Our relationships with others form a ubiquitous part of our everyday lives. In the classic analysis by Emile Durkheim (1951), suicide rates were higher among individuals who were less socially integrated. The loneliness and despair that characterize a lack of social connections may be responsible for such unfortunate outcomes. Less obvious, however, is the possibility that individuals with poor relationships may also be more at risk for physical disease endpoints such as cardiovascular disease, cancer, or infectious diseases. Is there evidence that such an association exists? If so, how is it that social relationships influence such disease processes? The answer to the first question is relatively well documented. In a recent meta-analysis of large prospective studies it was found that individuals with lower social support had higher mortality rates from all causes, including cardiovascular mortality (Holt-Lunstad, Smith, & Layton, 2010). In fact, the evidence linking social relationships to mortality was comparable to standard risk factors such as smoking and physical activity.
What is less known is the answer to the second question of how social relationships influence such long-term health outcomes. Our program of research has been aimed at examining how social relationships influence health at multiple levels of analysis. We have been examining the social (e.g., types of social interactions), cognitive (e.g., how these interactions are interpreted or construed), and physiological (e.g., cardiovascular, endocrine, and immune) processes associated with our all important social relationships (see Uchino, Cacioppo, & Kiecolt-Glaser, 1996; Uchino, 2004; Uchino, 2009 for reviews). For instance, in our program of research we have found that perceptions of supportive relationships predicts reduced cardiovascular reactivity during stress (Uchino & Garvey, 1997; Uno, Uchino, & Smith, 2000), lower blood pressure in older adults (Uchino, Kiecolt-Glaser, & Cacioppo, 1992; Uchino et al., 1995; Uchino et al., 1999), and lower ambulatory blood pressure during daily life (Bowen et al., 2013).
We have also developed a more general model for examining the health-related consequences
of social relationships that incorporates both positive and negative aspects (see
Uchino et al., 2001). A unique feature of our model is the specification of ambivalent
relationships that are viewed as relatively high in both positivity and negativity
(e.g., overbearing parent, volatile romance, "out of touch" friend, Fingerman, Hay,
& Birditt, 2004). Despite the positivity in such relationships, we have hypothesized
that the co-occurrence of negativity may be uniquely associated with worse health
outcomes. This may be because ambivalent ties require heightened vigilance during
social interactions or may be frustrating and ineffective sources of support during
times of need (Uchino et al., 2001). In addition, ambivalent ties are typically described
as "close," and hence there is more of an overlap between self-other representations
(Aron, Aron, Tudor, & Nelson, 1991) which can exacerbate any interpersonal stress
with such network ties. In fact, ambivalent ties engage in more negative behaviors
(e.g., criticism) and less emotionally supportive behaviors and thus appear stress-enhancing
(Reblin, Uchino, & Smith, 2010).
Ambivalent ties are also not an isolated feature of most individuals' social networks. They comprise almost 50% of important network members and hence have ample opportunity to influence health-related outcomes (Campo et al., 2009). In fact, we have found consistent evidence that ambivalent ties are related to worse outcomes compared to other relationship types (e.g., primarily positive or primarily negative) such as increased cardiovascular reactivity at both conscious and less conscious levels of processing (Holt-Lunstad, Uchino, Smith, & Hicks, 2007; Carlisle et al., 2012), higher ambulatory blood pressure during daily life (Birmingham et al., 2015; Holt-Lunstad, Uchino, Smith, Cerny, & Nealey-Moore, 2003; Uchino et al. 2013), increased inflammation (Uchino et al., 2013), faster cellular aging (Uchino et al.,2012), and greater coronary calcification (Uchino, Smith, & Berg, 2014). We are currently modeling the antecedent processes, contexts, and mechanisms by which ambivalent ties are health-relevant.
This research was generously supported by the National Institute of Mental Health, National Institute of Aging, and National Heart, Lung, and Blood Institute.
Post-doc, The Ohio State University (1993-1994)
Ph.D., The Ohio State University (Psychology, 1993)
M.A., The Ohio State University (Psychology, 1991)
B.A., University of Hawaii at Moanoa (Psychology, 1989)
Uchino, B.N., Smith, T.W., & Berg, C.A. (2014). Spousal relationship quality and cardiovascular risk: Dyadic perceptions of relationship ambivalence are associated with coronary calcification. Psychological Science, 25, 1037-1042.
Carlisle, M., Uchino, B.N., Sanbonmatsu, D.M., Smith, T.W., Cribbet, M.R., Birmingham, W., Light, K.A., & Vaughn, A.A. (2012). Subliminal activation of social ties moderates cardiovascular reactivity during acute stress. Health Psychology, 31, 217-225.
Uchino, B.N., Bowen, K., Carlisle, M., & Birmingham, W. (2012). What are the Psychological Pathways Linking Social Support to Health Outcomes? A Visit with the "Ghosts" of Research Past, Present, and Future. Social Science and Medicine., 74, 949-957.
Uchino, B.N., Cawthon, R.M., Smith, T.W., Kent, R.G., Bowen, K., & Light, K.C. (2015). A cross-sectional analysis of the association between perceived network social control and telomere length. Health Psychology, 34, 531-538.
Uchino, B.N., Birmingham, W., Berg, C.A. (2010). Are Older Adults Less or More Physiologically Reactive? A Meta-Analysis of Age-Related Differences in Cardiovascular Reactivity to Laboratory Tasks. Journal of Gerontology: Psychological Sciences., 65B, 154-162.
Uchino, B.N. (2009). Understanding the links between social support and physical health: A lifespan perspective with emphasis on the separability of perceived and received support. Perspectives in Psychological Science, 4, 236-255. Download
Campo, R.A., Uchino, B.N., Holt-Lunstad, J., Vaughn, A.A., Reblin, M., & Smith, T.W. (2009). The assessment of positivity and negativity in social networks: The reliability and validity of the Social Relationships Index. Journal of Community Psychology, 37, 471-486. Download
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