Assessment of cardiovascular reactivity across laboratory and natural settings

The purpose of this investigation was to examine the stability of heart rate and blood pressure reactions of individuals across laboratory challenges and a challenge in the natural environment. Undergraduate musicians' heart rates and blood pressures were measured during anticipation and in response to a mental arithmetic challenge and a visual-verbal concepts challenge in the laboratory and anticipation of a musical performance jury in the natural environment. Results revealed that systolic blood pressure reactivity measured in anticipation of laboratory challenges, but not during these tasks, was related to systolic blood pressure levels measured in anticipation to the musical performance jury. Generalization of heart rate and diastolic blood pressure reactivity across settings was not supported. Systolic blood pressure, diastolic blood pressure, and heart rate reactions were stable across laboratory tasks.     

Social support in ordinary life and laboratory measures of cardiovascular reactivity: gender differences in habituation-sensitization

Background: Gender differences in coronary heart disease are mirrored by gender differences both in cardiovascular reactivity to stress and in the nature and content of social support networks. However, little research has examined the association between cardiovascular reactivity in the laboratory and social support outside; and none has established whether gender differences in such associations can elucidate relevant psychosomatic mechanisms. In addition, in general, studies of cardiovascular reactivity fail to take adequate account of cardiovascular response habituation.Purpose: The present study sought to examine gender differences in associations between psychometrically assessed social support and cardiovascular reactivity and, in particular, response habituation patterns.Method: Ninety-two undergraduate men and women underwent two consecutive cardiovascular reactivity assessments, after having provided psychometric assessments of quantity and quality of social support in ordinary life.Results: Inverse associations between social support and cardiovascular reactivity during the second assessment suggested that highly-supported women exhibited cardiovascular response habituation. For men, the opposite trend—that of support-related cardiovascular sensitization—was found. Results were unaffected by performance of the task used to elicit reactivity or by participant ratings of task dimensions.Conclusions: These findings suggest that men and women differ in the degree to which social support in ordinary life moderates cardiovascular stress responses in laboratories. This difference is highlighted when looking at how cardiovascular responses fluctuate over repeated testing. Habituation-sensitization patterns suggest that, when dealing with difficult tasks, women may derive benefit from background social relationships whereas men may find that such background relationships bring additional pressures. This study was supported by a Scientific Research Grant from the Irish Heart Foundation.     

Hostility and perceived social support: interactive effects on cardiovascular reactivity to laboratory stressors

Background: Previous research has identified trait hostility and social isolation as possible psychosocial risk factors for coronary heart disease (CHD). However, few studies have examined hostility and social support simultaneously to determine their independent and possible interactive relations with CHD and disease-promoting mechanisms.Purpose: Hypotheses derived from a general interpersonal model were tested in a study examining trait hostility and perceived social support as predictors of cardiovascular reactivity to laboratory stressors.Methods: Healthy college students (53 men, 55 women) performed speech and mental arithmetic tasks while blood pressure and heart rate were monitored.Results: There was an interactive effect of hostility and perceived social support on systolic and diastolic blood pressure (SBP and DBP) reactivity. Higher hostility scores were associated with greater SBP reactivity for participants who were high in perceived social support; whereas for those with low social support scores, greater hostility was associated with somewhat less SBP reactivity. The same pattern was obtained for DBP, but only during the speech task.Conclusions: These findings encourage further research conceptualizing trait hostility within a general interpersonal framework that calls attention to both positive and negative person-environment transactions. Yung Chen is now at Duke University Medical Center. Suzanne Gilligan is now at the Consortium for Advanced Psychological Training, Michigan State University. Elliot Coups is now at Memorial Sloan-Kettering Cancer Center, Department of Psychiatry and Behavioral Sciences.     

Stability of cardiovascular reactivity to laboratory stressors: a 2 1/2 yr follow-up

The temporal stability of cardiovascular reactivity to laboratory stressors over a 2 1/2 yr period was studied. Subjects who had earlier received a cold pressor and a shock avoidance reaction time task were brought back for retesting using almost identical tasks. Cardiovascular variables that were common to both sessions included heart rate, systolic and diastolic blood pressure, and pre-ejection period. Correlations were computed to examine the association of responses across both sessions for the four cardiovascular variables during rest and the two tasks. Correlations of both heart rate and systolic blood pressure were high for all tasks and rest, whereas inconsistent correlations were found for diastolic pressure and pre-ejection period. Inconsistencies in diastolic pressure are speculated to be due to individual differences in beta-adrenergic response, whereas lack of consistent pre-ejection period associations may be due to differences in methodology. The results generally support the assumption of stability of cardiovascular reactivity.     

Extracranial and cardiovascular reactivity in migrainous subjects

It was hypothesized that extracranial vascular responses would differ from normal in migrainous subjects during psychological stress in accord with Malmo and Shagass' theory of symptom specificity. Physiological responses (systolic blood pressure, diastolic blood pressure, heart rate, respiration rate, facial temperature and temporal pulse amplitude) were recorded during laboratory stresses (isometric exercise, carbon dioxide rebreathing, cold pressor, head-up tilt, radiant heat, head-back tilt and mental arithmetic) in 20 migrainous subjects and 20 controls matched for age and sex. Increases in temporal pulse amplitude were larger in migrainous subjects during the psychologically stressful mental arithmetic test while facial temperature rose less than in the control group. Extracranial vascular responses were similar in migrainous and non-migrainous subjects during isometric exercise, cold pressor test, head-up tilt and radiant heat although temporal pulse amplitude responses differed during the first trial of the head-back tilt test. Facial temperature rose in migrainous subjects during carbon dioxide rebreathing but remained steady in non-migrainous subjects. The present findings support the hypothesis that physiological reactions of the cranial vasculature differ from normal in migrainous subjects particularly during psychological stress.     

Interpersonal behavior and cardiovascular reactivity in pharmacologically-treated hypertensives

This study examined the interpersonal behavior and concomitant cardiovascular reactivity (CVR) of hypertensive patients whose resting blood pressure was controlled by antihypertensive medication. Thirty hypertensive and 30 normotensive subjects matched for age, sex and occupational status were recruited from an industrial setting. The groups were compared on measures of interpersonal behavior, blood pressure and heart rate while they engaged in both role-played (RP) and naturalistic interactions (NI) requiring positive and negative assertion. Interpersonal behavior of the groups was generally similar, with two exceptions: hypertensives made fewer requests for new behavior in the negative RP and verbalized more praise statements in the positive NI. There were no differences between the groups on measures of CVR during interpersonal interactions. Overall effectiveness during scenes requiring negative assertion was associated with increased cardiovascular reactivity, especially for hypertensives. The interpersonal behavior and cardiovascular responses of patients taking beta-blocker medication did not differ from those taking diuretics. These findings are discussed with regard to methodological considerations pertinent to the assessment of interpersonal behavior and the issue of heterogeneity among hypertensives.     

Social approach behaviors in oxytocin knockout mice: comparison of two independent lines tested in different laboratory environments

Oxytocin mediates social affiliation behaviors and social memory in rodents. It has been suggested that disruptions in oxytocin contribute to the deficits in reciprocal social interactions that characterize autism. The present experiments employed a new social approach task for mice which is designed to detect low levels of sociability, representing the first diagnostic criterion for autism. Two lines of oxytocin knockout mice were tested, the National Institute of Mental Health line in Bethesda, and the Baylor/Emory line at the University of North Carolina in Chapel Hill. Similar methods were used for each line to evaluate tendencies to spend time with a stranger mouse versus with an inanimate novel object with no social valence. Adult C57BL/6J males were tested identically, as controls to confirm the robustness of the methods used in the social task. Comprehensive phenotyping of general health, neurological reflexes, olfactory and other sensory abilities, and motor functions was employed to assess both lines. No genotype differences were detected in any of the control measures for either line. Normal sociability, measured as time spent with a novel stranger mouse as compared to time spent with a novel object, was seen in both the NIMH and the Baylor/Emory lines of oxytocin null mutants, heterozygotes, and wild-type littermate controls. Normal preference for social novelty, measured as time spent with a second novel stranger as compared to time spent with a more familiar mouse, was seen in both the NIMH and the Baylor/Emory lines of oxytocin null mutants, heterozygotes, and wild-type littermate controls, with minor exceptions. Similar behavioral results from two independent targeted gene mutations, generated with different targeting vectors, bred on different genetic backgrounds, and tested in different laboratory environments, corroborates the negative findings on sociability in oxytocin mutant mice. Intact tendencies to spend time with another mouse versus with a novel object, in both lines of oxytocin knockouts, supports an interpretation that oxytocin plays a highly specific role in social memory, but is not essential for general spontaneous social approach in mice.     

The social construction of cardiovascular reactivity

One can view the “reactivity hypothesis” as having two basic forms: the individual difference or personality approach, which suggests that people who show exaggerated cardiovascular responses to stress are at increased risk of developing cardiovascular disease, and the situational or social psychological approach, which suggests that circumstances which give rise to unusually large responses are those that put people at risk of disease. Both versions rely on the generality of cardiovascular responses across situations. Evidence is presented from two studies which indicate that such generality may, however, be hard to come by. In the first study. examining the personality approach, we show that a simple change in setting dramatically attenuates the consistency of reactivity. In the second study, from the social psychological perspective, we show that subtle alterations in the situation have profound effects on group mean responses. In both cases, reactivity proved extremely sensitive to the context, suggesting that testing in arbitrary and artificial settings cannot be expected to generalize well to the real world. Instead, we argue, careful attention to psychological naturalism is essential, with the testing carefully matched to specific real-world phenomena of interest.     

Personality, effort perception and cardiovascular reactivity

Ratings of perceived exertion and neuroendocrine reactivity (plasma catecholamines) were measured in type A and type B student volunteers during a metabolically equivalent physical stressor (cycle ergometry). Analysis of variance demonstrated that type A underrated the perception of exertion as compared to type B. Therefore, this neuropsychobiological interaction could partly explain the relationship between type A and the tissue pathology in the development of accentuated coronary heart disease.     

Psychophysiological reactivity and the prediction of cardiovascular disorders

Two aspects of psychophysiological reactivity that might be relevant to subsequent cardiovascular morbidity were explored in this study. Thirty-six volunteers participated in a single experimental session, during which three taxing cognitive tasks were performed. Interbeat interval, pulse transit time, and respiratory and electrodermal variables were monitored throughout. Large differences between individuals in psychophysiological reactions to the tasks were recorded, and two forms of analysis were therefore performed. Firstly, there is evidence that people exhibiting Type A coronary-prone behaviour pattern show heightened cardiovascular reactions to challenging tasks, and this was tested by administering a student version of the Jenkins Activity Survey. However, high scores on the questionnaire were not associated with interbeat interval or transit time hyper-reactivity. Amongst male subjects the reverse trend was found, since those with scores at the Type B end of the scale produced greater cardiovascular reactions. The second analysis examined the relationship between cardiovascular and other psychophysiological reactions. Cardiovascular responses tended to be coordinated, so that subjects displaying large tachycardias also produced substantial modifications in transit time. Furthermore, haemodynamic hyper-reactivity was not reflected in generalised autonomic lability, since reactive individuals did not show exaggerated responses in electrodermal or respiratory variables. Thus people exhibiting large transit time and heart rate modifications may have specific disturbances in cardiovascular stability, putting them at risk for later haemodynamic disorder.     

Acculturation and cardiovascular reactivity of second-generation Turkish migrants in Germany

OBJECTIVE: Previous studies have shown that migration and acculturation lead to higher blood pressures and a higher prevalence of cardiovascular diseases. Heightened cardiovascular reactivity is considered as a risk factor for cardiovascular diseases. Therefore, the purpose of the present study was to examine cardiovascular reactivity in young and healthy second-generation Turkish migrants to Germany. METHOD: Forty-one Turkish and 20 German male students worked on a mental arithmetic task for 6 min and underwent the cold pressor test for 90 s. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were taken in intervals of 2 min at baseline and during task periods. Stroke volume (SV), cardiac output (CO), preejection period (PEP), and total peripheral resistance (TPR) were registered continuously by impedance cardiography. The Turkish volunteers were divided into weak and advanced acculturated migrants based on self-ratings given in a questionnaire. RESULTS: Advanced acculturated Turkish students showed greater HR and CO increases and greater PEP and TPR decreases to the mental arithmetic task than Germans or weak acculturated Turkish students. No group differences were found for the cold pressor test. CONCLUSION: Migrants' acculturation is associated with an enhanced beta-adrenergic activation pattern of the sympathetic nervous system that might put them at greater risk with regards to essential hypertension and coronary heart disease.     

Alexithymia, defensiveness and cardiovascular reactivity to stress

This article attempts to further our understanding of alexithymia by testing two conceptual questions about the construct: (a) Is alexithymia characterized by reduced autonomic activity? and (b) Can it be clearly distinguished from defensiveness? Eighty healthy university students completed a battery of personality scales including the Toronto Alexithymia Scale, measures of self-deception and impression management, depression, and anger-in. They also participated in three lab stress tasks: isometric handgrip; mental arithmetic; and a negative affect provocation task. Blood pressure and heart rate were monitored throughout the lab procedure. Analyses were conducted with tercile groups of low, medium, and high alexithymia scorers. The “high alexithymia” tercile showed smaller heart rate responses to the stress tasks and more anger-in behavior. Blood pressure responses did not differentiate the low/medium/high alexithymia subgroups. Alexithymia scores were unrelated to defensiveness, that is, there was no relationship between alexithmia and impression management or self-deception, and alexithymia was unrelated to depression. We conclude that students defined as “high alexithymia” on the Toronto Alexithymia Scale are not self-deceptive nor do they try to leave a particular impression; they tend to be somewhat hypoaroused autonomically, and they report as many psychological distress symptoms as do subjects with lower TAS scores.     

Role-played interpersonal interaction: Ecological validity and cardiovascular reactivity

Conflictual role-play scenarios have been used to model brief interpersonal interaction and to elicit cardiovascular reactivity in the laboratory. Here we discuss data suggesting that role-played interactions constitute an ecologically valid laboratory task that may improve laboratory-to-field generalization of cardiovascular response. Specifically, our research indicates that young adults perceive the stress associated with role-play scenarios as similar to that encountered in everyday life. Furthermore, these stress appraisals moderate cardiovascular response to role-play in men. We also find that a social stressor (i.e. speech task) is perceived as significantly more similar to a real-life stressor as compared to other standard laboratory tasks. We propose that particular constellations of cognitive, affective, and behavioral responses to laboratory-based social stressors, such as role-played interaction, may elicit different patterns of hemodynamic response. Further understanding of interrelations among cognitive, affective, behavioral, and physiological response patterns may assist in the study of cardiovascular reactivity as a potential mechanism linking personality factors and the development of cardiovascular disease.     

Effects of social stressors on cardiovascular reactivity in black and white women

Background: Behavioral scientists have theorized that perceived racism in social interactions may account for some of the observed disparities in coronary heart disease between Black and White Americans.Purpose: The objective was to examine whether racial stress influences cardiovascular reactivity, a risk factor for cardiovascular disease.Methods: We measured cardiovascular responses in Black and White women (n = 80) as they talked about 3 hypothetical scenarios: (a) being accused of shoplifting (racial stressor), (b) experiencing airport delays (nonracial stressor), and (c) giving a campus tour (control).Results: Relative to White women, Black women had significantly greater mean diastolic blood pressure reactivity (3.81 vs. 0.25 mmHg; p < .05) in response to the racial stressor than in response to the nonracial stressor. Black women exhibited significantly lower heart rate during recovery following the racial stressor than during recovery following the nonracial stressor (−0.37 beats/min vs. 0.86 beats/min; p < .001). Among Black women, those who explicitly made race attributions during the racial stressor had greater systolic but not diastolic blood pressure reactivity than those who did not make racial attributions (8.32 mmHg vs. 2.17 mmHg; p < .05).Conclusions: These findings suggest that perceived racism in social interactions may contribute to increased physiological stress for Black women. This work was supported by Grant CA91411 from the National Institutes of Health and a grant from the Professional Staff Congress of City University of New York. We are grateful for the excellent research assistance of Allyson Bunbury, Michael Gold, Mark Vegh, and Alex Libin. Teceta Thomas provided helpful comments on the article.     

Experimentally induced anger, cardiovascular reactivity, and pain sensitivity

It was investigated whether an angry state, induced by a computer task with harassing comments, would lead to a decrease in cold pressor pain threshold and tolerance in comparison to a neutral situation. It was hypothesized that an increase in cardiovascular activity might partially mediate effects of anger. Furthermore, it was examined whether subjects given the opportunity to express anger would show reduced cardiovascular activity and pain report compared to subjects not given this opportunity. Finally, trait measures for anger expression style and hostility were included. The results show an increase instead of the expected decrease in pain tolerance for subjects in the harassment condition compared to those in the neutral condition. While cardiovascular reactivity was positively related to pain threshold and tolerance, increased anger was associated with increased pain report. It is suggested that anger and cardiovascular reactivity may have important but sometimes opposing influences on pain.     

Behaviorally-induced cardiovascular reactivity among sons of reported hypertensive and normotensive parents

The principal purpose of this investigation was to contrast the stress-related cardiovascular responses of sons of reported hypertensive and normotensive parents in a sample of 80 young adult volunteers. Each subject was scheduled for a single, one-hour experimental session. Measures of heart rate (HR) and systolic and diastolic blood pressure (SBP, DBP) were obtained during baseline periods and while subjects performed a difficult and frustrating cognitive task. Each subject also completed a standard family health inventory and, after exclusion of individuals indicating lack of information, uncertainty regarding parental health status, or otherwise providing unusable data (e.g. adopted sons), 20 of 69 remaining subjects reported a parental history of hypertension. Results indicated that relative to sons of normotensives, subjects reporting a hypertensive parent exhibited significantly higher mean SBP measurements during their performance of the experimental task, but not during a preceding (i.e. pre-task) baseline interval. Subsequent analyses also revealed that among subjects exhibiting the most appreciable HR acceleration in response to the experimental stressor, reported histories of parental hypertension were associated with elevated SBP measurements during both baseline and task periods. No similar relationships were observed with respect to DBP.     

Platelet reactivity is a stable and global phenomenon in aspirin-treated cardiovascular patients

In healthy subjects, platelet hyperreactivity is a global phenomenon--as opposed to agonist-specific--and epinephrine-induced platelet aggregation (EPA) is a reliable marker of this phenotype. Few data are available on platelet reactivity and the relationship between EPA and aggregation induced by other agonists in cardiovascular patients. It was the objective of this study to characterise platelet reactivity in stable cardiovascular patients treated with aspirin and to derive a composite index integrating several aggregation pathways, suitable for selecting patients with extreme phenotypes for further proteomics analysis. Platelet reactivity to agonists was assessed in 110 patients twice, two weeks apart. Factorial analysis was used to determine whether the results obtained with the different agonists could be summarised in a single composite index. EPA correlated with the aggregation values obtained with each of the other agonists, with correlation coefficients of 0.44 to 0.55 (p < 0.001). We constructed a composite "platelet reactivity" index that included 60% of the information provided by each agonist. The results obtained at the first patient visit were consistent with those obtained at the second visit (r = 0.78, p<0.01). No clinical or biological parameters correlated with the composite index. The extreme phenotypes of six selected subjects were confirmed 12 months after the second visit. In conclusion, platelet reactivity in aspirin-treated cardiovascular patients is a global phenomenon that can be summarised by a composite index based on the aggregation responses to various agonists and integrating several activation pathways. This index is not dependent on clinical or biological variables, suggesting that genetic factors regulate platelet reactivity in these patients.     

Interactive relation of insulin and gender to cardiovascular reactivity in healthy young adults

High levels of insulin may promote hypertension pathogenesis, in part, via enhanced sympathetic nervous system (SNS) activity. This study examined potential interactive relations of fasting insulin levels, gender, and race to cardiovascular reactivity-a correlate of SNS activation. Hemodynamic re sponses to 4 laboratory challenges were determined by impedance cardiography in 64 healthy young adults (ages 18–26; 48% male; 50% White, 50% African American). Also examined were lipoprotein lipids, central and total adiposity, self-reported dietary factors, and physical activity. High-insulin (< 10,2 μU/ml) men showed greater total peripheral resistance and longer pre-ejection period responses than low-insulin (≤10.2 μUfml) men. High-insulin women displayed greater cardiac index responses than high-insulin men. High insulin levels were related to greater percentage body fat, dietary carbohydrate and fat intake, lower high-density lipoprotein (HDL) cholesterol (in men), higher total cholesterol (in women), and a trend toward higher triglycerides. Cardiovascular reactivity findings were unchanged after statistical adjustment for total and HDL cholesterol, triglycerides, percentage body fat, dietary carbohydrates, and fat. The Gender x Insulin (continuous scores) interaction accounted for 7% and 9% of the variance in cardiac index and total peripheral resistance responses, respectively. These results indicate that high insulin levels are associated with greater vascular reactivity in young men and cardiac reactivity in young women. Enhanced cardiovascular reactivity may constitute a biobehavioral dimension of the metabolic syndrome. This project was supported by the University of Maryland, Baltimore Graduate School’s Designated Research Initiative Fund. Preparation of this article was supported, in part, by National Institutes of Health Grant R29 AG15112 to Shari R. Waldstein. Thanks are extended to Serina Neumann, Karl Maier, Stephen Synowski, Joshua Merrill, Ann Clark. Nadine Dumorne, and other members of the Cardiovascular Behavioral Medicine laboratory for assisting with study administration. We also thank the staff of the University of Maryland, Baltimore County’s Student Health Service for their assistance with collection of blood samples.     

A comparison of dream content in laboratory dream reports of schizophrenic and depressive patient groups

We have been attracted to studying the dream for two different but interrelated reasons. In the usual clinical tradition, we have been drawn to study the dream for the insights it may provide into the personality of the dreamer. From a more theoretical point of view, we have been interested in the psychology of dreaming, especially in searching for evidence of a possible function that dreaming serves.We have pursued a series of studies of dream reports of schizophrenic and depressed patients both for the contribution they could make to our understanding of the personality of the dreamer and to elucidate possible functions of the dream. In a study of the spontaneously recalled dream reports of depressed, schizophrenic, and medical patients, we were able to distinguish among them based on the systematic analysis of the content of their dream reports.¹ The content differences, such as the most frequent character in the depressed being a family member, in the schizophrenic a stranger, and in the medical patient a friend, did indeed provide potentially valuable insights into the personality of the dreamer. In our studies of collected dream reports (REM dreams from the laboratory) of schizophrenic² and depressed patients³ before treatment and after significant improvement, we were able to show content differences which suggested that the collected dream report was reflective of the current emotional state of the patient. This supports the possibility that the dream may play some adaptational role in the psychic economy of the patient.The current report, which compares the content of REM-dream reports of depressed and schizophrenic patients, addresses itself both to the clinical problem, i.e., the light that dream reports may shed on the personality of depressed and schizophrenic patients, and to the psychology of dreaming, i.e., the possible functional significance of the dream.