Publications by authors named "Stephen B Manuck"

169 Publications

Day-to-day associations between sleep characteristics and affect in community dwelling adults.

J Sleep Res 2021 Feb 15:e13297. Epub 2021 Feb 15.

Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.

Despite the high co-occurrence of sleep and mood disturbances, day-to-day associations between sleep characteristics (sleep duration, continuity, and timing) and dimensions of mood (positive affect and negative affect) remain unclear. The present study aimed to test whether there is a daily, bidirectional association between these sleep characteristics and affective states, while addressing methodological limitations in the extant literature by using actiography and ecological momentary assessment methods. Participants were community dwelling, midlife adults (aged 30-54 years, N = 462, 47% male) drawn from the Adult Health and Behavior Project-Phase 2 study. Participants' sleep patterns were assessed with actiography over a 7-day monitoring period, and on 4 of those days, participants completed an ecological momentary assessment protocol that included hourly assessments of positive affect and negative affect during their wake intervals. Using hierarchical linear modelling, we tested whether participants' sleep characteristics on a given night predicted next-day affect and vice versa. We also explored whether nocturnal sleep characteristics would differentially associate with affect at different times of day (morning, afternoon, and evening) while controlling for multiple health behaviours. We found that when participants reported higher positive affect on a given day, they slept later that night (B = 0.22, p = .010). Although we found no other statistically significant associations in our primary analyses (all p > .05), we found several sleep-affect associations specific to time of day (B ranges: 0.01-0.18, all p ≤ .02), which warrants further study. Overall, our findings suggest that healthy adults may be resilient to daily fluctuations in their sleep and mood.
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http://dx.doi.org/10.1111/jsr.13297DOI Listing
February 2021

Is stressor-evoked cardiovascular reactivity a pathway linking positive and negative emotionality to preclinical cardiovascular disease risk?

Psychophysiology 2021 Mar 5;58(3):e13741. Epub 2020 Dec 5.

Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA.

Stressor-evoked cardiovascular reactivity, trait positive emotionality, and negative emotionality are all associated with cardiovascular disease. It is unknown, however, whether cardiovascular reactivity may constitute a pathway by which trait positive or negative emotionality relates to disease risk. Accordingly, this study modeled the cross-sectional relationships between trait positive and negative emotionality, stressor-evoked cardiovascular reactivity, and severity of a subclinical vascular marker of cardiovascular risk, carotid artery intima-media thickness (CA-IMT). The sample consisted of healthy, midlife adults free from clinical cardiovascular disease (N = 286; ages 30-54; 50% female). Trait positive and negative emotionality were measured by three questionnaires. Heart rate and blood pressure reactivity were assessed across three stressor tasks. CA-IMT was assessed by ultrasonography. Latent factors of positive and negative emotionality, blood pressure reactivity, heart rate reactivity, and CA-IMT were created using structural equation modeling. Greater negative emotionality was marginally associated with more CA-IMT (β = .21; p = .049), but lower blood pressure reactivity (β = -.19; p = .03). However, heightened blood pressure (β = .21; p = .03), but not heart rate reactivity (β = -.05; p = .75), associated with greater CA-IMT. Positive emotionality was uncorrelated with cardiovascular reactivity (blood pressure: β = -.04; p = .61; heart rate: β = .16; p = .11) and CA-IMT (β = .16; p = .07). Although trait negative emotionality associates with a known marker of cardiovascular disease risk, independent of positive emotionality, it is unlikely to occur via a stressor-evoked cardiovascular reactivity pathway.
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http://dx.doi.org/10.1111/psyp.13741DOI Listing
March 2021

Relationship between Dispositional Mindfulness, Psychological Health, and Diet Quality among Healthy Midlife Adults.

Nutrients 2020 Nov 6;12(11). Epub 2020 Nov 6.

Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.

Mindfulness, a practice of non-judgmental awareness of present experience, has been associated with reduced eating psychopathology and emotion-driven eating. However, it remains unclear whether mindfulness relates to diet quality. Thus, the purpose of this study was to examine whether dispositional mindfulness is associated with diet quality and to explore psychological factors relating dispositional mindfulness to diet quality. Community-dwelling adults ( = 406; = 43.19, = 7.26; = 27.08, = 5.28; 52% female) completed ratings of dispositional mindfulness, depressive symptoms, perceived stress, positive affect (PA), and negative affect (NA). Dietary intake was assessed using the Block Food Frequency Questionnaire, from which the 2015 Healthy Eating Index was derived. Analyses were conducted using the "lavaan" package in R with bias-corrected bootstrapped confidence intervals (BootCI). Age, sex, race, education, and BMI were entered as covariates in all models. Higher dispositional mindfulness was associated with higher diet quality ( = 0.11, = 0.03), and this effect was mediated through lower depressive symptoms (indirect effect = 0.06, = 0.02, BootCI = 0.104-1.42, = 0.03). Dispositional mindfulness was negatively correlated with perceived stress ( = -0.31, < 0.01) and NA ( = -0.43, < 0.01), as well as positively correlated with PA ( = -0.26, < 0.01). However, these factors were unrelated to diet quality. These cross-sectional data provide initial evidence that dispositional mindfulness relates to diet quality among midlife adults, an effect that may be explained in part by less depressive symptomatology. Given that lifestyle behaviors in midlife are leading determinants of risk for cardiovascular disease and neurocognitive impairment in late life, interventions to enhance mindfulness in midlife may mitigate disease risk. Additional research assessing the impact of mindfulness interventions on diet quality are warranted.
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http://dx.doi.org/10.3390/nu12113414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695007PMC
November 2020

Cortical thickness and resting-state cardiac function across the lifespan: A cross-sectional pooled mega-analysis.

Psychophysiology 2020 Oct 10. Epub 2020 Oct 10.

Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Understanding the association between autonomic nervous system [ANS] function and brain morphology across the lifespan provides important insights into neurovisceral mechanisms underlying health and disease. Resting-state ANS activity, indexed by measures of heart rate [HR] and its variability [HRV] has been associated with brain morphology, particularly cortical thickness [CT]. While findings have been mixed regarding the anatomical distribution and direction of the associations, these inconsistencies may be due to sex and age differences in HR/HRV and CT. Previous studies have been limited by small sample sizes, which impede the assessment of sex differences and aging effects on the association between ANS function and CT. To overcome these limitations, 20 groups worldwide contributed data collected under similar protocols of CT assessment and HR/HRV recording to be pooled in a mega-analysis (N = 1,218 (50.5% female), mean age 36.7 years (range: 12-87)). Findings suggest a decline in HRV as well as CT with increasing age. CT, particularly in the orbitofrontal cortex, explained additional variance in HRV, beyond the effects of aging. This pattern of results may suggest that the decline in HRV with increasing age is related to a decline in orbitofrontal CT. These effects were independent of sex and specific to HRV; with no significant association between CT and HR. Greater CT across the adult lifespan may be vital for the maintenance of healthy cardiac regulation via the ANS-or greater cardiac vagal activity as indirectly reflected in HRV may slow brain atrophy. Findings reveal an important association between CT and cardiac parasympathetic activity with implications for healthy aging and longevity that should be studied further in longitudinal research.
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http://dx.doi.org/10.1111/psyp.13688DOI Listing
October 2020

Does well-being associate with stress physiology? A systematic review and meta-analysis.

Health Psychol 2020 Oct 20;39(10):879-890. Epub 2020 Jul 20.

Department of Psychology, University of Pittsburgh.

Objective: The current meta-analysis tested whether trait indicators of well-being associate with stressor-evoked physiological reactivity and recovery in healthy adults.

Method: Medline, PsycINFO, and PubMed were used to identify relevant articles. Articles were included if they (a) measured cardiovascular or neuroendocrine (but not immune) physiology during or after an acute laboratory stress paradigm (b) measured indicators of hedonic well-being, eudaimonic well-being, or optimism, and (c) included healthy adult participants. Laboratory stress tasks included frustrating cognitive tasks, emotional recall tasks, and tasks involving social evaluation. Physiological variables were aggregated across cardiac (heart rate and cardiac output), hemodynamic (mean arterial pressure, systolic blood pressure, and diastolic blood pressure), HPA (cortisol), and autonomic (high frequency heart rate variability, skin conductance, and catecholamines) markers. Twenty-seven studies were included (n = 3,390; 54.6% women). Effect sizes and confidence intervals were estimated using a random-effects model with pooled variance.

Results: Contrary to expectations, optimism was associated with greater cardiac reactivity to cognitive stressors but did not associate with stress recovery. By contrast, hedonic well-being was associated with enhanced hemodynamic recovery following laboratory stressors but was not associated with stress reactivity.

Conclusions: Hedonic well-being, but not optimism, could potentially buffer against the effects of psychological stressors on physiological responding by relating to more complete recovery. Identifying the mechanisms contributing to these patterns of association may provide insights into psychological interventions for well-being and stress-related disease risk. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/hea0000979DOI Listing
October 2020

Adiposity covaries with signatures of asymmetric feedback learning during adaptive decisions.

Soc Cogn Affect Neurosci 2020 Nov;15(10):1145-1156

Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.

Unhealthy weight gain relates, in part, to how people make decisions based on prior experience. Here we conducted post hoc analysis on an archival data set to evaluate whether individual differences in adiposity, an anthropometric construct encompassing a spectrum of body types, from lean to obese, associate with signatures of asymmetric feedback learning during value-based decision-making. In a sample of neurologically healthy adults (N = 433), ventral striatal responses to rewards, measured using fMRI, were not directly associated with adiposity, but rather moderated its relationship with feedback-driven learning in the Iowa gambling task, tested outside the scanner. Using a biologically inspired model of basal ganglia-dependent decision processes, we found this moderating effect of reward reactivity to be explained by an asymmetrical use of feedback to drive learning; that is, with more plasticity for gains than for losses, stronger reward reactivity leads to decisions that minimize exploration for maximizing long-term outcomes. Follow-up analysis confirmed that individual differences in adiposity correlated with signatures of asymmetric use of feedback cues during learning, suggesting that reward reactivity may especially relate to adiposity, and possibly obesity risk, when gains impact future decisions more than losses.
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http://dx.doi.org/10.1093/scan/nsaa088DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657458PMC
November 2020

Social Integration and Diurnal Cortisol Decline: The Role of Psychosocial and Behavioral Pathways.

Psychosom Med 2020 Jul/Aug;82(6):568-576

From the Departments of Psychology (Dickman, Thomas, Anderson, Manuck) and Psychology and Psychiatry (Kamarck), University of Pittsburgh, Pittsburgh, Pennsylvania.

Objective: A growing number of studies have associated various measures of social integration, the diversity of social roles in which one participates, with alterations in hypothalamic-pituitary-adrenocortical (HPA) functioning. The pathways through which social integration may be linked to HPA functioning, however, are as yet unknown. The present study examined whether daily social interactions, affective responses, health behaviors, and personality help explain the association between social integration and diurnal cortisol slope.

Methods: A sample of 456 healthy, employed adults (53.9% female, 82.0% white, 72.2% bachelor's degree or greater, mean age of 42.86 years) completed a 4-day ecological momentary assessment protocol that measured cortisol, social interactions, affect, sleep, and physical activity at frequent intervals throughout the day. Social integration was measured at baseline.

Results: Regression results controlling for age, sex, race, and education indicated that more socially integrated individuals showed steeper cortisol slopes (B = -0.00253, p = .006). Exploratory analyses suggested that the consistency (i.e., reduced variability) in nightly sleep midpoint partially explained this association (B = -0.00042, 95% confidence interval = -0.00095 to -0.00001). Personality, mood, social interaction patterns, and nonsleep health behavior differences did not account for the association between social integration and HPA activity.

Conclusion: This study replicates previous findings linking social integration and HPA functioning, and it examines patterns of nightly sleep as possible pathways through which the association may operate. Results have implications for understanding mechanisms for health risk and for development of future interventions.
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http://dx.doi.org/10.1097/PSY.0000000000000825DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367491PMC
July 2021

Impulsivity and midlife cardiometabolic risk: The role of maladaptive health behaviors.

Health Psychol 2020 Aug 7;39(8):642-654. Epub 2020 May 7.

Department of Psychology.

Objective: The present study evaluated distinct facets of impulsivity related to cardiometabolic risk (CMR) to identify specific behavioral mechanisms driving these relationships.

Method: Community adults ( = 1,295) between 30 and 54 years old (53% female, 84% White) completed a battery of impulsivity measures, reported their engagement in health behaviors over the past week (i.e., cigarette smoking, alcohol use, physical activity, and dietary intake), and were assessed for CMR factors (i.e., blood pressure, insulin resistance, adiposity, and blood lipids). Structural equation modeling was used to estimate previously established hierarchical models of distinct facets of impulsivity and CMR. Indirect effects through the observed health behaviors were examined for each association between the latent impulsivity factors identified and the latent CMR factor.

Results: Neuroticism/negative emotionality was the only latent impulsivity factor directly related to heightened CMR (β = 0.09, 95% confidence interval [CI] [0.01, 0.16], = .020). Extraversion/positive emotionality indirectly related to lower CMR through greater physical activity (β = -0.04, 95% CI [-0.06, -0.02], < .001), and measures of inhibition (β = 0.02, 95% CI [0.001, 0.04], = .045) and delay discounting (β = 0.08, 95% CI [0.001, 0.15], = .049) indirectly related to CMR through saturated fat intake.

Conclusions: These findings indicate that distinct facets of impulsivity differentially relate to CMR through varied behavioral pathways and identify physical activity and saturated fat intake as being particularly important health behaviors to target when tailoring treatment approaches to the unique behavioral characteristics of individuals high on certain facets of impulsivity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/hea0000884DOI Listing
August 2020

Affective brain patterns as multivariate neural correlates of cardiovascular disease risk.

Soc Cogn Affect Neurosci 2020 Nov;15(10):1034-1045

Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213, USA.

This study tested whether brain activity patterns evoked by affective stimuli relate to individual differences in an indicator of pre-clinical atherosclerosis: carotid artery intima-media thickness (CA-IMT). Adults (aged 30-54 years) completed functional magnetic resonance imaging (fMRI) tasks that involved viewing three sets of affective stimuli. Two sets included facial expressions of emotion, and one set included neutral and unpleasant images from the International Affective Picture System (IAPS). Cross-validated, multivariate and machine learning models showed that individual differences in CA-IMT were partially predicted by brain activity patterns evoked by unpleasant IAPS images, even after accounting for age, sex and known cardiovascular disease risk factors. CA-IMT was also predicted by brain activity patterns evoked by angry and fearful faces from one of the two stimulus sets of facial expressions, but this predictive association did not persist after accounting for known cardiovascular risk factors. The reliability (internal consistency) of brain activity patterns evoked by affective stimuli may have constrained their prediction of CA-IMT. Distributed brain activity patterns could comprise affective neural correlates of pre-clinical atherosclerosis; however, the interpretation of such correlates may depend on their psychometric properties, as well as the influence of other cardiovascular risk factors and specific affective cues.
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http://dx.doi.org/10.1093/scan/nsaa050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7657455PMC
November 2020

Hostility Dimensions and Metabolic Syndrome in a Healthy, Midlife Sample.

Int J Behav Med 2020 Aug;27(4):475-480

University of Pittsburgh, Pittsburgh, PA, 15260, USA.

Objective: Evidence links trait hostility with components of the metabolic syndrome (MetS), a clustering of cardiometabolic risk factors, but which hostility dimensions (e.g., expressive or cognitive hostility) relate to MetS are not well known. Further, there may be age and sex differences in the extent to which hostility dimensions relate to MetS. The present study evaluated associations between dimensions of hostility and the metabolic syndrome and its individual components as well as the moderating effects of sex and age.

Methods: In a cross-sectional sample of 478 employed adults, a principal component analysis from common trait hostility questionnaires yielded a two-factor solution: expressive hostility (anger and aggression) and cognitive hostility (cynicism). Each of these two components of hostility was examined as predictors of each of two aggregated MetS outcomes: a dichotomous measure of MetS, based upon the NCEP-ATP III definition, and a continuous measure based upon the average of standardized scores for each component; and they were examined as predictors of individual MetS components as well.

Results: Expressive hostility was associated with MetS severity (b = 0.110, p = 0.04) and waist circumference (b = 2.75, p = 0.01). Moderation analyses revealed that elevated expressive hostility was associated with elevated waist circumference in women but not men. Cognitive hostility was not related to any metabolic syndrome component or aggregated outcome, and no moderation was observed.

Conclusions: Among multiple individual components and two aggregated scores, only trait dispositions to expressed hostile affect and behavior were associated with MetS severity and waist circumference. The effects were small but statistically significant. The association between cognitive hostility and metabolic syndrome measures may not be robust in a large sample of healthy, midlife adults.
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http://dx.doi.org/10.1007/s12529-020-09855-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7701982PMC
August 2020

Borderline personality disorder traits associate with midlife cardiometabolic risk.

Personal Disord 2020 03 24;11(2):151-156. Epub 2019 Oct 24.

University of Pittsburgh.

There is growing interest in relationships between borderline personality disorder (BPD) pathology and physical health outcomes. Diagnostic BPD and BPD-related traits, for instance, have been shown to associate with self-reported cardiovascular disease and various cardiometabolic risk factors. However, potential confounding of these associations by comorbid depression, which itself contributes to risk for heart disease, remains unresolved, and previous research is limited by nearly uniform reliance on self-reported health status. In the present study, we examine the association of BPD traits and contemporaneously assessed depressive mood with instrumented measures of cardiometabolic risk in a midlife community sample ( = 1,295). BPD pathology was measured using dimensional, multi-informant trait measures; depressive symptomology was self-reported; and cardiometabolic risk was indexed via multiple indicators of insulin resistance, adiposity, dyslipidemia, and blood pressure. Structural equation modeling was used to estimate the effects of BPD traits and depressive symptoms on aggregated cardiometabolic risk, adjusting for their shared variance. Results showed both BPD features and depressive symptomatology related to the extent of cardiometabolic risk; when examined simultaneously, only BPD associated independently with risk indicators. In further supporting a link between BPD pathology and cardiovascular disease risk, these findings warrant future work to elucidate intervening behavioral and biological mechanisms. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/per0000373DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7047517PMC
March 2020

Decoupling Personality and Acute Psychiatric Symptoms in a Depressed Sample and a Community Sample.

Clin Psychol Sci 2019 May 18;17(3):566-581. Epub 2019 Jan 18.

Department of Psychiatry, University of Toronto.

The association between depression and neuroticism is complex, but due to the difficulty in assessing neuroticism during mood episodes, the mechanisms underlying this relationship remain poorly understood. In this study, we sought to decompose neuroticism into finer-grained elements that were uncorrelated with psychiatric symptoms and to examine the incremental validity of those elements in explaining deficits in interpersonal functioning. A bifactor model with one general factor and six specific factors fit the data well in both a depressed (=807) and a community (=1,284) sample, and the specific factors were relatively independent of acute symptoms. Moreover, two specific factors (Angry Hostility and Self-Consciousness) accounted for incremental variance in interpersonal functioning problems in the community sample and in a subgroup of depressed participants. The results demonstrate that neuroticism can be decomposed into components that are distinct from symptoms and that are incrementally associated with deficits in interpersonal functioning.
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http://dx.doi.org/10.1177/2167702618813989DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6782051PMC
May 2019

The effects of omega-3 fatty acids on neuropsychological functioning and brain morphology in mid-life adults: a randomized clinical trial.

Psychol Med 2020 10 4;50(14):2425-2434. Epub 2019 Oct 4.

University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Background: The diet of most adults is low in fish and, therefore, provides limited quantities of the long-chain, omega-3 fatty acids (LCn-3FAs), eicosapentaenoic and docosahexaenoic acids (EPA, DHA). Since these compounds serve important roles in the brain, we sought to determine if healthy adults with low-LCn-3FA consumption would exhibit improvements in neuropsychological performance and parallel changes in brain morphology following repletion through fish oil supplementation.

Methods: In a randomized, controlled trial, 271 mid-life adults (30-54 years of age, 118 men, 153 women) consuming ⩽300 mg/day of LCn-3FAs received 18 weeks of supplementation with fish oil capsules (1400 mg/day of EPA and DHA) or matching placebo. All participants completed a neuropsychological test battery examining four cognitive domains: psychomotor speed, executive function, learning/episodic memory, and fluid intelligence. A subset of 122 underwent neuroimaging before and after supplementation to measure whole-brain and subcortical tissue volumes.

Results: Capsule adherence was over 95%, participant blinding was verified, and red blood cell EPA and DHA levels increased as expected. Supplementation did not affect performance in any of the four cognitive domains. Exploratory analyses revealed that, compared to placebo, fish oil supplementation improved executive function in participants with low-baseline DHA levels. No changes were observed in any indicator of brain morphology.

Conclusions: In healthy mid-life adults reporting low-dietary intake, supplementation with LCn-3FAs in moderate dose for moderate duration did not affect neuropsychological performance or brain morphology. Whether salutary effects occur in individuals with particularly low-DHA exposure requires further study.
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http://dx.doi.org/10.1017/S0033291719002617DOI Listing
October 2020

Neurobiological Functioning and the Personality-Trait Hierarchy: Central Serotonergic Responsivity and the Stability Metatrait.

Psychol Sci 2019 10 5;30(10):1413-1423. Epub 2019 Sep 5.

Department of Psychology, University of Pittsburgh.

Trait domains of the five-factor model are not orthogonal, and two metatraits have often been estimated from their covariation. Here, we focus on the stability metatrait, which reflects shared variance in conscientiousness, agreeableness, and (inversely) neuroticism. It has been hypothesized that stability manifests, in part, because of individual differences in central serotonergic functioning. We explored this possibility in a community sample ( = 441) using a multiverse analysis of (a) multi-informant five-factor-model traits and (b) stability as a predictor of individual differences in central serotonergic functioning. Differences in serotonergic functioning were assessed by indexing change in serum prolactin concentration following intravenous infusion of citalopram, a selective serotonin reuptake inhibitor. Results were mixed, showing that trait neuroticism, agreeableness, and conscientiousness, as well as the stability metatrait, were significantly associated with prolactin response but that these findings were contingent on a number of modeling decisions. Specifically, these effects were nonlinear, emerging most strongly for participants with the highest levels (or lowest, for neuroticism) of the component traits.
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http://dx.doi.org/10.1177/0956797619864530DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794900PMC
October 2019

Physical activity moderates the effects of daily psychosocial stressors on ambulatory blood pressure.

Health Psychol 2019 Oct 23;38(10):925-935. Epub 2019 May 23.

Department of Psychology.

Objective: Previous literature has shown an inconsistent relationship between physical activity and stressor-evoked blood pressure reactivity. Use of ecological momentary assessment (EMA) may facilitate detecting such a relationship. In this study, the moderating effects of regular physical activity on the magnitude of ambulatory blood pressure (ABP) responses to psychosocial stressors experienced in daily life were examined.

Method: Four hundred seventy-seven healthy working adults (ages 30-54) provided ABP readings and recorded their daily experiences, using electronic diaries (ED), over 4 monitoring days. Measures of momentary Task Strain (high demand, low control) and Social Conflict (rating of recent social interaction quality) were used as indices of stressor exposure, and an accelerometry device was used to create 2 indices of physical activity: weekly average and recent (30 min prior to each ED interview). Multilevel models were used to examine the moderating between- and within-person effects of physical activity on ABP fluctuations corresponding with the momentary psychosocial stressors.

Results: Weekly physical activity moderated the effects of ABP responses to Task Strain (systolic blood pressure [SBP]: p = .033; diastolic blood pressure [DBP]: p = .028) and Social Conflict (DBP: p = .020), with significant increases in SBP and DBP shown for less physically active individuals but not for more physically active individuals. Similarly, recent physical activity moderated within-person DBP responses to Task Strain (p = .025), with greater DBP increases following less active periods.

Conclusion: Our results demonstrate that weekly and recent physical activity may moderate the effects of ABP responses to daily psychosocial stress. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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http://dx.doi.org/10.1037/hea0000755DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6746585PMC
October 2019

Circulating Interleukin-6 concentration covaries inversely with self-reported sleep duration as a function of polymorphic variation in the glucocorticoid receptor.

Brain Behav Immun 2019 05 11;78:21-30. Epub 2019 Jan 11.

Department of Psychology, University of Pittsburgh, United States.

Growing evidence links extremes of self-reported sleep duration with higher circulating markers of inflammatory disease risk, although not all findings are consistent. Extremes of sleep duration also associate with activation of the hypothalamic-pituitary-adrenocortical (HPA) system and the peripheral release of cortisol, a glucocorticoid (GC) important in downregulating transcription of pro-inflammatory molecules. Polymorphic variation in the gene encoding the GC receptor (GR; NR3C1) modulates cellular sensitivity to GC-mediated anti-inflammatory signaling, thereby affecting levels of pro-inflammatory molecules. Thus, we hypothesized that extremes of self-reported sleep duration may covary with circulating levels of inflammatory markers as a function of allelic variation in NR3C1. Specifically, we examine the possibility that a single nucleotide polymorphism of the GR gene-(rs6198), the minor (G) allele of which confers reduced GR sensitivity-moderates an association of sleep duration with interleukin (IL)-6 and C-reactive protein (CRP) among a large sample (IL-6: N = 857; CRP: N = 929) of midlife community volunteers of European ancestry. Findings showed that sleep duration varied inversely with IL-6 (β = -0.087, p = .012), and this association was stronger among individuals homozygous for the rs6198 G-allele compared to alternate genotypes (β = -0.071, p = .039). We also found that sleep duration showed a U-shaped association with CRP (polynomial term: β = 0.093, p = .006), which was not moderated by rs6198 genotype. In conclusion, we show that a common genetic variant in the GR moderates an inverse association of self-reported sleep duration with circulating IL-6, possibly contributing to the increased disease risk observed among some short sleepers.
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http://dx.doi.org/10.1016/j.bbi.2019.01.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6488397PMC
May 2019

Multidimensional assessment of impulsivity-related measures in relation to externalizing behaviors.

Psychol Med 2019 07 4;49(10):1678-1690. Epub 2018 Sep 4.

Department of Psychology,University of Pittsburgh,Pittsburgh, PA,USA.

Background: Trait impulsivity is thought to play a key role in predicting behaviors on the externalizing spectrum, such as drug and alcohol use and aggression. Research suggests that impulsivity may not be a unitary construct, but rather multidimensional in nature with dimensions varying across self-report assessments and laboratory behavioral tasks. Few studies with large samples have included a range of impulsivity-related measures and assessed several externalizing behaviors to clarify the predictive validity of these assessments on important life outcomes.

Methods: Community adults (N = 1295) between the ages of 30 and 54 completed a multidimensional assessment of impulsivity-related traits (including 54 self-report scales of personality traits implicated in impulsive behaviors, and four behavioral tasks purporting to assess a construct similar to impulsivity) and reported on five externalizing behavioral outcomes (i.e. drug, alcohol, and cigarette use, and physical and verbal aggression). We ran an exploratory factor analysis on the trait scales, and then a structural equation model predicting the externalizing behaviors from the three higher-order personality factors (i.e. Disinhibition v. Constraint/Conscientiousness, Neuroticism/Negative Emotionality, and Extraversion/Positive Emotionality) and the four behavioral tasks.

Results: Relations between the self-report factors and behavioral tasks were small or nonexistent. Associations between the self-report factors and the externalizing outcomes were generally medium to large, but relationships between the behavioral tasks and externalizing outcomes were either nonexistent or small.

Conclusions: These results partially replicate and extend recent meta-analytic findings reported by Sharma et al. (2014) to further clarify the predictive validity of impulsivity-related trait scales and laboratory behavioral tasks on externalizing behaviors.
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http://dx.doi.org/10.1017/S0033291718002295DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043188PMC
July 2019

Ambulatory Blood Pressure Reactivity as a Moderator in the Association Between Daily Life Psychosocial Stress and Carotid Artery Atherosclerosis.

Psychosom Med 2018 10;80(8):774-782

From the Departments of Psychology and Psychiatry (Kamarck), Biostatistics (Li), Psychology (Wright), Medicine (Muldoon), and Psychology (Manuck), University of Pittsburgh, Pennsylvania.

Objective: We examined whether associations between daily psychosocial stressor exposures and carotid artery intima-medial thickness (IMT) may be stronger among those showing larger stress-related cardiovascular reactivity (CVR) during the course of daily living.

Methods: A total of 474 healthy working adults (ages 30-54 years) collected ambulatory blood pressure and recorded their daily experiences, using electronic diaries, during two 2-day periods for a week. Measures of mean momentary task strain and social conflict were used as indices of stressor exposure, and partial regression coefficients linking momentary strain and conflict with ambulatory blood pressure fluctuations were used as measures of CVR. IMT was assessed in the carotid arteries using B-mode ultrasound.

Results: After covariate adjustment, associations between mean task strain exposure and IMT were significant among those high in CVR to strain (for systolic blood pressure, p = .006, for diastolic blood pressure, p = .011) but not among those low in strain CVR. Similarly, associations involving mean conflict exposure were significant among those high in CVR to social conflict (p < .001 for systolic blood pressure, p = .001 for diastolic blood pressure) but not among low social conflict reactors. Significant moderation effects were more consistently shown for task strain than for social conflict, but the overall pattern of results was robust across two different types of statistical modeling procedures.

Conclusions: Individual differences in CVR may moderate the effects of daily psychosocial stress on subclinical CVD among healthy employed adults. Using ecological momentary assessment to measure stress exposure as well as stress reactivity may facilitate our ability to detect these effects.
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http://dx.doi.org/10.1097/PSY.0000000000000627DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7523702PMC
October 2018

Narcissist or narcissistic? Evaluation of the latent structure of narcissistic personality disorder.

J Abnorm Psychol 2018 07;127(5):496-502

Department of Psychology, University of Pittsburgh.

We investigated the latent structure of narcissistic personality disorder by comparing dimensional, hybrid, and categorical latent variable models, using confirmatory factor analysis (CFA), nonparametric and semiparametric factor analysis, and latent class analysis, respectively. We first explored these models in a clinical sample and then preregistered replication analyses in 4 additional data sets (with national, undergraduate, community, and mixed community/clinical samples) to test whether the best-fitting model would generalize across different data sets with different sample compositions. A 1-factor CFA outperformed categorical models in fit and reliability, suggesting the criteria do not serve to distinguish a narcissist class or subtypes; rather, a narcissistic dimension underlies the narcissistic personality disorder construct. The CFA also outperformed hybrid models, indicating that people fall within the same continuous distribution, rather than composing homogenous groups of relative severity (nonparametric factor analysis) or pulling apart into mixtures of discrete distributions (semiparametric factor analysis) along that spectrum. (PsycINFO Database Record
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http://dx.doi.org/10.1037/abn0000363DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6051431PMC
July 2018

Associations of immunometabolic risk factors with symptoms of depression and anxiety: The role of cardiac vagal activity.

Brain Behav Immun 2018 10 18;73:493-503. Epub 2018 Jun 18.

Department of Psychology, University of Pittsburgh, PA, United States.

Objectives: This study examined 1) the cross-sectional relationships between symptoms of depression/anxiety and immunometabolic risk factors, and 2) whether these relationships might be explained in part by cardiac vagal activity.

Methods: Data were drawn from the Adult Health and Behavior registries (n = 1785), comprised of community dwelling adults (52.8% women, aged 30-54). Depressive symptoms were measured with the Center for Epidemiological Studies Depression Scale (CES-D) and the Beck Depression Inventory-II (BDI-II), and anxious symptoms with the Trait Anxiety scale of the State-Trait Anxiety Inventory (STAI-T). Immunometabolic risk factors included fasting levels of triglycerides, high-density lipoproteins, glucose, and insulin, as well as blood pressure, waist circumference, body mass index, C-reactive protein, and interleukin-6. Measures of cardiac autonomic activity were high- and low-frequency indicators of heart rate variability (HRV), standard deviation of normal-to-normal R-R intervals, and the mean of absolute and successive differences in R-R intervals.

Results: Higher BDI-II scores, in contrast to CES-D and STAI-T scores, were associated with increased immunometabolic risk and decreased HRV, especially HRV likely reflecting cardiac vagal activity. Decreased HRV was also associated with increased immunometabolic risk. Structural equation models indicated that BDI-II scores may relate to immunometabolic risk via cardiac vagal activity (indirect effect: β = .012, p = .046) or to vagal activity via immunometabolic risk (indirect effect: β = -.015, p = .021).

Conclusions: Depressive symptoms, as measured by the BDI-II, but not anxious symptoms, were related to elevated levels of immunometabolic risk factors and low cardiac vagal activity. The latter may exhibit bidirectional influences on one another in a meditational framework. Future longitudinal, intervention, an nonhuman animal work is needed to elucidate the precise and mechanistic pathways linking depressive symptoms to immune, metabolic, and autonomic parameters of physiology that predispose to cardiovascular disease risk.
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http://dx.doi.org/10.1016/j.bbi.2018.06.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7066576PMC
October 2018

The interaction between monoamine oxidase A (MAOA) and childhood maltreatment as a predictor of personality pathology in females: Emotional reactivity as a potential mediating mechanism.

Dev Psychopathol 2018 Feb 22:1-17. Epub 2018 Feb 22.

University of Pittsburgh.

Research consistently demonstrates that common polymorphic variation in monoamine oxidase A (MAOA) moderates the influence of childhood maltreatment on later antisocial behavior, with growing evidence that the "risk" allele (high vs. low activity) differs for females. However, little is known about how this Gene × Environment interaction functions to increase risk, or if this risk pathway is specific to antisocial behavior. Using a prospectively assessed, longitudinal sample of females (n = 2,004), we examined whether changes in emotional reactivity (ER) during adolescence mediated associations between this Gene × Environment and antisocial personality disorder in early adulthood. In addition, we assessed whether this putative risk pathway also conferred risk for borderline personality disorder, a related disorder characterized by high ER. While direct associations between early maltreatment and later personality pathology did not vary by genotype, there was a significant difference in the indirect path via ER during adolescence. Consistent with hypotheses, females with high-activity MAOA genotype who experienced early maltreatment had greater increases in ER during adolescence, and higher levels of ER predicted both antisocial personality disorder and borderline personality disorder symptom severity. Taken together, findings suggest that the interaction between MAOA and early maltreatment places women at risk for a broader range of personality pathology via effects on ER.
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http://dx.doi.org/10.1017/S0954579417001900DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7057625PMC
February 2018

Socioeconomic Position and Age-Related Disparities in Regional Cerebral Blood Flow Within the Prefrontal Cortex.

Psychosom Med 2018 05;80(4):336-344

From the USC Suzanne Dworak-Peck School of Social Work (Hackman), University of Southern California, Los Angeles, California; and Department of Psychology (Kuan, Manuck, Gianaros), Center for the Neural Basis of Cognition (Gianaros), University of Pittsburgh, Pittsburgh, Pennsylvania.

Objective: Socioeconomic position (SEP) is associated with cerebrovascular health and brain function, particularly in prefrontal cortex and medial temporal lobe regions that exhibit plasticity across the life course. However, it is unknown whether SEP associates with resting cerebral blood flow (CBF), an indicator of baseline brain function, in these regions in midlife, and whether the association is (a) period specific, with independent associations for childhood and adulthood SEP, or driven by life course SEP, and (b) explained by a persistent disparity, widening disparity, or the leveling of disparities with age.

Methods: To address these questions, we analyzed cerebral perfusion derived by magnetic resonance imaging in a cross-sectional study of healthy adults (N = 443) who reported on childhood and adult SEP. Main effects were examined as an index of persistent disparity and age by SEP interactions as reflecting widening or leveling disparities.

Results: Stable high SEP across the lifespan was associated with higher global CBF and regional CBF (rCBF) in inferior frontal gyrus. However, childhood SEP was associated with rCBF in middle frontal gyrus, as moderated by age (β = 0.04, p = .035): rCBF was inversely associated with age only for those whose parents had a high school education or below. No associations were observed for the hippocampus or amygdala.

Conclusions: Life course SEP associations with rCBF in prefrontal cortex are suggestive of persistent disparities, whereas the age by childhood SEP interaction suggests that childhood disadvantage relates to a widening disparity, independent of global differences. These differential patterns in midlife may relate to disparities in later-life cerebrovascular and neurocognitive outcomes.
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http://dx.doi.org/10.1097/PSY.0000000000000566DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104768PMC
May 2018

Generalizable representations of pain, cognitive control, and negative emotion in medial frontal cortex.

Nat Neurosci 2018 02 1;21(2):283-289. Epub 2018 Jan 1.

Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA.

The medial frontal cortex, including anterior midcingulate cortex, has been linked to multiple psychological domains, including cognitive control, pain, and emotion. However, it is unclear whether this region encodes representations of these domains that are generalizable across studies and subdomains. Additionally, if there are generalizable representations, do they reflect a single underlying process shared across domains or multiple domain-specific processes? We decomposed multivariate patterns of functional MRI activity from 270 participants across 18 studies into study-specific, subdomain-specific, and domain-specific components and identified latent multivariate representations that generalized across subdomains but were specific to each domain. Pain representations were localized to anterior midcingulate cortex, negative emotion representations to ventromedial prefrontal cortex, and cognitive control representations to portions of the dorsal midcingulate. These findings provide evidence for medial frontal cortex representations that generalize across studies and subdomains but are specific to distinct psychological domains rather than reducible to a single underlying process.
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http://dx.doi.org/10.1038/s41593-017-0051-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5801068PMC
February 2018

Premenopausal Reproductive Health Modulates Future Cardiovascular Risk - Comparative Evidence from Monkeys and Women.

Yale J Biol Med 2017 09 25;90(3):499-507. Epub 2017 Sep 25.

Department of Psychology, University of Pittsburgh, Pittsburgh, PA.

Coronary heart disease (CHD) remains the major cause of mortality among postmenopausal women living in industrialized countries. Several lines of evidence suggest that ovarian hormones (especially estrogen) protect the coronary arteries of premenopausal women. However, it is also known that women commonly experience disruptions in cyclic hormonal function during their reproductive years. In this perspective, we hypothesize that if regular, cyclic ovarian function affords protection against CHD, ovulatory abnormalities in young women may conversely promote the development of atherosclerosis (the pathobiological process underlying CHD) in the years prior to menopause and thus substantially increase the risk of subsequent heart disease. This hypothesis is supported by evidence from premenopausal nonhuman primates showing that relatively common, subclinical ovarian disruptions - as may be induced by psychosocial stress - are associated with the initiation and acceleration of coronary artery atherosclerosis. If extending to women, these findings would suggest that ovarian dysfunction is an early biomarker for CHD risk and, further, that primary prevention of CHD should begin during the premenopausal phase of life.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5612192PMC
September 2017

Sleep duration partially accounts for race differences in diurnal cortisol dynamics.

Health Psychol 2017 05;36(5):502-511

Department of Psychology, University of Pittsburgh.

Objective: Emerging research demonstrates race differences in diurnal cortisol slope, an indicator of hypothalamic-pituitary-adrenocortical (HPA)-axis functioning associated with morbidity and mortality, with African Americans showing flatter diurnal slopes than their White counterparts. Sleep characteristics are associated with both race and with HPA-axis functioning. The present report examines whether sleep duration may account for race differences in cortisol dynamics.

Method: Participants were 424 employed African American and White adults (mean age = 42.8 years, 84.2% White, 53.6% female) with no cardiovascular disease (Adult Health and Behavior Project-Phase 2 [AHAB-II] cohort, University of Pittsburgh). Cortisol slope was calculated using 4 salivary cortisol readings, averaged over each of 4 days. Demographic (age, sex), psychosocial (socioeconomic status [SES], affect, discrimination), and health behaviors (smoking, alcohol use, physical activity) variables were used as covariates, and sleep (self-report and accelerometry) was also assessed.

Results: African Americans had flatter slopes than Whites (F(1, 411) = 10.45, B = .02, p = .001) in models adjusting for demographic, psychosocial, and health behavior covariates. Shorter actigraphy-assessed total sleep time was a second significant predictor of flatter cortisol slopes (F(1, 411) = 25.27, B = -.0002, p < .0001). Total sleep time partially accounted for the relationship between race and diurnal slope [confidence interval = .05 (lower = .014, upper .04)].

Conclusions: African Americans have flatter diurnal cortisol slopes than their White counterparts, an effect that may be partially attributable to race differences in nightly sleep duration. Sleep parameters should be considered in further research on race and cortisol. (PsycINFO Database Record
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http://dx.doi.org/10.1037/hea0000468DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5505864PMC
May 2017

Systemic inflammation and resting state connectivity of the default mode network.

Brain Behav Immun 2017 May 23;62:162-170. Epub 2017 Jan 23.

Department of Psychology, University of Pittsburgh, Pittsburgh, PA 15260, United States; Center for the Neural Basis of Cognition, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, PA 15213, United States.

The default mode network (DMN) encompasses brain systems that exhibit coherent neural activity at rest. DMN brain systems have been implicated in diverse social, cognitive, and affective processes, as well as risk for forms of dementia and psychiatric disorders that associate with systemic inflammation. Areas of the anterior cingulate cortex (ACC) and surrounding medial prefrontal cortex (mPFC) within the DMN have been implicated specifically in regulating autonomic and neuroendocrine processes that relate to systemic inflammation via bidirectional signaling mechanisms. However, it is still unclear whether indicators of inflammation relate directly to coherent resting state activity of the ACC, mPFC, or other areas within the DMN. Accordingly, we tested whether plasma interleukin (IL)-6, an indicator of systemic inflammation, covaried with resting-state functional connectivity of the DMN among 98 adults aged 30-54 (39% male; 81% Caucasian). Independent component analyses were applied to resting state fMRI data to generate DMN connectivity maps. Voxel-wise regression analyses were then used to test for associations between IL-6 and DMN connectivity across individuals, controlling for age, sex, body mass index, and fMRI signal motion. Within the DMN, IL-6 covaried positively with connectivity of the sub-genual ACC and negatively with a region of the dorsal medial PFC at corrected statistical thresholds. These novel findings offer evidence for a unique association between a marker of systemic inflammation (IL-6) and ACC and mPFC functional connectivity within the DMN, a network that may be important for linking aspects of immune function to psychological and behavioral states in health and disease.
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http://dx.doi.org/10.1016/j.bbi.2017.01.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402695PMC
May 2017

Omega-3 Supplementation and the Neural Correlates of Negative Affect and Impulsivity: A Double-Blind, Randomized, Placebo-Controlled Trial in Midlife Adults.

Psychosom Med 2017 Jun;79(5):549-556

From the Department of Psychology (Muldoon, Kuan, Schirda, Kamarck, Jennings, Manuck, Gianaros), University of Pittsburgh, Pennsylvania; Department of Psychology and Neuroscience (Ginty), Baylor University, Waco, Texas; Heart and Vascular Institute, Department of Medicine (Muldoon), University of Pittsburgh School of Medicine, Pennsylvania; and Department of Psychiatry (Jennings), University of Pittsburgh School of Medicine, Pennsylvania.

Objective: In clinical trials, omega-3 fatty acid supplementation improves symptoms in psychiatric disorders involving dysregulated mood and impulse control, yet it is unclear whether in healthy adults, omega-3 fatty acid supplementation affects mood, impulse control, and the brain systems supporting these processes. Accordingly, this study tested the hypotheses that eciosapentaenoic (EPA) and docosahexaenoic (DHA) acid supplementation reduces negative affect and impulsive behaviors in healthy adults and that these changes correspond to alterations in corticolimbic and corticostriatal brain systems, which support affective and impulsive processes.

Methods: Healthy volunteers (N = 272) consuming 300 mg/d or less of EPA and DHA were enrolled in a double-blind, randomized, placebo controlled clinical trial. The participants received either capsules providing 1000 mg of EPA and 400 mg of DHA versus identical appearing soybean oil capsules per day for 18 weeks. Negative affect and impulsivity were measured by questionnaire and ecological momentary assessment, as well as functional alterations in corticolimbic and corticostriatal brain systems evoked by standardized functional magnetic resonance imaging tasks.

Results: There were no group by time interactions for any questionnaire or ecological momentary assessment measures of mood and impulsivity. Likewise, no group by time interactions were observed for functional magnetic resonance imaging responses evoked within corticolimbic and corticostriatal systems.

Conclusions: In healthy adults with low intake of omega-3 fatty acids, moderate-dose supplementation for 18 weeks did not alter affect or impulsive behaviors nor alter corticolimbic and corticostriatal brain functionality.

Trial Registration: Trial number NCT00663871.
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http://dx.doi.org/10.1097/PSY.0000000000000453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5453831PMC
June 2017

The Role of Occupational Status in the Association Between Job Strain and Ambulatory Blood Pressure During Working and Nonworking Days.

Psychosom Med 2016 10;78(8):940-949

From the Social Sciences Division (Joseph), Pepperdine University, Malibu, California; Heart and Vascular Institute, Department of Medicine (Muldoon), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Departments of Psychology (Manuck); Psychiatry, Psychology, and Epidemiology (Matthews); and Psychology and Psychiatry (Kamarck), University of Pittsburgh, Pittsburgh, Pennsylvania; and National Institute for Occupational Safety and Health (MacDonald, Grosch), Washington DC.

Objectives: The objectives of this study were to determine whether job strain is more strongly associated with higher ambulatory blood pressure (ABP) among blue-collar workers compared with white-collar workers, to examine whether this pattern generalizes across working and nonworking days and across sex, and to examine whether this pattern is accounted for by psychosocial factors or health behaviors during daily life.

Methods: A total of 480 healthy workers (mean age = 43 years, 53% female) in the Adult Health and Behavior Project-Phase 2 completed ABP monitoring during 3 working days and 1 nonworking day. Job strain was operationalized as high psychological demand (> sample median) combined with low decision latitude (
Results: Covariate-adjusted multilevel random coefficient regressions demonstrated that associations between job strain and systolic and diastolic ABP were stronger among blue-collar workers compared with white-collar workers (b = 6.53 [F(1,464) = 3.89, p = .049] and b = 5.25 [F(1,464) = 6.09, p = .014], respectively). This pattern did not vary by sex, but diastolic ABP findings were stronger when participants were at work. The stronger association between job strain and ABP among blue-collar workers was not accounted for by education, momentary physical activity, or substance use, but was partially accounted for by covariation between higher hostility and blue-collar status.

Conclusions: Job strain is associated with ABP among blue-collar workers. These results extend previous findings to a mixed-sex sample and nonworking days and provide, for the first time, comprehensive exploration of several behavioral and psychosocial explanations for this finding.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067969PMC
http://dx.doi.org/10.1097/PSY.0000000000000349DOI Listing
October 2016

A Stage Model of Stress and Disease.

Perspect Psychol Sci 2016 07;11(4):456-63

University of Pittsburgh.

In this article, we argued that the term stress has served as a valuable heuristic, helping researchers to integrate traditions that illuminate different stages of the process linking stressful life events to disease. We provided a short history of three traditions in the study of stress: the epidemiological, psychological, and biological. The epidemiological tradition focuses on defining which circumstances and experiences are deemed stressful on the basis of consensual agreement that they constitute threats to social or physical well-being. The psychological tradition focuses on individuals' perceptions of the stress presented by life events on the basis of their appraisals of the threats posed and the availability of effective coping resources. The biological tradition focuses on brain-based perturbations of physiological systems that are otherwise essential for normal homeostatic regulation and metabolic control. The foci of these three traditions have informed elements of a stage model of disease, wherein events appraised as stressful are viewed as triggering affective states that in turn engender behavioral and biological responses having possible downstream implications for disease.
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http://dx.doi.org/10.1177/1745691616646305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5647867PMC
July 2016