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Recent research suggests that marital quality predicts the survival of patients with heart failure (HF), and it is hypothesized that a communal orientation to coping marked by first-person plural pronoun use (we talk) may be a factor in this. During a home interview, 57 HF patients (46 men and 16 women) and their spouses discussed how they coped with the patients' health problems. Analysis of pronoun counts from both partners revealed that we talk by the spouse, but not the patient, independently predicted positive change in the patient's HF symptoms and general health over the next 6 months and did so better than direct self-report measures of marital quality and the communal coping construct. We talk by the patient and spouse did not correlate, however, and gender had no apparent moderating effects on how pronoun use predicted health change. The results highlight the utility of automatic text analysis in couple-interaction research and provide further evidence that looking beyond the patient can improve prediction of health outcomes.

We investigated first-person plural pronoun use (we-talk) by health-compromised smokers and their spouses as a possible implicit marker of adaptive, problem-resolving communal processes. Twenty couples in which one or both partners used tobacco despite one of them having a heart or lung problem participated in up to 10 sessions of a smoking cessation intervention designed to promote communal coping, where partners define smoking as "our" problem, rather than "your" problem or "my" problem, and take collaborative action to solve it. We used the Linguistic Inquiry Word Count automatic text analysis program to tabulate first-person pronoun use by both partners from transcripts of a pretreatment marital interaction task and later intervention sessions. Results indicated that pretreatment we-talk by the patient's spouse predicted whether the patient remained abstinent 12 months after quitting, and residualized change in we-talk by both partners during the course of intervention (controlling for baseline levels) predicted cessation outcomes as well. These findings add to evidence regarding the prognostic significance of partner we-talk for patient health and provide preliminary documentation of communal coping as a possible mechanism of change in couple-focused intervention.

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Psychological distress and marital quality were assessed with male (n=128) and female (n=49) congestive-heart-failure patients and their spouses. Hopkins Symptom Check List-25 scores were in the distressed range for 57% of patients and 40% of spouses. This role difference was greater for men than women, and a gender difference (more distress in women than men) was greater for spouses than patients. The patient's distress, but not the spouse's, reflected the severity of the patient's illness, and distress for both partners correlated negatively with ratings of marital quality. Female-patient couples reported better relationship quality than male-patient couples, however, and a mediation analysis indicated that the gender difference in spouse distress could be explained by marital quality. Results highlight the contextual nature of CHF distress and suggest that role differences in distress vary by gender.