Population studies point to strong associations between an anxiety disorder in one partner and perceptions of poor marital quality by both partners (e.g., McLeod, 1994). A longitudinal analysis of 4,796 married couples indicated that baseline marital quality was a strong predictor of the onset of an anxiety disorder over a subsequent 2-year period (Overbeek et al., 2006). Recent data from the National Comorbidity Survey Replication have also demonstrated that marital distress is significantly associated with increased risk of having any concurrent anxiety disorder, particularly social anxiety disorder (SAD), generalized anxiety disorder (GAD), and posttraumatic stress disorder (PTSD; Whisman, 2007). The association between anxiety disorders and poor marital functioning does not appear to be an artifact of general social impairment (Whisman, Sheldon, & Goering, 2000) and is not better accounted for by age, gender, or comorbidity with depression or with alcohol or drug dependence (McLeod, 1994; Whisman, 1999, 2007). Moreover, adults with anxiety disorders may engage in interpersonal behaviors that elicit poor reactions from others or jeopardize opportunities for support and intimacy (e.g., Darcy, Davila, & Beck, 2005).
Prior research in this area has taken a predominantly nomothetic approach, in which associations between anxiety disorders and marital quality were examined across a group of individuals. These data tell us that, on average, adults with anxiety disorders are likely to experience poor relationship quality. However, it remains unknown whether a person affected by an anxiety disorder is more or less likely to experience relational difficulties on those occasions when he or she experiences elevated anxiety. Tennen, Affleck, Armeli, and Carney (2000) cautioned against using cross-sectional, between-person associations to draw inferences about how two variables are related within the same person. It is possible, for instance, that adults with anxiety disorders experience improved relationship quality during episodes of heightened anxiety because of increased support received from an intimate partner at this time.
In developing theoretical models and designing interventions, clinicians and researchers rely on idiographic formulations of how these processes unfold for a given person. Over the last decade, there have been significant advances in the procedural and analytic tools available to study idiographic processes over time. In particular, the daily diary method has proven to be a useful way to examine how two processes (e.g., marital quality and anxiety) covary within the same person over time. In the present study, daily diary reports were used to determine the within-person association between anxiety and relationship quality among adults with anxiety disorders and their partners.
One limitation of prior literature on anxiety disorders and relationship quality is the inconsistency across studies in how relationship quality is defined. Daiuto, Baucom, Epstein, and Dutton (1998) argued that it is important to distinguish relationship satisfaction (i.e., subjective appraisal of how happy one is in a relationship) from relationship adjustment (i.e., the quality of specific relational processes such as communication or problem-solving). The utility of this distinction is supported by previous studies showing that aspects of relationship adjustment (e.g., avoidance of communication) significantly predicted the outcome of treatment for an anxiety disorder, even when global relationship satisfaction was high (Craske, Burton, & Barlow, 1989; Marcaurelle, Belanger, & Marchand, 2003). Exclusive reliance on global evaluations of relationship satisfaction may therefore miss clinically useful information about areas of relationships more or less disrupted by anxiety. Even when couples describe their relationships as high functioning across multiple domains, couples who struggle to accommodate one partner’s anxiety symptoms (e.g., with effective support and communication) may experience more pronounced relational impact in the context of these symptoms (Craske et al., 1989). In observed interactions between agoraphobic women and their husbands, problem-solving difficulties were greater when the topic of discussion was the wife’s anxiety (Chambless, Bryan, Aiken, Steketee, & Hooley, 2001). In the present study, we used a measure of anxiety-specific relationship adjustment to provide a contextually sensitive assessment of relationship functioning. We hypothesized that anxiety-specific relationship adjustment would be more informative in predicting the strength of the association between anxiety and daily relationship quality than would a measure of global relationship functioning.
