Relation of cognitive appraisal to cardiovascular reactivity, affect, and task engagement

Positive affect and psychobiological processes relevant to health

Empirical evidence suggests that there are marked associations between positive psychological states and health outcomes, including reduced cardiovascular disease risk and increased resistance to infection. These observations have stimulated the investigation of behavioral and biological processes that might mediate protective effects. Evidence linking positive affect with health behaviors has been mixed, though recent cross-cultural research has documented associations with exercising regularly, not smoking, and prudent diet. At the biological level, cortisol output has been consistently shown to be lower among individuals reporting positive affect, and favorable associations with heart rate, blood pressure, and inflammatory markers such as interleukin-6 have also been described. Importantly, these relationships are independent of negative affect and depressed mood, suggesting that positive affect may have distinctive biological correlates that can benefit health. At the same time, positive affect is associated with protective psychosocial factors such as greater social connectedness, perceived social support, optimism, and preference for adaptive coping responses. Positive affect may be part of a broader profile of psychosocial resilience that reduces risk of adverse physical health outcomes.

'Adaptive' psychosocial factors in relation to home blood pressure: a study in the general population of southern Netherlands

BACKGROUND

Evidence is accumulating for an association between psychosocial stress and elevated blood pressure. However, studies focusing on adaptive psychosocial factors are scarce.

PURPOSE

We examined the association between putatively adaptive psychosocial factors and home blood pressure in a population study in the Netherlands.

METHOD

Resting blood pressure was measured of 985 female and 777 male participants between 20 and 55 years of age in their home setting. Questionnaires assessing problem-focused coping (active coping), adaptive emotion-focused coping (positive reinterpretation) and social support were completed.

RESULTS

When controlled for age, marital and socio-economic status, body mass index, parental history of hypertension, physical exercise, smoking, alcohol, coffee, and--in women--oral contraceptives, positive reinterpretation was associated with a lower prevalence of elevated home blood pressure (>or=140/90 mmHg): OR = 0.60, 95% CI = 0.40-0.88 (P = 0.009). Although all three psychosocial variables were associated with both systolic and diastolic blood pressure level, in multivariable analyses, only the associations between systolic blood pressure and positive reinterpretation (beta = -0.09, t = 3.25, P = 0.001) and active coping (beta = 0.07, t = 2.65, P = 0.008) remained significant.

CONCLUSION

Independent of other factors, only positive reinterpretation of the situation appeared to be related to more favorable blood pressure levels.

Why Do Older Men Report Low Stress Ratings? Findings from the Veterans Affairs Normative Aging Study

We examined the interplay between three explanatory hypotheses for why older adults appear to rate their problems as less stressful than do younger adults: age-related differences in personality, in types of problems, and in the appraisal process—specifically, the number of primary stress appraisals. A sample of 1,054 men from the Normative Aging Study (mean age = 65.02; range = 45 to 92) were interviewed about a problem in the past week. Personality did not mediate the effect of age on stress ratings. While general hassles and health problems both increased with age, they had opposite influences on stress ratings. Accounting for covariates, older men reported fewer appraisals, and the number of appraisals mediated the association between age and stress ratings. We found no moderating effects of problem type on these processes. Thus, lower stress ratings for everyday problems in later life may result from developmental changes in primary appraisal processes.

Perceived stress is associated with impaired T-cell response to HPV16 in women with cervical dysplasia

BACKGROUND

Infection with high-risk subtypes of human papillomavirus (HPV) is a central factor in the development of cervical neoplasia. Cell-mediated immunity against HPV16 plays an important role in the resolution of HPV infection and in controlling cervical disease progression. Research suggests that stress is associated with cervical disease progression, but few studies have examined the biological mechanisms that may be driving this association.

PURPOSE

This study examines whether stress is associated with immune response to HPV16 among women with cervical dysplasia.

METHODS

Seventy-four women presenting for colposcopy completed measures of health behaviors, stressful life events and perceived stress. A blood sample was obtained to evaluate proliferative T-cell response to HPV16, and a cervical sample was obtained during gynecologic exam for HPV-typing.

RESULTS

More than 55% tested positive for one or more HPV subtypes. Women who did not show proliferative responses to HPV (i.e. non-responders) were more likely to be HPV(+) compared to women who had a response (i.e. responders). Consistent with study hypotheses, logistic regression revealed that higher levels of perceived stress were associated with a non-response to HPV16, controlling for relevant covariates. Stressful life events were not associated with T-cell response to HPV.

CONCLUSIONS

Higher levels of perceived stress are associated with impaired HPV-specific immune response in women with cervical dysplasia, suggesting a potential mechanism by which stress may influence cervical disease progression.

Interpretations of ambiguous social situations and cardiovascular responses in adolescents

BACKGROUND

Previous research has documented effects of ambiguous outcome social situations on individual differences in cardiovascular reactivity in laboratory contexts.

PURPOSE

This study tested whether interpretations of ambiguous social situations are associated with daily life cardiovascular responses using ambulatory approaches.

METHODS

There were 206 high school adolescents assessed on interpretations of ambiguous social situations in the laboratory who then completed ambulatory monitoring of blood pressure (BP) and heart rate (HR) for 2 days.

RESULTS

Adolescents who perceived threat during ambiguous situations exhibited higher systolic BP when talking to others compared to occasions of not talking with anyone, whereas the opposite was true for those with low threat perception. For high-threat adolescents, higher systolic BP was found when interacting with friends, whereas for low threat adolescents, lower systolic BP was found when interacting with parents. Greater threat interpretations were also associated with elevated HR at night.

CONCLUSIONS

Understanding how adolescents perceive social interactions may help in gauging their daily cardiovascular responses.

Latinos, acculturation, and acculturative stress: a dimensional concept analysis

BACKGROUND

Acculturation can be conceived of as a process of adaptation to stressful changes. In the field of public health, research indicates that recently arrived Latino immigrants, presumably most affected by acculturative stress, have better health outcomes than those who have spent greater time in the United States. This "immigrant paradox" is not well understood but supports the distinction between the process of acculturation and acculturative stress.

AIM

To understand the nature of acculturative stress for Latinos in the context of political, historical, and societal forces.

RESULTS

Acculturative stress significantly affects the physical and mental health of many Latino immigrants. Types of stressors vary by ethnicity. Separation from family and lack of a community was the most often-cited stressor for new immigrants. Most Latino immigrants were adversely affected by discrimination.

CONCLUSION

By developing an understanding of acculturative stress, nurses can better attend to the needs of our increasingly diverse population.

How does optimism suppress immunity? Evaluation of three affective pathways

Studies have linked optimism to poorer immunity during difficult stressors. In this study, when 1st-year law students (N = 46) relocated to attend law school, reducing conflict among curricular and extracurricular goals, optimism predicted larger delayed-type hypersensitivity responses, indicating more robust in vivo cellular immunity. However, when students did not relocate, increasing goal conflict, optimism predicted smaller responses. Although this effect has been attributed to negative affect when difficult stressors violate optimistic expectancies, distress did not mediate optimism's effects on immunity. Alternative affective mediators related to engagement--engaged affect and fatigue--likewise failed to mediate optimism's effects, although all 3 types of affect independently influenced in vivo immunity. Alternative pathways include effort or self-regulatory depletion.

Neuroendocrine and cardiovascular correlates of positive affect measured by ecological momentary assessment and by questionnaire

The relationships between positive affect, salivary cortisol over the day, and cardiovascular responses to laboratory mental stress tests, were assessed in 72 healthy non-smoking men (mean age 33.6+/-8.8 years). Positive affect was measured by aggregating ecological momentary assessments (EMA) of happiness obtained at four times on each of 2 working days, and by questionnaire using the Positive and Negative Affect Schedule (PANAS). Saliva was sampled on 2 days, on waking, 30 and 60 min later, and four other times over the day. Blood pressure and heart rate responses to speech and mirror tracing tasks were measured over two sessions 4 weeks apart. Data were analysed using regression of positive affect on biology adjusting for age, body mass and negative affect, with additional adjustment for time of waking in cortisol analyses and for work stress in cardiovascular analyses. EMA positive affect was inversely associated with cortisol early in the day and with the cortisol increase after waking, controlling for age, body mass index, and negative affect (P=0.012). There was no relationship between PANAS positive affect and cortisol, or between EMA positive affect and cortisol later in the day. Diastolic pressure recovery post-stress was more rapid among participants with high positive affect (P=0.022) and with lower systolic pressure throughout the stress sessions, after controlling for covariates including negative affect. PANAS positive affect was also inversely associated with systolic pressure, but not with diastolic stress or heart rate. We conclude that positive affect is related to biological responses in the laboratory and everyday life that may be health protective. Effects were substantially stronger when positive affect was assessed by aggregating EMA samples than with questionnaire measures.

Cardiovascular stress responses in young adulthood associated with family-of-origin relationship experiences

OBJECTIVE

The impact of relationships within the family-of-origin on the development of physiological stress responses has significant consequences for long-term vulnerability to stress-related illness.

METHODS

The current study evaluated systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) responses to a challenge task in 150 young adults from families characterized by parental loss, divorce, or intact marriages.

RESULTS

Overall, higher-quality family relationships were associated with stronger recovery of SBP. For DBP and HR, interactions were found in which higher-quality family relationships were associated with stronger recovery in the loss group relative to the divorce and intact groups. Good support was found for a mediational model outlining self-regulatory abilities as a pathway linking family relationships to SBP reactivity and recovery.

CONCLUSIONS

Findings provide further evidence that family-of-origin relationship experiences can affect cardiovascular responses to later-life stress.

Engagement and arousal: optimism's effects during a brief stressor

Optimism is usually associated with better psychological and physiological adjustment to stressors, but some contradictory findings exist. The purpose of this study was to investigate how optimism could result in negative immunological changes following difficult stressors. Because optimists are likely to see positive outcomes as attainable, they may invest greater effort to achieve their goals. It is proposed that such engagement would be more physiologically demanding when pursuing difficult goals. Participants (N = 54) worked on 11 difficult or insoluble anagrams. Optimism when combined with high self-awareness increased time spent working on the anagrams and skin conductance and salivary cortisol during the recovery period. The results support the notion that the increased engagement that arises from optimism may lead to short-term physiological costs.

Effects of appraisal and coping on the neuroendocrine response to extreme stress

Although many people are exposed to extreme stress, only some of them develop psychobiological disturbances that can lead to posttraumatic stress disorder (PTSD) or other posttrauma psychopathology. This paper examines the effects of different types of appraisal and coping to find clues to how individuals differ in their neuroendocrine responses to extreme stress. It proposes a conceptual model for components of the adult response to stressors. Threat appraisal and defensive coping may play crucial roles in determining the neuroendocrine response to trauma with potential mental health consequences, particularly PTSD.

Cardiovascular reactivity and adaptation to recurrent psychological stress: Replication and extension

We analyzed the effects of evaluative observation and baseline duration on cardiovascular reactivity and adaptation to recurrent psychological stress. Cardiovascular reactivity to mental arithmetic stress was assessed in college men and women (N=224) during two pretest tasks, a test task, and a posttest task. Participants were assigned randomly in a 2 x 2 design to manipulations of baseline duration before the test task (4 min vs. 12 min) and evaluative observation during the test task (observed vs. control). Repeated exposure to stress attenuated cardiac but not vascular reactivity. Evaluative observation disrupted cardiac adaptation, resulting in a resurgence of beta-adrenergic cardiac reactivity during the test task. Cardiac adaptation resumed fully during the posttest task. Baseline duration had no effect on reactivity. The results replicate and extend previous work, and support the dual process theory of habituation and sensitization.

Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry

The present report meta-analyzes more than 300 empirical articles describing a relationship between psychological stress and parameters of the immune system in human participants. Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity and downregulation of some functions of specific immunity. Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences varied according to the kind of event (trauma vs. loss). Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.

Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry

The present report meta-analyzes more than 300 empirical articles describing a relationship between psychological stress and parameters of the immune system in human participants. Acute stressors (lasting minutes) were associated with potentially adaptive upregulation of some parameters of natural immunity and downregulation of some functions of specific immunity. Brief naturalistic stressors (such as exams) tended to suppress cellular immunity while preserving humoral immunity. Chronic stressors were associated with suppression of both cellular and humoral measures. Effects of event sequences varied according to the kind of event (trauma vs. loss). Subjective reports of stress generally did not associate with immune change. In some cases, physical vulnerability as a function of age or disease also increased vulnerability to immune change during stressors.