Heidi S. Kane

Pregnancy anxiety and prenatal cortisol trajectories.

Pregnancy anxiety is a potent predictor of adverse birth and infant outcomes. The goal of the current study was to examine one potential mechanism whereby these effects may occur by testing associations between pregnancy anxiety and maternal salivary cortisol on 4 occasions during pregnancy in a sample of 448 women. Higher mean levels of pregnancy anxiety over the course of pregnancy predicted steeper increases in cortisol trajectories compared to lower pregnancy anxiety. Significant differences between cortisol trajectories emerged between 30 and 31 weeks of gestation. Results remained significant when adjusted for state anxiety and perceived stress. Neither changes in pregnancy anxiety over gestation, nor pregnancy anxiety specific to only a particular time in pregnancy predicted cortisol. These findings provide support for one way in which pregnancy anxiety may influence maternal physiology and contribute to a growing literature on the complex biological pathways linking pregnancy anxiety to birth and infant outcomes.

Daily Self-Disclosure and Sleep in Couples

OBJECTIVE An emerging literature provides evidence for the association between romantic relationship quality and sleep, an important factor in health and well-being. However, we still know very little about the specific relationship processes that affect sleep behavior. Therefore, the goal of this study was to examine how self-disclosure, an important relational process linked to intimacy, relationship satisfaction, and health, is associated with sleep behavior. METHOD As part of a larger study of family processes, wives (n = 46) and husbands (n = 38) from 46 cohabiting families completed 56 days of daily diaries. Spouses completed evening diaries assessing daily self-disclosure, relationship satisfaction, and mood and morning diaries assessing the prior nights sleep. Multilevel modeling was used to explore the effects of both daily variation in and average levels across the 56 days of self-disclosure on sleep. RESULTS Daily variation in self-disclosure predicted sleep outcomes for wives, but not for husbands. On days when wives self-disclosed more to their spouses than their average level, their subjective sleep quality and sleep efficiency that night improved. Furthermore, daily self-disclosure buffered the effect of high negative mood on sleep latency for wives, but not husbands. In contrast, higher average levels of self-disclosure predicted less waking during the night for husbands, but not for wives. CONCLUSION The association between self-disclosure and sleep is one mechanism by which daily relationship functioning may influence health and well-being. Gender may play a role in how self-disclosure is associated with sleep.

Psychological, physiological, and behavioral responses to a partner in need: The role of compassionate love

This study examined the role of compassionate love (CL) in shaping cognitive, emotional, physiological, and behavioral responses to partner distress (N = 56 couples). One member of each couple (the support provider) observed his/her partner perform an easy or difficult stress task (designed to vary signals of partner distress). Support providers in the difficult (vs. easy) condition showed more partner focus, emotional distress, and blood pressure reactivity during the task and expressed more support afterward. Support providers high (vs. low) in CL showed greater partner focus and emotional empathy and sent more caring messages. Additional analyses suggest that CL increases sensitivity to a partner’s distress and that the link between CL and support behavior is mediated by increases in empathy and attention to one’s partner.

The Attachment System and Physiology in Adulthood: Normative Processes, Individual Differences, and Implications for Health

Attachment theory provides a conceptual framework for understanding intersections between personality and close relationships in adulthood. Moreover, attachment has implications for stress-related physiology and physical health. We review work on normative processes and individual differences in the attachment behavioral system, as well as their associations with biological mechanisms related to health outcomes. We highlight the need for more basic research on normative processes and physiology and discuss our own research on individual differences in attachment and links with physiology. We then describe a novel perspective on attachment and physiology, wherein stress-related physiological changes may also be viewed as supporting the social-cognitive and emotion regulatory functions of the attachment system through providing additional energy to the brain, which has implications for eating behavior and health. We close by discussing our work on individual differences in attachment and restorative processes, including sleep and skin repair, and by stressing the importance of developing biologically plausible models for describing how attachment may impact chronic illness.

Attachment, skin deep? Relationships between adult attachment and skin barrier recovery

This study examined the relationship between individual differences in adult attachment and skin barrier recovery. Dating couples (N = 34) completed a self-report measure of attachment anxiety and avoidance, and during two separate laboratory visits, normal skin barrier function was disrupted using a tape-stripping procedure, followed by a 20 min discussion of personal concerns in one visit and relationship problems in the other, counterbalanced randomly across visits. Skin barrier recovery was assessed by measuring transepidermal water loss up to 2 h after skin disruption. Multilevel modeling showed that skin barrier recovery did not differ between the personal concern or relationship problem discussions. Among women, greater attachment anxiety predicted faster skin barrier recovery across the two visits, while greater attachment avoidance predicted slower skin barrier recovery. Among men, greater attachment anxiety predicted slower skin barrier recovery during the personal concern discussion only. The observed effects remained significant after controlling for transepidermal water loss in undisturbed skin, suggesting that the relationship between attachment security and skin barrier recovery was not due to other skin-related factors like sweating. Cortisol changes, self-reported emotions, stress appraisals, and supportiveness ratings were tested as potential mediators, and none explained the relationships between attachment and skin barrier recovery. These findings are the first to demonstrate associations between individual differences in attachment style and restorative biological processes in the skin, even in a sample of young dating couples in satisfied relationships.

Asthma-related immune responses in youth with asthma: Associations with maternal responsiveness and expressions of positive and negative affect in daily life

Objectives Stressful family environments early in life have negative effects on physical health. However, less is known about the health effects of positive aspects of families. We examined the associations between maternal responsiveness and immune markers among youth with asthma and identified youth expressions of positive affect as a potential mechanism of these associations. Methods Forty-three youths with asthma (26 boys; aged 10–17 years) wore the Electronically Activated Recorder for 4 days to assess maternal responsiveness and youth expressions of affect from audio-recordings of daily life. Trained coders rated Electronically Activated Recorder sound files for expressions of maternal responsiveness and affect displayed by the youth. Peripheral blood mononuclear cells were isolated, cultured, and assayed to determine stimulated levels of interleukin (IL)-5, IL-13, and interferon-&ggr;. Results Greater maternal responsiveness was associated with decreased stimulated production of IL-5 (r = −0.38, p = .012) and IL-13 (r = −0.33, p = .031). Greater total positive affect in youth was linked to decreased stimulated production of IL-5 (r = −0.46, p = .002) and IL-13 (r = −0.37, p = .014). Total negative affect among youth was unrelated to immune responses. There was a significant indirect effect of maternal responsiveness via positive affect in youth on lower levels of IL-5 (95% confidence interval = −3.41 to −0.03) and IL-13 (95% confidence interval = −2.34 to −0.01) when adjusting for caregiver-youth conflict and negative affect among youth. Conclusions These results indicate the importance of positive family interactions for youth and provide preliminary evidence for a mechanism through which parenting can influence immune responses in youth with asthma.

Mothers’ Attachment is Linked to Their Children’s Anti-Inflammatory Gene Expression via Maternal Warmth

Research has demonstrated links between adult romantic attachment and one’s own physical health; little is known about links between adult attachment orientations and offspring health. Prior work has shown that parents’ greater attachment anxiety and avoidance predict less warmth toward their children. Extensive work has also shown that lower maternal warmth has negative downstream effects on offspring health. We tested the novel hypothesis that mothers’ dispositional romantic attachment would be linked—via maternal warmth—to their children’s expression of the glucocorticoid receptor gene NR3C1, higher expression of which is associated with healthier stress regulation and inflammatory response. In a sample of 132 youth with asthma, we found that mothers’ attachment anxiety and avoidance were both negatively associated with children’s expression of NR3C1, explained by lower youth-rated maternal warmth. Associations held after adjusting for demographic and psychosocial covariates. Implications for parents’ attachment influencing the health of offspring are discussed.

Youth secrets are associated with poorer sleep and asthma symptoms via negative affect

OBJECTIVE Among older children and adolescents, keeping secrets from parents is consistently associated with lower levels of psychological well-being. Further, concealing ones thoughts and emotions has been associated with poor physical health outcomes in adults. However, it remains an open question whether secret-keeping is associated with poorer health and health-related behaviors (such as sleep) among youth and, if those hypothesized links exist, what the psychological mechanisms might be. We investigated the associations among youth secrecy towards parents, daily asthma symptoms and daily sleep behaviors in a sample of low-income youth with asthma aged 10-17 and tested negative affect as a possible mediator of these associations. METHODS One hundred and seventy two youths reported the extent to which they kept secrets towards parents over a period of four days. Asthma symptoms, nighttime awakenings, sleep onset latency, and subjective sleep quality were assessed with daily diaries completed by youths. RESULTS More frequent secret-keeping was associated with more severe asthma symptoms, lower ratings of sleep quality and greater number of nighttime awakenings. Secrecy was also associated with increased negative affect, which accounted for the associations between secrecy and number of awakenings and daytime asthma symptoms. These findings remained significant after controlling for youth age and other relevant demographic factors. CONCLUSIONS Our findings suggest that secrecy towards parents can have consequential health outcomes for youth with asthma and point to the importance of investigating affective processes as mediators of the influence of secret-keeping on youth health.

The effects of interpersonal emotional expression, partner responsiveness, and emotional approach coping on stress responses.

Expressing emotions is a common strategy for coping with stress. Yet, little is known about the effects of using this strategy in close relationships, or when and for whom emotional expression is effective. This study examined romantic partner responsiveness and the dispositional tendency to use emotional approach coping (EAC; the processing and expression of emotions) as moderators of the effects of experimentally manipulated emotional expression on stress responses to a laboratory stressor. We brought couples (N = 145) to the lab and randomly assigned 1 partner (the participant) to perform a stressful task. We manipulated whether participants expressed their feelings about the task to their partner (expression vs. no-expression), and whether participants received supportive messages from their partners (as an indicator of partner responsiveness; support vs. no-support). We examined physiological stress responses (cortisol and salivary alpha-amylase [sAA]), negative emotional stress responses (anxiety and self-conscious emotions), and post-task ruminative thoughts. Participants high in EAC showed larger sAA and cortisol responses and reported more negative post-task ruminative thoughts after emotionally expressing to their partners, but partner support mitigated the effect on cortisol. Participants low in EAC showed smaller cortisol responses and reported less negative emotional responses and fewer negative post-task ruminative thoughts after emotionally expressing to their partners. Receiving partner support reduced negative emotional responses for people high in EAC, but increased negative emotional responses for those low in EAC. These results may help explain when and for whom emotional expression is an effective means of coping in the immediate context of a stressor. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Neighborhood Stress, Depressive Symptoms, and Asthma Morbidity in Youth

OBJECTIVE Living in a dangerous and disadvantaged neighborhood is consistently linked with poor health outcomes; however, few studies have investigated psychosocial mechanisms of this relationship. We hypothesized that a specific facet of depression-anhedonia-would partially explain the relationship between stressful neighborhoods and poor health in youth with asthma. METHOD 156 youths provided reports on their depressive symptoms, daily asthma symptoms, and peak expiratory flow rate (PEFR). Caregivers provided reports on neighborhood characteristics. RESULTS Youth residing in more at-risk neighborhoods experienced more symptoms of depression, greater asthma symptoms (both during the day and night), and marginally lower PEFR. Indirect effect analyses revealed that the relationship between neighborhood stress and youth asthma symptoms was partially explained by a key symptom of depression, anhedonia. CONCLUSIONS These findings suggest that the neighborhood-health link is partially explained by symptoms of depression tapping into difficulties experiencing pleasure and motivation.