In brief, our model contains five classes of variables. The first category includes chronic or
stable burdens and resources, which we have subdivided into factors according to level of
analysis: demographic factors (e.g., social class), factors involving personal attributes
(e.g., hostility), and factors relating to the person’s social/environmental context (e.g.,
supportive marital relationships). As a group, these factors can be construed as background
variables that influence susceptibility to or recovery from illness. Taken individually, these
factors can also have multiplicative effects as well that are typically not evaluated because
researchers usually only operate at one level of analysis. A second general class of variables
pertains to precipitating events that may trigger downstream changes in the pathways. These
factors can range from stressful life events defined broadly to more specific events, like initial
medical diagnoses. The third general category of variables is the pathways or factors that are
proposed to mediate the relationships between chronic burdens and resources or precipitating
events and disease and disability. We have somewhat arbitrarily divided the pathways into
psychological, behavioral, and biological categories. However, a general theme of PMBC is that
these are highly interrelated and interconnected. The psychological pathways refer to cognitive
or affective responses, such as negative affect and feelings of stress, whereas the behavioral
pathways refer to important health behaviors, e.g., physical activity, and restorative activities.
Restorative activities refer to activities that rejuvenate or restore individuals to some equilibrium,
such as a valued hobby or sleep. There are many important biological pathways that are relevant
on a disease-specific basis, but those that are the foci of the Center model refer to biological
processes that are proposed to be linked to psychological and behavioral factors and to a number
of disease endpoints. A final part of the model is disease-specific outcomes and disability, the
latter being assessed more broadly as functional status.

The assumption underlying the center’s theme is that the search for shared pathways can
have a multiplier effect and lead to a greater understanding of the development of a number of
important diseases, in addition to the target disease. Similarly, interventions based on
manipulation of the shared pathways can be used to test hypotheses about the utility of those
concepts in ameliorating the effects of different diseases and disabilities on quality of life.

These pathways – psychological, behavioral, and biological—were evaluated in the first phase
of PMBC via research projects in relation to infectious disease, breast cancer, osteoarthritis,
and subclinical atherosclerosis. In the current phase of PMBC, we are investing our efforts in
unpacking the most promising common pathways.

Administrative Structure
 

The structure of the Center is partly organized around the major domains of the PMBC model:
psychosocial and health behaviors Psychosocial and Health Behavior Assessment, (Core C)
restorative activities Sleep Assessment and Resources, (Core D) and
biological processes Biological and Biomedical Measurement, (Core E)
An Administrative Core (Core A) provides the overarching direction to the Center activities
and the Data Management and Statistical Core (Core B) provides guidance and training on
analytic tools and data management. The Developmental Infrastructure Component oversees
advanced training along with the Research Cores, organizes the annual Summer Institute, and
administers the pilot fund projects.

History of PMBC.Common Pathways Model.PMBC Theme.Administrative Structure