The biobehavioral family model as a framework for examining the connections between family relationships, mental, and physical health for adult primary care patients

Family and romantic relationships have been linked to adults' mental and physical health. Previous research has not explored possible mediators of these associations. The Biobehavioral Family Model (BBFM) is a biopsychosocial approach to health that integrates family emotional climate, biobehavioral reactivity (emotion dysregulation), and physical health outcomes into a comprehensive model. The present study examined the ability of the BBFM to explain connections between family processes and health for primarily uninsured, low-income adult primary care patients. Patient participants (18-65 years) reported their family functioning, romantic relationship satisfaction, anxiety, depression, illness symptoms, and physical well-being (n =125). We used path analyses to test separate models using family functioning and romantic relationship satisfaction as measures of family emotional climate. For Model 1, pathways between family functioning and depression, and depression and disease activity were significant, whereas the pathway between family functioning and disease activity was nonsignificant, indicating a mediation relationship. Anxiety also fits as an additional mediator (Χ² =4.135, p = 0.247, CFI = 0.992, RMSEA = 0.055). For Model 2, a significant mediation relationship was found; depression and anxiety mediate the association between romantic relationship satisfaction and disease activity (Χ₂ =11.309, p = 0.503, CFI =1.000, RMSEA = 0.000). Findings support the ability of the BBFM to explain the health quality of low-income, urban primary care patients. We offer clinical implications and recommendations for future research.