Psychological well-being, psychological distress, and clinical depression are manifestations of mental health studied in relation to social ties and health behavior. Following past research (Gorman & Read 2006, Uchino 2004), we made mental health a central component of our conceptual model. In Figure 1, mental health is a mediator of mediators—it is viewed as a channel through which other focal mediators of the social ties/health habits link operate. For example, social ties provide support that enhances psychological well-being as well as stress that contributes to psychological distress, which, in turn, is associated with increased physiological arousal (e.g., heart rate, stress hormones) that elicits behavioral coping responses and with greater propensities for unhealthy behavior in general (Kiecolt-Glaser & Glaser 2002). Importantly, mental health is likely a key source of bidirectionality in our model (not depicted in Figure 1) (Kassel et al. 2003). After all, mental health shapes the formation and quality of social ties throughout life (Repetti et al. 2002). Given the interplay of mental health with other explanatory mechanisms, we have already discussed mental health extensively in laying out the other pieces of the conceptual model. As such, we do not recap that research here.
