Marital status was unrelated to immediate unpleasantness (). We found a strong association with emotional suffering () but not with negative illness beliefs (). sex as a covariate revealed that the emotional response to pain was the .. Prior research on pain and marital status , for example, suggests. While findings revealed that marital status had little effect on depression levels .. While some research has specifically measured psychological health by. However, not all studies show moderating effects of sex on the relationship relationship between marital status and health is race/ethnicity. Just as one's sex black-white differences in the effects of divorce on the mental health of women (e.g.,. Gove and Shin .. Table 1 reveals that about 80% of the.
First, interaction with relatives was assessed by responses to the question "Of the relatives including any in household you feel closest to, how many do you see and how often?
The mean score for interaction with relatives in was Second, interactions with friends was assessed by responses to the following question: The mean score for interaction with friends in was Finally, an interaction with neighbors variable was assessed by responses to "How often do you get together with the neighbour which you see most frequently?
Scores on this 4-point scale were reverse coded such that high scores reflected more interaction. The mean interaction-with-neighbor score was 3. Change in health status variables.
On the basis of participants' responses to the interview questions, three measures were created to assess changes that occurred in health status over 7 years.
Perceived health was assessed both in and in by asking, "For your age, would you say, in general, your health is good, fair, or poor? These scores were subsequently reverse coded such that high scores reflected excellent health and low scores, poor health. Morbidity was assessed in and again in by summing the number of health problems. Individuals identified these problems from a list of problems or diseases encountered within the past year: A low score reflected low morbidity and a high score, high morbidity.
Again, the score was subtracted from the score to create a change in morbidity score. Functional independence was determined by asking the participants about their ability to perform basic activities of daily living as identified in other standardized measures Branch, Katz, Kniepman, and Papsidero ; Branch and Myers ; Katz, Ford, Moskowitz, Jackson, and Jaffee A functional independence score was created by summing the activities that respondents were able to perform independently.
Thus, higher scores reflected greater independence. The major independent variable, marital stability—transition, was determined by asking respondents about who lived in their households in and again in For the purposes of this study, four groups were identified on the basis of presence P or absence A of a spouse.
Spousal presence obviously referred to the presence of a spouse who lived in the home. Spousal absence from the household could be due to having never been married, the death or institutionalization of a spouse, or divorce or separation.
The P or A groups were further classified as having stability in marital status or as having experienced a transition. Table 1 shows the four groups identified in the present study, separately for women and men. The present—present PP stability group included those who reported living with a spouse in both and These individuals experienced stability in the sense that they remained married over the 7-year period of this study.
As shown in Table 1a greater proportion of men Respondents who were not living with a spouse in either or were classified into the absent—absent AA stability group. The absence of a spouse was for a variety of reasons e. Although some of these individuals had undergone a transition beforethey had all retained at least recent stability in marital status.
The present—absent PA transition group included individuals who were living with a spouse in but not in The final, absent—present AP transition group consisted of those respondents who were not living with a spouse in but were in The dependent variable, life satisfaction, was measured in and using Neugarten and associates LSIA. The LSIA was administered to study participants who were capable of responding to 20 statements i. These statements included such items as "I have gotten more of the breaks in life than most of the people I know" and "As I grow older, things seem better than I thought they would be.
A mean LSIA score was created for each individual, ranging from 0 to 1. Inthe mean LSIA index score was. Identifying Covariates Before addressing the major question of whether changes in life satisfaction varied depending on the stability of or transition in marital status, preliminary correlational analyses were undertaken to identify potential covariates.
Potential variables included demographics age, education, and incomesocial support interaction with relatives, neighbors, and friendsand heath status perceived health, morbidity, and functional capacity.
The Relationship between Marital Status and Psychological Resilience in Chronic Pain
A positive difference score indicated an increase and a negative difference score indicated a decline in life satisfaction over time. Because the relationships between each potential covariate and the LSIA change might differ by gender and stability—transition group, we examined correlations separately for men and women in the four groups i.
It should be noted that, owing to missing values on the potential covariates, the sample sizes for the calculation of a given coefficient may differ from those presented in Table 1. For example, in examining the correlations between potential covariates and the LSIA change score for women within the AP group, correlations were based on as few as 15 individuals, whereas Table 1 shows 17 individuals in the AP group. Table 2 shows that none of the demographic or social support variables correlated significantly with change in life satisfaction.
In contrast, there was some evidence for associations between changes in health and in life satisfaction. To clarify whether widows and widowers differed in their emotional response to pain, a final MANCOVA was conducted that included the term sex as a covariate along with pain intensity, age, and ethnicity.
The main effect for sexand the interaction of sex with marital status, were not significant. Finally, ANCOVA was conducted to determine whether the differences seen in emotional suffering between marital groups were a function of interpersonal support as measured by the MPI.
After controlling for pain sensation intensity, age, and ethnicity, the marital groups did not differ on this measure. Discussion Marital status was not associated with immediate pain-related unpleasantness.
Our hypothesis that being married would be associated with lower levels of pain-related emotional suffering was only weakly supported. The unexpected finding was that in the face of a condition threatening their lifestyle e.
Although separated and divorced subjects experienced the loss of a spousal relationship, only those subjects whose spouse had died experienced less emotional turmoil in response to pain.
Importantly, the level of perceived social support and severity of self-perceptions of pain impact e. For there to be emotional differences in response to pain higher level cognitive processes related to the consideration of future consequences and rumination concerning the past would seem necessary. Consistent with this notion immediate pain-related unpleasantness appears to be only modestly influenced by personality factors [ 13162125 ].
For this reason it is not surprising that in our subjects immediate unpleasantness did not differ as a function of marital status. Along these lines Leknes et al. Brain imaging studies suggest that unlike immediate unpleasantness, emotional suffering is associated with brain activation in regions associated with language processes, episodic memory, and executive function which serves to direct psychological operations to produce an emotional gestalt. Divorced and separated individuals differ from widows and widowers in that they were more active participants and presumably had more control over their change in marital status.
Losing a spouse to illness appears to have a different impact on an individual than divorce or separation. Experiencing the death of a loved one may lead an individual to develop additional coping strategies, or in some other way, make them less vulnerable to emotional distress in reaction to future lifestyle threat.
Given that lifetime expectancy in the United States is increasing, a spouse may survive many years following the death of their partner.
This finding speaks to the strength of the human spirit to recover and to develop new psychological strength, after misfortune.
Such psychological growth is not simply a product of wisdom that comes with age. There appears to be no sex difference with regard to this form of emotional resilience. Psychological flexibility involves interaction between the environment and cognition that allows an individual to persist, or change, in accordance with their values and long-term goals [ 40 ]. Component processes include mindfulness, value-based action, and acceptance. Prior research has demonstrated significant relationships between components of psychological flexibility and physical and emotional adaptation to chronic pain [ 41 ].
Consistent with our findings, older age per se is not associated with higher levels of such psychological flexibility [ 42 ]. Future studies examining the relationship between marital status and pain-related suffering might assess measures of psychological flexibility, such as acceptance.
A limitation of the study is that we did not include measures assessing the broader social network. Prior research on pain and marital status [ 43 ], for example, suggests that a nondistressed marital relationship is associated with less pain and better functioning in rheumatoid arthritis patients. While being married was only marginally associated with less pain-related emotional suffering, the importance of the quality of the marital relationship should be explored in future studies.
Pain Research and Treatment
Similarly, future studies may wish to further assess other contributions to suffering within the family system e. In addition, careful interviewing of widows and widowers might clarify the nature of gained resilience accounting for better emotional well-being. It should be noted that the pain duration for study subjects was about 2 years.
It is unclear whether the identified relationships between marital status and suffering would generalize to individuals with greater pain duration. Conclusions In this study, after statistically controlling for pain sensation intensity, age, and ethnicity, marital status was uniquely associated with emotional suffering. Interestingly, compared to all other marital categories, in response to a condition threatening their lifestyle e. Specifically, widowed subjects experienced significantly less frustration, fear, and anger than all other groups married, divorced, separated, or single.
Lastly, the limitations to the control of selection bias also need to be acknowledged.
The survival analysis we employed reduces the effects of selection bias by excluding situations where the prior existence of the focal disorder has an influence either on reduced chances of becoming married or increased chances of marriage dissolution.
However, it cannot eliminate the possible influence of factors that may both decrease the likelihood of getting married and increase the likelihood of mental disorder onset, such as personality, or history of sexual abuse. The fact that we found that marriage was associated with reduced onset of disorders which typically occur well before marriage the phobias is suggestive of some residual selection bias of this sort, though this would only apply to the contrast between the married and the never married.
These limitations notwithstanding, we believe this study is the most comprehensive to date on the relationship between marital status and mental disorder.
It provides unique information on the gender similarities and differences in the associations between being unmarried, married and previously married with a wide range of mental disorder first onsets.What makes a good life? Lessons from the longest study on happiness - Robert Waldinger
We thank the WMH staff for assistance with instrumentation, fieldwork, and data analysis. A complete list of WMH publications can be found at http: Giovanni di Dio Fatebenefratelli, Brescia, Italy.
Everyday stressors and gender differences in daily distress. Journal of Personality and Social Psychology.
Marital disruption and depression in a community sample.