Elsevier

Brain, Behavior, and Immunity

Volume 58, November 2016, Pages 272-279
Brain, Behavior, and Immunity

Full-length Article
Social role conflict predicts stimulated cytokine production among men, not women

https://doi.org/10.1016/j.bbi.2016.07.156Get rights and content

Highlights

  • Participants identified the most important roles and role conflict in their life.

  • Among men only, greater role conflict predicted greater inflammation.

  • Among men only, greater role conflict predicted less glucocorticoid sensitivity.

Abstract

Objective

To assess whether perceived role conflict is associated with stimulated pro-inflammatory cytokine production and glucocorticoid sensitivity, and whether these associations are moderated by sex.

Methods

153 healthy adults (aged 45.8 ± 5.5 years, 78% female) listed their 3 main social roles and indicated the amount of role conflict they perceived between each pair of social roles. Subsequently, participants underwent blood draws and leukocyte response to microbial challenge and glucocorticoid sensitivity were assessed by incubating whole blood with lipopolysaccharide (LPS) in the presence or absence of hydrocortisone. Stimulated levels of Interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor alpha (TNFα) were measured.

Results

Multiple regression analyses controlling for sociodemographics revealed significant sex × role conflict interactions for LPS-stimulated production of IL-1β, IL-6, and TNFα (all interaction ps < 0.05), and a marginal interaction on LPS-stimulated IL-8 production (interaction p < 0.10). Greater perceived role conflict was associated with greater pro-inflammatory cytokine production in response to microbial stimulation only among men, not women. There also were significant sex × role conflict interactions with respect to glucocorticoid sensitivity for IL-1β, IL-6, and TNFα production (all interaction ps < 0.05) and a marginal interaction for IL-8 (interaction p < 0.10). Greater perceived role conflict was unrelated to glucocorticoid sensitivity among women, but associated with less sensitivity to glucocorticoid signaling among men.

Conclusions

Perceived social role conflict, indicating greater perceived demand across multiple social roles, may take a greater toll on the regulation of inflammatory processes among men compared to women.

Introduction

Inhabiting multiple social roles is an integral part of people’s lives and finding a successful balance of meaningfully engaging in while simultaneously meeting the demands of different social roles represents an important contributor to a person’s well-being. Many studies have focused on the importance of social roles, although definitions, measures, and underlying theories vary greatly across studies. Most notably, the existing literature supports both the idea of role strain (Goode, 1960), which suggests that inhabiting more roles increases demands on the individual and comes at a cost with respect to overall well-being, as well as the idea of role enhancement (Sieber, 1974), which suggests that inhabiting more roles provides a more enriching and gratifying life experience.

The influence of social roles on outcomes related to physical health is understudied and existing findings differ depending on whether quantitative aspects (e.g., the number of social roles) or qualitative aspects (e.g., role conflict) are being considered. With respect to quantity, having more social roles is typically associated with health benefits, including reduced mortality risk over a 15-year period (Tamakoshi et al., 2013) and lower risk of chronic illness and need for prolonged medication use due to chronic illness (Nordenmark, 2004). Perhaps this indicates that people with more social roles are better integrated socially or have a greater sense of purpose in life (Uchino, 2006, Berkman et al., 2000). Several studies that focused on women have also found that a greater number of social roles is associated with better overall self-reported health (Collijn et al., 1996), lower prevalence of common health symptoms and chronic diseases (Lee and Powers, 2002), and lower risk of long-term sickness absence at work (Staland Nyman et al., 2012). Moreover, at least one study finds that the association between social roles and self-reported health is not explained by selection effects of those who are in better health being able to take on multiple roles (McMunn et al., 2006). However, it is important to note that studies focusing on the effects of an individual’s number of social roles are often limited by focusing on a select number of specific roles – that is, being a spouse, parent, and employee.

Other studies have linked qualitative aspects of social roles to health – for example, perceptions of role conflict – that is, the extent to which the responsibilities and demands associated with particular roles interfere with individuals’ abilities to fulfill the (at times competing) demands of other roles. Two studies focused on women linked greater levels of role conflict to poorer mental health and general health symptoms (Hecht, 2001, Oster and Scannell, 1999). In addition, one study focusing on physicians found that greater role conflict was associated with greater somatic complaints (Pomaki et al., 2007). These associations may be due to conflicting demands across roles resulting in higher levels of ongoing chronic stress for the individual experiencing role conflict (Terrill et al., 2012).

Shortcomings in most of these studies include the fact that participants are not provided with the opportunity to list their most important roles themselves, that previous studies have mostly focused on women, and that they have relied on self-reported health measures. With respect to the first, the frequently used coding of participants as spouse, parent, and employee is overly simplistic and problematic in that it focuses only on a small number of prescribed roles and assumes that these indeed are the most relevant to all participants in the study. Although this may be true for many, it is possible that participants would have chosen to include other social roles as being among the most meaningful to them, e.g., ‘friend’ or ‘athlete’. Similarly, this approach is overly simplistic in that it does not take into account the perceived quality of a role, i.e. how much individuals enjoy acting in a particular role, nor does it take into account how the demands of individual roles relate to each other. These are all aspects of social roles that have been shown to have effects on outcomes related to mental and physical health (Perrone and Civiletto, 2004, Plach, 2007, Plaisier et al., 2008, Reid and Hardy, 1999). Hence, letting participants spontaneously identify the most important roles they inhabit themselves and asking them to indicate perceived role conflict across these roles may result in a more valid assessment of roles and role conflict.

In addition, many of the studies investigating the influence of social roles on health outcomes have focused exclusively on women e.g., (Lee and Powers, 2002, McMunn et al., 2006, Staland Nyman et al., 2012). Two exceptions include the large-scale studies discussed above that reported an association between social roles and mortality and risk of chronic illnesses in a sample that included both men and women (Tamakoshi et al., 2013, Nordenmark, 2004). Another study found that multiple social roles were beneficial with respect to self-reported health among women but unrelated to self-reported health among men (Janzen and Muhajarine, 2003). Hence more research comparing the association between social roles and health across both men and women is needed to investigate whether patterns are similar across gender, especially in light of other research suggesting differing associations between psychosocial variables, such as social network support, and health among men and women (Shumaker and Hill, 1991, Shye et al., 1995).

Lastly, although some studies have addressed the links between social roles and health, most have focused on self-reported prevalence of symptoms, chronic illness, and general health. To our knowledge, no studies have examined the links between social roles and underlying physiological mechanisms that may help explain how and why social roles are associated with clinical health outcomes. Consequently, the present study focused on inflammation mechanisms by assessing the relations between perceived role conflict and in vitro production of pro-inflammatory cytokines following bacterial stimulation of immune cells, as well as on in vitro measures of glucocorticoid sensitivity. Greater pro-inflammatory responses to microbial challenge, and/or reduced glucocorticoid sensitivity, are indicative of poorer regulation of inflammatory processes, and if maintained over the long-term may increase risk for diseases involving inflammation. Taking advantage of ex vivo microbial challenge allows for the evaluation of the functional properties of monocytes under controlled conditions that could not ethically be performed in vivo, and as such provides important insights into important aspects of immune functioning. Previous studies have shown increased stimulated pro-inflammatory responses to bacterial challenge as well as reduced glucocorticoid sensitivity in response to other types of stressful life situations (Glaser and Kiecolt-Glaser, 2005, Miller et al., 2009, Miller et al., 2014).

In sum, the focus of the present study was to investigate the links between perceived role conflict (based on participant self-report of their most important social roles) and inflammatory outcomes including stimulated pro-inflammatory cytokine production in response to bacterial stimuli, as well as sensitivity of immune cells to glucocorticoid inhibition. We also tested moderating effects of sex to expand on the existing literature which has largely focused on evaluating the effects of social role conflict among women only and, when comparing men and women, has found contradictory effects. We hypothesized that greater perceived role conflict would be associated with heightened pro-inflammatory cytokine responses to bacterial stimuli and less sensitivity to the anti-inflammatory properties of cortisol. Given that existing studies have linked social roles in general as well as role conflict specifically to health-related outcomes among women (rather than men), we furthermore hypothesized that role conflict would more strongly predict pro-inflammatory cytokine responses and glucocorticoid sensitivity among women compared to men.

Section snippets

Participants

Participants were 153 healthy adults (aged 45.8 ± 5.5 years, 78% female) recruited as part of a larger study focused on adolescents and their families. The present analyses focused on participating parents. For this community-based sample, participating families were invited to participate with one adolescent child and either parent. In most cases mothers chose to participate. All participants were recruited through advertisements in the local media in the larger Vancouver, BC area between January

Results

Of the 459 roles reported across all participants, 317 (69.1%) roles pertained to family life (e.g., ‘father’, ‘daughter’, ‘spouse’); 64 (13.9%) roles pertained to participants’ social life (e.g., ‘friend’); 59 (12.9%) roles pertained to participants’ professional life (e.g., ‘employee’); 13 (2.8%) roles pertained to leisure activities (e.g., ‘athlete’); 6 (1.3%) roles pertained to involvement with organizations (e.g., ‘volunteer’). Men and women did not differ with respect to the types of

Discussion

To our knowledge, this is the first study to show an association between perceived role conflict and inflammatory processes including pro-inflammatory cytokine production in response to microbial challenge and glucocorticoid sensitivity. Specifically, we found that, among men, greater role conflict was associated with greater LPS-stimulated pro-inflammatory cytokine production, and as well with lower sensitivity of immune cells to the inhibitory properties of cortisol. These effects persisted

Conflict of interest and source of funding

The authors report no conflict of interest. This study was funded by the Canadian Institutes of Health Research (grant funding reference number: 97872; EC).

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