Program adherence and coping strategies as predictors of success in a smoking treatment program.

94 smokers (mean age 39 yrs) in a 6-wk behavioral smoking-cessation program were administered weekly questionnaires on their use of major program recommendations and other quitting strategies throughout treatment. An "affect-regulation" coping inventory was administered at the beginning and end of treatment. Adequate adherence was reported for most recommendations. Although a composite measure of adherence did not predict quitting success, adherence and coping assessments were associated with maintenance of treatment gains. Short-term maintenance was associated with an extensive affect-regulation repertoire and use of stimulus control strategies; long-term maintenance was associated with consistent self-monitoring of smoking during treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of task strain, social conflict, and emotional activation on ambulatory cardiovascular activity: Daily life consequences of recurring stress in a multiethnic adult sample.

Ambulatory blood pressure (ABP) may be an independent predictor of cardiovascular endpoints, but little is known about its psychosocial determinants. The acute effects of psychosocial processes on cardiovascular activity during daily life were examined by random-effects regression. Healthy adults (N?=?120) were monitored over a 6-day period with ABP monitors and computer-assisted self-report assessments. Task strain, social conflict, and emotional activation were rated following each ABP measurement, as were activity, posture, and other covariates. Results show that blood pressure) (BP) and heart rate (HR) were elevated during periods of emotional activation (high negative affect or high arousal). Diastolic BP was lower during periods involving high decisional control, and HR was lower during high-control, low-demand activities. There were substantial individual differences in the effects of psychosocial influences on ambulatory cardiovascular activity. Psychological factors are reliable determinants of ABP, which may account for the unique predictive value of ABP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychosocial mediators of racial differences in nighttime blood pressure dipping among normotensive adults.

Shallow declines in nocturnal compared with diurnal blood pressure (BP dipping) have been associated with cardiovascular disease. In U.S. samples, Blacks demonstrate less BP dipping compared with Whites. In a sample of 60 Black and 60 White normotensive adults we examined stress, social integration (including parental status), social support, and hostility as potential mediators of the association between race and BP dipping. The effect of race on diastolic BP dipping was partially mediated by parental status. The effect of race on heart rate dipping was partially mediated by stressful life events. No psychosocial factors mediated the relation between race and systolic BP dipping. Although psychosocial factors appear to account for some of the observed racial differences in nocturnal blood pressure decline, our data suggest that these differences cannot be attributed entirely to covarying psychosocial effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experiences of Demand and Control in Daily Life as Correlates of Subclinical Carotid Atherosclerosis in a Healthy Older Sample.

Daily experiences of demand and control were examined as correlates of carotid artery atherosclerosis among healthy adults (ages 50-70). Mediating effects of ambulatory blood pressure (ABP) were also explored. Participants (n=337) collected ABP and recorded daily experiences, using electronic diaries, over two 3-day periods. Carotid artery intima-medial thickness (IMT) was assessed using ultrasonography. Participants reporting higher task demands during daily life showed larger IMT, after adjustment for demographic covariates. This association was not limited to workplace ratings or to employed individuals. The association was mediated, in part, by daytime systolic blood pressure. Previous findings linking job stress with cardiovascular disease may reflect the broader impact of daily psychological demands, not necessarily associated with the workplace. (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)     

Peer relationships and diabetes: Retrospective and ecological momentary assessment approaches.

Objective: To examine the association of positive and negative aspects of friendship to psychological well-being, self-care behavior, and blood glucose control and to determine whether these relations were moderated by gender. Design: Adolescents with Type 1 diabetes (n = 76) completed baseline measures of friendship quality, depressive symptoms, and self-care. A measure of metabolic control was obtained from medical records. Adolescents also tested blood glucose periodically over the course of 4 days and completed ecological momentary assessments of interpersonal interactions and mood using PDAs. Main Outcome Measures: For between-groups analyses, primary outcomes were depressive symptoms, self-care behavior, and metabolic control. For within-groups analyses, primary outcomes were mood and blood glucose. Results: Results showed baseline reports of peer conflict but not support were associated with outcomes, particularly among girls. Conflict was more strongly related to poor metabolic control for girls than boys. Momentary interaction enjoyment and interaction upset were associated with mood, but were unrelated to blood glucose. Aggregate indices of enjoyable interactions were associated with fewer depressive symptoms and better self-care—especially among girls. Conclusions: These results suggest that the positive and negative aspects of peer relationships are related to the psychological well-being and physical health of adolescents with diabetes. (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)     

Application of ecological momentary assessment to the study of marital adjustment and social interactions during daily life.

The authors examined the utility of ecological momentary assessment for assessing spousal interactions in the natural environment among 245 healthy, married, older adults. Convergent validity for this method was demonstrated by (a) a positive association between marital adjustment (MA) and average diary ratings of agreeableness during spousal interactions and (b) an inverse association between MA and average diary ratings of conflict during spousal interactions. When agreeableness and conflict were examined simultaneously for spousal interactions, only agreeableness independently predicted MA. By contrast, when nonspousal interactions were examined, only conflict during nonspousal interactions was an independent predictor of MA. Results underscore the merit of obtaining representative measures of social interactions during daily life for understanding influences on and consequences of MA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multidimensional measurement model for cardiovascular reactivity: stability and cross-validation in two adult samples

The factor structure for measures of stress-related cardiovascular reactivity was examined in 2 samples: a university campus employee sample (N = 72) and a sample of young adult twins (N = 113). In both samples, 5 noninvasive cardiovascular measures were monitored during a series of challenging laboratory tasks. We developed a 2-factor model depicting vascular and cardiac influences on responding. With confirmatory factor analysis, this model was shown to be consistent with the data across both samples, across 2 testing sessions, and across 2 sets of tasks. Latent variables measuring cardiac and vascular reactivity were highly reliable on retest as well. Individual differences in cardiovascular reactivity to mental stress may be characterized by a stable, 2-dimensional pattern of response.     

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)