Dynamic associations between stress and relationship functioning in the wake of COVID-19: Longitudinal data from the German family panel (pairfam)

Individuals all across the world experienced significant disruptions in their personal and family life with the outbreak of the new coronavirus disease 2019 (COVID-19). The current study investigated dynamic associations between stress and relationship functioning over time in the face of the COVID-19 pandemic. Perceived stress, relationship satisfaction, and relationship quality (appreciation, intimacy, conflict) were reported by 1483 young to middle-aged participants who were in a romantic relationship and lived with their partner in 2018/2019 and in May–July 2020 (a few months after the onset of COVID-19). Data were analyzed using bivariate latent change score models. Relationship functioning (satisfaction, appreciation, intimacy) showed small decreases from before to during the pandemic. Contrary to expectations, levels of perceived stress also decreased on average from before to during the pandemic. Changes in relationship functioning were correlated with changes in stress over time, so that participants with greater decreases in relationship satisfaction, appreciation, and intimacy and greater increases in conflict from before to during the pandemic showed lesser decreases/greater increases in stress. Higher pre-pandemic relationship satisfaction was associated with greater decreases/lesser increases in stress from before to during the pandemic. Pre-pandemic levels of other measures of relationship functioning or stress were not associated with changes in outcomes over time. Results add to the literature demonstrating that stress is closely intertwined with the functioning of intimate relationships. Furthermore, they suggest that greater relationship satisfaction may serve as a protective factor for stressful life events

Daily support seeking as coping strategy in dual-smoker couples attempting to quit

Objective: Smoking cessation is a stressful event and lapses are frequent. The dynamic model of relapse has been criticized for not integrating interpersonal factors as phasic influences. Seeking social support, as a coping strategy to deal with cravings, may help to refrain from smoking. Design: Overall, 83 heterosexual dual-smoker couples reported on their craving, the extent of seeking social support from one's partner regarding smoking cessation, and their number of cigarettes smoked in smartphone-based end-of-day diaries, from a joint self-set quit date on across 22 consecutive days. Main outcome measure: Number of cigarettes smoked. Results: Multilevel analyses indicated that on days with higher-than-average levels of craving, male and female smokers reported more cigarettes smoked. Higher-than-usual support seeking was related to fewer cigarettes smoked that same day. For women only, we found a within-person interaction between craving and support seeking on smoking. On days with higher-than-average support-seeking, the effect of craving on smoking was attenuated. Conclusion: Findings confirm the relevance of interpersonal processes in the relapse process, such as support seeking as coping behavior. Further, as a 'first act' in initiating supportive interactions, support seeking is an important piece in the social support process and a promising target for interventions

Couples' daily self-regulation

Objective Regulating health behavior change often occurs in a dyadic context of romantic relationships. Dyadic approaches to standard health behavior change models are, however, barely considered. We investigated volitional processes of the Health Action Process Approach model for two health behaviors within a dyadic context of romantic couples. Specifically, we tested whether day-to-day volitional self-regulation predicted one's own and one's partner's cigarettes smoked (Study 1) and physical activity (Study 2). Methods In two dyadic intensive longitudinal studies (Study 1: 83 dual-smoker couples intending to jointly quit smoking; Study 2: 61 overweight couples intending to become physically active), heterosexual partners independently reported on intention, self-efficacy, action planning, and action control in end-of-day diaries. In Study 1, daily number of cigarettes smoked was assessed via self-report. In Study 2, daily moderate-to-vigorous physical activity (MVPA) was assessed objectively via accelerometers. In both studies, dyadic cross-lagged intensive longitudinal analyses based on the Actor-Partner Interdependence Model were applied. Results Across both studies, individual's own volitional self-regulation positively predicted one's own health behavior (less cigarettes smoked and more MVPA). One's partner's action control and intention also positively predicted one's own health behavior. A marginal partner effect for self-efficacy was found in the context of smoking only. Conclusions Behavioral self-regulation is not only relevant for individuals themselves, but some volitional processes may spill over to their partners. This highlights the need to specify couple-level processes involved in health behavior change, and to consider a social context of self-regulation

How Do People Experience and Respond to Social Control From Their Partner? Three Daily Diary Studies

Positive and negative forms of social control are commonly used to regulate another person's health-related behaviors, especially in couples. Social control efforts have been shown to result in desirable, but also undesirable effects on different outcomes. Little is known for which outcomes, when, and under which contextual conditions these different effects unfold in people's everyday lives. Using the dual-effects model of health-related social control, we predicted that same-day and previous-day positive social control would result in desirable effects on target behavior, and same-day positive control on affect. Same-day and previous-day negative control was assumed to result in undesirable effects on reactant responses (i.e., doing the opposite of what the partner wanted and hiding the unhealthy behavior), and same-day negative control on affect. Further, we explored whether it makes a difference if one or both partners intend to change their health behavior. Three daily diary studies addressed these questions for smoking (Studies 1 and 2), and physical activity (Study 3). Receiving more positive control related to more desirable target behavior, and feeling better; more negative control was associated with more reactant responses and feeling worse. Social control unfolded its effects within 1 day, but hardly across days, indicating that control and its reactions to it are fast-acting processes in daily life. The pattern of results were the same for couples with one and both partners intending to change their behavior. Further, results replicated when using partner-reported provided control. Based on these results, social control cannot be unanimously recommended as a behavior change strategy in couples. Future studies should follow up on dyadic and temporal dynamics of social control in couples' everyday lives in different contexts

Understanding Between-Person Interventions With Time-Intensive Longitudinal Outcome Data : Longitudinal Mediation Analyses

Acknowledgments The physical activity trial (Example 2) was funded by the Swiss National Science Foundation awarded to U.S. (PP00P1_133632/1). J.I. (P2ZHP1_155103) and C.B. (P2BEP1_158975) were supported by fellowships of the Swiss National Science Foundation. The authors thank Melanie Amrein, Pamela Rackow, and involved students for their contributions to the data collection in the eating behavior trial (Example 1). We also thank Niall Bolger for valuable discussions on this topic, and the New York University Couples Lab for helpful feedback on an earlier version of this manuscript.Peer reviewedPublisher PD

Do daily compensatory health beliefs predict intention to quit and smoking behavior? A daily diary study during smoking cessation

Compensatory health beliefs (CHBs) are a means to cope with motivational conflicts between intended health goals and the temptation for an unhealthy behavior. As CHBs can fluctuate on a daily basis, this study examined how daily CHBs are associated with daily intention to quit smoking and daily number of cigarettes smoked before and after a quit date at the between- and within-person level. The study comprised a prospective longitudinal design and investigated 83 women and 83 men for 32 consecutive days during an ongoing joint self-set quit attempt. Daily CHBs varied from day to day and between individuals. At the between-person level, higher women’s mean CHBs were associated with lower intention (b = −0.23, p = 0.04) and at the 10% level with more cigarettes smoked after the quit date (rate ratio (RR) = 1.92, p = 0.07). At the within-person level, women’s higher than usual CHBs were unrelated to intention to quit, but were related to less smoking before (RR = 0.96, p = 0.03) and at the 10% level after the quit date (RR = 0.91, p = 0.09). A marginally positive association between daily CHBs and smoking at the within-person level emerged for men. The negative effect of daily CHBs at the between-person level on smoking seems to unfold after the quit attempt and for women only

Let’s Enjoy an Evening on the Couch? A Daily Life Investigation of Shared Problematic Behaviors in Three Couple Studies

Symptom-system fit theory proposes that problematic behaviors are maintained by the social system (e.g., the couple relationship) in which they occur because they help promote positive relationship functioning in the short-term. Across three daily life studies, we examined whether mixed-gender couples reported more positive relationship functioning on days in which they engaged in more shared problematic behaviors. In two studies (Study 1: 82 couples who smoke; Study 2: 117 couples who are inactive), days of more shared problematic behavior were accompanied by higher daily closeness and relationship satisfaction. A third study with 79 couples post-stroke investigating unhealthy eating failed to provide evidence for symptom-system fit. In exploratory lagged analyses, we found more support for prior-day problematic behavior being associated with next-day daily relationship functioning than vice-versa. Together, findings point to the importance of a systems perspective when studying interpersonal dynamics that might be involved in the maintenance of problematic behaviors

App-based interventions to improve cancer outcomes rely on informational support from professionals: a systematic review.

The importance of social support for cancer patients is well-established, and mobile applications hold promise for implementation. This systematic review examines app-based interventions with social support components for cancer patients, investigating the use of different support functions from different sources and the impact on cancer-related symptoms and psychological outcomes. A systematic search across five databases (EMBASE, Scopus, PsycINFO, PubMed, Web of Science) yielded 449 records, of which 17 studies (12 controlled designs) were included. Two independent reviewers extracted data and assessed study quality, revealing a high risk of bias across studies. Social support was implemented through different app functions, including contact/chat functions (n = 9), automatic alerts based on app input (n = 6) and discussion forums (n = 5). Social support predominantly focused on informational support (n = 17), mostly from healthcare professionals. Emotional support was less common (n = 7). Results indicated some promising intervention effects for pain, fatigue, nausea/vomiting, insomnia, constipation and overall symptom distress, but heterogeneous effects for health-related quality of life. Overall, results were mixed, but indicate that mobile apps incorporating social support may hold promise for cancer patients. However, future studies should focus on measuring and reporting social support as an intervention mechanism to systematically investigate its specific impact and improve effectiveness.HighlightsApps for cancer patients predominantly include informational social supportEmotional social support is substantially less frequently includedApps focus on formal support sources like healthcare professionalsFirst results are somewhat promising for improving cancer-related symptoms

"We Feel Good": Daily Support Provision, Health Behavior, and Well-Being in Romantic Couples

Intimate partners are an important source of support when pursuing health goals. A vast amount of literature documents the role of social support in alleviating recipients' distress and facilitating health behaviors. Less studied is the phenomenon that providing support may entail a benefit for the provider, particularly in the context of health behavior change. In the present study, we investigated whether providing social support in daily life would be associated with more health behavior, and emotional and relational well-being that same day, using a sample of romantic couples aiming to become more physically active. Ninety-nine inactive and overweight heterosexual romantic couples (=198 individuals) participated in this dyadic daily diary study. Both partners reported on the provision of social support, positive and negative affect, and relationship satisfaction in electronic end-of-day diaries across 14 consecutive days. Moderate-to-vigorous physical activity (MVPA) was objectively assessed via triaxial accelerometers (Actigraph GT3X+). Using the Actor-Partner Interdependence Model (APIM), dyadic data analyses indicated that providing support to the partner was associated with higher own MVPA, more own positive affect, less own negative affect, and more own relationship satisfaction (actor effects), over and above the effect of support provision on outcomes in the other partner (partner effects). The present findings suggest that the provision of daily social support in couples is strongly associated with enhanced well-being not only at a personal level but also at a relational level. Providing social support may also serve the function of relationship maintenance. Thus, shifting the focus away from the recipient to examine beneficial effects of social support in providers is highly relevant. Future research should address the question of when, why, and how giving support is beneficial

A Dyadic Action Control Trial in Overweight and Obese Couples (DYACTIC)

BACKGROUND: Enhancing physical activity in overweight and obese individuals is an important means to promote health in this target population. The Health Action Process Approach (HAPA), which was the theoretical framework of this study, focuses on individual self-regulation variables for successful health behavior change. One key self-regulation variable of this model is action control with its three subfacets awareness of intentions, self-monitoring and regulatory effort. The social context of individuals, however, is usually neglected in common health behavior change theories. In order to integrate social influences into the HAPA, this randomized controlled trial investigated the effectiveness of a dyadic conceptualization of action control for promoting physical activity. METHODS/DESIGN: This protocol describes the design of a single-blind randomized controlled trial, which comprises four experimental groups: a dyadic action control group, an individual action control group and two control groups. Participants of this study are overweight or obese, heterosexual adult couples who intend to increase their physical activity. Blocking as means of a gender-balanced randomization is used to allocate couples to conditions and partners to either being the target person of the intervention or to the partner condition. The ecological momentary intervention takes place in the first 14 days after baseline assessment and is followed by another 14 days diary phase without intervention. Follow-ups are one month and six months later. Subsequent to the six-months follow-up another 14 days diary phase takes place.The main outcome measures are self-reported and accelerometer-assessed physical activity. Secondary outcome measures are Body Mass Index (BMI), aerobic fitness and habitual physical activity. DISCUSSION: This is the first study examining a dyadic action control intervention in comparison to an individual action control condition and two control groups applying a single-blind randomized control trial. Challenges with running couples studies as well as advantages and disadvantages of certain design-related decisions are discussed. This RCT was funded by the Swiss National Science Foundation (PP00P1_133632/1) and was registered on 27/04/2012 at http://www.isrctn.com/ISRCTN15705531