The current study sought to provide a better understanding of the reactions of bone-marrow volunteers to the possibility of donating by examining these volunteers in the context of their closest relationships. Using Tesser's (1988) self-evaluation maintenance (SEM) model as a guide, we examined the influence of spouses who are also volunteers on each member of the couple's distress levels and on the marrow volunteer's ambivalence about donating. We also examined the independent effects of known risk factors for donation-related distress and the combined effects of spouse volunteer status and these risk factors on distress levels. Questionnaire data were collected from 278 couples selected from 39 bone-marrow donor centers. Results demonstrated that when spouses of potential donors were engaged in any type of volunteer activity, members of the couple felt greater anxiety than when spouses were not volunteers. Additionally, other variables were found to have a conjoint effect with spouse volunteer status on volunteer and spouse anxiety levels.