Ana M. Pérez-García

A prospective study of the effects of psychological resources and depression in essential hypertension.

This study examined the influence of perceived health competence (PHC) and coping strategies in hypertension. Depressive mood state and dimensions of quality of life (QOL) (social support, satisfaction, well-being and free time) were also considered. One hundred and fifty participants were surveyed cross-sectionally and prospectively. Regression analysis revealed that the main predictors of the dimensions of QOL were PHC and depressive mood state. Emotional coping negatively predicted well-being. Unexpectedly, task-focused coping was unrelated to QOL domains. Longitudinal analyses did not support these relations. The data suggest that, in hypertension, PHC constitutes an important resource, whereas depressive mood state deteriorates QOL.

Gender and Social Support in the Context of Cardiovascular Disease

ABSTRACT Objective: Gender and social support (SS) can affect the level of adjustment to cardiovascular disease (CVD). In this study we attempted to determine the effects of both factors on negative mood state, quality of life (QOL) and perceived health control (PHC) in patients at high CVD risk or with CVD. We also tested for an interactive effect of gender and SS. Method: One hundred and fifty-three chronic outpatients (89 females and 60 males; 4 provided no information on gender) were assessed. Levels of social support were measured. Other psychosocial variables included were negative mood state, domains of QOL (satisfaction and free time) and PHC. Results: The results, as expected, indicated main effects of gender and social support. Females experienced higher negative mood state and lower PHC in comparison with males. Patients with low SS reported less satisfaction, free time and PHC and had more negative mood state. No interaction of gender by social support was found. Conclusions: Levels of social support and gender are important aspects that influence emotional and psychological functioning in patients with CVD. Specific interventions designed for females and individuals with poor emotional and instrumental support may contribute to positive changes in their adjustment.

TYPE-A BEHAVIOUR PATTERN'S (GLOBAL AND MAIN COMPONENTS) ATTENTIONAL PERFORMANCE CARDIOVASCULAR REACTIVITY, AND CAUSAL ATTRIBUTIONS IN THE PRESENCE OF DIFFERENT LEVELS OF INTERFERENCE

Abstract The present paper aims to analyse the performance of Type-A/Type-B individuals in a computerized Stroop-type task (Numeric and Symbolic series). An external interference condition (presence or absence of loud noise), following the design used by Matthews and Brunson (Journal of Personality and Social Psychology, 37, 2081–2090, 1979), was added. The results show that Type As perform the same at both levels of external interference, whereas Type Bs become worse with noise, and worse than Type As when in the noise condition. At the same time. Type As registered higher levels of reactivity (SBP) than Type Bs in the more interfering situation, but not in self-report data, and a defensive attributional style for failure or poor performance. Moreover, regression analyses with the main Type-A Behaviour Pattern (TABP) components (Competitiveness and Hostility-Impatience) as predictors revealed that the differences in performance and SBP are explained by Competitiveness. The results are discussed in terms of the characteristic Type-A need of control over the situations, the differential contribution of TABP components, and the attentional strategy (to focus on relevant task cues ignoring irrelevant noise-stimulation).

Type A behavior pattern and attentional performance

Abstract The main goal of the present study was to analyze the differential strategy Type A and B individuals use in the allocation of their available attentional resources, when they perform a stressful or involving task. In this context, we tested the hypothesis that Type A subjects focus their attention on task-relevant stimuli, ignoring, at the same time, task-irrelevant and environmental stimuli, which could interfere with their performance. To test this hypothesis, we have analyzed the performance (level of interference and error rate) of Type A and Type B subjects on a Stroop-type task, using a mixed 2×2×3 design—with the following factors and levels: Personality (Type A/Type B), Treatment (Control/Stress) and Attentional Condition (Global/Local/Divided). In summary, our present results, globally considered, showed that Type A subjects performed better (suffered less interference and made fewer errors) than Type Bs, although this effect was mainly due to the significant differences between Type A and Type B subjects in the Divided attention condition and under Control Instructions. Thus, our results only partially support the above mentioned hypothesis. These results are further discussed in relation to the difficulty level of the attentional tasks and the level of stress in the situation.

Cardiovascular reactivity, affective responses and performance related to the risk dimensions of coronary-prone behaviour

Abstract This study was designed to test the association between (a) components of the coronaryprone behaviour (Hostility, Competitiveness, Impatience, Job involvement, and Rumination), and (b) cardiovascular reactivity [Systolic blood pressure (SBP), Diastolic blood pressure (DBP), and heart rate (HR)], mood state, and performance. Sixty-one subjects volunteered in a laboratory session that included the performance of a mental arithmetic task and a reaction time task. The results showed that: (1) only the Hostility, Competitiveness, and Rumination dimensions were significantly associated with physiological reactivity (mainly SBP). This differential reactivity was particularly significant while subjects performed the mental arithmetic task. Individual differences in Competitiveness were also related to the reactivity during the reaction time task. (2) No significant relations appeared between these dimensions and mood responses. (3) Lastly, performance was only related to the Competitiveness dimension. The more competitive subjects were, the shorter their reaction time was. These results are interpreted as supporting the risk status of these coronary-prone dimensions. At the same time, suggestions concerning the more complex role the Competitiveness factor could be playing are made.

The role of personality and coping in adjustment disorder

Background Numerous studies have found that both personality and the coping strategies used in response to stress play important roles in the development of mental health problems, particularly adjustment disorder (AD), which is characterised by the onset of different emotional symptoms or behaviour in response to an identifiable stressor. Methods The aim of this study was to analyse the differences between 80 outpatients (68% female, average age 36) diagnosed with AD at a mental health unit and 80 controls (48% female, average age 39; people subjected to similar stress but with no psychopathology) with regard to personality, coping, and certain socio-demographic variables. Results Patients presented less extraversion and a considerably greater neuroticism than the control group. They employed disengagement strategies to a greater extent and humour strategies less frequently than the control group. Conclusions The results contribute to clarify a controversial diagnostic category that has been the subject of very little research. They also provide guidelines for intervention.

Coping strategies, depressive symptoms and quality of life in hypertensive patients: Mediational and prospective relations

This study examined whether depressive symptoms mediated the association between coping strategies and quality of life (QoL) in a sample of hypertensive patients, and the prospective contribution of depressive symptoms and coping strategies in the prediction of their QoL. One hundred and fifty patients (50% males and 50% females) with a diagnosis of essential hypertension were recruited from a general hospital. Symptoms of depression, coping and QoL measures (global score and dimensions) were collected at baseline. Sixty-three participants completed the QoL questionnaire again one year later (T2). The results indicated that the relations between emotion coping and QoL (global score, satisfaction and social support) were totally mediated by depressive symptoms. The association between emotion coping and well-being was, however, partially mediated by depressive symptoms. Furthermore, only baseline instrumental coping strategies predicted higher levels of QoL (global score, well-being and social support) at T2. Neither emotion coping nor depressive symptoms were significantly associated with prospective QoL. These findings suggest that depressive symptoms may be a mechanism linking the manner in which patients cope with their hypertension and their QoL. They also emphasise the adaptive role played by instrumental coping responses in the management of hypertension in the long term.