Assessing emotional processing difficulties in normotensive individuals with high and isolated blood pressure elevations

This study examined the effect of sense modality (auditory/visual) on emotional dampening (reduced responsiveness to emotions with elevation in blood pressure). Fifty‐six normotensive participants were assessed on tasks requiring labelling and matching of emotions in faces and voices. Based on median split of systolic and diastolic blood pressures (SBP and DBP, respectively), participants were divided into low BP, high BP and isolated BP groups. On emotion‐labelling tasks, analysis revealed reduced emotion recognition in the high BP than the low BP group. On emotion‐matching tasks, reduced emotion recognition was noted in high and also isolated BP group as compared to low BP group for the task that required matching a visual target with one of the four auditory distractors. Our findings show for the first time that even isolated elevations in either SBP or DBP may result in emotional dampening. Furthermore, the study highlights that the emotional dampening effect generalises to explicit processing (labelling) of emotional information in both faces and voices—and that these effects tentatively occur during more pragmatic and covert (matching) emotion recognition processes too. These findings require replication in clinical hypertensives.     

Race differences in stress-induced reactivity in young adults

The cardiovascular response to the stress of mental arithmetic was studied in young Black and White adults. Stress-induced reactivity was studied before and following 14 days of oral sodium loading (10 gm NaCl per day). Marginal hypertensives, both Black and White, had greater systolic blood pressure (SBP) levels (p less than 0.001) and greater diastolic blood pressure (DBP) levels (p less than 0.01) in response to stress. Whites had a greater SBP level during mental stress than Blacks (p = 0.008) and greater reactivity (change from baseline; p less than 0.001). The prevalence of sodium sensitivity was greater in Blacks (37.3%) than in Whites (18.4%). Sodium loading did not augment the BP reactivity to the mental stress in any of the racial or BP groups. These data demonstrate racial variation in the cardiovascular response to centrally mediated adrenergic stimuli. The results also suggest that mild BP elevation in Blacks may be regulated through changes in vascular resistance.     

Associations of blood pressure with self-report measures of anger and hostility among black and white men and women

This study examined associations between blood pressure (BP) and dispositional variables pertaining to anger and hostility. Black and White 25- to 44-year old male and female normotensives and unmedicated mild to moderate hypertensives completed four reliable self-report scales--the Cook-Medley Hostility (Ho) Scale, the Trait Anger subscale of the State-Trait Anger Scale (STAS-T), and the Cognitive Anger and Somatic Anger subscales of the Cognitive-Somatic Anger Scale--plus the Framingham Anger Scale and the Harburg Anger Scale. They also engaged in three laboratory tasks--Type A Structured Interview (SI), a video game, and a cold pressor task--that elicit cardiovascular reactivity. Ambulatory BP readings at home and at work were also obtained from most subjects. Blacks had significantly higher Ho and lower STAS-T scores than did Whites. Women reported higher levels of somatic anger than did men. White women showed significant positive correlations between STAS-T and systolic BP (SBP) and diastolic BP (DBP) both at rest in the laboratory and during the SI. Black women revealed significant positive relationships between STAS-T and SBP and DBP at rest in the laboratory and at work as well as with DBP during the cold pressor test. For Black men, cognitive anger and DBP at rest were positively related. In contrast, White men revealed significant negative correlations between Ho scores and SBP at rest and during the video game; these men also showed significant negative relationships between somatic anger and SBP and DBP reactivity during the cold pressor test. Women, but not men, showed significant positive relationships between all four anger measures and ambulatory BP at work. Whereas main effects relating anger and cardiovascular measures were not apparent as a function of race, Blacks demonstrated significantly greater SBP and DBP reactivity than Whites during the cold pressor test, with the converse occurring during the SI. Men demonstrated significantly greater DBP reactivity than women during the video game. The present findings indicate that self-reports on anger/hostility measures and cardiovascular responses to behavioral tasks differ as a function of race but that relationships between anger and BP regulation need to take into account possible race-sex interactions and selection of anger/hostility measures.     

Cardiovascular reactivity to psychological stress in aerobically trained versus untrained mild hypertensives and normotensives

Cardiovascular reactivity to video game and mental arithmetic stressors was compared among three groups of men: aerobically trained mild hypertensives, untrained mild hypertensives, and a comparison group of untrained normotensives. Relative to the untrained hypertensives, the trained hypertensives reacted to the video game with marginally smaller systolic blood pressure and diastolic blood pressure, but there were no significant differences between these groups in reactivity during the mental arithmetic task. Comparisons between each hypertensive group and the normotensive group showed that blood pressure (BP) reactivity of normotensives during the video game was generally similar to that of trained hypertensives but smaller than that of untrained hypertensives. These results indicate that aerobic training, which has been found to reduce resting BP in mild hypertensives, may also exert a favorable impact in reducing cardiovascular reactivity of hypertensives during some stressful situations.     

Neuropeptide and cardiovascular responses to intravenous catheterization in normotensive and hypertensive blacks and whites

Research suggests that heightened cardiovascular and neuroendocrine (typically catecholamine) responses to stressors may lead to the development of hypertension and that there may be race differences in patterns of reactivity that are potentially pathogenic. Certain neuropeptides exert profound effects on blood pressure (BP) and heart rate (HR), yet no published studies have examined relationships between these peptides, hypertensive status, race, and reactivity. Seventeen Black and 20 White normotensive and borderline-hypertensive male 19- to 50-year-olds underwent intravenous catheterization while cardiovascular and neuropeptide responses to the stress of being catheterized were examined. Results indicate that, in response to the stressor, Black hypertensives, showed significantly lower endorphin levels compared to Black normotensives, and White hypertensives showed significantly higher levels of beta-endorphin compared to White normotensives. Groups were not significantly different in endorphin levels at recovery. Black hypertensives also showed significantly higher stressor-induced HR and systolic and diastolic BP compared to White hypertensives and normotensives. Lower levels of beta-endorphin and lower urine sodium excretion were associated with higher BP and HR.     

Mental and physical stress as moderators of the postural response in insulin-dependent diabetic patients

Two simple stressors, mental arithmetic and isometric handgrip, were studied as moderators of the physiological response to standing in insulin-dependent diabetic patients and in healthy controls. Continuous (beat-to-beat) measures were taken of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and skin conductance (SC) during postural change under baseline and stressor conditions. Diabetic patients without symptoms of neuropathy and healthy controls showed generally similar responses to postural change and to the stressor conditions. SBP and DBP were more responsive to the mental and physical stressors than were HR or SC, especially after standing. Two diabetic patients with postural hypotension showed significant increases in overall BP levels and less of a fall in BP during postural change under the stressor conditions, despite minimal HR or SC responses. Results indicate that these strategies are effective in increasing BP during postural change in both diabetic and nondiabetic individuals and may be useful in the management of orthostatic hypotension.     

Cardiovascular intraindividual variability in later life: the influence of social connectedness and positive emotions

Healthy normotensive men and women (N=33) underwent a 60-day diary assessment of emotions and cardiovascular functioning. Individual differences in social connectedness and mood were measured in questionnaires, and positive emotions, negative emotions, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were assessed daily for 60 consecutive days. Results confirmed that the cardiovascular undoing effect of positive emotions is evident primarily in the context of negative emotional arousal. The daily associations between positive emotions and cardiovascular outcomes were linked to individual differences in social connectedness. Controlling for individual differences in mood levels, multilevel regression analyses showed that social connectedness predicted extended positive emotion, diminished SBP and DBP reactivity, and more rapid SBP recovery from daily negative emotional states.     

Impact of caffeine and psychological stress on blood pressure in black and white men

The purpose of this study was to examine the effects of caffeine and psychological stress on systolic blood pressure (SBP) and heart rate (HR) in 40 healthy Black and White male regular coffee drinkers. Half the subjects had a positive family history of hypertension (FH+), and half did not. The effects of 250 mg of caffeine versus placebo (3 mg) in decaffeinated coffee were compared in a within-subject, double-blind, cross-over design. SBP and HR were measured at rest, after caffeine ingestion, during mental arithmetic stress, and during recovery. Results confirmed previous findings with White men that a moderate dose of caffeine produced significant increases in SBP and little effect on HR and that the pressor effects of caffeine and stress combined additively. Contrary to expectations, no overall race or family history differences in SBP levels or in SBP reactivity were observed. FH+ Blacks, however, evidenced slower SBP recovery than Whites. Whites evidenced higher overall HR levels than blacks, but this difference was not specific to caffeine or to mental stress. Mechanisms of racial differences in reactivity underlying differential risk for hypertension are discussed, as well as the utility of caffeine as a pharmacologic probe for such differences.     

Blood pressure responses to hypnotic and nonhypnotic suggestions in normotensive subjects

Forty normotensive subjects participated on a voluntary basis in a study designed to compare the effect of suggestions on blood pressure (BP). Two experimental groups received suggestions presumed to be specific in lowering or raising BP after simple relaxation (relaxation group) or hypnotic induction (hypnotic group). A control group was used to record the BP changes over time. The time variable was significant for both systolic (SBP) and diastolic blood pressure (DBP). Induction procedures (hypnosis or relaxation) resulted in significant decreases in DBP in both experimental groups. In the control group there was a significant decrease in SBP. A specific suggestion to increase the BP resulted only in DBP increase in the hypnotic group. This group also gave an increase of both SBP and DBP over the entire experiment, whereas the relaxation group resulted in a significant decrease in SBP. There was no significant group variable, indicating no differences between the groups. Further research is needed to enable firm conclusions of the effect of suggestions on BP.     

Ambulatory blood pressure and heart rate in healthy male paramedics during a workday and a nonworkday.

Compared ambulatory blood pressure (BP) and heart rate (HR) in 30 paramedics during a 24-hr workday and a 24-hr nonworkday. During the 24-hr period as a whole, there were no BP differences between the workday and the nonworkday, but HR was higher during the nonworkday than during the workday. Systolic BP (SBP) recorded in the ambulance on the workday was elevated 9.8 mm Hg, compared to SBP recorded in a car on the nonworkday; it was also 7.2 mm Hg higher at the scene of an accident and at the hospital than during nonworkday activities. Ratings of moods in diaries indicated that paramedics felt more unhappiness, stress, and sadness and less feelings of pleasantness at work than at home. Rather than being elevated for the entire 24-hr period, work BP seemed to reflect the relatively high stress associated with specific situations in the work of a paramedic.     

Race, borderline hypertension, and hemodynamic responses to behavioral stress before and after beta-adrenergic blockade

Blood pressure (BP) and hemodynamic responses (cardiac output [CO] and total peripheral resistance [TPR]) to a competitive reaction-time task, previously shown to increase beta-adrenergic activity, were compared in 20 Black and 20 White young men, once following infusion of saline placebo and later repeated after infusion of the nonselective beta-antagonist, propranolol. Both racial groups included subjects with marginal systolic BP (SBP) elevations (n = 6 Whites, n = 5 Blacks) and subjects with normal BP (n = 14 Whites, n = 15 Blacks). Blacks with marginal SBP elevations showed greater diastolic BP increases during the stressor than their White counterparts, both before and after beta-blockade. Both Blacks and Whites with marginal SBP elevations showed greater CO increases during the task than normotensives prior to blockade. Independent of BP status, Black subjects consistently showed higher TPR responses to the task than Whites (lesser decreases before blockade and greater increases after blockade). Blacks also showed greater diminution than Whites after blockade in ionotropic myocardial responses (stroke volume, pre-ejection period, and CO) to the stressor. The possible contributions of alpha-adrenergic and beta-adrenergic influences to these racial group differences are discussed.     

Emotion Beliefs,Emotion Regulation,and Emotional Experiences in Daily Life

One potential factor that could influence how individuals with at least moderate symptoms of depression cope with upsetting events in their daily lives is the beliefs that these individuals hold about whether emotions are malleable or fixed. The current study adopted an experience sampling approach to examine how the beliefs about emotion’s malleability related to daily positive and negative affect and daily emotion regulation efforts among individuals with at least moderate symptoms of depression (N = 84). Results demonstrated that individuals having at least moderate symptoms of depression who held more malleable beliefs about emotions reported decreased negative affect both overall during the day and specifically in response to daily upsetting events. Additionally, these individuals who held more malleable beliefs about their emotions also reported more daily use of cognitive reappraisal to regulate their emotions in response to upsetting daily events. Results from the current study extend previous work examining the relationship between emotion malleability beliefs, emotional experiences, and emotion regulation to examine these relationships in people who are moderately depressed as they navigate the emotional landscape of their daily lives.     

Hemodynamic characteristics of young men at risk for hypertension at rest and during laboratory stressors.

Examined hemodynamic activity--at rest, during mental arithmetic, and during hand cold pressor--in young men varying in risk for hypertension. Classification into low-risk (n = 72), moderate-risk (n = 20), and high-risk (n = 13) groups was based on resting systolic blood pressure (SBP) and parental history of essential hypertension (PH). Dependent variables were SBP, diastolic BP (DBP), heart rate, and rate-pressure product (RPP). Progressively greater hemodynamic activity was seen across risk groups at rest and during the tasks. Risk groups differed significantly in SBP, DBP, and RPP at baseline (ps less than .003) and in size of response to mental arithmetic (ps less than .05) but not to cold pressor. These relationships were either absent or weaker when using either risk factor alone to form risk groups. These findings suggest that hemodynamic reactivity to mental stress is predicted better by a combination of resting SBP and PH than by either risk factor alone and that physiological reactivity may be an important accompaniment of increased risk for hypertension.     

An exploratory study on the development of beliefs about symptoms as signals of arterial hypertension

An exploratory study on the development of beliefs about symptoms as signals of arterial hypertension. In spite of hypertension is known as an asymptomatic health problem, most of the people with such a diagnosis are convinced of experiencing very specific symptoms associated to specific changes in blood pressure (BP). In addition, such beliefs may affect treatment adherence. Previous studies have shown that hypertensive patients use the information they considered right about BP symptoms to regulate the type of decisions they follow in adhering to treatment. The aim of this study is to explore specific variables related with the formation of beliefs about symptoms in a sample of 171 hypertensive patients. Results show that 81,3% of the patients perceived specific symptoms related to changes in hypertension as well as that variables related with the development of these beliefs were mostly: (1) the presence of symptoms during the diagnosis process, (2) the occurrence of hypertensive crisis, and (3) the information provided by others concerning the relationships between symptoms and BP changes. The importance of paying attention to the beliefs of specific symptoms as well as to the circumstances related with the formation process of such beliefs is discussed.     

Beliefs about emotion: implications for avoidance-based emotion regulation and psychological health

People’s beliefs about their ability to control their emotions predict a range of important psychological outcomes. It is not clear, however, whether these beliefs are playing a causal role, and if so, why this might be. In the current research, we tested whether avoidance-based emotion regulation explains the link between beliefs and psychological outcomes. In Study 1 (N?=?112), a perceived lack of control over emotions predicted poorer psychological health outcomes (increased self-reported avoidance, lower well-being, and higher levels of clinical symptoms), and avoidance strategies indirectly explained these links between emotion beliefs and psychological health. In Study 2 (N?=?101), we experimentally manipulated participants’ emotion beliefs by leading participants to believe that they struggled (low regulatory self-efficacy) or did not struggle (high regulatory self-efficacy) with controlling their emotions. Participants in the low regulatory self-efficacy condition reported increased intentions to engage in avoidance strategies over the next month and were more likely to avoid seeking psychological help. When asked if they would participate in follow-up studies, these participants were also more likely to display avoidance-based emotion regulation. These findings provide initial evidence for the causal role of emotion beliefs in avoidance-based emotion regulation, and document their impact on psychological health-related outcomes.     

Psychological stress tasks in the prediction of blood pressure level and need for antihypertensive medication: 9-12 years of follow-up.

Increased blood pressure (BP) reactivity to subtypes of psychological stimuli may differentially predict the development of future BP elevation or hypertension. The authors present the 9-12-year follow-up results of 82 (86%) of 95 male participants with different BP levels. They were healthy, untreated, and age-matched volunteers from a routine health checkup carried out on all 35-, 40-, and 45-year-olds from a medium-sized city. Intra-arterial systolic blood pressure (SBP) during the psychological tasks improved the prediction of future casual SBP and noninvasive 24-hr ambulatory SBP compared with predictions from casual diagnostic measurements. Diastolic blood pressure (DBP) was very useful when added to casual DBP in predicting the need for antihypertensive medication. Reactivity to active tasks especially predicts the need for antihypertensive medication.     

Behavioral predictors of blood pressure variation in hypertensives and normotensives

This study examined the relative impact of five behavioral factors--activity, posture, location, social involvement, and tension--on the 24-hr blood pressure (BP) variability of 21 normotensives, 18 borderline hypertensives, and 18 sustained essential hypertensives. Multiple-regression analyses indicated that within each diagnostic group, activity accounted for more variance in BP variability than any other behavioral dimension. For each behavioral dimension examined, the magnitude of the relationship with BP was generally greater for the normotensives than for both hypertensive groups. In contrast, variation due to individuals was a better predictor of BP variability for the two hypertensive groups than for the normotensive group. Number of months hypertensive and use of antihypertensive medication were related to BP variability for the sustained hypertensive group. Findings have implications for the use of ambulatory BP monitors and interpretation of resulting data.     

Task-related arousal of type A and type B persons: level of challenge and response specificity

To determine whether different levels of challenge had differential effects on the arousal levels of Type A and Type B persons, 30 Type A and 30 Type B male subjects worked on an intelligence test task (digits backwards recall) that was easy, moderately difficult, or extremely difficult. Arousal was measured in terms of systolic blood pressure, diastolic blood pressure, pulse rate, pulse volume, skin resistance, and subjective arousal. Results indicated that while working on the extremely difficult task, the Type A subjects evidenced reliably higher systolic blood pressure than did the Type B subjects (p = 0.1; difference = 7.52 mm of Hg) and that there were not reliable differences between the subjects in systolic blood pressure at other levels of challenge or on other measures of arousal.     

The relationship between beliefs about emotions and quality of life in irritable bowel syndrome

Suppression of undesirable emotions, as well as beliefs about the unacceptability of experiencing and expressing emotions, have both been shown to be related to poorer health-related outcomes in several clinical groups. Potential models through which these variables relate have yet to be tested in those with irritable bowel syndrome (IBS) and are therefore examined in the current article. Online questionnaires were administered to people with IBS (n = 84) to test a mediation model in which beliefs about the unacceptability of emotions are associated with greater emotional suppression, which in turn relates to increased affective distress and consequently poorer quality of life. An alternate model to test the direction of effect along with two further models using support-seeking as mediators of the same predictor and outcome were also tested. Emotional suppression and affective distress (in that particular order) mediate the relationship between beliefs about emotions and quality of life IBS. The models using support-seeking as mediators of the relationship between beliefs about emotions and the two outcomes were not supported. These findings suggest a role for emotional processing in medically unexplained symptoms and imply the need to address such beliefs about emotions in psychological therapies.     

Illness Perception and Well-Being Among Persons with Multiple Sclerosis and Their Caregivers

This study jointly examined illness beliefs held by persons with multiple sclerosis (PwMS) and caregivers in relation to well-being. A group of 68 PwMS and their caregivers completed the Revised Illness Perception Questionnaire, Psychological Well-being Scales, Satisfaction with Life Scale and Positive Affect and Negative Affect Schedule. Findings revealed that PwMS’ well-being was primarily predicted by their own illness beliefs, and that also caregivers’ well-being was primarily predicted by their own beliefs. Across the two groups, well-being was positively associated with their belief that they understood the disease, and inversely associated with their representations of negative emotions. In addition, among PwMS, well-being was inversely associated with the number of symptoms they specifically attributed to their illness, while among caregivers, well-being was positively associated with beliefs that treatment could control the disease. Based on the study findings, psychoeducational and cognitive-behavioral strategies are suggested to promote well-being among PwMS and caregivers.