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A Comparison of Marital Interaction Patterns Between Couples in Which the Husband Does or Does Not Have Alzheimer's Disease

^a Mental Illness Research, Education and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, California
^b Stanford University School of Medicine, Palo Alto, California
^c Family Studies Research Program, Veterans Affairs Palo Alto Health Care System, California
^d Pacific Graduate School of Psychology, Palo Alto, California.

Dolores Gallagher-Thompson, Mental Illness, Education, & Clinical Center (MIRECC), Mail Code: 182B, Veterans Affairs Palo Alto Health Care System, 795 Willow Rd., Menlo Park, CA 94025 E-mail: dolorest{at}stanford.edu.

Objectives. Our main purpose was to examine similarities and differences in patterns of interpersonal interaction between Alzheimer's disease (AD) caregiving and noncaregiving couples (n = 54).

Methods. Twenty-seven wives caring for moderately impaired husbands with probable AD and 27 noncaregiving wives from comparable sociodemographic backgrounds were videotaped in their homes during both mealtime and a future event planning task. In addition, they completed self-report questionnaires to assess depression, stress, relationship mutuality, and perceived hope.

Results. Compared with their counterparts, caregiving wives reported higher levels of depression and stress, but similar shared values and closeness. For the three factors developed from the Marital Interaction Coding System (MICS, version IV; Supportive Facilitative, and Rapport Building), a complex pattern of results was found in which disease status, type of task, and gender interacted significantly. Noncaregiving couples were more interactive overall and expressed more support to each other. Caregiving wives were found to be most facilitative during the planning task, whereas AD husbands were highest on interactions that built rapport (e.g., smiling) during that same task. Caregiving wives actually increased their facilitative behavior from the mealtime to planning task, probably reflecting the increased demand characteristics of the latter.

Discussion. This study is one of a small body of literature to describe the negative impact of AD on spousal communication as observed and coded in two videotaped interaction situations in the home. Suggestions are made for future research, including the inclusion of longitudinal designs and non-Caucasian couples.

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