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. 2023 Aug 21;57(9):753-764.
doi: 10.1093/abm/kaad017.

Concurrent and Prospective Associations Between Communicated Emotional Arousal and Adjustment Among Couples Coping With Cancer

Danielle M Weber  1 , Brian R W Baucom  2 , Donald H Baucom  1 , Melanie S Fischer  3 , Katherine Ramos  4 , Joan M Romano  5 , Laura S Porter  4 , Shelby L Langer  6
Affiliations

Concurrent and Prospective Associations Between Communicated Emotional Arousal and Adjustment Among Couples Coping With Cancer

Danielle M Weber et al. Ann Behav Med. .

Abstract

Background: The experience of cancer can create considerable emotional distress for patients and their committed partners. How couples communicate about cancer-related concerns can have important implications for adjustment. However, past research has primarily utilized cross-sectional designs and retrospective self-reports of couple communication. While informative, little is known about how patients and partners express emotion during conversations about cancer, and how these emotional patterns predict individual and relational adjustment.

Purpose: The current investigation examined how patterns of emotional arousal within couples' communication about cancer was associated with concurrent and prospective individual psychological and relational adjustment.

Methods: At baseline, 133 patients with stage II- breast, lung, or colorectal cancer and their partners completed a conversation about a cancer-related concern. Vocally expressed emotional arousal (f0) was extracted from recorded conversations. Couples completed self-report measures of individual psychological and relational adjustment at baseline and at 4, 8, and 12 months later.

Results: Couples who started the conversation higher in f0 (i.e., greater emotional arousal) reported better individual and relational adjustment at baseline. If the non-cancer partner had lower f0 relative to patients, this predicted worse individual adjustment across follow-up. Additionally, couples who maintained their level of f0 rather than decreasing later in the conversation reported improvements in individual adjustment across follow-up.

Conclusions: Elevated emotional arousal within a cancer-related conversation may be adaptive for adjustment, as it may reflect greater emotional engagement and processing of an important topic. These results may suggest ways for therapists to guide emotional engagement to enhance resilience in couples experiencing cancer.

Keywords: Adjustment; Cancer; Communication; Couples; Emotional arousal; Longitudinal.

Plain language summary

Cancer is a stressful experience for patients and their partners. We know that how couples communicate about cancer is important, but we do not know much about how couples express emotion during cancer conversations and how those emotional expressions affect well-being. Our study looked at how couples’ emotional arousal within cancer conversations relate to individual and relationship well-being. At the beginning of the study, cancer patients and their partners had a conversation about cancer. Within these conversations, we tracked the emotional arousal expressed in their voices. Couples also completed surveys about their well-being at the beginning of the study and later in time (4, 8, and 12 months later). We found that couples who started the conversation with higher emotional arousal had better initial well-being. Couples who remained higher in arousal later in the conversation improved in their individual well-being over time. We also found that if the non-cancer partner was low in arousal compared with patients, this predicted worse well-being over time. More research is needed, but these findings suggest that being emotionally aroused during conversations about important topics like cancer might be helpful for well-being, potentially because couples are discussing concerns and not backing off when it feels challenging.

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Figures

Fig. 1.
Fig. 1.
Couple-level f0 intercept predicts baseline relationship adjustment (A) and individual psychological adjustment (B). Note. Legend applies to A and B. f0 intercept is the level of emotional arousal at the start of the conversation. DAS Dyadic Adjustment Scale (i.e., relationship adjustment, where higher score = better relationship adjustment); POMS Profile of Mood States: Total Mood Disturbance (i.e., individual adjustment, where higher score = higher negative emotionality and worse adjustment).
Fig. 2.
Fig. 2.
Individual-level f0 intercept and role predict individual adjustment over time. Note. f0 intercept is the level of emotional arousal at the start of the conversation. POMS Profile of Mood States Total Mood Disturbance (individual adjustment, assessing overall negative emotionality). Simple slopes for partners are in black lines while simple slopes for patients in light gray, while low f0 is represented in solid lines and high f0 is represented in dotted lines. *p < .05.
Fig. 3.
Fig. 3.
Couple-level f0 quadratic change predicts individual adjustment over time. Note. (A) depicts visual representation of how different quadratic slopes (1 SD above and below mean of average quadratic trajectory) appear during course of conversation. (B) depicts how those trajectories of change in f0 as presented in (A) predict change over the course of the follow-up period. POMS Profile of Mood States Total Mood Disturbance (individual adjustment, assessing overall negative emotionality). *p < .05.
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