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COUPLES COPING
WITH STRESS
Emerging Perspectives on Dyadic Coping

Edited by Tracey A. Revenson,

Karen Kayser, and Guy Bodenmann

T.°°0
/•—"Vt>
DECADE
^/BEHAVIOR/

American Psychological Association • Washington, DC

Copyright © 2005 by the American Psychological Association. All rights reserved. Except as per-
mitted under the United States Copyright Act of 1976, no part of this publication may be repro-
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Library of Congress Cataloging-in-Publication Data

Couples coping with stress : emerging perspectives on dyadic coping / edited by Tracey A.
Revenson, Karen Kayser, and Guy Bodenmann.
p. cm. — (Decade of behavior) (APA science volumes)
Includes bibliographical references and index.
ISBN 1-59147-204-0 (alk. paper)
1. Marital psychotherapy. 2. Couples. 3. Stress (Psychology) 4. Adjustment (Psychology)
I. Revenson, Tracey A. II. Kayser, Karen. III. Bodenmann, Guy. IV. Series. V. Series: APA
science volumes

RC488.5.C64343 2005
616.89'1562—dc22
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British Library Cataloguing-in-Publication Data

A CIP record is available from the British Library.

Printed in the United States of America

First Edition
 To Richard S. Lazarus,
whose creativity and ideas influenced
the work of all the authors in this book.
APA Science Volumes
Attribution and Social Interaction: The Legacy of Edward E. Jones
Best Methods for the Analysis of Change: Recent Advances, Unanswered
Questions, Future Directions
Cardiovascular Reactivity to Psychological Stress and Disease
The Challenge in Mathematics and Science Education: Psychology's Response
Changing Employment Relations: Behavioral and Social Perspectives
Children Exposed to Marital Violence: Theory, Research, and Applied Issues
Cognition: Conceptual and Methodological Issues
Cognitive Bases of Musical Communication
Cognitive Dissonance: Progress on a Pivotal Theory in Social Psychology
Conceptualization and Measurement of Organism-Environment Interaction
Converging Operations in the Study of Visual Selective Attention
Creative Thought: An Investigation of Conceptual Structures and Processes
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Diversity in Work Teams: Research Paradigms for a Changing Workplace
Emotion and Culture: Empirical Studies of Mutual Influence
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Evolving Explanations of Development: Ecological Approaches to
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Examining Lives in Context: Perspectives on the Ecology of Human
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Global Prospects for Education: Development, Culture, and Schooling
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Measuring Patient Changes in Mood, Anxiety, and Personality Disorders:
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Occasion Setting: Associative Learning and Cognition in Animals
Organ Donation and Transplantation: Psychological and Behavioral Factors
Origins and Development of Schizophrenia: Advances in Experimental
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Psychological Testing of Hispanics
Psychology of Women's Health: Progress and Challenges in Research and
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Researching Community Psychology: Issues of Theory and Methods
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Sexism and Stereotypes in Modern Society: The Gender Science of Janet
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Sleep and Cognition
Sleep Onset: Normal and Abnormal Processes
Stereotype Accuracy: Toward Appreciating Group Differences
Stereotyped Movements: Brain and Behavior Relationships
 Studying Lives Through Time: Personality and Development
The Suggestibility of Children's Recollections: Implications for Eyewitness
Testimony
Taste, Experience, and Feeding: Development and Learning
Temperament: Individual Differences at the Interface of Biology and Behavior
Through the Looking Glass: Issues of Psychological Well-Being in Captive
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Uniting Psychology and Biology: Integrative Perspectives on Human
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Viewing Psychology as a Whole: The Integrative Science of William N.
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APA Decade of Behavior Volumes

Acculturation: Advances in Theory, Measurement, and Applied Research
Animal Research and Human Health: Advancing Human Welfare Through
Behavioral Science
Behavior Genetics Principles: Perspectives in Development, Personality, and
Psychopathology
Children's Peer Relations: From Development to Intervention
Computational Modeling of Behavior in Organizations: The Third Scientific
Discipline
Couples Coping With Stress: Emerging Perspectives on Dyadic Coping
Experimental Cognitive Psychology and Its Applications
Family Psychology: Science-Based Interventions
Memory Consolidation: Essays in Honor of James L. McGaugh
Models of Intelligence: International Perspectives
The Nature of Remembering: Essays in Honor of Robert G. Crowder
New Methods for the Analysis of Change
On the Consequences of Meaning Selection: Perspectives on Resolving
Lexical Ambiguity
Participatory Community Research: Theories and Methods in Action
Personality Psychology in the Workplace
Perspectivism in Social Psychology: The Yin and Yang of Scientific Progress
Principles of Experimental Psychopathology: Essays in Honor of Brendan A.
Maker
Psychosocial Interventions for Cancer
Racial Identity in Context: The Legacy of Kenneth B. Clark
The Social Psychology of Group Identity and Social Conflict: Theory,
Application, and Practice
Unraveling the Complexities of Social Life: A Festschrift in Honor of
Robert B. Zajonc
Visual Perception: The Influence of H. W. Leibowitz
 Contents

Contributors xi
Foreword xiii
Preface xv
Introduction 3
Tracey A. Revenson, Karen Kayser, and Guy Bodenmann

Part I. The Role of Stress in Dyadic Coping Processes 11

1. Marriages in Context: Interactions Between Chronic and Acute
Stress Among Newlyweds 13
Benjamin R. Karney, Lisa B. Story, and Thomas N. Bradbury
2. Dyadic Coping and Its Significance for Marital Functioning ... 33
Guy Bodenmann
3. A Contextual Examination of Stress and Coping Processes in
Stepfamilies 51
Melody Preece and Anita DeLongis

Part II. Social Support, Dyadic Coping, and Interpersonal

Communication 71
4. The Relationship Enhancement Model of Social Support 73
Carolyn E. Cutrona, Daniel W. Russell, and
Kelli A. Gardner
5. How Partners Talk in Times of Stress: A Process Analysis
Approach 97
Nancy Pistrang and Chris Barker
6. My Illness or Our Illness? Attending to the Relationship
When One Partner Is 111 121
Linda K. Acitelli and Hoda J. Badr
1. Couples Coping With Chronic Illness: What's Gender Got
to Do With It? 137
Tracey A. Revenson, Ana F. Abraido-Lanza,
S. Deborah Majerovitz, and Caren Jordan

Part III. Interventions to Enhance Dyadic Coping 157

8. A Model Dyadic-Coping Intervention 159
Kathrin Widmer, Annette Cina, Linda Charvoz,
Shachi Shantinath, and Guy Bodenmann
x CONTENTS

9. Enhancing Dyadic Coping During a Time of Crisis:

A Theory-Based Intervention With Breast Cancer Patients
and Their Partners 175
Karen Kayser
Author Index 195
Subject Index 203
About the Editors 209
 Contributors

Ana F. Abraido-Lanza, PhD, Mailman School of Public Health, Columbia

University, New York, NY
Linda K. Acitelli, PhD, Department of Psychology, University of Houston,
Houston, TX
Hoda J. Badr, PhD, Department of Behavioral Science, M. D. Anderson
Cancer Center, University of Texas, Houston
Chris Barker, PhD, Sub-Department of Clinical Health Psychology,
University College London, London, England
Guy Bodenmann, PhD, Institute for Family Research and Counseling,
University of Fribourg, Fribourg, Switzerland
Thomas N. Bradbury, PhD, Department of Psychology, University of
California—Los Angeles
Linda Charvoz, PhD, Institute for Family Research and Counseling,
University of Fribourg, Fribourg, Switzerland
Annette Cina, PhD, Institute for Family Research and Counseling,
University of Fribourg, Fribourg, Switzerland
Carolyn E. Cutrona, PhD, Institute for Social and Behavioral Research
and Department of Psychology, Iowa State University, Ames
Anita DeLongis, PhD, University of British Columbia, Department of
Psychology, Vancouver, Canada
Kelli A. Gardner, MS, Institute for Social and Behavioral Research and
Department of Psychology, Iowa State University, Ames
Caren Jordan, PhD, Department of Psychology, East Carolina University,
Greenville, NC
Benjamin R. Karney, PhD, Department of Psychology, University of
Florida, Gainesville
Karen Kayser, PhD, Graduate School of Social Work, Boston College,
Chestnut Hill, MA
S. Deborah Majerovitz, PhD, Department of Political Science and Psychology,
York College, The City University of New York, New York, NY
Melady Preece, PhD, Department of Psychology, University of British
Columbia, Vancouver, Canada
Nancy Pistrang, PhD, Sub-Department of Clinical Health Psychology,
University College London, London, England
Tracey A. Revenson, PhD, Social-Personality Psychology, The Graduate
Center of The City University of New York, New York, NY
Daniel W. Russell, PhD, Department of Human Development and Family
Studies, Iowa State University, Ames
Shachi Shantinath, PhD, Institute for Family Research and Counseling,
University of Fribourg, Fribourg, Switzerland
Lisa B. Story, MS, Department of Psychology, University of California—
Los Angeles
Kathrin Widmer, PhD, Institute for Family Research and Counseling,
University of Fribourg, Fribourg, Switzerland
 Foreword

In early 1988, the American Psychological Association (APA) Science Direc-

torate began its sponsorship of what would become an exceptionally success-
ful activity in support of psychological science—the APA Scientific
Conferences program. This program has showcased some of the most impor-
tant topics in psychological science and has provided a forum for collaboration
among many leading figures in the field.
The program has inspired a series of books that have presented cutting-
edge work in all areas of psychology. At the turn of the millennium, the series
was renamed the Decade of Behavior Series to help advance the goals of this
important initiative. The Decade of Behavior is a major interdisciplinary
campaign designed to promote the contributions of the behavioral and social
sciences to our most important societal challenges in the decade leading up to
2010. Although a key goal has been to inform the public about these scientific
contributions, other activities have been designed to encourage and further
collaboration among scientists. Hence, the series that was the "APA Science
Series" has continued as the "Decade of Behavior Series." This represents one
element in APA's efforts to promote the Decade of Behavior initiative as one
of its endorsing organizations. For additional information about the Decade of
Behavior, please visit http://www.decadeofbehavior.org.
Over the course of the past years, the Science Conference and Decade of
Behavior Series has allowed psychological scientists to share and explore
cutting-edge findings in psychology. The APA Science Directorate looks
forward to continuing this successful program and to sponsoring other confer-
ences and books in the years ahead. This series has been so successful that we
have chosen to extend it to include books that, although they do not arise from
conferences, report with the same high quality of scholarship on the latest
research.
We are pleased that this important contribution to the literature was sup-
ported in part by the Decade of Behavior program. Congratulations to the
editors and contributors of this volume on their sterling effort.

Steven J. Breckler, PhD Virginia E. Holt

Executive Director for Science Assistant Executive Director
for Science
 Preface

In a New Yorker book review, Rebecca Mead (2003) cited John Milton's
Doctrine and Discipline of Divorce (1643), in which he instructs Parliament
that "In God's intention, a meet and happy conversation is the chiefest and
noblest end of marriage" (p. 80). Mead suggested that by conversation Milton
meant much more than the "marital chatter about school districts or visits to
the in-laws" ... or even the familiar, forlorn spousal inquiry, "What are you
thinking about?" (p. 80). On the contrary, we take Milton's use of the word con-
versation on its face. These small everyday concerns, worries, and challenges
are the stuff of which marriages, and more specifically marital coping, are
made.
This volume addresses the construct of dyadic coping between people in
intimate relationships. By strict definition, dyadic coping involves both
partners and is the interplay between the stress signals of one partner and the
coping reactions of the other or a genuine act of common (shared) coping. As
the chapters in this volume illustrate, the construct of dyadic coping is
nuanced, interpreted differently by the chapter authors to include processes
such as everyday communication, interpersonal conflict, joint problem solving,
the giving and receiving of emotional support, and dealing with life stressors
as a we not just two Is. We are excited to share innovative conceptualizations
and cutting-edge research on dyadic coping in this book.
This volume emerged from two international conferences on stress and
coping processes among couples organized by Guy Bodenmann of the Univer-
sity of Fribourg, Switzerland, and Karen Kayser of Boston College, Massa-
chusetts. In 1999, Bodenmann and Kayser had started collaborative work on
dyadic coping and realized the need for scientific exchange among scholars
working on these issues from different perspectives. The first invited confer-
ence, held in Fribourg, Switzerland, on September 18-19, 2000, was dedicated
to this idea and provided an excellent platform. A small group of well-known
researchers who had been working in the area of stress and coping in couples
was brought together for 3 intensive days of presentation, discussion, and
critique. Researchers came from Austria, Canada, Germany, Italy, Switzer-
land, and the United States. The conference was particularly successful in
that it brought together researchers from different psychological traditions
(close relationships, marital therapy, and health psychology) and whose schol-
arly networks had had only minimal contact to that point. A clear consensus
at the end of the conference was that many ideas had only been touched on and
that the group needed to continue working together to refine the notion of
dyadic coping and its application to clinical practice. A second conference was
held in Chestnut Hill, Massachusetts, at Boston College on October 12-14,
2002. With funding from the Science Directorate of the American Psychologi-
cal Association (APA), the circle of presenters and discussants was enlarged
and a small "audience" participated in the discussions as well.
xvi PREFACE

The primary aim of this book is to present current approaches on stress

and coping in couples, to bring American and European contributions
together, and to stimulate further fruitful scientific exchange on this topic of
growing importance. Intended primarily for scholars in the field of marital
research, stress and coping research, and interpersonal relationships, the book
also serves as a useful reader for practitioners. As the idea of dyadic coping is
a new and innovative approach in the area of marital therapy, this volume
should be of interest to therapists as well.
Although the conference attendees raised the idea of a collaborative pub-
lication at the first conference, it was not until the APA Science Directorate
became involved that this book became a reality. We thank the APA Science
Directorate and Boston College for funding the 2002 conference that started
the seed of this book germinating. We also would like to thank Michelle Taylor
of Boston College for coordinating the 2002 Boston Conference, Deborah
McCall of the APA Science Directorate for assisting us with the conference
planning, Mary Lynn Skutley and Phuong Huynh of APA Books for shep-
herding us through the publication process, Kate Silfen for her careful editing,
and Adeane Bregman for her diligent research on the artwork for the book. We
thank Alberto Godenzi, Dean of the Boston College Graduate School of Social
Work, who generously released Karen Kayser from her teaching responsibili-
ties to work on the conference. We are grateful to Michael Smyer, Associate
Vice President for Research at Boston College, for his encouragement and
support for the conference on which this book is based. We also thank all of the
authors of the chapters for their cooperative and engaged work (and willing-
ness to write quickly) and their contributions to this book. We would like to
thank Linda Roberts for her thorough review and helpful critique of the book
manuscript. Most important, we thank the other half of our own couples:
Edward Seidman, Fred Groskind, and Corinne Bodenmann helped us cope
with putting this book together while enjoying all the stresses and pleasures
of married life (of which our children Molly Revenson; Emma Groskind; and
Arliss, Aimee, and Ruben Bodenmann are a large part). And finally, thanks to
Kit Kittredge and Molly Mclntyre, whose images kept the first two authors
sane during the summer of 2003 as they juggled their own American girls and
editing this book.

Reference
Mead, R. (2003, August 11). Love's labors: Monogamy, marriage, and other menaces. The New
Yorker, pp. 80-81.
COUPLES COPING
WITH STRESS
 Introduction
Tracey A. Revenson, Karen Kayser, and
Guy Bodenmann

Over the past 30 years, the lion's share of research on stress and coping has
focused almost exclusively on the coping efforts used by individuals, describ-
ing types or modes of coping strategies and their effects on physical and
mental health outcomes. Major life stressors do not limit their influence to
individuals but instead spread out like crabgrass to affect the lives of others
in the individual's social network: family, friends, coworkers, neighbors, and
even whole communities. Quite simply, people cope in the context of relation-
ships with others. And those "others" are affected by the same stressors in a
pattern of radiating effects (Kelly, 1971). Yet relatively few coping
researchers have investigated how intimate partners cope with stress as a
couple or how the coping efforts of partners mutually influence each other. It
seems that an essential step toward further clarification of the relationship
between stress and health involves examining coping as it naturally occurs
within the context of significant relationships, in particular, the marital or
marital-type relationship.
The past decade has witnessed the development of several theoretical
frameworks for studying how couples cope together with life stress. Whereas
there were only a few contributions published on stress and coping in couples
before the 1990s, an increasing amount of theoretical and empirical work
on this topic has emerged in the last decade (see Fig. 1). A number of
researchers, primarily in the United States and Western Europe, became
interested in how coping research could move past the individual level to

frequencies
400

300

200

100

1961-1965 1971-1975 1981-1985 1991-1995

1966-1970 1976-1980 1986-1990 1996-2001
| -e- Stress -*-Coping |
Figure 1. Growth in publications on stress and coping among couples over a 40-year
period.
4 REVENSON, KAYSER, AND BODENMANN

include the family context and began developing theoretical frameworks,

empirical research, and innovative practice models to address these issues.
These developments surfaced at a time in our social history when stress
permeates Western society and radical social changes challenge couples and
families. For example, the dramatic increase in women working outside the
home has led to juggling of work and family life (Artis & Pavalko, 2003; Crosby
& Jaskar, 1993; Shelton & John, 1996). The likelihood of becoming a caregiver
for an older family member who has a chronic mental or physical health con-
dition is increasing for both women and men and has led to the type of stress
known as caregiver burden (Marks, 1996; Marks, Lambert, & Choi, 2002;
Schulz, O'Brien, Bookwala, & Fleissner, 1995). Economic stressors and strains
have pushed many couples to increase their work hours in order to maintain
a lifestyle promoted by the larger culture. Daily fears of terrorism and violence
ranging from urban crime to political conflicts, wars, and ethnic clashes, are
present worldwide.
Coupled with this multiplicity of daily and chronic stressors are the dwin-
dling resources in our social environment to deal with them. Almost every
form of social capital has been on the decrease (Putnam, 2000). As these
resources become less available in the larger society, more pressure is placed
on intimate partners and family members to deal with the stresses of daily
life. Without the coping abilities and skills to manage the stress, many couple
relationships suffer or break down. Karney, Story, and Bradbury (see chap. 1,
this volume) suggest that this inability to cope with stress, coupled with
poverty and low social resources, is a key reason for the high divorce rate in
Western countries. At the very least, we know it is a fundamental and ubiqui-
tous reason for seeking counseling and psychotherapy.
A major critique of stress and coping theories is that coping is not an indi-
vidual process but occurs within a social and historical context (Revenson,
2003). Newer theoretical approaches such as relationship-focused coping
(Coyne & Fiske, 1992), interpersonal regulatory processes (DeLongis &
O'Brien, 1990; O'Brien & DeLongis, 1997), coping congruence (Revenson, 1994,
2003) and the systemic-transactional conceptualization of stress and coping
(Bodenmann, 1995, 1997) have expanded the original stress and coping
theories laid down in the 1970s and 1980s (e.g., Lazarus & Folkman, 1984;
Lazarus & Launier, 1978; Pearlin, Lieberman, Menaghan, & Mullan, 1981;
Pearlin & Schooler, 1978) and bring the notion of coping within the context of
intimate relationships to the foreground. Dyadic coping involves both partners
and is the interplay between the stress signals of one partner and the coping
reactions of the other, a genuine act of shared coping.

Themes Embedded in this Volume

This volume presents new approaches in stress and coping research that focus
on dyadic relationships, in particular, marital or long-term intimate relation-
ships. The chapters present theoretical frameworks, formative research to test
those frameworks, and translation of research findings into practice princi-
 INTRODUCTION

pies. Emerging perspectives, the phrase used in the book's subtitle, captures
the character of the scholarship presented in this volume. Although the schol-
arship is original and at times pathbreaking, it is not always fully developed
or without logical flaws. A first effort to assemble ideas that bridge several dis-
ciplines and two continents is bound to seem provisional. Definitions of dyadic
coping differ from chapter to chapter, for example. Thus, the collection of per-
spectives in this volume creates a somewhat dizzying array of overlapping
conceptualizations rather than a single cohesive conceptual model that is
ready to be widely applied. We hope that this volume serves as a necessary
first step to move the scholarship toward a heightened awareness of points of
convergence and divergence and toward more integrative models to be tested.
Five prominent themes described below emerge from the individual
chapters and are woven through the volume.

Conceptual Frameworks for Dyadic Coping Must Be Dyadic

Almost all the chapters have something to say about the conceptual under-
pinnings of dyadic coping processes: What should we be looking for? These con-
ceptual issues frame the questions that are asked in couples research and
point to methodologies that are needed to answer "couple-level" questions.
Most importantly the dyad, or relationship, should be the unit of analysis at
all stages of the research process, from conceptualizing the problem through
methods and measurement to data analyses and interpretation. Conceptual-
ization of the pattern of coping between two people—in Lazarus' terms, the
person-environment transaction (Lazarus & Launier, 1978)—is the essential
beginning of couples research. Obtaining data from both partners indicates
progress in recognizing the limitations of individual constructions of coping,
but collecting data from both partners does not in and of itself constitute
dyadic-level research. Several chapters in this book (see chaps. 1, 3, & 7) illus-
trate how analyses at multiple levels of analysis can be utilized to reveal
dyadic or couple-level coping.

Know Thy Stressor

A second theme is how the nature of the stressor affects dyadic coping
processes. Literally hundreds of studies have shown that the properties of
stressors shape coping efforts and adaptation (Cohen, Kessler, & Gordon,
1997). These properties include the magnitude of the stressor (minor stressors
such as daily hassles or small life events vs. major stressors); the duration and
nature of stress exposure (acute, intermittent, repeated, or chronic); the
domain of stress (work, family, or medical); and the stressor's radiating effects
on other stressors (i.e., stress contagion). The first chapter of this book, by
Karney and his colleagues, emphasizes the distinction between acute versus
chronic stressors as they affect marital quality among newlyweds. In chapter
3, Preece and DeLongis illustrate the confluence and reciprocal influences of
major and minor stresses within the realm of stepparenting. Other chapters
6 REVENSON, KAYSER, AND BODENMANN

focus on single major life stressors, such as chronic or life-threatening illness

(see chaps. 5, 6, & 7, this volume), depression (see chap. 5, this volume), and
the transition to parenthood (see chap. 5, this volume).

Dyadic Coping With Stress Is a Process

Apart from the differentiation of the various forms of stress, it is critical to

capture the dynamics of the coping process (Lazarus & Launier, 1978; Pearlin
et al., 1981). The experience of dyadic-level stress in couples is a process of
mutual influence in which the stress of one partner affects the other if the
partners' coping skills (independently and jointly) are not sufficient to handle
the stressor. It also makes sense to distinguish different phases within the
stress and coping process and to assess stress and coping on multiple levels
(individual and partner) within a specific social context. Bodenmann (see
chap. 2, this volume) proposes an integrative framework for studying dyadic
stress that is useful for both planning research and understanding different
coping processes in intimate relationships. Several chapters (e.g., chaps. 5, 8,
& 9, this volume) use a similar model of dyadic coping for understanding
marital interactions under stress and developing innovative interventions and
treatments.
We should note that although all the contributors share a general frame-
work of dyadic-level coping, the chapters in this volume constitute "variations
on a theme." Moreover, this volume is the first to present most of the current
models of dyadic coping in one place. It is intriguing to see how many differ-
ent models of dyadic coping are proposed and how each one captures a slightly
different perspective. For example, Cutrona and her coauthors (see chap. 4,
this volume) emphasize interpersonal trust as both a predictor of and compo-
nent of dyadic coping; whereas Revenson and her coauthors (see chap. 7, this
volume), Acitelli and Badr (see chap. 6, this volume), and Preece and DeLongis
(see chap. 3, this volume) focus more on the fit or congruence between
partners' coping and how it operates within the larger social context of family.

Dyadic Coping Within an Interpersonal Framework

The fourth theme emphasizes the interdependence of the constructs of coping

and social support. Specifically, the success of coping efforts is heavily deter-
mined by others' responses. Although coping and support are overlapping
concepts, they are not indistinguishable and each offers something unique to
the understanding of human adaptation (see chap. 2, this volume). Moreover,
it is important to separate social support transactions with persons outside of
the marriage or dyadic unit from those with the spouse or partner. Both are
essential components of dyadic coping processes, but are quite different.
Almost all the chapters in this volume explore the mechanisms by which
dyadic coping facilitates the exchange of social support and how social support
processes influence coping processes. Some chapters focus on the broad concept
of support provision as it affects marital quality (see chap. 4, this volume) or
 INTRODUCTION 7

adaptation to major stress (see chap. 7, this volume); whereas others focus on
interpersonal communication processes (see chaps. 5 & 6, this volume).

Translating Research Into Intervention

A final theme of this volume is the translation of dyadic-coping research into

psychosocial interventions. Although the last section is devoted to intervention
research on dyadic coping, applications to practice are emphasized throughout
all of the chapters. The applications are illustrated in clinical work with indi-
vidual couples (see chaps. 5 & 9, this volume) as well as more comprehensive
interventions for couples facing marital distress (see chap. 8, this volume).

Content and Organization

This book is organized into three parts. The first part, "The Role of Stress in
Dyadic Coping Processes," begins our examination of the concept of dyadic
stress, its effect on couples' coping processes and relationship outcomes, and
theoretical frameworks used to study dyadic coping processes. In chapter 1,
Karney, Story, and Bradbury use longitudinal data on newly married couples
to investigate the differential effects of acute and chronic stress on marital
outcomes. Often the role of the external environment is overlooked as
researchers focus primarily on the internal working of the couple's relationship
and not its context. These authors offer a new perspective on understanding
stress and use a multilevel methodology to systematically answer the question,
"What kinds of negative outcomes are predicted by what kinds of stress?"
In chapter 2, Bodenmann expands on the concept of dyadic stress and
coping with an innovative and dynamic theory of the dyadic coping process. He
presents a typology of dyadic coping that distinguishes both positive and
negative forms. This theory is supported by empirical findings on more than
1,000 couples, using multiple methods of data collection and various research
designs. He investigates the questions, "How does stress affect marriage?" and
"How does dyadic coping affect the relationship between stress and marital
quality?"
Preece and DeLongis (chap. 3) expand interpersonal stress and coping to
the rich context of stepfamilies. They examine how couples in stepfamilies use
five coping strategies to manage interpersonal stressors and report findings on
the connection between coping and relationship quality between parents and
children. A unique feature of their research is the focus on both short-term
(i.e., within the course of a single day) and long-term predictors (i.e., across 2
years) of relationship quality in stepfamilies. The authors illustrate how
multilevel models can assist with the methodological problems that challenge
researchers studying these complex systems of stepfamilies.
The second part of this book, "Social Support, Dyadic Coping, and Inter-
personal Communication," contains chapters that focus on the interplay
between dyadic coping and social support processes. In chapter 4, Cutrona,
Russell, and Gardner present a model of relationship enhancement in which
they explain how social support enhances health and well-being within the
8 REVENSON, KAYSER, AND BODENMANN

context of intimate relationships. They grapple with the question of how social
support influences health and bring to light a neglected mechanism in the
process through which supportive acts influence health: interpersonal trust.
Drawing on both experimental and longitudinal naturalistic studies of
couples, the authors offer compelling evidence for the interactions among
social support, attributions, and trust. For the practitioner, they offer valuable
suggestions for interventions and assessment of social support in intimate
relationships. The chapter provides a new perspective on the long-range impli-
cations of how well or poorly couples support each other during difficult
times—both for the relationship and health and well-being of each partner.
Pistrang and Barker (chap. 5) take the study of social support to a micro-
level of analysis as they examine partners' responses during conversations of
helping interactions. Using a narrative approach, they untangle partners'
communication processes as they cope with serious stresses, including breast
cancer and the transition to parenthood. Their study provides a unique
dimension to this volume, in that the analysis focuses intensively on conver-
sational analysis and has direct application to preventive therapy for couples.
In their role as therapist researchers, Pistrang and Barker extend more con-
ventional narrative approaches to what they describe as a tape-assisted recall
method in which the partners are asked to review their own conversations
and identify moments of empathy and lack of empathy and provide alterna-
tives for communication. This communication analysis is embedded in a
broader discussion of why social support is important for couples under
stress, how this particular approach fills some gaps in the communication
and psychotherapy literatures, and how an understanding of empathy and
support needs to recognize the full range of formal and informal support. It is
interesting to note that the research procedures in themselves seem to have
therapeutic benefits to the couples.
The last two chapters of this part focus on how gender influences the
coping process and exchange of support within a relational context. Although
both chapters also focus extensively on a particular stressor, chronic illness,
the chapter by Acitelli and Badr builds on an interpersonal relationships
framework and emphasizes the notion of relationship awareness; in contrast,
the chapter by Revenson and her colleagues comes from a health psychology
perspective and focuses on how the context of the illness shapes dyadic
coping processes.
In chapter 6, Acitelli and Badr contend that how couples cope with chronic
illness may depend on who is the ill spouse—the husband or wife. Whether
spouses perceive the illness as my illness or our illness has implications for
coping and the provision of support. They propose that it is better for the well-
being of a relationship for partners to view the illness as a relationship issue
rather than an individual issue. In support of this, they present findings from
two studies that address the relationship between gender and relationship
talk, with samples of "healthy" couples and couples coping with a serious
illness. These data present a compelling case that men and women behave dif-
ferently and expect different types of support from their partners depending
on whether they are in the role of the patient or the well spouse. Furthermore,
which spouse—the husband or the wife—engages in relationship talk will
have an impact on the relationship satisfaction.
 INTRODUCTION 9

Revenson, Abraido-Lanza, Majerovitz, and Jordan expand on the influ-

ence of gender on dyadic coping in chapter 7 but use a social ecological model
to guide their work. The conceptualization of coping congruence is used as a
framework to analyze the fit between the partners' coping styles. To capture
the interpersonal nature of coping, Revenson and her colleagues conducted a
cluster analysis on coping behaviors of couples with rheumatic disease to
describe how husbands and wives cope as a unit and how the medical, inter-
personal, sociocultural, and temporal contexts affect couples' coping. The
question, "What's gender got to do with it?" is addressed not only through
these coping profiles but also by examining the division of household labor
when either the husband or wife is ill.
The third and final part of this book focuses on specific psychosocial inter-
ventions with couples designed to enhance their coping with stress in general
or with a specific stressor such as cancer. Widmer, Cina, Charvoz, Shantinath,
and Bodenmann (chap. 8) describe then- marital distress prevention program,
Couples Coping Enhancement Training (CCET). This program integrates
cognitive-behavioral approaches with theories of stress and coping and aims
to strengthen the coping competencies of both partners through enhanced
dyadic communication and dyadic coping. Based on the framework of dyadic
coping presented in chapter 2, the six modules of the program focus on fur-
thering partners' understanding and knowledge of stress, enhancing their
individual coping and dyadic coping, improving their exchange and fairness in
their relationships, fostering marital communication, and improving problem-
solving skills. The authors present two outcome studies that evaluate the
effectiveness of the program on marital quality, dyadic coping, individual
coping, communication behaviors, and dyadic adjustment.
In chapter 9, Kayser describes an innovative couple-level intervention to
assist couples who are coping with the recent diagnosis of breast cancer. The
Partners in Coping Program (PICP) consists of a series of skill-based inter-
ventions designed to help couples enhance their interpersonal functioning
(communication, coping strategies, problem solving, and emotional support),
use help from others, realign family responsibilities, and provide continuity in
their lives. This program is also based on the theory of dyadic stress and
coping as conceptualized by Bodenmann (chap. 2) and employs cognitive-
behavioral interventions with both partners. Preliminary findings from a
clinical trial using a randomized group design support the intervention to
enhance the dyadic coping of couples faced with the challenges of early-stage
breast cancer.
The study of coping on a dyadic level represents a next step in under-
standing process as well as outcome, particularly when individuals are coping
with stressors that affect both spouses. We cannot continue to separate the
study of coping processes from that of social support. Whether we choose to
conceptualize social support as a form of coping assistance (Thoits, 1986) or as
a mode of coping (Bodenmann, 1997; O'Brien & DeLongis, 1997), much of what
is considered coping involves the appraisals, actions, emotions, and feedback
of others (Lazarus, 1999). Taken together, the chapters in this volume provide
the field with both a new and exciting conceptualization of dyadic coping
processes and a challenging set of unanswered questions that will guide future
research.
10 REVENSON, KAYSER, AND BODENMANN

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Coyne, J. C., & Fiske, V. (1992). Couples coping with chronic and catastrophic illness. In M. A. P.
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cation to the families of Alzheimer's patients. In M. A. P. Stephens, J. H. Crowther, S. E.
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