ness as a precursor of conjugal adjustment. Methods Four parental couples were interviewed. Interviews were analysed in two ways: inductive thematic analysis and rating of verbal content with the We-ness Coding Scale. Results Participants report that conjugal resilience involves the identification of the couple as a team and cohesion in the couple. Being a team generates certain collaborative interactions that lead to conjugal resilience. A sense of we-ness in parents is associated with fluctuation in the frequency of themes. Discussion Participants’ vision of conjugal resilience introduced novel themes. The sense of we-ness facilitates cohesion and the process of conjugal resilience.