Reactivity In Women Research Articles

Cardiovascular reactivity to simulated social stress

This study tested the hypotheses that blood pressure reactivity to simulated social stress would be positively correlated with resting pCO2 and with increased variability of blood pressure in the natural environment. Sixty white and black men and women participated in a role-playing task involving scenarios describing common infringements of their rights. Blood pressure was higher during the role playing task than during a preceding structured interview and an intervening rest period, and decreased after role playing. Heart rate changes were small by comparison, though heart rate reactivity of women was greater than that of men. Blood pressure reactivity was not correlated with resting pCO2 and was inversely correlated with ambulatory systolic blood pressure variability. Resting pCO2 was, however, correlated with mean 24-h ambulatory systolic and diastolic blood pressure. This study confirms that social stress elevated blood pressure acutely via a vascular mechanism, is consistent with the view that hyperresponsive individuals tend to avoid arousing situations, and further implicates pCO2 in long-term blood pressure regulation. Copyright © 1999 John Wiley & Sons, Ltd.

300 Psychophysiological measures of reactivity in women

300 Psychophysiological measures of reactivity in women

Blunted cardiovascular and catecholamine stress reactivity in women with bulimia nervosa

Cardiovascular and catecholamine responses to mental stressors were investigated in women with bulimia nervosa (BN) and in healthy control subjects. Fifteen women with BN and 15 control subjects completed psychosocial questionnaires before laboratory testing, where they were exposed to an interpersonally based speech stressor and a serial math task. Blood pressure, heart rate, epinephrine, norepinephrine and, via impedance cardiography, systolic time intervals, cardiac output and total peripheral resistance were measured at rest and during stress. Results indicated that BN was associated with blunted sympathetic activation in response to mental stress, indicated by increased pre-ejection period responses and blunted systolic blood pressure, heart rate and epinephrine responses. In contrast, women with BN had elevated cortisol levels when compared with control women. In addition, despite equivalent performance between groups, bulimic women reported feeling significantly more confused, frustrated, inadequate and dissatisfied with their performance during tasks. Psychosocial questionnaires also indicated that women with BN perceived more stress, had worse coping skills, lower self-esteem and sense of mastery, reported less social support, had worse mood, had greater anxiety and were more depressed when compared with control women. These results are interpreted as reflecting physiological and psychological profiles indicative of distress vs. active effort coping in BN. © 1998 Elsevier Science Ireland Ltd. All rights reserved.

Stress and personality as factors in women's cardiovascular reactivity

An experiment was conducted to investigate the relationships among Type A behavior, hostility and cardiovascular reactivity (CVR) in women. Changes in heart rate, blood pressure and skin conductance from baseline to task levels were used to assess reactivity. These measures were obtained from 96 women during a seated baseline period, a reaction time task and during an oral IQ quiz. Analyses indicated that Type A and high hostile women were more reactive to an oral IQ quiz and reaction time stressors than Type B and low hostile women. Specifically, Type As showed significantly greater increases in systolic blood pressure in the reaction time task and greater mean arterial pressure and systolic blood pressure increases in the IQ quiz. High hostiles evidenced significantly higher systolic blood pressure and diastolic blood pressure in the RT task and higher mean arterial pressure and diastolic blood pressure in the IQ quiz. It was concluded that Type A personality and hostility can predict greater reactivity in women to two different stressors. The oral quiz generated greater reactivity than the RT task and thus may be a more stressful task.

Arterial Reactivity Is Enhanced in Genetic Males Taking High Dose Estrogens

Objectives. We sought to assess whether high dose estrogen treatment is associated with enhanced arterial reactivity in genetic males.Background. Although estrogens have been shown to enhance arterial reactivity in women, and are thereby thought to confer cardiovascular benefit, the vascular effects of long-term estrogen therapy in genetic males is unknown.Methods. We studied the arterial physiology of 30 genetic males—15 male to female transsexuals receiving long-term high dose estrogen therapy and 15 healthy male control subjects matched for age, smoking history and vessel size. Using external vascular ultrasound, brachial artery diameter was measured at rest, after flow increase (causing endothelium-dependent dilation [EDD]) and after nitroglycerin (GTN), an endothelium-independent dilator. Blood pressure, cholesterol and testosterone levels were also measured in each subject.Results. Total testosterone and free testosterone index levels were lower in the transsexuals compared with the control subjects (p < 0.001). In contrast, EDD was significantly higher in the transsexuals than in the control males (mean [±SD] 7.1 ± 3.1% vs. 3.2 ± 2.8%, p = 0.001), as was the GTN response (21.2 ± 6.7% vs. 14.6 ± 3.3%, p = 0.002). Total and high density lipoprotein cholesterol, blood pressure levels and baseline vessel size were similar in the two groups. On multivariate analysis, enhanced EDD was associated independently with estrogen therapy (p = 0.02) and with low total cholesterol (p = 0.04). An enhanced GTN response was also significantly associated with estrogen therapy (p = 0.03).Conclusions. Long-term treatment with high dose estrogens is associated with enhanced arterial reactivity in genetic males, which may be due to the effects of estrogen excess or androgen deprivation, or both.(J Am Coll Cardiol 1997;29:1432–6)

Salivary cortisol levels and stress reactivity in human aging.

While homeostatic mechanisms are generally believed to become less efficient in the aging organism, evidence for changes in hypothalamic-pituitary-adrenal function is inconclusive. Previous studies report higher, lower, or unchanged basal cortisol levels in human aging. Delayed recovery of glucocorticoids to baseline following stress exposure has been observed in aging rats, but the generalizability of these findings to humans remains unclear. Salivary-free cortisol was measured at home and in response to a laboratory speech task in 56 healthy men and women in three age groups (range 43-86 yr). Higher basal cortisol levels were observed in older age groups. Gender, recent life stress, and current distress showed no relationship to basal levels. The magnitude of cortisol responses to the speech task differed by age, with the smallest responses in the oldest group. This pattern was robust in men, with the youngest subjects (40-59 yr) showing both the largest and the most prolonged responses. While women > 70 yr were least likely to show any response, other analyses failed to show age effects on reactivity in women, perhaps because anticipatory baseline elevations limited subsequent cortisol response. Results indicate moderate increases in basal cortisol levels, but do not support the hypothesis that cortisol responses to a stressor increase in magnitude or duration during normal human aging. Gender differences in stress reactivity warrant further investigation.

Evaluation Interferes with Social Support: Effects on Cardiovascular Stress Reactivity in Women

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.

The Psychophysiology of cardiovascular reactivity

In this presentation cardiovascular reactivity (CVR) was discussed in relation to several prominent hypotheses regarding its stability and personality and social factors that appear as moderators of this reactivity. A call for additional research on cardiovascular reactivity in women was made in view of the relatively scarce amount of work on CVR in women.

Effect of mood and food cues on body image in women with bulimia and controls.

The present study evaluated body image assessment and cue reactivity in women with bulimia and controls in response to neutral, mood, and food cues in isolation, and mood and food cues in combination. Subjects were 7 women with bulimia nervosa and 8 control women. Food cues were individualized high-risk/favorite foods. Low mood was elicited using the Musical Mood Induction Procedure. Order of cue presentation was random across subjects. Body image and cue reactivity were assessed using a computer version of the silhouette method and self-report ratings, respectively. Women with bulimia consistently rated their current body as being larger and their body image satisfaction as being lower than control women. In addition, women with bulimia differentially rated their current body and a picture of a healthy weight woman as being larger following exposure to food and/or mood cues. Ratings of ideal body were differentially affected by mood cues for control women. Ratings of body satisfaction were not affected by cue presentation. Mere presentation of high-risk foods in the absence of eating was sufficient to elicit urges to binge in women with bulimia. Body size estimation is not only affected by enduring characteristics (i.e., bulimia nervosa), but also more transient factors such as short-term exposure to salient food and mood cues.

Cerebral artery blood flow in relation to age and menopausal status

To investigate vascular reactivity in women's cerebral arteries from reproductive age to postmenopause. The pulsatility index (PI) was measured cross-sectionally in the internal carotid and middle cerebral arteries of 120 women, using a Doppler ultrasound system. Fifteen women were enrolled in each of eight 5-year intervals, spanning ages 20-59 years. In the population as a whole, there was a slight but statistically significant correlation between age and the PI in both arteries, but not after excluding postmenopausal subjects. A significant correlation was found between PI and months since menopause (but not chronologic age) in the postmenopausal women. There was also a statistically significant difference in the PI values for both arteries between pre- and postmenopausal women of similar age. Menopause causes a significant increase in the PI of women's cerebral arteries. In postmenopausal women, there is a significant correlation between the PI of the internal carotid and middle cerebral arteries and menopausal but not chronologic age. This effect may be one of the mechanisms by which menopause is associated with the known higher risk for coronary heart disease observed in women.

Salivary reactivity in women with bulimia nervosa across treatment

We examined salivary reactivity to a high-risk binge food in women with bulimia before and after cognitive-behavioral treatment. Prior to treatment, there was no change in salivation after presentation of high-risk food cues. After treatment, salivation increased significantly (p = .002) over baseline after presentation of the same foods. Salivary reactivity was negatively correlated with systolic blood pressure, but was unrelated to heart rate, self-report anxiety, or depression. Changes in salivary reactivity may be meaningful clinical index worthy of further investigation in this population.

The Anger Recall interview and cardiovascular reactivity in women: An examination of context and experience

Recent research has focused on the role of hostility as a risk factor for coronary heart disease. Hostility has been linked independently to cardiovascular mortality and, as a component of Type A behavior, to atherogenesis and myocardial infarction; however, the mechanisms by which hostility manifests its effects on the cardiovascular system have not been determined. In addition, hostility has been evaluated as a trait measure, with little emphasis on how anger-provoking episodes may be perceived by individuals. The present study seeks to evaluate the affective experience of hostility, through an anger recall interview, and relate qualities of that experience to one potential mechanism of cardiovascular risk, cardiovascular reactivity. Fifty-eight women, classified by structured interview as Type A or B, participated in an anger recall interview while their heart rate and blood pressure were monitored. Type A women manifested greater systolic reactivity when their anger was in response to frustration of autonomy needs, while Type B women exhibited greater heart rate reactivity in response to frustration of affiliation needs. All women who suppressed anger expression experienced higher pressor responses than women who expressed anger assertively. Future investigations may find the content of an interview as useful as the procedure itself in studies of cardiovascular reactivity.

Systemic Cell-Mediated Immune Reactivity in Women with Recurrent Vulvovaginal Candidiasis

It has been suggested that impaired cell-mediated immunity (CMI) against Candida antigens is responsible for susceptibility to recurrent vulvovaginal candidiasis (RVVC) in adult women. To address this, we conducted a comprehensive longitudinal study examining in vivo and in vitro systemic CMI reactivity in RVVC patients. Results showed that RVVC patients frequently demonstrated a transient loss of Candida-specific delayed cutaneous skin test reactivity during episodes of symptomatic vaginitis. In contrast, in vitro peripheral blood lymphoproliferation and Th1-type lymphokine production by RVVC patients in response to a T cell mitogen and multiple Candida and bacterial antigens were similar to controls both during acute episodes of vaginitis and during periods of infection-free remission. These results suggest that women with RVVC have no detectable impairment of systemic CMI in peripheral blood and that transient reductions in skin test reactivity appear to be a result of vaginal Candida infection and not a predisposing factor to RVVC.

Menstrual cycle and premenstrual syndrome: Modifiers of cardiovascular reactivity in women.

Fifteen women prospectively diagnosed with PMS and 15 non-PMS women were each tested twice for cardiovascular stress reactivity and behavioral performance, once during the follicular phase and once during the luteal phase of their cycle. Although blood pressure and heart rate responses to stress did not differ across the menstrual cycle in either group of women, for the non-PMS women, differences in hemodynamic responses were observed across the 2 phases. The luteal phase was associated with greater stroke volume responses and lesser vascular tone. For the PMS women, none of their cardiovascular measures differed across their cycle. Instead, these women showed significantly attenuated blood pressure and heart rate responses compared with non-PMS women, irrespective of cycle phase.

Menstrual cycle and premenstrual syndrome: modifiers of cardiovascular reactivity in women.

Fifteen women prospectively diagnosed with PMS and 15 non-PMS women were each tested twice for cardiovascular stress reactivity and behavioral performance, once during the follicular phase and once during the luteal phase of their cycle. Although blood pressure and heart rate responses to stress did not differ across the menstrual cycle in either group of women, for the non-PMS women, differences in hemodynamic responses were observed across the 2 phases. The luteal phase was associated with greater stroke volume responses and lesser vascular tone. For the PMS women, none of their cardiovascular measures differed across their cycle. Instead, these women showed significantly attenuated blood pressure and heart rate responses compared with non-PMS women, irrespective of cycle phase.

Anger and denial as predictors of cardiovascular reactivity in women

The relationship between behavioral and physiological reactivity and cardiovascular disease has been extensively researched in men, indicating that the expression of anger may be a contributory factor in the development of coronary heart disease. Few studies, however, have focused on women. Among these, women generally have been found to be less reactive to laboratory tasks than men. In the present study, 45 women aged 19–21 years were selected to represent three groups—(1) low anger/low denial, (2) high anger/low denial, and (3) low anger/high denial—based on their scores on the State-Trait Anger Expression Inventory and the Marlowe-Crowne Social Desirability Scale. Subjects received three conditions: (1) no feedback, (2) error feedback without observer present, and (3) error feedback with observer present. As hypothesized, women who reported a high level of denial and low anger exhibited elevated stress-related reactivity. The results are suggestive of a subgroup of highly reactive women not previously identified within the literature. The hypothesis that all groups would display greater reactivity in a condition providing error feedback with observation was not supported.

Gender differences in blood pressure control during a variety of behavioral stressors.

This study assessed gender differences in hemodynamic response patterns to behavioral stressors. In addition, the extent to which gender differences in cardiovascular reactivity were a function of the type of challenge was determined by employing tasks relying on stereotypically male areas of competence and a task relying on stereotypically female areas of competence. Sixteen female and 15 male graduate, medical or dental students were exposed to two speech tasks and two math tasks. While there were no significant differences in blood pressure reactivity between the genders, females exhibited significantly greater cardiac output increases across all tasks than males, while males tended to respond with greater increases in total peripheral resistance compared with females. Furthermore, during two of the tasks, significantly more females were classified as myocardial hyperreactors (based on increases in cardiac output), while significantly more males were vascular hyperreactors (based on increases in total peripheral resistance). A post hoc analysis also indicated an apparent association between oral contraceptive use and higher cardiovascular reactivity among the females tested. This association may have been a consequence of the decision to test all women during days 10 to 14 of the menstrual cycle when reactivity in women not using oral contraceptives may be suppressed.

Enzyme-linked immunosorbent assay for the diagnosis of trichomoniasis in women.

An enzyme-linked immunosorbent assay-(ELISA) using whole Trichomonas vaginalis as antigen was developed for measurement of serum antibody to T. vaginalis. Sera from six women who denied ever having had genital contact were used as the negative control. Of 38 women with proved T. vaginalis infection, 25 (66%) had elevated ELISA values. Values were usually very stable over weeks to months of follow-up. Among a matched comparison group of 38 women attending the same clinic who did not have T. vaginalis infection (as detected by wet mounts), an elevated value was present in only eight (21%) of 38 (P less than 0.001). Thus, in this group of women, the sensitivity was 66%, the specificity, 79%, the predictive value of a positive test, 76%, and the predictive value of a negative test, 70%. Our ELISA clearly demonstrates more reactivity in women with T. vaginalis. Its usefulness as a marker of current infection is probably limited, but it could be of considerable value for seroepidemiologic studies.

Temporal consistency of individual differences in cardiac response to a video game

Three experiments are reported which examined the temporal stability of cardiac reactions to a video game of the ‘space invaders’ genre. Experiment 1 also addressed the matter of inter-task consistency; in addition to the video game, subjects were presented with an unsignalled reaction time task and led to believe that relatively quick reactions attracted financial reward, while slower ones brought either a burst of loud noise or withdrawal of money previously earned. Forty-two male subjects were tested on both tasks on two occasions, a week apart. Of the two tasks, the video game elicited the greater reactivity. In addition, individual variations in reactivity showed striking temporal stability for both tasks. However, inter-task consistency was much less marked; in fact, a significant inter-task correlation was obtained only on the first occasion of testing. It is probable that limited consistency here was in some measure due to the ineffectiveness of our reaction time task in eliciting substantial reactivity. Finally, reactivity was independent of baseline heart rate level. In experiment 2, three extreme high and three extreme low cardiac reactors were selected from an initial sample of 23 male subjects, on the basis of reactivity during an initial session with the video game, and subsequently studied during four further sessions. Once more, impressive stability of heart rate reactivity was apparent over sessions. In experiment 3, we examined the reliability of individual variations in cardiac reactivity in women and the issue of whether temporal stability is constrained by menstrual cycle effects. Twenty-four females were tested on the video game both preovulatory and postovulatory, with half being tested first during the preovulatory phase and half being tested first during the postovulatory phase. Again, the most striking finding was the marked stability of individual variations in cardiac reactivity over both time and menstrual cycle phase.

Human leucocyte antigens and mixed lymphocyte reaction in severe pre-eclampsia.

Human leucocyte antigens (HLA) and mixed lymphocyte reactions (MLR) were studied in 38 women with severe pre-eclampsia and their husbands. Thirty-nine women with normal pregnancies and their husbands served as controls. Thirty-three of the control women were matched for age and parity with members of the study group. Infants were studied when possible. HLA compatibility was increased in the pre-eclamptic group compared with matched controls and with theoretical estimates for possible matings. The one-way MLR at delivery showed diminished response of maternal to paternal and cord cells in pre-eclamptic women. This reduced maternal reactivity in women with pre-eclampsia may have a role in the illness, and paternal/maternal histocompatibility may be a feature of the severe form.