Cardiovascular Reactivity and the Presence of Pets, Friends, and Spouses: The Truth About Cats and Dogs

ArticleinPsychosomatic Medicine 64(5):727-39 · September 2002with 2,257 Reads
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Abstract
The purpose of this study was to examine the effects of the presence of friends, spouses, and pets on cardiovascular reactivity to psychological and physical stress. Cardiovascular reactivity was examined among 240 married couples, half of whom owned a pet. Mental arithmetic and cold pressor were performed in one of four randomly assigned social support conditions: alone, with pet or friend (friend present for non-pet owners), with spouse, with spouse and pet/friend. Relative to people without pets, people with pets had significantly lower heart rate and blood pressure levels during a resting baseline, significantly smaller increases (ie, reactivity) from baseline levels during the mental arithmetic and cold pressor, and faster recovery. Among pet owners, the lowest reactivity and quickest recovery was observed in the pet-present conditions. People perceive pets as important, supportive parts of their lives, and significant cardiovascular and behavioral benefits are associated with those perceptions.

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    FACTORS AFFECTING SINGLE MOTHER WORK SATISFACTION The purpose of the study was to determine, based on selected variables, sources of single mother work satisfaction. An assumption was made that the level of work satisfaction will be affected by a higher level of social support and its measures - a higher mental resilience, age, and more children in the family. The results obtained with the Work Satisfaction Scale (SSP), the Berlin Social Support Scale (BSSS), the Short Resilience Scale, and the Resilience Measurement Scale (SPP-25) showed that satisfaction with work in single mothers is increased by the available emotional support (p=.01) and mental resilience (p<.001). Satisfaction with life in single mothers is not increased by the number of children (p=.005). Key words: single mother, satisfaction with work, personal and social resources
  • Article
    Full-text available
    Touch is central to mammalian communication, socialisation, and wellbeing. Despite this prominence, interpersonal touch is relatively understudied. In this preregistered investigation, we assessed the influence of interpersonal touch on the subjective, neural, and behavioural correlates of cognitive control. Forty-five romantic couples were recruited (N=90; dating>6 months), and one partner performed an inhibitory control task while electroencephalography was recorded to assess neural performance monitoring. Interpersonal touch was provided by the second partner, and was manipulated between experimental blocks. A within-subject repeated-measures design was used to maximise statistical power, with our sample size providing 80% power for even small effect sizes (ds > .25). Results indicated that participants were not only happier when receiving touch, but also showed increased neural processing of mistakes. Further exploratory cognitive modelling using indirect effects tests and drift diffusion models of decision making revealed that touch was indirectly associated with both improved inhibitory control and increased rates of evidence accumulation (drift rate) through its influence on neural monitoring. Thus, beyond regulating emotion and stress, interpersonal touch appears to enhance the neurocognitive processes underling flexible goal-directed behaviour.
  • Article
    Full-text available
    People often recruit social resources to manage their emotions, a phenomenon known as interpersonal emotion regulation (IER). Despite its importance, IER’s psychological structure remains poorly understood. We propose that two key dimensions describe IER: (1) individuals’ tendency to pursue IER in response to emotional events, and (2) the efficacy with which they perceive IER improves their emotional lives. To probe these dimensions, we developed the Interpersonal Regulation Questionnaire (IRQ), a valid and reliable measure of individual differences in IER. Factor analyses of participants’ responses confirmed tendency and efficacy as independent dimensions of IER (Study 1; N = 285), and demonstrated independence between how individuals engage with IER in response to negative, versus positive, emotion. In Study 2 (N = 347), we found that individuals high in IER tendency and efficacy are more emotionally expressive, empathetic, and socially connected. Two subsequent studies highlighted behavioral consequences of IER dimensions: people high in IER tendency sought out others more often following experimentally-induced emotion (Study 3; N = 400), and individuals high in IER efficacy benefitted more from social support after real-world emotional events (Study 4; N = 787). Finally, a field study of social networks in freshman dormitories revealed that individuals high in IER tendency and efficacy developed more supportive relationships during the first year of college (Study 5; N = 193). These data (i) identify distinct dimensions underlying IER, (ii) demonstrate that these dimensions can be stably measured and separated from related constructs, and (iii) reveal their implications for relationships and well-being.
  • Article
    Studies consistently find that higher levels of social support improve the psychological and physiological health of older people, but findings from empirical research are mixed regarding the presence of a “pet effect”— the idea that living with an animal can improve human health, psychological wellbeing, and longevity. We examined the assocations among social support, dog and cat ownership, and successful aging in a panel of 5,688 people between the ages of 50 and 74 years. Utilizing GLM, we tested for the presence of a complement (independent or additive effects) and/or hydraulic (interactive effect) association of pets and human support on four indicators of successful aging (pain, functional ability, chronic illnesses, and subjective successful aging). Supporting the hydraulic hypothesis, we found that having a dog was associated with fewer chronic illnesses, higher functional ability, and higher levels of subjective success when people lack human support. Similarly, having both a dog and a cat was associated with higher functional ability, less pain, and higher levels of subjective success when people lack human support. Supporting the complement hypothesis, we found that having a cat was associated with more chronic illnesses and lower levels of subjective successful aging. Findings carry practical implications for supporting pet ownership of older people, suggesting that dogs have a positive association with successful aging.
  • Article
    Therapy dogs have been shown in many different situations to reduce stress and improve outcomes, but their effects on academic performance are unknown. I hypothesized that interaction with therapy dogs prior to exams would reduce stress in students and improve exam scores. In study 1, participants who chose to interact with the therapy dogs showed a significantly larger stress decrease and scored 5.5 points higher on their final exam than those who did not interact. In study 2, investigating memory retrieval, participants assigned to interact with therapy dogs immediately prior to their final exam showed a marginally larger stress reduction, but no difference in exam score, compared with those who watched a movie about dogs. To investigate memory consolidation, in study 3, participants were assigned to interact with therapy dogs or watch a movie immediately after learning some material. A significant interaction between condition and exam question type suggests that, compared with those who watched a movie about dogs, interacting with therapy dogs impaired memory for material learned just prior to the manipulation, but enhanced memory for material encountered at other times. Overall, interaction with therapy dogs appears to reduce stress, but had no effect on memory retrieval in study 2, and differentially affected memory consolidation of associated material in study 3.
  • Article
    Full-text available
    Dogs may be beneficial in reducing cardiovascular risk in their owners by providing social support and motivation for physical activity. We aimed to investigate the association of dog ownership with incident cardiovascular disease (CVD) and death in a register-based prospective nation-wide cohort (n = 3,432,153) with up to 12 years of follow-up. Self-reported health and lifestyle habits were available for 34,202 participants in the Swedish Twin Register. Time-to-event analyses with time-updated covariates were used to calculate hazard ratios (HR) with 95% confidence intervals (CI). In single- and multiple-person households, dog ownership (13.1%) was associated with lower risk of death, HR 0.67 (95% CI, 0.65–0.69) and 0.89 (0.87–0.91), respectively; and CVD death, HR 0.64 (0.59–0.70), and 0.85 (0.81–0.90), respectively. In single-person households, dog ownership was inversely associated with cardiovascular outcomes (HR composite CVD 0.92, 95% CI, 0.89–0.94). Ownership of hunting breed dogs was associated with lowest risk of CVD. Further analysis in the Twin Register could not replicate the reduced risk of CVD or death but also gave no indication of confounding by disability, comorbidities or lifestyle factors. In conclusion, dog ownership appears to be associated with lower risk of CVD in single-person households and lower mortality in the general population.
  • Article
    This study provides some clarification and extends literature by investigating the effects of the use of social networking sites by organizational employees on job satisfaction, organizational commitment and employee job performance. A survey was conducted to empirically test the proposed research model consisting of latent constructs: social networking site use, organizational commitment, job satisfaction, and employee job performance. Data of this confirmatory study was collected from 279 employees of various organizations operating in Pakistan. The model was analyzed employing variance-based structure equation modeling. Statistical software was used to assess both measurement and structural models. Results indicate that social networking sites use is not directly associated with employee job performance but with the mediating effects of job satisfaction that is also nested with the mediating effect of organizational commitment. This study is expected to both substantiate existing theories of management, and provide some extensions to social support theory.
  • Chapter
    Incorporating trained, registered, and insured dogs into animal-assisted activities has gained support in professional practice and research. This chapter begins by defining therapy dogs—both what they are and what they are not. It then provides an evidence based rationale for therapy dogs as a complementary part of animal-assisted activities. Next is a discussion of common objections to bringing dogs into a facility and practical ways to address each issue. Three main types of animal-assisted activities are discussed. The remainder of the chapter examines setting programmatic goals and concludes with a conceptualization of the partnership, participants, protocols, and products that hold the greatest promise for yielding data about initiatives that involve therapy dogs.
  • Thesis
    Les symptômes psychologiques et comportementaux de la démence (SPCD) sont fréquents et peuvent concerner jusqu’à 90 % des patients atteints de la maladie d’Alzheimer. Considérant l’efficacité limitée et l’ampleur des effets secondaires observés avec les traitements psychotropes en France, la majorité des directives existantes soulignent l’importance de la recherche clinique sur la maladie d’Alzheimer et une amélioration de l’évaluation des approches non pharmacologiques (ANP). En 2016, Le recours à la médiation animale, comme prise en soins, en établissements d’hébergement pour personnes âgées dépendantes (EHPAD) est de plus en plus fréquent. Nous avions montré les bienfaits de cette ANP sur l'apathie dans la maladie d'Alzheimer et avons souhaité en démontrer son efficacité. Notre étude évalue et mesure, principalement à l’aide de l’Inventaire Neuropsychiatrique version Equipe soignante (NPI-ES), comment la présence du chien dans la psychothérapie des malades Alzheimer est associée à des niveaux de SPCD chez des femmes et des hommes, âgés en moyenne de 85 ans qui vivent en institution. Nous nous sommes concentrés sur le bien-être et la construction d’émotions positives de la personne âgée démente, en particulier sur la revalorisation de l’estime de soi, la stimulation, la remobilisation et le maintien des capacités cognitives préservées, comme base thérapeutique possible dans l’association de la présence du chien avec la diminution significative des SPCD.
  • Thesis
    Full-text available
    La relación humano-perro tiene una historia evolutiva particularmente extensa. Los primeros perros fueron utilizados como guardianes, guías y compañeros de caza, asumiendo luego roles cruciales en el desarrollo de la agricultura. Aunque tratados como subordinados, gradualmente fueron convirtiéndose en valorados compañeros. Actualmente constituyen el prototipo de animal de compañía, destacándose sus posibilidades de establecer una estrecha relación bidireccional con los humanos. Sin embargo, los vínculos entre humanos y animales han sido tradicionalmente excluidos de consideraciones académicas serias. Con el surgimiento de la antrozoología, hace poco más de 30 años, el estudio de las interacciones humano-animal comenzó su ininterrumpido crecimiento, principalmente en los países más desarrollados. Con el objetivo de describir la relación humano-perro en Ciudad Autónoma de Buenos Aires, se realizó un estudio transversal, mediante encuestas, que involucró a 425 participantes (hombres: 119; mujeres: 306) mayores de 21 años (M = 42.96, DE = 16.08), todos los cuales habían residido con sus perros de compañía por más de un año. Los participantes completaron un cuestionario sociodemográfico y seis medidas de la relación humano-perro: Interacción Dueño-Perro, Cercanía Emocional Percibida, Costos Percibidos, Antropomorfismo, Voluntad de Adaptación y Beneficios Percibidos. Todos los aspectos de la relación se asociaron entre sí excepto por Costos Percibidos, que sólo se asoció positivamente con la Voluntad de Adaptación y negativamente al Antropomorfismo. La tendencia al antropomorfismo fue el aspecto relacional que más se asoció con la percepción de relaciones humano-perro exitosas, en tanto resultó la única faceta de la relación asociada con la percepción de menores costos y de mayores beneficios. Por otro lado, el antropomorfismo no se relacionó con la cantidad de personas o hijos en la vivienda, mientras que sí lo hizo intensamente con la Cercanía Emocional Percibida. Las mujeres manifestaron mayores niveles de proximidad emocional y antropomorfismo, pero no difirieron de los hombres en las demás variables relacionales. La edad de los custodios se asoció con menor percepción de costos y de intensidad en las interacciones con el perro. La menor edad de los hijos se asoció con menor cercanía emocional y mayor percepción de costos. Los perros de mayor tamaño resultaron más beneficiosos, aunque no más costosos para sus custodios. La raza de los perros y su estado reproductivo no mostraron relación con la intensidad de la relación, más que una leve asociación entre raza de perro y comportamientos ligados a la identidad social o estatus del custodio. Los resultados destacaron que la relación con los perros era concebida como un vínculo de familia, de elevada proximidad afectiva e intensidad en las interacciones, por el que los custodios estaban dispuestos a afrontar múltiples costos. Las descripciones realizadas permitieron identificar estrategias para fomentar relaciones humano-perro más exitosas, así como intervenciones ligadas al bienestar de humanos y perros. En suma, esta investigación se propone contribuir a destacar la relevancia y legitimidad del estudio de las interacciones humano-animal.
  • Article
    Social interactions play an important role in people’s life and people’s health but their scope and intensity tend to decrease with age, challenging social support dynamics and increasing the risk of social isolation and helplessness. In Portugal, policymakers still seem to rely on traditional social relations in eldercare, while contextual changes and trends are redefining family roles and behaviors and defying the established social support structure. In this work, we aim to examine the scope, structure and experiences of the informal social support network available in the country for stroke patients 6 months after their discharge from the acute care unit in the context of a larger study. The results seem to confirm the importance of family as a source of social support and shed light on different bonding experiences with non-kin social groups, such as neighbors and friends. A coordinated care provision, combining formal and informal support is vital and beneficial for patients, their caregivers and the care system.
  • Article
    Pets can reduce stress in their owner; however, they are not always permitted in public and institutional places. This study examined the impact of people viewing a picture of their pet versus other images on stress levels. One hundred and twenty participants were randomly assigned to one of six conditions. These involved completing a mental arithmetic task while viewing a picture of either their personal pet; an unfamiliar animal; a familiar, supportive person; a stranger; a pleasant image of nature; or no image. Stress was measured through subjective and physiological methods. For participants, viewing a picture of their pet did not reduce their stress response to the task, while viewing a picture of a familiar, supportive person increased the stress response, relative to the controls. Post-stressor, participants in the personal-pet condition rated the picture as making them feel more relaxed, compared with the other conditions. Active interaction with a pet may be required to reduce stress.
  • Article
    Este artigo visa levantar, por meio de construções teórico-científicas, os benefícios que a Terapia Assistida por Animais (TAA) pode gerar quando utilizada para tratamento com crianças que apresentam algum comprometimento neurodesenvolvimental. O contato humano-animal é conhecido desde a antiguidade, porém, apenas na atualidade estudos em torno deste viés estão crescendo. Portanto, foi realizada uma revisão crítica da literatura, analisando os dados coletados a partir de análise de conteúdo. Os resultados apontam o potencial benéfico deste tipo de intervenção com crianças com dificuldades sociais, cognitivas e físicas. Os animais mais utilizados são cachorros e cavalos para tratamento de crianças com Transtorno do Espectro Autista, Síndrome de Down e Deficiência Intelectual. Dessa forma, há uma possibilidade de que os profissionais da Psicologia, e de outras áreas da saúde, utilizem ou encaminhem para a Terapia Assistida por Animais (TAA) seus pacientes. Ainda assim, conclui-se que há a necessidade de mais estudos empíricos.
  • Article
    Purpose/Objectives: The study examined whether the bond with a companion dog is associated with well-being among people with cancer, and described the perceived benefits, challenges, and needs accompanying the relationship with the dog. Design: The design was cross-sectional. Sample: Participants were 140 people recently diagnosed with cancer with at least one dog in their household. Methods: The online survey included measures of the human–pet bond, depressive symptoms, positive affect, and health-related quality of life, as well as open-ended questions about the experience of having a dog since being diagnosed with cancer. Findings: Although the bond with a companion dog was not directly linked with well-being, the association between the human–pet bond and depressive symptoms depended in part on treatment status. Conclusions: Companion dogs may play an important role in the lives of people recently diagnosed with cancer. Implications for psychosocial providers: Health care providers can help to support the bond with a companion dog.
  • Chapter
    In this book we have considered how human-animal companionship in the context of domestic violence might be better understood. Most importantly this has involved advocating for an intersectional feminist understanding of domestic violence inclusive of species concerns. Part of this has involved us arguing for a new iteration of The Link, one that allows for animals to be constituted as victims of domestic violence in their own right. As one part of this involves raising awareness of animal victims of domestic violence, in this final chapter we reflect on historical changes associated with feminists making domestic violence a public, not just a personal, problem. Our interest in the love, empathy, and healing possibilities of human-animal companionship that has been evident throughout this book continues in this chapter through our discussion of the need to value the labour that companion animals perform, especially their emotion work. Recognising their labour necessitates us thinking about what companion animals might get out of their relationships with humans and whether they are ‘voiceless.’ In practical terms, we must also think about the necessary provisions for animals in the context of domestic violence, including suitable housing for human and animal victims. For illustrative and inspirational purposes, we point to several current relevant policy and programme examples. We end with a discussion of six key commitments that need to be shown by humans towards companion animals for the notion of the significant other to become truly meaningful.
  • Chapter
    The paper describes and evaluates an explorative approach to quantify the relationship between trainable animals and their owners. Data on human-animal interaction has been collected by using Pebble smartwatches and by observing different kinds of animal training sessions. Tracking movement of horses and dogs with the Pebble Watch was successful with horses but not with dogs. Besides the breed and behavior of the animal, weather conditions and the way of attaching the Pebble influenced the measurement quality. In summary, the experiment indicates that there might be a connection between the heart rate (BPM), the average movement (VMC), and the mood data (pleasance and activation) of an animal and its owner during training sessions.
  • Article
    The growing body of literature exploring pet loss suggests that many bereaved pet owners experience disenfranchised grief. Disenfranchised grief occurs when a loss is unacknowledged and the bereaved are unable to express their grief. When grief is considered illegitimate, the bereaved may experience a variety of adverse psychological outcomes, including increased distress and reduced quality of life. Additionally, when grief is inhibited, the individual may be less likely to experience positive changes such as posttraumatic growth. Few studies have considered the relationship between disenfranchisement and posttraumatic growth following the loss of a companion animal. This study investigated the relationship between disenfranchised grief, memorialization, and posttraumatic growth in bereaved pet owners. Grief severity was assessed as a moderator. Using an online survey, respondents (n = 133) completed standardized measures, including the Pet Bereavement Questionnaire, the Loss of Social Support subscale from the Grief Experience Questionnaire, and the Posttraumatic Growth Inventory-Short Form (PTGI-SF). As hypothesized, there was a significant interaction between disenfranchised grief, grief severity, and posttraumatic growth, suggesting that disenfranchised grief inhibits posttraumatic growth when grief severity is high. Contrary to the hypothesis, there was no relationship between memorial quantity or type and posttraumatic growth. Overall, this study shows that disenfranchised grief can inhibit posttraumatic growth following the loss of a pet, highlighting the complicated relationship between posttraumatic growth, grief intensity, and disenfranchised grief.
  • Article
    Background: People living with human immunodeficiency virus (PLHIV) are approximately twice as likely to be depressed compared with HIV-negative individuals. Depression is consistently associated with low antiretroviral therapy (ART) adherence, an important step within the HIV care continuum related to HIV disease progression and overall health. One factor that may have positive psychosocial benefits and promote ART adherence is dog ownership. Research indicates that dog ownership is associated with lower depression, and initial evidence suggests its positive impact on psychosocial outcomes for PLHIV. Objective: The aim of our study was to expand the existing research by examining the relationship between current dog ownership and depression for a sample of PLHIV while controlling for demographic characteristics and other potential confounders. Methods: Participants aged 18 years or older and who self-reported an HIV diagnosis were recruited via social media into When Dogs Heal, a cross-sectional Web-based survey to collect data among adult PLHIV. The research visit was conducted via a Web-based survey, and there was no in-person interaction with the participant. Primary outcome measures included demographic questions (age, race, ethnicity, gender, and sexual orientation), pet ownership (type of pet owned and current dog ownership), depression (Center for Epidemiologic Studies Depression Scale, 10 items), and resilience (Resilience Research Centre Adult Resilience Measure, 28 items). Results: A total of 252 participants were enrolled into the study in January 2016, with a final analytic sample of 199 participants. Mean age was 49 years, 86.4% (172/199) of participants were male, and 80.4% (160/199) were white. Current dog ownership was prevalent among the sample (68.3%, 136/199). Bivariate analysis indicated that there was no significant relationship between depression and demographic characteristics (age, race, ethnicity, gender, and sexual orientation), with P>.05. The multivariate logistic regression, including age, race, ethnicity, gender, resilience, and current dog ownership, was significant, with P<.001. Of the 6 predictor variables, only 2 were statistically significant: dog ownership and resilience. Noncurrent dog owners had 3 times higher odds of depression in comparison with current dog owners: odds ratio 3.01; 95% CI 1.54-6.21. Conclusions: Growing evidence suggests that dog ownership reduces the likelihood of depression and, therefore, may confer long-term health benefits on PLHIV. Future studies should explore whether dog-specific interventions are a feasible and efficacious intervention to improve outcomes among PLHIV.
  • Article
    The physician utilization behavior of 938 Medicare enrollees in a health maintenance organization was prospectively followed for 1 year. With demographic characteristics and health status at baseline controlled for, respondents who owned pets reported fewer doctor contacts over the 1-year period than respondents who did not own pets. Furthermore, pets seemed to help their owners in times of stress. The accumulation of prebaseline stressful life events was associated with increased doctor contacts during the study year for respondents without pets. This relationship did not emerge for pet owners. Owners of dogs, in particular, were buffered from the impact of stressful life events on physician utilization. Additional analyses showed that dog owners in comparison to owners of other pets spent more time with their pets and felt that their pets were more important to them. Thus, dogs more than other pets provided their owners with companionship and an object of attachment.
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  • Book
    In this groundbreaking work, distinguished contributors explore the myriad relationships between networks of social support and the development, treatment, and rehabilitation of individuals with cardiovascular disease. Chapters span the range from conceptual to methodological issues, and take into account gender, environmental, and cultural differences. The book will provide a wealth of information for clinicians and students in the fields of behavioral medicine, psychophysiology, and cardiovascular disease.
  • Article
    Research findings have suggested that social support decreases cardiovascular reactivity and reduces the incidence of cardiovascular disease. The authors describe 2 studies evaluating the association between social support and cardiovascular reactivity to a stressor: In both studies, it was predicted that the presence of a supportive person would exert a buffering effect on cardiovascular reactivity. In Study 1, 68 participants were randomly assigned to 1 of 3 conditions: alone, supportive, and nonsupportive. In Study 2, 60 participants were randomly assigned to 1 of 3 conditions: highly supportive, supportive, and nonsupportive. in both studies, a speech was the stressor: Results in both studies showed net significant differences in cardiovascular reactivity between supportive and nonsupportive conditions. The results failed to support the reactivity buffering effects of social support. Findings are explained in terms of evaluation apprehension theory, familiarity of support provider and level of social support.
  • Article
    An 18-item Likert-format Pet Attitude Scale was developed. It was found to have a Chronbach’s Alpha of.93 and test-retest reliability of .92. Correlations with the Mini-Mult, Eysenck Personality Inventory, Allport-Vernon-Lindzey Study of Values, and the Personality Research Form were determined. Varimax rotation yielded three factors, labeled love and interaction, pets in home, and joy of pet ownership. Kennel workers had significantly higher scores than social work students, an indication of criterion-oriented validity as well as face validity.
  • Article
    An 18-item Likert-format Pet Attitude Scale was developed. It was found to have a Chronbach’s Alpha of.93 and test-retest reliability of .92. Correlations with the Mini-Mult, Eysenck Personality Inventory, Allport-Vernon-Lindzey Study of Values, and the Personality Research Form were determined. Varimax rotation yielded three factors, labeled love and interaction, pets in home, and joy of pet ownership. Kennel workers had significantly higher scores than social work students, an indication of criterion-oriented validity as well as face validity.
  • Article
    We examined the role of social support in moderating cardiovascular reactivity to behavioral stress. Fifty female students performed a stressful math task while alone or in the presence of a close female friend. The friend-present condition was either high or low in evaluation potential. Subjects in the non-evaluative friend-present condition showed reduced systolic blood pressure reactivity compared to those alone during the task. Subjects in the evaluative friend-present condition did not differ from the others on any cardiovascular measure. Perceived closeness to the friend and length of the friendship positively correlated with size of the systolic blood pressure reduction in subjects assigned to friend-present conditions, regardless of evaluation condition. Simultaneous monitoring of the friends' cardiovascular activity revealed that the non-evaluative friends showed decreasing blood pressure during the task, whereas the evaluative friends did not. The findings suggest that the measurable benefit of social support may require protocols with minimal or no element of evaluation.
  • Article
    Full-text available
    Social support has been linked to long-term physiological change and health status. However, the effects of social support on physiological functions and health have not been uniform. Understanding of these relationships may be fostered by isolating the elementary components of social support and studying their individual and interactive effects on physiological response. To examine the potential of this approach, we conducted an experiment in which subjects performed arithmetic problems in one of three social contexts: alone, observed by a same-sex stranger, or observed by a same-sex friend
  • Article
    Describes the development of the Relationship Closeness Inventory (RCI), which draws on the conceptualization of closeness as high interdependence between two people's activities proposed by Kelley et al. (1983). The current "closest" relationship of individuals ( N = 241) drawn from the college student population served as the basis for RCI development, with the closest relationship found to encompass several relationship types, including romantic, friend, and family relationships. The development and psychometric properties of the three RCI subscales (Frequency, Diversity, Strength), their scoring, and their combination to form an overall index of closeness are described. The RCI's test–retest reliability is reported and the association between RCI score and the longevity of the relationship is discussed. RCI scores for individuals' closest relationships are contrasted to those of not-close relationships, to a subjective closeness index, and to several measures of relationship affect, including Rubin's (1973) Liking and Loving scales. Finally, the ability of the RCI to predict relationship break up is contrasted to that of the Subjective Closeness Index, an index of the emotional tone of the relationship, and to relationship longevity. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
  • Article
    This volume is intended as a guide for doing social support research, as a compendium of . . . work in this field, and as a source of information on the implications of existing work for social policy. . . . We focus on nonprofessional (informal) social support provided by friends, relatives, and acquaintances. This book is of special interest to the large interdisciplinary group of research professionals concerned with the role of psychosocial factors in both physical and mental health. It is also of special interest to practitioners involved in the increasing number of programs designed to support or establish natural helping networks. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
  • Article
    Full-text available
    Cognitive appraisal theories of stress and emotion propose that cognitive appraisals precede physiological responses, whereas peripheralist theories propose that physiological arousal precedes cognitive processes. Three studies examined this issue regarding threat and challenge responses to potential stress. Study 1 supported cognitive appraisal theory by demonstrating that threat and challenge cognitive appraisals and physiological responses could be elicited experimentally by manipulating instructional set. Studies 2 and 3, in contrast, found that manipulations of physiological response patterns consistent with challenge and threat did not result in corresponding changes in cognitive appraisal. Appraisals in Study 3, however, were related to subjective pain independent of the physiological manipulation. These studies suggest a central role for cognitive appraisal processes in elicitation of threat and challenge responses to potentially stressful situations. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
  • Article
    From among 250 MMPI items that discriminated significantly between teachers scoring high and teachers scoring low on the Minnesota Teacher Attitude Inventory, two sets of 50 items were selected (principally on the basis of content) to form a Hostility (Ho) Scale and a Pharisaic virtue (Pv) scale. "The Ho scale… reveals a type of individual characterized by a dislike for and distrust of others. The Pv scale… reveals a type of person who described himself as preoccupied with morality and ridden with fears and tensions." (PsycINFO Database Record (c) 2012 APA, all rights reserved)
  • Article
    The effect of the presence of a friendly animal on children's blood pressures and heart rates while resting and their cardiovascular responses to verbalization were examined. The presence of the dog resulted in lower blood pressures both while the children (N = 38) were resting and while they were reading. The effect of the presence of the dog was greater when the dog was present initially than when it was introduced in the second half of the experiment. We speculate that the animal causes the children to modify their perceptions of the experimental situation and the experimenter by making both less threatening and more friendly. This study provides insight into the use of pets as adjuncts in psychotherapy. (C) Williams & Wilkins 1983. All Rights Reserved.
  • Article
    A perceived availability of social support measure (the ISEL) was designed with independent subscales measuring four separate support functions. In a sample of college students, both perceived availability of social support and number of positive events moderated the relationship between negative life stress and depressive and physical symptomatology. In the case of depressive symptoms, the data fit a “buffering” hypothesis pattern, i.e., they suggest that both social support and positive events protect one from the pathogenic effects of high levels of life stress but are relatively unimportant for those with low levels of stress. In the case of physical symptoms, the data only partially support the buffering hypothesis. Particularly, the data suggest that both social support and positive events protect one from the pathogenic effects of high levels of stress but harm those (i.e., are associated with increased symptomatology) with low levels of stress. Further analyses suggest that self-esteem and appraisal support were primarily responsible for the reported interactions between negative life stress and social support. In contrast, frequency of past social support was not an effective life stress buffer in either the case of depressive or physical symptomatology. Moreover, past support frequency was positively related to physical symptoms and unrelated to depressive symptoms, while perceived availability of support was negatively related to depressive symptoms and unrelated to physical symptoms.
  • Article
    To examine the effects of social support on cardiovascular reactions to behavioral stress, the present study tested the relative contribution of three elements of social support: the presence of another person in the laboratory; the presence of a person considered to be a friend; and physical touch. Sixty undergraduate females were assigned to one of the following groups: alone (A); friend present-touch (FT); friend present-no touch (FNT); stranger present-touch (ST); and stranger present-no touch (SNT). Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) measures were obtained across baseline phases and during presentation of two behavioral challenges (mental arithmetic, mirror-tracing). The findings suggest that neither the presence of a stranger nor physical touch are related to attenuated cardiovascular reactions to stress; rather, if the extent of cardiovascular reactivity is related to social support, the presence of a friend may be the important mediating variable.
  • Article
    Full-text available
    Autonomic responses were measured while 45 adult women performed a standard experimental stress task in the laboratory with only the experimenter present and 2 weeks later at home in the presence of a female friend, pet dog, or neither. Results demonstrated that autonomic reactivity was moderated by the presence of a companion, the nature of whom was critical to the size and direction of the effect. Ss in the friend condition exhibited higher physiological reactivity and poorer performance than subjects in the control and pet conditions. Ss in the pet condition showed less physiological reactivity during stressful tasks than Ss in the other conditions. The results are interpreted in terms of the degree to which friends and pets are perceived as evaluative during stressful task performance. Physiological reactivity was consistent across the laboratory and field settings.
  • Article
    In this study we investigated the effects of nonevaluative social interaction on the cardiovascular response to psychological challenge. Thirty-nine college-age females appeared accompanied ("Friend" condition) or unaccompanied ("Alone" condition) to an experimental laboratory. In the Friend condition, partners were present while the subject participated in two laboratory tasks, and the partners' evaluation potential was minimized by design. Subjects in the Friend condition showed reduced heart rate reactivity to both tasks, relative to the Alone group, an attenuated task-related systolic blood pressure response to one of the tasks, and a reduced diastolic blood pressure increase during a solitary interview. In two other instances, partner-related response reductions were apparent only for Type A subjects. None of these effects was accompanied by differences in task performance or self-reported emotional response. Interpersonal support may reduce cardiovascular responsivity to stress, an effect with possible implications for understanding the association between social relationships and cardiovascular risk.
  • Getting Started with PROC Mixed Software
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  • Article
    Previous research suggests that anger has important social and health consequences, particularly cardiovascular health. The pathogenic aspects of anger have not been identified, however, in part because of a reliance on unidimensional measures of anger. The present article describes psychometric data for an inventory that is sensitive to the multidimensional nature of the anger construct. It was hypothesized that the newly developed Multidimensional Anger Inventory (MAI) would include scales reflective of the following dimensions of anger: frequency, duration, magnitude, mode of expression, hostile outlook, and range of anger-eliciting situations. The mode of expression dimension was expected to contain separate anger-in, anger-out, guilt, brood, and anger-discuss measures. The inventory was administered to two populations: male and female college students and male factory workers. Factor analyses of the MAI within the two samples showed that the frequency, duration, and magnitude dimensions clustered together to form an anger-arousal factor that accounted for 64% and 71% of the variance in the two samples, respectively. The range of anger-eliciting situations and hostile outlook emerged as separate dimensions, as hypothesized. Mode of anger expression was best described by two dimensions labeled anger-in and anger-out. Psychometric analyses of the scale showed that it possessed adequate test-retest reliability (r = 0.75) and high internal consistency (alpha = .84 and .89 for the two samples). The validity of the scale was supported by the expected pattern of relations with other inventories designed to assess anger or hostility. Comparisons of MAI scores between (college versus factory) and within (male versus female) populations were made.
  • Article
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    The purpose of this article is to determine whether the positive association between social support and well-being is attributable more to an overall beneficial effect of support (main- or direct-effect model) or to a process of support protecting persons from potentially adverse effects of stressful events (buffering model). The review of studies is organized according to (a) whether a measure assesses support structure or function, and (b) the degree of specificity (vs. globality) of the scale. By structure we mean simply the existence of relationships, and by function we mean the extent to which one’s interpersonal relationships provide particular resources. Special attention is paid to methodological characteristics that are requisite for a fair comparison of the models. The review concludes that there is evidence consistent with both models. Evidence for a buffering model is found when the social support measure assesses the perceived availability of interpersonal resources that are responsive to the needs elicited by stressful events. Evidence for a main effect model is found when the support measure assesses a person’s degree of integration in a large social network. Both conceptualizations of social support are correct in some respects, but each represents a different process through which social support may affect well-being. Implications of these conclusions for theories of social support processes and for the design of preventive interventions are discussed.
  • Article
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    The findings of this study confirm the independent importance of social factors in the determination of health status. Social data obtained during patients' hospitalization can be valuable in discriminating 1-year survivors. These social data can add to the prognostic discrimination beyond the effects of the well-known physiological predictors. More information is needed about all forms of human companionship and disease. Thus, it is important that future investigations of prognosis in various disease states include measures of the patient's social and psychological status with measures of disease severity. The phenomenon of pet ownership and the potential value of pets as a source of companionship activity or attention deserved more careful attention that that recorded in the literature. Almost half of the homes in the United States have some kind of pet. Yet, to our knowledge, no previous studies have included pet ownership among the social variables examined to explain disease distribution. Little cost is incurred by the inclusion of pet ownership in such studies, and it is certainly by the importance of pets in the lives of people today and the long history of association between human beings and companion animals. The existence of pets as important household members should be considered by those who are responsible for medical treatment. The need to care for a pet or to arrange for its care may delay hospitalization; it may also be a source of concern for patients who are hospitalized. Recognition of this concern by physicians, nurses, and social workers may alleviate emotional stress among such patients. The therapeutic uses of pets have been considered for patients hospitalized with mental illnesses and the elderly. The authors suggest that patients with coronary heart disease should also be included in this consideration. Large numbers of older patients with coronary heart disease are socially isolated and lonely. While it is not yet possible to conclude that pet ownership is beneficial to these patients, pets are an easily attainable source of psychological comfort with relatively few risks.
  • Article
    Social support and pet ownership, a nonhuman form of social support, have both been associated with increased coronary artery disease survival. The independent effects of pet ownership, social support, disease severity, and other psychosocial factors on 1-year survival after acute myocardial infarction are examined prospectively. The Cardiac Arrhythmia Suppression Trial provided physiologic data on a group of post-myocardial infarction patients with asymptomatic ventricular arrhythmias. An ancillary study provided psychosocial data, including pet ownership, social support, recent life events, future life events, anxiety, depression, coronary prone behavior, and expression of anger. Subjects (n = 424) were randomly selected from patients attending participating Cardiac Arrhythmia Suppression Trial sites and completed baseline psychosocial questionnaires. One year survival data were obtained from 369 patients (87%), of whom 112 (30.4%) owned pets and 20 (5.4%) died. Logistic regression indicates that high social support (p < 0.068) and owning a pet (p = 0.085) tend to predict survival independent of physiologic severity and demographic and other psychosocial factors. Dog owners (n = 87, 1 died) are significantly less likely to die within 1 year than those who did not own dogs (n = 282, 19 died; p < 0.05); amount of social support is also an independent predictor of survival (p = 0.065). Both pet ownership and social support are significant predictors of survival, independent of the effects of the other psychosocial factors and physiologic status. These data confirm and extend previous findings relating pet ownership and social support to survival among patients with coronary artery disease.
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    This study examined whether highly cynical individuals benefit less from social support during an acute stressor than individuals low in cynicism. College students (52 men, 52 women) performed a stressful speech task alone or in the presence of a supportive confederate. There was an interactive effect of social support and cynicism on cardiovascular reactivity: Low cynicism participants who received support has smaller increases in blood pressure during the speech than low cynicism participants without support and high cynicism participants with or without support. Participants' psychological stress appeared to mediate the main effects of support on blood pressure reactivity, but not the Support x Cynicism interaction. Results suggest that cynical attitudes may undermine the stress buffering potential of interpersonal support.
  • Article
    This study examines the possibility that social support operates as a moderator of cardiovascular reactivity in women. Two models by which social support may operate were examined: the direct effects and buffering models. Twenty-six subjects were exposed to four conditions while playing a video game: two levels of stress (low, high) and two levels of social support (alone, together). Blood pressure and heart rate were monitored continuously. Ratings of stress were obtained for each condition. Results indicated that the support manipulation produced significant main effects for diastolic blood pressure and stress ratings, with lower diastolic blood pressure and ratings observed in the "together" condition, and that the interaction between support and stress produced lower reactivity for the cardiovascular measures in the high stress (but not the low stress) condition. No interaction was found for the stress ratings. We conclude that the results provide support for both the buffering and direct effects models. Implications concerning the (within-subjects) design of the study and the stress ratings are discussed.
  • Article
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    This study examined whether social support can reduce cardiovascular reactivity to an acute stressor. College students gave a speech in one of three social conditions: alone, in the presence of a supportive confederate, or in the presence of a nonsupportive confederate. Systolic and diastolic blood pressure were measured at rest, before the speech, and during the speech. While anticipating and delivering their speech, supported and alone subjects exhibited significantly smaller increases in systolic and diastolic blood pressures than did nonsupported subjects. Supported subjects also exhibited significantly smaller increases in systolic blood pressure than did alone subjects before and during the speech. Men had higher stress-related increases in blood pressures than did women; but gender did not moderate the effects of social support on cardiovascular reactivity. These results provide experimental evidence of potential health benefits of social support during acute stressors.
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    To assess the value of service dogs for people with ambulatory disabilities. Randomized, controlled clinical trial. Environments of study participants. Forty-eight individuals with severe and chronic ambulatory disabilities requiring use of wheelchairs who were recruited from advocacy and support groups for persons with muscular dystrophy, multiple sclerosis, traumatic brain injury, and spinal cord injury. Participants were matched on age, sex, marital status, race, and the nature and severity of the disability in order to create 24 pairs. Within each pair, participants were randomly assigned to either the experimental group or a wait-list control group. Experimental group members received trained service dogs 1 month after the study began, and subjects in the wait-list control group received dogs in month 13 of the study. Dependent variables evaluated were self-reported assessments of psychological well-being, internal locus of control, community integration, school attendance, part-time work status, self-esteem, marital status, living arrangements, and number of biweekly paid and unpaid assistance hours. Data collection occurred every 6 months over a 2-year period, resulting in five data collection points for all subjects. Significant positive changes in all but two dependent measures were associated with the presence of a service dog both between and within groups (P<.001). Psychologically, all participants showed substantial improvements in self-esteem, internal locus of control, and psychological well-being within 6 months after receiving their service dog. Socially, all participants showed similar improvements in community integration. Demographically, all participants showed increases in school attendance and/or part-time employment. Economically, all participants showed dramatic decreases in the number of both paid and unpaid assistance hours. Trained service dogs can be highly beneficial and potentially cost-effective components of independent living for people with physical disabilities.
  • Article
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    In this review, the authors examine the evidence linking social support to physiological processes and characterize the potential mechanisms responsible for these covariations. A review of 81 studies revealed that social support was reliably related to beneficial effects on aspects of the cardiovascular, endocrine, and immune systems. An analysis of potential mechanisms underlying these associations revealed that (a) potential health-related behaviors do not appear to be responsible for these associations; (b) stress-buffering effects operate in some studies; (c) familial sources of support may be important; and (d) emotional support appears to be at least 1 important dimension of social support. Recommendations and directions for future research include the importance of conceptualizing social support as a multidimensional construct, examination of potential mechanisms across levels of analyses, and attention to the physiological process of interest.
  • Article
    We investigated whether the effects on cardiovascular reactivity of social support from an audience member depend only on the behavior of that person or also depend on the relationship between the audience and the actor. That is, is there any added reduction in physiological response if the person who is nodding and smiling supportively is also a friend? Ninety subjects gave a speech to an observer. In two of the conditions, this observer was a confederate of the experimenter and a stranger to the subject. This confederate acted in either a supportive or neutral manner during the speech. In the final condition, this observer was a friend, brought by the subject, who was then trained to show support in the same manner as the supportive confederate. The comparison of the two confederate conditions tested the effect of support, holding the relationship constant. The comparison of friend and confederate supportive conditions tested the effect of the relationship, holding the supportive behaviors constant. All participants were female. Both supportive conditions produced significantly smaller cardiovascular increases than the confederate-neutral condition, and the friend-supportive condition produced significantly smaller systolic blood pressure increases than the confederate-supportive (friend-supportive: 7.9 mm Hg: confederate-supportive: 14.9 mm Hg; confederate-neutral: 22.9 mm Hg). Differences for diastolic pressure and heart rate were not significant, although the data followed the same pattern. Social support from a friend attenuated cardiovascular reactivity in a laboratory setting to a greater degree than support from a stranger. The subjects' construal of the supportive behaviors can have an effect on reactivity, over and above the effects of the actual behaviors themselves.
  • Article
    Recent research has suggested that cardiovascular recovery from stress can play a potential role in hypertension pathogenesis. Sixty-nine studies were included in a meta-analytic review to evaluate the effect of various hypertension risk factors (e.g., race, lack of exercise) on cardiovascular recovery from stress. Small mean effect sizes were observed for studies examining hypertension status and race as risk factors associated with delayed diastolic blood pressure recovery. Lack of fitness was also associated with delayed heart rate recovery. These results revealed that, for the specified risk factors and cardiovascular variables, high-risk individuals exhibited delayed cardiovascular recovery as compared with low-risk individuals. Further, the relationships between hypertension status, race, and cardiovascular recovery were typically associated with the use of "active" laboratory stressors. The relationship between lack of fitness and cardiovascular recovery was also associated with the use of "active" and exercise laboratory stressors.
  • Article
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    We tested whether the presence of a stranger reduces cardiovascular responses during stressful tasks if the evaluation potential of the stranger is minimized and whether cardiovascular responses are affected by the quality of support in a friendship. Undergraduate women performed stressful tasks in one of three conditions: Alone, with a same-sex Stranger, or with a same-sex best Friend. The stranger and friend could not hear participants' responses. Alone women had the greatest increases in SBP and HR while women in the Stranger and Friend conditions did not differ in their responses. In the Friend condition, HR responses were smallest in women who were highly satisfied with the support that they generally received from their friend. We conclude that the presence of a nonevaluative friend or stranger can reduce cardiovascular responses and that the quality of supportive ties modulates the impact of those ties on responses to stress.
  • Article
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    Laboratory research indicates that the presence of a supportive other can reduce physiological responses to a stressor. Whether there are gender differences, either on the part of the provider or the recipient, in this social support effect is explored. Such differences might shed some light on the frequent epidemiological reports of gender differences in social support and health. Male and female subjects gave an impromptu speech and received either standardized supportive or nonsupportive feedback from a male or female confederate. Blood pressure and heart rate were monitored continuously during baseline and speech periods. Speakers with a supportive female audience showed a systolic increase of 25 mm Hg over baseline. Those with a nonsupportive female audience increased 36 mm Hg. A supportive male audience led to increases of 32 mm Hg, and a nonsupportive male audience 28 mm Hg. There was no significant effect of gender of subject. Results indicate that social support provided by women reduced cardiovascular changes for both male and female speakers compared with presence of a nonsupportive female audience. Social support from men did not. These findings suggest a possible mechanism that might help explain the epidemiological literature on the relationship between gender, social support, and health. The findings are consistent with the notion that married men are healthier because they marry women. Women do not profit as much from marriage or suffer as much from separation, in terms of health outcomes, because the support they gain or lose is the less effective support of a man. These findings render more plausible the possibility that differences in social support might contribute to health differences, through the dampening of cardiovascular responses to stress.
  • Article
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    Social support and integration have been linked to health and longevity in many correlational studies. To explain how social relationships might enhance health, investigators are examining the effects of social support on physiological processes implicated in disease. Much of this research focuses on testing the social support-reactivity hypothesis, which maintains that social support enhances health by reducing psychobiologic reactivity to stressors. This article identifies the basic assumptions, problems, and prospects of this research endeavor. The major problems discussed include: (a) inconsistent findings across studies; (b) unidentified cognitive and emotional mediators; (c) individual differences in response to social support; and (d) a lack of experimental studies on the role of social support in adjustment to chronic stress. Besides raising consciousness about these problems, I offer ideas for advancing research in this area.
  • Article
    Research findings have suggested that social support decreases cardiovascular reactivity and reduces the incidence of cardiovascular disease. The authors describe 2 studies evaluating the association between social support and cardiovascular reactivity to a stressor. In both studies, it was predicted that the presence of a supportive person would exert a buffering effect on cardiovascular reactivity. In Study 1, 68 participants were randomly assigned to 1 of 3 conditions: alone, supportive, and nonsupportive. In Study 2, 60 participants were randomly assigned to 1 of 3 conditions: highly supportive, supportive, and nonsupportive. In both studies, a speech was the stressor. Results in both studies showed no significant differences in cardiovascular reactivity between supportive and nonsupportive conditions. The results failed to support the reactivity buffering effects of social support. Findings are explained in terms of evaluation apprehension theory, familiarity of support provider, and level of social support.
  • Article
    The impact of pet ownership on depression was tested among a sample of gay and bisexual men (n = 1,872). Multivariate analyses, controlling for demographics and baseline depressive symptomatology, showed that neither pet ownership nor the presence of HIV infection was associated with depression. Depression was influenced by the presence of AIDS and by having relatively few confidants. Analyses among HIV-infected men only showed that persons with AIDS who owned pets reported less depression than persons with AIDS who did not own pets. This beneficial effect of pet ownership occurred principally among persons who reported fewer confidants. These results suggest that by enhancing companionship for some HIV-infected persons, pets may buffer the stressful impact of AIDS.
  • Article
    Oscillometric pressure is measured by analysing, in relation to the cuff pressure, low-amplitude cuff-pressure pulsations generated by each arterial pulse. The cuff pressure is sampled at the pulse rate, introducing measurement variations, which are compounded by artefactual pulses. To study the consistency of measurements with and without artefacts using simulated waveforms. The Propaq Smartcuf (with and without electrocardiographic synchronization), the Welch Allyn 52 000 (before and after its software had been upgraded), the Critikon DINAMAP 8100 and Compact TS and the Criticare 507 NJC were evaluated. Each monitor recorded 15 determinations at 120/80 (93) mmHg without and with either low-frequency or high-frequency artefacts generated by the Bio-Tek BP-Pump simulator. Consistency of measurements was defined as SD of less than 2 mmHg for at least two of the systolic, diastolic and mean arterial pressures with all less than 3 mmHg. All monitors except the Critikon 8100 satisfied the consistency criteria without artefacts with most SD less than 1 mmHg. Several satisfied the criteria with a severe low-frequency artefact (all recorded SD were less than 6 mmHg). None satisfied the criteria with a severe high-frequency artefact. High systolic blood pressures were typically recorded with a severe tremor artefact, though the Criticare device, which measures during cuff inflation, recorded lower systolic blood pressures. The Propaq device with electrocardiographic synchronization had the lowest variability, with synchronization increasing determination time. Oscillometric monitors are more sensitive to a high-frequency artefact than they are to a low-frequency artefact. Signal-processing techniques can improve consistency of measurements. Simulators can evaluate a monitor's consistency with and without artefacts.
  • Article
    The underuse of cardiovascular recovery as an adjunct to reactivity may stem from a lack of research on how to assess the process reliably. We explore the test-retest reliability of three simple, intuitive approaches to measuring recovery, and of a more sophisticated curve-fitting technique. Eighteen young normotensive subjects experienced three stressors twice each, with 10-min baseline, 3-min task, and 20-min recovery periods and continuous monitoring of heart rate and blood pressure. Reactivity showed moderate reliability, but the three simple approaches to measuring recovery revealed essentially none. However, the curve-fitting approach, using a three-parameter (amount, speed, and level of recovery) logistic function was reliable. This approach, capturing the inherently dynamic process of cardiovascular recovery, may allow researchers to usefully add the assessment of recovery to paradigms exploring reactivity as a risk factor for cardiovascular disease.
  • Article
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    In the present study, we evaluated the effect of a nonevaluative social support intervention (pet ownership) on blood pressure response to mental stress before and during ACE inhibitor therapy. Forty-eight hypertensive individuals participated in an experiment at home and in the physician's office. Participants were randomized to an experimental group with assignment of pet ownership in addition to lisinopril (20 mg/d) or to a control group with only lisinopril (20 mg/d). On each study day, blood pressure, heart rate, and plasma renin activity were recorded at baseline and after each mental stressor (serial subtraction and speech). Before drug therapy, mean responses to mental stress did not differ significantly between experimental and control groups in heart rate (94 [SD 6.8] versus 93 [6.8] bpm), systolic blood pressure (182 [8.0] versus 181 [8.3] mm Hg), diastolic blood pressure (120 [6.6] versus 119 [7.9] mm Hg), or plasma renin activity (9.4 [0.59] versus 9.3 [0.57] ng. mL(-1). h(-1)). Lisinopril therapy lowered resting blood pressure by approximately 35/20 mm Hg in both groups, but responses to mental stress were significantly lower among pet owners relative to those who only received lisinopril (P<0.0001; heart rate 81 [6.3] versus 91 [6.5] bpm, systolic blood pressure 131 [6.8] versus 141 [7.8] mm Hg, diastolic blood pressure 92 [6.3] versus 100 [6.8] mm Hg, and plasma renin activity 13.9 [0.92] versus 16.1 [0.58] ng. mL(-1). h(-1)). We conclude that ACE inhibitor therapy alone lowers resting blood pressure, whereas increased social support through pet ownership lowers blood pressure response to mental stress.
  • Article
    Motion artifact tends to degrade oscillometric noninvasive blood pressure measurement (NIBP) accuracy and other aspects of performance (measurement time, patient comfort, false-positive readings). Medical personnel generally have not fully appreciated the extent of these degradations, in part because NIBP provides no waveform display to allow visualization of artifact disruption (unlike the electrocardiography (ECG) and pulse oximetry (SpO2) patient channels). More importantly, the magnitude and frequency of NIBP errors has also gone unappreciated because the auditory noise produced by transport vibration prevents accurate quantification of NIBP accuracy by the traditional auscultatory method. To overcome these problems, a commercially available NIBP simulator was modified to permit the superimposition of repeatable motion artifact waveforms from a function generator onto known patient blood pressure profiles available in the NIBP simulator. The superimposed artifact waveforms had been collected under transport conditions. This methodology enabled comparisons between artifact-free NIBP readings, on the one hand, and artifact-contaminated readings on the other. Monitors under test were subjected to multiple combinations of patient and artifact profiles. Measurement errors were expressed as a percent deviation of the artifact-contaminated readings from the expected (artifact-free) readings. Statistical analyses of the data compared the performance of the different monitor types with nonparametric tests of inference (Kruskal-Wallis H test, Mann-Whitney U test, and chi-squared test). These analyses demonstrated statistically significant differences in performance including accuracy, yield (incidence of values within various error categories), retries, measurement time, and false-positive readings under artifact-only conditions. The method further demonstrated that the monitor using ECG synchronization to filter motion artifact achieved statistically and clinically significant improvements in accuracy without compromising clinical expectations for measurement time. This approach provided a reproducible and quantifiable method by which to assess and differentiate the artifact tolerance of different NIBP technologies.