Kevin T. Larkin

Psychophysiologic Reactivity as a Dimension of Individual Differences

Studies of hemodynamic and neuroendocrine reactions to behavioral stimuli comprise a substantial portion of laboratory research in cardiovascular behavioral medicine. It is widely thought that exaggerated physiologic responses to psychological challenge, or stress, may be implicated in the etiology or clinical expression of certain cardiovascular disorders, including coronary heart disease and essential hypertension (Manuck & Krantz, 1986). As described in the previous chapter, behaviorally elicited physiologic reactions vary in their magnitude and patterning, in part, as a function of the nature of the eliciting stimuli (i. e., stimulus specificity). It is also well established that individuals exposed to the same experimental stimulus exhibit marked variability in cardiovascular and neuroendocrine responses. The present chapter addresses several issues relating to the latter phenomenon, individual differences in psychophysiologic reactivity. Considered specifically are three attributes of individual differences that have significance for current hypotheses linking cardiovascular and neuroendocrine reactivity to aspects of cardiovascular disease: (1) the temporal stability of individual differences in psychophysiologic reactivity; (2) the reproducibility of these individual differences under varying stimulus conditions; and (3) the generalization of individual differences in physiologic responses from laboratory evaluations to measurements obtained in field (or natural) settings. Consideration of these issues is preceded by a discussion of common aspects of protocols used in psychophysiologic assessment, as well as of related matters regarding the quantitative expression of individual differences in reactivity.

Biofeedback of Heart Rate Variability and Related Physiology: A Critical Review

Low heart rate variability (HRV) characterizes several medical and psychological diseases. HRV biofeedback is a newly developed approach that may have some use for treating the array of disorders in which HRV is relatively low. This review critically appraises evidence for the effectiveness of HRV and related biofeedback across 14 studies in improving (1) HRV and baroreflex outcomes and (2) clinical outcomes. Results revealed that HRV biofeedback consistently effectuates acute improvements during biofeedback practice, whereas the presence of short-term and long-term carry-over effects is less clear. Some evidence suggests HRV biofeedback may result in long-term carry-over effects on baroreflex gain, which is an area most promising for future investigations. On the other hand, concerning clinical outcomes, there is ample evidence attesting to efficacy of HRV biofeedback. However, because clinical and physiological outcomes do not improve concurrently in all cases, the mechanism by which HRV biofeedback results in salutary effects in unclear. Considerations for the field in addressing shortcomings of the reviewed studies and advancing understanding of the way in which HRV biofeedback may improve physiological and clinical outcomes are offered in light of the reviewed evidence.

The effect of social support and physical touch on cardiovascular reactions to mental stress

To examine the effects of social support on cardiovascular reactions to behavioral stress, the present study tested the relative contribution of three elements of social support: the presence of another person in the laboratory; the presence of a person considered to be a friend; and physical touch. Sixty undergraduate females were assigned to one of the following groups: alone (A); friend present-touch (FT); friend present-no touch (FNT); stranger present-touch (ST); and stranger present-no touch (SNT). Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) measures were obtained across baseline phases and during presentation of two behavioral challenges (mental arithmetic, mirror-tracing). The findings suggest that neither the presence of a stranger nor physical touch are related to attenuated cardiovascular reactions to stress; rather, if the extent of cardiovascular reactivity is related to social support, the presence of a friend may be the important mediating variable.

Competencies for psychology practice in primary care.

This article reports on the outcome of a presidential initiative of 2012 American Psychological Association President Suzanne Bennett Johnson to delineate competencies for primary care (PC) psychology in six broad domains: science, systems, professionalism, relationships, application, and education. Essential knowledge, skills, and attitudes are described for each PC psychology competency. Two behavioral examples are provided to illustrate each competency. Clinical vignettes demonstrate the competencies in action. Delineation of these competencies is intended to inform education, practice, and research in PC psychology and efforts to further develop team-based competencies in PC.

Anticipation of Performance among Musicians: Physiological Arousal, Confidence, and State-Anxiety

Physiological responses (heart rate and blood pressure) and self-report measures of state-anxiety and confidence were obtained in 22 student musicians during a baseline-laboratory session and before a jury. All participants exhibited increased heart rate, systolic blood pressure, diastolic blood pressure, and self-reported anxiety from the laboratory to the jury. Males exhibited higher systolic blood pressure increases prior to the jury compared to females, but females exhibited higher self-reported anxiety than males. Additionally, females reported increased confidence prior to the jury and males did not. Individuals with higher heart rate increases before the jury reported less confidence and somewhat higher self-reported anxiety.

Validation of the Polar Heart Rate Monitor for Assessing Heart Rate During Physical and Mental Stress

Abstract The Polar Vantage XL heart rate monitor provides an ambulatory, inexpensive method of continuously measuring heart rate. To examine the validity of the Polar monitor for measuring heart rate during resting periods and while engaging in two stressful tasks, 30 students participated in a 1-hour laboratory session. Heart rates were measured simultaneously using the Polar monitor and electrocardiography (ECG) during a hand grip exercise and a mental arithmetic task, each preceded by a 4-min resting period. Within-subject correlations between the two devices were significant (mean r = 0.98, P < .001). All correlations, except for three participants, exceeded r = 0.90. Between-task correlation analyses revealed high correlations (i. e., rs ≥ 0.98) between the Polar monitor and ECG. The Polar monitor obtained readings that were slightly, though significantly higher than readings obtained using ECG. The correspondence between observed mean heart rates from the Polar monitor and ECG suggest that the Polar...

Application of the Competency Model to Clinical Health Psychology

In response to the growing emphasis on defining professional competence within applied psychology (e.g.,clinical, neuropsychology, counseling, school), in 2007 American Psychological Association Division 38(Health Psychology) sponsored a summit meeting with a specific focus on revisiting the standards of graduatecurricula and training in clinical health psychology. Using the cube model of core competency domains ofprofessional psychology as a framework, summit participants were charged with identifying the foundationaland functional competencies expected of a well-trained, entry-level clinical health psychologist. As a productof these discussions, the present article is presented as an initial effort to identify the competencies and beginthe discussion in clinical health psychology. As such it is likely to be of interest to a wide audience, includingclinical training programs with an existing or planned emphasis in clinical health psychology, practitionersinterested in acquiring the competencies required to practice as a clinical health psychologist, and studentsevaluating potential graduate and postgraduate training options in clinical health psychology.Keywords: clinical, health psychology, competencyC

Cynical Hostility and the Accuracy of Decoding Facial Expressions of Emotions

To examine the relation between cynical hostility and the accuracy of decoding facial expressions of emotions, 101 young adult participants completed the Cook–Medley Hostility Scale and Ekmans Pictures of Facial Affect. Results revealed that higher hostility scores were correlated with a greater number of errors in decoding facial expressions of emotions. Hostile individuals were more likely than nonhostile individuals to label inaccurately facial expressions of “disgust” as being “anger” and of “happiness” as being “neutral.” Results also revealed that males were more likely than females to label incorrectly facial expressions of disgust as anger. Partial correlations, controlling for gender, revealed that the relation between hostility and inaccurate perceptions of facial portrayals of happiness was significant, whereas the relation between hostility and inaccurate perceptions of facial displays of disgust was no longer significant.

Perceived stress and anxiety sensitivity in the prediction of anxiety-related responding: A multichallenge evaluation

We have provided a laboratory evaluation of emotional reactivity to physiological (hyperventilation), cognitive (mental arithmetic), and social (speech) challenge procedures, and investigated how preexperimental levels of perceived stress, anxiety sensitivity, and negative-evaluation sensitivity predicted anxious and fearful responding. Participants were 37 nonclinical individuals. Dependent measures included a multimethod assessment involving self-reported anxiety, frequency and intensity of bodily sensations, and heart rate and blood pressure responses to the challenges. Our results indicated that preexperimental levels of perceived stress were more predictive than other theoretically relevant variables of self-reported anxiety-related reactivity to cognitive and social challenges, whereas anxiety sensitivity was a better predictor of the emotional response to hyperventilation. Collectively, these findings are consistent with theoretical accounts of anxiety pathology, and suggest that perceived stress is an important process variable to consider in understanding the determinants of anxiety-related responding.

Psychophysiological arousal in older adults: a critical review.

In spite of the relatively high prevalence rates of anxiety disorders (AD) and related symptoms, very little is known about the experience, presentation, and assessment of anxiety in later life. Because the physiology of the autonomic nervous system changes with age, an enhanced understanding of how these developmental changes affect the somatic-physiological response patterns to anxiety-evoking stimuli among older adults may help explain whether we can generalize current assessment and treatment practices and procedures for AD from younger to older adults. In this paper, we describe and critically evaluate studies that have employed psychophysiological recording of autonomic arousal to anxiety-arousing or stressful stimuli among samples of younger and older adults. The conclusions one can draw from the review are quite limited by both the paucity of relevant literature and the methodological limitations of the published studies.