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Cardiovascular Reactivity During Positive and Negative Marital Interactions

  • Nealey-Moore
  • Published:
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Abstract

Marriage reduces risk of cardiovascular disease (CVD) but marital stress increases risk, perhaps through cardiovascular reactivity (CVR). However, previous studies have lacked controls necessary to conclude definitively that negative marital interactions evoke heightened CVR. To test the specific effects of marital stress on CVR, 114 couples engaged in positive, neutral, or negative interactions in which speaking and task involvement were controlled. Compared to positive and neutral conditions, negative discussions evoked larger increases in systolic blood pressure, heart rate, and cardiac output, and larger decreases in peripheral resistance and pre-ejection period—similarly for men and women. Hence, CVR could contribute to the effects of marital difficulties on CVD. Previous evidence of sex differences in this effect might reflect factors other than simple reactivity to negative interactions.

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Notes

  1. After participants completed questionnaires at the conclusion of the discussion task, they underwent a second 10-min baseline and participated in a second marital interaction task. Using the Couples Problem Inventory (Gottman et al. 1977), participants selected an issue that was currently contentious for both of them (e.g., money, children, in-laws). After a 3-min preparation period, participants took three 1-min turns speaking about the topic and three 1-min turns listening to their spouse in a structured interaction similar to the first task described above (speaking order was counterbalanced). They then continued to discuss the topic for an additional 4 min in an unstructured format. The physiological measures described above were recorded during these periods. Further, spouse ratings of friendliness and dominance, and self-reported anxiety and anger, were assessed as in the first task. This second task provided another opportunity to test sex differences in responses to marital conflict, again in a controlled task but one more closely resembling those used in prior research.

  2. Statistical control of baseline physiological values and BMI did not alter the results reported in the remaining analyses of CVR.

  3. Relative to baseline values, the second conflict discussion task evoked significant increases in self-reported anxiety and anger, SBP, DBP, CO, and HR, and significant decreases in TPR, PEP, and RSA. For the physiological variables, these changes were generally largest while participants spoke, smallest while they prepared for the task and listened to their spouse, and intermediate during the final unstructured discussion period. Men and women did not differ on changes in any of the physiological measures, all p-values >.20. However, women did report larger increases in anxiety (2.01 vs. 1.11, SE = .28, .35), F(1,111) = 7.66, p < .01, eta-squared = .065, and anger (1.74 vs. .87, SE = .36, .33), F(1,111) = 6.59, p < .02, eta-squared = .056) than did men. Further, women’s changes in anxiety were significantly correlated with their SBP reactivity during the task, r(113) = .32, p < .001, and their DBP reactivity, r(113) = .23, p < .02; their changes in anger were correlated with their DBP reactivity, r(113) = .23, p < .02. None of the associations between men’s reported change in affect and CVR during the second task approached significance. Hence, although the conflict discussion evoked expected increases in negative affect and CVR, as in the first task men and women did not differ in their cardiovascular responses. However, women did report larger increases in negative affect, and as in some prior research (Kiecolt-Glaser and Newton 2001) these affective changes were related to CVR for women but not men.

  4. Consistent with these findings, men and women did not differ in any cardiovascular response to the second conflict task (see footnote 3), even during a final unstructured portion of the task closely resembling commonly used marital interaction tasks. The fact that no sex differences emerged during that unstructured portion of the task is inconsistent with several prior studies (Kiecolt-Glaser and Newton 2001), but could reflect the fact that the preceding structured portion of the discussion made the task engagement of men and women more similar than they otherwise would have been if only an unstructured task was used.

  5. Additional findings support the validity of the negative interaction task used here as an analogue for more realistic marital conflict. First, participants’ ratings of their spouses’ behavior during this task were significantly correlated with their ratings of the spouse during the second, more traditional marital conflict discussion described in footnotes 1 and 3; correlations (n = 40) for wives’ and husbands’ ratings of spouse friendliness and dominance ranged from .67 to .84, all p-values < .001. Further, as was the case for these ratings during the second and more traditional task, ratings of friendliness and dominance during the negative task were significantly correlated with participant’s reports of general levels of marital conflict as assess by the Quality of Relationship Inventory-Conflict Scale (Pierce et al. 1991); correlations (n = 40) ranged from .42 (absolute value) to .78, all p-values <.01. Heart rate and blood pressure responses to the negative discussion and traditional conflict tasks were significantly correlated; correlations (n = 40) ranged from a low of .29, p < .07 (husbands’ DBP) to a maximum value of .75, p < .001 (husbands’ HR); wives’ values were r(40) = .46 to .67. When comparing mean responses to these two tasks directly, compared to the traditional conflict task described in footnote 1 the negative discussion task evoked: similar increases in anger, F(1,39) = .18; larger increases in anxiety, F(1,39) = 6.05, p < .02; equal ratings of the spouses’ dominance, F(1,39) = 1.93, p > .17; ratings of spouse as more hostile, F(1,39) = 5.57, p < .03; equal DBP reactivity, F(1,39) = .04; greater SBP response, F(1,39) = 18.39, p < .001; and greater HR reactivity, F(1,39) = 39.72, p < .001. Hence, although the smaller responses to the traditional task could reflect the fact that it was always presented second and hence participants may have habituated somewhat, it is clear that the negative task was not less stressful than the more commonly used and potentially more realistic conflict discussion. Further, perceptions of the spouse’s level of warmth and dominance during the negative task were closely correlated with the couples’ reports of general conflict in the marriage. Together, these findings provide additional evidence beyond the manipulation checks of the validity of the negative task as a manipulation of marital conflict.

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  1. Department of Psychology, University of Puget Sound, 1500 N. Warner St. #1046, Tacoma, WA, 98416, USA

    Jill B. Nealey-Moore

  2. Department of Psychology, University of Utah, Salt Lake City, UT, USA

    Timothy W. Smith, Bert N. Uchino & Chrisana Olson-Cerny

  3. School of Medicine, University of Washington, Seattle, WA, USA

    Melissa W. Hawkins

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Nealey-Moore, J.B., Smith, T.W., Uchino, B.N. et al. Cardiovascular Reactivity During Positive and Negative Marital Interactions. J Behav Med 30, 505–519 (2007). https://doi.org/10.1007/s10865-007-9124-5

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