The role of pain behaviors in the modulation of marital conflict in chronic pain couples.

Sixty-one married male chronic benign back patients and their spouses were recruited in order to examine the relationship between marital conflict/stress and patient pain behaviors. The results suggest that marital conflict in pain couples is associated with increases in subsequent display of pain behaviors which, in turn, are associated with greater negative affective responses and more punitive behaviors by the spouse. A positive association was found between punitive spouse behaviors and patient physical and psychosocial impairment. The findings are discussed in terms of their clinical implications and the need for further experimental study of these relationships.