1. Stability of mental health among couples over 5 years: does one partner influence the other one? Stéphane Cullati a,b, Delphine Courvoisier a, Claudine Burton-Jeangros c a Division of clinical epidemiology, Geneva University Hospitals & University of Geneva b Quality of care Unit, Geneva University Hospitals c Department of Sociology, University of Geneva

2. 2 Introduction Research on health outcomes has emphasized that individuals are dependent of their significant others, such as partner, children, parents, etc. (Monden 2007). For example: –social position on mortality, –psychological trait on health outcomes, –depression on cognitive functionning. Partner mental health may have an impact on the mental health of the other member of the couple.

3. 3 Introduction Examining the impact of the intraindividual variability of mental health on each partner has been little studied. How to study the intraindividual variability across time? –Multi-level modeling –Correlations between standard deviations But stable part is not excluded The latent state trait models represent one solution to model the variable part, by excluding the stable part.

4. 4 Evolution of mental health among couples Questions: 1.Is mental health stable or variable over time among women and men living together? 2.Does mental health of one partner vary due to variation of mental health of the other one?

5. 5 Method Population: adults, living in Switzerland, participating to the national Swiss Panel Households survey (data available at http://www.swisspanel.ch). Selection criteria: –respondents living in couple, married or not –who answered to 5 waves between 2000 and 2004, without interruption (N=624):  Sample of 624 couples; women were 44.2 years old (SD=12.2) and men: 46.8 years old (SD=12.2) Mental health was assessed by two indicators: depression, optimism (11-points Likert items, from 0 to 10)

6. 6 Model To assess variability of mental health through time, we used latent state trait to distinguish between stable component and momentary variations of mental health for each partner: –Stable component was represented by 1 latent variable –Situational component by 5 occasion-specific latent variable To assess relationship between mental health of both partner, we used a multiconstruct latent state trait (Schermelleh-Engel 2004).

7. 7 Y ik, i = 2 indicators (Y1 depression, Y2 optimism) k = 5 occasions (waves) Y 11 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25 (Steyer et al. 1992; Steyer et al. 1999 )

8. 8 Y ik =  ik + ik T Y 11 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25  T1T1         

9. 9 Y ik =  ik + ik T + iik IST i Y 11 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25  T1T1          IST 2     

10. 10 Y 11 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25  T1T1          IST 2      Y ik =  ik + ik T + iik IST i +  ik W k W1W1     W2W2     W3W3     W4W4     W5W5    

11. 11 Y ik =  ik + ik T + iik IST i +  ik W k + E ik Y 11 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25  T1T1          IST 2      W1W1     W2W2     W3W3     W4W4     W5W5     E 11 E 21 E 12 E 22 E 13 E 23 E 14 E 24 E 15 E 25

12. 12 Y 11 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25  T1T1          IST 2      W1W1     W2W2     W3W3     W4W4     W5W5     E 11 E 21 E 12 E 22 E 13 E 23 E 14 E 24 E 15 E 25

13. 13 Y 11 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25  T1T1          IST 2      W1W1     W2W2     W3W3     W4W4     W5W5     E 11 E 21 E 12 E 22 E 13 E 23 E 14 E 24 E 15 E 25 Y 11 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25  T1T1          IST 2      W1W1     W2W2     W3W3     W4W4     W5W5     E 11 E 21 E 12 E 22 E 13 E 23 E 14 E 24 E 15 E 25 Women Men

14. 14 Model identificationX2X2 dfX 2 /dfCFIRmsea 1 Measurement invariance271.601961.390.9850.025 2 Autoregressive structure, parameters all equals 247.431931.280.9890.021 2a Correlation of trait between partners 237.101921.240.9910.020 2b Correlation between partner's O w 246.051921.280.9890.021 2c Cross-lagged regression (O w at T on partner's O w at T+1) 245.701921.280.9890.021

15. 15 Couples (N=624) WomenMen Depression ConsistencyIsconSpecificityReliabilityConsistencyIsconSpecificityReliability W1.66.69 W2.62 W3.65.64 W4.70.71 W5.63.60 Optimism W1.57.52 W2.59.52 W3.63.59 W4.60.55 W5.61.59

16. Couples (N=624) WomenMen Depression ConsistencyIsconSpecificityReliabilityConsistencyIsconSpecificityReliability W1.51.66.53.69 W2.49.62.51.62 W3.52.65.52.64 W4.56.70.58.71 W5.50.63.49.60 Optimism W1.22.57.18.52 W2.25.59.23.52 W3.23.63.20.59 W4.24.60.22.55 W5.24.61.20.59

17. Couples (N=624) WomenMen Depression ConsistencyIsconSpecificityReliabilityConsistencyIsconSpecificityReliability W1.51.15.66.53.16.69 W2.49.13.62.51.12.62 W3.52.13.65.52.12.64 W4.56.15.70.58.13.71 W5.50.13.63.49.11.60 Optimism W1.22.16.19.57.18.16.52 W2.25.13.20.59.23.12.16.52 W3.23.22.18.63.20.24.14.59 W4.24.17.19.60.22.17.15.55 W5.24.19.61.20.26.14.59

18. 18 Y 11 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25 Y21Y21 Y12Y12 Y22Y22 Y13Y13 Y23Y23 Y14Y14 Y24Y24 Y15Y15 Y25Y25 1.99 0.49 1.62 0.52.25.22.23.22 Women Men 0.26 M= 8.67 M=8.05.58.50.35.49

19. 19 Question 1: Is mental health stable or variable over time among women and men living together? Men and women have a high level of mental health (8.67 and 8.05). Women have a more variable mental health than men. Both men and women have a mostly stable mental health: about 75% of the variance of the observed variables depended on a stable trait of mental health and 25% were accounted by situational influences. Autoregressive influence of one occasion-specific variable upon the next one were significantly different from zero, albeit low at.2 for both sexes.

20. 20 Question 2: Does mental health of one partner vary due to variation of mental health of the other one? Stable mental health of one partner impact on the stable component of the other one. Deviation of mental health in one partner does not impact on those of the other one neither during the same year, nor the next year.

21. 21 Discussion A multi-construct latent state trait model was appropriate to examine 3 hypothesis: –reciprocal influences of the stable mental health, –reciprocal influences of the state mental health, –cross-lagged influences of the state mental health. This model allowed solving whether the stable influences or the unstable influences were decisive on the partner. Evolution of mental health of respondents is influenced by their own history and by the history of the stable part of their partner's mental health. Change of mental health of one partner does not explain change of mental health of the other one.

22. 22 Discussion Other longitudinal studies examined cognitive functionning and found an influence between partner among older (Gerstorf 2009) or ethnic subgroups (Hinton 2009) whereas our study examined the general population. Further resarch is needed to examine change among subgroups (younger vs older, educated vs less educated).

23. 23 Discussion Strengths: –measure of mental health includes positive and negative states of mood –precisely assess the reliability of the construct –significant number of waves Limitations: –selection bias of the most stable respondents (the more healthy?) –acceptable reliability (.6) –time frame between each occasion is 1 year –high attrition of the Swiss Households Panel between 1999 and 2004.

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