Psychosocial correlates of job strain in a sample of working women.

BACKGROUND: This study identifies potential mediators of job strain effects on health by determining whether psychosocial factors known to predict an increased risk of cardiovascular disease and all-cause mortality are higher among women who report high levels of job strain. METHODS: Measures of job strain and other psychosocial risk factors were obtained in a sample of 152 female employees of a local corporation. Canonical correlation and analyses of covariance were used to assess relationships between job demands and decision latitude and other psychosocial risk factors. RESULTS: A significant (P = .002) solution to the canonical correlation analysis showed that high job demands and low decision latitude were correlated with a pattern of psychosocial factors consisting of (1) increased levels of negative emotions like anxiety, anger, depression, and hostility; (2) reduced levels of social support; and (3) a preponderance of negative compared with positive feelings in dealings with coworkers and supervisors. This pattern was confirmed by analyses of covariance that adjusted for demographic and specific job characteristics. CONCLUSIONS: The canonical correlation analysis results provide empirical support for the job strain construct. The most important finding is that health-damaging psychosocial factors like job strain, depression, hostility, anxiety, and social isolation tend to cluster in certain individuals.

Cardiovascular and emotional responses in women: the role of hostility and harassment.

The relation of hostility and harassment to cardiovascular and emotional responses was examined by having 51 women (ages 18-26) high and low in hostility complete a task with or without harassment. Harassed high hostile Ss showed greater systolic blood pressure (SBP) increases during task and recovery periods than did harassed low hostile Ss and nonharassed Ss. Harassed low hostile Ss evidenced greater SBP increases during task and recovery periods than did nonharassed Ss. Among high hostile women, cardiovascular elevations during the task were associated with self-reported levels of negative affect. Antagonistic hostility, relative to neurotic hostility, was positively associated with harassment-induced SBP changes. These results support the hypothesis that hostile people exhibit excessive behaviorally induced cardiovascular responses to interpersonally challenging tasks that evoke anger-related emotional states.

The type A behavior pattern, physical fitness, and psychophysiological reactivity.

Joint effects of the Type A behavior pattern and aerobic fitness were examined with regard to heart rate (HR) and blood pressure (BP) changes elicited by laboratory challenges. Sixty-one college students were classified as Type A or B using the Structured Interview (SI), and as physically fit or sedentary using self-reports of activity level and estimated VO2max values obtained on a step test. Subjects were challenged with the SI, presentation of a snake, mental arithmetic, a cold pressor task, and two competitive card games. Significant A-B differences were found only on the SI and the card games. During the SI: As displayed significantly greater BP increases than Bs; sedentary subjects showed greater BP increases than fit subjects; and sedentary As revealed greater BP increases than either fit As, fit Bs, or sedentary Bs. In contrast, during the competitive games, physically fit As showed reliably greater BP increases than either sedentary As, sedentary Bs, or fit Bs. Since the physically fit subjects were almost exclusively varsity athletes and the sedentary subjects were college students who reported following a sedentary lifestyle, the differences between sedentary and fit groups may have been due to differences in aerobic fitness or to the improved ability of competitive athletes or those engaged in fitness training to match arousal level to task requirements.

Hostility and adrenergic receptor responsiveness: evidence of reduced beta-receptor responsiveness in high hostile men.

We examined the relation of Cook and Medley Hostility (Ho) scores to alpha- and beta-adrenergic receptor responsiveness to pharmacological agonists in 22 normotensive and 14 hypertensives (aged 18-34) white males, matched for age and body mass. alpha-Adrenergic receptor responsiveness was measured by the phenylephrine dose required to increase mean blood pressure by 25 mmHg (PD25). beta-Adrenergic responsiveness was measured by the isoproterenol dose needed to increase heart rate by 25 bpm (CD25), and to lower systemic vascular resistance by 40% (VD40). Relative to men with low Ho scores (< or = 21), men with high Ho scores (> or = 21) showed significantly reduced vascular beta 2-adrenergic receptor responsiveness (VD40). Moreover, the decreased vascular responsiveness was more pronounced in borderline hypertensive men with high Ho scores. Ho scores were also marginally significant in predicting cardiac beta 1- and beta 2-adrenergic receptor responsiveness, such that men with high Ho scores showed decreased responsiveness as indexed by a larger CD25. Vascular alpha 1-adrenergic responsiveness was not associated with hostility. These observations suggest that hostility, alone or in conjunction with BP status, is associated with reduced cardiovascular beta-adrenergic receptor responsiveness.

Relations of trait depression and anxiety to low lipid and lipoprotein concentrations in healthy young adult women.

OBJECTIVE: Recent evidence suggests that naturally occurring low cholesterol concentrations (<4.14 mmol/liter) are associated with depression as well as poor psychological health. For the most part, these associations have been observed in men. The current study assessed the relation of naturally occurring low lipid and lipoprotein concentrations to trait measures of depression and anxiety in 121 healthy young adult women. METHODS: Fasting lipid samples were collected at the same time as health history. Trait depression and anxiety were assessed using the Neuroticism, Extraversion, Openness-Personality Inventory (NEO-PI) depression subscale and Spielberger's Trait Personality Inventory (STPI) anxiety subscale. Analyses were conducted using both univariate and multivariate procedures. RESULTS: NEO depression was inversely associated with total cholesterol (p = .027), triglycerides (p = .012), and the ratio of total cholesterol to high-density lipoprotein cholesterol (p = .059). Similarly, STPI anxiety was inversely associated with total cholesterol (p = .002), low-density lipoprotein cholesterol (p = .016), triglycerides (p = .024), and ratio of total cholesterol to high-density lipoprotein cholesterol (p = .075). These associations were significant after adjustment for age, body mass index, physical activity, oral contraceptive use, and hostility. Neither depression nor anxiety was associated with high-density lipoprotein cholesterol. Univariate analyses indicated that women with low total cholesterol concentrations (<4.14 mmol/liter), relative to those with moderate to high cholesterol levels, were more likely to have higher scores on the NEO depression subscale (27 of 69 (39%) vs. 10 of 52 (19%)) and STPI anxiety subscale (24 of 69 (35%) vs. 11 of 52 (21%)). CONCLUSIONS: In healthy young adult women, low lipid and lipoprotein concentrations are inversely associated with trait measures of depression and anxiety. These findings are independent of age, body mass index, physical activity, and other factors known to influence lipid concentrations.

Comparative bioavailability and safety of two intramuscular ceftriaxone formulations.

OBJECTIVE: To determine if two ceftriaxone solutions of different concentrations are bioequivalent when administered intramuscularly. DESIGN: Double-blind, single-dose, two-period, randomized crossover study. SETTING: A clinical research center. SUBJECTS: Seventeen healthy volunteers. INTERVENTION: Ceftriaxone 500 mg administered in either 2 or 1.4 mL of lidocaine 1% solution, with final ceftriaxone concentrations of 250 and 350 mg/mL, respectively. MAIN OUTCOME MEASURES: Blood samples were assayed for ceftriaxone concentrations with HPLC and pharmacokinetic parameters were calculated from the resulting plasma-concentration time profiles: maximum plasma concentration (Cmax) of ceftriaxone and areas under the concentration-time curve (AUC) from 0 to 36 h and 0 to infinity were the primary parameters considered in the determination of bioequivalence. RESULTS: The two solutions were generally well tolerated and had similar safety profiles. Administration of both solutions resulted in similar mean values for all pharmacokinetic parameters. Statistical analysis showed no significant differences between the two solutions in any pharmacokinetic parameter, indicating that the two solutions are statistically bioequivalent (p < or = 0.05). The 90% CI for the ratio of the means for AUC0-36 (0.86 to 1.11), AUC0.36 (0.89 to 1.14), and Cmax (0.84 to 1.12) are within the Food and Drug Administration range of bioequivalence (0.80 to 1.25). CONCLUSIONS: These results demonstrate that the more concentrated solution of ceftriaxone (350 mg/mL) is bioequivalent to the currently marketed solution of 250 mg/mL.

Hostility-related differences in the associations between stress-induced physiological reactivity and lipid concentrations in young healthy women.

We examined the relations of fasting lipid levels to stress-induced neuroendocrine and cardiovascular responses as a function of hostility in 36 healthy young women. Participants were women who scored above 17 (n = 23) or below 12 (n = 13) on the Cook-Medley Hostility (Ho) Inventory. Lipids were determined following an overnight fast. Individuals participated in a solvable anagram task, which evoked significant physiological responses in all participants. The Ho group by total serum cholesterol (TSC) and the Ho group by low-density lipoprotein (LDL) cholesterol interactions significantly predicted heart rate (HR) and norepinephrine (Ne) responses. For high Ho women, elevations in TSC and LDL cholesterol were associated with smaller HR responses and larger Ne responses. In contrast, for low Ho women, elevations in TSC and LDL cholesterol were associated with larger HR responses and smaller Ne responses. Results also indicated a significant Ho group by TSC to high density lipoprotein (HDL) cholesterol ratio interaction for cortisol. For high Ho women, larger cortisol responses were associated with a greater TSC to HDL cholesterol ratio. For low Ho women, larger cortisol responses were associated with a smaller TSC to HDL cholesterol ratio. Lastly, higher TSC and LDL cholesterol levels were significantly associated with larger epinephrine responses. The findings suggest that stress-induced physiological responses are differentially associated with fasting lipids as a function of hostility in healthy young women.

The relationships between dimensions of hostility and cardiovascular reactivity as a function of task characteristics.

The present study examined the independent relationships between dimensions of hostility and cardiovascular responses to a laboratory task with and without harassment. Fifty-three males, aged 18 to 26, with a negative parental history of cardiovascular disease were selected on the basis of their scores on the Cook and Medley Hostility (Ho) scale (greater than 24 or less than 14). Factor-analysis of six separate measures of hostility/anger resulted in a two-factor solution; Factor 1 representing antagonistic hostility and Factor 2 representing neurotic hostility. Results showed that high factor scores on antagonistic hostility were significantly associated with greater systolic blood pressure (SBP) and forearm blood flow (FBF) changes and poorer SBP recovery to harassment. In addition, high factor scores on neurotic hostility significantly predicted greater FBF changes to harassment. Additional correlational analysis showed that cardiovascular responses were positively associated with self-reported negative affects but only for subjects with high scores on either dimension. These results are in agreement with recent evidence suggesting that only antagonistic hostility may be related to increased severity of coronary artery disease and that the degree of interpersonal conflict moderates the association between coronary-prone behaviors and cardiovascular responses.

Situational determinants of cardiovascular and emotional reactivity in high and low hostile men.

Various epidemiologic studies have found that high scores on the Cook and Medley Hostility (Ho) scale are associated with increased risk of coronary heart disease (CHD), severity of atherosclerosis, and all-cause mortality. One plausible biological mechanism suspected of contributing to increased risk of CHD is sympathetic nervous system-mediated hyperresponsivity to environmental stressors. The present study evaluated cardiovascular reactivity among young men with high versus low Ho scores during performance of an anagram task with or without harassment. Compared to performing the task alone, harassment led to increased cardiovascular arousal that was more pronounced for the high Ho subjects than the low Ho subjects. Moreover, harassment produced increases in self-rated anger, irritation, and tension, but it was only among those subjects with high Ho scores that increased anger and irritation were associated with enhanced cardiovascular arousal. While suggesting a role for anger- and irritation-induced cardiovascular arousal in pathogenesis of CHD, these findings indicate that situation characteristics mediate the relationship between Ho scores and cardiovascular reactivity, and that there may be a differential biological link between anger/irritation and cardiovascular responses in men with high and low Ho scores.

Cardiovascular reactivity among hostile men and women: the effects of sex and anger suppression.

This study examined cardiovascular reactivity differences among hostile men and women. Sixty-four individuals (33 women 31 men; M = 19.9 years of age) were selected from a sample of 105 volunteers based on their Cook-Medley Hostility Scale scores (Cook & Medley, 1954; less than or equal to 24). Analyses revealed no significant sex differences in Cook-Medley Hostility scores. At baseline, men had higher mean systolic blood pressure (SBP) level. However, during the Stroop Color-Word Conflict Task (Stroop, 1935), high-hostile men and women exhibited similar cardiovascular responses. Further analyses revealed that cardiovascular responses to the Stroop task were differentially associated with among men and women as a function of anger suppression. For women, anger suppression was positively associated with diastolic blood pressure (DBP) responses and negatively associated with SBP responses. In contrast, anger suppression was negatively associated with DBP changes and not associated with SBP responses for men. The results suggest that personality factors, such as high hostility and anger suppression, may influence the degree to which men and women differ in their cardiovascular responses to interpersonal stressors.

The relation of hostility to lipids and lipoproteins in women: evidence for the role of antagonistic hostility.

We examined the relation of antagonistic, neurotic, and cynical hostility to lipids and lipoproteins in 77 healthy women (aged 18-26) selected for having high (> 17) or low (< 12) scores on the Cook-Medley Hostility (Ho) scale. Fasting lipids were determined during the luteal phase of the menstrual cycle for oral contraceptive (OC) non-users (N = 41), and during pills 15-21 for OC users (N = 36). Factor scores for antagonistic and neurotic hostility were derived from a principal component of the Buss-Durkee Hostility Inventory, Spielberger's Anger Expression, and the NEO-Personality Inventory. High Ho scores were significantly associated with higher cholesterol. Antagonistic hostility significantly predicted cholesterol, low density lipoprotein cholesterol, triglycerides, and the ratio of cholesterol to high density lipoprotein cholesterol, with higher antagonistic hostility scores associated with higher levels. Neurotic hostility did not predict lipids. Results suggest a potential pathophysiological mechanism that may contribute to the association between hostility and coronary heart disease. Moreover, a measure of antagonistic hostility, relative to cynical and neurotic hostility, was the best predictor of lipid levels.

Biobehavioral basis of coronary-prone behavior in middle-age men. Part II: Serum cholesterol, the Type A behavior pattern, and hostility as interactive modulators of physiological reactivity.

Prior research suggests that the Type A behavior pattern, Cook and Medley Hostility (Ho) scores, and Total Serum Cholesterol (TSC) are positively associated with physiological changes to behavioral stressors. The objective of the present study was to determine whether TSC interacts with the Type A behavior pattern and hostility to affect cardiovascular and neurohormonal responses to a mental arithmetic task (MATH). For Type A individuals, elevated TSC was associated with larger catecholamine and cortisol responses to MATH. In contrast, for Type B subjects, cholesterol was negatively associated with neurohormonal responses. The interaction between Ho score and TSC predicted a similar pattern of responses whereby, in high hostile men only, TSC was positively associated with MATH-induced changes in catecholamines and heart rate. While the mechanisms responsible for the differences in the lipid-reactivity association as a function of coronary-prone behavior measures remain to be elucidated, this differential association may play a role in the heightened risk of coronary disease among hostile Type A men.

The relationship between hostility and beta-adrenergic receptor physiology in health young males.

OBJECTIVE: We examined the relationship between hostility and mononuclear leukocyte (MNL) beta-adrenergic receptor function in a sample of young healthy males. METHOD: Thirty subjects were selected for having scored above 20 (N = 11) and below 14 (N = 19) on the Cook-Medley Hostility (Ho) scale. MNL beta-adrenergic receptor function was characterized in terms of receptor density (Bmax) and ligand-binding affinity (Kd) in homogenized cells, and intracellular cyclic adenosine monophosphate (cAMP) responses to saline, isoproterenol, and forskolin in whole cells. Subjects also completed the Multidimensional Anger Inventory (MAI), which assesses dimensions of anger. RESULTS: Relative to men with low Ho scores, men with Ho scores above 20 showed lower receptor number and greater forskolin-stimulated cAMP. Moreover, high hostile men reported a greater frequency of anger, longer duration of anger, more frequent brooding, and a hostile outlook. CONCLUSIONS: These data indicate that adrenergic receptor down-regulation is associated with hostility. This association may be linked to hostile persons' propensity for excessive and prolonged neuroendocrine responses to either psychological stressors or the experience of chronic stress associated with frequent and prolonged bouts of anger.

Neuroendocrine, cardiovascular, and emotional responses of hostile men: the role of interpersonal challenge.

OBJECTIVE: We examined the effects of hostility and harassment on neuroendocrine, cardiovascular, and emotional responses in 52 healthy white men. METHODS: Subjects were preselected on the basis of scores in the top and bottom quartiles (above 23 and below 15, respectively) on the Cook and Medley Hostility (Ho) scale. Subjects participated in a solvable anagram task. Thirty subjects were harassed by the technician during the task. RESULTS: Harassed subjects with high Ho scores exhibited enhanced and prolonged blood pressures, heart rate, forearm blood flow, forearm vascular resistance, norepinephrine, testosterone, and cortisol responses relative to low-Ho subjects in the harassed condition and high and low-Ho subjects in the nonharassed condition. Heightened physiological reactivity in high-Ho subjects was correlated with arousal of negative affects. CONCLUSIONS: The findings are consistent with the general hypothesis that high hostile men show excessive behaviorally-induced cardiovascular and neuroendocrine responsivity to interpersonal challenging situations. Moreover, in high-Ho men, the stress-induced cardiovascular and neuroendocrine hyperreactivity is associated with the arousal of negative affects such as anger.

The influence of dietary cholesterol on cardiac and hepatic Beta-adrenergic receptors in egyptian sand rats.

We examined the effects of dietary cholesterol on cardiac and hepatic beta-adrenergic receptor functioning. Age-matched adult desert rodents (Psammomys obesus) were randomized to either a 5% cholesterol diet (CD, n = 20), or normal rabbit chow (RC, n = 18). After a 2-month exposure to the diets, animals were sacrificed and tissue from both heart and liver were retained for radioligand bindings studies. In heart tissue, cholesterol fed animals, relative to controls, showed an increased production of adenosine 3,5>-cyclic monophosphate (cAMP) in response to isoproterenol. Cholesterol supplementation was not associated with an increase in heart beta-adrenergic receptor number. Animals fed the 5% cholesterol diet showed significant increases in the number of beta-adrenergic receptor sites in hepatic tissue (M = 13.2 vs. 10.4 pmol/mg protein, CD and RC, respectively). The increased number of receptor sites in the liver was accompanied by a significant increase in isoproterenol-stimulated cAMP production. Results are supportive of the hypothesis that dietary cholesterol contributes to an upregulation of beta-adrenergic receptor function in cardiac, as well as hepatic tissue. These findings may be relevant to the observations of excessive stress-induced cardiovascular reactivity in persons with high cholesterol levels.

Biobehavioral basis of coronary-prone behavior in middle-aged men. Part I: Evidence for chronic SNS activation in Type As.

In previous research using young male subjects, the Type A behavior pattern was linked with cardiovascular and neurohormonal hyperresponsivity to laboratory stressors. The main objective of the present study was to determine whether the positive association between the Type A pattern and such physiological hyperreactivity is also present among healthy middle-aged men. Subjects were 28 middle-aged (35-50 years) white males who were classified as Type A (n = 16) or Type B (n = 12) on both the Structured Interview and the Jenkins Activity Survey. In two laboratory sessions, one week apart, subjects participated in either a mental arithmetic task or a sensory intake task. Twenty-four-hour urine collection was completed on a third day. Results showed that while no A/B differences in reactivity to either task were found, Type A subjects exhibited chronic elevation of plasma neurohormones on both laboratory days. The catecholamine elevations found across experimental periods on two laboratory days among Type A men generalized to more naturalistic settings, as indexed by 24-hr urinary excretion rates. The chronic elevations in both sympathetic nervous system and hypothalamic-pituitary-adrenal axis function we observed in middle-aged Type A men could account for epidemiological findings of increased coronary risk in this group.

Stress in employed women: impact of marital status and children at home on neurohormone output and home strain.

OBJECTIVE: To evaluate the biological and psychological effects of role overload, we examined the effects of marital (or partnership) status and parental status (defined as having children at home) on daily excretion of urinary catecholamines and cortisol in a sample of 109 employed women. Other measures included work and home strain, and social support. METHODS: Urine collection was conducted on two consecutive workdays in three separate aliquots, a) overnight, b) daytime, and c) evening. Repeated-measures analysis of covariance with age and caffeine consumption as covariates was conducted on levels of epinephrine, norepinephrine, and cortisol in the three aliquots averaged across the 2 days. RESULTS: We found a significant main effect of parental status on 24-hour cortisol excretion, (p < .01) such that women with at least one child living at home excreted significantly more cortisol, independent of marital status or social support. Women with children at home also reported higher home strain (p < .001) but not work strain. A significant period of day effect for catecholamine levels was found (norepinephrine, p < .001; epinephrine, p < .0001) with all subjects showing an increase during the workday and little or no decline in levels during the evening. Catecholamine levels were unrelated to marital status, parental status, or social support. CONCLUSIONS: These findings indicate that working women with children at home, independent of marital status or social support, excrete greater amounts of cortisol and experience higher levels of home strain than those without children at home.