MARITAL FIGHTING CAN BRING MORE THAN PSYCHOLOGICAL ILLS

COLUMBUS, Ohio -- Arguments between husbands and wives usually leave them both sick at heart. But new research here suggests such negative behavior within a marriage may actually make people physically ill.

A study of newlywed couples at Ohio State University Medical Center showed that arguments between husbands and wives can weaken their immune systems, making them possiblymore susceptible to illness. According to the study, women are at more risk than are their husbands.

Janice Kiecolt-Glaser, professor of psychiatry and psychology; Ronald Glaser, professor of medical microbiology and immunology; and William Malarkey, professor of internal medicine, reported their findings at a presentation Aug. 20 in Toronto at the annual meeting of the American Psychological Association. The results also appeared in a recent issue of the journal Psychosomatic Medicine.

The results are among the latest supporting a link between stress and physical health, and they surprised the research team whose earlier work on medical students, divorced women, and Alzheimer's disease caregivers has strengthened this new field of psychoneuroimmunology.

"We really didn't expect to see real changes in the first year," Kiecolt-Glaser explained. "This is avery happy, healthy group. Usually, by the end of the first two years of marriage, there is a sharp decline inmarital quality. But during the first year, people still fight with the gloves on."

What the researchers found was that couples in the study who demonstrated negative behaviors toward each other during discussions -- sarcasm, putdowns, overt nastiness and dismissals -- showed indications of a weakened immune system compared to other couples who behaved more positively.

Physicians have known that people facing depression and other psychological problems also seem more vulnerable to illness. In fact, earlier studies -- many by this research team -- showed a host of physiological changes in immune status among people under stress. But what wasn't clear was whether the stress caused the drop in immune function or if the weakened immune function added to the effects of stress.

"It's a chicken-and-egg problem. Which came first?" Kiecolt-Glaser asked. That's why they turned to newlywed couples to answer the question.

They assembled a list of more than 2,200 couples and asked for personal and medical histories and health habits. They ruled out people who smoked, drank excessively, had chronic or acute health problems, or who were undergoing any psychological or psychiatric treatments. They also asked participants to complete a questionnaire that helped gauge their happiness as a couple.

From these, they narrowed the study down to 90 couples. These tended to be about 25 years old, well-educated (more than half were college graduates), and had combined annual incomes of more than $43,000. Most couples had dated for about three years before marriage, and three out of five had lived together before getting married.

The couples were individually brought to the university's Clinical Research Center for a 24-hour period. In each case, the researchers inserted a IV into the husband and wife through which they could take blood samples at regular intervals during the experiment.

After a short adjustment period, a member of the research team met with the couple and began a discussion of topics both had identified as causing problems. The couples then were asked to try to resolve the problems during the next half-hour. During this time, researchers monitored heart rate and blood pressure for each participant, as well as taking blood samples for later analysis. Videotape cameras recorded the couples' discussions, and those tapes were later analyzed to identify whether the couples behaved positively or negatively.

After the experiment, the researchers analyzed the blood samples for specific indicators of immune function. They looked at the level of natural killer cells (NK cells) in the blood, how well blood cells replicate in the presence of two plant chemicals -- Con A and PHA -- and when exposed to a specific monoclonal antibody. They also measured the level of certain white blood cells vital to the immune system -- T-lymphocytes -- and the level of antibodies to a latent Epstein Barr virus.

"We found that couples who were more hostile during the problem discussion also showed greater immunological change after 24 hours together in the Clinical Research Center," they described in their journal article.

The analysis showed that the function of NK cells had fallen, as had other cells' ability to replicate with Con A, PHA or the monoclonal antibody. It also showed that the levels of antibodies to the Epstein Barr virus and the blood pressure readings had increased. All of these indicated a weakened immune response.

What impact such changes have on health is, however, a tougher question.

"Imunologists don't know how much one or more of these different aspects of the immune response has to change before you become at risk for infectious disease," Glaser said. "What we see here as statistically significant may or may not be biologically significant. That's the question we have to solve."

Both Kiecolt-Glaser and Glaser believe the results they've found so far are really an underestimate of what may occur at home.

"What happens in a laboratory setting is a toned down version of what probably happens at home," she said.

John Cacioppo, professor of psychology, and Maryann Chee and Tamara Newton, both postdoctoral fellows in psychiatry, were also part of the research team. The project was supported by the National Institute of Mental Health, the National Center for Research Resources and the National Cancer Institute.

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Contact: Janice Kiecolt-Glaser, (614) 293-5120; Kiecolt-Glaser.1@osu.edu; or Ronald Glaser, (614) 292-5526; Glaser.1@osu.edu.

Written by Earle Holland, (614) 292-8384; Holland.8@osu.edu.