Jack Sparacino

Type A behavior pattern and hypertension among inner-city black women.

Inner-city Black women were administered Rosenman and Friedmans A-B interview and invited to discuss stress experiences and traditional coronary heart disease risk factors while their blood pressure was monitored at two-minute intervals. Results revealed the essential reliability of the A-B classification for the sample and demonstrated a general congruence with type A behaviors reported in previous (mostly white male) samples. While type A Black women were not significantly more likely to be hypertensive than type B women, analyses of the intrasubject blood pressure variability revealed an interaction between A-B and hypertensive-normotensive status. Consistent with earlier findings, hypertensives were more variable than normotensives, but this was true only for type Bs: type As were intermediate and not differentiated in their variability. This finding calls attention to the possible adaptive function of type A behavior among stressed inner-city Black females and raises the question of whether Rosenman and Friedmans personality theory might be objectionably simplistic.

Self-monitoring and blood pressure.

The association between self-monitoring (regulation and control of nonverbal and expressive behavior) and blood pressure was examined in a field study of 594 municipal employees. For persons not taking antihypertensive medication, the Acting/Extraversion scale was mildly positively associated with resting blood pressure among whites in general, blue collar, clerical, and professional groups. Stronger positive correlations were obtained for attorneys and customer service representatives. These results are contrasted with slightly negative associations for blacks in general, first-level supervisors, and a group of previously studied union stewards. An interactive effect was also obtained between Acting/Extraversion and relative participation in work versus nonwork groups and activities; Acting/Extraversion and systolic pressure were inversely related for employees more active in extrawork groups but not related among other workers. Differential consequences of greater or lesser interpersonal involvement and emotional regulation in different jobs are considered.

Physical Attractiveness and Blood Pressure Sex and Age Differences

Four studies were conducted to investigate the relationship between physical attractiveness and resting blood pressure. In two samples of adolescents, there were significant sex by attractiveness interaction effects on blood pressure. Unattractive females had significantly higher mean pressures than attractive females, even when controlling for obesity. The attractiveness of males was not generally related to their blood pressures. A fourth study investigated the generalizability of the sex by attractiveness interaction effect to an older sample of adults, but no significant effects were found. Taken together, these results suggested sex and age differences in the motivational salience of physical attractiveness and help illuminate the internal arousal potential of external physical characteristics.

Type A (coronary-prone) behavior and transient blood pressure change.

A study was conducted to delineate further the physiological mechanisms underlying the type A behavior patterns influence on coronary heart disease. It was suggested that while chronically elevated blood pressure is apparently not associated with overall A–B distinctions (at least not for males), acting in a type A fashion may be accompanied by temporary increases in blood pressure. Changes in the speech characteristics of 33 black inner-city women during the A–B interview and subsequent unstructured dialogue were analyzed at one-minute intervals and correlated with concomitant blood pressure measurements. Differences in the speech characteristics of women classified type A as opposed to B were consistent with recent studies of white males (e.g., type As spoke significantly faster than type Bs). Further, within-subject blood pressure elevations were significantly associated with louder/more explosive, longer speech episodes. Additional research is urged which examines biochemical and physiological changes as a function of type A behavior considered as a transient state as well as a relatively enduring trait.

Psychological correlates of blood pressure: a closer examination of hostility, anxiety, and engagement.

Recent studies by other investigators have shown that hypertensives are more hostile and anxious than normotensives. The first part of this study examined the relationship between blood pressure measured daily over a one-week period and responses to a series of questions specifically developed to distinguish hypertensives from normotensives. Responses from this sample of undergraduates did not distinguish those with high blood pressure from those with normal values. Mean resting blood pressure was related to hostility and anxiety factor scores among males but not among females. Our second study used a sample of municipal employees and examined blood pressure as a function of comparable anxiety and hostility scores as well as a trait measure of overall “engagement-involvement.” More highly engaged workers were no different in anxiety or hostility than less engaged workers. There was some evidence of more variable blood pressure for the former group. It is suggested that stable personality traits such as hostility and anxiety may both precede and follow the diagnosis of blood pressure. For nurses it is important to assess the patients general psychological profile as well as his or her emotional state at the time of measurement. Repeated blood pressure readings are recommended especially for highly engaged individuals.

PHYSICAL ATTRACTIVENESS AND OCCUPATIONAL PRESTIGE AMONG MALE COLLEGE GRADUATES

A set of archival data was used to test the hypothesis that physical attractiveness is positively associated with socioeconomic status among men. Consistent with earlier research, more attractive men earned equivalent grades while undergraduates. They were also no more likely to have subsequently earned a graduate degree or to have held jobs characterized by higher status as indexed by Duncan (1961) prestige scores. Attractiveness itself was stable over the 25 yr. for those initially judged to be intermediate in attractiveness. Those who were initially most and least attractive were judged to have declined and increased, respectively, over the period in question, providing evidence for a regression toward the mean.

Density of Dormitory Living and Stress: Mediating Effects of Sex, Self-Monitoring, and Environmental Affective Qualities:

Mediating effects of sex, self-monitoring, and environmental perception were examined in a study of the effects of social density on stress. Subjects were 53 male and 49 female dormitory residents living in single (n=38) vs triple (n=64) occupancy rooms. Measures of stress included blood pressure, heart rate, and psychosomatic symptomatology. It was hypothesized that the potential negative effects of high density would be greatest for males, low self-monitors, and persons judging their environment as relatively arousing and unpleasant. None of the major hypotheses were supported, and there was a tendency for singles to have higher mean systolic and diastolic blood pressure and greater diastolic variability.

Blood pressure, stress, and mental health.

Evidence of the interaction between psychological factors and blood pressure is reviewed with a focus on stressful events and mental health. While the hypertensive personality remains an elusive and perhaps fictional entity, and indices of psychological distress, psychopathology, or poor adjustment do not correlate highly with blood pressure or hypertension, environment stressors such as the threat of unemployment and job pressures adversely affect blood pressure and mental health across groups of individuals. Recent studies suggest that the diagnosis of hypertension may elicit clinically significant psychological distress and anxiety. Adverse reactions to antihypertensive medication may interact with and exacerbate pre-existing distress. Implications for nurses dealing with hypertensive patients are discussed.