Circulating human heat shock protein 60 in the plasma of British civil servants: relationship to physiological and psychosocial stress.

Background: The Whitehall cohort studies (I and II) of British civil servants have identified sociodemographic, psychosocial, and biological risk factors for coronary heart disease (CHD). To identify mechanisms responsible for susceptibility to CHD, specific biological markers of stress are increasingly being measured. One marker linked to susceptibility to CHD is heat shock protein (Hsp) 60.

Greater intima-media thickness in the carotid bulb is associated with reduced baroreflex sensitivity.

The aim of this study was to evaluate the association between resting baroreflex sensitivity (BRS) and carotid intima-media thickness (IMT), a putative marker of subclinical atherosclerosis. Participants were 64 men and 18 women (median age, 57 years; range, 40 to 70 years), who did not have a previous history of coronary artery disease or treatment for hypertension. Resting BRS was measured during a 9-min baseline period using the noninvasive sequence technique; carotid IMT was subsequently determined using ultrasonography.

Pre-morbid predictors of psychological adjustment to cancer.

This study examined the potential role of social support, neuroticism, and self-efficacy as predictors of the short-term and long-term adaptation to the diagnosis of cancer. Psychological adjustment was defined in terms of psychological distress. It is argued that these factors may provide insights that might be helpful in the provision of medical care to patients.

Coping and health service utilisation in a UK study of paediatric sickle cell pain.

Aims: To assess sickle cell pain and coping in children and to examine the relation between these factors and the utilisation of health services.

Methods: Cross sectional study involving 67 children with sickle cell disease attending three London hospitals. Interviews and questionnaires involved measures of pain, health service utilisation, and coping responses (measured with the Coping Strategies Questionnaire (CSQ), revised for children with sickle cell disease).

The contribution of gender-role orientation, work factors and home stressors to psychological well-being and sickness absence in male- and female-dominated occupational groups.

The associations of work stress, types of work and gender-role orientation with psychological well-being and sickness absence were investigated in a questionnaire survey of 588 male and female nurses and 387 male and female accountants. We hypothesised that health might be impaired among women working in the male-dominated occupation (accountancy), and men in the female-dominated occupation (nursing), but that effects might be moderated by job strain (perceptions of high demand and low control), work and home hassles, and traditional male (instrumentality) and female (expressivity) psychological characteristics. Responses were analysed from 172 female and 61 male nurses, and from 53 female and 81 male commercial accountants.

Health behaviour, risk awareness and emotional well-being in students from Eastern Europe and Western Europe.

Life expectancy and other indices of health have deteriorated markedly in the former socialist countries of Eastern Europe over recent decades. The possible roles of lifestyles, knowledge about health and behaviour, emotional wellbeing and perceptions of control were assessed in a cross-sectional survey of young adults of similar educational status in Eastern and Western Europe. As part of the European Health and Behaviour Survey, data were collected in 1989-1991 from 4170 university students aged 18-30 years from Austria, Belgium, the Federal Republic of Germany, the Netherlands and Switzerland, and from 2293 students from the German Democratic Republic, Hungary and Poland.

Locus of control and health behaviour revisited: a multivariate analysis of young adults from 18 countries.

The inconsistent and small associations between health locus of control and health behaviour found in previous studies may be due to the use of small samples, and an overreliance on correlations as measures of association. We assessed relationships between internal powerful others and chance health locus of control, health values, and ten health-related behaviours (physical exercise, smoking, alcohol consumption, breakfast, tooth-brushing, seat belt use, and consumption of fruit, fat, fibre and salt) in 4358 female and 2757 male university students from 18 European countries. Multivariate logistic modelling, assessing the odds of engaging in healthy behaviour with graded changes in locus of control, identified substantial associations.

The structure of symptom report in asthma: a reevaluation.

Objectives: We studied the structure of symptom report in a sample of British asthma patients using the Asthma Symptom Checklist (ASC).

Methods: The ASC was administered to 193 patients, together with a questionnaire on demographics and asthma-related information and the Perceived Control of Asthma Questionnaire.

Results: Principal Component Analysis yielded evidence for a six-dimensional structure of the ASC, with positively correlated subscales for panic-fear, irritation, obstruction-dyspnea, obstruction-congestion, fatigue, and hyperventilation symptoms.

Psychosocial factors and adherence to treatment advice in childhood atopic dermatitis.

Poor adherence to maintenance treatment for atopic dermatitis and anxiety about using topical steroids are common features seen among children with atopic dermatitis and their mothers. No systematic study exploring factors associated with adherence to treatment advice on atopic dermatitis has been carried out to date. This study seeks to generate hypotheses regarding the relationship between a range of psychosocial factors and adherence to treatment advice on atopic dermatitis.

Social support at work, heart rate, and cortisol: a self-monitoring study.

This study assessed the influence of work social support on self-monitored heart rate, blood pressure, and salivary cortisol recorded on 3 work days and 2 leisure days from 61 nurses and 32 accountants (40 men, 53 women). Heart rate and blood pressure were higher during the day at work than in the evening or on leisure days. Cortisol was higher on leisure than work days and was lower in the evening than in the day.

Blood pressure reactions to acute psychological stress and future blood pressure status: a 10-year follow-up of men in the Whitehall II study.

Objective: The aim of this study was to examine whether blood pressure reactions to mental stress predicted future blood pressure and hypertension.

Methods: Blood pressure was recorded at an initial medical screening examination after which blood pressure reactions to a mental stress task were determined. A follow-up screening assessment of blood pressure and antihypertensive medication status was undertaken 10 years later.

Neighborhood problems as sources of chronic stress: development of a measure of neighborhood problems, and associations with socioeconomic status and health.

The impact of the residential neighborhood on health and well-being is being increasingly recognized in behavioral medicine, with evidence for neighborhood-level effects that are independent of the individual characteristics of residents. This study addressed the possibility that the effects of neighborhood are due in part to exposure to community-wide stressors rather than variations inprotective factors such as social capital. A questionnaire survey including a 10-item neighborhood problems scale and measures of self-reported health, health behaviors, and social capital was completed by 419 residents of 18 higher socioeconomic status (SES) neighborhoods and 235 residents of 19 lower SES neighborhoods.

Acute mental stress elicits delayed increases in circulating inflammatory cytokine levels.

The influence of acute mental stress on cardiovascular responses and concentrations of inflammatory cytokines up to 2 h later was assessed in 12 subjects exposed to stress and in eight control subjects. Beat-by-beat recordings of finger blood pressure and heart rate were made at rest and during two behavioural tasks (colour-word interference and mirror tracing). Blood was drawn after adaptation and at 45 min and 2 h after the tasks, and assayed for interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), interleukin-1 receptor antagonist (IL-1Ra), C-reactive protein (CRP) and haematocrit.

Depressive symptoms, social support, and personal health behaviors in young men and women.

This study investigated the relationship of depressive symptoms, social support, and a range of personal health behaviors in 2,091 male and 3,438 female university students from 16 countries. Depressive symptoms and social support were measured using the short Beck Depression Inventory and the Social Support Questionnaire; 9 personal health behaviors were also assessed. After the authors took age, social support, and clustering by country into account, depressive symptoms were significantly associated with lack of physical activity, not eating breakfast, irregular sleep hours, and not using a seat belt in both men and women, and additionally with smoking, not eating fruit, and not using sunscreen among women.

Job control, perceptions of control, and cardiovascular activity: an analysis of ambulatory measures collected over the working day.

Objective: To assess the influence of job control as a personal characteristic, and momentary perceptions of lack of control, on blood pressure and heart rate monitored over the working day.

Methods: The study was carried out with a sample of 122 school teachers (45 men, 77 women), divided into high and low job control groups on a standard questionnaire. Blood pressure and heart rate were measured every 20 min using ambulatory techniques, and ratings of concurrent perceived control were also obtained.

Psychological, cardiovascular, and metabolic correlates of individual differences in cortisol stress recovery in young men.

The relationship of free salivary cortisol stress recovery and basal cortisol with psychological, cardiovascular and metabolic factors was investigated in 82 healthy young men. Blood pressure, heart rate, cortisol and mood were assessed during a single laboratory session involving mental arithmetic and speech tasks, and lipid profiles were analysed from a fasting blood sample. Participants were divided into high (n=31) and low (n=51) cortisol stress recovery groups on the basis of the magnitude of changes between the peak cortisol responses to tasks and the lowest levels recorded at the end of a 30 min post-stress rest period.

The impact of behavioral counseling on stage of change in fat intake, physical activity, and cigarette smoking in adults at increased risk of coronary heart disease.

Objectives: This study assessed stages of change in fat intake, physical activity, and cigarette smoking during a randomized controlled trial of behavioral counseling.

Methods: Twenty general practices (primary health care centers) were randomized to lifestyle counseling by behavioral methods or to usual health promotion. A total of 883 patients were selected for the presence of 1 or more of the following risk factors: cigarette smoking, high cholesterol, or a combination of a high body mass index and low physical activity.

Emotion and pulmonary function in asthma: reactivity in the field and relationship with laboratory induction of emotion.

Objective: We investigated the modulation of pulmonary function by mood states in the daily life of asthmatic patients and nonasthmatic control subjects and its relationship to the airway effects of laboratory induction of emotion using films.

Methods: Twenty asthmatic patients and 20 nonasthmatic control subjects participated in a laboratory session in which various emotions (ie, anxiety, anger, depression, happiness, elation, contentment, and neutrality) were induced by films. Respiratory resistance (Ros) was measured by forced oscillation.

Mental stress induces transient endothelial dysfunction in humans.

Background: Mental stress has been linked to increased morbidity and mortality in coronary artery disease and to atherosclerosis progression. Experimental studies have suggested that damage to the endothelium may be an important mechanism.

Methods And Results: Endothelial function was studied in 10 healthy men (aged 50.

Sociodemographic and psychological predictors of changes in dietary fat consumption in adults with high blood cholesterol following counseling in primary care.

The associations between sociodemographic variables, psychological factors, and changes in dietary fat consumption over 4 months were assessed in a randomized controlled trial of behavioral counseling versus standard advice. Patients were 141 men and 150 women, with an average age of 52.1 years and total cholesterol level of 7.

Migration, culture conflict and psychological well-being among Turkish-British married couples.

This study assessed culture conflict within marriage and the psychological well-being of Turkish men and women and their British partners. The hypothesis was tested that among migrants who are well established economically and socially within a new country, the perception of cultural conflict within marriage might override acculturation as a determinant of psychological well-being. Interviews were carried out with 33 relatively affluent Turkish men (n = 23) and women (n = 10) who had been born in Turkey and had been resident in the UK for an average of 12.

Psychosocial factors in the development of hypertension.

The role of psychosocial factors in human hypertension is being investigated with three research strategies: epidemiological studies of blood pressure, psychological characteristics and life experience in population samples, naturalistic studies of the covariation between blood pressure, psychological state and everyday life events, and experimental studies of cardiovascular and neuroendocrine responses to behavioural stimuli. This article summarizes recent research on hypertension and psychological traits, job characteristics and social support, emphasizing the convergent knowledge deriving from complementary research strategies. The roles of stress-induced cardiovascular responses and prejudicial life styles in mediating influences on risk of hypertension are discussed.

Psychosocial predictors of changes in physical activity in overweight sedentary adults following counseling in primary care.

Background: Increasing regular physical activity in adults at elevated risk of cardiovascular disease is an important target for preventive medicine. This study evaluated demographic, social and cognitive predictors of self-reported changes in physical activity after 4 and 12 months in a randomized trial of behavioral counseling in primary care.

Method: Data were analyzed from 234 male and 271 female sedentary patients with a body mass index of 25-35 (age 49.

Stress, social support and cardiovascular activity over the working day.

The influence of stress on ambulatory blood pressure monitored over the working day, and the potential buffering effect of social support, was assessed in 104 school teachers (37 men and 67 women). Blood pressure and heart rate were measured every 20 min and energy expenditure was assessed using accelerometers. Participants rated the degree of stress they were experiencing at the time of each measurement on a seven-point scale.