Stress and illness in low-income women: the roles of hardiness, John Henryism, and race.

This study examines the stress-illness relationship in a biracial group (African-American and Caucasian-American) of low-income women. Two personality constructs, hardiness and John Henryism, were studied for their possible moderating influences on the stress-illness relationship. One hundred women, with family incomes below the poverty line, completed questionnaires of stress, illness, hardiness, and John Henryism. Hierarchical regression models indicated that hardiness moderated the stress-illness relationship, with high stress, low hardy women having higher levels of illness. In addition, race also moderated the effect of stress, with high stress, Caucasian women having higher levels of illness. However, John Henryism had no effect on stress-related illness in these low-income women. Analyses of additional stress measures indicated that hardy women perceive their external environments as less stressful, although high and low hardy women have similar levels of network stress. Correlational analyses indicated that life-event stress, network stress and low-income concerns were all associated with illness scores. Thus, a range of stress measures are linked to physical illness in low-income women; furthermore, hardiness and being African-American both buffered the effects of stress on illness.

Psychophysiological correlates of individual differences in patterns of hemodynamic reactivity.

The present study delineates a method for the quantification of six hemodynamic reactivity patterns, in response to a laboratory stressor, and examines the psychophysiological correlates of individual differences in these patterns. One hundred and ninety-four young adult men and women participated in rest periods and two laboratory stressors, mental arithmetic and an anger recall interview. Measures were taken of blood pressure, heart rate, and cardiac output, from which total peripheral resistance was derived, as well as state reports of feelings during the tasks. Six hemodynamic reactor patterns were identified: Non-reactors, Mild Myocardials, Mild Vasculars, Myocardials, Vasculars, and Dual Reactors, each associated with a unique profile of cardiac output and total peripheral resistance change. Myocardial reactors to the interview had the highest resting levels of blood pressure and total peripheral resistance. Dual reactors had the largest increases in diastolic reactivity; Dual and Myocardial reactors had the largest increases in systolic reactivity. The extreme reactor groups (Dual, Myocardial, Vascular) all reported greater task invigoration than the Non-reactors, who reported greater efforts to relax. Reactor groups were similar on anger-related trait affect. Based on both resting blood pressure and magnitude of task-induced reactivity, Myocardial and Dual reactors may be at the greatest risk for subsequent hypertension.

Hostility and the cardiovascular reactivity of women during interpersonal confrontation.

In order to explore the association between hostility and women's health, this study examined the relationship of hostility to cardiovascular reactivity during stressful, interpersonal confrontations. Prior to the task, each participant's level of hostility, methods of coping with stress, and perceived social support were evaluated. Blood pressure and heart rate were monitored in ninety females during two discussions with a disagreeing confederate. In one discussion, participants were given positive feedback concerning their performance, while in a second discussion, participants were given non-positive feedback concerning their effectiveness in expressing their viewpoint. The results indicate that low hostile women displayed greater systolic blood pressure and heart rate increases than high hostile women during the discussions. In addition, participants exhibited greater systolic blood pressure and diastolic blood pressure reactivity during the positive feedback condition than during the non-positive feedback condition. However, for diastolic blood pressure, these results were qualified by an interaction, such that low hostile women displayed greater reactivity during the positive feedback condition than during the non-positive feedback condition, while high hostile women were equally reactive in both feedback conditions. State assessment of coping styles indicated that high hostile women may be less reactive due to withdrawal and lack of engagement during the task, while low hostile women may show greater engagement, especially when encouraged by positive feedback.

An alternative approach for achieving cardiovascular baseline: viewing an aquatic video.

Due to the importance of baseline and recovery levels in the computation of reactivity, two studies were conducted to determine an alternative method to traditional rest for achieving baseline and recovery levels of cardiovascular measurements. Watching a relaxing, aquatic video was compared with a traditional resting baseline to determine the better method for achieving low baseline levels. In addition, watching the video was compared with traditional rest during 5-min post-task recovery periods. Systolic (SBP) and diastolic blood pressure (DBP) decreased more during the baseline period when subjects viewed the video than when subjects rested quietly. Similarly, subjects displayed greater recovery following the mental tasks when they watched a video than when they merely sat quietly. It is recommended that researchers standardize baseline procedures by showing a relaxing video before administering tasks for the assessment of cardiovascular reactivity.

Family history of hypertension: a psychophysiological analysis.

Family history of hypertension (positive and negative) and gender groups were compared on cardiovascular responses at rest, during stressors and during recovery. Two tasks were employed, mental arithmetic and an anger recall interview. Both levels and reactivity measures of blood pressure, heart rate, cardiac output and total peripheral resistance were included. In addition, participants filled out several questionnaires measuring state feelings during the task and recovery periods, trait anger/hostility and emotions. Both men and women with a positive family history of hypertension exhibited higher tonic levels of blood pressure and heart rate at rest, recovery and during both tasks. They also exhibited greater heart rate reactivity during the mental arithmetic task and greater blood pressure reactivity to both tasks when post-math recovery, but not initial rest, was used as a covariate. Positive family history individuals reported less trust and gregariousness, more depression and aggression, less awareness of somatic responses to the tasks and less effort to relax during the post-task rest periods. Finally, significant correlations were found between low anger expression how anger experience and high anger control and task SBP levels in positive family history individuals.

Cardiovascular reactivity among hostile men and women: the effects of sex and anger suppression.

This study examined cardiovascular reactivity differences among hostile men and women. Sixty-four individuals (33 women 31 men; M = 19.9 years of age) were selected from a sample of 105 volunteers based on their Cook-Medley Hostility Scale scores (Cook & Medley, 1954; less than or equal to 24). Analyses revealed no significant sex differences in Cook-Medley Hostility scores. At baseline, men had higher mean systolic blood pressure (SBP) level. However, during the Stroop Color-Word Conflict Task (Stroop, 1935), high-hostile men and women exhibited similar cardiovascular responses. Further analyses revealed that cardiovascular responses to the Stroop task were differentially associated with among men and women as a function of anger suppression. For women, anger suppression was positively associated with diastolic blood pressure (DBP) responses and negatively associated with SBP responses. In contrast, anger suppression was negatively associated with DBP changes and not associated with SBP responses for men. The results suggest that personality factors, such as high hostility and anger suppression, may influence the degree to which men and women differ in their cardiovascular responses to interpersonal stressors.

Differential hostility profiles accompany different hemodynamic response patterns.

Cardiovascular reactivity has been proposed as a mechanism by which psychosocial variables may lead lo coronary heart disease. Although reactivity as a generalized response has been linked lo psychological factors, there are specific hemodynamic profiles that underlie blood pressure reactivity. This study characterized subsets of young adults as myocardial or vascular reactors, in response to three laboratory tasks: mental arithmetic, videogame, and anger recall interview. Vascular reactors had higher diastolic blood pressure increases to all tasks, whereas reactor groups were equivalent at rest and on systolic blood pressure responses. Correlational analyses were conducted to determine whether psychological dimensions are uniquely associated with myocardial or vascular reactors' cardiovascular responses, at rest and during acute stressors. For myocardial reactors, resting systolic blood pressure was higher in hostile and suspicious individuals, whereas reactivity was linked to impulsivity. For vascular reactors, low trust, low gregariousness, and high depression were associated with diastolic reactivity to tasks. The predictive validity of hostility, distrust, sociability, and depression for cardiovascular pathology may vary with reactor type.

Gender differences in patterns of dynamic cardiovascular regulation.

The purpose of this research was to examine the role of gender in hemodynamic response patterns to stress. Sixty-four male and 55 female young adults were administered a protocol of rest, mental arithmetic, video game, and anger recall interview while blood pressure, heart rate, and cardiac impedance measures were obtained. Men had higher levels of systolic blood pressure and cardiac output and greater reactivity to tasks, indexed by increases in cardiac output and diastolic blood pressure. Extreme groups of myocardial and vascular reactors were formed from cardiac output and total peripheral resistance change scores during mental arithmetic. The myocardial reactors exhibited greater sensitivity to task demands, whereas vascular reactors exhibited comparable total peripheral resistance increases to all tasks. Vascular reactors exhibited greater diastolic blood pressure reactivity than myocardial reactors. Future studies should address the predictive validity of these reactor patterns for the subsequent development of coronary heart disease.

The anger recall interview and cardiovascular reactivity in women: an examination of context and experience.

Recent research has focused on the role of hostility as a risk factor for coronary heart disease. Hostility has been linked independently to cardiovascular mortality and, as a component of Type A behavior, to atherogenesis and myocardial infarction; however, the mechanisms by which hostility manifests its effects on the cardiovascular system have not been determined. In addition, hostility has been evaluated as a trait measure, with little emphasis on how anger-provoking episodes may be perceived by individuals. The present study seeks to evaluate the affective experience of hostility, through an anger recall interview, and relate qualities of that experience to one potential mechanism of cardiovascular risk, cardiovascular reactivity. Fifty-eight women, classified by structured interview as Type A or B, participated in an anger recall interview while their heart rate and blood pressure were monitored. Type A women manifested greater systolic reactivity when their anger was in response to frustration of autonomy needs, while Type B women exhibited greater heart rate reactivity in response to frustration of affiliation needs. All women who suppressed anger expression experienced higher pressor responses than women who expressed anger assertively. Future investigations may find the content of an interview as useful as the procedure itself in studies of cardiovascular reactivity.

Gender and cardiovascular responses: what is the role of hostility?

Two experiments are reported investigating hostility group by gender effects on heart rate and blood pressure. In experiment 1, 58 males and 59 females were tested with a protocol that included baseline, reaction time with and without harassment, and recovery. In experiment 2, 55 males and 50 females participated in a procedure of baseline, Stroop color--word conflict, anger recall interview, and recovery. Based on Buss-Durkee subscales, genders were divided into high and low neurotic hostility and expressed hostility groups. High expressed hostility was associated with greater diastolic reactivity to all tasks in males, but not in females. Low expressed hostility was associated with greater heart rate and systolic reactivity, specifically during the anger recall interview. High neurotic hostility in males and females was associated with greater diastolic reactivity to the anger task only, while low Neurotic hostility males had higher resting systolic pressures. These results suggest that outward expression of hostility in men may increase their coronary heart disease risk; however, results for both men and women support an association between cardiovascular reactivity and a lack of match between self-reported anger management style and task demands.

The relationship of parenting styles and social competency to Type A behavior in children.

This study examined parenting styles, Type A behavior in parents and children, and social competence in children. Fifty 1st-6th grade children, parents, and their teachers participated. Type A behavior in parents was associated with a controlling style of parenting, but not with pressuring the child to achieve. Parenting styles of achievement pressure and high control were related to impatient and aggressive behaviors in children, as measured by the MYTH, a teacher-scored Type A behavior instrument. In addition, impatience and aggressiveness in the children were negatively correlated with the child's social competency and ability to function in school. Parenting practices, Type A behavior, and social competency in children may play important roles in the origins of detrimental components of Type A behavior, such as impatience and aggression.

A prospective study of women's health: the effects of stress, hardiness, locus of control, Type A behavior, and physiological reactivity.

This study was a five-year follow-up of women who had participated in a previous experiment. At time one, we obtained measures of hardiness, Type A behavior, locus of control, stress, illness, and physiological reactivity. At time two, we obtained measures of illness for the past twelve months. Multiple regression analyses support the hypotheses that both hardiness and locus of control buffer the effects of stress on illness. Furthermore, Type A classification was associated with greater illness frequency and resting systolic blood pressure predicted future health status. An examination of all variables simultaneously revealed that future illness frequency is best predicted by locus of control x stress, high resting systolic blood pressure and low systolic reactivity. Future illness severity was best predicted by locus of control and resting systolic blood pressure. These results support the hypotheses that hardiness and locus of control buffer the effects of stress on health in women employed as clerical workers; however, the predictive power of hardiness in these women is largely accounted for by the contribution of locus of control.

Family history of hypertension, gender, and cardiovascular responsivity during stress.

The relationships of family history of hypertension and gender to cardiovascular responses to stress were investigated in this research. One hundred twenty-three subjects were monitored while they rested and performed two tasks, reaction time and Ravens progressive matrices. Positive-family history males exhibited higher levels of systolic blood pressure than the negative male group and higher levels of rate pressure product than the positive-family history female group. Positive-family history males also had heart rate levels as high as the females. Female subjects did not differ from each other based on family history. In addition, subjects were grouped by gender and by high- or low-heart rate reactivity. The results suggest that heart rate reactivity has equally broad effects on cardiovascular function for males and females; for males, this reactivity during rests and tasks also tends to be associated with family history of hypertension.

Physiological correlates of the coronary-prone behavior pattern in women during examination stress.

This research is an assessment of the physiological correlates of Type A behavior in college-aged women. Subjects were monitored while they took a midterm statistics examination; the dependent variables were systolic and diastolic blood pressure, heart rate, and heart rate variability. Type A or B behavior was assessed with the student form of the Jenkins Activity Survey. The results indicated that Type A women had higher levels of systolic blood pressure and heart rate, and lower levels of heart rate variability. Thus, when the stressor was a genuine examination, Type A behavior in young women was associated with increased physiological response levels compared to Type B's, a finding consistent with the hypothesis that Type A behavior is associated with sympathetic nervous system activity.

Relationship of racial stressors to blood pressure responses and anger expression in black college students.

The physiological effects of racism, as a stressor, were examined as they related to blood pressure (BP) and anger experiences in Black college students. Current research has failed to consider the stressful effects of racism as a factor contributing to the higher incidence of essential hypertension among Blacks. Twenty-seven Black college students viewed three excerpts showing racist situations involving Blacks; anger-provoking, nonracist situations; and neutral situations. After each scene, BP was taken, and a mood checklist was administered. The Framingham Anger Scale and the Anger Expression Scale were administered. Analyses revealed that BP significantly increased during the presentation of racist stimuli but not of anger-provoking or neutral stimuli. Self-reports of state anger, as measured by the mood checklist, were significant for both the anger-provoking and racist stimuli. BP scores were significantly correlated to the two trait anger measures. Exposure to racist stimuli was associated with BP increases among Blacks. Such cumulative exposure to racism may have important implications for the etiology of essential hypertension.

Control, type A behavior and cardiovascular responsivity in adult women employed as clerical workers.

The purpose of the present study was to examine the relationship among control, Type A behavior and cardiovascular responsivity in female clerical workers. Control was examined by assessing locus of control and by employing a learned helplessness paradigm. Helplessness was varied by three treatment conditions on a concept identification task: (1) a helplessness condition where noncontingent feedback was provided, (2) a moderate helplessness condition, and (3) a no helplessness (no feedback) condition. The effects of these treatments on performance were examined by measuring trials to criterion on a subsequent anagram task. Heart rate and blood pressure were monitored during rest periods and tasks. Both Types A and B women exhibited learned helplessness. Type As who experienced the helplessness treatment responded with greater increases in systolic blood pressure and greater decreases in heart rate variability on the anagram task. During the helplessness task itself, Type A women with an external locus of control were the most reactive group as indexed by heart rate and heart rate variability. For those women experiencing moderate helplessness, external locus of control Type As had higher systolic blood pressure levels on both tasks. These results suggest that task-induced lack of control or external locus of control is associated with increased cardiovascular reactivity in Type A women.

Aerobic power and cardiovascular response to stress.

The relationship between aerobic fitness as measured by maximal O2 uptake (VO2max) and the cardiovascular response to laboratory stressors was examined in two experiments. First, 34 male college students were screened on the basis of their heart rate (HR) response to a reaction time-shock avoidance (RT-AV) task. The six individuals showing an average HR increase of 45 beats/min (reactives) and the six subjects showing an average increase of 8 beats/min (nonreactives) did not differ in VO2max (47.7 +/- 2 vs. 48.7 +/- 1 ml.kg-1.min-1, respectively). However, a statistically significant association between a reported family history of hypertension and peak HR response to RT-AV was seen. In the second series of experiments, the plasma catecholamine and cardiovascular responses of eight elite endurance-trained athletes (VO2max 70.6 +/- 1 ml.kg-1.min-1) and eight untrained volunteers (VO2max 45.5 +/- 1 ml.kg-1.min-1) were compared on the following: RT-AV, reaction time for monetary reward (RT-AP), cold pressor, isometric handgrip, and orthostatic challenge (standing). The trained group exhibited a significantly lower mean HR at rest (P less than 0.05), otherwise there were no significant differences between the two groups. The results indicate that although individual differences (e.g., family history of hypertension and high resting HR) can be related to the potential for cardiovascular responses to novel laboratory challenges, the contribution of fitness to this characteristic is much less clear. Further exploration of questions pertaining to fitness and stress should focus on individuals with a predisposition to stress reactivity.

Allocation of attention and physiological responsivity in the type A coronary-prone individual.

Recent studies have suggested that persons exhibiting the Type A coronary-prone behavior pattern allocate their attention to the environment differently than those not exhibiting the pattern. The present study was done to relate such differences in cognitive responding to cardiovascular changes during a dual-focus task. Heart rate and blood pressure were monitored in Types A and B male college students while they performed a color/word conflict primary task and a reaction-time secondary task. There were no differences in the behavioral performance of the Types A and B individuals. However, Types A and B subjects differed in mean heart rate, heart-rate variability, and phasic heart-rate pattern to the reaction-time stimuli. The reaction-time paradigm appears a fruitful base from which to explore cognitive/physiological response relations for Type A and Type B individuals.

On the role of posterior parietal and prefrontal cortex in visuo-spatial perception and attention.

Monkeys with bilateral removal of caudal prefrontal cortex (area 8) or dorso-lateral parietal cortex (areas 5 and 7) or the inferior temporal cortex (area TE) were presented with two versions of a go-left/go-right visuo-spatial discrimination. In the first task they had to displace either the left or right of two identical plaques according to whether both plaques were black or white respectively. There were no performance differences among groups. In the second task, the two plaques were always red and the appropriate response was indicated by whether a spatially remote third plaque was black or white. Both the prefrontal and parietal groups were impaired relative to the inferotemporal group on this task. The results indicate that whether an impairment occurs on a task that is thought to test the perception of egocentric space may depend on whether the animal has to notice and attend to a remote cue, and that an attentional disorder may also explain impairments reported on tests of allocentric perception where the critical cue is spatially remote from the response site.