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One day at a time : the influence of daily spouse support on pain, negative affect, and catastrophizing among individuals with rheumatoid arthritis Holtzman, Susan Beth

Abstract

Using a daily process methodology, the current study sought to gain a more comprehensive understanding of the mechanisms through which day-to-day spouse support may influence well-being among individuals with rheumatoid arthritis (RA). Social support was operationalized as perceptions of positive and negative responses from the spouse, as well as levels of satisfaction with these responses. In addition to investigating the direct effects of spouse support on pain and negative affect, the current study examined whether support influences pain catastrophizing and protects against its detrimental effects on well-being. Sixty-nine married individuals with RA took part in an initial background interview, followed by twice daily telephone interviews (regarding pain intensity, negative affect, catastrophizing and spouse support) for one week. Multi-level modeling indicated several pathways through which spouse support, particularly satisfaction with spouse responses, impacts the vicious cycle of pain, negative affect and catastrophizing. Consistent with past research, catastrophizing was associated with increases in pain and negative affect concurrently, and over the course of the day. However, when participants reported increases in satisfaction with spouse responses they were less likely to experience increases in negative affect due to catastrophizing. Satisfaction with spouse responses also reduced the likelihood of feeling overwhelmed and helpless in dealing with daily pain. The relationship between morning pain and evening catastrophizing was attenuated when participants reported increases in satisfaction with spouse responses. Negative affect was also associated with increases in catastrophizing across the day, but only when participants reported decreases in satisfaction with spouse responses. An important role of negative spouse responses also emerged. For example, morning perceptions of spouse complaints were associated with increases in pain over the course of the day. However, perceptions of spouse avoidance did not influence day to-day well-being in the current study. Overall, findings are consistent with a model in which spouse support can both help and hinder individuals as they attempt to cope with daily pain, and suggests the importance of involving close others in treatments to reduce pain and catastrophizing.

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