Category: Health Psychology / Behavioral Medicine - Adult
Not all spousal support is helpful; indeed, some can be harmful (Cutrona, 2012). This may be especially true for couples in which one member has chronic low back pain (CLBP). Therefore detailed examination of support and pain outcomes is warranted. This study examines longitudinal relationships between types of perceived spousal support and pain outcomes.
Couples (n=105) containing one spouse with CLBP and one pain-free spouse completed electronic diaries for 2 weeks. At 9 am and 12, 3, 5, and 8 pm, CLBP patients reported their perception of types of spousal support they received from spouses (advice, encouragement, love, help, listening, other) and their own pain intensity, interference, and catastrophizing. Non-patient spouses rated the amount of pain behaviors they observed (e.g., pain-avoidant posturing, grimacing).
Hierarchical linear models tested lagged relations between types of perceived support and pain 3 hours later. Types of support were group mean centered to capture within subject associations. Time and the pain outcome on the prior interval were controlled. Gender was a level-two main effect and moderator.
The majority of effects were found for advice. Patients who perceived advice from partners reported lower levels of pain interference in the next 3 hours (b=-.22, p<.01). Gender moderated the relationship between advice and pain intensity (b=.30, p < .05). Husbands who perceived advice from their wives reported less pain (b=-.28, p<.01). The gender moderation effect for advice also approached significance for pain catastrophizing (b=.54, p=.058); husbands who perceived advice from their wives engaged in lower levels of pain catastrophizing (b=-.55, p < .01). Turning to the other types of support, gender moderated the relationship between love and pain behaviors (b=.53, p < .05). When wives perceived love from their husbands, there was a trend for husbands to see more pain behaviors (b=.31, p=.07). Gender also moderated the relationship between listening and pain intensity (b=-.28, p < .05), but simple effects within gender were not significant.
Types of perceived support are differentially related to later pain outcomes. There are also gender differences in these effects. When included in a model with other types of support, advice related to positive outcomes in men. After perceiving advice, men had lower levels of pain intensity, pain interference, and pain catastrophizing in the next 3 hours. Women also had less pain interference after receiving advice from partners. Thus, further investigation is needed to test the usefulness of advice longitudinally and to examine the characteristics of supportive advice. When patients view partner advice as supportive they may benefit, thus interventions to enhance supportive advice may be useful.
Niki Sarrafian– Doctoral Student, University of La Verne
Samin Seraji– University of La Verne
Chelsea Feller– University of La Verne
Kristina Post– Assistant Professor, University of La Verne, La Verne, California
David Smith– Professor, University of Notre Dame, Notre Dame, Indiana
John Burns– Rush University Medical Center
Laura Porter– Duke University Medical Center
Francis Keefe– Duke University Medical Center