The effects of perceived discrimination on ambulatory blood pressure and affective responses to interpersonal stress modeled over 24 hours.

Objective: This research examined the impact of perceived discrimination on ambulatory blood pressure (ABP) and daily level affect during social interaction. Design: For 24 hrs, adult Black and White participants wore an ABP monitor and completed palm pilot diary entries about their social interactions. Main Outcome Measures: Mean level and time-trend trajectories of blood pressure and heart rate were examined as well as mean level measures of positive and negative affect after stressful and nonstressful social interactions. Results: Analyses showed that, after controlling for important covariates, perceived discrimination predicted the slopes of both wake and nocturnal ABP responses, with those who reported more discrimination having steeper daytime trajectories for systolic and diastolic blood pressure and less nighttime dipping in heart rate over time as compared to those who had reported relatively infrequent discrimination. High levels of perceived discrimination were also related to positive and negative affective responses after stressful encounters. Conclusions: These results suggest that, regardless of race, perceived discrimination is related to cardiovascular and affective responses that may increase vulnerability to pathogenic processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trait hostility and ambulatory blood pressure among traffic enforcement agents: The effects of stressful social interactions.

This study investigated the hypothesis that trait hostility is associated with heightened cardiovascular reactivity to potentially stressful social interactions but not to nonsocial activities in the workplace. Participants were 73 (39 women) New York City traffic enforcement agents (TEAs) who patrol the streets and issue summonses for vehicular and parking violations. During their patrols, TEAs face potentially stressful interactions when they encounter motorists and pedestrians who may be angry about receiving summonses. Mood and ambulatory blood pressure were initially measured when TEAs were recently hired and attending classes at the training academy (Time 1), and were subsequently assessed again once the TEAs began independently patrolling the city streets (Time 2). Random effects regression models yielded a significant interaction of hostility and work activity on ambulatory systolic blood pressure at Time 2. For those high in hostility, but not for those low in hostility, systolic blood pressure levels were higher while interacting with members of the public than during nonsocial work activities. The findings support the notion that situational factors affect the association of hostility to cardiovascular reactivity, and that interpersonal stressors in the workplace elicit cardiovascular activation among those high in hostility. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Social relationships and ambulatory blood pressure: Structural and qualitative predictors of cardiovascular function during everyday social interactions.

Healthy normotensive men and women (N=102) underwent a 3-day ambulatory blood pressure (BP) assessment in which a BP reading was taken 5 min into each social interaction. After each interaction, participants completed a diary that included structural categorization of the relationship and ratings of the quality of the relationship with the interaction partner. Random regression analyses revealed that interactions with family members and spouses were associated with lower ambulatory BP. Interactions with ambivalent network members (characterized by both positive and negative feelings) were associated with the highest ambulatory systolic BP, an effect that was independent of the familial effects on BP. Although there were psychological correlates associated with both structural and functional aspects of relationships, no evidence was found that these mediated the primary findings involving ambulatory BP. These data highlight the influence of both structural and qualitative aspects of relationships on ambulatory BP and possibly health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cardiovascular reactivity to and recovery from psychological challenge as predictors of 3-year change in blood pressure.

The authors examined whether cardiovascular reactivity to and recovery from psychological challenge predict 3-year change in blood pressure (BP) among 216 initially normotensive, community-dwelling adults. Clinic BP assessments were conducted at baseline and follow-up. BP and heart rate (HR) readings were obtained before, during, and after 5 psychological tasks at baseline. Following adjustment for traditional predictors of BP and lifestyle factors, poorer systolic BP recovery across the tasks was associated with greater 3-year increases in clinic systolic and diastolic BP. Both diastolic BP recovery and HR recovery were also related to 3-year change in clinic BP, though cardiovascular reactivity measures were not. These findings suggest that the duration of stress-related cardiovascular responses may be important for predicting longitudinal changes in BP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reported exposure and emotional reactivity to daily stressors: The roles of adult age and global perceived stress.

A central goal of daily stress research is to identify resilience and vulnerability factors associated with exposure and reactivity to daily stressors. The present study examined how age differences and global perceptions of stress relate to exposure and emotional reactivity to daily stressors. Sixty-seven younger (Mage = 20) and 116 older (Mage = 80) adults completed a daily stress diary and measures of positive and negative affect on 6 days over a 14-day period. Participants also completed a measure of global perceived stress. Results revealed that reported exposure to daily stressors is reduced in old age but that emotional reactivity to daily stressors did not differ between younger and older adults. Global perceived stress was associated with greater reported exposure to daily stressors in older adults and greater stress-related increases in negative affect in younger adults. Furthermore, across days on which daily stressors were reported, intraindividual variability in the number and severity of stressors reported was associated with increased negative affect, but only among younger adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hostility explains some of the discrepancy between daytime ambulatory and clinic blood pressure.

The authors examined whether hostility explained the discrepancy commonly observed between clinic and daytime ambulatory blood pressures, Daytime ambulatory blood pressure (DABP) was assessed every 45 min over 6 days in healthy adults ( N=120). After controlling for demographic variables, time-varying covariates such as position and activity level, and clinic blood pressure (CBP), the Cook-Medley Hostility Scale was significantly associated with daytime ambulatory diastolic blood pressure. No support was obtained for mediation by psychological factors. Discrepancies between DABP and CBP may be due, in part, to differences in the degree to which these 2 types of measures are associated with individual differences in hostility. These results suggest that the addition of hostility to CBP may improve its predictive power. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blood pressure reactivity and cognitive function in the Baltimore Longitudinal Study of Aging.

Objective: Several blood pressure indexes of autonomic dysregulation, including stress-induced blood pressure responses (i.e., reactivity), have been associated previously with stroke, silent cerebrovascular disease, and decreased cognitive function. Design: The authors examined the cross-sectional relations among systolic blood pressure (SBP) and diastolic blood pressure (DBP) reactivity and cognitive function in a sample of stroke- and dementia-free older adults (n = 73, 53% male, 72% Caucasian, mean age = 70.14 years) from the Baltimore Longitudinal Study of Aging. Main Outcome Measures: Age, education, baseline, and reactive blood pressure levels were regressed on cognitive test scores measuring the domains of attention, learning and memory, verbal functions/language skills, and perceptuo-motor speed. A Bonferroni correction was employed and results significant at the standard p     

Do behavioral responses mediate or moderate the relation between cardiovascular reactivity to stress and parental history of hypertension?

To examine whether differences in behavioral responses to stress mediated or moderated the relation between cardiovascular response to stress and parental history of hypertension, 64 healthy undergraduates--16 men with hypertensive parents (PH+), 16 men without hypertensive parents (PH-), 16 PH+ women, and 16 PH- women--participated in a mental arithmetic task, mirror tracing task, and 2 interpersonal role plays. PH+ participants exhibited higher resting heart rates than PH - participants and higher resting systolic blood pressures (SBPs) than PH- women. PH+ participants exhibited greater SBP responses to tasks and engaged in more negative verbal and nonverbal behavior across tasks than PH- counterparts. Differences in behavioral responding neither mediated nor moderated the observed relation between parental history status and SBP response to stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Risk and resilience factors in coping with daily stress in adulthood: The role of age, self-concept incoherence, and personal control.

This study observed young, middle-aged, and older adults (N = 239; Mage = 49.6 years; range = 18–89 years) for 30 consecutive days to examine the association between daily stress and negative affect, taking into account potential risk (i.e., self-concept incoherence) and resilience (i.e., age, perceived personal control) factors. Results indicated that younger individuals and individuals with a more incoherent self-concept showed higher average negative affect across the study. As well, individuals reported higher negative affect on days that they experienced more stress than usual and on days that they reported less control than usual. These main effects were qualified by significant interactions. In particular, the association between daily stress and negative affect was stronger on days on which adults reported low control compared with days on which they reported high control (i.e., perceptions of control buffered stress). Reactivity to daily stress did not differ for individuals of different ages or for individuals with different levels of self-concept incoherence. Although all individuals reported higher negative affect on days on which they reported less control than usual, this association was more pronounced among younger adults. The current study helps to elucidate the role of risk and resilience factors when adults are faced with daily stress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Aging and Cardiovascular Reactivity to Stress: Longitudinal Evidence for Changes in Stress Reactivity.

Although age differences in cardiovascular function are well documented, little research has provided longitudinal evidence for age-related changes in cardiovascular reactivity to stress. In this study, the authors report such data from a follow-up of their prior work (B. N. Uchino, D. Uno, J. Holt-Lunstad, & J. B. Flinders, 1999) with participants between the ages of 30 to 70 (n=108, mean follow-up=10 months, range=7 to 16 months). Results revealed longitudinal evidence for an age-related increase in systolic blood-pressure reactivity and parasympathetic withdrawal to acute stress. The implications of these findings are discussed in light of the increased cardiovascular disease risk with age, as well as the links between aging, emotions, and physiology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness is a unique predictor of age-related differences in systolic blood pressure.

A population-based sample of Caucasians, African Americans, and Latino Americans, 50-68 years of age (M = 57.5), from Cook County, Illinois (N = 229), was tested to examine how loneliness and co-occurring psychosocial factors (depressive symptoms, perceived stress, social support, and hostility) were related to indices of cardiovascular and endocrine functioning. Extending prior research, the authors found that loneliness was associated with elevated systolic blood pressure (SBP) and age-related increases in SBP, net of demographic variables, health behavior variables, and the remaining psychosocial factors. Loneliness was not associated with differences in autonomic or endocrine functioning. Although the results are limited by the cross-sectional methods used, they are consistent with the hypothesis that cardiovascular disease contributes to increased morbidity and mortality among lonely individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The perceived stress reactivity scale: Measurement invariance, stability, and validity in three countries.

There is accumulating evidence that individual differences in stress reactivity contribute to the risk for stress-related disease. However, the assessment of stress reactivity remains challenging, and there is a relative lack of questionnaires reliably assessing this construct. We here present the Perceived Stress Reactivity Scale (PSRS), a 23-item questionnaire with 5 subscales and 1 overall scale, based on an existing German-language instrument. Perceived stress reactivity and related constructs were assessed in N = 2,040 participants from the United Kingdom, the United States, and Germany. The 5-factor structure of the PSRS was found to be similar in the 3 countries. In the U.S. sample the questionnaire was applied using 2 modes of administration (paper–pencil and computerized), and measures were repeated after 4 weeks. Measurement invariance analyses demonstrated full invariance across mode of administration and partial invariance across gender and countries. Scale scores differed between countries and genders, with women scoring higher on most scales. Overall, reliability analysis suggested good stability of PSRS scores over a 4-week period, and validation analysis showed expected associations with related constructs such as self-efficacy, neuroticism, chronic stress, and perceived stress. Perceived stress reactivity was also associated with depressive symptoms and sleep. These associations were particularly strong when individuals scoring high on perceived stress reactivity were exposed to chronic stress. In sum, our findings suggest that the PSRS is a useful and easy-to-administer instrument to assess perceived stress reactivity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Autonomic stress reactivity and executive functions in successful and unsuccessful criminal psychopaths from the community.

A significant gap in the psychopathy literature is the lack of studies comparing "successful," nonconvicted psychopaths with "unsuccessful," convicted psychopaths. This study tested the hypothesis that successful psychopaths show increased autonomic stress reactivity and better neuropsychological function compared with unsuccessful psychopaths. A total of 26 controls, 16 unsuccessful psychopaths, and 13 successful psychopaths were assessed on psychophysiological measures recorded during an emotional manipulation, the Wisconsin Card Sorting Test (WCST), Wechsler Memory Scale–Revised subtests, and childhood stressors. Compared with controls, unsuccessful psychopaths showed reduced cardiovascular stress reactivity. In contrast, successful psychopaths showed heightened reactivity, better WCST performance, and more parental absence than unsuccessful psychopaths and controls. The implications of these findings and the generalizability of existing psychopathy research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Low life purpose and high hostility are related to an attenuated decline in nocturnal blood pressure.

Objective: An attenuation of the nighttime decline in blood pressure (BP) predicts cardiovascular disease and cardiovascular-related mortality, beyond daytime BP levels. We investigated whether positive and negative psychological attributes were associated with sleep–wake BP ratios and examined sleep parameters as potential mediators of these relationships. Design: Two hundred twenty-four participants (50% men; 43% Black; mean age = 60 years) underwent ambulatory BP monitoring for 2 days and nights. Self-reports of positive and negative psychological attributes were collected. In-home polysomnography was conducted for 2 nights, and a wrist actigraph was worn for 9 nights. Main Outcome Measures: Sleep–wake mean arterial pressure (MAP) ratios. Results: After adjustment for demographics, body mass index, and hypertensive status, low life purpose and high hostility were associated with high sleep–wake MAP ratios. Depression, anxiety, and optimism were not related to MAP ratios. Sleep latency, fragmentation, architecture, and the apnea–hypopnea index were examined as potential mediators between psychological attributes and MAP ratios; only long sleep latency mediated the relationship between hostility and MAP ratios. Conclusion: Low life purpose and high hostility are associated with high sleep–wake BP ratios in Black and White adults, and these relationships are largely independent of sleep. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Chronic stress influences cardiovascular and neuroendocrine responses during acute stress and recovery, especially in men.

This study tests the influence of chronic stress on cardiovascular and neuroendocrine responses to and recovery from acute stressors and whether the effects are gender specific. Sixty-two healthy, middle-aged persons (50% women) performed mental-arithmetic and public-speaking tasks and relaxed thereafter for 1 hr while their cardiovascular and neuroendocrine functions were measured. Participants with higher levels of chronic stress showed lower systolic blood pressure (SBP) and epinephrine (E; men only) and marginally lower levels of norepinephrine (NE) responses to the tasks and showed lower levels of cortisol and marginally lower NE responses during recovery. Relative to women, men had high diastolic blood pressure (DBP) responses to the tasks and high SBP, DBP, and E responses during recovery. Gender differences in cardiovascular disease in midlife may be due to gender differences in inability to recover quickly, in addition to enhanced acute-stress response. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Magnitude and duration of cardiovascular response to anger in Vietnam veterans with and without posttraumatic stress disorder.

This study investigated the cardiovascular responses to a relived anger task in 118 male Vietnam combat veterans (62 with posttraumatic stress disorder [PTSD] and 56 without PTSD). Participants completed standardized diagnostic measures, hostility measures, and a laboratory session in which they relived a self-chosen anger memory while heart rate (HR), systolic blood pressure, and diastolic blood pressure (DBP) were measured continuously using an Ohmeda Finapres monitor. Compared with veterans without PTSD, PTSD veterans took less time to feel anger, had greater mean HR and DBP response during relived anger, and reported greater anger and anxiety during the task. There was a significant relationship between covert hostility and anger response during and after the anger task only in participants with PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Blood lead (Pb) levels: A potential environmental mechanism explaining the relation between socioeconomic status and cardiovascular reactivity in children.

Objective: A number of studies have shown an association between socioeconomic status (SES) and cardiovascular reactivity to acute stress. In addition, the authors recently reported that higher early childhood blood lead (Pb) levels are associated with significantly greater total peripheral (vascular) resistance (TPR) responses to acute stress. It is not known whether the SES-TPR association is mediated by underlying differences in blood lead levels. Design: Participants were 9.5-year-old children (N = 122) with established early childhood blood lead levels. Main Outcome Measures: Family SES was measured using the Hollingshead Index, blood lead levels were abstracted from pediatrician and state records, and children's cardiovascular responses to acute stressors were measured in the laboratory with impedance cardiography and an automated blood pressure monitor. Results: Lower family SES was shown to be associated with significantly higher blood lead levels as well as significantly heightened systolic blood pressure, diastolic blood pressure, and TPR responses to acute stress tasks. A mediational analysis confirmed that Pb was a significant mediator of the SES-TPR reactivity association; some evidence also suggested moderation. Conclusion: These results suggest the importance of considering the chemical environment as well as social and psychological environment when evaluating cardiovascular effects of low SES. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood reactivity to daily negative events in early adolescence: Relationship to risk for psychopathology.

Emotional responses to negative daily experiences in young adolescents may provide important clues to the development of psychopathology, but research is lacking. This study assessed momentary mood reactivity to daily events as a function of risk profile in a school sample, ages 11-14. High-risk (HR, n = 25) and low-risk (LR, n = 106) subgroups completed frequent self-reports of mood and events for 5 days. HR adolescents reported more negative events involving family and peers. Multilevel modeling results showed that negative events, especially if stressful, were associated with increased negative and decreased positive affects, with heightened responses in HR adolescents. HR adolescents with greater stress over the last 3 months showed additional increases in depressed mood following negative events. Altered reactivity to and dysfunctional appraisals of daily events may link adolescent risk profiles to later mental health problems. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are changes in blood pressure and total cholesterol related to changes in mood? An 18-month study of men and women.

The authors investigated the within-person association of reported mood with blood pressure and total cholesterol (TC) levels, each assessed 4 times over an 18-month period in 128 men and 154 women. Change over time in tense arousal was significantly positively associated with changes over time in systolic blood pressure (SBP) and diastolic blood pressure (DBP) but not TC. A change in hedonic tone was significantly associated with SBP (an increase in negative affect was associated with an increase in SBP) but not with DBP or TC. There were no sex differences in associations of mood with SBP or TC. However, increases in tense arousal and negative affect were significantly associated with an increase in DBP for women but not men. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conflict and collaboration in middle-aged and older couples: II. Cardiovascular reactivity during marital interaction.

Marital strain confers risk of cardiovascular disease (CVD), perhaps though cardiovascular reactivity (CVR) to stressful marital interactions. CVR to marital stressors may differ between middle-age and older adults, and types of marital interactions that evoke CVR may also differ across these age groups, as relationship contexts and stressors differ with age. The authors examined cardiovascular responses to a marital conflict discussion and collaborative problem solving in 300 middle-aged and older married couples. Marital conflict evoked greater increases in blood pressure, cardiac output, and cardiac sympathetic activation than did collaboration. Older couples displayed smaller heart rate responses to conflict than did middle-aged couples but larger blood pressure responses to collaboration—especially in older men. These effects were maintained during a posttask recovery period. Women did not display greater CVR than men on any measure or in either interaction context, though they did display greater parasympathetic withdrawal. CVR to marital conflict could contribute to the association of marital strain with CVD for middle-aged and older men and women, but other age-related marital contexts (e.g., collaboration among older couples) may also contribute to this mechanism. (PsycINFO Database Record (c) 2010 APA, all rights reserved)