title: Marital relationships in amyotrophic lateral sclerosis.
abstract: Our objective was to determine change over time in quality of marital relationships of people with ALS (pwALS). Fifty pwALS and their spouse carers completed measures of marital intimacy, pwALS's functional status, their own psychological status, and beliefs about the pwALS's illness. Twenty-seven dyads completed two further assessments, at six-monthly intervals. Post-ALS diagnosis ratings of current marital relationship did not change over time for pwALS or their spouses. However, spouse carers' ratings of their current marital relationship were lower than their ratings prior to illness onset. After adjusting for the pre-illness marital relationship, pwALSs' current ratings of their marital relationship were initially predicted by their self-rated psychosocial functional impairment and satisfaction with their personal relationships, and subsequently by levels of self-esteem. After adjusting for ratings of the pre-illness marital relationship, carers' current marital intimacy scores at first and second interview were predicted by ratings of the patients' psychosocial functional impairment and by feelings of burden at the third interview. In conclusion, quality of the pre-illness marital relationship is a significant predictor of ongoing marital relationship in both pwALS and their spouse carers. Additionally, social and psychological rather than disease symptoms are important predictors of marital relationship quality after ALS diagnosis.
authors.affiliation: Cancer Research UK Promoting Early Presentation Group, Institute of Psychiatry, King's College London, St. Thomas' Hospital, London, UK.
authors.forename: Louise
authors.initials: L
authors.lastname: Atkins
authors.forename: Richard G
authors.initials: RG
authors.lastname: Brown
authors.forename: P Nigel
authors.initials: PN
authors.lastname: Leigh
authors.forename: Laura H
authors.initials: LH
authors.lastname: Goldstein
mesh_terms: D000368:Aged; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications / Q000523:psychology*; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology; D001294:Attitude to Health; D003863:Depression / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008393:Marriage / Q000523:psychology*; D008875:Middle Aged; D019370:Observation; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012189:Retrospective Studies; D012931:Social Environment; D012944:Social Support; D013997:Time Factors