Objective To assess blood pressure (BP) reactivity as recently separated adults completed a laboratory task asking to mentally reflect on their relationship experiences. Marital separations and the experience of divorce are associated with increased risk for early mortality and poor health outcomes. Few studies, however, have investigated the potential psychophysiological mechanisms that may account for these broad-based associations. Method Seventy recently separated or divorced community-dwelling adults (26 men) completed self-report measures of divorce-related psychological adjustment. During a laboratory visit, quasi-continuous BP was assessed across four task periods, including a divorce-specific mental activation task (DMAT). A task-rated emotional difficulty (TRED) index was computed based on participants’ immediate appraisals of the task demands. Results After accounting for relevant health-related covariates and depressed mood, participants who reported higher degrees of divorce-related emotional intrusion and physical hyperarousal demonstrated significantly elevated resting BP at entry into the study. When assessing change from a within-person control task to the DMAT, a three-way interaction indicated that men reporting high TRED scores evidenced significant increases in BP, whereas men reporting low TRED scores evidenced significant decreases in BP. Women evidenced no significant changes in BP across study periods. Conclusions Results suggest that divorce-related emotional intrusion-hyperarousal and real-time ratings of emotional difficulty (when people think about their separation experience) may play a specific role in BP reactivity, especially for men. These data shed new light on the potential mechanisms that may link marital dissolution and poor health.

Marital separation and divorce increase risk for all-cause morbidity and mortality. Using a laboratory analogue paradigm, the present study examined attachment anxiety, language use, and blood pressure (BP) reactivity among 119 (n = 43 men, 76 women) recently separated adults who were asked to mentally reflect on their relationship history and separation experience. We created a language use composite of verbal immediacy from participants’ stream-of-consciousness recordings about their separation experience as a behavioral index of attachment-related hyperactivation. Verbal immediacy moderated the association between attachment anxiety and BP at the beginning of a divorce-specific activation task. Participants reporting high attachment anxiety who discussed their separation in a first-person, present-oriented and highly engaged manner evidenced the highest levels of BP at the start of the divorce-specific task. Results provide a deeper understanding of the association between marital dissolution and health and suggest that verbal immediacy may be a useful behavioral index of hyperactivating coping strategies.

Although marital separation is an inherently social experience, most research on adults’ psychological adjustment following a romantic separation focuses on intrapersonal characteristics, or individual differences (e.g., attachment style, personality, longing) that condition risk for poor psychological outcomes. We know little about how these individual differences interact with interpersonal processes, such as contact between ex-partners. In the current study, we sought to understand how adults’ continued attachment to (and longing for) an ex-partner, and both nonsexual and sexual contact with an ex-partner (CWE and SWE, respectively), are related to adults’ post-separation psychological adjustment among 137 (n = 50 men) adults reporting recent marital separations. Data revealed that (1) less separation acceptance was associated with poorer psychological adjustment; (2) among people having CWE, those reporting less acceptance reported significantly poorer adjustment relative to those reporting more acceptance; (3) among people reporting more acceptance, those having CWE reported significantly better adjustment relative to those not having CWE; (4) among people not having SWE, those reporting less acceptance reported significantly poorer adjustment relative to those reporting more acceptance; and (5) among people reporting less acceptance, those having SWE reported significantly better adjustment relative to those not having SWE. We discuss the findings in terms of adult attachment, pair-bonding, and the loss of coregulatory processes following marital separation.

Since 2005, coccidioidomycosis has increased among inmates at a California prison. Our initial investigation found an incidence of 3,323 cases/100,000 persons. Black race, age ≥41 years, and residence on Yard C were significantly associated with coccidioidomycosis ( p < .05). Inmates at this prison have continued to be at risk for coccidioidomycosis.

The number of cases of coccidioidomycosis and associated hospitalizations increased in California during 2000-2013. During that period, a total of 1,098 death records listed coccidioidomycosis as a cause, averaging 78 deaths annually (range: 43-108). The death rate peaked in 2006 and was significantly higher among males than among females, among African American patients than among white patients, and among residents of the coccidioidomycosis-endemic region of California than among residents of the less endemic regions (p<0.001). A higher death rate was associated with increasing age and was highest (8.8 per 1 million population) among adults aged ≥75 years. Of coccidioidomycosis-associated deaths, 31.9% had a contributing cause of death of severe/disseminated disease, 31.8% of unspecified -coccidioidomycosis, and 28.3% of pulmonary unspecified coccidioidomycosis, per International Classification of Diseases codes. Diabetes was a contributing cause in 19.3% of deaths, and other immunocompromising conditions were a contributing cause in 15.9% of deaths. Populations at higher risk for coccidioidomycosis--associated deaths are similar to those at higher risk for coccidioidomycosis-associated hospitalizations and infection. Awareness for coccidioidomycosis among these groups and their providers is important for proper diagnosis and care.

Similar to recent increases among adults, reported pediatric coccidioidomycosis cases and hospitalizations have increased in California since 2000, disproportionately affecting certain demographic groups. The burden of coccidioidomycosis among California children emphasizes the need for more awareness and research into this reemerging fungal disease in endemic and nonendemic areas.

Substantial acute/pulmonary and disseminated coccidioidomycosis was seen among pediatric patients at this infectious disease clinic in California. In endemic areas, increased coccidioidomycosis awareness and vigilance among families and providers is necessary to facilitate early diagnosis and appropriate management.

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