A comparison of psychologically-induced cardiovascular reactivity in laboratory and natural environments

This study focused on the possible role of heart rate reactivity in the development of essential hypertension in female subjects. Baseline heart rate, systolic and diastolic blood pressures, taken over a 6 week period, were used for comparison with the same measures taken during a laboratory session involving relaxation, cold pressor, mental arithmetic and exercise, and before and after an academic examination. Information about personality and lifestyle was included in subsequent univariate and multivariate analyses. Significant increases were produced in heart rate by the mental arithmetic task (p less than 0.00005), in systolic pressure by the exercise task (p less than 0.00005) and in systolic pressure prior to the examination (p less than 0.001). No significant diastolic effects were found. When subjects were divided into high and low reactors, on the basis of their heart rate reactivity to mental arithmetic, there was little difference in cardiovascular activity between the groups in any other condition. Significant effects on reactivity were found for diet, regular daily exercise and type A personality. The results are discussed in terms of Obrist's theory of the genesis of essential hypertension.     

Blood pressure in healthy men and women under laboratory and naturalistic conditions

Thirty healthy nonsmoking men and 30 women underwent a laboratory reactivity assessment with systolic (SBP) and diastolic blood pressure (DBP), and heart rate (HR) recorded at rest and during behavioral (mirror image tracing, mental arithmetic, color word conflict task and a semistructured Type A interview), and physical tasks (isometric exercise and the cold pressor test). Casual SBP and DBP were measured in a physician's clinic. Four months earlier SBP, DBP and HR had been monitored during a day at work and a day at home. Readings obtained in the clinic, at rest and during stress in the laboratory were related to real-life levels, reactivity (work—home difference) and variability.

For men level of cardiovascular activation at rest and during all stressors in the laboratory correlated with levels at work and at home. The best laboratory/real-life relation was observed for SBP. Systolic blood pressure levels during stress correlated with the work—home difference. Systolic blood pressure reactivity (laboratory stress levels—rest levels) to most behavioral tasks correlated with SBP levels at work and home. Daily variability and reactivity correlated with SBP reactivity to mental arithmetic and the color word conflict task. For women, levels of SBP and HR at rest and during all stressors correlated with SBP and HR at work and at home. The best laboratory/real-life relation for women was observed for HR reactivity. Casual BP in the clinic correlated with work blood pressure but generally not with daily reactivity or variability.

We conclude that BP and HR levels measured in the laboratory generalizes to real life BP and HR in both men and women and also to real life SBP reactivity in men. Laboratory induced SBP reactivity also shows a weak relation to real life SBP levels, variability and reactivity in men.     

Type D personality is related to cardiovascular and neuroendocrine reactivity to acute stress

OBJECTIVE: The relationship between Type D personality (the joint tendency towards negative affectivity [NA] and social inhibition [SI]) and laboratory indices of cardiovascular health was examined. METHOD: 173 undergraduates (86 male) completed a stress protocol involving a mental arithmetic task with harassment. Blood pressure, heart rate (HR), and salivary cortisol were measured both prior to and during the task. RESULTS: The relationships between personality and both resting and reactivity levels were examined. Results indicated that socially inhibited men demonstrated heightened blood pressure reactivity. NA was related to dampened HR change during the stress task in men. Correlational analyses indicated that both Type D dimensions were associated with greater cortisol reactivity to stress; however, results no longer remained significant in more stringent regression analyses. CONCLUSION: Findings are consistent with the noted relationship between Type D and cardiovascular disease (CVD), and suggest a possible pathway to disease via an association with physiological hyperreactivity.     

Effects of an aerobic rowing training regimen in young adults with Down syndrome

Effects of a rowing exercise regimen on cardiovascular fitness of young adults with Down syndrome were examined. Sixteen young males with trisomy 21 (mean age 21.3, mean IQ 38.8) were randomly assigned to either a control or exercise group. All participants performed pre- and posttraining graded exercise tests on a treadmill and rowing ergometer. The exercise group performed a 16-week rowing ergometry training regimen. Following training, no changes in cardiovascular fitness had occurred for this group. However, they reached significantly higher levels of work performance for both treadmill and rowing ergometer posttraining tests. Results show that an exercise training regimen did not improve the cardiovascular fitness of young adults with Down syndrome but did improve exercise endurance and work capacity.     

Physical fitness level and autonomic reactivity to psychosocial stress

Two studies explored the influence of aerobic fitness level on autonomic reactivity to psychosocial stress. Experiment 1 employed a correlational, repeated measures design. A total of 45 men who were physically trained, untrained, or training were tested at three-week intervals over nine weeks. The measure of autonomic reactivity was lability in electrodermal activity during two speeded mental tasks designed to induce psychosocial stress. In the initial test session, trained subjects showed faster autonomic recovery from this stress than did untrained or training subjects; in subsequent test sessions involving the repeated administration of the same tasks, the three groups were indistinguishable. Experiment 2 employed 60 subjects who were randomly assigned to 10-week aerobic exercise, meditation, or music appreciation programs. In each session, two psychosocial stressors selected from a battery of six tasks were counterbalanced across treatments and sessions. Over the course of the study, participants in the exercise program improved significantly in physical fitness and also showed faster recovery in the electrodermal response. This quicker autonomic recovery may allow the aerobically fit to cope more effectively with emotional stress.     

Long-term effects of a brief distraction intervention on children's laboratory pain reactivity

This 2-year follow-up study examined the effects of a brief behavioral intervention on task-based coping and pain reactivity to the cold pressor task (CPT). In the original study by Fanurik et al. (1993), 64 children (aged 8 to 10) whose coping style was categorized as "attender" or "distracter," based on primary coping strategy during baseline CPT trials, received a 5-minute intervention (attention-focusing, distraction training, or control, randomly assigned). In the present study, 51 (32 female) of the original sample were readministered the CPT, and their coping style and pain responsivity were reassessed. Both distracters and attenders given distraction training preferred use of distraction at follow-up. The distraction training group also demonstrated greater tolerance at follow-up compared to controls, although pain ratings did not differ by intervention group. Our findings suggest that a brief distraction intervention has long-term effects on task-based coping and experimental pain reactivity.     

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.     

A comparison of adherence to hypoglycemic medications between Type 2 diabetes patients with and without serious mental illness

Inadequate self-management of chronic medical conditions like Type 2 diabetes may play a role in the poor health status of individuals with serious mental illnesses. We compared adherence to hypoglycemic medications and blood glucose control between 44 diabetes patients with a serious mental illness and 30 patients without a psychiatric illness. The two groups did not differ in their ability to manage a complex medication regimen as assessed by a performance-based measure of medication management capacity. However, significantly fewer patients with a mental illness self-reported nonadherence to their hypoglycemic regimens compared to those without a mental illness. Although individuals with mental illnesses also had better control of blood glucose, this metabolic parameter was not correlated with adherence to hypoglycemic medications in either patient group. The experience of managing a chronic mental illness may confer advantages to individuals with serious mental illnesses in the self-care of co-occurring medical conditions like Type 2 diabetes.     

An aerobic exercise program for young people with cerebral palsy in specialist schools: A phase I randomized controlled trial

ABSTRACT

Purpose: To evaluate the safety, adherence, and estimates of effect of an aerobic exercise program in specialist schools for young people with cerebral palsy. Methods: Nineteen students with cerebral palsy were randomly allocated to an intervention group who completed an aerobic exercise program (27 sessions over nine weeks) or a control group who completed social/art activities over the same time. Results: There were no serious adverse events and the exercise program was completed with high rates of attendance (77%) and adherence to target heart rate zones (79%). Effect sizes favored the intervention group for measures of cardiovascular performance (sub-maximal treadmill test, effect size d = 0.7; muscle power sprint test, d = 0.9) and participation (Preference for Active-Physical Activities, d = 0.6). Conclusions: An aerobic exercise program in specialist schools for young people with cerebral palsy, that may improve measures of cardiovascular performance, can be completed safely, with moderately high levels of adherence.     

Vigorous,aerobic exercise versus general motor training activities: Effects on maladaptive and stereotypic behaviors of adults with both autism and mental retardation

Examined the effects of antecedent exercise conditions on maladaptive and stereotypic behaviors in 6 adults with both autism and moderate to profound mental retardation. The behaviors were observed in a controlled environment before and after 2 exercise and 1 nonexercise conditions. From the original group of 6 participants, 2 were selected subsequently to participate in aerobic exercise immediately before performing a community-integrated vocational task. Only antecedent aerobic exercise significantly reduced maladaptive and stereotypic behaviors in the controlled setting. Neither of the less vigorous antecedent conditions did. When aerobic exercise preceded the vocational task, similar reductions were observed. There were individual differences in response to antecedent exercise. Use of antecedent aerobic exercise to reduce maladaptive and stereotypic behaviors of adults with both autism and mental retardation is supported.The authors acknowledge the important assistance provided by the following people: The staff and management of the Behavior Development and Learning Center at Camarillo State Hospital and Developmental Center directed by Israel Perel, Ellie Kimbauer, Judy Baptista, Kristine Herman, and especially the participants.     

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.     

The effects of exercise training on mental well-being in the normal population: a controlled trial

This study was designed to compare the effects of two aerobic training programmes of differing intensities on mood and mental well-being with those of a credible attention-placebo condition. One hundred and nine sedentary adult volunteers from the local population were assigned to four conditions: high intensity aerobic training, moderate intensity aerobic training, attention-placebo and waiting list. Training was carried out over a 10 week period. Subjects were assessed before and after training with psychological measures and the 12 min walk-run test, and follow-up evaluations were undertaken after 3 months. Ninety-four subjects began the programme and the adherence rate averaged 80%, with no significant differences in number of drop-outs between conditions. Appropriate changes in estimated maximum oxygen consumption were observed in the three active conditions with the 12 min walk-run test. Psychological benefits were seen with the moderate exercise condition but not in the high exercise or attention-placebo conditions. These effects were manifest immediately after training on measures of tension/anxiety and confusion, and at follow-up on measures of perceived coping ability. The mechanisms underlying this pattern of results are discussed and the relative importance for health of vigorous activity and physical fitness is considered.     

Impact of exercise training on plasma adrenocorticotropin response to a well-learned vigilance task

Plasma adrenocorticotropin hormone (ACTH), cortisol, heart rate, self-reported state anxiety and total reaction time responses in physically active (n=8) and sedentary (n=11) middle-aged men were compared during performance of a well-learned, psychologically challenging task. The groups were similar in age (active: 39.9±8.4 yr vs. sedentary: 44.4±7.2 yr) and trait anxiety (29.4±5.2 vs. 34.5±12.6), but they had different maximal oxygen consumption relative to lean body weight (68.6±7.1 vs. 44.7±4.6 ml · kg⁻¹ · min⁻¹). During performance of the psychological protocol, the total group had significant increases in heart rate and state anxiety, whereas both ACTH and cortisol remained near baseline levels. ACTH and cortisol were not different between the groups. The sedentary group exercise trained for 4 mo, which resulted in an 18% improvement in maximal aerobic capacity ( O₂ max). Exercise intervention did not significantly alter the neuroendocrine response compared to pre-training values or compared to a corresponding control group. These findings suggest that enhanced cardiovascular fitness resulting from exercise training does not affect anterior pituitary-adrenocortical activity during performance of a practiced vigilance task.     

Disordered eating behaviour is associated with blunted cortisol and cardiovascular reactions to acute psychological stress

Research suggests a potential dysregulation of the stress response in individuals with bulimia nervosa. This study measured both cardiovascular and cortisol reactions to a standardised laboratory stress task in individuals identified as showing disordered eating behaviour to determine whether dysregulation of the stress response is characteristic of the two branches of the stress response system. Female students (N=455) were screened using two validated eating disorder questionnaires. Twelve women with disordered eating, including self-induced vomiting, and 12 healthy controls were selected for laboratory stress testing. Salivary cortisol and cardiovascular activity, via Doppler imaging and semi-automatic blood pressure monitoring, were measured at resting baseline and during and after exposure to a 10-min mental arithmetic stress task. Compared to controls the disordered eating group showed blunted cortisol, cardiac output, heart rate, and stroke volume reactions to the acute stress, as well as an attenuated vasodilatory reaction. These effects could not be accounted for in terms of group differences in stress task performance, subjective task impact/engagement, age, BMI, neuroticism, cardio-respiratory fitness, or co-morbid exercise dependence. Our findings suggest that disordered eating is characterised by a dysregulation of the autonomic stress-response system. As such, they add further weight to the general contention that blunted stress reactivity is characteristic of a number of maladaptive behaviours and states.     

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 randomized controlled trial of patient‐reported outcomes with tai chi exercise in Parkinson's disease

A previous randomized, controlled trial of tai chi showed improvements in objectively measured balance and other motor‐related outcomes in patients with Parkinson's disease. This study evaluated whether patient‐reported outcomes could be improved through exercise interventions and whether improvements were associated with clinical outcomes and exercise adherence. In a secondary analysis of the tai chi trial, patient‐reported and clinical outcomes and exercise adherence measures were compared between tai chi and resistance training and between tai chi and stretching exercise. Patient‐reported outcome measures were perceptions of health‐related benefits resulting from participation, assessed by the Parkinson's Disease Questionnaire (PDQ‐8) and Vitality Plus Scale (VPS). Clinical outcome measures included motor symptoms, assessed by a modified Unified Parkinson's Disease Rating Scale–Motor Examination (UPDRS‐ME) and a 50‐foot speed walk. Information on continuing exercise after the structured interventions were terminated was obtained at a 3‐month postintervention follow‐up. Tai chi participants reported significantly better improvement in the PDQ‐8 (?5.77 points, P = 0.014) than did resistance training participants and in PDQ‐8 (?9.56 points, P < 0.001) and VPS (2.80 points, P = 0.003) than did stretching participants. For tai chi, patient‐reported improvement in the PDQ‐8 and VPS was significantly correlated with their clinical outcomes of UPDRS‐ME and a 50‐foot walk, but these correlations were not statistically different from those shown for resistance training or stretching. However, patient‐reported outcomes from tai chi training were associated with greater probability of continued exercise behavior than were either clinical outcomes or patient‐reported outcomes from resistance training or stretching. Tai chi improved patient‐reported perceptions of health‐related benefits, which were found to be associated with a greater probability of exercise adherence. The findings indicate the potential of patient perceptions to drive exercise behavior after structured exercise programs are completed and the value of strengthening such perceptions in any behavioral intervention.     

Anger suppression, reactivity, and hypertension risk: Gender makes a difference

The present study investigated gender-related differences in cardiovascular reactivity and the role of anger inhibition and risk for future hypertension. Tonic blood pressure served as an index of hypertension risk. Twenty-eight female and 26 male college students with high and low normal blood pressure were recruited on the basis of their mean arterial pressure. Continuous measures of heart rate and blood pressure were taken while participants carried out a series of behavioral manoeuvres including mental arithmetic, interpersonal challenge, a frustrating psychomotor test, and the cold pressor test. Participants also completed inventories assessing trait anxiety, trait anger, anger expression, and Type A. The results are in concordance with previous findings and show higher cardiovascular reactivity in men than in women and in subjects at risk for hypertension. Within the male group, a combination of hypertension risk and anger suppression led to the highest reactivity, whereas in female subjects, differences in anger-in had no effect on reactivity. The implications of these results are discussed in light of sex differences in cardiovascular morbidity and mortality.     

Vasopressin peptide (DDAVP) may narrow the focus of attention in normal elderly

Administration of DDAVP (1 desamino-8-D-arginine vasopressin), a form of vasopressin with little pressor action, has been shown to improve cognitive performance in the elderly. It remains unclear whether memory processes are specifically influenced or more general processes are altered. Fifteen elderly subjects performed a central mental arithmetic task and a peripheral choice reaction time task in DDAVP and control conditions. DDAVP slowed reaction times to peripheral lights but did not alter arithmetic performance. The results suggest that DDAVP increases the proportion of attention allocated to primary task performance by decreasing attention to secondary tasks. This shift does not appear to be mediated by any action of DDAVP on peripheral cardiovascular function.     

Power spectral analysis of heart rate variability in Type As during solo and competitive mental arithmetic task.

It has been reported that there are differences in autonomic balance between Type As and Type Bs. This study evaluated the sympathovagal interaction in Type A (N = 10) and Type B (N = 10) male students during mental arithmetic task in a solo and a competitive condition by the spectral component analysis of heart rate variability (HRV). The low-frequency (LF) component to high-frequency (HF) component ratio was significantly greater in Type As than in Type Bs, though no significant differences were found in task performance, heart rate change, and blood pressure between the two subject groups in both conditions. The present findings indicate that there was a significant difference in sympathovagal balance between Type As and Type Bs, and that Type As showed dominant sympathetic activity. The results suggest that the power spectral analysis of HRV, which is convenient and non-invasive, has enough sensitivity to discriminate differences in autonomic balance between Type A subjects and Type B subjects, not only during the solo and competitive task period but also during the resting period.