Relational and psychological mediators of change in low‐income couples' perceived health

Abstract

Experimental tests of the association between relationship functioning and physical health are limited. Although associations are hypothesized to be partially mediated through improved psychological functioning, tests are mostly limited to lab-based studies. The present study evaluated relational and psychological mediators of change in perceived health in a sample of 742 low-income couples (1,484 individuals) who participated in a randomized controlled trial of two online relationship education programs and a waitlist control group. Results partially supported the Strengths and Strains Model of Relationships and Physical Health. Relationship functioning and some psychological functioning were mediators of change in perceived health. Future research is needed to understand how relationship functioning improved perceived health through mediators other than psychological functioning tested here.

Advancing understanding of the mechanistic pathways underlying close relationships and physical health: Conclusion to the special issue

“…For instance, Alen et al (2020) found that high‐frequency heart rate variability plays a protective role that explains how higher perceptions of parental warmth in childhood predict better cardiovascular health and lower mortality risk in midlife, and Stanton et al's (2020) findings suggest that self‐expansion potential—positive, optimistic beliefs about how relationships will help us grow in the future—is associated with more positive perceptions of health via greater positive affect. In contrast, Roddy and Doss (2020) found that psychological distress and insomnia predict poorer health outcomes. Interestingly, some mechanisms may branch into both protective and deleterious health pathways; Crowley et al (2020), for example, showed that support marshaling is associated with better or poorer health depending on whether the support is perceived by recipients as effective.…”

“…Moreover, some examined unique samples at high risk for poor health, such as individuals who have recently lost a spouse (LeRoy et al, 2020) or couples with one partner who has cancer (Ramos et al, 2020). The papers also investigated the effects of relationship functioning on several different types of health outcomes, including biomarkers (Jaremka et al, 2020; Maki, 2020), perceived health (Ramos et al, 2020; Roddy & Doss, 2020; Stanton, Spence, Kähkönen, & Dobson, 2020; Woods et al, 2020), health behavior (Crowley, Burke, Denes, Allred, & Carberry, 2020), symptoms and diagnoses (Cortez et al, 2020; LeRoy et al, 2020; Woods et al, 2020), and mortality (Alen et al, 2020). Most of the papers documented significant associations between relationship functioning, mechanistic variables, and health outcomes.…”

“…Alen et al (2020), Jaremka et al (2020), and LeRoy et al (2020) all examined biological mechanisms by testing the mediating role of heart rate variability, inflammation, and Epstein–Barr virus antibody titers, respectively. The behavioral variables investigated include support marshaling (Crowley et al, 2020), communication behaviors (Ramos et al, 2020), and conflict frequency (Roddy & Doss, 2020). Woods et al (2020) offered a cross‐category perspective by examining the unique roles of negative affect reactivity (a psychological mediator) and allostatic load (a biological mediator).…”

“…However, some papers in the special issue propose promising methodological strategies for better addressing causality. For instance, Roddy and Doss (2020) conducted a randomized control trial of multiple online‐based self‐help programs for couples with a waitlisted control group, and Cortez et al (2020) used a sample assessed four times over an 8‐year period when individuals frequently enter marriage for the first time to compare selective versus causal effects of marriage on health. Utilizing a wider range of methods, including experimental ones, will help the relationships and health field document and estimate causal effects more precisely as the field moves forward.…”

“…The current set of papers suggest that taking a more refined approach could be generative. Both Woods et al (2020) and Roddy and Doss (2020), for example, tested the effects of positive and negative relationship processes separately. Even within positive and negative relationship processes, further narrowing to more specific relationship processes that promote better health may be useful for finding “active ingredients” that can be targeted in future interventions.…”