ACTIVE COPING AND SOCIAL SUPPORT EFFECT ON REACTIVITY

该提案提出了一系列实验室研究，旨在回答 社会心理因素在发展中的作用问题 高血压和相关心血管疾病的风险。 四项研究是 提出了前3个重点是积极应对和社会影响 支持正常血压和临界高血压受试者。 研究4是 关注白色被毛高血压的可能原因。 研究1-3跟进了我们的发现，这些发现表明，科普能力 降低血压和心率反应，当努力 任务是可控的。 许多研究表明科普 增加反应性;然而，在这些研究中，努力与 由于应对反应的可用性而增强控制。 研究1和 2测试积极应对是（至少）2的函数的命题 独立的组成部分--增强的控制力和努力性--我们 假设对反应性有相反影响。 此外，我们测试 社会支持代表能力的特殊情况， 以科普，因此可能会发挥其反应性降低的效果，因为 其加强控制的方面，以及其他可用的应对措施， 应答 此外，我们还提出， 正常血压和临界高血压人群可以更好地 当对每种成分的反应存在差异时， 积极的应对-加强控制和努力-被单独审查。 在第四项研究中，我们建议跟进试验数据， 观察到，一部分年轻的血压正常的人表现出预期的 血压升高（使用连接到Finapres的指套测量） 监视器），在进入MD的房间之前。 我们假设 这些预期的反应是（1）与受试者的病史有关， 医疗经验;（2）与老年人中观察到的白色大衣反应有关 （3）不只是一般反应的一个例子。 为了检验这些命题，我们建议检查受试者 在实验室中（为了确定预期状态，并执行 一般反应性测试）以及在医疗诊所中， 可以观察到对MD的响应。

This proposal presents a series of laboratory studies designed to answer questions concerning the role of psychosocial factors in the development of hypertension and related cardiovascular disease. Four studies are proposed. The first 3 focus on effects of active coping and social support in normotensive and borderline hypertensive subjects. Study 4 is concerned with a possible cause of White Coat Hypertension. Studies 1-3 follow up our findings which show that ability to cope reduces blood pressure and heart rate reactivity, when the effortfulness of the task is controlled. Many studies show that ability to cope increases reactivity; however, in those studies effort co-varies with the enhanced control due to availability of a coping response. Studies 1 and 2 test the proposition that active coping is a function of (at least) 2 separate components--enhanced control and effortfulness--which we hypothesize have opposite effects on reactivity. In addition, we test the proposition that social support represents a special case of ability to cope, and therefore may exert its reactivity-reducing effects because of its control-enhancing aspects, as would other available coping responses. In addition, we propose that reactivity differences between normotensive and borderline hypertensive populations can be better understood when differences in the response to each of the components of active coping--enhanced control and effort--are examined individually. In Study 4, we propose to follow up on pilot data in which we have observed that a proportion of young normotensives show an anticipatory rise in blood pressure (taken using a finger-cuff attached to a Finapres Monitor), prior to the entry into the room of an MD. We hypothesize that these anticipatory responses are (1) related to the subject's history of medical experiences; (2) related to the White Coat response seen in older patients; and (3) is not simply an instance of generalized reactivity. In order to test these propositions, we propose to examine the subjects in the laboratory (in order to determine anticipator status, and perform general reactivity tests) as well as in the medical clinic, where responses to the MD can be observed.