Evidence linking poverty with poor mental and physical health outcomes is well documented, but until recently little research has focused on the underlying psychological factors that mediate these relationships. This report represents the first step toward exploring how two emerging theories, allostatic load and system justification theory, can be harmonized to provide a more comprehensive understanding of the mechanisms that propagate poverty. Specifically, this report addresses the question of how poverty-related stress might moderate the degree to which an impoverished individual is inclined to justify a system that fundamentally does not favor them. Promising future research will be addressed. / text

Delirium is a state of acute confusion and is common in hospitalized older adults. Delirium is associated with significant increases in morbidity and mortality, as well as healthcare costs. Delirium also is associated with functional and cognitive decline, as well as need for institutionalization and rehabilitation. Delirium can cause psychosocial distress for patients and families. While much is understood about the epidemiology of delirium, the pathophysiological mechanisms that lead to the development of delirium are less clearly defined.The purpose of this study was to investigate the relationship of allostatic load (AL), a composite measure of primary (i.e. acute) stress mediators and secondary (i.e. chronic) stress outcomes and delirium in the hospitalized older adult. Development of the Allostatic Load & Delirium in Hospitalized Elderly model provided a theoretical framework for the study.Forty- four participants, ranging from 66 to 93 years of age (M = 76 years of age) were recruited from three intensive care units and enrolled once they were determined not to have a cognitive deficit or prevalent delirium, as assessed by the Standardized Mini-Mental State Examination and Confusion Assessment Method (CAM), respectively. Ten AL components reflective of acute and chronic stress were collected upon admission. Allostatic load was calculated as the sum of the number of components for which the participant was rated in the highest risk quartile. Allostatic load subsets based on acute and chronic components were also calculated. Incident delirium was assessed 48 -72 hours after admission with the CAM.Findings indicated that the incidence of delirium was 29.2%. The subset AL score based on components considered primary stress mediators was significantly related to delirium; however, no other variables were associated with delirium. Logistic regression modeling indicated that an AL subset of primary stress mediators did predict the incidence of delirium (OR 2.5, 95% CI = 1.12, 5.79; X2 (1) = 5.668, p < .05).The findings from this study exploring the relationship between AL and delirium in the hospitalized older adult suggest that an AL score based on primary mediators may be useful in predicting delirium in the hospitalized older adult.

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Thesis advisor: Rebekah Levine Coley / Theories of upward mobility argue that academic and employment success grant individuals improved health, yet emerging evidence suggests that striving for such mobility in the context of marginalization may actually dysregulate physiological stress responses and compromise health. It is still unclear whether these associations operate as a function of cumulative exposure to risk (including both socioeconomic and racial/ethnic marginalization), or whether they would emerge outside of such collective risk. Further, little is known about how the school context, one of the most central contexts in adolescent development, affects associations between mobility and health, despite evidence that opportunities for socioeconomic comparisons or for discrimination at school may further exacerbate these associations. Drawing on data from the National Longitudinal Study of Adolescent Health, a longitudinal survey of a nationally representative school-based sample of adolescents in the United States (N=14,797), the current study sought to clarify links between achievement and physiological health. Multilevel regression analyses considered prospective associations between achievement and health while attending to potential variation in links across the socioeconomic spectrum and across racial/ethnic groups. Additionally, school-level factors were taken into account and explored as potential augmenting mechanisms in these links. Findings suggested promotive links between achievement and physiological health, but also suggested that such links were not shared broadly by all youth. Although links did not vary across the socioeconomic spectrum, Asian American youth demonstrated some greater health payoffs of achievement compared to their non-Hispanic White peers, while non-Hispanic Black and Mexican American youth largely experienced reversed links. These results suggest additional evidence that striving for academic achievement while experiencing racial/ethnic marginality may engender dysregulation of the stress-response system. Thus, findings are discussed in relation to the social and historical contexts that may contribute to such divergent links. However, the school-level factors considered did not moderate links among achievement, individual characteristics, and physiological health, pointing to the importance of future research considering alternate social and contextual mechanisms in these relationships. / Thesis (PhD) — Boston College, 2017. / Submitted to: Boston College. Lynch School of Education. / Discipline: Counseling, Developmental and Educational Psychology.

Given rising work and family demands in our society for both men and women, the experience of work-family conflict is commonplace. Work-family conflict occurs when the demands of work or family make it difficult to meet the demands of the alternate domain. A sizeable body of research has established work-family conflict and its nomological network. Despite decades of research, we have yet to form a precise understanding of when work-family conflicts occur and what happens when a conflict arises. The current research addresses these questions using an experience sampling, episodic approach. Two primary research questions are addressed. First, I used border and boundary theory to identify when work-family conflict episodes are likely to occur. Second, I used stressor-strain and allostatic load theories to examine what happens with regard to psychological, physiological, and behavioral strain following an episodic work-family conflict over time. The results suggest work-family conflict occurs when individuals transition in between work and family domains. Further, family-to-work conflict tends to occur in the morning, while work-to-family conflict tends to occur in the afternoon. Fatigue showed significant reactivity at the time of a family-to-work conflict and recovered in the following time point. Unhealthy eating also showed a sleeper pattern, such that unhealthy eating increased at the end of the day, following a work-to-family conflict. Unexpectedly, fatigue decreased at the time of a family-to-work conflict, indicating family-to-work conflict may be a restorative, rather than taxing. Post-hoc analyses showed some evidence that work-to-family conflict accumulation is associated with increased strain over the course of three days. Again, results suggest family-to-work conflict accumulation may reduce, rather than increase, strain. Implications for the theoretical relationship between work-family conflict and strain, as well as border/boundary theory are discussed. In addition, practical implications for flexible work initiatives and episodic research design are considered.

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This study expanded the current literature by assessing PTSD in relation to reactivity and recovery from negative emotional arousal among OEF/OIF/OND Veterans. Cardiac impedance was employed during a speech task and a trauma imagery procedure. Those in the PTSD-S group displayed lower SBP and higher TPR reactivity relative to the PTSD- and PTSD+ groups; lower CO reactivity relative to the PTSD+ group; and more CO recovery than those in the PTSD+ group to the trauma task. For speech task, Veterans in the PTSD-S group exhibited lower HR reactivity for both speech preparation and delivery than those in the PTSD- group. Depression was not a significant mediator in the relation between PTSD and reactivity. However, further analyses revealed that it served as a moderator between PTSD and reactivity during speech preparation (SBP, HR, and PEP reactivity), and speech delivery (HR, PEP, and CO reactivity). Simple slopes analysis revealed that depression was positively associated with HR and SBP (speech preparation) and HR (speech delivery) for those in the PTSD-S group. For those in the PTSD- group, depression was positively associated with PEP during the speech task (to include preparation) and negatively associated with SBP and CO (speech preparation) and HR and CO (speech delivery). For those in the PTSD+ group, depression was negatively associated with CO and positively associated with PEP. For the most part, Veterans in the PTSD-S group exhibited lower reactivity to both tasks than Veterans in the PTSD+ group or combat-exposed controls without PTSD. In light of the emerging evidence relating blunted reactivity to unhealthy behaviors and negative health outcomes (e.g., depression, obesity), it would appear that both extremes, exaggerated and diminished reactivity are maladaptive responses to stress and that the most optimally response to stress is a moderate reaction.

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Higher levels of allostatic load (AL), a composite measure of the impact of chronic stress on the body, are found among socially marginalized groups compared to privileged groups. AL is associated with premature aging and death, as well as a variety of chronic health conditions that impact quality of life. Effects of AL may be offset by physical activity (PA). Queer populations (including those who identify as lesbian, gay, or bisexual) may be at risk for elevated AL due to repeated exposure to discrimination in the form of sexual minority stress. There is mixed literature on sexual orientation differences in PA and research on AL among queer populations is limited. This study describes sexual orientation differences in the 1) prevalence of PA and mean AL levels and 2) association between PA and AL. Data from the 2001-2015 National Health and Nutrition Examination Survey were used to fit sex-stratified linear regression models assessing sexual orientation (heterosexual, gay/lesbian, bisexual, and heterosexual with same-sex experience) differences as well as sexual orientation-specific associations in PA and AL. AL was assessed using 8 biomarkers, while PA was assessed using metabolic equivalent of task (MET)-hours/week calculated from the Global Physical Activity Questionnaire. Models were adjusted for race/ethnicity, income, education, relationship status, veteran status, and citizenship status. Overall, heterosexual adults reported more PA than their same-sex queer counterparts. Gay men had lower (0.8), while bisexual men had higher AL scores (1.9) than heterosexual men (1.2). Among women, AL score was similar across sexual orientation groups. Overall, more PA was associated with lower AL scores among men and women (badjusted = -0.00508, padjusted=-0.00505, punadjusted =-0.00934, punadjusted =-0.03269, p=0.04), and heterosexual women with same-sex experience (bunadjusted =-0.01059, p=0.02). After adjusting for covariates the association was no longer statistically significant. Consistent with previous work, PA was inversely associated with AL score. PA may be an important modifiable behavior to mitigate some sexual orientation disparities in health.