Interactions between caregiving and sex and the antibody response to COVID-19 vaccination.

OBJECTIVE: Antibody response to vaccination is a powerful paradigm for studying the effects of chronic stress on immune function. In the present study, we used this paradigm to examine the interaction between caregiving (as a type of chronic stress) and sex on the antibody response to a single dose of a COVID-19 vaccination; recent research has called for examination of sex differences on health outcomes among family caregivers. A three-way interaction between caregiving, sex and psychological distress was also examined. METHODS: COVID-19 antibody data was extracted from 165 caregivers (98 females) and 386 non-caregivers (244 females) from the UK's Understanding Society COVID-19 study. Relevant socio-demographics, health and lifestyle, and distress variables were gathered as potential covariates. RESULTS: In a 2 x 2 ANOVA we found the interaction between caregiving and sex was significant; male caregivers had a lower antibody response to the vaccine compared to female caregivers F (1,547), =24.82, p < .001, η2 = .043. Following adjustment, male caregivers had the lowest antibody response relative to all other groups. The three-way interaction model, controlling for covariates was also significant, R2 = .013, p = .049; the conditional effects for the three-way interaction revealed that male caregivers, compared to the other groups had a lower antibody response at both low and medium levels of psychological distress. CONCLUSION: This study found evidence of a three-way interaction between caregiving, sex and distress on antibody response. Male caregivers had poorer antibody response to a single shot of the COVID-19 vaccination than female caregivers and male and female non-caregivers and this was evident at low and medium levels of distress. Our findings will be discussed in relation to the caregiver-and sex interactions during the pandemic.

Promoting physical activity in rheumatoid arthritis through a physiotherapist led behaviour change-based intervention (PIPPRA): a feasibility randomised trial.

Physical activity (PA) is recommended as a key component in the management of people with rheumatoid arthritis (RA). The objective of this study was to examine the feasibility of a physiotherapist led, behaviour change (BC) theory-informed, intervention to promote PA in people with RA who have low levels of current PA. A feasibility randomised trial (ClinicalTrials.gov NCT03644160) of people with RA over 18 years recruited from outpatient rheumatology clinics and classified as insufficiently physically active using the Godin-Shephard Leisure Time Physical Activity Questionnaire. Participants were randomised to intervention group (4 BC physiotherapy sessions in 8 weeks) delivered in person/virtually or control group (PA information leaflet only). Feasibility targets (eligibility, recruitment, and refusal), protocol adherence and acceptability were measured. Health care professionals (HCPs) involved in the study and patients in the intervention and control arms were interviewed to determine acceptability. Descriptive statistics were used to analyse the data with SPSS (v27) with interviews analysed using content analysis using NVivo (v14). Three hundred and twenty participants were identified as potentially eligible, with n = 183 (57%) eligible to participate, of which n = 58 (32%) consented to participate. The recruitment rate was 6.4 per month. Due to the impact of COVID-19 on the study, recruitment took place over two separate phases in 2020 and 2021. Of the 25 participants completing the full study, 23 were female (mean age 60 years (SD 11.5)), with n = 11 allocated to intervention group and n = 14 to control. Intervention group participants completed 100% of sessions 1 & 2, 88% of session 3 and 81% of session 4. The study design and intervention were acceptable overall to participants, with enhancements suggested. The PIPPRA study to improve promote physical activity in people with RA who have low PA levels was feasible, acceptable and safe. Despite the impact of COVID-19 on the recruitment and retention of patients, the study provides preliminary evidence that this physiotherapist led BC intervention is feasible and a full definitive intervention should be undertaken. Health care professionals involved in the study delivery and the patient participants described a number of positive aspects to the study with some suggestions to enhance the design. These findings hence inform the design of a future efficacy-focused clinical trial.

Social network size moderates the association between loneliness and cardiovascular reactivity to acute stress.

Loneliness and objective measures of social isolation (e.g., social network size) have been associated with increased risk of cardiovascular disease (CVD). However, the evidence is mixed and the precise causal mechanisms remain unclear. Cardiovascular reactivity (CVR) to acute stress has been posited as a proposed mechanism. This study aimed to investigate: (i) effects of loneliness and social isolation on CVR to stress and, (ii) whether the loneliness - CVR relationship was moderated by social network size. Two hundred and six participants from the Pittsburgh Cold Study underwent a modified version of the Trier Social Stress Task. Cardiovascular measures of systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR) were taken throughout the laboratory stress trial. Hierarchical regression analyses found that social network size was positively associated with DBP reactivity (ß = 0.19 95 % CI [0.05, 0.29] p = 0.005), while loneliness was not. In addition, social network size moderated the loneliness - DBP reactivity relationship such that a higher number of outer social network ties were beneficial at lower levels of loneliness but not higher. The current study contributes new evidence linking loneliness and social network size to cardiovascular psychophysiology but raises questions about the loneliness - CVD relationship. The findings confirm the importance of social network size and highlight that the characteristics of the networks may be more important than the number of networks.

Online Support Groups for Family Caregivers: Scoping Review.

BACKGROUND: Caregiving can affect people of all ages and can have significant negative health impacts on family caregivers themselves. Research has shown that social support acts as a buffer against many negative health impacts. A common source of social support is support groups. Although traditionally, these groups were conducted in a face-to-face setting, the advent of the internet, social media applications, and the smartphone have seen online support groups (OSGs) develop as a space where many caregivers seek support. The number of OSGs has increased exponentially, but there is no clear consensus on what factors or characteristics of OSGs contribute to social support development within them or what types of OSGs are available to family caregivers. OBJECTIVE: This study aimed to conduct a scoping review to contribute to the understanding of the types and characteristics of OSGs for family caregivers. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, the CINAHL, PsychInfo, Psych Articles, Social Sciences, Communication Source, Medline, and Web of Science databases were searched for studies (caregiver focused, adults aged 18 years or older, online social support groups, caring for a living person, peer-reviewed journal publications on empirical research). In total, 19 studies were included in the review. The research questions were (1) what type of social support groups are online for adult family caregivers, (2) what the communication mediums and characteristics of these OSGs are, and (3) what psychosocial or other factors make OSGs successful or unsuccessful for participants. RESULTS: In response to the first research question, we found that the majority of OSGs took place on public text-based forums and were illness specific. Where demographics were reported, participants were predominately women, White, and working with university-level education. There were a variety of caregiving relationships. For the second research question, the most common communication medium found was text-based communication, with the use of emojis, photos, and GIF (Graphics Interchange Format) files as part of these exchanges. Most frequently, the OSGs were asynchronous with a degree of anonymity, not time-limited by the frequency of contact or duration, and moderated by peer or professional moderators or facilitators. Results for the third research question explored the overarching categories of safe communication and engagement and group management. These described successful OSGs as having a focus on similar others with shared lived experiences communicated in a nonjudgmental space overseen by trained peer or professional facilitators. CONCLUSIONS: There are several key considerations for OSGs to be successful for family caregivers. A general recommendation for practitioners is to give importance to building active moderation and multifaceted structures of support to meet different levels of caregiver needs and the ability to engage.

Correction: Professional Development of Behavior Analysts in Europe: A Snapshot for 21 Countries.

[This corrects the article DOI: 10.1007/s40617-022-00754-0.].

Social Identity and Online Support Groups: A Qualitative Study with Family Caregivers.

BACKGROUND: The purpose of this study was to explore whether a sense of collective or shared group identity was developed in one established online social support group for family caregivers and, if so, what did group identification mean for the group members and how was this cultivated in the group. METHODS: Eighteen semi-structured interviews were carried out with members of a family caregiver online support group in Ireland. Inductive and deductive reflexive thematic analysis drawing on the social identity approach (SIA) generated four main themes and several related subthemes. RESULTS: The first main theme generated was The group are a Tribe and the Tribe gets it, with subthemes: Invisibility as a common experience, my Tribe understands I am more than just a carer and Just being part of the Tribe can be enough. The second main theme generated was the Tribe is a lifeline and life-changing, with related subthemes: Our connection relieves experiences of loneliness and social isolation and Sharing knowledge, experience and support made me feel visible. The third and fourth main themes generated were The leadership of group moderators helped create the Tribe identity and Lessons that can be learnt. These findings are discussed in relation to the social identity approach, social isolation and loneliness. CONCLUSIONS: We concluded that group identity can be cultivated through considered, active and balanced moderation, creating a safe, welcoming and supportive space where family caregivers are able to have fun and seek information, advice and emotional support, which helps relieve loneliness and social isolation.

Type D personality and cardiovascular reactivity to acute psychological stress: A systematic review and meta-analysis.

OBJECTIVES: Type D personality has been associated with adverse cardiovascular health, with atypical cardiovascular reactions to psychological stress considered a possible mechanism of effect. However, studies examining Type D personality and cardiovascular reactions to acute stress have yielded mixed findings. Here, we conducted a systematic review and meta-analyses to examine if, and under what conditions, Type D personality is associated with cardiovascular reactivity to stress; a particular focus was placed on sex and the social salience of the stressor as potential moderators of effects. METHOD: Electronic databases (Medline, PsycArticles, PsycInfo, CINAHL, PubMed, Web of Science) were searched for relevant publications. A total of 401 articles were retrieved and screened for eligibility. Inclusion criteria included studies with nonclinical samples employing a resting baseline period followed by a psychological stress task period and measurement of cardiovascular reactivity. Following screening and removal of irrelevant articles, 17 peer-reviewed studies were included in the review. RESULT: Type D personality was associated with lower blood pressure reactivity to acute psychological stress. Subgroup analyses revealed an association between Type D personality and lower cardiovascular reactivity among females, but not males. Additionally, Type D personality was primarily associated with lower cardiovascular reactivity in response to nonsocial stressors. CONCLUSIONS: Type D personality is associated with lower blood pressure reactivity to acute psychological stress, particularly among females and in response to nonsocial stressors. This lower response may be indicative of blunted cardiovascular reactivity and therefore signals an increased risk of adverse health outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

'I learnt so much about being active': experiences of people with rheumatoid arthritis on the impact of a physiotherapist-led intervention to encourage physical activity.

INTRODUCTION: Physical activity (PA) is an important component in improving the health of people with rheumatoid arthritis (RA). A Physiotherapist-led Intervention to Promote PA in people with RA (PIPPRA) was undertaken using the Behaviour Change (BC) Wheel. A qualitative study was conducted post intervention involving participants and healthcare professionals who participated in a pilot RCT. METHODS: Face-to-face semi-structured interviews were conducted with the schedule exploring: experience and views of the intervention; experience and suitability of outcome measures used; and perceptions of BC and PA. Thematic analysis was used as an analytical approach. The COREQ checklist provided guidance throughout. RESULTS: Fourteen participants and eight healthcare staff participated. Three main themes were generated from participants: (1) positive experience of intervention - 'I found it very knowledgeable to help me get stronger'; (2) improvement in self-management - '… motivate me maybe to go back to doing a little bit more exercise'; and (3) negative impact of COVID-19 - 'I don't think doing it online again would be really good at all'. Two main themes were generated from healthcare professionals: (1) positive learning experience of delivery - 'Really made me realise the importance of discussing physical activity with patients'; and (2) positive approach to recruitment - 'Very professional team showing the importance of having a study member on site'. DISCUSSION: Participants had a positive experience of being involved in a BC intervention in order to improve their PA and found it acceptable as an intervention. Healthcare professionals also had a positive experience, in particular the importance of recommending PA in empowering patients.

Feasibility of a physiotherapist-led behaviour change intervention to improve physical activity in people with rheumatoid arthritis.

INTRODUCTION: Physical activity (PA) interventions incorporating behaviour change (BC) theory are needed to improve PA levels in people with rheumatoid arthritis. A pilot feasibility study of a Physiotherapist-led Intervention to Promote PA in Rheumatoid Arthritis (PIPPRA) was undertaken to obtain estimates for recruitment rate, participant retention and protocol adherence. METHODS: Participants were recruited at University Hospital (UH) rheumatology clinics and randomly assigned to control group (physical activity information leaflet) or intervention group (four BC physiotherapy sessions in 8 weeks). Inclusion criteria were diagnosis of RA (ACR/EULAR 2010 classification criteria), aged 18+ years and classified as insufficiently physically active. Ethical approval was obtained from the UH research ethics committee. Participants were assessed at baseline (T0), 8 weeks (T1) and 24 weeks (T2). Descriptive statistics and t-tests were used to analyse the data with SPSS v22. RESULTS: 320 participants were approached about the study with n=183 (57%) eligible to participate and n=58 (55%) consented to participate (recruitment rate: 6.4 per month; refusal rate 59%). Due to the impact of COVID-19 on the study, n=25 (43%) participants completed the study (n=11 (44%) intervention and n=14 (56%) control). Of the 25, n=23 (92%) were female, mean age was 60 years (s.d. 11.5). Intervention group participants completed 100% of BC sessions 1 and 2, 88% completed session 3 and 81% completed session 4. DISCUSSION: The intervention to promote physical activity was feasible and safe and provides a framework for larger intervention studies. Based on these findings, a fully powered trial is recommended.

Type D personality is associated with lower cardiovascular reactivity to stress in women.

OBJECTIVE: This study examines if Type D personality is (1) associated with cardiovascular reactivity to acute stress in a healthy sample, and (2) has predictive utility for cardiovascular reactivity above its individual subcomponents (negative affect; NA, social inhibition; SI), as well as anxiety and depression. DESIGN: Undergraduate students (n = 173) competed a standardised cardiovascular reactivity experimental protocol consisting of resting baseline and stressor phase (mental arithmetic), with systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored throughout. MAIN OUTCOME MEASURES: The main outcome measures were cardiovascular reactivity to the stressor, which was operationalised as the difference between resting baseline and the stressor phase for SBP, DBP and HR. RESULTS: The continuous Type D interaction term (NA × SI) significantly predicted lower SBP reactivity to the mental arithmetic stressor amongst women, independent of NA, SI and confounding variables. Moreover, this remained significant after adjustment for anxiety and depressive symptoms. Depression, NA and SI were also significant independent predictors of SBP reactivity amongst women. CONCLUSION: Type D personality is associated with lower SBP reactivity to acute stress in women, which may be indicative of blunted cardiovascular reactivity. This association was independent of NA, SI, Anxiety and Depression.

Experiences of people with multiple sclerosis participating in a social cognitive behavior change physical activity intervention.

BACKGROUND: Understanding the experiences of people with MS taking part in physical activity interventions is critical to inform future interventions. AIM: The aim was to gain insight into the experiences of people with MS taking part in a behavior change group physical activity intervention with a novel social cognitive theory component. METHODS: A qualitative semi-structured interview format was utilized. Questions focussed on expectations, views and beliefs at being involved in the study, beliefs on physical activity, and subjective evaluation of the trial content and delivery. Seventeen people were interviewed and data were analyzed using thematic analysis. RESULTS: Three themes were generated: psychological and social factors, intervention processes, and MS identity. The acceptance of MS as an identity acted as an initial barrier to exercise, with a more positive, exercise-enabling identity post-intervention. Psychological factors such as self-efficacy and anxiety, as well as social factors such as social support, were found to play an important role in how participants experienced the program. Similarly, intervention processes included support for group-based activities and structure of exercise classes, and were also inter-linked to the other themes. CONCLUSION: It appears that group-based exercise interventions are acceptable and feasible for people with MS. The qualitative findings support previously reported quantitative findings that the Step it Up intervention is effective at promoting physical activity and improving psychological outcomes.

Blunted cardiovascular reactivity to psychological stress and prospective health: a systematic review.

Novel research demonstrates that lower or 'blunted' cardiovascular reactions to stress are associated with a range of adverse outcomes. The aim of the current review was (1) to examine the prospective outcomes predicted by blunted cardiovascular reactivity and (2) to identify a range of blunted cardiovascular reaction levels that predict these outcomes. Electronic databases were systematically searched (Medline, PsycArticles, PsycInfo, CINAHL, PubMed, Web of Science). Studies were included if they examined the prospective influence of blunted cardiovascular reactivity to psychological stress (SBP, DBP or HR) on a negative health, behavioural or psychological outcome. A total of 23 studies were included in the review. Blunted reactivity predicted (1) adverse cardiovascular health, primarily in cardiac samples (e.g., myocardial infarction, carotid atherosclerosis) and (2) outcomes associated with motivational and behavioural dysregulation in healthy samples (e.g., obesity, smoking addiction, depression). The cardiovascular reactivity threshold levels that were predictive of adverse health outcomes ranged between -3.00-12.59 bpm (14.41% to 136.59% lower than the sample mean) and -2.4-5.00 mmhg (65.99% to 133.80% lower than sample mean), for HR and DBP respectively. We posit that blunted reactions lower than, or equal to, the ranges reported here may be utilised by clinicians and researchers to identify individuals who are at increased risk of adverse cardiovascular health outcomes, as well as outcomes associated with motivational and behavioural dysregulation.

Cluster analysis reveals distinct patterns of childhood adversity, behavioral disengagement, and depression that predict blunted heart rate reactivity to acute psychological stress.

BACKGROUND: There is considerable evidence documenting associations between early life adversity, behavioral disengagement, and depression with blunted cardiovascular reactivity to acute psychological stress. However, while often examined as independent predictors, it is also likely that a combination of these factors uniquely relate to cardiovascular reactivity. PURPOSE: The present study employed multivariate cluster analysis to examine if distinct combinations of these outcomes relate to cardiovascular stress reactivity. METHODS: Participants (N = 467) were predominantly female (60.6%) with a mean age of 19.30 years (SD = 0.82). Measures of early life adversity, behavioral disengagement, and depression were completed; in addition, participants had their blood pressure and heart rate monitored throughout a standardized stress testing session. Cardiovascular reactivity was calculated as the difference between mean stress and mean baseline cardiovascular values. RESULTS: Analyses revealed two clusters with distinct patterns of exposure to early life adversity, levels of behavioral disengagement and depression, uniquely related to cardiovascular reactivity. In unadjusted models, Cluster 1 that was characterized by greater exposure to early life adversity, higher levels of behavioral disengagement and depression, was associated with lower systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) reactivity. Cluster 2 was characterized by reactivity values similar to the sample means. In fully adjusted models, Cluster 1 predicted heart rate reactivity to stress. CONCLUSIONS: The present study identifies a behavioral cluster that is characteristic of a blunted heart rate reactivity profile, significantly extending the research in this area.

Behavioural clusters characteristic of cardiovascular reactivity profiles relate to poorer health outcomes.

OBJECTIVES: Blunted cardiovascular reactivity is associated with a distinct behavioural profile of greater exposure to early life adversity, coupled with higher levels of behavioural disengagement and symptoms of depression. The present study sought to extend on this work by investigating if behavioural clusters with distinct patterns of reactivity were related to health and behavioural outcomes at baseline and at a 4-year follow-up. METHODS: Hierarchical cluster analyses were conducted using longitudinal data drawn from the Midlife Development in the United States (MIDUS 2) Biomarker Project and the MIDUS 3 follow-up 4 years later. During MIDUS, 2 participants (N = 513) underwent a standardized stress testing protocol and had their blood pressure and heart rate monitored throughout. In addition, hierarchical cluster analyses were conducted on responses from measures of early life adversity, behavioural disengagement and depression. Binary logistic regressions were conducted to determine whether cluster membership was related to health and behavioural outcomes which were taken at both time points. RESULTS: Three behavioural clusters emerged with statistically different blood pressure reactivity patterns. The cluster characterized by greater exposure to early life adversity, higher levels of behavioural disengagement and depressive symptoms, had relatively lower blood pressure reactivity patterns compared with both the exaggerated reactivity cluster and the cluster similar to the sample mean. In fully adjusted models, this cluster was associated with hypertension (p = .050) and depressed affect (p = .033), while Cluster 1 characteristic of an exaggerated blood pressure reactivity profile was associated with depressed affect (p < .001). Cluster membership did not significantly predict future health status. CONCLUSION: This study extends research on behavioural clusters characteristic of reactivity profiles to demonstrate how they relate to health and behavioural outcomes during MIDUS 2.

Life event stress is associated with blunted cardiovascular responding to both personally salient and personally non-salient laboratory tasks.

Life event stress has been associated with blunted cardiovascular reactivity to acute psychological stress. However, recent studies have suggested that blunted reactivity to stress only arises when the laboratory tasks are not personally salient to the individual. We re-analyzed data from 136 healthy young adults where we had previously reported a negative association between life event stress and cardiovascular reactivity to two combined stressors. Participants completed a mental arithmetic task and a personally salient speech task, following a formal baseline period with Finometer-assessed cardiovascular parameters. The reanalyses examined reactivity to the verbal mental arithmetic (personally non-salient) and speech (personally salient) tasks separately and found that life event stress was negatively associated with diastolic blood pressure reactivity, to both the personally non-salient, ß = -.20, p = .023, and personally salient stressors, ß = -.24, p = .004. Life event stress was negatively associated with systolic blood pressure reactivity to the personally salient stressor only, ß = -.20, p = .021, and was not associated with heart rate reactivity. This study provides evidence against the argument that blunted reactivity to stress emerges as a result of stressor context, with findings indicating that low reactors show lower reactivity to both personally salient and personally non-salient stress.

Professional Development of Behavior Analysts in Europe: A Snapshot for 21 Countries.

Behavior analysts are not recognized or regulated as a distinct profession in Europe. For the most part, European behavior analysts adhered to the standards set by the U.S.-based Behavior Analyst Certification Board (BACB). However, the BACB certification has not been recognized officially in any European jurisdiction. The recent decision by the BACB to discontinue eligibility of non-U.S. residents to apply for the BCBA exam by the end of 2022 has brought the issue of professional regulation outside of the United States into sharp focus. This article offers a snapshot in time of professional recognition of behavior analysts in 21 European countries. It stems from the Erasmus+ funded EuroBA project and its Professional Advisory Group (PAG). The EuroBA project aims to develop common standards and competences for behavior analysts to facilitate national regulation and mutual recognition across Europe.

State level income inequality affects cardiovascular stress responses: Evidence from the Midlife in the United States (MIDUS) study.

RATIONALE: The slow and insidious effects of income inequality on health means that their effects can be difficult to reveal, taking many years to become apparent. These effects can also be experienced differently according to subjective status and ethnicity making the relation between income inequality and health difficult to understand. Cardiovascular reactions to acute stress are indicative of future health outcomes. OBJECTIVE: To examine whether short to medium term income inequality affected cardiovascular responses to acute stress whilst accounting for ethnic groups and subjective status. METHOD: Participants state of residence was available for 1155 people who participated in the MIDUS biomarker data project. This detail was used to merge the relevant US state level inequality data 1, 5, 10 and 15 years prior to the MIDUS biomarker data project which assessed cardiovascular responses to acute stress. RESULTS: Our analysis demonstrated an association between inequality 5, 10 and 15 year prior and cardiovascular reactions to acute stress. Subjective community status and Black and minority ethnic group membership interacted to affect the association between inequality and cardiovascular reactions. CONCLUSIONS: In states where income inequality was high, less healthy cardiovascular responses were evident. However lower subjective community status and Black and Ethnic minority group members interacted with income inequality such that their impact was variable contingent on state level inequality. These findings extend the literature on income inequality and health and particularly highlights a psychophysiology pathway linking income inequality and health.

Time of day of vaccination does not relate to antibody response to thymus-independent vaccinations.

Variable responses to vaccination are of historical and current concern, particularly among vulnerable groups. Biochemical and behavioural methods of improving vaccination response have been examined. There is some evidence that vaccinating in the morning could enhance vaccine responses, however, this has consistently been shown in thymus-dependent vaccinations, such as influenza. The present analysis of data from two observational studies of the association between psychosocial factors and vaccination response. These data included response to a thymus-independent vaccination - pneumococcal polysaccharide vaccine, examined morning versus afternoon vaccine administration in 75 healthy young adults and 61 parents, including 32 caregivers of a child with a development disability and 29 control parents. In both datasets, timing of vaccination was not related to antibody response. This suggests that effects of time of day may be limited to thymus-dependent vaccinations although replication in a large randomised controlled trial using other thymus-dependent vaccinations is required.

Smokers show an altered hemodynamic profile to active stress: Evidence of a dysregulated stress response in young adults.

Tobacco smoking has been associated with lower cardiovascular reactivity to psychological stress in middle-aged samples, but its impact on cardiovascular reactivity to stress in young adults remains unclear. The present study examined whether young healthy adults showed differing cardiovascular stress reaction profiles depending on their smoking status. Across two laboratory studies (N = 64 and N = 114), we asked participants to complete cognitive stress-tasks while undergoing continuous hemodynamic monitoring. In both studies, there was not a statistically signification association between systolic blood pressure, diastolic blood pressure, or heart rate reactivity to stress (all ps > .05). However, examination of the underlying hemodynamic profile of the stress response suggested differences between non-smokers and smokers in both studies. In Study 1, non-smokers exhibited the expected myocardial response to the active stress-task; however, smokers exhibited a mixed hemodynamic profile. In Study 2, smokers evidenced a weaker myocardial profile to the active stress-tasks compared to non-smokers. However, the examination of the continuous hemodynamic profile score (HP) did not identify statistical differences. These results highlight that any level of the smoking habit is associated with an altered hemodynamic profile in response to stress in smokers, which may have important implications for long-term cardiovascular health. The findings also suggest that controlling for smoking behavior in reactivity research examining blood pressure and heart rate responses to stress in young adults is not necessary.