Depressive symptom clusters and 5-year incidence of coronary artery calcification: the coronary artery risk development in young adults study.

BACKGROUND: Because depression is a multidimensional construct and few studies have compared the relative importance of its facets in predicting cardiovascular risk, we evaluated the utility of depressive symptom clusters in predicting the 5-year incidence of coronary artery calcification (CAC). METHODS AND RESULTS: Participants were 2171 middle-aged adults (58% female; 43% black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study who were free of cardiovascular disease. Depressive symptom clusters (z scores) were measured by questionnaires in 2000 to 2001, and CAC was measured by electron beam computed tomography in 2000 to 2001 and 2005 to 2006. There were 243 cases (11%) of incident CAC, defined as the absence of CAC at baseline and the presence of CAC at follow-up. Total depressive symptoms (odds ratio, 1.16; 95% confidence interval, 1.02-1.33; P=0.03) and the depressed affect cluster (odds ratio, 1.17; 95% confidence interval, 1.03-1.33; P=0.02) predicted incident CAC; however, the somatic, interpersonal distress, low positive affect, and pessimism clusters did not. The depressed affect-incident CAC relationship was independent of age, sex, race, education, and antidepressant use; was similar across sex and racial groups; and was partially accounted for by tobacco use and mean arterial pressure. CONCLUSIONS: In contrast to recent results indicating that the somatic cluster is the most predictive of cardiovascular outcomes, we found that the prospective association between depressive symptoms and incident CAC was driven by the depressed affect cluster. Our findings raise the possibility that there may not be 1 facet of depression that is the most cardiotoxic across all contexts.

Blood pressure reactivity predicts somatic reactivity to stress in daily life.

The purpose of the present study was to examine whether stress-somatic symptom associations may be more pronounced among individuals whose bodies exhibit higher levels of cardiovascular reactivity to a laboratory social stress task. During an initial laboratory session, participants delivered a 5-min speech and individual differences in cardiovascular reactivity were quantified. The same participants subsequently completed a 15-day experience sampling protocol, in which daily levels of stress and somatic symptoms were assessed. Multi-level modeling was used to assess associations among laboratory cardiovascular reactivity, daily stress and somatic symptoms. Daily symptom reports included a set of commonly experienced physical symptoms reflective of general bodily dysfunction. Individuals displaying high levels of laboratory systolic blood pressure reactivity experienced more somatic symptoms on high-stress days, but this was not the case for individuals low in systolic blood pressure reactivity. The results bridge two hitherto distinct health psychology literatures showing that cardiovascular and somatic reactivity to stress are associated. Stress reactivity individual differences in one system may indicate more general differences in bodily reactivity across systems.

The effects of warning smokers on perceived risk, worry, and motivation to quit.

BACKGROUND: Research concerning motives for smoking cessation has focused on beliefs (cognitions) that people have, especially risk perceptions, with less attention directed to worry (negative affect) concerning one's smoking. PURPOSE: We tested a manipulation to encourage smokers to think and worry more about their smoking behavior. We contrasted risk perceptions and worry as predictors of contemplation to quit smoking. METHODS: Smokers were randomly assigned to two conditions in which they carried personal digital assistants for 2 weeks. When signaled, smokers read smoking consequence statements or daily hassle statements. RESULTS: After 2 weeks, experimental smokers reported greater perceived risk and worry about developing a medical condition compared to control smokers. Both perceived risk and worry independently mediated the relationship between the experimental manipulation and increased contemplation to quit smoking; however, worry was the strongest mediator in a multiple mediation model. CONCLUSION: Worry may be foremost for motivating smokers to attempt quitting.

Neuroticism's importance in understanding the daily life correlates of heart rate variability.

Individual differences in high-frequency heart rate variability (HRV) have been conceptualized in terms of a greater capacity to self-regulate problematic outcomes, but have also been conceptualized in terms of greater moment-to-moment flexibility. From a self-regulation perspective, higher HRV should be inversely correlated with trait neuroticism and problematic daily outcomes. From a flexibility perspective, high HRV should result in more state-like functioning--that is, functioning that is more contextual and less trait-like in nature. In the latter case, HRV and trait neuroticism may interact to predict problematic outcomes such that neuroticism should be a less consequential predictor at higher levels of HRV. The flexibility perspective was systematically supported in a daily experience-sampling protocol. Implications focus on theories of neuroticism and HRV.