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Lanier AL, Stump HM, Daram NR, Maxwell RA, Dhanraj DN. Racial differences in hypertensive disorders in pregnancy during the COVID-19 pandemic. Pregnancy Hypertens 2024; 36:101113. [PMID: 38490151 DOI: 10.1016/j.preghy.2024.101113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/04/2024] [Accepted: 02/17/2024] [Indexed: 03/17/2024]
Abstract
OBJECTIVE To compare rates of pregnancy induced hypertensive disorders during the period of the COVID-19 pandemic to prior, baseline years. METHODS We conducted a retrospective study of 17,742 patients on rates for pregnancy induced hypertensive disorders delivering at 2 local hospitals before (Cohort 1; January 2018 to December 2019; n = 8245) and after (Cohort 2; February 2020 to February 2022; n = 9497) the onset of the COVID-19 pandemic. The primary outcomes were rates of gestational hypertension, pre-eclampsia, and chronic hypertension in patients.Wecompared by year (2018-2022), by patient COVID infection status, and by racial demographics. RESULTS During the pandemic (Cohort 2), there were lower rates of chronic hypertension (7.4 % vs 6.5 %, p =.02), higher rates of gestational hypertension (26.3 % vs 27.8 %, p =.03), and higher rates of preeclampsia (11.3 % vs 13.1 %, p <.001) compared to years prior to the pandemic (Cohort 1). When evaluating by year, rates of chronic hypertension did not statistically change while rates for preeclampsia increased in the first year of the pandemic and remained high, and rates for gestational hypertension did not increase until the second year of the pandemic. When evaluating by COVID infection status, rates for gestational hypertension were significantly higher for individuals with a positive COVID infection status (COVID negative = 27.4 % vs. COVID positive = 32.8 %; p <.004). Rates of preeclampsia did not differ according to COVID infection status (p = 0.15). CONCLUSION In this study, rates of pregnancy induced hypertensive disorders increased during the COVID pandemic regardless of COVID infection status.
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Affiliation(s)
- Ariel L Lanier
- Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Hannah M Stump
- Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Naveena R Daram
- Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Rose A Maxwell
- Associate Professor/Research Director, Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - David N Dhanraj
- Associate Professor/Chair, Department of Obstetrics and Gynecology, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA.
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Lewis TT, Parker R, Erving CL, Udaipuria S, Murden RJ, Fields ND, Booker B, Moore RH, Vaccarino V. Financial responsibility, financial context, and ambulatory blood pressure in early middle-aged African-American women. Soc Sci Med 2024; 345:116699. [PMID: 38412624 PMCID: PMC11014723 DOI: 10.1016/j.socscimed.2024.116699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/06/2024] [Accepted: 02/15/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND African-American women have excess rates of elevated blood pressure (BP) and hypertension compared to women of all other racial/ethnic backgrounds. Several researchers have speculated that race and gender-related socioeconomic status (SES) stressors might play a role. OBJECTIVE To examine the association between a novel SES-related stressor highly salient among African-American women, financial responsibility for one's household, and 48-h ambulatory BP. We further examined whether aspects related to African-American women's financial context (e.g., single parenthood, household income, marital status) played a role. METHODS Participants were N = 345 employed, healthy African-American women aged 30-46 from diverse SES backgrounds who underwent 48-h ambulatory BP monitoring. Linear regression analyses were conducted to examine associations between self-reported financial responsibility and daytime and nighttime BP, adjusting for age, SES and other sociodemographics, cardiovascular risk factors, financial strain and depressive symptoms. Interactions between financial responsibility and single parenthood, household income, and marital/partnered status were tested. RESULTS In age-adjusted analyses, reporting financial responsibility was associated with higher daytime systolic (β = 4.42, S.E. = 1.36, p = 0.0013), and diastolic (β = 2.82, S.E. = 0.98, p = 0.004) BP. Associations persisted in fully adjusted models. Significant associations were also observed for nighttime systolic and diastolic BP. There were no significant interactions with single parenthood, household income, nor marital/partnered status. CONCLUSION Having primary responsibility for one's household may be an important driver of BP in early middle-aged African-American women, independent of SES, financial strain, and across a range of financial contexts. Future studies examining prospective associations are needed, and policy interventions targeting structural factors contributing to financial responsibility in African-American women may be warranted.
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Affiliation(s)
- Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Rachel Parker
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christy L Erving
- Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Raphiel J Murden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nicole D Fields
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Bianca Booker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Reneé H Moore
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA, USA
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Guo X, Wang Y, Kan Y, Wu M, Ball LJ, Duan H. The HPA and SAM axis mediate the impairment of creativity under stress. Psychophysiology 2024; 61:e14472. [PMID: 37968552 DOI: 10.1111/psyp.14472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 10/01/2023] [Accepted: 10/03/2023] [Indexed: 11/17/2023]
Abstract
With the ever-changing social environment, individual creativity is facing a severe challenge induced by stress. However, little is known regarding the underlying mechanisms by which acute stress affects creative cognitive processing. The current research explored the impacts of the neuroendocrine response on creativity under stress and its underlying cognitive flexibility mechanisms. The enzyme-linked immuno sorbent assay was employed to assess salivary cortisol, which acted as a marker of stress-induced activation of the hypothalamic-pituitary-adrenal (HPA) axis. Eye blink rate (EBR) and pupil diameter were measured as respective indicators of dopamine and noradrenaline released by the activation of the sympathetic-adrenal-medullary (SAM) axis. The Wisconsin card task (WCST) measured cognitive flexibility, while the alternative uses task (AUT) and the remote association task (RAT) measured separately divergent and convergent thinking in creativity. Results showed higher cortisol increments following acute stress induction in the stress group than control group. Ocular results showed that the stress manipulation significantly increased EBR and pupil diameter compared to controls, reflecting increased SAM activity. Further analysis revealed that stress-released cortisol impaired the originality component of the AUT, reducing cognitive flexibility as measured by perseverative errors on the WCST task. Serial mediation analyses showed that both EBR and pupil diameter were also associated with increased perseverative errors leading to poor originality on the AUT. These findings confirm that physiological arousal under stress can impair divergent thinking through the regulation of different neuroendocrine pathways, in which the deterioration of flexible switching plays an important mediating role.
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Affiliation(s)
- Xiaoyu Guo
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China
- Key Laboratory of Human Development and Mental Health of Hubei Province, School of Psychology, Central China Normal University, Wuhan, China
| | - Yifan Wang
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China
| | - Yuecui Kan
- Department of Medical Psychology, Psychological Science and Health Management Center, Harbin Medical University, Harbin, China
| | - Meilin Wu
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China
| | - Linden J Ball
- School of Psychology & Computer Science, University of Central Lancashire, Preston, UK
| | - Haijun Duan
- Key Laboratory of Modern Teaching Technology, Ministry of Education, Shaanxi Normal University, Xi'an, China
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Zawadzki MJ, Graham-Engeland JE, Robles PL, Hussain M, Fair EV, Tobin JN, Cassells A, Brondolo E. Acute Experiences of Negative Interpersonal Interactions: Examining the Dynamics of Negative Mood and Ambulatory Blood Pressure Responses Among Black and Hispanic Urban Adults. Ann Behav Med 2023; 57:630-639. [PMID: 37335887 PMCID: PMC10354846 DOI: 10.1093/abm/kaad033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Negative interpersonal interactions are associated with acute increases in ambulatory blood pressure (ABP). Yet, the mechanisms underlying this relationship are unclear. PURPOSE This study tested whether negative interpersonal interactions predict higher ABP both in the moment and during subsequent observations, and whether increases in negative mood mediate these relations. These associations were tested among Black and Hispanic urban adults who may be at higher risk for negative interpersonal interactions as a function of discrimination. Race/ethnicity and lifetime discrimination were tested as moderators. METHODS Using a 24-hr ecological momentary assessment (EMA) design, 565 Black and Hispanic participants (aged 23-65, M = 39.06, SD = 9.35; 51.68% men) had their ABP assessed every 20 min during daytime accompanied by an assessment of negative interpersonal interactions and mood. This produced 12,171 paired assessments of ABP and self-reports of participants' interpersonal interactions, including how much the interaction made them feel left out, harassed, and treated unfairly, as well as how angry, nervous, and sad they felt. RESULTS Multilevel models revealed that more intense negative interpersonal interactions predicted higher momentary ABP. Mediation analyses revealed that increased negative mood explained the relationship between negative interpersonal interactions and ABP in concurrent and lagged analyses. Discrimination was associated with more negative interpersonal interactions, but neither race/ethnicity nor lifetime discrimination moderated findings. CONCLUSIONS Results provide a clearer understanding of the psychobiological mechanisms through which interpersonal interactions influence cardiovascular health and may contribute to health disparities. Implications include the potential for just-in-time interventions to provide mood restoring resources after negative interactions.
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Affiliation(s)
- Matthew J Zawadzki
- Department of Psychological Sciences, University of California, Merced, CA, USA
| | | | - Patrick L Robles
- Department of Sociomedical Sciences, Columbia University, New York, NY, USA
| | - Maryam Hussain
- Department of Psychological Sciences, University of California, Merced, CA, USA
- Clinical Research and Development, Lucid Lane, Inc., Los Altos, CA, USA
| | - Emily V Fair
- Department of Biobehavioral Health, The Pennsylvania State University, State College, PA, USA
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Arroyave-Atehortua D, Cordoba-Sanchez V, Zambrano-Cruz R. Perseverative Cognition as a Mediator Between Personality Traits and Blood Pressure. Vasc Health Risk Manag 2023; 19:363-370. [PMID: 37405254 PMCID: PMC10317524 DOI: 10.2147/vhrm.s385007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/27/2023] [Indexed: 07/06/2023] Open
Abstract
Purpose Several authors link hypertension with psychological dispositions such as stress, personality, and anxiety, some propose that stress is not enough to explain arterial hypertension and others propose the perseverative cognition model to explain. The aim of this study was to relate personality traits and blood pressure profile of a group of workers, examining the results of perseverative cognition as a possible mediating variable concerning blood pressure. Patients and Methods Cross-sectional design study, with a sample of 76 employees of a Colombian university. The NEO-FFI, RRS, and blood pressure measurement instruments were applied; data were reviewed through correlation and mediation analysis. Results We found evidence of association between neuroticism and perseverative cognition (rho=0.42 with brooding; rho =0.32 with reflection), but no evidence about mediation of perseverative cognition between personality and blood pressure. Conclusion It is necessary to keep researching the mechanisms related to the occurrence of hypertension.
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Affiliation(s)
| | - Veronica Cordoba-Sanchez
- School of Social, Human Sciences and Education, Institución Universitaria de Envigado, Envigado, Antioquia, Colombia
| | - Renato Zambrano-Cruz
- Psychology Faculty, Cooperative University of Colombia, Medellín, Antioquia, Colombia
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Wettstein A, Jenni G, Schneider I, Kühne F, grosse Holtforth M, La Marca R. Predictors of Psychological Strain and Allostatic Load in Teachers: Examining the Long-Term Effects of Biopsychosocial Risk and Protective Factors Using a LASSO Regression Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5760. [PMID: 37239489 PMCID: PMC10218379 DOI: 10.3390/ijerph20105760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 04/28/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
Teacher stress significantly challenges teachers' health, teaching quality, and students' motivation and achievement. Thus, it is crucial to identify factors that effectively prevent it. Using a LASSO regression approach, we examined which factors predict teachers' psychological strain and allostatic load over two years. The study included 42 teachers (28 female, Mage = 39.66, SD = 11.99) and three measurement time points: At baseline, we assessed teachers' (a) self-reports (i.e., on personality, coping styles, and psychological strain), (b) behavioral data (i.e., videotaped lessons), and (c) allostatic load (i.e., body mass index, blood pressure, and hair cortisol concentration). At 1- and 2-year follow-ups, psychological strain and allostatic load biomarkers were reassessed. Neuroticism and perceived student disruptions at baseline emerged as the most significant risk factors regarding teachers' psychological strain two years later, while a positive core self-evaluation was the most important protective factor. Perceived support from other teachers and the school administration as well as adaptive coping styles were protective factors against allostatic load after two years. The findings suggest that teachers' psychological strain and allostatic load do not primarily originate from objective classroom conditions but are attributable to teachers' idiosyncratic perception of this environment through the lens of personality and coping strategies.
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Affiliation(s)
- Alexander Wettstein
- Department of Research and Development, University of Teacher Education Bern, 3012 Bern, Switzerland
| | - Gabriel Jenni
- Department of Research and Development, University of Teacher Education Bern, 3012 Bern, Switzerland
| | - Ida Schneider
- Department of Research and Development, University of Teacher Education Bern, 3012 Bern, Switzerland
| | - Fabienne Kühne
- Department of Research and Development, University of Teacher Education Bern, 3012 Bern, Switzerland
| | - Martin grosse Holtforth
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Bern, 3012 Bern, Switzerland
- Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, 3010 Bern, Switzerland
| | - Roberto La Marca
- Department of Research and Development, University of Teacher Education Bern, 3012 Bern, Switzerland
- Clinica Holistica Engiadina, Centre for Stress-Related Disorders, 7542 Susch, Switzerland
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Zurich, 8050 Zurich, Switzerland
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7
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Ballesio A, Zagaria A, Lombardo C. Perseverative Cognition and Psychotic-Like Experiences in Young Adults: A Cross-Lagged Panel Model. Psychopathology 2023; 56:397-402. [PMID: 36731449 DOI: 10.1159/000528859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 12/24/2022] [Indexed: 02/04/2023]
Abstract
Psychotic-like experiences (PLEs), including persecutory ideation, bizarre experiences, and perceptual abnormalities, are considered risk factors for psychotic disorders and mental distress in the general population. The cognitive-affective mechanisms associated with PLEs remain under-investigated. We aimed to longitudinally assess the reciprocal associations between perseverative cognition (PC), an emerging transdiagnostic factor of psychopathology, and PLEs facets in young adults. Participants (n = 160) from the general population completed measures of PC and PLEs at baseline and at 2-month follow-up. A two-wave, three-variable, cross-lagged panel model was implemented controlling for well-established correlates of PC and PLEs such as depression, anxiety, and symptoms of sleep disturbance. Both PLEs and PC exhibited substantive rank-order stability (β ranged from 0.359 to 0.657, ps < 0.001). Cross-lagged effects revealed that baseline PC was associated with bizarre experiences at 2-month follow-up (β = 0.317; p < 0.01). This effect overcame the well-established cut-off for practical significance. In contrast, no baseline PLEs were associated with PC at follow-up. Findings suggest the presence of a monodirectional, rather than bidirectional, association between PC and bizarre experiences in young adulthood. Results should be interpreted in light of the relatively small, non-clinical, and convenient sample.
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Affiliation(s)
- Andrea Ballesio
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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Ambatiello LG. Stress-induced arterial hypertension. TERAPEVT ARKH 2022; 94:908-913. [DOI: 10.26442/00403660.2022.07.201733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 11/22/2022]
Abstract
Stress is considered as one of the factors associated with the development of many diseases, including the cardiovascular system. The history of studying stress as a risk factor for hypertension began in the first half of the 20th century and continued after the introduction of 24-hour blood pressure monitoring (ABPM) into clinical practice. Then it turned out that there is normotension, stable hypertension and latent hypertension: masked (when clinical BP is within the normal range, and arterial hypertension is recorded according to ABPM and/or self-monitoring of BP) and white coat hypertension (increased BP during a visit to the doctor when normal values of blood pressure according to ABPM or self-monitoring of BP). Currently, both variants of latent hypertension are classified as stress-induced arterial hypertension. Several models have been proposed for the study of stress, but two of them are more common in clinical studies: the Karasek model (based on an imbalance between job demands and job decision latitude) and the Siegrist model (based on an imbalance of effort and reward). There are only few studies in where attempts have been made to link the increase in BP with the parameters of stress response (for example, with hormonal levels) or genetic predisposition. The review discusses the most significant studies of stress-induced arterial hypertension published to date.
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Tomitani N, Kanegae H, Kario K. Self-monitoring of psychological stress-induced blood pressure in daily life using a wearable watch-type oscillometric device in working individuals with hypertension. Hypertens Res 2022; 45:1531-1537. [PMID: 35672456 DOI: 10.1038/s41440-022-00946-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 04/14/2022] [Accepted: 04/22/2022] [Indexed: 11/09/2022]
Abstract
This study investigated psychological stress-induced blood pressure (BP) elevation according to self-measured data obtained by a wearable watch-type oscillometric device for multiple days in 50 working hypertension patients (mean ± SD age: 60.5 ± 8.9 years; 92.0% men; 96% treated for hypertension). Participants were asked to self-measure their BPs at five predetermined times as well as at any additional time points at their own discretion under ambulatory conditions for a maximum of 7 days. At the time of each BP measurement, participants self-reported their location, emotion, and degree of stress. A total of 1220 BP readings with self-reported situational information were obtained from 50 participants over 5.5 ± 1.2 days. Systolic BP (SBP) and diastolic BP (DBP) measured during moments of self-reported negative emotions (i.e., anger, tension, anxiety, or sadness) were significantly higher (5.0 ± 1.3 and 2.0 ± 0.8 mmHg, both p < 0.05) than those during moments of self-reported positive emotions (i.e., happiness or calm). SBP/DBP were significantly increased under a moderate or high degree of stress by [4.5 ± 1.1]/[2.5 ± 0.7] and [10.2 ± 3.0]/[4.7 ± 1.8] mmHg, respectively. As a result, it was estimated that SBP/DBP increased 15.2/8.5 mmHg in the presence of highly stressful negative emotions. In conclusion, self-measurement of BP monitoring with a wearable device for multiple days is a feasible method to detect daily stress-induced BP elevation in working adults.
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Affiliation(s)
- Naoko Tomitani
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Hiroshi Kanegae
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.,Genki Plaza Medical Center for Health Care, Tokyo, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
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Vaessen T, Rintala A, Otsabryk N, Viechtbauer W, Wampers M, Claes S, Myin-Germeys I. The association between self-reported stress and cardiovascular measures in daily life: A systematic review. PLoS One 2021; 16:e0259557. [PMID: 34797835 PMCID: PMC8604333 DOI: 10.1371/journal.pone.0259557] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 10/21/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Stress plays an important role in the development of mental illness, and an increasing number of studies is trying to detect moments of perceived stress in everyday life based on physiological data gathered using ambulatory devices. However, based on laboratory studies, there is only modest evidence for a relationship between self-reported stress and physiological ambulatory measures. This descriptive systematic review evaluates the evidence for studies investigating an association between self-reported stress and physiological measures under daily life conditions. METHODS Three databases were searched for articles assessing an association between self-reported stress and cardiovascular and skin conductance measures simultaneously over the course of at least a day. RESULTS We reviewed findings of 36 studies investigating an association between self-reported stress and cardiovascular measures with overall 135 analyses of associations between self-reported stress and cardiovascular measures. Overall, 35% of all analyses showed a significant or marginally significant association in the expected direction. The most consistent results were found for perceived stress, high-arousal negative affect scales, and event-related self-reported stress measures, and for frequency-domain heart rate variability physiological measures. There was much heterogeneity in measures and methods. CONCLUSION These findings confirm that daily-life stress-dynamics are complex and require a better understanding. Choices in design and measurement seem to play a role. We provide some guidance for future studies.
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Affiliation(s)
- Thomas Vaessen
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Center for Mind-Body Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Aki Rintala
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland
| | - Natalya Otsabryk
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Wolfgang Viechtbauer
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Martien Wampers
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center KU Leuven, KU Leuven-University of Leuven, Leuven, Belgium
| | - Stephan Claes
- Center for Mind-Body Research, Department of Neurosciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center KU Leuven, KU Leuven-University of Leuven, Leuven, Belgium
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
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Joseph NT, Chow EC, Peterson LM, Kamarck TW, Clinton M, DeBruin M. What Can We Learn From More Than 140,000 Moments of Ecological Momentary Assessment-Assessed Negative Emotion and Ambulatory Blood Pressure? A Systematic Review and Meta-Analysis. Psychosom Med 2021; 83:746-755. [PMID: 34267091 DOI: 10.1097/psy.0000000000000966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Two decades of research has examined within-person associations between negative emotion states and ambulatory blood pressure (ABP) using ecological momentary assessment (EMA), but no meta-analysis has been conducted. We conducted this systematic review and meta-analysis to quantify the magnitude of this association and identify moderators, review strengths and weaknesses in conceptual and measurement approaches, and provide recommendations. METHODS We searched databases (PsycINFO, PubMed), identified 15 studies, and obtained data from 13 studies (n = 2511; 142,307 observations). RESULTS Random-effects meta-analyses demonstrated small effect r values between momentary negative emotions and systolic ABP (r = 0.06) and diastolic ABP (r = 0.05; p values < .001). Meta-regressions found that effects were larger among studies focused on anxiety, multidimensional negative emotions, predominantly female samples, or less observations of each participant (p values from .003 to .049). A qualitative review found that few studies examined moderators contributing to the substantial interindividual differences in this association. CONCLUSIONS The small association between momentary negative emotion and ABP extends laboratory findings on the association between the experiential and physiological aspects of emotion to the daily, natural emotional experiences of individuals. This literature could be strengthened by determining interindividual and intraindividual moderators of this association (e.g., trait negative emotion and state positive emotion), examining differential associations of different negative emotions with ABP, and standardizing EMA protocols. Although the effect is small, to the extent that repeated emotion-related cardiovascular reactivity may contribute to cardiovascular disease risk, identifying daily life triggers of emotion is important.
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Affiliation(s)
- Nataria T Joseph
- From the Department of Psychology (Joseph, Chow), Pepperdine University, Malibu, California; Department of Psychology (Peterson), Bryn Mawr College, Bryn Mawr; Departments of Psychology and Psychiatry (Kamarck), University of Pittsburgh, Pittsburgh, Pennsylvania; McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas (Clinton); and Department of Psychology, Fuller Theological Seminary, Pasadena, California (DeBruin)
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12
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Self-Rated Health and Age-Related Differences in Ambulatory Blood Pressure: The Mediating Role of Behavioral and Affective Factors. Psychosom Med 2020; 82:402-408. [PMID: 32150013 PMCID: PMC7196491 DOI: 10.1097/psy.0000000000000795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Despite the well-established association between self-rated health (SRH) and health, little is known about the potential psychobiological mechanisms responsible for such links and if these associations differ by age. The main goals of this study were to investigate the links between SRH and ambulatory blood pressure (ABP), if age moderated the risk, and the health behavior/affective mechanisms responsible for such links. METHODS A total of 188 men and women (94 married couples; ages, 18-63 years) completed a standard measure of SRH and a 1-day ABP assessment. Multilevel models were run to examine whether SRH was associated with daily ABP and whether these links were moderated by age. The Monte Carlo method was used to construct confidence intervals for mediation analyses. RESULTS Results indicated that poor SRH was associated with higher ambulatory systolic blood pressure (SBP; b = 3.14, SE = 0.68, p < .001) and diastolic blood pressure (DBP; b = 1.34, SE = 0.43, p = .002) levels. Age also moderated the links between SRH and ambulatory SBP (b = 0.19, SE = 0.08, p = .011) and DBP (b = 0.14, SE = 0.05, p = .004), with links being stronger in relatively older individuals. However, only daily life negative affect significantly mediated the age by SRH interaction for both ambulatory SBP and DBP. CONCLUSIONS These results highlight the potential psychobiological mechanisms linking SRH to longer-term health outcomes. Such work can inform basic theory in the area as well as intervention approaches that target such pathways.
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