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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.

The Biobehavioral Family Model (BBFM) is a biopsychosocial model of health that has been substantiated across multiple studies. However, the findings of those studies are limited given the lack of representation of Black/African American individuals in the samples. Discrimination is a chronic and pervasive stressor for many African American families, yet little is known about connections between discrimination, family relationships, and health. Using Data from the Midlife Development in the United States (MIDUS) Milwaukee project (n ϭ 592), this study tested the pathways of the BBFM with a sample comprised only of African American individuals Additionally, it tested how discrimination influenced the pathways of the BBFM. Results of model testing found that family support (above and beyond romantic partner relationship quality and family strain) was a key factor in respondents' mental and physical health and that family support mediated the association between discrimination and mental health. The findings suggest the importance of including discrimination when examining family health pathways for African Americans and exploring the influence of relationships beyond the romantic partnership when examining health.

This study tests the inclusion of social support as a distinct exogenous variable in the Biobehavioral Family Model (BBFM). The BBFM is a biopsychosocial approach to health that proposes that biobehavioral reactivity (anxiety and depression) mediates the relationship between family emotional climate and disease activity. Data for this study included married, English-speaking adult participants (n = 1,321; 55% female; M age = 45.2 years) from the National Comorbidity Survey Replication, a nationally representative epidemiological study of the frequency of mental disorders in the United States. Participants reported their demographics, marital functioning, social support from friends and relatives, anxiety and depression (biobehavioral reactivity), number of chronic health conditions, and number of prescription medications. Confirmatory factor analyses supported the items used in the measures of negative marital interactions, social support, and biobehavioral reactivity, as well as the use of negative marital interactions, friends' social support, and relatives' social support as distinct factors in the model. Structural equation modeling indicated a good fit of the data to the hypothesized model (χ(2)  = 846.04, p = .000, SRMR = .039, CFI = .924, TLI = .914, RMSEA = .043). Negative marital interactions predicted biobehavioral reactivity (β = .38, p < .001), as did relatives' social support, inversely (β = -.16, p < .001). Biobehavioral reactivity predicted disease activity (β = .40, p < .001) and was demonstrated to be a significant mediator through tests of indirect effects. Findings are consistent with previous tests of the BBFM with adult samples, and suggest the important addition of family social support as a predicting factor in the model.

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, 2 (35) ϭ 411.01, p Ͻ .001; root mean square error of approximation (RMSEA) ϭ .062, comparative fit index (CFI) ϭ .952; standardized root-mean-square residual (SRMR) ϭ .034 and health appraisal, 2 (35) ϭ 376.80, p Ͻ .001; RMSEA ϭ .058, CFI ϭ .956; SRMR ϭ .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.

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Given that those with anxiety disorders have higher rates of divorce and are more likely to be single, examining the relationship quality with relatives and friends, in addition to romantic partners, may be important for understanding the onset and course of anxiety disorders.