ACTIVE COPING AND SOCIAL SUPPORT EFFECT ON REACTIVITY

这项提案提出了一系列实验室研究，旨在回答 关于心理社会因素在发展中的作用的问题 高血压和相关的心血管疾病。四项研究是 建议。前3个重点关注积极应对和社会的影响 对血压正常和临界高血压受试者的支持。研究4是 关注可能导致白大衣高血压的原因。 研究1-3跟进了我们的发现，表明有能力应对 降低血压和心率反应性，当努力时 的任务是受控的。许多研究表明，应对的能力 增加反应性；然而，在这些研究中，努力与 由于提供了应对措施，加强了控制。研究1和 2检验积极应对是(至少)2的函数的命题 独立的组件--增强的控制性和易用性--我们 假设对反应性有相反的影响。此外，我们还测试了 认为社会支持是能力的一种特例的主张 来应对，因此可能会发挥其减少反应性的作用，因为 其加强控制的方面，以及其他可用的应对措施 回应。此外，我们提出，反应性之间的差异 血压正常和临界高血压人群可以更好地 理解当对每个组件的响应不同时 主动应对--加强控制和努力--分别进行了研究。 在研究4中，我们建议对我们已有的试点数据采取后续行动 观察到一部分年轻的正常血压者表现出预见性 血压升高(用戴在Finapres上的指套测量) 显示器)，在进入MD的房间之前。我们假设 这些预期反应(1)与受试者的 医疗经历；(2)与老年人的白大衣反应有关 患者；以及(3)不是简单的全身性反应的例子。 为了检验这些命题，我们建议对受试者进行考察 在实验室中(以确定预期者状态，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的反应。

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.