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CHRONIC BURDENS AND RESOURCES

CHRONIC BURDENS AND RESOURCES. Tom Kamarck, Barbara Anderson, Vicki Helgeson, Karen Matthews, Richard Schulz Andrew Steptoe, discussant Pittsburgh Mind-Body Center External Advisory Board Meeting October 10, 2006. Psychological. Pathways. Chronic Burdens. and. Resource Bank:.

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CHRONIC BURDENS AND RESOURCES

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  1. CHRONIC BURDENS AND RESOURCES Tom Kamarck, Barbara Anderson, Vicki Helgeson, Karen Matthews, Richard Schulz Andrew Steptoe, discussant Pittsburgh Mind-Body Center External Advisory Board Meeting October 10, 2006

  2. Psychological Pathways Chronic Burdens and Resource Bank: Biological • Demographics Pathways: • Social/environmental Disability • Personal attributes & Disease Psychosocial Interventions Precipitating Behavioral Events Pathways: • Health habits, • Restorative activities Life Span Development/Aging

  3. Psychological Pathways Chronic Burdens and Resource Bank: Biological • Demographics Pathways: • Social/environmental Disability • Personal attributes & Disease Psychosocial Interventions Precipitating Behavioral Events Pathways: • Health habits, • Restorative activities Life Span Development/Aging SOCIOECONOMIC STATUS CHRONIC STRESS SOCIAL ISOLATION/SUPPORT

  4. CONCEPTUAL AND MEASUREMENT CHALLENGES • DEARTH OF WIDELY ACCEPTED MEASURES/INDICATORS • Chronic stress • PLETHORA OF WIDELY ACCEPTED MEASURES/INDICATORS • SES and Social Integration/Support • SEARCH FOR “ACTIVE INGREDIENTS” • OBJECTIVE CONDITIONS VS. MEANING/APPRAISAL VS. AFFECTIVE RESPONSE • CHALLENGE OF THE “OVERLAP”

  5. FUTURE DIRECTIONS--I • Assessment of proximal mechanisms linking social environment and health 1. EMA approach 2. Contextual assessment approach 3. Interpersonal approach 4. Environmental assessment approach

  6. EMA APPROACH

  7. Fig. 4. Association between mean Task Demand and Carotid IMT Fig. 5. Association between mean Dec Control and IMT DAILY EXPERIENCE AS FRAMEWORK FOR UNDERSTANDING HEALTH EFFECTS OF CHRONIC (OCCUPATIONAL) STRESS Mean ratings of Task Demand and Task Control relate in the expected direction with measures of carotid artery atherosclerosis

  8. DAILY EXPERIENCE AS FRAMEWORK FOR UNDERSTANDING HEALTH EFFECTS OF SES • Matthews et al. (2000) • 50 men, 50 women matched on occupational prestige. • Lower occupational prestige social conflict • Gallo et al. (2005) • 108 working women. • Lower occupational prestige perceived control • positive affect • social conflict

  9. CONTEXTUAL ASSESSMENT APPROACH Life Events and Difficulties Schedule (LEDS) Context Event or Difficulty Determining Meaning Situation Contextual Threat Rating

  10. INTERPERSONAL APPROACH INTERPERSONAL CIRCUMPLEX

  11. INTERPERSONAL CIRCUMPLEX AS FRAMEWORK FOR UNDERSTANDING HEALTH EFFECTS OF MARITAL STRESS Smith (2006) During marital disagreements Hostile behavior in women, Dominant behavior in men Coronary artery calcification INTERPERSONAL CIRCUMPLEX AS FRAMEWORK FOR UNDERSTANDING HEALTH EFFECTS OF SES Gallo et al. (2006) Low SES individuals Perceived exposure to more hostile, dominant behavior from others. Helped explain inverse association between SES and perceived health.

  12. BUILT ENVIRONMENT APPROACH Roux, 2003, J Urban Health: Bulletin of NY Academy of Medicine, 80, 569-589.

  13. FUTURE DIRECTIONS --II • Multimodal assessment of Social Environmental Constructs 1. Independent vs. shared variance 2. Synergistic effects Occupational stress and SES Occupational stress and marital status

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