The health consequences of stress in couples: A review and new integrated Dyadic Biobehavioral Stress Model

Abstract

Despite marriage's health benefits, all couples experience stress that can increase morbidity and mortality risks. Marital stress can alter endocrine, cardiovascular, and immune function-key pathways from troubled relationships to poor health. This review discusses how partners "get under each other's skin" to influence psychological, behavioral, and biological health. Then, I offer a comprehensive Dyadic Biobehavioral Stress Model to build on this foundational work and inspire transdisciplinary research integrating psychoneuroimmunological and relational lenses. This conceptual and empirically driven model provides promising new directions to investigate mechanisms linking individuals' relationships behaviors to their own and their partners' health, with particular emphasis on biological pathways. These mechanisms may impact each partner's physical health outcomes, such as disease development, illness severity, and accelerated biological aging. Risk and protective factors across developmental stages and diverse contexts are also discussed to help explain how, and under what conditions, partners influence each other's health. Research applying this model can push the boundaries of our current understanding on dyadic stress its far-reaching health effects on self-report and biological markers across the lifespan.

Keywords: Dyadic coping; Inflammation; Interdependence; Marriage; Psychoneuroimmunology; Stress reactivity.

Fig. 1

M. Rosie Shrout, PhD. Dr. Shrout is an Assistant Professor in Purdue University's Human Development and Family Studies Department, as well as a Faculty Associate of Purdue University's Center on Aging and the Life Course. She earned her PhD in Interdisciplinary Social Psychology from the University of Nevada, Reno in 2019 where she worked with Dr. Daniel Weigel. Then she received a Presidential Postdoctoral Fellowship with Dr. Janice Kiecolt-Glaser in the Ohio State University's Institute for Behavioral Medicine Research. As a social-health psychologist with specialized training in psychoneuroimmunology, Dr. Shrout studies how couples' stress affects their relationships and health using dyadic, biobehavioral, and longitudinal methods. Her work focuses on the underlying psychological, behavioral, and biological pathways connecting stress to people's own and their partners' relational and physical health across adulthood. Though relationships often provide health benefits, all couples experience stress that poses risks to partners' relationship quality, emotional and physical well-being, and longevity. Through transdisciplinary and collaborative work, Dr. Shrout's research addresses why some couples grow stronger and healthier through hardship, while others experience relationship and health problems. With an emphasis on three common and yet challenging stressors—infidelity, conflict, and chronic illness—she considers how sociodemographic and developmental-contextual factors affect how people perceive stress, use their resources, and experience relationship and health problems. Dr. Shrout's goal is to identify factors that put couples' relationships and health at risk and to inform interventions on how couples can grow closer and stronger during turbulent times. Dr. Shrout has received several grants, fellowships, and awards supporting her research. Most notable among these honors include a prestigious Bilinski Dissertation Fellowship, the University of Nevada, Reno's most Outstanding Graduate Student Researcher, and Ohio State University's Presidential Postdoctoral Fellowship.

Fig. 2

An illustration of the Dyadic Biobehavioral Stress Model showing how relational and health mechanisms connect stress to people's own and their partners' health across diverse developmental and contextual factors. Biobehavioral health mechanisms span psychological, behavioral, and biological factors. Neg. ​= ​negative; pos. ​= ​positive; inflam. ​= ​inflammation; HRV ​= ​heart rate variability.