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A harsh early family environment is related to mental and physical health in adulthood. An important question is why family environment in childhood is associated with these outcomes so long after its initial occurrence. We describe a program of research that evaluates a model linking these variables to each other. Specifically, we hypothesize that low social competence and negative emotional states may mediate relations between a harsh early family environment and physiological/ neuroendocrine responses to stress, as well as long-term health outcomes. We report evidence that the model characterizes self-rated health, cortisol responses to stress, and, in males only, elevated cardiovascular responses

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The biopsychosocial model has dominated research and theory in health psychology. This article expands the biopsychosocial model by applying systems theories proposed by developmental scholars, including Bronfenbrenner's ecological models and Sameroff's transactional model, as well as contemporary philosophical work on dynamic systems. The proposed dynamic biopsychosocial model construes human health as a product of the reciprocal influences of biological, psychological, interpersonal, and macrosystem contextual dynamics that unfold over personal and historical time. The importance, or centrality, of these influences varies within a person over time. The model is explicated using two hypothetical case studies derived from existing interdisciplinary health research. Implications for health, theory, research, and policy are discussed. | RETHINKING THE BIOPSYCHOSOCIAL MODEL OF HEALTH: UNDERSTANDING HEALTH AS A DYNAMIC SYSTEMDynamic interpersonal, biological, and psychological systems interact with contextual factors to shape health over the life span. This manuscript integrates theoretical perspectives that promote health understanding and considers the implications of these perspectives for research and policy related to health psychology. We first outline the dynamic biopsychosocial model of health, highlighting its conceptual roots and then present two hypothetical research-based examples that clarify the model's utility for understanding health.The model shown in Figure 1 and discussed below is an expanded version of the biopsychosocial model. The model integrates existing conceptualizations of the biopsychosocial model (Engel, 1980) with other systems models, especially those proposed by Urie Bronfenbrenner, Arnold Sameroff, and Evan Thompson. The major goals of this paper are to (a) explain the interactive elements of the dynamic biopsychosocial model and (b) use Bronfenbrenner's work to elaborate interpersonal dynamics in social environments and introduce centrality as a factor that modulates influences on health. | COMPONENTS OF A DYNAMIC BIOPSYCHOSOCIAL MODEL OF HEALTHThis model conceptualizes biological, psychological, interpersonal, and contextual effects on health as dynamics. Each dynamic captures a set of interactive forces or systems that affect health. The term dynamics is used to emphasize that