Couples Coping with Breast Cancer Across the Developmental Trajectory: Examining the Role of Mutuality in Predicting Dyadic Coping of Patients and Partners in Younger and Older Dyads

Background and Purpose. Despite the extensive literature available about the psychosocial adaptation to breast cancer, the experience of younger women and their partners has been mostly neglected by the research. While younger couples have been identified at higher risk because of less collaborative behaviors, higher vulnerability to distress, and poorer quality of life, in most contributions couples are treated as a homogeneous group. Using the Relational-Cultural Model of dyadic coping (Kayser, Watson, & Andrade, 2007) as framework, this study was designed to examine the differential impact of the illness on younger dyads by comparing them to a group of older couples.

Methods.Data were collected on 86 couples using a cross-sectional survey of demographic, clinical and psychosocial measures. Patients and partners completed measures of quality of life (FACT-B for patients, Illness Intrusiveness Scale and Quality of Life Questionnaire for Spouses for partners), dyadic coping (Dyadic Coping Scale) and mutuality (Mutual Psychological Development Questionnaire). Patients below the age of 45 and their partners were considered younger couples and compared to the remaining 51 older couples. The Actor-Partner Interdependence Model (APIM) was used to examine actor and partner effects of mutuality on dyadic coping.

Results. Younger women reported significantly worse quality of life than older patients, with affected functioning in physical, social and emotional domains. Similarly, younger partners experienced higher illness intrusiveness, worse emotional well-being, and higher hostile dyadic coping compared with their older counterparts. While among older dyads the interdependence of patients and partners’ mutuality significantly reduced only maladaptive coping behaviors, younger couples’ positive and negative coping styles were the result of both actor and partner effects of mutuality, indicating higher interdependence in their relationship.  

Conclusions and Implications. Younger couples’ adaptation to breast cancer is significantly compromised not only because of the more negative impact of the illness on the individual’s well-being, but also as a result of higher reciprocal influence of mutuality in predicting both adaptive and maladaptive dyadic coping behaviors. Future studies should continue to examine the developmental trajectory of dyadic coping over the life-span and psychosocial interventions should be developed to promote positive adaptation to cancer in a time of higher vulnerability for younger dyads.