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  • Writer's pictureNay

Nay Says: Social Ambivalence and Disease

Psychologist Julianne Holt-Lunstad from Brigham Young University and psychologist Bert N. Uchino from the University of Utah constructed a theoretical model looking at how social ambivalence plays a vital role in one’s biological and physical health. Their theory is called Social Ambivalence and Disease, or SAD model.

The SAD model builds off of the preexisting research and evidence linking social relationships to mortality, and creates a template to understand this connection more broadly.

Specifically, the model suggests that Predisposing Antecedent Ambivalence Processes such as transference and personality/individual differences leads to Processes That Maintain Relationship Ambivalence such as internal barriers and coping strategies, which then leads to Interpersonal Mechanisms such as stress enhancement and support interference, which finally leads to Health Relevant Consequences such as acute and chronic disease outcomes.

The investigators classify the dynamic of these social relationships by seeing how the individual perceives and behaves to their network. The relationship with respect to their health is classified as supportive, aversive, indifferent, and ambivalent. The variation of positive and negative aspects of these classifications are further detailed throughout the article. But, the investigators stress the importance of more research and application.

It is mentioned that more focus needs to be on the relationship-specific antecedent processes (previous and common individual experiences), health behaviors and treatment adherence, positive adaptiveness of ambivalent relationships, and on methodology to see if there is a more concrete way of applying the SAD model.

Nonetheless, psychologists need to further research the growing impact that ambivalence has on health, and medical providers need to factor in or assess social ambivalence as it pertains to one’s health.

Nay Says

The SAD model is a well explained and thought out theory that lays the foundation of ambivalence on health. Though these psychologists focused more on biological and physical health, I believe that elements of this theory can be transformed to tackle cognitive and mental health too. Specifically, the act of transference demonstrates that the individual is projecting their own past feelings or attachment upon someone else, which could potentially represent some degree of ambivalence. The individual could then form an insecure attachment that could then lead to unhealthy future experiences and misleading perceptions. The direct link is not outlined in this article, but other research in conjunction with this article may be able to showcase such a clear link.

It was also admirable to see that the researchers believe there is still a wider net to cast on this subject. It is abundantly clear that more needs to be studied, especially since healthcare providers are not valuing the importance of ambivalence in people’s lives. The more research conducted in this arena, the more accepting and receptive healthcare professionals would be in implementing this as part of their consults and assessments for treating a particular patient.

In essence, there is ambivalence about incorporating ambivalence in understanding people’s well-being. But, I am optimistic, since the SAD model has laid the groundwork for everyone to learn and investigate further.

This article is based on the following research:

Holt-Lunstad, J., & Uchino, B. N. (2019). Social Ambivalence and Disease (SAD): A Theoretical Model Aimed at Understanding the Health Implications of Ambivalent Relationships. Perspectives on Psychological Science, 14(6), 941–966.


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