Thoughtful words help ease impact of marital strife on immune system

"Previous research has shown that couples who are hostile to each other show health impairments and are at greater risk of disease," said Jennifer Graham, assistant professor of biobehavioral health, Penn State. "We wanted to know if couples who use thoughtfulness and reasoning in the midst of a fight incur potential health benefits."

Individuals in a stressful situation -- as in a troubled relationship -- typically have elevated levels of chemicals known as cytokines. These proteins are produced by cells in the immune system and help the body mount an immune response during infection. However, abnormally high levels of these proteins are linked to illnesses such as cardiovascular disease, type-2 diabetes, arthritis and some cancers.

"Typically, if you bring people to a lab and put them under stress, either by engaging them in a conflict or giving them a public speaking task, you can see an increase in proinflammatory cytokines such as Interleukin-6 (Il-6) and tumor necrosis factor-alpha (TNF-alpha)," explained Graham.

Using data collected by Janice K. Kiecolt-Glaser, distinguished university professor, S. Robert Davis Chair of Medicine and professor of psychiatry and psychology, Ohio State University College of Medicine; and Ronald Glaser, director, Institute for Behavioral Medicine Research, Kathryn & Gilbert Mitchell Chair in Medicine and professor of molecular virology, immunology and medical genetics, the researchers looked at levels of Il-6 and TNF-alpha in 42 married heterosexual couples both before and after marital discussion tasks.

"We specifically looked at words that are linked with cognitive processing in other research and which have been predictive of health in studies where people express emotion about stressful events," explained Graham. "These are words like -- think, because, reason, why -- that suggest people are either making sense of the conflict or at least thinking about it in a deep way."

For the study, the 42 couples made two separate overnight visits over two weeks. "We found that, controlling for depressed mood, individuals who showed more evidence of cognitive discussion during their fights showed smaller increases in both Il-6 and TNF-alpha cytokines over a 24-hour period," said Graham, whose findings appear in the current issue of Health Psychology.

During their first visit, couples had a neutral, fairly supportive discussion with their spouse. But during the second visit, couples focused on the topic of greatest contention between them.

"An interviewer figured out ahead of time what made the man and woman most upset in terms of their relationship and we gave each person a turn to talk about that issue," said Graham.

Researchers measured the levels of cytokines before and after the two visits and used linguistic software to determine the percentage of certain types of words from a transcript of the conversation.

The researchers' results suggest that people who used more cognitive words during the fight showed a smaller increase in the Il-6 and TNF-alpha. Cognitive words used during the neutral discussion had no effect on the cytokines.

When they averaged the couples' cognitive words during the fight, they found a low average translated into a steeper increase in the husbands' Il-6 over time. There were no effects on the TNF-alpha. However, neither couple's nor spouse's cognitive word use predicted changes in wives' Il-6, or TNF-alpha levels for either wives or husbands.

Graham speculates that women may be more adept at communication and perhaps their cognitive word use had a bigger impact on their husbands. Wives were also more likely than husbands to use cognitive words.

Other researchers in the study include Timothy J. Loving, assistant professor, University of Texas at Austin; Jeffrey R. Stowell, assistant professor, Eastern Illinois University; and William B. Malarkey, professor of internal medicine, Ohio State University College of Medicine.

The National Institutes of Health funded this work.