Spousal relationship quality and cardiovascular risk: dyadic perceptions of relationship ambivalence are associated with coronary-artery calcification

Does leader-member exchange ambivalence hinder employee well-being? Exploring relations with work engagement and emotional exhaustion

Recent research has introduced the concept of leader-member exchange (LMX) ambivalence and has shown that it can be detrimental to employee task performance. Drawing on self-determination theory and models of LMX development, this research investigates whether LMX ambivalence may also negatively influence employee well-being. In a two-wave field study with 278 employees in a large police organisation, we found that LMX ambivalence was significantly associated with two focal measures of work-related well-being: work engagement and emotional exhaustion, through its influence on psychological need fulfilment. Perceived positive meaning in work was found to buffer the negative effects of LMX ambivalence on psychological need fulfilment and well-being. Overall, these results contribute to the occupational health literature by demonstrating that psychological need fulfilment helps explain why LMX ambivalence negatively affects work related well-being outcomes and underscores the important role of positive meaning in work as a buffer for these relationships.

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.

Doing it all: Effects of Family Responsibilities and Marital Relationship Quality on Mothers' Ambulatory Blood Pressure

BACKGROUND

The shared provider responsibility between married couples does not translate to equally shared division of childcare (CC) and household labor. While some marriages contain highly positive aspects, marriages may also simultaneously contain both positive and negative aspects. The negativity in these relationships can negate the positivity and could potentially lead to the detriment of mothers' health.

PURPOSE

We examined mothers' ambulatory blood pressure (ABP) associated with their marital relationship quality and perceived equity with her spouse on CC and household tasks.

METHODS

We investigate these associations using a mixed multilevel model analysis on a sample of 224 mothers in heterosexual marriages, all of whom had children under the age of 18 years currently living in the home.

RESULTS

Mothers' perception of equity in the division of CC responsibilities contributed to lower ABP. Additionally, mothers in supportive marital relationships (low negativity and high positivity) had lower ABP than those in ambivalent relationships (both high negativity and positivity). There was a crossover interaction such that the effect of relationship quality on ABP was moderated by the perception of equity in the division of CC. For mothers who report doing all the CC, they had lower ABP if they had a supportive marital relationship compared with mothers in ambivalent relationships. Whereas mothers who report more equity in CC and have a supportive relationship have higher ABP compared with mothers in ambivalent relationships.

CONCLUSIONS

This study has implications related to dynamics within marital relationships. These results demonstrate important relational influences on mothers' ABP.

Association of age at first sexual intercourse and lifetime number of sexual partners with cardiovascular diseases: a bi-directional Mendelian randomization study

Background

Limited studies have explored the association between sexual factors [age at first sexual intercourse (AFS) and lifetime number of sexual partners (LNSP)] and cardiovascular diseases (CVDs), leaving the causality inconclusive.

Methods

We performed a bi-directional Mendelian randomization (MR) study to investigate the causality between sexual factors and CVDs, including coronary artery disease, myocardial infarction, atrial fibrillation (AF), heart failure (HF), and ischemic stroke (IS). Single-nucleotide polymorphisms (SNPs) for sexual factors were extracted from the UK Biobank. Statistics for each CVD were derived from two different databases. MR estimates were calculated per outcome database and were combined through meta-analysis. Several complementary sensitivity analyses were also performed.

Results

The primary analysis suggested that AFS was causally associated with the risk of CVDs; the odds ratios (ORs) ranged from 0.686 [95% confidence interval (CI), 0.611-0.770] for HF to 0.798 (95% CI, 0.719-0.886) for AF. However, the association between AFS and IS (OR, 0.844; 95% CI, 0.632-1.126) was not consistent in the meta-analysis after excluding SNPs related to confounders. Moreover, non-significant associations were found between LNSP and CVDs. Reverse direction MR analysis showed that CVDs were not associated with sexual factors.

Conclusions

Genetic evidence suggested that AFS was causally associated with the risk of CVDs except for IS, whereas non-significant association of LNSP with CVDs was detected. Further investigation into AFS could be warranted in preventing the progression of CVDs.

Better together: Relationship quality and mental health among cardiac patients and spouses

Reductions in marital relationship quality are pervasive post-cardiac event. It is not yet understood how relationship quality is linked to mental health outcomes in couples where one member has established cardiovascular disease (CVD) and the interdependence within dyads is seldom measured. This research is required as psychological distress has been independently linked to CVD incidence, morbidity, and mortality. This study assessed associations of relationship quality with depression and anxiety among patients with CVD and their spouses. Participants completed questionnaires measuring four dimensions of relationship quality and mental health. Data were analyzed using an Actor-Partner Interdependence Model with hierarchical moderation analyses. 181 dyads (N = 362 participants) comprised the study sample. Most patients had coronary artery disease (66.3%) and 25.9% were female. Patients reported higher relationship satisfaction and fewer anxiety symptoms than did spouses. Patients and spouses with high dyadic consensus and affectional expression reported fewer mental health symptoms, but only when the other partner also perceived high levels of consensus and affectional expression in the relationship. Patients and spouses with low dyadic cohesion reported worse mental health symptoms (actor effects), but those effects were no longer significant when both the patient and the spouse appraised the relationship as having high levels of dyadic cohesion. Taken together, relationship quality is linked to mental health symptoms in patients with CVD and their spouses. Longitudinal and experimental studies are now warranted to further substantiate the cross-sectional findings of this study.

What happens when leader is ambivalent and employee is indifferent? A moderated mediation model of LMX ambivalence and employee creativity

Purpose

Leader–member exchange (LMX) relationship is a crucial context for individuals’ generation of creative ideas. Unlike the fruit research between LMX quality and employee creativity, the relationship between LMX ambivalence and employee creativity is scarce. This study thus aims to examine the effect of LMX ambivalence on employee creativity.

Design/methodology/approach

This study conducted an on-site survey of research and development teams in China and distributed paired questionnaires with a time lag of one month. Data from 116 leaders and 484 subordinates were collected and analyzed.

Findings

The results showed that LMX ambivalence was directly negatively or indirectly negatively related to employee creativity via self-efficacy. Employee cynicism acted as a potential personal moderator of the effect of LMX ambivalence, specifically, employee cynicism attenuated the negative influence of LMX ambivalence on employee creativity via self-efficacy.

Originality/value

This study extends our knowledge of the complex effects of LMX relationships by empirically exploring whether and how LMX ambivalence influences employee creativity, with self-efficacy introduced as one crucial underlying mechanism. Meanwhile, this study enriches the existing cynicism literature by demonstrating the role of employee cynicism as a buffer in the relationship between LMX ambivalence and employee creativity.

Adolescent Relational Roots of Adult Blood Pressure: A Fourteen-Year Prospective Study

Intensity in adolescent romantic relationships was examined as a long-term predictor of higher adult blood pressure in a community sample followed from age 17 to 31. Romantic intensity in adolescence--measured via quantity of time spent alone with a partner and duration of the relationship--was predicted by parents' psychologically controlling behavior, and was in turn found to predict higher resting adult systolic and diastolic blood pressure even after accounting for relevant covariates. The prediction to adult blood pressure was partially mediated via conflict in non-romantic adult friendships and intensity in adult romantic relationships. Even after accounting for these mediators, however, a direct path from adolescent romantic intensity to higher adult blood pressure remained. Neither family income in adolescence nor trait measures of personality assessed in adulthood accounted for these findings. Results are interpreted both as providing further support for the view that adolescent social relationship qualities have substantial long-term implications for adult health, as well as suggesting a potential physiological mechanism by which adolescent relationships may be linked to adult health outcomes.

The impact of patient and partner personality traits on learning success for a cognitive rehabilitation intervention for patients with MCI

The Memory Support System (MSS) is the memory compensation tool used in the HABIT Healthy Action to Benefit Independence and Thinking^® Program. People diagnosed with mild cognitive impairment (pwMCI; n = 153) participated in this cognitive rehabilitative programme with a partner. We first aimed to determine if prior research on the positive impact of higher baseline cognitive status on successful MSS learning would be replicated in a new sample. We further evaluated the impact of the pwMCI's and partner's personality traits, as measured by the Ten Item Personality Inventory, on successful learning. Better global cognitive status was again shown to increase the odds for MSS learning success. In terms of personality, the highest odds of learning success occurred when the pwMCI was high in Openness to Experience (OR = 5.43), followed by high partner Openness (OR = 2.53) or high Openness in both the pwMCI and partner (OR = 2.31). In sum, when the pwMCI possessed both better cognitive status and openness to new experience they were better able to master a cognitive rehabilitation tool for MCI.

Spousal emotional support and relationship quality buffers pupillary response to horror movies

Being satisfied in marriage provides protective stress buffering benefits to various health complications but the causal mechanisms and speed at which this is accomplished is less well understood. Much of the research on health and marriage has conceptualized marital quality in a unidimensional way, with high levels of either positivity or negativity. This conceptualization may not fully capture the nuanced benefits of marital relationships. Pupillometry is an innovative method which captures the effects of marital stress buffering on the body’s autonomic nervous system in real time; pupil dilation occurs within 200ms to stress exposure. Additionally, this method records hundreds of readings per second, providing precision and sensitivity. This preregistered experiment aimed to conceptually replicate previous pupillometry stress buffering results and extend the previous findings by including a generalizable, real-life stressor—viewing a horror movie—and multidimensional relationship quality effects. Eighty-three couples (166 participants) were quasi-grouped, based on a self-reported multidimensional relationship quality scale, to either supportive or ambivalent marital relationship conditions. They were then randomly assigned to either a spousal support (i.e., handholding) or non-support (spousal absence) condition and watched clips from both horror and nature movies while pupil dilation was measured. Tonic pupillary response results revealed that the horror video clips elicited a stress response and there were significant differences between the support and non-support conditions, as well as marital relationship quality conditions. These results frame the precision, speed, and sensitivity of pupillometry as a potentially fruitful method to investigate the causal mechanisms linking stress buffering and supportive marital relationships.

Non-spousal family support, marital status, and heart problems in adulthood

OBJECTIVES

Support from one's spouse has long been documented as a significant determinant of health for married individuals. However, non-spousal family support may play an important role in health particularly for unmarried individuals. Therefore, this study examined whether the association between non-spousal family support and diagnosis of heart problems differed by marital status and whether gender and education moderated these associations.

DESIGN

Data came from the first two waves of the Midlife in the United States (MIDUS) study. This study selected respondents who participated in both waves of MIDUS and were not diagnosed with a heart problem at Wave 1 (N = 3,119).

MAIN OUTCOME MEASURES

Participants reported whether they had any heart trouble. Discrete-time event history analysis was used to examine the risk of heart problems between MIDUS Waves 1 and 2.

RESULTS

A higher level of non-spousal family support was associated with a lower risk of developing a heart problem only among unmarried women and unmarried individuals with high school education or less, and not for married individuals.

CONCLUSION

Findings highlight the importance of considering specific sources of family support when studying heart health, and the health-protective role of non-spousal family support for those who are not married.

Modelling ambivalent triads in family research

This research focuses on ambivalence in family networks and presents a framework for investigating how triadic configurations, beyond specific dyads, may affect individual outcomes such as well-being. First, the paper introduces the ambivalent triad census, counting the frequencies of 18 non-isomorphic triads in which ties can be positive, negative, or ambivalent, in non-directed networks, and proposes the linear combinations of three theoretical mechanisms (ambivalent balance, diffusion of stress, divide and conquer) predicting how embeddedness in an ambivalent triad may affect individual well-being. Second, the ambivalent triad census is applied to 300 non-directed family networks, 150 stepfamilies and 150 first-time families, in which mothers reported about the relationships with and between family members. Results show that mothers embedded in triads exhibiting more ambivalent balance and less diffusion of stress score higher on social self-esteem. The study emphasizes the importance of studying ambivalence in higher-level relational structures, such as triads, in families.

The balance of giving versus receiving social support and all-cause mortality in a US national sample

While numerous studies exist on the benefits of social support (both receiving and giving), little research exists on how the balance between the support that individuals regularly give versus that which they receive from others relates to physical health. In a US national sample of 6,325 adults from the National Survey of Midlife Development in the United States, participants were assessed at baseline on hours of social support given and received on a monthly basis, with all-cause mortality data collected from the National Death Index over a 23-y follow-up period. Participants who were relatively balanced in the support they gave compared to what they received had a lower risk of all-cause mortality than those who either disproportionately received support from others (e.g., received more hours of support than they gave each month) or disproportionately gave support to others (e.g., gave many more hours of support a month than they received). These findings applied to instrumental social support (e.g., help with transportation, childcare). Additionally, participants who gave a moderate amount of instrumental social support had a lower risk of all-cause mortality than those who either gave very little support or those who gave a lot of support to others. Associations were evident over and above demographic, medical, mental health, and health behavior covariates. Although results are correlational, one interpretation is that promoting a balance, in terms of the support that individuals regularly give relative to what they receive in their social relationships, may not only help to strengthen the social fabric of society but may also have potential physical health benefits.

The Healing Hearts Together Randomized Controlled Trial and the COVID-19 Pandemic: A Tutorial for Transitioning From an In-Person to a Web-Based Intervention

Supportive couple relationships are associated with reduced risk of chronic illness development, such as cardiovascular disease, as well as improved secondary prevention. Healing Hearts Together (HHT) is an 8-week couples-based intervention designed to improve relationship quality, mental health, quality of life, and cardiovascular health among couples in which one partner has experienced a cardiac event. A randomized controlled trial began in October 2019 to test the efficacy of the in-person, group-based HHT program as compared to usual care. In March of 2020, all recruitment, assessments, and interventions halted due to the COVID-19 pandemic. Guided by optimal virtual care principles, as well as by Hom and colleagues’ four-stage framework—consultation, adaptation, pilot-testing, and test launch—this paper is a tutorial for the step-by-step transition planning and implementation of a clinical research intervention from an in-person to a web-based format, using the HHT program as an example. Clinical and research considerations are reviewed, including (1) privacy, (2) therapeutic aspects of the intervention, (3) group cohesion, (4) research ethics, (5) participant recruitment, (6) assessment measures, (7) data collection, and (8) data analyses. This tutorial can assist clinical researchers in transitioning their research programs to a web-based format during the pandemic and beyond.

Social Relationships and Loneliness in Late Adulthood: Disparities by Sexual Orientation

OBJECTIVE

This is the first national study to examine disparities in loneliness and social relationships by sexual orientation in late adulthood in the United States.

BACKGROUND

Prior studies have shown that lesbian, gay, and bisexual (LGB) individuals often struggle with social relationships across the life course, likely because of stigma related to sexual orientation. However, little is known about whether loneliness is more prevalent among LGB people than among other groups in late adulthood, and if so, which relationships contribute to the loneliness gap.

METHOD

We analyzed data from a nationally representative sample of older adults from the 2015-2016 National Social Life, Health, and Aging Project (N = 3,567) to examine the disparity in loneliness by sexual orientation and identify links between this disparity and multiple dimensions of social relationships, including partner, family, friend, and community relationships.

RESULTS

Older LGB adults were significantly lonelier than their heterosexual counterparts, primarily due to a lower likelihood of having a partner and, to a lesser extent, lower levels of family support and greater friend strain. While they were also disadvantaged in the size of close family and frequency of community participation, these factors were less relevant to their loneliness. Overall, the conventionally defined inner layers of relationships (partnership and family) contributed more to the loneliness disparity than the outer layers of relationships (friends and community).

CONCLUSION

These findings suggest that strengthening the partnerships and family relationships of sexual minorities is essential to reducing the loneliness gap.

Learning a new way of living together: a qualitative study exploring the relationship changes and intervention needs of patients with cardiovascular disease and their partners

OBJECTIVES

Cardiovascular disease (CVD) not only affects the patient, but has implications for the partner. Emerging evidence suggests that supportive couple relationships enhance CVD outcomes and reduce patient and partner distress. To date, however, little research has been done to address the couple relationship as a potentially important component of cardiac care. This article examines the impact of CVD on the couple relationship and assesses the perceived needs and desired intervention components of patients with CVD and their partners.

DESIGN

Qualitative study using directed and conventional content analysis.

SETTING

Single-centre, tertiary cardiac care hospital that serves a population of 1.4 million in the Champlain region of Ontario, Canada.

PARTICIPANTS

Patients with CVD and their partners (n=32, 16 couples) participated in focus groups. Patients were mainly male (75%), white (87.5%), aged 64.4 years (range 31-81 years), with varied cardiac diagnoses (50% coronary artery disease; 18.75% valve disease; 18.75% heart failure; 12.5% arrhythmia).

RESULTS

Five categories were generated from the data reflecting changes within the couple relationship as a result of CVD: (1) emotional and communication disconnection; (2) overprotection of the patient; (3) role changes; (4) adjustment to lifestyle changes; and (5) positive relationship changes. Three categories were constructed regarding intervention needs and desired resources: (1) practical resources; (2) sharing with peers; and (3) relationship enhancement.

CONCLUSIONS

Overall, the data suggest that there were profound changes in the couple relationship as a result of CVD, and that there is considerable need to better support the caregiving spouses and the couple as a unit. These results call for interventions designed to provide instrumental support, peer-sharing opportunities and relationship quality enhancement to help couples cope with CVD. Future studies should examine whether couples-based programming embedded into cardiac rehabilitation can be effective at improving relationship quality and reducing patient and partner stress in the aftermath of a cardiac event.

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.

Emotion, Social Relationships, and Physical Health: Concepts, Methods, and Evidence for an Integrative Perspective

Emotional characteristics and processes are robust predictors of the development and course of major medical illnesses and premature mortality, as are a variety of indicators of the presence and quality of personal relationships. Despite clear evidence of close interconnection between these two domains of risk and protection, affective characteristics and relationships have largely been studied separately as influences on health. After a recent conference on integrative perspectives on emotions, relationships and health co-sponsored by the American Psychosomatic Society and the Society for Affective Science, the present review builds on prior calls for integration, related theory, and current research to outline what is known about the interconnection of these domains as it specifically relates to their overlapping influences on health. Areas of interest include the following: their interconnected roles over the course of development, which may inform current efforts to understand the influence of early life events on adult health; the parallel positive and negative factors in both domains that could have distinct influences on health; the role of emotion regulation in relationship contexts; and measurement, design, and analysis approaches to capture the dyadic and dynamic aspects of these interconnected influences on health. We conclude with a discussion of an emerging research agenda that includes the following: common biological foundations of affective and relationship processes, the cultural embeddedness of affective and relationship processes, the potential contribution of affective-relational processes to health disparities, and implications for intervention research.

Associations Between Romantic Relationship Factors and Body Mass Index Among Weight Loss Surgery Patients

The current study utilized a sample of 183 patients, in romantic relationships, who were either pre- or post-weight loss surgery (WLS), to assess (a) associations between romantic relationship factors and pre- and post-surgery body mass index (BMI), (b) the positive and negative influences of obesity in romantic relationships, and (c) the influence of romantic relationship factors on BMI and the reciprocal. Correlations, confirmatory factor analysis, and multiple linear regression were conducted. Patients endorsed greater negative influence of obesity in their romantic relationships compared to positive influences, and their romantic relationship quality was predicted by several variables, including BMI, in pre- and post-surgery patient groups.

Emotions in Social Relationships and Their Implications for Health and Disease: Introduction to the Special Issue of Psychosomatic Medicine

Social relationships and emotions are important to health and disease, but research in this area has largely progressed along parallel and distinct historical paths. These areas are critically linked because relationships are among the most powerful elicitors of health-relevant emotions and emotions can in turn influence relationships for better or worse. Conceptually, relationships and emotions can have mediational, reciprocal, and interactive influences on health outcomes, associations that seem dependent on the broader sociocultural context. The articles in this issue of Psychosomatic Medicine are based on a joint meeting of the American Psychosomatic Society and the Society for Affective Science titled "Emotions in social relationships: implications for health and disease." Recent research and conceptual models that fall at the interface of relationships, emotions, and health are highlighted in this special issue. Future work that capitalizes on these links will be critical if this area is to fulfill its potential in terms of new scientific insights and intervention opportunities.

Bisexuality, Union Status, and Gender Composition of the Couple: Reexamining Marital Advantage in Health

It has long been documented that married individuals have better health outcomes than unmarried individuals. However, this marital advantage paradigm has been developed primarily based on heterosexual populations. No studies to date have examined the health effects of marriage among bisexuals, one of the most disadvantaged but understudied sexual minority groups, although a few have shown mixed results for gays and lesbians. Similarly, no research has examined how the gender composition of a couple may shape bisexuals' health outcomes above and beyond the effects of sexual orientation. We analyzed pooled data from the 2013-2017 National Health Interview Survey (n = 154,485) and found that the health advantage of marriage applied only to heterosexuals and, to a lesser extent, gays and lesbians. Married bisexuals, however, exhibited poorer health than unmarried bisexuals when socioeconomic status and health behaviors were adjusted for. Moreover, bisexuals in same-gender unions were healthier than bisexuals in different-gender unions primarily because of their socioeconomic advantages and healthier behaviors. Together, our findings suggest that bisexuals, particularly those in different-gender unions, face unique challenges in their relationships that may reduce the health advantage associated with marriage.

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.

High-quality relationships strengthen the benefits of a younger subjective age across adulthood

Feeling younger than one's chronological age-a younger subjective age bias-has been consistently linked to healthy aging. However, little is known about conditions under which such benefits are strengthened. In high-quality relationships, partners affirm individuals' self-views and offer support that can encourage individuals to engage in behaviors compatible with their subjective age. Thus, we hypothesized the benefits of a younger subjective age bias would be stronger among adults in high-quality relationships. Hypotheses were supported in a 10-year longitudinal study of married adults (ages 34-84; N > 600): Relationship quality moderated the effect of subjective age bias on memory performance and heart rate variability, such that individuals in higher-quality relationships showed stronger beneficial effects of a younger subjective age bias. Results suggest psychological and relational resources may work together to jointly influence healthy aging. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Comparison of One-Year Survival After Acute Coronary Syndrome in Patients ≥75 Years of Age With Versus Without Living With Spouse

Patients with acute coronary syndrome (ACS) face high postevent mortality. This study aims to evaluate the impact of living without spouse on 1-year mortality of ACS patients. This retrospective study enrolled a total of 600 consecutive patients (≥75 years of age) with ACS hospitalized in our hospital between January 2013 and December 2016. Patients' clinical characteristics, laboratory values, hospital course, demographic characteristics, and angiographic data were collected. Patients were divided into 2 groups according to living with (n = 396) or without (n = 204) spouse. Patients living without spouse were older (79 [77,82] vs 77 [76,80], p <0.001), more frequently female (54.9% vs 31.8%, p <0.001), less smokers (23.5% vs 38.9%, p <0.001), lower left ventricular ejection fraction value (52.1±10.7% vs 54.4±9.8%, p = 0.021) compared with patients living with spouse. In addition, compared to patients living with spouse, patients living without spouse were less likely to get percutaneous coronary intervention (41.2% vs 54.0%, p = 0.003) during hospitalization and had higher 1-year mortality post-ACS (22.1% vs 13.4%, p = 0.006). Multivariate logistic regression analysis showed that living without spouse remained an independent risk factor for 1-year mortality after ACS in patients ≥75 years (odds ratio 2.350, 95% confidence interval 1.245 to 4.434, p = 0.008), after adjusted with age, gender, heart rate, systolic blood pressure, left ventricular ejection fraction value at baseline, hemoglobin, white blood cell, alanine aminotransferase, albumin, creatinine, brain natriuretic peptide, type of ACS, severe heart failure at admission, percutaneous coronary intervention treatment, β blocker, diuretics application during hospital. In conclusion, living without spouse is an independent risk factor for 1-year all-cause mortality in ACS patients ≥75 years.

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.

Toward a psychology of Homo sapiens: Making psychological science more representative of the human population

Two primary goals of psychological science should be to understand what aspects of human psychology are universal and the way that context and culture produce variability. This requires that we take into account the importance of culture and context in the way that we write our papers and in the types of populations that we sample. However, most research published in our leading journals has relied on sampling WEIRD (Western, educated, industrialized, rich, and democratic) populations. One might expect that our scholarly work and editorial choices would by now reflect the knowledge that Western populations may not be representative of humans generally with respect to any given psychological phenomenon. However, as we show here, almost all research published by one of our leading journals, Psychological Science, relies on Western samples and uses these data in an unreflective way to make inferences about humans in general. To take us forward, we offer a set of concrete proposals for authors, journal editors, and reviewers that may lead to a psychological science that is more representative of the human condition.

Loneliness in the older adult marriage: Associations with dyadic aversion, indifference, and ambivalence

Marriage protects against loneliness, but not all marriages are equally protective. While marriage is a highly interdependent relationship, loneliness in marital dyads has received very little research attention. Unlike most studies proposing that positive and negative marital qualities independently affect loneliness at the individual level, we used a contextual approach to characterize each partner's ratings of the marriage as supportive (high support, low strain), ambivalent (high support, high strain), indifferent (low support, low strain), or aversive (low support, high strain), and examined how these qualities associate with own and partner's loneliness. Using couple data from the Wave II National Social Life, Health and Aging Project (N=953 couples), we found that more than half of the older adults live in an ambivalent, indifferent, or aversive marriage. Actor-partner interdependence models showed that positive and negative marital qualities synergistically predict couple loneliness. Spouses in aversive marriages are lonelier than their supportively married counterparts (actor effect), and that marital aversion increases the loneliness of their partners (partner effect). In addition, wives (but not husbands) in indifferent marriages are lonelier than their supportively married counterparts. These effects of poor marital quality on loneliness were not ameliorated by good relationships with friends and relatives. Results highlight the prominent role of the marriage relationship for imbuing a sense of connectedness among older adults, and underscore the need for additional research to identify strategies to help older adults optimize their marital relationship.

Aspects of the parent-child relationship and parent metabolic outcomes

Much is known about the effect of parent-child relationships on child health; less is known about how parent-child relationships influence parent health. To assess the association between aspects of the parent-child relationship and parent metabolic outcomes, and whether these associations are moderated by parent gender. Five metabolic outcomes (systolic and diastolic blood pressure, heart rate, total cholesterol and glycated hemoglobin) were assessed among 261 parents (45.83 ± 5.50 years) of an adolescent child (14.57 ± 1.072 years). Parents completed questionnaires assessing their child's hassles and the quality of their days with their child. Parents' perceptions of their child's hassles were associated with parent heart rate (B = 2.954, SE = 1.267, p = 0.021) and cholesterol (B = 0.028, SE = 0.011, p = 0.010), such that greater perceived child hassles were associated with higher heart rate and cholesterol levels, on average. These associations were not moderated by parent gender (all ps > 0.30). Parent report of their day with their child was not associated with parent metabolic outcomes (all ps > 0.20). Parent gender moderated the association between parent report of their day with their child and parent systolic blood pressure (B = 13.861, SE = 6.200, p = 0.026), such that less positive reports were associated with higher blood pressure readings among fathers, but not mothers. This study suggests that parent metabolic health may in part be influenced by aspects of the parent-child relationship.

Partner relationship satisfaction, partner conflict, and maternal cardio-metabolic health in the year following the birth of a child

Intimate partner relationship quality during the child-bearing years has implications for maternal health. The purpose of this study was to test whether partner satisfaction, partner conflict, and their interaction predicted maternal cardio-metabolic health at 12-months postpartum. Women were recruited in 5 U.S. sites. Partner conflict and satisfaction were measured at 6-months postpartum, and cardio-metabolic indicators (blood pressure, waist-hip ratio, glycosylated hemoglobin, total cholesterol:HDL ratio) were assessed at 6- and 12-months. Cardio-metabolic indices were scored continuously (CM risk) and using clinical risk cutoffs (CM scores). A significant conflict-by-satisfaction interaction emerged for the CM risk, b(SE) = .043 (.016), p = .006, and CM scores, b(SE)= .089 (.028), p = .002, such that when partner satisfaction was low, low partner conflict was associated with poorer postpartum cardio-metabolic health. This is the first study to examine close relationships and cardio-metabolic health during the child-bearing years, an issue warranting further attention.

Attachment and telomere length: more evidence for psychobiological connections between close relationships, health, and aging

Individuals with a history of poor interpersonal relationships are more likely to demonstrate negative health outcomes than those who have had high quality relationships. We sought to evaluate how attachment orientations, stress-induced respiratory sinus arrhythmia (RSA), and self-reported stress were associated with length of telomeres measured from peripheral blood mononuclear cells. Participants (N = 213) completed self-report measures of attachment and stress. Measurement of RSA was conducted before and after a stressful task and a blood draw was completed for analysis of telomere length. Attachment orientations were not directly associated with telomere length; however, we found that high attachment anxiety was associated with shorter length of telomeres via high self-reported stress. Attachment avoidance was also associated with telomere length via self-reported stress, but only among those with high stress-induced RSA. Exploratory analyses of T cell subsets indicated that stress was most strongly associated with telomeres from CD8CD28+ cells in comparison to CD8CD28- and CD4 cells. Study findings indicate that attachment orientations are associated with telomere length via stress, providing novel insights into the mechanisms through which close relationships can impact health and aging.

Interpersonal mechanisms linking close relationships to health

Close relationships play a vital role in human health, but much remains to be learned about specific mechanisms of action and potential avenues for intervention. This article provides an evaluation of research on close relationships processes relevant to health, drawing on themes from major relationship science theories to present a broad conceptual framework for understanding the interpersonal processes and intrapersonal pathways linking relationships to health and disease outcomes. The analysis reveals that both social connection and social disconnection broadly shape biological responses and behaviors that are consequential for health. Furthermore, emerging work offers insights into the types of social dynamics that are most consequential for health, and the potential pathways through which they operate. Following from this analysis, the authors suggest several research priorities to facilitate the translation of discoveries from relationship science into relationship-based interventions and public health initiatives. These priorities include developing finer grained theoretical models to guide research, the systematic investigation of potential mediating pathways such as dyadic influences on health behavior and physiological coregulation, and taking into account individual differences and contextual factors such as attachment style, gender, socioeconomic status, and culture. In addition, a pressing need exists for laboratory and field research to determine which types of interventions are both practical and effective. (PsycINFO Database Record

Relationships and Health: The Critical Role of Affective Science

High-quality social relationships predict a range of positive health outcomes, but no broadly accepted theory can explain the mechanisms of action in this area. The central argument of this article is that affective science can provide keys for integrating the diverse array of theoretical models concerning relationships and health. From nine prominent theories, we cull four components of relational affect that link social resources to health-related outcomes. This component model holds promise for integrating research from the different theoretical perspectives and for generating new, mechanistic questions about the connection between relationships and health. The article closes by outlining three empirical study ideas that illustrate ways in which the different components can be studied together in the context of mechanism-focused research.

Is the Relationship between Depression and C Reactive Protein Level Moderated by Social Support in Elderly?-Korean Social Life, Health, and Aging Project (KSHAP)

OBJECTIVE

To investigate the buffering effects of social support as an effects modifier in the association between depression and inflammation in the elderly.

METHODS

We analyzed the Korean Social Life, Health, and Aging Project (KSHAP) for questionnaire, clinical, and laboratory data of 530 older adults living in a rural community. Multivariate regression models were used to investigate the association between depressive symptoms and C-reactive protein level (CRP), a marker of inflammation, at varying levels of social support.

RESULTS

Social support affected the association between depressive symptoms and CRP level in both sexes. However, the direction of effects modification was different for men and women. In men, a higher CRP level was significantly associated with depressive symptoms only among those with lower support from a spouse or family members. By contrast, in women, the association was significant only among subgroups with higher spousal or family support. Social support from neighbors or friends did not affect the depression-inflammation relationship in men but modestly affected the relationship in women.

CONCLUSION

Our findings suggest that social support may have a buffering effect in the relationship between depression and inflammation in elderly Koreans. But the influence of social support may run in different directions for men and women.

Wanting to Stay and Wanting to Go

The present research examined the subjective experience of deciding whether or not to end a romantic relationship. In Study 1, open-ended reasons for wanting to stay in a relationship versus leave were provided by three samples and categorized by trained coders, resulting in 27 distinct reasons for wanting to stay (e.g., emotional intimacy, investment) and 23 reasons for wanting to leave (e.g., conflict, breach of trust). In Study 2, we examined endorsement of specific stay/leave reasons among participants currently contemplating either a breakup or a divorce. Most stay and leave reasons mapped onto global ratings of satisfaction and commitment. Attachment anxiety was associated with stronger endorsement of many reasons for wanting to both stay and leave. Further, many participants were simultaneously motivated to both stay in their relationships and leave, suggesting that ambivalence is a common experience for those who are thinking about ending their relationships.

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

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.

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 Strength of Family Ties: Perceptions of Network Relationship Quality and Levels of C-Reactive Proteins in the North Texas Heart Study

BACKGROUND

Although the quality of one's social relationships has been linked to important physical health outcomes, less work has been conducted examining family and friends that differ in their underlying positivity and negativity.

PURPOSE

The main aim of this study was to examine the association between supportive, aversive, and ambivalent family/friends with levels of C-reactive proteins.

METHODS

Three hundred participants from the North Texas Heart Study completed the social relationships index and a blood draw to assess high-sensitivity C-reactive proteins (hs-CRPs).

RESULTS

After standard controls, the number of supportive family members predicted lower hs-CRP levels, whereas the number of ambivalent family members predicted higher hs-CRP levels. These links were independent of depressive symptoms and perceived stress.

CONCLUSIONS

These data highlight the importance of considering specific types of relationships and their underlying positive and negative aspects in research on social ties and physical health.

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

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

Social Relationships and Sleep Quality

BACKGROUND

The quality of social relationships and social support appears to be associated with physical health outcomes and sleep quality. Almost all previous research in this area focuses on positive aspects of relationships.

PURPOSE

The present study thus intended to examine the links between supportive, aversive, ambivalent, and indifferent network ties and sleep quality.

METHODS

Relationship data, Pittsburgh Sleep Quality Index (PSQI)-assessed sleep quality, and depression were examined in 175 middle-aged and older adults.

RESULTS

Consistent with hypotheses, supportive ties were positively related to sleep quality, while aversive ties predicted worse sleep quality, associations that were primarily seen for close relationships. Ambivalent and indifferent ties were not significant predictors of sleep quality. Importantly, depression was found to mediate the link between relationship quality and sleep quality.

CONCLUSIONS

These data suggest the more specific types of social relationships that may be linked to poor sleep quality and that depression appears to underlie these associations.

The influence of oxytocin on volitional and emotional ambivalence

Moral decisions and social relationships are often characterized by strong feelings of ambivalence which can be a catalyst for emotional distress and several health-related problems. The anterior cingulate cortex (ACC) has been identified as a key brain region in monitoring conflicting information, but the neurobiological substrates of ambivalence processing are still widely unknown. We have conducted two randomized, double-blind, placebo-controlled, functional magnetic resonance imaging experiments involving 70 healthy male volunteers to investigate the effects of the neuropeptide oxytocin (OXT) on neural and behavioral correlates of ambivalence. We chose moral decision-making and the imagery of partner infidelity as examples to probe volitional and emotional ambivalence. In both experiments, intranasal OXT diminished neural responses in the ACC to ambivalence. Under OXT, moral dilemma vignettes also elicited a reduced activation in the orbitofrontal cortex, and the imagery of partner infidelity was rated as less arousing. Interestingly, the OXT-induced differential activation in the ACC predicted the magnitude of arousal reduction. Taken together, our findings reveal an unprecedented role of OXT in causing a domain-general decrease of neural responses to ambivalence. By alleviating emotional distress, OXT may qualify as a treatment option for psychiatric disorders with heightened ambivalence sensitivity such as schizophrenia or obsessive-compulsive disorder.