Relationship quality, individual wellbeing, and gender – A series of longitudinal studies

Using multiple theories, three studies examined the association between relationship quality, individual wellbeing (e.g., psychological distress), and gender across multiple time points. In Study 1 applied life course theory concepts (e.g., roles, role configurations, role trajectories) and second order latent class analyses were then conducted. Using four relationship role trajectories were identified from these analyses. Relationship role trajectories differed on wellbeing, wherein individuals in stable marriages with higher satisfaction consistently reported greater wellbeing (i.e., lower depression and higher life satisfaction). Study 2 sought to determine the direction of the association between individual wellbeing and relationship quality. This study specifically examined if this direction differed for positive or negative dimensions of wellbeing and for men and women. Notably, relationship satisfaction and life satisfaction were mutually influential over three time points, but life satisfaction was only related to later conflict in a single direction. Additionally, depression was only related to later relationship conflict and relationship satisfaction for women. Lastly, Study 3 examined how changes in relationship quality and gendered manifestations of psychological distress (i.e., depression and alcohol use) differed by gender. The study also sought to understand how changes in one manifestation of psychological distress and changes in relationship quality were related and how this association differed for men and women. Women reported lower initial levels of relationship quality and alcohol use but higher initial levels of depression. Men and women differed on change in alcohol use, with women decreasing less than men. Finally, both change in alcohol use and depression were related to change in relationship quality for women, but not men. The reverse direction did not differ by gender, although change in relationship quality was related to change in depression for both men and women. Implications for future research, policy, and mental health practitioners are discussed in each study

In Their Own Words: How Opioids Have Impacted the Lives of “Everyday” People Living in Appalachia

Introduction: The opioid epidemic is ravaging people, families, and communities in Appalachia. However, limited research has examined how “everyday” people (e.g., not chronic pain patients, not medical professionals) living in these communities how opioids have impacted their lives. Objective: Identify the perception of the opioid epidemic on individuals, families, and communities from people living in region most impacted regions. Methods: Patients were recruited at Remote Area Medical clinics throughout Central and Southern Appalachia to complete interviews online (N = 169) or over the phone (N = 26), including one open-ended question about how opioids have impacted their lives. Results: Using the qualitative method content analysis, several themes were identified, including both the positive and negative impact of opioids from the online interviews. Additionally, resiliency was found to be a common theme and a theme not often emphasized by scholars and the media. These themes also highlight the importance of social support in these communities. Further, in the phone interviews, we were able to replicate the themes, and an additional theme was identified: Systemic Cause of Opioids. Conclusion: Opioid intervention must be comprehensive and include the cultural context that recognizes community ties, family and kinship support, resilience, and systemic barriers to addressing the opioid epidemic. Future interventions must harness the existing resiliency and social support in these communities to effectively combat the opioid crisis in Appalachia. Otherwise, opioids will remain the insider and further insulate Appalachian communities from systemic recovery

Differences in Distress Between Rural and Non-rural Appalachian Breast Cancer Patient / Caregiver Dyads During the First Year of Treatment

Introduction: Breast cancer patients and their caregivers living in rural Appalachia face substantial health disparities compared to their non-rural Appalachian counterparts. However, there is limited research on how these specific health disparities in rural Appalachian communities may impact patient psychological distress and caregiver strain during the first year of breast cancer treatment. Purpose: The purpose of the current study was to assess differences in patient psychological distress (depression and anxiety) and caregiver strain between rural non-rural Appalachian breast-cancer-affected dyads (patients and their caregivers) during the first year of treatment. Methods: A total of 48 Appalachian breast cancer patients (with a Stage I through Stage III diagnosis) and their identified caregiver (together, ‘dyads’) were identified from The University of Tennessee Medical Center across 2019 to 2020. Dyads completed follow-up surveys throughout the first year of treatment. In this prospective pilot study, measures on anxiety, depression and caregiver strain were self-reported and then analyzed using RM-ANOVA. Results: There was a statistically significant higher number of reports of patient depression and caregiver strain in rural-residing dyads compared to non-rural-residing dyads. However, there was not a statistically significant difference between rural and non-rural Appalachian dyads for patient-reported anxiety during the first year of treatment. Implications: The higher reported patient depression and caregiver strain among rural-residing Appalachian patients may indicate the need for implementing remote (e.g., telehealth) Cognitive Behavioral Therapy (CBT) to address the psychological needs of rural-residing dyads. Additionally, greater education from physicians to rural dyads on what to expect during treatment could alleviate caregiver strain