Symptom Study in Context: Effects of Marital Quality on Signs of Parkinson’s Disease during Patient-Spouse Interaction

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Abstract
Hypokinesia, the inability to initiate or maintain movement, represents one of the most disabling aspects of Parkinson's disease (PD), and displays intriguing moment-to-moment variability from environmental stressors. Correlates of orofacial hypokinesia (characteristics of spontaneous eye blink and speech) were coded from videotaped interactions for PD patients in maritally distressed and nondistressed dyads. Significant changes occurred only for the patients in distressed relationships on the two strongest neurophysiologic measures of orofacial hypokinesia, rate and duration of spontaneous eye blink. Further analyses suggest two possible explanations for these temporal symptom changes. Distressed spouses may exacerbate symptoms by exposing the patient to negativity. Alternately, nondistressed spouses may compensate for the demands of the interactional task by assuming a greater share of the conversation relative to the patient's contribution. Results are linked to existing literature; the role of social and familial support in chronic illness is discussed.