A psychological factor apparently associated with neoplastic disease.

"A growing body of literature suggests that there are some correlations between personality organization and the occurrence of malignant disease… . Our data suggest that under certain conditions, early emotional trauma [in this instance, early birth of a sib] may interact with other factors and play a part in the etiology of a later malignancy… psychological factors apparently must be viewed as being of some significance in the development of malignant disease, and to integrate this knowledge with the physiological findings in this field" is needed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial and socioeconomic factors associated with glycated hemoglobin in nondiabetic middle-aged men and women.

The authors tested associations between glycated hemoglobin (HbA1c; an index of glucose homeostasis and an indicator of cardiovascular disease risk in nondiabetic populations) and socioeconomic status (defined by grade of employment) and psychosocial factors in 234 British civil servants. HbA1c concentration was inversely related to grade of employment. Higher HbA1c was associated with greater waist-hip ratio, lower control at work, lower internal locus of control, lower active coping, and lower social support. Control at work, internal and chance locus of control, and active coping were also related to socioeconomic status. The association of social support but not other psychosocial factors with HbA1c, was independent of socioeconomic status. HbA1c may complement measures of the metabolic syndrome and insulin resistance in studies of psychosocial factors in cardiovascular disease risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital status and quality in middle-aged women: Associations with levels and trajectories of cardiovascular risk factors.

The current study compared cardiovascular risk profiles and trajectories (i.e., within-person changes) of women who were married or cohabitating and who had high relationship satisfaction with those of women with moderate or low satisfaction and with those of women who were single, divorced, and widowed. Participants were 493 women from the Healthy Women Study, a prospective investigation of health during and after the menopausal transition. Risk factors were measured across more than 5 occasions and 13 years, on average. Data were analyzed using a multilevel modeling technique. Overall, women in relationships with high satisfaction had lower levels of biological, lifestyle, and psychosocial risk factors when compared with the other groups. In some cases, women in satisfying marriages also showed a lower risk trajectory on risk factors relative to other women. Hence, marriage appears to confer health benefits for women, but only when marital satisfaction is high. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subjective social status, objective socioeconomic status, and cardiovascular risk in women.

Objective: Subjective perceptions of personal social status may relate to health beyond the effects of objective socioeconomic status (SES). The authors examined the relationship between subjective social status (SSS) and psychosocial, behavioral, and physical cardiovascular risk factors in middle-aged women. Design: Ninety-two women (90.2% White) completed ladder-based, pictorial self-report measures of SSS relative to others in their community and in the United States. Psychosocial measures of depression, anxiety, pessimism, stress, and social support and behavioral risk factors of fruit and vegetable consumption, leisure physical activity, and body-mass index were obtained. In addition, women underwent measurement of clinic blood pressure and assessment of daytime ambulatory systolic and diastolic blood pressure (SBP; DBP) over 2 consecutive days. Results: Community SSS was significantly inversely related to anxiety, pessimism, stress, and daytime ambulatory DBP after controlling for objective SES and U.S. SSS. Women with lower U.S. SSS showed less healthy dietary and exercise behaviors and, contrary to predictions, lower clinic and ambulatory DBP. Conclusion: This study provides additional evidence that perceptions of one's position in the social hierarchy could have important health implications beyond the impact of objective SES. Further, the cardiovascular risk implications of perceived community versus U.S. social status appear to be distinct. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Burnout and risk of cardiovascular disease: Evidence, possible causal paths, and promising research directions.

Burnout is characterized by emotional exhaustion, physical fatigue, and cognitive weariness, resulting from prolonged exposure to work-related stress. The authors review the accumulated evidence suggesting that burnout and the related concept of vital exhaustion are associated with increased risk of cardiovascular disease and cardiovascular-related events. The authors present evidence supporting several potential mechanisms linking burnout with ill health, including the metabolic syndrome, dysregulation of the hypothalamic-pituitary-adrenal axis along with sympathetic nervous system activation, sleep disturbances, systemic inflammation, impaired immunity functions, blood coagulation and fibrinolysis, and poor health behaviors. The association of burnout and vital exhaustion with these disease mediators suggests that their impact on health may be more extensive than currently indicated. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress symptoms and subclinical cardiovascular disease in police officers.

The present study examined associations of posttraumatic stress disorder (PTSD) symptoms with subclinical cardiovascular disease in police officers. A stratified sample of 100 police officers was randomly selected from the Buffalo, New York, Police Department. Cardiovascular disease biomarkers were assessed by ultrasound of the brachial artery (flow-mediated dilation [FMD]). PTSD symptoms were measured with the Impact of Event Scale (IES). FMD was lowest in the severe PTSD symptom category when compared to the mild PTSD symptom category (1.91 vs. 5.15% increase, respectively; p=.21) even after adjustment for lifestyle and demographics. In conclusion, higher PTSD symptomatology in this police sample was associated with a nearly twofold reduction in brachial artery FMD, a biomarker for subclinical cardiovascular disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mastery, sense of coherence, and mortality: Evidence of independent associations from the epic-norfolk prospective cohort study.

This study investigated the association between 2 distinct personal coping resources (mastery and sense of coherence) and all-cause, cardiovascular, and cancer mortality. During follow-up (up to 6 years), 994 deaths were recorded among 20,323 participants, ages 41 to 80 years, in the European Prospective Investigation into Cancer Study in the United Kingdom. A strong sense of mastery was associated with lower rates of mortality from all causes, cardiovascular disease, and cancer, after adjusting for age, sex, and prevalent chronic physical disease. The association with all-cause mortality was observed for both men and women and remained following further adjustment for cigarette smoking, social class, hostility, neuroticism, and extroversion. Analysis of the joint association between mastery and sense of coherence revealed both personal coping dispositions to be independently associated with lower rates of all-cause mortality. In addition, these data suggested that the association for mastery was specific to cardiovascular mortality, whereas the association for sense of coherence was specific to cancer mortality. These results may aid future study of coping resources as determinants of persistent well-being. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Occupation and subclinical carotid artery disease in women: Are clerical workers at greater risk?

The current study examined cardiovascular risk factors and carotid atherosclerosis in 362 women (ages 42-50 years) who were working in clerical, blue-collar, or white-collar jobs or who were not employed. Risk factors were measured premenopausally and ultrasound measures of carotid atherosclerosis were obtained approximately 11 years later. Clerical and blue-collar workers had more atherogenic profiles on physical, behavioral, and psychosocial risk factors when compared with white-collar and nonemployed women. Clerical workers had greater carotid intima-media thickness relative to all other groups and more focal plaque when compared with white-collar workers. Risk factors and workplace characteristics did not account for the greater carotid atherosclerosis observed in clerical workers. Further research is needed to investigate why clerical work may increase cardiovascular risk. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Major depressive disorder is associated with attenuated cardiovascular reactivity and impaired recovery among those free of cardiovascular disease.

Objective: To examine cardiovascular reactivity and recovery to laboratory stress among a naturalistic sample of individuals diagnosed with major depressive disorder (MDD) and healthy control participants. Prospective evidence suggests that MDD confers risk for cardiovascular disease equal to or greater than the risk associated with depressed mood. Enhanced cardiovascular reactivity has been proposed as a mechanism explaining increased risk, but data are inconsistent as to whether depressed individuals exhibit enhanced or attenuated reactivity. Further, few studies have examined appraisal and recovery differences. Design: Participants diagnosed with MDD (N = 25) and healthy control participants (N = 25) engaged in a cardiovascular reactivity protocol including 2 tasks, each followed by a brief recovery period. Main outcome measures: Blood pressure, heart rate, pre-ejection period, cardiac output and total peripheral resistance were assessed. Appraisals of tasks were assessed prior to each task. Results: Depressed participants exhibited significantly less systolic blood pressure, heart rate, and cardiac output reactivity during speech, less heart rate reactivity during mirror tracing, and less heart rate recovery after speech and mirror tracing than controls. Depressed participants appraised the tasks as more demanding, threatening, and stressful and reported being less able to cope than controls. Appraisals were related to heart rate reactivity, but appraisals did not mediate the relationship between depression group and reactivity. Conclusion: Impaired recovery rather than exaggerated cardiovascular reactivity may partially explain the increased prospective cardiovascular disease risk in depressed individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Misperceived risk among female adolescents: Social and psychological factors associated with sexual risk accuracy.

This study of 411 urban female adolescents had 3 objectives: (a) assess the relationship between perceived risk and sexual risk behavior (condom use, number of partners, partner risk, presence of STDs, and aggregate sexual risk), (b) assess the accuracy of risk perceptions, and (c) identify variables related to inaccurate sexual risk perceptions. Participants were classified as accurate or inaccurate risk perceivers on the basis of actual sexual behavior and perceived risk. Accurate versus inaccurate risk perceivers were compared on psychological maintenance variables (self-esteem, distress, and coping), relationship context variables (partnership duration and pressure to have unprotected sex), and risk knowledge at different levels of sexual risk. Approximately half of the participants underestimated the risk of their sexual behavior. Accurate and inaccurate risk perceivers differed on risk knowledge, partnership duration, and pressure to have unprotected sex. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hostility predicts metabolic syndrome risk factors in children and adolescents.

The authors tested in 134 African American and European American children whether hostility measured at study entry predicted the metabolic syndrome risk factors an average of 3 years later. Hostility was measured with the Cook-Medley Hostility Scale (W. W. Cook & D. M. Medley, 1954) and with ratings of Potential for Hostility from interview responses. Metabolic syndrome was based on having at least 2 of the following risk factors above the 75th percentile of scores for their age, race, and gender group: body mass index, insulin resistance index, ratio of triglycerides to high-density lipoprotein cholesterol, and mean arterial blood pressure. Children who exhibited high hostility scores at baseline were likely to exhibit the metabolic syndrome at the follow-up. The results highlight the potential importance of early prevention and intervention of behavioral risk factors for cardiovascular disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Smoking is associated with higher cardiovascular risk in young women than in men: the Tecumseh Blood Pressure Study

Consumers in the United States continue to eat raw or undercooked foods of animal origin despite public health warnings following several well-publicized outbreaks. We investigated an outbreak of Salmonella serotype Typhimurium infection in 158 patients in Wisconsin during the 1994 Christmas holiday period. To determine the vehicle and source of the outbreak, we conducted cohort and case-control studies, and environmental investigations in butcher shop A. Eating raw ground beef purchased from butcher shop A was the only item significantly associated with illness [cohort study: relative risk = 5.8, 95% confidence interval (CI) = 1.5-21.8; case control study: odds ratio = 46.2, 95% CI = 3.8-2751]. Inadequate cleaning and sanitization of the meat grinder in butcher shop A likely resulted in sustained contamination of ground beef during an 8-day interval. Consumer education, coupled with hazard reduction efforts at multiple stages in the food processing chain, will continue to play an important role in the control of foodborne illness.     

Do agonistic motives matter more than anger? Three studies of cardiovascular risk in adolescents.

Objectives: Three motivational profiles have been associated with recurring psychological stress in low-income youth and young adults: Striving to control others (agonistic striving), striving to control the self (transcendence striving), and not asserting control (dissipated striving). Agonistic striving has been associated with elevated ambulatory blood pressure during daily activities. Three studies tested the hypotheses that: (1) agonistic striving is associated with poor anger regulation, and (2) agonistic striving and poor anger regulation interactively elevate blood pressure. Design: Motivational profiles, anger regulation, and ambulatory blood pressure were assessed in a multiethnic sample of 264 urban youth. Main Outcome Measures: (1) anger regulation/recovery during laboratory challenge; (2) anger/blood pressure during daily activities (48 hours). Results and Conclusion: Replication of the profiles in distant cities showed they occur with similar frequency across differences of region, race, and gender. Analyses controlling for body size, race, and gender revealed that individuals with the agonistic striving profile had higher ambulatory pressure, especially during social encounters. They became more openly angry and aggressive when challenged but did not exhibit difficulty regulating anger in the laboratory, nor did they feel angrier during monitoring. However, individuals with the agonistic striving profile who did display poor anger regulation in the lab had the highest blood pressure; deficient self-regulatory capability amplified the positive association between agonistic striving and cardiovascular risk in both genders and all ethnic groups. Although anger is thought to increase cardiovascular risk, present findings suggest that anger and elevated blood pressure are coeffects of agonistic struggles to control others. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Impact of major cardiovascular disease risk factors, particularly in combination, on 22-year mortality in women and men

BACKGROUND: The appropriateness of current cardiovascular disease (CVD) risk factor guidelines in women continues to be debated. OBJECTIVE: To present new data on the appropriateness of current CVD risk factor guidelines, for women and men, from long-term follow-up of a large population sample. METHODS: Cardiovascular disease risk factor status according to current clinical guidelines and long-term impact on mortality were determined in 8686 women and 10503 men aged 40 to 64 years at baseline from the Chicago Heart Association Detection Project in Industry; average follow-up was 22 years. RESULTS: At baseline, only 6.6% of women and 4.8% of men had desirable levels for all 3 major risk factors (cholesterol level, <5.20 mmol/L [<200 mg/dL]; systolic and diastolic blood pressure, <120 and <80 mm Hg, respectively; and nonsmoking). With control for age, race, and other risk factors, each major risk factor considered separately was associated with increased risk of death for women and men. In analyses of combinations of major risk factors, risk increased with number of risk factors. Relative risks (RRs) associated with any 2 or all 3 risk factors were similar: for coronary heart disease mortality in women, RR= 5.72 (95% confidence interval [CI], 2.35-13.93), and in men, RR = 5.51 (95% CI, 3.10-9.77); for CVD mortality in women, RR = 4.54 (95% CI, 2.33-8.84), and in men, RR = 4.12 (95% CI, 2.56-6.37); and for all-cause mortality in women, RR = 2.34 (95% CI, 1.73-3.15), and in men, RR = 3.20 (95% CI, 2.47-4.14). Absolute excess risks were high in women and men with any 2 or all 3 major risk factors. CONCLUSIONS: Combinations of major CVD risk factors place women and men at high relative, absolute, and absolute excess risk of coronary heart disease, CVD, and all-cause mortality. These findings support the value of (1) measurement of major CVD risk factors, especially in combination, for assessing long-term mortality risk and (2) current advice to match treatment intensity to the level of CVD risk in both women and men.     

Childhood sexual abuse and sexual risk behavior among men and women attending a sexually transmitted disease clinic.

Childhood sexual abuse (CSA) is associated with a wide range of negative outcomes. The authors investigated the relation between CSA and sexual risk behavior in 827 patients recruited from a sexually transmitted disease (STD) clinic. Overall, CSA was reported by 53% of women and 49% of men and was associated with greater sexual risk behavior, including more sexual partners, unprotected sex, and sex trading. Alcohol use for men and drug use for women mediated the relation between CSA and the number of sexual partners in the past 3 months; intimate partner violence mediated the relation between CSA and the number of episodes of unprotected sex in the past 3 months for women. These results document the prevalence of CSA among patients seeking care for an STD and can be used to tailor sexual risk reduction programs for individuals who were sexually abused. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Implicit measures of early-life family conditions: Relationships to psychosocial characteristics and cardiovascular disease risk in adulthood.

Objectives: An implicit measure of early-life family conditions was created to help address potential biases in responses to self-reported questionnaires of early-life family environments. We investigated whether a computerized affect attribution paradigm designed to capture implicit, affective responses (anger, fear, warmth) regarding early-life family environments was (a) stable over time, (b) associated with self-reports of childhood family environments, (c) able to predict adult psychosocial profiles (perceived social support, heightened vigilance), and (d) able to predict adult cardiovascular risk (blood pressure) either alone or in conjunction with a measure of early-life socioeconomic status. Method: Two studies were conducted to examine reliability and validity of the affect attribution paradigm (Study 1, N = 94) and associated adult psychosocial outcomes and cardiovascular risk (Study 2, N = 122). Results: Responses on the affect attribution paradigm showed significant correlations over a 6-month period, and were moderately associated with self-reports of childhood family environments. Greater attributed negative affect about early-life family conditions predicted lower levels of current perceived social support and heightened vigilance in adulthood. Attributed negative affect also interacted with early-life socioeconomic status (SES) to marginally predict resting systolic blood pressure (SBP), such that those individuals high in early-life SES but who had implicit negative affect attributed to early-life family conditions had SBP levels that were as high as individuals low in early-life SES. Conclusion: Implicit measures of early-life family conditions are a useful approach for assessing the psychosocial nature of early-life environments and linking them to adult psychosocial and physiological health profiles. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Depression and distress predict time to cardiovascular disease in dementia caregivers.

Objective: This study assessed the impact of depressive symptoms and distress from patient problem behaviors on time to developing a diagnosis of cardiovascular disease (CVD) in a sample of 643 dementia family caregivers. Design: A longitudinal, prospective design was used. Over an 18-month period, caregivers free from a CVD diagnosis at baseline were assessed at 6, 12, and 18-month follow-ups for the onset of CVD. Main Outcome Measures: Days to the onset of CVD was the primary outcome. Results: Over the length of the study, 32 participants (5%) reported a diagnosis of CVD. After adjusting for sociodemographic and health factors (e.g., high blood pressure, age, smoking history), greater depressive symptoms (p = .040) and distress from patient problem behaviors (p = .034) were significant predictors of time to CVD diagnosis. Conclusion: This study suggests that increased depressive symptoms and reaction to patient problem behaviors (i.e., distress) may increase caregivers' risk for experiencing negative health outcomes, specifically CVD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comprehension of grammatical and emotional prosody is impaired in Alzheimer's disease.

Previous research has demonstrated impairment in comprehension of emotional prosody in individuals diagnosed with Alzheimer's disease (AD). The present pilot study further explored the prosodic processing impairment in AD, aiming to extend our knowledge to encompass both grammatical and emotional prosody processing. As expected, impairments were seen in emotional prosody. AD individuals were also found to be impaired in detecting sentence modality, suggesting that impairments in affective prosody processing in AD may be ascribed to a more general prosodic processing impairment, specifically in comprehending prosodic information signaled across the sentence level. AD participants were at a very mild stage of the disease, suggesting that prosody impairments occur early in the disease course. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's intellectual and emotional-behavioral adjustment at 4 years as a function of cocaine exposure, maternal characteristics, and environmental risk.

The authors examined 223 children at age 4 years for the effects of prenatal cocaine exposure, exposure to other substances, maternal and environmental risk factors, and neonatal medical problems on IQ, externalizing problems, and internalizing problems. Regression analyses showed that maternal verbal IQ and low environmental risk predicted child IQ. Cocaine exposure negatively predicted children's overall IQ and verbal reasoning scores, but only for boys. Cocaine exposure also predicted poorer short-term memory. Maternal harsh discipline, maternal depressive symptoms, and increased environmental risk predicted externalizing problems. In contrast, only maternal depressive symptoms predicted internalizing problems. These findings indicate that early exposure to substances is largely unrelated to subsequent IQ or adjustment, particularly for girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association between depressive symptoms and mortality risk in chronic kidney disease.

Objective: Previous examinations of depression as a predictor of mortality in end-stage renal disease have yielded inconsistent findings. We sought to clarify the possible link with mortality by assessing depression at an earlier stage of renal impairment before the uremic disease state and depressive symptoms become highly confounded, and then following patients during the period of disease progression. Design: Prospective design using an assessment of depression before initiation of renal replacement therapy to predict mortality status an average of 81 months later in patients in the early stages of chronic kidney disease. Main Outcome Measures: Mortality status. Results: After controlling for relevant mortality risk factors (i.e., age, gender, presence of diabetes and cardiovascular disease, and potassium level), results of Cox regression analyses indicated that higher levels of nonsomatic depression symptoms were predictive of an increased mortality risk, χ2(1, N = 359) = 8.02, p = .005. Patients with nonsomatic depression scores 1 SD above the mean had an estimated mortality rate 21.4% higher than average scorers in this sample. Conclusion: Clinical implications of these findings point to the importance of assessment and treatment of depressive symptoms in patients with chronic kidney disease. (PsycINFO Database Record (c) 2010 APA, all rights reserved)