The Role of Close Relationships in the Mental and Physical Health of Latino Americans

Modeling Connections for Latino Americans Using the Biobehavioral Family ModelClose relationships are linked to mental and physical illness (Carr & Springer, 2010). Distressed close relationships are associated with an increased risk of mood disorders (Whisman, 2007), anxiety disorders (Priest, 2013), and chronic health conditions including heart disease (De Vogli, Chandola, & Marmot, 2007) and poor self-rated physical health (Liu & Umberson, 2008). This is in part because close relationships, such as familial and romantic relationships, are more emotionally intense than other relationships, and because they continue across time (Weihs, Fisher, & Baird, 2002). Recently, there has been an increase in research to understand how connections between close relationships and health occur (Carr & Springer, 2010). The biobehavioral family model (BBFM; Wood, 1993), a model that explains the connections between family relationships and mental and physical health, is an important attempt to theorize the pathways by which close relationships influence the mental and physical health of individuals.The Biobehavioral Family Model. The BBFM is a biopsychosocial approach (Engel, 1977) to understanding the effects of family functioning on the emotional reactivity and physical health outcomes of individual family members (Wood, 1993). Developed using general systems theory (von Bertalanffy, 1969) and concepts from Minuchin's psychosomatic family model (Minuchin, Rosman, & Baker, 1978), the model's authors theorized that social, emotional, and physical factors mutually influence one another, and that the quality of close relationships may worsen or buffer against the development of physical health concerns (Wood, 1993; Wood & Miller, 2002). However, though theoretically the model suggests a circular pattern of causality (i.e., family affects health, and health can affect family), the model has only ever been tested in the direction suggesting that relational processes affect internal individual emotional reactions, which in turn affect health outcomes.The BBFM focuses on three specific variables: negative family emotional climate, biobehavioral reactivity, and disease activity. Negative family emotional climate is defined as the negativity of the emotional processes in a family, including hostility, criticism, and conflict (e.g., Wood et al., 2007), romantic relationship distress, and dysfunctional patterns of family behavior (Woods & Denton, 2014). The biobehavioral reactivity construct represents emotion regulation or dysregulation. Within the model, the construct highlights how an individual family member responds to emotional stimuli, specifically from the family environment (Wood et al., 2008). Past research has used measures of depression and anxiety to operationally define biobehavioral reactivity (e.g., Wood et al., 2007; Woods & Denton, 2014). The disease activity construct is the activation of the psychophysiological processes of illness (Wood, 1993). The construct is often operationalized by the presence of chronic illness or self-reported health (e.g., Wood et al., 2007; Woods & Denton, 2014). The model predicts that negative family emotional climate exacerbates the biobehavioral reactivity of individual family members, which influences the development of physical health symptoms that are part of chronic illness (Miller & Wood, 2003; Wood, 1993). Biobehavioral reactivity involves several biological systems, including the autonomic nervous system and hypothalamic-pituitary-adrenal axis. Specifically, the BBFM suggests that emotional interpretations of stimuli, including close family relationships, affect the neuroendocrine activity of the body, which results in emotional and behavioral responses, including experiences of fear, anxiety, depression, and other emotional states (Seeman, 2001). These heightened emotional states may decrease the body's immune response, making a person more susceptible to illness, or may exacerbate symptoms that are already present (e. …