The role of relational mutuality in psychological and physical health outcomes in a rheumatoid arthritis sample

Abstract

The quality of spouse/partner relationships has been linked with health outcomes. Mutuality, the interest in sharing cognitive and emotional experiences in couple communications, is theorized as having importance for women's psychological health and self esteem. Mutuality was tested as a predictor of health outcomes in a rheumatoid arthritis (RA) sample (N = 54) at baseline (Time 1) and six months later (Time 2). Mutuality inversely predicted depressive symptoms at both times of measure. Mutuality failed to predict physical disability and disease flares at both times of measure. Sex differences in mutuality's links with health outcomes were explored. Results suggest that mutuality is an important predictor of depressive symptoms for women. Women who reported more mutuality in communications with their spouses/partners reported fewer depressive symptoms at both times of measure. However, no conclusions can be drawn regarding mutuality's prediction of depressive symptoms for men. Self-esteem was tested as a mediator of mutuality's link with health outcomes. Self-esteem mediated the link between mutuality and depressive symptoms at Time 2. In addition, mutuality was tested as a protective factor relative to health outcomes. Cross-lagged associations between mutuality and health outcomes at both times of measure were examined in structural equation models to determine whether mutuality drives health outcomes or vice versa. Neither mutuality nor health outcomes demonstrated temporal precedence; no support was provided for the hypothesis that mutuality is a protective factor. Finally, depressive symptoms were tested as a risk factor for physical health outcomes. Cross-lagged associations between depressive symptoms and physical health outcomes at both times of measure were examined in structural equation models to determine whether depressive symptoms drive physical health outcomes or vice versa. Temporal precedence of depressive symptoms was observed relative to disease flares, suggesting that depressive symptoms may be a risk factor for disease flares. Limitations, findings, and future directions are discussed.