Anger management style,degree of expressed Anger,and gender influence cardiovascular recovery from interpersonal harassment

The hypothesis that the degree to which individuals expressed anger during harassment would mediate relationships between anger management style and cardiovascular recovery from harassment was examined in a college sample of 31 men and 32 women. Subjects told stories about Thematic Apperception Test cards during nonharassment and harassment phases. Words spoken during the storytelling reflecting aggressive behavior and angry/hostile affect were coded from audiotapes. Responses on the Anger-out subscale (AOS) of the Anger Expression Inventory were positively correlated with expression of angry/hostile affect words, and with SBP increases during harassment. During recovery, high AOS men and low AOS women showed sustained SBP, while men who expressed much anger and women who expressed little anger showed sustained SBP. Additional tests provided support for the hypothesis: SBP responses of high AOS men and low AOS women during recovery were partly mediated by the degree to which subjects expressed anger during harassment.     

Relative effects of harassment, frustration, and task characteristics on cardiovascular reactivity.

Effects of anger induction procedures such as frustration and harassment on cardiovascular reactivity have been demonstrated in a wide range of experimental situations. Similarly, heightened cardiovascular reactivity has been associated with a diverse range of tasks involving active coping, competition and interpersonal interaction. The present study sought to directly compare the relative effects of these two important ways of inducing cardiovascular changes. One hundred and five university students performed two tasks that differed in the degree of active coping and interpersonal competition: a competitive psychomotor task and a problem-solving task. States of anger were induced during both tasks by means of harassment, frustration or frustration+harassment. Task-related changes in heart rate, systolic blood pressure, diastolic blood pressure, pulse volume amplitude and respiratory sinus arrhythmia amplitude were monitored. The competitive psychomotor task produced greater cardiovascular reactivity than did the problem-solving task. Harassment and frustration+harassment provoked more cardiovascular reactivity than did frustration alone. However, harassment and frustration+harassment had the greatest cardiovascular effects in the competitive task, whereas frustration had the greatest cardiovascular effects in the problem-solving task. In this sense, the increases on cardiovascular reactivity seem to depend on the interaction between anger induction procedures and the context in which anger is provoked.     

Effect of trait hostility on cardiovascular responses to harassment in young men

Hostile individuals may experience more extreme and frequent episodes of anger than nonhostile persons and thus may have exaggerated physiological responses to their environments. Such responses may be associated with increased risk of cardiovascular disease. This study examined cardiovascular responses of 24 low-versus 21 high-hostile young men to a mental arithmetic task administered with and without provocation in a 2 x 2 (Groups x Tasks) repeated measure design. Hostility classifications were based on weighted interview ratings of Potential for Hostility. As predicted, high-hostile men showed differentially greater heart rate, blood pressure, and rate-pressure product changes only in response to the task administered with harassment (ps > .05). Similarly, high-hostile men reported more distress, tenseness, irritation, and greater concentration during the harassing task, compared to low-hostile men (ps > .051) Also, the harassing task elicited greater increases in vascular resistance and greater decreases in stroke volume for all subjects, relative to the neutral task (ps> .003). Results suggest that hostile persons faced with anger-evoking situations may produce a constellation of exaggerated cognitive-emotional and cardiovascular responses consistent with increased risk of cardiovascular disease. This article was supported by the Medical Research Service of the Department of Veterans Affairs and the Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center.     

Hostility and cardiovascular reactivity to stress in women and men

The relationship of Cook Medley hostility scores (Ho) to blood pressure and heart rate reactivity was examined in 56 women and 56 men. Stress was elicited by an unsolvable anagram task that was described as easily solvable. Both men and women scoring high on Ho had greater blood pressure responses to the task. Those scoring high on Ho also reported more anger in response to the tasks, but anger was not associated with blood pressure reactivity. It was concluded that situations evoking suspiciousness and mistrust rather than anger may be necessary to elicit increased blood pressure reactivity among high Ho subjects.     

Dimensions of anger-hostility and cardiovascular reactivity in provoked and angered men

This study investigated the relationship between two dimensions of anger-hostility-the expression of anger-hostility and the experience of anger-hostility-and cardiovascular reactivity in provoked and angered men. A serial subtraction task was administered to 41 male undergraduates who were provoked and angered. A measure of the expression of anger-hostility correlated positively and significantly with systolic and diastolic blood pressure (BP) reactivity. There were no significant correlations between a measure of the experience of anger-hostility and cardiovascular reactivity. The two types of anger-hostility were also found to relate differentially to life-style variables that have been identified as risk factors for coronary heart disease (CHD), with only the expression of anger-hostility showing positive relationships with these life-style CHD risk factors. These findings are discussed within the context of a similar differential relationship between the two dimensions of anger-hostility and CAD and CHD. Finally, significant negative relationships were obtained between the experience of anger-hostility and resting BP and heart rate levels. These findings are discussed within the context of other data suggesting that trait anxiety-neuroticism may have protective properties.The research reported in this paper was supported in part by Research Grant HL-36027 from the National Heart, Lung, and Blood Institute.     

Hypertension risk factors and cardiovascular reactivity to mental stress in young men

Hypertension risk may be associated with increased pressor response to mental stress. However, studies using family history as a predictor of reactivity have obtained mixed results. We assessed cardiovascular responses to mental arithmetic stress (a 5-min serial subtraction task) in male medical students (n = 220) at three levels of hypertension risk based on parental history and the subject's systolic blood pressure (SBP): low (SBP < 125 mm Hg and 0 or 1 hypertensive parent), moderate (resting SBP ≥ 125 mm Hg or 2 hypertensive parents), or high (resting SBP ≥ 125 mm Hg and 1 or 2 hypertensive parents). High risk men showed the greatest blood pressure responses ( + 22/ + 16 mm Hg), while moderate and low-risk groups showed correspondingly smaller responses ( + 17/ + 13 and + 14/ + 11 mm Hg, p's < 0.02). Family history alone did not predict differential reactivity. This study replicates and extends our previous work suggesting the importance of using both family history and resting blood pressure level in determining future risk for hypertension in studies of cardiovascular reactivity in relation to hypertension risk in males.     

Situational determinants of cardiovascular and emotional reactivity in high and low hostile men

Various epidemiologic studies have found that high scores on the Cook and Medley Hostility (Ho) scale are associated with increased risk of coronary heart disease (CHD), severity of atherosclerosis, and all-cause mortality. One plausible biological mechanism suspected of contributing to increased risk of CHD is sympathetic nervous system-mediated hyperresponsivity to environmental stressors. The present study evaluated cardiovascular reactivity among young men with high versus low Ho scores during performance of an anagram task with or without harassment. Compared to performing the task alone, harassment led to increased cardiovascular arousal that was more pronounced for the high Ho subjects than the low Ho subjects. Moreover, harassment produced increases in self-rated anger, irritation, and tension, but it was only among those subjects with high Ho scores that increased anger and irritation were associated with enhanced cardiovascular arousal. While suggesting a role for anger- and irritation-induced cardiovascular arousal in pathogenesis of CHD, these findings indicate that situation characteristics mediate the relationship between Ho scores and cardiovascular reactivity, and that there may be a differential biological link between anger/irritation and cardiovascular responses in men with high and low Ho scores.     

Speech rate,loudness, and cardiovascular reactivity

This paper reports the results of two studies that investigated the relationship between speech rate, loudness, and cardiovascular reactivity (CVR). One study involved the separate manipulation of speech rate and loudness and assessed its effects on CVR during a routine reading task. The second study involved the simultaneous manipulation of both loudness and speech rate and studied its effects on CVR within the context of a personal interview. In both studies, the reduction of speech rate and/or loudness was associated with a significant reduction in CVR. On the other hand, increasing speech rate and/or loudness had no, or only a very minimal, effect on CVR. It is suggested that in the absence of emotional arousal, especially anger-arousal, rapid and loud speech per se is not associated with significant cardiovascular hyperreactivity. On the other hand, our findings suggest that training people to speak slowly and softly may be an effective approach for the control of cardiovascular hyperreactivity.     

Coffee, caffeine, and cardiovascular disease in men

BACKGROUND. For many years, an association between coffee consumption and the risk of coronary heart disease has been suspected. Although based on small numbers of end points, a prospective study has suggested a particularly strong association between recent coffee drinking and the incidence of cardiovascular disease. METHODS. We examined prospectively the relation of coffee consumption with the risk of myocardial infarction, need for coronary-artery bypass grafting or angioplasty, and risk of stroke in a cohort of 45,589 U.S. men who were 40 to 75 years old in 1986 and who had no history of cardiovascular disease. RESULTS. During two years of follow-up observation, 221 participants had a nonfatal myocardial infarction or died of coronary heart disease, 136 underwent coronary-artery surgery or angioplasty, and 54 had a stroke. Total coffee consumption was not associated with an increased risk of coronary heart disease or stroke. The age-adjusted relative risk for all cardiovascular disease among participants who drank four or more cups of coffee per day was 1.04 (95 percent confidence intervals, 0.74 to 1.46). Increasing levels of consumption of caffeinated coffee were not associated with higher risks of cardiovascular disease. Higher consumption of decaffeinated coffee, however, was associated with a marginally significant increase in the risk of coronary heart disease (relative risk, 1.63; 95 percent confidence interval, 1.02 to 2.60). Finally, we observed no pattern of increased risk across the subgroups of participants with increasing intakes of caffeine from all sources. Adjustment for major cardiovascular-risk indicators, dietary intake of fats, and cholesterol intake did not materially alter these associations. CONCLUSIONS. These findings do not support the hypothesis that coffee or caffeine consumption increases the risk of coronary heart disease or stroke.     

Psychophysiological responses to anger provocation among Asian Indian and white men

To examine cultural differences in response to anger provocation, affective, cognitive, behavioral, and cardiovascular responses to social confrontation, role plays were measured in 20 Indian male immigrants in the United States and 40 White men. Participants engaged in 2 interactions with a nonacquiescent male confederate and were instructed to suppress or express their anger in counterbalanced order. Following each role play, participants state anger, and resentful and reflective cognitions pertaining to anger were assessed. Participants’ videotaped behavioral responses were assessed for problem-solving skills and negative and positive verbal and nonverbal behaviors. Blood pressure and heart rate (HR) responses were recorded throughout the session. Results revealed that Indian participants used more introspective strategies comprising of repression and rational coping self-statements to anger provocation than their White counterparts. White participants experienced significantly higher HR responses and showed more awareness of physiological sensation compared to the Indian participants, but only when asked to exhibit their anger. Indian participants had a faster diastolic blood pressure (DBP) recovery when allowed to engage in anger inhibition (which is a culturally determined mode of functioning) compared to when they had to exhibit anger before inhibiting it. White men showed a heightened cardiac response to anger expression, something not seen among Indian men. Indian men, in contrast, exhibited delayed DBP recovery from anger expression and increased introspective cognitive strategies when asked to engage in anger exhibition, a behavior not congruent with their culture of origin.     

Anger expression, hostility, anxiety, and patterns of cardiac reactivity to stress.

The majority of studies investigating the relationships between psychological characteristics and cardiovascular reactivity to stress use a research strategy in which discrete traits are evaluated in isolation. The present study examined the effects of additive and/or interactive relationships among traits on cardiac reactivity to a mental arithmetic task. In addition, impedance cardiographic techniques were employed to examine potential relationships between such psychological traits and a specific measure--pre-ejection period (PEP)--of sympathic influence on the heart. Forty-nine undergraduate men performed a mental arithmetic task while continuous measures of PEP and interbeat interval (IBI) were collected. The subjects then completed questionnaires measuring anger expression, hostility, and trait anxiety. Analyses of variance (ANOVAs) showed a significant main effect for anger-out on PEP change from baseline, but not for IBI. Results also showed that anger-in interacted with anger-out and hostility to affect both PEP and IBI changes significantly. Other results indicated that subjects in the high anger-in/low anger-out and high anger-in/low hostility groups did not show significant PEP change, although they nevertheless showed significant IBI change. These results highlight the importance of the consideration of interactions among traits in predicting cardiac reactivity and of the importance of measuring specific indexes of sympathetic arousal.     

Aerobic exercise training and cardiovascular reactivity to psychological stress in sedentary young normotensive men and women

Forty-five (22 women) sedentary young (18-30 years old) nonsmoking normotensive volunteers engaged in either 6 weeks of aerobic training (AT), weight training (WT), or a no-treatment (NT) condition to determine whether AT lowers systolic (SBP) and diastolic (DBP) blood pressure, heart rate (HR), and rate-pressure product (RPP) during rest, psychological stress, and recovery periods. Estimated VO(2)max increased for the AT (32.1+/-1.1 to 38.4+/-1.0 ml.kg(-1).min(-1)). A smaller increase for the WT (30.5+/-1.1 to 33.8+/-1.0) was likely due to increased leg strength, and VO(2)max did not change for the NT (32.5+/-1.1 to 32.9+/-1.0). Heart rate and RPP levels were lower during psychological stress and recovery after training for AT relative to the WT and NT. Overall SBP was also lower in the AT relative to the NT but not the WT. In conclusion, aerobic training lowered cardiovascular activity levels during psychological stress and recovery in healthy young adults, implying a protective role against age-related increases in coronary heart disease for individuals who adopt aerobic exercise early in life and maintain the behavior across the life span.     

Self-awareness, alcohol consumption, and reduced cardiovascular reactivity

Seventy-two healthy males were divided into Type A and Type B groups using the Jenkins Activity Survey. Subjects were subdivided further into high and low self-awareness categories on the private self-consciousness factor of the Self-Consciousness Scale. After random assignment to consume alcohol (0.85 g/kg) or a placebo, subjects were exposed to four stressors presented at random: a self-disclosing speech, aversive noise, insoluble anagrams, and mental arithmetic. Blood pressure, heart rate, and finger pulse amplitude were monitored throughout. Among the major findings was increased systolic blood pressure (SBP) reactivity during the speech among Type As low in private self-consciousness. Alcohol dampened autonomic responsiveness only in this group. When self-involvement was measured as the ratio of first-person pronouns to total words spoken during the speech, sober Type As displayed a strong correlation between self-references and SBP reactions during the speech and arithmetic tasks. Alcohol attenuated the correlation, resulting in SBP response dampening, but it did not affect pronoun use. These results have implications for the study of individual differences in cardiovascular reactivity, sensitivity to alcohol effects, and the relation of alcohol consumption to coronary heart disease.     

Dominance, gender, and cardiovascular reactivity during social interaction

Associations between trait dominance and cardiovascular reactivity were examined in previously unacquainted healthy men and women. Subjects participated in three mixed-gender dyadic interactions with the same partner while their cardiovascular responses were assessed. Among men, but not women, trait dominance was positively and significantly associated with systolic blood pressure reactivity. For men and women, diastolic blood pressure reactivity was positively and significantly associated with trait dominance while participants prepared to interact and with partner's trait dominance while they interacted. All effects held after controlling for trait hostility. Dominance merits attention as a correlate of cardiovascular reactivity, a finding that parallels emerging patterns in the cardiovascular disease literature. Gender and gender-related social factors as potential moderators of this relationship are discussed.     

Gender differences in cardiovascular reactivity

Pronounced cardiovascular reactivity to stress is a behavioral mechanism that may underlie the pathophysiology of coronary heart disease (CHD). Based on the greater incidence of CHD among males than among females, the purpose of the current investigation was to test the hypothesis that in young adults (ages 17–29), males (n=47) show more cardiovascular reactivity than females (n=61) to two stressors, a video game and cigarette smoking. Five of the six comparisons did not support the hypothesis: females were higher on heart rate and diastolic blood pressure reactivity to both Stressors; males were higher on systolic blood pressure reactivity to the video game only. The results suggest that females may be particularly physiologically reactive to cigarette smoking.Conduct of this research was supported by a research grant from the National Heart, Lung, and Blood Institute (HL-36027).     

Hostility and anger expression in African American and European American men is associated with cardiovascular and lipid reactivity

Physiological stress reactivity has been examined with respect to cynical hostility and anger expression, but primarily among Caucasians. Investigations of African Americans are far fewer and have focused only on the cardiovascular system. This study compared the relationships between hostility and anger expression on the one hand, and both cardiovascular and lipid reactivity on the other, among African Americans and European Americans. Forty-six men participated in a study examining cardiovascular and lipid reactivity to a speech stressor. African American men low in cynical hostility had greater blood pressure reactivity to the stressor; this effect appeared to be due primarily to low cynical men with high Anger In. Independent of ethnicity, those with a general tendency to either always express or always inhibit the expression of anger had higher triglyceride reactivity, relative to those with a more flexible style of anger expression. These results suggest that it is important to examine ethnicity in relationship to measures of hostility and anger expression, to uncover vulnerable individuals.     

Psychopathy, startle blink modulation, and electrodermal reactivity in twin men

Psychopathy is a personality disorder with interpersonal-emotional and antisocial deviance facets. This study investigated these facets of psychopathy prospectively using normal-range personality traits in a community sample of young adult men who completed a picture-viewing task that included startle blink and skin conductance measures, like tasks used to study psychopathy in incarcerated men. Consistent with prior research, scores on the interpersonal-emotional facet of psychopathy ("fearless dominance") were associated with deficient fear-potentiated startle. Conversely, scores on the social deviance facet of psychopathy ("impulsive antisociality") were associated with smaller overall skin conductance magnitudes. Participants high in fearless dominance also exhibited deficient skin conductance magnitudes specifically to aversive pictures. Findings encourage further investigation of psychopathy and its etiology in community samples.