1. Courtney Roberts Spouses’ cardiovascular reactivity to their partners’ suffering

2. Caregiver May Experience… Physical symptoms Psychological distress Existential or spiritual stress Emotional distress Likely to mediate link between partners’ suffering and caregivers’ increased risk for cardiovascular disease

3. Aims of the Study Examine the extent to which exposure to a partner’s suffering affects cardiovascular reactivity in an experimental setting Examine the extent to which the nature of the relationship influenced a person’s cardiovascular response to another person’s suffering Relationship type and closeness can influence emotional and physiological convergence between two individuals Compared cardiovascular reactivity to spouses’ versus opposite-sex strangers’ physical suffering while performing a pain-eliciting task

4. Hypothesis of Study Exposure to suffering in a laboratory setting will uniquely influence caregiving spouses’ cardiovascular functioning Watching a stranger perform a pain-eliciting task will increase caregivers’ systolic and diastolic BP and heart rate compared with watching a habituation stimulus Caregivers will have higher BP and HR responses to watching a partner’s than a stranger’s physical suffering Talking about the partner’s physical, psychological, and spiritual suffering will increase the caregiver’s BP and HR compared with talking about a mundane interaction like having lunch with a partner

5. Participants of the Study 53 care recipients with Osteoarthritis and their caregiving spouses 27 women and 26 men; about 69 years old

6. Preparation of Participants Habituation Video- 2 standardized videos were made of a healthy older man and healthy older woman, each walking back and forth across an 8-ft. space for 3 minutes without expressing any pain Stranger performing pain-eliciting log task- 2 standardized videos were made of one older male “stranger” and one older female “stranger” expressing pain while performing a log-carrying task for 3 minutes; strangers were instructed to freely express pain verbally and nonverbally as they experienced it Examined overall differences in pain expression between the stranger and partner videos using independent observers 10 independent observers rated the pain expression of one of the stranger videos and one of the 10 randomly selected partner videos on a scale from 0-10

7. Procedure Videotaping the care recipient perform the pain-eliciting log task- each couple came into the laboratory for a 2-hour session; the experimenter escorted the caregiver to a waiting room. The care recipient was videotaped performing the pain-eliciting log-carrying task in a separate area of the lab. The care recipient was instructed to freely express pain verbally and nonverbally as he or she experienced it. Baseline- next, the caregiver was taken to a sound and electrically shielded chamber that was used to separate the caregiver from the external lab environment and reduce electrical noise in the physiological recordings. Habituation & exposure to partner’s and stranger’s physical suffering- Caregiver privately viewed the habituation stimulus, then they watched the videotape either of his/her partner or opposite sex stranger performing log-carrying task. Verbal accounts of mundane reaction- caregivers were asked to give 2 verbal accounts about the care recipient.

8. BP, HR, and Relationship For each condition, a systolic BP and diastolic BP mean were calculated by averaging each of the 3 automated measurements taken over the 3-min periods Caregivers were asked to report their level of marital satisfaction using the Marital Adjustment Test at the beginning of the lab session in a separate room from their spouse 16 item measure with different rating lebels

9. Results Significant effects of gender on baseline BP such that men had higher systolic and diastolic BP than women; older caregivers had higher systolic BP at baseline Medications did not have a significant effect on any of the physiological indicators Caregivers are physiologically reactive to suffering Results were consistent with hypotheses No significant effects of marital satisfaction on changes in reactivity from control to experimental condition for any of the physiological indicators

10. Implications of the Study Merely observing the suffering of partners or talking about the suffering of partners affects caregivers’ well-being Future research should examine different types of relationships Interventions that address a partner’s suffering have received little attention in the caregiver intervention literature Intervention strategies that directly affect the suffering of the care recipient may be particularly effective in alleviating caregiver distress The results of the study indicate that heightened cardiovascular stress caused by exposure to a loved one’s suffering may be one pathway to caregivers’ increases risk for cardiovascular disease Major strength: one of the first to use experimental methods with ecologically valid stimuli to examine emotional processes in the context of caring for older adults Important implications for interventions suggest that caregivers are likely to benefit from efforts to alleviate care recipients’ suffering