Autonomy, positive relationships, and IL-6: evidence for gender-specific effects.

A strong body of evidence suggests that women value relationships and relationship-related values more than do men, whereas men value autonomy and autonomy-related values more than do women. In a cross-cultural study that included 127 samples from 70 countries, men consistently reported valuing power, stimulation, achievement, and self-direction more than women; in contrast, women reported assigning greater value to benevolence and universalism than men (Schwartz & Rubel, 2005). Such a pattern has been repeatedly demonstrated across a wide range of ages and cultures (Badger, Simpson, & Jenson, 1998; Beutel & Marini, 1995; Caricati, 2007; Ferssizidis et al., 2010; Jensen, McGhie, & Jensen, 1991; Marini, Fan, Finley, & Beutel, 1996; Knafo & Spinath, 2011; Schartz & Rubel-Lifschitz, 2009; Stimpson, Neff, Jensen, & Newby, 1991; Weisgram, Bigler, & Liben, 2010). It should be noted that men and women do not construe the meanings of these values in different ways, suggesting that such gender differences are not due to differences in the way men and women define such values (Struch, Schwartz, & van der Kloot, 2002). Two well-studied aspects of eudaimonic psychological well-being, positive relationships and autonomy, reflect values associated with gender (Ryff & Keyes, 1995). Positive relationships have been defined as the degree to which the quality—and not just the size—of one’s social network is adequate for providing resources in a variety of situations (Ryff & Keyes, 1995). Congruent with their greater preference for relationship-promoting values, women report more positive relationships (Ryff & Keyes, 1995; Ryff, Lee, Essex, & Schutte, 1994; Ryff, 1989). Autonomy is characterized by self-determination, independence, resistance to social pressures to think and act in certain ways, and the use of personal standards for the measurement of one’s own behavior. Consistent with their greater endorsement of autonomy-centered values, men tend to report greater autonomy and related traits than women, though these differences appear to be less robust (Cross & Madson, 1997; Ryff, Lee, Essex, & Schutte, 1994). Well-being in areas consistent with one’s gender-linked values (e.g., autonomy in men) may be more health-protective than well-being in other areas (e.g., positive relationships in men). In one study of 76 American adolescents with Type 1 diabetes, daily interpersonal conflict was more strongly associated with poor metabolic control among girls than among boys (Helgeson, Lopez, & Karmarck, 2009). In another study of 888 Swedish adults, becoming unemployed was associated with greater somatic complaints among men only, whereas family status (i.e., being single or divorced) was the strongest predictor of somatic complaints among women (Isaksson, Johansson, Ballagh, & Sjoberg, 2004). Finally, several studies have provided evidence that work stress has a greater negative impact than marital stress on cardiovascular health among men, whereas the opposite appears to be true for women (Orth-Gomer et al., 2000; Smith & Brown, 1991; Theorell, Perski, Orth-Gomer, Hamsten, & de Faire, 1991). Thus, aspects of psychosocial functioning that reflect gender-linked values may be more or less relevant to health depending on one’s gender. Interleukin-6 as a Biomarker for Physical and Psychological Well-Being Interleukin-6 (IL-6) is a pleiotropic cytokine that has been associated with the pathogenesis of a variety of diseases. Levels of IL-6 predict adverse health outcomes such as cardiovascular events, osteoporosis, systemic lupus, prostate cancer, and Alzheimer’s disease (e.g., Eriksson et al., 2011; Papanicolaou, Wilder, Manolagas, & Chrousos, 1998; Ridker, Rifai, Stampfer, & Hennekens, 2000). IL-6 also correlates with negative psychosocial states such as depression, anxiety, and stress (Dentino et al., 1999; Gruenewald et al., 2009; Petersen et al., 2008; Howren, Lamkin, & Suls, 2009; Penninx et al., 2003). IL-6 may be a mechanism linking interactions among gender, psychological functioning, and outcomes such as somatic complaints and cardiovascular health. Some evidence links psychological well-being to lower IL-6 in both genders. In a large sample of American men and women (ages 35–86), positive relationships were associated with lower IL-6, though only at lower levels of education (Morozink, Friedman, Coe, and Ryff, 2010). Social integration, support, and engagement also predicted lower IL-6 in women with cancer (Lutgendorf, Anderson, Sorosky, Buller, & Lubaroff, 2000; Costanzo et al., 2005; Lutgendorf, Russell, Ullrich, Harris, & Wallace, 2004). In two studies of older (ages 61–91) women, positive relationships predicted lower IL-6, even in the presence of poor sleep (Friedman et al., 2005) or stressful transitions (Friedman et al., 2007). The one study to examine the association between autonomy and IL-6 failed to find a relationship in the sample as a whole, which included men and women (Morozink et al., 2010). No studies have examined the possibility that gender moderates the correlation of gender-linked aspects of well-being with IL-6. Certain aspects of well-being may be more strongly associated with lower inflammation when consistent with gender-linked values. Additionally, known gender differences in positive relationships, autonomy, and IL-6 suggest the importance of investigating gender differences in links between these aspects of well-being and IL-6. Recent meta-analytic evidence suggests that the relationship of autonomy to negative psychological functioning may be curvilinear, providing a potential explanation for the lack of significant links between autonomy and health or IL-6 in previous studies. The study in question, which included 63 societies and 420,599 individuals, demonstrated that, in addition to a protective main effect of autonomy, there was a quadratic association between autonomy and psychological symptoms such that the greatest symptoms were associated with moderate societal autonomy (Fischer and Boer, 2011). The authors do not provide an interpretation of this curvilinear effect; however, this pattern warrants consideration and further exploration in independent samples. We argue that individuals may benefit from social acquiescence at lower levels of autonomy and from self-directedness at higher levels of autonomy, while individuals may experience deleterious effects at moderate levels of autonomy, which may indicate greater conflict between one’s own priorities and the priorities of others. The Current Study: Gender, Well-being, and IL-6 No studies have examined the possibility that the associations of gender-linked well-being variables such as positive relationships and autonomy with IL-6 differ by gender. The current study therefore tested the hypothesis that gender moderates the associations of both positive relationships and autonomy with IL-6. It was predicted that positive relationships would be associated with lower IL-6 only or more strongly in women, and that autonomy would be associated with lower IL-6 only or more strongly in men. Additionally, because recent meta-analytic evidence suggests curvilinear effects of certain aspects of well-being on psychological health, quadratic effects were also considered.