Spousal Influence on Diabetes Self-care: Moderating Effects of Distress and Relationship Quality on Glycemic Control

Background Spouses often attempt to influence patients' diabetes self-care. Spousal influence has been linked to beneficial health outcomes in some studies, but to negative outcomes in others. Purpose We aimed to clarify the conditions under which spousal influence impedes glycemic control in patients with type 2 diabetes. Spousal influence was hypothesized to associate with poorer glycemic control among patients with high diabetes distress and low relationship quality. Methods Patients with type 2 diabetes and their spouses (N = 63 couples) completed self-report measures before patients initiated a 7-day period of continuous glucose monitoring. Mean glucose level and coefficient of variation (CV) were regressed on spousal influence, diabetes distress, relationship quality, and their two- and three-way interactions. Results The three-way interaction significantly predicted glucose variability, but not mean level. Results revealed a cross-over interaction between spousal influence and diabetes distress at high (but not low) levels of relationship quality, such that spousal influence was associated with less variability among patients with low distress, but more among those with high distress. Among patients with high distress and low relationship quality, a 1 SD increase in spousal influence predicted a difference roughly equivalent to the difference between the sample mean CV and a CV in the unstable glycemia range. Conclusions This was the first study to examine moderators of the link between spousal influence and glycemic control in diabetes. A large effect was found for glucose variability, but not mean levels. These novel results highlight the importance of intimate relationships in diabetes management.

SPOUSAL INFLUENCE ON EARLY RETIREMENT DECISIONS: ORIGINS AND MECHANISMS

The interdependence between partners raises considerable interest in the sociology of life course, work and families. Partner influences play a particularly important role in the work domain, because each partner’s work decisions have profound effects on the couple as a whole. In contrast to previous research, this study pays detailed attention to the role partners play in workers’ labor market decisions by using the case of early retirement decisions. We hypothesize that partners’ preferences for older workers’ retirement originate from altruism and self-interest. For example, partners might prefer workers to retire early because the worker’s job is highly stressful or partners might prefer workers to retire early to increase possibilities for joint leisure. Moreover, we expected that partners influence older workers’ early retirement behavior via persuasion and pressure. So, partners might either convince workers to change their preferences, or they might pressure workers to act according to the partners’ preferences, irrespective of workers’ own preferences. To adequately estimate partners’ and workers’ preferences for workers’ early retirement, we used an instrumental variable approach. This was possible due to the multi-actor longitudinal data available from a large representative sample of older workers and their partners in the Netherlands. The results support that partners’ preferences originate in altruism and self-interest and that partners influence workers through persuasion and pressure. Gender differences were marginal, with stronger signs for altruistic origins among female than male partners.

Why Singles Prefer to Retire Later

This study goes beyond a purely financial perspective to explain why single older workers prefer to retire later than their partnered counterparts. We aim to show how the work (i.e., its social meaning) and home domain (i.e., spousal influence) contribute to differences in retirement preferences by relationship status. Analyses were based on multiactor data collected in 2015 among older workers in the Netherlands ( N = 6,357) and (where applicable) their spouses. Results revealed that the social meaning of work differed by relationship status but not always as expected. In a mediation analysis, we found that the social meaning of work partically explained differences in retirement preferences by relationship status. We also show that single workers preferred to retire later than workers with a “pulling” spouse, earlier than workers with a “pushing” spouse, and at about the same time as workers with a neutral spouse.

Spousal influence: A study of women with eating and body image concerns

Eating disorder literature often overlooks those exhibiting eating and body image concerns without an eating disorder diagnosis. Supportive spouses may ameliorate negative body image and eating behavior, but spouses who exhibit both supportive and non-supportive behaviors concurrently (ambivalent) may send mixed messages. Eating disorder behaviors and spousal interactions were assessed in 61 women who demonstrated eating disordered behavior and body dissatisfaction but were not clinically diagnosed with an eating disorder. Spouses mostly provided messages of reassurance. However, some women were unable to overcome their internalized negative body image. Feelings of social comparison were seen with ambivalent spouses. Supportive relationships may be protective, but actual interventions may be needed to change negative body image.

Educational Assortative Mating and Income Dynamics in Couples: A Longitudinal Dyadic Perspective

The gender-gap reversal in education could have far-reaching consequences for marriage and family lives. Using data from the National Longitudinal Survey of Youth 1979 and longitudinal multilevel dyad models, this study investigated how educational assortative mating shaped income dynamics in couples over the marital life course. Based on educational assortative mating, couples were grouped into three categories—educational hypergamy (wives less educated than their husbands), homogamy, and hypogamy (wives more educated than their husbands). Results showed that change in husbands’ income with marital duration was similar across couples, whereas change in wives’ income varied by educational assortative mating such that wives in educational hypogamy exhibited more positive change in income over the marital life course. The findings underscored the asymmetric nature of spousal influence and gender change in heterosexual marriages.