B. Kent Houston

Stress and Coping

Stress and coping are topics of substantial current interest, and much has been said and could be said about these topics. In considering stress, it is important to define the term for purposes of clear communication and theory construction, yet it has been defined in numerous ways and is frequently used without a clear referent. One purpose of the present chapter, then, is to discuss the definitions of stress and to try to deal with some of the problems associated with traditional approaches to defining the concept by distinguishing psychological from physiological stress. In doing so, a phenomenological definition of psychological stress will be provided.

Psychophysiological Responsivity and the Type A Behavior Pattern.

Abstract Studies were reviewed in which the psychophysiological responses of Type A and B subjects were studied in various contexts. It appears that Type As manifest greater psychophysiological arousal than Type Bs in solitary as well as interpersonal situations in which there is a moderate external incentive to accomplish something. and there is an intermediate probability of failing to accomplish that something. Further, Type As appear to manifest greater psychophysiological arousal than Type Bs in interpersonal situations in which another person annoys or harasses the subject. Why Type As respond in these situations with greater psychophysiological arousal was discussed in terms of the possibilities that (a) these situations may engage some defining characteristic(s) of Type As, (b) Type As may fear and therefore try to avoid failure more vigorously than Type Bs, and (c) Type As may be more motivated to gain and maintain control over important environmental events and therefore are more aroused by threats to such control than Type Bs.

Response to stress, cognitive coping strategies, and the type A behavior pattern.

This study was conducted to examine (a) whether Type A individuals respond with more psychophysiological arousal to threat to self-esteem than to threat of shock, (b) whether differences between Type A and Type B individuals in psychophysiological responses are greater under high than low stress, and (c) whether Type A and Type B individuals differ in how they cognitively cope with stress. Eighty-four college males served as subjects. The results indicated that the Type A subjects manifested higher pulse rates across all conditions and greater systolic and diastolic blood pressure in response to threat to self-esteem than did Type B subjects. The Type A subjects also employed more suppression in response to both threat to self-esteem and threat of shock and employed more denial in response to threat to self-esteem than did Type B subjects. Implications regarding the means by which Type A behavior increases the risk of premature heart disease are discussed.

Hostility, anger expression, cardiovascular responsivity, and social support

Sixty male subjects completed the Cook-Medley Hostility Scale (Ho), the anger-in, anger-out, and anger-discuss measures of anger expression from the Framingham Heart Study, and a measure of social support. Subjects also performed two challenging tasks while systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) were monitored. Neither SBP, DBP, nor PR responses to the tasks were found to be related to the Ho or anger expression scales. Quality of social support was not found to be related to the Ho scale but was related negatively to the anger-discuss scale. The more subjects reported discussing their anger with others, the less social support they reported having. A negative correlation was found between the Ho and anger-out scales. The possibility is discussed that the relation between either of these two measures and coronary heart disease may be mediated or moderated by the other variable.

Family history of hypertension, gender, and cardiovascular reactivity and stereotypy during stress

Thirty subjects with a family history of hypertension and 28 subjects without such a history performed a Stroop Color-Word Interference task, a mental arithmetic task (serial subtraction of sevens), and a shock avoidance task (repeating digits backward while expecting to be shocked for mistakes). Systolic and diastolic blood pressure and pulse rate were recorded while subjects anticipated, undertook, and recovered from the shock avoidance task and undertook and recovered from the Stroop and mental arithmetic tasks. It was found that compared to nonfamily history subjects, family history subjects manifested reliably greater cardiovascular reactivity during each task and in anticipation of the shock avoidance task. These results are congruent with the notion that excessive sympathetic nervous system reactivity—possibly genetically determined—is involved in the development of some form(s) of essential hypertension. Further, the results indicated that family history subjects manifested greater consistency, or stereotypy, of cardiovascular response across the experimental tasks than nonfamily history subjects. The possible role of cardiovascular stereotypy in the development of essential hypertension is also discussed.

Hostility in Employed Women Relation to Work and Marital Experiences, Social Support, Stress, and Anger Expression

Ninety-one women employed full-time outside the home were administered the Cook-Medley Hostility Scale. Information concerning various work -and nonwork-related variables was obtained by questionnaire and interview. Women with higher hostility scores reported having more stressful job experiences and feeling more daily stress and tension. Hostility scores were not found to be significantly related to stressful marital experiences or quality of general social support, although there were trends for hostility scores to be negatively related to social support from specific sources-namely, the womens supervisors and husbands. Finally, higher hostility scores were found to be related to greater outward expression of anger. The possibility is mentioned that having more stressful work and other daily experiences may contribute to mediating the relation between the Cook-Medley Hostility Scale and coronary artery disease in women.

Hostility-related variables and plasma lipid levels

The present study was conducted to examine whether lipid levels would be related to cynical hostility (an attitudinal component of hostility), expressive hostility (a behavioral component of hostility), and neurotic hostility (an emotional component of hostility). Subjects were 74 men and 54 women who were free of potential medical factors affecting lipoprotein levels. Across both genders, expressive hostility was found to be positively related to total cholesterol and low-density lipoprotein (LDL). Neurotic hostility was not related to lipid levels for either men or women. These results are congruent with other evidence, suggesting that expressive hostility but not hostile emotions contributes to atherogenesis. For men but not women, cynical hostility was found to be positively related to LDL. These results for men are congruent with findings, albeit not consistent, of a relation between cynical hostility and coronary artery disease.

Type A behavior in employed women: Relation to work, marital, and leisure variables, social support, stress, tension, and health.

Ninety-one women employed full-time were administered the Jenkins Activity Survey (JAS; Jenkins, Rosenman, & Zyzanski; 1974) and the Framingham Type A Scale (FTAS; Haynes, Levine, Scotch, Feinleib, & Kennel, 1978). Information concerning various work and nonwork-related variables was obtained via questionnaire or interview. Type A women had higher occupational levels and reported more demanding jobs and higher stress and tension than Type B women. Type A and B women did not differ in their reports of marital adjustment or in total hours spent in leisure activities. Type A behavior was related to both self-reported stress and tension--and for married women only, poorer self-reported physical health. Social support from various sources was not found to be related to Type A or Type B. Curiously, Type A was related to more reported stress and tension for women who felt they had many sources of support but not for women who did not perceive their having many sources of support.

Heritability of hostility-related emotions, attitudes, and behaviors

Hostility-related variables have been categorized as to kinds of emotions, attitudes, and behaviors. Relatively few studies have explored whether genetic factors contribute to individual differences in these variables. Moreover, the majority of this research has involved male subjects. The present study utilized the twin method to evaluate the influence of genetic factors on hostility-related emotions, namely, trait anger and irritability, hostility-related attitudes, namely cynical hostility and suspiciousness, and hostility-related behaviors, namely, physical, verbal, and indirect aggression in adult women. Responses on the measure of trait anger showed evidence of significant heritability. However, evidence for a genetic component to responses on the irritability scale was less clear. There was no support for the notion of a genetic component to the measure of suspiciousness, and the evidence of a genetic contribution for cynical hostility was not significant. It was expected that due to environmental influences for women, only certain forms of aggression would show genetic variance, namely, verbal and indirect as opposed to physical forms. The results were generally congruent with these expectations.

Assessing Hostile Automatic Thoughts: Development and Validation of the HAT Scale

Similar to the measurement of automatic thoughts in depressed persons (Hollon & Kendall, 1980), the Hostile Automatic Thoughts (HAT) Scale was developed and validated as a 30-item self-report index. Comprised of three components, the HAT Scale reflects recurring hostile thoughts that involve physical aggression (11 items), derogation (10 items), and revenge (9 items) toward other people. In a first study, the procurement of an item pool reflecting a full array of hostile thoughts is described, along with exploratory factor analysis, item selection, internal reliability, and convergent and discriminant validation information. In a second cross-validational study, the factor structure is substantiated via confirmatory factor analyses, as is the internal reliability, and the convergent and discriminant validity. The findings related to the HAT Scale are reviewed, including its use as a state, trait, or situation-specific index.