Richard J. Contrada

Self-regulation, health, and behavior: A perceptual-cognitive approach

Abstract Self-regulation systems are designed to adapt to threats via coping procedures that make efficient use of resources based upon valid representations of the environment. We discuss two components of the common-sense model of health threats: illness representations (e.g., content and organization) and coping procedures (e.g., classes of procedure and their attributes - outcome expectancies, time-lines, dose-efficacy beliefs, etc.). Characteristics of each of these domains, and the connection between the two, are critical to understanding human adaptation to problems of physical health. Rather than posing a barrier to factors outside the person that control behavior, an emphasis on subjective construal involves a view of the person as an active problem-solver embedded in a bidirectional system of sensitivity and responsiveness vis a vis the social, physical, and institutional environments in which health threats occur and through which intervention efforts may be directed.

Coping with racism: a selective review of the literature and a theoretical and methodological critique

Racism is a stressor that contributes to racial/ethnic disparities in mental and physical health and to variations in these outcomes within racial and ethnic minority groups. The aim of this paper is to identify and discuss key issues in the study of individual-level strategies for coping with interpersonal racism. We begin with a discussion of the ways in which racism acts as a stressor and requires the mobilization of coping resources. Next, we examine available models for describing and conceptualizing strategies for coping with racism. Third, we discuss three major forms of coping: racial identity development, social support seeking and anger suppression and expression. We examine empirical support for the role of these coping strategies in buffering the impact of racism on specific health-related outcomes, including mental health (i.e., specifically, self-reported psychological distress and depressive symptoms), self-reported physical health, resting blood pressure levels, and cardiovascular reactivity to stressors. Careful examination of the effectiveness of individual-level coping strategies can guide future interventions on both the individual and community levels.

Repressive coping and verbal-autonomic response dissociation: The influence of social context.

This study examined whether verbal-autonomic response dissociation in repressive copers is potentiated by conditions that enhance social evaluative concerns. Women classified as repressive, low-anxious, or high-anxious gave a self-disclosing speech in either a private condition (a single researcher observed) or a public condition (3 researchers ostensibly observed). Repressors exhibited heart rate elevations that were greater in magnitude than their self-reports of negative affect, but only in the public condition. High-anxious Ss in both conditions showed an opposite pattern of verbal-autonomic dissociation in which self-reported negative affect exceeded cardiac response. Low-anxious Ss in both conditions showed little responsivity in either channel. Results are interpreted within a self-regulatory framework in which differences in self-concept in the domain of emotionality predispose repressive and high-anxious individuals to engage in contrasting, emotion-focused coping styles.

Psychosocial Factors in Outcomes of Heart Surgery: The Impact of Religious Involvement and Depressive Symptoms

This article reports a prospective study of religiousness and recovery from heart surgery. Religiousness and other psychosocial factors were assessed in 142 patients about a week prior to surgery. Those with stronger religious beliefs subsequently had fewer complications and shorter hospital stays, the former effect mediating the latter. Attendance at religious services was unrelated to complications but predicted longer hospitalizations. Prayer was not related to recovery. Depressive symptoms were associated with longer hospital stays. Dispositional optimism, trait hostility, and social support were unrelated to outcomes. Effects of religious beliefs and attendance were stronger among women than men and were independent of biomedical and other psychosocial predictors. These findings encourage further examination of differential health effects of the various elements of religiousness.

Ethnicity-Related Sources of Stress and Their Effects on Well-Being

Early research on ethnicity focused on the stereotyped thinking, prejudiced attitudes, and discriminatory actions of Euro-Americans. Minority-group members were viewed largely as passive targets of these negative reactions, with low self-esteem studied as the main psychological outcome. By contrast, recent research has increasingly made explicit use of stress theory in emphasizing the perspectives and experiences of minority-group members. Several ethnicity-related stressors have been identified, and it has been found that individuals cope with these threats in an active, purposeful manner. In this article, we focus on ethnicity-related stress stemming from discrimination, from stereotypes, and from conformity pressure arising from ones own ethnic group. We discuss theory and review research in which examination of ethnicity-related outcomes has extended beyond self-esteem to include psychological and physical well-being.

Alexithymia and Repression: Contrasting Emotion-Focused Coping Styles

&NA; A number of conceptually similar emotion‐focused coping styles have been related to physical well‐being. We assessed the relationship between two of these constructs, alexithymia and repressive coping, on the basis of both psychometric and psychophysiological comparisons. Questionnaires were used to classify 86 healthy female subjects as low anxious, high anxious, or repressors. These subjects then completed a self‐report measure of alexithymia and participated in a stressful laboratory task in which they delivered a self‐disclosing speech. Emotional response patterning was assessed by comparing self‐reported negative affect to heart rate responses elicited during the stressful speech task. Results indicated that the alexithymia scores of high anxious subjects were significantly greater than those of repressors. Consistent with the psychometric data, high alexithymics exhibited an emotional response pattern characteristic of high anxious subjects (self‐reported negative affect greater than heart rate), whereas low alexithymics exhibited a response pattern characteristic of repressors (heart rate greater than self‐reported negative affect). The results suggest that alexithymia and repressive coping are quite distinct, with repression being more similar to low alexithymia than to high alexithymia.

Type A behavior, personality hardiness, and cardiovascular responses to stress.

Type A behavior and hardiness were examined as predictors of cardiovascular responses to stress in 68 male undergraduates. Systolic and diastolic blood pressure (SBP and DBP) and heart rate were monitored while subjects performed a difficult mirror-tracing task. Type A assessments based on the Structured Interview, but not those based on the Jenkins Activity Survey, were associated with significantly enhanced SBP and DBP elevations. Hardiness was associated with significantly reduced DBP responsiveness. In addition, a significant interaction indicated that the Type B-high hardiness group showed the least DBP reactivity. A near-significant interaction (p = .06) suggested that Type B-high hardiness subjects also reported the least anger. Further exploration of the data indicated that the challenge component of hardiness accounted for its relationship to DBP reactivity. These results have implications both for the psychophysiologic study of Type A behavior and for understanding the health-promoting effects of hardiness.

Task difficulty, cardiovascular response, and the magnitude of goal valence.

Sixty-four young women expected to perform an easy, moderately difficult, or extremely difficult memory task with the opportunity to earn a small incentive for good performance. Cardiovascular (heart rate, systolic and diastolic blood pressure) and subjective measures were taken immediately prior to task performance. Both systolic blood pressure (SBP) responses and ratings of goal attractiveness were nonmonotonically related to expected task difficulty, with the most pronounced SBP elevations and highest goal attractiveness in the moderately difficult task condition. Product-moment correlations among cardiovascular response measures revealed a strong positive association between systolic and diastolic pressure (but not heart rate) change in the easy condition, positive relationships among all measures in the moderately difficult condition, and no significant correlations in the extremely difficult condition. Subjective measures of arousal were not affected by the task difficulty manipulation. Principal findings are discussed in terms of a theoretical model proposed by Brehm (1979) that states that motivation varies as a nonmonotonic function of the difficulty of goal attainment. Intercorrelations among cardiovascular response variables are considered in terms of their possible indication of the mechanisms underlying blood pressure changes associated with variations in motivation.

Trait Hostility and Ambulatory Cardiovascular Activity: Responses to Social Interaction

This study examined trait hostility and social interaction in relation to ambulatory cardiovascular activity in 40 male and 39 female undergraduates. Participants wore an ambulatory blood pressure monitor and completed diary entries while engaged in everyday activities. Diary reports indicating that participants had been talking were used to identify cardiovascular readings taken during social interaction. Interaction effects for overall diastolic blood pressure and heart rate levels indicated that hostility was positively associated with these variables in men only. In addition, hostility was associated with higher systolic blood pressure during social interaction, an effect primarily due to data for men. Because physical activity was controlled statistically, it is likely that these effects were mediated by psychological processes. These findings are consistent with the hypothesis that cardiovascular reactivity to social interaction mediates the relationship between hostility and coronary disease, and they may have implications for understanding sex differences in coronary risk.

Quality of Life Following Cardiac Surgery: Impact of the Severity and Course of Depressive Symptoms

Objectives: The purpose of this study was to examine the impact of the severity and course of depressive symptoms on change in quality of life (QOL) 6 months after cardiac surgery. Methods: Ninety patients were interviewed before heart surgery and 2 and 6 months after surgery. Depressive symptoms were assessed using the Beck Depression Inventory, and QOL was assessed using physical and psychosocial functioning indices derived from the Medical Outcomes Study instrument. Multiple regression examined the effects of the severity and course of depressive symptoms on QOL adjusting for demographic and biomedical predictors. Results: Higher levels of presurgical depressive symptoms predicted poorer physical functioning after cardiac surgery. A similar effect on psychosocial functioning fell short of significance. An increase in depressive symptoms 2 months after surgery was significantly predictive of poorer physical and psychosocial functioning at 6 months. The effect of increased depressive symptoms on psychosocial functioning was significantly stronger in patients with high presurgical Beck Depression Inventory scores. Conclusions: Both preoperative depressive symptoms and postoperative increases in depressive symptoms seem associated with poorer QOL 6 months after cardiac surgery. Further examination of these associations and the mechanisms they reflect may provide a basis for guiding treatment decisions before and after coronary artery bypass graft surgery. BDI = Beck Depression Inventory; CABG = coronary artery bypass graft surgery; MI = myocardial infarction; MOS = Medical Outcomes Study; QOL = quality of life; SF-36 = MOS 36-item short form health survey.