Interpersonal interactions and experiences may contribute to the association between SEP and cardiovascular health through the mechanism of physiological activation. Recurring patterns of everyday social experiences and their physiological effects may be a pathway linking the broader social context to cardiovascular disease. (PsycINFO Database Record

A variety of aspects of personality and emotional adjustment predict the development and course of coronary heart disease (CHD), as do indications of marital quality (e.g., satisfaction, conflict, strain, disruption). Importantly, the personality traits and aspects of emotional adjustment that predict CHD are also related to marital quality. In such instances of correlated risk factors, traditional epidemiological and clinical research typically either ignores the potentially overlapping effects or examines independent associations through statistical controls, approaches that can misrepresent the key components and mechanisms of psychosocial effects on CHD. The interpersonal perspective in personality and clinical psychology provides an alternative and integrative approach, through its structural and process models of interpersonal behavior. We present this perspective on psychosocial risk and review research on its application to the integration of personality, emotional adjustment, and marital processes as closely interrelated influences on health and disease.

Objective: Obstructive sleep apnea (OSA), a serious respiratory disorder, confers increased risk of cardiovascular disease and mortality. Adherence to the standard and effective treatment, continuous positive airway pressure (CPAP), is often poor. Personal relationships can influence adherence, but some forms of partner involvement (e.g., support, encouragement) have positive effects on CPAP adherence, whereas others (e.g., criticism, blame) are counterproductive. In the former, constructive partner efforts may enhance a patient’s sense of autonomy, an important foundation for self-care. The present study examined how patients’ perceptions of autonomy support from an intimate partner predict adherence to CPAP, and whether it is an independent predictor, relative to generally positive partner behavior (i.e., partner responsiveness) and partner negativity (i.e., negative social control). Method: Ninety-two married or cohabiting OSA patients (mean age 49.7 years) completed measures of perceived partner autonomy support, responsiveness, and negative social control at Days 14 and 60 of CPAP treatment. Objective daily CPAP machine adherence data were collected for 60 days. Results: Perceived partner autonomy support predicted more minutes of CPAP used per night and increasing CPAP use over time. These effects were independent of the significant adverse effects of partner negative social control and the more limited beneficial effects of partner responsiveness. Conclusion: The study findings establish perceived partner autonomy support as an interpersonal predictor of adherence that is independent of negative social control and perceived partner responsiveness, and may inform psychosocial interventions for CPAP adherence and more general couple approaches to chronic illness management.

Cardiovascular reactivity (CVR), such as increases in blood pressure, during stressful marital interactions have been identified as a possible mechanism linking marital discord with cardiovascular disease (CVD). Both expressions of and exposure to negative behavior during marital conflict may influence CVR, but analytic approaches to date have not permitted firm conclusions as to whether CVR during conflict reflects an individual's own actions, actions of the spouse, or both. Additionally, evidence suggests health-relevant marital interaction varies along the affiliation dimension (i.e., warmth vs. hostility) and control dimension (i.e., dominance vs. submissiveness) of social behavior, but there is much less research on the latter. To address these issues, the present study used the Actor-Partner Interdependence Model (APIM) to examine associations of behavioral measures of affiliation and control with concurrent changes in blood pressure (i.e., CVR) during a marital conflict discussion in 146 middle-aged couples. Factor analyses of observer-coded behaviors during conflict discussions revealed a single factor for husbands and for wives, characterized by high hostility and dominance, and low warmth. The validity of these behavioral factors was supported by their predicted associations with spouse ratings of behavior during the conflict discussions, concurrent increases in anger, and reports of overall marital quality. Although expression of and exposure to negative conflict behaviors were correlated, only expression independently predicted increases in blood pressure. Exposure to negative partner behavior might alter other elements of physiological burden contributing to CVD risk, but the individual's own behavioral expressions are more closely associated with concurrent blood pressure reactivity.

Marriage and similar intimate relationships are central in the lives of most adults, and the number of older adults in such relationships continues to grow (Brown & Lin, 2012). Simply being a partner in these relationships confers protection from health problems and emotional difficulties associated with aging (Holt-Lunstad, Smith, & Layton, 2010;Shiovitz-Ezra & Leitsch, 2010). The quality of such relationships, however, matters as well. Conflict, strain, and disruption in intimate relationships are common, and these indications of marital discord confer risk of age-related diseases, such as coronary heart disease (CHD; Robles, Slatcher, Trombello, & McGinn, 2014). Further, the development of age-related chronic illness is often a significant stressor affecting marital quality, as the couple attempts to cope with the many related concerns, demands, and limitations in functioning. Hence, health and marital discord may be reciprocally related over time (Smith, Baron, & Grove, 2014). Marital discord also increases the risk of depression and loneliness (Ayalon,