The other side of the coin: Blunted cardiovascular and cortisol reactivity are associated with negative health outcomes

A cornerstone for research into the link between stress and health has been the reactivity hypothesis; cardiovascular reactivity to psychological stressors, if prolonged or exaggerated, can promote the development of cardiovascular disease. However, it has recently been argued that low or blunted reactivity is also associated with negative health outcomes. As such, in this special issue we present further evidence implicating that cardiovascular and stress hormone responses to acute stress at the other end of the response spectrum can also be considered a pathway to ill health. In this introductory article, we explore and review the origins of and potential mechanisms underlying blunted responses to acute stress. In so doing, we aim to highlight: what is currently known regarding this new conceptualization of the reactivity hypothesis; the potential explanations for blunted reactivity; the pathways underlying associations with health outcomes; and where this field is headed in terms of developing our understanding of the link between reactivity and health.     

Health psychology and the arts: a conversation

Critical approaches within health psychology continue to explore new methods of working and new theoretical ideas from other disciplines. One area that remains under-explored is the potential links with the arts. This special issue contains a selection of empirical and theoretical reports on the linkages between health psychology and the arts. It includes arts and health projects in clinical, community and educational contexts; projects with young and old people, projects with people from different social and ethnic background and projects using different forms of art. This article introduces the special issue and uses a dialogic format to consider some of the broader issues.     

Hormone/brain relations serving the unity of the body

Papers in this special issue of Physiology and Behavior illustrate some of the roles of steroid and thyroid hormones in achieving a modern version of what physiologists have described as ‘the unity of the body’. Included are papers on stress physiology and on endocrine disruptors, studied at several levels.     

Qualitative research in health psychology: developments and directions

There is ongoing debate within psychology about the legitimacy of qualitative methods, although this debate has only recently begun within the subdiscipline of health psychology. In the health arena, psychology has been one of the last disciplines to adopt qualitative methods for research. This issue of the Journal of Health Psychology provides a forum for some health psychologists to present their research using qualitative methods. Their work covers a range of health issues and draws on a variety of qualitative methods, documenting the diversity and utility of these methods for health research. In this article, we consider the background to this qualitative turn, review the content of this special issue and consider the direction for qualitative research in health psychology.     

Interpretative phenomenological analysis and the new genetics

This article offers an introduction to the use of interpretative phenomenological analysis (IPA) to conduct research on psychological and social issues in the new genetics. Some key methodological points in the employment of IPA are highlighted. The article examines some of the important issues for health psychologists that arise following advances in new genetic technologies and introduces the articles in this special issue. The article discusses the particular contribution that IPA can make to research in health psychology generally, and to the new genetics in particular.     

The role of health care communication in the development of complementary and integrative medicine

In recent years, complementary medicine (CM) approaches are integrated within a growing number of health care services worldwide. Implementation of CM within primary, secondary and tertiary settings of health care requires attention to a variety of communication challenges. In this special issue of Patient Education and Counseling 23 articles are presented about the patient–provider communication on complementary approaches, and the implementation and integration of CM in health care. Parallel to CM integration in the clinical arena, this special issue emphasizes the importance of two complementary axes: in medical education and in research, particularly on management of chronic illness and life-threatening diseases. The three legs of the integrative stool – research, education, and clinical practice – are perceived in the light of open, non-judgmental patient–health care provider–CM practitioner communication and a patient-centered bio-psycho-social–cultural–spiritual agenda.     

Attachment and physical health: introduction to the special issue

ABSTRACT

Over the last 40 years, researchers have made considerable progress identifying the ways in which attachment security shapes individuals’ social and emotional functioning. In recent years, new investigations have shed light on connections between attachment and physiological systems in the body. The goal of this special issue is to focus attention on how attachment may be related to biological markers that relate to physical health, including inflammation, cortisol, and cardiometabolic risk. The papers in this special issue, highlighted in this introduction, demonstrate that these links may exist across the lifespan. We conclude with several examples of extensions of this work might emerge in the years to come.     

Blunted cardiovascular and cortisol reactivity to acute psychological stress: A summary of results from the Dutch Famine Birth Cohort Study

The Dutch Famine Birth Cohort Study is a large population based study of late middle aged, overall healthy men and women whose health has been followed from 50 to 65 years of age. In a sample of 725 cohort members, an extensive psychological stress protocol was performed during which cardiovascular and cortisol responses were measured. In line with many previous studies, results showed that increased blood pressure responsiveness to the stress protocol was associated with an increased risk for hypertension 5 years later. However, decreased cardiovascular and/or cortisol stress reactivity were associated with obesity and the risk of becoming obese, symptoms of depression and anxiety, a poor self-reported health, poor lung function, and poor cognitive function (all p for statistical tests < 0.05). These associations generally survived adjustment for a range of potential confounders, including resting cardiovascular and cortisol activity, commitment to the stress tasks, sex, age, smoking and use of medication. Results from these studies agree with recent evidence that low biological reactivity to acute psychological stress may not always be beneficial for health but instead seems to be a marker for a range of negative health outcomes. Future studies have to point out whether low stress reactivity precedes or follows these negative health outcomes.     

Introduction: The end of sex as we once knew it

This special issue of Physiology and Behavior is devoted to papers summarizing sex differences that are now recognized to include not only reproductive behaviors, but also non-reproductive processes and phenomena such as feeding, thirst, pain, sensory processes, mood, cognitive function, the effects of stress, and the propensity for drug abuse. The purpose of this brief introduction is to trace some of the main themes and historical highlights in the discovery that the entire nervous system appears to be a target of reproductive hormones, as well as being subject to developmentally programmed sex differences.     

Theory and concepts of prevention science as applied to clinical psychology.

This article provides an overview for this special issue on prevention science in clinical psychology. A brief historical perspective on prevention in clinical psychology is presented. An even greater emphasis on prevention in the future is related to changes in the current health-care system and their likely impact on psychological practice as we move into the next century. Conceptual and theoretical models of the prevention enterprise are addressed with a distinction drawn between health promotion and disease prevention in the areas of mental disorders and general physical health. The classification of preventive interventions is discussed and methodological challenges to outcomes research are outlined. The article concludes with a discussion of training and public policy implications and a brief overview of the other articles included in this special issue on prevention science.     

Trauma, attachment, and intimate relationships

Intimate relationships can both affect and be affected by trauma and its sequelae. This special issue highlights research on trauma, attachment, and intimate relationships. Several themes emerged. One theme is the exploration of the associations between a history of trauma and relational variables, with an emphasis on models using these variables as mediators. Given the significance of secure attachment for healthy relationships, it is not surprising that attachment emerges as another theme of this issue. Moreover, a key component of relationships is trust, and so a further theme of this issue is betrayal trauma (J. J. Freyd, 1996 ). As the work included in this special issue makes clear, intimate relationships of all types are important for the psychological health of those exposed to traumatic events. In order to best help trauma survivors and those close to them, it is imperative that research exploring these issues be presented to research communities, clinical practitioners, and the public in general. This special issue serves as one step toward that objective.     

The role of health care communication in the development of complementary and integrative medicine

In recent years, complementary medicine (CM) approaches are integrated within a growing number of health care services worldwide. Implementation of CM within primary, secondary and tertiary settings of health care requires attention to a variety of communication challenges. In this special issue of Patient Education and Counseling 23 articles are presented about the patient–provider communication on complementary approaches, and the implementation and integration of CM in health care. Parallel to CM integration in the clinical arena, this special issue emphasizes the importance of two complementary axes: in medical education and in research, particularly on management of chronic illness and life-threatening diseases. The three legs of the integrative stool – research, education, and clinical practice – are perceived in the light of open, non-judgmental patient–health care provider–CM practitioner communication and a patient-centered bio-psycho-social–cultural–spiritual agenda.     

Low forced expiratory volume is associated with blunted cardiac reactions to acute psychological stress in a community sample of middle-aged men and women

It has been argued recently that blunted cardiovascular reactions to acute psychological stress have adverse behavioural and health corollaries that reflect dysregulation of the neural systems that support motivation. We examined the association between cardiovascular reactions to a standard stress task, the paced auditory serial arithmetic rest, and forced expiratory volume in one second, an effort, hence motivation, dependent assessment of lung function measured by spirometry. Low forced expiratory volume, expressed as a ratio to height squared was associated with blunted heart rate, but not blood pressure, stress reactivity, r = .17, p < .001. The association survived adjustment for smoking, a range of anthropometric and sociodemographic covariates, resting heart rate and stress task performance, β = .11, p = .005. As such, our results provide support for the hypothesis that blunted stress reactivity may be a peripheral marker of a dysfunction in the brain systems that support motivated behaviour.     

The importance of affectively-laden beliefs about health risks: the case of tobacco use and sun protection

Affect is gaining prominence in health behavior research. However, little is known about the relative influence on behavior of specific affectively-laden beliefs about health risks (affective likelihood, worry, anticipated regret), particularly in comparison to cognitive likelihood beliefs. We investigated this issue in relation to two very different cancer-related behaviors. In two prospective studies [tobacco use (N = 1,088); sunscreen use (N = 491)], hierarchical linear and logistic regression analyses revealed that affectively-laden risk beliefs predicted intentions and behaviors more strongly than cognitive likelihood beliefs. Cognitive likelihood contributed independently only for sunscreen use intentions. Smoking-related outcomes were most strongly associated with anticipated regret. Sunscreen-related outcomes were most strongly associated with affective likelihood. Affectively-laden beliefs might be stronger predictors of some cancer-related behaviors than traditional cognitive likelihood measures. Including affective aspects of health risk beliefs in health behavior interventions and theoretical models, including investigating their interrelationships in different behavioral contexts, could advance both theory and practice.     

Virology 50th Anniversary Special Issue: A Publisher's Note

A Publishers Note introduces this special issue, commemorating Virology's 50th birthday, with a look back at its prestigious history, and the scientific progress that has been made in the field since the launch of the journal in 1954. It provides a list of the top 100 most-cited papers published in the journal to date.     

Women’s Reproductive Health in Sociocultural Context

Purpose

The special issue on Women’s Reproductive Health in Cultural Context covers multiple dimensions of women’s reproductive health and how it might be shaped by cultural meanings, social and gender inequities, and power differentials, employing a variety of methodological approaches. On the one hand, it aims to bring to the forefront the conversation about how women’s health is uniquely experienced and constructed in local settings, and on the other hand, it aims to draw broader conclusions from a perspective of interconnectedness of women and the shared issues that they face.

Methods and Results

The special issue was initiated through a call for submissions and includes ten articles on the topic of women’s reproductive health in cultural context.

Conclusions

The articles provide many insights into how the context in which they live can disadvantage women and endanger their health, as well as offer perspectives on women’s resistance to disempowering and stigmatizing discourses and practices. It aims to be of interest to scholars in behavioral medicine, psychology, and other social sciences

     

Men in (and out of) therapy: central concepts, emerging directions, and remaining challenges

This article introduces the special issue on recent conceptual, practical, and research developments relevant to men and therapy. The paper reviews the considerable shifts that have emerged in our understanding and measurement of masculinity as it pertains to men's health and therapy. In addition, this introduction outlines the primary focus of each article in this special issue and describes the general guidelines offered to the contributors. Collectively, these special-issue articles describe promising paradigms, provide useful examples, and stress the need for further research on men, masculinity, and the therapeutic process.     

Trait dominance is associated with vascular cardiovascular responses,and attenuated habituation,to social stress

Both exaggerated and diminished levels of cardiovascular reactivity have been associated with cardiovascular ill health. Dysregulation of hemodynamic mechanisms which control cardiovascular functioning may account for some individual differences in health outcomes. Trait dominance has also been associated with poor cardiovascular health in studies of humans and animals. The current study investigated the relationship between trait dominance and cardiovascular habituation to repeated social stress in humans.     

Cardiovascular consequences of expressing,experiencing, and repressing anger

Psychoanalytic theory's pathogenic view of repression gave rise to the widely held belief that the expression of anger is beneficial to mental and physical health. The present paper reviews a number of experimental and correlational studies which demonstrate that the full expression of anger, with its vocal manifestations, is associated with significant cardiovascular hyperreactivity. Furthermore, epidemiological studies indicate that such expressions of anger are also related to coronary heart disease (CHD) and to some physiological and hormonal changes that have been implicated in the pathophysiology of CHD. On the other hand, neither the mere experience of anger nor its repression has any of the above negative cardiovascular consequences, although the repression of anger seems to have other untoward health consequences.The preparation of this article and some of the research reported therein were supported by a grant from the National Heart, Lung, and Blood Institute (HL-036027).