تعارضات زناشویی و سلامت: فرآیندها و عوامل حفاظتی

Marital conflict has been identified as a risk factor for poor health in marriage partners and their children. However, the mechanisms through which marital conflict influences health have not been fully elucidated. Furthermore, there is variability in health outcomes associated with marital conflict. The current endeavor proposes that the impact of marital conflict on physical health is due, at least in part, to excessive sympathetic arousal and incorporates the Polyvagal Theory to explain how vagal regulation (an index of parasympathetic regulation) may aggregate or attenuate the risk for poor health outcomes in the context of conflict. Examination of intervening variables, such as vagal regulation, allows for elucidation of the relation between marital conflict and health problems in children and adults. Specifically, this paper proposes that individuals with high vagal regulation will be protected from the impact of marital conflict on physical health by the mitigation of detrimental sympathetic arousal, whereas individuals with low vagal regulation will be more vulnerable to the effects of marital conflict on health. Support for this proposition is provided through the presentation of literature on vagal regulation as a protective factor against negative health outcomes in children exposed to marital conflict.

The relation between marriage and physical health has been recognized for many decades and explored in various forms. Initially, it was thought that marital status per se was protective of the health of marriage partners. This idea spawned many large-scale studies examining the relation between marital status and health (e.g., Berkson, 1962, Carter & Glick, 1976, Gove, 1973, Ortmeyer, 1974 and Verbrugge, 1979). Although these studies partially supported the proposed association between marital status and health, they also indicated that the relation was more complex than previous formulations indicated. Following this first generation of research, a movement developed that continues to the present to explore specific characteristics of marriage that relate to the physical health of the partners and children of the marriages. Presently, missing from this literature to our knowledge is an explication of the physiological processes that can account for the relation and particularly those that act as moderators (i.e., factors that change the relation between risk and outcome variables when present; Baron & Kenny, 1986).

Based on this literature, it is apparent that characteristics of marriage, particularly conflict, have impact on the health of individuals. Conflict generally results in physiological arousal, particularly arousal of the SNS. Chronic and sustained SNS arousal is associated with decrements in immune functioning. Such processes likely account at least partially for the relation between marital status and health. Therefore, individuals with adaptive vagal regulation may not only avoid this potentially harmful sympathetic arousal but also may be able to respond in a more adaptive manner using emotional regulation and communication. Thus, examination of vagal regulation in the context of marital conflict may assist in identifying individuals who are at greatest risk for health problems associated with marital conflict and further aid in the prediction of health outcomes among individuals. In addition, preliminarily work by Gottman suggests that vagal regulation could also potentially aid in the prediction of marital outcomes.