Core--Mechanisms and Measures

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The purpose of this core is to add the study of causal mechanisms by which stress, emotions, and cognitions can contribute to the development of hypertension (HTN) and chronic cardiovascular diseases (CVD) to already existing Behavioral Medicine (BM) randomized controlled trials (RCTs). A set of psychometric measures that assess Cognitive Adaptation theory (CA) and a set of biochemical and physiological measures that assess the AIIostatic Load (AL) model will be standardized to create two batteries. These two theories and their associated measures were selected because they both argue that there is a common mechanism by which the effects of stress impact upon health and disease outcome. The corollary of this argument is that BM interventions, while utilizing distinct treatments, all operate to reduce stress and impact upon health through one common pathway. Alternatively, there may be one unique mechanism associated with each type of BM intervention. This core will allow us to test these conjectures about the ways in which BM RCTs impacts disease. The proposed mechanisms battery will initially be assessed pre- and post-intervention in three currently funded behavioral RCTs in which common mechanism hypotheses were not originally included. We have chosen three RCTs that are testing how stress, anger, and motivational interviewing interventions impact upon blood pressure. Additionally, this standardized battery will be made available to other RCTs that are either ongoing or planned.