Mental Health 513others, more depression, and worse diabetes
control (Helgeson & Fritz, 1996). Interper-
sonal stressors explained the link of unmiti-
gated communion to increased depression
and poor control over diabetes. Presumably,
those characterized by unmitigated com-
munion were taking care of others at the ex-
pense of taking care of themselves.Caregiving
Aside from the personality trait of unmiti-
gated communion, the caregiving aspect of the
female gender role may be linked to depression.
People characterized by unmitigated commu-
nion may be more likely to be caregivers; how-
ever, people can end up in the caregiver role
regardless of their level of unmitigated com-
munion. Events such as a spouse becoming ill,
parents growing older and needing care, and
children becoming sick can happen to anyone.
A review of the literature on parents of chil-
dren with cancer shows that mothers are more
distressed than fathers (Clarke et al., 2009).
It is not clear if these differences are due to a
general sex difference in distress or to women
being more distressed than men when they
are caregivers. Women traditionally shoulder
more of the burden of caregiving responsibili-
ties than men. Caregiving is also more likely
to lead to distress in women than in men.
A longitudinal study of dual-earner couples
who transitioned into caregiving showed that
the transition led to a greater increase in dis-
tress among men than women (Chesley &
Moen, 2006). One reason may be that some
women decrease or cease employment when
they become caregivers (Pavalko & Woodbury,
2000), whereas men are more likely to ob-
tain assistance with caregiving (Yee & Schulz,
2000). In a meta-analytic review of the care-
giving literature, women reported greater bur-
den than men (d=+.34), greater depression
than men (d=+.34), and a greater number ofUnmitigated communion is also associ-
ated with rumination (Nolen-Hoeksema et al.,
2008). However, the nature of the rumina-
tion may be more about other people’s prob-
lems than one’s own. Two laboratory studies
showed that people high in unmitigated com-
munion ruminate about others’ problems
(Fritz & Helgeson, 1998). In one study, a con-
federate disclosed a problem to the partici-
pant. In the second study, a friend disclosed a
problem to the participant. Participants who
scored high on unmitigated communion re-
ported more intrusive thoughts about the dis-
closer’s problem two days later, whether the
discloser was a friend or a stranger.
Consistent with the differential vulner-
ability hypothesis, some evidence suggests
that people who score high on unmitigated
communion are more reactive to interper-
sonal stress. Two studies of college students
and one study of women with fibromyalgia
have shown that interpersonal stress is more
strongly related to distress among individu-
als high rather than low in unmitigated com-
munion (Nagurney, 2007, 2008; Reynolds
et al., 2006). Similar findings appeared in a
study that measured a construct related to
unmitigated communion, interpersonal sen-
sitivity (how much feelings and behavior of
others affect the self). In a study that involved
12 weekly phone calls with adult women who
had osteoarthritis or rheumatoid arthritis,
the relation of interpersonal stress to nega-
tive affect was stronger for those who scored
high on interpersonal sensitivity (Smith &
Zautra, 2002).
The vulnerability to interpersonal
stress has implications for the self-neglect
aspect of unmitigated communion. In a
study of adolescents with diabetes, older
adolescents (ages 15 to 18) who scored high
on unmitigated communion reported being
more upset by stressful events that involvedM13_HELG0185_04_SE_C13.indd 513 6/21/11 12:55 PM