Social Relationships and Cardiovascular Health: An Examination of Mechanisms

描述（由申请人提供）：社会关系与较低的心血管发病率和死亡率可靠相关。大多数研究都被解释为反映了社会支持的有益影响。然而，在支助过程中关系的积极和消极方面的共同贡献尚未得到充分考虑。此外，人们对与心血管疾病相关的机制知之甚少。在本研究中，我们提出了一个概念模型，突出了支持过程中关系的积极和消极方面的可分离性。这一框架表明，个人的社会支持网络可以启发式地分为积极性（即支持）、消极性（即厌恶）或积极和消极兼而有之（即矛盾心理）。这一框架与现有的关系和健康模式相结合，在不同的分析层次上形成了将关系与健康联系起来的突出机制。因此，本应用程序的主要目的是(a)检验该模型在分析关系对健康影响方面的效用，以及(b)阐明关系与心血管结果之间的基本心理、行为和生理机制。我们在五个综合研究中追求这些目标。在三项研究中，我们利用社会认知范式(a)操纵对关系质量的感知，(b)破坏或激活与现有关系相关的心理过程，研究了不同关系与急性压力下心血管反应和恢复之间的联系。第四项研究将通过在已婚夫妇中测试社会关系与日常生活动态血压（ABP）之间的关系来解决这些基于实验室的协议的普遍性。最后一项研究将检验婚姻关系与近期炎症免疫标记物之间的联系。炎症免疫标记物在年龄较大、与健康关系更密切的已婚夫妇中会增加患心血管疾病的风险。上述所有研究将评估基本机制，以帮助阐明在每种范式中关系可能影响心血管功能的过程。重要的是，我们的初步研究为提出的研究的可行性和潜力提供了证据。

DESCRIPTION (provided by applicant): Social relationships have been reliably related to lower cardiovascular morbidity and mortality. Most of this research has been interpreted as reflecting the beneficial influences of social support. However, the joint contribution of positive and negative aspects of relationships in the context of support processes has hot been adequately considered. In addition, little is known of the mechanisms linking relationships to cardiovascular outcomes. In the present research we propose a conceptual model that makes salient the separability of positive and negative aspects of relationships during support. This framework suggests that an individual's social support network can be heuristically classified as sources of positivity (i.e., support), negativity (i.e., aversion), or both positivity and negativity (i.e., ambivalence). This framework, combined with existing relationships and health models, makes salient mechanisms linking relationships to health at different levels of analysis. Thus, the major aims of this application are to (a) examine the utility of this model for analyzing the health effects of relationships, and (b) to elucidate basic psychological, behavioral, and physiological mechanisms linking relationships to cardiovascular outcomes. We pursue these aims in five integrative studies. In three studies, we investigate the links between differing relationships and cardiovascular reactivity and recovery in response to acute stress by utilizing social-cognitive paradigms that (a) manipulate perceptions of relationship quality and (b) disrupt or activate psychological processes associated with existing relationships. A fourth study will address the generalizability of these lab-based protocols by testing the association between social relationships and daily life ambulatory blood pressure (ABP) following work in married couples. A final study will examine the links between relationships and recent immune markers of inflammation that confer increased risk for cardiovascular disease in an older, more health-relevant population of married couples. All of the above studies will assess basic mechanisms to help elucidate the processes by which relationships may influence cardiovascular function in each paradigm. Importantly, our preliminary research provides evidence for the feasibility and potential of the proposed research.