Standardized stress reduction interventions and blood pressure habituation: Secondary results from a randomized controlled trial.

Meta-analyses suggest a small association between cardiovascular responses to acute stressors and cardiovascular disease, but a recent review suggests that this effect may be underestimated due to insufficient consideration of individual differences in habituation to repeated stressors. OBJECTIVE: The present article reports new analyses of a published randomized controlled trial comparing the effects of mindfulness-based stress reduction (MBSR), cognitive behavioral therapy (CBT), and a passive control condition on blood pressure habituation-a secondary outcome. Psychological mediators of intervention effects were examined. METHOD: Participants (138 healthy adults reporting moderate/high stress) were randomly assigned to 6-week MBSR, CBT, or a waitlist control. Analyses were conducted on 86 participants who subsequently completed stressful speech and mental arithmetic tasks during two posttreatment visits scheduled 48 hr apart. Blood pressure was measured -15, +0, +5, +10, +25, +35, and +60 min poststressor onset. RESULTS: There were no between-condition differences in blood pressure habituation (all ps > .05). However, both MBSR and CBT led to increased perceived control over thoughts, F(2, 72) = 5.20, p = .008, and individuals who displayed a greater change in perceived control over thoughts also displayed greater habituation to the speech portion of the stressor, F(6, 799) = 2.32, p = .020. Results implied an indirect effect of stress reduction interventions on blood pressure habituation via change in perceived control over thoughts (b = -3.93, SE = 1.98, 95% CI: [-8.392, -0.701]). CONCLUSION: Stress reduction interventions that increase perceived control over thoughts may benefit cardiovascular health by promoting blood pressure habituation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Assessment of donor fear enhances prediction of presyncopal symptoms among volunteer blood donors.

BACKGROUND: Fear is an important contributor to the risk of presyncopal reactions to blood donation. However, concern that asking donors about their fears may increase the risk of reactions is a potential impediment to incorporating fear assessment into donor screening. STUDY DESIGN AND METHODS: Before donation, participants responded to a series of questions that either did (n = 488) or did not (n = 494) include questions related to fear of seeing blood drawn. Immediately after donation all participants provided ratings of presyncopal reactions. RESULTS: Among those asked predonation fear questions, fear was most strongly related to presyncopal symptoms when compared against other donor characteristics (e.g., age, number of prior donations, body mass index, estimated blood volume, blood pressure, and pulse). However, Mann-Whitney U tests revealed that being asked about fear before donation was not associated with higher reports of presyncopal reactions for the sample as a whole, nor among novice donors. Further, regression analyses indicated that fear remained a significant predictor of presyncopal reactions in final models that included age and number of prior donations as significant predictors. CONCLUSION: Predonation assessment of fear of blood draws may help to identify donors who are most likely to benefit from brief interventions designed to enhance donor coping, reduce risk of presyncopal reactions, and increase donor retention.

Mechanical energy expenditures and movement efficiency in full body reaching movements.

The effect of target location, speed, and handedness on the average total mechanical energy and movement efficiency is studied in 15 healthy subjects (7 males and 8 females with age 22.9 +/- 1.79 years old) performing full body reaching movements. The average total mechanical energy is measured as the time average of integration of joint power, potential energy, and kinetic energy respectively. Movement efficiency is calculated as the ratio of total kinetic energy to the total joint power and potential energy. Results show that speed and target location have significant effects on total mechanical energy and movement efficiency, but reaching hand only effects kinetic energy. From our findings we conclude that (1) efficiency in whole body reaching is dependent on whether the height of the body center of mass is raised or lowered during the task; (2) efficiency is increased as movement speed is increased, in part because of greater changes in potential energy; and (3) the CNS does not appear to use movement efficiency as a primary planning variable in full body reaching. It may be dependent on a combination of other factors or constraints.

Fear of movement/(re)injury in chronic pain: a psychometric assessment of the original English version of the Tampa scale for kinesiophobia (TSK).

The Tampa scale for kinesiophobia (TSK) was developed to measure fear of movement/(re)injury in chronic pain patients. Although studies of the Dutch adaptation of the TSK have identified fear of movement/(re)injury as an important predictor of chronic pain, pain-related avoidance behaviour, and disability, surprisingly little data on the psychometric properties of the original English version of the TSK are available. The present study examined the reliability, construct validity and factor structure of the TSK in a sample of chronic pain patients (n=200) presenting for an interdisciplinary functional restoration program. Consistent with prior evaluations of the Dutch version of the TSK, the present findings indicate that the English TSK possesses a high degree of internal consistency and is positively associated with related measures of fear-avoidance beliefs, pain catastrophizing, pain-related disability and general negative affect. The TSK was not related to individual differences in physical performance testing as assessed using standardised treadmill and lifting tasks. Confirmatory factor analyses suggest that the TSK is best characterized by a three-factor trait method model that includes all 17 of the original scale items and takes into account the distinction between positively and negatively keyed items. The results of the present study provide important details regarding the psychometric properties of the original English version of the TSK and suggest that it may be unnecessary to remove the negatively keyed items in an attempt to improve scale validity.

Assessment of opiate modulation of pain and nociceptive responding in young adults with a parental history of hypertension.

This double blind, placebo-controlled study examined the effects of an opiate antagonist, naltrexone, on nociceptive flexion reflex (NFR) thresholds and subjective pain in individuals with and without a parental history of hypertension. Using a repeated measures design, NFR threshold was repeatedly assessed on two testing days after administration of either placebo or naltrexone. Immediately after NFR threshold was determined, participants rated the level of pain experienced during the preceding NFR assessment, and at the end of each session participants' electrocutaneous pain threshold was assessed. Two primary findings were obtained. First, individuals with a parental history of hypertension exhibited attenuated pain sensitivity. Second, endogenous opioid blockade was associated with increased pain ratings in women but with increased pain threshold in men. In sum, the present study did not support a direct involvement of the endogenous opioid system in the attenuated pain sensitivity observed in individuals at increased risk for hypertension.

The influence of acute anxiety on assessment of nociceptive flexion reflex thresholds in healthy young adults.

The nociceptive flexion reflex (NFR) is a polysynaptic withdrawal reflex that occurs in response to painful stimulation. In human studies, NFR responsiveness has been used as a direct measure of nociception as well as an indirect measure of supraspinal modulation of nociceptive transmission. Previous studies have suggested that anxiety may influence NFR responding, and therefore it has been recommended that anxiety be reduced by familiarizing participants with assessment methodology prior to formal NFR assessment. The present study was designed to assess the influence of anxiety on NFR threshold. Using a repeated measures design, 40 men and women completed an NFR threshold assessment twice within session one, and twice again during a second session conducted 24h later. Within each assessment session, state anxiety was measured at the beginning of the session and immediately following each NFR threshold assessment. Results indicated that although anxiety increased in response to NFR threshold assessment and was positively related to subjective pain reports, anxiety was not related to observed NFR threshold levels. These findings suggest that individual differences in anxiety do not significantly affect NFR threshold level determinations under standard testing conditions.