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Journal of Clinical Psychology in Medical Settings, Vol 4, No.

4, 1997

Introduction to Special Issue


Intimate Relationships and Health: Research and
Practice
Approximately 100 million people who live in the United States suffer
from some type of chronic illness such as diabetes or arthritis. Although
the chances of acquiring a chronic illness increase with age, three-quarters
of those who currently fall into this group are persons under age 65. It is
estimated that by the year 2030, approximately 150 million Americans will
suffer from some type of chronic condition. In 1990, the total costs for
people with chronic conditions amounted to approximately $659 billion,
which includes $425 billion for direct health care costs and $234 billion in
indirect costs such as time lost from work (Hoffman, Rice, & Sung, 1996).
People with chronic conditions do not exist within a vacuum: they are wage
earners, have ongoing associations with health care professionals, and have
families. Consequently, chronic illness affects many different systems within
our society and will likely continue to have increasing and alarming effects
given the above statistics.
The focus of this special issue is the reciprocal association among illness and intimate relationships. The articles in this issue address the effects
of illness on intimate relationships, as well as how relationship status (i.e.,
being or not being in an intimate relationship) and relationship quality
(how satisfying the relationship is) affect disease and health status.
Included in this issue are three empirical investigations of the impact
of a chronic illness on relationship functioning. Levin, Sher, and Theodos
explore how agreement or disagreement in coping strategies between a husband and a wife affects both psychological and relationship distress in
couples coping with infertility. Schmaling, Afari, Barnhart and Buchwald
investigate the association among disease severity, medical utilization, and
relationship satisfaction among couples in which one person has asthma.
Romano, Turner, and Jensen examine the intimate environments of patients with chronic pain and their spouses and how they differ from those
of couples without health problems. Additionally, O'Mahoney and Carroll
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Introduction to Special Issue

present a comprehensive review and integration of the literature on the


impact of breast cancer on relationship functioning.
Two articles explore how relationship status or intimacy factors (such
as satisfaction, excitement, and closeness) covary with illness and illness-risk
behaviors. Rankin-Esquer, Miller, Myers, and Taylor examine the impact
of marital status on disease outcomes in a population-based study of persons with coronary heart disease. McNeal investigates relationship variables
which may hinder condom use among gay male couples, thereby increasing
our understanding of factors associated with illness-risk behaviors in a highrisk population.
The articles that comprise this issue focus on six disparate medical
populations. The overwhelming conclusion of the articles, taken singly and
as a series, is that health care providers cannot fully comprehend the nature
of illness, its treatment, and its impact if the role of patients' intimate relationships is not addressed.
Tamara Goldman Sher
Karen Schmaling
Guest Editors

REFERENCES
Hoffman, C., Rice, D., & Sung, H. (1996). Persons with chronic illness. Journal of the American
Medical Association, 276, 1473-1479.

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