Acute effects of alcohol on cardiovascular reactivity to stress in college-age Type A (coronary prone) individuals

Healthy college-age males and females classified as Type A or Type B were randomly assigned to an alcohol (N=24) or a no-alcohol condition (N=24). Subjects were exposed to a verbal stress quiz while blood pressure, heart rate, peripheral vascular response (PVR), and self-reported anxiety indices were monitored. Results indicated that alcohol effected a reduction in resting levels of systolic blood pressure and a tonic reduction in the peripheral vascular response. Alcohol attenuated the systolic blood pressure, heart rate, and PVR to stress and efffected a decrease in anxiety following the Stressor. When analyzed relative to the participants' drinking experience, data indicated that the strongest stress-modulating effect of alcohol was evidenced by Type A subjects who have been identified as long-term drinkers. During recovery from stress Type A subjects identified as short-term drinkers maintained high levels of PVR. Types A and B subjects who did not ingest alcohol evidenced high PVR levels during stress. The findings are discussed in terms of the protective action of moderate chronic alcohol use on cardiovascular disease risk reduction in persons evidencing the coronary-prone behavior pattern.     

Reduced emotional stress reactivity to a real-life academic examination stressor in students participating in a 20-week aerobic exercise training: A randomised controlled trial using Ambulatory Assessment

ObjectivesTo examine if a preventive 20-week aerobic exercise intervention (AET) can improve emotional stress reactivity during real-life stress.DesignRandomised controlled trial; within-subject design.MethodSixty-one inactive students were randomly assigned to a waiting control and an AET group. To capture the situation-specific, intra-individual data in real life, electronic diaries were used. Participants reported their moods and perceived stress (PS) repeatedly over two days during their daily routines pre- and post-intervention. The pre-intervention baseline assessment was scheduled at the beginning of the semester, and the post-intervention assessment was scheduled at a real-life stressful episode, an academic examination. For the aerobic fitness assessment, both groups completed a cardiopulmonary exercise test on the treadmill before and after the intervention. Multilevel models (MLMs) were conducted to compare within- and between-subject associations.ResultsSignificant emotional stress reactivity was evident in both groups during all assessment periods. However, participants in the AET group showed lower emotional stress reactivity compared with their control counterparts after the 20-week training programme during the real-life stress episode (the academic examination).ConclusionsAET conferred beneficial effects on emotional stress reactivity during an academic examination, which is likely an extremely stressful real-life situation for students.AET appears to be a promising strategy against the negative health effects of accumulated emotional stress reactivity.     

Response of the pituitary-adrenal axis in terms of type a behaviour,hostility and vital exhaustion in healthy middle-aged men

Abstract

Pituitary-adrenal axis was studied in terms of Type A behaviour, hostility and vital exhaustion among 69 healthy middle-aged men. The results showed that psychological factors could explain a significant proportion of the biologically manipulated responses of HPA axis, but they worked in different ways. Type A behaviour was related to a high level of mean basal ACTH and a low level of cortisol response to ACTH stimulation after dexamethasone suppression; hostility was related to a high level of mean basal cortisol and a high cortisol in cortisol/ACTH ratio, while vital exhaustion was characterized by a low level of mean basal ACTH and a decreased ACTH in relation to cortisol. The adrenocortical patterns, i.e. a high ACTH-low cortisol; a high cortisol; and a low ACTH-low mean basal cortisol, as related to Type A behaviour, hostility and exhaustion, respectively, are in line with the traditional physiological stress model and suggest that different adrenocortical responses might be able to identify different mental stress processes. Sense of control has been suggested to be a key concept for psychological understanding of this finding.     

Motilin-and neuropeptide Y-like immunoreactivity in a psychophysiological stress experiment on patients with functional dyspepsia

Background  The aim of the study was to compare plasma motilin-like immunoreactivity (MOT-LI) and neuropeptide Y (NPY)-like immunoreactivity (NPY-LI) in patients with functional dyspepsia (FD) during a controlled psychophysiological experiment. Method  25 patients (12 men, 13 women), age 24–50, with recurrent FD, and 25 pair-wise sex- and age-matched community control subjects were studied. In an experiment, after a rest period, subjects were studied during a 15-min stress interview. The aim of the interview was to elicit anxiety. Before and during the intervention blood samples were drawn for peptide analyses. Outcome measures were the Gastrointestinal Symptom Rating Scale, fasting blood glucose, heart rate and blood pressure as well as the subjects’ self-ratings on visual analogue scales. The plasma concentrations of MOT-LI and NPY-LI are given as anti-logarithms. Results  Mean plasma MOT-LI concentration was 7.3 (CI: 5.7–9.4) pmol/L in the patient group, and 7.9 (CI: 6.1–10.2) pmol/L in the control group. Mean plasma NPY-LI concentration was 14.2 (CI: 12.3–16.4) pmol/L in the patient group, and 13.4 (CI: 11.8–15.3) pmol/L in the control group. Using ANCOVA (covariates: group, gender, age, body mass index and smoking) MOT-LI was related to lower indigestion symptomatology (p<0.04) and positive change in joyfulness during the interview (p<0.03). In the patient group delta motilin correlated with increased joyfulness (p<0.03) and decreased sadness (p<0.03). The NPY-LI increase during the interview was related to higher fasting blood glucose before the interview (p<0.01) and a stronger increase in systolic blood pressure during the test (p<0.05). Conclusion: During a stress interview plasma MOT-LI is positively related to less indigestion symptomatology and joyfulness, while changes in plasma NPY-LI were positively related to sympathetic nervous system activity, but not to gastrointestinal symptoms.     

Preliminary evidence of attenuated blood pressure reactivity to acute stress in adults following a recent marital separation

Objective: This study explores cardiovascular reactivity during an acute-stress task in a sample of recently separated adults.

Design: In a cross-sectional design, we examined the association between adults’ subjective separation-related distress and changes in heart rate and blood pressure across the acute-stress laboratory paradigm in a sample of 133 (n = 49 men) recently separated adults.

Main outcome measures: Heart rate (HR) and Blood pressure (BP) were recorded across a resting baseline period, a math stressor task, and a recovery period.

Results: Multilevel analyses revealed that adults who reported greater separation-related distress exhibited higher initial BP and a slower linear increase in BP across the study period. In addition, adults reporting greater separation-related distress evidenced significantly slower declines in diastolic blood pressure (DBP) following the acute-stress task. HR reactivity was not moderated by separation-related distress.

Conclusions: In recently separated adults, preliminary evidence suggests that the context of the stressors may reveal differential patterns of problematic reactivity (exaggerated or blunted responding). Greater emotional intrusion and hyperactivity symptoms may index increased risk for blunted cardiovascular reactivity to general stressors. This pattern of reactivity is consistent with models of allostatic load that emphasise the deleterious effect of hyporesponsivity to environmental demands.     

Gender differences in type a behavior and hostility within an organizational setting

Abstract

Recent investigations suggest that the hostility component of the Type A behavior patter (TABP) is a greater detriment to health than the overall pattern. Some researchers suggest that certain Type A characteristics (e.g., job-involvement) are actually adaptive. This study compared the relative relationship of the TABP and hostility to career-related achievement and psychosocial adjustment among 223 service-delivery employees. Male and female participants completed the Jenkins Activity Survey and the MMPI Hostility Scale as part of a cardiovascular disease risk factor screening. The TABP was positively associated with managerial status for both men and women. However, the TABP was positively related to psychosocial adjustment variables among men only. Hostility was significantly related to undesirable outcomes including lower job status, life dissatisfaction, and unfavorable perceptions of the workplace for both men and women. Discussion addresses organizational factors which might perpetuate hostility and the TABP, as well as gender differences in the experience of these constructs.     

Testing mediator variables in a physical activity intervention for women with type 2 diabetes

ObjectivesA limited understanding of the mechanisms of behavior change has hindered the development of more effective interventions. The aim of this study was to identify potential mediators of objectively measured physical activity (PA) behavior change in women with type 2 diabetes (T2DM).DesignMediation test of a randomized controlled trial.MethodWomen with T2DM (n = 93) from the control group (standard PA materials, n = 44) and the full intervention group (control + stage-matched printed material and telephone counseling, n = 49) of a larger PA intervention trial were included. PA outcomes were minutes of MET weighted moderate and vigorous PA/week (self-report) and steps/3-days (objective) recorded at baseline and 12-months. Social-cognitive constructs were measured and tested in a mediating variable framework.ResultsPerceived behavioral control and barrier self-efficacy mediated intervention effects on objective PA (proportion of intervention effect mediated = 18% and 24% respectively). Intention was a mediator of objective PA (23%).ConclusionPerceived behavior control, barrier self-efficacy, and intention are effective mechanisms of PA behavior change in women with T2DM.     

Text‐message reminders plus incentives increase adherence to antidiabetic medication in adults with type 2 diabetes

Some adults with Type 2 diabetes mellitus have difficulty adhering to their oral medication regimens. The current study used a multiple baseline design with 3 adults with Type 2 diabetes. Medication taking was monitored remotely in real time via an electronic pill bottle. During the intervention, monetary incentives were delivered contingent on evidence of adherence to taking medication at specified times. Text‐message reminders were also sent if medication was not taken. Adherence increased for all participants. Future studies should separate the relative contributions of text‐message and incentive components of the intervention.     

The Use of a Personal Trainer to Enhance Participation of Older Adults with Severe Disabilities in a Community Water Exercise Class

Inclusive instruction was provided for three older adults with profound mental retardation in a water exercise class at a local YMCA. The older adults were taught to exercise through the use of systematic prompting. A multiple baseline design across participants with an embedded reversal was used to evaluate the impact of a personal trainer. The three participants performed the exercise, but regressed without the assistance of the trainer, as demonstrated by the reversal. Data collected during peer prompting and maintenance conditions indicated that the participants continued to exercise at levels higher than baseline but lower than with a personal trainer.     

Brief strategic therapy in first myocardial infarction patients with increased levels of stress: a randomized clinical trial

Background: Little is known about the impact of interventions targeting chronic stress levels on clinical outcomes among myocardial infarction (MI) patients with increased levels of stress. Objectives: To examine the impact of the addition of brief strategic therapy (BST) to usual care (UC) on clinical outcomes in first MI patients with increased levels of stress. Design: Eighty-one patients were randomly assigned to BST in conjunction with UC (medical treatment, risk factor information, and guidance on unhealthy behavior change) or to UC. Methods: The outcome measures were scores on the Perceived Stress Scale, reinfarction and cardiac mortality rates, and scores on the Health Survey. Measures were taken before, post-treatment, and at two follow-ups. Results: Patients subjected to BST showed reduced perceived stress at post-treatment and maintained decreased levels at follow-ups. At 1-year follow-up, they had a lower rate of non-fatal reinfarction, and at 2.5-year follow-up, they had a lower rate of fatal reinfarction. Their mental and physical health was improved at post-treatment and this was sustained at follow-ups. Conclusion: The addition of BST to UC favorably influences the disease course after MI in patients with increased levels of stress.