Avoidance May Be Bad for the Heart:A Comparison of Dyadic Initiator Tendency in Cardiac Rehabilitation Patients and Matched Controls

摘要

The psychophysiologic model of marital distress proposes that demand/ withdraw dyadic communication activates cardiovascular reactivity in the withdrawing partner, which eventually leads to cardiac illness. Thirty-one patients (23 men and 8 women) in a cardiac rehabilitation program were matched to community controls. Participants completed the Initiator Style Questionnaire, a measure of a person's tendency to initiate relationship problem discussions. As hypothesized, cardiac rehabilitation patients (M = 42.53, 95% CI 37.6-47.5) reported being less likely to initiate relationship problem discussions than did community controls (M = 60.79, 95% CI 54.7-66.8). Consistent with the model, cardiac patients rated themselves as less initiating (M = 39.12, 95% CI 32.96-45.28) than they rated their partners (M = 45.94, 95% CI 38.98-52.90); in contrast, matched controls rated themselves as more initiating (M = 63.04, 95% CI 57.36-68.70) than they rated their partners (M = 58.54, 95% CI 42.98-67.78). Further analysis found that female patients accounted for this finding. The results add further support for the psychophysiologic model. Index Terms: cardiac illness, cardiac rehabilitation, cardiovascular reactivity, couple communication