Effect of Angry Perseverative Cognition on Ambuatory BP

摘要 我们假设愤怒诱导的持之以恒的认知(或沉思)是血压升高的决定因素，这种认知可能在实验室的愤怒后恢复过程中观察到，也可能在自然环境中的动态监测过程中观察到。持续的血压升高反过来又增加了终末器官损害(EOD)的独立风险。本研究的主要目的是通过研究影响愤怒持久型思维持久性的情境因素，并结合反思性特质测量，扩展我们对愤怒持久型认知在持续血压升高中的作用的理解。具体地说，我们将研究情景因素的影响：引发愤怒回忆的社交遭遇(通过扩展的A型结构化面试；ESI)与从事持之以恒的愤怒认知或沉思的特质倾向交互作用。我们发现，在实验室中，这一特征的测量是行为沉思和血压恢复不良的有用预测指标，初步数据表明，倾向于进行此类认知的人往往具有更高的动态血压水平。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。采用混合设计(1-Better(特质反省水平)，1-In(挑衅或愤怒与中性回忆))。有不同特征反思水平的参与者在中立状态下佩戴动态血压监测仪，然后在激怒状态下再次佩戴 社会互动(相隔一个月，平衡)。在课程的实验室部分 会议在清晨举行，我们将在任务前、任务和任务后(15分钟恢复)期间持续评估BP；此外，还将评估任务后认知。在恢复期结束后，参与者将在接下来的24小时内立即佩戴动态血压监测仪，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)操纵的主效应(愤怒回忆诱导会产生更多的任务后愤怒认知，在实验室评估的BP恢复较差，以及动态血压升高)；(2)特质结构的主效应(在特质反思者中得分高的人倾向于报告更多的愤怒想法，并证明比低特质反思者更高的动态血压)；(3)这些因素之间的相互作用，使得在沉思的特质测量上得分较高的参与者，以及其愤怒回忆被激发的参与者，将证明愤怒认知的频率最高，实验室中BP恢复最差，而动态血压最高。我们的长期目标是了解BP持续升高和最终EOD可能涉及的一种可能的认知机制。

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.