The Biobehavioral Family Model: Close relationships and allostatic load.

RATIONALE This study tested the inclusion of allostatic load as an expansion of the biobehavioral reactivity measurement in the Biobehavioral Family Model (BBFM). The BBFM is a biopsychosocial approach to health which proposes biobehavioral reactivity (anxiety and depression) mediates the relationship between family emotional climate and disease activity. METHODS Data for this study included a subsample of n = 1255 single and married, English-speaking adult participants (57% female, M age = 56 years) from the National Survey of Midlife Development in the United States (MIDUS II), a nationally representative epidemiological study of health and aging in the United States. Participants completed self-reported measures of family and marital functioning, anxiety and depression (biobehavioral reactivity), number of chronic health conditions, number of prescribed medications, and a biological protocol in which the following indices were obtained: cardiovascular functioning, sympathetic and parasympathetic nervous system activity, hypothalamic pituitary adrenal axis activity, inflammation, lipid/fat metabolism, and glucose metabolism. RESULTS Structural equation modeling indicated good fit of the data to the hypothesized family model (χ (2) = 125.13 p = .00, SRMR = .03, CFI = .96, TLI = .94, RMSEA = .04) and hypothesized couple model (χ(2) = 132.67, p = .00, SRMR = .04, CFI = .95, TLI = .93, RMSEA = .04). Negative family interactions predicted biobehavioral reactivity for anxiety and depression and allostatic load; however couple interactions predicted only depression and anxiety measures of biobehavioral reactivity. CONCLUSION Findings suggest the importance of incorporating physiological data in measuring biobehavioral reactivity as a predicting factor in the overall BBFM model.