Continuity in hostile family relationships mediated by family psychopathology: An application of systems perspective.

Grounded in the family systems theory within the life course systems perspective, this study sought to investigate (a) long-term transmission processes of hostility from interparental relationships to parent-young adult relationships and (b) the mediational roles of parents' and adolescents' psychopathology in these long-term processes. Research has examined the long-term transmission of hostility from interparental relationships to young adults' relationships with their parents. However, less is known about how this transmission process differs for father-young adult and mother-young adult relationships and if psychopathology is a mechanism that contributes to the transmission of hostility. Utilizing a structural equation model and prospective, longitudinal data from couples in enduring marriages and their offspring (n = 345 families), we examined long-term associations between interparental hostility when offspring were adolescents and young adults (1990 and 2001), adolescents' hostile relationships with their fathers and mothers (1991), and young adults' hostile relationships with their fathers and mothers (2003) as well as the mediating roles of fathers', mothers', and adolescents' psychopathology (1992 and 1994). Interparental hostility was more strongly linked to hostility between mothers (rather than fathers) and their young adult offspring. Fathers', mothers', and adolescents' psychopathology uniquely mediated the transmission processes. This study elucidated transmission processes of interparental hostility to young adults' relationship hostility with their parents and offers insights into the unique mediational roles of each family member's psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Adolescent chronic pain links parental rejection to young adult biopsychosocial problems.

Little is known about the mediating role of adolescent chronic pain in the connection between adolescent parental rejection and psychosocial and physical health (i.e., disease risk) outcomes in young adulthood (YA). To address this gap, the present study tested a model of a successively contingent developmental process that integrates neurophysiological research and the life course developmental perspective. The model included parental rejection and chronic pain in adolescence and depressive symptoms, low education attainment, economic hardship and allostatic load in YA. The study utilized 13 years of prospective data from a nationally representative sample of 11,030 US adolescents. The findings largely supported the hypothesized model. Adolescent chronic pain, as influenced by parental rejection, was associated with depressive symptoms and economic hardship in YA. In addition, parental rejection directly influenced depressive symptoms, education level and economic hardship, all of which, in turn, contributed to greater physical health risk (i.e., allostatic load) in YA. These associations persisted even after controlling for adolescent illness, depressive symptoms, age, sex and race/ethnicity. Multi-group analysis showed that female participants were more vulnerable to stressful parental rejection and socioeconomic difficulties in YA. The theoretical and practical implications of these findings are discussed.

Life transition events and depressive symptom trajectories during young adulthood: The influence of adverse family and individual contexts in adolescence.

Because sequential patterns of multiple transition events (i.e., college graduation, full-time employment, marriage, and parenthood) are associated with turning points in depressive symptom trajectories during young adulthood, the present study used a sample of 446 White adolescents (52.3% females; 15.58 years old, on average) over 18 years (1992 to 2010) to (a) identify distinct longitudinal joint processes between these sequential patterns of life transition events and turning points of depressive symptom trajectories by using a person-centered modeling approach and (b) investigate the influence of adverse family and individual contexts (negative family economic events, hostile relationships with parents, and impulsive sensation seeking) in adolescence on these longitudinal joint processes. We identified six longitudinal joint processes: (a) traditional transition pattern with no turning points in depressive symptom trajectories, (b) traditional transition pattern with turning points in depressive symptom trajectories in the mid-to-late 20s, (c) early parenthood transition pattern with no turning points in depressive symptom trajectories, (d) early parenthood transition pattern with turning points in depressive symptom trajectories in the mid-to-late 20s, (e) precocious transition pattern with no turning points in depressive symptom trajectories, and (f) precocious transition pattern with depressive symptom turning points (or fluctuations) throughout young adulthood. Negative family economic events, hostile relationships with parents, and impulsive sensation seeking in adolescence influenced these longitudinal joint processes. Hostile relationships with parents also uniquely influenced turning points in depressive symptoms during young adulthood while impulsive sensation seeking uniquely influence sequential patterns of life transition events. Clinical implications are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Religiosity and Physical Health of Middle-Old Aged African Americans: The Linking Role of Self-Control.

Objective: This study examined a psychological process (i.e., sense of control) that links religiosity to self-reported physical health in older African Americans. Methods: Two waves of data from 231 middle-old aged African Americans (AAs) were used to test two specific hypotheses: (a) religiosity influences changes in sense of control middle-old aged AAs, and (b) sense of control influences changes in global physical health in middle-old aged AAs. The analysis used two modeling approaches: (a) an autoregressive cross-lagged modeland (b) a parallel growth/change model. Results: The results of both types of models showed that religiosity positively influenced changes in sense of control and that sense of control positively influenced changes in physical health in middle-old aged AAs over time. Discussion: These findings provide evidence that sense of control links religiosity to physical health in older African Americans. The theoretical and practical implications of the findings are discussed.

Early socioeconomic adversity and young adult diabetic risk: an investigation of genetically informed biopsychosocial processes over the life course.

The present study investigated a comprehensive model that integrates contributions of early socioeconomic adversity (ESA) and multiple polygenic scores (PGSs) through different mechanisms leading to diabetic risk in early adulthood. The study used prospective, longitudinal data from the National Longitudinal Study of Adolescent and Adult Health (Add Health) with a sample of 5,728 youth of European ancestry. The results showed that both ESA and PGSs were involved in different mechanisms. ESA contributed additively to educational failures, BMI, depressive symptoms, and diabetes risk over the life course (an additive process). Also, ESA launched a cascading process that connected these outcomes in a successively contingent manner. In addition to ESA, youths' multiple PGSs directly contributed to educational, psychological, and BMI outcomes. Multiple PGSs for education, BMI, and type 2 diabetes influenced not only youth outcomes that they were supposed to predict directly but also additional youth outcomes showing biological pleiotropy. The findings highlight the value of incorporating molecular genetic information into longitudinal developmental life course research and provide insight into malleable characteristics and appropriate timing for interventions addressing youth developmental and health outcomes.

Explaining Physical Health Disparities and Inequalities Over the First Half of the Life Course: An Integrative Review of Add Health Studies.

This integrative review of research utilizing the National Longitudinal Study of Adolescent to Adult Health draws on previous research detailing pathways linking early socioeconomic adversity in childhood and adolescence (Wave 1 in 1995 and prior) to physical health outcomes in young adulthood (Wave 5 in 2015). Health outcomes considered included specific diseases, disease risk, and morbidity as prospectively measured by parent-reported and self-reported health outcomes as well as clinical biomarkers. A heuristic research framework was developed from the comprehensive review focused on 4 study designs and identifying total associations, physiological pathways, stress pathways, and resources pathways linking early socioeconomic adversity to physical health outcomes for young adults, as well as potential modifiers of these pathways. The appropriateness of different analytical strategies used in these research studies including approaches for analysis of change in health are discussed. Taken together, review findings suggest the merit of an integrated perspective taking a long view over early life course to explain cumulative physical health risk over the first half of the life course by assessing multiple pathways simultaneously. Looking forward, the review findings also emphasize the need for the investigation of the continuity and change in these pathways over the second half of the life course.

Dissemination trial for Health for Hearts United: Model development, preliminary outcomes and lessons learned.

Background: Cardiovascular disease CVD), the leading cause of death in the U.S., is a particular problem for African Americans (AAs). Church-based health interventions are effective in reducing CVD risk, yet few have been successfully disseminated. This paper describes the model development, preliminary health outcomes, and lessons learned from the Health for Hearts United (HHU) dissemination trial which evolved from the longitudinal Reducing CVD Risk Study in a two-county area in North Florida. Community-based participatory research approaches and the socio-ecological model guided the study. Methods: Data for this paper were from health leaders (n = 25) in the first six churches investigated, and the outreach participants (n = 86) they engaged. Health leaders completed survey items (daily servings of fruits/vegetables [F/V], fat consumption [FAT], and daily minutes of physical activity [PA]) and clinical measures (body mass index [BMI]; waist, hip and abdomen circumferences; and systolic and diastolic blood pressure [BP]). For outreach participants, a brief CVD Awareness Quiz was administered. Data were analyzed using description statistics, Pearson correlations, and repeated measures analysis of variance. Results: Findings showed that the dissemination model was implemented by 100% of the churches, and resulted in health outcomes changes for health leaders (significant increases between pre- and post-test in F/V; significant decreases in FAT, BMI, abdomen circumference, with educational level and marital status as selected significant covariates) and in a significant increase in CVD awareness for outreach participants. Lessons learned are discussed. Although preliminary, the results suggest that the HHU dissemination model has promise for reducing CVD risk in AA's.

Lower Life Satisfaction and Inflammation in African American Adults: Body Adiposity Mediation and Sex Moderation.

Both lower life satisfaction (LLS) and chronic inflammation are underlying conditions for numerous diseases. We investigated their associations in African American adults, within the context of three hypotheses: (a) perceived LLS will be positively associated with inflammation measured by serum C-reactive protein (CRP); (b) this association will be mediated by body adiposity; and (c) these associations will be moderated by sex. Participants (n = 83; >45 years; 59% women) were a subsample of a larger church-based intervention to reduce cardiovascular risks and were assessed at baseline and after 6 months. Body adiposity (BMI/hip/waist circumferences) was measured by standardized methods and CRP with ELISA. LLS was self-reported. The analyses were conducted in the structural equation modeling (SEM) framework. The direct relationship between LLS and CRP was significant for all participants but was mediated by BMI/hip/waist circumferences. Multi-group SEM analysis provided evidence for sex moderation by showing that the mediating pathway from LLS to CRP through BMI, and to a lesser extent through hip/waist circumferences, was significant only in women. In conclusion, perceived LLS was positively associated with the level of inflammation mediated by BMI/hip/waist circumference, with the association between LLS and CRP being stronger in women. These findings contribute to the current literature untangling mediation/moderation processes in which perceived LLS may contribute to adiposity-related inflammation. They also add to precision medicine development, suggesting that stress and inflammation-reducing interventions should focus on African Americans, particularly women.

Midlife financial strain and later-life health and wellbeing of husbands and wives: Linking and moderating roles of couple intimacy trajectories.

This study investigates (a) heterogeneous trajectories of couple intimacy over the mid-later years (average ages of 40-65) and (b) how these intimacy classes are differentially associated with spouses' midlife financial strain as well as their later-life health and wellbeing outcomes. The sample was comprised of white couples in long-term marriages from the rural Mid-west who experienced the economic downturn of the farm crisis in late 1980s. Couple-level measures of emotional intimacy and sexual intimacy were created by summing husbands' and wives' reports. Using growth mixture modeling with a sample of 304 couples, conjoint intimacy classes were identified from trajectories of couple emotional intimacy and sexual intimacy. Three qualitatively different latent intimacy classes of couples were identified: Consistently High, Moderate and Increasing, and Chronically Low. Intimacy classes were differentially associated with midlife financial strain and later-life health and wellbeing. Spouses with consistently high and moderate and increasing intimacy in their mid-later years averaged lower financial strain in early midlife and better health and wellbeing outcomes in later years (>67 years) compared to those with consistently low intimacy after controlling for lagged health measures. The identification of couple intimacy trajectory groups provides a potentially useful prognostic tool for counseling efforts that can promote and develop resiliency factors to aid in the redirection of adverse couple intimacy trajectories.

En el presente estudio se investigan las a) trayectorias heterogéneas de la intimidad de la pareja durante los años de la mediana edad y la vejez (edades promedio de 40 a 65 años) y b) cómo estas clases de intimidad se asocian diferencialmente con la presión económica de la mediana edad de los cónyuges, así como con los resultados en la salud y el bienestar en la vejez. La muestra estuvo compuesta de parejas blancas en matrimonios duraderos de zonas rurales del centro de los Estados Unidos que sufrieron la recesión económica de la crisis agrícola a fines de la década de los ochenta. Las medidas a nivel de la pareja de la intimidad emocional y la intimidad sexual se crearon sumando los informes de los esposos y las esposas. Utilizando un modelo de combinación de crecimiento con una muestra de 304 parejas, se identificaron clases de intimidad conjunta a partir de las trayectorias de la intimidad emocional y la intimidad sexual de la pareja. Se identificaron tres clases de parejas cualitativamente diferentes según su intimidad latente: constantemente alta, moderada y en aumento, y crónicamente baja. Las clases de intimidad estuvieron asociadas diferencialmente con la presión económica en la mediana edad y la salud y el bienestar en la vejez. Los cónyuges con intimidad constantemente alta, y moderada y en aumento entre la mediana edad y la vejez promediaron una menor presión económica a principios de la mediana edad y mejores resultados en la salud y el bienestar durante la vejez (más de 67 años) en comparación con aquellos que tenían una intimidad constantemente baja después de tener en cuenta las medidas de salud retardadas. La identificación de los grupos de trayectorias de la intimidad de la pareja ofrece una herramienta de pronóstico que puede ser útil para el trabajo de terapia orientado a personas y a parejas, ya que puede promover y desarrollar factores de resiliencia que ayuden a redirigir las trayectorias desfavorables de la intimidad de la pareja.

Higher-order trajectories of pain and depressive symptoms link midlife financial stress to women's well-being in later life.

Objectives: Consistent with biopsychosocial models, shared pathophysiological conditions underlying both physical pain and depressive symptoms can result in the clustering of pain and depressive symptoms. However, previous studies have not investigated a higher-order construct capturing both pain and depressive symptoms over time. Furthermore, research has not identified trajectory antecedents (e.g. perceived family financial stress) and their consequences for later-life health and well-being. The present study sought to address these gaps in the research.Method: Using prospective data over 23 years from 244 long-term married women, the present study estimated latent growth curves in a structural equation model (more specifically a parallel trajectory model was estimated).Results: Family financial strain in midlife was, on average, associated with a higher initial level (ß = .37, p < .001) and rate of change (ß = .20, p = .045) of pain-depressive symptoms trajectories, which, in turn, contributed to health and well-being challenges, including the level and rate of change in physical limitations (ß = .50, p < .001 and 0.43, p < .001, respectively), memory impairment (ß = .47 and .47, p < .001, respectively), and loneliness (ß = .63, p = < .001 and .28, p = .022, respectively) in later years. The adverse influence of family financial strain on pain-depressive symptoms trajectories weakened under high levels of marital closeness (ß = -.10, p = .032). Conclusion: These findings emphasize the necessity of policies and interventions that focus on reducing adults' stressful life circumstances and further developing protective factors that can aid in the redirection of adverse pain-depressive symptoms trajectories.Supplemental data for this article are available online at https://doi.org/10.1080/13607863.2021.1993129.

Life course trajectories of chronic financial strain and acute stress reactivity: Steeling in response to recovery from strain.

The steeling hypothesis suggests experiencing moderate strain may improve an individual's ability to cope with future strain, whereas crisis theory suggests that experiencing temporary strain will reduce the effect of future strain. The current study improves on past research by utilizing data from two independent prospective panel studies (one of 553 white rural Midwesterner women and 451 men and one of 624 African American women) spanning 26 and 22 years, respectively. We utilize growth mixture modeling to identify latent groups based on trajectories of financial strain and test interactions between class membership and later acute stressful events on chronic illness and physical health using three subscales from the RAND SF-12. We find being a group that experienced a period of temporary strain weakened the effect of later acute stressors on physical health for both samples and chronic illness for the African American sample. Results support crisis theory and highlight the importance of considering chronic strain as a life course process.

Early life course processes leading to educational and economic attainment in young adulthood: Contributions of early socioeconomic adversity and education polygenic score.

The present study investigated an integrated life course model, drawn from the life course theoretical perspective, to elucidate youth's additive, cascading, and cumulative life course processes stemming from early socioeconomic adversity and education polygenic score (education PGS) as well as potential interactions between them (GxE), which contribute to subsequent young adult socioeconomic outcomes. Additionally, the independent, varying associations among social and genetic predictors, life-stage specific educational outcomes (educational achievement in adolescence and educational attainment, in later stages), and young adult economic outcomes were examined. The study used prospective, longitudinal data from the National Longitudinal Study of Adolescent and Adult Health (Add Health) with a sample of 5,728 youth of European ancestry. Early family socioeconomic adversity and individual education PGS were associated with life stage-specific educational outcomes through additive and cascading processes linked to young adults' economic outcomes (personal earnings) through a cumulative process. A GxE moderation existed between individuals' education PGS and early socioeconomic adversity at multiple life stages, explaining variation in adolescent educational outcomes. Both early socioeconomic adversity and education PGS were persistently associated with youth's educational and economic outcomes throughout the early life course. In sum, the findings based on the integrated life course model showed how additive, cascading, and cumulative processes were related and conditioned one another, generating specific life course patterns and outcomes. The findings highlight the value of incorporating molecular genetic information into longitudinal developmental life course research and provide insight into malleable characteristics and appropriate timing for interventions addressing youth developmental characteristics.

How Early Stressful Life Experiences Combine With Adolescents' Conjoint Health Risk Trajectories to Influence Cardiometabolic Disease Risk in Young Adulthood.

Research has primarily focused on additive (unique) associations between early stressful life experiences (specifically, socioeconomic adversity and maltreatment) and young adults' cardiometabolic disease risk without considering multiplicative (synergistic) influences. Furthermore, research has not fully considered the varying patterns of health risk trajectories (e.g., substance use, obesogenic-related behaviors, depressive symptoms) across adolescence and the transition to young adulthood that may link earlier stressful experiences and later cardiometabolic disease risk. This study examined heterogeneity in conjoint health risk trajectories from adolescence to the transition to young adulthood and their additive and multiplicative (synergistic) influences with early stressful life experiences on cardiometabolic disease risk in young adulthood using data from the National Longitudinal Study of Adolescent to Adult Health (n = 9,421; 55.6% female) over a period of 13 years. Four distinct conjoint health risk trajectories were identified considering trajectories of substance use behaviors, obesogenic-related behaviors, and depressive symptoms: (a) overall high-risk, (b) behavioral risks, (c) psycho-obesogenic risks, and (d) overall low-risk. Socioeconomic adversity and maltreatment were additively and multiplicatively associated with cardiometabolic disease risk in young adulthood. Individuals with overall high-risk conjoint trajectories averaged higher cardiometabolic disease risk in young adulthood when they were exposed to early socioeconomic adversity. Implications for personalized interventions for individuals who have experienced multiple forms of health risks are discussed.

Modeling longitudinal dyadic processes in family research.

In this article, several dyadic analyses are applied to illustrate how they can be used to answer distinct research questions regarding associations between dyad members over time (longitudinal interdependence). This article focuses on how to conceptualize and empirically assess distinct dyadic processes, including time-sequential processes involving change in rank-order, parallel change processes involving intra-individual changes, dynamic dyadic processes involving both intra-individual changes and time-specific deviations (from intra-individual change), and accelerated dyadic processes involving acceleration of intra-individual change. These dyadic processes are depicted by four different dyadic models; a cross-lagged autoregressive model, a dyadic latent growth model (with and without structured residuals), and a dyadic latent change score model, respectively. These four longitudinal dyadic models are illustrated using a sample of 251 husbands and wives in enduring marriages. Each model focuses on a different dyadic process demonstrating distinct ways to empirically assess longitudinal interdependence; thus, when analyzing data, dyadic researchers must weigh the advantages and disadvantages of each and select the modeling approach that is most appropriate for the research question. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Midlife Marital and Financial Stress and the Progression of Later-Life Health Problems for Husbands and Wives.

Objectives: Locating the family systems theory within the life course stress process perspective, this study investigates how husbands' and wives' marital and financial stress were implicated in their subsequent physical health, psychological distress, and loneliness. Methods: Using prospective data from 254 husbands and wives over 27 years, a path model examined the influence of marital stress and family financial stress during midlife (40-50 years) on later-life (65+ years) physical health, psychological distress, and loneliness. Results: For wives, loneliness was a mechanism linking marital stress to their health outcomes and their husbands' physical health. For husbands, physical health was a mechanism linking financial strain to husbands' health outcomes and wives' physical health. Discussion: The findings emphasize the consideration of midlife financial and marital stress for policies and programs for older adults, particularly the prevention of loneliness and improving interpersonal processes, as ways to protect from earlier stressful experiences.

Midlife family financial strain, sense of control and pain in later years: An investigation of rural husbands and wives.

Research focussing on individual biopsychosocial processes leading to physical pain as a health condition is rare. The present study investigated sense of control as a mechanism linking early midlife stress to later-life physical pain for husbands and wives in long-term marriages. Using data from 508 rural husbands and wives over 27 years (1991-2017) with respondents in their early middle years (<42 years on average) in 1991 and in their later years (>67 years on average) in 2017, this study utilized a comprehensive analytical model in an structural equation modelling framework. Family financial stress (FFS) trajectories in early middle years were associated with depleted sense of control, which was related to increased physical pain in later years after controlling for concurrent physical illness, family income and age. In cross-lagged analyses FFS influenced physical pain over mid-later years. Physical pain also influenced FFS, suggesting a bi-directional association between FFS and physical pain. Findings elucidate how early midlife FFS influences the progression of physical pain over mid-later years through sense of control. Findings suggest effective intervention and prevention programs should focus on FFS in early years of adulthood as well as the maintenance and development of adults' sense of control.

Heterogeneity in Husbands' and Wives' Physical Pain Trajectories Over Mid-Later Years: Biopsychosocial Stratification and Implications for Later-Life Well-Being.

BACKGROUND AND OBJECTIVES: The present study investigated pain trajectories of husbands and wives over their mid-later years, the grouping of these trajectories, and differences in baseline biopsychosocial profiles and health and well-being outcomes in later years across the pain trajectory groups. RESEARCH DESIGN AND METHODS: Growth mixture modeling was used to identify latent classes of 244 husbands' and wives' physical pain trajectories over their mid-later years (1994-2015, average ages of 44-65 years). Analyses were conducted to identify how these pain trajectory classes were associated with respondents' biopsychosocial profiles in 1994 and health and well-being in later years (2017 [>67 years]). RESULTS: The individual pain trajectories of husbands and wives were clustered into 3 heterogeneous groups with differing trajectory patterns. Nonnormative pain trajectory groups (with either a high pain level and/or persistent pain) were associated with adverse baseline biopsychosocial characteristics. These groups also experienced poorer health and well-being outcomes in later years (2017) compared to those with consistently low pain after controlling for lagged measures in 2015. DISCUSSION AND IMPLICATIONS: The identification of pain trajectory groups and characteristics of group members provides a potentially useful prognostic tool for early preventive intervention efforts, treatment, and policy formation. Such interventions can promote and develop resiliency factors, thereby aiding in the redirection of middle-aged husbands' and wives' adverse pain trajectories.

Pathways of the family stress model in midlife on physical health in later adulthood.

The current study examined economic adversity and physical health outcomes in line with the family stress model (FSM) for husbands and wives in enduring marriages. Data came from 243 husbands and wives who participated from early middle to later adulthood. Assessments included observational and self-report measures. Economic hardship and economic pressure were assessed in early middle adulthood. Feelings of hostility and observed harsh couple interaction were examined in middle adulthood, and physical impairment was assessed in later adulthood. Results indicated that economic hardship related to economic pressure. In addition, economic pressure indirectly related to physical impairment via hostility and harsh couple interaction. For husbands, economic pressure was also directly associated with their own physical impairment in later adulthood. Finally, economic pressure was indirectly associated with husband to wife harsh couple interaction through wife hostility. Similarly, economic pressure was indirectly associated with wife to husband harsh couple interaction through husband hostility. Results suggest that economic adversity as experienced in early middle adulthood has long-term health consequences into later adulthood. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Couple processes of family economic hardship, depressive symptoms, and later-life subjective memory impairment: moderating role of relationship quality.

OBJECTIVES: To examine a) processes through which family economic hardship (FEH) contributes to spouses' mental health and subsequent subjective memory impairment (SMI) in later years and b) the moderating effect of overall relationship quality on these associations. METHODS: With prospective data over 27 years from a sample of 224 husbands and wives in enduring marriages, the present study utilized latent growth curves to identify how FEH trajectories are associated with both spouses' depressive symptoms trajectories across their mid-later years (average age 40-65 years) and subsequent SMI in later life (> 67 years). The moderating role of relationship quality between depressive symptoms and SMI was also examined. RESULTS: FEH experiences across the mid-later years (1991-2015) explained variation in husbands' and wives' depressive symptoms trajectories (1994-2015). Change in depressive symptoms was associated with husbands' and wives' SMI in later life (2017) after taking the level of depressive symptoms into account. Spousal dependencies, including partner effects, existed among husbands' and wives' depressive symptoms trajectories and SMI outcomes. Some of these dependencies were moderated by couples' overall relationship quality. CONCLUSION: FEH has a persistent influence on husbands' and wives' SMI in later years. Depressive symptoms mediated the influence of FEH on later wellbeing. The findings are discussed as they relate to family systems and life course stress process theories. Implications are addressed at multiple levels including national- and state-policies and clinical interventions.

How Midlife Chronic Stress Combines with Stressful Life Events to Influence Later Life Mental and Physical Health for Husbands and Wives in Enduring Marriages.

Objectives: To investigate how midlife chronic stress (40-50 years) and subsequent acute stressful events (50-65 years) influence husbands' and wives' later life mental and physical health (65+ years). Methods: Dyadic structural equation modeling was used with prospective data over 25 years from 256 husbands and wives in enduring marriages. Results: For both spouses, midlife chronic stress influenced the occurrence of subsequent acute stressful life events, which in turn influenced both depressive symptoms and poor physical health in later years. For both spouses, midlife chronic stress also directly influenced depressive symptoms. Wives' midlife chronic stress also directly influenced their own poor physical health and husbands' depressive symptoms in later years. Discussion: These findings enhance our knowledge about the long-term joint influence of midlife chronic stress and acute stressful life events on health outcomes of husbands and wives in later years and identify dependencies between spouses, which can inform health preventive intervention programs.