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

• Author: Jacob B. Priest,Sarah B. Woods,Patricia N. E. Roberson
• Date: 01 March 2019
• DOI: http://doi.org/10.1111/famp.12357
• Published date: 01 March 2019

In Our Lives and Under Our Skin: An Investigation of

Specific Psychobiological Mediators Linking Family

Relationships and Health Using the Biobehavioral

Family Model

JACOB B. PRIEST*

PATRICIA N. E. ROBERSON

†

SARAH B. WOODS

‡

The objective of this study was to use the Biobehavioral Family Model (BBFM) to delin-

eate which psychophysiological variables link romantic and family relationship satisfac-

tion 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 betwe en

positive and negative family emotional climate variables and disease activity. This model

found that current and past family variables had larger associations with the psychophysi-

ological variables than romantic partner variables; depressive symptoms, anxie ty, and

inflammation partially mediated associations between family relationships and heal th;

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.

Keywords: Families and Health; Biopsyc hosocial; Mental Health; Chronic Health

Conditions; Biobehavioral Family Model; Biomarker

Fam Proc 58:79–99, 2019

INTRODUCTION

Research has repeatedly shown that romantic and family relationships contribute to

adult mental and physical health (e.g., Carr & Springer, 2010; D’Onofrio & Lahey,

2010; Hartmann, Bazner, Wild, Eisler, & Herzog, 2010; Martire, Lustig, Schulz, Miller, &

Helgeson, 2004). This research has primarily focused on three ways in which family rela-

tionships affect health: (1) direct biological pathways (e.g., genetics, infection, toxic envi-

ronments), (2) learned and shared health behaviors (e.g., smoking, diet, exercise), and (3)

psychophysiological pathways (e.g., psychological and physiological stress reactions

related to family distress) (Campbell, 2003; Gruenewald & Seeman, 2010; Hartmann

et al., 2010). Though the three pathways likel y mutually influence one another over time

and across the lifespan, psychophysiological mechanisms have garnered increasing focus

*Department of Psychological and Quantitative Foundations, University of Iowa, Iowa City, IA.

†

Department of Human Ecology, University of California, Davis, Davis, CA.

‡

Department of Family Medicine, University of Texas Southwestern Medical Center, Dallas, TX.

Correspondence concerning this article should be addressed to Jacob B. Priest, Department of Psycho-

logical and Quantitative Foundations, University of Iowa, Iowa City, IA. E-mail: jacob-b-priest@uiowa.edu

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Family Process, Vol. 58, No. 1, 2019 ©2018 Family Process Institute

doi: 10.1111/famp.12357

in the literature (Gruenewald & Seeman, 2010; Robles, Slatcher, Trombello, & McGinn,

2014). Despite increasing evidence of psychophysiological mediators linking families and

health, relationship researchers often ignore the connections between biological and

romantic and family relationship processes (D’Onofrio & Lahey, 2010). Understanding

psychophysiological stress reactivity is critical to understanding how relationship experi-

ences impact health outcomes in order to determine the most effective prevention and

intervention efforts to improve health outcomes for family members across the life course

(Farrell & Simpson, 2016).

The purpose of this study was to expand the understanding of how psychophysiological

variables link close relationships to health by addressing relevant gaps in the literature.

Specifically, these limitations include that most research on close relationships and health

focuses primarily on romantic relationships (i.e., marriage) while ignoring other family

relationships. Additionally, the assessment of family relationships is often a broad con-

struct that does not explore positive and negative aspects of relationships separately.

Moreover, research on close relationships and health often examines only one psychophys-

iological variable or a composite variable, thereby ignoring the possibility that specific psy-

chophysiological variables may overlap or serve as intervening mechanisms while others

may not (Smith, Baron, & Grove, 2014). Lastly, families and health research often lacks a

theoretical foundation, which may limit the applicability of findings for intervention.

An example of recent research that faces these limitations includes a recent study con-

ducted by Donoho, Crimmins, and Seeman (2013). Using the same dataset as the present

study, the researchers investigated the associations between marital support and strain

and two markers of inflammation. Though the purpose of this research was to investigate

one pathway by which marriage affects health, the authors only loosely draw from theory,

examine solely the effects of marital relationships (for those married at least 10 years),

and include only two biomarkers of inflammation, despite the seven biomarkers included

in the data. Further investigation using this comprehensive dataset is possible and war-

ranted (Donoho et al., 2013).

Overall, the purpose of addressing the gaps outlined here was twofold. The first goal

was to expand the measurement and assessment of family and psychophysiological vari-

ables in order to delineate specific pathways that link close relationships to health. We did

this by including both positive and negative measures of both romantic partner and family

relationships, and by examining links between these measures, nine psychophysiological

variables, and health outcomes. The second goal was to couch these findings in the

hypotheses of the Biobehavioral Family Model (BBFM; Wood, 1993) and, in so doing, be

able to demonstrate how the specific pathways found in this dataset could further inform

the development of this theoretical model, as well as family interventions.

Current Limitations in Biopsychosocial Research

Family relationships are ignored

Though many studies have linked lower romantic relationship satisfaction to worse

mental and physical health (e.g., Kiecolt-Glaser & Newton, 2001; Robles et al., 2014;

Whisman, 2007), family relationships, those close relationships beyond the committed

romantic relationship (e.g., children, siblings, parents, in-laws, etc.), are often igno red

when examining adult mental health and chronic disease (Carr & Springer, 2010; Hart-

mann et al., 2010; Robles et al., 2014). Only slightly more than half (51.4%) of adults in

the United States report living with a spouse. There is also a continual decrease in the

number of married adults and increase in those who report never having married (U.S.

Census Bureau, 2015). These changing demographics suggest that ignoring family rela-

tionships in examinations of adult health could exclude many unmarried adults.

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