Oxy-cope rearrangements of bicyclo[3.2.0]heptenones. Synthesis of bicyclo[4.2.1]non-1(4)-en-6-ones and bicyclo[5.2. 1]dec-1(10)-en-5-ones.

6-exo-Methylbicyclo[3.2.0]hepten-7-ones and their 2-alkylidene analogues are readily prepared from dialkyl squarates. These compounds undergo facial oxy-Cope ring expansions upon treatment with vinyllithium; the former leads to bicyclo[4.2. 1]non-1(4)-en-6-ones and the latter to the first examples of bicyclo[5.2.1]dec-1(10)-en-5-ones, compounds having exceptionally strained bridgehead double bonds. The transformations are controlled by the 6-exo-methyl group in the starting material along with the substituent at position-1 (bridgehead) which force attack of the lithium reagent from the concave face of the starting material, thus allowing the cyclopentenyl or alkylidene groups to participate in the sigmatropic event.

Gender differences in cardiovascular reactivity.

Pronounced cardiovascular reactivity to stress is a behavioral mechanism that may underlie the pathophysiology of coronary heart disease (CHD). Based on the greater incidence of CHD among males than among females, the purpose of the current investigation was to test the hypothesis that in young adults (ages 17-29), males (n = 47) show more cardiovascular reactivity than females (n = 61) to two stressors, a video game and cigarette smoking. Five of the six comparisons did not support the hypothesis: females were higher on heart rate and diastolic blood pressure reactivity to both stressors; males were higher on systolic blood pressure reactivity to the video game only. The results suggest that females may be particularly physiologically reactive to cigarette smoking.

Components of hostility as predictors of sudden death and myocardial infarction in the Multiple Risk Factor Intervention Trial.

We tested the hypothesis that hostility is associated with increased relative risk (RR) for coronary death and nonfatal myocardial infarction among participants in the prospective Multiple Risk Factor Intervention Trial (MRFIT). Cases (N = 192) were compared with matched controls (N = 384) on a variety of behavioral characteristics associated with the Type A behavior pattern (TABP), including three different but interrelated components of hostility. Logistic regression analyses revealed that only two of the eight TABP attributes analyzed on the overall sample were significant. Only total Potential for Hostility, when dichotomized into "low" and "high" categories, and the antagonistic interpersonal component of hostility (Stylistic Hostility) had positive unadjusted associations with coronary heart disease (CHD) incidence (RR = 1.7, p = 0.003; and RR = 1.5, p = 0.016, respectively). The global TABP and related paralinguistic attributes were not significantly related to CHD incidence. After adjustment for the traditional risk factors of age, serum cholesterol, blood pressure, and cigarette smoking, only dichotomous Potential for Hostility showed a significant relative risk (RR = 1.5, p = 0.032). Ordinal logistic regression revealed a nonsignificant effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Potential for hostility and dimensions of anger.

Recent reviews have linked Potential for Hostility derived from the Structured Interview (SI) to coronary artery disease, independent of the global Type A pattern. The present study examined the construct validity of Potential for Hostility ratings by correlating Potential for Hostility with 21 scales from four widely used anger/hostility measures: 7 scales from the Anger Self-Report, 8 scales from the Buss-Durkee Hostility Inventory, the total score from the Novaco Anger Inventory, and 5 scales from the Multidimensional Anger Inventory. The pattern of correlations revealed that Potential for Hostility was significantly related to scales reflecting awareness and arousal of anger, particularly the verbal expression of anger. To identify underlying anger dimensions, the 21 scales were factor-analyzed. Examination of two and three rotated principal components confirmed previous solutions. The first component, representing anger-arousing and -eliciting situations and anger awareness, was labeled Experience of Anger. The second component, consisting of scales dealing with either physical assault or verbal expression of anger, was labeled Expression of Anger. When a third factor was retained, it contained scales of suspicion, mistrust-suspicion, and guilt: It was therefore labeled Suspicion-Guilt. Potential for Hostility was correlated only with the Expression of Anger factor in the two-factor solution; in the three-factor solution, Potential for Hostility was correlated equally with the Experience of Anger and Expression of Anger factors but was not correlated with the Suspicion-Guilt factor. The implications of these results for the assessment of hostility are discussed.

Smoking, caffeine, and stress: effects on blood pressure and heart rate in male and female college students.

This study examined the independent and joint effects of cigarette smoking and caffeine consumption on blood pressure (BP) and heart rate (HR) reactions to stress in male and female college students. Following an initial physiological baseline, participants received one of four experimental treatments (paced smoking, caffeine, smoking plus caffeine, or neither) and had BP and HR measured before, during, and after two stressful tasks. The results revealed that, compared with the control condition, caffeine ingestion enhanced the magnitude of stress-induced systolic BP and HR reactions. Smoking combined additively with stress, and the joint effect of smoking and caffeine was no greater than either taken alone. Males and females were generally similar in their BP and HR responses to smoking, caffeine, and stress. Inconsistencies with previous research and possible physiological mechanisms underlying the observed effects are discussed.

Components of Type A, hostility, and anger-in: relationship to angiographic findings.

Previous research has linked the Type A coronary-prone behavior pattern to angiographically documented severity of coronary atherosclerosis (CAD). The present study sought through component scoring of the Type A Structured Interview (SI) to determine what elements of the multidimensional Type A pattern are related to coronary disease severity in a selected group of patients with minimal or severe CAD. Multivariate analyses controlling for the major risk factors showed no relationship between global Type A and extent of disease. Of all attributes measured, only Potential for Hostility and Anger-In were significantly and positively associated with the disease severity, including angina symptoms and number of myocardial infarctions. Further analysis revealed that Potential for Hostility and Anger-In were interactive in their association, such that Potential for Hostility was associated with disease endpoints only for patients who were high on the Anger-In dimension. These findings support previous research in suggesting that anger and hostility may be the critical aspects of the Type A pattern in predisposing individuals to risk of CAD.

Components of type A, hostility, and anger-in: further relationships to angiographic findings.

In a previous study of patients undergoing angiography at Duke University Medical Center, we reported that of all components of the Type A behavior pattern (TABP), only Potential for Hostility and Anger-In were significantly associated with extent of coronary artery disease (CAD). The present study was undertaken to replicate these findings using a different patient population. Tape-recorded structured interviews from 125 angiography patients at Massachusetts General Hospital were blind scored using the component scoring system employed in the Duke study. The results confirmed our previous findings. Global TABP was completely unrelated to extent of CAD, while Potential for Hostility and Anger-In were significant independent predictors of disease severity. These findings argue for a reconceptualization of the manner in which the TABP is defined and assessed.

Selective cardiovascular effects of stress and cigarette smoking in young women.

In an earlier study, we found that men who smoked a cigarette and then engaged in a mildly stressful activity (video game) evidenced pronounced increases in heart rate and blood pressure, which were approximately equal to the sum of the effects produced by either smoking alone or stress alone. In the present study, a 2 (smoke vs. sham smoke) X 2 (stress vs. no stress) factorial design was used to evaluate the impact of stress and smoking on the cardiovascular responses of young women. The results revealed that the combination of stress and cigarette smoking produced blood pressure and heart rate responses that were larger than the additive effects of smoking and stress taken separately.

Familial resemblance in components of the type A behavior pattern: a reanalysis of the California type A twin study.

Rosenman and colleagues reported no heritability of global Type A behavior assessed by the Structured Interview (SI) method, although some of the self-report scales correlated with global Type A behavior did have heritable components. Recent factor analyses of coded SI responses revealed four independent dimensions: clinical ratings, primarily of speech stylistics; and self-reports of pressured drive, anger, and competitiveness. It may be that some of these dimensions have a heritable base, whereas others do not. We report here reanalyses of the available SI responses from the Rosenman sample. In this subsample, tape recorded interviews with 80 monozygotic and 80 dizygotic twin pairs were scored for the extent of self-reported Type A behaviors, the major speech stylistics considered to be indicative of Pattern A, and the observable Type A behaviors (e.g., signs of hostility). Then scores for the major dimensions measured by the SI were calculated and scores for which there were sufficient data were subjected to twin analyses by the method of Christian et al. These analyses showed that individual differences in the clinical ratings factor and certain ratings loading on it--specifically, loudness of speech, competition for control of the interview, and potential for hostility--might have a heritable component. These results are discussed in the context of the importance of hostility as a predictor of subsequent coronary heart disease events as well as of total mortality, other data on the heritability of emotionality, and a temperament approach to understanding the origins of the Type A behavior pattern.

Desirability of control versus locus of control: relationship to paralinguistics in the type A interview.

David Glass has suggested that need for control is an important dimension underlying the Type A coronary-prone behavior pattern. However, this hypothesis has never been directly tested. Findings from the present study supported the hypothesis by showing a significant relationship between measures of desire for control and the Type A pattern as assessed by both the structured interview and questionnaire methods, and with Type A voice stylistics. In contrast, locus of control scores correlated only with the questionnaire-based measure of Type A, and were unrelated to desire for control scores, interview-defined Type A, and Type A noncontent speech characteristics. Some evidence suggests the hypothesis that autonomic nervous system arousal can create psychological discomfort that may serve to increase both need for control and Type A vocal stylistics. In addition, such vocal mannerisms may actually facilitate control of the social environment. Evidence implicating genetic factors in these processes is discussed.

Component analysis of the type A coronary-prone behavior pattern in male and female college students.

Two studies investigated the psychological dimensions encompassed by the Rosenman Structured Interview (SI) method of assessing the Type A behavior pattern. In Study 1, female students completed the SI and Jenkins Activity Survey (JAS). Factor analysis of the verbal stylistic and answer content components of the SI yielded a 5-factor solution, with one factor--Clinical Rating--accounting for most nonerror variance in Type A ratings. The remaining factors were derived from answer content and correlated more substantially with JAS Type A ratings than with SI Type A ratings. In Study 2, male and female college students completed the SI and JAS and a battery of questionnaires that tap trait dimensions implied by the conceptual definition of Type A. For both males and females, SI ratings of Type A could almost be completely predicted by scores on the Clinical Rating factor. For both sexes, content dimensions of the SI related to other measures of Type A and to Type A-consistent traits, whereas the Clinical Rating factor was only modestly associated with such traits. Moreover, sex differences were observed in the trait constellations composing SI and JAS definitions of Type A. These results suggest that a discrepancy exists between conceptual and operational definitions of the Type A pattern.

Selective cardiovascular effects of stress and cigarette smoking.

The purpose of the present study was to determine how cigarette smoking and psychological stress combine to affect cardiovascular function. Stress was operationally defined as playing a series of difficult video games under challenging instructional conditions. Following an initial test game, 51 smokers were randomly assigned to a 2 (smoke vs. sham smoke) X 2 (stress vs. no stress) design. The results showed that the subjects who sham smoked (inhaled unlit cigarettes) under no stress evidenced minimal changes in cardiovascular parameters. Subjects who smoked under no stress evidenced approximately 12 mmHg increase in systolic blood pressure (SBP) and 9 mmHg increases in diastolic blood pressure (DBP), and a 15 beat-per-minute increase in heart rate (HR). These effects were similar in magnitude to those seen in subjects who sham smoked under stress. By contrast, subjects who smoked under stress showed markedly larger increases in all cardiovascular parameters, approximately doubling the magnitude of the observed response over that seen with either smoking or stress alone. Correlational analyses suggested the presence of stable individual differences in autonomic lability or sensitivity. Possible mechanisms are suggested whereby stress and smoking may combine to heighten the risk for coronary disease.

Propranolol medication among coronary patients: relationship to type A behavior and cardiovascular response.

The present correlational study compared behavioral and psychophysiological characteristics of coronary patients who were either medicated or not medicated with the beta-adrenergic blocking drug propranolol. Eighty-eight patients were given a structured Type A interview (SI) and a history quiz while heart rate and blood pressure were monitored. Data were analyzed controlling for age, sex, extent of coronary artery disease, and history of angina. Results indicated that patients taking propranolol (n = 65) were significantly lower in intensity of Type A behavior than patients not taking propranolol (n = 23). No effects were obtained for patients medicated or not medicated with diuretics, nitrates, or other CNS active drugs. Propranolol patients also showed lesser heart rate and rate-pressure product responses to the interview, but did not differ in blood pressure responses. Components of Type A which were lower in propranolol patients included speech stylistics (loud/explosive, rapid/accelerated, potential for hostility). Content of responses to the SI and scores on the Jenkins Activity Survey did not differ between the groups. An explanation for these results is offered in terms of the effects of propranolol on peripheral sympathetic responses, and evidence for a physiological substrate for Type A behavior. A conceptualization of the Type A pattern in terms of cognitive and physiological components is advanced, and implications for clinical intervention are discussed.

Unique and common variance in structured interview and Jenkins Activity Survey measures of the type A behavior pattern.

The aim of the present study was to identify factors that account for similarities and discrepancies in classification of Type A and B behavior by the Structured Interview (SI) and by the Jenkins Activity Survey (JAS). Two diverse samples were administered the SI and the JAS. SI questions were coded for content of response and psychomotor behavior during the interview. Frequency of specific Type A speech characteristics and clinical judgments were also rated. Analyses revealed that the SI estimate of Type A could be predicted by the subjects' promptness of response, voice emphasis, hurried speech, and judgements of competitiveness, hostility, and energy level. The latter three judgments were also measured somewhat by the JAS. Interviewer ratings of subjects' overt motor behavior and appearance did not relate to SI assessments. The JAS estimate of Type A could be predicted by subjects' reports of pressured drive, which was also measured by SI. This pattern of interrelationships was similar in the two samples in spite of sample differences in age, health status, geographical location, interview and JAS forms, and raters. Overall, the correlations between the SI and JAS assessment were low and suggested a considerable degree of independence between the two measures. In light of these results, they should not be used as interchangeable measures of Type A behavior.

Challenge-induced cardiovascular response as a predictor of minor illnesses.

Male college students (n = 64) participated in a competitive "TV tennis game" while their heart rate and blood pressure were monitored. Subsequently, their health records were inspected to determine frequency of illnesses. Subjects who responded during the contest with extreme increases in heart rate and diastolic blood pressure were significantly more likely to have frequent minor illnesses than those responding with moderate or low increases.

Interpersonal interaction and cardiovascular response in type A subjects and coronary patients.

The present study tested the hypothesis that Type A subjects respond with greater cardiovascular response than Type B subjects during the structured interview used to assess the Type A pattern. Coronary patients (n = 31) and patient controls (n = 33) were subjected to the interview and a history quiz while ECG and blood pressure were monitored. As predicted, Type A relative to Type B subjects evidenced significantly greater increases in both systolic and diastolic blood pressure, which were sustained over the course of the entire 12-15 minute interview. Type A subjects compared with B's also showed significantly greater blood pressure elevations during the quiz. Coronary patients displayed significantly greater Type A attributes than control subjects and tended to show greater blood pressure elevations than controls during the interview. In addition, the quiz induced significant elevations in the blood pressure of coronary patients, but not patient controls, over that displayed during the interview, despite the presence of beta-adrenergic blocking medication. Implications of the findings for coronary-prone behavior and coronary heart disease are discussed.

The structured interview and questionnaire methods of assessing coronary-prone behavior in male and female college students.

Several self-report measures of type A behavior were compared with the Rosenman and Friedman structured interview method of assessment in male and female college students. The student version of the Jenkins Activity Survey was found to correlate relatively weakly with the interview for both males and females, while scales derived from the Gough and Thurstone inventories showed moderate correlations with interview typing for both sexes. A brief scale derived from a recent reanalysis of the Framingham study correlated with the interview appreciably greater for females than for males. In all, these data suggest the need for caution in using only paper-and-pencil tests to assess type A behavior.

Components of the type A coronary-prone behavior pattern and cardiovascular responses to psychomotor performance challenge.

The present study tested the general hypothesis that behavioral attributes most predictive of the incidence of coronary heart disease (CHD) in epidemiological research would also be most predictive of sympathetic autonomic nervous system (ANS) arousal in response to performance challenges. Subjects (n = 50) were challenged to respond rapidly and accurately on three tasks involving either perceptual-motor or cognitive skills, while the experimenter monitored blood pressure, heart rate, and galvanic skin potential. The hypothesis was generally confirmed in that (1) type A subjects showed significantly greater cardiovascular changes indicative of sympathetic ANS arousal than type B subjects, (2) the Rosenman and Friedman structured interview was a better predictor of this arousal than the Jenkins Activity Survey, as is the case in CHD, and (3) the stylistic and behavioral components of the type A pattern (as defined by the structured interview) which are most predictive of CHD were also found to be the best predictors of challenge-induced sympathetic ANS arousal. The implications of these results for refinements in the definition, assessment, and modification of coronary-prone behavior are discussed.