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LIBRARY

Liingan Stan:
Una-verity

  
     

  

This is to certify that the

thesis entitled

EQUITY, ANDROGYNY, AND ROLE CONFLICT IN THE
MARRIAGES OF MEDICAL STUDENTS AND OF
MEDICAL HOUSE STAFF

presented by

Meredith Ford Taylor

has been accepted towards fulfillment
of the requirements for

Ph.D. degree in Psychology

 

Date flG/Zé‘ /?Z7

0-7639

EQUITY, ANDROGYNY, AND ROLE CONFLICT IN THE
MARRIAGES OF MEDICAL STUDENTS AND OF
MEDICAL HOUSE STAFF

By

Meredith Ford Taylor

A DISSERTATION

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

DOCTOR OF PHILOSOPHY
Department of Psychology

1979

ABSTRACT

EQUITY, ANDROGYNY, AND ROLE CONFLICT IN
THE MARRIAGES OF MEDICAL STUDENTS AND
OF MEDICAL HOUSE STAFF

By
Meredith Ford Taylor

Equity theory postulates that in personal relationships one
experiences equity and feels content to the extent that one
perceives oneself as giving as much as one receives. Defined as a
perceived imbalance between what one gives and receives, inequity
is assumed to produce efforts to restore equity. It was hypoth-
esized that in the case of marriages involving medical trainees,
the medical spouse would typically experience overbenefit (getting
more) and that the non-medical spouse would experience underbenefit
(giving more).

Sex-role socialization theory led to the hypothesis that
female medical trainees experience greater overbenefit than males,
because the women are departing further than the men from their
traditional spouse role. Further, it was proposed that the medical
women's overbenefit would be contingent upon the degree of conflict
that they perceive between what they should be doing as a wife and
what they are doing. This was operationally defined as role

conflict.

Meredith Ford Taylor

It was further hypothesized that level of psychological
androgyny would predict the wife role expectations held by the
medical women. The degree of equity anticipated for husbands of
medical women was hypothesized to vary contingent upon the role
conflict he perceives for his wife. Also, his level of androgyny
was expected to predict his level of expectations for his wife.

Sixty-four women, 4l medical students and 23 house staff,
of the Medical School of University of Wisconsin (Madison) and
their spouses agreed to participate in the study. A matching
sample of male medical students, house staff, and their spouses was
obtained. All subjects received questionnaires composed of (l) the
Traupmann-Utne-Hatfield (1978) Scale, to measure equity; (2) the
Bem Sex-Role Inventory, to measure androgyny; (3) the Taylor Role
Questionnaire developed for this study, to measure expectations and
role conflict; (4) the Spanier Dyadic Adjustment Scale, to measure
marital satisfaction; and (5) nine open-ended questions to evaluate
anticipated restoration of equity in the future. The questionnaires
were separately posted to each spouse and returned by mail. 231
persons completed the study out of 234 who had agreed by telephone
to take part.

The hypothesis that medical spouses would perceive over-
benefit and non-medical spouses would perceive underbenefit was
confirmed. Women in medicine did not perceive themselves as more
overbenefited than men, nor were their husbands experiencing more

underbenefit than female spouses. Instead, the persons experiencing

Meredith Ford Taylor

more inequity were males in medicine (overbenefit) and their non-
medical wives (underbenefit).

Results requiring measurement of role conflict, or dif-
ference between performance and expectation for the wife, were
hampered by the failure of the Taylor Role Questionnaire to achieve
adequate reliability for difference scores for three of its four
Subroles. The reliable Subrole, Emotional/Sexual/Supportive
Partner, yielded a small but statistically significant correlation
between role conflict and perceived inequity, as predicted.

Androgyny failed to predict any variable as hypothesized.
It did not predict expectation level and it did not predict the
difference between performance and expectation (role conflict
score).

Post hoc analyses revealed that although non-medical wives
reported more inequity, they viewed themselves as no less happy
than the other women.

Although the literature indicates that medical training is
stressful for women, in this study a greater degree of potential
strain was exhibited in the marriages of men in medicine and their
non-medical wives. Conclusions suggested an increased focus on
these partners and consideration of fundamental changes which would

alter the stress level presently inherent in medical education.

To
Margaret Ford Taylor
and

Frank William Taylor

Much Loved Parents, Role Models, and Supporters

ii

ACKNOWLEDGMENTS

First of all, I would like to thank my Chairperson, John
Hurley, for being consistently himself. This meant that he
supported my efforts, believed in me when I was having trouble
doing so, and was available to give help any time I requested it.

He assumed that on the whole I knew where I was going and what I
wanted, and I have always appreciated that. His excellent sense of
humor helped me to keep things in perspective, and he was adept at
both cheering and encouraging me during sometimes harried phone
calls from Madison, Wisconsin. For all this, I am most grateful.

I would also like to thank Elaine Donelson, Al Aniskiewicz,
and Ralph Levine for their contributions to my study as committee
members. Lucy R. Ferguson also deserves my thanks for her years
of support. She would have been a valued committee member if a
California sabbatical had not lured her away.

I extend very special thanks to Marjorie Klein, for without
her this study would literally never have been done. Her research
facilities and most of all her empathy and excitement about the
project made it possible to work in Madison, "in limbo." I hope our
personal and professional association may continue and increase in
the future.

Don Fullerton, John Anderson, and Kitty Jewell were of
great help to me in the early days of developing the study. Jane

iii

Traupmann gave many helpful suggestions along the way. Her
enthusiasm for equity research is contagious and I look forward to
our further explorations of the data together. Rob Jones and Jane
Taves helped me to do battle with a variety of computer monsters,
and to find that they are not that bad after all.

I am also extremely grateful to the subjects who partici-
pated in the study. They were almost invariably sympathetic and
cooperative, and they defied the stereotype of the medical trainee
who is too overburdened to volunteer for anything. Nevertheless, I
know it took real effort to make the time.

Finally, of course, I want to thank my family and friends.
My parents deserve and receive a page to themselves. I thank my
brother Bill for continually proving in his own way that family
matters. I am not sure what it means to him, but it means a lot to
me.

I could not list the friends who deserve to be thanked.
Linda Bloom, Roger Faulkner, Howard and Debby Bonem, and Beverly
Youtz, may her memory flourish, will have to stand here to represent
the complete group of friends whose love and support make all the
difference in my life and in my work.

As a postscript, I refer any reader who has come this far
to Appendix A, which is a short tale about how this study probably

began.

iv

TABLE OF CONTENTS

LIST OF TABLES

INTRODUCTION

Roles for Women and Potential Role Conflict
The Woman Physician . . .
Research on Marital Satisfaction .

Equity Theory and Dual- Career Relationships

Extensions of Equity Theory. .

Influence of Role Conflict on Perceived
Equity/Inequity .

Hypotheses Concerning Equity/Inequity
Hypothesis l .

Hypothesis 2
Hypothesis 3
Hypothesis 4 .

Hypotheses Interrelating Equity, Role Conflict
and Androgyny. . . .
Hypothesis 5
Hypothesis 6
Hypothesis 7
Hypothesis 8

Hypotheses Concerning Level of Androgyny of Spouses :

Hypothesis 9
Hypothesis l0.
Hypothesis ll .
Hypothesis lZ.
Hypothesis l3. .
Hypotheses Concerning Restoration of Equity
Hypothesis l4. .
Hypothesis Concerning Demographic Variables
Hypothesis l5. . .
An Attempt to Estimate Predictive Power .
Hypothesis l6 . . . . . .

METHOD

Subjects
Procedure .
Measures

Page

vii

—-l

RESULTS

Statistical Treatment of the Data .

Hypotheses Concerning Equity/Inequity. .
Hypotheses Interrelating Role Conflict, Equity,

and Androgyny
Hypotheses Concerning Level of Androgyny of Spouses
Hypotheses Concerning Demographic Variables .
An Attempt to Estimate Predictive Power

Discussion

The Taylor Role Questionnaire .
Hypotheses Concerning Equity/Inequity. .
Hypotheses Interrelating Role Conflict, Equity,

and Androgyny
Hypotheses Concerning Level of Androgyny of Spouses
An Attempt to Estimate Predictive Power . .

Conclusions
NOTES
REFERENCES .
Appendix
A. A CAUTIONARY TALE .
B GENERAL INSTRUCTION SHEET
C. INTRODUCTION AND CONSENT FORM .
D DEMOGRAPHIC GENERAL INFORMATION SHEET
E. BEM SEX-ROLE INVENTORY
TAYLOR ROLE QUESTIONNAIRE
G. TRAUPMANN-UTNE-HATFIELD (1978) SCALE
H. SPANIER (1976) DYADIC ADJUSTMENT SCALE .
I. OPEN-ENDED QUESTIONNAIRE
J. STRESS ADJUSTMENT SCALE .
K. FIRST LETTER TO SUBJECTS
L. SECOND LETTER TO SUBJECTS

vi

109
111
113
116
119
122
142
158
164
158
171
173

Table

10.

11.

LIST OF TABLES

Items Included Within Subroles of the Taylor
Role Questionnaire (Wording Given for Wife's
Form) . . . . . .

Standardized Item Alphas: Internal Reliability of
the Four Subroles of the Taylor Role
Questionnaire . . . . .

Correlation Coefficients Between Subrole Scales of
the Taylor Role Questionnaire (TRQ)

Traupmann-Utne-Hatfield (1978) Scale Scores

Comparing Medical Spouses and Non-Medical Spouses .

Traupmann- -Utne- Hatfield (1978) Scale Scores
(Females versus Males) . . .

Traupmann-Utne-Hatfield (1978) Scale Scores:
Medical Students and House Staff and Their
Non-Medical Spouses . . . . . .

Traupmann-Utne-Hatfield (1978) Scale Scores
Comparing Medical Persons, Non-Medical Persons,
and Dual-Medical Couples . .

Taylor Role Questionnaire Scores for All Females:
Role Conflict Score (Performance Minus
Expectations) .

Taylor Role Questionnaire Scores for All Males:
Role Conflict Score (Performance Minus
Expectations) .

Female Medical Persons and Their Spouses: TRQA
Scores--Level of Expectations . . .

Female Medical Persons and Their Spouses: TRQc-A

Scores-~Performance Minus Expectation (Role
Conflict) . . . . .

vii

Page

49

51

53

6O

61

63

65

67

68

73

75

Table Page

12. Relative Predictive Power for Variables in this
Study: Dependent Variable--Marital Satisfaction
(Score on Spanier Dyadic Adjustment Scale) . . . 79

13. Dyadic Adjustment Scale Scores Comparing Medical

Persons, Non-Medical Persons, and Dual-Medical
Couples . . . . . . . . . . . . . 85

viii

INTRODUCTION

Roles for Women and Potential Role Conflict

 

In the United States today the majority of married women
work outside the home. In March, 1977, over 22 million married
women were in the work force. Of these women, half were mothers
with children under the age of eighteen (U.S. Department of Labor,
1978b). There is perhaps no better illustration of the fact that
at least statistically, the "typical" married woman is no longer
following her traditional social role.

This change, however, does not imply an abandonment of the
traditionally expected roles for women. It would be more accurate
to say that "appropriate behavior“ for women has become a contro-
versial subject, one which can generate confusion and conflict,
especially for the woman herself.

In the traditional framework, the woman's first respon-
sibility of course was to the three roles of wife, housewife, and
mother. Any work outside the home took place before marriage
(Lewis, 1978). Over the years, most American women have worked as
a matter of necessity, because the family needed money and one
income was not sufficient (U.S. Department of Labor, 1978a). In
many cases the job was of relatively low status and low pay. In
this instance (still often true) the woman's primary commitment

continued to be to the family--her role as worker was, in a sense,

to be "better" in the roles of wife and mother. In this way she
was more or less within traditional expectations.

The career employed woman, however, is in a different
situation. Her work involves her at a professional level in some-
thing which she finds intrinsically satisfying. A career is not
just "for the family,“ it requires an investment of energy and
psychological commitment. It may also require far more than 40
hours per week.

At this point the conflict of "appropriate" roles for women
may begin. Alpenfels (1962) expressed it: "The woman who has a
profession but no husband or children nevertheless continues to
feel somewhat less than a woman. And the woman who has both a
husband and children but no profession continues to feel somewhat
less than a person" (p. 85). But presumably the issue is not
either/or, but how to manage all of the potential roles of career
worker, wife, housewife, and mother. The conflict, however, can
remain. Citing Coser and Rokoff (1971), Cummings (1977) commented
" . . . women are caught in a double bind. If they have small
children and continue to work, they are considered unfit mothers.
If they stay home to care for them, they are considered unfit
careerists" (p. 71). As St. John-Parsons (1978) pointed out, it is
still assumed that for a woman the family will always come first.
It is also assumed that for a true career person (i.e. a man) the
career will come first.

Sales (1978) defined this double bind as an example of

role conflict: "any situation in which incompatible expectations

 

are placed on a person because of position membership" (p. 159).
She distinguished between two forms of role conflict. The first
can be construed as somewhat the more psychological and internalized,
though there are certainly ample social pressures to support it.
The "good" woman is expected to be nurtUrant, self-sacrificing,
passive, and emotionally available. The "good" career person,
however, may be expected to be competitive, analytic, aggressive, and
to make independent judgments. One can try to compartmentalize life,
but as Sales (1978) expressed it, "It is hard for a woman who is
independent and assertive at work to become the compliant wife on her
return" (p. 159).

Sales (1978) identified a second kind of role conflict
which is rooted more in the logistics of daily life. Someone must
perform the tasks inherent in the roles of wife, housewife, and
mother, be it husband, wife, or a paid housekeeper. The solution to
this dilemma has predominantly been that the wife/mother assumes the
role of career person in addition to the other three roles. This is
true both for working class women and for professional women
(Bryson, Bryson, & Johnson, 1978; Lein, et al., 1974; St. John-
Parsons, 1978). As a result, despite the remarkable energy displayed
by these women (Gump, 1972), they are likely to feel seriously pres-
sured. It is obvious that the more demanding the career role, the
more commitment in time and energy it will require, and the more
heavy the feeling of "role overload" (Sales, 1978) is likely to

become.

Literature related to the dual-career marriage has also

described the phenomenon of the "two-person career, i.e. a profes—
sion so demanding that the efforts of both the individual and his/
her spouse are required to be really successful in the career

(Hunt & Hunt, 1977; Papanek, 1973). As women enter the professions
which have traditionally been seen as "two-person," the conflict
between their fulfilling the expectations of their career and the

traditional feminine roles could be seen to approach a maximum

level.

The Woman Physician

 

The practice of medicine has traditionally been viewed as
one of these "two-person" careers (Coombs, 1971). There has been
extensive examination of the time demands of medical study and the
practice of medicine and the impact of these demands on the medical
student of either sex (Campbell, 1973; Coombs & Boyle, 1971). It
has become something of a truism to view medical school as an
intensive socialization period, with considerable psychological
stress on the individual future physician. It is also generally
recognized that medicine as a career is extremely demanding. The
high rates of suicide, alcoholism, and drug abuse among physician
populations have been attributed at least in part to the high
pressure atmosphere of medicine (a'Brook, et al., 1967; British
Medical Journal, 1964; Craig & Pitts, 1968; Dublin & Spriegelman,
1947; Fox, 1957; Ostermann, 1967; Steppacher & Mausner, 1974).

There has also been some examination of the impact of the
medical career on the physician's marriage (Berman, 1979; Coombs,
1971). The ideal wife of a physician has been described as very
nearly the perfect partner for a "two-person career"--one who is
warm and supportive, and yet who functions very capably for long
periods of time without interacting much with her husband (Coombs,
1971). Somewhat surprisingly, there is no comprehensive body of
research on physician marriages. A recent article titled
"Forgotten Persons: Physicians' Wives and Their Influence on
Medical Career Decisions" (Skipper & Gliebe, 1977), underlined the
minimal examination of these relationships. A recently published
volume on the socialization processes in medical school may go
some distance toward remedying this lack (Coombs, 1978).

In medicine, as in the other high status professions, women
have traditionally been in a minority (Astin & Bayer, 1972; Joreen,
1970; U.S. Department of Labor, 1976). Only recently have their
numbers increased to substantial proportions of medical school
entering classes. In 1965, women formed 8% of the entering classes.
In the 1974-1975 school year, women formed 22% of the entering
classes (U.S. Department of Labor, 1976). There has been a cor-
responding increase in the research literature examining various
aspects of the experience of women medical students and women
physicians.

In examining the personality characteristics of female
medical students, they have been demonstrated as a group to be

unusually well adjusted and psychologically healthy. This has held

true both when the women were compared to a normative sample of
other women and when they were compared to their peer group of
male medical students (Cartwright, 1972a; Cartwright, 1972b;
Fruen, Rothman, & Steiner, 1974; Hutchins, Reitman, & Klaub, 1967;
Shapiro, 1971). In fact for a time it was commonly acknowledged
(Barclay, 1973) that medical schools "liked female applicants
better" because they were better qualified!

Despite this impressive array of credentials in both
academic skills and personality configuration, it is generally
agreed that most women in medical school experience marked
psychological stress, amounting almost to a life crisis (Campbell,
1973; Lopate, 1968). Empirical and theoretical work has traced
this stress to a number of roots. In the first place, women in
medicine are entering a profession that has been traditionally
male identified and, despite the shift in ratio of the sexes,
continues to be male dominated. A woman in any male identified
profession may be perceived as deviant and the sanctions applied to
deviant persons may be applied to her (Abramowitz, Weitz, Schwartz,
Amira, Gomes, & Abramowitz, 1975; Nadelson & Notman, 1972). Women
in medical school have traditionally seen few women on the staff
and therefore have had few role models to follow (Roeske & Lake,
1977). Women students are potentially high achievers, and yet if
they surpass their male peers they may be caught in the classic
double bind in which women are rewarded for achieving as much as

possible and yet simultaneously told that surpassing men will stamp

them as unfeminine and unlovable (Chesler, 1972; Horner & Walsh,
1973). Women in medical school may also face sexist comments which
most directly denigrate women patients, but by obvious extrapola-
tion denigrate all women (Batt, 1972; Campbell, 1973; Howell, 1974;
Spiro, 1975). Women in medical school may also face exclusion

from the traditional "old boy" network of informal contacts that
can provide learning experiences and professional contacts for
career advancement (Epstein, 1970). Finally, female medical stu-
dents may experience discrimination based on expectations that they
will enter certain clearly delimited specialties (Ducker, 1978) and
that they will practice less than their male counterparts.

This issue of female versus male productivity in medicine
has long been under scrutiny. A recent review article reported
conflicting data on the percentage of women physicians who con-
tinued in full time practice all their professional lives (Nemir,
1978). Studies have found that full time practice of women
physicians correlated inversely with number of children and similar
measures of family responsibility (Heslop, Molloy, & Waal-Manning,
1973; Ulyatt 8 Ulyatt, 1973; Woodside, 1974). Reduced rates of
full time practice will hardly be surprising as long as multiple
commitments are a reality for professional women, especially if the
male half of the dual-career marriage rarely assumes half of the
parenting responsibility.

Most of these stresses experienced by women in medical
school could be classified as varieties of role conflict, as

previously described. These must be dealt with, in addition to the

basic stress which every medical student assumes as he or she
attempts to assimilate a vast quantity of technical material and
to achieve a professional identity. A dual-career marriage in
which the wife is a medical student or house staff member could be
taken as an extreme example of the career pressures exerted on

persons in dual-career relationships.

Research on Marital Satisfaction

Before examining research on the dual-career marriage and
factors affecting perceived satisfaction in such a marriage, it is
appropriate to briefly review the factors seen as affecting marital
satisfaction in general. The broad field of research in marriage
and marital satisfaction is complex and burgeoning at an increasing
rate each year. The issue of evaluating marital satisfaction or
marital adjustment accurately or even considering it to be a
theoretically valid or unitary phenomenon has been the subject of
controversy (Craddock, 1974; Laws, 1971; Marini, 1976; Spanier,
1976). This study will take Spanier's (1976) pragmatic viewpoint
that, for purposes of research, it continues to be useful to
attempt to measure marital satisfaction or adjustment as reported
by the individuals involved, even though this may be strongly
affected by social desirability factors.

Marital adjustment has been examined at length and signif-
icant correlations have been obtained with a large number of
variables including self-reported personality variables (Hurley

& Silvert, 1966), demographic similarities (Luckey, 1960a),

congruence of spouses' perceptions of themselves (Kotlar, 1965),
congruence of spouses' perceptions of their mates (Hurley &
Silvert, 1966), a combination of personality and demographic
factors (Bentler & Newcomb, 1978), and many other areas. Two
findings which are especially likely to have impact on this study
are the general reports that level of marital satisfaction or
adjustment tends to decrease over the number of years married
(Crago & Thorp, 1968; Luckey, 1966), and that marital satisfaction
tends to decrease with the advent of children (Hurley & Palonen,
1967; Rollins & Cannon, 1974). On the basis of these findings,
this study will attempt to achieve a sample population in which the
variables of number of years married and number of children are
equated between the two groups being examined and compared, couples
in which the woman is the physician or medical student and couples
in which the man is the physician or medical student. These vari-
ables will also be examined to evaluate their impact on marital
satisfaction (Hypothesis 15). This study will combine several
areas of marital research by focusing upon roles and personality
variables, and by employing an interactive theory about

relationships.

Equity Theory and Dual-Career Relationships
The persons in a dual-career marriage bring a variety of
personal resources and coping strategies to bear upon their profes-
sional and personal lives. This study will attempt to focus upon

the impact of working/professional life on marriage and private

10

life. A recently expanded theory in social psychology appears to
be well suited for application to dual-career relationships.

Equity theory, as summarized by Walster, Walster, & Berscheid (1978)
is an attempt to develop a general theory of social behavior that
will integrate a variety of previous theories, explain previously
accumulated empirical data, and predict further behavior. Equity
theory "attempts to integrate the insights of reinforcement theory,
cognitive consistency theory, psychoanalytic theory, and exchange
theory" (Walster, Walster, & Berscheid, 1978, p. 2). Equity theory
at its simplest states that in a relationship, if one gives as much
as one gets, one experiences equity and feels content. However, if
one either gives more gr_gets more, one will experience inequity
and feel distress. The fundamental propositions of equity theory
as they apply to this study are:

Proposition 1. Individuals will try to maximize their
outcomes (where outcomes equals rewards minus costs).

Proposition III. When individuals find themselves partici-
pating in inequitable relationships, they will become distressed.
The more inequitable the relationship, the more distress the
individual will feel.

Proposition IV. Individuals who discover they are in an
inequitable relationship will attempt to eliminate their distress
by restoring equity. The greater the inequity that exists, the
more distress they will feel, and the harder they will try to

restore equity.

11

Equity theory appears to be potentially very useful in the
examination of dual-career relationships. In such relationships
the woman (and sometimes the man) is stepping outside her (or his)
traditionally assigned role behaviors. This study will give major
emphasis to the women's roles and their possible role conflict.

As the woman and her spouse deal with the multiple requirements of
dual-career family life, it is highly likely that the woman cannot
complete all aspects of her traditional roles as wife, housewife,
and mother as elaborately as a woman can who does not work outside
the home. Simple lack of time suggests that adding the career

role will require that less time be given to the traditional roles.
This could be perceived by either partner as role conflict: career
role versus traditional roles. One or both partners may perceive
less performance within the traditional roles as a “failing,"
experience inequity as a result, and seek to restore equity.

For this reason, equity theory also appears well suited to
an examination of the marriages of all medical students and
physicians. With the prevailing theme of "sacrifice" used to
describe them, medical spouses could well be expected to experience
inequity (Coombs, 1971). In fact, all persons involved in "two-
person careers" could be expected to perceive inequity in the rela-
tionship. This would be true, of course, only if the individuals
ceased to regard themselves as a unit, and considered themselves as
separate persons. At such a time, an arrangement in which one
person's entire occupation is to provide the support functions

which enable another person to work is likely to be viewed as

12

inequitable. The growth of the feminist movement which encourages
development for women as individuals would tend to increase the
perception of inequity in such cases.

Equity theory predicts that if there is perceived inequity
there is an attempt to restore equity. Is this hypothesis of
inequity correct? In an attempt to restore equity, how is this

done?

Extensions of Equity Theory

At this point it is essential to review some of the already
achieved elaborations of equity theory. In the first place, an
equitable relationship exists if the person scrutinizing the
relationship concludes that the participants are receiving equal
relative gains from the relationship. The "scrutineer" (the word
used by Walster, et al., 1978) may be an outside observer or either
of the participants, and scrutineers very commonly disagree about
what constitutes equity or inequity.

Equity theory also postulates that where inequity is
perceived, individuals will try to restore equity (Proposition IV).
There are two ways to restore equity: by restoring actual equity
and by restoring psychological equity. Restoring actual equity
would involve altering the actual gains of one or both partners.
Restoring psychological equity would involve exaggerating or
distorting reality, to give the scrutineer the impression that the

inequitable relationship is, in fact, equitable.

13

Equity theory as presented by Walster, Walster, and
Berscheid (1978) attempted to proceed into the area of intimate
relationships, but they acknowledged that this is the most
theoretical and speculative of the kinds of relationships examined.
The majority of the empirical verifications of equity theory
involved social psychology experiments in which the "relationship"
between the participants was fleeting and equity could be evaluated
as present or absent on the basis of very limited interactions.
There has been some effort to extend research into the area of
intimate relationships. In a recent study, Traupmann (1978)
applied equity theory by asking a group of 100 newly-wed couples to
evaluate their perceived equity and marital satisfaction. As
equity theory had predicted, those who felt equity in their rela-
tionship were happiest. Those who perceived inequity but felt they
were getting more than they were giving were next happiest, and
those who perceived inequity and felt they were giving more and
gaining less were least happy.

As Walster, Walster, and Berscheid stated in their volume
(1978), intimate relationships are varied and complex. In an on-
going intimate relationship it will be much more difficult to
calculate inequity. Participants in casual relationships may
expect specific repayment for each favor. Intimates may tolerate
long term imbalances, confident that they have an unlimited future
to set things straight. Intimates also become the possessors of
increasingly powerful rewards and punishments. And as a relation-

ship grows, the variety of potential rewards and punishments

14

increases. Walster, Walster, and Berscheid (1978) theorized that
the variety of resources could be viewed from the framework of
Uriel Foa and associates (Donnenwerth & Foa, 1974; Foa, 1971;
Teichman, 1971; Turner, Foa, & Foa, 1971). In this theory the
resources of interpersonal exchange fall into six classes (1) love,
(2) status, (3) information, (4) money, (5) goods, and (6) services.
Walster, Walster, and Berscheid (1978) hypothesized that intimates
exchange not only those items which are obviously and universally
of value (such as money) but also highly symbolic and particular-
istic items. One of the most intriguing and relatively unexplored
areas is how intimates decide what is the "fair exchange" for what.

Walster, Walster, and Berscheid (1978) also raised the
important point that intimates, through identification and empathy,
come to define themselves as a unit. In this way gains are linked
for the two persons--they are a unit, a couple, not two individuals.
The equity theorists felt that the crucial issue is whether in any
given situation the people are interacting as individuals or as a
unit.

In the instances of the medical marriage and the dual-
career marriage there are undoubtedly many times when a couple acts
as a unit and they perceive themselves as such. However, under the
high level of stress induced and with medical school absorbing such
a substantial amount of the medical student/house staff spouse's
time, it will be hypothesized in this study that parties in the
medical marriage will often perceive themselves as individuals, and

experience some degree of inequity.

15
Influence of Role Conflict on Perceived
Equity/Inequity

A mediating variable for the experiencing of inequity may
be role conflict, as defined by Sales (1978) and described
previously. Medical students or house staff spouses are expected
to behave in certain ways as spouses and in certain ways as
medical students or house staff. The medical environment exerts
pressure to be "doctors first" (Coombs, 1971). If students/house
staff obey this pressure, their expected behavior as spouse is
likely to suffer, possibly leading to perceived inequity. They may
perceive the inequity themselves (I am letting my spouse down) or
it may be perceived by the spouse (My spouse is letting me down) or
both may be true. Since women, as noted earlier, are expected as
part of the traditional feminine role to always "put the family
first," their potential distress and perception of role conflict is
even greater than that for men.

Walster, Walster, and Berscheid (1978) also summarized some
relevant findings regarding the ways people restore equity.
Research done by Morgan and Sawyer (1967), Benton (1971), and
Traupmann (Note 5) suggested that strangers find even momentary
inequities distressing, while intimates do not. This would seem to
support the earlier theory that intimates construe their life
together over a longer time span, in which there will be ample
opportunity for things to "even out." For this reason it will be

emphasized that subjects in this study are to evaluate the present.

16

From the framework of equity theory and from the impact of
traditional sex roles and potential role conflict, the following

hypotheses emerge.

Hypotheses Concerning Equityllnequity

Hypothesis 1

 

In medical student and medical house staff marriages there
will be some conflict for all married persons between the role of
spouse and the role of medical student/house staff. From the
resulting failure to live up to some expectations about the rela-
tionship, both spouses will perceive inequity at the present time
in their relationship. Medical students and house staff will
perceive themselves as overbenefited (i.e. getting more than they
are giving) and spouses will perceive themselves as underbenefited
(giving more than they are getting). Some exceptions to this will
be noted in Hypothesis 3. Perceived equity/inequity will be
operationally defined as each individual's score on the Traupmann-
Utne-Hatfield (1978) Scale (TUH). Scores above zero are considered
as perceived overbenefit and scores below zero are considered as
perceived underbenefit. A score of zero is considered a perception

of complete equity.

Hypothesis 2

As noted in the research review, female medical students/
house staff are likely to perceive themselves as deviating even more
from their traditional role as spouse than are male students/house

staff. For this reason it is hypothesized that female married

17

medical students/house staff will perceive more inequity in their
marriages than will male married medical students/house staff. As
before, the medical student or house staff member will feel over-
benefited and the spouse underbenefited. On the Traupmann-Utne-
Hatfield (1978) Scale, female married medical students/house staff
should have even higher positive scores than their male counter-
parts. The spouses of female married medical students/house staff
should have even lower negative scores on the TUH than the spouses
of male medical students/house staff. Possible exceptions to this

are noted in Hypothesis 3.

Hypothesis 3

 

Equity theory suggests that when persons are strongly
identified with each other, there is less perception of inequity.
As a rough correlate of identification, it is hypothesized that
medical students or house staff whose spouses are either medical
students or house staff or other physicians will perceive less
inequity than will medical students/house staff who are not part of
a "dual-medical couple." Accordingly, on the Traupmann-Utne-
Hatfield (1978) Scale, female medical students and house staff
married to "non-medical" spouses will have a higher positive score
than do female medical students and house staff who are part of a
"dual-medical couple." Non-medical is defined as a person who is
neither a house staff member, nor a medical student, nor another

- physician.

18

In turn, male medical students and house staff married to
"non-medical“ spouses will also have a higher positive score on the
TUH than do male medical students/house staff who are part of a

dual-medical couple.

Hypothesis 4

 

Following the results of Traupmann (1978), persons who
report equity should report most marital satisfaction, while those
reporting increasing amounts of inequity should report decreasing
marital satisfaction. Those reporting inequity and overbenefit
should report the next most satisfaction, while those reporting
inequity and underbenefit should report least marital satisfaction.

Marital satisfaction will be operationally defined as each
individual's score on the Dyadic Adjustment Scale developed by
Spanier (l976). Equity/inequity will continue to be operationally
defined as the score on the Traupmann-Utne-Hatfield (1978) Scale.

Hypotheses Interrelating Equity, Role Conflict
and Androgyny

Hypothesis 2 is contingent upon several assumptions: that
the married woman in medical school/house staff training perceives
herself as not fully performing the traditional female spouse role,
that she is not entirely comfortable with this, and that as a
result, she (and possibly her spouse) feels she is not fulfilling
expectations as a wife. The expectations could be her own about

herself, or her spouse's expectations about her, or both.

19

There are, in effect, at least two contributing portions of
this potential failure to meet expectations. One is the level of
expectations within the minds of the wife and her spouse as to what
a "wife" should do. The other portion is her level of performance
as perceived by both wife and husband. If either wife or husband
perceive that she is not meeting the level of expectations that
they hold for the "wife role," they are likely to view this as a
result of the time demands of the medical education setting. In
fact, this is quite a realistic viewpoint (Robinson, 1978).

Within this study, it will be assumed that most of the discrepancy
between expectations in the wife role and performance of the wife
role will be attributed to the fact that the wife is involved in
medical education. There will be an effort to evaluate this
directly. This attribution of the discrepancy to activity in
medicine falls within the definition of role conflict.

It is possible that for some married female medical
students and house staff there will be no role conflict no matter
how high their expectations of themselves in the feminine spouse
role are. These would be the "superwomen" who perform all aspects
expected in both the feminine spouse role and the medical role.
These persons would experience no role conflict.

Another mediating variable, however, may operate on the
level of expectations which exist within the minds of the women and
their spouses. Personality research has developed the concept of
psychological androgyny, which postulates that a single individual

may possess characteristics which are considered traditionally

20

masculine and also traditionally feminine (Bem, 1974; Spence,
Helmreich, & Stapp, 1975). Research suggests that the androgynous
individual, one who possesses a high number of qualities from both
sex-role categories, may be a flexible, adaptable, and healthy
individual (Bem, 1975; Bem & Lenny, 1976; Bem, Martyna, & Watson,
1976). One could postulate that, focusing upon female medical
students and house staff, their level of androgyny would have an
effect upon the expectations they place on themselves as wives.

In the first place, it should be clearly stated that any group of
female medical students and house staff is likely to be more
androgynous than an average population of young women in that age
group. But within a population of women medical students/house
staff, there can still be a considerable range. Both of these
assumptions will be examined empirically.

Androgyny literature suggests that the androgynous
individual moves freely in and out of behaviors considered typical
for his or her sex (Bem & Lenney, 1976). One can, by extrapolation,
hypothesize that since the androgynous female medical student or
house staff member has heavy time commitments in her more "mascu-
line" role as a medical person (achievement oriented, requiring
independent judgment, etc.), she might comfortably lower her
expectations for some of her feminine spouse role commitments. To
put it another way, a flexible stance may be the best way to
minimize role conflict. A woman might begin medical school with
expectations for herself that to take really good care of her

family in the feminine role, she will bake her own bread and do all

21

the family laundry. In the "superwoman" approach, she would
continue to do these things despite being in medical school, and
avoid role conflict in that way. With a flexible set, she might
decide it was still sufficient care for the family to buy good
bakery bread, and have her husband do the laundry. In this way,
she too would avoid perceiving role conflict, but in quite a
different fashion.

For the "feminine" female medical student (one with a
greater number of stereotypically feminine attributes and a fairly
low number of stereotypically masculine attributes), her self-image
might make it more likely that she would begin with and probably
maintain a higher level of feminine spouse role expectations than
her androgynous colleague. This might be, in part, a reaction,
since she would almost certainly view many of her medical activities
as "masculine" and might want to continue her traditionally feminine
behavior to maintain consistency in her view of herself. If this
were the case, the "feminine" female medical student/house staff
member has an uncomfortable set of choices. She must either be a
"superwoman" or through sheer time pressure, not complete some of
the aspects of her traditional spouse role, and experience the role
conflict.

Thus, the perceived discrepancy between expectations and
performance could be influenced both by level of androgyny
(operating on the level of expectations) and by level of perform-
ance. A woman with a high femininity score and high level of

expectations for the traditional female spouse role would perceive

22

no discrepancy if she were able to maintain a high level of perfor-
mance of the feminine role. Therefore, she would perceive no conflict
between being a wife and being in medical education. An androgynous
woman might have a lower level of expectations for herself within the
traditional female spouse role and be able to perform up to those
expectations. Therefore, she too would perceive no conflict between
being a wife and being a medical student/house staff member. For the
purposes of this study, the discrepancy between expectation and per-
formance will be assumed to be largely due to the time pressures
exerted on the women by being involved in medical education. There-
fore, this discrepancy score will be considered a measure of the role
conflict perceived between the roles of wife and medical student/

house staff.

Hypothesis 5

 

Level of role conflict willpredict level of inequity. The
greater the discrepancy between expectations and performance, the
greater the perceived inequity. Level of expectations and level of per-
formance will be operationally defined as the answers to section (A) of
each question on the Taylor Role Questionnaire (TRQ). Level of perfor-
mance will be operationally defined as the answers to section (C) on each
question on the TRQ. A discrepancy score will be calculated (part C
minus part A for each question)and this will be operationally defined
as the role conflict score. In this fashion, a positive score would
indicate performance greater than level of expectations, while a

negative score indicates performance below the level of expectations.

23

For all female medical students/house staff and their spouses, the
greater the degree of perceived role conflict and the more negative

the score, the greater should be the degree of perceived inequity.

Hypothesis 6

The androgyny scores for the female medical students and
house staff will be compared to the androgyny scores for Bem's
(1974) population of Stanford undergraduates and the other women
within the study. It is hypothesized that the level of androgyny
for the medical women will be significantly higher than it will be
for the other two groups. Androgyny will be operationally defined
as a high level of both the masculinity and femininity scores on
the Bem Sex-Role Inventory (BSRI). A masculine sex-role type will
be operationally defined as an individual with a high score on
the masculinity scale and a low score on the femininity scale. A
feminine sex-role type would be the reverse. An individual with
low scores on both scales would be operationally defined as an
undifferentiated sex-role type. Because of the potential dif-
ficulties in determining what should constitute a "low" or "high"
level on the scales, multiple regression techniques will be used
in this study to evaluate the influence of the masculinity and
femininity scales on the BSRI. See the Measures section of this
paper and Bem and Watson (Note 1) for more discussion.

It is hypothesized, therefore, that the mean scores on both
the masculinity and femininity scales of the BSRI will be signif-

icantly higher for the sample of female medical persons, when

24

comparing them to the sample of women undergraduates from Stanford

and to the non-medical women in this study.

Hypothesis 7

 

Androgynous female medical students and house staff should
have lower expectations of "feminine" spouse role behavior of
themselves than feminine female medical students and house staff.
Masculinity and femininity scores on the BSRI will be used to
determine whether increasing scores on both_the masculinity and
femininity scales predict a lower level of expectations of feminine
spouse role behavior. Feminine spouse role expectations will
continue to be operationally defined as the score of section (A)

of each question on the TRQ.

Hypothesis 8

 

It is possible that some women medical students/house staff
who hold high expectations for their feminine spouse role perform-
ance can be "superwomen" and perform up to the level of any degree
of expectation. It is more likely, however, from the pragmatic
limit of number of hours in the day, that performance level in the
feminine spouse role is roughly comparable for all women medical
students/house staff, regardless of their expectations or degree
of androgyny. For this reason, it is hypothesized that the
performance level for the feminine spouse role will show no signif-
icant differences for all women medical students/house staff,
regardless of their scores on the Bem Sex-Role Inventory.

Performance on the feminine spouse role will continue to be

25

operationally defined as the answers to part (C) of each question
on the Taylor Role Questionnaire. Accordingly, the masculinity
and femininity scores on the BSRI should not significantly predict

the performance level.

Hypotheses Concerning Level of Androgyny of Spouses

 

The marital satisfaction research on the whole suggests
that spouses influence each other powerfully. A good deal of
recent research on marriage has focused on the ways this influence
is exerted, defining it as the use of power within the family or
conflict resolution in the family (Bahr 8 Rollins, 1971; Barry,
1970; Cromwell 8 Olson, 1975; Olson 8 Rabunsky, 1972; Richmond,
1976; Rollins 8 Bahr, 1976). Other research on marriage suggests
that spouses select each other on the basis of having similar
attitudes (Byrne 8 Blaylock, 1963; Levinger 8 Breedlove, 1966) and
values (Coombs, 1966; Murstein, 1970; Murstein, 1976). Consequently
it is assumed that husbands and wives will resemble each other in
their expectations for the feminine spouse role, and that they will
influence each other toward similar expectations. In the same way,
they should mutually influence each other's perceptions of role
conflict and equity.

If her level of androgyny enables a wife to adopt a more
flexible stance towards her feminine spouse role, the attitude of
her husband can have a great impact on her working outside the home
(Parnes, Jusenius, Blau, Nestil, Shortlidge, 8 Sandell, 1976).

Successfully bringing off a dual-career marriage requires

26

flexibility, understanding, and a capacity to accommodate to
changing conditions (Rostow, 1965) from both spouses. These may
include role reversals at times (Birnbaum, 1975; Hoffman 8 Nye,
1974; Rapoport 8 Rapoport, 1971). An inflexible and traditionally
"masculine" attitude, at least about maintaining a sense of
control, has been shown to be inversely correlated with the wife
having a career (Winter, Steward, 8 McClelland, 1977). In fact,
that study commented "Since women's career level is predicted by
Self-Definition scores of both women themselves (Stewart, 1975;
Stewart 8 Winter, 1974) and of their husbands, it seems likely that
Self—Definition involves a general freedom from ascribed roles,
both for one's self and for others" (Winter, et al.,1977, p. 164).
All of these descriptions of flexibility and freedom from ascribed
roles strongly suggest the androgynous individual described by Bem
and Lenney (1976). Therefore, it could be hypothesized that
increasingly androgynous husbands will have declining expectations
for their wives in the feminine spouse role. There should also be
a corresponding impact on his perceptions of role conflict and his

perceptions of equity within the relationship.

Hypothesis 9

 

Therefore, the masculinity and femininity score on the Bem
Sex-Role Inventory for the husbands of the female medical students/
house staff should predict their expectations of their wives'
feminine spouse role behavior. Increased masculinity agg_

femininity scores (increased androgyny) should predict decreasing

27

expectations for the female spouse role. This might be due in
part to the willingness of androgynous husbands to assume with
comfort some of the traditionally feminine behaviors that their
wives do not have time to do. This could range from doing the
laundry to taking care of the children. Expectations for the
feminine spouse role continues to be operationally defined as the

answers to part (A) of each question on the TRQ.

Hypothesis lO

 

If the previous hypotheses are confirmed, all women medical
students/house staff will be performing at roughly equivalent
levels and their level of expectations of themselves for the
feminine role will be predicted by their scores on the BSRI.
Accordingly, the masculinity and femininity scores for the BSRI
should also predict significantly the discrepancy score (role
conflict score) on the TRQ. An increase in bgth_masculinity and
femininity scores should predict less discrepancy score, or, a

shift from negative scores to less negative or positive scores.

Hypothesis ll

 

For the husbands of the women medical students/house staff
as well, their masculinity and femininity scores on the BSRI should
also predict their perceived discrepancy score for their wives on

the TRQ. Increasing androgyny should predict less role conflict.

28

Hypothesis 12

 

Hypothesis 9 is predicted, in part, on the assumption that
husbands and wives influence each other by exchanging their views
and values. Accordingly, a husband who perceives a certain
discrepancy between his expectations for his wife and her
performance level will be likely to influence his wife's view of
the discrepancy between her own expectations for herself and her
performance. In turn, her views will influence his, and, of
course, both processes occur simultaneously. This will be examined
empirically by correlating the difference scores for husbands and
wives among the sample of female medical students/house staff and

their spouses. A significant positive correlation is predicted.

Hypothesis 13

 

If Hypothesis 10 and 11 are confirmed and the masculinity
and femininity scores on the BSRI significantly predict the
discrepancy score (role conflict score) on the TRQ and if
Hypothesis 4 is confirmed, such that there is a significant
correlation between the role conflict score and both equity/
inequity score and the marital satisfaction measure (Spanier), then
the androgyny measures should be significant predictors of the

equity/inequity score and of the marital happiness score.

Hypotheses Concerning_Restoration of Equity
Equity theory research has found that in a state of
perceived inequity, persons attempt to restore equity,

either in actuality or psychologically. It has also been

29

found that in experimental situations, people conunonlj/ try to
restore actual equity only when they can do so exactly to an even
level (i.e. leaving neither participant overbenefited or under-
benefited). If they can only approximate restoring equity in
reality, they tend to restore equity psychologically. For example,
if they have wronged someone and cannot make it "just right" they
may denigrate the victim, "oh well, he had it coming."

There is little evidence on whether intimates will seek to
restore equity in actuality or psychologically. There is some
evidence that partners seek to restore actual equity. Unfortun-
ately, much of this is anecdotal. Among research studies,
Komarovsky (1971) examined 58 families in which the husband lost
his job during the 1937-38 depression. Komarovsky found that in 13
of the 58 families, when the husband lost his job, he began to lose
his authority. Two forms of major change occurred. In one group,
the couple's relationship evolved to become more egalitarian so
that, for example, the man began, for the first time, to take on
household duties. In the second group, in a few cases the husband's
and wife's status were reversed.

Walster, Traupmann, and Walster (Note 8) looked at how a
person's perceptions of equity should color his or her attitudes
toward extra-marital sex. In general, their results supported
equity theory, in showing that underbenefited partners, as compared
to overbenefited partners or equitably treated partners, were
willing to engage in extra—marital sex much sooner in the time span

of their relationships.

30

In situations involving intimates, one will probably know
too much about the other partner and be too much invested to
achieve psychological equity by denigrating the victim. For
intimates who perceive relatively little inequity, restoration of
equity in the near future may be possible, especially considering
the wide range of interchangeable resources at the disposal of
intimates. If an enormous "debt" of inequity has been accumulated,
however, restoration of an exact equity would seem much more
difficult. In this case, an attempt to restore psychological
equity would seem more likely.

In the case of medical marriages the most likely rational-
ization to restore equity appears to be the "pie in the sky"
approach (Berman, 1979; Coombs, 1971). In other words, the medical
person and his or her spouse will anticipate that after medical
school and residency, the doctor will be more available in the
spouse role. There is also the prospect of other inputs in the
form of increased income and prestige. These latter may be
realistic expectations, but the hope of more "spouse time" probably

is not (Berman, 1979; Coombs, 1971).

Hypothesis 14

 

Medical students/house staff and their spouses who report
more perceived inequity should more often envision increased time,
attention, and other "spouse-role" activities after completion of
medical school and residency. Individuals (both medical students/

house staff and their spouses) who perceive less inequity should

31

anticipate that future interactions as spouses will continue much
as they are at present.

Amounts of perceived equity/inequity will continue to be
operationally defined as the individual's score on the Traupmann-
Utne-Hatfield (1978) Scale. Anticipated changes in the marriage
following medical education will be operationally defined as
responses to the questions #8 and #9 of the open-ended
questionnaire (Appendix I). These will be judged by independent
raters to provide a score for the amount of increase in "spouse-
role" activities anticipated.

Individuals who perceive inequity above the median level
for their group (grouping students/house staff and spouses
separately) will expect greater increases in spouse-role behavior
than will persons with perceived inequity below the median level

for their group.

Hypothesis Concerning Demographic Variables

Hypothesis 15

 

The marriage literature reviewed above suggests that
marital satisfaction may be influenced by number of years married
and number of children. It is hypothesized that within this
sample, these factors will have relative little power to predict
marital satisfaction, as defined by the Spanier (1976) Dyadic
Adjustment Scale.

32

An Attempt to Estimate Predictive Power

Hypothesis l6

 

Among all the variables being examined in this study, a
regression equation will be employed to estimate the relative power
of these factors in influencing marital satisfaction for the persons
in this study. Marital satisfaction will continue to be opera-
tionally defined as the score on the Spanier Dyadic Adjustment

Scale.

METHOD

Subjects

Subjects were drawn from the population of 44 married
female medical students and 26 married female house staff members
at the University of Wisconsin Medical School, Madison, Wisconsin,
and the spouses of these women. From the 163 male married medical
students and 178 male married house staff at this school, a
matching sample was generated, with an attempt to match the female
sample on the basis of year in medical education, status (if a
medical student) in the Independent Study Program (ISP), number of
years married, number of children, and occupation of spouse.

The match proceeded in the following fashion. Initially
all women within a year in medical school were contacted, and their
consent obtained. From that data, an attempt was made to obtain a
matching group within that medical year. Once all women within a
given medical school year had been contacted and given their
consent, a list was made giving the ISP status, the number of years
married, number of children and occupation of the husband for each
couple. Then with one "target" couple in mind from the female
list, a couple was selected at random from the list of married male
medical students within the same year in medical school. If this
couple agreed to participate in the study, information was obtained

from them about number of years married, number of children and

33

34

wife's occupation. (ISP status was known and ISP couples were
always called first in the attempt to match another ISP couple.)
Often this male-identified couple did not match the female-
identified "target" couple but instead was a good match for another
female-identified couple on the list. On that basis it was
accounted "a match" and another male-identified couple within the
medical year was contacted at random in the continuing attempt to
match the "target" couple. Once a "target" couple was matched, of
course, the next unmatched female—identified couple became the
"target couple."

This method was relatively successful, but less than
perfect. At the end of a list of female-identified couples in a
class, one or two might remain unmatched. Two additional attempts
were made per couple to attempt to match them; if these were
unsuccessful, the attempt was abandoned because the number of
male-identified couples was becoming too much greater than the
number of female-identified couples.

For the residents the match attempt was somewhat different.
Residents were identified by specialty in the available directory,
not by year in training. Accordingly, all female-identified
couples in a specialty were contacted and then the attempt was made
to match with male-identified couples within the same specialty on
the basis of number of children, number of years married, and
position in training (i.e., whether in an early year or a later
year in the residency). There were only 10 female residents not

part of a dual-medical marriage, and the match was quite

35

successful, resulting in only one "extra" male-identified couple
due to difficulty in matching.

Within both resident and student groups, the first
priority was given to matching on the number of children. If this
was accomplished fairly easily then a roughly comparable number of
years married and the occupation of the spouse were the next
priorities, in that order. These variables were emphasized because
of the marriage literature which suggests that marital satisfaction
changes with the birth of children and to some degree simply through
passage of time. Since some of the students and the house staff
were in effect already part of both male-identified and female-
identified groups because they were married to each other, the
sample size was reduced accordingly.

Names, addresses and phone numbers of the students and
house staff were obtained through the office of Dr. John Anderson,
Assistant Dean of Students at the University of Wisconsin Medical
School. Procedures for obtaining subjects were developed in con-
sultation with Dr. Anderson, and had his consent. Dr. Anderson's
office was also able to supply marital status for the students and
house staff, the names of their spouses, whether or not students
were in ISP, and the area of specialty for the house staff

subjects.

Procedure
The students/house staff and their spouses were contacted

by phone at their residences and the study described briefly to

36

them along the lines of the Introduction/Consent Form which forms
Appendix C. This included the information that subjects would be
asked not to discuss the questionnaire with the spouse until both
had completed it, that the questionnaire would be sent to one
spouse at a time, and that couples would be paid $10.00 as a way of
thanking them for participating. The initial phone contact also
noted that confidentiality would be observed. Any areas of
interest or concern about the study were explored with the
potential subject; the only reservation being a detailing of
specific hypotheses. Subjects were uniformly very understanding
about the fact that explaining exact hypotheses might bias their
answers. As may be imagined from the high ratio of persons agree-
ing to participate to persons contacted, the potential subjects
were, in general, extremely cooperative. A number indicated that
being paid was not necessary. One dual-medical couple went so far
as to insist that they would not participate if they had to be
paid.

If the individuals agreed to participate in the study,
they were asked to consult their spouse to see if she or he was
also willing. In some cases this required a second phone call to
determine if the spouse wanted to participate. After both spouses
agreed to take part, the questionnaire was mailed to one. Which
spouse received the questionnaire first was determined by the
convenience of the persons involved. In some cases one partner had

heavy time commitments within the next ten days while the other one

37

did not, and so forth. After the questionnaire was returned by the
first spouse it was mailed to the second spouse.

The questionnaire consisted of (l) a request for some
general demographic information, (2) the Bem Sex-Role Inventory,
(3) the Taylor Role Questionnaire which was generated for this
study, (4) the Traupmann-Utne-Hatfield (1978) Scale, (5) the
Dyadic Adjustment Scale created by Spanier (1976), and (6) nine
open-ended questions regarding experience as a medical student or
house staff person or the spouse of one. These instruments are
described in the Measures section.

If a partner had not returned the questionnaire by mail
within ten days from the time he or she should have received it, an
attempt was made to contact the subject by phone. If the person
could not be reached, calls were continued until he or she was
contacted. If the subject still did not return the questionnaire
within an additional ten days, he or she was again contacted by
phone. This process was repeated as necessary. As will be seen
below, this method was quite productive. In a few cases the
individual could not be contacted by phone for extended periods,
and in that case a letter was mailed to his home address.

0f the 44 married women medical students, all 44 were
contacted. Two refused to participate in the study, and one had to
be eliminated by reason of being a friend of the investigator and
knowing too much about the study. All the rest agreed to partici-
pate in the study. All of these women and their spouses completed

the study.

38

Of the 26 married women house staff, all were contacted.
Two refused to participate and one had to be eliminated by reason
of being a friend of the investigator and knowing too much about
the study. The remaining 23 women agreed to participate. All 23
of these couples completed the study.

Among the male medical students (who were not married to
another person in medicine), 49 were contacted by telephone. Of
these, 41 couples agreed to participate in the study. Thirty-nine
couples completed the study, and of the remaining two couples, one
spouse in each had completed the study.

Among the male house staff (who were not married to another
person in medicine), 23 were contacted. Of these, 12 couples
agreed to participate in the study. Eleven couples completed the
study, and of the remaining couple, one spouse had completed it.

There were 25 couples in which both partners were involved
in medicine either as student, resident, or NO. All of these
dual-medical couples completed the study.

Among the couples refusing to participate in the study, a
number gave no reason for refusal. One person was extremely
concerned about the confidentiality of the results and refused on
that basis. One student and one resident indicated they were
simply too busy. Two students indicated they were willing but
couldn't spare the time until some weeks had passed (in one case
this amounted to two months!). Two student couples refused and
one resident couple refused because the couples were divorcing.

Two resident couples and one student couple agreed initially to

39

participate and then refused after one partner felt uncomfortable
upon reading the questionnaire.

The subject pool resulting consisted of the following
couples: 39 couples with a male medical student and a non-medical
spouse, 29 couples with a female medical student and a non-medical
spouse, 6 medical student-medical student marriages, 5 medical
student-resident marriages, and 2 female student-male MD marriages.
The remaining couples were 10 couples with a female resident and a
non-medical spouse, 11 couples with a male resident and non-medical
spouse, lO marriages between two residents, and 2 female residents
married to male MD“s. In this case "resident" is used loosely to
refer to any member of the house staff, whether or not he or she
is officially referred to as an intern (first year post medical
school) or a resident. MD means that a person is in practice and
not in training; obviously all the house staff persons are MD's. A
"non-medical" spouse is a person who is neither a medical student,
a member of the house staff, or an MD in practice. These spouses
included a substantial number of nurses and others directly
involved in medical care. This brings the sample to a total of 114
couples. There were in addition three "unpaired" persons, whose
spouses did not complete the study: one wife of a male medical
student, one male medical student whose wife was not in medicine,
and one wife of a resident, to bring the total sample to 231
persons. Of these, 25 couples were dual-medical couples.

The mean age for the 88 students in the sample was 25.6

years, with a minimum age of 22 years and a maximum age of 43 years.

40

Medical students had been married for a mean of 4.3 years, with a
minimum length of marriage of 1 year, and a maximum length of
marriage of 25 years. Number of years married was rounded to the
nearest number of whole years; no subject had been married for less
than six months. Medical students had a mean of 0.5 children, with
a minimum of no children and a maximum of 5 children.

The mean age for the 69 non-medical spouses of medical
students was 27.3 years, with a minimum age of 22 years and a
maximum age of 54 years. The non-medical spouses of medical
students had been married for a mean of 4.7 years, and had a minimum
length of marriage of one year and a maximum length of marriage of
25 years. These non-medical spouses had a mean of 0.6 children,
with a minimum of no children and a maximum of 5 children.

The mean age for the 48 residents in the sample was 28.8
years, with a minimum age of 26 years and a maximum age of 35 years.
Residents had been married for a mean of 4.9 years, with a minimum
length of marriage of one year and a maximum length of marriage of
16 years. Residents had a mean of 0.3 children, with a minimum of
no children and a maximum of three children.

The mean age of the 22 non-medical spouses of residents was
29.8 years, with a minimum of 25 years and a maximum of 52 years.
The non-medical spouses of residents had been married for a mean of
6.3 years, with a minimum length of marriage of 2 years, and a
maximum length of marriage of 16 years. These spouses had a mean
of 0.5 children, with a minimum of no children and a maximum of 3

children.

41

For the four MOSH the only group not included in the groups
described above, their mean age was 31.5 years, with a minimum of
26 years and a maximum of 35 years. They had been married for a
mean of 8.7 years, with a minimum of 2 years and a maximum of 16
years. The MDs had a mean of 0.5 children, with a minimum of no
children, and a maximum of one child.

After receipt of the questionnaire from the second spouse,
the couple was sent a letter thanking them for their participation
and enclosing a check for $10.00. The letter also explained that
an additional letter would be forthcoming after the data were
analyzed, containing a brief summary of the hypotheses of the study
and the results. The subjects were invited either then or at any
time to contact the investigator for more information about the
study. The letter sent with the check forms Appendix K.

After analysis of the data, a letter was again sent to all
subjects, summarizing the hypotheses and results of the study, and
again inviting contact if there was any desire for more information.
This final letter forms Appendix L.

Once questionnaires were received, names were removed and

replaced by a code.

Measures
For the study, each subject was mailed a questionnaire
consisting of 9 parts in all. The first portion was simply a
general instruction sheet, which requested that the subject read

and sign the first of the two copies of the Introduction and Consent

42

Form enclosed and then retain the second copy. The instruction
sheet also repeated the instructions given by telephone: to please
fill out the form in the order given, to complete a section at a
sitting, not to "labor over" the form and to mail it back to the
investigator when finished. A large self—addressed, stamped
envelope was enclosed with each questionnaire.

The subject was also asked not to discuss his or her
answers with the spouse until both had finished the study. Finally,
it was noted that the investigator would telephone if the form were
not received within roughly ten days. This instruction sheet forms
Appendix B.

The second section of the questionnaire consisted of the
Introduction and Consent Form itself. This introduction briefly
outlined the purpose of the study and some of the investigator's
interests. It repeated most of the instructions on the instruction
sheet (Appendix B), and added that after forms were received back
from both partners, a check for $10.000 would be mailed to the
couple as a way of thanking them for participating. It also
requested no discussion of the study with friends or colleagues
until June 1, 1979, in the hope of not influencing the answers of
any other subjects.

The Introduction also briefly described the nature of the
questions and information on the rest of the questionnaire. This
information had also been repeated during the initial telephone

contact to obtain consent to send the questionnaire.

43

Finally, the Introduction and Consent Form emphasized
limits of possible benefit from participating in the study and the
confidentiality of the material. The investigator offered to send
a copy of the results of the study and answer any questions that
might emerge during the course of the study. Subjects were told
that they were free to withdraw from the study at any time. The
last portion of the form was a standard authorization for participa-
tion in the project. The Introduction and Consent Form forms
Appendix C.

The next portion of the questionnaire was titled General
Information and requested basic demographic information, including
the occupations of the subject's parents, his position in birth
order in his family of origin, number of years married, number and
ages of children and the like. These items were requested in hope
of performing post hoc analyses to examine the effect of various
demographic variables. These analyses are not included in the
present study. From the literature review on marriage, number of
children, their ages, and number of years married were of
particular interest. This information sheet forms Appendix D.

The next portion of the questionnaire was titled for
convenience Section A, and consisted of the two pages of the Bem
Sex-Role Inventory (BSRI). This comprises Appendix E. This
measure was developed to evaluate the psychological concept of
androgyny, i.e., that an individual could possess attributes both
traditionally assigned to males and traditionally assigned to

females. Each individual receives a masculinity score and a

44

femininity score, derived from the mean of the twenty items
identified as respectively masculine and feminine. In her present
method of scoring the scale, Bem suggests calculating the mascu-
linity and femininity scores for each subject, obtaining the
medians for the masculinity and femininity scores based on the
total sample, sexes combined, and then classifying subjects
according to whether their masculinity and femininity scores fall
above or below the medians. Persons with a masculinity score
above the median and a femininity score below the median would be
classified as masculine; persons with the reverse would be clas-
sified as feminine. Persons with both scores above the median
would be classified as androgynous, and persons with both scores
below the median would be classified as undifferentiated (Bem,
1977).

The drawback of using this scoring method, however, is that
it places persons who receive scores on two continuous variables
into categories that are dichotomous. For this reason, in this
study the raw scores of the masculinity and femininity score and
the product of these scores will be used in multiple regression
equations to determine if the masculinity and femininity scores
have predictive power as is hypothesized in this study. This use
of the scores with multiple regression techniques is actually
recommended by Bem and her colleague (Bem 8 Watson, Note 1).

The next section of the questionnaire was the Taylor Role
Questionnaire (TRQ). It forms Appendix F. It was the author's

wish to employ an instrument that would evaluate both the behavior

45

a wife felt she should be displaying and the behavior she was
presently displaying. In a similar fashion an instrument was

needed to report expectations for the wife and perceived performance
by the wife, from the point of view of her husband. It was also
desirable to evaluate the degree that each spouse thought the wife's
career affected her behavior in the traditional role.

In a review of available instruments, none was available
which met these rather specialized requirements. A number of
instruments have examined the areas of expected roles for husbands
and wives and discrepancies between expectations and performance in
role (Craddock, 1974; Crago 8 Tharp, 1968; Hurvitz, 1960; Larson,
1974; Quick 8 Jacob, 1973; Tharp, 1963). However, these instruments
did not focus upon the wife alone and did not assess impact of the
wife's career. Therefore, the Taylor Role Questionnaire was
devised. The scales cited above were consulted in an attempt to
include all the areas traditionally encompassed within the role of
wife. This included both task-focused aspects and the emotionally
supportive role which has been traditionally assigned to wives
(Parsons 8 Bales, 1955). Some items were also directly suggested
by the literature on dual-career marriages. For example, Bryson,
Bryson, 8 Johnson (1978) found that even though dual-career couples
attempted to divide child care tasks evenly, they continued to be
viewed as primarily the wife's responsibility. A key "test" was the
fact that the wife almost always was the spouse who left work to

care for a child who became ill.

46

The TRQ suffers from drawbacks owing its newly created
status. Its intent on the whole was to evaluate discrepancies

between expectations for traditional wife behaviors and the

 

performance of them. Some biasing of responses was implied because
there were no questions posed such as "I expect my wife to change
the oil in the car," or "I expect myself to mow the lawn." It is
possible that in couples in which there is substantial role
reversal of the traditional tasks, that this scale would not assess
dissatisfaction with self or spouse accurately.

Nevertheless, one assumption of this study was that while
some individuals may be attempting to alter their expectations of
themselves or their spouse away from the stereotypical female role,
such a stereotype tends to linger on and to be subtly influential.
This in part explains the general instruction on the TRQ to describe
oneself (or spouse) in part (A) of each question as the "ideal
spouse." It was somewhat contradictory to word each part (A) later
on in the scale "I expect myself . . ." since it is by no means
inevitable that persons expect themselves to be the ideal spouse.
However, the intent of using the word "ideal" was to reduce some
tendency of persons to say, in effect, "I had better expect only
what I know I can (bg_or) gg_," and to give them a more free rein
to express wishes that they might ordinarily attempt to suppress.
This is based on an assumption that within the medical marriage,
spouses are continually living with and coping with an unpleasant
level of deprivation and at the same time often wishing it were not

so. Nevertheless, at some pragmatic level spouses also must expect

47

certain things and it was a measurement of the difference between
that expectation in the present (with its tinges of wishful thinking)
and performance in the present that was desired.

This wording may need to be re-worked or otherwise adapted
to a more effective approach. A number of subjects commented upon
the "ideal" versus "expectation" contradiction, as they found it
confusing or unrealistic. One subject offered the useful suggestion
of attempting to evaluate expectations before medical school and
then during medical school and the residency, to observe the pos-
sible shifts in expectations.

Because the TRQ was given to all persons in the study, its
wording had to be changed to make it appropriate to the status of
the individual subject. The TRQ was given to male medical persons
and their non-medical wives in part to equalize the amount of time
required by all subjects to complete the study and in part to
permit post hoc examinations of hypotheses about the male medical
person and his wife which are not included in the present study.

For female medical persons, their part (0) of each question
asked about the influence of their status as a medical student or
intern/resident on their behavior. For males with a female medical
person as a spouse, their part (0) of each question asked about
the influence of her medical status on her behavior.

For females who were not in medicine, their part (0) asked
about the influence of their occupation on their behavior. For
their husbands, part (0) again asked about the influence of the

wives' occupations.

48

For those women whose occupation was to be at home in the
role of wife and mother, part (0) had to be either deleted or
re-worded for it to make sense. It was re-worded to ask about the
influence of the husband's medical status on their behavior. For
the husbands of homemaker wives, their section (0) reflected this
change. To avoid an extremely cumbersome Appendix F (amounting to
42 pages), the full length TRQ is included only in the version for
the female medical person. The initial two pages, appropriately
labelled, are included for each of the other five versions of the
questionnaire.

To evaluate the reliability of the TRQ, the 21 questions
were broken down into four subroles: Homemaker (consisting chiefly
of task-oriented behaviors), Emotional/Sexual/Supportive Partner,
Social Partner, and Child Care. See Table 1 for a detailing of
items included. Since part (A) and part (C) of each question were
to be examined separately and then a difference score amounting to
(C) minus (A) was to be derived and also examined in other
hypotheses, the subroles were examined for the reliability of
part (A) and part (C) separately.

The items to be included in each subrole were derived from
both the logic of their content and a non-systematic review of the
data which suggested that items 10 and 12 did not reflect associa-
tion with any of the subroles. On this basis, coefficient alpha or
internal consistency was computed for each of the four subroles.
both for part (A) and for part (C). These standardized item alphas

are presented in Table 2.

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49

 

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.chmuocm pocv mcHaaogm conga mg» ow op Homnxo H .m
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mcHacoz .oz sapH aHocnsm

 

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50

 

 

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mcHucoz .oz EmpH mHoLnsm

 

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51

 

 

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52

On the basis of these reliability estimates, it appeared
that Subrole III, Social Partner, was not a sufficiently reliable
scale to receive emphasis in the formulation of conclusions. Since
it was formed of only two items, it was probably too short a scale
to achieve high internal consistency. Subrole IV, Child Care, was
also open to question, in part because the 34 couples with children
composed such a small percentage of the total of 114 complete
couples. Subrole II, however, Emotional/Sexual/Supportive Partner,
showed sufficiently high internal consistency to be used with rather
more confidence. Subrole I, Homemaker, appeared to show enough
internal consistency to be interpreted with some caution.

Predictions within this study depended upon reliability
estimates for both the scores of parts (A) and (C) for each ques-
tion, and upon the reliability of the difference scores generated
by subtracting (A) from (C).

The correlations between parts (A) and (C) for each subrole
are shown in Table 3. In a multi-trait, multi-method approach to
investigating perceptions about the wife's role, a correlation
between part (A), expectations, and part (C), performance, would be
desirable. It would indicate that indeed these were two different
perspectives on the same part of the wife's role.

For this study, however, the optimal result would have
been some correlation between parts (A) and (C) but not a large one.
In this fashion it would be indicated that these were two perspec-
tives on the same aspect of the wife's role, but the difference

score would still have adequate reliability.

53

TABLE 3.--Corre1ation Coefficients Between Subrole Scales of the
Taylor Role Questionnaire (TRQ).

 

 

IA IC IIA IIC IIIA IIIC IVA IVC
IA .66 .37 .02 .27 .10 .52 .49
IC .17 .22 .17 .26 .54 .62
IIA .23 .48 .09 .40 .35
IIC .14 .44 .28 .30
IIIA .46 .25 .30
IIIC .15 .08
IVA .84

IVC

 

54

With the internal consistency figures shown in Table 2 and
the correlations shown in Table 3, the standard formula for
reliability of difference scores was used to estimate reliability
for discrepancy scores for each subrole.

For Subrole I, Homemaker, the difference score was estimated
to have a reliability of 0.34, too low for use with much confidence.
For Subrole II, Emotional/Sexua1/Supportive Partner, the difference
score had a reliability estimate of 0.80 which was high enough to
be used in examining hypotheses. For Subroles III and IV, Social
Partner, and Child Care, the reliability estimate for their dif-
ference scores was zero. This was due to the poor reliability for
the separate scores on Subrole III and the very high correlation
between parts (A) and (C) on Subrole IV.

These reliability estimates limited the conclusions that
could be drawn from any test involving the TRQ difference scores.

The next section of the questionnaire was labelled Section
C, and forms Appendix G. This is the Traupmann-Utne-Hatfield
(1978) Scale, which was developed by members of the research team of
the Walster, et al. (1978) book on equity theory. The scale was
developed to measure the level of equity intimate couples perceive
in their relationships. Reliability and validity data are available
on an earlier form of the scale (Traupmann-Utne-Walster [1977]
Scale) which confirm its reliability and construct validity
(Traupmann, Peterson, Utne, 8 Hatfield, Note 7). However, this
earlier version of the scale required that each respondent calculate

his or her inputs to the scale for each of roughly 20 areas, then

55

to calculate his/her partner's inputs for the 20 areas, then to
calculate his/her outcomes for each of the 20 areas and finally to
calculate the partner's outcomes for the 20 areas. Afterward the
experimenters performed the necessary computations to determine

the perceived level of equity or inequity. As this was incorporated
into a face to face interview format, it was feasible for the
Traupmann, et al. research team; but even they found it cumbersome.
It was clearly impractical for incorporation into a pencil and
paper questionnaire in this study that was already of substantial
length. On that basis, an unpublished revision of the scale, the
Traupmann-Utne-Hatfield (1978) Scale was used. This repeats the 25
areas of the 1977 Scale and the instructions for response, but is
different in that the respondent is requested to make the "calcula-
tion" internally as to whether in this area the partner or the
respondent is "getting a better deal," or whether respondent and
partner are equal for this area.

On pre-tests of a revised version of the 1977 Scale with
samples of male and female college students, Traupmann, Utne and
Hatfield found that when asked to calculate mentally "who gets a
better deal" over only four very broad areas labelled Personal,
Emotional, Day-to-Day, and Opportunities Gained and Lost, the
validity of a scale this brief was confirmed. In essence, the
experimenters found that requesting the subject to "do the calcu-
lating" internally was as effective as the more laborious 1977
Scale (Traupmann, Hatfield, 8 Wexler, Note 6). For this study the

longer 25 area version of the scale was chosen rather than the four

56

area version, in the interest of potentially finer post hoc analysis
of the relationship dynamics of the couples studied. The portions
requesting a rating of "How important is this to you?" were not used
to weight responses by the subjects because they had not been used
previously in the calculation of reliability and validity for the
other versions of the scale.

The next portion of the questionnaire was labelled Section
D for the subjects' convenience and forms Appendix H. This is the
Dyadic Adjustment Scale, created by Spanier (1976) as a tool for
assessing the quality of marriage and other similar dyads. It was
included in the study to provide a measure of marital satisfaction
with well standardized reliability and validity. In this way the
relationship between equity/inequity scores and a marital satisfac-
tion measure could once again be explored for this sample popula-
tion, and the predictive validity of the Taylor Role Questionnaire
could be examined.

The next to last portion of the questionnaire was labelled
Section E and forms Appendix I. It consisted of nine open-ended
questions regarding the experience of the respondent as either a
person in medical education or the spouse of such a person, or both.
Respondents were told they could make their answers as long or as
short as they desired. In fact, some respondents did not complete
this section at all, although this was unusual. These questions
were phrased to elicit the ways in which the respondents might
perceive overbenefit or underbenefit "accumulating" in their lives,

and their ideas about how in the future this inequity (if it was

57

perceived) might be restored. Analysis of this portion of the
questionnaire requires training of independent raters, and as will
be noted in the discussion of results, this was not possible at the
time of the present study.

The final portion of the questionnaire as mailed to the
subjects was labelled the Stress Adjustment Scale. This forms
Appendix J, and is included only because it could conceivably have
affected answers to the other portions of the questionnaire. This
scale was a pilot measure for Ms. Dorothea Torstenson, who is a
research colleague of the investigator and a researcher interested
in studying the effects of stress on medical students from the view-
point of family organization theory. Ms. Torstenson was an official
co—investigator for the study during review by the University of
Wisconsin, Madison, Center for Health Sciences, Committee for the
Protection of Human Subjects; and her name is mentioned as such in

the Introduction and Consent form.

RESULTS

Statistical Treatment of the Data
All significance levels given in this study were for two-

tailed tests.

Hypotheses Concerning Equity/
Ineguity

Hypothesis l.--For Hypothesis 1, a number of analyses of

 

variance were performed. In a comparison of the entire sample,
medical spouses were compared with non-medical spouses. The
hypothesis was confirmed, as medical spouses saw themselves as
significantly overbenefited on the TUH, in comparison to the non-
medical spouses (p_< .004). The mean for medical spouses was 0.94,
versus -2.64 for the non-medical spouses. To see if separating out
the dual-medical couples would alter this effect and to see if
separating out the house staff and their spouses would alter the
effects, further analyses were made. With the dual-medical

couples removed, medical spouses saw themselves as significantly
overbenefited (p_< .002) compared to their non-medical spouses.

The revised mean of 1.89 for medical spouses substantially exceeded
the -2.64 mean for the non-medical spouses. Obviously the dual-
medical spouses had lower mean scores on equity/inequity than their
medical colleagues. Table 5 shows that the dual-medical mean score

(-0.76) actually was one of slight underbenefit, although the

58

59

underbenefit was greater among the men (-l.04) than among the women
(-O.48).

Removing all house staff couples and leaving only couples
composed of medical students and their non—medical spouses, medical
spouses saw themselves as significantly overbenefited (p,< .02) as
compared to their non-medical spouses. The mean for the medical
student spouse was 2.23. For the non-medical spouse the mean was

-2.22. See Table 4.

Hypothesis 2.--For Hypothesis 2, another series of

 

analyses of variance were performed. On a direct comparison of all
persons in medicine, comparing males versus females, the difference
in equity/inequity scores was not significant. Interestingly
enough, the direction of the scores was the reverse of that
predicted. The mean for males was 1.82, while the mean for females
was -0.09.

Removing the dual-medical couples, a comparison of all
persons in medicine by sex revealed a similar but statistically
insignificant result (p_< .11). For the spouses within these non-
dual couples (i.e., non-medical persons married to medical
students or to house staff), the difference was significant
(p_< .02) but opposite to the predicted direction. Female spouses
perceived themselves as more underbenefited than did male spouses.
In fact, the mean for male spouses was one of very modest

overbenefit.

6O

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mmmzoom Houpomz

 

 

 

oNH. v.m *Nm mm.oH mo.o- Hm ~m.m om.o -coz cpmsp oco mpcmopmmm
. . . - . . mmmsoom Hoopomz
80 v m S R a 2 N 8 a m 8 N -82 +8.: ea 3:83pm
. . . 1 . . mmmooom Hoopomz-coz cpmsp
moo v.m *Hm mm m we N om Hm m mm H oco mpcmopmmm oco mpomoopm
woo. v.m Hm mo.o oo.~- oeH mm.m em.o mHosom Hopoh
Hm>mp z .o.m m z .o.m m
appHpoooogm

mmzoom Hoopomsicoz

mmooom Hoopomz

 

.mmmaoom

Hoopom21coz oco mmmooom Hoopomz moHLoosou mmpoom mHoom HmmmHH oHmpmpozumcp=-::oEo:ophuu.o mpm<h

61

 

 

 

 

as. v.m mm me.o eo.H- mm Np.o me.o- maHaaoo Haupoaz-pa=o
mam: mum

om. v.m mm mm.p 80.0- oe «H.9H m~.m- co mamawamopwwpwa2wmou
. .m . . . . mmmooom HoopomZTcoz

op v oe em m mm m am pm a me o app: mpcaoapm Haopoaz
No. v.m mm NN.H mH.o mm op.op Hp.e- mamaoam Haupoaz-eoz
mmmooo opp m .:o

Hp. v.m Hm No.m NN.m mm op.m m_.o sppz mcwmhoa.waupomn

mp. v.m OH om.w No._ co oo.m mo.o- maOmLaa Haopoaz HH<

Ho>mp z .o.m H z .o.m m
szHHoooocm mmHoz mmHoEmH

 

.HmmHoz mzmpm> mmHoEmHV mmgoom mHoum HmHmHV oHmpppoximcpzuccosoooghuu.m mpm<~

62

Removing the residents and their spouses, and continuing the
same series of tests, in comparing medical students by sex, the
difference was non-significant. The means once again were the
reverse of the predicted direction.

For the non-medical spouse of the medical student, the
trend continued, although statistical significance was not reached
in the comparison by sex (a; = -0.69, 6 = -3.28).

Given these values from one-way analyses, it was not
surprising that (on a two-way analysis of variance of couples, with
dual-medical couples excluded) medical persons were significantly
(p_< .004) overbenefited and females were significantly (p_< .004)

underbenefited, as shown in Table 6.

Hypothesis 3.--In an analysis of variance comparing the

 

pooled groups of dual-medical couples and non-dual couples, across
sex, no statistically significant difference was found. However,
in a two-way ANOVA comparing medical persons who have non-medical
spouses, the non-medical spouses, and dual-medical persons, the
main effects for medical status and for sex were significant.
These means were in the direction predicted, as medical spouses
were overbenefited compared to the non-medical spouses. For
females, dual-medical spouses had a mean between the other two
groups. For the male group of dual-medical persons, the dual-
medical spouses included four MD's, who were the only medical
persons who were not in training. As a post hoc test, data were

analyzed both with and without the scores from these MD's. With

63

TABLE 6.--Traupmann-Utne-Hatfield (1978) Scale Scores: Medical
Students and House Staff and Their Non-Medical Spouses.

 

 

 

 

Medical Spouses Non-Medical Spouses
Sex _ _
X 5.0. N X 5.0. N
Female 0.15 9.79 39 ~4.7l 10.80 52
Male 3.22 8.02 51 0.13 7.22 39

 

Main effect for sex significant, p_< .004.
Main effect for medical status significant, p_< .004.

64

the MD's included, dual-medical spouses had a mean score below

that for the non-medical male spouses. Removing four male MD's,
however, shifted the mean for dual-medical males from -1.04 to 0.14,
almost identical to the 0.13 mean for male non-medical spouses.

In the one-way ANOVAs suggested by this hypothesis, female
medical students and house staff who are dual-medical spouses were
not significantly different from female students/staff who were
married to non-medical spouses. Among the male persons in medicine
(MD's included), the dual-medical husbands felt significantly under-
benefited compared to the male medical persons married to non-
medical spouses, as predicted. Among the male persons in medicine
with the MD's removed (so that the comparison was between two
student/house staff groups), the difference approached significance
(p_< .06) and once again the mean was greater for non-dual males.

In summarizing the findings for Hypotheses l, 2, and 3, the
prediction that, in comparison to each other, medical spouses would
feel overbenefited and non-medical spouses would feel underbenefited
was strongly confirmed. In regard to sex differences, however, it
was the medical males married to non-medical women who felt the most
overbenefited, and their spouses who felt the most underbenefited.
As shown in Table 7, it was this contrast that accounted for the
main effects of sex and medical status. In dual-medical couples
both partners felt somewhat underbenefited, although the difference
between partners was slight.

A post hoc analysis of variance of discrepancy scores on the

Taylor Role Questionnaire was performed to further probe these

65

TABLE 7.--Traupmann-Utne-Hatfield (1978) Scale Scores Comparing
Medical Persons, Non—Medical Persons, and Dual-Medical

 

 

 

 

Couples.
Medical Persons Dual-Medical Non-Medical
Sex (Non-Dual) Couples Spouses
)1 5.0. N 2 5.0. N )1 5.0. N

 

Female 0.15 9.88 39 -0.48 6.72 25 -4.71 10.80 52
MD's In
-l.O4 8.48 25
Male 3.22 8.02 51 0.13 7.22 39
MD's Out
0.14 8.40 21

 

Main effect for sex significant, p < .02.
Main effect for medical status significant, p < .01.

66

results. Statistically significant differences in perceived role
conflict were found. Role conflict was operationally defined as
the discrepancy between perceived performance minus perceived
expectations on the TRQ. For the TRQ Subrole II, Emotional/Sexual/
Supportive Partner, the difference was significant (p_ < .04).
Women married to medical spouses had a mean score of -4.35. Dual-
medical women had a mean score of -5.24 and medical women with
non-medical spouses had a mean score of -7.10. For Subrole I,
Homemaker, and for Subrole 111, Social Partner, the means fell in
the same direction, although the probability levels differed as
given in Table 8. Interpretation of these values, however, is
weakened by the poor reliability of these difference scores.

For the spouses of these women, there were significant
differences only on the Homemaker Subrole, where men in medicine
married to non-medical women saw themselves as significantly
"ahead." See Table 9. Apparently the women in medicine did
perceive role conflict as defined in this study, but rather than
feeling uncomfortable and overbenefited, they took it in stride.
Of course, role conflict as defined here was based on the tradi-

tional wife role.

Hypothesis 4.--A Pearson §_was calculated on the entire

 

sample, correlating the score on the Spanier Dyadic Adjustment
Scale and the absolute value of the score on the TUH, such that

greater amounts of inequity (either overbenefit or underbenefit)

67

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©MMZ mNNZ Nmflz
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prppaanoca gppz case: Haopomz Haopoaz-pa=o Haopooz-=oz mpocnsm

 

mm>HmmEmsp mcpopgommo

mocpz mucospomcmov mpoom poHHmcou mHom

”mmHoEmu HH< Lop

*.Hmcoppopomoxm
mmpoom mgpoccoppmmoo mHom LoHaop--.m mpm<~

68

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2. L. 8.? was 2.0 85.5. 3.88 "H:
. . n . u . . mepcom m>ppgooosm
Bo. v m 3.0- 85 m: 232.88: ”H
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mm>p3 epoch mcpoppommo

 

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macHz mocoeLoHLmov mpoom poHchoo mHom "mmHoz HH< Lop mmcoom mppoccoppmmoo mHom conoh--.m mpm<~

69

were correlated with the marital satisfaction score. A correlation
was found of -0.30 (p_< .0001).

This result confirmed the theoretical premise that either
perceived overbenefit or perceived underbenefit is not a comfortable
position in a marital dyad. It also supported the construct vali-
dity of the Traupmann-Utne-Hatfield (1978) Scale.

Hypotheses Interrelating Role
Conflict, Equity, and Androgyny

 

Hypothesis 5.--For the sample of female medical persons and

 

their spouses, a Pearson r_was calculated to determine the possible
correlation between the discrepancy scores of the Subroles of the
TRQ and the absolute value of the score on the TUH equity/inequity
measure. Two significant correlations were found, for Subrole II,
Emotional/Sexua1/Supportive Partner, at -O.19 (p_ < .02) and for
Subrole III, Social Partner at -O.17 (p < .03). The correlation for
Subrole III, Social Partner, however, has relatively little meaning
as the reliability level of this discrepancy score was so poor (see
Measures section). The correlation for Subrole 11 suggested that,
as predicted, when the discrepancy score increased its numerical
value (implying the woman was coming closer to or surpassing
expectations), perceived inequity diminished. For Subrole I,
Homemaker, there was a correlation of -O.14 (p_< .07). The correla-
tion was not computed for Subrole IV, Child Care, because of its
greatly reduced sample size (16 couples with children).

These findings tended to support the construct validity of

the TRQ. For this group of individuals it would be logical to have

70

less investment in a wife's performance of the task-oriented
behaviors in Subrole I, Homemaker, than in her performance of the
emotionally oriented aspects of Subrole 11. However, the predictive
power of the discrepancy score on Subrole I was weakened due to the
fairly high correlation between part (A) and part (C), and the
resulting reliability estimate of 0.34 for that discrepancy score.
Therefore, the lack of correlation may be due in part to this low
reliability. Persons who are women in medicine or their spouses
would also be more likely to find Subrole II, Emotional/Sexual/
Supportive Partner, more important than Subrole I, and apparently
this was the case. Because this correlation accounted for less
than 4% of the shared variance of the measures, this point should

not be overemphasized.

Hypothesis 6.--In a comparison of the means and standard

 

deviations on the Bem Sex-Role Inventory (BSRI), the 64 female
medical persons had a mean masculinity score of 4.78, with a
standard deviation of 0.48. For the femininity score, their mean
score was 5.02, with a standard deviation of 0.38.

For 279 Stanford University undergraduate women in Bem's
(1974) sample, the mean masculinity score was 4.57, with a standard
deviation of 0.69, and the mean femininity score was 5.01, with a
standard deviation of 0.52.

For the 52 non-medical women in this study, their mean

masculinity score was 4.37, with a standard deviation of 0.76, and

71

their mean femininity score was 5.21, with a standard deviation of
0.51.

Student's tftests were performed and the statistical
significance evaluated, taking into account the differences in
variance between the samples. Medical women's mean masculinity
and femininity scores significantly (p_< .02) exceeded those of
both the undergraduate women and the non-medical women in the
study. Therefore, the hypothesis was confirmed.

The small BSRI standard deviations among the medical women
seem noteworthy, and sharply decreased the likelihood that the

Bem scores could have predictive power.

Hypothesis 7.--A multiple regression equation was calculated

 

four times, with the dependent variable being each of the four
Subrole scores for part (A) of each of the TRQ questions, and the
independent variables being (1) BSRI masculinity score; (2) BSRI
femininity score; and (3) the product of those two scores. None of
the resulting beta weights attained significance, so Bem scores
were not significant predictors and in this sample increasing
androgyny did not significantly predict the level of expectations

of feminine spouse behavior for the female medical persons.

Hypothesis 8.--For all women in medicine, a multiple
regression equation was again calculated, with each of the four
Subrole scores of the TRQ for part (C) as the dependent variable

and the BSRI scores as the independent variables. As had been

72

hypothesized, the Bem scores did not significantly predict level of
performance.

Hypotheses Concerning Level of

Androgyny of Spouses

Hypothesis 9.--Four multiple regression equations were

 

performed using as dependent variables each of the four Subrole
scores for part (A) of the TRQ. The sample examined included the
female medical persons and their spouses, and beta weights were
determined to see if the BSRI scores were significant predictors
in the case of husbands, wives, or both. The only significant
predictors were status as husband or wife. The androgyny measure
continued to have no predictive power.

To examine the reason for the husband/wife difference, a
post hoc ANOVA was performed, examing the (A) scores on the four
Subroles with comparisons by sex. For all four Subroles the women
expected significantly more of themselves than did their husbands.
This did not contradict anything previously hypothesized. It
supported the assumption that women in medicine continue to be
influenced by the traditional expectations for women. Further
post hoc analyses would be desirable, however, to see if this
finding is true only among women in medicine, or if it is true for
women in general. See Table 10 for a complete presentation of data

for these one-way analyses.

Hypotheses 10 and ll.--Since Hypothesis 7 was not confirmed,

 

it was improbable that Hypothesis 11 would be confirmed. Four

73

 

mem comm mH u zH

 

 

 

mo. v.m om.m om.m_ me.m oo.mH memo oppgo ">H
moo. v.m mo.~ em.m Ho.N mm.op Lacpeaa Hapuom ”HHH
Hooo. v.m om.m “H.5m om.m mo.me cw”wnmmmw”wwmwmmnw "HH
Hoooo. v.m mm.e ou.m~ He.e mm.p~ capaEan: ”H
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ppHHpaanoaa apocnam

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How u 2V mmHoEmu

 

.mcoppopomoxw Ho Hm>mpnummcoom <omh

"mmmooom ppmcp oco mcomgmm Hoopomz mHoEmH--.oH mpm<~

74

multiple regression equations were calculated, with the discrepancy
scores (C minus A) on each of the four TRQ Subroles as dependent
variables and the Bem scores and status as husband or wife as
independent variables. As in Hypothesis 9, the androgyny measure
had no predictive significance. The low reliability of discrepancy
scores on Subroles III and IV weakened, of course, the likelihood
that difference scores on these Subroles would respond as had been
theorized. However, even the relatively more reliable Subrole II,
Emotional/Sexua1/Supportive Partner, discrepancy score was not
predicted by the Bem scores.

There was, however, significant prediction by status as
spouse. Post hoc one-way analyses of variance were performed on
the four Subroles. As shown in Table 11, in Subrole II, Emotional/
Sexual/Supportive Partner, and in Subrole III, Social Partner, the
woman in medicine saw herself as doing a "much worse job" than her
husband perceived her as doing. Yet despite a significant correla-
tion between their own perceived inequity and the TRQ discrepancy
scores (Hypothesis 5), these women did not perceive themselves as
greatly overbenefited (letting down husband). This could be
explained several ways. A possibility is that this measure of
discrepancy was limited because it was based on the traditional
role only. If these women value themselves for less traditional
behaviors and their husbands do likewise, their discrepancy in
these areas may not markedly influence overall happiness or

satisfaction.

75

 

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e d. o o I o o I
ma v mm N oo o mH N om o mpou oHH;u ">H
Hoooo. v.m mm.N mm.o- mo.N ON.N- cmoppom Hopoom HHHH
. . . . . - cmcppom m>ppgoooom
mm. v.m mm.e mN.o- mm.e mp..- LaxasaEOI "H
.a.m x .o.m x
Hm>mp - -
Appppaaaoca apoanzm

Hoo 1 2H mmHaz

Ave n 2V mmPoEmu

 

coppopomoxm mocpz mocoELoHLmo--mmpoom <noomh

.Hpu__pcoo apomv

“mmmooom Epoch oco mcomcma Hoopomz mHoEmm--.HH mpm<p

76

Second, it has been determined in a number of studies
that the husband's perceptions are more predictive of marital
satisfaction and adjustment than are the wife's perceptions (Barry,
1970; Luckey, 1960a). This finding may be reflected in this study
by a high expectation by the wife for being emotionally available
to her spouse. The husbands may be somewhat more realistic about
the extent to which they expect their wives to be emotionally
available. Accordingly, the husbands did not feel "let down" by
the wives, and possibly this accOunted for the fact that neither

medical wives nor their husbands perceived much inequity.

Hypothesis 12.--A Pearson §_was calculated for the

 

discrepancy scores of female medical persons and their spouses for
each of the three Subroles of the TRQ which hold substantial
sample size. Two of these correlations were significant. For
Homemaker, the correlation was 0.50 (p_< .0001). For Emotional/

Sexual/Supportive Partner, the correlation was 0.29 (p_< .02).

Hypothesis 13.--In light of the fact that Hypotheses 10
and 11 were rejected and that the Bem scores had no predictive
power in hypotheses tested thus far, it was unlikely that
Hypothesis 13 would be confirmed. In two regression equations the
BSRI scores for female medical persons and their spouses failed to
significantly predict either the Dyadic Adjustment Scale score or
the absolute value of the score on the Traupmann-Utne-Hatfield

(1978) Scale.

77

Hypothesis 14.--Analysis of this hypothesis requires

 

access to independent raters who can evaluate the written
responses to the open-ended questionnaire while remaining blind to
the hypotheses of the study and the equity/inequity scores of the
individuals. Such raters were not accessible at the time of the
present quantitative analysis. A post hoc analysis of these
written answers is planned.

Hypotheses Concerning_0emographic

Variables

Hypothesis 15.--A multiple regression equation was calcu-

 

lated with data from the entire sample. The dependent variable
was the Spanier Dyadic Adjustment Scale score and the independent
variables were number of years married, number of children, and
status as either medical student, intern/resident/spouse of a
student or spouse of a resident. Individuals in dual-medical
couples were identified by their medical status if they were
students or residents. None of the independent variables in
combination did not significantly predict the Spanier score. This
confirmed the hypothesis that within this sample these demographic
variables were not strongly influential.

An Attempt to Estimate
Predictive Power

 

Hypothesis 16.--0n the basis of the preceding hypotheses, a

 

multiple regression equation was calculated for the entire sample.
The dependent variable was the score on the Dyadic Adjustment Scale

and the independent variables were the absolute value of the score

78

on the Traupmann—Utne-Hatfield measure, the four discrepancy (role
conflict) scores on the TRQ, and the three possible BSRI scores,
masculinity, femininity and the product of the masculinity and
femininity scores.

In the resulting equation five of the variables achieved a
significant F level at p_< .05. Three were significant at better
than the p_< .01 level. In order, these were the role conflict
score on Subrole II (Emotional/Sexua1/Supportive Partner), the
femininity score on the BSRI, and the absolute value of the equity/
inequity score on the Traupmann-Utne-Hatfield (1978) Scale. For
all the independent variables, standardized beta weights, F
values, and simple correlations with the dependent variable are

presented in Table 12.

Discussion

The Taylor Role Questionnaire

 

The present findings suggest that the Taylor Role Question-
naire had satisfactory internal consistency for three of its four
Subroles. However, the reliability of discrepancy scores was low
for Subrole I (0.34) and essentially zero for Subroles III and IV.
Accordingly, only Subrole II, Emotional/Sexua1/Supportive Partner,
has moderately high internal consistency for both responses to
parts (A) and (C), and also for the discrepancy score calculated by
subtracting (A) from (C). Subrole 11 received some construct
validation by showing significant correlations, as predicted, in

Hypotheses 5 and 12.

79

 

ngou oppcuv >H mHognzm

 

mo. v.m moo.o Nc. moo.- cab co mgoom Hoooomcompo
. . . . apowoomv HHH mpognzm
mo v m. oN o mN NO ONE co mgoom Hocoomgompo
. . .- .- Hcaxaeasozv H apocazm
mo v.m mN N mo oH oak :o mgoom mocoomgompo
mo. v m. mo.¢ m_.- HN.- Hmmm co aeoom appeppzomaz
. . . . Hmmm co mmgoum
mo v.m “NH m mH ON prcpcpemu oco prcszomoz mo poooogm
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Ho. v.m NH.mH mm. wN. Hmmm co aeoom Appapcpeaa
. . . . ApmcowHOEmv HH mpognzm
Ho v.m mm NH Hm Hm oak co mpoom mocoomgompo
mHooHLo>
Hm>mp pcmocmomo op pzmpmz opmm
prppaaaoaa a coppaHacLoo oaNpoLaocapm mHaaHLa> pcaocaamocH
apaspm

 

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”Hoopm mpzp :H mmpnopgo> Low Lmzom m>ppopumgm m>ppopmmuu.NH upm<h

80

Hypotheses Concerning Equity]
Ineguity

The significant findings of Hypotheses l, 2, 3, and 4
supported the view that within the medical marriage the medical
spouse tends to feel that he or she is "getting a better deal"
while the non-medical spouse feels he or she is "getting a poorer
deal." Although true as an overview, this sense of overbenefit
seemed to come most strongly from the male medical student married
to a non-medical wife, and the sense of underbenefit came largely
from the non-medical wives of interns/residents (Table 5).

The predictions that women in medicine would feel even more
overbenefited than their male counterparts and that their spouses
would feel more underbenefited than the wives of medical persons
were not confirmed. Within the sample women perceived themselves
as significantly underbenefited as compared to men. This was due
to (a) the greater sense of underbenefit perceived by the non-
medical wives, (b) the relatively small sense of overbenefit
experienced by the female medical persons with non-medical spouses,
and (c) the underbenefit (though very small) perceived by women in
dual-medical couples.

Inevitably there are many possible reasons for these
findings, and without further exploration they must remain specula-
tive. However, the present data suggest that women in medicine and
their spouses, either in medicine or not, have adjusted relatively
well to the situation and are not in fact distressed by the wife's

career role. The main exceptions to this rule were the dual-medical

81

MD husbands. Their mean inequity score averaged much lower than
any other group examined, although there was a considerable range
within this group. Since these persons were no longer in training,
perhaps the element of identification with a medical student/house
staff wife has been reduced, and they felt entitled to more from
their wives. The literature on medical socialization suggests that
after residency training is finished, physicians work as hard or
even harder than they did when they were residents. Perhaps these
four men have followed that pattern and now experience themselves
as needing more from their wives and also putting more into the
relationship in terms of income and prestige. All of these factors
could increase their perceived inequity.

The finding that, on the whole, the women in medicine and
their husbands perceived rather little inequity was surprising in
view of the fact that these women had high expectations for them-
selves in the female spouse role and saw themselves as failing to
reach those expectations (Tables 10 and 11). For women in medicine
and their spouses there was also a significant (p_< .02) correla-
tion, although small (-0.19), between discrepancy scores on the
more reliable Subrole II, Emotional/Sexual/Supportive Partner, and
amount of perceived inequity.

The assumption that discrepancy between performance and
expectations was attributed to being in medicine received
empirical support. Part (D) of each question asked "To what extent
is your behavior (in this area) influenced by . . . (your occupa-

tion [for non-medical wives]/being a medical student or intern/

82

resident [for medical wives])?" In tytests comparing the means of
answers to this question, medical women had significantly higher
scores for Subroles I, II, and III. In other words, as compared to
the non-medical wives working outside the home, being in medicine
had greater impact upon the wife role than other occupations had.

By contrast, the husbands of medical and non-medical women
saw a significant difference only for Subrole II, Emotional/Sexual/
Supportive Partner. On that Subrole husbands viewed medicine as
having more impact than other occupations.

Evidently there is a flaw in the logic which hypothesized
that a woman who sees herself as not performing the behaviors she
expects of herself must experience this as inequity, i.e., getting
more from her spouse than she is giving. Perhaps the correlation
between discrepancy score and perceived inequity was due to husbands
alone, rather than their wives. A number of other explanations are
also possible. As noted above, perhaps these women are holding up
rather unrealistically high expectations for themselves. They are
likely to be high achievers; perhaps they set high goals for them-
selves in these areas as well. However, it may be that not meeting
these goals is simply not overwhelmingly important to these women,
so it does not induce feelings of distress or guilt, or any of the
other emotions that might be imagined to accompany perceived
inequity.

In addition, the women's spouses perceive less discrepancy

between expectation and performance than do their wives. The wives

83

must be aware of their husbands' points of view; perhaps the wives'
perceptions of inequity in fact has more to do with their husbands'
sense of the level to which they are "failing at the job" than
their own. This would be in accord with the marriage research
previously cited, showing that the most powerful predictors of
marital satisfaction and adjustment were the husbands' perceptions
about the relationship (Barry, 1970; Luckey, 1960a).

It is also possible that these women see themselves as
making contributions to their marriage that were untapped by the
TRQ. These might be aspects outside the traditional wife role, but
such non-traditional inputs are likely to be extremely important
for these couples. In that way a lack of input from the wife in
the more traditional aspects could be balanced back to equity.

In contrast to the women in medicine and their spouses,
the non-medical wives and their medical husbands are, by the
definitions of equity theory, experiencing distress. This dif-
ference may be attributable to the fact that for almost all men
married to women in medicine, they have an active career and often
one of equal status. Of course, roughly 40% (25 of 64) of the
women in medicine in this study were married to other physicians
or future physicians. An unsystematic inspection of the data
suggested that non-medical wives were much more likely to be cast
in the role of the support person of the two-person career than
were the husbands of women in medicine. These wives were more
likely to be in a job which was apparently to support the couple,

rather than a job which provided a distinctive and active career.

84

It is equally possible that this support role prevented the wife
from being a homemaker and starting a family if that were her
preference. In line with these possible reasons for perceived
inequity, it will be especially interesting to examine the open-
ended questions, in particular to review what these wives state
that they miss most and what changes they anticipate subsequent to
medical training.

The finding that non-medical wives felt underbenefited and
their husbands felt overbenefited is also interesting in light of
an examination of the Spanier marital adjustment scores for these
groups. As shown in Table 13, two post hoc analyses of variance
compared the groups of (1) medical persons married to non-medical
persons, (2) dual-medical persons, and (3) non-medical spouses,
for each sex. The women showed no significant differences in
marital happiness or adjustment scores. There was a statistically
significant difference (p_ < .02) among the males. Non-medical
spouses had the highest mean score (115.1%.medical spouses were
next highest (110.8), and dual-medical males were lowest (107.8).
The MD's mean was 111.3.

Obviously the non-medical women felt strongly under-
benefited (as confirmed in Hypotheses l, 2 and 3) but did not
describe themselves as significantly less happy in their marriages,
despite a significant inverse correlation (-0.30) between marital
happiness score and perceived equity/inequity score (Hypothesis 4).
This incongruity may be partially attributed to the relatively

modest correlation, since it accounts for only 9% of the shared

85

 

 

 

 

 

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86

variance despite its statistical significance. A number of other
explanations are possible. This could be an area in which responses
are biased by the knowledge that it is more socially acceptable and
desirable to describe one's marriage as happy. The Spanier scale
assesses marital satisfaction quite overtly, and was so character-
ized in the initial telephone contact with potential subjects. It
is also possible that underbenefited spouses, despite the instruc-
tions of this study, justified their present inequity to themselves
with a rationale that it would be balanced out by future rewards,
and therefore the marriage on the whole leaves them content.
Finally, a number of authors have pointed out that while
married women report symptoms and problems, such as feelings of
depression, being unhappy most of the time, sometimes feeling like
they are about to go to pieces, and being bothered by pains and
ailments, to a greater extent than do unmarried women, they also
report that they are happy more often than do unmarried women
(Bernard, 1972a, 19726; Donelson, 1977). How is this apparent
paradox possible? One explanation is that these women are on the
whole happy and fulfilled in spite of their problems, or in the
instance of this study, despite their perceived inequity. They
have been taught to value the nurturant role of wife, and possibly
the role of the support partner in the two-person career, and to
find that satisfying. Alternatively, perhaps these women are
confusing “happiness" with adjustment to the expectations held by
themselves and the society. Having married, which they understood

to be the only appropriate thing for a woman, they are trying to

87

adjust to marriage and please their husbands. They may interpret
their conformity to societal expectations as a signal of assurance
of happiness and health (Bernard, 1972a, 1972b; Donelson, 1977).

For the non-medical wives this could be very much the case, because
to "marry a doctor" is in many ways the ultimate success in con-
forming to the expectations of this society. It might be para-
phrased: "I must be happy. I'm married, aren't I, and my husband's
going to be a doctor." If this is true, the literature on the
physician marriage suggests that such a basis for satisfaction may
not be very reliable.

In contrast to the medical/non-medical couple, for dual-
medical couples their equity/inequity scores are much closer to
equity and they are less likely to experience distress. However,
since both partners perceive a small amount of underbenefit, these
dual-medical couples apparently suffer from a sense of "not enough
to go around." Each spouse, especially the males, seems to think
that the other one really should be doing a little more. This does
not seem surprising in the light of the complex life-style
required by dual-career marriages.

It should be noted that throughout this study there is a
distinct possibility of response bias, since the researcher
presented her interests very openly in the initial telephone
contact with subjects and also in all the introductory information.
This included a direct statement that her prime interests were in
women, in this case women in medicine and non-medical wives, and in

dual-career marriages. Some of the professed contentment of women

88

in medicine and their spouses, as displayed on the Traupmann-
Utne-Hatfield (1978) Scale, might be attributed to an effort to
"look good." However, such an effort would likely have also
extended to the males in medicine and to their wives.

Hypotheses Interrelating Role
Conflict, Equity, and Androgyny

 

The attempt to predict scores on the Taylor Role Question-
naire from the androgyny scores of the Bem Sex-Role Inventory
encountered two methodological problems. In the first place the
very low internal consistency values of the TRQ expectation scores
for Subrole III, Social Partner, were such that predicting them
would have been unlikely even if the theoretical premise were
entirely correct. Furthermore, the low reliability level for
Subrole I discrepancy scores and the zero reliability level for
Subrole III and Subrole IV discrepancy scores suggest again that
predicting them would have been unlikely even with accurate theory.

The second methodological problem was that the range of the
Bem scores was so limited for the female medical persons that it
would have been difficult to predict any other score from these
minor differences.

Given these methodological problems, it was difficult to
evaluate whether the theoretical construct is totally at fault or
not. In post hoc analyses, numerous regression equations were
constructed to see if the Bem scores would significantly predict
expectation, performance, or discrepancy scores for either the

sample of non-medical women, or the sample of all women in the

89

study. Of course at least the scores for Subrole II, Emotional/
Sexual/Supportive Partner, should have been reliable enough to be
predicted. A number of the TRQ scores were predicted at statis-
tically significant levels by Bem scores, but these varied greatly
depending on the sample being examined. Also in several cases there
was a more or less spurious significance, since the "significant"
independent variable had very little simple correlation with the
dependent variable. While it appears from Hypothesis 14 that at
least the femininity score may have some predictive power for
marital adjustment, androgyny does not appear to have a strong
effect on role expectations or performance. I

There are at least two possible theoretical explanations
for this lack of predictive power. Kaplan (1979) pointed out that
while Bem (1975, 1976) implied that situationally appropriate
behavior, flexibility, effectiveness, and integration are being
measured by finding a balance between masculinity and femininity,
this is a possible but not a necessary outcome. To put it another
way, one can have high levels of both masculine and feminine
attributes and apply them in inappropriate, counterproductive, and
poorly integrated ways. Kaplan and her therapy practicum students
gave the BSRI to their incoming clients and found that, for these
women, androgyny represented what they termed a dualistic stage.
Here the masculine and feminine attributes remained polarized and
each trait was independent of the other. The individual in such a
situation can choose to apply (appropriately or inappropriately)

either masculine or feminine attributes in any given situation.

9O

Kaplan looked forward to a further development which she termed a
Hybgig_stage in which ". . . anger is tempered by love, rather than
love being incompatible with anger; (and) dependency is tempered by
assertiveness, rather than assertiveness being threatened by the
recognition of one's dependency needs" (pp. 226-227). In short,
increasing androgyny may predict an individual who is flexible
enough to alter her expectations for herself in the feminine spouse
role, but this is not necessarily going to be the case.

Second, as Orlofsky (Note 2) stated ". . . sex roles may
not be a unitary phenomenon (comprising closely related person-
ality traits, interests, attitudes and role behaviors) as tradi-
tional conceptions and even some current conceptions seem to
presume . . ." (p. 11). Spence (Note 3) pointed out that many
sex-role behaviors are only weakly related to masculine and
feminine personality traits. For example, behaviors with strong
social norms such as sex-typing of career choice, sexual prefer-
ence, and even attitudes toward the roles of men and women tend to
be closely related to gender but weakly related to within-sex
differences in masculine and feminine personality traits (Spence,
Note 3). By these accounts it is far from theoretically certain
that increased androgyny would indeed predict a decrease in expecta-
tions for the feminine spouse role.

From this study it also appears that the significantly more
"traditionally feminine" woman in medicine who is very uncomfortable

deviating from a traditional role probably does not exist. It is

91

certainly possible that the rigors of pre-medical training have

eliminated such persons long before medical school.

Hypotheses Concerning Level of
Androgyny of Spouses

 

The hypothesis that increasing androgyny in husbands would
predict decreasing expectations for feminine spouse role behavior
was rejected. A very recent study by Orlofsky (Note>2) on psycho-
logical androgyny and male-female attraction in fact suggested that
even persons who are androgynous continue to describe as their
ideal partner someone who is sex-typed. In his study, masculine-
typed males described as ideal partners women closer to the
androgynous range than did androgynous males. Androgynous men
described as ideal partners women who were feminine, rather than
androgynous. If the more androgynous male finds the more feminine
female attractive, it seems possible, but by no means certain, that
he would also find an increase rather than a decrease in feminine
spouse role behavior desirable.

This is, of course, only one possible reason for the rejec-
tion of the hypothesis. It is also possible, as noted above, that
these expectations are simply not strongly tied to an individual's
level of psychological androgyny.

An Attempt to Estimate
Predictive Power

The regression equation of Hypothesis 16 suggested that in

the present sample demographic factors such as number of children

or years married were not predictive of marital satisfaction level.

92

Instead three of the variables examined in this study had predictive
significance at p_< .01 and at least modest correlations with the
dependent variable, marital satisfaction score. These three
variables were the BSRI femininity score (:_= .39), the discrepancy
score or role conflict score on the TRQ for Emotional/Sexual/
Supportive Partner (§_= .31), and the absolute value of the score
on the Traupmann-Utne-Hatfield (1978) Scale ([_= -.26). As the
femininity score had shown such inconsistent predictive power in
regression equations involving all the women in the sample,

further post hoc analysis will be required to explain its influence.
It is possible that an increasing femininity score among men is
predictive of increasing marital satisfaction for them. It could
be argued that this would suggest a more emotionally sensitive and
adept man, who might be a better partner and part of a happier
marriage.

The correlation between the role conflict score for
Emotional/Sexual/Supportive Partner and marital satisfaction sug-
gests that this portion of the wife role may have been seen as
important by the entire sample.

The influence of the inequity score has already been
discussed, but it is interesting to note once again that it has
predictive power for the marital happiness score. The finding
that non-medical wives experience inequity and yet report them-
selves as happy remains unexplained. Perhaps further post hoc

analysis will reveal stronger influences from the BSRI femininity

93

score or the role conflict score which outweigh the influence of

the equity/inequity score.

Conclusions

 

The results of this study suggest that while the medical
marriage may never be easy, the view that it holds more dif-
ficulties for the woman in medicine than the man is probably
incorrect. It seems that the focus of future research should
probably center upon the male in medicine and his non-medical wife,
as they are experiencing inequity at its greatest level. However,
this will require careful exploration, as the women in this study
reported themselves as equally happy in their marriages, while
among the men the dual-medical husband was least happy, the medical
husband with a non-medical wife reported himself next happiest,
and the non-medical husband with a medical wife reported himself
happiest.

This study originally postulated that persons who experi-
ence a considerable amount of inequity will anticipate a "balancing"
time for restoration of equity later in the marriage. This was to
be examined in this study because such restoration of equity, if it
is expected in terms of increasing time and attention from the
medical spouse, is unlikely. The disappointment of such an
expectation could be a serious strain upon a medical marriage.

In the absence of analysis of the open-ended questions,
this hypothesis remains untested. After these data are examined

there should be considerably more information which could help

94

persons in the medical marriage examine realistically their future
plans.

While this study attempted to pinpoint factors in relation-
ships and personality variables that would influence the way
couples dealt with medical education, it did not approach the more
clinical area of how to actively assist couples in this coping
process. There are evidently two ways to go about this: assist
the couples to change their less successful behaviors, or alter
the way medical education is presently structured. One of the
subjects in the study commented that he and his wife managed their
life style by being part of a group of dual-career couples who met
socially, exchanged child care, and generally provided a supportive
network. Such successful support systems deserve research
attention.

From the other viewpoint, another subject remarked
pointedly, "Why doesn't someone change the system to reduce the
stress, instead of studying ways to cope with it?" Why not,
indeed? At present the system of medical education shows little
sign of altering, and in fact has little impetus to do so while
there are many applicants for few places, both in medical school
and the more desirable residencies. There seems to be relatively
little consideration of the idea that time to be a spouse or
parent might make one a better physician, or a doctor who lived
longer and suffered less from the ills that plague the profession
(Stuff, Note 4). Until persons within the profession and medical

educators are more open to that viewpoint, future research in this

95

area will, of necessity, focus upon factors which influence stress

and the ways to cope with it.

NOTES

96

NOTES

1Bem, s. L., & Watson, c. Scoring packet: Bem Sex-Role
Inventory. Unpublished manuscript, April 1976. Available from
Department of Psychology. Uris Hall, Cornell University, Ithaca,
New York 14863.

2Orlofsky, J. Esychological androgypy and male-female
attraction. Paper presented at the meeting of the American
Psychological Association, New York, September, 1979.

3Spence, J. T. Traits, roles, and the concept of androngy.
Paper presented at the conference on Perspectives in the Psychology
of Women, Michigan State University, East Lansing, May, 1977.

4Stuff, P. Myths reggrding practice patterns, productivity,
and careers: Research review. Paper presentediat the first annUEl
meeting of Women in Medicine in Wisconsin, Marc Plaza Hotel,
Milwaukee, Wisconsin, May 10, 1979.

 

5Traupmann, J. Equity restoration and friendship.
Unpublished manuscript. University of Hisconsin, Madison, 1975.

6Traupmann, J., Hatfield, E., 8 Wexler, P. Equity and
sexual satisfaction. Manuscript submitted for publication,
October, 1979.

 

7Traupmann, J., Peterson, R., Utne, M., & Hatfield, E.
Measuring equity in intimate relations. Manuscript submitted for
publication, May, 1979.

8Walster, E. J., Traupmann, J., 8 Walster, G. W. Equity
and extramarital sex. Manuscript submitted for publication, 1978.

 

97

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APPENDICES

108

APPENDIX A

A CAUTIONARY TALE

109

APPENDIX A

A CAUTIONARY TALE

Once upon a time a young woman could not decide if she
wanted to go to medical school or to graduate school. She felt she
was probably interested in becoming a psychotherapist in either
case, so she sought out persons to tell her about both. She was
concerned about combining a career and a family life for herself.

At her local college counseling center she spoke to a
psychiatrist, who told her he "did not know a single woman
psychiatrist who was happily married." He also stated he was glad
he personally had married a teacher and not a dumb nurse (like his
classmates), because now his son was smart enough to get into
medical school. When the young woman pointed out that apparently
his wife and child existed in his view only for his benefit, he was
surprised.

The young woman did not go to medical school. In the
broadest sense, this study is dedicated to all persons, past,
present and future, who are changing the world so that it will be

harder to see it as he did.

110

APPENDIX B

GENERAL INSTRUCTION SHEET

111

APPENDIX B

GENERAL INSTRUCTION SHEET

MEDICAL EDUCATION AND MARRIAGE STUDY

General Instructions:
Please first read the enclosed Introduction and Consent Form.

Then sign your name to both copies of the form, and retain one for
yourself, and return one copy to the study. Your partner will do
the same.

Fill out the rest of the questionnaire at your leisure. It is
recommended that you fill out the questionnaire in the order given,
and that you complete a section at a sitting. You may notice that
similar information is asked in several different ways--please bear
with that. Do not "labor over" completing the questionnaire--the
entire process should take roughly an hour. When you have finished
the questionnaire, just put in into the enclosed envelope and mail
it back.

Please do not discuss the contents of the questionnaire with your
spouse until you have both finished it.

Thank you very much for participating in the study. If I have not
received the form back from you in roughly ten days, I will be
contacting you by telephone. If you have any questions, don't
hesitate to call me, Meredith Taylor, 233-8882.

112

APPENDIX C

INTRODUCTION AND CONSENT FORM

113

APPENDIX C

MEDICAL EDUCATION AND MARRIAGE
INTRODUCTION AND CONSENT FORM

The purpose of this study is to utilize certain personality
theories and theories about relationships to look at the impact of
medical education on the marriages of medical students, medical
house staff, and their spouses. Medical students and house staff
were selected as a group to be studied partly because theirs is a
particularly demanding and time consuming profession, both as a
student and as a practitioner. It is hoped that this study will
increase understanding of the kinds of stress medical education
places on marriage, and will enable couples to tolerate the stress
more comfortably. Meredith Taylor and Dorothea Torstenson are the
principal investigators for this study. There are several aspects
of this study, and the portion with Meredith Taylor as principal
investigator will give some special emphasis to the activities of
the female spouse, and to the female medical students or house
staff and their spouses. This is because female medical students/
house staff are usually part of a dual-career marriage (both spouses
involved in a career). Although of course many male students/house
staff are also part of a dual-career marriage, women within marriage
and dual-career relationships are two of Ms. Taylor's areas of
special interest.

For the study you and your spouse will be asked to complete
a questionnaire, described below. You will have roughly a week's
time to complete it. As it states on the forms themselves, just
fill them out at your leisure. It is recommended that you finish a
section at one sitting, and you are asked to finish them in the
order given. Please don't discuss the questions or your answers
with your spouse until both partners have finished the study. This
is to avoid influencing each other's answers. In addition, please
don't discuss the study with your friends or colleagues, since they
may also be taking part. The study will be completed by roughly
June 1, 1979, so you could discuss it freely after that time.

Roughly a week after you have received the packet in the
mail, you will be contacted by Meredith Taylor or Dorothea
Torstenson by telephone. She will check on whether you have
finished the questionnaire and have had a chance yet to mail it
back. As soon as the forms are received from both partners, a
check for $10.00 per couple will be mailed to you, as a way of
thanking you for your participation. The funds will be supplied by
the investigators and Michigan State University.

114

115

In the questionnaire you will be asked (1) some general
information about yourself (age, education, etc.), (2) to describe
yourself, (3) to describe what the wife of the couple is expected
to do under ideal circumstances, and what she can actually do right
now, (4) to describe your marriage in more general terms, looking
especially at "give and take," (5) to evaluate how satisfied you
are with your marriage right now, (6) to comment on some open-ended
questions about the effect of medical education on your marriage,
and (7) to estimate some of the stress you have experienced, and
your adjustment to it. This may seem to be a large number of areas,
but completing the questionnaire should take no more than an hour
or so.

We are very hopeful that this study will help other persons
in medicine and couples to adapt to medical school and practice,
and to foster satisfying and rewarding marital relationships. We
must in fairness state that this is not intended as a counseling
or workshop situation, and your particular relationship may not
benefit directly from the study. It is quite possible, however,
that you will find the time and thought invested useful to your
relationship.

After the forms are completed, the data from the study will
be pooled and analyzed. For the analysis of data, your answers
will be identified by code, not by name. This same data may be
used again in the light of different theories, and we would like
your permission to use your data in the future. For this study and
for any future analysis of data, your responses will be confidential
and reported only in summaries. For the present study it is pos-
sible that we may wish to contact you for a follow-up interview. We
would like your permission to do this. Your participation in any
further interviewing is, of course, always up to you.

After the study is completed, we would be happy to send you
a copy of the results and/or explain in detail the theories behind
the study. We are available to discuss any issues that come up
during the study, if you so desire. You are free to withdraw from
the study at any time.

Please sign the authorization below.

Authorization: I, , have read the above and decide
(name of subject)

to participate in the research project above. My signature also

indicates that I have received a copy of this consent form.

 

 

 

Signature Date

233-8882 or 263-6100
Signature of Principal Investigator Telephone

Please sign and retain the second copy of this form. Just tear it
out of the staple.

 

APPENDIX D

DEMOGRAPHIC GENERAL INFORMATION SHEET

116

APPENDIX D

DEMOGRAPHIC GENERAL INFORMATION SHEET

GENERAL INFORMATION

(PLEASE PRINT)

1.
2.
3.

10.

11.

12.

Your name

 

Your date of birth

 

Today's date

 

Your sex

 

Number of years you have been married

 

Do you have any children?

 

If yes, what are their ages and sexes

 

(If insufficient room, please use the back.)

Is this your first marriage?

 

If not, please give the length of your previous marriage(s),
when they ended, and whether they ended through anullment,
divorce, or death.

 

 

(If insufficient room, please use the back?)
In the family in which you grew up, what was your father's

occupation? Your mother's?

 

 

Did your parents separate, either through death or divorce?
If so, how old were you?

 

 

Where were you in the birth order in your family? (i.e.
middle child with older sister and younger brother, etc.)

Your occupation

 

Spouse's occupation

 

If you were/are a medical student at UW, were/are you an ISP
student?

 

117

118

13. What level of education have you completed?

 

 

14. What level of education has your spouse completed?

 

 

If any item provides insufficient space, please use the back.

APPENDIX E

BEM SEX-ROLE INVENTORY

119

APPENDIX E

BEM SEX-ROLE INVENTORY

SECTION A

On the following page, you will be shown a large number of
personality characteristics. We would like you to use those
characteristics in order to describe yourself. That is, we would
like you to indicate, on a scale from 1 to 7, how true of you
these various characteristics are. Please do not leave any
characteristic unmarked.

Example: sly

Mark a 1 if it is NEVER OR ALMOST NEVER TRUE that you are
sly.

Mark a 2 if it is USUALLY NOT TRUE that you are sly.

 

 

 

 

Mark a 3 if it is SOMETIMES BUT INFREQUENTLY TRUE that you
are sly.

Mark a 4 if it is OCCASIONALLY TRUE that you are sly.

Mark a 5 if it is OFTEN TRUE that you are sly.

Mark a 6 if it is USUALLY TRUE that you are sly.

Mark a 7 if it is ALWAYS OR ALMOST ALWAYS TRUE that you are

 

sly.

Thus, if you feel it is sometimes but infrequently true that you are
"sly," never or almost never true that you arefimalicibus," always
or almost always true that you are "irresponsible," and often true
that you are "carefree," then you would rate these characteristics
as follows:

 

 

 

 

 

Sly 3 Irresponsible 7

 

 

 

 

 

 

 

 

Malicious 1 Carefree 5

 

 

120

121

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

l 2 3 4 5 6 7
l l 4 l l l I
I T I T l T 1
NEVER OR USUALLY SOMETIMES BUT OCCASIONALLY OFTEN USUALLY ALWAYS 0R
ALHOST INFREQUENTLY TRUE TRUE TRUE ALMOST
NEVER TRUE TRUE ALWAYS TRUE
Self reliant Reliable Warm
Yielding Analytical Solemn
Helpful Sympathetic Willing to take
a stand
Defends own Jealous
beliefs Tender
Has leadership
Cheerful abilities Friendly
Moody Sensitive to the Aggressive
needs of others
Independent Gullible
Truthful
Shy Inefficient
Willing to take risks
Conscientious Acts as a leader
Understanding
Athletic Childlike
Secretive
Affectionate Adaptable
Makes decisions
Theatrical easily Individualistic
Assertive Compassionate Does not use
harsh language
Flatterable Sincere
Unsystematic
Happy Self-sufficient
Competitive
Strong personality Eager to soothe
hurt feelings Loves children
Loyal
Conceited Tactful
Unpredictable ,
Dominant Ambitious
Forceful
Soft-spoken Gentle
Feminine
Likable Conventional
Masculine

 

 

 

 

APPENDIX F

TAYLOR ROLE QUESTIONNAIRE

122

APPENDIX F - TAYLOR ROLE QUESTIONNAIRE
VERSION FOR FEMALE MEDICAL STUDENTS OR HOUSE STAFF

SECTION B

In this section we will be asking about the activities and expecta-
tions for the wife in the couple. On the whole this section asks
only about things often traditionally expected of wives. At the
end of the section there will be a space for comments. If you feel
that important areas were not covered in the section as it stands,
please make note of the things that were omitted in the "Comments"
portion.

This section also omits any mention of expectations and activities
for the husband. Clearly there is a full set of these for husbands
as well, but in this study we chose to focus on the wife, and hope
future research will focus on the husband in equal depth.

Every individual has certain ideal expectations of the way he or
she will behave as a spouse. In this section we would like you to
describe how you would like to be as a spouse, and what at the
present time you are able to do. While it is likely that no spouse
ever meets their ideal, we would like you to describe in part (a)
of each question your ideal for yourself. In part (b) of each
question, we would like you to estimate how much the activity
described matters to you, and in part (c) we would like you to
describe how you are right 333,

 

For each question, simply circle the number that is the best answer.

1. (a) I expect to do the cooking.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

Not
Crucial 7 6 5 4 3 2 1 Important
(c) Presently I do the cooking.
Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Completely 7 6 5 4 3 2 1 223m

123

2.

124

(a) I expect to do the household cleaning.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I do the household cleaning.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Not

 

 

 

Completely 7 6 5 4 3 2 1 At All
(a) I expect to do the laundry.

Always 7 6 5 4 3 2 1 Never

(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I do the laundry.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

1 Not

Completely 7 6 5 4 3 2 At All

(a) I expect to do the clothing maintenance (mending, dry
cleaning, etc.).

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I do the clothing maintenance.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

1 Not

Completely 7 6 5 4 3 2 At All

5.

125

(a) I expect to do the grocery shopping.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I do the grocery shopping.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced by
being a medical student or intern/resident?

 

 

 

Completely 7 6 5 4 3 2 1 figtAI]
(a) I expect to do the other shopping (not grocery).

Always 7 6 5 4 3 2 1 Never

(b) How much does this matter to you?

. Not
Cruc1a1 7 6 5 4 3 2 1 Important
(c) Presently I do the other shopping.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

 

 

 

Completely 7 6 5 4 3 2 1 22tA11
(a) I expect to show affection towards my hsuband.

Always 7 6 5 4 3 2 1 Never

(b) How much does this matter to you?

Crucial 7 6 5 4 3 2 1 ¥ggortant
(c) Presently I do show affection toward my husband.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Completely 7 6 5 4 3 2 ‘ thA11

8.

10.

126

(a) I expect to respond to affectionate overtures from my

 

 

husband.
Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1a1 7 6 5 4 3 2 1 Important

(c) Presently I do respond to affectionate overtures from my
husband.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

 

 

Not
Completely 7 6 5 4 3 2 1 At All
(a) I expect to respond to sexual overtures from my husband.
Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?
. Not
Cruc1a1 7 6 5 4 3 2 1 Important

 

(c) Presently I do respond to sexual overtures from my husband.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

1 Not

Completely 7 6 5 4 3 2 At All

(a) I expect to take the initiative in sexual activity.

Always 7 6 5 4 3 2 1 Never

 

 

(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 Important
(c) Presently I do take the initiative in sexual activity.

Not
Always 7 6 5 4 3 2 1 At All

 

11.

12.

13.

127

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

 

 

Completely 7 6 5 4 3 2 1 22‘“,
(a) I expect to spend time alone with my husband at home--
talking or doing things together.
Often 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?
. Not
Cruc1al 7 6 5 4 3 2 Important

 

(c) Presently I do spend time alone with my husband at home--
talking or doing things together.

Often 7 6 5 4 3 2 1 Never

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Completely 7 6 5 4 3 2 1 22“”,

(a) I expect to go out socially with my husband--such as to a
movie or dinner.

 

 

Often 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1a1 7 6 5 4 3 2 1 Important

(c) Presently I do go out socially with my husband--such as to
a movie or dinner.

Often 7 6 5 4 3 2 1 Never

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Completely 7 6 5 4 3 2 1 NgtAll

(a) I expect to go out socially with my husband and mix with
other couples, or friends generally.

Often 7 6 5 4 3 2 1 Never

14.

15.

128

(b) How much does this matter to you?

Not

Crucial 7 5 5 4 3 2 1 Important

 

(c) Presently I do go out socially with my husband and mix
with other couples, or friends generally.

Often 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Completely 7 6 5 4 3 2 1 NitA11

(a) I expect to listen to what is troublesome in my husband's
life, and to share his joys too.

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?
Crucial 7 6 5 4 3 2 1 ¥g§ortant

 

(c) Presently I do listen to what is troublesome in my
husband's life, and share his joys too.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Not

 

 

 

Completely 7 6 5 4 3 2 1 At All
(a) I expect to be supportive and encouraging of my husband.
Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 Important

(c) Presently I am supportive and encouraging of my husband.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Not

Completely 7 6 5 4 3 2 1 At All

 

16.

17.

129

(a) I expect to help maintain the contacts with our extended
family (parents and in-laws, brothers and sisters, etc.).

 

 

As Much as
Possible 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1a1 7 6 5 4 3 2 1 Important
(c) Presently I do help maintain the contacts with our extended

family.

As Much as
Possible 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Complete1y 7 6 5 4 3 2 ‘ 22t411

(a) I expect to express appreciation for the things my husband
does for me.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I do express appreciation for the things he does

for me.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Completely 7 6 5 4 3 2 1 figtAl]

 

The following questions are only for couples with children.

18.

(a) I expect to provide the child care for our child(ren).

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?
Crucial 7 6 5 4 3 2 1 N°t

 

Important

19.

20.

21.

130

(c) Presently I do provide the child care for our child(ren).
Always 7 6 5 4 3 2 1 Never

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Not

 

 

 

Completely 7 6 5 4 3 2 1 At All

(a) I expect to be responsible for the care given to our
child(ren), though I may not give it personally.

Always 7 6 5 4 3 2 1 Never

(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I am responsible for the care given to our

child(ren), though I may not give it personally.
Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

 

 

 

Not
Completely 7 6 5 4 3 2 1 At All
(a) If our child(ren) is/are ill, I expect to take care of it.
Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?
. Not
Cruc1a1 7 6 5 4 3 2 1 Important

(c) Presently, if our child(ren) is/are ill, I take care of it.
Always 7 6 5 4 3 2 1 Never

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?

Not
Completely 7 6 5 4 3 2 1 At All
(a) I expect to be the disciplinarian for our child(ren).

Always 7 6 5 4 3 2 1 Never

131

(b) How much does this matter to you?
. Not
Cruc1a1 7 6 5 4 3 2 1 Important

(c) Presently I am the disciplinarian for our child(ren).

Always 7 6 5 4 3 2 1 Never

(d) To what extent is your behavior (in this area) influenced
by being a medical student or intern/resident?
Not
Completely 7 6 5 4 3 2 1 At All

Comments: (Please use back if needed.)

VERSION FOR HUSBANDS 0F FEMALE MEDICAL STUDENTS
OR HOUSE STAFF

SECTION B

In this section we will be asking about the activities and expecta-
tions for the wife in the couple. On the whole this section asks
about things often traditionally expected of wives. At the end of
the section there will be a space for comments. If you feel that
important areas were not covered in the section as it stands,
please make note of the things that were omitted in the "Comments"
section.

This section also omits any mention of expectations and activities

for the husband. Clearly there is‘a full set of those for husbands
as well, but in this study we chose to focus on the wife, and hope

future research will focus on the husband in equal depth.

Every individual has certain ideal expectations of the way his or
her spouse will behave. In this section we would like you to
describe how you would like your spouse to be, and what at the
present time she is able to do. While it is likely that no spouse
ever performs at the ideal level, we would like you in part (a) of
each question to describe your ideal spouse. In part (b) of each
question, we would like you to estimate how much the activity
described matters to you, and in part (c) we would like you to
describe how your spouse is right 33!,

For each question, simply circle the number that is the best answer.
1. (a) I expect my wife to do the cooking.

 

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1a1 7 6 5 4 3 2 Important
(c) Presently she does the cooking.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
being a medical student or intern/resident?

Completely 7 6 5 4 3 2 1 Kit“,

132

2.

133

(a) I expect my wife to do the household cleaning.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1a1 7 6 5 4 3 2 1 Important

(c) Presently she does the household cleaning.
Always 7 6 5 4 3 2 1 Never

(d) To what extent is her behavior (in this area) influenced by
being a medical student or intern/resident?

(a) I expect my wife to do the laundry.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important

(c) Presently she does the laundry.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
being a medical student or intern/resident?

Not
Completely 7 6 5 4 3 2 1 At All

(a) I expect my wife to do the clothing maintenance (mending,
dry cleaning, etc.).

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 Important
(c) Presently she does the clothing maintenance.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
being a medical student or intern/resident?

1 Not

Completely 7 6 5 4 3 2 At All

VERSION FOR MALE MEDICAL STUDENTS OR HOUSE STAFF

(WIVES EMPLOYED OUTSIDE THE HOME)

SECTION B

In this section we will be asking about the activities and
expectations for the wife in the couple. On the whole this section
asks about things often traditionally expected of wives. At the
end of the section there will be a space for comments. If you feel
that important areas were not covered in the section as it stands,
please make note of the things that were omitted in the "Comments"
section.

This section also omits any mention of expectations and activities
for the husband. Clearly there is a full set of these for husbands
as well, but in this study we chose to focus on the wife, and hope
future research will focus on the husband in equal depth.

Every individual has certain ideal expectations of the way his or
her spouse will behave. In this section we would like you to
describe how you would like your spouse to be, and what at the
present time she is able to do. While it is likely that no spouse
ever performs at the ideal level, we would like you in part (a) of
each question to describe your ideal spouse. In part (b) of each
question, we would like you to estimate how much the activity
described matters to you, and in part (c) we would like you to
describe how your spouse is right 333,

 

For each question, simply circle the number that is the best answer.

1. (a) I expect my wife to do the cooking.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently she does the cooking.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
her occupation?

Completely 7 6 5 4 3 2 ‘ NgtAn

134

2.

135

(a) I expect my wife to do the household cleaning.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 Important
(c) Presently she does the household cleaning.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
her occupation?

Not

 

 

 

Completely 7 6 5 4 3 2 1 At All
(a) I expect my wife to do the laundry.

Always 7 6 5 4 3 2 1 Never

(b) How much does this matter to you.

Crucial 7 6 5 4 3 2 1 #ggortant
(c) Presently she does the laundry.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
her occupation?

Complete1y 7 6 5 4 3 2 I 22tA11

 

(a) I expect my wife to do the clothing maintenance (mending,
dry cleaning, etc.).

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

Crucial 7 6 5 4 3 2 1 Never

 

(c) Presently she does the clothing maintenance.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
her occupation?

Not

Completely 7 6 5 4 3 2 1 At All

VERSION FOR WIVES OF MALE MEDICAL STUDENTS
OR HOUSE STAFF

(WIVES EMPLOYED OUTSIDE THE HOME)

SECTION B

In this section we will be asking about the activities and expecta-
tions for the wife in the couple. On the whole this section asks
only about things often traditionally expected of wives. At the
end of the section there will be a space for comments. If you feel
that important areas were not covered in the section as it stands,
please make note of the things that were omitted in the "Comments"
portion.

This section also omits any mention of expectations and activities
for the husband. Clearly there is a full set of these for husbands
as well, but in this study we chose to focus on the wife, and hope
future research will focus on the husband in equal depth.

Every individual has certain ideal expectations of the way he or
she will behave as a spouse. In this section we would like you to
describe how you would like to be as a spouse, and what at the
present time you are able to do. While it is likely that no spouse
ever meets their ideal, we would like you to describe in part (a)
of each question your ideal for yourself. In part (b) of each
question, we would like you to estimate how much the activity
described matters to you, and in part (c) we would like you to
describe how you are right 333,

 

For each question, simply circle the number that is the best answer.

1. (a) I expect to do the cooking.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I do the cooking.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced by
your occupation?

Completely 7 6 5 4 3 2 1 223A”

136

2.

137

(a) I expect to do the household cleaning.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I do the household cleaning.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced by
your occupation?

 

 

 

Completely 7 6 5 4 3 2 1 223A],
(a) I expect to do the laundry.

Always 7 6 5 4 3 2 1 Never

(b) How much does this matter to you?

Crucial 7 6 5 4 3 2 1 ¥g§ortant
(c) Presently I do the laundry.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by your occupation?

Com letel 7 6 5 4 3 2 1 N°t
p 3 At All

(a) I expect to do the clothing maintenance (mending, dry
cleaning, etc.).

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 At All
(c) Presently I do the clothing maintenance.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced
by your occupation?

Completely 7 6 5 4 3 2 1 NgtAll

VERSION FOR MALE MEDICAL STUDENTS OR HOUSE STAFF
(HOMEMAKER WIVES)

SECTION B

In this section we will be asking about the activities and expecta-
tions for the wife in the couple. 0n the whole this section asks
about things often traditionally expected of wives. At the end of
the section there will be a space for comments. If you feel that
important areas were not covered in the section as it stands, please
make note of the things that were omitted in the "Comments" section.

This section also omits any mention of expectations and activities
for the husband. Clearly there is a full set of these for husbands
as well, but in this study we chose to focus on the wife, and hope
future research will focus on the husband in equal depth.

Every individual has certain ideal expectations of the way his or
her spouse will behave. In this section we would like you to
describe how you would like your spouse to be, and what at the
present time she is able to do. While it is likely that no spouse
ever performs at the ideal level, we would like you in part (a) of
each question to describe your ideal spouse. In part (b) of each
question, we would like you to estimate how much the activity
described matters to you, and in part (c) we would like you to
describe how your spouse is right 333_

 

For each question, simply circle the number that is the best answer.

1. (a) I expect my wife to do the cooking.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1a1 7 6 5 4 3 2 1 Important
(c) Presently she does the cooking.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
your being a medical student or intern/resident?

1 Not

Completely 7 6 5 4 3 2 At All

138

2.

139

(a) I expect my wife to do the household cleaning.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently she does the household cleaning.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
your being a medical student or intern/resident?

Not

 

 

 

Completely 7 6 5 4 3 2 1 At All
(a) I expect my wife to do the laundry.

Always 7 6 5 4 3 2 1 Never

(b) How much does this matter to you?

Crucial 7 6 5 4 3 2 1 ¥ggortant
(c) Presently she does the laundry.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
your being a medical studentor intern/resident?

Completely 7 6 5 4 3 2 1 figtA],

(a) I expect my wife to do the clothing maintenance (mending,
dry cleaning, etc.).

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently she does the clothing maintenance.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is her behavior (in this area) influenced by
your being a medical student or intern/resident?

Completely 7 6 5 4 3 2 1 22tA11

VERSION FOR WIVES OF MALE MEDICAL STUDENTS OR
HOUSE STAFF

(HOMEMAKER WIVES)

SECTION B

In this section we will be asking about the activities and expecta-
tions for the wife in the couple. On the whole this section asks
only about things often traditionally expected of wives. At the end
of the section there will be a space for comments. If you feel that
important areas were not covered in the section as it stands, please
make note of the things that were omitted in the "Comments" portion.

This section also omits any mention of expectations and activities

for the husband. Clearly there is a full set of these for husbands
as well, but in this study we chose to focus on the wife, and hope

future research will focus on the husband in equal depth.

Every individual has certain ideal expectations of the way he or she
will behave as a spouse. In this section we would like you to
describe how you would like to be as a spouse, and what at the pre-
sent time you are able to do. While it is likely that no spouse ever
meets their ideal, we would like you to describe in part (a) of each
question your ideal for yourself. In part (b) of each question, we
would like you to estimate how much the activity described matters to
you, and in part (c) we would like you to describe how you are right
now.

For each question, simply circle the number that is the best answer.

1. (a) I expect to do the cooking.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I do the cooking.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced by
your husband being a medical student or intern/resident?

Not

Completely 7 6 5 4 3 2 1 At All

 

140

2.

141

(a) I expect to do the household cleaning.

 

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1al 7 6 5 4 3 2 1 Important
(c) Presently I do the household cleaning.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced by
your husband being a medical student or intern/resident?

 

 

 

Completely 7 6 5 4 3 2 1 33'6“]
(a) I expect to do the laundry.

Always 7 6 5 4 3 2 1 Never

(b) How much does this matter to you?

Crucial 7 6 5 4 3 2 1 Qggortant
(c) Presently I do the laundry.

Always 7 6 5 4 3 2 1 Never

 

(d) To what extent is your behavior (in this area) influenced by
your husband being a medical student or intern/resident?

Completely 7 6 5 4 3 2 1 figtA1]

(a) I expect to do the clothing maintenance (mending, dry
cleaning, etc.).

 

Always 7 6 5 4 3 2 1 Never
(b) How much does this matter to you?

. Not
Cruc1a1 7 6 5 4 3 2 1 Important

 

(c) Presently I do the clothing maintenance.
Always 7 6 5 4 3 2 1 Never

(d) To what extent is your behavior (in this area) influenced by
your husband being a medical student or intern/resident?

Completely 7 6 5 4 3 2 1 figtAll

APPENDIX G

TRAUPMANN-UTNE-HATFIELD (1978) SCALE

142

APPENDIX G
TRAUPMANN-UTNE-HATFIELD (1978) SCALE

SECTION C
Introduction:

In this section we are interested in the give-and-take that
goes on in marriage. We'd like to ask you some questions about the
kinds of things you put into your marriage, and the kinds of things
you get out of it.

Clearly, we know that most people don't ordinarily keep
careful track of exactly what they're giving and getting from their
marriages. They certainly don't pull their relationship apart and
think about the various aspects of their marriage, one by one. But
in order for us to get some idea of what goes on in marital rela-
tionships, we have to ask you and the others in the study to spell
333 some of the give-and-take that naturally occurs.

We will look at some of the critical areas in any marriage.
When you glance over the list, the underlined headings will give you
a sense of the ground we will cover. First we'd like to ask about
your and your partner's personal characteristics--like your looks
and intelligence (Items 1 - 4). Then we cover your emotional
assets and liabilities (Items 5 - 15). Finally, we cover daily
sorts of concerns that come up in a long-term relationship (Items
16 - 25) for a total of 25 areas.

For each of the 25 areas, you will be asked to make two
ratings. The first is .

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

143

144

The second rating for each area will be
How important is this area to you?
8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant
6. Fairly important 2. Very unimportant
5. Slightly important 1. Extremely unimportant

Circle the number that is the best answer.

AREAS INVOLVED IN THE MARITAL GIVE AND TAKE
PERSONAL CONCERNS

Social Grace

 

1. Social Grace: Some people are sociable, friendly, relaxed in
social settings. Others are not.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your marriage
"stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant

7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1 Extremely unimportant
Intellect

2. Intelligence: Some people are intelligent and informed.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

145

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1 Extremely unimportant

Appearance

 

3.

Physical Attractiveness: Some people are physically
attractive.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?
8. Extremely important 4. Slightly unimportant

7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant

Concern for Physical Appearance and Health: Some people take
care of their physical appearance and conditioning, through
attention to such things as their clothing, cleanliness,
exercise, and good eating habits.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

146

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.

-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?
8 Extremely important 4 Slightly unimportant
7. Very important 3. Fairly unimportant
6 2
5 l

Fairly important Very unimportant
Slightly important Extremely unimportant

EMOTIONAL CONCERNS

Liking and Loving

5.

Liking: Some people like their partners and show it. Others
do not.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant

Love: Some people feel and express love for their partners.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

147

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1 Extremely unimportant

Understanding and Concern

 

 

7. Understanding and Concern: Some people know their partner's
personal concerns and emotional needs and respond to them.
Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.

-1. My partner is getting a slightly better deal.

0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant

7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1 Extremely unimportant
Acoeptance
8. Accepting and Encouraging Role Flexibility: Some people let

their partners try out different roles occasionally, for
example, letting their partner be a "baby" sometimes, a "mother£'
a colleague or a friend, an aggressive as well as a passive
lover, and so on.

148

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up“?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1 Extremely unimportant

Appreciation

 

9.

Expression of Appreciation: Some people openly show apprecia-
tion for their partner's contributions to the relationship--
they don't take their partner for granted.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner
puts in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.

-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1 Extremely unimportant

Ehysical Affection

 

10.

Showing Affection: Some people are openly affectionate--
touching, hugging, kissing.

s_e_a

11.

12.

149

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5 Slightly important 1 Extremely unimportant

Sexual Pleasure: Some people participate in the sexual aspect
of a relationship; working to make it mutually satisfying and
fulfilling.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant

Sexual Fidelity: Some people live up to (are "faithful" to)
their agreements about extra-marital relations.

150

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner
puts in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

 

8. Extremely important 4. Slightly unimportant

7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant
Security/Freedom
13. Commitment: Some people commit themselves to their partners

and to the future of their relationship together.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner
puts in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant

14.

151

Respecting Partner's Need to be Free and Independent Person:
Some people allow their partners to develop as an individual
in the way that they choose: for example, they allow their
partners freedom to go to school or not; to work at the kind
of job or career they like; to pursue outside interests; to
do things by themselves or with their friends; to simply be
alone sometimes.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1 Extremely unimportant

Plans and Goals for the Future

 

15.

Plans and Goals for the Future: Some people plan for and dream
about their future together.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

152

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5 Slightly important 1 Extremely unimportant

DAY-TO-DAY CONCERNS

Day-to-Day Maintenance

 

16.

Day-to-Day Maintenance: Some people contribute time and
effort to household responsibilities such as grocery shopping,
making dinner, cleaning and car maintenance. Others do not.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4 Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2 Very unimportant

5 Slightly important 1 Extremely unimportant

Finances

17.

Finances: Some people contribute income to the couple's
"joint account."

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

153

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1 Extremely unimportant

Sociability

 

18.

19.

Easy—to-Live-With: Some people are easy to live with on a
day-to-day basis: that is, they have a sense of humor,
aren't too moody, don't get drunk too often, and so on.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant

Companionship: Some people are good companions, who suggest
interesting activities for both of them to do together, as
well as going along with their partner's ideas about what they
might do for fun.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

20.

21.

154

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant

Conversation: Some people tell partners about their day's
events and what's on their minds . . . and are also interested
in hearing about their partner's concerns and daily activities.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.

-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant

Fitting In: Some people are compatible with their partner's
friends and relatives; they like the friends and relatives,
and the friends and relatives like them.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

155

My partner is getting a much better deal.

My partner is getting a somewhat better deal.
My partner is getting a slightly better deal.
We are both getting an equal deal.

I am getting a slightly better deal.

I am getting a somewhat better deal.

I am getting a much better deal.

How important is this area to you?

8.
7.
6.
5.

Extremely important 4.

Very important 3. Fairly unimportant
Fairly important 2.
Slightly important 1

Slightly unimportant

Very unimportant
Extremely unimportant

Decision-Making

 

22. Decision-Making: Some pe0ple take their fair share of the
responsibility for making and carrying out decisions that
affect both partners.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3.
-2.
-1.

0.
+1.
+2.
+3.

My partner is getting a much better deal.

My partner is getting a somewhat better deal.
My partner is getting a slightly better deal.
We are both getting an equal deal.

I am getting a slightly better deal.

I am getting a somewhat better deal.

I am getting a much better deal.

How important is this area to you?

8.
7.
6.
5.

Extremely important 4. Slightly unimportant
Very important 3.

Fairly important 2. Very unimportant
Slightly important 1

Fairly unimportant

Extremely unimportant

Remembering Special Occasions

 

23. Remembering Special Occasions: Some people are thoughtful
about sentimental things, such as remembering birthdays, your
anniversary, and other special occasions.

156

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?
8. Extremely important 4. Slightly unimportant
7. Very important Fairly unimportant
6.
5

3.
Fairly important 2. Very unimportant
Slightly important 1 Extremely unimportant

OPPORTUNITIES GAINED AND LOST

Opportunities Gained

 

24.

Chance to be Married: Marriage gives many people the oppor-
tunity to partake of the many life experiences that depend upon
being married; for example, the chance to become a parent and
even a grandparent, the chance to be included in "married
couple" social events, and finally, having someone to count on
in old age.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.

-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

157

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant

Opportunities Foregone

 

25.

Opportunities Foregone: Marriage necessarily requires people
to give up certain opportunities, in order to be in this
relationship. The opportunities could have been other pos-
sible mates, a career, travel, etc.

Considering what you put into your marriage in this area,
compared to what you get out of it, and what your partner puts
in compared to what (s)he gets out of it, how does your
marriage "stack up"?

-3. My partner is getting a much better deal.

-2. My partner is getting a somewhat better deal.
-1. My partner is getting a slightly better deal.
0. We are both getting an equal deal.

+1. I am getting a slightly better deal.

+2. I am getting a somewhat better deal.

+3. I am getting a much better deal.

How important is this area to you?

8. Extremely important 4. Slightly unimportant
7. Very important 3. Fairly unimportant

6. Fairly important 2. Very unimportant

5. Slightly important 1. Extremely unimportant

APPENDIX H

SPANIER (1976) DYADIC ADJUSTMENT SCALE

158

APPENDIX H

SPANIER (1976) DYADIC ADJUSTMENT SCALE

SECTION 0

Most persons have disagreements in their relationships. Please
indicate below the approximate extent of agreement or disagreement
between you and your partner for each item on the following list.

Almost Occa- Fre- Almost
Always Always sionally quently Always Always
Agree Agree Disagree Disagree Disagree Disagree

1. Handling
family
finances

2. Matters of
recreation

3. Religious
matters

4. Demonstra-
tions of
affection

5. Friends

6. Sex
relations

7. Convention-
ality
(correct
or proper
behavior)

8. Philosophy
of life

9. Ways of
dealing with
parents or
in-laws

159

160

Almost Occa- Fre- Almost
Always Always sionally quently Always Always
,Agree Agree [Msagree Disagree Disagree Disagree

. Aims, goals
and things
believed
important

. Amount of

time spent
together

. Making
major
decisions

. Household

tasks

. Leisure time

interests and
activities

. Career

decisions

More
All Most Often
the of the Than Occas-

1133_ Time Not sional1y Rarely Never

 

. How often do

you discuss
or have you
considered
divorce,
separation or
terminating
your rela-
tionship?

. How often do

you or your
mate leave
the house
after a
fight?

161

More
All Most Often
the of the Than Occa-
Time Time Not sionally, Rarely Never

 

 

. In general,
how often do
you think
that things
between you
and your
partner are
going well?

. Do you
confide in
your mate?

. Do you ever
regret that
you married?

. How often do

you and your
partner
quarrel?

. How often do

you and your
partner "get
on each
other's
nevers"?

Almost
Every Every Occa-
Day Day sional1y, Rarely Never

 

 

 

. Do you kiss
your mate?

Most Some Very None
All of of of Few of of
Them Them Them Them Them

 

. Do you and your mate
engage in outside
interests together?

162

How often would you say the following events occur between you and
your mate?

Less
Than Once or Once or
Once a Twice a Twice a Once a More
Never Month Month Week Day Often

 

 

25. Have a
stimulating
exchange of
ideas

26. Laugh
together

27. Calmly
discuss
something

28. Work
together on
a project

 

These are some things about which couples sometimes agree and
sometimes disagree. Indicate if either item below caused dif-
ferences of opinions or were problems in your relationship during
the past few weeks.

(Check yes or no)
Yes No
29. Being too tired for sex.

30. Not showing love.

31. The dots on the following line represent different degrees of
happiness in your relationship. The middle point, "happy,"
represents the degree of happiness of most relationships. Please
circle the dot which best describes the degree of happiness, all
things considered, of your relationship.

0 1 2 3 4 5 6

 

Extremely Fairly A Little Happy Very Extremely Perfect
Unhappy Unhappy Unhappy Happy Happy

163

32. Which of the following statements best describe how you feel
about the future of your relationship? Place a check beside
your answer.

I want desperately for my relationship to succeed, and would
go to almost any length to see that it does.

I want very much for my relationship to succeed, and will do
all I can to see that it does.

I want very much for my relationship to succeed, and will do
my share to see that it does.

It would be nice if my relationship succeeded, but I can't do
much more than I am doing now to help it succeed.

It would be nice if it succeeded, but I refuse to do any more
than I am doing now to keep the relationship going.

My relationship can never succeed, and there is no more that
I can do to keep the relationship going.

APPENDIX I

OPEN-ENDED QUESTIONNAIRE

164

APPENDIX I

OPEN-ENDED QUESTIONNAIRE

SECTION E

This is a section of open-ended questions, for you to provide some
additional answers that represent your experience in your own
words. Please make them as long or as short as you wish, and use
the back or additional paper if you prefer.

We want to be certain we understand these answers, so

PLEASE PRINI, TYPE, OR MAKE A GREAT EFFORT TO WRITE CLEARLY

1.

What do you feel the impact of medical school or your status as
intern/resident has been on your marriage?

00 you feel medical school/residency has been an added stress
factor on your marriage?

Every major life change requires readjustments in the way you
live. In the medical school/residency context, most people
have to give up something which they "miss most." What do you
think you miss most?

If your answer to #3 above was more related to your life as an
individual than to your life as half of a couple, what do you
think you miss most that relates to your marriage?

165

166

5. For Question 5, partners who are in medical school/residency,
or M05 should answer part (a) and partners who are not should
answer part (b).

(a) What does your spouse do as an occupation?

Does it make your situation (working in medicine) any
easier, or harder?

(b) What is your occupation?

Do you think your position makes things any easier, or
harder for your spouse?

Does your spouse's occupation make things easier, or
harder for you in your job?

6. Briefly describe what would be a typical day for you.

167

How much time do you and your spouse spend together in an
average week?

What kind of time is it--"close" (talking together might be an
example), or a little more separate (both reading in the same
room might be an example)?

00 you anticipate any changes in your marriage after you (your
spouse) finishes his/her residency? What kind of changes?

(If you both are medical students/house staff, you might want
to mention changes that would occur as first one of you and then
the other finished.)

If you felt that in this situation (being a medical student or
intern/resident, or the spouse of one) you had to give things
up, do you foresee any ways in which it will be "made up" to
you?

APPENDIX J

STRESS ADJUSTMENT SCALE

168

APPENDIX J
STRESS ADJUSTMENT SCALE

Please rate each of the following items by circling the reSponse that best describes
your W .

~17 3:.
Q Q5) N7
:35? we 8
lb a: Sic: m
a: 41 p.03 a
‘0 5 gm “‘0
1. Household responsibilities ST SS ‘NS
2. Housing situation ST SS NS

U)
F)
U)
U)
2
U)

3. Money

U)
H
U)
U)
2
U)

4. Personal autonomy/independence

5. Your occupation or work (includes student, homemaker)

U)
H;
U)
U)
2
U)

6. Quality of communication with partner

U)
H
U)
U)
2
U)

7. Amount of time spent with partner

U)
H
U)
U)
2
U)

8. Sexual relations

U)
0')
U)
U)
2
U)

9. Relationships with friends

U)
H
U)
U)
2
U)

10. Relationships with relatives (outside of immed. family)

11. Relationships with your children (if applicable) ST SS NS

‘fiafiafiéfifiaaiaiwkr
s
5

Please rate each of the following items on the basis of its importance to your life
satisfaction.

6. 61 s. 64

§§§§§§§

hv A1 in” ~q
1. Household responsibilities VI IN 51 NI
2. Housing situation VI IM SI NI
3. Money VI IM SI NI
4. Personal autonomy/independence VI IM SI NI
5. ‘Your occupation or work (includes student,homemaker) VI IM SI NI
6. Quality of communication with partner VI IM SI NI
7. Amount of time spent with partner VI 1M SI NI
8. Sexual relations VI IM SI NI
9. Relationships with friends VI IN SI NI
10. Relationships with relatives (outside of immed.fami1y) VI IM 51 NI
11. Relationships with your children (if applicable) VI 1M 51 NI

169

170

If you were married prior to medical school, please complete the rest of this survey.

Please rate each of the following items on the basis of the agigfigmgfl; that was
required when one or both of you entered medical school.

A;
~: 0
SQ 2
. , *0 «re .
5‘6” s'é’ S'é' §
’32 VS. “'3
ans ”a *6 §
1. Household responsibilities MC’ sc LC NC
2. Housing situation MC SC LC NC
3. Money MC SC LC NC
u. Personal autonomy/independence MC SC LC NC

5. Your occupation or work (includes student, homemaker) MC SC LC NC

6. Duality of communication with partner MC SC LC NC
7 Amount of time spent with partner MC SC LC NC
8. Sexual relations MC SC LC NC
9. Relationships with friends MC SC LC NC
10. Relationships with relatives (outside immed.family) MC SC LC NC
11. Relationships with your children (if applicable) NC SC LC NC

Please rate each of the following items on the basis of how successfully you think

you have.masjgrgg_1hg_gh§pggg indicated above.

5?
53:? c: f§ i?
Ika3 a; ‘% a;
as st .5: as
0:0 .‘C‘ ~32 £13,4-.
S.» ‘73 N 3:3
< ~ 5 E 3‘
1. Household responsibilities MG MA T0 WO
2. Housing situation MG MA TO WO
3. Money MG MA T0 NO
u. Personal autonomy/independence ~ MG MA T0 W0
3. Your occupation or work (includes student, homemaker) MG MA TO WO
6. Quality of communication with partner MG MA T0 N0
7. Amount of time spent with partner MG MA T0 WO
8. Sexual relations MG MA TO WO
9. Relationships with friends MG MA TO WO

10. Relationships with relatives (outside immed. family) MG MA T0 NO
11. Relationships with your children (if applicable) MG MA T0 WO

APPENDIX K

FIRST LETTER TO SUBJECTS

171

APPENDIX K
FIRST LETTER TO SUBJECTS

32l Island Dr., Apt. 6
Madison, WI 53705
Jun , l979

Dear

First of all I would like to thank you again for your cooperation
and help with the Medical Education and Marriage Study. You are
very busy people and I have been impressed and gratified by your
willingness to make the time to take part.

Enclosed you will find your check. For the sake of simplicity I
have made it payable to only one partner but it and my thanks are
certainly intended for both.

My present plan is to send all of you by mail a brief summary of

my hypotheses about the study and the results of the analysis of my
data. I will be sending that as soon as the analysis is completed
and I hope that will be sometime in July or perhaps August. If you
are planning to move before that time and haven't given me your

new address, you might want to contact me so I will send the
results to your new home. Otherwise, I will assume letters will be
forwarded. Some of you may want more information than is provided
in the summary of results, and I will encourage you at that time to
contact me by mail or phone and ask for more details.

If you are very curious now (between about June I and the time data
is analyzed) about my hypotheses and ways I developed the study,
please feel free to write or call now. We can talk on the phone or
set up a time to meet.

Thanks again.

Sincerely,

Meredith F. Taylor

172

APPENDIX L

SECOND LETTER TO SUBJECTS

I73

APPENDIX L

SECOND LETTER TO SUBJECTS

343 Island Dr., Apt. 3
Madison, WI 53705

Dear

First of all, I would like to thank you once again for your
participation. You may feel you have already been thanked enough,
but you will realize what a remarkable group you comprise when I
tell you that out of nearly 120 couples who agreed to do the study,
only three failed to complete it. I received almost universal
interest and sympathy (for the plight of the researcher and graduate
student) and I am very grateful.

The official title of the study is "Equity Theory,
Androgyny, and Role Conflict in the Marriages of Medical Students
and of Medical House Staff." In essence, I combined a theory about
relationships, a portion of personality theory and rather funda—
mental ideas about sex-role socialization to create my hypotheses.

I will first outline the hypotheses very generally, and
then fill in some details. At its simplest, I hypothesized that
medical education would be a hard time for any married couple; that
it would be harder for women in medicine and their spouses than for
men in medicine and their spouses, and that it would be hardest of
all for the women and their spouses if they were attempting to
maintain a traditional model for marriage.

For hypotheses about how the couples might feel about their
relationship, I drew from equity theory. Equity theory was
developed by Elaine Hatfield and G. William Walster here at the
University of Wisconsin. It theorizes that in any relationship, if
one gives as much as one gets, one experiences equity and feels
content. However, if one either gives pr_gets more, one will feel
discontent and seek to restore equity, in one way or another. I
hypothesized that medical persons were likely to experience over-
benefit (getting more than giving) and all non-medical persons were
likely to experience underbenefit (giving more than getting) under
the pressure of medical education. I attempted to measure this
(and all other questions about equity) with the Traupmann-Utne-
Hatfield (1978) Scale, which was the section on which you indicated
"who gets a better deal." This hypothesis was quite strongly

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confirmed; medical persons do feel overbenefited and their spouses
feel underbenefited.

I had further related hypotheses. I predicted women medical
persons would feel they "got too much" even more than male medical
persons. I also predicted their spouses would feel they "got even
less" than the female spouses of men in medicine. I predicted this
on the basis of sex-role theory. My idea was that while at this
point the society seems to be moving away from the traditional
model of marriage, that is still how most of us were raised and it
may still be a strong influence. By a traditional model of marriage,
I mean several overlapping concepts: the wife takes care of the home
and children while the husband works; also the wife is the emotional
and socially adept partner while the husband makes decisions and acts
as a leader, etc. In any case, I predicted that since women in
medicine might have difficulty fulfilling the "at home" roles, they
might feel that they were not giving enough in the relationship.
Hence the prediction developed that they would feel more over-
benefited. Males in medicine might not be able to offer a great deal
in the "husband" role at home either, but I hypothesized that since
it was traditional for the husband to be the "breadwinner" and work
hard outside the home, that this would be less troublesome to both
spouses.

This hypothesis was rejected. There were no significant
differences on equity between male/female medical persons or between
male/female spouses. However, when I pooled all persons into a
division by sex as well as medical/non-medical, it became clear that
women felt significantly underbenefited compared to men. Most of
this was because males in medicine felt so overbenefited and their
non-medical spouses felt so underbenefited. This was contrary to my
prediction.

I had also hypothesized that "dual-medical couples" (both
partners either physicians or in medical training) would experience
less inequity than other couples. 0n the whole this was confirmed,
although it was not clear that dual-medical couples were signif-
icantly different from couples with the wife in medicine and the
husband not in medicine.

In dual-medical couples both partners feel slightly under-
benefited, the men more than the women. I interpreted this as a
feeling of "not quite enough to go around," which certainly seems
reasonable considering the hectic life of a dual-medical couple.

Most of my other hypotheses focused upon the women in
medicine and their spouses. I feel apologetic about omitting the
men and their spouses, but my grounding in sex-role theories made me
feel much more clear about what to attempt to predict among the
women and their spouses. I hypothesized that medical women might
ppt_feel they were overbenefited for one of two reasons. First they

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(and/or the spouse) might have altered their level of expectations
about what they should be doing to be "the kind of wife I feel good
about being/being with," or simply have had those expectations at a
very down to earth level in the first place. So in that case,
achieving the expected goal for "wife-like“ behavior might be
reasonable and do-able in addition to keeping up with medical
education.

Second, I hypothesized that some women (and their spouses)
might have very high expectations for themselves and brin it_pff.
That would mean (to take a somewhat far-fetched example managing
to still serve a four course dinner promptly at 7:00 each night, no
matter what.

So, I tried to measure how people saw their expectations of
themselves (or spouse) and also how they saw the "performance" level.
I theorized that a high difference score between expectation and
performance would be attributed to the woman being in medicine, and
that a high difference score would predict more feelings of inequity.
A statistically significant correlation between discrepancy scores
and amount of inequity was found, although it was not a very powerful
one.

I also felt that discrepancy and inequity should correlate
with the measure of marital happiness. Therefore, you completed both
the instrument describing expectations for yourself (or spouse) and
the level of performance for yourself or spouse, and the marital
satisfaction measure. These measures did correlate significantly as
anticipated, but again it was not a very powerful correlation.

Finally, I used an aspect of personality theory to attempt
to predict which persons, among female students/house staff and
their spouses, would have the easiest time re-adjusting their
expectations for what the wife "should be doing," or who would have
least need to readjust. Personality theory has developed the concept
of psychological androgyny, which proposes that attributes
identified as stereotypically masculine or feminine are not polar
opposites, but are independent of each other. The theory and some
follow-up research suggests that individuals high on both are
flexible and adaptable. Accordingly, I hypothesized that an increase
in androgyny would predict a decline in expectations for self or
spouse, and also a decline in the discrepancy score (difference
between expectations and performance). This hypothesis was rejected.
Although the women in medicine are quite androgynous, the androgyny
:cogesdhad no power to predict expectations held either by wives or

us an 5.

Any explanation of results which disconfirm hypotheses is
always a little suspect, since one untested theory is as good as the
next. For my hypotheses concerning equity/inequity, I would hazard
a number of guesses. The first is that the level of investment in a

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quite egalitarian marriage is high in Madison and within this
medical school. It is possible that I highlighted this awareness
by presenting my study as one which focused on women. In any case,
apparently the male medical person is aware that his wife may be
playing "second fiddle," and he is concerned about it. The wives
seem equally aware. As a secondary factory within this idea, I
would hypothesize that more women spouses are supporting the family
in "marking time" jobs than are the male spouses of female medical
persons. In this way, female spouses might feel underbenefit now,
though the scale may "balance" over time.

One other point is worth mentioning. When I examined the
scores on the marital satisfaction measure, all subgroups of women
came out with scores which were essentially the same. In other
words, although the non-medical wives felt quite underbenefited, they
did not report themselves as less happy. Among the men, differences
were statistically significant but fairly small. The men who
described themselves as happiest were non-medical men married to
medical wives. The next happiest were the medical men married to
non-medical wives. The least happy were the men in dual-medical
marriages. Obviously the relationship between perceiving inequity
and seeing one's self as happy is not as simple and straightforward
as one might assume.

The open-ended questionnaire is a potential source of
direct information from you on how you see who has experienced
overbenefit and underbenefit. It was also intended to draw from
you comments on how the balance of equity might be restored over
time if it is out of balance now. I use this tentative language
because analysis of such data requires using unbiased raters who are
blind to the hypotheses of the study. I did not have access to such
persons at the moment and was forced to postpone that analysis.
However, there is a good chance I will be able to finish in the near
future.

This study became quite complicated. At its close I had
sixteen hypotheses and tested fifteen of them. For this reason this
summary is a fast overview of the results. I hope you will contact
me if you are interested in hearing more details about it.

As a closing note, I would like to share with you both my
sense of satisfaction and my sense of frustration with this project.
I have had feelings during the year of this study that I was taking
a very complex phenomenon and fitting it into a number of rather
rigid theories that, in truth, only explain a small portion of what
is happening in the lives of real people. In some ways, I see that
as the fundamental dilemma of social science research, especially
for dissertations, as something small enough to handle becomes
removed from reality. If I could do this study with indefinite time
and funds, I would begin with unstructured interviews and ask all of

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you what you see as making marriage plus medicine stressful, how
you coped with it, what worked the best, and what you would like to
see changed.

. My only consolation for myself is that I at least made a

beginning in an area I see as interesting and important. I would
also present to you very openly one of my biases: that medicine,
as it now exists, does not allow people enough time to be human.
Specifically, it does not acknowledge that a person who has time to
be an affectionate spouse and parent might be a better doctor
because of it. This is not, of course, a phenomenon limited to
medicine by any means. At the moment, the society as a whole
rewards "achievement" more than "nurturance." If this is to shift
in any way within medicine, it is very likely that only the persons
within the field can do it. If my research either now or in the
future can provide you with any leverage to do the job, I will be
most happy to supply it.

I would like, once again, to invite you to contact me if
you would like any further information about the study. If you are
interested in the specific research I used, I will be happy to give
you the citations.

My thanks, one last time, and my good wishes.

Sincerely,

Meredith F. Taylor