1. CHRONIC BURDENS AND RESOURCES Tom Kamarck, Barbara Anderson, Vicki Helgeson, Karen Matthews, Richard Schulz Andrew Steptoe, discussant Pittsburgh Mind-Body Center External Advisory Board Meeting October 10, 2006

2. Chronic Burdens and Resource Bank:  Demographics  Social/environmental  Personal attributes Psychological Pathways Psychosocial Interventions Behavioral Pathways :  Health habits,  Restorative activities Biological Pathways: Disability & Disease Precipitating Events Life Span Development/Aging

3. Chronic Burdens and Resource Bank:  Demographics  Social/environmental  Personal attributes Psychological Pathways Psychosocial Interventions Behavioral Pathways :  Health habits,  Restorative activities Biological Pathways: Disability & Disease Precipitating Events Life Span Development/Aging SOCIOECONOMIC STATUS CHRONIC STRESS SOCIAL ISOLATION/SUPPORT

4. CONCEPTUAL AND MEASUREMENT CHALLENGES DEARTH OF WIDELY ACCEPTED MEASURES/INDICATORS –Chronic stress PLETHORA OF WIDELY ACCEPTED MEASURES/INDICATORS –SES and Social Integration/Support SEARCH FOR “ACTIVE INGREDIENTS” OBJECTIVE CONDITIONS VS. MEANING/APPRAISAL VS. AFFECTIVE RESPONSE CHALLENGE OF THE “OVERLAP”

5. FUTURE DIRECTIONS--I Assessment of proximal mechanisms linking social environment and health 1. EMA approach 2. Contextual assessment approach 3. Interpersonal approach 4. Environmental assessment approach

6. EMA APPROACH

7. Mean ratings of Task Demand and Task Control relate in the expected direction with measures of carotid artery atherosclerosis Fig. 4. Association between mean Task Demand and Carotid IMT Fig. 5. Association between mean Dec Control and IMT DAILY EXPERIENCE AS FRAMEWORK FOR UNDERSTANDING HEALTH EFFECTS OF CHRONIC (OCCUPATIONAL) STRESS

8. DAILY EXPERIENCE AS FRAMEWORK FOR UNDERSTANDING HEALTH EFFECTS OF SES Matthews et al. (2000) 50 men, 50 women matched on occupational prestige. Lower occupational prestige social conflict Gallo et al. (2005) 108 working women. Lower occupational prestige perceived control positive affect social conflict

9. CONTEXTUAL ASSESSMENT APPROACH Life Events and Difficulties Schedule (LEDS) Context Situation Determining Meaning Event or Difficulty Contextual Threat Rating

10. INTERPERSONAL APPROACH INTERPERSONAL CIRCUMPLEX

11. Smith (2006) During marital disagreements Hostile behavior in women, Dominant behavior in men Coronary artery calcification Gallo et al. (2006) Low SES individuals Perceived exposure to more hostile, dominant behavior from others. Helped explain inverse association between SES and perceived health. INTERPERSONAL CIRCUMPLEX AS FRAMEWORK FOR UNDERSTANDING HEALTH EFFECTS OF MARITAL STRESS INTERPERSONAL CIRCUMPLEX AS FRAMEWORK FOR UNDERSTANDING HEALTH EFFECTS OF SES

12. BUILT ENVIRONMENT APPROACH Roux, 2003, J Urban Health: Bulletin of NY Academy of Medicine, 80, 569-589.

13. FUTURE DIRECTIONS --II Multimodal assessment of Social Environmental Constructs 1. Independent vs. shared variance 2. Synergistic effects Occupational stress and SES Occupational stress and marital status