Health Psychology

Ewart, Craig K.; Taylor, C. Barr; Kraemer, Helena C.; Agras, W. Stewart

doi: 10.1037/0278-6133.10.3.155pmid: N/A

Theories linking anger and blood pressure (BP) reactivity to cardiovascular disease must be able to identify naturally occurring stressors that arouse emotion with sufficient frequency to cause chronic physiologic stress. We examined the impact of normal family arguments on 43 patients (24 women, 19 men) with essential hypertension. Patients and their partners discussed a threatening disagreement for 10 min while BP and conversation were recorded. Discussing problems increased BP, but the causal pathways differed by sex. In women, hostile interaction and marital dissatisfaction were associated with increased BP; “supportive” or “neutral” exchanges were unrelated to BP. In men, BP fluctuations were related only to the patient’s speech rate. These findings are consistent with other research on sex differences in communication and social problem-solving styles and implicate different mechanisms (frequent anger, active coping) through which marital discord could increase risk. Implications for intervention are considered.Key words: hypertension, hostility, marital conflict, cardiovascular reactivity, marital therapy, heart disease risk

MacKinnon, David P.; Johnson, C. Anderson; Pentz, Mary Ann; Dwyer, James H.; Hansen, William B.; Flay, Brian R.; Wang, Eric Yu-I

doi: 10.1037/0278-6133.10.3.164pmid: N/A

Describes (a) the effects of a social-influences-based drug prevention program (the Midwestern Prevention Project) on the mediating variables it was designed to change and (b) the process by which the effects on mediating variables changed use of drugs (tobacco, alcohol, and marijuana). Students in 42 middle schools and junior high schools in Kansas City, Missouri, and Kansas City, Kansas, were measured in the fall of 1984 (N = 5,065) and again 1 year later (N = 5,008) after 24 of the schools had been through the program. Compared to students in control schools, students in program schools became less likely to express belief in the positive consequences of drug use, less likely to indicate that they would use such drugs in the future, more likely to report that their friends were less tolerant of drug use, and more likely to believe that they were better able to communicate with their friends about drug or school problems. Change in perceptions of friends’ tolerance of drug use was the most substantial mediator of program effects on drug use. There was evidence that intentions to use and beliefs about the positive consequences of use may also mediate program effects on drug use.Key words: smoking, alcohol, drugs, adolescence, prevention

Gerrard, Meg; Gibbons, Frederick X.; Warner, Teddy D.

doi: 10.1037/0278-6133.10.3.173pmid: N/A

People generally underestimate their own vulnerability to negative events such as illness or accidents. It has been suggested that this illusion of “unique invulnerability” is due to selective focus on one’s own risk-reducing behaviors, to the exclusion of others’ risk-reducing behaviors and one’s own risk-increasing behaviors. The current study examined the effects of reviewing sexual and contraceptive behavior on perceived vulnerability to unplanned pregnancy. Our results indicated that review of pregnancy-related behaviors decreased perceived vulnerability among two groups of subjects: those who considered unplanned pregnancy to be most undesirable and those who had the most confidence in the efficacy of their contraceptive behavior. The data also support the hypothesis that selective focus is a source of the illusion of invulnerability.Key words: perceived vulnerability, sexual and contraceptive behavior, risk behaviors, unplanned pregnancy, HIV infection vulnerability, illusion of invulnerability

Gallant, Sheryle J.; Hamilton, Jean A.; Popiel, Debra A.; Morokoff, Patricia J.; Chakraborty, Prabir K.

doi: 10.1037/0278-6133.10.3.180pmid: N/A

Evaluated changes in daily ratings of moods and symptoms in 30 normally cycling women and 23 men. Women were randomly assigned to two groups for manipulating awareness of the study focus (aware vs. unaware). Principal-components analysis revealed six factors (Dysphoric Moods, Well-Being, Physical Symptoms, Personal Space, Food Cravings, Depression) that accounted for 70% of the variance in daily ratings. Repeated-measures analyses revealed cyclic variation on each factor and no significant differences between aware and unaware women during premenstrual or menstrual phases on any measure. Unaware women reported less well-being than men during the premenstrual phase but did not differ on any other measure. Aware women did not differ from men in premenstrual or menstrual ratings on any measure. The way these findings relate to retrospective symptom reports, menstrual attitudes, and changes in moods and symptoms across the week was examined.Key words: awareness of study focus, daily ratings of menstrual cycle moods and symptoms, gender differences

Catania, Joseph A.; Coates, Thomas J.; Stall, Ron; Bye, Larry; Kegeles, Susan M.; Capell, Frank; Henne, Jeff; McKusick, Leon; Morin, Steven; Turner, Heather; Pollack, Lance

doi: 10.1037/0278-6133.10.3.190pmid: N/A

Freund, Anne; Johnson, Suzanne Bennettss; Silverstein, Janet; Thomas, Julia

doi: 10.1037/0278-6133.10.3.200pmid: N/A

Conducted 24-hr recall interviews concerning daily diabetes management with seventy-eight 6- to 19-year-old patients and their parents. Patients and parents were interviewed independently nine times over 3 months. Data obtained were used to construct 13 adherence measures. All measures yielded statistically significant estimates of parent-child concordance. Parent-child agreement was higher for weekday versus weekend behaviors and when based on nine versus three interviews. For the sample as a whole, parent-child concordance remained stable over the course of the study. Compared to the older patients, the 6- to 9-year-olds exhibited poorer parent-child agreement on measures involving time (e.g., injection and exercise-duration measures). This deficit disappeared, however, as the children became more practiced with the interview procedure. The dietary and glucose-testing measures exhibited moderate stability over the 3-month study. Lower stability estimates were obtained for the exercise and injection measures.Key words: adherence, diabetes, children

Schneider, Mark S.; Friend, Ronald; Whitaker, Paul; Wadhwa, Nand K.

doi: 10.1037/0278-6133.10.3.209pmid: N/A

Fluid noncompliance in patients with end-stage renal disease (ESRD) is a widespread problem with severe consequences for health. In addition, ESRD patients report considerable stress in relation to their illness and dialysis treatment. The present study examined the role of cognitive and emotional variables in fluid noncompliance, symptomatology, and stress. Fifty hemodialysis patients were assessed (a) on the cognitive variables of locus of control, self-evaluations of their past compliance, and self-efficacy to resist fluid intake and (b) on the emotional variables of depression, anger, and anxiety. Results showed that cognitive variables accounted for fluid noncompliance and predicted future adherence. Patients high in negative emotions complied equally as well as patients low in negative emotions but were found to report substantially more symptomatology and distress associated with their treatment. The implications of these findings for treatment of ESRD patients and future research are discussed.Key words: symptom distress, fluid compliance, end-stage renal disease (ESRD)

Spring, Bonnie; Wurtman, Judith; Gleason, Ray; Wurtman, Richard; Kessler, Kenneth

doi: 10.1037/0278-6133.10.3.216pmid: N/A

Directlymeasured food intake in 31 overweight female smokers to test whether (a) calorieand carbohydrate intakes increase after smoking cessation and (b) double-blindd-fenfluramine (30 mg), a serotonin-releasing drug, suppresses weight gain,overeating, and dysphoric mood associated with stopping smoking. Placebotreatedpatients grew dysphoric after smoking withdrawal and ate 300 kcal/day more from2 to 28 days after, showing a 3.5-lb weight gain. Fat and protein intakes didnot change, but carbohydrate intake increased (30% to 40%). D-fenfluramineprevented postcessation dysphoria. Although drug-treated patients ate morecarbohydrate snacks just after quitting, they returned to baseline by 4 weeks,showing a 1.8-lb weight loss. Agents that enhance brain serotonin-mediatedneurotransmission may help prevent weight gain, overeating, and dysphoric moodafter smoking withdrawal.Key words:cigarette smoking, smoking cessation, weight, carbohydrates, food intake

Frankish, James; Linden, Wolfgang

doi: 10.1037/0278-6133.10.3.224pmid: N/A

Examinedcardiovascular-response adaptation patterns in high- versus low-cardioreactivewomen. Responses to a mental-arithmetic-plus-noise task were compared withintrials (3 min each), across trials (three per session), and across two sessionsseparated by a 4-week interval. Forty-four normotensive women (mean age=22.5years) completed the study. Heart rate (HR), systolic blood pressure (SBP), anddiastolic blood pressure (DBP) were monitored. Analyses of variance wereemployed to analyze the repeated-measures design and indicated consistentdecreases in HR, SBP, and DBP response magnitudes across visits, trials, andminutes. Decreases in HR were greatest from Minute 1 to Minute 2 within eachtrial and, similarly, from Trial 1 to Trial 2 within each visit. BP responsesshowed a delayed onset of within-trial adaptation. Reactivity groups were formedfor (a) SBP reactivity for HR and DBP analyses and (b) HR reactivity for SBPanalyses. Although high reactors (top tercile) showed greater adaptation to taskrepetition in all responses compared to low reactors (lowest tercile), they alsoconsistently displayed greater responses. Even during the final task, SBP and HRresponses discriminated between high and low reactors.Key words:cardiovascular adaptation, laboratory stress, responsivity

Towner, Elizabeth A.; Ybasco, Florence A.; Rezai, Niloufar; Rose, Kristin M.; Contrada, Richard J.

doi: 10.1037/h0090348pmid: N/A

The following is an abstract of the winning paper submitted for the 1990 Student Research Award Competition in association with the 98th annual meeting of the American Psychological Association. Ms. Towner’s paper was presented as a poster at the meeting.