Jennifer Morozink Boylan

Objective: We analyzed qualitative data about social relationships and examined their quantitative associations with concurrent and prospective cardiovascular health (CVH). Methods: Cross-sectional analyses involved the Midlife in the United States (MIDUS) Study wave 2 (M2) and Refresher (MR) biomarker samples (N=2036). Longitudinal analyses involved participants with both M2 and MIDUS wave 3 (M3) biological data (N=650). Participants wrote responses to the question “What do you do to make your life go well?” Judges evaluated each response for 11 aspects of relationships (e.g., communication, mentoring). CVH was assessed at M2, MR, and M3 via the American Heart Association’s Life’s Essential 8 measure (i.e., a composite of diet, physical activity, smoking, sleep, blood pressure, cholesterol, glucose, BMI). Pre-registered linear regression models examined associations between each positive relationship aspect and CVH. Results: Positive relationships were mentioned in 71.8% of responses. Aspects of relationships that were associated with CVH in unadjusted cross-sectional or longitudinal models included positively evaluating a relationship (i.e., loving, caring, respecting), spending time together, and physical intimacy. None of the relationship subthemes were associated with concurrent or prospective CVH after adjusting for sociodemographic factors and response word count. Conclusions: Qualitative assessments captured unique perspectives on social relationships that are relevant for well-being and are not well-represented with self-report measures. Although relational subthemes did not show significant associations with CVH, the null findings may reflect limited statistical power rather than the absence of meaningful effects. Promises and challenges of mixed methods biopsychosocial science and medicine research are discussed.

Objective: To identify culturally grounded well-being practices among Black men in midlife and examine their associations with physiological health. Methods: Analyzing data from the 2004–2005 Midlife in the United States (MIDUS) study, we examined, 116 open-ended responses to the question, “What do you do to make your life go well?” Network topic modeling identified six topics: (1) interpersonal kindness and positive mindset; (2) caring for children; (3) practicing spirituality and faith; (4) maintaining social connections and well-being; (5) avoiding stress; and (6) meaningful work and daily activities. Topic scores, reflecting participants’ tendency to discuss these themes, predicted allostatic load and inflammation in structural equation models adjusting for body mass index, chronic conditions, psychological and subjective well-being, age, income, and education. Results: Greater emphasis on meaningful work and daily activities predicted lower inflammation and allostatic load, independent of demographic and psychological covariates ( p <.05). Other topics were not associated with physiological dysregulation. Conclusion: Everyday narratives of meaningful work and engagement among Black men are closely linked to physiological health markers, highlighting strengths-based, culturally grounded pathways for public health intervention and health equity.

Socioeconomic disparities in cardiovascular health are well established, but the role that stress and related physiological changes play in such disparities is still unclear. There is tentative evidence for a correlation between lower socioeconomic position and poorer cardiovascular response to stress, but observational designs do not allow for conclusions regarding causality. The current study presents results from a systematic review and meta-analysis on experimental manipulations of social rank and changes in cardiovascular reactivity and cortisol. A meta-analysis was conducted (N = 2,005), including 25 studies (20 cardiovascular and five cortisol) and 71 effects (66 cardiovascular and five cortisol). Primary analyses showed a nonsignificant effect of social rank manipulations on physiological outcomes (g = -0.04, p = .54, SE = 0.07, 95% confidence interval [CI] [-0.18, 0.09]). However, moderator analyses revealed that for studies that manipulated social rank based on socioeconomic factors (e.g., personal income, parental income/education), lower rank was significantly associated with heightened cardiovascular reactivity (g = -0.24, p = .006, SE = 0.09, 95% CI [-0.41, -0.07]). No significant effect was found for studies that used performance-based social rank manipulations (i.e., cognitive tasks such as word tracing and number counting). Results support the potentially causal influence of lower socioeconomic position on poorer cardiovascular health through elevated cardiovascular stress reactivity. We discuss the relevance of these findings to the role of psychophysiology for socioeconomic disparities in cardiovascular health. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Long-term trajectories of psychological well-being were investigated using data from a national longitudinal study known as MIDUS (Midlife in the U.S.) The central question was whether educational status and age were associated with gains, losses, or persistent disadvantage on widely studied dimensions of eudaimonic well-being such as personal growth, purpose in life, and self-acceptance. Findings from a sample of adults (N = 6908), aged 25–74 at baseline, showed primarily loss across the 20-year period (1995–2015). Those with a high school education or less showed persistently lower levels of six distinct aspects of well-being compared to those with more education across time. In addition, purpose in life declined for all age groups. Losses over time for autonomy, environmental mastery, and personal growth were steeper for the oldest age group (i.e., 61 years and older) compared to younger (i.e., 40 years and younger) and midlife (i.e., 41–60 years) adults, while losses for self-acceptance were steepest for young adults compared to the two older age groups. The role of structural inequalities in understanding variation in these well-being trajectories and their implications for future health are considered.

Background: Religiousness and spirituality (R/S) are associated with lower morbidity and mortality, yet the physiological mechanisms underlying these associations are under-studied. Chronic inflammation is a plausible biological mechanism linking R/S to downstream health given the sensitivity of the immune system to the social environment and the role of inflammation in many chronic diseases. Purpose: The purpose of the present study was to examine associations between multiple R/S dimensions and two markers of chronic inflammation, interleukin-6 (IL-6) and C-reactive protein (CRP). Methods: In this cross-sectional study, data came from biological subsamples of two cohorts from the Midlife in the United States (MIDUS) Study (combined N = 2,118). Predictors include six R/S measures (service attendance, spirituality, private religious practices, daily spiritual experiences, religious coping, and R/S-based mindfulness). Outcomes include log-transformed IL-6 and CRP. Covariates include age, gender, cohort, race, educational attainment, body mass index (BMI), smoking status, and physical activity. Results: Older adults, women (vs. men), non-White (vs. White) adults, those with higher BMIs, current smokers, and those not meeting physical activity guidelines had significantly higher IL-6 and CRP. In fully adjusted models, greater spirituality, daily spiritual experiences, religious coping, and R/S-based mindfulness were associated with lower IL-6. Higher spirituality was also associated with lower CRP. Conclusions: Many dimensions of R/S may be health protective for adults given their associations with lower levels of chronic inflammation. Findings underscore the importance of examining multiple dimensions of R/S to understand mechanistic pathways.

Despite considerable progress in recent years, research in cardiac psychology is not widely translated into routine practice by clinical cardiologists or clinical health psychologists. Self-determination theory (SDT), which addresses how basic psychological needs of autonomy, competence, and relatedness contribute to the internalization of motivation, may help bridge this research–practice gap through its application to shared decision-making (SDM). This narrative review discusses the following: (a) brief background information on SDT and SDM, (b) the application of SDT to health behavior change and cardiology interventions, and (c) how SDT and SDM may be merged using a dissemination and implementation (D&I) framework. We address barriers to implementing SDM in cardiology, how SDM and SDT address the need for respect of patient autonomy, and how SDT can enhance D&I of SDM interventions through its focus on autonomy, competence, and relatedness and its consideration of other constructs that facilitate the internalization of motivation.

We examined prospective associations between religiousness/spirituality (R/S; i.e., service attendance, R/S identity, R/S coping, spirituality) and all-cause mortality in the Midlife in the United States (MIDUS) sample, including whether having a purpose in life and positive social support are indirect pathways through which R/S predicts mortality. We examined service attendance and a composite of R/S identity, R/S coping, and spirituality from the baseline wave (1995–1996; n = 6120 with complete data), purpose in life and positive social support from the second wave (2004–2006), and vital status through 2020 (n = 1711 decedents). Cox regression models showed that attending religious services more than weekly and approximately weekly was associated with a lower mortality risk compared to never attending in the adjusted models (>weekly vs. never, HR (95% CI) = 0.72 (0.61, 0.85); weekly vs. never, HR (95% CI) = 0.76 (0.66, 0.88)). The R/S composite was also associated with lower mortality risk in the adjusted models (HR (95% CI) = 0.92 (0.87, 0.97)). Indirect effects from R/S to mortality via purpose in life and positive social support were significantly different from zero. These findings highlight the importance of multidimensional aspects of R/S for population health and point to purpose in life and positive social support as underlying pathways between R/S and mortality.