If someone asked me to pick the most influential finding that has come out of relationship science to date, I’d say it’s this: relationships matter for health. In 1988, House and colleagues published their classic research paper showing that social isolation is a powerful predictor of premature death.1 Since then, dozens of studies have tested and consistently replicated this link. Indeed, a recent meta-analysis of 148 studies (over 300,000 participants!) showed that people with stronger social relationships are about 50% more likely to survive over a 7.5 year period compared to those with weak social ties.2 This is a huge effect: it suggests that social isolation is more dangerous than a number of well-established risk factors of mortality, such as obesity and physical inactivity.

In response to these findings, many policy-makers, health practitioners, and members of the general public have started viewing social relationships not just as a nice-to-have, but as a fundamental human need. Humans simply must have close relationships in order to survive and thrive (for a more theoretical discussion about the human need for relationships, see this post). However, the issue of how relationships affect health is not as well-understood. What aspects of social relationships are particularly important (i.e., specificity), and in what way do social relationships influence the body (i.e., mechanism)? These sorts of questions about specificity and mechanism are what many researchers in the field are now grappling with.

In a study recently published in Psychological Science, Slatcher, Selcuk, and Ong3 tested a specific path through which relationships—in this case, romantic relationships—might influence health. They predicted that one aspect of romantic relationships that may be particularly important for health is partner responsiveness.

A responsive partner is someone who makes you feel understood (the feeling that this person “gets” you), validated (they respect your perspectives and feelings), and cared for (they’re concerned about your well-being, and they want the best for you). In a previous post, I talked about how having a responsive partner is like navigating a relationship in easy-mode: it’s much easier to work through issues with a partner who is understanding, validating, and caring, compared to when the partner lacks these characteristics. But there is also some research suggesting that people might in fact be physically healthier when they feel that their partner is responsive to their needs.4,5

How exactly could a partner’s responsiveness “get under the skin” to influence health? Slatcher and colleagues predicted that the partner’s responsiveness might affect cortisol production. Cortisol is a hormone that helps to regulate a diverse set of functions in the human body, ranging from higher-order functions like learning and memory, to more basic functions like immune system responses and the breaking down of food (i.e., metabolism). New research suggests that the body’s rhythm of cortisol production throughout the day has important implications for health. People with “steeper” cortisol profiles—higher cortisol output in the morning, with declining output throughout the rest of the day—tend to have better health outcomes compared to people with flatter cortisol profiles.6,7

Slatcher and colleagues predicted that having a high-quality romantic relationship—in which the person feels that their partner is responsive to their needs—might lead to long-term improvements in how the body produces cortisol. To test this, the researchers analyzed over a thousand participants who were either married or living with their partners. Participants indicated how responsive they thought their partner was by rating how much they thought their partner cared about them, understood their feelings, and appreciated them. Participants also provided four saliva samples per day over a four-day period, so that researchers could determine their cortisol profiles. Ten years later, the same participants again complete the same measures, allowing the researchers to examine how responsiveness might predict changes in cortisol profiles over time.

The researchers found that, indeed, people who felt their partners were more responsive at Time 1 had healthier cortisol profiles ten years later: they had higher cortisol levels shortly after waking up, as well as a steeper decline in cortisol levels throughout the day. This was true even for people who were no longer with the same partner, suggesting that people may benefit from high-quality romantic relationships even after those relationships have ended. Further, these effects held controlling for a number of other relevant factors, such as gender, age, and depressive symptoms, suggesting that the results could not be attributed to these other things. However, the researchers did find that their results were partially explained by negative emotion: people with more responsive partners subsequently tended to experienced fewer negative emotions, which helped to explain their improved cortisol profiles.

These results suggest that having a thoughtful, caring romantic partner, even temporarily, may have a lasting, positive impact on how our bodies function. However, as this is the first study of its kind, more research is needed before we can feel confident about this conclusion, particular the causal link. It’s difficult to say, especially just from this single study, that responsive partners cause people to produce cortisol more effectively. Further, if responsive partners do improve cortisol profiles, it’s not at all clear how that process happens. The negative emotion results give us a clue—perhaps responsive partners lead to steeper cortisol profiles because they help people to regulate their emotions more effectively?—but at this point we can only speculate about the specific mechanisms that might be at work.

The question of why healthy relationships go hand-in-hand with healthy bodies is one of the field’s biggest puzzles. This new study represents one of science’s more ambitious attempts to fit the pieces together.

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Samantha Joel – Science of Relationships articles

Samantha’s research examines how people make decisions about their romantic relationships. For example, what sort of factors do people take into consideration when they try to decide whether to pursue a potential date, invest in a new relationship, or break up with a romantic partner?

1House, J. S., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241, 540-545.

2Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: A meta-analytic review. PLoS Medicine, 7, e1000316.

3Slatcher, R. B., Selcuk, E., & Ong, A. D. (2015). Perceived partner responsiveness predicts diurnal cortisol profiles 10 years later. Psychological Science. Advanced online publication.

4Khan, C. M., Iida, M., Stephens, M. A. P., Fekete, E. M., Druley, J. A., & Greene, K. A. (2009). Spousal support following knee surgery: Roles of self-efficacy and perceived emotional responsiveness. Rehabilitation Psychology, 54, 28-32.

5Seluk, E., & Ong, A. D. (2013). Perceived partner responsiveness moderates the association between received emotional support and all-cause mortality. Health Psychology, 32, 231-235.

6Kumari, M., Shipley, M., Stafford, M., & Kivimaki, M. (2011). Association of diurnal patterns in salivary cortisol with all-cause and cardiovascular mortality: Findings from the Whitehall II study. The Journal of Clinical Endocrinology & Metabolism, 96, 1478-1485.

7Dmitrieva, N. O., Almeida, D. M., Dmitrieva, J., Loken, E., & Pieper, C. F. (2013). A day-centered approach to modeling cortisol: Diurnal cortisol profiles and their associations among U.S. adults. Psychoneuroendocrinology, 38, 2354-2365.

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