Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-02T21:06:30.278Z Has data issue: false hasContentIssue false
  • English
  • Français

Marital satisfaction, conflict communication, attachment style and psychological distress in couples with a hospitalized depressed patient

Published online by Cambridge University Press:  24 June 2014

Gilbert M. D. Lemmens ,
Ann Buysse ,
Els Heene ,
Ivan Eisler  and
Koen Demyttenaere
Gilbert M. D. Lemmens*
Affiliation:
Department of Psychiatry, University Hospital Leuven, Leuven, Belgium
Ann Buysse
Affiliation:
Faculty of Psychology and Educational Sciences, University Ghent, Ghent, Belgium
Els Heene
Affiliation:
Faculty of Psychology and Educational Sciences, University Ghent, Ghent, Belgium
Ivan Eisler
Affiliation:
Section of Family Therapy, Institute of Psychiatry, King’s College, University of London, London, UK
Koen Demyttenaere
Affiliation:
Department of Psychiatry, University Hospital Leuven, Leuven, Belgium
*
Gilbert M. D. Lemmens, MD, Department of Psychiatry, University Hospital Leuven, Kapucijnenvoer 33, 3000 Leuven, Belgium. Tel: +32 16 332620; Fax: +32 16 332640; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

There has been fairly consistent empirical support for the association between major depressive disorder and marital dissatisfaction. However, this evidence is limited mostly to out-patient and population-based samples. Further, the role of possible mediating factors such as attachment style and conflict communication are less well investigated in major depression.

Objective:

The present study aims to investigate whether couples with a depressed partner and nonclinical couples differ in marital satisfaction, attachment style, psychological distress and conflict communication. Gender differences are also investigated.

Methods:

Seventy-seven couples, who participated in a family intervention trial, were compared with 77 age- and gender-matched nonclinical couples.

Results:

The depressed patients reported more psychological distress and attachment difficulties and less marital satisfaction than their partners and the nonclinical couples. Partners perceived their relationship as more satisfying than the nonclinical couples. The clinical couples reported less mutual constructive and more mutual avoidant communication in their relationship compared with the nonclinical couples. Finally, female depressed patients reported higher levels of psychological symptoms and were more avoidant attached than male patients.

Conclusions:

This study shows important differences in several individual and relational characteristics between couples with a depressed partner and nonclinical couples. Further research will be necessary to clarify whether the investigated psychosocial variables play a causal and/or a maintaining role in depression.

Keywords

attachmentconflict communicationmajor depressionmarital satisfactionpsychological distress
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 19 , Issue 2 , April 2007 , pp. 109 - 117
Copyright
Copyright © 2007 Blackwell Munksgaard

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Whisman, MA. The association between depression and marital dissatisfaction. In: Beach, SRH, ed. Marital and family processes in depression: a scientific foundation for clinical practice. Washington, DC: American Psychological Association, 2001:3–24. CrossRefGoogle Scholar
Coyne, JC, Benazon, NR. Not agent blue: effects of marital functioning on depression and implications for treatment. In: Beach, SRH, ed. Marital and family processes in depression: a scientific foundation for clinical practice. Washington, DC: American Psychological Association, 2001:25–43. CrossRefGoogle Scholar
Coyne, JC, Thompson, R, Palmer, SC. Marital quality, coping with conflict, marital complaints and affection in couples with a depressed wife. J Fam Psychol 2002;16:26–37. CrossRefGoogle ScholarPubMed
Kendler, KS, Karkowski, LM, Prescott, CA. Causal relationship between stressful life events and the onset of major depression. Am J Psychiatry 1999;156: 837–841. CrossRefGoogle ScholarPubMed
Whisman, MA, Bruce, ML. Marital distress and incidence of major depressive episode in a community sample. J Abnorm Psychol 1999;108:674–678. CrossRefGoogle Scholar
Weisman, MM. Advances in psychiatric epidemiology: rates and risks for major depression. Am J Public Health 1987;77:445–451. CrossRefGoogle Scholar
Sloan, DM, Strauss, ME, Quirk, SW, Sajatovic, M. Subjective and expressive emotional responses in depression. J Affect Disord 1997;46:135–141. CrossRefGoogle ScholarPubMed
Leff, J, Vaugh, C. The interaction of life events and relatives’ expressed emotion in schizophrenia and depressive neurosis. Br J Psychiatry 1980;136:146–153. CrossRefGoogle ScholarPubMed
Hooley, JM, Orley, J, Teasdale, JD. Levels of expressed emotion and relapse in depressed patients. Br J Psychiatry 1986;148:642–647. CrossRefGoogle ScholarPubMed
Hooley, JM, Teasdale, JD. Predictors of relapse in unipolar depressives: expressed emotion, marital distress, and perceived criticism. J Abnorm Psychol 1989;98:229–235. CrossRefGoogle ScholarPubMed
Hooley, JM, Licht, DM. Expressed emotion and causal attributions in the spouses of depressed patients. J Abnorm Psychol 1997;106:298–306. CrossRefGoogle ScholarPubMed
Okasha, A, El Akabawi, AS, Snyder, KS, Wilson, AK, Youssef, I, El Dawla, AS. Expressed emotion, perceived criticism and relapse in depression: a replication in an Egyptian community. Am J Psychiatry 1994;151:1001–1005. Google Scholar
Butzmaff, RL, Hooley, JM. Expressed emotion and psychiatric relapse: a meta-analysis. Arch Gen Psychiatry 1998;55:547–552. CrossRefGoogle Scholar
Kessler, RC, Walters, EE, Forthofer, MS. The social consequences of psychiatric disorders, III: probability of marital stability. Am J Psychiatry 1998;155:1092–1096. CrossRefGoogle ScholarPubMed
Bruce, ML. Divorce and psychopathology. In: Dohrenwend, BP, ed. Adversity, stress and psychopathology. New York: Oxford University Press, 1998: 219–234. CrossRefGoogle Scholar
Wade, TJ, Cairney, J. Major depressive disorder and marital transition among mothers: results from a national panel study. J Nerv Ment Dis 2000;188:741–750. CrossRefGoogle ScholarPubMed
Gotlib, IH, Lewinhsohn, PM, Seeley, JR. Consequences of depression during adolescence: marital status and marital functioning in early adulthood. J Abnorm Psychol 1998;107:686–690. CrossRefGoogle ScholarPubMed
McCarthy, G. Attachment style and adult love relationships and friendships: a study of a group of women at risk of experiencing relationship difficulties. Br J Med Psychol 1999;72:305–321. CrossRefGoogle ScholarPubMed
Mikulincer, M, Florian, V, Cowan, PA, Cowan, CP. Attachment security in couple relationships: a systematic model and its implications for family dynamics. Fam Process 2002;41:405–434. CrossRefGoogle Scholar
Carnelley, K, Pietromonaco, P, Jaffe, K. Attachment, caregiving, and relationship functioning in couples: effects of self and partner. Pers Relat 1996;3:257–277. CrossRefGoogle Scholar
Heavey, CL, Larson, BM, Zumtobel, DC, Christensen, A. The communication patterns questionnaire: the reliability and validity of a constructive communication subscale. J Marriage Fam 1996;58:796–800. CrossRefGoogle Scholar
Christensen, A. Dysfunctional interaction patterns in couples. In: Noller, P, Fitzpatrick, MA, eds. Perspectives on marital interaction. Philadelphia: Multilingual Matters, 1988:31–52. Google Scholar
Christensen, A, Heavey, CL. Gender and social structure in the demand/withdraw patterns of relational conflict. J Pers Soc Psychol 1990;59:73–81. CrossRefGoogle Scholar
Cauglin, JP, Vangelisti, AL. An individual difference explanation of why married couples engage in the demand/withdraw pattern of conflict. J Soc Pers Relat 2000;17:523–551. CrossRefGoogle Scholar
Mickelson, KD, Kessler, RC, Shaver, PR. Adult attachment in a nationally representative sample. J Pers Soc Psychol 1997;73:1092–1106. CrossRefGoogle Scholar
Christensen, A, Shenk, JL. Communication, conflict and psychological distance in nondistressed, clinic and divorcing couples. J Consult Clin Psychol 1991;59:458–463. CrossRefGoogle ScholarPubMed
Heavey, CL, Christensen, A, Malamuth, NM. The longitudinal impact of demand and withdrawal during marital conflict. J Consult Clin Psychol 1995;63:797–801. CrossRefGoogle ScholarPubMed
Byrne, M, Carr, A, Clark, M. Power in relationships of women with depression. J Fam Ther 2004;26:407–429. CrossRefGoogle Scholar
Heene, E, Buysse, A, Van Oost, P. A categorical and dimensional perspective on depression within a non-clinical sample of couples. Fam Process 2003;42:133–149. CrossRefGoogle Scholar
Carnelly, K, Pietromonaco, P, Jaffe, K. Depression, working models of others, and relational functioning. J Pers Soc Psychol 1994;66:127–140. CrossRefGoogle Scholar
Bifulco, A, Moran, PM, Ball, C, Bernazzanni, O. Adult attachment style. I Its relationship to clinical depression. Soc Psychiatry Psychiatr Epidemiol 2002;37:50–59. CrossRefGoogle ScholarPubMed
Reis, S, Grenyver, BFS. Fear of intimacy in women: relationship between attachment styles and depressive symptoms. Psychopathology 2004;37:299–303. CrossRefGoogle ScholarPubMed
Troisi, A, D’Argenio, . The relationship between anger and depression in a clinical sample of young men: the role of insecure attachment. J Affect Disord 2004;79:269–272. CrossRefGoogle Scholar
Heene, E, Buysse, A, Van Oost, P. Indirect pathways between depressive symptoms and marital distress: the role of conflict communication, attributions, and attachment style. Fam Process 2005;43:413–440. CrossRefGoogle Scholar
Gupta, M, Coyne, JC, Beach, SRH. Couples treatment for major depression: critique of the literature and suggestions for some different directions. J Fam Ther 2003;25:317–346. CrossRefGoogle Scholar
Whisman, MA, Uebacker, LA, Weinstock, LM. Psychopathology and marital satisfaction: the importance of evaluating both partners. J Consult Clin Psychol 2004;72:830–838. CrossRefGoogle ScholarPubMed
American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th edition. Washington, DC: American Psychiatric Press, 1994. Google Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KHet al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and the validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 1998;59:34–57. Google ScholarPubMed
Overbeek, T, Schruers, K, Griez, E. M.I.N.I.: Mini International Neuropsychiatric Interview, Dutch version 5.0.0 (DSM-IV). Maastricht: University of Maastricht, 1999. Google Scholar
Spanier, GB. Measuring dyadic adjustment: new scales for assessing the quality of marriage and similar dyads. J Marriage Fam 1976;38:15–28. CrossRefGoogle Scholar
Spanier, GB. Dyadic adjustment scale manual. North Tonawanda: Multi-Health Systems, 1989. Google Scholar
Heene, E, Buysse, A, Van Oost, P. Assessments of relational functioning: the adaptation of Dutch assessments instruments. Ned Tijdschr Pychol 2000;55:203–216. Google Scholar
Messer, SC, Reiss, D. Family and relational issues measures. In: Rush, AJ, ed. Task force for the handbook of psychiatric measures. Handbook of psychiatric measures. Washington, DC: American Psychiatric Association, 2000: 239–260. Google Scholar
Bradbury, TN. Assessment: assessing the four fundamental domains of marriage. Fam Relat 1995;44:459–468. CrossRefGoogle Scholar
Collins, NL, Read, SJ. Adult attachment, working models, and relationship quality in dating couples. J Pers Soc Psychol 1990;58:644–663. CrossRefGoogle ScholarPubMed
Arrindell, WA, Ettema, JHM. Dimensional structure, reliability and validity of the Dutch translation of the Symptom Checklist (SCL-90). Ned Tijdschr Psychol 1981; 36:77–108. Google Scholar
Arrindell, WA, Ettema, JHM. Dutch translation of the Symptom Checklist (SCL-90). Manual. Lisse: Swets & Zeitlinger, 1986. Google Scholar
Gotlib, IH, Whiffen, VE. Depression and marital functioning: an examination of specificity and gender differences. J Abnorm Psychol 1989;98:23–30. CrossRefGoogle ScholarPubMed
Benazon, NR, Coyne, JC. Living with a depressed spouse. J Fam Psychol 2000;14:71–79. CrossRefGoogle ScholarPubMed
McLean, PD, Hakistian, AR. Clinical depression: comparative efficacy of outpatient treatment. J Consult Clin Psychol 1979;47:818–836. CrossRefGoogle Scholar
McLean, PD, Miles, JE. Training physicians in psychosocial care: an analysis of a program failure. J Med Educ 1975;50:900–902. Google ScholarPubMed
Beach, SRH, Fincham, FD, Katz, J. Marital therapy in the treatment of depression: toward a third generation of therapy and research. Clin Psychol Rev 1998;18:635–661. CrossRefGoogle Scholar
Whiffen, VE, Kallos-Lilly, AV, MacDonald, BJ. Depression and attachment in couples. Cogn Ther Res 2001;25:577–590. CrossRefGoogle Scholar
Fonagy, P. An attachment theory approach to the treatment of the difficult patient. Bull Meninger Clin 1998;62:147–169. Google Scholar
Goering, PN, Lancee, WJ, Freeman, JJ. Marital support and recovery from depression. Br J Psychiatry 1992;160:76–82. CrossRefGoogle ScholarPubMed
Byrne, M, Carr, A. Depression and power in marriage. J Fam Ther 2000;22:408–427. CrossRefGoogle Scholar
Kessler, RC, Nelson, CB, McGonagle, KA, Liu, J, Swartz, M, Blazer, DG. Comorbidity of DSM-III-R major depressive disorders in the general population: results from the US National Comorbidity Survey. Br J Psychiatry 1996;168:17–30. CrossRefGoogle Scholar
Sartorius, N, Ustun, TB, Lecrubier, Y, Wittchen, HU. Depression comorbid with anxiety: results from the WHO study on psychological disorders in primary health care. Br J Psychiatry 1996;168:38–43. CrossRefGoogle Scholar
The ESEMeD/MHEDEA 2000 Investigators. 12-month comorbidity patterns and associated factors in Europe: results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatr Scand 2004;109:28–37. CrossRefGoogle Scholar
Marin, A, Backenstrass, M, Mundt, CH. Sampling biases in a marital study on severe major depression. Psychopathology 1999;32:12–22. CrossRefGoogle Scholar