David Marsh and Dr. Julianne Holt-Lunstad, Department of Psychology
The purpose of this study is to determine the effects of marital quality on certain cardiovascular health risks, including diabetes, blood pressure, and cholesterol levels. Relationships, including that of marriage, have long since been known to correlate with these physiological markers (Wickrama, 1997). Our study, however, is different, as it is the first study to include a marriage therapy intervention. This type of study carries with it more weight than just a correlation study, but obviously brings with it more difficulty. We are in the final stages of gathering data. We have studied more than 210 participants and anticipate being finished this summer. Though the project is still ongoing, I will share with you some interesting preliminary data that I have gathered, analyzed, and presented at two conferences.
We hypothesized that improving marital satisfaction would decrease cardiovascular risks. To test our hypothesis, we organized our recruits into two groups- control and intervention. The intervention group was composed of couples who scored below a certain mark on a marriage quality scale, called the Revised Dyadic Adjustment Scale. Both groups were assessed for both biological risk factors as well as marital distress. The risk factors include cortisol, blood pressure, oxytocin, weight, hip and waist measurements, glucose, triglycerides, cholesterol, and hemoglobin-A1c. Marital distress is measured by the Dyadic Adjustment Scale (DAS).
Following the initial assessment, the intervention group received three months of emotion focused therapy. This was provided at no charge at the BYU Comprehensive Clinic. Following the three month period, both groups are again assessed for any changes in either their biology or marital quality. The study is based on the assumption that the emotion focused therapy will induce positive changes in
the perceived marital quality of struggling couples, and that biological health markers will also improve.
In writing, this seems like a fairly simple undertaking. I quickly learned that working with such a large, dynamic group introduces a lot of unanticipated problems. Recruiting has been difficult and has prolonged the project longer than hoped. I believe this is largely due to the taboo subject of marital distress. I’ve found that couples, whether distressed or not, are often more difficult to work with than single participants. Scheduling two people is much more difficult than one person, and resulted in dropped appointments, procrastination, and other problems. Distressed couples often changed their minds regarding their willingness to attend counseling sessions, and often did not reach their minimum requirements of four visits over the three month intervention period. Even more extreme, a few couples decided to be divorced while participating, and obviously were not able to complete the study.
Also adding to the difficulty of the study is the fact that since some of our most important biological markers are hormones, namely cortisol and oxytocin, medications and pregnancies disqualify participants from the study. Unplanned changes in both medication and pregnancies occurred for a few couples, resulting in being disqualified from continuing the study. Another constant headache for us was keeping the three month intervention period consistent for all of the participants. Often our participants were not available at the three month mark and would insist on pushing back the final screening. This introduces unwanted variables, and we tried hard to keep everybody consistent so as to get the most valid results possible.
As mentioned earlier, I did gather and present some preliminary data. Though the data is not directly related to the overall purpose of the study, it does shed light on the relationships between aspects of marriage and health markers, and was a significant learning experience for me as I was able to, in a way, conduct my own study. I wanted to see if any individual signs of affection in marriage correlated to any specific health markers. One of the many surveys our participants took to measure marital quality included information on how often they participated in different forms of affection, including: kissing, hugging, sitting close together, sexual intercourse, massaging, and hand holding. I then correlated each individual measure with each of the biological markers previously mentioned and was excited to see several relationships show a significant correlation.
Our results indicate a negative relationship between overall amount of physical affection and diastolic ambulatory blood pressure (r = -.38, p = .02), Hemoglobin-A1c (r = -.38, p < .001), and VLDL cholesterol (r = -.20, p < .05). Also, higher amounts of physical affection predicts lower levels of hemoglobin-A1c. Hugging and sexual intercourse were the most powerful forms of affection to lead to lower hemoglobin-A1c. Hemoglobin-A1c is typically used to test for diabetes, and a measurement above 5% is typical of diabetic patients. These results suggest that couples who engage in more hugging and sexual intercourse are at a lower risk for developing diabetes. Several theories can be used to explain the mechanism for this. For example, it is possible that higher amounts of affection may indirectly affect other health behaviors, such as exercise or healthy eating, in order to be more attractive to their spouse.
I presented this preliminary data during poster presentation sessions at two conferences: the American Psychosomatic Association National Conference in San Antonio, Texas, and the Mary Lou Fulton Conference at Brigham Young University. We won first prize at the Fulton Conference in the Graduate Psychology category. I know that both of these experiences provided a way for me to positively represent BYU and share this useful research with others. I benefited from this experience as well. I feel that my education has been enriched because while working on these experiences, I learned a lot about my field, working with others, and presenting.
As much as I enjoyed the Fulton conference, the American Psychosomatic Association conference was even more memorable to me. I was extremely impressed by the caliber of researchers and scholars present at this conference. Presenting to these intimidating people pushed me and helped me to be increasingly familiar and knowledgeable about my subject. Many of them knew I was an undergraduate and a beginner in health psychology, and were very kind and helpful. I felt that I was able to rub shoulders with the very best in the field. The poster impressed a great number of them and we received a lot of excellent feedback. Hemoglobin-A1c is relatively new and understudied and to see research on focused on its correlations was very exciting to many of them. A number of researchers took down the information for the BYU Behavioral Medicine lab to receive more information in hopes to potentially study similar subjects. For perhaps the first time, I finally understood the difference I’m making to the field of health psychology and was proud to be a part of it. I’m appreciative to my mentor, student colleagues, and all of the donors who made my participation in the study possible. I sincerely thank you.