"Clingy” spouses - whether spending every waking moment with their partners or constantly telephoning when they’re not together - are at greater risk for heart problems and poor mental health after their spouses die, according to new research from psychologists at Rice.
The study, "Attachment orientations and loss adjustment among bereaved spouses,” examined mental and physical health outcomes for people who recently lost a spouse.
"Based on our previous work, we know that there is a link between bereavement and levels of inflammation in the body, which can ultimately result in an elevated risk of heart problems,” said Angie LeRoy, a postdoctoral research fellow at Rice. "We wanted to figure out whether being a ’clingy’ spouse or a more ’distant’ one puts a person at greater risk for heart disease after their spouse is gone.”
People display different levels of anxiety or avoidance when it comes to relationships with their partners, LeRoy said. For example, researchers refer to what some people might call "clingy" spouses as "anxiously attached," because they tend to reach out to their partners excessively in times of need and they fear abandonment. By comparison, spouses who are "avoidantly attached” are less needy and more distant, preferring to handle stress on their own rather than overly relying on their partner.
"These differences in how people relate to their romantic partners - for example, feeling a great fear of abandonment - tends to develop from childhood experiences with early caregivers,” LeRoy said.
To conduct the study, the researchers recruited 100 people who had lost a spouse three months earlier and administered questionnaires about mental health. They also examined blood draws to look for risk factors for heart trouble, including the presence of pro-inflammatory cytokines , an indicator of inflammation.
The researchers found that anxiously attached people (the "clingy" type) had much greater risk for higher levels of inflammation in their blood. That conclusion was reached even after researchers controlled for a number of other factors including age, gender, sleep quality and health behaviors like exercise, smoking and drinking alcohol. These anxiously attached spouses also reported not only greater symptoms of grief, but also worse mental and physical health when compared with less anxiously attached people.
In contrast, the avoidantly attached spouses (the more distant type) did not exhibit the same heightened inflammatory response; in fact, they reported better mental and physical health outcomes after losing a spouse, compared with those of less avoidantly attached people. The researchers said this could mean that the distant types are more resilient to the stress of bereavement right after a loss.
"Only time will tell whether these distant types continue to do better the longer the bereavement period goes on,” LeRoy said.
The exact ways relationships influence health are unclear, said Chris Fagundes, an associate professor of psychology at Rice and the principal investigator for the study. He said that certain behavioral characteristics - including differing ways of relating to a spouse or partner - make some people better or worse suited to regulate their emotions, which impacts the level of inflammation in the blood. The ability to regulate emotions and stay calm has been linked to better health outcomes, according to Fagundes’ previous research.
"For anxiously attached individuals who fear abandonment, the loss of a spouse is pretty much their worst fear come to life,” Fagundes said. "Meanwhile, avoidant people learned at some point in their lives that the best way to protect themselves is keeping their emotional distance, even from their spouses. Although this avoidant behavior isn’t usually considered a good thing, we did find that these individuals appeared far less susceptible to the negative health risks associated with losing a spouse.”
The researchers hope this work will shed light on which people have greater risk for heart problems in the days and weeks following the death of a spouse. They said future work will focus on the long-term effects of bereavement, including more in-depth exploration of patients’ mental and physical health.
"If we are able to identify who is most at risk for mental and physical health problems immediately after the loss, we will be able to deliver appropriate care sooner,” Fagundes said. "In addition, by knowing the psychological makeup of those most at risk, we will be able to develop tailored interventions that take into account the individual needs of each widow(er). Studies like this get us one step closer to making precision medicine a reality in mental health care, which is a national priority.”
The paper was co-authored by Tess Gabert, a medical student at Brown University; Luz Garcini, an assistant professor at UT Health San Antonio; Kyle Murdock, an assistant professor at Pennsylvania State University; and Jacoba Heijnen, an immunologist at University of Texas MD Anderson Cancer Center. These co-authors completed their research for the paper while working or studying at Rice.