Doctor of Philosophy, The Ohio State University, 2011, Psychology

Advanced and recurrent breast cancer patients experience negative biobehavioral sequelae following diagnosis. Poor marital quality has also been shown to worsen biobehavioral trajectories in earlier-stage cancer patients (e.g., Yang & Schuler, 2009; Schuler et al., under review). However, the contribution of poor marital quality among advanced or recurrent cancer patients coping with a health crisis remains unclear. This study tested the longitudinal covariation between poor marital quality and psychological distress, individual differences, health behaviors, endocrine and immune functioning, and physical health in advanced and recurrent breast cancer patients (N=98). Mixed-effects modeling compared trajectories for women in distressed marriages (n=23) to those in non-distressed marriages (n=75) at diagnosis and across a 12-month follow-up. Compared with patients in a non-distressed marriage, those in a distressed marriage showed significantly greater baseline total mood disturbance (p<.001) and differential rate of mood disturbance change across follow-up (p=.018). Immune differences were also present, with the Distressed group showing significantly higher Con A at baseline relative to the Non-Distressed group (p=.052), which persisted across 12-month follow-up. Clinical relevance and recommendations are described.

Committee: Barbara Andersen PhD (Advisor); Daniel Strunk PhD (Committee Member); Robert Cudeck PhD (Committee Member); Steven Beck PhD (Committee Member); Helen Everts PhD (Other) Subjects: Behavioral Psychology; Behavioral Sciences; Behaviorial Sciences; Clinical Psychology; Families and Family Life; Psychobiology; Psychology; Psychotherapy; Social Research