Anger and denial as predictors of cardiovascular reactivity in women

Abstract

Behavioral and physiological reactivity, and its relationship to cardiovascular disease has been studied in men for a number of years, and the expression of anger has been identified as a possible contributing factor. Few studies, however, have focused specifically on the reactivity of women, and those which have suggest that women are less reactive to laboratory tasks than men. For the present study, 45 undergraduate women, ages 19-21 were selected from a larger sample of 135 women to represent three discrete groups: (1) low anger/low denial, (2) high anger/low denial, and (3) low anger/high denial, based on their scores on the State-Trait Anger Expression Inventory, 1 and the Marlowe-Crowne Social Desirability Scale. It was hypothesized that the three groups would show reliable differences in heart rate and blood pressure during presentation of a stressful laboratory stimulus, the Stroop Color and Word Test. Each subject received three counterbalanced conditions: (1) no feedback, (2) error feedback without observer present, (3) error feedback with observer present. As hypothesized, women who reported a high level of denial and a low level of anger exhibited reliably greater systolic blood pressure to the no-feedback condition than subjects who reported low levels of denial and anger. The hypothesis that all groups°w ould display greater reactivity in a condition which T provided error feedback with observation was not supported. (Eliot, Buell & Dembroski, 1982;Obrist, 1981). The reasons for this are still somewhat unclear.Investigations of the etiology and effects of hyperreactivity have followed three independent, yet seemingly related, lines of research. As early as 1911, Walter Cannon addressed the association between anger and the neuroendocrine mediation of the "fight-flight" response, the physiological reactivity associated with the mobilization of energy. Much later, in the early 1950's, investigators studying the relationship between cardiovascular reactivity and hypertension found that Cardiovascular Reactivity 1 compared to normotensives, hypertensive individuals manifested larger systolic blood pressure increases to stimuli which elicited both pain and anger (Schacter, 1957).Concurrently, other researchers utilized a harrassment paradigm with men to study the effects of psychological stress on hypertension. They found that individuals could be grouped according to whether or not they expressed their feelings (especially those of anger and anxiety), and that these groups evidenced differential degrees of reactivity in blood pressure and heart rate (Funkenstein, King, & Drolette, 1954).A third line of investigation focused on coronary heart disease. Friedman and Rosenman (1961) (1982), Contrada (1984), and. A 1 portion of this data will be discussed here. (Glass, 1983;Eliot, 1979;Haft, 1974; Raab, Chaplin, & Bajusc, 1989; Ardlie, Glew, & Schwartz, 1968). These effects have been observed in animals (Manuck, Kaplan, & Clarkson, 1983a;1985a) and also in acute and chronic studies of humans (Franke...

Ambulatory stress psychophysiology: the study of “compensatory and defensive counterforces” and conflict in a natural setting.

“…This is exemplified in our present research. Specifically, studies have shown the "repressive coping style" (i.e., high scores on the MC in combination with low scores on anxiety or anger) to predict greater autonomic responses to laboratory stressors such as mental arithmetic or Stroop tasks (31,33,52). In contrast, in the natural setting; paramedics identified as "repressive copers" did not show greater cardiovascular responsivity than other groups.…”

“…As measured by the Marlowe-Crowne Social Desirability Scale (MC; 29), defensiveness represents a coping style characterized by an orientation away from threatening information and a denial or minimization of distress and negative emotions. High scores on the MC, either alone or in combination with low scores of trait anxiety or anger, the latter identified as a "repressive coping" style, have been found to be associated with increased BP and HR reactivity to laboratory stressors in both clinical (30) and nonclinical populations (31)(32)(33). Moreover, these effects were found to be independent of gender and other cardiac risk factors, e.g., weight, smoking history (31).…”

Hostility and differences between clinic, self-determined, and ambulatory blood pressure.

“…The elevated DBP levels shown by high defensive subjects in the clinic when compared with home or ambulatory settings suggests a blood pressure hyperresponsivity to potentially threatening contexts, which parallels the blood pressure reactivity displayed by high defensive, normotensive subjects to standardized laboratory stressors (21,22). Contrary to studies in which defensiveness was found to have a moderating effect on the relationships between hostility or anxiety and differences in blood pressure (22,23), no similar effect was obtained in the present study, which may reflect differences between the populations studied (healthy vs. hypertensives) or the absence of a clearly defined interpersonal stressor in the present study. Given that normal and hypertensive individuals differ in their psychological profiles, it would be worthwhile to examine relationships between individual characteristics and differences in blood pressure assessment in healthy populations.…”

“…An index of defensiveness was included on the basis of research indicating a moderating influence of defensive coping on relations between blood pressure reactivity and anxiety (21), trait anger (22), and cynical hostility (23). The major questions of the study were: (1) Are there significant differences in levels of SBP and DBP as a function of the three assessment methods?…”

Social desirability and self-reported weight and height

“…It consists of 33 true ± false items purported to measure defensiveness, protection of self-esteem, and affect inhibition. 12,13 Examples include,`before voting, I thoroughly investigate the quali®cations of all candidates' and`I am always careful about my manner of dress.' The MCSDS has been found to have an internal consistency of r 0.88, and test ± retest reliability of r 0.89.…”