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

Abstract

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

Acknowledgments

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