Cardiovascular and behavioral response to social confrontation: measuring real-life stress in the laboratory

The interactive effect of family conflict history and physiological reactivity on different forms of aggression in young women

Evidence indicates that patterns of biological reactivity underlie different forms of aggression, but greater precision is needed in research targeting biopsychosocial processes that underlie such differences. This study investigated how sympathetic and parasympathetic nervous system (SNS and PNS) responses to social stress were associated with multiple forms of aggression in an ethnically-diverse sample of young adult females; it further examined whether early life exposure to family conflict moderated these relationships. In the context of high levels of family conflict history, greater SNS activation during a social conflict task was associated with more direct proactive aggression and increasing RSA was associated with more direct reactive aggression. Greater SNS activation during the task was associated with more direct reactive aggression regardless of family conflict history. Our findings affirm the need to capture the contributions of multiple physiological systems simultaneously and the importance of considering family history in the study of aggression.

Effects of Religious Orientation and Gender on Cardiovascular Reactivity Among Older Adults

Recent attention has focused on the relationship between religiosity and health. Although many pathways have been proposed to account for this relationship, little empirical research has investigated specific pathways in relation to specific physiological functions. This study assessed the roles that religious orientation and gender play in moderating psychophysiological reactivity to laboratory stressors among older adults. Those participants characterized by an intrinsic religious orientation (IO) demonstrated less reactivity than did those characterized by an extrinsic religious orientation. Gender did not influence reactivity. There was some evidence that the effect of religious orientation is more pronounced for interpersonal than cognitive-type stressors, although the strongest findings were evident when stressors were aggregated. The magnitude of these effects suggests that they are of practical significance. Given these results and the known relationship between reactivity and hypertension, it is proposed that IO may result in decreased risk of developing hypertension in older adults.

Hostile behavior links negative childhood family relationships to heart rate reactivity and recovery in young adulthood

Prior research has demonstrated that vulnerability to stress is influenced by early life experiences. This study evaluates the impact of negative childhood family relationships on cardiovascular stress reactivity in young adulthood. Participants (age 18-22) from families characterized by negative (n=39) or positive relationships (n=36) engaged in a role-play conflict task. Hostile/aggressive verbal behaviors during the task were observed, and blood pressure (BP) and heart rate (HR) responses were measured before, during, and after the task. Participants from negative families engaged in more hostile/aggressive verbal behavior during the task and showed attenuated HR reactivity. Hostile/aggressive verbal behavior predicted attenuated HR reactivity and recovery. Path analyses linked negative family relationships to more hostile verbal behavior during the task, and attenuated HR reactivity and recovery. These results support the development of hostile/aggressive behavior in social situations as a pathway linking childhood adversity to stress vulnerability across the lifespan.

If at first you don't succeed: the neuroendocrine impact of using a range of strategies during social conflict

Using a variety of cognitive or behavioral strategies to manage stressful situations may be more adaptive than relying on a narrow selection. Although research has explored the psychological benefits of a range of coping responses, the physiological impact within and across stressful situations has not been examined. Moreover, research has primarily relied upon self-reports of what people believe they generally do across stressful situations, which may be subject to recall bias. This study observed and coded the range of behavioral response strategies that young adults (n=74, mean age 18.1) used to manage a laboratory-based, interpersonal conflict task and collected self-reports of the cognitive strategies used to manage similar stressors. Analyses examined the impact of response range on cortisol activity during the task. Greater range of observed response strategies predicted lower cortisol reactivity (t(133)=2.65; p=.009), whereas the range of self-reported strategies was unrelated to cortisol reactivity (t(133)=.53; p=.60). Results support observational assessment as an important supplement to self-reports of responses to stress and suggest that the range of strategies used to manage the momentary demands of a stressful situation may help explain individual differences in the impact of stress on physiological systems.

Gender differences, anger expression, and cardiovascular risk

Research has established the influence of serum cholesterol and anger management style as cardiovascular risk factors. However, mixed and sometimes contradictory results have created uncertainty with respect to contributions of anger. Some incongruities may be accounted for on the basis of gender differences since a number of studies have employed male samples rather than female samples or mixed samples. The present study examined both gender and anger management style in relation to cardiovascular risk. One hundred three (72 men and 31 women) midlevel executives completed questionnaires and a blood draw during a week long, succession training program within a large international organization. Gender, anger expression, and anger expressed outward were significant predictors for levels of high-density lipids, low-density lipids/very low-density lipids, and triglycerides, and cardiovascular risk ratios. Results replicate and extend previous research. Anger held inward and anger control were significant for men but not women, contrary to earlier gender-specific findings.

Sex Differences in Cardiovascular Reactivity

Sex differences in cardiovascular reactivity to stress are well documented, with some studies showing women having greater heart rate responses than men, and men having greater blood pressure responses than women, while other studies show conflicting evidence. Few studies have attended to the gender relevance of tasks employed in these studies. This study investigated cardiovascular reactivity to two interpersonal stressors consistent with different gender roles to determine whether response differences exist between men and women. A total of 26 men and 31 women were assigned to either a traditional male-oriented task that involved interpersonal conflict (Conflict Task) or a traditional female-oriented task that involved comforting another person (Comfort Task). Results demonstrated that women exhibited greater heart rate reactions than men independent of the task type, and that men did not display a higher reactivity than women on any measure. These findings indicate that sex of participant was more important than gender relevance of the task in eliciting sex differences in cardiovascular responding.

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.

A prospective study of social support, anger expression and risk of periodontitis in men

BACKGROUND

Stress is associated with poor oral hygiene, increased glucocorticoid secretion that can depress immune function, increased insulin resistance and potentially increased risk of periodontitis.

METHODS

The authors examined the association between social support, anger expression and periodontitis in 42,523 male, U.S.-based, health professionals. Subjects were aged 40 to 75 years in 1986, and more than half were dentists. The men were free of a diagnosis of periodontitis at the start of follow-up in 1996.

RESULTS

Subjects who reported having at least one close friend had a 30 percent lower risk of developing periodontitis compared with those who did not have a close friend (relative risk, or RR = 0.70; 95 percent confidence interval, or CI, 0.51-0.96). Men who participated in religious meetings or services had a 27 percent lower risk of developing periodontitis compared with men who did not participate in religious meetings (RR = 0.73; 95 percent CI, 0.64-0.83). After the authors adjusted for potential confounding variables, men whose anger scores were in the top quintile were 72 percent more likely to report having periodontitis compared with men whose scores were in the lowest quintile (RR = 1.72; 95 percent CI, 1.39-2.12). Men who reported being angry on a daily basis had a 43 percent higher risk of developing periodontitis compared with men who reported being angry seldom.

CONCLUSION

Reduced social isolation and anger expression may play an important role in maintaining oral health, as well as general health and well-being.

CLINICAL IMPLICATIONS

When treating patients with periodontitis, clinicians should be cognizant of the social and behavioral factors that may affect oral health.

Stress influence on genesis, onset and maintenance of cardiovascular diseases: literature review

BACKGROUND

Recent mortality profiles in Brazil show that circulatory diseases are the leading cause of death in Brazil. These disorders contribute to 34% of deaths, with 50% of those deaths occurring in people under 50 years of age, that is, in people who are still active in the workforce. We assume that the growing incidence of cardiovascular diseases has occurred as the globalization of Brazil continues and brings with it the associated health risk factors of modern lifestyles, including stress.

AIM

This paper reports the evidence on the influence of stress in the development, onset and progress of cardiovascular diseases. We aim to define the concept of stress and to point systematically to the interrelationships between its emotional and bodily manifestations through a discussion of the history and study of stress. We then suggest that factors leading to the experience of stress in Brazil are no different than in any other modern nation. We further offer a perspective on nursing interventions currently undertaken in Brazil in both hospital and community settings, with their more recent emphasis on health promotion and prevention.

METHODS

An extensive literature review was undertaken. The data presented here were selected from reviews and clinical studies described in MEDLINE, LILACS, SciELO databases, as well as in the classical literature. We also refer to the current Brazilian literature on the prevalence of cardiovascular diseases and their associated risk factors.

CONCLUSIONS

The incidence of cardiovascular diseases in Brazil is rising. Because of the globalization of Brazilian society, with its consequent competitiveness and accelerated modern lifestyles, Brazilians are no less immune to the usual health risk factors associated with cardiovascular diseases. Stresses associated with a modern lifestyle, however, are emerging as a new and major risk for developing cardiovascular diseases in Brazil.

Cardiovascular reactivity to psychological challenge: conceptual and measurement considerations

OBJECTIVE AND METHODS

This article is a selective review of recent findings bearing on the conceptualization and measurement of cardiovascular reactivity to psychological challenge, with a focus on several issues relevant to the reliability, content validity, construct validity, and criterion validity of these measures.

RESULTS AND CONCLUSIONS

With respect to reliability, use of standardized task demands and aggregated scores are associated with enhanced short-term reliability, but the long-term reliability of cardiovascular reactivity has not been sufficiently documented. With respect to content validity, existing evidence suggests that "vascular" or "cardiac" tasks may evoke responses that reflect similar distributions of individual difference, whereas associations between responses to "physical" and "psychological" tasks are modest. The evidence is not clear at present with respect to the importance of including affective or interpersonal stimuli as part of trait reactivity assessments. With respect to construct validity, existing data show that cardiovascular reactivity to psychological challenge is largely independent of standard measures of autonomic function. With respect to criterion validity, recent studies point to a number of methodological limitations that may have restricted our ability to detect lab-to-life generalizability of reactivity measures in the past. Continued progress in understanding and measuring reactivity as an individual difference dimension is essential in helping us to evaluate emerging evidence examining the relationship between reactivity and disease risk.

Biobehavioral responses to interpersonal conflict during anger expression among anger-in and anger-out men

To examine whether typical modes of anger expression (ie., anger-in, anger-out) were related to cardiovascular, affective, behavioral, and cognitive responses to interpersonal conflict, 20 anger-in and 20 anger-out undergraduate men participated in 2 role plays, one in which they were instructed to exhibit their anger overtly and the other in which they inhibited their anger Results showed that anger-in individuals used significantly more repression self-statements than anger-out individuals across both role play interactions (p <.01). Anger-out persons showed exaggerated diastolic blood pressure response in contrast to anger-in participants, but only during the exhibited anger role play (p <.04). When the anger exhibition role play followed anger inhibition, diastolic bloodpressure responses were more intense (p <. 05), and heart rate recovery was significantly slower (p <.03) among anger-outparticipants in contrast to anger-in participants. These findings indicate that modes of anger expression (trait) and contextual demands of the interaction (state) interact in complex ways to influence biobehavioral reactions to anger provocation.

The Yale Interpersonal Stressor (YIPS): affective, physiological, and behavioral responses to a novel interpersonal rejection paradigm

Given links between interpersonal functioning and health as well as the dearth of truly interpersonal laboratory stressors, we present a live rejection paradigm, the Yale Interpersonal Stressor (YIPS), and examine its effects on mood, eating behavior, blood pressure, and cortisol in two experiments. The YIPS involves one or more interaction(s) between the participant and two same-sex confederates in which the participant is made to feel excluded and isolated. In Experiment 1, 50 female undergraduates were randomly assigned to the YIPS or a control condition. Participants in the YIPS condition experienced greater negative affect and less positive affect than did those in the control condition. Further, restrained eaters ate more following the YIPS than did nonrestrained eaters. In Experiment 2, 25 male and female undergraduates completed the YIPS. The YIPS induced significant increases in tension, systolic blood pressure (SBP), and diastolic blood pressure (DBP) from baseline, while significantly decreasing positive affect. The YIPS appeared particularly relevant for women, resulting in significantly greater increases in cortisol and SBP for women compared to men. The YIPS, then, provides an alternative to traditional, achievement-oriented laboratory stressors and may allow for the identification of individuals most vulnerable to interpersonal stress.

The effects of racial stressors and hostility on cardiovascular reactivity in African American and Caucasian men

This study examined the effects of race-related stressors and hostility on cardiovascular reactivity in 31 African American and 31 Caucasian men. Participants viewed 3 film excerpts that depicted neutral, anger-provoking (but race-neutral), and racist situations. Participants exhibited significantly greater diastolic blood pressure reactivity to anger-provoking and racist stimuli compared with neutral stimuli. In addition, high hostility was associated with higher recovery systolic and diastolic blood pressure levels after exposure to the films. Although the results failed to confirm previous reports of greater reactivity to racism in African Americans, the findings suggest that diastolic blood pressure levels may remain elevated after exposure to racist stimuli. These results indicate that even indirect exposure to interpersonal conflict elicits significant reactivity, which can persist after exposure to the stressor, especially among high-hostile men.