Biomedical subjects

Craig K Ewart

Publications and source records attributed to Craig K Ewart.

13 recordsLinked to original sources

PubMed2006

Urban stress and health in developing countries: development and validation of a neighborhood stress index for India.

Stress caused by chronic difficulties encountered by people residing in poor urban neighborhoods is associated with health problems and disease in developed countries, but the relationship between neighborhood stress and health in developing nations, such as India, has not been assessed. In this study, the authors administered the City Stress Inventory, a self-report measure assessing stress experienced as a function of environmental conditions unique to living in large cities that was validated in the United States, to 163 high school students in New Delhi, India. Components of urban stress in India, with some modifications, appear to be similar to components of urban stress reported by adolescents in the United States. Urban stress was predictive of high blood pressure as reported by the adolescents 'parents. In addition, urban stress also predicted health habits, such as chewing tobacco and alcohol use, and psychosocial characteristics, such as hostility. Adolescents' reports of parental stress concerning money and social pressures were also associated with city stress. The current study indicates that the City Stress Inventory is valid in an Indian sample and is predictive of health problems.

Adolescent↗

PubMed2005

Early antecedents of adult work stress: social-emotional competence and anger in adolescence.

We hypothesized that youth with elevated coronary heart disease (CHD) risk who exhibit diminished social-emotional competence and frequent anger in adolescence experience increased occupational stress after becoming adults. Perceived job control and support from coworkers in 57 young Black and White men and women were regressed on measures of social problem-solving skill (SPS) and anger arousal (AR) obtained 5 years earlier when participants were in high school. In models controlling for grade point average (GPA), SPS and GPA independently predicted coworker support in adulthood; anger in high school predicted diminished job control. These findings suggest that occupational stress may have identifiable social-emotional antecedents early in life.

Adolescent↗

PubMed2005

Assessing cardiovascular reactivity in working women with the social competence interview.

The Social Competence Interview (SCI), an interview to induce cardiovascular reactivity through recounting a stressful life experience, was used with a sample of 120 working women employed as childcare providers. Women recounted their most stressful work factor while cardiovascular reactions were monitored at 2-minute intervals (data points included 4 baseline, 6 SCI, and 3 recovery). Increases were found when comparing mean baseline and SCI measures: systolic blood pressure (SBP) increased 10.00 mmHg; diastolic blood pressure (DBP)increased 10.63 mmHg; and heart rate increased 4.57 beats per minute. Consistent with the literature SBP and DBP were higher for some subgroups of women (those who were 50 years or older, were obese, or had 4 or more risk factors) across all data points. There were no time by individual difference interactions, indicating that the patterns of change over time were the same across groups. In a logistic regression, comparing women who reached SBP > or = 140 mmHg and/or DBP > or = 90 mmHg during the SCI versus those who did not, higher BP was associated with being older and obese, having a higher level of acceptance coping, and a lower level of suppression of competing activities coping.

Adaptation, Psychological↗

PubMed2004

Sociotropic cognition moderates stress-induced cardiovascular responsiveness in women through effects on total peripheral resistance, but not cardiac output.

Although cardiovascular disease (CVD) remains the leading cause of mortality in women, few studies have examined the role of psychosocial factors in its development. This study examined the moderating effects of sociotropic cognition (SC), a need for social acceptance and approval, on psychosocial stress-induced cardiovascular responsiveness (CVR) and affect reactivity in women. Sixty-eight normotensive, college-aged females were randomly assigned to a low or high social threat condition. Measures of systolic, diastolic and mean arterial blood pressures (SBP, DBP and MAP, respectively), heart rate (HR), cardiac output (CO), total peripheral resistance (TPR) and negative affect were collected during rest, and under conditions of high vs. low interpersonal threat. A two-step hierarchical regression analysis was performed to predict all response variables (BPs, HR, CO, TPR and affect). Increases in SBP, DBP, MAP, TPR and negative affect were greater in the high threat than low threat condition. Changes in SBP, MAP and TPR positively covaried with SC under conditions of high interpersonal threat, but showed no significant covariation in the low threat condition. The data suggest that an excessive need for social acceptance may contribute to rises in BP through an increase in TPR, but not CO under conditions of high social threat.

Adolescent↗

PubMed2004

Anger cognitions and cardiovascular recovery following provocation.

The current study describes the creation and validation of the Anger Cognitions Inventory (ACI) to assess the cognitive appraisals associated with resentful and reflective anger. The ACI was created based on a content analysis of self-reports of participants' thoughts and feelings following anger provocation in the laboratory. Exploratory and confirmatory factor analyses on two separate college student samples (N = 267 and N = 276, respectively) revealed five subscales which could validly be grouped into resentful and reflective anger. Convergent and divergent validity data showed that resentful anger correlated positively with anger-out/trait anger and reflective anger correlated positively with anger-in/brooding. A second study showed positive correlations between rumination and delayed cardiovascular recovery following anger provocation. Limitations of both studies include restricted samples which limit generalizability of results and cardiovascular recovery data collected in Study II which does not include assessment of autonomic balance between vagal and sympathetic responsivity.

Adolescent↗

PubMed2004

Agonistic interpersonal striving: social-cognitive mechanism of cardiovascular risk in youth?

The social competence model (SCM) of cardiovascular disease (CVD) risk identifies combinations of goal-oriented strivings, expressive behaviors, and social skill deficits that contribute to persisting interpersonal difficulties and chronic health-damaging stress in youth. SCM hypotheses were tested on 187 Black and White adolescents who completed the Social Competence Interview (SCI) and later underwent ambulatory blood pressure (ABP) monitoring. Cluster analyses of stress narratives assessed via SCI identified 3 predicted stress profiles: agonistic (interpersonally focused), transcendent (self-development focused), and avoidant. Group comparisons using social, hemodynamic, and ABP data supported the SCM hypothesis that youths who exhibit the agonistic striving profile display diminished social competence, negative social impact, and heightened cardiovascular responding during a stress interview, and elevated ABP during normal social interactions, thus suggesting higher risk of CVD.

Adolescent↗

PubMed2004

Vigilance to a persisting personal threat: unmasking cardiovascular consequences in adolescents with the Social Competence Interview.

We report the first systematic study of hemodynamic responses to the Social Competence Interview, using the original Ewart protocol, which focuses attention on a persisting personal threat. Physiologic changes in 212 African American and Caucasian urban adolescents during the Social Competence Interview, mirror tracing, and reaction time tasks showed that the Social Competence Interview elicits a pronounced vasoconstrictive response pattern, with diminished cardiac activity, that is more typical of alert mental vigilance than of active coping. This pattern was observed in all race and gender subgroups. Results suggest that the Social Competence Interview may be a broadly useful procedure for investigating the role of threat-induced vigilance in cardiovascular and other diseases.

Adolescent↗

PubMed2003

Development and testing of the Cholesterol-Lowering Diet Self-Efficacy Scale.

A cornerstone of treatment for hypercholesterolemia is dietary therapy. However, maintaining adherence to the therapeutic diet has been difficult for patients. There is evidence that self-efficacy is a predictor of positive behavior change like that involved in or necessary for initiating or maintaining recommended diet therapy for cholesterol reduction. This paper reports on two studies guided by Bandura's self-efficacy theory. The first study focuses on development and initial psychometric evaluation of an instrument measuring self-efficacy for adhering to a cholesterol-lowering diet in a sample of 44 cardiac rehabilitation patients; the second establishes psychometric properties of the instrument in a sample of 228 subjects treated for hypercholesterolemia. In both studies, subgroups completed the instrument a second time to provide data on the instrument's temporal stability. The Cholesterol-Lowering Diet Self-Efficacy Scale consists of 33 statements, some with branches for a total of 56 items. The scale measures several components of the eating habits domain related to adhering to a cholesterol-lowering eating plan, and shows good reliability and validity. Reported self-efficacy is related to prior persistence and past success in modifying and maintaining dietary changes, and also to concurrent measures of dietary adherence behaviors. The scale is psychometrically sound thus far and seems adequate in identifying success in achieving and maintaining a cholesterol-lowering eating plan.

Adult↗

PubMed2003

Anger in young black and white workers: effects of job control, dissatisfaction, and support.

This cross-sectional study tested the hypothesis that characteristics of work that contribute to job strain also increase anger in young service-sector workers. A new measure of anger directed at coworkers, supervisors, and customers was regressed on job strain indices (job control, coworker and supervisor support, dissatisfaction) in models that controlled for dispositional negative affect and work status. Results in a sample of 230 young Black and White men and women revealed that low levels of job control and social support, and high levels of job dissatisfaction, were independently associated with increased work-related anger. Moreover, social support moderated the impact of low job control on anger directed at coworkers. Findings indicate that anger experienced at work may be an early marker of job stress, which has been prospectively related to cardiovascular disease.

Adult↗

PubMed2002

Discovering how urban poverty and violence affect health: development and validation of a Neighborhood Stress Index.

Health problems of the urban poor have been attributed to psychosocial effects of environmental stress. Testing such models requires an ability to measure neighborhood characteristics that make life stressful. The City Stress Inventory (CSI) uses self-report to assess perceived neighborhood disorder and exposure to violence. Data from an interracial sample of urban adolescents show the CSI to be internally consistent, stable, and correlated with census indices of social disadvantage. Validity for stress research is indicated by correlations with trait depression, anger, hostility, self-esteem, and mood changes during a debate with an unfamiliar peer. The CSI can be completed by persons with an 8th-grade education.

Adolescent↗

PubMed2002

Measuring stress resilience and coping in vulnerable youth: the Social Competence Interview.

A brief interview to measure stress coping capabilities was developed and tested in 4 samples of African American and White adolescents in low-income neighborhoods of 2 large U.S. cities. The Social Competence Interview (SCI) is a 10-min social stressor that assesses physiological and social-emotional responses to a recurring real-life problem. A new behavioral coding system using audiotapes permits reliable and valid assessment of components of social competence, including Interpersonal Skills (expressiveness, empathy), Goal-Oriented Strivings in coping (self defense, social acceptance, competitiveness, stimulation-pleasure, approval, self improvement), and Social Impact (high vs. low affiliation/control). High SCI expressiveness and self-defensive striving create a critical-aggressive social impact, which is correlated with increased hostility and anger.

Adaptation, Psychological↗

PubMed2002

Cardiovascular reactivity during social and nonsocial stressors: do children's personal goals and expressive skills matter?

The relationships between social competence and cardiovascular reactivity were evaluated in 180 children (ages 8-17; 52% female; 53% Caucasian). Participants performed a social task (Social Competence Interview [SCI]) and 2 nonsocial tasks while reactivity measures were obtained. Social competence was coded from SCI audiotapes. Among adolescents, higher scores on the Acceptance-Affiliation subscale were associated with increased heart rate (HR) and blood pressures and with decreased HR variability during the SCI. Among boys, greater Acceptance-Affiliation scores were associated with increased vascular reactivity during the SCI. During the nonsocial tasks, higher Self-Defensiveness and Expressiveness scores were associated with increased cardiac output and stroke volume among African American children. Personal strivings and expressive skills do matter for understanding cardiovascular responses in children.

Adolescent↗

PubMed1988

Hypertension Intervention Pooling Project.

Data from 12 independently designed and conducted randomized trials of behavioral interventions for hypertension, consisting principally of variants of relaxation and biofeedback therapies, were aggregated to assess current progress of research in this area. Meta-analytical methods revealed a statistically significant decrease in diastolic blood pressure for nonmedicated patients at the end of intervention. No significant improvement was detected in medicated patients, but potential differential effectiveness of prescribed medications and differences in compliance among patients prohibits separation of changes due to behavioral treatments alone. The need to devise criteria for selection of patients, and to establish the most appropriate patient-treatment match is emphasized.

Behavior Therapy↗