Protective buffering among couples coping with heart disease: Behavior, intentions, and psychological distress

Abstract

Protective buffering (PB; Coyne & Smith, 1991), which involves hiding worries and concerns from one's partner, was examined in a sample of 60 congestive-heart-failure (CHF) patients and their spouses. Earlier studies suggest that PB is ironically associated with increased distress for the person who protects (actor effect) and perhaps also for the "protected" spouse (partner effect), though evidence for the latter is mixed (Suls, Green, Rose, Lounsbury, & Gorden, 1997). This study reexamined the PB-distress link, taking into account methodological variations and ambiguities in previous research, including (a) the source of PB ratings (self vs. other), (b) ratings of PB in general vs. a specific stressful situation, and (c) the actor's intentions to protect self vs. partner. In separate interviews, patients and spouses described their own and their partner's PB using Suls et al.'s revision of Coyne and Smith's PB scale; participants also completed the same 25-item HSCL distress measure used in those studies and, for the specific stressful situation, the PANAS negative affect scale. Although PB scores showed rank-order consistency across the general and specific measurement contexts, participants reported higher mean levels of spouse-directed PB in general then in the specific stressful situation. Strikingly, perceptions of one's partner's PB correlated more highly with the respondent's own PB than with PB reported by the partner (suggesting a possible projective process). As in previous studies, data from both patients and spouses revealed intrapersonal associations between PB and distress (actor effects) when these constructs were assessed in general. A somewhat different picture emerged, however, for the recalled specific situation, where partner effects of both PB behavior and protective intentions were implicated more clearly in participant distress. Exploratory analyses also identified marital quality as a potential moderator of links between spouse PB and patient distress: Among couples reporting lower marital quality, for example, patient distress was ironically elevated when spouses intended to protect the patient more than themselves. Overall, the results highlighted the importance of measurement specificity in studying PB and its association with psychological distress.