Social strain and cardiovascular reactivity to acute psychological stress: Examining the mediating role of self-esteem.

The primary aims of the current study were to (1) examine the association between perceptions of social strain from a spouse/partner, other family members and friends, and cardiovascular reactivity to acute stress, and (2) to identify if the association between perceived social strain and cardiovascular reactivity to acute stress was mediated via self-esteem. A sample of 659 participants completed measures assessing social strain from a spouse/partner, from other family members and from friends, and completed a standardized cardiovascular reactivity protocol consisting of resting baseline and stressor phase (mental arithmetic and Stroop). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were monitored throughout the baseline and stressor phases. Greater social strain from family members and from friends were significantly associated with blunted blood pressure reactivity to acute psychological stress. Moreover, diminished self-esteem significantly mediated the association between social strain from all sources and both cardiovascular and psychological responses to acute stress. Results for the association between social strain and cardiovascular reactivity appeared to remain largely robust in follow-up analyses adjusting for perceived social support from various sources. However, after adjusting for depressive symptoms, both the direct and mediating effects of self-esteem on cardiovascular reactivity became non-significant. The direct association between social strain from family members on diminished blood pressure reactivity withstood adjustment for depression. These findings indicate a potential mechanistic pathway that may facilitate the association between social strain and adverse physical health outcomes.