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The present study explored how spouses’ reports of marital dissatisfaction (independent variable) are associated with depression symptoms (mediator) and physical health (dependent variable) over time. Data were from the Marriage Matters Panel Survey (Nock et al., ). We used autoregressive cross‐lagged models to test temporal connections between variables for newlywed husbands, wives and couples (N=707 couples) at Waves 1, 2 and 3, spanning five years. Results indicated physical health is an important predictor, as are wives’ depression symptoms and husbands’ marital dissatisfaction (all three demonstrate partner effects). However, the effects of health are no longer observed at Time 2. For wives there is a reciprocal relationship between marital dissatisfaction and depression symptoms; for husbands, marital dissatisfaction leads to increased depression. This study provides additional support that marital dissatisfaction, depression and physical health are interrelated across time. Practitioner points Assessment and treatment using a biopsychosocial approach is critical to fully understanding connections between marriage, depression and health for couples Repeated assessment of marital dissatisfaction in couple therapy may be necessary, as effects of dissatisfaction are corrosive over time and predict other areas of wellbeing Attending to and exploring gender differences in couples may be helpful, as links between marital dissatisfaction, depression and health vary for men and women

Introduction:Research is needed to determine mechanisms of effect linking family relationships and chronic pain for adults. Guided by the Biobehavioral Family Model (BBFM), the present study examined indirect effects between a negative family emotional climate and chronic pain disease activity, as mediated by biobehavioral reactivity. Method: Data for this study are from the Midlife Development in the United States; specifically, a subsample of participants who reported experiencing chronic pain (n ϭ 1,461, ages 32-84). Participants self-reported family strain, biobehavioral reactivity (i.e., anxiety, depression), and chronic pain disease activity (i.e., pain interference, global health). A subsample of participants (n ϭ 1,070) completed an intimate partner strain measure, indicating they were married/in a committed relationship. Structural equation models were tested with maximum likelihood estimation and bootstrapping. Results: Family strain was indirectly associated with chronic pain disease activity via biobehavioral reactivity-Model 1; 2 (10) ϭ 40.75, p Ͻ .000, root mean square error of approximation [RMSEA] ϭ .07, comparative fit index [CFI] ϭ .96, standardized root-mean-square residual [SRMR] ϭ .04; partial mediation occurred for partnered participants. This finding was replicated when modeling family strain simultaneously with intimate partner strain, though intimate partner strain was not associated with chronic pain disease activity-Model 2; 2 (5) ϭ 8.29, p ϭ .14, RMSEA ϭ .03, CFI ϭ .99, SRMR ϭ .01. Discussion: These findings add to the growing literature that emphasizes the role of family relationships in chronic pain. Future research is needed to replicate our use of the BBFM to specify pathways of effect, incorporating relational and observational data, with diverse samples.

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