Objective: Romantic relationships significantly influence both physical and mental well-being, particularly under stressful circumstances such as coping with cancer. The current study aimed to explore the associations between mutual appreciation, attachment styles (avoidant, anxious), and relationship satisfaction among couples coping with cancer compared to control couples.
Sample and Setting: The study included 102 dyads (204 individuals): 57 dyads coping with cancer and 45 control dyads. All couples were in committing relationships without severe cognitive or mental disorders.
Procedure: Participants independently completed standardized self-report questionnaires measuring relationship satisfaction (CSI), mutual appreciation (based on different versions of PPR scales), and attachment style (ECR–Revised). An Actor–Partner Interdependence Models (APIM) using linear mixed-effects models were applied, along with additional alignment analyses.
Results: Relationship satisfaction was positively associated with mutual appreciation (actor β = 1.087, partner β = 0.360, p < .001). Actor’s anxious (β = -0.346, p < .001) and actor’s avoidant attachment (β = -0.493, p < .001) negatively predicted satisfaction. Avoidant attachment had stronger negative effects among cancer couples (interaction β = -0.447, p = .0057). Additional analyses revealed that dyadic alignment, showed that alignment in appreciation and attachment predicted higher satisfaction in all sample, while alignment in attachment styles predicted higer satisfaction particularly among cancer couples. Notably, satisfaction levels did not significantly differ between cancer and control groups.
Conclusion and Clinical Implications: In general, mutual appreciation enhances relationship satisfaction, whereas avoidant attachment poses significant risks specifically during cancer-related stress. Targeted psycho-oncological interventions emphasizing emotional openness, appreciation, and relational alignment may improve dyadic satisfaction among couples coping with cancer.