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We gratefully acknowledge grant support from NIMH & NICHD (#’s 2R01HD058305 & R01-MH58066).

The Body Remembers: Adolescent Family and Romantic Relationship Qualities Predict Indicators of Physical Health at Ages 25-27 Joe Allen Joseph Tan Jessica Kansky University of Virginia. Lauren Everhart Chris Hafen , Ph.D . Meghan Costello Gabby Hunt Elie Hessel, Ph.D.

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We gratefully acknowledge grant support from NIMH & NICHD (#’s 2R01HD058305 & R01-MH58066).

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  1. The Body Remembers:Adolescent Family and Romantic Relationship Qualities Predict Indicators of Physical Health at Ages 25-27Joe AllenJoseph TanJessica KanskyUniversity of Virginia Lauren Everhart Chris Hafen, Ph.D. Meghan Costello Gabby Hunt Elie Hessel, Ph.D. Christy McFarland, Ph.D. Emily Marston, Ph.D. Erin Miga, Ph.D. Amanda Hare, Ph.D. David Szwedo, Ph.D. Collaborators: Maryfrances Porter, Ph.D. Kathleen McElhaney, Ph.D. Emily Loeb Sarah Coe-Odess Rachel Narr We gratefully acknowledge grant support from NIMH & NICHD (#’s 2R01HD058305 & R01-MH58066). Copies of related papers are available at:www.Teenresearch.org

  2. Social Relationships and Physical Health • Surprisingly Powerful Links • Social isolation linked to: • Numerous Health Problems • Including Early Mortality • Effects Comparable to Physical Risk Factors (e.g., cigarette smoking)

  3. Social Relationships and Physical Health • Hypothesized Mechanisms • Health Behavior • Poor Physical Health as Creating Social Isolation • Stress/Allostatic Load

  4. Social Relationships and Physical Health • Hypothesized Mechanisms • Humans as Pack Animals • Needing Social Contact to Thrive

  5. Are There Social Relationship Qualities In Adolescence That Can Help Explain Long-term Physical Outcomes?

  6. Sample • 184 Adolescents (followed from age 13 to 29), their Parents, Best Friends, Other Friends, Romantic Partners (Blood samples from 108 thus far). • Intensive Interviews and Observations with all parties (Total N over first 15 years ~ 3400). • Equal numbers of Males and Females • Socio-economically Diverse (Median Family Income= $40- $60K) • 31% African American; 69% European American • Very Low Attrition (96% participation rate in current phase)

  7. Prior Findings

  8. Assessing Global Adult Health at 26 • 5-item Self-Report Scale (Medical Outcomes Study Short-form Health Survey, DeSalvo , 2006) • Cronbach’sα =.83

  9. Assessing Global Adult Health at 26 Links from Prior Literature Objective Markers of Illness Global Health Assessment Future Illness Early Mortality

  10. Two Potential Predictors of Long-Term Health Outcomes Close Friendship Quality (Age 13) • Combination of Two Peer-report Measures: • Inventory of Parent and Peer Attachment (Armsden & Greenberg, 1987) • Friendship Quality Questionnaire (Parker & Asher, 1993) Allocentrism/Communal Focus (Ages 14-17) • Combination of Three Peer-report Measures: • Teen as Follower (age 14) • Teen Influenced by Peers (Age 16) • Teen Assertiveness (Age 17; reverse-scored) • The Opposite of ‘Rugged Individualism’

  11. Age 13 Age 14-17 Age 25-27 Gender -.16* History of Serious Illness Prior to Age 18 Body Mass Index Family Income .19** -.20** .21** -.19** -.20** Close Friendship Quality Physical Health Quality Allocentrism vis-a-vis Peers .15* -.19** -.17* -.32** Internalizing Symptoms .19** Depressive Symptoms Potential Mediated Pathway to Health Quality Direct Pathway to Health Quality Friendship Indirectly Predicts Adult Reported Health Quality (via Reduced Internalizing Symptoms) (Allen, Uchino, & Hafen, 2015. Running with the pack: Teen peer-relationship qualities as predictors of adult physical health Psychological Science)

  12. Age 13 Age 14-17 Age 25-27 Gender -.16* Body Mass Index History of Serious Illness Prior to Age 18 Family Income .19** -.20** .21** -.19** -.20** Close Friendship Quality Physical Health Quality Allocentrism vis-a-vis Peers .15* -.19** -.17* -.32** Internalizing Symptoms .19** Depressive Symptoms Potential Mediated Pathway to Health Quality Direct Pathway to Health Quality Communal Focus Directly Predicts Adult Reported Health Quality (Allen, Uchino, & Hafen, 2015. Running with the pack: Teen peer-relationship qualities as predictors of adult physical health Psychological Science)

  13. On to the Question ofMechanisms

  14. Interleukin-6 • Cytokine (small protein involved in cell signalling). • Key part of immune system, regulating the maturation, growth, and responsiveness of particular cell populations • Measured via blood samples • High levels in blood stream predict: • Tumor progression in cancer • Arthritis • Osteoporosis • Cardiovascular disease • Mortality risk • High levels are linked to markers of premature aging

  15. Why Conflict Might Predict Levels of Interleukin-6 • Links to Social Stress • Associations with high stress roles in Adulthood • Caring for a parent with Alzheimer’s Disease • Likely Mechanism: Chronic Stress Reactions • Release of Cortisol  Immune System Effects • Conflictual Relationships as a Potentially Potent Social Stressor

  16. Do Adolescent Conflict Management PatternsPredictAdult Levels of Interleukin-6?

  17. Adolescent Conflict Management PredictsAdult Levels of Interleukin-6 Age 13 Age 21 Age 26 _ Age 16 Family Income -.17* -.24** Interleukin-6 Autonomy w/ Peer* -.14* -.19** Conflict Resolution w/ Peer .19* .62*** .15* Rom. Auton. Struggles* Body Mass Index Romantic Rel. Stress R2 = .54*** R2change = .13*** Poor Conflict Management Processes at Multiple Stages Predict Higher Adult Levels of Interleukin-6 (Allen, Narr, & Loeb, 2016. Mid-adolescent peer relationship qualities as predictors of physical health outcomes at ages 25-27. SRAoc. for Res. in Adol.)

  18. From Adolescent Relationship Qualities to Adult Health:The Role of the Stress Response System

  19. Primary Hypothesis Support in close relationships under stress in adolescence will predict more effective physiological responding to stress in adulthood.

  20. Cardiovascular Reactivity to Stress • Change in Heart Rate when Under Stress • Flexible deployment of physiological resources • Associated with Sensitivity to Environment • The Opposite of ‘burnout’ of the stress reaction system seen with chronic stress (e.g., dirunal cortisol patterns and poor child care) • Reactivity is Associated with LOWER levels of Prior Family Discord and Concurrent Aggression

  21. Cardiovascular Reactivity Assessment • Baseline Heart Rate Assessment • 10 minutes resting (watching relaxing video) • 2 Stress tasks (Trier Stress Test) 6 minutes each • Explaining why a shoplifting accusation against you is false • Difficulty Mental arithmetic • Cardiovascular Reactivity = Heart rate under stress, accounting for baseline heart rate

  22. Concurrent Relationship to Lack of Sleep Problems Cardiovascular Reactivity Sleep Problems -.20* Low Levels of Cardiovascular Reactivity to Stress are Concurrently Linked to Sleep Difficulties Pittsburgh Sleep Quality Index 19 items assessing sleep disturbance & daytime dysfunction and links both health and social functioning (Buysse, Reynolds III et al., 1989; Cacioppo, Hawkley et al., 2002a).

  23. Adolescent Relationship Quality PredictsAdult Cardiovascular Reactivity to Stress Age 13 Age 21 Age 25-27 Age 16 Cardiovascular Reactivity -.12 .02 -.25** -.18* Baseline Heart Rate Body Mass Index Gender Family Income R2 = .14***

  24. Observed Relatedness in Father-Adolescent Interactions (Age 13) • 7-minute Disagreement Discussion • Coded with Autonomy & Relatedness Coding System for Parent-Teen Interactions (Allen et al., 2001) • Behaviors that Facilitate Friendly Resolution of the Disagreement: • Signs of Active Listening • Supportive/Validating Statements • Dyadic Assessment: Summing codes for both parties’ behaviors • Intraclass Correlation Coefficient (Inter-rater reliability) =.86

  25. Adolescent Relationship Quality PredictsAdult Cardiovascular Reactivity to Stress Age 13 Age 21 Age 25-27 Age 16 Cardiovascular Reactivity -.10 .02 .16 -.15 .36*** Baseline Heart Rate Body Mass Index Gender Family Income Observed Relatedness w/ Father R2 = .26*** R2change = .12*** Positive Interactions with Fathers at 13 Predict Greater Cardiovascular Reactivity at 25-27

  26. Observed Support in Teen-peer Interactions (Age 16) • Supportive Behavior Task & Coding System (Allen et al., 2001) • 8-minute interaction task between teen and best friend • Teen discusses a problem or question about which they could use help from friend • Coded for degree of peer engagement with the teen in the task • Intraclass Correlation Coefficient (Inter-rater reliability) =.81

  27. Adolescent Relationship Quality PredictsAdult Cardiovascular Reactivity to Stress Age 13 Age 21 Age 25-27 Age 16 Cardiovascular Reactivity .33*** Observed Support from Peers -.18* -.09 .14* -.12 Baseline Heart Rate Body Mass Index Gender Family Income R2 = .23*** R2change = .09*** Receiving Support from a Best Friend at 16 Predicts Greater Cardiovascular Reactivity at 25-27.

  28. Observed Relatedness in Romantic Partner Interactions (Age 21) • 7-minute Revealed Differences Task • Coded with Autonomy & Relatedness Coding System for Romantic Partner Interactions (Allen et al., 2001) • Behaviors that Facilitate Friendly Resolution of the Disagreement: • Signs of Active Listening • Supportive/Validating Statements • Dyadic Assessment: Summing codes for both parties’ behaviors • Intraclass Correlation Coefficient (Inter-rater reliability) =.74

  29. Adolescent Relationship Quality PredictsAdult Cardiovascular Reactivity to Stress Age 13 Age 21 Age 25-27 Age 16 Cardiovascular Reactivity Observed Relatedness w/ Romantic Partner .31*** 09 -.02 .17* -.20* Baseline Heart Rate Body Mass Index Gender Family Income R2 = .23*** R2change = .09*** Positive Interactions with a Romantic Partner at 21 Predict Greater Cardiovascular Reactivity at 25-27.

  30. How Do These Predictors Add Up? • Simply redundant? • Early factors predict, but only if mediated via later factors? • Early adolescence matters, regardless of what comes after?

  31. Adolescent Relationship Quality PredictsAdult Cardiovascular Reactivity to Stress Age 13 Age 21 Age 25-27 Age 16 Cardiovascular Reactivity Observed Relatedness w/ Romantic Partner .24* .34*** Observed Support from Peers -.13 -.06 .09 -.14* -.24* Baseline Heart Rate Body Mass Index Gender Family Income .40*** Observed Relatedness w/ Father R2 = .32*** R2change = .19*** Direct and Mediated Predictions from Adolescent Supportive Interactions to Adult Cardiovascular Reactivity

  32. What we’re seeing… Predictions are from brief snippets of interaction… demonstrating links from relationship support in adolescence to flexible physiological responding to stress in adulthood… largely in accord with predictions from attachment theory.

  33. Limitations • Correlational not Causal • Did not have baseline CVR assessments – Direction of effects? • Need to Understand Psychological and Physiological Processes that Might Account for these Links • How Physical Stress Response Patterns Develop? • Links to Other Physical Health Indices? Copies of related papers are available at:www.TeenResearch.org

  34. Conclusions • Robust links: Supportive interactions in adolescence flexible stress response patterns in adulthood • Growing research linking adolescent relationship qualities to adult physical health • Significant life span health/aging implications • We routinely fund preventive physical health care to prevent future physical health problems—perhaps social health care warrants similar treatment • Need for interventions to enhance adolescent relationships Copies of related papers are available at:www.TeenResearch.org

  35. Thank you. Copies of related papers are available at:www.TeenResearch.org

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