Evolving the biobehavioral family model: the fit of attachment.

The 1993 Biobehavioral Family model (BBFM) posits that family relational patterns and biobehavioral reactivity interact so as to influence the physical and psychological health of the children. The revised 1999 BBFM incorporates parent-child attachment as a pivotal construct. The current study tests the 1999 BBFM by predicting, in asthmatic children, that child perception of parental relationship quality, triangulation of child in marital conflict, and parent-child security of relatedness will be associated with hopelessness and vagal activation (one mechanism of airway compromise in asthma). In this study, 22 children with asthma (11 males/11 females, aged 8 to 16), watched, alone, an emotionally challenging movie, then engaged in family discussion tasks (problem solving, loss, conflict, cohesion) and completed the Children's Perception of Interparental Scale, the Relatedness Questionnaire, The Multidimensional Scale of Anxiety in Children, and the Hopelessness Scale for Children. Heart rate variability, measured at baseline and throughout the movie and family tasks, was used to compute respiratory sinus arrhythmia (RSA)--an inferential measure of vagal activation. The child's perception of parental conflict showed trends of association with triangulation and insecure father-child relatedness. Triangulation and hopelessness also were associated with insecure father-child relatedness, all of which were associated with vagal activation. Insecure mother-child relatedness was correlated only with hopelessness. Anxiety was not related to any variables. These findings lend support to the 1999 BBFM, and suggest a key role for parent-child attachment.