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Emotional Behavior in Couples with bvFTD: Implications for Caregiver Relationship Satisfaction and Psychological Well-being



Emotional Behavior in Couples with bvFTD:

Implications for Caregiver Relationship Satisfaction and Psychological Well-being


Anna Sapozhnikova

Doctor of Philosophy in Psychology

University of California, Berkeley

Professor Robert W. Levenson, Chair

Emotions are an important part of marital life. Prior research indicates that patients with behavioral variant frontotemporal dementia (bvFTD) experience significant impairments in socioemotional functioning, including emotional blunting, inappropriate behavior and decreased empathy (Neary et al., 1998). These changes in patients often strain marriages and can lead to a decline in marital satisfaction and increase the risk of depression in the healthy spouse (Ascher et al., 2010, Braun et al., 2010). However, few studies have explored the emotional dynamics of couples living with bvFTD in a systematic way (Braun et al., 2009). The aim of this study was to extend our understanding of the emotional dynamics of couples where one spouse has bvFTD as well as to understand the association between emotional behavior during the marital interaction and the caregiving spouse’s relationship satisfaction and psychological well-being, looking specifically at depression.

This study examined emotional behavior and emotional reciprocity of couples where one spouse is diagnosed with either bvFTD (N=30) or Alzheimer’s disease (N=30) in the context of a 10-minute naturalistic marital interaction in comparison to healthy controls (N=29). Emotional behavior was coded using the Specific Affect Coding System (SPAFF), which consists of five positive emotional behavior codes, ten negative emotional behavior codes, and a neutral code. Emotional reciprocity between spouses was established using the Allison and Liker (1982) statistic. The study also examined the relationship between positive and negative emotional behavior as well as escalating and de-escalating patterns of emotional reciprocity and the caregiving spouse’s self-reported marital satisfaction and levels of depression.

The current findings reveal a loss of humor and reciprocity of positive emotion and an exacerbation in negative emotion (e.g., criticism, sadness) and conflict escalation in couples with bvFTD during a marital interaction. Furthermore, low positive emotion, high negative emotion and conflict escalation are associated with low marital satisfaction and high negative emotion is related to increased levels of depression in the spousal caregiver.

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