The Biobehavioral Family Model: Testing Social Support as an Additional Exogenous Variable

Abstract

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.

Review of Family Relational Stress and Pediatric Asthma: The Value of Biopsychosocial Systemic Models

“…More explicitly, we propose that a warm family emotional climate, secure internal attachment models within the pregnant mother, and good relationship quality between the pregnant mother and an intimate partner, and between the pregnant mother and other family members, will buffer the effect of external socioeconomic stress on the pregnant mother (Woods, Priest, & Roush, 2014). In contrast, hostile family emotional climate, insecure maternal attachment, compromised partner and family relationships will fail to buffer, and even exacerbate, the effect of external stressors on the pregnant mother.…”

Examining Differentiation of Self as a Mediator in the Biobehavioral Family Model

“…The Biobehavioral Family Model (BBFM; Wood, ) is a biopsychosocial model of health (e.g., Lim, Wood, & Miller, ; Lim, Wood, Miller, & Simmens, ; Priest & Woods, ; Priest et al., ; Woods & Denton, ; Woods, Priest, & Roush, ). The BBFM examines how negative family emotional climate contributes to individual family members experiencing greater biobehavioral reactivity (i.e., depression, anxiety, and psychophysiological stress) resulting in increased disease activity (i.e., chronic health conditions).…”

“…The BBFM examines how negative family emotional climate contributes to individual family members experiencing greater biobehavioral reactivity (i.e., depression, anxiety, and psychophysiological stress) resulting in increased disease activity (i.e., chronic health conditions). Originally developed to explain associations between family relationships and health for children (Wood, ), recent research has shown the model's utility in examining association between family relationships and health for adults (e.g., Priest & Woods, ; Priest et al., ; Woods & Denton, ; Woods et al., ).…”

“…The family emotional climate is hypothesized as the “the overall intensity and valence of emotional exchange (Wood et al., ) that occurs in a family system.” Recent research has shown the importance of exploring the family emotional climate and intimate partner emotional climate as distinct factors for adults (Woods et al., ). The family emotional climate represents the level, intensity, frequency, and balance of positive and negative emotional exchanges that occur with parents, children, or other relatives (Wood et al., ); whereas the intimate partner emotional climate represents the level, intensity, and frequency of positive and negative exchanges that occur within an intimate partnership (Woods et al., ). The hypotheses of the BBFM suggest that if the family and intimate partner emotional climates are more negative then the relational processes that occur within this system may produce or exacerbate stress dysregulation (Wood et al., ).…”

“…Specifically, Wood () hypothesized that biobehavioral reactivity is comprised of the “behavioral, emotional, and physiological response” that a person has to their family emotional climate. Previous research has used measures of depression and anxiety symptoms (Lim et al., , ; Priest & Woods, ; Woods & Denton, ; Woods et al., ) as well as allostatic load (Priest et al., ) to operationalize this construct. Allostatic load is the “wear and tear that results from chronic over activity or under activity” of physiological systems (e.g., the cardiovascular system; McEwen, , p. 171).…”