Blood pressure and heart rate responses to an intrusion on personal space

Abstract: Yaezawa and Yoshida's (1981 ) findings on the effects of an intrusion on personal space were reinvestigated. Thirty-five female students were confronted with the approach of a male stranger, and blood pressure (BP) and heart rate (HR) were monitored. Throughout the model's approach, HR showed a significant triphasic change (an initial decrease, a subsequent increase, and then a secondary decrease), whereas subjective feelings of anxiety and tension showed significant, gradual increases. These trends were similar to those of Yaezawa and Yoshida's . Nonetheless, their explanation that the triphasic change in HR reflected once hightened and then relieved tension, which was incongruent with the subjective ratings, seemed questionable. As the BP elevated to a moderate degree in spite of the modest HR changes, total peripheral resistance must have been increasing during the model's approach. Blood pressure elevations via this sort of hemodynamic pressor mechanisms have often been reported when a person can only tolerate passively during exposure to stress. This seems to be the case in an intrusion on personal space.     

Body fat distribution and hemodynamic stress responses in premenopausal obese women: a preliminary study.

To examine the relationship between body fat distribution and hemodynamic stress responses, cardiovascular responses to a speech task and a forehead cold pressor task were evaluated with 24 premenopausal women classified a priori as either centrally or peripherally obese. Results showed that women with central adiposity exhibited greater stress-related increases in diastolic blood pressure and total peripheral resistance, whereas women with peripheral adiposity exhibited greater stress-related increases in cardiac output. Depression, self-consciousness, hostility, and mood scores did not explain significant variance in the stress response differences between regional adiposity groups. The findings suggest that central adiposity may increase the risk of cardiovascular disease in women at least in part by enhancing vascular responses to stress.     

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.     

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.     

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.     

Patterns of cardiovascular responses to stress as a function of race and parental hypertension in men

This study investigated cardiovascular responses to two stressors known to elicit either beta-adrenergic (mental arithmetic) or alpha-adrenergic (forehead cold pressor) reactivity in Black and White men. Participants in each group were selected for presence or absence of parental hypertension. Based on previous research, Blacks were expected to show smaller cardiovascular responses to the beta-adrenergic mental arithmetic task and greater responses to the alpha-adrenergic cold pressor relative to the Whites. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate, forearm blood flow, and forearm vascular resistance were assessed during a resting baseline, a prestress period, and during and after each experimental procedure. Unlike previous findings, no significant racial differences in cardiovascular responses were found during either task. However, Black participants had significantly higher SBP and DBP levels throughout the cold pressor periods. Parental history did not significantly influence cardiovascular responses in either group. The results are discussed in relation to previous research on racial differences in stress reactivity and their implications for future research.     

Balance of blood pressure equivalents as a new quantitative scale for identifying cardiac versus vascular reactor: Comparisons with Gregg, Matyas and James' (2002) hemodynamic profile scale

Abstract:  A quantitative scale for identifying cardiac versus vascular reactor, balance of blood pressure equivalents ( BE ), was newly advocated and compared with a very recently advocated one, hemodynamic profile ( HP ), by Gregg, Matyas and James (2002). BE was defined as " (Δ Q/Q ₀) P ₀'  − ( Δ R/R ₀ )P ₀." Here, P ₀ , Q ₀, and R ₀ were mean blood pressure ( P ), cardiac output ( Q ), and total peripheral resistance ( R ) during baseline, and Δ Q and Δ R were the difference scores of Q and R from baseline to stress, respectively. This was named as BE because the two terms in the formula indicated changes in Q and R in their blood pressure equivalents. Comparisons of the BE and HP scales were carried out, theoretically, in a newly introduced pressor space, on orthogonality with the extent of elevation of P (Δ P ); and then, practically, by using hypothetical data. In summary, it was shown that data points in the neighborhood in the pressor space can be judged as having not so different hemodynamic balance whether the BE or HP scale was used. As a merit, the BE scale seemed helpful to an intuitive understanding of the hemodynamics during stress. As a demerit, it cannot maintain the quasi-orthogonal relationship with Δ P when Q or R changes profoundly in the face of stress.     

Type A behavior pattern, parental history of hypertension, and cardiovascular reactivity in college males

Two risk factors for cardiovascular disorders, parental history of hypertension and the Type A behavior pattern, were investigated concurrently with respect to cardiovascular reactivity to challenging situations. Sixty-four college males were given both the Structured Interview (SI) and Jenkins Activity Survey (JAS) for the Type A behavior pattern and a family health questionnaire to determine parental history of hypertension. The students were monitored for blood pressure (BP), heart rate (HR), and pulse transit time (PTT) response to four tasks: cold pressor, isometric handgrip exercise, a reading comprehension task, and backwards digit span. Type As based on SI classification had significantly higher HR levels across all tasks than did Type Bs, as well as higher diastolic BP levels in the cold pressor task. No main effects for Type A-B using JAS classification were found. Positive parental history students had higher HR and shorter PTT levels across all the tasks. Type A and parental history did interact in a limited way on some tasks, but the interactions were also dependent on the Type A classification used.     

Sensory information,fear level,and reactions to pain1

An experiment was conducted to investigate the conditions under which sensory information has beneficial versus detrimental value as preparatory information to assist individuals in coping with stress. Fourteen high fear and twelve low fear college women underwent exposure to the cold pressor test. Half of each fear group was provided with sensory information about the sensations produced by the cold pressor and half received a control message. Distress judgments made during the cold pressor showed (a) that sensory information effectively reduced distress for low fear women, but (b) sensory information exacerbated the distress of high fear women—at least during early portions of the cold pressor test. The data generally support Leventhal's (1979) perceptual-motor theory of emotion and have pragmatic implications for those persons who provide preparatory information to individuals anticipating a stressful encounter.     

Hemodynamic responses to active and passive coping tasks and the prediction of future blood pressure in Thai participants: A preliminary prospective cohort study

Cardiovascular responses to mental stress tests have been related to future blood pressure (BP) levels. However, most studies have been completed in North America and Europe; only one study has been conducted in Asia. Therefore, the study explored whether cardiovascular responses to mental stress predict future resting BP in Thailand. Hemodynamic measures were obtained from 101 healthy adults before, during and after mental arithmetic, a speech task, and a cold pressor task. A follow‐up assessment of resting BP was undertaken 1 year later. Results showed that Thais responded to standardized mental stress tasks with large and significant cardiovascular reactivity. Regression analyses indicated that, after adjustment for baseline BP and traditional risk factors, heightened systolic blood pressure (SBP) responses to mental arithmetic were associated with increased future SBP (ΔR² = .045). These findings suggest that BP reactivity predicts future BP and may play a role in the development of hypertension. In addition, Thais displayed large cardiovascular responses to standardized mental stress tasks, of a similar magnitude to previous studies of North Americans and Europeans.     

Active and passive distraction using a head-mounted display helmet: effects on cold pressor pain in children.

OBJECTIVE: The current study tested the effectiveness of interactive versus passive distraction that was delivered via a virtual reality type head-mounted display helmet for children experiencing cold pressor pain. DESIGN: Forty children, aged 5 to 13 years, underwent 1 or 2 baseline cold pressor trials followed by interactive distraction and passive distraction trials in counterbalanced order. MAIN OUTCOME MEASURES: Pain threshold and pain tolerance. RESULTS: Children who experienced either passive or interactive distraction demonstrated significant improvements in both pain tolerance and pain threshold relative to their baseline scores. In contrast, children who underwent a second cold pressor trial without distraction showed no significant improvements in pain tolerance or threshold. CONCLUSION: Although both distraction conditions were effective, the interactive distraction condition was significantly more effective. Implications for the treatment of children's distress during painful medical procedures are discussed.     

Effects of pre-learning stress on memory for neutral, positive and negative words: Different roles of cortisol and autonomic arousal

Stress can have enhancing or impairing effects on memory. Here, we addressed the effect of pre-learning stress on subsequent memory and asked whether neutral and emotionally valent information are differentially affected by specific stress components, autonomic arousal and stress-induced cortisol. Ninety-six healthy men and women underwent either a stressor (modified cold pressor test) or a control warm water exposure. During stress, participants showed comparable autonomic arousal (heart rate, blood pressure), while 60 percent showed an increase of cortisol (responders vs. 40 percent non-responders). Ten minutes after the cold pressor test neutral, positive and negative words were presented. Free recall was tested 1 and 24 h later. Overall, positive and negative words were better recalled than neutral words. Stress enhanced the recall of neutral words independently of cortisol response. In contrast, the free recall of negative words was enhanced in cortisol responders in the 1-h but not 24-h test which might suggest different effects of cortisol on consolidation and reconsolidation processes. Recall for positive words was unaffected by stress-induced cortisol. To summarize, (i) pre-learning stress can enhance memory for neutral words independently of cortisol and (ii) stress effects on memory for negative words appear to rely on stress-induced cortisol elevations, the absence of this effect for positive words might be at least partly due to differences in arousal evoked by positive vs. negative words.     

Pain perception to the cold pressor test during the menstrual cycle in relation to estrogen levels and a comparison with men.

Animal and human research has shown that pain sensitivity changes during the menstrual cycle. This has sometimes been ascribed to hormonal variations. The aim of the present study was to examine how perception of pain, induced by the cold pressor test to the dominant hand, was related to gender and phases of the menstrual cycle. A repeated-measures design was used, where twenty-two female students participated at two different phases of the menstrual cycle (days 2-4 and days 20-24). A control group of nineteen male students participated on two occasions, separated by a three week period. The cycle phase during which each woman began her participation was randomized. Pain was induced using the cold pressor test. Pain threshold was determined as the duration of time between when the subject first reported pain and exposure to the painful stimulus. Pain tolerance was determined as the duration of time until the subject withdraw her/his hand from the test water because the pain was too intensive. The results showed that men tolerated significantly greater pain than women. Women's pain threshold was significantly higher during the second phase of the menstrual cycle. Systolic pressure was higher in men than women, increasing more in men in response to cold pressor testing than women. Further research, including measurements of plasma hormone levels during the menstrual cycle, is needed to clarify the role played by estrogens in pain perception.     

Effects of anxiety sensitivity on anxiety and pain during a cold pressor challenge in patients with panic disorder

Fear of anxiety symptoms, or anxiety sensitivity (AS), has been extensively studied in anxiety disorders and more recently has been linked to other psychopathological conditions including pain. Asmundson and colleagues have suggested that AS may act as a risk factor for chronic pain and several studies have demonstrated an association between AS, avoidance behaviors and pain. The present study assessed whether AS levels would be predictive of pain and anxiety during a brief pain induction task. Clinical participants meeting DSM-IV criteria for panic disorder (n = 22) were age and sex matched with nonclinical controls (n = 22) and exposed to a 2-min cold pressor challenge. Diagnostic status and AS were significantly predictive of pain and anxiety during the cold pressor task. Moreover, AS appears to mediate the relationship between diagnostic status and pain. However, AS appears to be only indirectly associated with pain through its contribution to anxiety.     

Potassium supplementation induces beneficial cardiovascular changes during rest and stress in salt sensitive individuals.

The typical American diet includes high salt and low potassium, a pattern linked to elevated blood pressure (BP) in cross-cultural studies. This study compared resting and stress cardiovascular responses on a high salt, low potassium diet to those observed during 2 interventions: salt restriction and potassium supplementation. Forty-seven percent of the primarily normotensive sample (n = 67 adults) were salt sensitive, showing a decrease in mean arterial pressure > or = 5 mmHg during low salt and equivalent reductions during high potassium. The equivalent benefits of the interventions were maintained, but not enhanced, during exposure to behavioral stress (i.e., no effect on reactivity). Salt resistants (SRs) exhibited no change in resting or stress BP across the diets. High salt increased cardiac index in both groups, whereas vascular tone was decreased only in the SR group. High potassium produced hemodynamic benefits similar to low salt, even with continued high salt intake.     

Ambulatory and laboratory blood pressure in individuals with negative and positive family history of hypertension.

Undertook 24-hr ambulatory blood pressure (BP) monitoring in men and women with and without family history of essential hypertension. Cardiovascular functions were also recorded in the laboratory during mental arithmetic, image star tracing, isometric exercise, and the cold pressor test. Ambulatory daytime, but not nighttime, systolic and diastolic BP as well as heart rate (HR) level and variability was higher in those with than without family history. During sleep, HR level and variability were higher among those with family history; at rest in the laboratory, however, all cardiovascular functions were similar in both groups. The strongest laboratory-based predictor of daytime BP was stress-induced BP levels. BP reactivity also significantly predicted daytime BP but with less accuracy. The best predictor of BP and HR at sleep was resting cardiovascular functions. Thus, ambulatory BP recordings add information to resting and stress-induced levels in identifying cardiovascular risk reactions.     

Psychophysiological responding as a function of age: The importance of matching

Few studies in the past which have employed psychophysiological measures have controlled for age. We have studied the effects of age on the heart rate, hand surface temperature, cephalic vasomotor response, and frontal electromyographic activity (EMG) of 73 normal individuals who varied in age from 18 to 68 years and were evenly divided into younger, middle, and older age groups. Comparisons were made between groups across eight conditions — baseline, relax body, warm hand, relax facial muscles, mental arithmetic, positive imagery, negative imagery, and cold pressor. Results indicated a direct linear relationship between age and electromyographic activity during relax facial muscles and mental arithmetic conditions. There was also a linear relationship between age and hand surface temperature during stressor conditions. Most important, significant interactions were found for both frontal EMG and heart rate measures with age. Post hoc analyses revealed differences on the frontal EMG levels between younger and older age groups during negative imagery, warm hand, and cold pressor conditions. Heart rate differences were found during positive imagery between the younger age group and the medium age group and during cold pressor between the younger age group and both the medium and the older groups. The implications of these findings are discussed.This research was supported in part by NINCDS Grant NS-15235.     

Use of virtual reality distraction to reduce claustrophobia symptoms during a mock magnetic resonance imaging brain scan: a case report.

The present case series with two patients explored whether virtual reality (VR) distraction could reduce claustrophobia symptoms during a mock magnetic resonance imaging (MRI) brain scan. Two patients who met DSM-IV criteria for specific phobia, situational type (i.e., claustrophobia) reported high levels of anxiety during a mock 10-min MRI procedure with no VR, and asked to terminate the scan early. The patients were randomly assigned to receive either VR or music distraction for their second scan attempt. When immersed in an illusory three-dimensional (3D) virtual world named SnowWorld, patient 1 was able to complete a 10-min mock scan with low anxiety and reported an increase in self-efficacy afterwards. Patient 2 received "music only" distraction during her second scan but was still not able to complete a 10-min scan and asked to terminate her second scan early. These results suggest that immersive VR may prove effective at temporarily reducing claustrophobia symptoms during MRI scans and music may prove less effective.     

In Vivo Hippocampal Acetylcholine Release During Exposure to Acute Stress

Hippocampal extracellular acetylcholine (ACh) and choline levels were evaluated using in vivo microdialysis in male Fischer 344 rats before, during, and following an 80-min exposure to two different stress conditions. Measurements were taken in rats restrained and immersed in a water bath containing either 37 degreesC (normothermic-restraint) or 20 degreesC (cold-restraint) water. Results were compared to normothermic-freely-moving rats. Cold-restrained rats displayed decreased ACh levels during cold exposure relative to both normothermic-restrained and normothermic-freely-moving rats. By the end of the cold exposure period and following removal from cold, ACh levels had returned to near-baseline values. Normothermic-restrained rats had levels similar to those of normothermic-freely-moving rats, except for a marked increase in ACh following removal from restraint. Cold-restrained rats displayed a gradual elevation in choline levels during cold stress, followed by a gradual decline after stress termination, whereas both normothermic-restrained and normothermic-freely-moving rats displayed gradual decreases during the microdialysis session. These findings demonstrate that central cholinergic neurotransmission can be altered by the application of, and removal from, acute stressors. In addition, the results suggest a possible relationship between the magnitudes of both the stressor and its cholinergic consequences.     

Reliability of 2D:4D measurements using a direct method suitable for clinical settings

The second to fourth digit ratio (2D:4D) indicates androgen exposure during early development. Numerous methods are used in the assessment of 2D:4D, however, some are not reliable enough and others are difficult to perform in large epidemiological studies. We assessed the reliability of 2D:4D using a direct method with a caliper, and compared it with a computer-assisted analysis on scanned images. Both methods were moderately correlated, but the scan method produced slightly lower 2D:4D. The main source of variation was differences between subjects (real variation). Reliability was higher among men and among younger participants. All reliability coefficients were higher than 0.8 when three repeated measurements were averaged. Our results suggest that reliability is influenced by participants’ characteristics. Digit ratios determined directly with calipers are reliable when repeated measurements are averaged.