Psychosomatic Medicine

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Psychosomatic Medicine:
doi: 10.1097/PSY.0b013e31821188ca
Original Articles

Affiliation and Control During Marital Disagreement, History of Divorce, and Asymptomatic Coronary Artery Calcification in Older Couples

Smith, Timothy W. PhD; Uchino, Bert N. PhD; Florsheim, Paul PhD; Berg, Cynthia A. PhD; Butner, Jonathan PhD; Hawkins, Melissa PhD; Henry, Nancy J.M. PhD; Beveridge, Ryan M. PhD; Pearce, Gale PhD; Hopkins, Paul N. MD, MSPH; Yoon, Hyo-Chun MD, PhD

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Objective: To examine behavioral observations of affiliation (ie, warmth versus hostility) and control (ie, dominance versus submissiveness) and prior divorce as predictors of coronary artery calcification (CAC) in older couples. In some but not all studies, marital disruption and low marital quality have been shown to confer risk of coronary artery disease (CAD). Inconsistencies might reflect limitations of self-reports of marital quality compared with behavioral observations. Also, aspects of marital quality related to CAD might differ for men and women.

Methods: Couples underwent computed tomography scans for CAC and marital assessments, including observations of laboratory-based disagreement. Participants were 154 couples (mean age, 63.5 years; mean length of marriage, 36.4 years) free of prior diagnosis of CAD.

Results: Controlling traditional risk factors, we found behavioral measures of affiliation (low warmth) accounted for 6.2% of variance in CAC for women, p < .01, but not for men. Controlling behavior (dominance) accounted for 6.0% of variance in CAC for men, p < .02, but not for women. Behavioral measures were related to self-reports of marital quality, but the latter were unrelated to CAC. History of divorce predicted CAC for men and women.

Conclusions: History of divorce and behavioral-but not self-report-measures of marital quality were related to CAD, such that low warmth and high dominance conferred risk for women and men, respectively. Prior research might underestimate the role of marital quality in CAD by relying on global self-reports of this risk factor.

CAD = coronary artery disease; CAC = coronary artery calcification; CHD = coronary heart disease; IPC = interpersonal circumplex; MAP = mean arterial blood pressure; SASB = structural analysis of social behavior.

Copyright © 2011 by American Psychosomatic Society

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