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Biomedical subjects

T M Dembroski

Publications and source records attributed to T M Dembroski.

34 records · Page 2Linked to original sources

Challenge-induced cardiovascular response as a predictor of minor illnesses.

Male college students (n = 64) participated in a competitive "TV tennis game" while their heart rate and blood pressure were monitored. Subsequently, their health records were inspected to determine frequency of illnesses. Subjects who responded during the contest with extreme increases in heart rate and diastolic blood pressure were significantly more likely to have frequent minor illnesses than those responding with moderate or low increases.

Blood Pressure↗

The structured interview and questionnaire methods of assessing coronary-prone behavior in male and female college students.

Several self-report measures of type A behavior were compared with the Rosenman and Friedman structured interview method of assessment in male and female college students. The student version of the Jenkins Activity Survey was found to correlate relatively weakly with the interview for both males and females, while scales derived from the Gough and Thurstone inventories showed moderate correlations with interview typing for both sexes. A brief scale derived from a recent reanalysis of the Framingham study correlated with the interview appreciably greater for females than for males. In all, these data suggest the need for caution in using only paper-and-pencil tests to assess type A behavior.

Adolescent↗

Interpersonal interaction and cardiovascular response in type A subjects and coronary patients.

The present study tested the hypothesis that Type A subjects respond with greater cardiovascular response than Type B subjects during the structured interview used to assess the Type A pattern. Coronary patients (n = 31) and patient controls (n = 33) were subjected to the interview and a history quiz while ECG and blood pressure were monitored. As predicted, Type A relative to Type B subjects evidenced significantly greater increases in both systolic and diastolic blood pressure, which were sustained over the course of the entire 12-15 minute interview. Type A subjects compared with B's also showed significantly greater blood pressure elevations during the quiz. Coronary patients displayed significantly greater Type A attributes than control subjects and tended to show greater blood pressure elevations than controls during the interview. In addition, the quiz induced significant elevations in the blood pressure of coronary patients, but not patient controls, over that displayed during the interview, despite the presence of beta-adrenergic blocking medication. Implications of the findings for coronary-prone behavior and coronary heart disease are discussed.

Aged↗

Components of the type A coronary-prone behavior pattern and cardiovascular responses to psychomotor performance challenge.

The present study tested the general hypothesis that behavioral attributes most predictive of the incidence of coronary heart disease (CHD) in epidemiological research would also be most predictive of sympathetic autonomic nervous system (ANS) arousal in response to performance challenges. Subjects (n = 50) were challenged to respond rapidly and accurately on three tasks involving either perceptual-motor or cognitive skills, while the experimenter monitored blood pressure, heart rate, and galvanic skin potential. The hypothesis was generally confirmed in that (1) type A subjects showed significantly greater cardiovascular changes indicative of sympathetic ANS arousal than type B subjects, (2) the Rosenman and Friedman structured interview was a better predictor of this arousal than the Jenkins Activity Survey, as is the case in CHD, and (3) the stylistic and behavioral components of the type A pattern (as defined by the structured interview) which are most predictive of CHD were also found to be the best predictors of challenge-induced sympathetic ANS arousal. The implications of these results for refinements in the definition, assessment, and modification of coronary-prone behavior are discussed.

Adolescent↗

Stress effects on affiliation preferences among subjects possessing the type A coronary-prone behavior pattern.

An experiment tested the hypothesis that when subjects who display the Type A coronary-prone behavior pattern are placed under stress, they prefer to wait for the stressful event with others, but desire to work under stress alone. One half of 25 Type A and 25 Type B (non-coronary-prone) subjects were told that they would receive painful electric shock while working on a mental task, while the other one half were told that they would receive subliminal stimulation. Both groups were then given the choice of waiting for the event with others or alone and the choice of working on the task alone, in the company of others, or in a leader-directed group. The results showed that Type As relative to Type Bs tended to wait in the company of others regardless of threat level, but displayed a marked preference to work alone under high threat. This decision to work alone was not influenced by waiting preference. Subsequent correlational studies showed that coronary patients (n = 40) reported a greater preference for working alone when under pressure than matched controls (n = 40), as did Type A college students (77% vs. 14% for Type Bs) when asked their preference within the context of the structured interview that is used to assess the Type A pattern. The significance of the findings for increasing the understanding of affiliative preferences and coronary-prone behavior are discussed.

Choice Behavior↗

Physiologic reactions to social challenge in persons evidencing the type A coronary-prone behavior pattern.

Physiologic measures were recorded in Type A1 (n = 10) and Type B (n = 14) subjects while they engaged in a reaction-time task after receiving instructions emphasizing the need for rapid and accurate performance. Although resting levels were not significantly different, Type A's responded with significantly greater increases than B's in both heart rate and systolic blood pressure, suggesting greater sympathetic arousal. A significant baseline difference between the Types in heart rate variability was also observed suggesting greater lability in sympathetic-parasympathetic function in Type A's. No differences between the Types were obtained for either galvanic skin potential (GSP) or speed of reaction. It is suggested that the paradigm used in the present study offers an inexpensive and efficient means by which cardiovascular reactivity in Type A's and B's may be explored in other and larger groups of subjects.

Adolescent↗

Familial resemblance in components of the type A behavior pattern: a reanalysis of the California type A twin study.

Rosenman and colleagues reported no heritability of global Type A behavior assessed by the Structured Interview (SI) method, although some of the self-report scales correlated with global Type A behavior did have heritable components. Recent factor analyses of coded SI responses revealed four independent dimensions: clinical ratings, primarily of speech stylistics; and self-reports of pressured drive, anger, and competitiveness. It may be that some of these dimensions have a heritable base, whereas others do not. We report here reanalyses of the available SI responses from the Rosenman sample. In this subsample, tape recorded interviews with 80 monozygotic and 80 dizygotic twin pairs were scored for the extent of self-reported Type A behaviors, the major speech stylistics considered to be indicative of Pattern A, and the observable Type A behaviors (e.g., signs of hostility). Then scores for the major dimensions measured by the SI were calculated and scores for which there were sufficient data were subjected to twin analyses by the method of Christian et al. These analyses showed that individual differences in the clinical ratings factor and certain ratings loading on it--specifically, loudness of speech, competition for control of the interview, and potential for hostility--might have a heritable component. These results are discussed in the context of the importance of hostility as a predictor of subsequent coronary heart disease events as well as of total mortality, other data on the heritability of emotionality, and a temperament approach to understanding the origins of the Type A behavior pattern.

Adult↗

Components of Type A, hostility, and anger-in: relationship to angiographic findings.

Previous research has linked the Type A coronary-prone behavior pattern to angiographically documented severity of coronary atherosclerosis (CAD). The present study sought through component scoring of the Type A Structured Interview (SI) to determine what elements of the multidimensional Type A pattern are related to coronary disease severity in a selected group of patients with minimal or severe CAD. Multivariate analyses controlling for the major risk factors showed no relationship between global Type A and extent of disease. Of all attributes measured, only Potential for Hostility and Anger-In were significantly and positively associated with the disease severity, including angina symptoms and number of myocardial infarctions. Further analysis revealed that Potential for Hostility and Anger-In were interactive in their association, such that Potential for Hostility was associated with disease endpoints only for patients who were high on the Anger-In dimension. These findings support previous research in suggesting that anger and hostility may be the critical aspects of the Type A pattern in predisposing individuals to risk of CAD.

Anger↗

Components of hostility and the severity of coronary artery disease.

Previous research has linked various measures of hostility to the prevalence and incidence of coronary heart disease (CHD). The present study sought to determine whether some dimensions of hostility are differentially related to angiographically documented severity of coronary artery disease (CAD). Specifically, a hostility measure that correlates with indices of neuroticism was compared with a hostility measure unrelated to neurotic tendencies. For patients 60 years and younger, results were significant, revealing that neurotic hostility was inversely associated with severity of CAD whereas nonneurotic hostility scores were positively related to extent of disease. Overall hostility scores derived from the combination of the two kinds of hostility measures were unrelated to CAD severity. Results suggest that the multidimensional nature of the hostility construct should be appreciated in attempts to associate measures of hostility with manifestations of CHD.

Adult↗

Effects of beta-adrenergic stimulation and blockade on cardiovascular reactivity, affect, and type A behavior.

The present study examined the acute effects of drugs that stimulate or block sympathetic nervous system activity on components of Type A behavior, affect, and cardiovascular responses to mental stressors. Either propranolol (a beta-adrenergic blocker), isoproterenol (a beta-agonist), or placebo was infused intravenously at different times in 12 healthy males. In two sessions, placebo (saline) was administered first, followed by a structured interview, challenging mental arithmetic test, and completion of affect scales. The procedure was then repeated with one of the active drugs, presented in counterbalanced order. Results indicated reliable drug effects on both heart rate (HR) and systolic blood pressure (SBP) reactivity to the tasks, with change scores to the tasks markedly increased by isoproterenol. Anxiety and hostility ratings paralleled results for HR and BP, with much of this effect being due to higher affect ratings for isoproterenol. The effect of the drugs on Type A behavior was unexpected, with global Type A and several components lowered by isoproterenol and unaffected by propranolol. These data are discussed in terms of the interfering effects of anxiety on Type A speech components. The influence of isoproterenol on affect and reactivity might reflect the physiologic action of a beta 2-adrenergic positive feedback loop which increases release of endogenous norepinephrine, and/or potentiating effects of emotion on reactivity to stress.

Adult↗

Components of hostility as predictors of sudden death and myocardial infarction in the Multiple Risk Factor Intervention Trial.

We tested the hypothesis that hostility is associated with increased relative risk (RR) for coronary death and nonfatal myocardial infarction among participants in the prospective Multiple Risk Factor Intervention Trial (MRFIT). Cases (N = 192) were compared with matched controls (N = 384) on a variety of behavioral characteristics associated with the Type A behavior pattern (TABP), including three different but interrelated components of hostility. Logistic regression analyses revealed that only two of the eight TABP attributes analyzed on the overall sample were significant. Only total Potential for Hostility, when dichotomized into "low" and "high" categories, and the antagonistic interpersonal component of hostility (Stylistic Hostility) had positive unadjusted associations with coronary heart disease (CHD) incidence (RR = 1.7, p = 0.003; and RR = 1.5, p = 0.016, respectively). The global TABP and related paralinguistic attributes were not significantly related to CHD incidence. After adjustment for the traditional risk factors of age, serum cholesterol, blood pressure, and cigarette smoking, only dichotomous Potential for Hostility showed a significant relative risk (RR = 1.5, p = 0.032). Ordinal logistic regression revealed a nonsignificant effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗