The relationship of stress, type A behavior and powerlessness to physiological responses in female clerical workers

The present study examined the relationship of stress levels, Type A behavior, and feelings of powerlessness to physiological reactivity in a group of adult women employed as secretaries. Reactivity was assessed by monitoring blood pressure, heart rate and frontalis EMG while subjects engaged in a series of tasks: rest, mental arithmetic, vigilance, a structured interview and a work interview. When Type A behavior was assessed by a structured interview, Type A's had higher overall levels of systolic and diastolic blood pressure, a tendency toward greater EMG reactivity, and high stress Type A's had higher heart rates than low stress Type A's. When Type A was assessed by a questionnaire, Type A interacted with stress levels and lack of control such that high stress, high powerlessness Type A's had higher overall levels of systolic and diastolic blood pressure and high powerlessness Type A's had higher levels of heart rate than high powerlessness Type B's. While reactivity was not related to Type A behavior, it was related to stress levels. Women with high levels of background stress responded with larger increases in systolic blood pressure and a tendency toward larger increases in heart rate. This research emphasizes the importance of examining multiple factors, especially when relating individual differences in risk to psychophysiological reactivity.     

Type A behavior and physiological responsivity in young women

The purpose of this study was to assess the coronary-prone behavior pattern and physiological responses to stress in young women. Thirty-seven women, aged 18–25 yr, were tested; half were studying in nontraditional fields for women, half in traditional. Based on the Jenkins Activity Survey, women in the male-dominated fields of study were more Type A. Subjects were monitored while resting and while solving mental arithmetic problems and visual puzzles; the dependent variables were heart rate, and blood pressure. Comparisons were made based on both the Jenkins Activity Survey and the structured interview, and using both median splits and extreme groups. There were no physiological differences between Types A and B women. Possible methodological issues accounting for the lack of results are considered.     

Anxiety, type A behavior, and cardiovascular disease

Males with anxiety disorders appear to have increased mortality due to circulatory system disease, and Type A behavior is a risk factor for coronary heart disease (CHD). Thus, we determined Type A behavior in anxious patients. Fifty-seven DSM-III defined anxiety disorder patients completed the Jenkins Activity Survey (JAS) and Symptom Checklist-90-Revised (SCL-90-R). Significantly more male (92%) than female (52%) anxious patients had Type A behavior. Correlations between the JAS scales and SCL-90-R subscales were also different between male and female patients; in males, significant correlations were observed for SCL-90-R anxiety with both JAS Type A and JAS Hard-Driving and Competitive, and for SCL-90-R hostility with JAS Hard-Driving and Competitive. However, there were no consistent correlations between the JAS and the SCL-90-R subscales in females. A trend for fathers of anxious patients to have an increased prevalence of CHD was also observed. The increased incidence of Type A behavior in male, but not in female, anxious patients suggest a mechanism for increased mortality due to circulatory disease in male anxiety patients.     

At-risk drinking in employed men and women

Background: “At-risk”drinking is associated with a variety of negative health and social consequences. However, little is known about the characteristics of at-risk drinkers or of changes in at-risk status over time.Purpose: The objective was to examine the correlates of at-risk drinking and the prospective predictors of maintenance or change in at-risk status.Method: Participants were 4,322 employed individuals assessed at baseline and 4 years later. At-risk drinking was defined as 2 or more drinks per day for men and 1 or more drinks per day for women.Results: The baseline prevalence of at-risk drinking was 11%. Four percent of baseline not-at-risk individuals transitioned to at-risk drinking at follow-up, and 54% of the baseline at-risk individuals remained at-risk at follow-up. Several demographic-, work-, and tobacco-related variables differentiated at-risk groups and were prospective predictors of change in at-risk drinking status among those individuals who were not at risk at baseline. However, none of the constructs predicted change among at-risk drinkers.Conclusion: The data suggest that at-risk drinking is of public health concern. Eleven percent of the participants met criteria for at-risk drinking. Further, at-risk and not-at-risk drinkers differed on numerous characteristics, and their drinking may be influenced by different factors. This article was supported by grants from the National Cancer Institute (P01 CA51671, R01 CA94826, R01 CA89350, R25 CA57730)     

Changes in emotional empathy, affective responsivity, and behavior following severe traumatic brain injury

This study was designed to examine the relationship between deficits in empathy, emotional responsivity, and social behavior in adults with severe traumatic brain injury (TBI). A total of 21 patients with severe TBI and 25 control participants viewed six film clips containing pleasant, unpleasant, and neutral content whilst facial muscle responses, skin conductance, and valence and arousal ratings were measured. Emotional empathy (the Balanced Emotional Empathy Scale, BEES: self-report) and changes in drive and control in social situations (The Current Behaviour Scale, CBS: relative report) were also assessed. In comparison to control participants, those in the TBI group reported less ability to empathize emotionally and had reduced facial responding to both pleasant and unpleasant films. They also exhibited lowered autonomic arousal, as well as abnormal ratings of valence and arousal, particularly to unpleasant films. Relative reported loss of emotional control was significantly associated with heightened empathy, while there was a trend to suggest that impaired drive (or motivation) may be related to lower levels of emotional empathy. The results represent the first to suggest that level of emotional empathy post traumatic brain injury may be associated with behavioral manifestations of disorders of drive and control.     

Differential responsivity of mood, behavior, and cognition to cholinergic agents in elderly neuropsychiatric populations

To evaluate the possible differential responsivity of Alzheimer patients to cholinergic agents, a series of pharmacologic challenge studies in 83 neuropsychiatric patients and controls were performed contrasting a cholinergic antagonist (scopolamine) with two cholinergic agonists (arecoline and nicotine). Alzheimer patients displayed significantly greater behavioral and cognitive responses to central cholinergic blockade at lower scopolamine doses than age-matched controls or elderly depressives. These differential changes could not be explained by group differences in the sedative, physiologic, or pharmacokinetic effects of the drug. In addition, the elderly, age-matched control subjects did reveal a profile of cognitive deficits at the highest dose (0.5 mg), which temporarily mimicked the baseline impairments found in early Alzheimer's disease. Together, these findings with scopolamine suggest an increased sensitivity to cholinergic blockade in Alzheimer's disease and demonstrate the first direct evidence of anticholinergic modelling of dementia in normal elderly subjects. To investigate further the postsynaptic cholinergic responsivity in Alzheimer's disease, patients were studied with arecoline and nicotine. While the cognitive effects of both agents were modest at best, there were significant differences in mood and behavioral responses between arecoline and nicotine in Alzheimer subjects. These behavioral changes occurred at much lower doses in the Alzheimer patients than those required in normal controls, once more supporting the notion of increased behavioral sensitivity to cholinergic agents in Alzheimer's disease. In addition, the differential mood effects between these two cholinergic agonists raise new questions about receptor selectivity in the cholinergic regulation of mood.     

Perceived self in educated employed and educated unemployed women.

The purpose of this study was to compare the perceived self-concept of employed and unemployed educated women. The study also examined the relationship of perceived self-concept with the type of employment and period of service of the employed women. The sample consisted of 150 employed and 150 unemployed educated married women residing in an urban area of Patna. The self-concept scale of Deo (1985) was used in the study. The findings showed that the perceived self of the employed women scored relatively higher in each of the five attributes of the perceived self; ie. Aesthetic, Emotional, Character, Intellectual and Social. It was concluded, from this study, that employment leads to a higher self-concept among educated women, which however varied with different types of employment.     

Occupation, type A behavior and self-reported angina pectoris

The utility of the Type A Behavior Pattern (TABP) as an explanatory concept in psychosomatic medicine has recently been challenged by the appearance of data casting doubt on associations between the TABP and coronary disease. The present study examined an interactive view of the relationship between the TABP and self-reported angina pectoris by suggesting that the TABP exerts a pathogenic influence only under certain occupational conditions. The data gave broad support to this view, and while the results are as yet preliminary, they point to a means of extending the usefulness of the TABP as a variable in epidemiological studies of cardiovascular disease.     

Hardiness, type A behavior, and physical symptoms in a Japanese sample

This study examined the possible mediating effects of hardiness and Type A behavior on the relationship between stressful life events and physical and psychological well-being in a Japanese male sample (N = 78). The ANOVA showed the main effects of hardiness on both physical symptoms and depression. It is indicated that hardiness protects individuals from both physical symptoms and depression. There was a significant stressful life events x Type A interaction, indicating that the Type As tended to possess physical symptoms even when stressful life events decreased. No three-way interaction among hardiness, Type A behavior, and stressful life events was found. The results suggested that hardiness and Type A were independently related to physical and psychological well-being. Implications for the influence of Japanese culture on hardiness and Type A behavior are discussed.     

Social behavior,hormones and adult neurogenesis

A variety of experiences have been shown to affect the production of neurons in the adult hippocampus. These effects may be mediated by experience-driven hormonal changes, which, in turn, interact with factors such as sex, age and life history to alter brain plasticity. Although the effects of physical experience and stress have been extensively characterized, various types of social experience across the lifespan trigger profound neuroendocrine changes in parallel with changes in adult neurogenesis. This review article focuses on the influence of specific social experiences on adult neurogenesis in the dentate gyrus and the potential role of hormones in these effects.     

Job characteristics,occupational status,and ambulatory cardiovascular activity in women

Background: Prior research concerning the effects of occupational status and work stress on ambulatory blood pressure (AmBP) has seldom included women, and available results are equivocal. Moreover, the concurrent effects of occupational status and job characteristics have rarely been investigated. Some research is consistent with the idea that stressful job characteristics are especially detrimental to health in low-status workers, creating a cumulative physiological burden.Purpose: To examine the independent and joint effects of occupational status and perceived demands, control, and social support at work on AmBP and heart rate (HR) in women.Methods: One hundred eight women (M age = 41.07 years) wore an AmBP monitor for 2 days and completed a self-report assessment of job control, demands, and support (i.e., Karesek et al.’s Job Content Questionnaire).Results: After controlling for numerous potential confounds, occupational status and job characteristics accounted for 18% and 22% of the inter-individual variability in ambulatory systolic blood pressure (SBP) and HR, respectively. Occupational status independently predicted ambulatory cardiovascular activity and interacted with job characteristics, particularly in relation to SBP.Conclusions: Inasmuch as ambulatory SBP and HR predict future cardiovascular morbidity and mortality, women with both lower status occupations and stressful job circumstances could be at disproportionately high cardiovascular risk. Laura Bogart is now with RAND Corporation, Santa Monica, California. This research was supported in part by a Kent State University Summer Research and Creativity Grant and by NIH Grant MH66101-01. We thank Amy Jones and Evangelia Banou for assistance with data collection and data entry.     

Childhood maltreatment as a risk factor for adult cardiovascular disease and depression

BACKGROUND: Traumatic experiences in childhood are linked to adult depression and cardiovascular disease. Depression is twice as common in women than men, and depression after cardiovascular events is more common in women than men. However, sex differences in these relationships have not been comprehensively investigated using a nationally representative sample in which demographic factors related to these illnesses can be controlled. METHOD: Data come from the Part 2 sample of the U.S. National Comorbidity Survey, a nationally representative sample containing over 5000 adults. Relationships between childhood maltreatment (sexual abuse, physical abuse, neglect), adult depression (DSM-III-R), and cardiovascular disease were examined using multiple logistic regression models with a specific emphasis on the evaluation of sex differences. RESULTS: Childhood maltreatment was associated with a significant increase in cardiovascular disease for women only and with a significant increase in lifetime depression for both genders. A history of childhood maltreatment removed the natural protection against cardiovascular disease for women and depression for men. Although depression and cardiovascular disease were correlated, depression did not contribute to the prediction of cardiovascular disease in women when controlling for history of childhood maltreatment. CONCLUSIONS: Gender is important in evaluating potential psychiatric and physical correlates of childhood maltreatment. Maltreatment is a potent risk factor for cardiovascular disease in women and for depression in both women and men. Effective clinical assessment should recognize the role of childhood abuse or neglect in adult health and disease. Research on the consequences of childhood maltreatment should focus on both psychiatric and physical outcomes.     

Cardiovascular response as a function of predisposition, coping behavior and stimulus type

The present study investigated cardiovascular responses to three different laboratory stressors in either low or high heart rate reactors. It was predicted that there would be stimulus specific responses for either a mild pressure pain, mental arithmetic, or projective test stimulus. Mild pain was to reflect a passive coping condition, and mental arithmetic an active one while the projective test was to represent an ambiguous stimulus condition permitting idiosyncratic behavioral responding. Blood pressure and heart rate responses revealed the predicted small response to mild pressure pain and the predicted stress response to mental arithmetic. Low and high heart rate reactors did not differ in response to mild pain or the projective task but differed greatly in response to the arithmetic task. The data further indicated that low heart rate reactors responded with a larger response in blood pressure and heart rate to the projective test than to the mental arithmetic, whereas the high heart rate reactors displayed an inverse pattern. Psychological trait or situational, behavioral variables failed to predict the physiological response.     

A niche for adult neurogenesis in social behavior

The structural and functional changes occurring into the brain is the hallmark of its tremendous capacity for dealing with the complexity that we are facing throughout life. It is also the hallmark of what neuroscientists refer as neuroplasticity. The continuous generation of cohorts of new neurons in some discrete regions of the adult brain, including the olfactory system, is a newly recognized form of neuroplasticity that has been recently the focus of neuroscience studies. Several lines of evidence indicate that this recruitment of newly-generated neurons is extremely sensitive to the overall neuronal activity of the host circuits. Therefore, adult neurogenesis represents, not only a constitutive replacement mechanism for lost neurons, but also a process supporting a capacity of neural plasticity in response to specific experience throughout life. The remarkable complexity of the social life offers a host of daily challenges that require a diversity of brain mechanism to make sense of the ever-changing social world.This review describes some recent findings which have begun to define reciprocal relationships between the production and integration of newborn neurons in the adult brain and social behavior. These studies demonstrate how this domain of research has the potential to address issues in the functional contribution of adult neurogenesis in the expression of some social traits as well in the role of some social contexts to finely regulate the production, survival and integration of adult newborn neurons.     

The anxiety levels,quality of sleep and life and problem-solving skills in healthcare workers employed in COVID-19 services

ObjectiveThe present study aims to investigate the level of anxiety experienced by healthcare workers employed in COVID-19 services, the effects of anxiety on sleep quality and quality of life and, the relationship between these variables and problem-solving skills of the healthcare workers.Material and methodThe study was conducted in two healthcare facilities which serve as pandemic hospitals. 140 healthcare workers, who were employed in the COVID-19 outpatient clinics or emergency departments, participated in the present study. All participants were submitted to the Pittsburgh Sleep Quality Index (PSQI), Problem Solving Inventory (PSI), World Health Organization Quality of Life-BREF (WHOQOL-BREF), Beck Anxiety Inventory (BAI).FindingsThe number of participants without anxiety was 41(29%), with mild anxiety was 53(38%). Clinically significant anxiety findings were found in only 33% of the participants. A positive correlation was found between the participants’ BAI scores and PSQI, PSI scores, and a negative correlation with the WHOQOL-BREF scores. PSQI and PSI scores of nurses were statistically higher when compared to those of physicians and staff. WHOQOL-BREF scores were found to be lower.ConclusionHealthcare workers might develop psychiatric symptoms such as anxiety and sleep disturbance. Such symptoms could adversely affect the problem-solving skills of healthcare workers and cause a deterioration in their quality of life.     

Non-fatal cardiovascular disease, malignancies, and other co-morbidity in adult haemophilia patients

Introduction

With increasing life expectancy, more haemophilia patients will be confronted with age-related problems. To ensure optimal care, it is important to know the occurrence of both fatal and non-fatal cardiovascular disease, malignancies and other types of co-morbidity in these patients. Our aim was to retrospectively assess the occurrence of co-morbidity and causes of death in a substantial birth-cohort of haemophilia patients.

Methods

Data on all types of co-morbidity were collected from medical records of 408 haemophilia patients (204 severe, 204 non-severe) born before 1971, and compared with the Dutch age-matched general male population.

Results

Ten patients had 11 myocardial infarctions, none of which were fatal. The cumulative incidence of non-fatal myocardial infarction was significantly lower in patients with severe haemophilia than in the general population (0.5% versus 4.8%), but was not decreased in patients with non-severe haemophilia (4.4%). Intracranial bleeding occurred significantly more often in haemophilia patients. The occurrence of non-virus related malignancies, and other non-virus related co-morbidities was similar in haemophilia patients and the general population. HIV infection was present in 12% of patients, and hepatitis C infection in 56%. Seventy-eight patients (19%) were deceased. Main causes of death were malignancies, AIDS, hepatitis C, and intracranial bleeding.

Conclusions

Our results showed a decreased occurrence of myocardial infarction in patients with severe haemophilia, suggesting a protective effect of very low clotting factor levels on thrombotic cardiac events. No differences were found between haemophilia patients and the general population in the occurrence of any other type of non-virus related co-morbidity.     

Anger, negative emotions, and cardiovascular reactivity during interpersonal conflict in women

OBJECTIVE: In order to evaluate the relationship between women's subjective emotional discomfort with anger and cardiovascular responses to stress, cardiovascular and affective responses were examined during two anger-provoking conditions: one in which anger would be in self-defense, and one in which anger would be in defense of a significant other. METHODS: A total of 42 healthy, normotensive women aged 18-35 years recruited a close female friend to participate in the study with them, and were randomly assigned to one of two harassment conditions: (i) Self-Harass, where women were harassed while performing a math task; (ii) Friend-Harass, where women witnessed a close female friend being harassed while their friend performed a math task. RESULTS: Self-Harass and Friend-Harass women reported feeling equally angry, annoyed, and irritated (all P's<.01) during their respective anger-provocation conditions. However, Self-Harass women reported experiencing significantly greater increases in feelings of depression and guilt during anger provocation (P's<.05) relative to Friend-Harass women. Interestingly, it was also the Self-Harass women who exhibited significantly greater elevations in heart rate (HR), cardiac output (CO), systolic blood pressure (SBP), forearm blood flow (FBF), and significant reductions in forearm vascular resistance (FVR; P's<.001) relative to Friend-Harass women during anger provocation. CONCLUSIONS: Results suggest that women may experience other negative emotions (e.g., guilt, depression) when anger is in self-defense relative to when it is in defense of others, and that these emotions may play a more important role than anger in moderating cardiovascular reactivity (CVR) during interpersonal conflict.     

Type A behavior and the social production of cardiovascular disease

Since the turn of the century, there has been a continued interest within medicine in the psychosocial and behavioral risks for cardiovascular disease. Current research supports type A behavior and its components as risk factors. At various points in time, researchers have suggested that the context in which emotion and behavior occurs is an important determinant of the risk-enhancing nature of these factors, but little systematic work has been done. It is argued here that future research on cardiovascular disease should more explicitly take social context into account to provide a better understanding of the nature of disease, and to provide more accurate models for medical education and patient care.