The Biobehavioral Family Model: Close relationships and allostatic load.

RATIONALE: This study tested the inclusion of allostatic load as an expansion of the biobehavioral reactivity measurement in the Biobehavioral Family Model (BBFM). The BBFM is a biopsychosocial approach to health which proposes biobehavioral reactivity (anxiety and depression) mediates the relationship between family emotional climate and disease activity. METHODS: Data for this study included a subsample of n = 1255 single and married, English-speaking adult participants (57% female, M age = 56 years) from the National Survey of Midlife Development in the United States (MIDUS II), a nationally representative epidemiological study of health and aging in the United States. Participants completed self-reported measures of family and marital functioning, anxiety and depression (biobehavioral reactivity), number of chronic health conditions, number of prescribed medications, and a biological protocol in which the following indices were obtained: cardiovascular functioning, sympathetic and parasympathetic nervous system activity, hypothalamic pituitary adrenal axis activity, inflammation, lipid/fat metabolism, and glucose metabolism. RESULTS: Structural equation modeling indicated good fit of the data to the hypothesized family model (χ (2) = 125.13 p = .00, SRMR = .03, CFI = .96, TLI = .94, RMSEA = .04) and hypothesized couple model (χ(2) = 132.67, p = .00, SRMR = .04, CFI = .95, TLI = .93, RMSEA = .04). Negative family interactions predicted biobehavioral reactivity for anxiety and depression and allostatic load; however couple interactions predicted only depression and anxiety measures of biobehavioral reactivity. CONCLUSION: Findings suggest the importance of incorporating physiological data in measuring biobehavioral reactivity as a predicting factor in the overall BBFM model.

The biobehavioral family model: testing social support as an additional exogenous variable.

This study tests the inclusion of social support as a distinct exogenous variable in the Biobehavioral Family Model (BBFM). The BBFM is a biopsychosocial approach to health that proposes that biobehavioral reactivity (anxiety and depression) mediates the relationship between family emotional climate and disease activity. Data for this study included married, English-speaking adult participants (n = 1,321; 55% female; M age = 45.2 years) from the National Comorbidity Survey Replication, a nationally representative epidemiological study of the frequency of mental disorders in the United States. Participants reported their demographics, marital functioning, social support from friends and relatives, anxiety and depression (biobehavioral reactivity), number of chronic health conditions, and number of prescription medications. Confirmatory factor analyses supported the items used in the measures of negative marital interactions, social support, and biobehavioral reactivity, as well as the use of negative marital interactions, friends' social support, and relatives' social support as distinct factors in the model. Structural equation modeling indicated a good fit of the data to the hypothesized model (χ(2)  = 846.04, p = .000, SRMR = .039, CFI = .924, TLI = .914, RMSEA = .043). Negative marital interactions predicted biobehavioral reactivity (ß = .38, p < .001), as did relatives' social support, inversely (ß = -.16, p < .001). Biobehavioral reactivity predicted disease activity (ß = .40, p < .001) and was demonstrated to be a significant mediator through tests of indirect effects. Findings are consistent with previous tests of the BBFM with adult samples, and suggest the important addition of family social support as a predicting factor in the model.