The Relationship between Perceived Stress and Marital Satisfaction in Couples with Infertility: Actor-Partner Interdependence Model

Abstract

Background: Infertility, one of life's great stressors, may adversely affect marital satisfaction. No studies have investigated the relationship between perceived stress and marital satisfaction at the dyadic level. The current study assessed the actor and partner effects of perceived stress on marital satisfaction in husband-wife dyads using an innovative dyadic analysis approach, the Actor-Partner Interdependence Model (APIM).

Materials and methods: In this cross-sectional study, we recruited a total of 141 infertile couples. Marital satisfaction and stress were assessed using the ENRICH Marital Satisfaction Scale (EMS Scale) and Perceived Stress Scale-4 Item (PSS-4), respectively. Dyadic data have been analysed by the APIM approach, with distinguishable dyads. In this approach, actor effect is the impact of a person's perceived stress on his/her own marital satisfaction. Partner effect is the impact of a person's perceived stress on the partner's marital satisfaction.

Results: Both men and women's perceived stress exhibited an actor effect on their marital satisfaction (β=-0.312, P<0.001, β=-0.405, P<0.001, respectively). Women's perceived stress had a negative relationship to the marital satisfaction of their partner (β=-0.174, P=0.040). Although the partner effect of men's perceived stress on woman's marital satisfaction was not significant (β=-0.138, P=0.096), women whose husbands had higher levels of stress were more likely to have poorer marital satisfaction. Both actor and partner effects of perceived stress on marital satisfaction were similar among men and their wives.

Conclusion: The findings of this study have highlighted that marital satisfaction in patients with infertility was influenced by not only their own perceived stress, but also their spouses' perceived stresses. Therefore, psychological interventions that target a reduction in perceived stress and enhancement of marital satisfaction in the context of infertility should treat the couple as a unit.

Keywords: Actor-Partner Interdependence Model; Infertility; Marital Satisfaction; Stress.

Fig.1

Actor-Partner Interdependence Model (APIM) of perceived stress and marital satisfaction. E_m; Actor effect of husband’s perceived stress on his own marital satisfaction, E_m; Actor effect of wife’s perceived stress on her own marital satisfaction, P_fm; Partner effect of the husband’s perceived stress on his wife’s marital satisfaction, P_mf; Partner effect of the wife’s perceived stress on the husband’s marital satisfaction, E_m and E_f; Residual errors on marital satisfaction for men and women, respectively, ^*; P<0.05, and ^***; P<0.001.