Fig. 1

The effects of index cumulative illness burden on future spouse cumulative illness burden. Causal mediation analysis models examining the effects of index CIB (cumulative illness burden) at baseline and its change on future spouse CIB in A all subjects, B the low CIB group, and C the high CIB group. “Baseline index CIRS” refers to the CIRS scores of the index participants at the baseline visit. “Change in index CIRS” refers to the change in CIRS scores (ΔCIRS) of the index participants between the baseline visit and the 6-year follow-up visit. The spouse CIRS scores were assessed once, at the 8-year follow-up visit, and is presented as “8-year spouse CIRS.” Numbers next to arrows correspond to unstandardized regression coefficients. Black arrows indicate statistically significant effects. ACME, average causal mediation effect; ADE, average direct effect. ^†p < .01, *p < .05, **p < .01, ***p < .001