Stability of mental health among couples over 5 years: does one partner

influence the other one?

Stéphane Cullatia,b, Delphine Courvoisiera, Claudine Burton-Jeangrosc

aDivision of clinical epidemiology, Geneva University Hospitals & University of Geneva

bQuality of care Unit, Geneva University Hospitals

cDepartment of Sociology, University of Geneva

2

Introduction• Research on health outcomes has emphasized that

individuals are dependent of their significant others, such as partner, children, parents, etc. (Monden 2007). For example: – social position on mortality, – psychological trait on health outcomes, – depression on cognitive functionning.

• Partner mental health may have an impact on the mental health of the other member of the couple.

3

Introduction

• Examining the impact of the intraindividual variability of mental health on each partner has been little studied.

• How to study the intraindividual variability across time?– Multi-level modeling– Correlations between standard deviations

• But stable part is not excluded• The latent state trait models represent one solution to

model the variable part, by excluding the stable part.

4

Evolution of mental health among couples

Questions:

1. Is mental health stable or variable over time among women and men living together?

2. Does mental health of one partner vary due to variation of mental health of the other one?

5

Method• Population: adults, living in Switzerland, participating to

the national Swiss Panel Households survey (data available at http://www.swisspanel.ch).

• Selection criteria: – respondents living in couple, married or not – who answered to 5 waves between 2000 and

2004, without interruption (N=624): Sample of 624 couples; women were 44.2 years

old (SD=12.2) and men: 46.8 years old (SD=12.2)• Mental health was assessed by two indicators:

depression, optimism (11-points Likert items, from 0 to 10)

6

Model

• To assess variability of mental health through time, we used latent state trait to distinguish between stable component and momentary variations of mental health for each partner:– Stable component was represented by 1 latent

variable– Situational component by 5 occasion-specific latent

variable• To assess relationship between mental health of both

partner, we used a multiconstruct latent state trait (Schermelleh-Engel 2004).

7

Yik,

i = 2 indicators (Y1 depression, Y2 optimism)

k = 5 occasions (waves)

Y11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

(Steyer et al. 1992; Steyer et al. 1999 )

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Yik = ik + ikTY11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

T1

9

Yik = ik + ikT + iikISTi Y11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

T1

IST2

10

Y11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

T1

IST2

Yik = ik + ikT + iikISTi + ikWk

W1

W2

W3

W4

W5

11

Yik = ik + ikT + iikISTi + ikWk + EikY11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

T1

IST2

W1

W2

W3

W4

W5

E11

E21

E12

E22

E13

E23

E14

E24

E15

E25

12

Y11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

T1

IST2

W1

W2

W3

W4

W5

E11

E21

E12

E22

E13

E23

E14

E24

E15

E25

13

Y11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

T1

IST2

W1

W2

W3

W4

W5

E11

E21

E12

E22

E13

E23

E14

E24

E15

E25

Y11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

T1

IST2

W1

W2

W3

W4

W5

E11

E21

E12

E22

E13

E23

E14

E24

E15

E25

Wom

en Men

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Model identification X2 df X2/df CFI Rmsea

1 Measurement invariance 271.60 196 1.39 0.985 0.025

2 Autoregressive structure, parameters all equals

247.43 193 1.28 0.989 0.021

2a Correlation of trait between partners

237.10 192 1.24 0.991 0.020

2b Correlation between partner's Ow 246.05 192 1.28 0.989 0.021

2c Cross-lagged regression (Ow at T on partner's Ow at T+1) 245.70 192 1.28 0.989 0.021

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Couples (N=624)

Women MenDepression Consistency Iscon Specificity Reliability Consistency Iscon Specificity Reliability

W1 .66 .69

W2 .62 .62

W3 .65 .64

W4 .70 .71

W5 .63 .60

Optimism

W1 .57 .52

W2 .59 .52

W3 .63 .59

W4 .60 .55

W5 .61 .59

Couples (N=624)

Women MenDepression Consistency Iscon Specificity Reliability Consistency Iscon Specificity Reliability

W1 .51 .66 .53 .69

W2 .49 .62 .51 .62

W3 .52 .65 .52 .64

W4 .56 .70 .58 .71

W5 .50 .63 .49 .60

Optimism

W1 .22 .57 .18 .52

W2 .25 .59 .23 .52

W3 .23 .63 .20 .59

W4 .24 .60 .22 .55

W5 .24 .61 .20 .59

Couples (N=624)

Women MenDepression Consistency Iscon Specificity Reliability Consistency Iscon Specificity Reliability

W1 .51 .15 .66 .53 .16 .69

W2 .49 .13 .62 .51 .12 .62

W3 .52 .13 .65 .52 .12 .64

W4 .56 .15 .70 .58 .13 .71

W5 .50 .13 .63 .49 .11 .60

Optimism

W1 .22 .16 .19 .57 .18 .18 .16 .52W2 .25 .13 .20 .59 .23 .12 .16 .52W3 .23 .22 .18 .63 .20 .24 .14 .59W4 .24 .17 .19 .60 .22 .17 .15 .55W5 .24 .19 .19 .61 .20 .26 .14 .59

18

Y11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

Y11

Y21

Y12

Y22

Y13

Y23

Y14

Y24

Y15

Y25

1.99

0.49

1.62

0.52

.25

.22

.22

.22

.23

.22

.22

.22

Wom

enM

en0.26

M= 8.67M=8.05 .58

.50

.50

.50

.50 .35

.35

.35

.35

.49

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Question 1: Is mental health stable or variable over time among women and men living together?

• Men and women have a high level of mental health (8.67 and 8.05). Women have a more variable mental health than men.

• Both men and women have a mostly stable mental health: about 75% of the variance of the observed variables depended on a stable trait of mental health and 25% were accounted by situational influences.

• Autoregressive influence of one occasion-specific variable upon the next one were significantly different from zero, albeit low at .2 for both sexes.

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Question 2: Does mental health of one partner vary due to variation of mental health of the other one?

• Stable mental health of one partner impact on the stable component of the other one.

• Deviation of mental health in one partner does not impact on those of the other one neither during the same year, nor the next year.

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Discussion• A multi-construct latent state trait model was appropriate

to examine 3 hypothesis: – reciprocal influences of the stable mental health,– reciprocal influences of the state mental health,– cross-lagged influences of the state mental health.

• This model allowed solving whether the stable influences or the unstable influences were decisive on the partner.

• Evolution of mental health of respondents is influenced by their own history and by the history of the stable part of their partner's mental health.

• Change of mental health of one partner does not explain change of mental health of the other one.

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Discussion

• Other longitudinal studies examined cognitive functionning and found an influence between partner among older (Gerstorf 2009) or ethnic subgroups (Hinton 2009) whereas our study examined the general population.

• Further resarch is needed to examine change among subgroups (younger vs older, educated vs less educated).

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Discussion

• Strengths: – measure of mental health includes positive and

negative states of mood– precisely assess the reliability of the construct– significant number of waves

• Limitations: – selection bias of the most stable respondents (the

more healthy?)– acceptable reliability (.6)– time frame between each occasion is 1 year– high attrition of the Swiss Households Panel between

1999 and 2004.

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Cited references• Gerstorf, D., C. A. Hoppmann, K. J. Anstey and M. A. Luszcz. 2009. Dynamic

links of cognitive functioning among married couples: longitudinal evidence from the Australian Longitudinal Study of Ageing. Psychol Aging, 24 (2): 296-309.

• Hinton, L., Y. Hagar, N. West, H. M. Gonzalez, D. Mungas, L. Beckett and M. N. Haan. 2009. Longitudinal influences of partner depression on cognitive functioning in latino spousal pairs. Dement Geriatr Cogn Disord, 27 (6): 491-500.

• Monden C., (2007). Partners in health ? Exploring resemblance in health between partners in married and cohabitaint couples. Sociology of Health and Illness. 29: 391-411.

• Schermelleh-Engel, K., N. Keith, H. Moosbrugger and V. Hodapp. 2004. Decomposing Person and Occasion-Specific Effects: An Extension of Latent State-Trait (LSI) Theory to Hierarchical LST Models. Psychological Methods, 9 (2): 21-.

• Steyer R., Ferring D., Schmitt M.J., (1992). States and Traits in Psychological Assessment. European Journal of Psychological Assessment. 8: 79-98.

• Steyer R., Schmitt M.J., Eid M., (1999). Latent state-trait theory and research in personality and individual differences. European Journal of Personality. 13: 389-408.