Our overarching aim, consistent with a life span perspective, is enhancing understanding of how childhood and adult adversities and relationships, contribute to early midlife adult physical health outcomes. A second central aim is examining how individuals'salient demographic characteristics-ethnicity/race and socioeconomic position-influence specific health outcomes (metabolic syndrome, cardiovascular disease, diabetes mellitus) and their predictors (e.g., specific adversities, health risk behaviors, individual, and relationship dimensions). This multi-method (psychosocial, sociological, and metabolic approaches) project will examine links from early and ongoing adversities to early signs of physical illness, not yet expressed as impairing symptoms. Collaborators include developmental psychologists, internal medicine/metabolism expert, psychiatrists, and a multivariate longitudinal statistician. Much evidence points to childhood adversity and/or sustained relationship stress rendering individuals vulnerable to developing physical health problems, especially cardiovascular disease (CVD), at a relatively young age. This "accelerated aging" is likely associated with specific health risk behaviors. We specifically focus on hypothesized influences of 1) salient adverse experiences and individual characteristics, associated with economic hardship, racism, and exposure to violence, 2) perturbations of relationships in families-marriage and romantic relationships--as they influence midlife health outcomes, and 3) how variations in midlife adults'midlife physical health are influenced by their current mental health, and close social relationships (peer and family). These individual and relationship dimensions represent both protective and vulnerability factors linking early experience and midlife physical illness. At a next level we address contributions of larger contexts (beyond family) through including two deliberately different samples: from our ongoing midlife longitudinal project;and a second, community sample of Black adults, same age and socioeconomic range as our current high and low risk White sample. This new sample (n = 250), recruited through a community quota sampling design, will lead to refining planned analyses considering psychosocial (relationship and individual) predictions of health related outcomes across contrasting ethnic/racial groups and economic strata.
Four specific aims convey our new directions: 1) Assessment of Theoretically and Clinically Significant Physical Health Outcomes, 2) Adversity and Relationship Predictors of Midlife Physical Health Status, 3) Individual Predictors of Midlife Physical Health Status, and 4) The unfolding of relationship adversities, individual characteristics and physical health changes within midlife. We will examine the fourth aim through a longitudinal approach, following participants every 6 months (over 2.5 years) on acute and chronic stressors, social supports, competences, changing health status, and health risk behaviors between baseline and later physiological health risk assessments.
Relevance Our proposed study focuses on metabolic syndrome and diabetes, precursors to cardiac health problems, which are prevalent in middle age. It is important to study psychological symptoms, along with physical symptoms, because often the physical symptoms of cardiovascular health problems are unnoticeable until the patient's health is severely endangered. With the ability to alert patients of their risk of developing cardiovascular disease, patients can take an active preventive measure to protect themselves against potential future health problems.
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