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

Positive sexuality, relationship satisfaction, and health: a network analysis

Introduction

Positive sexuality, defined as the happiness and fulfillment individuals derive from their sexual experiences, expressions, and behaviors, has been linked to relationship satisfaction and health. However, the intricate associations between positive sexuality and relationship functioning and health indicators have rarely been explored from a network perspective. This approach, by analyzing the interconnections among these factors within a broader system, can offer insights into complex dynamics and identify key variables for targeted interventions.

Methods

The present study applied network analysis to uncover interconnections between positive sexuality, relationship satisfaction, and health indicators, highlight the most relevant variables and explore potential gender-based differences in a sample of 992 partnered individuals (51% women, aged 18-71 years). Networks were estimated via Gaussian Graphical Models, and network comparison test was used to compare men and women.

Results

Results indicated that variables related to positive sexuality were more highly interconnected than the rest of the network. There were small-to-negligible connections between positive sexuality and relationship satisfaction variables, both of which had negligible or no connections with health. The network was globally invariant across gender, though a few connections were gender-specific. The most important variables, regardless of gender, related to pleasurable feelings during sexual intercourse.

Discussion

The findings underscore the importance of enhancing positive sexual experiences within intimate relationships and have implications for research and clinical practice in positive sexuality.

The Performance of Wearable AI in Detecting Stress Among Students: Systematic Review and Meta-Analysis

BACKGROUND

Students usually encounter stress throughout their academic path. Ongoing stressors may lead to chronic stress, adversely affecting their physical and mental well-being. Thus, early detection and monitoring of stress among students are crucial. Wearable artificial intelligence (AI) has emerged as a valuable tool for this purpose. It offers an objective, noninvasive, nonobtrusive, automated approach to continuously monitor biomarkers in real time, thereby addressing the limitations of traditional approaches such as self-reported questionnaires.

OBJECTIVE

This systematic review and meta-analysis aim to assess the performance of wearable AI in detecting and predicting stress among students.

METHODS

Search sources in this review included 7 electronic databases (MEDLINE, Embase, PsycINFO, ACM Digital Library, Scopus, IEEE Xplore, and Google Scholar). We also checked the reference lists of the included studies and checked studies that cited the included studies. The search was conducted on June 12, 2023. This review included research articles centered on the creation or application of AI algorithms for the detection or prediction of stress among students using data from wearable devices. In total, 2 independent reviewers performed study selection, data extraction, and risk-of-bias assessment. The Quality Assessment of Diagnostic Accuracy Studies-Revised tool was adapted and used to examine the risk of bias in the included studies. Evidence synthesis was conducted using narrative and statistical techniques.

RESULTS

This review included 5.8% (19/327) of the studies retrieved from the search sources. A meta-analysis of 37 accuracy estimates derived from 32% (6/19) of the studies revealed a pooled mean accuracy of 0.856 (95% CI 0.70-0.93). Subgroup analyses demonstrated that the accuracy of wearable AI was moderated by the number of stress classes (P=.02), type of wearable device (P=.049), location of the wearable device (P=.02), data set size (P=.009), and ground truth (P=.001). The average estimates of sensitivity, specificity, and F1-score were 0.755 (SD 0.181), 0.744 (SD 0.147), and 0.759 (SD 0.139), respectively.

CONCLUSIONS

Wearable AI shows promise in detecting student stress but currently has suboptimal performance. The results of the subgroup analyses should be carefully interpreted given that many of these findings may be due to other confounding factors rather than the underlying grouping characteristics. Thus, wearable AI should be used alongside other assessments (eg, clinical questionnaires) until further evidence is available. Future research should explore the ability of wearable AI to differentiate types of stress, distinguish stress from other mental health issues, predict future occurrences of stress, consider factors such as the placement of the wearable device and the methods used to assess the ground truth, and report detailed results to facilitate the conduct of meta-analyses.

TRIAL REGISTRATION

PROSPERO CRD42023435051; http://tinyurl.com/3fzb5rnp.

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.

The health consequences of stress in couples: A review and new integrated Dyadic Biobehavioral Stress Model

Despite marriage's health benefits, all couples experience stress that can increase morbidity and mortality risks. Marital stress can alter endocrine, cardiovascular, and immune function-key pathways from troubled relationships to poor health. This review discusses how partners "get under each other's skin" to influence psychological, behavioral, and biological health. Then, I offer a comprehensive Dyadic Biobehavioral Stress Model to build on this foundational work and inspire transdisciplinary research integrating psychoneuroimmunological and relational lenses. This conceptual and empirically driven model provides promising new directions to investigate mechanisms linking individuals' relationships behaviors to their own and their partners' health, with particular emphasis on biological pathways. These mechanisms may impact each partner's physical health outcomes, such as disease development, illness severity, and accelerated biological aging. Risk and protective factors across developmental stages and diverse contexts are also discussed to help explain how, and under what conditions, partners influence each other's health. Research applying this model can push the boundaries of our current understanding on dyadic stress its far-reaching health effects on self-report and biological markers across the lifespan.

The Critical Need to Recognize That Families Matter for Adult Health: A Systematic Review of the Literature

A systemic approach to researching families and health should capture the complex network within which family members are embedded, including multiple family relationships and larger systems of health care. However, much of the families and health research focused on adult family members has focused solely on intimate partnerships, usually the marital relationship. This neglects the remainder of the powerfully influencing family relationships adults retain, and may increasingly focus on as they age. We conducted a systematic review of the families and adult health literature, retaining 72 articles which were subsequently thematically coded to highlight main foci of this area of research. Results highlight six themes, which include family relationship quality, family composition, behavioral factors in health and health care, psychophysiological mediators, caregiving, and aging health. Findings support an underrepresentation of family members, other than the intimate partner, in research on adult health.

Towards Positive Aging: Links between Forgiveness and Health

Forgiveness may serve as an essential positive resource to help individuals cope emotionally with stressful events, ultimately influencing health. Examination of how individuals forgive within the context of close relationships can provide useful information about positive aging. In this study, we examine how the severity of a recent transgression committed by a spouse/partner or other close social relationship is associated with self-reported physical health among older adults. We also examine how state forgiveness (i.e., in context of a specific event) can offset the potentially negative impact of transgressions on health and further compare the impact when the transgressor is a spouse/partner versus another close social relationship. Data are from the Detroit Community Survey, a cross-sectional survey of social relations, forgiveness, humility, and health in the Detroit Metropolitan Area. Respondents age 50 and older were selected for analysis (N=380). Structural equation models indicated that greater transgression severity was associated with worse self-rated health. Further, state forgiveness was found to play a significant moderating role. Among older adults who were more likely to forgive their transgressor, experiencing a more severe transgression was associated with worse health. In contrast, among older adults less likely to forgive, there was no association between transgression severity and self-rated health. Additionally, among older adults less likely to forgive, the transgressor being a close other social relationship was associated with worse health compared to when it was a spouse/partner. In contrast, when more likely to forgive there was no association between who the transgressor was and self-rated health. This study contributes to a better understanding of how interpersonal stress, specifically a recent transgression experienced within the context of close social relationships, can be harmful to older adults’ health. Findings highlight the importance of forgiveness as a resource that can help facilitate positive aging.

Family versus intimate partners: Estimating who matters more for health in a 20-year longitudinal study

This study tested the extent to which the emotional climate (positive and negative relationship quality) in family relationships and intimate partnerships are each uniquely linked to specific domains of aging health outcomes, over and above the impact of earlier health. Data included partnered participants who completed all three waves of the Midlife Development in the United States (MIDUS). We used measures of family and intimate partner strain and support, at MIDUS 1, 2, and 3, and estimated the effects of each on subsequent morbidity and health appraisal (i.e., 10 and 20 years later). Autoregressive cross-lagged paths were modeled using maximum likelihood estimation with robust standard errors. Family strain was associated with later health in both the morbidity, χ²(35) = 411.01, p < .001; root mean square error of approximation (RMSEA) = .062, comparative fit index (CFI) = .952; standardized root-mean-square residual (SRMR) = .034 and health appraisal, χ²(35) = 376.80, p < .001; RMSEA = .058, CFI = .956; SRMR = .032 models. Morbidity and health appraisal also predicted later family emotional climate, reciprocally. Intimate partner emotional climate-health pathways were nonsignificant at each wave, in both models. Results are novel and may be the first to indicate the quality of family relationships are a more powerful predictor of aging health than the quality of intimate partnerships. Findings implicate the health of adults should be considered in the systemic context of families. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Toward a Mechanistic Understanding of Links Between Close Relationships and Physical Health

Although researchers have made great strides in identifying links between close relationship processes and physical health, we know less about the psychological and behavioral mechanisms underlying these links. As we move toward considering relationships as a public health issue, understanding mechanistic pathways in relationships–health links is crucial for designing efficient and effective interventions. In this review, we outline criteria for establishing a construct as a relationships–health mechanism. We then discuss how best to test potential mechanisms of relationships–health links and identify some promising mechanism candidates on the basis of initial evidence (emotion, attachment, sleep, and substance abuse). We conclude by recommending key directions for future research.

In Our Lives and Under Our Skin: An Investigation of Specific Psychobiological Mediators Linking Family Relationships and Health Using the Biobehavioral Family Model

The objective of this study was to use the Biobehavioral Family Model (BBFM) to delineate which psychophysiological variables link romantic and family relationship satisfaction variables to health outcomes. Data from individuals who reported being partnered from the second wave of the National Survey of Midlife Development in the United States (MIDUS II), Project 4 (n = 812) were used to test a structural equation model which explored which psychophysiological variables potentially mediated associations between positive and negative family emotional climate variables and disease activity. This model found that current and past family variables had larger associations with the psychophysiological variables than romantic partner variables; depressive symptoms, anxiety, and inflammation partially mediated associations between family relationships and health; and, contrary to the hypotheses, romantic partner and family support were linked to worse health outcomes. However, the findings should be viewed with regard to the cross-sectional design of the study. Overall, the findings support the use of the BBFM as a model that can guide clinical interventions.

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.

Family Socialisation Styles and Hostility in the Adolescent Population

The affective involvement of parents in the socialization of their children is fundamental for the proper psychological and emotional adjustment of adolescents, although we know that it is difficult to study. In this research, the relationship between parenting style and hostility was analysed in Spanish adolescents. Five-hundred and thirty-six adolescents participated in this study (53.7% males and 46.3% females), between the ages of 12 and 18 (M = 15.76, SD = 1.43), enrolled in 4 compulsory Secondary Education centers of the Castellon province. Family socialization was evaluated through the parental styles: authoritative, indulgent, authoritarian and negligent, and hostility, through the Cook–Medley Hostility Scale Criteria assessment. A multivariate analysis of variance (MANOVA) was carried out with multiple regression analysis. The results showed that hostility and compound hostility are higher in adolescents from authoritarian and authoritative families than in adolescents from indulgent families. It was also observed that the Mother’s Strictness/Imposition had the greatest effect on hostility, as well as a low acceptance/involvement of the father. Regarding parental styles, it was observed that mother’s deprivation, physical coercion, and mother’s verbal coercion were the greatest predictors of hostility. No differences were observed depending on the gender.

Sexual intimacy in couples is associated with longer telomere length

High-quality relationships have been shown to be beneficial for physical and mental health. This study examined overall relationship satisfaction and perceived stress as well as daily reports of partner support, partner conflict, and physical intimacy obtained over the course of one week in a sample of 129 high and low stress mothers. Telomere length was examined in whole blood, as well as the two cell subpopulations: peripheral blood mononuclear cells (PBMCs) and granulocytes. Telomerase activity was measured in PBMCs. Analyses revealed no statistically significant associations of telomere length with current relationship satisfaction, daily support or conflict, or perceived stress. In contrast, women who reported any sexual intimacy during the course of the week had significantly longer telomeres measured in whole blood and PBMCs, but not in granulocytes. These relationships held covarying for age, body mass index, perceived stress, the relationship indices, and caregiver status. Sexual intimacy was not significantly related to PBMC telomerase activity. These data provide preliminary data that sexual intimacy is associated with longer telomere length. Future studies investigating these associations are warranted.

Mothers' Attachment is Linked to their Children's Anti-Inflammatory Gene Expression via Maternal Warmth

Research has demonstrated links between adult romantic attachment and one's own physical health; little is known about links between adult attachment orientations and offspring health. Prior work has shown that parents' greater attachment anxiety and avoidance predicts less warmth toward their children. Extensive work has also shown that lower maternal warmth has negative downstream effects on offspring health. We tested the novel hypothesis that mothers' dispositional romantic attachment would be linked-via maternal warmth-to their children's expression of the glucocorticoid receptor gene NR3C1, higher expression of which is associated with healthier stress-regulation and inflammatory response. In a sample of 132 youth with asthma, we found that mothers' attachment anxiety and avoidance were both negatively associated with children's expression of NR3C1, explained by lower youth-rated maternal warmth. Effects held after adjusting for demographic and psychosocial covariates. Implications for parents' attachment influencing the health of offspring are discussed.

Protective Processes Underlying the Links between Marital Quality and Physical Health

Although the links between marital quality and physical health are now well established, the psychological processes through which marriage impacts health remain unclear. Additionally, prior research on the links between marriage and health has focused mainly on how negative aspects of relationships (e.g., conflict, hostility) can be damaging to one's physical health. In this article, we describe the strength and strain model of marital quality and health, which provides a roadmap for studying protective factors underlying marriage-health links. We home in one relationship process-partner responsiveness-and one broad class of psychological mechanisms-affective processes-to illustrate core aspects of the model. Our review suggests that future research will profit from a greater integration of theory from the social psychology of close relationships into studies of relationships and health.