Effects of posttraumatic stress disorder status and covert hostility on cardiovascular responses to relived anger in women with and without PTSD

Previous literature has found greater heart rate (HR) and blood pressure (BP) responses during relived anger, and a positive association between covert hostility and relived anger, in male veterans with posttraumatic stress disorder (PTSD). This study investigated hostility and cardiovascular responses to a relived anger task in 120 women (70 with PTSD and 50 without PTSD). Women with PTSD reported greater hostile beliefs and covert hostility than non-PTSD controls, reported greater anger and anxiety during the anger recall task, and had higher resting HR. In general, the relationship between PTSD and cardiovascular response was moderated by covert hostility, which was associated with greater baseline diastolic BP and greater HR during relived anger and anger recovery among women with PTSD, but not among non-PTSD controls. Results suggest that the relationship between PTSD and cardiovascular response is moderated by hostility.     

Effects of posttraumatic stress disorder status and covert hostility on cardiovascular responses to relived anger in women with and without PTSD

Previous literature has found greater heart rate (HR) and blood pressure (BP) responses during relived anger, and a positive association between covert hostility and relived anger, in male veterans with posttraumatic stress disorder (PTSD). This study investigated hostility and cardiovascular responses to a relived anger task in 120 women (70 with PTSD and 50 without PTSD). Women with PTSD reported greater hostile beliefs and covert hostility than non-PTSD controls, reported greater anger and anxiety during the anger recall task, and had higher resting HR. In general, the relationship between PTSD and cardiovascular response was moderated by covert hostility, which was associated with greater baseline diastolic BP and greater HR during relived anger and anger recovery among women with PTSD, but not among non-PTSD controls. Results suggest that the relationship between PTSD and cardiovascular response is moderated by hostility.     

Do temperamentally shy children process emotion differently than nonshy children? Behavioral,psychophysiological, and gender differences in reticent preschoolers

We examined regional brain electrical activity (EEG), heart rate, and subjective responses at rest and during the presentation of videoclips designed to elicit a range of emotions (e.g., sadness, anger, happiness, fear) among a sample of healthy 4-year-old children selected for temperamental shyness. We found that shy children exhibited significantly greater relative right central EEG activation at rest and during the presentation of the fear-eliciting videoclip than nonshy children. Shy females displayed greater relative right mid-frontal EEG activation during the sad, happy, and fear videoclips than shy males who displayed greater relative left mid-frontal EEG activation. These results (1) suggest that recent frontal EEG activation/emotion models might be gender-specific and (2) appear to provide the first empirical evidence for recent theoretical notions linking the origins and maintenance of temperamental shyness in children to difficulty in regulating fear responses.     

Relative right versus left frontal EEG in neonates

Although infants have been noted to have greater relative right or left frontal EEG as early as the neonatal period, other ways in which these newborns differ have not been reported. In this study, 48 newborns were divided on the basis of greater relative right versus greater relative left frontal EEG to determine whether these groups differed in other ways at the neonatal period including behavior, physiology, and biochemistry. We also were interested in whether these EEG patterns were related to any prenatal maternal variables including mood states (depression, anxiety, anger) and biochemistry as well as fetal activity. The greater relative right frontal EEG newborns had mothers with lower prenatal and postnatal serotonin and higher postnatal cortisol levels. The mothers of the greater relative right frontal EEG newborns also had greater relative right frontal EEG activation and lower vagal tone. The greater relative right frontal EEG newborns themselves had elevated cortisol levels, showed a greater number of state changes during sleep/wake behavior observations, and performed less optimally on the Brazelton Neonatal Behavior Assessment (T. B. Brazelton, 1973) including the habituation, motor, range of state, excitability, and depressive symptoms scales. These data suggest that greater relative right frontal EEG newborns may be at greater risk for developmental problems than those with greater relative left frontal EEG activation. In addition, a discriminant function analysis correctly classified 67% of the newborns' EEGs by prenatal maternal variables, suggesting that these might be used to target pregnant women for prenatal intervention.     

Silent myocardial ischemia and cardiovascular responses to anger provocation in older adults

To determine if older, asymptomatic individuals with no prior history of coronary heart disease with exercise-induced silent myocardial ischemia (SI) during graded exercise treadmill testing exhibit exaggerated cardiovascular reactivity to anger provocation, we compared 42 SI participants and 95 controls. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) changes from baseline to three tasks & #x2014;anger recall, speech role-play, and mental arithmetic with harassment & #x2014;were assessed. Compared to controls, SI displayed greater HR responses for the speech role-play task only. The SI group was significantly older, had higher levels of fasting glucose and triglycerides, and had lower HDL-cholesterol. In multiple regression analyses, after controlling for these differences, SI was significantly associated with greater HR responses to the speech role-play. In sum, the SI group had significantly exaggerated HR responses to the speech role-play task, whereas SBP and DBP reactivity were comparable between groups. This suggests minimally enhanced cardiovascular reactivity among older SI patients that may nonetheless increase risk for cardiac events. This work was supported by National Institute on Aging (NIA) K24AG00930, NIA R29AG15112, aDepartment ofVeteran Affairs Geriatric Research, Education and Clinical Center Grant (GRECC), a VAMerit Grant, and the University of Maryland Claude D. Pepper Older Americans Independence Center (P60-AG12583). We thank Stephen Boyle for his assistance with data collection and development of the speech-role play task. We also thank Aron Siegman for his contributions to the initial conceptualization of this study. Correspondence concerning this article should be addressed to Shari R.Waldstein, Ph.D., Department of Psychology, University of Maryland Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250.     

Cardiovascular and electrocortical markers of anger and motivation during a simulated driving task

The experience of anger may have consequences for the long-term health of the individual. The psychophysiological manifestation of anger can vary in response to the motivational context of anger provocation. The current study was designed to investigate how motivational context (challenge vs. threat) influenced the cardiovascular system and frontal EEG asymmetry. 29 male participants completed a simulated driving journey with a fixed time schedule. Anger was induced by exposing participants to traffic delays at an early (challenge) and later point (threat) on the simulated route. A number of dependent variables were recorded, including 32 channels of EEG, measures of cardiovascular impedance, blood pressure and fEMG activity from the corrugator supercilii. The results indicated that traffic delays significantly increased blood pressure, heart rate, TPR and corrugator activity whilst reducing the relative level of left frontal activation in the EEG. However, there was little evidence for a consistent distinction between the early (challenge) and late (threat) introduction of traffic delay. The consequences of these findings for capturing the cardiovascular and electrocortical responses to anger induction are discussed.     

Cardiovascular Reactivity of Patients With Essential and Renal Hypertension in an Emotion-Triggering Interview

Blood pressure reactivity to mental stress in hypertensives is much higher than in normotensives. The authors' aim in this study was to examine whether different cardiovascular responses can be induced by various stimuli in hypertensive subgroups. The authors matched 10 essential hypertensives (EHs), 10 renal hypertensives (RHs), and 10 normotensives (Ns) according to age and gender, examined them during an emotion-stimulating interview, and measured blood pressure (BP) and heart rate (HR) during the phases of the interview. They observed differences in BP reactivity between EHs/RHs and Ns under some stimuli but not between EHs and RHs, as well as a marked difference in the product of systolic BP (SBP) and HR between both hypertensive groups in the anger/rage phase (p = .028) and the baseline 2 (p = .02). This shows a higher cardiovascular activation under mental stress and a lower recovery in EHs and more sensitivity to perturbation or higher central tension compared with RHs.     

The relationships of impulsivity and cardiovascular responses: The role of gender and task type

The present study was conducted to assess the relationships of impulsivity with both baseline cardiovascular levels and reactivity during two laboratory stressors in both female and male young adults. Heart rate (HR), blood pressure (BP), and heart rate variability (HRV) were measured at rest and during a reaction time and speech task in one hundred and one undergraduate students. Impulsivity was measured using the Barratt Impulsiveness Scale-11 and Block's Ego-Undercontrol Scale. Males and females responded similarly to both laboratory tasks and also did not differ on the impulsivity scales. For males, higher scores on impulsivity were associated with higher systolic BP levels at rest but decreased systolic BP and HR reactivity during the preparation of the speech task; females showed no relationships of resting cardiovascular levels with impulsivity, but more impulsive females did show decreased HR response during speech preparation. No significant relationships were found between impulsivity and either HRV levels or reactivity. It is speculated that tasks involving a degree of planning may be important to find relationships between impulsivity and cardiovascular reactivity, especially in males.     

Trait anger predicts relative left frontal cortical activation to anger-inducing stimuli.

Building on past research that has suggested that relatively greater left frontal cortical activity is associated with approach-related anger and that individuals who are high in trait anger are more likely to evidence angry responses, the present research tested whether individuals high in trait anger would be more likely to evidence relatively greater left frontal cortical activity in response to anger-eliciting pictorial stimuli. In the experiment, participants were exposed to pictures intended to evoke anger, fear/disgust, positive, or neutral affective reactions. Electroencephalographic (EEG) activity was recorded continuously, and alpha power was derived from the EEG to measure cortical activity. Trait anger was measured using the Buss and Perry Aggression Questionnaire [Buss, A.H., Perry, M., 1992. The aggression questionnaire. Journal of Personality and Social Psychology, 63, 452-459]. Results revealed that trait anger was positively related to greater relative left frontal cortical activity to anger-evoking pictures but not to other types of pictures.     

Adrenocorticotropin responses to interpersonal stress: effects of overt anger expression style and defensiveness.

This study evaluated the influence of overt anger expression style and defensiveness on the hypothalamic-pituitary-adrenocortical (HPA) responses to acute psychological stress. These personality traits are thought to modulate the stress cardiovascular response and influence disease risk, however, little is known about their influence on HPA responses. Forty-six young, healthy male volunteers worked on counterbalanced extended public-speaking and mental arithmetic. The sample was dichotomitized into groups low vs. high in anger-out, using Spielberger's Anger-Expression Inventory, and in defensiveness, using the Marlowe-Crown Social Desirability Scale. Serum cortisol and adrenocorticotropic hormone (ACTH) concentrations were measured before and after performing each task. Heart rate (HR) and blood pressures (BP) were obtained continuously in 2-min intervals before, during and after the tasks. Public speaking produced greater adrenocortical and cardiovascular stress responses than mental arithmetic, and the greatest increases in ACTH occurred in subjects high in anger-out and defensiveness. These preliminary findings provide evidence that a mismatch between traits of preferred anger expression style and defensive style produces pronounced adrenocorticotropic responses during socially salient stress.     

Physiologic responses to cognitive challenge during pregnancy: effects of task and repeat testing.

Physiological responses to stress during pregnancy are believed to influence birth outcomes. Researchers have studied pregnant women in laboratory stressor paradigms to investigate these associations, yet normative data on cardiovascular and respiratory responses to laboratory challenge during pregnancy are not yet established. To begin to establish such normative data, this study examined the effects of task and repeat stressor exposure on reactivity in third-trimester pregnant women. Thirty-one healthy pregnant women (mean age=27 years; range 18-36) between the 33rd and 39th week of pregnancy, were instrumented for continuous electrocardiography, blood pressure (BP), and respiration data. Subjects rested quietly for a 5-min baseline and then performed both a mental arithmetic stressor and a Stroop color-word-matching task, each 5 min in length and each followed by a 5-min recovery period. The order of the tasks was counterbalanced. After each 5-min period, subjects rated the period on a 10-point stress scale. Averaged across task type and challenge period, systolic and diastolic BP and respiration rate increased significantly in response to cognitive challenge, but heart rate (HR) did not. When data were examined for task and period effects, the following results emerged: the Stroop task elicited significantly greater systolic BP and HR reactivity than the arithmetic task, yet subjects rated the arithmetic task as more stressful. Averaged across task type, subjects showed greater systolic BP reactivity during the second challenge period compared to the first. Finally, women's BP tended to drift upward and did not return to baseline during the first recovery period. These findings indicate that averaging data across tasks and periods can obscure the time course of response patterns that may be important in the study of associations between maternal stress and perinatal development, as well as in other research on reactivity to repeat stress exposure.     

Cardiovascular reactivity of patients with essential and renal hypertension in an emotion-triggering interview

Blood pressure reactivity to mental stress in hypertensives is much higher than in normotensives. The authors' aim in this study was to examine whether different cardiovascular responses can be induced by various stimuli in hypertensive subgroups. The authors matched 10 essential hypertensives (EHs), 10 renal hypertensives (RHs), and 10 normotensives (Ns) according to age and gender examined them during an emotion-stimulating interview, and measured blood pressure (BP) and heart rate (HR) during the phases of the interview. They observed differences in BP reactivity between EHs/RHs and Ns under some stimuli but not between EHs and RHs, as well as a marked difference in the product of systolic BP (SBP) and HR between both hypertensive groups in the anger/rage phase (p = .028) and the baseline 2 (p = .02). This shows a higher cardiovascular activation under mental stress and a lower recovery in EHs and more sensitivity to perturbation or higher central tension compared with RHs.     

Frontal brain asymmetry and emotional reactivity: A biological substrate of affective style

Individuals differ dramatically in the quality and intensity of their response to affectively evocative stimuli. On the basis of prior theory and research, we hypothesized that these individual differences are related to variation in activation of the left and right frontal brain regions. We recorded baseline brain electrical activity from subjects on two occasions 3 weeks apart. Immediately following the second recording, subjects were exposed to brief positive and negative emotional film clips. For subjects whose frontal asymmetry was stable across the 3-week period, greater left frontal activation was associated with reports of more intense positive affect in response to the positive films, whereas greater right frontal activation was associated with more intense reports of negative affect in response to the negative film clips. The methodological and theoretical implications of these data are discussed.     

Anterior electroencephalographic asymmetry changes in elderly women in response to a pleasant and an unpleasant odor

Greater left than right frontal EEG activation has been associated with increased positive and/or decreased negative affect, whereas greater right than left frontal activation has been associated with the opposite pattern. Substantial research has documented the trait properties of asymmetry, as well as responses to pleasant and unpleasant stimuli. The present study examined changes in anterior alpha asymmetries in response to pleasant (vanilla), unpleasant (valerian), and neutral (water) odors. As predicted, vanilla produced relative left frontal activation compared to valerian and water. Frontal asymmetry did not differ in response to valerian compared to water. The results are consistent with the hypothesis that the left frontal region of the brain is involved in positive/approach-related emotion, and extend previous results into the olfactory realm.     

Effects of alexithymia on the activity of the anterior and posterior areas of the cortex of the right hemisphere in positive and negative emotional activation

The aim of the present work was to assess the effects of alexithymia (a psychoemotional disorder associated with difficulties in identifying and describing personal feelings) on regional activity in the cerebral cortex during positive and negative emotional activation in a non-clinical set of subjects. EEG (62-channel) recordings were made during presentation of special emotional video clips to alexithymics (17 subjects) and controls (27 subjects). Alexithymia was found to influence EEG activity in the theta-2, alpha-1, and alpha-2 ranges; alexithymics showed greater reactivity in the anterior and/or posterior areas of the cortex of the right hemisphere in all frequency ranges during watching of both positive and negative clips. The similarity of the responses of alexithymics in conditions of positive and negative emotional activation identifies the increase in emotional reactivity, independent of the sign of the incoming emotional information, as non-specific. This phenomenon may provide evidence of the need for recruiting additional cognitive resources for identifying emotional feelings in relation to the impairments of the symbolic perception of emotional information seen in alexithymics observed here.     

Functional asymmetry in the descending cardiovascular pathways from dorsomedial hypothalamic nucleus

Neurons in the dorsomedial hypothalamus (DMH) play a key role in mediating tachycardia elicited by emotional stress. DMH activation by microinjections of the GABA_A antagonist evokes tachycardia and physiological changes typically seen in experimental stress. DMH inhibition abolishes the tachycardia evoked by stress. Based on anatomic evidences for lateralization in the pathways from DMH, we investigated a possible inter-hemispheric difference in DMH-evoked cardiovascular responses. In anesthetized rats we compared changes in heart rate (HR), renal sympathetic activity (RSNA), mesenteric blood flow (MBF) and tail vascular conductance produced by activation of right (R) and left (L) sides of the DMH. We also evaluated the tachycardia produced by air jet stress after inhibition of R or L DMH. There were always greater increases in RSNA when bicuculline was injected ipsilaterally to the side where these parameters were recorded (average ΔRSNA: L=+50% and R=+26%; P<0.05). Compared to pre-injection values, right DMH activation caused pronounced decrease (0.87±0.1% vs. 0.4±0.11%/mm Hg; P<0.05), whereas bicuculline methiodide (BMI) into left DMH produced no significant changes (0.95±0.09% vs. 1.04±0.25%/mm Hg) in tail vascular conductance. R or L DMH disinhibition produced decreases in MBF, but no differences in the range of these changes were observed. Activation of the right DMH caused greater tachycardia compared to the left DMH activation (average ΔHR: R=+92 bpm; L=+48 bpm; P<0.05). Tachycardia evoked by air jet stress was smallest after right DMH inhibition (average ΔHR: R=+57 bpm and L=+134 bpm; P<0.05). These results indicate that the descending cardiovascular pathways from DMH are predominantly lateralized and the right DMH might exert a prominent control on heart rate changes during emotional stress.     

Suppressed anger, evaluative threat, and cardiovascular reactivity: a tripartite profile approach.

Despite decades of theory and research implicating suppressed anger in the development of cardiovascular disorders involving cardiovascular reactivity (CVR), to date the theoretical components of low anger expression, guilt feelings over agonistic reactions, and defensive strivings to avoid social disapproval have not been used conjointly to profile suppressed anger for the prediction of CVR. The purpose of this study, then, was to cluster analyze measures of anger expression, hostility guilt, and social defensiveness to create a suppressed anger profile (low anger expression, high hostility guilt, high social defensiveness) and a non-suppressed profile from a sample of college males. Social evaluative threat may be a potent stressor for people who defensively suppress anger expression. Thus, to examine the combined effects of suppressed anger and social evaluative threat, participants, prior to telling a story to a Thematic Apperception Card (TAT), were randomly assigned to either a high-threat (story will be compared to stories created by the mentally ill) or a low-threat condition (story used to study effects of talking on cardiovascular responses). Blood pressure (BP) and heart rate (HR) were monitored during a rest period and the subsequent TAT card period. As predicted, suppressed anger males in the high-threat condition showed the highest levels of diastolic BP and HR change from the rest period. The suppressed anger group's systolic BP reactivity was independent of threat manipulation. Research implications are discussed.     

Mothers' frontal EEG asymmetry in response to infant emotion states and mother-infant emotional availability, emotional experience, and internalizing symptoms

This study examined the links between mothers' frontal EEG asymmetry at rest and during videos of their 5- to 8-month-old infants expressing three emotion states (joy, anger/distress, and neutral interest), mother-infant emotional availability (EA) in the home, mothers' depressive and anxious symptoms, and mothers' emotional experience in response to infant emotion cues. Greater relative right frontal activity at rest was associated with greater maternal anxiety, but was unrelated to EA or mother-reported emotional experience in response to infant emotion cues. A shift toward greater relative right frontal activation in response to infant emotional stimuli was associated with lower maternal anxiety, greater mother-infant EA, and mothers' experience of sadness, concern, irritability, and the absence of joy in response to seeing their own infant in distress. These findings suggest that mothers' in the moment empathetic responding to their infant's emotions, indexed by a shift in frontal EEG asymmetry in response to infant emotional displays, is related to mother-infant EA in the home. Implications for conceptualizing parenting risk are discussed.     

Differential hostility profiles accompany different hemodynamic response patterns

Cardiovascular reactivity has been proposed as a mechanism by which psychosocial variables may lead lo coronary heart disease. Although reactivity as a generalized response has been linked lo psychological factors, there are specific hemodynamic profiles that underlie blood pressure reactivity. This study characterized subsets of young adults as myocardial or vascular reactors, in response to three laboratory tasks: mental arithmetic, videogame, and anger recall interview. Vascular reactors had higher diastolic blood pressure increases to all tasks, whereas reactor groups were equivalent at rest and on systolic blood pressure responses. Correlational analyses were conducted to determine whether psychological dimensions are uniquely associated with myocardial or vascular reactors' cardiovascular responses, at rest and during acute stressors. For myocardial reactors, resting systolic blood pressure was higher in hostile and suspicious individuals, whereas reactivity was linked to impulsivity. For vascular reactors, low trust, low gregariousness, and high depression were associated with diastolic reactivity to tasks. The predictive validity of hostility, distrust, sociability, and depression for cardiovascular pathology may vary with reactor type.     

Alexithymia predicts attenuated autonomic reactivity, but prolonged recovery to anger recall in young women.

Alexithymia has been prospectively associated with all-cause mortality and with cardiovascular morbidity. Here, stress-induced autonomic reactivity and recovery were examined as potential pathways linking alexithymia to cardiovascular disease. The relation of alexithymia to blood pressure, heart rate, and other cardiovascular parameters derived from impedance cardiography (N = 80) and heart rate variability (N = 40) was evaluated during rest, an anger recall task and recovery in women (ages 18-30). During anger recall, alexithymia was associated with significantly attenuated heart rate and stroke index reactivity, greater low frequency power, and with marginally dampened blood pressure and high frequency power reactivity. Overall, this response pattern suggests blunted sympathetic activation and diminished vagal withdrawal. Alexithymia was also related to slower diastolic blood pressure and quicker preejection period recovery implying abbreviated sympathetic arousal and possibly greater vagal modulation. These results impart some evidence for the hypoarousal model of alexithymia during reactivity, but the hyperarousal model during recovery. Autonomic dysregulation during and following acute emotional stress is suggested as a possible physiological pathway connecting alexithymia to cardiovascular disease.