abstract: The prevalence of chronic illness among children in the United States is on the rise (CDC, 2014). Having a child with a chronic illness can be a substantial source of stress for a couple, including physical, emotional, and financial demands of caregiving as well as difficult decision-making regarding the child’s health (Mayo Clinic, 2015). Coping with such stressors can have a negative effect on the couple’s well-being, and, if not managed within the relationship, can lead to increased negative outcomes for both partners. Partners can, however, learn to cope with stress by engaging in the coping process together with dyadic coping (DC). Couples can engage in positive (i.e., supportive emotion-focused, supportive problem-focused, and delegated) or negative forms of DC. DC has been shown to mitigate stress for couples, while increasing reports of individual well-being (IWB) and relational well-being (RWB), but it has not been examined in the context of couples with a child with a chronic illness. To bridge this gap, the present study examined how couples cope with general stress as well as stress associated with their child’s diagnosis of a chronic illness (CI-related stress) and whether positive DC and negative DC moderate association between stress (general stress and CI-related stress) and well-being (IWB and RWB). Consistent with hypotheses, there were significant main effects of both types of stress (general and CI-related stress) on both types of well-being (IWB and RWB). Contrary to the hypotheses that DC (positive DC and negative DC) would moderate the associations between both types of stress and both types of well-being, only one significant interaction was found between CI-related stress and negative DC on IWB. Implications of these findings are discussed. / Dissertation/Thesis / Masters Thesis Counseling 2016

Background: It has been proposed that depression plays a role in how psoriasis affects quality of life. However, primary data are limited. Objective: To investigate the role depression plays in how patients experience psoriasis. Methods: Cross-sectional study conducted between January and May 2005. Recruitment of 265 adults with prevalent psoriasis through Internet advertisements. Standardized assessment of depressive symptoms, health-related quality of life (HRQL), illness-related stress, and clinical severity of psoriasis using validated scales. Results: Thirty-two percent of all participants screened positive for depression. We observed a graded relationship between depressive symptoms and HRQL impairment (p < 0.001). Only 16.5% of those with high depression scores were currently treated for depression. Both dissatisfaction with antipsoriatic treatment and illness-related stress were highly associated with depression. After adjustment for HRQL, patients with more severe psoriasis were less likely depressed, although this association failed to reach statistical significance (multiadjusted odds ratio 0.37; 95% CI 0.13–1.02; p = 0.06). Conclusion: Patients with high subjective distress and low objective measures of psoriasis should be evaluated for depression. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.

Background: It has been proposed that depression plays a role in how psoriasis affects quality of life. However, primary data are limited. Objective: To investigate the role depression plays in how patients experience psoriasis. Methods: Cross-sectional study conducted between January and May 2005. Recruitment of 265 adults with prevalent psoriasis through Internet advertisements. Standardized assessment of depressive symptoms, health-related quality of life (HRQL), illness-related stress, and clinical severity of psoriasis using validated scales. Results: Thirty-two percent of all participants screened positive for depression. We observed a graded relationship between depressive symptoms and HRQL impairment (p < 0.001). Only 16.5% of those with high depression scores were currently treated for depression. Both dissatisfaction with antipsoriatic treatment and illness-related stress were highly associated with depression. After adjustment for HRQL, patients with more severe psoriasis were less likely depressed, although this association failed to reach statistical significance (multiadjusted odds ratio 0.37; 95% CI 0.13–1.02; p = 0.06). Conclusion: Patients with high subjective distress and low objective measures of psoriasis should be evaluated for depression. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.