Relationship partner social behavior and continuous positive airway pressure adherence: The role of autonomy support

OBJECTIVE

Obstructive sleep apnea (OSA), a serious respiratory disorder, confers increased risk of cardiovascular disease and mortality. Adherence to the standard and effective treatment, continuous positive airway pressure (CPAP), is often poor. Personal relationships can influence adherence, but some forms of partner involvement (e.g., support, encouragement) have positive effects on CPAP adherence, whereas others (e.g., criticism, blame) are counterproductive. In the former, constructive partner efforts may enhance a patient's sense of autonomy, an important foundation for self-care. The present study examined how patients' perceptions of autonomy support from an intimate partner predict adherence to CPAP, and whether it is an independent predictor, relative to generally positive partner behavior (i.e., partner responsiveness) and partner negativity (i.e., negative social control).

METHOD

Ninety-two married or cohabiting OSA patients (mean age 49.7 years) completed measures of perceived partner autonomy support, responsiveness, and negative social control at Days 14 and 60 of CPAP treatment. Objective daily CPAP machine adherence data were collected for 60 days.

RESULTS

Perceived partner autonomy support predicted more minutes of CPAP used per night and increasing CPAP use over time. These effects were independent of the significant adverse effects of partner negative social control and the more limited beneficial effects of partner responsiveness.

CONCLUSION

The study findings establish perceived partner autonomy support as an interpersonal predictor of adherence that is independent of negative social control and perceived partner responsiveness, and may inform psychosocial interventions for CPAP adherence and more general couple approaches to chronic illness management. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

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.

Strained Bedfellows: An Actor-Partner Analysis of Spousal Attachment Insecurity and Sleep Quality

Background

The quality of interpersonal ties-especially closer relationships-appears to be associated with physical health outcomes. Sleep is one pathway through which relationships and health appear to be linked, but this has been inadequately investigated in the context of dyadic attachment.

Purpose

The present study examined links between relationship-specific attachment anxiety (which can involve preoccupation with one's partner, negative relationship cognitions, and fear of abandonment) and avoidance (e.g., low emotional investment or intimacy) and sleep quality.

Methods

Attachment, assessed using the Experience in Close Relationship (ECR), was used to predict Pittsburgh Sleep Quality Inventory (PSQI)-assessed sleep quality in 92 married heterosexual couples via actor-partner interdependence models. Depression was examined as a potential mediator of this association.

Results

Consistent with hypotheses, actors' anxious attachment predicted diminished quality of their own sleep, whereas actors' avoidant attachment was unrelated to their own sleep quality. Results further suggested that couples in which both spouses were higher in attachment anxiety experience better sleep quality (b = -0.74, SE = 0.28, p = .0082, 95% CI [-1.287, -0.196]). Conversely, couples in which both spouses were higher in attachment avoidance showed poorer sleep quality (b = 0.56, SE = 0.23, p = .0188, 95% CI [0.095, 1.016]). These effects were found to be independent of marital satisfaction and depression. Some evidence was also consistent with mediation of links between attachment and sleep quality via depression.

Conclusions

Results suggest adult romantic attachment and sleep are associated in complex ways, highlighting the importance of dyadic approaches to the study of relationships, sleep, and health.

Enemies and friends in high-tech places: the development and validation of the Online Social Experiences Measure

BACKGROUND

Interpersonal positivity and negativity are separable dimensions both recognized as having important effects on health. Though online social interactions and research examining them are increasingly common, no validated instrument has heretofore been developed to examine social support and social negativity specifically in online contexts. The present studies describe the development and validation of the Online Social Experiences Measure (OSEM) to allow for assessment of online social positivity and negativity simultaneously.

METHODS AND RESULTS

In Study I, responses to a potential item pool were collected from participants (N = 557), who were then subdivided into two groups for the purposes of cross-validation via exploratory and confirmatory factor analyses. Results suggested the emergence of two factors: online social support (OSEM+ subscale) and online social negativity (OSEM- subscale). Across Studies I and II (N = 139), the OSEM showed good convergent and discriminant validity, and both subscales had high internal consistency. Study II included an ambulatory cardiovascular assessment and found the OSEM- subscale to be predictive of elevated diastolic blood pressure and heart rate. The OSEM+ subscale was predictive of more favorable cardiovascular readings for some types of participants (e.g. those with a greater number of online-only social ties).

CONCLUSIONS

Overall, results suggest online social positivity and negativity may have implications for physical health, and that the OSEM may be a useful tool in understanding online social processes.

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.

The body remembers: Adolescent conflict struggles predict adult interleukin-6 levels

Struggles managing conflict and hostility in adolescent social relationships were examined as long-term predictors of immune-mediated inflammation in adulthood that has been linked to long-term health outcomes. Circulating levels of interleukin-6 (IL-6), a marker of immune system dysfunction when chronically elevated, were assessed at age 28 in a community sample of 127 individuals followed via multiple methods and reporters from ages 13 to 28. Adult serum IL-6 levels were predicted across periods as long as 15 years by adolescents' inability to defuse peer aggression and poor peer-rated conflict resolution skills, and by independently observed romantic partner hostility in late adolescence. Adult relationship difficulties also predicted higher IL-6 levels but did not mediate predictions from adolescent-era conflict struggles. Predictions were also not mediated by adult trait hostility or aggressive behavior, suggesting the unique role of struggles with conflict and hostility from others during adolescence. The implications for understanding the import of adolescent peer relationships for life span physical health outcomes are considered.

Social support and sleep: A meta-analysis

OBJECTIVE

While the implications of social support are increasingly well understood, no meta-analytic review to date has examined the intersection of the social support and sleep literatures. The aims of this meta-analysis were primarily to review the association between social support and sleep and additionally to test several proposed moderators from prior work.

METHOD

Using a literature search and the ancestry approach, the review identified 61 studies with a total of 105,437 participants.

RESULTS

Random-effects modeling showed that greater social support was significantly related to improved sleep outcomes (Zr = -.152). These results were not moderated by the operationalization of support, study design, or chronic conditions.

CONCLUSIONS

These data indicate a robust association between social support and favorable sleep outcomes. (PsycINFO Database Record

Gender and racial/ethnic differences in sleep duration in the North Texas heart study

OBJECTIVE

Short sleep duration has been linked with a wide array of poor mental and physical health outcomes. Such risks, however, may be moderated by demographic factors such as gender and race/ethnicity. In a diverse community sample, the current study examined the relationship between gender, race/ethnicity and objectively measured sleep duration, controlling for select potential confounds.

METHODS

Participants were 300 community adults (50% female), aged 21 to 70 years, and included 60% non-Hispanic Whites, 15% non-Hispanic Blacks, 19% Hispanic/Latino, and 6% other. As part of a larger study, participants wore an actigraphy device over two nights to assess sleep duration (averaged across both nights). Gender and race/ethnicity were used as grouping variables in a two-way analysis of covariance (ANCOVA) predicting objectively assessed total sleep time, with age, income, and employment status as covariates.

RESULTS

On average, males slept 34 min less than females (P=.002). After controlling for socioeconomic factors, there was a gender by race/ethnicity interaction (P=.030). Within males, Hispanics slept 45 min less than non-Hispanic Whites (P=.002) and 57 min less than non-Hispanic others (P=.008). Males also slept significantly less than females within the non-Hispanic White (difference=-22.9; P=.016) and the Hispanic (difference=-77.1; P<.001) groups.

CONCLUSIONS

Extending previous research, the current study provides additional evidence for differences in objective sleep duration based on gender and race/ethnicity in daily life. These data suggest that risk associated with sleep duration is patterned in important ways across gender and race/ethnicity; such information can be used to tailor prevention efforts.

Life satisfaction and inflammation in couples: an actor-partner analysis

Life satisfaction has been linked to lower cardiovascular disease mortality. However, much less is known about the biological mechanisms linking life satisfaction to physical health. In addition, the dyadic context of life satisfaction has not been considered despite increasing evidence that partners influence each other in health-relevant ways. These questions were addressed with 94 married couples who completed measures of life satisfaction and had their blood drawn for determination of interleukin-6 (IL-6) and C-reactive protein (CRP). Actor-partner models showed that higher actor levels of life satisfaction predicted lower levels of IL-6 and CRP (p's < .05), whereas partner levels of life satisfaction did not predict any measure of inflammation. The actor results were not mediated by marital satisfaction or health behaviors. Finally, no actor × partner interactions were significant and these links were not moderated by marital satisfaction. These data highlight inflammation as a potentially important biological mechanism linking actor reports of life satisfaction to lower cardiovascular mortality.

Evaluating the longitudinal risk of social vigilance on atherosclerosis: study protocol for the North Texas Heart Study

INTRODUCTION

Psychosocial factors are increasingly recognised as important determinants of cardiovascular disease risk. The North Texas Heart Study aims to understand the mechanisms responsible for this association with a focus on social vigilance (ie, scanning the environment for social threats). There is also growing interest in supplementing traditional methods (eg, survey assessment of psychosocial risk paired with cross-sectional and longitudinal health outcomes) with daily or repeated momentary assessment of psychosocial factors. However, there are relatively few longitudinal studies directly comparing these approaches with hard endpoints.

METHODS AND ANALYSIS

The North Texas Heart Study proposes a longitudinal measurement burst design to examine psychosocial determinants of subclinical atherosclerosis. A sample of 300 healthy community participants, stratified by age and gender, will complete survey measures, as well as 2 days of ecological momentary assessment at baseline and at a 2-year follow-up. A range of psychosocial and behavioural factors, objective biomarkers, as well as carotid intima-media thickness (cIMT) will be assessed at both time points. Unadjusted and adjusted models will evaluate cross-sectional associations and determinants of change in the cIMT.

ETHICS AND DISSEMINATION

The Institutional Review Board at the study coordinating institute (University of North Texas) has approved this study. Positive, negative or inconclusive primary and ancillary findings will be disseminated in scientific journals and conferences.

The quality of social networks predicts age-related changes in cardiovascular reactivity to stress

Although existing life span models suggest that positivity in relationships should benefit the health of older adults, much less is known about how relationships that contain both positive and negative aspects (i.e., ambivalent ties) might influence age-associated cardiovascular risk. Given the increased interpersonal stress associated with ambivalent ties, the SAVI model would predict that older adults might be more negatively influenced given age-related changes in physiological flexibility. In this study, the quality of an individual's social network (i.e., supportive, ambivalent, aversive) was used to predict cardiovascular reactivity during laboratory stress across a 10-month follow-up period in 108 participants between the ages 30 to 70. Results revealed evidence that the number of ambivalent network ties predicted greater increases in diastolic blood pressure reactivity. Importantly, there was an Age × Ambivalent Ties interaction in which the number of ambivalent ties was related to greater increases in systolic blood pressure reactivity primarily in older adults. These data are discussed in terms of the health implications of social networks across the life span. (PsycINFO Database Record

Racial and Ethnic Variation in the Association of Social Integration with Mortality: Ten-year Prospective Population-based US Study

Substantial data link social relationships with mortality but few studies have examined whether these associations are consistent across racial and ethnic groups. The purpose of the present study was to evaluate the presence and form of the social relationship/mortality association in a representative sample of US Black (n = 4,201), non-Hispanic White (n = 20,217) and Hispanic (n = 5,097) groups. In models adjusted for age, sex, chronic disease, socioeconomic status and smoking social integration was inversely related to ten-year survival in all groups. However, among Whites the association was linear and graded whereas among Blacks the association was linear but was statistically significant only for the highest level of social integration (hazard ratio [HR] = 0.66, 95% confidence interval = 0.47-0.94). A threshold pattern was observed among Hispanics, in that lower mortality risk was found for all social integration categories above the lowest level (HRs from 0.58 to 0.52, P's < 0.01) and each of the higher social integration categories were in turn equivalent. Received social support was unrelated to mortality across all groups. Higher social integration is associated with a survival advantage for Blacks and Whites. For Hispanics, moderate and high levels of social integration were equally protective.

Marital Quality Buffers the Association Between Socioeconomic Status and Ambulatory Blood Pressure

BACKGROUND

Socioeconomic status is robustly associated with rates of death and disease. Psychophysiological stress processes are thought to account for a portion of this association.

PURPOSE

Although positive and supportive relationships can buffer psychophysiological stress responses, no studies have examined whether the quality of a primary adult relationship-marriage-may buffer the negative association between socioeconomic status and stress-related disease processes.

METHODS

The current study examines the interaction between income and marital quality (supportive vs. ambivalent) on individuals' daily ambulatory blood pressure, a valid and reliable indicator of cardiovascular risk.

RESULTS

Results revealed that supportive marital relationships buffered the otherwise higher ambulatory diastolic blood pressure associated with low income.

CONCLUSIONS

Results are consistent with the buffering hypothesis of social support and suggest that a supportive spouse may buffer stress-related autonomic processes linking low socioeconomic status to risk for cardiovascular disease.

Hierarchy and health: Physiological effects of interpersonal experiences associated with socioeconomic position

OBJECTIVE

The inverse association between socioeconomic position (SEP) and cardiovascular disease may involve social psychophysiological processes. To test effects of aspects of SEP on physiological reactivity, we experimentally manipulated 3 features of social context related to social hierarchy-social rank or status relative to an interaction partner, the partner's degree of dominant behavior, and the presence of social-evaluative threat.

METHOD

The study design was a 2 × 2 × 2 × 2 (Participant Relative Status [high vs. low] × Partner Dominance [high vs. low] × Evaluative Threat [high vs. low] × Sex [male vs. female]) factorial, and 180 undergraduates participated. Cardiovascular and salivary cortisol responses were measured while participants engaged in a controlled interaction task with a prerecorded confederate partner.

RESULTS

Lower participant relative status resulted in greater increases in systolic (SBP) and diastolic blood pressure (DBP). Interacting with a more dominant partner resulted in greater increases in SBP and heart rate (HR), and larger changes in cardiac sympathetic and parasympathetic activation. Higher levels of social-evaluative threat evoked larger increases in HR and SBP. In some cases, these effects were stronger in men than in women, and aspects of the low status social context had synergistic effects on some physiological outcomes.

CONCLUSION

Interpersonal interactions and experiences may contribute to the association between SEP and cardiovascular health through the mechanism of physiological activation. Recurring patterns of everyday social experiences and their physiological effects may be a pathway linking the broader social context to cardiovascular disease. (PsycINFO Database Record

Dispositional optimism and sleep quality: a test of mediating pathways

Dispositional optimism has been related to beneficial influences on physical health outcomes. However, its links to global sleep quality and the psychological mediators responsible for such associations are less studied. This study thus examined if trait optimism predicted global sleep quality, and if measures of subjective well-being were statistical mediators of such links. A community sample of 175 participants (93 men, 82 women) completed measures of trait optimism, depression, and life satisfaction. Global sleep quality was assessed using the Pittsburgh Sleep Quality Index. Results indicated that trait optimism was a strong predictor of better PSQI global sleep quality. Moreover, this association was mediated by depression and life satisfaction in both single and multiple mediator models. These results highlight the importance of optimism for the restorative process of sleep, as well as the utility of multiple mediator models in testing distinct psychological pathways.

Social Support, Physiological Processes, and Health

Social relationships serve important functions in people's everyday lives. Epidemiological research indicates that supportive relationships may also significantly protect individuals from various causes of mortality, including cardiovascular disease. An important issue is how social support influences such long-term health outcomes. In this article, we review evidence indicating that social support may influence mortality via changes in the cardiovascular, endocrine, and immune systems. These data suggest that it may be worthwhile to incorporate social-support interventions in the prevention and treatment of physical health problems.

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.

Attitude similarity and familiarity and their links to mental health: An examination of potential interpersonal mediators

Similarity and familiarity with partner's attitudes are linked to positive relationship outcomes, while interpersonal variables have been linked to mental health. Using multilevel models (MLMs), we modeled the associations between these attitudinal variables and mental health outcomes in 74 married couples. We found that higher levels of attitude similarity in couples were linked to lower depression, while higher levels of attitude familiarity in couples were associated with greater satisfaction with life. Mediational analyses indicated marital satisfaction and interpersonal stress mediated the link between attitude similarity and depression. Marital satisfaction also mediated the link between familiarity and satisfaction with life. This study is the first linking attitude familiarity to mental health and provides evidence that familiarity and similarity have mental health effects partly due to their interpersonal consequences.

Perceived Social Support Trajectories and the All-Cause Mortality Risk of Older Mexican American Women and Men

Although numerous studies of non-Hispanic Whites and Blacks show that social integration and social support tend to favor longevity, it is unclear whether this general pattern extends to the Mexican American population. Building on previous research, we employed seven waves of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to examine the association between perceived social support trajectories and the all-cause mortality risk of older Mexican Americans. Growth mixture estimates revealed three latent classes of support trajectories: high, moderate, and low. Cox regression estimates indicated that older Mexican American men in the low support trajectory tend to exhibit a higher mortality risk than their counterparts in the high support trajectory. Social support trajectories were unrelated to the mortality risk of older Mexican American women. A statistically significant interaction term confirmed that social support was more strongly associated with the mortality risk of men.