Attachment in Couples Coping with Cancer: Associations with Observed Communication and Long-Term Health

Katherine Ramos (), Karena Leo, Laura S. Porter, Joan M. Romano, Brian R. W. Baucom and Shelby L. Langer
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Katherine Ramos: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
Karena Leo: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
Laura S. Porter: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC 27705, USA
Joan M. Romano: Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA 98195, USA
Brian R. W. Baucom: Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
Shelby L. Langer: Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, USA

IJERPH, 2023, vol. 20, issue 7, 1-17

Abstract: Cancer poses a threat to well-being that may activate the attachment system and influence interpersonal dynamics, such as communication. Research indicates that avoidant and anxious attachment, as well as communication, are independently associated with poorer psychosocial well-being, yet studies examining links between attachment, communication, and long-term physical well-being are lacking. We examined (a) associations between patient and partner attachment (measured with the adult attachment scale [AAS-Revised]) and observed communication (across affect [the Relational Affective Topography System (RATS) coding system] and behavior [the Asymmetric Behavior Coding System (ABCS) coding system]) and (b) the extent to which attachment and communication independently predicted long-term physical well-being (measured by the Functional Assessment of Cancer Therapy-General Population [FACT-GP]). Participants were 134 couples [mean age 53.9 ( SD = 13.4), 86.2% Caucasian, 66% of patients, 36% of partners female]. Patient participants had either breast, colorectal, or lung cancer. Couples individually completed self-report measures of attachment (baseline) and physical well-being (baseline and 4, 8, and 12 months later). At baseline, couples engaged in a 15 min videorecorded cancer-related conversation coded for communication behavior and affective expression. Patients and partners with higher anxious and avoidant attachment exhibited more negative affect and negative approach behaviors. A greater avoidant attachment was associated with less positive affective expression. Attachment insecurity and affective expression were prospectively linked with physical well-being. Findings indicate that attachment is associated with overt communication behaviors and that insecure attachment and affective expression may be risk factors for poorer health outcomes.

Keywords: cancer; couple communication; attachment; dyadic coping; physical well-being (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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