京都大学 / 0048 / 新制・課程博士 / 博士(人間・環境学) / 甲第19795号 / 人博第766号 / 新制||人||184(附属図書館) / 27||人博||766(吉田南総合図書館) / 32831 / 京都大学大学院人間・環境学研究科共生人間学専攻 / (主査)教授 立木 秀樹, 准教授 櫻川 貴司, 教授 日置 尋久 / 学位規則第4条第1項該当 / Doctor of Human and Environmental Studies / Kyoto University / DFAM

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Stress has traditionally been conceptualized as an intrapsychic phenomenon with detrimental effects on one's physiological and psychological health when coping resources are perceived to be inadequate (Lazarus & Folkman, 1984). However, empirical findings from the past three decades suggest that stressful life events have crossover effects from one person to another, namely from one romantic partner to the other (Bodenmann et al., 2006). Hence, stress experienced in the context of romantic relationships is now better understood as an interpersonal phenomenon with potential negative interpersonal (i.e., relationship satisfaction) and intrapersonal ramifications (i.e., mental health) for both partners (Papp & Witt, 2010; Randall & Bodenmann, 2009; Rusu et al., 2016). Due to the interdependent nature of couple relationships, romantic partners engage in a joint stress management process called dyadic coping in an attempt to restore individual and relational homeostasis, and buffer against these negative consequences (Bodenmann et al., 2006). Emerging research has found that common dyadic coping (CDC), which is a specific form of dyadic coping that occurs when both partners conjointly work together towards mitigating or resolving stressors experienced as a dyad, is the most salient form of dyadic coping for couples facing stressors (Falconier et al., 2015). The romantic attachment framework has provided valuable direction to researchers in their understanding of couples coping with stress as insecure romantic attachment is well-known to interfere with adequate coping (Mikulincer & Shaver, 2016). Given that romantic attachment has been found to be a predictor of relationship functioning and protective factor against mental health disorders (Cassidy & Shaver, 2016; Mikulincer & Shaver, 2016), researchers have been increasingly focused on studying the mechanisms by which they are related. While few studies have examined dyadic coping within a romantic attachment framework (Alves et al., 2019; Fuenfhausen & Cashwell, 2013; Levesque et al., 2017; Levey, 2003; Meuwly et al., 2012), far fewer have narrowed the focus to the ways in which CDC may explain the development of interpersonal (i.e., relationship satisfaction) and intrapersonal outcomes (i.e., mental health) using dyadic data analyses. The unique nature of CDC therefore necessitates research elucidating its role in these links within and between romantic partners. Therefore, the present thesis expands the existing literature on CDC through a romantic attachment lens in two independent yet complimentary studies. The objective of the first study was to evaluate how CDC mediates the relationship between insecure romantic attachment (i.e., attachment anxiety and attachment avoidance) and relationship satisfaction among couples in good health sampled from the community. The objective of the second study was to examine the potential mediational effects of CDC on the association between insecure romantic attachment (i.e., attachment anxiety and attachment avoidance) and mental health indicators of depression and anxiety among couples in which one partner has a diagnosis of cardiac illness. The first study was an investigation of the interpersonal process of CDC as a potential mediator of the association between insecure romantic attachment (i.e., attachment anxiety and attachment avoidance) and relationship satisfaction. The sample consisted of 187 heterosexual couples (N = 374 individuals) from the community. An Actor-Partner Interdependence Mediation Model (APIMeM) was used to assess actor, partner, and direct and indirect effects. Results revealed that the higher men were on attachment avoidance, the less likely they and their partner were to engage in joint coping efforts, which in turn appeared to make men less satisfied with their romantic relationship. However, the degree to which avoidantly attached women felt satisfied with their romantic relationship was solely influenced by their own CDC. Results also showed that the higher men and women were on attachment avoidance, the less they engaged in joint coping efforts, which in turn made them less satisfied with their relationship. Results also revealed that the higher men (but not women), were on attachment anxiety, the less they engaged in CDC, which in turn made men less satisfied with their relationship. Lastly, the higher men were on attachment avoidance (but not women), the less their partner engaged in joint coping efforts, which in turn made men less satisfied with their relationship. In the second study, we examined the potential mediational effects of CDC on the relationship between insecure romantic attachment (i.e., attachment anxiety and avoidance) and mental health outcomes (i.e., depression and anxiety). The sample consisted of 181 patients and their spouses (N = 362 individuals), where one of the partners had received a cardiac diagnosis. An APIMeM was used to test hypothesized relations. While the hypothesized mediations were not confirmed, our results provide partial support to the tested model since patient and spouse attachment anxiety were significantly related to their own mental health. Results also showed that patient and spouse attachment avoidance were associated both with their own and their partner's CDC.

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Yes / The discrepancy between caregiver-ratings and self-ratings of abilities is commonly used to assess awareness in people with dementia. We investigated the contribution of caregiver and dyadic characteristics to the difference in perspective between caregiver-informants and people with dementia about difficulties experienced, when considering awareness of condition. Methods: We conducted exploratory cross-sectional analyses using data from the IDEAL cohort. Participants were 1,038 community-dwelling people with mild-to-moderate dementia, and coresident spouse/partner caregivers. The Representations and Adjustment to Dementia Index (RADIX) checklist reporting difficulties commonly experienced in dementia was completed by 960 caregiver-informants and 989 people with dementia. Difference in scores was calculated for 916 dyads. Demographic information, cognition, informant-rated functional ability and neuropsychiatric symptoms were recorded for the person with dementia. Self-reported data were collected on mood, comorbidity, religion, importance of religion, relationship quality, and caregiver stress. Results: For most dyads, caregivers reported more RADIX difficulties than people with dementia. Caregiver RADIX ratings were more closely associated with informant-rated functional ability and neuropsychiatric symptoms than with cognition. More RADIX difficulties and higher stress were reported by female caregivers. Greater RADIX difference was associated with more caregiver stress, and older age but less depression in people with dementia. Conclusion: Few dyadic characteristics were important, but caregiver stress was higher where caregivers reported more RADIX difficulties and/or the difference in perspective was greater, whereas partners with dementia reported better mood. In addition to offering information about awareness of condition, the caregiver rating and difference in perspectives could indicate where more support is needed. / The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The IDEAL study was funded jointly by the Economic and Social Research Council (ESRC) and the National Institute for Health and Care Research (NIHR) through grant ES/L001853/2. m. ESRC is part of UK Research and Innovation (UKRI). ‘Improving the experience of Dementia and Enhancing Active Life: a longitudinal perspective on living well with dementia. The IDEAL-2 study’ is funded by Alzheimer’s Society, grant number 348, AS-PR2-16-001.

Le post-partum immédiat recèle les fondamentaux de la situation anthropologique, tant pour le bébé que pour la mère et le père et pour le socius. La première matrice de la vie psychique subordonnée à « l’espace dyadique fondamental » procède de la complexe alchimie entre la tessiture de l’investissement maternel et le tempérament et les capacités de régulation du bébé, sans négliger la structure en abyme qui encadre le maternage. A partir d’une clinique étendue dans le champ de la périnatalité cette recherche s’intéresse avec une double méthodologie qualitative clinique (Chapitre 1) et quantitative « outillée » (Chapitre 2 et 3), à la construction d’un espace dyadique, indispensable à la croissance du bébé et à l’investissement maternel, aux vicissitudes de cette construction, à la fonction régulatrice des rituels (relayés par les dispositifs de soins périnataux actuels) qui offrent une scansion au travail de l’enfantement. La communication dyadique entre mère est bébé, dont nous repérons le point d’orgue précoce vers deux mois avec les premières protoconversations, est étudié comme une co-génése transmodale et asymétrique complexe, tant par la psychanalyse que par la théorie de l’attachement, l’approche développementale et les neurosciences. Cet espace unique et original, renouvelé à chaque nouvelle naissance se trame à partir des « les formants de l’investissement maternel », constituée par les vecteurs de la vie psychique et leur combinatoire qui fournissent l’économie nécessaire à la situation maternante. A partir des trois grands courants de pensée conceptuelle et de traitement thérapeutique des troubles du lien précoce nous recensons le formant « en transformation » celui de « la transmission » le formant « en séduction ». Ces avancées théorico-cliniques ont un triple objectif, construire une lecture nouvelle de l’intersubjectivité primaire, de l’édification de la conscience de soi chez le bébé, des mécanisme normaux et pathologiques des identifications et de l’empathie, soutenir le principe des soins, l’édification d’une sémiologie dyadique de la psychopathologie précoce et ouvrir sur un modèle incluant la dimension du précoce et de ses formes de symbolisation dans les cures d’adultes et la prise en charge institutionnelle des populations précaires ou limites. / The immediate postpartum period contains the basics of the anthropological situation, for the baby as well as for the mother and the father and the socius. Psychic life first matrix subject to “the basic dyadic space” comes from the complex alchemy between the range of maternal investment and disposition and the baby’s original control abilities, without ignoring the play within a play which surrounds mothering. From an extended study in the perinatal field, this research takes an interest, with a double methodology of qualitative study (chapter 1) and quantitative “equipped” one (chapter 2 and 3), in the construction of a dyadic space, essential for the baby’s development and for the maternal investment, to this construction ups and downs, for regulatory functions of these rituals (relayed by current perinatal cares) which gives a scansion to childbirth work. Dyadic communication between mother and baby, with a climax around two months old with the first protoconversations, is studied as an asymmetrical transmodal complex co-genesis by both psychoanalysis and attachment theory, by developmental approaches and neurosciences. This unique and original space, which is renewed after every birth, is woven from “the forming of maternal investment” composed from psychic life vectors and their combination which provides enough energy for the mothering situation. From the three major schools of conceptual thoughts and from therapeutic treatments of early relationship disorder, we identify the forming “in transformation”, the “transmission” one and the forming “in seduction”. These breakthroughs have a triple purpose: to built a new reading of primary intersubjectivity, the building of baby’s self-awareness, normal and pathological mechanism of identification and empathy, to support the principle of cares and the edification of a dyadic semiology of the early psychopathology and to lead to a model that will include the aspect of the “early” and its symbolism form in adult therapy and the institutional support of fragile or borderline population.