The association between communication behavior and psychological distress among couples coping with cancer: Actor-partner effects of disclosure and concealment

Objective: This study applies the Actor-Partner Interdependence Model (APIM) to explore the associations between disclosure and concealment with depression and anxiety among patients with cancer and their partners. Method: 90 patient-spouse dyads completed the Self-Disclosure Index (SDI), the Self-Concealment Scale (SCS), the Couples Illness Self-Concealment (CISC) questionnaire, and anxiety and depression via the Patient-Reported Outcomes Measurement Information System (PROMIS) and the Hospital Anxiety and Depression Scale (HADS). Results: Significant actor effects were found for most variables, showing disclosure is negatively and concealment is positively associated with depression and anxiety (β between |0.29| to |0.65|, p ≤.029). Partner's effect showed a negative association between patients' self-disclosure and their spouses' depression (β = −0.35, p =.043). Patients' anxiety was negatively associated with similarity in all communication variables (β between −0.21 to −0.22, p =.042). Conclusions: Dyadic communication is an important correlate of distress among couples coping with cancer. Specifically, concealment behaviors have a positive association with distress, whereas disclosure is related to lower levels of anxiety and depression among both partners. In addition, whereas patients are affected more strongly than their spouses by the dyadic similarity, spouses seem to be more attuned to their partners' behaviors and therefore potentially more related to patients' propensity for sharing.