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Biomedical subjects

R B Williams

Publications and source records attributed to R B Williams.

At least 289 records · Page 16Linked to original sources
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Cynicism and paranoid alienation in the Cook and Medley HO Scale.

Factor analysis of responses from 1002 men and women were used to define two subscales of the Cook and Medley Hostility Scale. Both the Cynicism and the Paranoid Alienation subscale described attitudes of mistrust and alienation, and both were correlated with MMPI factors measuring aspects of psychopathology. It was suggested that measures of the broader domain of Agreeableness-Antagonism be examined as possible predictors of CHD.

Coronary Disease↗
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Social support, type A behavior, and coronary artery disease.

The interaction of Type A behavior and social support in relation to the degree of coronary artery disease (CAD) severity was investigated. One hundred thirteen patients undergoing diagnostic coronary angiography received the Type A structured interview (SI) and completed a battery of psychometric tests, including the Perceived Social Support Scale (PSSS). Statistical analyses revealed a Type by social support interaction, such that the probability of significant CAD was inversely related to the level of social support for Type As but not Type Bs. Type As with low levels of social support had more severe CAD than Type As with high levels of social support. On the other hand, this relationship was not present for Type Bs. These results are consistent with the hypothesis that social support moderates the long-term health consequences of the Type A behavior pattern.

Adult↗
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Suspiciousness, health, and mortality: a follow-up study of 500 older adults.

Scores on Factor L of the 16 PF, a measure of suspiciousness that is closely related to the Cook and Medley hostility scale, predicted survival in a sample of 500 older men and women during a follow-up of approximately 15 years. Those individuals with scores indicating higher levels of suspiciousness had greater mortality risk. This association remained significant after controlling for age, sex, physician's ratings of functional health, smoking, cholesterol, and alcohol intake. In addition, Factor L was associated with physician's ratings of health at the initiation of follow-up. These findings add to the weight of evidence that implicates a set of negative interpersonal attitudes in the domain of hostility, anger, cynicism, and mistrust as a prospective marker of individuals at risk for adverse health outcomes.

Aged↗
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Opioid dysfunction and risk for hypertension: naloxone and blood pressure responses during different types of stress.

Opioidergic inhibition of sympathetic nervous system responses may be deficient in persons at risk for essential hypertension (McCubbin et al: Hypertension 7:808, 1985). The opiate antagonist naloxone increases blood pressure responses during psychological stress in young adults with low causal blood pressure, but has no pressor effect in subjects with high casual blood pressure. The purpose of the present study was to determine the role of altered baroreflex function in the abnormal pressor effect of naloxone in persons at risk for hypertension development. We tested this by comparison of the effects of naloxone on responses to psychological stress with responses to orthostatic stress in persons with high and low casual blood pressure. The results suggest that abnormal opioidergic control of systolic blood pressure responses to psychological stress is not likely a result of altered baroreflex function. Persons at risk for hypertension show evidence of an opioid peptide lesion that can probably be localized either at the adrenal medullae or at levels of central autonomic control that are parallel with or rostral to baroreflex circuits.

Adolescent↗
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Racial differences in blood pressure and forearm vascular responses to the cold face stimulus.

The mechanisms responsible for the higher incidence of essential hypertension in blacks than in whites are the object of much research attention. One hypothesis is that the development of hypertension in blacks is associated with exaggerated blood pressure reactivity, particularly those responses mediated by vasoconstriction. Racial differences in blood pressure responses to cold stimulation of the forehead, a known alpha-adrenergic vasoconstrictive stimulus, were examined in health, college-age males. Compared to white subjects, black subjects exhibited significantly greater increases in systolic and diastolic blood pressure, as well as increases in forearm vascular resistance, in response to cold stimulation. This preliminary evidence of increased peripheral vascular reactivity in blacks suggests that known racial differences in hypertension prevalence might derive in part from physiological differences in sympathetic nervous system reactivity.

Adolescent↗
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Type A behavior and angiographically documented coronary atherosclerosis in a sample of 2,289 patients.

To determine the relationship between Type A behavior pattern and angiographically documented coronary atherosclerosis (CAD), we analyzed risk factor, behavioral, and angiographic data collected on 2,289 patients undergoing diagnostic coronary angiography at Duke University Medical Center between 1974 and 1980. Multivariable analyses using ordinal logistic regression techniques showed that Type A behavior as assessed by the structured interview (SI) is significantly associated with CAD severity after age, sex, hyperlipidemia, smoking, hypertension, and their various significant interactions were controlled for. This relationship, however, is dependent upon age. Among patients aged 45 or younger, Type A's had more severe CAD than did Type B's; among patients aged 46-54, CAD severity was similar between Type A's and B's; and among patients 55 and older, there was a trend toward more severe CAD among Type B's than among Type A's. These Type A-CAD relationships did not appear to be the result of various factors relating to the selection of patients for angiography. Type A behavior as assessed by the Jenkins Activity Survey was unrelated to CAD severity. These findings suggest that SI-determined Type A behavior is associated with more severe CAD among younger patients referred for diagnostic coronary angiography. The reversal of the Type A-CAD relationship among older patients may be due to survival effects. Inadequate sample sizes, use of assessment tools other than the SI, and failure to consider the Type A by age interaction could account for failures to find a Type A-CAD relationship in other studies. We conclude that the present findings are consistent with the hypothesis that Type A behavior is involved in the pathogenesis of CAD, but only in younger age groups. The Type A effect in the present data is small relative to that of both smoking and hyperlipidemia, however, and future research should focus more specifically on the hostility and anger components of Type A behavior, particularly in younger samples.

Adult↗
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Exercise training in healthy type A middle-aged men: effects on behavioral and cardiovascular responses.

Thirty-six healthy Type A men (means = 44.4 years) were randomly assigned to either an aerobic exercise training group or a strength and flexibility training group. Subjects completed a comprehensive psychological assessment battery before and after the exercise programs consisting of behavioral, psychometric, and psychophysiological testing. The behavioral assessment consisted of repeated Type A interviews that were videotaped for subsequent component analyses. The psychometric testing included two self-report questionnaires to assess Type A behavior. The psychophysiological test consisted of a standard behavioral challenge, a mental arithmetic task, performed while cardiovascular responses were monitored. Aerobic exercise (AE) training consisted of 12 weeks of continuous walking or jogging at an intensity of at least 70% of subjects' initial maximal oxygen consumption (VO2max) as determined by an initial treadmill test. Strength and flexibility (SF) training consisted of 12 weeks of circuit Nautilus training with no aerobic exercise. After 12 weeks of exercise, the AE group increased their VO2max by 15%, while the SF group did not change. Both groups experienced decreases in overt behavioral manifestations of the Type A behavior pattern and self-reported Type A traits. However, the AE group showed an attenuation of heart rate, systolic and diastolic blood pressure, and estimated myocardial oxygen consumption (MVO2) during the task and had lower blood pressure, heart rate, and (MVO2) during recovery. In contrast, the SF group showed a significant reduction only in DBP during the task, which was likely due to habituation. These results support the use of aerobic exercise as a method for reducing cardiovascular risk among healthy Type A men.

Adult↗
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The Cook-Medley hostility scale: item content and ability to predict survival.

Previous studies have identified the MMPI-based Cook and Medley hostility scale (Ho) as a predictor of health outcomes. To achieve a better understanding of the construct measured by this scale, Ho items were classified on an a priori basis. Six subsets were identified: Cynicism, Hostile Attributions, Hostile Affect, Aggressive Responding, Social Avoidance, and Other. Study 1 examined the correlations of these subsets with scales of the NEO Personality Inventory in two samples of undergraduates. Good convergent and discriminant validity were demonstrated, but there was some evidence that items in the Social Avoidance and Other categories reflect constructs other than hostility. Study 2 examined the ability of the Ho scale and the item subsets to predict the 1985 survival of 118 lawyers who had completed the MMPI in 1956 and 1957. As in previous studies, those with high scores had poorer survival (chi 2 = 6.37, p = 0.012). Unlike previous studies, the relation between Ho scores and survival was linear. Cynicism, Hostile Affect, and Aggressive Responding subsets were related to survival, whereas the other subsets were not. The sum of the three predictive subsets, with a chi 2 of 9.45 (p = 0.002), was a better predictor than the full Ho scale, suggesting that it may be possible to refine the scale and achieve an even more effective measure of those aspects of hostility that are deleterious to health.

Adaptation, Psychological↗
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A caution on the use of the MMPI K-correction in research on psychosomatic medicine.

The MMPI K scale is widely used to screen for invalid responses and to adjust substantive scale scores for defensiveness. In a normal volunteer sample, correlations of MMPI clinical scales and the Cook-Medley Hostility (HO) scale with self-reports and peer ratings on the NEO Personality Inventory (NEO-PI) were decreased rather than increased by K-correction. Similarly, in a medical sample, structured interview-based ratings of Potential for Hostility were better predicted by uncorrected HO scores than by K-corrected HO scores. Finally, in a prospective study of mortality among lawyers, uncorrected HO scores were a significant predictor of all-cause mortality; K-corrected scores were not. The data suggest that, under some circumstances, the K scale may measure substantive traits rather than defensiveness, and should be used and interpreted with caution. Its use is probably contraindicated for most research on psychiatrically normal subjects.

Adult↗
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Situational determinants of cardiovascular and emotional reactivity in high and low hostile men.

Various epidemiologic studies have found that high scores on the Cook and Medley Hostility (Ho) scale are associated with increased risk of coronary heart disease (CHD), severity of atherosclerosis, and all-cause mortality. One plausible biological mechanism suspected of contributing to increased risk of CHD is sympathetic nervous system-mediated hyperresponsivity to environmental stressors. The present study evaluated cardiovascular reactivity among young men with high versus low Ho scores during performance of an anagram task with or without harassment. Compared to performing the task alone, harassment led to increased cardiovascular arousal that was more pronounced for the high Ho subjects than the low Ho subjects. Moreover, harassment produced increases in self-rated anger, irritation, and tension, but it was only among those subjects with high Ho scores that increased anger and irritation were associated with enhanced cardiovascular arousal. While suggesting a role for anger- and irritation-induced cardiovascular arousal in pathogenesis of CHD, these findings indicate that situation characteristics mediate the relationship between Ho scores and cardiovascular reactivity, and that there may be a differential biological link between anger/irritation and cardiovascular responses in men with high and low Ho scores.

Adolescent↗
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Caffeine effects on cardiovascular and neuroendocrine responses to acute psychosocial stress and their relationship to level of habitual caffeine consumption.

The effects of a moderate dose of caffeine on cardiovascular and neuroendocrine stress reactivity were examined in 25 healthy male subjects selected as habitual or light consumers of caffeine. Measurements were taken under resting conditions before and after administration of caffeine (3.5 mg/kg) or placebo, during a stressful laboratory task, and in a post-stress recovery period. Caffeine elevated blood pressure and plasma norepinephrine levels at rest, effects which added significantly to the effects of stress. Caffeine potentiated stress-related increases in plasma epinephrine and cortisol stress, more than doubling the responses observed in the control condition. These effects were present in both habitual and light consumers and level of habitual caffeine consumption did not affect their magnitude. Results indicate that caffeine can potentiate both cardiovascular and neuroendocrine stress reactivity and that the habitual use of caffeine is not necessarily associated with the development of tolerance to these effects.

Adaptation, Psychological↗
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The relationships between dimensions of hostility and cardiovascular reactivity as a function of task characteristics.

The present study examined the independent relationships between dimensions of hostility and cardiovascular responses to a laboratory task with and without harassment. Fifty-three males, aged 18 to 26, with a negative parental history of cardiovascular disease were selected on the basis of their scores on the Cook and Medley Hostility (Ho) scale (greater than 24 or less than 14). Factor-analysis of six separate measures of hostility/anger resulted in a two-factor solution; Factor 1 representing antagonistic hostility and Factor 2 representing neurotic hostility. Results showed that high factor scores on antagonistic hostility were significantly associated with greater systolic blood pressure (SBP) and forearm blood flow (FBF) changes and poorer SBP recovery to harassment. In addition, high factor scores on neurotic hostility significantly predicted greater FBF changes to harassment. Additional correlational analysis showed that cardiovascular responses were positively associated with self-reported negative affects but only for subjects with high scores on either dimension. These results are in agreement with recent evidence suggesting that only antagonistic hostility may be related to increased severity of coronary artery disease and that the degree of interpersonal conflict moderates the association between coronary-prone behaviors and cardiovascular responses.

Adolescent↗
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Predicting personality in adulthood from college MMPI scores: implications for follow-up studies in psychosomatic medicine.

To assess the long-term predictive utility of Minnesota Multiphasic Personality Inventory (MMPI) content scales, 1,960 individuals who had completed the MMPI in college in 1964 or 1965 were administered two measures of adult personality, the NEO Personality Inventory (NEO-PI) and the Cook and Medley MMPI Hostility scale, in 1988. A comparison group of 274 men and women in the Baltimore Longitudinal Study of Aging were given both MMPI and NEO-PI between 1981 and 1987. Predictive correlations between MMPI scales and NEO-PI factors were qualitatively similar to concurrent correlations, but approximately half as large in magnitude. Theoretically, these correlations were interpreted to mean that about half the variance in basic dimensions of personality is stable from college age into middle adulthood. Practically, the relatively modest correlations suggest that predictive studies of medical outcomes probably require large samples, and that baseline data from adults (e.g., over age 30) may be more useful for future studies. The combination of stability and change suggests that the decade of the 20s may be a particularly fruitful time to conduct research on interventions to alter personality and their effects on health outcomes.

Adolescent↗
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Biobehavioral basis of coronary-prone behavior in middle-aged men. Part I: Evidence for chronic SNS activation in Type As.

In previous research using young male subjects, the Type A behavior pattern was linked with cardiovascular and neurohormonal hyperresponsivity to laboratory stressors. The main objective of the present study was to determine whether the positive association between the Type A pattern and such physiological hyperreactivity is also present among healthy middle-aged men. Subjects were 28 middle-aged (35-50 years) white males who were classified as Type A (n = 16) or Type B (n = 12) on both the Structured Interview and the Jenkins Activity Survey. In two laboratory sessions, one week apart, subjects participated in either a mental arithmetic task or a sensory intake task. Twenty-four-hour urine collection was completed on a third day. Results showed that while no A/B differences in reactivity to either task were found, Type A subjects exhibited chronic elevation of plasma neurohormones on both laboratory days. The catecholamine elevations found across experimental periods on two laboratory days among Type A men generalized to more naturalistic settings, as indexed by 24-hr urinary excretion rates. The chronic elevations in both sympathetic nervous system and hypothalamic-pituitary-adrenal axis function we observed in middle-aged Type A men could account for epidemiological findings of increased coronary risk in this group.

Adult↗
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Biobehavioral basis of coronary-prone behavior in middle-age men. Part II: Serum cholesterol, the Type A behavior pattern, and hostility as interactive modulators of physiological reactivity.

Prior research suggests that the Type A behavior pattern, Cook and Medley Hostility (Ho) scores, and Total Serum Cholesterol (TSC) are positively associated with physiological changes to behavioral stressors. The objective of the present study was to determine whether TSC interacts with the Type A behavior pattern and hostility to affect cardiovascular and neurohormonal responses to a mental arithmetic task (MATH). For Type A individuals, elevated TSC was associated with larger catecholamine and cortisol responses to MATH. In contrast, for Type B subjects, cholesterol was negatively associated with neurohormonal responses. The interaction between Ho score and TSC predicted a similar pattern of responses whereby, in high hostile men only, TSC was positively associated with MATH-induced changes in catecholamines and heart rate. While the mechanisms responsible for the differences in the lipid-reactivity association as a function of coronary-prone behavior measures remain to be elucidated, this differential association may play a role in the heightened risk of coronary disease among hostile Type A men.

Adult↗
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Caffeine and cholesterol: interactions with hostility.

The consumption of caffeinated beverages has been linked to elevated serum cholesterol and an increased risk of coronary disease, although the relationships are inconsistent across studies and remain controversial. The effect of caffeine on cholesterol and coronary disease risk may be modulated by other factors. Using cohort data from a subsample of the University of North Carolina Alumni Heart Study, we investigated whether the relationships between caffeinated beverage consumption and serum lipid and lipoprotein levels in middle-aged men and women were modulated by levels of trait hostility. After adjustment for other risk factors, higher caffeinated beverage intake was associated with higher low-density lipoprotein cholesterol levels and a higher ratio of total to high-density lipoprotein cholesterol, both indicative of greater coronary disease risk. The interactive effects of hostility and caffeine intake were ambiguous, although there were trends for caffeine intake to have stronger effects on low-density lipoprotein and on total cholesterol in people with less hostility. Additional studies of personality characteristics and other factors that can modulate the cholesterol-raising effects of coffee drinking may be warranted because they might clarify the health consequences associated with coffee drinking and lead to the identification of individuals who would benefit most from changes in their coffee drinking.

Adult↗
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Stress in employed women: impact of marital status and children at home on neurohormone output and home strain.

OBJECTIVE: To evaluate the biological and psychological effects of role overload, we examined the effects of marital (or partnership) status and parental status (defined as having children at home) on daily excretion of urinary catecholamines and cortisol in a sample of 109 employed women. Other measures included work and home strain, and social support. METHODS: Urine collection was conducted on two consecutive workdays in three separate aliquots, a) overnight, b) daytime, and c) evening. Repeated-measures analysis of covariance with age and caffeine consumption as covariates was conducted on levels of epinephrine, norepinephrine, and cortisol in the three aliquots averaged across the 2 days. RESULTS: We found a significant main effect of parental status on 24-hour cortisol excretion, (p < .01) such that women with at least one child living at home excreted significantly more cortisol, independent of marital status or social support. Women with children at home also reported higher home strain (p < .001) but not work strain. A significant period of day effect for catecholamine levels was found (norepinephrine, p < .001; epinephrine, p < .0001) with all subjects showing an increase during the workday and little or no decline in levels during the evening. Catecholamine levels were unrelated to marital status, parental status, or social support. CONCLUSIONS: These findings indicate that working women with children at home, independent of marital status or social support, excrete greater amounts of cortisol and experience higher levels of home strain than those without children at home.

Adult↗