Figure 1: SHARED PSYCHOBIOLOGICAL
PATHWAYS MODEL - PMBC-1
The Shared Psychobiological
Pathways Model
 The
model contains five classes of variables. The first category includes
chronic or stable
burdens and resources.
This general category can be further 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.
A
second general class of variables pertains to acute 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 acute precipitating events and disease
and disability. The
pathways are divided into psychological, behavioral, and biological categories.
However, a general theme
of the Mind/Body Center is that these are highly interrelated and
interconnected.
The
psychological pathways refer to cognitive or affective responses, such
as negative affect and
feeling of stress, whereas
the behavioral pathways refer to important health behaviors, such as
smoking. Restorative
activities are listed as a potential behavioral pathway and refer to activities
that rejuvenate or restore
individuals to some equilibrium, such as a valued hobby, in addition to
sleep and physical exercise.
There are many important biological pathways that are relevant on
a disease-specific basis,
but those that are the focus of the Center model refer to processes that
are proposed to be linked
to psychological and behavioral factors and to a number of disease
endpoints.
The
shared pathways studied in our Center projects are cardiovascular, neuroendocrine,
and
metabolic indicators.
A final part of the model is disease-specific outcomes and disability,
the
latter being assessed more
broadly as functional status.
PMBC-I Study Populations
All
analyses addressing the evaluation goals were performed on baseline data
obtained from
studies carried out by PMBC
Investigators. The four studies were:
 1.
Risk
for Respiratory Illness
2.
Risks
for Subclinical Cardiovascular Disease
3.
Osteoarthritis
Interventions
4.
Breast
Cancer Interventions
The sample characteristics
for each study and for the combined sample are presented below
in Table 1.
Table 1: DEMOGRAPHIC
CHARACTERISTICS FOR THE PMBC-1 STUDIES
Evaluating Measures
Evaluation
of PMBC I core psychosocial measures followed three main objectives:
1.
Evaluate reliability and validity of each measure, including their relation
to core biological
measures
assessed in PMBC I projects (With the exception of catecholamine measures
which
were transformed using square root transformation, none of the other summary
indicators
were transformed.)
2.
Examine data reduction possibilities
3.
Identify subset of measures for testing mind-body relationships in future
PMBC studies.
Some scales used across the
PMBC-I projects were shortened based upon published and
unpublished data; items
included were believed to capture the essence of the scale. Also, item
wording as altered in some
cases to accommodate the range of populations used in the PMBC
studies.
A downloadable table of the
descriptive statistics for each of the core (administered in all projects)
and subcore (administered
in some but not all projects) psychosocial measures is available here
in both MS
Word, and pdf formats.
Other
detailed results of these analyses are available upon request.
Conclusions and
Recommendations
The
following criteria were used to select the subset of measures to be recommended
for
future PMBC studies:
1.
Good psychometric qualities
2.
At least moderate (and consistent across studies) bivariate relationships
with other
psychosocial
measures, biological measures and health indicators
3.
Important role within PMBC I model, as established by Canonical Correlation
analyses
Based on the above criteria,
the following Master List of Psychosocial Measures was established:
Social
Network scale
ISEL
Marital
Satisfaction Scale
General
Health Perception question from SF36
Mastery,
Self-esteem, Optimism (MESTOP)
Life
Engagement Test
Hostile
Affect subscale of Cook-Medley Hostility scale
Emotionality
of Big 5 Goldberg Adjective List
Anger-In
sub-scale of Spielberger Anger Expression Scale
Life
Satisfaction Scale
Perceived
Stress
Depression
(CES-D)
Sleep
Efficiency
Restorative
Activities Scale
Core-C
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