Effect of Angry Perseverative Cognition on Ambuatory BP

摘要 我们假设，愤怒引起的持续性认知（或反刍）是血压升高（BP）的决定因素，这种认知可以在实验室的愤怒后恢复期间观察到，在自然环境中的动态监测。持续的血压升高反过来又赋予终末器官损伤（EOD）的独立风险。本研究的主要目标是通过研究影响这些想法的持续性的情境因素，与反刍的特质措施相互作用，来扩展我们对愤怒的持续性认知在持续BP升高中的作用的理解。具体来说，我们将研究一个情境因素的影响：一个愤怒回忆引发的社会遭遇（通过扩展A型结构化面试; ESI）与特质倾向的互动，从事持续的愤怒认知，或反刍。我们发现，在实验室中，这种特征的测量是行为反刍和血压恢复不良的有用预测因子，初步数据表明，倾向于从事这种认知的人往往具有较高的动态血压水平。我们将使用实验室和动态血压监测组件来研究这种类型的认知。提出了一个混合设计（1-之间（特质反刍水平），1-内（挑衅或愤怒与中性回忆）。具有不同程度的特质反刍的参与者在中性和激怒期间都戴着动态血压监测器 社会互动（间隔一个月，平衡）。在实验室部分， 在清晨进行的第一次训练中，我们将在任务前、任务和任务后（15分钟恢复）期间连续评估BP;此外，还将评估任务后认知。恢复期后，受试者将在随后的24小时内佩戴动态BP监测仪，并完成电子日记，提供有关体力活动、情绪和认知的信息。我们假设，我们将观察到（1）操纵的主要影响（愤怒回忆诱导将产生更大的任务后愤怒认知，实验室评估的BP恢复较差，以及动态BP升高）;（2）特质结构的主效应（在特质反刍上得分高的人往往会报告更多的愤怒想法，并且比低特质反刍者的动态血压更高）;（3）这些因素之间的相互作用，如在反刍特质测量中得分较高的参与者，其愤怒回忆被激发，将证明愤怒认知的频率最高，实验室中血压恢复最差，动态血压最高。我们的长期目标是了解一种可能的认知机制，这种机制可能与持续的血压升高和最终的EOD有关。

Abstract We hypothesize that anger-induced perseverative cognition (or rumination) is a determinant of elevated blood pressure (BP) and such cognitions may be observed during post-anger recovery in the laboratory, and during ambulatory monitoring in the natural environment. Sustained BP elevation in turn confers independent risk for end organ damage (EOD). The main goal of the present research is to extend our understanding of the role angry perseverative cognition in sustained BP elevation by studying situational factors that influence the perseverative nature of these thoughts, in interaction with trait measures of rumination. Specifically, we will study the effects of a situational factor: an anger-recall provoking social encounter (via the Extended Type A Structured Interview; ESI) in interaction with trait tendencies to engage in perseverative angry cognitions, or rumination. We have found measures of this trait to be a useful predictor of behavioral rumination and poor BP recovery in the laboratory, and preliminary data indicate that persons who tend to engage in such cognitions tend to have higher ambulatory BP levels. We will use both a laboratory and an ambulatory BP monitoring component to study this type of cognition. A mixed design (1-between (level of trait rumination), 1- within (provocation or anger vs. neutral recall) is proposed. Participants with varying levels of trait rumination wear the ambulatory BP monitor during both a neutral and then again during an angerprovoking social interaction (one month apart, counterbalanced). During the laboratory portion of the session, which occurs early in the morning, we will assess BP continuously during pre-task, task, and post-task (15-minute recovery) periods; in addition, post-task cognitions will be assessed as well. Immediately following the recovery period, participants will wear an ambulatory BP monitor for the succeeding 24-hour period, and will complete an electronic diary, providing information concerning physical activity, mood, and cognitions. We hypothesize that we will observe (1) a main effect of the manipulation (anger-recall induction will produce greater post-task angry cognitions, poorer BP recovery assessed in the laboratory, and elevated ambulatory BP); (2) a main effect of the trait construct (persons who score high on trait rumination will tend to report more angry thoughts, and evidence higher ambulatory BP, than low trait ruminators); and (3) an interaction between these factors, such that participants who score higher on trait measures of rumination, and whose anger-recall is provoked, will evidence the highest frequency of angry cognition, the poorest BP recovery in the laboratory, and the highest ambulatory BP. Our long term aims are to understand one of the possible cognitive mechanisms that may be implicated in sustained BP elevations and eventual EOD.