Childhood cumulative risk and later allostatic load: mediating role of substance use. Stress self-management: an intervention for women with physical disabilities. Allostatic load is associated with chronic conditions in the Boston Puerto Rican Health Study. Don't hide your happiness! Positive emotion dissociation, social connectedness, and psychological functioning. Upward spirals of the heart: Autonomic flexibility, as indexed by vagal tone, reciprocally and prospectively predicts positive emotions and social connectedness
OBJECTIVE The present study investigated the long-term impact of exposure to  poverty-related stressors during childhood on allostatic load , an index of physiological dysregulation , and the potential mediating role of substance use . METHOD Participants ( n = 162 ) were rural children from New York State , followed for 8 years ( between the ages 9 and 17 ) .  Poverty- related stress was computed using the cumulative risk approach , assessing stressors across 9 domains , including environmental , psychosocial , and demographic factors . Allostatic load captured a range of physiological responses , including cardiovascular , hypothalamic pituitary adrenal axis , sympathetic adrenal medullary system , and metabolic activity . Smoking and alcohol/drug use were tested as mediators of the hypothesized childhood risk-adolescent allostatic load relationship . RESULTS Cumulative risk exposure at age 9 predicted increases in allostatic load 8 years later . Smoking , but not alcohol and drug use , was a significant mediator of the prospect i ve , longitudinal relationship between childhood cumulative risk and adolescent allostatic load . CONCLUSIONS The present paper contributes to the underst and ing of the role of early life stress in health across the life span and of the mechanisms by which adverse childhood environments impact health as children emerge into early adulthood . This knowledge will have implication s for early intervention efforts PURPOSE We sought to develop and evaluate the efficacy of an innovative , theory-driven , group stress self-management intervention design ed to ameliorate stress and promote health among women with physical disabilities such as spinal cord injury , multiple sclerosis , and arthritis . METHODS We recruited a voluntary sample of 78 community-living women with disabilities who were r and omly assigned to either the group stress management intervention or the wait-listed control group  , and we used a within- and between-groups pretest/posttest design with a 3-month follow-up . RESULTS Group differences in changes over time on measures of perceived stress and mental health offer support for the efficacy of the intervention . At the 3-month follow-up assessment , the intervention group also showed greater improvement on measures of pain and role limitations owing to physical health when compared the wait-listed control group . Perceived stress was supported as a mediator of the effect of the intervention on mental health . We found support for social connectedness and self-efficacy as mediators of the relation between the intervention and perceived stress ; however , there was relatively weak evidence for differential change over time in those proposed mediators . CONCLUSION This study provides the first of its kind , that is , an evaluation of the efficacy of a stress self-management intervention design ed specifically for women with physical disabilities . The results are consistent with a model in which the stress management intervention enhances self-efficacy and social connectedness , which leads to reduced stress , which then contributes to improved mental health Puerto Ricans living in the United States mainl and present multiple disparities in prevalence of chronic diseases , relative to other racial and ethnic groups . Allostatic load ( AL ) , or the cumulative wear and tear of physiological responses to stressors such as major life events , social and environmental burden , has been proposed as a possible mechanism for the inequalities observed in minority groups , but has not been studied in Puerto Ricans . The aim of this study was to determine the association of AL to six chronic diseases ( abdominal obesity , hypertension , diabetes , and self-reported cardiovascular disease ( CVD ) , arthritis and cancer ) in Puerto Ricans , and to contrast AL to metabolic syndrome ( MetS ) . Participants of the Boston Puerto Rican Health Study ( n=1116 , ages 45 - 75 years ) underwent a  home-based interview  , where question naires were completed and biological sample s collected . A summary definition of AL was constructed using clinical ly-defined cutoffs and medication use for 10 physiological parameters in different body systems . Logistic regression models were run to determine associations between AL score and disease status , controlling for age , sex , smoking , alcohol use , physical activity , total fat intake and energy intake . Parallel models were also run with MetS score replacing AL . We found that increasing categories of AL score were significantly associated with abdominal obesity , hypertension , diabetes and self-reported cardiovascular disease ( CVD ) and arthritis , but not with self-reported cancer . The strength of associations of AL with all conditions , except diabetes and cancer , was similar to or larger than those of MetS score . In conclusion , Puerto Rican older adults experienced physiological dysregulation that was associated with increased odds of chronic conditions . AL was more strongly associated with most conditions , compared to MetS , suggesting that this cumulative measure may be a better predictor of disease . These results have prospect i ve research implication s for Puerto Ricans and other ethnic groups It is now clear that positive emotion leads to enhanced psychological functioning . What is less clear , however , is just why this is so . Drawing on a social-functional perspective , we argue that positive emotional behavior that accurately signals to others the individual 's internal state will enhance social connectedness . Positive emotional behavior that does not accurately signal a person 's experience -- such as a smile that is not felt -- may impede social connectedness and , in turn , psychological functioning . This perspective suggests that ( a ) the degree to which experience and behavior are dissociated during positive emotional episodes , over and above level of positive behavior , should predict worse psychological functioning and ( b ) the effect of dissociation should be mediated by social connectedness . To test these hypotheses , we conducted a short-term prospect i ve longitudinal study , with a baseline assessment of depressive symptoms and well-being at Time 1 . Six months later , at Time 2 , we used a novel within-individual laboratory paradigm to measure the degree to which positive emotional behavior was dissociated from ( vs. coherent with ) a participant 's positive emotional experience . We also assessed level of positive behavior and experience . Then , another 6 months later , we assessed social connectedness as a mediator and depressive symptoms and well-being as outcomes at Time 3 . Even when controlling for baseline functioning and for level of positive emotion behavior and experience , we found that greater positive experience-behavior dissociation at Time 2 predicted higher levels of depressive symptoms and lower levels of well-being at Time 3 . As predicted , these associations were mediated by social connectedness Vagal tone ( VT ) , an index of autonomic flexibility , is linked to social and psychological well-being . We posit that the association between VT and well-being reflects an " upward spiral " in which autonomic flexibility , represented by VT , facilitates capitalizing on social and emotional opportunities and the result ing opportunistic gains , in turn , lead to higher VT . Community-dwelling adults were asked to monitor and report their positive emotions and the degree to which they felt socially connected  each day for 9 weeks . VT was measured at the beginning and end of the 9-week period . Adults who possessed higher initial levels of VT increased in connectedness and positive emotions more rapidly than others . Furthermore , increases in connectedness and positive emotions predicted increases in VT , independent of initial VT level . This evidence is consistent with an " upward spiral " relationship of reciprocal causality , in which VT and psychosocial well-being reciprocally and prospect ively predict one another
These studies overwhelmingly support the notion that social connectedness correlates negatively with allostatic load .
Several moderators of this relationship were also identified , including gender , social status , and quality of social ties .
The current evidence strongly indicates that the more socially connected individuals are , the less likely they are to experience chronic stress and associated allostatic load .
The negative association between social connectedness and various chronic diseases can thus , at least partially , be explained by the buffering qualities of social connectedness against allostatic load .
We argue that assessing social connectedness in clinical and epidemiological setting s may therefore represent a considerable asset in terms of prevention and intervention
In the present review , we argue that social disconnectedness could and should be included in primary -care screening protocol s for the detection of cardiometabolic disease .
Empirical evidence indicates that weak social connectedness represents a serious risk factor for chronic diseases , including cardiovascular disease , diabetes , and various cancers .
Weak social connectedness , however , is largely regarded as a second-tier health-risk factor in clinical and research setting s. This may be because the mechanisms by which this factor impacts on physical health are poorly understood .
Budding research , however , advances the idea that social connectedness buffers against stress-related allostatic load-a known precursor for cardiovascular disease and cancer .
The present paper review s the empirical knowledge on the relationship between everyday stress , social connectedness , and allostatic load .