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Lone A, Othman Albotuaiba A. Association Between Big Five Personality Traits and Hypertension in Saudi Patients: A Case Control Study. Psychol Res Behav Manag 2023; 16:3427-3435. [PMID: 37664136 PMCID: PMC10473415 DOI: 10.2147/prbm.s416828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 08/05/2023] [Indexed: 09/05/2023] Open
Abstract
Background The association between personality traits and hypertension is complex and has so far not been studied in depth. Objective The present study aims to explore the connection between the Big Five personality traits and hypertension. Methods This case control study includes 310 participants, and the relationship between personality traits and hypertension was investigated in normotensive and hypertensive patients by the Big Five Inventory-10. We examined the association of each of the Big Five personality traits in hypertensive patients and a control group using binary logistic regression analysis. Results The findings of the study revealed that amongst the Big Five personality factors, low conscientiousness (OR: 1.09, 95% CI: 0.92-1.29, P<0.005) and high neuroticism (OR: 0.54, 95% CI: 0.45-0.66, P<0.001) were related with high risk of hypertension. Male, older people, and physically inactive individuals have been found to be at a higher risk of hypertension. No significant relationship was found between hypertension and marital status, education, or smoking habits. Conclusion These results suggested that a low score in conscientiousness trait and a high neuroticism score may be an additional risk factor of hypertension. Thus, it may be worthy to investigate further in order to identify patients at risk and develop a more individual treatment strategy. Cognitive behavioral therapy and pharmacological options can be used preemptively in high-risk patients.
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Affiliation(s)
- Ayoob Lone
- Department of Clinical Neurosciences, College of Medicine, King Faisal University, AlHasa, 31982, Saudi Arabia
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Emotional stability, conscientiousness, and self-reported hypertension in adulthood. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017. [DOI: 10.1016/j.paid.2016.02.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Cunningham TJ, Seeman TE, Kawachi I, Gortmaker SL, Jacobs DR, Kiefe CI, Berkman LF. Racial/ethnic and gender differences in the association between self-reported experiences of racial/ethnic discrimination and inflammation in the CARDIA cohort of 4 US communities. Soc Sci Med 2012; 75:922-31. [PMID: 22682683 PMCID: PMC3417223 DOI: 10.1016/j.socscimed.2012.04.027] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 02/26/2012] [Accepted: 04/21/2012] [Indexed: 01/15/2023]
Abstract
Inflammation is etiologically implicated in cardiometabolic diseases for which there are known racial/ethnic disparities. Prior studies suggest there may be an association between self-reported experiences of racial/ethnic discrimination and inflammation, particularly C-reactive protein (CRP). It is not known whether that association is influenced by race/ethnicity and gender. In separate hierarchical linear models with time-varying covariates, we examined that association among 901 Black women, 614 Black men, 958 White women, and 863 White men in the Coronary Artery Risk Development in Young Adults (CARDIA) study in four US communities. Self-reported experiences of racial/ethnic discrimination were ascertained in 1992-93 and 2000-01. Inflammation was measured as log-transformed CRP in those years and 2005-06. All analyses were adjusted for blood pressure, plasma total cholesterol, triglycerides, homeostatic model assessment for insulin resistance (HOMA-IR), age, education, and community. Our findings extend prior research by suggesting that, broadly speaking, self-reported experiences of racial/ethnic discrimination are associated with inflammation; however, this association is complex and varies for Black and White women and men. Black women reporting 1 or 2 experiences of discrimination had higher levels of CRP compared to Black women reporting no experiences of discrimination (β = 0.141, SE = 0.062, P < 0.05). This association was not statistically significant among Black women reporting 3 or more experiences of discrimination and not independent of modifiable risks (smoking and obesity) in the final model. White women reporting 3 or more experiences of discrimination had significantly higher levels of CRP compared to White women reporting no experiences of discrimination independent of modifiable risks in the final model (β = 0.300, SE = 0.113, P < 0.01). The association between self-reported experiences of racial/ethnic discrimination and CRP was not statistically significant among Black and White men reporting 1 or 2 experiences of discrimination. Further research in other populations is needed.
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Affiliation(s)
- Timothy J Cunningham
- Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA.
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Paul VG, Rauch AV, Kugel H, Ter Horst L, Bauer J, Dannlowski U, Ohrmann P, Lindner C, Donges US, Kersting A, Egloff B, Suslow T. High responsivity to threat during the initial stage of perception in repression: a 3 T fMRI study. Soc Cogn Affect Neurosci 2011; 7:980-90. [PMID: 22133562 DOI: 10.1093/scan/nsr080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Repression designates coping strategies such as avoidance, or denial that aim to shield the organism from threatening stimuli. Derakshan et al. have proposed the vigilance-avoidance theory of repressive coping. It is assumed that repressors have an initial rapid vigilant response triggering physiological responses to threat stimuli. In the following second stage repressors manifest avoidant cognitive biases. Functional magnetic resonance imaging at 3T was used to study neural correlates of repressive coping during the first stages of perception of threat. Pictures of human faces bearing fearful, angry, happy and neutral expressions were briefly presented masked by neutral faces. Forty study participants (20 repressive and 20 sensitizing individuals) were selected from a sample of 150 female students on the basis of their scores on the Mainz Coping Inventory. Repressors exhibited stronger neural activation than sensitizers primarily in response to masked threatening faces (vs neutral baseline) in the frontal, parietal and temporal cortex as well as in the cingulate gyrus, basal ganglia and insula. There was no brain region in which sensitizers showed increased activation to emotion expression compared to repressors. The present results are in line with the vigilance-avoidance theory which predicts heightened automatic responsivity to threatening stimuli in repression.
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NyklÍ*ek I, Vingerhoets A, Denollet J. Emotional (Non-)Expression and Health: Data, Questions, and Challenges. Psychol Health 2010. [DOI: 10.1080/08870440290025740] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Lévesque K, Moskowitz DS, Tardif JC, Dupuis G, D'antono B. Physiological stress responses in defensive individuals: age and sex matter. Psychophysiology 2010; 47:332-41. [PMID: 20070571 DOI: 10.1111/j.1469-8986.2009.00943.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The association between defensiveness and physiological responses to stress were evaluated in 81 healthy working men and 118 women, aged 20 to 64 years (M=41; SD=11.45). Participants underwent laboratory testing during which they were exposed to interpersonal stressors. Heart rate (HR), heart rate variability (HRV), blood pressure (BP), and salivary cortisol were measured. Defensiveness was evaluated using the Marlowe-Crowne Social Desirability Scale. In women, higher defensiveness was associated with greater BP and HR reactivity to stress (p<.05). In older men, lower defensiveness was associated with increased systolic BP reactivity to stress (p<.02), delayed HRV recovery (p<.02), and greater salivary cortisol levels (p<.02). In conclusion, greater defensiveness was associated with increased reactivity to stress in women whereas in older men, lower defensiveness was associated with elevated cardiovascular, autonomic, and endocrine responses to stress.
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Affiliation(s)
- Karine Lévesque
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
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Lévesque K, Bureau S, Moskowitz DS, Tardif JC, Lavoie J, Dupuis G, D'Antono B. Defensiveness and metabolic syndrome: impact of sex and age. Biol Psychol 2008; 80:354-60. [PMID: 19150480 DOI: 10.1016/j.biopsycho.2008.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2008] [Revised: 12/18/2008] [Accepted: 12/19/2008] [Indexed: 10/21/2022]
Abstract
The association between defensiveness and metabolic burden, as well as the moderating effects of sex and age were evaluated in 199 healthy working men (N=81) and women (N=118), aged 20-64 years (M=41; S.D.=11.45). Defensiveness (Marlowe-Crowne Social Desirability Scale) and parameters of metabolic syndrome (MS; waist circumference, HDL, triglycerides, glucose, 24h ambulatory blood pressure) were obtained. In men, defensiveness was inversely related to MS burden (Beta=-.288; p=.001), as well as to individual measures of SBP, DBP, glucose and waist circumference (p<.05). In older women, high defensiveness was associated with a greater MS burden (p=.050) and glucose level (p=.005) while the reverse was true in younger women (p=.012). In conclusion, defensiveness was associated with a worse metabolic profile in older women but may be protective for men and younger women. Understanding the pathophysiological processes underlying these associations could elucidate sex and age differences and inform prevention efforts.
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Affiliation(s)
- Karine Lévesque
- Research Center, Montreal Heart Institute and Université de Montréal, 5000 Belanger Street, Montreal, Quebec, Canada H1T 1C8
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Low anxiety males display higher degree of salt sensitivity, increased autonomic reactivity, and higher defensiveness. Am J Hypertens 2008; 21:1292-7. [PMID: 18948961 DOI: 10.1038/ajh.2008.300] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Psychological parameters such as heightened anxiety and defensiveness are associated with increased cardiovascular morbidity and mortality. Autonomic dysfunction is considered to be an important pathogenetic pathway. Little research has been done regarding potential links between emotional factors and salt sensitivity. The aim of the present study was to determine whether subjects with different levels of trait anxiety differ in the degree of salt sensitivity and autonomic reactivity to a mental stress task. METHODS Seventy-two young normotensive men were phenotyped for salt sensitivity and underwent a standardized mental stress test and psychological assessment. According to their trait anxiety test scores, they were classified as low-, moderate- or high-anxiety subjects. A measure of defensiveness was used to assess self-deceptive tendencies. RESULTS Low-anxiety subjects displayed a higher degree of salt sensitivity compared to moderate- and high-anxiety subjects (P < 0.001), increased heart rate (HR) and electrodermal responses to the stressor compared to moderate-anxiety subjects (P < 0.01 and P < 0.05 respectively) and elevated levels of self-deception compared to moderate- and high-anxiety subjects (P < 0.001). CONCLUSION Low-anxiety subjects were characterized by a higher degree of salt sensitivity and increased autonomic responsiveness. Defensiveness was also shown to be elevated in this group and might be the underlying psychological trait explaining these findings. Future research on the associations of anxiety and cardiovascular risk should implement measurement of defensiveness in order to identify these subjects at potential risk for cardiovascular disease despite self-reports of low anxiety.
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Abstract
The emotional style of repressive coping in relation to blood pressure and cardiovascular disease has received increasing attention during the past 25 years. Repressive coping describes the capacity to render events and feelings inaccessible to consciousness. Intrapsychic conflicts involving unacceptable wishes, fantasies, and impulses can be hidden from conscious awareness. Repressive (or defensive) coping has been associated with elevated blood pressure levels, essential hypertension, and paroxysmal hypertension. Cardiovascular patients who use a repressive style have shown mixed results during recuperation. The repressive coping style is easily assessed with two pencil-and-paper measures, which clinicians could administer. Knowledge that a patient uses repressive emotional coping could help physicians better treat this unique group. For patients recovering from cardiovascular events, intervention styles can be adopted that fit the repressive personality. More research in this area will be a challenge to psychologists and internal medicine specialists.
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Affiliation(s)
- Lillian Gleiberman
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48106-0739, USA.
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Steiner H, Erickson SJ, MacLean P, Medic S, Plattner B, Koopman C. Relationship between defenses, personality, and affect during a stress task in normal adolescents. Child Psychiatry Hum Dev 2007; 38:107-19. [PMID: 17356922 DOI: 10.1007/s10578-007-0046-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Accepted: 01/05/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Although there are extensive data on the relationship between personality and stress reactivity in adults, there is little comparable empirical research with adolescents. This study examines the simultaneous relationships between long term functioning (personality, defenses) and observed stress reactivity (affect) in adolescents. METHODS High school students (N = 169; mean age 16; 73 girls) were asked to participate in two conditions of the Stress Induced Speech Task (SIST): Free Association and Stressful Situation. Immature and mature defenses, distress and restraint personality dimensions, and negative and positive affect were examined. RESULTS Greater reported use of immature defenses was significantly associated with negative affect, whereas greater reported use of mature defenses was significantly associated with greater positive affect. Although personality style was also a significant predictor of negative affect across two out of three conditions, defenses were better overall predictors of affect than were personality dimensions. Gender was also a significant predictor of negative affect, wherein girls reported more negative affect than boys. DISCUSSION Defenses and personality style predict affective response during a moderately stressful task. Immature defenses and, to a lesser extent, the distress personality dimension predict mobilization of negative affect, whereas mature defenses predict the reporting of positive affect. These results relate to processes central to psychotherapy: defensive responding, personality style, and affective reactivity during the recounting of stressful events.
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Affiliation(s)
- Hans Steiner
- Center for Psychiatry and The Law, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA 94305-5719, USA.
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Westmaas JL, Jamner LD. Paradoxical effects of social support on blood pressure reactivity among defensive individuals. Ann Behav Med 2006; 31:238-47. [PMID: 16700637 DOI: 10.1207/s15324796abm3103_5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Social support can reduce cardiovascular responses to an acute stressor. However, prior clinical research suggests that defensive individuals may react negatively to social support. PURPOSE This experiment examined whether emotional support provided during a speech stressor would escalate rather than decrease blood pressure (BP) reactivity among defensive individuals. METHODS After completing personality measures, 176 female undergraduates were randomly assigned to give a speech in 1 of 3 social conditions: alone, or with a neutral or supportive confederate present. Mean arterial BP was assessed at baseline, immediately before, and during and after the stressor. RESULTS In the supportive condition, defensiveness predicted higher BP reactivity during anticipation (beta = .35, p = .04) and delivery of the speech (beta = .32, p = .03), and longer recovery to baseline BP levels (beta = .35, p = .01). In the absence of support (i.e., alone and neutral conditions), defensiveness was not associated with BP reactivity. Defensiveness also predicted greater dissociation between subjective stress and BP responses (beta = .35, p = .05), but only in the supportive condition. CONCLUSIONS According to results, the provision of social support during stressors does not benefit defensive individuals' BP reactivity but has the opposite effect.
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Affiliation(s)
- J Lee Westmaas
- Department of Psychology, State University of New York at Stony Brook, NY 11794-2500, USA.
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Zhang J, Niaura R, Todaro JF, McCaffery JM, Shen BJ, Spiro A, Ward KD. Suppressed hostility predicted hypertension incidence among middle-aged men: the normative aging study. J Behav Med 2005; 28:443-54. [PMID: 16179978 DOI: 10.1007/s10865-005-9016-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2004] [Indexed: 12/23/2022]
Abstract
This study tested whether suppressed hostility predicted incident hypertension (HTN) in initially nonhypertensive men, using prospective data from the Normative Aging Study. Six hundred twenty-seven men who completed the MMPI and participated in a subsequent laboratory assessment were included in the study. The Cook-Medley Hostility scale (Ho), a suppression factor, and other risk factors were used to predict incident HTN over a 3-year period. Logistic regression showed a significant three-way interaction among Ho, suppression, and age in predicting incident HTN. Among middle-aged men (<or=60 years) with higher suppression, a 1-point decrease in the Ho score was associated with an 18% increase in HTN risk. This relationship remained significant after controlling for relevant risk factors. Among older participants, the HoxSuppression interaction was not predictive of HTN incidence. These results provide support for the Suppressed Hostility hypothesis in middle-aged men.
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Affiliation(s)
- Jianping Zhang
- Department of Psychology, Indiana University - Purdue University, Indianapolis, Indiana 46202, USA.
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Schwerdtfeger A, Schmukle SC, Egloff B. Interactive effects of avoidant coping and parental hypertension on Rate Pressure Product reactivity in women. Ann Behav Med 2005; 29:106-15. [PMID: 15823784 DOI: 10.1207/s15324796abm2902_5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Previous research suggests that personality, situational context variables, and genes might interact to potentiate cardiovascular stress responses. PURPOSE Our purpose is to examine interactive effects of dispositional avoidant coping and parental hypertension on cardiovascular reactivity to three different laboratory stressors. METHOD Participants were 63 healthy female students. Stressors were an evaluated videotaped speech, the cold pressor, and viewing of the speech video. Heart rate and blood pressure were continuously recorded during baselines and tasks. RESULTS After controlling for age, body mass index, smoking status, reported exercise, alcohol consumption, oral contraceptive use, parental hypertension, and avoidant coping, the interaction term of parental hypertension and avoidant coping was the best predictor of rate pressure product (RPP) reactivity to the speech task and to the video-viewing task. In contrast, reactivity to the cold pressor was not significantly predicted by this interaction term. Furthermore, there were no significant main effects of parental hypertension and avoidant coping on RPP reactivity in any of the tasks. There were no significant interactive effects for diastolic blood pressure. CONCLUSIONS Consistent with an interactive model of cardiovascular reactivity, parental hypertension plus avoidant coping led to enhanced RPP reactivity. This effect, however, was only evident during self-threatening stressors. The results suggest that the coincidence of genetic and personality factors might enhance risk for cardiovascular diseases.
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MacGregor MW, Davidson KW, Barksdale C, Black S, MacLean D. Adaptive defense use and resting blood pressure in a population-based sample. J Psychosom Res 2003; 55:531-41. [PMID: 14642984 DOI: 10.1016/s0022-3999(03)00022-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES There is an accumulating body of research related to the psychosomatic study of blood pressure. One variable that has received attention is defense use. We examined the relation between defense use and blood pressure in men and women of different ages. METHODS A random sample of 667 participants was selected from a population-based study. Resting blood pressure was obtained, and each participant was rated for defense use by a trained observer using Defense-Q. An Adaptive Defense Profile (ADP) score was calculated for each participant, and this score was related to blood pressure. RESULTS Regression analyses revealed a significant main effect for the ADP score for both diastolic and systolic blood pressure. Those persons with higher ADP scores had lower diastolic and systolic blood pressure. As well, a significant Age x Sex x ADP score interaction was found for diastolic blood pressure. Older women with a less ADP score had higher diastolic blood pressure. CONCLUSIONS These findings suggest the continued investigation of defense use and blood pressure.
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Habra ME, Linden W, Anderson JC, Weinberg J. Type D personality is related to cardiovascular and neuroendocrine reactivity to acute stress. J Psychosom Res 2003; 55:235-45. [PMID: 12932797 DOI: 10.1016/s0022-3999(02)00553-6] [Citation(s) in RCA: 157] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Martine E Habra
- Department of Psychology, University of British Columbia, 2136 West Mall, V6T 1Z4, Vancouver, BC, Canada.
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Pedersen SS, Denollet J. Type D personality, cardiac events, and impaired quality of life: a review. ACTA ACUST UNITED AC 2003; 10:241-8. [PMID: 14555878 DOI: 10.1097/00149831-200308000-00005] [Citation(s) in RCA: 162] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Psychological distress has been associated with the pathogenesis and progression of coronary heart disease (CHD) but little is known about the determinants of distress as a coronary risk factor. Although it has become unfashionable to focus on personality factors since research on Type A behaviour yielded inconsistent findings, personality may comprise a major explanatory factor of individual differences in stress-related CHD. This article focuses on Type D--the distressed--personality, which describes patients who experience increased negative emotions and tend to inhibit the expression of these emotions in social interactions. METHODS The article reviews research on Type D personality in the context of CHD. RESULTS Accumulating evidence indicates that cardiac patients with the Type D personality are at increased risk for cardiovascular morbidity and mortality (odds ratios ranging from 4.1-8.9, P<0.0001) independent of standard cardiac risk factors. Type D patients are also at increased risk for psychological distress, clustering of psychosocial risk factors, impaired quality of life, and seem to benefit less from medical and invasive treatment. Preliminary evidence suggests that physiological hyper-reactivity and activation of pro-inflammatory cytokines may be responsible for the detrimental effect of Type D personality on cardiac prognosis. CONCLUSIONS There is an urgent need to adopt a personality approach in the identification of patients at risk for stress-related cardiac events. Type D is a stable personality construct that may be of special interest not only in CHD, but in other chronic cardiac conditions as well.
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Affiliation(s)
- Susanne S Pedersen
- Medical Psychology, Department of Psychology and Health, Tilburg University, The Netherlands
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Rutledge T, Linden W. Defensiveness and 3-year blood pressure levels among young adults: the mediating effect of stress-reactivity. Ann Behav Med 2003; 25:34-40. [PMID: 12581934 DOI: 10.1207/s15324796abm2501_05] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Stress-reactivity has long been proposed to act as a possible mechanism linking psychological factors and increases in blood pressure (BP). This study used results from an intensive cardiovascular investigation to examine the mediating role of reactivity in the relationship between defensiveness and 3-year ambulatory BP levels. A total of 125 male and female participants (M = 29.1 years) completed a protocol including laboratory reactivity testing, 8- to 12-hr ambulatory BP monitoring, and standardized response style instruments. Further, participants returned 3 years later for an identical second test protocol. Results indicated that high- and low-defensiveness participants did not differ on Year 1 BP, but the high-defensiveness group showed higher BP during the reactivity tasks and on Year 3 ambulatory measures. Statistical mediation testing supported reactivity levels as an intervening mechanism between defensiveness and 3-year BP levels.
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Anderson DE, Chesney MA. Gender-specific association of perceived stress and inhibited breathing pattern. Int J Behav Med 2002; 9:216-27. [PMID: 12360838 DOI: 10.1207/s15327558ijbm0903_04] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Stress can potentiate the development of hypertension via inhibition of renal excretory function. One potential mediating mechanism is an inhibited breathing pattern, because hypoventilation can decrease renal sodium excretion acutely via effects on pCO2 and acid-base balance. Large individual differences in resting breathing patterns have been well-documented, with some individuals maintaining slow frequency and high pCO2. Whether this breathing pattern is related to chronic stress has not been investigated. This study reports that high perceived stress over the past month was associated with significantly lower frequency breathing at rest, independently of age, race, or body mass index. This finding was more marked in women than in men. In addition, slow breathing frequency was independently associated with higher resting end tidal CO2 in both men and women. This is the first known report of an association of sustained stress with an inhibited breathing pattern in humans, and points to a pathway by which chronic stress might contribute to the development of hypertension, especially in women.
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Affiliation(s)
- David E Anderson
- National Institute on Aging, National Institutes of Health, Laboratory of Cardiovascular Science, 5600 Nathan Shock Drive, Baltimore, MD 21224, USA
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Abstract
OBJECTIVE Previous literature has shown that the psychological trait of defensiveness is related to elevated sympathetic reactivity to stress and to several cardiac risk factors. The aim of this study was to examine whether these previous findings on defensiveness extend to an asthmatic population. METHODS Defensiveness was measured by the Marlowe-Crowne Social Desirability Scale using a quartile split: high (upper 25%) and low (bottom 75%). Twenty-two defensive and 66 nondefensive participants with asthma were exposed to laboratory tasks (initial baseline rest period, reaction time task, and a shop accident film). RESULTS During the tasks there was evidence of lower skin conductance levels and greater respiratory sinus arrhythmia amplitudes among defensive patients with asthma. After exposure to the tasks, defensive patients with asthma showed a decline on spirometry test measures compared with nondefensive asthmatic patients, who displayed an increase. CONCLUSIONS These data confirm individual response stereotypy and suggest that defensiveness may be characterized by sympathetic hypoarousal and parasympathetic hyperarousal among patients with asthma. Future studies are needed to determine whether defensiveness is a risk factor for stress-induced bronchoconstriction.
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Affiliation(s)
- Jonathan M Feldman
- Department of Psychology, Rutgers University, New Brunswick, New Jersey, USA
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Abstract
OBJECTIVE Acute and chronic psychological distress have been associated with coronary heart disease (CHD) but little is known about the determinants of distress as a coronary risk factor. Broad and stable personality traits may have much explanatory power; this article selectively focuses on negative affectivity (NA; tendency to experience negative emotions) and social inhibition (SI; tendency to inhibit self-expression in social interaction) in the context of CHD. METHODS The first part of this article reviews research on NA and SI in patients with CHD. The second part presents new findings on NA and SI in 734 patients with hypertension. RESULTS Accumulating evidence suggests that the combination of high NA and high SI designates a personality subtype ("distressed" type or type D) of coronary patients who are at risk for clustering of psychosocial risk factors and incidence of long-term cardiac events. Type D and its contributing low-order traits (dysphoria/tension and reticence/withdrawal) could also be reliably assessed in a community-based sample of patients with hypertension. This finding was replicated in men and women, and in Dutch- and French-speaking subjects. Type D hypertensives reported more depressive affect than their non type D counterparts. CONCLUSIONS There is an urgent need to adopt a personality approach in the identification of patients at risk for cardiac events. NA and SI are broad and stable personality traits that may be of special interest not only in CHD, but in other chronic medical conditions as well.
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Affiliation(s)
- J Denollet
- Department of Clinical Health Psychology, Tilburg University, Netherlands.
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