Chronic pain is a debilitating condition that can have an impact on various facets of interpersonal functioning. Although some studies have examined the extent to which family members are affected by an individual's chronic pain, none have examined patients' perceptions of feeling that they have become a burden to others. Research on self-perceived burden in different medical populations, such as cancer, amyotrophic lateral sclerosis, and stroke, has shown that it is associated with physical symptoms and, more robustly, with psychological difficulties and concerns. The present study examined the prevalence and predictors of self-perceived burden in a tertiary chronic pain sample. Participants were consecutive patients (N = 238) admitted to an outpatient, interdisciplinary, chronic pain management program at a rehabilitation hospital. At admission, participants completed a battery of psychometric questionnaires assessing self-perceived burden, as well as a number of clinically relevant constructs. Their significant others (n = 80) also completed a measure of caregiver burden. Self-perceived burden was a commonly reported experience among chronic pain patients, with more than 70% of participants endorsing clinically elevated levels. It was significantly correlated with pain intensity ratings, functional limitations, depressive symptoms, attachment anxiety, pain self-efficacy, and caregiver burden. Self-perceived burden was also correlated with an item assessing suicidal ideation. In a hierarchical regression model, depressive symptoms, pain self-efficacy, and adult attachment significantly predicted self-perceived burden after controlling for demographic and pain-related variables. In conclusion, self-perceived burden is a clinically relevant and commonly reported interpersonal experience in patients with longstanding pain.
This study examined the intrapersonal, dyadic, and mediational relationships underlying romantic attachment (Experiences in Close Relationships), dyadic empathy (Interpersonal Reactivity Index for Couples), and psychological partner aggression (Revised Conflict Tactics Scales) in 193 community-based couples. In women, attachment insecurity predicted lower dyadic empathy and greater psychological aggression. In men, attachment insecurity predicted lower perspective taking, higher empathic concern, and greater psychological aggression. Partner effects were found for men, with their attachment predicting their female partner's dyadic empathy and psychological aggression. In women, low perspective taking mediated the relationship between: (1) their anxiety over abandonment and their psychological aggression; and (2) their avoidance of intimacy and their psychological aggression. Findings are consistent with the attachment theory and clinical implications are discussed.
This article includes three studies aimed at adapting the Interpersonal Reactivity Index (Davis, 1980), a measure of general cognitive and emotional empathy, to assess empathy expressed within a romantic relationship. We examined the factorial structure of the Interpersonal Reactivity Index for Couples (IRIC). Results supported the use of the 2-factor measure (Dyadic Perspective Taking and Dyadic Empathic Concern) in 3 independent samples (individuals in heterosexual relationships, individuals in same-sex relationships, and partners of heterosexual couples). The IRIC also demonstrated good convergent, discriminant, concurrent, predictive, and incremental validity as well as adequate internal consistency and stability over 18 months.
Researchers and practitioners have noted the importance of considering individual characteristics as well as couple dynamics when attempting to understand couples and sexual difficulties. Using a dyadic approach, this study examined the links between 2 forms of romantic attachment insecurity (anxiety and avoidance) and sexual dissatisfaction among members of couples seeking couple therapy. A large clinical sample of 242 French-speaking couples completed the Experiences in Close Relationships Scale and the Index of Sexual Satisfaction. Analyses based on the actor-partner interdependence model revealed that both attachment anxiety and avoidance predicted individuals' own sexual dissatisfaction (actor effects). The authors also observed 2 partner effects: (a) anxiety in men predicted female partners' sexual dissatisfaction and (b) avoidance in women predicted male partners' sexual dissatisfaction. The results support attachment theory and have clinical implications for emotion-focused couple therapy and other approaches to couple therapy.
Attachment researchers have proposed that the attachment, caregiving, and sexual behavioral systems are interrelated in adult love relationships (Mikulincer & Shaver, 2007 ). This study examined whether aspects of partners' caregiving (proximity, sensitivity, control, compulsive caregiving) mediated the association between their attachment insecurities (anxiety and avoidance) and each other's sexual satisfaction in two samples of committed couples (Study 1: 126 cohabiting or married couples from the general community; Study 2: 55 clinically distressed couples). Partners completed the Experiences in Close Relationships measure (Brennan, Clark, & Shaver, 1998 ), the Caregiving Questionnaire (Kunce & Shaver, 1994 ), and the Global Measure of Sexual Satisfaction (Lawrance & Byers, 1998 ). Path analyses based on the actor-partner interdependence model (APIM) revealed that caregiving proximity mediated the association between low attachment avoidance and partners' sexual satisfaction in distressed and nondistressed couples. Sensitivity mediated this association in nondistressed couples only. Control mediated the association between men's insecurities (attachment-related avoidance and anxiety) and their partners' low sexual satisfaction in nondistressed couples. Attachment anxiety predicted compulsive caregiving, but this caregiving dimension was not a significant mediator. These results are discussed in light of attachment theory and their implications for treating distressed couples.
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