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Background: Individuals engage in a range of behaviors to maintain close relationships. One behavior is self-silencing or inhibiting self-expression to avoid relationship conflict or loss. Self-silencing is related to poor mental health and self-reported physical health in women but has not been examined in relation to cardiovascular health, particularly using direct measures of the vasculature., Purpose: To test associations between self-silencing and carotid atherosclerosis in midlife women; secondary analyses examined moderation by race/ethnicity., Methods: Women (N = 290, ages 40-60) reported on self-silencing in intimate relationships and underwent physical measurements, blood draw, and ultrasound assessment of carotid intima-media thickness (IMT) and plaque. Associations between self-silencing and mean IMT and plaque index (0, 1, ≥2) were tested in linear regression and multinomial logistic regression models, respectively, followed by interaction terms between self-silencing and race, adjusted for demographic factors, CVD risk factors, partner status, depression, physical activity, and diet., Results: Forty-seven percent of women demonstrated carotid plaque. Greater self-silencing was related to increased odds of plaque index ≥2 (e.g., for each additional point, odds ratio [95% confidence interval] = 1.16 [1.03-1.31], p = .012), relative to no plaque). Moderation analyses indicated that self-silencing was related to odds of plaque index ≥2 in non-white women (1.15 [1.05-1.26], p = .004), but there was no significant relationship in white women (1.01 [0.97-1.06], p = .550). No associations emerged for IMT., Conclusions: Among midlife women, self-silencing was associated with carotid plaque, independent of CVD risk factors, depression, and health behaviors. Emotional expression in relationships may be important for women's cardiovascular health., (© Society of Behavioral Medicine 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Exposure to low socioeconomic status (SES) in childhood predicts increased morbidity and mortality. However, little prospective evidence is available to test pathways linking low childhood SES to adult health., Purpose: In the current study, indirect effects through positive parenting in adolescence and adult SES were tested in the association between childhood SES and adult health behaviors and psychological resources., Methods: Men (n = 305; 53% Black) were followed longitudinally from ages 7 to 32. SES was measured annually in childhood (ages 7-9) and again in adulthood (age 32) using the Hollingshead index. Parenting was assessed annually (ages 13-16) using caregivers' and boys' self-report of supervision, communication, and expectations for their son's future. Health behaviors (cigarette and alcohol use, fruit and vegetable consumption, and physical activity) and psychological resources (optimism, purpose in life, self-mastery, and self-esteem) were assessed in adulthood (age 32)., Results: Structural equation modeling showed that higher childhood SES was associated with more positive parenting in adolescence and higher adult SES. Higher childhood SES was indirectly associated with healthier behaviors and higher psychological resources in adulthood through pathways involving positive parenting during adolescence and SES in adulthood. Findings were consistent in both racial groups., Conclusions: Positive parenting in adolescence was an important pathway in understanding associations among childhood SES and health behaviors and psychological resources in adulthood. Low childhood SES was prospectively associated with healthier behaviors and greater psychological resources in part through more positive parenting in adolescence.