The Biobehavioral Family Model

Depressed mood and environmental mastery as potential pathways linking family relationship quality and disease self‐management for African Americans with hypertension

“…Moreover, the addition of mastery into the BBFM suggests a potential mechanism of effect in the model that is worthwhile of future study. Of note, the BBFM's construct of family emotional climate allows for theorizing the role of supportive family processes and provides an advantage over alternate family health models due to its consideration of both positive and negative family relationship quality (Wood, 2018). Thus, incorporating considerations of family-level resilience (Patterson, 2002) in future tests of the BBFM with African Americans facing chronic illness will be an important next step.…”

“…Developing this knowledge has been limited by a lack of organizing, specified, multilevel systemic models. One such multilevel, systemic theoretical model that posits pathways by which family relationships impact health is the Biobehavioral Family Model (BBFM; Wood, 1993; Wood, 2018). Developed first to theorize stress pathways to pediatric asthma, the model has subsequently been expanded, and supported, for use in explaining the health of adult family members (Priest et al, 2019; Woods et al, 2014; Woods et al, 2020; Woods & Denton, 2014) including African Americans (Priest et al, 2020).…”

“…The BBFM posits that family relational process impacts physical health via psychobiological stress pathways, or, biobehavioral reactivity (Wood, 2018). Biobehavioral reactivity is “conceptualized as the degree or intensity with which an individual family member responds physiologically, emotionally, and behaviorally to stressors or emotional stimuli” (p. 3–4, Wood et al, 2021).…”

“…Biobehavioral reactivity, as defined in the BBFM, is similar to emotion regulation/dysregulation, in that it reflects an individual family member's ability to regulate their response to stressful emotion, including behavioral and physiological responses experienced in the face of distress. As a result, biobehavioral reactivity is most often operationalized as disorders of emotion regulation or stress exacerbation, especially negative affect (i.e., hopelessness, loneliness, irritability, shame; Woods et al, 2020) and depression (Priest et al, 2019; Roberson et al, 2018; Wood, 2018; Woods & Denton, 2014). Depressed mood reflects emotion dysregulation, including psychological (e.g., sadness, guilt) and physiological (e.g., insomnia, psychomotor agitation) symptoms comprising biobehavioral reactivity in the face of chronic, prolonged stress.…”

“…In other words, biobehavioral reactivity serves as the pivotal mechanism of effect in the model, whereby chronic family stress conveys negative effects on physical health via chronic stress experienced by individual family members. The BBFM also theorizes reciprocal pathways of effect among family functioning and individual wellbeing, whereby relational, emotional, and biological processes are considered mutually impactful (Wood, 1993; Wood, 2018). In other words, the BBFM posits how family relationship quality affects the etiology and potentiation of disease, but also suggests that worsening disease activity can increase individual and family stress.…”