Document Type
Article
Publication Date
2-13-2025
Abstract
Objective:
Although growing evidence indicates that distinct affect regulation strategies (e.g., positive reappraisal, anger suppression) predict mortality risk, the biological processes involved remain understudied. We investigated the association of various affect regulation exposures with mortality risk while examining the role of allostatic load.
Method:
In 2004-2006, 1,941 participants from the Midlife in the United States longitudinal study completed validated scales assessing use of nine general and emotion-specific regulatory strategies (e.g., denial, anger expression). A standard deviation-based algorithm was also used to characterize how flexibly participants regulate their affect (lower, moderate, or greater variability). Participants further provided data on relevant covariates and 24 allostatic load biomarkers (e.g., cortisol, glucose). Cox regressions modeled hazard ratios (HRs) and 95% confidence intervals (CI) examined associations of affect regulation variables and all-cause mortality risk until 2022. The confounding, mediating, and moderating role of allostatic load was examined in subsequent models.
Results:
In fully-adjusted models, only greater vs. lower affect regulation variability (HR=1.54; 95%CI=1.11-2.14) significantly predicted a higher mortality risk. Associations were relatively unchanged with further inclusion of allostatic load in models and allostatic load did not mediate affect regulation-mortality relationships. Yet, when evaluating moderation effects, greater vs. lower and moderate variability as well as denial were marginally or significantly related to higher mortality risk among adults with lower allostatic load only.
Conclusions:
Allostatic load may modify rather than confound or mediate the association between some dimensions of affect regulation and mortality risk. Future work should evaluate the potential roles of allostatic load among diverse samples.
Recommended Citation
Ng, Amanda E. PhD, MPH*; Gruenewald, Tara PhD, MPH†; Juster, Robert-Paul PhD‡,§; Trudel-Fitzgerald, Claudia PhD§,∥,¶. Affect Regulation and Mortality Risk: The Role of Allostatic Load. Biopsychosocial Science and Medicine ():10.1097/PSY.0000000000001378, February 13, 2025. | https://doi.org/10.1097/PSY.0000000000001378
Copyright
Society for Biopsychosocial Science and Medicine
Comments
This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Biopsychosocial Science and Medicine in 2025 following peer review. This article may not exactly replicate the final published version. The definitive publisher-authenticated version is available online at https://doi.org/10.1097/PSY.0000000000001378.