MacArthur SES & Health Network
MacArthur SES & Health Network

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Support & Social Conflict: Section Two - Social Conflict

Summary prepared by Teresa Seeman in collaboration with the Psychosocial Working Group. Last revised April 2008.

Chapter Contents

  1. Definition and Background
  2. Measurement
  3. Relation to SES
  4. Relationship to Health
  5. Limitations
  6. Network Usage
  7. Conclusions
  8. Selected Bibliography

Definition and Background

Social conflict refers to the various types of negative social interaction that may occur within social relationships (e.g., arguments, criticism, hostility, unwanted demands), and may include physical violence.


To date, social conflict has been a relatively neglected aspect of social relationships in sociological and epidemiological research on social relationships and health. Existing measures generally consist of a small number of items asking about the frequency of various types of negative social interaction (i.e., demands, criticism); items are generally asked with respect to specific types of relationships (e.g., spouse, friends) (Seeman et al, 1994; Schuster et al, 1990). The Test of Negative Social Exchange (TENSE) provides perhaps the most extensive assessment, with 45 items generating 4 subscales (hostility/impatience, insensitivity, interference, ridicule) (Ruehlman and Karoly 1991). Psychometrics for this measure include alpha coefficients of .7 or higher for all subscales and test-retest reliabilities of .65 or higher. The TENSE also exhibits good convergent and discriminant validity (Ruehlman and Karoly 1991). National data from the Mid-Life in the US (MIDUS) study also show reasonable internal reliability, with coefficient alphas of .79-.81 for scales measuring social conflict with family, friends and spouse (measures derived from (Schuster et al 1990). Evidence of construct validity in terms of correlations with other measures is also seen for MIDUS data (unpublished data).

Relationship to SES

Numerous studies reveal that household income is inversely associated with family conflict and turmoil ((Conger and Donnellan 2007) (Conger and Elder 1994) (Evans 2004) (Bradley and Corwyn 2002) (Stoneman and others 1999; Taylor and others 1997)) as well as higher levels of social conflict more generally in adults (Ryff, Seeman, unpublished analyses of MIDUS data), (Schuster and others 1990) and children (Bolger and others 1995).

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Relationship to Health

Research on links between social conflict and health outcomes in adults is considerably less extensive than that focused on social support. The most consistent evidence points to the strong relationship between conflict and poorer psychological well-being ((Ruehlman and Karoly 1991) (Burg and Seeman 1994)); evidence also points to links between hostility and coronary heart disease ((Smith 1992) (Smith and others 2004)). Evidence for health effects among children is largely related to psychological and/or behavioral outcomes ((Erel and Burman 1995) (Hetherington and others 1998) (Cummings and Davies 1994) (Gerard and others 2006) (Grych and Fincham 1990) (Dogan and others 2007) (Harold and Conger 1997) (Buehler and others 2007) (Davies and Cummings 1994) (Davies and others 2002) (Grych and Fincham 1990)).

Growing research corroborates the potentially negative health impacts of social conflict, showing relationships between social conflict and greater physiologic arousal both with respect to blood pressure ((Ewart and others 1991) (Gerin and others 1992)) and neuroendocrine activity (Kiecolt-Glaser and others 1994) as well as greater psychological distress ((Schuster and others 1990) (Rook 1990) for review see also (Burg and Seeman 1994)). To date, evidence linking social conflict and health is largely indirect, stemming from research linking hostility to cardiovascular risks and longevity ((Smith and others 2004) (Smith 1992)) along with related evidence that those reporting greater hostility also report greater interpersonal conflict and appear to be more physiologically reactive to such conflict ((Hardy and Smith 1988) (Smith and others 2004)).

As in the case of adults, children exposed to social conflict exhibit heightened physiological reactivity. Preschoolers exposed to videotapes of angry adult interactions exhibit increases in heart rate and blood pressure (El-Sheikh and others 1989) along with impaired cortisol mobilizations (Davies and others 2007) and elevated catecholamines ((Gottman and Katz 1989) (Katz and Gottman 1995)). Children's sleep quality is also impaired among those living in more conflicted households (El-Sheikh and others 2006). Both children and adults from family environments with greater hostility and less cohesion and warmth manifest greater physiological reactivity to stressors ((Luecken and Lemery 2004) (Luecken 1998) (Taylor and others 2004) (Woodall and Matthews 1989) (Wright and others 1998) (Wright and others 1993)). Research also demonstrates relationships between childhood exposure to conflict and/or physical violence and increased risks for depression ((Burge and Hammen 1991) (Downey and Walker 1992) (Koverola and others 1993)), headaches and stomachaches (Mechanic and Hansell 1989), shorter stature at ages 7 and 33 (Montgomery and others 1997) as well as increased risk of heart attack (O'Rand and Hamil-Luker 2005) and mortality (Sorenson and Peterson 1994). Increased levels of reported stressors in both day-care and family environments (some reflecting social stressors) have also been related to increased incidence of respiratory illness though specific measures of family conflict were not related to illness (Boyce and others 1995).

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Currently the greatest limitations relate to the relative lack of attention to this aspect of social relationships. They include both the lack of good measurement instruments as well as the lack of specific research focusing on more negative aspects of social interaction, either with respect to their relative prevalence across population subgroups (i.e., descriptive research) or their relationship to health outcomes.

Network Usage

Measures of social conflict are currently under investigation using data from both the Successful Aging cohort, the Mid-Mac (MIDUS) national survey as well as data developed by the MacArthur SES network based on the Coronary Artery Risk Development in Young Adults (CARDIA) study.


This area of research has, to date, received much less attention than have more positive aspects of social interactions in terms of potential relationships to health outcomes. Existing data suggest that more negative aspects of social interaction are importantly and negatively related to both SES and health, suggesting that we should include consideration of both more negative as well as more positive characteristics of individuals social ties in our models of SES and health. As in the case of social support, there is no established measure of negative aspects of social interactions, though the psychometric data from the Mid-Mac scales suggests that these may be a good first choice. At this time, there has been little or no research on the possible role of such negative social interactions in the SES-health model. As with positive social interactions, it is likely that negative qualities of social interactions function as mediators and moderators of SES effects on health. However, all of these relationships remain to be investigated.

Selected Bibliography

Bolger KE, Patterson CJ, Thompson WW, Kupersmidt JB. (1995) Psychosocial Adjustment among Children Experiencing Persistent and Intermittent Family Economic Hardship. Child Dev 66(4):1107-1129.

Boyce WT, Chesney M, Alkon A, Tschann JM, Adams S, Chesterman B, Cohen F, Kaiser P, Folkman S, Wara D. (1995) Psychobiologic reactivity to stress and childhood respiratory illnesses: results of two prospective studies Psychosom Med 57(5):411-422.

Bradley RH, Corwyn RF. (2002) Socioeconomic status and child development. Annu Rev Psychol 53:371-99.

Buehler C, Lange G, Franck KL. (2007) Adolescents' cognitive and emotional responses to marital hostility. Child Dev 78(3):775-89.

Burg MM, Seeman TE. (1994) Families and Health: the negative side of social ties. Ann Behav Med 16:109-115.

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Burge D, Hammen C. (1991) Maternal communication: predictors of outcome at follow-up in a sample of children at high and low risk for depression. J Abnorm Psychol 100(2):174-80.

Conger RD, Donnellan MB. (2007) An interactionist perspective on the socioeconomic context of human development. Annu Rev Psychol 58:175-99.

Conger RD, Elder GH, Jr. (1994) Families in troubled times. New York: Aldine de Gruyter.

Cummings EM, Davies PT. (1994) Children and marital conflict: The impact of family dispute and resolution. New York: Guilford.

Davies PT, Cummings EM. (1994) Marital conflict and child adjustment: an emotional security hypothesis. Psychol Bull 116(3):387-411.

Davies PT, Harold GT, Goeke-Morey MC, Cummings EM, Shelton K, Rasi JA. (2002) Child emotional security and interparental conflict. Monogr Soc Res Child Dev 67(3):i-v, vii-viii, 1-115.

Davies PT, Sturge-Apple ML, Cicchetti D, Cummings EM. (2007) The role of child adrenocortical functioning in pathways between interparental conflict and child maladjustment. Dev Psychol 43(4):918-30.

Dogan SJ, Conger RD, Kim KJ, Masyn KE. (2007) Cognitive and parenting pathways in the transmission of antisocial behavior from parents to adolescents. Child Dev 78(1):335-49.

Downey G, Walker E. (1992) Distinguishing family-level and child-level influences on the development of depression and aggression in children at risk. Dev Psychopathol 4:81-95.

El-Sheikh M, Buckhalt JA, Mize J, Acebo C. (2006) Marital conflict and disruption of children's sleep. Child Dev 77(1):31-43.

El-Sheikh M, Cummings EM, Goetsch V. (1989) Coping with adults' angry behavior: behavioral, physiological, and self-report responding in preschoolers. Dev Psychol 325:490-498.

Erel O, Burman B. (1995) Interrelatedness of marital relations and parent-child relations: a meta-analytic review. Psychol Bull 118(1):108-32.

Evans GW. (2004) The environment of childhood poverty. Am Psychol 59(2):77-92.

Ewart CK, Taylor CB, Kraemer HC, Agras WS. (1991) High blood pressure and marital discord: not being nasty matters more than being nice. Health Psychol 10(3):155-63.

Gerard JM, Krishnakumar A, Buehler C. 2006. Marital conflict, parent-child relations, and youth maladjustment J Fam Issues 27(7):951-975.

Gerin W, Pieper C, Levy R, Pickering TG. (1992) Social support in social interaction: a moderator of cardiovascular reactivity. Psychosom Med 54(3):324-36.

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Gottman JM, Katz LF. (1989) Effects of marital discord on young children's peer interaction and health. Dev Psychol 25(3):373-381.

Grych JH, Fincham FD. (1990) Marital conflict and children's adjustment: a cognitive-contextual framework. Psychol Bull 108(2):267-90.

Hardy JD, Smith TW. (1988) Cynical hostility and vulnerability to disease: social support, life stress, and physiological response to conflict. Health Psychol 7(5):447-59.

Harold GT, Conger RD. (1997) Marital conflict and adolescent distress: the role of adolescent awareness. Child Dev 68(2):333-50.

Hetherington EM, Bridges M, Insabella GM. (1998) What matters? What does not? Five perspectives on the association between marital transitions and children's adjustment. Am Psychol 53(2):167-84.

Katz LF, Gottman JM. (1995) Vagal tone protects children from marital conflict. Dev Psychopathol 7:83-92.

Kiecolt-Glaser JK, Malarkey WB, Cacioppo JT, Glaser R. (1994) Stressful personal relationships: immune and endocrine function. In: Glaser R, Kiecolt-Glaser JK, editors. Handbook of Human Stress and Immunity. San Diego: Academic Press. p 321339.

Koverola C, Pound J, Heger A, Lytle C. (1993) Relationship of child sexual abuse to depression. Child Abuse Negl 17(3):393-400.

Luecken LJ. (1998) Childhood attachment and loss experiences affect adult cardiovascular and cortisol function. Psychosom Med 60(6):765-72.

Luecken LJ, Lemery KS. (2004) Early caregiving and physiological stress responses. Clin Psychol Rev 24(2):171-91.

Mechanic D, Hansell S. (1989) Divorce, family conflict, and adolescents' well-being. J Health Soc Behav 30(1):105-16.

Montgomery SM, Bartley MJ, Wilkinson RG. (1997) Family conflict and slow growth. Arch Dis Child 77(4):326-30.

O'Rand AM, Hamil-Luker J. (2005) Processes of cumulative adversity: childhood disadvantage and increased risk of heart attack across the life course. J Gerontol B Psychol Sci Soc Sci 60 Spec No 2:117-24.

Rook KS. (1990) Parallels in the study of social support and social strain. J Soc Clin Psychol 9:118-132.

Ruehlman LS, Karoly P. (1991) With a little flak from my friends: Development and preliminary validation of the Test of Negative Social Exchange (TENSE). Psychol Assess: J Consult Clin Psychol 3(1):97-104.

Schuster TL, Kessler RC, Aseltine RH, Jr. (1990) Supportive interactions, negative interactions, and depressed mood. Am J Community Psychol 18(3):423-38.

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Seeman TE, Berkman LF, Blazer D, Rowe JW. (1994) Social ties and support and neuroendocrine function. MacArthur Studies of Successful Aging. Ann Behav Med 16:95-106.

Smith TW. (1992) Hostility and health: current status of a psychosomatic hypothesis. Health Psychol 11(3):139-50.

Smith TW, Glazer K, Ruiz JM, Gallo LC. (2004) Hostility, anger, aggressiveness, and coronary heart disease: an interpersonal perspective on personality, emotion, and health. J Pers 72(6):1217-70.

Sorenson SB, Peterson JG. (1994) Traumatic child death and documented maltreatment history, Los Angeles. Am J Public Health 84(4):623-7.

Stoneman Z, Brody GH, Churchill SL, Winn LL. (1999) Effects of residential instability on Head Start children and their relationships with older siblings: influences of child emotionality and conflict between family caregivers. Child Dev 70(5):1246-62.

Taylor SE, Lerner JS, Sage RM, Lehman BJ, Seeman TE. (2004) Early environment, emotions, responses to stress, and health. J Pers 72(6):1365-93.

Taylor SE, Repetti RL, Seeman T. (1997) Health psychology: what is an unhealthy environment and how does it get under the skin? Annu Rev Psychol 48:411-47.

Woodall KL, Matthews KA. (1989) Familial environment associated with type A behaviors and psychophysiological responses to stress in children. Health Psychol 8(4):403-26.

Wright LB, Treiber F, Davis H, Bunch C, Strong WB. (1998) The role of maternal hostility and family environment upon cardiovascular functioning among youth two years later: socioeconomic and ethnic differences. Ethn Dis 8(3):367-76.

Wright LB, Treiber FA, Davis H, Strong WB, Levy M, Van Huss E, Batchelor C. (1993) Relationship between family environment and children's hemodynamic responses to stress: a longitudinal evaluation. Behav Med 19(3):115-21.

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