Adulthood EAS-temperament and carotid artery intima-media thickness: the Cardiovascular Risk in Young Finns study

We examined the association between adulthood emotionality-activity-sociability temperament scale and preclinical atherosclerosis and, whether this association is mediated by cardiovascular risk factors (low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure and body-mass index (BMI)). The participants were a nationally representative sample of 537 men and 811 women from the Cardiovascular Risk in Young Finns study aged 15-30 years at the baseline in 1992 and aged 24-39 years at the follow-up in 2001. Carotid atherosclerosis was assessed by ultrasound scans of the common carotid artery intima-media thickness (IMT) and brachial flow-mediated dilation (FMD). In men, there was an association between the temperament dimension activity and IMT (β = 0.08, p = 0.036) which was partially mediated by BMI (β decreased from 0.08 to 0.05; p-value of Sobel test = 0.002). However, after correction for multiple comparisons the association between IMT and the temperament dimension activity in men was only of borderline significance. In women, there were no associations between temperament and IMT or FMD. These results suggest that a highly active temperament may contribute to early signs of atherosclerosis in men and that body mass may mediate this association.     

Temperament in childhood predicts body mass in adulthood: the Cardiovascular Risk in Young Finns Study.

This study examined associations of temperament at ages 6 to 12 with body-mass index (BMI) and waist circumference (WC) at ages 24 to 30 years. The participants were 619 men and women derived from the population-based Cardiovascular Risk in Young Finns Study. Temperament was operationalized as (negative) emotionality, sociability, and activity. High emotionality predicted increased BMI, independently of WC, and independently of childhood and adulthood risk factors for adult obesity. None of the temperament dimensions had any associations with WC after controlling for BMI. The findings suggest that temperamental difficulty in childhood may be a useful risk indicator for general body mass in adulthood, and the mechanisms relating temperament with body mass should be further explored.     

Cardiac autonomic reactivity and recovery in predicting carotid atherosclerosis: the cardiovascular risk in young Finns study.

The present study examined the association of cardiac autonomic task-induced reactivity and recovery to preclinical atherosclerosis. Thirty-three men and 33 women aged 24-39 years participated in the ongoing epidemiological Cardiovascular Risk in Young Finns study. The authors measured heart rate (HR), respiratory sinus arrhythmia (RSA), and preejection period (PEP) during the mental arithmetic and speech tasks in 1999. Carotid atherosclerosis was assessed by measuring the thickness of the common carotid artery intima-media complex (IMT) with ultrasound in 2001. Higher HR, RSA, and PEP reactivity were associated with lower IMT values even after adjusting for cardiovascular risk factors (lipid levels, obesity, and blood pressure). In addition, better HR recovery after the mental arithmetic task was associated with lower IMT values, and this association persisted after all adjustments. Thus, higher task-induced cardiac autonomic reactivity and better HR recovery were related to less preclinical atherosclerosis. The authors concluded that cardiac pattern of reactivity and quick recovery may be associated with better cardiovascular health, and therefore all reactivity occurring in challenging situations should not automatically be considered as potentially pathological.     

Relationship between chronic stress and carotid intima-media thickness (IMT) in elderly Alzheimer's disease caregivers

The stress associated with providing care for a spouse diagnosed with Alzheimer's disease can have adverse effects on cardiovascular health. One potential explanation is that chronic caregiving stress may contribute to the development of atherosclerosis. The purpose of this study was to determine whether the duration that one has provided care is associated with the degree of atherosclerotic burden, as measured by carotid artery intima-media thickness (IMT). One hundred and ten Alzheimer caregivers [mean age 74?±?8 (SD) years, 69% female] underwent in-home assessment of carotid artery IMT via B-mode ultrasonography. Data regarding medical history, blood pressure, and multiple indicators of caregiving stress were also collected. Multiple regression indicated that duration of care was positively associated with IMT measured in the internal/bifurcation segments of the carotid artery (β?=?0.202, p?=?0.044) independent of risk factors such as age, gender, body mass index, smoking history, sleep quality, hypertension status, and caregiving stressors. Duration of care was positively associated with IMT in the common carotid artery, but the relationship was not significant. These findings provide more evidence of the link between chronic caregiving stress and cardiovascular disease and indicate that enduring the experience of caregiving over a period of years might be associated with atherosclerotic burden.     

EAS temperaments as predictors of unemployment in young adults: A 9-year follow-up of the Cardiovascular Risk in Young Finns Study

EAS temperament traits (negative emotionality, activity, sociability) are known to be associated with psychosocial adjustment. We examined whether these traits also predict unemployment in young adults. The participants (n = 1493–1893) were from the population based Cardiovascular Risk in Young Finns Study. EAS temperaments were assessed three times during a 9-year period from 1992 to 2001. Unemployment status and duration of unemployment were assessed in 2001 when the participants were from 24- to 39 -year olds. Especially higher negative emotionality and lower activity were associated with greater likelihood of reporting unemployment at the end of the follow-up. Higher negative emotionality and lower sociability and lower activity predicted unemployment duration. These results suggest that temperament traits are associated with risk of unemployment.     

Cardiovascular reactivity in hypertensives: differential effect of expressing and inhibiting emotions during moments of interpersonal stress

This study investigated cardiovascular reactivity of hypertensive adults during periods of emotional stress. Two types of instructions were given at different moments, to the same subject, either to express or to suppress feelings during role-play. Expressing, but not inhibiting, emotions elicited significantly higher reactivity during responding to negative scenes, followed by responding during the positive interactions. Blood pressure increases in both expressing and inhibiting conditions, were also found during the instruction periods. Results indicated that socially demanding situations represent a stressor whose effects may vary depending on whether or not respondents regulate expression of emotions. It is suggested that the difficulty in expressing emotions found in some hypertensive individuals may have the function of controlling or reducing blood pressure reactivity.     

Hypertension risk and caffeine's effect on cardiovascular activity during mental stress in young men

Examined the cardiovascular effects of caffeine plus behavioral stress in men low versus high in risk of essential hypertension. Caffeine (3.3 mg/kg, equivalent to 2 to 3 cups of coffee) or placebo was given on alternate days to 19 low-risk men (negative for parental hypertension and low-normal resting blood pressure, BP) and 20 high-risk men (positive history, high-normal BP). Forty minutes later, each worked for 15 min on a demanding psychomotor task during which BP, cardiac output, and vascular resistance were determined. During rest, caffeine raised vascular resistance in both groups. During the task, it supra-additively increased the systolic BP response by enhancing the rise in cardiac output, producing equivalent BP rises in both groups. Due to the higher resting pressures of the high-risk men, caffeine plus the task resulted in 50% of these having transient BP of 140/90 mg Hg or greater. Caffeine in combination with mental stress may produce undesirable BP in those at risk for hypertension.     

The electronic teaching theater: Interactive hypermedia and mental models of the classroom

The introduction of hypermedia into the classroom presents both an opportunity to expand the power of teaching through electronic facilitation of the media and a challenge to redesign the classroom and instructional environment to exploit the enhanced features of hypermedia. This paper briefly surveys the current state of computers in the classroom and then argues that a more integrated approach is required. To this end, the concept of an electronic teaching theater is proposed which takes advantage of hypermedia and collaborative work environments. The aim of the electronic teaching theater is not to totally redesign the classroom and instructional interaction, but rather to facilitate it using well understood metaphors to lay out the dynamics of classroom interaction on the electronic media and to use the results from research in human/computer interaction to design the interface. To facilitate the application of hypermedia, a model of instructional interaction among the students, the instructors, the course material, and the products of instruction is presented. A number of component models pertaining to course preparation, lectures, note taking, and other instructional activities are then discussed that should prove useful in designing the electronic classroom. The origin of these models is the mental representation of the interaction as perceived by the teacher and the student. The idea is to start with such models as a base metaphor, to instantiate the metaphors in the electronic classroom, and then to explore innovations in the technology that go beyond the strict application of the metaphor. This work was supported in part by a grant from AT&T to the University of Maryland during the author’s visit to the Medical Research Council—Applied Psychological Unit, Cambridge, England. Appreciation is expressed to Patricia Wright and Richard M. Young for their helpful comments on this paper.     

Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Parsing the relations between SES and stress reactivity: examining individual differences in neonatal stress response

In an effort to further delineate the reported relations between socioeconomic status (SES) and stress reactivity in children, associations between three domains of perinatal risk: socio-demographic, obstetrical complications, and maternal psychological factors during the perinatal period, and cortisol and behavioral reactivity were examined in 100 healthy African American neonates whose families resided in low-income environments. Behavioral and cortisol response to a heel stick and the Neonatal Behavioral Assessment Scale (NBAS) was measured within the first 2 days of life. Significant associations were found between socio-demographic risk, obstetrical complications, and maternal psychological factors and neonatal behavior and cortisol in the context of the NBAS; few significant associations were found in the context of the heel stick. Greater magnitude of perinatal risk was associated with both higher and lower than average neonatal stress reactivity. The results provide preliminary data on the types of perinatal experiences that may have significant effects on stress reactivity in humans, especially in the context of families living in poverty. Application of these data to the hypothesis that prenatal stress results in programming of the fetal/neonatal stress response system is discussed.     

Community types and mental health: a multilevel study of local environmental stress and coping

Research has found that neighborhood structural characteristics can influence residents' mental health. Few studies, however, have explored the proximal reasons behind such influences. This study investigates how different types of communities, in terms of environmental stressors (social and physical disorder and fear of crime) and social resources (informal ties and formal organizational participation), affect well-being, depression, and anxiety in adult residents. Data are from a survey of 412 residents nested in 50 street blocks. Block stressors and resources were cluster analyzed to identify six block types. After controlling for several individual- and block-level characteristics, results from multilevel models suggest that in communities facing relatively few stressors, higher levels of formal participation are associated with better mental health. Because high levels of formal participation were not found in communities with higher levels of stressors, the impact of participation in such contexts could not be examined. However, results suggest that in communities where stressors are more common, isolation from neighbors may have a protective effect on mental health.     

The effect of prenatal androgen exposure on the development of neural reactivity systems: A study of the HEXACO Personality Inventory

The ratio of the lengths of the second and fourth digits of hands (2D:4D) seems to vary as a function of systematic differences in prenatal androgen exposure (Hönekopp & Watson, 2010). The 2D:4D ratio has been shown to be related to a variety of personality attributes. This study predicted that 2D:4D would covary with scores on the emotionality dimension of the six-facet HEXACO personality assessment, due to emotionality’s relationship with neural reactivity systems controlled by the amygdala (Hines, Allen, & Gorski, 1992), but that 2D:4D would relate to no other facet. Consistent with hypotheses, data showed that men had smaller ratios than women on both the right, t(405) = 2.84, p < .05, d = .28, and left hands, t(405) = 4.51, p < .05, d = .45, and the relationship between 2D:4D and emotionality was outside of sampling error of zero, r = .18, p < .001. Additionally, 2D:4D was unrelated to the remaining HEXACO facets. Findings suggest that prenatal testosterone exposure has an organizing effect on personality traits.     

Gender,attachment, and relationship duration on cardiovascular reactivity to stress in a laboratory study of dating couples

Stress related to relationship events has been a strong predictor of cardiovascular reactivity. This four‐phase laboratory study used a multiple‐nested design to examine variations in diastolic blood pressure (DBP) and rate‐pressure product (RPP: pulse rate [PR] × systolic blood pressure [SBP]) as a function of stress appraisal using 33 college‐aged dating couples. Individual participants filled out questionnaires designed to assess the length of their relationships (couple‐level factor), gender and attachment styles (individual‐level factors); watched a film clip depicting relationship distress; discussed relationship problems; then received instruction for relaxation. Individuals’ self‐reported stress and negative affect levels (experimental phase‐level factors), DBP, SBP, and PR were also measured at each study phase. Hierarchical linear modeling analyses revealed that relationships with longer duration were associated with higher levels of DBP and RPP as perceived stress levels increased. Also, as perceived stress levels increased, men or individuals high in the anxiety dimension of attachment showed higher DBP and RPP reactivity, whereas individuals high in the avoidance dimension of attachment showed lower RPP reactivity. As the negative affect level increased, individuals high in the avoidance dimension of attachment showed lower RPP reactivity. Findings imply that under relationship stress, individuals high in avoidance or anxiety dimensions of attachment may be vulnerable to a range of physical symptoms, such as cardiovascular disease or hypertension.     

A Tuesday in the life of a flourisher: the role of positive emotional reactivity in optimal mental health

Flourishing--a state of optimal mental health--has been linked to a host of benefits for the individual and society, including fewer workdays lost and the lowest incidence of chronic physical conditions. The aim of this paper was to investigate whether and how routine activities promote flourishing. The authors proposed that flourishers thrive because they capitalize on the processes featured in the broaden-and-build theory of positive emotions, specifically by experiencing greater positive emotional reactivity to pleasant events and building more resources over time. To test these hypotheses, the Day Reconstruction Method (DRM) was administered to a prescreened community sample of adults (n = 208), and they were recontacted two to three months later. Results showed that relative to those who did not flourish or were depressed, people who flourish generally responded with bigger "boosts" in positive emotions in response to everyday, pleasant events (helping, interacting, playing, learning, spiritual activity), and this greater positive emotional reactivity, over time, predicted higher levels of two facets of the cognitive resource of mindfulness. In turn, these higher levels of mindfulness were positively associated with higher levels of flourishing at the end of study, controlling for initial levels of flourishing. These results suggest that the promotion of well-being may be fueled by small, yet consequential differences in individuals' emotional experience of pleasant everyday events. Additionally, these results underscore the utility of the broaden-and-build theory in understanding the processes by which flourishing is promoted and provide support for a positive potentiation perspective.     

Lipid reactivity to stress: I. Comparison of chronic and acute stress responses in middle-aged airline pilots.

Lipids increase during psychological stress, but no studies have compared the effects of acute and chronic stressors on lipid responsivity in the same individuals. One hundred middle-aged men (n = 92) and women (n = 8) were examined during high chronic occupational stress, low chronic stress, and acute laboratory stressors. In addition to measures of perceived stress and affect, an extensive battery of lipid and lipoprotein measures was undertaken at each time point. Most lipid parameters were significantly increased during the chronic and acute stressors, although the responses to the different stressors were not consistently associated. For example, significant correlations among the chronic and acute stress responses were apparent for the apoproteins, but not for total, low density lipoprotein, or high density lipoprotein cholesterol. The factors and processes regulating these variables during stress may be different during acute and chronic stressors.     

Skills training in the long-term management of stress and occupational burnout

The current managed healthcare environment stresses brief and effective short-term therapy. However, often this short-term treatment does not lead to long-term behavioral changes and clients return to therapy many times for help with the same dysfunctional behavioral patterns. The main problem with these traditional forms of treatment is the assumption that clients have the basic skills to change their ineffective behaviors. Yet, many people lack the basic skills to manage our highly stressful society, and may take years to master new behavioral management skills. Examining the relationship between stress and coping, this study explored both short-and long-term approaches to behavioral change relative to occupational burnout, and focused upon the teaching of skills to manage stress. Subjects who participated in a 6-week stressmanagement program reported only temporary decreases in burnout, while those subjects who received 1-hour coping “refresher” sessions at 5 months, 11 months, and 17 months showed consistent decreases in burnout throughout a 2 1/2 year period. These results suggest that psychologists can be much more effective behavioral change agents through long-term approaches that emphasize teaching new skills to manage chronic behavioral problems. Given the changes in the health insurance industry and the way therapeutic services are provided, the field may need to rethink approaches that are grounded in personality theory and abnormal psychology to approaches that emphasize principles of learning theory.     

Skills training in the long-term management of stress and occupational burnout

The current managed healthcare environment stresses brief and effective short-term therapy. However, often this short-term treatment does not lead to long-term behavioral changes and clients return to therapy many times for help with the same dysfunctional behavioral patterns. The main problem with these traditional forms of treatment is the assumption that clients have the basic skills to change their ineffective behaviors. Yet, many people lack the basic skills to manage our highly stressful society, and may take years to master new behavioral management skills. Examining the relationship between stress and coping, this study explored both short-and long-term approaches to behavioral change relative to occupational burnout, and focused upon the teaching of skills to manage stress. Subjects who participated in a 6-week stressmanagement program reported only temporary decreases in burnout, while those subjects who received 1-hour coping “refresher” sessions at 5 months, 11 months, and 17 months showed consistent decreases in burnout throughout a 2 1/2 year period. These results suggest that psychologists can be much more effective behavioral change agents through long-term approaches that emphasize teaching new skills to manage chronic behavioral problems. Given the changes in the health insurance industry and the way therapeutic services are provided, the field may need to rethink approaches that are grounded in personality theory and abnormal psychology to approaches that emphasize principles of learning theory.