Hüse Lajos, Barnucz Nóra, Konyáriné Ménesi Tünde, Fónai Mihály Results of Hungarian battered men research

PDF Abstrakt

Rocznik: 2014

Tom: XIX

Numer: 3

Tytuł: Results of Hungarian battered men research

Autorzy: Hüse Lajos, Barnucz Nóra, Konyáriné Ménesi Tünde, Fónai Mihály

PFP

DOI: https://doi.org/10.14656/PFP20140302

Polskie Forum Psychologiczne, 2014, tom 19, numer 3, s. 305-319
DOI: 10.14656/PFP20140302

MARITAL SATISFACTION, DIFFERENTIATION
OF SELF AND STRESS PERCEIVED BY WOMEN
Kinga Kaleta
Instytut Pedagogiki i Psychologii, Uniwersytet Jana Kochanowskiego w Kielcach
Institute of Pedagogy and Psychology, The Jan Kochanowski University in Kielce

Summary. Differentiation of self refers to the ability to modulate affect, maintain a  clear sense of self, and balance intimacy and autonomy in significant relationships. The author tested whether differentiation mediated the relationship between marital satisfaction and stress perceived by women. The sample consisted of 220 married women. Marital satisfaction was found to be inversely correlated with perceived stress. Greater marital satisfaction also coincided with better differentiation of self (less emotional reactivity, greater I position, less emotional cutoff and fusion with others), while lower level of differentiation was significantly associated with higher feeling of stress. Differentiation of self also mediated the linkage between marital satisfaction and stress perceived by women. The results support searching hypothesis. Key words: marital satisfaction, stress, differentiation of self

Introduction Marital studies conducted in the past few decades have given a lot of attention to the problem of stress which plays a significant role in the understanding the quality, stability and experiencing the relationship by the spouses (Neff, Karney, 2004; Randall, Bodenmann, 2009) Researchers have been especially interested in relationships between different types of stress and subjective evaluation of marital quality, most often referred to as satisfaction (Braun-Gałkowska, 1985; Bradbury, Fincham, Beach, 2000). Marital satisfaction is a complex and dynamic process in which the key role is played by assessment of interactions between spouses and emotional climate of their relationship. This assessment may be expressly positive, explicitly negative, or ambivalent, where equally positive and negative evaluations related to one’s marriage coexit (Fincham, Linfield, 1997; Kaleta, 2014). Thus, in case of diversified satisfaction, marriage is perceived as the source of various experiences – pleasant, unpleasant or both at the same time. For studies have shown, that satisfied spouses display larger range of positive behaviours and emotions, whereas the unsatisfied ones – negative, such as high level of criticism, whining, engaging in serious quarrels and frequent disagreements, but also avoiding confrontations with the spouse and withdrawal from interaction (Gottman, Krokoff, 1989; Bradbury, Fincham, Beach, 2000; Leggett et al., 2012). Negative marital experiences of this kind may especially be the source of stress for the partners. In accordance with the transactional model of stress and coping, confrontation of one’s own capabilities with requirements, resulting from the relationship and the context of its functioning, plays a decisive role in experiencing stress by the spouses (cf. Ogińska-Bulik, Juczyński, 2008). In numerous situations, marital relation may be assessed as exceeding one’s personal resources, threatening the well-being and evoking the state of unpleasant emotional tension, which corresponds to the definition of stress adopted in considerations herein (Plopa, Makarowski, 2010). Studies have confirmed the relationship between marital satisfaction and perceived stress and its aspects: emotional tension, intrapsychic stress and external stress (Plopa, 2008; Plopa, Makarowski, 2010; Kaleta 2014). It is believed that women are especially sensitive to what is going on in their marital interactions and in that sense they serve as “barometers of the relationship functioning” (Fincham, Linfield, 1997, p. 499). This, among other things, results from higher importance women attach to interpersonal relationships, more complex and differentiated conceptions of relationships (Wong, Csikszentmihalyi, 1991), as well as more emotional involvement in relationships with family members when compared to men (Strazdins, Broom, 2004). Women do far more emotional work in families than their husbands, which involves integrating emotions of family members, providing support and regulating interpersonal conflicts (Strazdins, 2000). This work, performed also for the benefit of their spouse, is demanding and costly. For this reason, when compared to men, women experience lower marital satisfaction and face more conflicts in the marital dyad, including marital burnout, health effects and psychological distress (Erickson, 1993; Strazdins, Broom, 2004; Plopa, 2005; Vandeleur et al., 2009). Therefore, it appears particularly interesting to get more insight into relationships between women’s marital satisfaction and the level of stress they perceive. Relationships between marital satisfaction and perceived stress are not simple, which has been especially highlighted in studies results of which reveal no or minor relationships between variables. In that case, mediating factors are examined, such as e.g. reactivity (Neff, Karney, 2009), marital attributions (Graham, Conoley, 2006) or previous stress management training (Neff, Broady, 2011), and new ones are continued to be discovered. Differentiation of Self may be one of them, to date not recognized as a mediator between marital satisfaction and perceived stress, despite explicit relationship between both variables. Differentiation of self Differentiation of self, the key concept of the family systems theory developed by Murray Bowen (1966), is the degree to which one is able to balance intrapsychic strona 306

and interpersonal components of their own self (Bowen, 1978). On an intrapsychic level, differentiation of self refers to the ability to distinguish thoughts from feelings and to choose between being guided by one’s intellect or one’s emotions at a given moment (Bowen, 1976, 1978; Goldenberg, Goldenberg, 2006). On an interpersonal level, differentiation refers to the ability to experience intimacy with others but as an autonomous being not responding automatically to emotionality of others. Theoretically, at least four factors determine the level of differentiation of self: emotional reactivity, I position, emotional cut-off and fusion with others (Kerr, Bowen, 1988; Skowron, Friedlander, 1998). Poorly differentiated individuals tend to be more emotionally reactive, display problems with forming of their own convictions or objective opinion, and in relationships – poor sense of self and inclination to engage in fusion or emotional cut-off (Kerr, Bowen, 1988). In highly differentiated individuals, their intellect functions based on objective assessments (Kołbik, 1999), emotions are consciously experienced, close relationships are established without fear, in the manner allowing them to take an I position in accordance with one’s personal beliefs and convictions (Bowen, 1978). One’s level of differentiation of self is also reflected in the satisfaction in close relationships, such as a marital relation, and in functioning under stress. Highly differentiated individuals establish more flexible boundaries in marriage (Kaleta, 2011), whereas poorly differentiated individuals respond to tension in the dyad with withdrawal from interaction, keeping distance or seeking excessive intimacy with the spouse or other individuals, which leads to problems in the relationship. In stressful situations, highly differentiated individuals are more resilient to stress and develop fewer dysfunctional symptoms than poorly differentiated individuals (Kerr, Bowen, 1988). Theoretical grounds allow us therefore to link differentiation of self to both variables, marital satisfaction and stress, and these relationships have already been the focus of empirical analysis. Studies on differentiation of self and marital satisfaction have led to the general conclusion that the higher the level of differentiation, the more satisfied the spouses are with their relationship. Emotional cut-off appears to play a particularly important role (Skowron, Friedlander, 1998; Skowron, 2000; Peleg, 2008; Knerr, Bartle-Haring, 2010), which points to the fundamental importance of emotional availability during creating and maintaining a satisfactory relationship. Moreover, higher differentiation allows for more explicit and satisfying communication of spouses regarding their sexuality, which increases satisfaction with sexual life and their general marital satisfaction (Timm, Keiley, 2011). A link was also revealed between higher differentiation of self, measured as lower emotional reactivity and triangulation in the family of origin with the actual marital functioning, that is with less emotional flooding during quarrels and higher satisfaction in the dyad (Gubbins, Perosa, Bartle-Haring, 2010). As far as relationships of the differentiation of self and stress are concerned, their analysis was most often performed in the context of environmental or situational stress. Tuason and Friedlander (2000) failed to record any relationships between exposure to stress (according to the list of stressful life events) and the level of differentiation of self. Murdock and Gore (2004) on the other hand, have shown that differentiation of self is significantly (negatively) linked with perceived stress, related with experiencing various stressful events, and with coping strategies. In subsequent analyses, the authors (Krycak, Murdock, Marszalek, 2012) explained that the measured type of stress – actual stress (stressful events) or perceived stress (experiencing its impact) plays a significant role. When individuals in a specific situation of receiving genetic counselling and/or testing for predisposition to breast cancer or colorectal cancer were studied, differentiation of self was negatively linked to experiencing stress (measured level of intrusive thoughts and avoidance; Bartle-Haring, Gregory, 2003). Also in patients with fibromyalgia syndrome (a rheumatologic disorder), differentiation of self was negatively associated with perceived stress related to daily life and evaluation of disease severity (Murray, Daniels, Murray, 2006). Also, differentiation of self correlated with study-related stress: the less reactivity, tendency to engage in emotional cut-off and fusion and the higher ability to take an I position, the lower level of academic stress (Skowron, Wester, Azen, 2004). Studies on acculturative stress on the other hand, highlighted the significance of an I position for a stronger cultural identitfication (Roytburd, Friedlander, 2008). Despite existence of studies linking differentiation to both, marital satisfaction and stress, no relationships between all variables at the same time have been examined. In the literature, despite searching for direct links between differentiation and different variables, this variable has been examined using meditational and moderational models (Murdock, Gore, 2004; Skowron, Wester, Azen 2004; Sandage, Jankowski, 2010; Hooper, Doehler 2011; Krycak, Murdock, Marszalek, 2012; Jankowski et al., 2013). A particularly explicit trend is observed positioning differentiation of self as the mediator for psychological well-being and a buffer for psychological distress (Hooper, Doehler, 2011). Differentiation of self also mediates or moderates relationships between different variables and marital quality, e.g. between forgiveness and marital distress (Dekel, 2010). According to Baron and Kenny (1986), the mediating effect of variable on the relation between two other variables should be tested when there is significant association between these variables, and when proposed mediating variable is linked to other variables (in the described way). As already shown, marital satisfaction and perceived stress are associated, and differentiation of self is separately linked to these variables. As Bowen (1976, 1978; Kerr, Bowen, 1988) and Skowron, Wester, Azen (2004), we assumed that negative linkage between marital satisfaction and perceived stress operates through one’s level of self differentiation. Therefore, it appears legitimate to treat differentiation as a variable mediating between the level of marital satisfaction and perceived stress, and on the basis of analysis presented above, emotional reactivity, an I position, emotional cut-off, fusion with others as well as general level were expected to be significant mediators between these variables. For the evaluation of the role of differentiation of self, a procedure suggested by Baron and Kenny (1986) was used and a model developed by Skowron, Wester and Azen (2004) was adapted. Figure 1 presents the variables and relationships between them. In the suggested model, marital satisfaction is the independent variable, differentiation of self – mediator, whereas perceived stress – dependent variable.

Figure 1. T he model of relationships between variables – adaptation of the model developed by Skowron, Wester and Azen (2004; cf. Hooper, Doehler, 2011; Krycak, Murdock, Marszalek, 2012) In line with assumptions of the procedure for evaluation of the mediating effect, a direct relationship between the predictor and criterion variable, that is between marital satisfaction and perceived stress is tested in path C. Path A assumes a significant relationship between marital satisfaction (independent variable) and differentiation of self (mediator). Path B assumed that differentiation of self is associated with perceived stress with controlled marital satisfaction, whereas in path C’, it was assumed that marital satisfaction is linked to the level of experienced stress with the controlled differentiation of self. Mediating role of the differentiation of self is determined by comparison of indicators in paths C and C’.

Method Sample Purposive sampling method was applied and the sample was composed of married women. Study participants included 239 females, 220 of whom were qualified for the final data analysis. 19 sets of questionnaires were rejected due to missing data or the fact of not being married (maidens, widows or divorced). Participants were aged from 25 to 57 (M = 42.42; SD = 6.75). 40.9% of respondents had completed secondary, 20.3% college and 38.8% higher education. Period over which participants have been married ranged from 1 to 35 years (M = 18.61; SD = 7.57). The majority of women (96.4%) had children, with a mean of 1.81 children (SD = 0.81). Tools In order to measure marital satisfaction, the Well-matched Marriage Questionnaire (KDM-2) developed by Plopa and Rostowski (Plopa, 2008), being a revised version of the questionnaire released in 1980’s by Rostowski was used. It has the purpose of evaluating marital satisfaction treated as a multi-dimensional variable composed of four specific dimensions of the marital interaction, determined as a result of the factor analysis, that is: intimacy, self-fulfilment, similarity and disappointment. These form subscales of the questionnaire which also allows to measure general level of marital satisfaction. The questionnaire is composed of 32 items (each subscale featuring from 7 to 10) respondents are asked to refer to using a 5-level scale determined by the following responses: strongly agree, agree, neither agree nor disagree, disagree, strongly disagree. Reliability coefficients (Cronbach’s alpha) for KDM-2 subscales range from 0.80 to 0.88. In this study, only general marital satisfaction indicator, being the total of scores obtained in individual subscales (in case of disappointment, reversed scores), has been used. It ranges from 32 to 160, and the higher the result, the higher satisfaction from the relationship with the spouse. The level of stress was measured using Perceived Stress Questionnaire developed by Plopa and Makarowski (2010), which not only allows to estimate general stress level, but also specific aspects thereof, that is: emotional tension, external stress and intrapsychic stress. The questionnaire is composed of 27 items, each subscale corresponding to a particular stress dimension featuring 7 items, and 6 items for the lying scale, detecting the tendency to present things untruthfully in favourable light. Respondents have to choose one response from 5 possibilities (true, rather true, hard to say, rather false and false) which are assigned from 5 to 1 points, and in case of some statements, reversed score is applied. Reliability coefficients for specific dimensions achieve satisfactory values (Cronbach’s alpha ranges from 0.697 to 0.811). Overall score ranges between 21 and 105, and the higher the score, the higher level of stress is displayed by a respondent. In the studies referred to above, general level of stress was considered only. Level of differentiation of self was measured using DSI-R (Differentiation of Self Inventory – Revised) developed by Skowron and associates (Skowron, Friedlander, 1998; Skowron, Schmitt, 2003), and adapted in Poland by Kriegelewicz (2009). The questionnaire is made of 46 items and allows to estimate the general level of differentiation of self, as well as to measure individual aspects thereof, included in four subscales: emotional reactivity, an I position, emotional cut-off and fusion. The first two subscales feature 11 statements each, the following two – 12 statements each. Respondents have to refer to them using 6-level scale, from 1 (completely false) to 6 (completely true). Possible scores in the emotional reactivity and I position scales range from 11 to 66, whereas in the emotional cut-off and fusion – from 12 to 72. Higher score obtained in the emotional reactivity, cut-off and fusion dimensions means higher levels thereof, whereas in case of the I position – lower level therestrona 310

of, which always corresponds to poorer differentiation of self. Also, the higher the general score (ranging from 46 to 276), the poorer differentiation of self. Reliability coefficient (Cronbach’s alpha) for the entire tool in Polish on the other hand was 0.92, whereas its value for specific scales ranged from 0.78 to 0.85.

Results Table 1 presents coefficients of correlations between marital satisfaction, perceived stress and differentiation of self and dimensions thereof. Table 1. Means, standard deviations and correlations (Pearson’s r) between analysed variables Variables 1. Marital satisfaction 2. Emotional reactivity 3. I position 4. Emotional cutoff 5. Fusion with others 6. Differentiation of Self – general score Perceived stress **p < 0.01

Note. Higher scores on the DSI indicate more emotional reactivity, emotional cut-off, fusion with others, weaker ability to take I position, and lower level of general differentiation of self

As shown in table 1, marital satisfaction displays a statistically significant negative correlation with perceived stress. Marital satisfaction is also significantly linked to the differentiation of self and its components, that is: the higher the satisfaction, the lower emotional reactivity, stronger I position, lower tendency to engage in fusion and emotional cut-off, and generally higher differentiation of self. Poorer differentiation of self in all dimensions (higher DSI scores) on the other hand, is positively linked to perceived stress understood as experiencing emotional tension, intrapsychic stress and external stress altogether. Further data analysis was intended to evaluate the mediating effect of specific dimensions of differentiation of self (each one separately). To that end, a series of hierarchical regressions was performed, summarized in table 2.

General level of differentiation B SE

Table 2. Differentiation of self as a mediator between marital satisfaction and perceived stress – summary of mediation analyses

Results of regression analysis show that high marital satisfaction is associated with low level of difficulties linked to differentiation of self (path A), whereas high level of poor differentiation of self is linked to high perceived stress (path B). Thus – besides a significant relationship between an independent and dependent variable (path C) – two basic conditions of the mediating procedure developed by Baron and Kenny (1986) were met. What is more, the relationship between marital satisfaction and perceived stress was always weaker in the presence of mediators (path C’) than during their absence (path C), and in two instances (of emotional cut-off and general level of differentiation of self) its significance disappeared, which points to a  considerable mediating role of differentiation. In addition, the mediating effect was confirmed by the Sobel test – its value and significance is presented in table 2.

Discussion The purpose of the study was to test the mediating role of the differentiation of self in relation to marital satisfaction and stress perceived by women. Results have shown that differentiation of self is a significant mediator of the relationship between marital satisfaction and stress experienced by female respondents. Emotional reactivity, an I position and fusion mediate in marriage only to some extent, whereas emotional cut-off and general level of differentiation is a complete mediator. Obtained results also allow to integrate separate findings on links between differentiation of self and marital satisfaction and stress. In the conducted study, significant relationships between all dimensions of differentiation and marital satisfaction in women were observed, which is worth comparing with previous studies. In an American study, of all individual dimensions of differentiation of self only less emotional cut-off was the predictor of higher marital satisfaction (Skowron, Friedlander, 1998; Skowron, 2000; Knerr, Bartle-Haring, 2010). Significant relationships between all components of the differentiation and marital satisfaction were obtained, either when the total score from four DSI subscales was considered (Skowron, Friedlander, 1998), or when scores of spouses were taken together (Skowron, 2000). In an Israeli study (Peleg, 2008), marital satisfaction in women was significantly linked to cut-off only, whereas in men, emotional reactivity and an I position were also important. In an Iranian study (Yousefi et al., 2009) on the other hand, all dimensions of the differentiation showed positive correlations with marital satisfaction. Therefore, relationships between analysed variables show both cross-sexual and cultural differentiation. Relationships found in this study between marital satisfaction and all aspects of differentiation of self in women may be explicated by referring to selected mechanisms. Firstly, the discussed study revealed negative link between marital satisfaction and emotional reactivity. Converging outcomes are provided by researchers dealing with psychophysiology of marriage who have demonstrated that high physiological arousal accompanying emotions experienced during interactions between spouses is a strong predictor of decreased marital satisfaction (Levenson, Gottman, 1983; Gottman, Levenson, 1992). Lower level of emotional flooding during misunderstandings between spouses is, on the other hand, related to higher satisfaction with their relationship (Gubbins, Perosa, Bartle-Haring, 2010). Therefore, excessive emotional arousal and marital satisfaction attenuate one another. Possible interpretation of the above is that in spouses with high reactivity, changes and tensions in the dyad evoke strong feelings and lead to accompanying arousal, which generate fairly unreasonable and extreme evaluations of marriage, making it difficult to function in the relationship in a stable and satisfactory manner. It should be noted, that excessive reactivity primarily involves reacting with fear (Skowron, Friedlander, 1998; Tuason, Friedlander, 2000), and, as found by Gottman and Krokoff (1989), wife’s frequent reactions with fear and sadness are especially unfavourable for long-lasting relationships. What is interesting, this does not apply to anger or contempt, as expressing these feelings requires overcoming the fear of rejection, and thus it apeears to be a component of higher differentiation of Self. An ability to express constructive anger would be more typical of individuals with a strong I position, who in this manner may speak their mind or defend themselves against peer pressure, including pressure of one’s spouse. This cability to take an I position by women was found to be positively linked to their marital satisfaction. What is more, a negative relationship was found to exist between marital satisfaction and emotional cut-off and fusion. According to Bowen (1978), both extreme ways of functioning in relationships are a form of defence against fear, and in the long term they lead to frustration and dissatisfaction with the relationship (Gubbins, Perosa, Bartle-Haring, 2010). Obtained results are coherent with findings reported by Gottman and Krokoff (1989) in their longitudinal study identifying three dysfunctional patterns of marital interactions exerting the most powerful impact on deterioration of marital quality: withdrawal from interaction, defensiveness (which includes whining) and stubbornness. All these attitudes converge with emotional cut-off. Interestingly, marital disagreements and conflicts deteriorating marital satisfaction at a given moment, are not particularly harmful for the relationship longitudinally, unless they are accompanied by withdrawal, defensiveness and stubbornness. In view of the above, emotional cut-off may be understood as a barrier for marital communication and impediment to searching for methods of coping with tension and stress in marriage (Peleg, 2008). Withdrawal from interaction is also linked to a growing feeling of loneliness in the relationship (Gottman, 1999) and it cuts an individual off from possible support of the spouse which is significantly linked to satisfaction with the relationship (Neff, Broady, 2011; Landis et al., 2013). Fusion also leads to problems in the relationship. It refers to individuals who feel completely dependent from their environment and constantly expect satisfaction of their needs and provision of support in close relationships (Kerr, Bowen, 1988). At the same time, due to an autonomy deficit, partners in a fusion may believe that they are utterly responsible for happiness, suffering, mistakes or failures of their spouse. This leads to never-ending series of spouse-addressed accusations and blaming oneself for the inability to satisfy mutual expectations in a satisfactory way (Peleg, 2008). What is more, fusion generates a situation in which individuals lose the sense of personal identity, therefore marital relation may be perceived as a threat to one’s own self. strona 314

Obtained results therefore show that women’s ability to control their emotionality and to establish an intimate bond, at the same time keeping their autonomy and individuality, acting as components of good differentiation of self, is an important element of a successful marriage. These results converge with Bowen’s theory (1978; Kerr, Bowen, 1988), which emphasized that the level of differentiation of self is of fundamental importance for possible experiencing of intimacy and community in the marital dyad, and that marital problems are especially generated when partners are poorly differentiated. Moreover, the level of differentiation of self may mediate in linking marital satisfaction to stress perceived by women. The degree to which specific marital interactions are linked to perceived stress, partially depends on emotional reactivity, the ability to take an I position, tendency to engage in fusion with others and fully on the emotional cut-off. Obtained results may be explicated by indicating the role of differentiation of self in stress management. Firstly, differentiation of self determines the manner of perceiving events (Kerr, Bowen 1988), and studies have confirmed its mediating role between stress events and perceived stress (Krycak, Murdock, Marszalek, 2012). Poorly differentiated individuals are guided by emotions rather than by rational processes in evaluating daily life events, and therefore they are more prone to experience them as stress. Higher differentiation of self, on the other hand, allows to calm down more easily in a stressful situation, behave in a more flexible manner and not surrender to emotions and pressure of the circumstances or other people (Skowron, Friedlander, 1998), which allows to perceive the same events as less stressful. This was revealed in a study on conflicts and interpersonal stress at a workplace (Cavaiola et al., 2012). Individuals displaying more emotional reactivity and cutoff, indicated conflicts with their colleagues, superiors or clients at work as a major source of stress much more often than individuals with less tendency in this respect. In light of the above, constantly fluctuating marital satisfaction depending on current events (Neff, Karney, 2009) in poorly differentiated individuals may, due to high level of anxiety, be assessed as a threat, which serves as ground for evaluating the phenomena as stressful. Second explanation of the mediating role of differentiation of self is related to a theoretical assumption that more highly differentiated individuals use more constructive coping style with stress. Studies have shown that high differentiation of self is related to a reflective coping, whereas poor differentiation, to reactive (emotional) and suppressive styles (Murdock, Gore, 2004). Thus, poorly differentiated individuals are less able to cope with tension in the relationship with their spouse, and while observing their lower effectiveness, they capture themselves as less able and their environment as excessively demanding, which is intensified by stress. What is more, poor differentiation of self makes it difficult to receive social support. From the study and findings arrived at by Krycak, Murdock and Marszalek (2012), it follows that individuals who in their reactions are guided by emotions or tend to engage in cut-off in relationships, considerably lose emotional support of other people. This happens due to distance they develop or due to wearisome nature of behaviours associated with emotional reactivity. Loss of support leads to experiencing psychological distress. Studies have shown that poorer differentiation of self predicts more symptoms of distress (somatization, obsessive-compulsive disorder, interpersonal hypersensitivity, depression and anxiety; Skowron, Friedlander, 1998; Tuason, Friedlander, 2000; Bartle-Haring, Gregory, 2003; Murdock, Gore, 2004; Skowron, Wester, Azen, 2004), which additionally prevent adjustment to a difficult situation. Finally, limitations of the conducted study should be mentioned. One of them was the sampling method, and the fact that the sample was composed of females only. Literature review has shown that relationships between some tested variables were differentiated cross-sexually. Therefore, sex could be a moderating variable, and in subsequent studies men should be considered and differences analysed. Another issue is the cross-sectional character of the study. Due to changes in marital satisfaction and perceived stress, longitudinal study would be more advisable. 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