Anna C Phillips

Health Psychology

PhD
39.91

Publications

  • Source
    Anna C Phillips, Geoff Der, Douglas Carroll
    [Show abstract] [Hide abstract]
    ABSTRACT: Self-reported health has a well established relationship to later mortality, although the reasons are not entirely understood. This study examined the association of a similar self-reported measure of fitness with mortality and compared it to that of self-reported health. The study had a prospective cohort design with multiple sampling points. Participants were 858 men and women from Glasgow and the surrounding area of Scotland, aged 59 when self-reported health and fitness data were first collected in 1991/92. They were re-interviewed at age 64 and 69 and mortality was tracked for 16.5 years in total. Hazard ratios for all cause mortality were estimated for those that reported poor health or poor fitness relative to others their age, taking into account a range of covariates, some of which were also time varying. In both unadjusted and covariate adjusted models, self-reported fitness was at least as good a predictor of mortality as self-reported health. In a mutually adjusted model, both again emerged as significant predictors. Poor subjective health with poor subjective fitness appeared to be a particularly lethal combination. Both self-reported health and self-reported fitness were independent predictors of mortality. Where the objective assessment of aerobic fitness is not feasible, a simple measure of subjective fitness could prove a useful alternative.
    British Journal of Health Psychology 08/2009; 15(Pt 2):337-46. DOI:10.1348/135910709X466180 · 2.70 Impact Factor
  • Source
    Anna C Phillips, Geoff Der, Douglas Carroll
    [Show abstract] [Hide abstract]
    ABSTRACT: Exaggerated cardiovascular reactions to acute psychological stress have been implicated in a number of adverse health outcomes. This study examined, in a large community sample, the cross-sectional and prospective associations between reactivity and self-reported health. Blood pressure and heart rate were measured at rest and in response to an arithmetic stress task. Self-reported health was assessed concurrently and 5 years later. In cross-sectional analyses, those with excellent/good self-reported health exhibited larger cardiovascular reactions than those with fair/poor subjective health. In prospective analyses, participants who had larger cardiovascular reactions to stress were more likely to report excellent/good health 5 years later, taking into account their reported health status at the earlier assessment. The findings suggest that greater cardiovascular reactivity may not always be associated with negative health outcomes.
    Psychophysiology 06/2009; 46(5):1020-7. DOI:10.1111/j.1469-8986.2009.00843.x · 3.18 Impact Factor
  • Source
    Anna C Phillips, Geoff Der, Kate Hunt, Douglas Carroll
    [Show abstract] [Hide abstract]
    ABSTRACT: Exaggerated haemodynamic reactions to acute psychological stress have been implicated in a number of adverse health outcomes. This study examined, in a large community sample, the cross-sectional associations between haemodynamic reactivity and self-reported smoking status. Blood pressure and heart rate were measured at rest and in response to a 3-minute arithmetic stress task. Participants were classified as current, ex-, or non-smokers by their response to a simple prompt. Smokers had significantly smaller SBP and DBP reactions to acute stress than ex- and non-smokers; current and ex-smokers had lower HR reactivity. These effects remained significant following adjustment for a host of variables likely to be associated with reactivity and/or smoking. Although the act of smoking acutely increases haemodynamic activity, the present findings contribute to a growing body of literature showing that smokers have blunted reactivity to mental stress. They also support the hypothesis that blunted reactivity may be characteristic of a range of dependencies. The present results also suggest that smoking status needs to be considered in the design and analysis of stress reactivity studies.
    International journal of psychophysiology: official journal of the International Organization of Psychophysiology 05/2009; 73(3):273-8. DOI:10.1016/j.ijpsycho.2009.04.005 · 2.65 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Few studies have explored the relationship between major mental health disorders and metabolic syndrome (MetS), although both have been linked to cardiovascular disease. The present study examined the cross-sectional associations of major depressive disorder (MDD) and generalized anxiety disorder (GAD) with MetS in a large study of male US veterans. The analyses were cross-sectional. Participants (n = 4256) were drawn from the Vietnam Experience Study. From military service files, telephone interviews, and a medical examination, occupational, socio-demographic, and health data were collected. One-year prevalence of MDD and GAD was determined with DSM-III criteria. Metabolic syndrome was ascertained from data on: body mass index, fasting blood glucose or a diagnosis of diabetes, blood pressure, high-density lipoprotein cholesterol, and triglyceride levels. In models that adjusted for age (p = .01) and additionally for place of service, ethnicity, marital status, smoking, alcohol consumption, IQ at enlistment, household income in midlife, and education grade achieved (p = .02), GAD was positively associated with MetS. Major depressive disorder was not related to MetS. Depression has very much been the focal condition for studies on mental health and physical health outcomes. The current data suggest that future research should perhaps pay equal attention to GAD.
    Biological psychiatry 05/2009; 66(1):91-3. DOI:10.1016/j.biopsych.2009.02.020 · 9.47 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Older spousal caregivers of dementia patients have been found to show a relatively poor antibody response to medical vaccination. In the present case control study in a different caregiving environment, we sought to compare antibody responses to vaccination in parents of children with disabilities and parents of typically developing children. At baseline assessment, 32 parents of children with developmental disabilities and 29 parents of typically developing children completed standard measures of perceived stress and child problem behaviors. They also provided a blood sample and were then vaccinated with the thymus-dependent trivalent influenza vaccine. Further blood samples were taken at 1- and 6-month follow-ups. Relative to parents of typically developing children (mean titer = 458, standard deviation (SD) = 155.7 at 1 month follow-up and mean titer = 265, SD = 483.0 at 6-month follow-up), caregivers (mean titer = 219, SD = 528.4 at 1-month follow-up and 86, SD = 55.0 at 6-month follow-up) mounted a poorer antibody response than controls to the B/Malaysia strain of the vaccine. The negative impact of caregiving on antibody response to vaccination would not seem to be restricted to older spousal caregivers, but is also evident in younger parents caring for children with developmental disabilities. The behavioral characteristics of the care recipients may be a determinant of whether or not antibody response to vaccination is compromised.
    Psychosomatic Medicine 04/2009; 71(3):341-4. DOI:10.1097/PSY.0b013e31819d1910 · 4.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine whether the 1-year prevalence of major depressive disorder (MDD), generalized anxiety disorder (GAD), and their comorbidity were associated with subsequent all-cause and cardiovascular disease (CVD) mortality during 15 years in Vietnam veterans. Participants (N = 4256) were from the Vietnam Experience Study. Service, sociodemographic, and health data were collected from service files, telephone interviews, and a medical examination. One-year prevalence of MDD and GAD was determined through a diagnostic interview schedule based on the Diagnostic and Statistical Manual of Mental Disorders (version IV) criteria. Mortality over the subsequent 15 years was gathered from US army records. MDD and GAD were positively and significantly associated with all-cause and CVD mortality. The relationships between MDD and GAD and CVD mortality were no longer significant after adjustment for sociodemograhics, health status at entry, health behaviors, and other risk markers. Income was the covariate with the strongest impact on this association. In analyses comparing comorbidity and GAD and MDD alone, with neither diagnosis, comorbidity proved to be the strongest predictor of both all-cause and CVD mortality. GAD and MDD predict all-cause mortality in a veteran population after adjusting for a range of covariates. However, those with both GAD and MDD were at greatest risk of subsequent death, and it would seem that these disorders may interact synergistically to affect mortality. Future research on mental disorders and health outcomes, as well as future clinical interventions, should pay more attention to comorbidity.
    Psychosomatic Medicine 04/2009; 71(4):395-403. DOI:10.1097/PSY.0b013e31819e6706 · 4.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The origins and persistence of psychological morbidity in caregivers are not fully understood. The present analysis examined the relationship between the strain and burden of caregiving and depression and anxiety in a large community sample. Social support and sleep quality were investigated as potential mediators. Cross-sectional and prospective observational study. Individuals caring for someone other than their own child (N=393) were identified from a population of 2,079. Caregiving strain and burden, social support, and sleep quality were assessed. Participants completed the hospital anxiety and depression scale at the same time and 5 years later. Caregiving strain and burden were associated with depression and anxiety symptoms cross-sectionally, and with a worsening of symptoms 5 years later. Sleep quality appeared to mediate the cross-sectional relationships. The demands of caregiving and associated sleep disruption contribute to symptoms of depression and anxiety in caregivers.
    British Journal of Clinical Psychology 02/2009; 48(Pt 4):335-46. DOI:10.1348/014466508X397142 · 1.90 Impact Factor
  • Source
    Anna C Phillips
    Psychology Health and Medicine 02/2009; 14(1):125-6. DOI:10.1080/13548500802027335 · 1.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Exaggerated cardiovascular reactions to psychological stress are considered a risk factor for cardiovascular morbidity. Social support may reduce such risk by attenuating cardiovascular reactivity to stress. To examine the effects of three independent social support variables and their interaction on cardiovascular reactivity to acute stress. The variables were stranger or friend presence, active supportive or passive presence, and male or female presence. Cardiovascular reactions to mental arithmetic stress were measured in 112 healthy young women tested in one of eight distinct independent conditions: active supportive male friend; active supportive female friend; passive male friend; passive female friend; active supportive male stranger; active supportive female stranger, passive male stranger; and passive female stranger. Support from a friend rather than a stranger was associated with attenuated blood pressure reactivity, but only when the supporter was a male friend. Support from a male stranger or female friend was associated with augmented blood pressure reactivity. This interaction between the intimacy and sex of the supporter on cardiovascular reactivity extends the findings of previous laboratory studies of social support and can, to an extent, be interpreted in terms of the Social Comparison Theory.
    Annals of Behavioral Medicine 02/2009; 37(1):38-45. DOI:10.1007/s12160-008-9077-0 · 4.20 Impact Factor
  • Source
    Douglas Carroll, Anna C Phillips, George M Balanos
    [Show abstract] [Hide abstract]
    ABSTRACT: The reactivity hypothesis postulates that large magnitude cardiovascular reactions to psychological stress contribute to the development of pathology. A key but little tested assumption is that such reactions are metabolically exaggerated. Cardiac activity, using Doppler echocardiography, and oxygen consumption, using mass spectrometry, were measured at rest and during and after a mental stress task and during graded submaximal cycling exercise. Cardiac activity and oxygen consumption showed the expected orderly association during exercise. However, during stress, large increases in cardiac activity were observed in the context of modest rises in energy expenditure; observed cardiac activity during stress substantially exceeded that predicted on the basis of contemporary levels of oxygen consumption. Thus, psychological stress can provoke increases in cardiac activity difficult to account for in terms of the metabolic demands of the stress task.
    Psychophysiology 02/2009; 46(2):270-5. DOI:10.1111/j.1469-8986.2008.00762.x · 3.18 Impact Factor
  • Source
    Phillips, A.C
    Psychology Health and Medicine 01/2009; 14:125-126. · 1.53 Impact Factor
  • Source
    Lord, J.M, Phillips, A.C, Arlt
    Handbook of immunosenescence., 01/2009; Springer.
  • Phillips, A.C, Carroll
  • Source
    Phillips, A.C, Carroll
    The Psychologist 01/2009; 22:122-125. · 0.41 Impact Factor
  • Source
    Janet M. Lord, Anna C. Phillips, Wiebke Arlt
    [Show abstract] [Hide abstract]
    ABSTRACT: Although ageing is a complex process, we now know much of what happens with age at the cellular and tissue level. In contrast, our understanding of how the various age-related changes interact to result in frailty and pathology is incomplete. For example, ageing is accompanied by a loss of immune function (Immunesenescence), an increase in the level of circulating proinflammatory cytokines (Inflammaging), a decline in adrenal androgen production (Adrenopause) whilst concurrently peripheral glucocorticoid availability increases. In this article we propose that these changes in combination increase the susceptibility of older adults to the adverse effects of physical and emotional stress, exacerbating the age-related decline in immune competence and exposing the older individual to increased risk of infections. We have focused upon the effects of stress and ageing on neutrophil function, an element of the immune system that has received less attention from immunogerontologists, despite the primary role of neutrophils in fighting bacterial infections and the major contribution of such infections to agerelated morbidity and mortality. We propose that physical and emotional stressors elicit an exaggerated response in older adults that synergises with the age-related loss of neutrophil function, to compromise antibacterial mechanisms. Moreover, the molecular basis of this effect may lie with the significant changes in tissue concentrations of cortisol and dehydroepiandrosterone in peripheral target cells including the immune compartment.
    Handbook of immunosenescence, 12/2008: chapter Synergistic effects of Ageing and Stress on Neutrophil function: pages 475-495; Springer.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Variation in response to vaccination, particularly in vulnerable groups, provides a strong rationale for developing vaccine adjuvants. If there were consistent diurnal variation in immune response, this could inform a simple intervention for enhancing vaccine efficacy. Data from two studies are presented examining morning versus afternoon vaccine administration; in the first, hepatitis A vaccine was administered to young adults, and in the second, influenza vaccine to older community-based adults. Men, but not women, vaccinated in the morning mounted a better peak antibody response to both hepatitis A and the A/Panama influenza strain. These results indicate that it would be worthwhile testing this effect in a large randomized control trial with vaccination during time periods representing the extremes of hormonal and cytokine diurnal rhythms.
    Psychophysiology 08/2008; 45(4):663-6. DOI:10.1111/j.1469-8986.2008.00662.x · 3.18 Impact Factor
  • Source
    Douglas Carroll, Anna C Phillips, Geoff Der
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the association between adiposity and the magnitude of cardiovascular reactions to acute psychological stress cross-sectionally and prospectively in a large community sample. Blood pressure and heart rate (HR) were measured at rest and in response to a brief time-pressured mental arithmetic stress in 1647 adults. At the same session and 5 years later, height, weight, waist and hip circumference were measured and body mass index (BMI) and waist-hip ratio were computed. Obesity was defined as a body mass index of > or = 30 kg/m(2). Contrary to expectations, the most robust and consistent results to emerge from cross-sectional analyses were negative associations between all three measures of adiposity and HR reactivity; those with greater BMI and waist-hip ratios and those categorized as obese displayed smaller HR reactions to stress. In prospective analyses, high HR reactivity was associated with a reduced likelihood of becoming obese in the subsequent 5 years. Our analyses suggest that it is low, not high, HR reactivity that is related to adiposity. Low HR reactivity, probably by reflecting generally blunted sympathetic nervous system reactions to challenge, may be a risk marker for developing obesity.
    Psychosomatic Medicine 07/2008; 70(6):653-60. DOI:10.1097/PSY.0b013e31817b9382 · 4.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In older populations, caregiving for a spouse with dementia has been associated with a poor antibody response to vaccination. The present study examined whether younger caregivers, specifically the parents of children with developmental disabilities, would also show a diminished antibody response to vaccination. At baseline assessment, 30 parents of children with developmental disabilities and 29 parents of typically developing children completed standard measures of depression, perceived stress, social support, caregiver burden, and child problem behaviours. They also provided a blood sample and were then vaccinated with a pneumococcal polysaccharide vaccine. Further blood samples were taken at 1- and 6-month follow-ups. Caregivers mounted a poorer antibody response to vaccination than control parents at both follow-ups. This effect withstood adjustment for a number of possible confounders and appeared to be, at least in part, mediated by child problem behaviours. The negative impact of caregiving on antibody response to vaccination is not restricted to older spousal caregivers, but is also evident in younger parents caring for children with developmental disabilities. The behavioural characteristics of the care recipients may be a key consideration in whether or not immunity is compromised in this context.
    Brain Behavior and Immunity 07/2008; 23(3):338-46. DOI:10.1016/j.bbi.2008.05.006 · 6.13 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although the chronic stress of caring for a sick/disabled relative has been associated with poorer immunity using a range of outcomes, its impact on secretory immunoglobulin A (S-IgA) in saliva has yet to be examined. Three hypotheses were tested in analyses of data from a large community sample: first, caregivers would have lower S-IgA secretion rates than non-caregivers; second, the impact of caregiving on S-IgA would be particularly apparent in older participants; third, for caregivers, caregiving burden would be negatively associated with S-IgA. The sample comprised three distinct age cohorts, one young (N=623), one middle aged (N=639), and the other elderly (N=582). Participants were classified as caregivers if they regularly cared for somebody other than routine childcare. Caregiving strain was measured and a caregiving burden index was then derived as the composite of the number of people being cared for, the type of care provided, and the residential status of the person being cared for. From 2-min saliva samples, S-IgA secretion rate was measured. There was a significant caregiver status by age cohort interaction; caregivers in the eldest cohort had lower S-IgA secretion rates than their non-caregiving counterparts. Caregiving strain and burden and S-IgA were related, such that caregivers who experienced greater strain and burden had lower S-IgA secretion rates. These findings resonate with those from other studies using different immune outcomes. Considered together, it is clear that that the chronic stress of caregiving has widespread effects on immunity.
    Brain Behavior and Immunity 06/2008; 22(4):565-72. DOI:10.1016/j.bbi.2007.11.007 · 6.13 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Evidence shows that psychosocial factors are associated with immunoglobulin G response to medical vaccinations. As yet, there are no reports of whether the earlier immunoglobulin M response is similarly susceptible. This study examined the association between psychological stress, social support and the immunoglobulin M response to vaccination with pneumococcal capsular polysaccharides. Stressful life events in the previous year and customary social support were measured by standard questionnaires at baseline in 74 healthy students (41 females). The response to five common pneumococcal serotypes was assessed at baseline and 5 days following vaccination. Social support, particularly tangible social support, was positively associated with the antibody response to two of five serotypes, after controlling for baseline titre. These associations survived adjustment for demographics and health behaviours. There was no association between life events stress and immunoglobulin M response. It appears that psychosocial factors affect both the immunoglobulin M and immunoglobulin G responses to vaccination.
    Biological Psychology 06/2008; 78(2):211-5. DOI:10.1016/j.biopsycho.2008.01.001 · 3.47 Impact Factor