Social ties and cardiovascular function: an examination of relationship positivity and negativity during stress

While You Are Sleeping: Marital Ambivalence and Blunted Nocturnal Blood Pressure

Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one's own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.

Social support and telomere length: a meta-analysis

Previous studies have shown that lower social support is associated with higher all-cause mortality (Holt-Lunstad et al. in PLoS ONE Medicine 7:e1000316, 2010). While social support has been associated with system-specific biological measures (e.g., cardiovascular), there is the need to elucidate more general biological mechanisms linking social support to health risk across a number of diseases. In this meta-analytic review, the link between social support and telomere length (Cawthon et al. in Lancet 361:393-395, 2003) was conducted based on the updated PRISMA guidelines (Page et al., 2021). Across 17 studies, higher social support was not significantly related to longer telomere length (Zr = 0.010, 95% CI [- 0.028, 0.047], p > 0.05). The confidence interval indicated that the bulk of plausible values were small to null associations. Little evidence for bias was found as shown by funnel plots and Kendall's Tau. Moderator analyses focusing on the measure of support, health of sample, age, type of assay specimen, and gender were not significant. In conclusion, this review showed no significant relationship between social support and telomere length and highlights important future directions.

Complex assessment of relationship quality within dyads

Higher quality relationships have been linked to improved outcomes; however, the measurement of relationship quality often ignores its complexity and the possibility of co-occurring positivity and negativity across different contexts. The goal of this study is to test the added benefit of including multiple dimensions, contexts, and perspectives of relationship quality from both individuals in predicting marital functioning. The Social Relationships Index assessed positive and negative dimensions of relationship quality under neutral, positive, and support-seeking contexts for 183 heterosexual married couples. Models showed that the inclusion of multiple dimensions of relationship quality across all three contexts improved prediction of marital functioning for both women and men. The use of multidimensional multicontextual relationship quality assessments is highly recommended.

Ambivalence in the Early Years of Marriage: Impact on Ambulatory Blood Pressure and Relationship Processes

BACKGROUND

Marriage is associated with lower cardiovascular morbidity and mortality, but quality matters. Marriages characterized by ambivalent behaviors (containing both highly positive and highly negative behaviors concurrently) may not confer the same cardiovascular benefits as characterized by purely positive behavior. Ambivalence is assumed to take time to develop but couples in the early years of marriage may already exhibit ambivalent behaviors and thus be at increased risk for future cardiovascular events.

PURPOSE

The purpose of this study was to determine the frequency of spouse and own ambivalent behavior, the impact on interpersonal (i.e., responsiveness, disclosure, affective interactions) processes, and ambulatory blood pressure (ABP) in individuals in the early years of marriage.

METHODS

In 84 young married couples, objective and subjective ambivalence, interpersonal functioning, and ABP over a 24-hr period were assessed.

RESULTS

As predicted, ambivalence developed early in marriage. Regarding interpersonal processes, spousal and own objective ambivalent behavior was associated with lower spousal responsiveness (p < .01), disclosure (p < .05), and more negative (p < .03) and less positive interactions (p < .001). Physiologically, ambivalent spousal behavior was associated with higher systolic blood pressure (p = .02) and higher diastolic blood pressure (p = .04). Measures of subjective ambivalence were congruent.

CONCLUSIONS

Early marriages already contain ambivalent behavior; in such cases, individuals may not receive the cardiovascular protection of a supportive marriage.

Social Ambivalence and Disease (SAD): A Theoretical Model Aimed at Understanding the Health Implications of Ambivalent Relationships

The protective influence of social relationships on health is widely documented; however, not all relationships are positive, and negative aspects of relationships may be detrimental. Much less is known about the relationships characterized by both positivity and negativity (i.e., ambivalence). This article provides a theoretical framework for considering the influence of ambivalent relationships on physical health, including reasons why ambivalence should be considered separately from relationships characterized as primarily positive (supportive) or primarily negative (aversive). We introduce the social ambivalence and disease (SAD) model as a guide to understanding the social psychological antecedents, processes, and consequences of ambivalent relationships. We conclude by highlighting gaps in the literature and features of the SAD model that may serve as a guide to future research on potential health-relevant pathways of ambivalent relationships.

Spousal influence: A study of women with eating and body image concerns

Eating disorder literature often overlooks those exhibiting eating and body image concerns without an eating disorder diagnosis. Supportive spouses may ameliorate negative body image and eating behavior, but spouses who exhibit both supportive and non-supportive behaviors concurrently (ambivalent) may send mixed messages. Eating disorder behaviors and spousal interactions were assessed in 61 women who demonstrated eating disordered behavior and body dissatisfaction but were not clinically diagnosed with an eating disorder. Spouses mostly provided messages of reassurance. However, some women were unable to overcome their internalized negative body image. Feelings of social comparison were seen with ambivalent spouses. Supportive relationships may be protective, but actual interventions may be needed to change negative body image.

Close Relationships and Health: The Interactive Effect of Positive and Negative Aspects

Most health research focuses on the independent associations of positive or negative aspects of close relationships with health outcomes. A small but growing literature has begun to examine interactive effects of positive and negative aspects. These interactive effects frequently predict health independently or above-and-beyond main effects of either the positive or the negative aspects, suggesting unique relationship processes or emergent features of these close relationship patterns. Our goal in this review is to lay out the existing approaches to studying the interactive effects of positive and negative aspects of close relationships, and to review available evidence linking these interactive effects to health outcomes. We conclude by discussing important unresolved issues and highlighting critical directions for future research.

No laughing matter: Latinas' high quality of conversations relate to behavioral laughter

Latinx in the United States have greater life expectancy than other groups, in spite of their socioeconomic and psychosocial disadvantage. This phenomenon has been described as the Latinx health paradox. This investigation observed the interplay of cultural processes and social networks to shed light on this paradox. Latina (N = 26) and White-European (N = 24) mothers wore a digital recorder as they went about their daily lives. Four conversation styles were characterized from the recordings to measure the mothers' quality of their conversations (small talk and substantive conversations) within different social networks (with the father vs. other adults). As a positive indicator of well-being, laughter was assessed during the conversations. Results demonstrated that Latina mothers tend to laugh more than White-European mothers; and that this relation is mediated by substantive conversations with others. This suggests that Latinas' cultural processes afford meaningful conversations, which relates to more behavioral laughter, a process that may have positive implications on well-being.

Associations of ambivalent leadership with distress and cortisol secretion

Ambivalent social ties, i.e., whereby a relationship is evaluated simultaneously in positive and negative terms, are a potential source of distress and can perturb health-relevant biological functions. Social interactions at the workplace, in particular with supervisors, are often described in ambivalent terms, but the psychological and psychobiological impact of such interactions has received little scientific attention. The current study examined associations between ambivalent attitudes towards one's supervisor, perceived distress (general and work-related), and diurnal dynamics of the stress hormone cortisol. 613 employees evaluated their supervisor in terms of positive and negative behaviors, which was combined into an ambivalent index. Higher ambivalence was associated with higher perceived distress and work-related stress (p < .001), and with a larger cortisol awakening response and higher day-time secretion post-awakening (p < .01). The present study is the first to identify ambivalence towards supervisors as a predictor of employee distress and stress-related endocrine dysregulation. In consequence, focusing solely on positive or negative leader behavior may insufficiently capture the true complexity of workplace interactions and attempts to compensate negative behaviors with positive are unlikely to reduce distress-but quite the opposite-by increasing ambivalence.

Childhood close family relationships and health

Emerging data suggest that during childhood, close family relationships can ameliorate the impact that adversity has on life span physical health. To explain this phenomenon, a developmental stress buffering model is proposed in which characteristics of family relationships including support, conflict, obligation, and parenting behaviors evolve and change from childhood to adolescence. Together, these characteristics govern whether childhood family relationships are on balance positive enough to fill a moderating role in which they mitigate the effects that childhood adversities have on physical health. The benefits of some family relationship characteristics are hypothesized to stay the same across childhood and adolescence (e.g., the importance of comfort and warmth from family relationships) whereas the benefits of other characteristics are hypothesized to change from childhood to adolescence (e.g., from a need for physical proximity to parents in early childhood to a need for parental availability in adolescence). In turn, close, positive family relationships in childhood operate via a variety of pathways, such as by reducing the impact that childhood stressors have on biological processes (e.g., inflammation) and on health behaviors that in turn can shape physical health over a lifetime. (PsycINFO Database Record

Association of social support during emergency department evaluation for acute coronary syndrome with subsequent posttraumatic stress symptoms

We examined the associations of different aspects of social support during emergency department (ED) evaluation for an acute cardiac event with perceptions of threat in the ED and subsequent posttraumatic stress symptoms (PSS) in 484 patients. Participants were enrolled in the ED where they reported on their perceptions of threat in the ED. Social support in the ED and PSS were assessed at inpatient bedside or by telephone a median of 3 days later. Positive aspects of social support were not associated with subsequent PSS. Anxiety-provoking social support was significantly associated with increased PSS at follow-up. Greater ED threat perception partially mediated that relationship.

It's Complicated: Marital Ambivalence on Ambulatory Blood Pressure and Daily Interpersonal Functioning

BACKGROUND

Marriage decreases cardiovascular morbidity although relationship quality matters. While some marriages contain highly positive aspects (supportive), marriages may also simultaneously contain both positive and negative aspects (ambivalent). Individuals whose spouses or own behavior is ambivalent may not experience the same cardiovascular-protective benefits of marriage.

PURPOSE

The purpose of this study is to elucidate the physiological pathways by which marital quality may influence long-term health and examine ambivalent behavior on interpersonal-functioning and ambulatory blood pressure (ABP).

METHODS

Interpersonal functioning and ABP were examined in 94 couples.

RESULTS

Spousal and own ambivalent behavior was associated with lower intimacy (ps < .01) and higher systolic ABP (ps < .01). Spousal ambivalent behavior was associated with lower ratings of partner responsiveness (p < .01) and less self- and spousal-disclosure (ps < .05). Mediational analyses indicated that own behavior mediated links between spousal ambivalent behavior and ABP.

CONCLUSIONS

Despite the positivity in relationships, individuals whose spouses' or own behavior is ambivalent may not receive cardiovascular protection from this positivity.

The Hispanic health paradox: From epidemiological phenomenon to contribution opportunities for psychological science

Similar to non-Hispanic Blacks, Hispanics/Latinos experience a range of psychosocial and physical health challenges, including high rates of poverty, neighborhood segregation, discrimination, poor healthcare access, and high rates of obesity, diabetes, and undiagnosed and late-stage diagnosed diseases. Despite such risks, Hispanics generally experience better physical health and lower mortality than non-Hispanic Whites, an epidemiological phenomenon commonly referred to as the Hispanic or Latino health paradox. With the basic phenomenon increasingly well-established, attention now turns to the sources of such resilience. The current aims are to briefly examine the epidemiological paradox and highlight potential sociocultural resilience factors that may contribute to the paradoxical effects. We conclude with presentation of a framework for modeling sociocultural resilience and discuss future directions for psychological contributions.

College student mental health and quality of workplace relationships

OBJECTIVE

The goal of this study was to examine the effect of quality of workplace relationships on the mental health of employed undergraduates, with work-related variables as a potential mechanism.

PARTICIPANTS

Participants were 170 employed students (76% female, average age = 19.9) recruited in March 2011. Most worked part-time and had been at their jobs over a year.

METHODS

Students were recruited from an undergraduate introductory psychology course and completed online surveys about the quality of workplace relationships, mental health (ie, somatic stress symptoms, depression, anxiety, and life satisfaction), and work-related variables (ie, job satisfaction, support, turnover and burnout).

RESULTS

Students who reported having workplace relationships with co-occurring positivity and negativity had worse self-reported mental health outcomes than students reporting having wholly positive relationships. The relationship between workplace relationship quality and mental health was mediated by negative work-related variables.

CONCLUSIONS

Workplace relationships-even in part-time employment settings-influence college students' mental health.

Family functioning, marital satisfaction and social support in hemodialysis patients and their spouses

A growing number of studies have demonstrated the importance of marital quality among patients undergoing medical procedures. The aim of the study was to expand the literature by examining the relationships between stress, social support and family and marriage life among hemodialysis patients. A total of 114 participants, including 38 patients and their spouses and 38 healthy controls, completed a survey package assessing social support, stress, family functioning and marital satisfaction and quality. We found that hemodialysis patients and spouses were less flexible in family adaptability compared with the healthy controls. Patients and spouses had more stress and instrumental social support compared with healthy people. Stress was negatively associated with marital satisfaction. Instrumental support was not associated with family or marital outcomes. The association between marital quality and support outside of family was positive in healthy individuals but was negative in patients and their spouses. Family adaptability was positively associated with support within family as perceived by patients and positively associated with emotional support as perceived by spouses. In conclusion, findings suggest that social support may promote adjustment depending on the source and type. Future research should pay more attention to the types and sources of social support in studying married couples.

Social stressors and cardiovascular response: influence of ambivalent relationships and behavioral ambivalence

OBJECTIVE

The protective influence of social relationships on health is well documented; however, not all relationships are positive and negative aspects of relationships may be detrimental. Relatively less is known about the relationships characterized by both positivity and negativity (i.e., ambivalence). The goal of this study was to examine the relative influence of ambivalence in relationship quality and social behavior on cardiovascular response.

METHODS

104 healthy young adults were randomly assigned to bring in either a supportive or ambivalent same-sex friend to the experiment. Participants were also randomly assigned to receive positive, negative, ambivalent or ambiguous feedback from their friend after giving a series of speeches. Cardiovascular response was obtained before, during, and after the social stressor (speech task).

RESULTS

Results indicate a significant effect of relationship type before, during, and after the stressor task. Adjusting for baseline, heart rate reactivity and anxiety was significantly higher among those assigned to ambivalent friends relative to those assigned to supportive friends during the stressor task (ps<.05). There was also a significant effect of behavioral feedback during the speech task, such that those receiving ambivalent messages had the greatest systolic blood pressure (SBP) and diastolic blood pressure (DBP) reactivity (p<.05); however, there was no interaction between relationship and feedback conditions. Those in the ambivalent friend condition also exhibited significantly higher SBP, DBP, and anxiety during the baseline and recovery periods (ps<.05).

CONCLUSIONS

These findings suggest that both relationship quality and the actions of relationships may have a significant influence on health-relevant physiology.

Clinical Implications of Impaired Sleep

Despite its pervasiveness in primary care, deficient sleep often is underappreciated as a cue to other health risks. Accordingly, this review discusses contemporary evidence-based perspectives on impaired sleep and its associations with other lifestyle medicine concerns, including obesity, cardiovascular conditions, psychological problems, and health-compromising habits. The potential clinical benefits of promoting sleep health also will be considered.

Risk and Resilience in Coping With Chronic Life Stress

This review discusses evidence-based perspectives on risk and resilience in coping with chronic life stress. Future directions for inquiry and practice also are addressed.