Relationship quality and physical health: Responsiveness as an active ingredient predicting health across the lifespan.

A growing body of research has established responsiveness as a robust predictor of physical health. Here, we evaluate the extent to which this work establishes partner responsiveness as an active ingredient- a specific component within the broader construct of relationship quality that accounts for a demonstrated association between relationship quality and health. We review work demonstrating that responsiveness predicts a wide range of physical health outcomes, above and beyond other facets of relationship quality, and that it moderates the effects of other protective processes and risk factors. Finally, we discuss how new methodological and interdisciplinary approaches can provide generalizable, causal, and mechanistic evidence to further validate responsiveness as an active ingredient linking relationships and health.

Behavioral, cognitive, and socioemotional pathways from early childhood adversity to BMI: Evidence from two prospective, longitudinal studies.

Childhood adversity is associated with higher adult weight, but few investigations prospectively test mechanisms accounting for this association. Using two socioeconomically high-risk prospective longitudinal investigations, the Minnesota Longitudinal Study of Risk and Adaptation (MLSRA; N = 267; 45.3% female) and the Fragile Families and Child Wellbeing Study (FFCWS; n = 2,587; 48.5% female), pathways between childhood adversity and later body mass index (BMI) were tested using impulsivity, emotion dysregulation, and overeating as mediators. Childhood adversity from 0 to 5 years included four types of adversities: greater unpredictability, threat/abuse, deprivation/neglect, and low socioeconomic status. Parents reported on child impulsivity, emotion dysregulation, and overeating. Height and weight were self-reported and measured at 32 and 37 years in MLSRA and at 15 years in FFCWS. FFCWS results indicated that threat, deprivation, and low socioeconomic status predicted greater impulsivity and emotion dysregulation at 5 years, which in turn predicted greater overeating at 9 years and higher BMI z-score at 15 years. Early unpredictability in FFCWS predicted higher BMI through greater impulsivity but not emotion dysregulation at age 5. MLSRA regression results replicated the threat/abuse → emotion dysregulation → overeating → higher BMI pathway. These findings suggest that different dimensions of early adversity may follow both similar and unique pathways to predict BMI.

Social network structure and combating social disconnection: Implications for physical health.

Disconnection from one's social network has detrimental links to physical health outcomes, and there has been increased interest in treating social disconnection as a public health issue. Two perspectives guide much of the research on social networks, social disconnection, and physical health. One perspective emphasizes the quality of social ties over the quantity of social ties, whereas the other emphasizes quantity over quality. In this article, we discuss the importance of combining these perspectives to promote forming networks consisting of a few close relationships in addition to some peripheral ties to effectively combat social disconnection and maintain and promote better health. We also highlight important avenues for future research, including identifying critical moderators (e.g., age, culture) and using social network interventions to address issues of causality.

Good Theories in Need of Better Data: Combining Clinical and Social Psychological Approaches to Study the Mechanisms Linking Relationships and Health.

The study of intimate relationships and health is a fast-growing discipline with numerous well-developed theories, many of which outline specific interpersonal behaviors and psychological pathways that may give rise to good or poor health. In this article, we argue that the study of relationships and health can move toward interrogating these mechanisms with greater precision and detail, but doing so will require a shift in the nature of commonly used research methods in this area. Accordingly, we draw heavily on the science of behavior change and discuss six key methodologies that may galvanize the mechanistic study of relationships and health: dismantling studies, factorial studies, experimental therapeutics, experimental mediation research, multiple assessments, and recursive modeling. We provide empirical examples for each strategy and outline new ways in which a given approach may be used to study the mechanisms linking intimate relationships and health. We conclude by discussing the key challenges and limitations for using these research strategies as well as novel ideas about how to integrate this work into existing paradigms within the field.

Psychosocial experiences modulate asthma-associated genes through gene-environment interactions.

Social interactions and the overall psychosocial environment have a demonstrated impact on health, particularly for people living in disadvantaged urban areas. Here, we investigated the effect of psychosocial experiences on gene expression in peripheral blood immune cells of children with asthma in Metro Detroit. Using RNA-sequencing and a new machine learning approach, we identified transcriptional signatures of 19 variables including psychosocial factors, blood cell composition, and asthma symptoms. Importantly, we found 169 genes associated with asthma or allergic disease that are regulated by psychosocial factors and 344 significant gene-environment interactions for gene expression levels. These results demonstrate that immune gene expression mediates the link between negative psychosocial experiences and asthma risk.

Socioeconomic status, financial stress, and glucocorticoid resistance among youth with asthma: Testing the moderation effects of maternal involvement and warmth.

OBJECTIVES: Children who grow up in more socioeconomically disadvantaged homes experience greater levels of inflammation and worse asthma symptoms than children from more advantaged families. However, recent evidence suggests that certain family-level factors can mitigate health disparities associated with socioeconomic status (SES). In a sample of youth with asthma, we investigated the potential buffering effects of maternal involvement and warmth on SES disparities in asthma-related immune responses, assessed via glucocorticoid resistance (GR) of immune cells. METHODS: One hundred and forty-three youth (10-16 years of age) with asthma completed measures of maternal involvement and warmth, and their primary caregivers reported their levels of education, income, and financial stress. Peripheral blood mononuclear cells from youth's blood were isolated, cultured, and assayed to determine mitogen-stimulated (PMA/INO + Etho) and mitogen/hydrocortisone-stimulated (PMA/INO + Cort) levels of two Th-2 cytokines (i.e., interleukin-5, interleukin-13) and one Th-1 cytokine (i.e., interferon-γ). GR was calculated by subtracting log-transformed cytokine concentration in the PMA/INO + Etho samples from log-transformed cytokine concentration in the PMA/INO + Cort samples. RESULTS: Both maternal involvement and warmth moderated the indirect pathway from family SES to GR of Th-2 cytokines via financial stress. Specifically, we found that low family SES was associated with elevated GR of Th-2 cytokines via increased financial stress among youth reporting low levels of maternal involvement and warmth, but not among those reporting high levels of maternal involvement or warmth. CONCLUSIONS: These results highlight the protective role of maternal involvement and warmth in health-related biological processes modulated by family SES among youth with asthma.

Life stress and cortisol reactivity: An exploratory analysis of the effects of stress exposure across life on HPA-axis functioning.

Stressful experiences affect biological stress systems, such as the hypothalamic-pituitary-adrenal (HPA) axis. Life stress can potentially alter regulation of the HPA axis and has been associated with poorer physical and mental health. Little, however, is known about the relative influence of stressors that are encountered at different developmental periods on acute stress reactions in adulthood. In this study, we explored three models of the influence of stress exposure on cortisol reactivity to a modified version of the Trier Social Stress Test (TSST) by leveraging 37 years of longitudinal data in a high-risk birth cohort (N = 112). The cumulative stress model suggests that accumulated stress across the lifespan leads to dysregulated reactivity, whereas the biological embedding model implicates early childhood as a critical period. The sensitization model assumes that dysregulation should only occur when stress is high in both early childhood and concurrently. All of the models predicted altered reactivity, but do not anticipate its exact form. We found support for both cumulative and biological embedding effects. However, when pitted against each other, early life stress predicted more blunted cortisol responses at age 37 over and above cumulative life stress. Additional analyses revealed that stress exposure in middle childhood also predicted more blunted cortisol reactivity.

The Dual Impact of Early and Concurrent Life Stress on Adults' Diurnal Cortisol Patterns: A Prospective Study.

Major life stress often produces a flat diurnal cortisol slope, an indicator of potential long-term health problems. Exposure to stress early in childhood or the accumulation of stress across the life span may be responsible for this pattern. However, the relative impact of life stress at different life stages on diurnal cortisol is unknown. Using a longitudinal sample of adults followed from birth, we examined three models of the effect of stress exposure on diurnal cortisol: the cumulative model, the biological-embedding model, and the sensitization model. As its name implies, the cumulative model focuses on cumulative life stress. In contrast, the biological-embedding model implicates early childhood stress, and the sensitization model posits that current life stress interacts with early life stress to produce flat diurnal cortisol slopes. Our analyses are consistent with the sensitization model, as they indicate that the combination of high stress exposure early in life and high current stress predict flat diurnal cortisol slopes. These novel findings advance understanding of diurnal cortisol patterns and point to avenues for intervention.

Perceived Partner Responsiveness, Daily Negative Affect Reactivity, and All-Cause Mortality: A 20-Year Longitudinal Study.

OBJECTIVE: This study tested longitudinal associations between absolute levels of perceived partner responsiveness (PPR; how much people perceive that their romantic partners understand, care for, and appreciate them), daily negative affect reactivity and positive affect reactivity, and all-cause mortality in a sample of 1,208 adults for three waves of data collection spanning 20 years. We also tested whether longitudinal changes in PPR predicted mortality via affect reactivity. METHODS: Data were taken from the National Survey of Midlife Development in the United States. PPR was assessed at waves 1 and 2, affect reactivity to stressors was assessed by daily diary reports at wave 2, and mortality status was obtained at wave 3. RESULTS: Mediation analyses revealed absolute levels of PPR at wave 1 predicted wave 3 mortality via wave 2 affective reactivity in the predicted direction, but this did not remain robust when statistically accounting for covariates (e.g., marital risk, neuroticism), ß = .004, 95% confidence interval = -.03 to .04. However, wave 1-2 PPR change predicted negative affect (but not positive affect) reactivity to daily stressors at wave 2, which then predicted mortality risk a decade later (wave 3); these results held when adjusting for relevant demographic, health, and psychosocial covariates, ß = -.04, 95% confidence interval = -.09 to -.002. CONCLUSIONS: These findings are among the first to provide direct evidence of psychological mechanisms underlying the links between intimate relationships and mortality and have implications for research aiming to develop interventions that increase or maintain responsiveness in relationships over time.

Self-Disclosure and Perceived Responsiveness Among Youth With Asthma: Links to Affect and Anti-Inflammatory Gene Expression.

Self-disclosure and perceived responsiveness are important building blocks of social relationships that have long-lasting consequences for health and well-being. However, the conditions under which self-disclosure and responsiveness are likely to benefit health, and how early in life these benefits arise, remain unclear. Among 141 youth (aged 10-17) with asthma, we investigated how average daily levels of self-disclosure and responsiveness are linked to positive and negative affect and the expression of the glucocorticoid receptor gene NR3C1, a marker of improved regulation of stress physiology and immune functioning. Higher levels of self-disclosure were associated with higher NR3C1 expression and positive affect only when perceptions of responsiveness were high. Furthermore, perceived responsiveness was linked to NR3C1 expression for females but not males. These results suggest that the potential benefits of self-disclosure depend on the extent to which interaction partners are perceived as responsive and that these benefits emerge prior to adulthood.

Maternal attachment avoidance is linked to youth diurnal cortisol slopes in children with asthma.

Prior evidence suggests that an individual's attachment orientation is linked to the health and health-related biology of his/her romantic relationship partners. The current study examined whether this effect extends to parent-child relationships. Specifically, we investigated the association between maternal attachment anxiety and avoidance and diurnal cortisol of offspring. In a sample of 138 youth with asthma and their primary caregivers, caregivers reported their attachment orientations, and their children (aged 10-17) supplied four saliva samples per day over four days to assess diurnal cortisol patterns. Growth curve analyses revealed no links to caregiver attachment anxiety, but caregiver attachment avoidance was significantly associated with children's diurnal cortisol slopes, such that greater attachment avoidance predicted flatter diurnal cortisol slopes. Maternal warmth did not mediate this link. These results support the possibility that an individual's adult attachment orientation may "get under the skin" of family members to influence their health-related biology. Future research should seek to determine the causal direction of this association and mechanisms of this effect.

Early maternal sensitivity, attachment security in young adulthood, and cardiometabolic risk at midlife.

Children who experience high-quality early parenting tend to have better physical health, but limited research has tested whether this association extends into adulthood using prospective, observational assessments. Likewise, mechanisms that may explain such links have not yet been illuminated. In this study, we test whether the quality of early maternal sensitivity experienced during the first 3½ years of life predicts cardiometabolic risk at midlife (ages 37 and 39 years) via attachment representations measured in young adulthood (ages 19 and 26 years). We do so by comparing the predictive significance of two different forms of attachment representations coded from the Adult Attachment Interview (AAI): (a) secure base script knowledge and (b) coherence of mind. Using data from the Minnesota Longitudinal Study of Risk and Adaptation, we find that early maternal sensitivity is negatively associated with cardiometabolic risk at midlife. Secure base script knowledge (but not coherence of mind) partially mediated this link. These findings are consistent with the possibility that early parenting has lasting significance for physical health in part by promoting higher levels of secure base script knowledge.

Attachment and Jealousy: Understanding the Dynamic Experience of Jealousy Using the Response Escalation Paradigm.

Jealousy is a complex, dynamic experience that unfolds over time in relationship-threatening situations. Prior research has used retrospective reports that cannot disentangle initial levels and change in jealousy in response to escalating threat. In three studies, we examined responses to the Response Escalation Paradigm (REP)-a 5-stage hypothetical scenario in which individuals are exposed to increasing levels of relationship threat-as a function of attachment orientations. Highly anxious individuals exhibited hypervigilant, slow escalation response patterns, interfered earlier in the REP, felt more jealousy, sadness, and worry when they interfered, and wanted to engage in more vigilant, destructive, and passive behaviors aimed at their partner. Highly avoidant individuals felt more anger when they interfered in the REP and wanted to engage in more partner-focused, destructive behaviors. The REP offers a dynamic method for inducing and examining jealousy and introduces a novel approach to studying other emotional experiences.

Socioeconomic status, family negative emotional climate, and anti-inflammatory gene expression among youth with asthma.

The glucocorticoid receptor gene NR3C1 is an important down-regulator of inflammation and is typically under-expressed in individuals with low socioeconomic status (SES). Negative emotionality has been suggested as a potential mediator of SES disparities in health outcomes. In this study, we expand this literature by naturalistically assessing negative emotionality in a key emotional environment: the family. In a sample of 104 youth with asthma (10-17 years) and their primary caregiver, we assessed SES via caregiver report, emotional expression by youth and parents in the home over four days using the electronically activated recorder (EAR), and NR3C1 expression via blood collected from youth. Although there was not a direct effect of SES on NR3C1 expression, bootstrapping mediation analyses showed a significant indirect path such that lower SES was associated with a more negative family emotional climate, which in turn predicted reduced NR3C1 expression. No mediation effects were found for family positive emotional climate. This research demonstrates the importance of examining the effects of SES on emotion expression in the family context and suggests a critical biopsychosocial pathway underlying SES-based health disparities that may extend beyond youth.

Affective processes as mediators of links between close relationships and physical health.

Close relationships are known to predict physical health outcomes. The time has come for a shift toward achieving a better understanding of the underlying mechanisms. One promising group of psychological mechanisms is affective processes, such as discrete emotions, emotion regulation, and affect reactivity. In this paper, we discuss the evidence linking relationship functioning with both the positive and negative valences of each affective process, considering the contributions of different types of close relationships across the lifespan, and the evidence for each affective process impacting physical health. We note evidence suggesting that affective processes may also have a causal impact on relationship function. When available, we review literature testing full mediational pathways, from relationship functioning to affective processes to physical health, as the ideal methodology for testing these links. Finally, we identify core themes and propose key future directions for this research.

Effects of relationship functioning on the biological experience of stress and physical health.

In this paper, we outline how relationship functioning affects the biological experience of stress and its consequences for physical health. Negative relationship perceptions and processes, such as attachment insecurity, hostility, and frequent conflict, tend to heighten stress responses and generate worse health over time, whereas positive relationship perceptions and processes, such as responsiveness, support, and intimacy, are generally associated with reduced or buffered stress responses and improved health (with some caveats). Future research should focus on the mechanisms behind these effects, the extent to which they can be changed or reversed, incorporating developmental perspectives, and effects of individual differences on these processes.

The impact of stress at different life stages on physical health and the buffering effects of maternal sensitivity.

OBJECTIVE: Many studies indicate that early life stress leads to negative health outcomes in adulthood, and some suggest that high-quality parenting might buffer these effects. Most prior research, however, has relied on cross-sectional retrospective reports of stress and parenting. Our study tests how coder-rated stress and parenting quality assessed at different life stages predict adult health outcomes in a prospective, longitudinal study. METHOD: Participants were 163 individuals in the Minnesota Longitudinal Study of Risk and Adaptation studied since birth. Physical health was assessed at age 32 with body mass index, self-reports of symptoms and illnesses experienced, and self-ratings of overall physical health. Stress was assessed by coder-rated interviews involving participants or their mothers at 16 time points partitioned into 5 life stages: early childhood, middle childhood, adolescence, young adulthood, and at age 32 (when health was assessed). Parenting quality was measured by coder ratings of each mother's provision of sensitive, responsive support at 7 time points between birth and age 13. RESULTS: Early childhood, adolescent, and concurrent stress predicted adult health outcomes at age 32. Early childhood and adolescent stress, and adolescent and concurrent stress, both showed a "dual-risk" pattern, such that experiencing higher stress at both of these life stages predicted the worst health outcomes. Higher maternal sensitivity, however, buffered these deleterious effects. CONCLUSION: Our prospective data reveal that early childhood and adolescence are important developmental periods during which stress is influential for adult physical health. However, parenting interventions that promote greater sensitivity may help children in high-stress environments avoid negative adult health outcomes. (PsycINFO Database Record

Buffering the responses of avoidantly attached romantic partners in strain test situations.

Strain tests are unique contexts that have important implications for relationships, but they have rarely been studied in social interactions. We investigate how more avoidant individuals (responders) react when their romantic partners (askers) request cooperation with an important plan/goal that requires a major sacrifice from responders. As predicted, more avoidant responders were less accommodating when asked to sacrifice and showed drops in trust and commitment following the strain test discussion. However, certain asker behaviors-expressing confidence that the responding partner will facilitate the request, and acknowledging their sacrifices in doing so-led more avoidant responders to react more positively during and after the strain test discussions. Showing responsiveness, another positive asker behavior, promoted growth in trust and commitment, but it did not help more avoidant responders react more positively to the asker's goal. Blending key principles of interdependence and attachment theory, this is the first behavioral observation study to identify the specific partner behaviors that help highly avoidant people respond constructively in strain test situations and to suggest how avoidant partners can become more trusting and committed in their romantic relationships. (PsycINFO Database Record

Relational Effects on Physical Activity: A Dyadic Approach to the Theory of Planned Behavior.

OBJECTIVE: Despite growing appreciation of how close relationships affect health outcomes, there remains a need to explicate the influence romantic partners have on health behavior. In this paper, we demonstrate how an established model of behavior change-the theory of planned behavior (TPB)- can be extended from an individual level to a dyadic (couple) model to test the influence that relationship partners have on a key determinant of health behavior-behavioral intentions. METHODS: Two hundred romantic couples (400 individuals) completed TPB measures regarding physical activity for themselves and their romantic partner as well as a measure of relationship quality. RESULTS: Above and beyond the individual-level TPB predictors of behavioral intentions (i.e., attitudes, subjective norms, and perceived behavioral control), the romantic partner's perceived behavioral control (PBC) regarding physical activity predicted each individual's behavioral intentions and moderated the influence of each individual's PBC on his or her own behavioral intentions. Additionally, the romantic partner's perceptions of each individual's TPB measures predicted each individual's behavioral intentions to be physically active. Quality of the relationship also moderated some partner influences on individuals' intentions. CONCLUSIONS: This paper provides a roadmap for integrating a dyadic framework into individual-level models of behavior change. The findings suggest that data from both partners and relationship quality are important to consider when trying to understand and change health-related behavior such as physical activity. The results broaden the potential applications of the TPB as well as our understanding of how romantic partners might influence important health-related practices. (PsycINFO Database Record