<p dir="ltr">Background—Adverse Childhood Experiences (ACEs) are events that occur before age 18, such as abuse and neglect, which are potentially traumatic. ACEs can lead to profound negative impacts on physical and psychological health and social relationships. Despite this, positive social connections can mitigate these effects. However, individuals with ACEs may struggle to form healthy relationships because of mistrust, leading to continued exposure to detrimental social environments. Additionally, ACE-exposed adults often internalize stigma.</p><p dir="ltr">Methods—Utilizing data spanning from 1995 to 2014, Chapter 2 examines 629 adults from the MIDUS II: Biomarker study. Employing counterfactual modeling, the study estimates the treatment effect of ACE exposure on well-being and employs weighted multilevel mixed models to analyze life course changes. Chapter 3 uses 1,243 respondents from the MIDUS II: Biomarker study, employing latent class analysis to identify social relationship patterns and assess their mediation between ACEs and the pursuit/enjoyment of new relationships. Chapter 4 uses experimental data from 493 respondents, employing vignette experiments to gauge perceptions of warmth and competence, with gender and happiness examined as moderators, and threat, status, four stigmatizing descriptions as mediators.</p><p dir="ltr">Results—ACE exposure is associated with increased chronic conditions, lower self-rated health, diminished psychological and social well-being. However, the strength of the treatment effects differs based on the type and number of ACE exposures. Latent Class Analysis of social relationships indicates four classes: healthy, ambivalent, kin-focused, and difficult, with higher ACEs linked to a decreased probability of being in the “healthy” class. ACEs also predict reduced enjoyment of interactions with new people, mediated 41% by the current social relationship class. ACE vignettes are perceived as less warm and competent, with happiness moderating some ACE-related perceptions. Status, “mentally ill”, and “damaged” emerged as strong mediators.</p><p dir="ltr">Conclusion—While ACE exposure is related to lower well-being, the rate of decline does not differ from non-ACE-exposed individuals across time. Those in strained relationships are less likely to enjoy new social interactions, potentially perpetuating ACE-related health consequences. Addressing interpersonal trust issues in ACE-exposed adults through social interventions may mitigate these effects. Additionally, there is stigma against each of the ten ACEs, and the medicalization of ACEs contributes to stigma.</p>

<p dir="ltr">As the US population ages, scientists and policy makers are giving renewed attention to not just increasing the quantity of years lived but improving the quality of those years. Disability, defined as difficulty in performing basic, necessary, socially defined tasks such as bathing and eating, represents a threat to quality of life. Disability has been acknowledged as a major public health issue among policy makers, practitioners, and multidisciplinary researchers for older adults, yet few have investigated the lifetime predictors of this condition. The purpose of this dissertation is to (1) identify how exposure to stressful events across the life course influences disability, (2) examine the role that social relationships play in disability onset in later life, and (3) investigate the appraisal of stress rather than just the discrete occurrence of an event to understand how this subjective experience alters disability status in later life. This dissertation aims to understand how these relationships vary among demographic groups, with two chapters identifying racial, ethnic, and nativity disparities, and one explaining the moderating effect of gender. Drawing from life course theories including the stress process and cumulative inequality, this dissertation uses longitudinal data from the Health and Retirement Study (HRS) to examine the effect of lifetime stress exposure, adult social relationships, and chronic stress appraisal on the occurrence and onset of disability among adults 50 years and older. This dissertation is composed of an introductory chapter, three empirical chapters, and a concluding chapter.</p><p dir="ltr">The first empirical study investigates disparities in stress and disability and further examines how the relationship between stress exposure (both cumulatively and domain-specific) and disability differs by race, ethnicity, and nativity. The second empirical chapter examines the gendered relationship between patterns of social relationship quality in adulthood (identified by high quality, adverse, indifferent, or ambivalent) and the onset of disability in later life. The third empirical chapter builds on the conceptual design of the first chapter, but instead examines chronic stress exposure and chronic stress appraisal and how each has a unique influence on later-life disability for White, Black, US-born Hispanic, and foreign-born Hispanic adults. Overall, findings reveal that higher levels of stress exposure, more detrimental patterns of relationship quality, and appraising stress as upsetting are associated with an earlier onset of disability in later life among adults in the United States. Although empirical chapter 2 did not find any racial, ethnic, and nativity differences among social relationships and disability, negative relationship patterns (i.e., adverse and ambivalent) are associated with disability at a younger age for all older adults. In addition, men who report adverse or indifferent relationships have higher odds of disability than men in high quality relationships. The two chapters examining different conceptualizations of stress exposure and disability find racial, ethnic, and nativity differences. Compared to White adults, cumulative stress burden, particularly childhood traumatic events, are especially harmful for US-born Hispanic adults. Moreover, appraising chronic stressors as more upsetting has a detrimental influence on later-life disability for Black adults, but a protective effect for foreign-born Hispanic adults.</p><p dir="ltr">This dissertation highlights several lifetime antecedents of disability and identifies that it is important to account for demographic factors when addressing interventions to reduce the overall occurrence of disability. Disability is more prevalent among older adults and represents a threat to quality of life. Interventions aimed at reducing exposure to stressful experiences and improving quality of relationships may alleviate some of the noxious effects that disability has on optimal aging.</p>

<p dir="ltr"><a href="" target="_blank">The goal of this study was to contribute to the research on determinants of caregiving by exploring whether adult children’s health problems shape their involvement in their mothers’ care. Drawing from equity theory and contingent exchange theory (Davey & Eggebeen, 1998; Davey & Norris, 1998; Walster et al., 1978), I proposed that adult children with health problems would be less likely to be their mothers’ primary caregivers but more likely to be their mothers’ secondary caregivers compared to their healthier siblings. Additionally, based on gender role development theories (Chodorow, 1978; Gilligan, 1982; Leaper & Friedman, 2007), I hypothesized that health problems would reduce sons’, but not daughters’, likelihood of serving as their mothers’ primary caregivers. The results of both the quantitative and qualitative analyses revealed that from both the mothers’ and children’s perspectives, adult children with and without health problems were equally as likely to serve as their mothers’ primary or secondary caregivers. Furthermore, the results suggested that daughters were expected to provide care despite their own health obstacles, whereas this expectation was not present for sons. The findings suggested that adult children with health problems are still participants in their mothers’ care and should be included in conversations regarding planning for their mothers’ future care needs and current caregiving arrangements. Additionally, the findings highlighted how providing care comes at a higher cost for children with health problems compared to their healthier siblings. Future research should investigate how additional support to caregivers with health problems may lead to better caregiving outcomes for both the caregivers and care recipients.</a></p>