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UBC Theses and Dissertations

Cardiovascular risk and autonomic changes during high and low affect provocations Lamensdorf, Angela Mona-Lisa 1988

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CARDIOVASCULAR RISK AND AUTONOMIC CHANGES DURING HIGH AND LOU AFFECT PROVOCATIONS By ANGELA MONA-LISA LAMENSDORF B.Sc.> The U n i v e r s i t y of Ghana> 1984 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS i n THE FACULTY OF GRADUATE STUDIES ('" • ' P s y c h o I ogy ) Ue a c c e p t t h i s t h e s i s a s c o n f o r m i n g t D t h e r e q u i r e d s t a n d a r d THE UNIVERSITY OF B R I T I S H COLUMBIA AUGUST 1788 c ) A n g e I a M o n a - L i s a L a m e n s d o r f j 1788 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department The University of British Columbia 1956 Main Mall Vancouver, Canada V6T 1Y3 DE-6G/81) ABSTRACT i i Does h a v i n g a p o s i t i v e f a m i l y h i s t o r y o f e s s e n t i a l h y p e r t e n s i o n p r e d i s p o s e one t D 9 r e a t e r c a r d i o v a s c u l a r r e a c t i v i t y ? C o u l d r e a c t i v i t y be a s s e s s e d w i t h s t r e s s t a s k s t h a t have g r e a t e r e x t e r n a l v a l i d i t y t h a n t r a d i t i o n a l l a b o r a t o r y s t r e s s o r s ? To answer t h e s e q u e s t i o n s ? 2b s u b j e c t s w i t h p a r e n t a l h i s t o r y of e s s e n t i a l h y p e r t e n s i o n and 3b s u b j e c t s w i t h o u t ) were i n d u c e d t o c o n v e r s e w i t h an e x p e r i m e n t e r on ( a ) a n e u t r a l t o p i c ( t h e w e a t h e r ) ? and (b) an a f f e c t i v e t o p i c ( a f r u s t r a t i n g p e r s o n or e v e n t ) . The t o p i c s were s e l e c t e d f r o m a I i s t of 2b b e c a u s e t h e y had been r a t e d by u n d e r g r a d u a t e s as b e i n g t h e l e a s t and most a r o u s i n g t o p i c s t o t a l k a b o u t w i t h a s t r a n g e r i n an e x p e r i m e n t a l s i t u a t i o n . The r a t i n g s y i e l d e d no i n t e r a c t i o n s o f s e x of e x p e r i m e n t e r w i t h sex of t h e s u b j e c t . S u b j e c t s a l s o p e r f o r m e d a m e n t a l a r i t h m e t i c t a s k w h i c h i s a s t a n d a r d l a b o r a t o r y s t r e s s o r . The o r d e r of t a s k p r e s e n t a t i o n was r a n d o m l y a s s i g n e d w i t h i n g r o u p s b u t matched a c r o s s g r o u p s and sex t o c o n t r o l s e q u e n c e e f f e c t s . F o r e a c h s u b j e c t ? a 15-m i n u t e b a s e I i n e p e r i o d was a l lowed b e f o r e e a c h t a s k . R e a d i n g s of b l o o d p r e s s u r e ? h e a r t r a t e and r a t e o f r e s p i r a t i o n were made a t m i n u t e one? t h r e e ? and f i v e of e a c h t a s k p h a s e . E a c h c o n v e r s a t i o n t a s k c o n s i s t e d of f i v e m i n u t e s of t a l k i n g f o l lowed by I i s t e n i n g f o r f i v e m i n u t e s t o t h e e x p e r i m e n t e r . The t a s k s were s e p a r a t e d by f i v e - m i n u t e i n t e r v a l s t o a l l o w r e t u r n t o b a s e l i n e l e v e l s . R e s u l t s i i i i n d i c a t e d t h a t compared t o i n d i v i d u a l s w i t h o u t p a r e n t a l h i s t o r y of h y p e r t e n s i o n ? i n d i v i d u a l s w i t h p a r e n t a l h i s t o r y d i s p l a y e d h i g h e r l e v e l s o f b l o o d p r e s s u r e ( b u t n o t h e a r t r a t e and r a t e of r e s p i r a t i o n ) w h e t h e r t a l k i n g or l i s t e n i n g . When peak v a l u e s were c o n s i d e r e d ; p o s i t i v e p a r e n t a l h i s t o r y s u b j e c t s showed g r e a t e r r e a c t i v i t y t o t h e a f f e c t i v e t o p i c on d i a s t o l i c b l o o d p r e s s u r e . The r e s u l t s a l s o i n d i c a t e d t h a t t h e t h r e e k i n d s of s t r e s s o r s y i e l d e d d i f f e r e n t l e v e l s of p h y s i o l o g i c a l r e s p o n s e s w i t h t h e math t a s k and t a l k p h a s e of t h e a f f e c t t a s k y i e l d i n g h i g h e r l e v e l s o f b l o o d p r e s s u r e and h e a r t r a t e t h a n t a l k a b o u t t h e w e a t h e r . The d i f f e r e n c e b e t w een t h e math and a f f e c t i v e t a s k s was n o t s i g n i f i c a n t on s y s t o l i c b l o o d p r e s s u r e ? b u t math y i e l d e d h i g h e r r e s p o n s e s on h e a r t r a t e and lower r e s p o n s e s on d i a s t o l i c b l o o d p r e s s u r e > t h a n t a l k i n g a b o u t a f r u s t r a t i n g e v e n t or p e r s o n . T h ese r e s u l t s s u g g e s t t h a t a more g e n e r a l i z a b I e s t r e s s s t i m u l u s s u c h as an a f f e c t - l a d e n c o n v e r s a t i o n ? can be r e a s o n a b l y s t a n d a r d i z e d a c r o s s s u b j e c t s and e l i c i t s an a I p h a - a d r e n e r g i c v a s o - c o n s t r i c t i v e r e s p o n s e ? a r e s p o n s e more r e a d i l y g i v e n by i n d i v i d u a l s w i t h p o s i t i v e p a r e n t a l h i s t o r y t h a n i n d i v i d u a l s w i t h o u t . The r e s u l t s a l s o s u g g e s t t h a t i n d i v i d u a l s w i t h p o s i t i v e p a r e n t a l h i s t o r y of h y p e r t e n s i o n have h i g h e r b l o o d p r e s s u r e l e v e l s t h a n i n d i v i d u a l s w i t h o u t . W i t h r e s p e c t t o t h e s i m i l a r i t y of t h e f i n d i n g s of t h i s s t u d y ? w i t h t h o s e of o t h e r s t u d i e s w h i c h have u s e d o l d e r p o p u l a t i o n s ? i t i s p r o p o s e d t h a t t h e s e r e s u l t s a r e g e n e r a l i z a b l e t o o l d e r p o p u l a t i o n s and p r o v i d e e v i d e n c e t h a t i v a p o s i t i v e f a m i l y h i s t o r y of e s s e n t i a l h y p e r t e n s i o n may be c o n s i d e r e d a r i s k f a c t o r f o r l a t e r c a r d i o v a s c u l a r d i s e a s e . V TABLE OF CONTENTS A b s t r a c t T a b l e o f c o n t e n t s L i s t o f Tab I e s L i s t o f F i g u r e s A c k n o w I e d g e m e n t 1. I n t r o d u c t i o n F o r e w a r d F a m i l y H i s t o r y and B l o o d P r e s s u r e FH J CV R i s k ? and A c u t e R e a c t i v i t y +FH and P e r s o n a l i t y V a r i a b l e s D i f f i c u l t i e s a s s o c i a t e d w i t h R e s e a r c h page i i page v page v i i page i x page x page 1 page 3 page 4 on F H / A u t o n o m i c A c t i v i t y I n t e r a c t i o n s page 7 Summary page B A f f e c t and B1ood P r e s s u r e page 9 A f f e c t ? s p e e c h and B l o o d P r e s s u r e page 11 L i s t e n i n g ? A f f e c t and B l o o d P r e s s u r e page 16 Summary and H y p o t h e s e s page 20 Methodo1ogy page 21 P i l o t S t u d y 1 S u b j e c t s page 21 Method page 22 R e s u l t s page 22 P i l o t S t u d y 2 S u b j e c t s page 25 Method page 25 R e s u l t s page 27 D i s c u s s i o n page 27 M a i n S t u d y E x p e r i m e n t a l D e s i g n page 28 S u b j e c t s page 28 E x p e r i m e n t a l T a s k s page 29 B u s s - D u r k e e H o s t i 1 i t y S c a l e page 32 P r o c e d u r e page 34 A p p a r a t u s page 35 3 . R e s u I t s S u b j e c t i v e Task E v a l u a t i o n s FH and H o s t i I i t y P h y s i o l o g i c a l f i n d i n g s The e f f e c t o f age T o p i c and ph a s e of c o n v e r s a t i o n The Math t a s k D i s c u s s i o n Fam i Iy Hi s t o r y A f f e c t and n e u t r a l s p e e c h How v a l i d a r e c o n v e r s a t i o n a l t a s k s ? 4 . page 38 page 39 page 41 page 43 page 49 page 57 page 59 page 64 page 67 page 68 v i C o m p a r i s o n w i t h S t o n e y and Matthem5 >(1788> page b9 .... w i t h D i m s d a l e e t a l (1988) page 70 The o r i e n t i n g r e f l e x i n +FH s u b j e c t s ? page 72 I s s u e s r e l a t e d t o M e t h o d o l o g y C o n v e r s a t i o n as a L a b . t o o l page 75 S u b j e c t s page 7b R a t e o f R e s p i r a t i o n page 78 Impr o v e m e n t s i n D e s i g n page 78 Summary and C o n c l u s i o n s F u t u r e d i r e c t i o n s page 77 page 80 5. R e f e r e n c e s page 82 b. A p p e n d i c e s A. C o n v e r s a t i o n r a t i n g s c a l e B. L e t t e r t o p a r e n t s C. P a r e n t s - 1 Q u e s t i o n n a i r e D. C o n v e r s a t i o n s E. BDHI S c a r i ng t h e BDHI F. R a t i o n a l e I n s t r u c t i ons G. C o n s e n t f o r m H. P e r s o n a l D a t a Q u e s t i o n n a i r e I . Task V a l i d a t i o n Q u e s t i o n n a i r e J . D e b r i e f i n g f o r m s page page page page page page page page page page page page 87 88 8? 70 73 77 78 78 100 101 102 103 V l l L i s t o f Tab I e s T a b l e 1 Mean A r D u s a b i I i t y r a t i n g s on t h e t o p i c o f w e a t h e r . page 23 T a b l e 2. Mean r a t i n g s f o r 'The p e r s o n you d e s p i s e t h e most' page 24 T a b l e 3. Mean r a t i n g s f o r 'The m o s t f r u s t r a t i n g p e r s o n o r e v e n t page 25 T a b l e 4. Mean Change s c a r e s o n p h y s i o l o g i c a l m e a s u r e s f r o m b a s e I i n e t o s p e e c h t a s k s page 27 T a b l e 5. Mean a n x i e t y r a t i n g o f t a s k s by +FH and -FH s u b j e c t s page 40 T a b l e 6 Mean r a t i n g s o f p e r s o n a l r e l e v a n c e d u r i n g a f f e c t i v e and n e u t r a l c o n v e r s a t i o n s . page 41 T a b l e 7. Mean S c o r e s o t h e BDHI f o r +FH and -FH s u b j e c t s page 42 T a b l e 8. Manova summary t a b l e of e f f e c t o f f a m i l y h i s t o r y (FH) o n HR, SBP > DBF > 8. RR. (2FH X 2 TOPICS X 2 PHASES OF CONVERSATION). page 44 T a b l e 9. Mean SBP v a l u e s f o r +FH and -FH s u b j e c t s a t d i f f e r e n t c o n v e r s a t i o n p h a s e s . page 45 T a b l e 10. Mean DBP v a l u e s o f +FH and _FH s u b j e c t s a t d i f f e r e n t c o n v e r s a t i o n p e r i o d s . page 46 T a b l e 11. Mean H e a r t R a t e v a l u e s of +FH and -FH s u b j e c t s d u r i n g d i f f e r e n t p h a s e s of c o n v e r s a t i o n . page 47 T a b l e 12. Mean r a t e o f r e s p i r a t i o n v a l u e s D f +FH and -FH s u b j e c t s d u r i n g d i f f e r e n t p h a s e s D f c o n v e r s a t i o n page 48 T a b l e 13. Age d i s t r i b u t i o n o f s u b j e c t s page 49 T a b l e 14. Mean peak v a l u e s o f e a c h c o n v e r s a t i o n an HR page 54 T a b l e 15. Mean peak v a l u e s D f e a c h c o n v e r s a t i o n p h a s e SBP page 55 v i i i T a b l e 16 Mean peak v a l u e s o f DBP t a k e n a t e a c h c o n v e r s a t i o n p h a s e page 56 T a b l e 17 Mean p h y s i o l o g i c a l i n d i c e s of a r o u s a l on two d i f f e r e n t t o p i c s o f c o n v e r s a t i o n a t d i f f e r e n t p h a s e s o f c o n v e r s a t i o n . page 58 Tab I e 18 Mean p h y s i o l o g i c a l r e a d i n g s t a k e n d u r i n g s p e e c h t a s k s and math page 6D i x L i s t o f F i g u r e s F i g u r e 1. Mean SBP v a l u e s a t d i f f e r e n t t a s k p h a s e s page 51 F i g u r e 2. Mean DBP v a l u e s a t d i f f e r e n t t a s k p h a s e s page 52 F i g u r e 3. +FH vs -FH on peak DBP m e a s u r e s u s i n g Change s c a r e s page 53 F i g u r e 4. The e f f e c t s o f d i f f e r e n t t a s k s on HR page 61 F i g u r e 5. The e f f e c t s o f d i f f e r e n t t a s k s on SBP page 62 F i g u r e 6. The e f f e c t s o f d i f f e r e n t t a s k s on DBP page 63 X ACKNOWLEDGEMENT To my s u p e r v i s o r ? Dr. W o l f g a n g L i n d e n ? a b i g t h a n k - y o u f o r a l l h i s s u p p o r t and s u g g e s t i o n s w h i c h s h a p e d t h e t h e s i s i n t o what i t has t u r n e d o u t t o be. To t h e o t h e r members o f t h e c o m m i t t e e ? many t h a n k s f o r t h e g r u e l I i n g d e f e n c e ! To t h e D e p a r t m e n t ? t h a n k s f o r t h e l o g i s t i c s u p p o r t we so o f t e n t a k e f o r g r a n t e d . And f i n a l l y t o t h e CV l a b . r e s e a r c h team o f 1987= J i m F r a n k i s h ? A a r o n H a i t ? F r a n Wen? C a r o l y n Ryan? L a u r a T i n c k l e r and E r i c Ochs? me da mo a s e ! 1 FOREWORD A c c o r d i n g t o a G h a n a i a n p r o v e r b ? a c r a b does n o t g i v e b i r t h t o a b i r d ! T h i s v e r y i n t e r e s t i n g way of s a y i n g • " l i k e p a r e n t l i k e c h i l d " i s t h e r e c e n t f o c u s on d e t e r m i n a n t s of r i s k f a c t o r s i n e s s e n t i a l h y p e r t e n s i o n r e s e a r c h . R e s u l t s f r o m s t u d i e s on e s s e n t i a l h y p e r t e n s i o n (EH) have p a i n t e d t o p a r e n t a l h i s t o r y o f h y p e r t e n s i o n as a r i s k f a c t o r and have l i n k e d t h i s w i t h h i g h c a r d i o v a s c u l a r (CV) r e a c t i v i t y . I t a p p e a r s t h a t n o r m o t e n s i v e s w i t h a p o s i t i v e f a mi l y h i s t o r y (+FH) of h y p e r t e n s i o n have been f o u n d t o m a n i f e s t g r e a t e r s y m p a t h e t i c a ! l y d r i v e n CV r e a c t i v i t y t o s t r e s s t h a n n o r m o t e n s i v e s w i t h no fami l y h i s t o r y (-FH) of EH. Even more i m p o r t a n t ? e x c e s s i v e s y m p a t h e t i c n e r v o u s s y s t e m r e a c t i v i t y a f p a s s i b l e g e n e t i c o r i g i n i s t h o u g h t t o be i n v o l v e d i n t h e p a t h o g e n e s i s o f one or more f o r m s of EH. C o u p l e d w i t h e x c e s s i v e CV r e a c t i v i t y t o l a b o r a t o r y s t r e s s o r s i s a t e n d e n c y f o r c e r t a i n +FH i n d i v i d u a l s t o r e p o r t r e l a t i v e l y l e s s n e g a t i v e a f f e c t ' t h a n -FH i n d i v i d u a l s . T h i s t e n d e n c y has been t e r m e d D e n i a l by J o r g e n s e n and H o u s t o n ? ( 1 7 8 6 ) . A t t h e p h y s i o l o g i c a l l e v e l ? L y n c h ( 1 785) has c o n c e p t u a l i z e d i n c r e a s e d r e s p o n s i v i t y d u r i n g d i a l o g u e ? as t h e l o s s of t h e c a r d i a c o r i e n t i n g r e f l e x . He p o s i t s t h a t i n s t e a d o f o r i e n t i n g t o new n o n - t h r e a t e n i n g s t i m u l i w i t h d e c r e a s e d h e a r t r a t e and no change i n b l o o d p r e s s u r e ? h y p e r t e n s i v e s show p h y s i o l o g i c a l r e a c t i o n s t h a t a r e c o m p a r a b l e w i t h t h o s e shown by l a b o r a t o r y a n i m a l s when t h e y •feel t h r e a t e n e d ; w i t h e l e v a t e d h e a r t r a t e and b l o o d p r e s s u r e . L y n c h t h e r e f o r e p o s t u l a t e d t h a t i n d i v i d u a l s w i t h EH n o t o n l y have h i g h Cv1 r e a c t i v i t y > b u t have a l s o l o s t t h e a b i l i t y t o a t t e n d t a n o v e l s t i m u l i * s u c h as l i s t e n i n g d u r i n g d i a l o g u e . O t h e r s t u d i e s o f a d i f f e r e n t n a t u r e c i t e d by Ui I I i a m s j B a r e f o o t and S h e k e l l e (1982)> have l e n t s u p p o r t t o t h i s t e n t a t i v e h y p o t h e s i s by s h o w i n g t h a t men w i t h EH t e n d t o be more v i g i I a n t > and have h i g h e r l e v e l s D f t e s t o s t e r o n e t h a n n o n - h y p e r t e n s i v e men. In a n i m a l s * s u c h h i g h l e v e l s of t e s t o s t e r o n e have been shown t o be a c o n t r i b u t i n g f a c t o r t o c h r o n i c a l l y e l e v a t e d b l o o d p r e s s u r e . T h i s s t u d y was d e s i g n e d t o (1) t e s t t h e i n t e r a c t i v e e f f e c t s o f fami l y h i s t o r y w i t h a u t o n o m i c r e s p o n s e s t o a f f e c t - p r o v o k i n g and m e n t a l l y c h a l l e n g i n g t a s k s d u r i n g s p e e c h as we I I as I i s t e n i n g p h a s e s and (2) t e s t f o r t h e s t a b i I i t y of h y p e r r e s p o n s e p r e d i s p o s i t i o n s a c r o s s d i f f e r e n t c l a s s e s o f l a b o r a t o r y t a s k s . FAMILY HISTORY AND BLOOD PRESSURE 3 F a m i l y H i s t o r y ? C a r d i q v a s c u I a r R i s k and A c u t e R e a c t i v i t y Rase and C h esney ( 1 7 8 6 ) r e v i e w e d t h e I i t e r a t u r e on CV r e a c t i v i t y i n n o r m o t e n s i v e s a t r i s k f o r EH? and a d d r e s s e d t h e q u e s t i o n o-f w h e t h e r e x a g g e r a t e d s t r e s s r e a c t i v i t y was a p r e c u r s o r t o or a c o n s e q u e n c e D f EH. The s t u d i e s r e v i e w e d showed t h a t compared t o a g e - m a t c h e d c o n t r o l s whose p a r e n t a l n o r m o t e n s i v e s t a t u s was d i r e c t l y c o n f i r m e d ? a d u l t s o n s of a h y p e r t e n s i v e p a r e n t showed s i g n i f i c a n t l y g r e a t e r v a s c u l a r r e s p o n s e t o i n f u s e d n o r e p i n e p h r i n e ? and t h a t 19 o u t of 27 s t u d i e s r e v i e w e d by M a t t h e w s and R a k a c z k y ( i n p r e s s ) p r o d u c e d c l e a r e v i d e n c e t h a t f a m i l i a l h i s t o r y D f EH or c o r o n a r y h e a r t d i s e a s e i s a s s o c i a t e d w i t h e l e v a t e d s t r e s s -i n d u c e d c h a n g e s i n b l o o d p r e s s u r e ? h e a r t r a t e ? a n d / o r p l a s m a r e n i n a c t i v i t y . O n l y 4 o f t h e s t u d i e s f a i l e d t o f i n d s u c h a f a mi I i a l r i s k e f f e c t . Rose and Chesney n o t e d t h a t i n s p i t e o f t h e h e t e r o g e n e i t y of methods used? s u c h c o n s i s t e n t g r o u p d i f f e r e n c e s showed t h e r o b u s t n e s s of f a m i l i a l h i s t o r y of CV r e a c t i v i t y i n a d u l t s . These g r o u p d i f f e r e n c e s have a l s o been d e m o n s t r a t e d i n c h i I d r e n as young as 5 y e a r s of age. T win s t u d i e s on t h e s u b j e c t a l s o seem t o p o i n t t o fami I i a l modes of CV r e s p o n s e t o s t r e s s o r s . Rose and C h e s n e y ' s r e v i e w i n d i c a t e s t h a t CV r e s p o n s e s o f m o n o z y g o t i c t w i n s t o l a b o r a t o r y s t r e s s o r s have g r e a t e r c o r r e l a t i o n t h a n r e s p o n s e s o f d i z y g o t i c t w i n s ? w h i c h i n t u r n a r e more h i g h l y c o r r e l a t e d t h a n CV r e s p o n s e s D f s i b l i n g s . T h e r e was no c o r r e l a t i o n f o u n d b e tween r e s p o n s e s o f u n r e l a t e d b u t a g e -matched c o n t r o l s . T hese c o r r e l a t i o n s h o l d t r u e a l s o f o r r e s t i n g b l o o d p r e s s u r e . The s t u d i e s r e v i e w e d had l a r g e s a m p l e s i z e s (n=2D0 p a i r s o f n o r m a t e n s i v e t w i n s ; H i n e s * e t a l . 1957? n=239 n o r m o t e n s i v e a d o l e s c e n t s and young a d u l t s ? Rose e t a l 1 9 8 4 ) * and t h e r e f o r e do n o t seem t o r e f l e c t m e r e l y s p u r i o u s f i n d i n g s . In one of t h e s t u d i e s q u o t e d by Rose and C h e s n e y * t h e a u t h o r s * C a r r o l l * H e w i t t * L a s t * e t . a l . * ( 1 9 8 5 ) * were a b l e t o f i t t h e o b s e r v e d d a t a t o a model w h i c h i n c l u d e d a p a r a m e t e r of a d d i t i v e g e n e t i c i n f l u e n c e * and one of i d i o s y n c r a t i c e x p e r i e n c e . T h i s y i e l d e d a h e r i t a b i l i t y e s t i m a t e o f .48* s u g g e s t i n g t h a t n e a r l y h a l f o f t h e i n d i v i d u a l v a r i a t i o n i n c a r d i a c r e a c t i v i t y t o s t r e s s was due t o u n d e r l y i n g g e n e t i c v a r i a t i o n * g i v i n g f u r t h e r s u p p o r t t o t h e h y p o t h e s i s t h a t t h e +FH f a c t o r may p r e d i s p o s e one t o EH. P o s i t i v e F a m i l y H i s t o r y and P e r s o n a l i t y v a r i a b l e s . A h a l f c e n t u r y ago* p e r s o n a l i t y r e s e a r c h on EH was p s y c h o a n a l y t i c i n n a t u r e * ( A l e x a n d e r * 1 9 3 9 ) . EH was t h o u g h t t o be a p h y s i c a l m a n i f e s t a t i o n of u n c o n s c i o u s c o n f I i c t s c e n t e r e d a r o u n d t h e e x p r e s s i o n o f h o s t i I i t y * a g g r e s s i o n * r e s e n t m e n t * r a g e * r e b e l I i o n * a m b i t i o n and d e p e n d e n c y ( A l e x a n d e r 1 9 3 9 ) . A r e v i e w o f t h e p e r s o n a l i t y l i t e r a t u r e by L i n d e n and F e u e r s t e i n ( 1 9 8 1 ) * l i s t e d p e r s o n a l i t y f a c t o r s i n EH o b s e r v e d i n r e s e a r c h as a n x i e t y * h o s t i l i t y * d i f f i c u l t i e s w i t h a s s e r t i v e n e s s and e m o t i o n a l c o n t r o l ? low s e l f esteem? p r o b l e m s w i t h r e l a t i o n s h i p s ? p e s s i m i s m and a t e n d e n c y t o w a r d s a n e g a t i v e c o g n i t i v e s e t . The a u t h o r s f i t t e d t h e s e p e r s o n a l i t y c h a r a c t e r i s t i c s i n t o a s o c i a l c o m p e t e n c e model and s u g g e s t e d t h a t h y p e r t e n s i v e s may l a c k c e r t a i n s o c i a l s k i l l s i . e . ? be o v e r l y h o s t i l e and a g g r e s s i v e or be o v e r l y s u b m i s s i v e ? a t e n d e n c y w h i c h f i t s i n w i t h t h e o r i g i n a l p s y c h o a n a l y t i c c o n c e p t u a l i z a t i o n a b o v e . Whether t h e e x p r e s s i o n o r s u p p r e s s i o n o f h o s t i l i t y l e a d s t o EH or w h e t h e r i t i s EH w h i c h l e a d s t o t h e i n a p p r o p r i a t e e x p r e s s i o n o f h o s t i l i t y i s a c a s e o f w h i c h comes f i r s t ; t h e c h i c k e n o r t h e egg? C e r t a i n p a t t e r n s c o n c e r n i n g t h e e x p r e s s i o n o f a f f e c t have been I i n k e d w i t h p a r e n t a l h i s t o r y of h y p e r t e n s i o n . F o r i n s t a n c e ? J o r g e n s e n and H o u s t o n (1786) f o u n d t h a t amongst a g r o u p o f s u b j e c t s who had u n d e r g o n e a s e r i e s o f m e n t a l a r i t h m e t i c t a s k s ? a s u b - g r o u p o f +FH s u b j e c t s had a p e r s o n a l i t y p a t t e r n o f d e n i a l and unwi I I i n g n e s s t o a d m i t t o n e u r o t i c f e e l i n g s of a g g r e s s i v e n e s s . T hese same s u b j e c t s showed t h e h i g h e s t s y s t o l i c and d i a s t o l i c b l o o d p r e s s u r e d u r i n g s t r e s s ? b u t d i d not d i f f e r f r o m o t h e r s u b j e c t s on r e p o r t e d c h a n g e i n a n g e r or a n x i e t y . Thus r e l a t i v e t o t h e i r h e i g h t e n e d CV r e a c t i v i t y ? t h e y r e p o r t e d p a r t i c u l a r l y I i t t I e n e g a t i v e a f f e c t . J o r g e n s o n and H o u s t o n (1786) i n t e r p r e t e d t h i s as s u p p r e s s i o n o r d e n i a l o f e m o t i o n a l i t y . I n t e r e s t i n g l y ? t h i s l a c k o f c o r r e s p o n d e n c e ( d e s y n c h r a n y ) b e tween d i f f e r e n t m e a s u r e s of a f f e c t ? i n t h i s c a s e s e l f - r e p a r t v e r s u s p h y s i o l o g i c a l ? i s p a r t i c u l a r l y 6, p r o n o u n c e d i n t h e o f f s p r i n g o f h y p e r t e n s i v e s . J o r g e n s o n and H o u s t o n made m e n t i o n of a g r o u p of -FH s u b j e c t s who had s i m i I a r p e r s o n a l i t y c h a r a c t e r i s t i c s t o t h o s e m e n t i o n e d above* b u t who d i d n o t show t h e same h i g h r e a c t i v i t y as t h e +FH s u b j e c t s . The a u t h o r s t h e r e f o r e c o n c l u d e d t h a t s y m p a t h e t i c n e r v o u s s y s t e m h y p e r - r e a c t i v i t y may be i n f l u e n c e d by b o t h h e r e d i t y and p e r s o n a l i t y f a c t o r s * p l a c i n g t h o s e w i t h a p o s i t i v e f a m i l y h i s t o r y and p a r t i c u l a r p e r s o n a l i t y f e a t u r e s a t h i g h r i s k f o r EH. They p o s t u l a t e d t h a t s u c h i n d i v i d u a l s may have h i g h a r o u s a b i l i t y w h i c h when m a n i f e s t e d as i n c r e a s e d h e a r t r a t e and b l o o d p r e s s u r e * may l e a d t o some d e g r e e of p h y s i c a l d i s c o m f o r t . S u c h i n d i v i d u a l s w o u l d be most I i k e l y t o have a p e r s o n a l i t y p a t t e r n o f d e n i a l and unwi I I i n g n e s s t o a d m i t t o f e e l i n g s o f a n x i e t y and a g g r e s s i v e n e s s . S u c h i n d i v i d u a l s a r e a l s o more I i k e l y t o f e e l c o n c e r n e d * a n x i o u s or t h r e a t e n e d a b o u t t h e i r f e e l i n g s . T h i s i n t u r n may i n c r e a s e CV r e a c t i v i t y i n a r o u s i n g s i t u a t i o n s . In I i n e w i t h t h e I i t e r a t u r e t h a t shows t h a t EH has many f o r m s * J o r g e n s e n and H o u s t o n a l s o d i s c o v e r e d a sub g r o u p of +FH i n d i v i d u a l s who had h i g h s c o r e s on r e p o r t e d n e u r o t i c f e e I i n g s and a g g r e s s i o n * b u t who s c o r e d r e l a t i v e l y low an D e n i a l . 7 D i f f i c u l t i e s A s s o c i a t e d w i t h R e s e a r c h an F a m i l y  H i s t a r y / A u t o n o m i c A c t i v i t y I n t e r a c t i o n s A p o t e n t i a l p r o b l e m c o n n e c t e d w i t h t h i s a r e a o f r e s e a r c h i s t h e d i f f i c u l t y o f v e r i f y i n g t h e r e p o r t s D f s u b j e c t s c o n c e r n i n g f a m i l y h i s t o r y . W i t h d i s e a s e s s u c h as h e a r t a t t a c k s ? m i g r a i n e h e a d a c h e s and s t r o k e s ? a c c u r a c y o f r e p o r t i n g i s I i k e l y t o be h i g h b e c a u s e o f t h e s a l i e n t n a t u r e of t h e s e d i s e a s e s . W i t h EH however? a c c u r a c y o f r e p o r t s i s no t as h i g h b e c a u s e o f i t s v e r y i n s i d i o u s n a t u r e and a l s o b e c a u s e p a r e n t s may s t i I I be r e l a t i v e l y young a t t h e t i m e o f t h e s t u d y b u t may y e t go an t o d e v e l o p t h e d i s e a s e l a t e r . H a s t r u p ? H o t c h k i s s ? and J o h n s o n ( 1785) r e p o r t e d t h a t t h e o v e r a l I i n a c c u r a c y r a t e a f u n d e r g r a d u a t e s t u d e n t s ' r e p o r t s on p a r e n t a l h y p e r t e n s i o n was 8.7% t h i s i s s i m i l a r t o t h e ID.27, r e p o r t e d by H a s t r u p ? L i g h t and Obr i s t ( 1 7 8 2 ) . I n a c c u r a c y r e f e r s t o a c o m b i n a t i o n o f b o t h f a l s e p o s i t i v e and f a l s e n e g a t i v e c a t e g o r i e s o f r e s p o n s e . The a u t h o r s a l s o r e p o r t e d t h a t h y p e r t e n s i o n was r e p o r t e d f o r 18% of t h e p a r e n t p a p u l a t i o n by t h e s u b j e c t s . 18% a p p r o a c h e s t h e e x p e c t e d b a s e r a t e o f EH i n t h e A m e r i c a n p o p u l a t i o n o f t h e 45-54 age g r o u p (Lew 1 7 7 3 ) . Thus? i t w o u l d seem t h a t u n d e r g r a d u a t e s t u d e n t s ' " r e p o r t s o f p a r e n t a l h y p e r t e n s i o n a r e r e a s o n a b l y a c c u r a t e . However? H a s t r u p e t a l ( 1 7 8 5 ) recommended t h a t r e s e a r c h e r s m i g h t use s e l f r e p o r t f o r s c r e e n i n g and t h e n v e r i f y w i t h p a r e n t s l a t e r . F u r t h e r m o r e ? r e s e a r c h e r s may ask a b o u t r e p o r t s on g r a n d p a r e n t s e s p e c i a l l y i n c a s e s where p a r e n t s a r e s t i I I y o ung. Summary In sum; +FH p r e d i s p o s e s one t o EH. R e s e a r c h f i n d i n g s d e m o n s t r a t e t h a t s u c h i n d i v i d u a l s have h i g h CV r e a c t i v i t y t o a v a r i e t y D f d i f f e r e n t l a b o r a t o r y s t r e s s o r s . T h i s e x c e s s i v e r e a c t i v i t y seems t o be p r e s e n t a l r e a d y i n c h i l d h o o d . L o n g i t u d i n a l s t u d i e s i n d i c a t e t h a t p a t t e r n s D f r e a c t i v i t y a p p e a r t o be s t a b l e c h a r a c t e r i s t i c s of r e s p o n d i n g a v e r t i m e . F u r t h e r m o r e ; i t has been s p e c u l a t e d t h a t a s u b g r o u p of s u c h i n d i v i d u a l s may have l e a r n e d t o cope w i t h t h i s e x c e s s i v e r e a c t i v i t y by d e v e l o p i n g c e r t a i n p e r s o n a l i t y c h a r a c t e r i s t i c s w h i c h u n f o r t u n a t e l y ; h e i g h t e n t h e p h y s i o l o g i c a l a r o u s a l e ven mar e . W i t h t h i s i n m i n d ; i t i s p o s t u l a t e d t h a t i n d i v i d u a l s w i t h a p o s i t i v e f a m i l y h i s t o r y of e s s e n t i a l h y p e r t e n s i o n w i l l show g r e a t e r CV r e a c t i v i t y t o a v a r i e t y of s t r e s s o r t a s k s . AFFECT AND BLOOD PRESSURE 9 I t i s t h o u g h t t o d a y t h a t e m o t i o n s c a n be c o n c e p t u a l i s e d as h a v i n g f i v e c o m p o n e n t s ; ( 1) s u b j e c t i v e e x p e r i e n c e ? (2) a u t o n o m i c n e r v o u s s y s t e m r e s p o n s e s ? ( 3 ) c o g n i t i v e a p p r a i s a l o f t h e s t i m u l a t i n g e v e n t as p o s i t i v e or n e g a t i v e ? ( 4 ) f a c i a l e x p r e s s i o n s and (5) r e a c t i o n s t o t h e p e r c e i v e d s o u r c e o f e m o t i o n ? ( A t k i n s o n ? A t k i n s o n ? S m i t h and H i l g a r d ? 1 9 8 7 ) . Thus e m o t i o n s - a r e r e g a r d e d as t r i g g e r e d by e x t e r n a l e v e n t s . They a l s o a r e presumed t o a c t i v a t e t h e a u t o n o m i c n e r v o u s s t y s e m . U s i n g t h i s c o n c e p t o f e m o t i o n ? L a z a r u s ( 1 9 6 6 ) p o s t u l a t e d t h a t when a p e r s o n i s f a c e d w i t h a t h r e a t t o w h i c h d i r e c t a c t i o n s a r e n o t f e a s i b l e he or she wi I I engage i n c o g n i t i v e m a n i p u l a t i o n s of t h e t h r e a t i n o r d e r t o r e d u c e t h e i n t e n s i t y o f t h e s t r e s s r e s p o n s e . Thus i f t r e a t e d as r e s p o n s e s t o p e r c e i v e d s i t u a t i o n s ? e m o t i o n s may be r e g a r d e d as end s t a t e s i n a s e q u e n c e o f p s y c h o p h y s i o l o g i c a l b e h a v i o u r s e m i t t e d by t h e p e r s o n . May and J o h n s o n ? ( 1 9 7 3 ) i n v e s t i g a t e d t h e e f f e c t s of i n t e r n a l l y e l i c i t e d t h o u g h t s on A u t o n o m i c N e r v o u s S y s t e m (ANS) a c t i v i t y e m p l o y i n g a t i m e - l o c k e d t e c h n i q u e . T h e i r r e s u l t s showed t h a t i n t e r n a l l y e v o k e d t h o u g h t s do p r o d u c e p h y s i o l o g i c a l c h a n g e s ? t h e d i r e c t i o n o f w h i c h i s p a r t l y d e p e n d e n t on t h e a f f e c t i v e n a t u r e o f t h e c o g n i t i v e e v e n t . In t h i s s t u d y ? h e a r t r a t e was t h e most s e n s i t i v e p h y s i o l o g i c a l m e a s u re. May and J o h n s o n d i s c u s s e d t h e s e r e s u l t s w i t h p a r t i c u l a r r e f e r e n c e t o t h e p h y s i o l o g i c a l p r o c e s s e s o p e r a t i v e i n s y s t e m a t i c d e s e n s i t i z a t i o n . Ahead of i t s t i m e r e a l l y ? t h e s e r e s u l t s c o u l d e x p l a i n why c o n t i n u o u s e x p o s u r e t o f e a r e d s t i m u l i s o m e t i m e s f a i Is t o r e d u c e f e a r i n p h o b i c s . In a f e a r e d s i t u a t i o n ? s u c h as e v o k e d t h r o u g h i m a g e r y i n s y s t e m a t i c d e s e n s i t i z a t i o n ? or t h r o u g h i n v i v o e x p o s u r e ? a p e r s o n c a n h i d e c o g n i t i v e l y by s e l f - e v o k i n g s a f e t y images and t h e r e b y e s c a p i n g t h e f e a r e d s i t u a t i o n ? t h u s p r e v e n t i n g h a b i t u a t i o n . The n o t i o n t h a t humans use c o g n i t i o n t o r e d u c e t h e i n t e n s i t y o f human s t r e s s i s f u r t h e r s u p p o r t e d by B a k e r ? Sandman and P e p i n s k y ( 1 9 7 5 ) . In t h e i r r e s e a r c h ? 20 s u b j e c t s d i s c u s s e d a n e u t r a l t o p i c and an a f f e c t - a r o u s i n g t o p i c . H a l f were g i v e n a 5 - m i n u t e r e h e a r s a l whi l e t h e o t h e r h a l f had o n l y 30 s e c o n d s o f r e h e a r s a l p r i o r t o v e r b a l p r e s e n t a t i o n s . R e s u l t s i n d i c a t e d t h a t d i s c u s s i n g an a f f e c t - a r o u s i n g t o p i c (whom you d i s l i k e t h e m a s t ) ? e v o k e d e l e v a t e d h e a r t r a t e l e v e l s ? I D W f r e q u e n c y of t o n i c g a l v a n i c s k i n p o t e n t i a l (GSP) and h i g h b a s a l GSP. S u b j e c t s a l s o p r o d u c e d more words f o r t h e a f f e c t i v e t a s k t h a n f o r t h e n e u t r a l t a s k . B a k e r e t a l i n t e r p r e t e d t h i s t o mean t h a t s u b j e c t s may have needed t o t a l k more t o n e u t r a l i s e t h e i n t e n s i t y o f t h e s t i m u l u s . The s h o r t e r r e h e a r s a l c o n d i t i o n r e s u l t e d i n s h o r t e r p h a s i c GSP r e s p o n s e s d u r i n g t h e s p e e c h p e r i o d t h a n d i d t h e l o n g e r r e h e a r s a l c o n d i t i o n . I t was s p e c u l a t e d by t h e a u t h o r s t h a t 30 s e c o n d s was n o t s u f f i c i e n t t i m e f o r s u b j e c t s t o 11 c o g n i t i v e l y n e u t r a l i z e t h e a f f e c t i v e c o n t e n t of t h e s t i m u l u s . The d i f f e r e n c e s b e t ween a f f e c t - a r o u s i n g and n e u t r a l t o p i c s on p h y s i o l o g i c a l i n d i c e s were f o u n d m a i n l y d u r i n g t h e r e h e a r s a l p h a s e of t h e e x p e r i m e n t . D u r i n g t h e s p e e c h phase? p h y s i o l o g i c a l r e a c t i o n s on e i t h e r t a s k were n o t s i g n i f i c a n t l y d i f f e r e n t . T h i s c o u l d have been b e c a u s e t h e r e h e a r s a l p e r i o d l e d t o i n c r e a s i n g a n t i c i p a t o r y a n x i e t y t o s u c h an e x t e n t t h a t when s u b j e c t s f i n a l l y s p o k e ? t h e o n l y p o s s i b l e r e a c t i o n was a d a p t a t i o n and t h e r e f o r e t h e d e c r e a s i n g h e a r t r a t e . I t w o u l d have i m p r o v e d t h e d e s i g n f u r t h e r i f t h e o r d e r o f t a s k s had been c o u n t e r b a l a n c e d . However? i n t h i s c a s e ? a n e u t r a l t a s k was a l w a y s f o l l o w e d by an a f f e c t i v e t a s k . N e v e r t h e l e s s ? t h e I i t e r a t u r e seems t o p o i n t t o a v e r y s t r o n g r e l a t i o n s h i p b e t ween a f f e c t p r o v o c a t i o n and c o r r e s p o n d i n g a u t o n o m i c n e r v o u s s y s t e m a r o u s a l . A f f e c t ? S p e e c h and B l o o d P r e s s u r e E x t e n d i n g t h e above r e s e a r c h i n t o t h e a r e a of h y p e r t e n s i o n ? Ad I e r ? Herman? S c h a f f e r e t 3 1.(1776) f o u n d t h a t i n s u b j e c t s w i t h EH? b l o o d p r e s s u r e r o s e i n r e s p o n s e t o e m o t i o n a l c o n t e n t ? r a t e o f s p e e c h and t h e number o f words s p o k e n by a p a t i e n t . S e v e r a l r e s e a r c h e r s have n o t e d a s i g n i f i c a n t c o r r e l a t i o n b e t ween t h e h o s t i l e c o n t e n t of h y p e r t e n s i v e s ' 1 s p e e c h and e l e v a t i o n s i n b l o o d p r e s s u r e ( K a p l a n ? G o t t s c h a l k ? M a g l i o c c o e t a l . I960). I t has a l s o been r e p o r t e d t h a t a f t e r h y p e r t e n s i v e s u b j e c t s f i n i s h e d 12 s p e a k i n g ? t h e i r b I a o d p r e s s u r e r e m a i n e d e l e v a t e d f o r an e x t e n d e d p e r i o d of t i m e ? ( L y n c h 1 9 8 5 ) . L y n c h e s ( 1985) book e x p l a i n s t h e o b s e r v a t i o n s made by him and h i s c o l l e a g u e s ? of t h e b l o o d p r e s s u r e r e a c t i o n s of h y p e r t e n s i v e s d u r i n g t h e r a p y . They o b s e r v e d t h a t r e s t i n g b l o o d p r e s s u r e l e v e l s i n h y p e r t e n s i v e s were D n l y m a r g i n a l l y h i g h e r t h a n i n n o r m o t e n s i v e s w h e r e a s h e a r t r a t e d i d n o t show any d i f f e r e n c e s b e t ween t h e g r o u p s . However? when h y p e r t e n s i v e s began t o t a l k ? t h e i r b l o o d p r e s s u r e w o u l d r i s e f a s t e r and go up much h i g h e r t h a n t h a t of n o r m o t e n s i v e s . In c l i n i c a l s i t u a t i o n s ? L y n c h n o t e d t h a t bIDod p r e s s u r e s went as h i g h as 25D mm Hg? e ven when h y p e r t e n s i v e s were on m e d i c a t i o n . N e e d l e s s t o s a y s u c h r e s e a r c h has i m p o r t a n t c l i n i c a I impI i c a t i D n s f o r t h e d i a g n o s i s and t r e a t m e n t o f EH. S h o u l d b l o o d p r e s s u r e be assumed t o have been normal i s e d by m e d i c a t i o n when a l I t h a t has been a c h i e v e d i s l o w e r i n g o f p r e s s u r e a t r e s t ? How u s e f u l i s m e d i c a t i o n i f s p e e c h t r i g g e r s s u c h r e a c t i v i t y ? P e r h a p s more u s e f u l d e f i n i t i o n s o f ' h e a l t h y ' b l o o d p r e s s u r e l e v e l s w o u l d be i n t e r m s of r a t e of change d u r i n g s p e e c h or r a t e o f r e c o v e r y f r o m s p e e c h . As Manuck e t a l ( 1 9 8 2 ) s u g g e s t ? r e s e a r c h needs t o be c o n d u c t e d i n t h i s p a r t i c u l a r a r e a . In o t h e r r e s e a r c h ? L y n c h ( 1 9 8 5 ) c o n s i s t e n t l y d i s c o v e r e d t h a t s p e e c h t r i g g e r e d s i g n i f i c a n t i n c r e a s e s i n b l o o d p r e s s u r e and h e a r t r a t e i n s i t u a t i o n s o f d i r e c t i n t e r a c t i o n ? i n r e a d i n g a l o u d or a l o n e ? f o r a l l age 13 g r o u p s ; i r r e s p e c t i v e of g e n d e r . T h e i r r e s e a r c h i n d i c a t e d t o them t h a t s p e e c h c o n t e n t was n o t i m p o r t a n t i n a r o u s i n g t h e CV s y s t e m . R a t h e r i Long? L y n c h ) M a c h i r a n e t a l ( 1 7 8 2 ) i n f e r r e d f r o m t h e i r r e s e a r c h t h a t t h e s t a t u s of a p e r s o n t o whom s p e e c h was d i r e c t e d ? r a t e and volume of s p e e c h ( F r i e d m a n ? Thomas? KuI i c k - C i u f f o e t a l 1782) were t h e r e l e v a n t f a c t o r s i n CV a r o u s a l d u r i n g s p e e c h . T h i s c o n c l u s i o n i s c o n t r a r y t o e x p e c t a t i o n and t o o t h e r r e s e a r c h f i n d i n g s w h i c h w i l l be d i s c u s s e d l a t e r i n t h i s s e c t i o n . The n a t i o n t h a t s p e e c h c o n t e n t i s u n i m p o r t a n t i n c a u s i n g b l o o d p r e s s u r e e l e v a t i o n was f u r t h e r s u p p o r t e d by a r a t h e r p o o r Iy c o n t r o l l e d s t u d y c o n d u c t e d by W i l l i a m ? K i m b a l l and W i l l a r d ( 1 7 7 2 ) . In t h i s s t u d y ? s u b j e c t s went t h r o u g h two i n t e r v i e w s and two word a s s o c i a t i o n t a s k s . In one i n t e r v i e w ? t h e i n t e r v i e w e r was p a s s i v e and d i d not m a i n t a i n eye c o n t a c t w i t h t h e s u b j e c t s . He showed q u e s t i o n s t o s u b j e c t s on c a r d s . In t h e o t h e r i n t e r v i e w ? t h e i n t e r v i e w e r was warm and i n t e r a c t i v e w i t h t h e s u b j e c t s . The r e s u l t s i n d i c a t e d t h a t s u b j e c t s had h i g h e r DBP d u r i n g t h e warm? i n t e r a c t i v e i n t e r v i e w t h a n d u r i n g t h e c a r d i n t e r v i e w . The a u t h o r s ' i n t e r p r e t a t i o n of t h e s e r e s u l t s was t h a t t h e c o n t e n t of t h e i n t e r v i e w s had n o t s i g n i f i c a n t l y c o n t r i b u t e d t o t h e o b s e r v e d d i f f e r e n c e s b e t w een t h e two g r o u p s s i n c e b o t h i n t e r v i e w s had been on t h e same t o p i c s . To them? t h e warmth and i n c r e a s e d i n t e r a c t i o n had been t h e c a u s a l f a c t o r . T h i s 14 i n t e r p r e t a t i o n of r e s u l t s is not f u l l y j u s t i f i e d in the I ight of the f a c t that in the i n t e r a c t i v e i n t e r v i e w ) a l though speech content was the same) other f a c t o r s were a l s o i n c l u d e d such as the i n t e r a c t i o n between i n t e r v i e w e r and s u b j e c t . It is a l s o I i k e l y that s u b j e c t s may have t a l k e d more in the in terv i ew s i t u a t i o n . Bes ideds the demand c h a r a c t e r i s t i c s may l i k e l y have d i f f e r e d between the two s i t u a t i o n s and c o u l d have caused the d i f f e r e n c e i n CV r e a c t i v i t y . Thus the three s t u d i e s mentioned above conc luded that speech content is not important for CV a r o u s a l . However* in none of the above s t u d i e s was there adequate m a n i p u l a t i o n of speech content as an independent v a r i a b l e . Bes ides the problem of i n s u f f i c i e n t c o n t r o l ) the U) i I I i am et al study had a sample s i z e of seven per group; and fur thermore d i s c a r d e d sys to I ic but not d i a s t o l i c b lood p r e s s u r e r e a d i n g s ; for u n c l e a r reasons . In a well c o n t r o l l e d study by L i n d e n (1787)) 31 s u b j e c t s completed 4 tasks > t a l k i n g out loud in the presence of an exper imenter about a t o p i c of personal r e l e v a n c e ) c o u n t i n g out loud when alone and when with an exper imenter ) and c o u n t i n g s u b v D c a I l y . P h y s i o l o g i c a l measures taken d u r i n g these tasks i n d i c a t e d that the motor e f f o r t s r e q u i r e d for speech p r o d u c t i o n in a low demand s i t u a t i o n were a s s o c i a t e d with very low> t y p i c a l l y n o n - s i g n i f i c a n t l e v e l s of autonomic a c t i v a t i o n . The r e s u l t s a l s o i n d i c a t e d that t a l k i n g about p e r s o n a l l y 15 r e l e v a n t m a t e r i a l t r i g g e r e d d r a m a t i c a l l y l a r g e r r e s p o n s e s on n e a r l y a l I a u t o n o m i c i n d i c e s . Thus L i n d e n c o n c l u d e d t h a t s p e e c h c o n t e n t has s i g n i f i c a n t i m p a c t on a u t o n o m i c a c t i v a t i o n d u r i n g s p e e c h . The c o n c l u s i o n r e a c h e d by L i n d e n ( 1 7 87) i s f u r t h e r s u p p o r t e d i n a t i m e l y and i n t e r e s t i n g s t u d y by D i m s d a I e J Young? Moore 8. S t r a u s ? ( 1 7 8 7 ) . They a d d r e s s e d t h e q u e s t i o n o f t h e e f f e c t s o f b e h a v i o u r a l s t r e s s on l e v e l s o f p l a s m a n o r e p i n e p h r i n e . In t h i s e x p e r i m e n t ? b a s e I i n e m e a s u r e s were t a k e n D f n o r e p i n e p h r i n e and b I o o d p r e s s u r e l e v e l s d u r i n g 16 m i n u t e s o f l i s t e n i n g t o s o f t m u s i c . Then t h e s u b j e c t s ( i .e.? 5 n o r m o t e n s i v e s and 6 h y p e r t e n s i v e s ) were i n t e r v i e w e d i n a • " f r i e n d l y and n o n - c o n f r o n t a t i v e manner" on a t o p i c o f p e r s o n a l meaning to e a c h s u b j e c t . N o r e p i n e p h r i n e l e v e l s were c o n t i n o u s l y measured and b l o o d p r e s s u r e r e a d i n g s were t a k e n e v e r y 2 m i n u t e s . R e s u l t s i n d i c a t e d t h a t n o r e p i n e p h r i n e l e v e l s c o r r e l a t e d r=0.6 w i t h b l o o d p r e s s u r e l e v e l s t h r o u g h o u t t h e s t r e s s i n t e r v i e w . B o t h n o r e p i n e p h r i n e and b l o o d p r e s s u r e i n d i c e s were h i g h e r i n h y p e r t e n s i v e s t h a n n o r m o t e n s i v e s ? b o t h r o s e i n a I i n e a r f a s h i o n d u r i n g t h e i n t e r v i e w b u t more n o t i c e a b l y so i n h y p e r t e n s i v e s . An i n t e r e s t i n g f i n d i n g was t h a t t h e b l o o d p r e s s u r e o f n o r m o t e n s i v e s r o s e s o l i d l y i n t D t h e h y p e r t e n s i v e r a n g e d u r i n g t h e i n t e r v i e w . D i m s d a l e e t . a l . c o n c l u d e d t h a t i d i o s y n c r a t i c p s y c h o l o g i c a l s t i m u I i c a n p r o f o u n d l y a l t e r haemodynamics and n e u r o c h e m i s t r y . However? t h e y had o n l y a v e r y s m a l I 16 number of s u b j e c t s and the des ign d i d not i n c l u d e a non-s t r e s s f u l t a l k i n g task to a l low for a comparison between responses d u r i n g s t r e s s f u l and n o n - s t r e s s f u l speech s i t u a t i o n s . In s p i t e of t h i s ? the r e p o r t e d average b lood p r e s s u r e increase s of +12 mm Hg are h igher than those r e p o r t e d in D t h e r s t u d i e s for n o n - s t r e s s f u l speech tasks (Linden? 1787? Long e t . a l . ? 1782? Friedman e t . a l .> 1782) Thus* in cognizance of the r e s e a r c h f i n d i n g s that +FH s u b j e c t s have g r e a t e r CV r e a c t i v i t y ? and that a f f e c t i v e speech content g i v e s r i s e to g r e a t e r autonomic r e a c t i v i t y ? i t is p o s t u l a t e d that +FH normotens ives w i l l show p a r t i c u l a r l y high l e v e l s of CV r e a c t i v i t y d u r i n g speech tasks on t o p i c s of personal r e l e v a n c e . Even on n e u t r a l t o p i c s ? i t is expected that +FH s u b j e c t s wi I I d i s p l a y g r e a t e r autonomic responses . L i s t e n i n g ? A f f e c t and Blood p r e s s u r e •"•"..if one had a c h o i c e between soothing? i n t e r e s t i n g c o n v e r s a t i o n and del i c i o u s soup? of course? one would r a t h e r choose to l i s t e n than eat..'''' (A Ghanaian proverb) In most of the r e s e a r c h on CV r e a c t i v i t y to i d i o s y n c r a t i c a f f e c t i v e c h a l l e n g e s ? a t t e n t i o n has been focussed on r e a c t i v i t y d u r i n g speech and sometimes on r a t e s of recovery to b a s e l i n e a f t e r speech. R a r e l y has a t t e n t i o n been p a i d to what happens when p e o p l e I i s t e n . L y n c h ( 1 7 8 5 ) n o t e d t h a t when p a t i e n t s l i s t e n e d t o t h e t h e r a p i s t t a l k i n g a b o u t h i m s e l f or r e a d i n g p o e t r y ) t h e i r b l o o d p r e s s u r e w o u l d f a l l ) s o m e t i m e s even b e l o w t h e b a s e l i n e m e a s u r e s . I t seemed t o L y n c h t h a t d u r i n g t h i s p e r i o d p a t i e n t s c o u l d d r o p t h e i r f i g h t / f l i g h t v i g i l a n c e and d e f e n s i v e I i s t e n i n g and t r u l y a t t e n d e d t o what he was s a y i n g . T h i s seemed t o s u g g e s t a l i n k b e t w een a t t e n t i o n a l m echanisms and t h e CV s y s t e m . L y n c h c i t e d a s t u d y by Beck and K a t c h e r ( 1 7 8 3 ) i n w h i c h 15 h y p e r t e n s i v e and 20 n o r m o t e n s i v e s u b j e c t s r e a d a l o u d and q u i e t l y ) s t a r e d a t a b l a n k w a l I i n a r e l a x e d manner and t h e n w a t c h e d a s c h o o l of t r o p i c a l f i s h i n a 25 - g a I Ion t a n k . B l o o d p r e s s u r e was h i g h e s t when p e o p l e s p o k e and l o w e s t when t h e y w a t c h e d t h e f i s h . Thus t h e r e was a d i f f e r e n c e b e t ween p a s s i v e r e l a x a t i o n and a c t i v e l y a t t e n d i n g t o t h e e x t e r n a l e n v i r o n m e n t i n a r e l a x e d s t a t e . L y n c h l i n k e d t h i s o b v s e r v a t i o n w i t h S o k o l o v ' s c o n c e p t o f t h e o r i e n t i n g r e f l e x . S o k o l o v ( 1 7 6 3) n o t e d t h a t t h e o r i e n t i n g r e f l e x i s a s s o c i a t e d w i t h s y s t e m i c CV c h a n g e s . Thus f o r e x a m p l e ) h e a r t r a t e s l o w s down) and i n humans) b l o o d f l o w i n c r e a s e s i n t h e b r a i n and d e c r e a s e s i n t h e s u r f a c e r e g i o n s o f t h e f i n g e r s . L y n c h e s ( 1 7 6 7 ) work w i t h dogs a l s o c o n f i r m e d t h e s e f i n d i n g s and showed t h a t once a dog o r i e n t e d t o a s t i m u l u s ; t h e r e f l e x d i s a p p e a r e d ) and h e a r t r a t e w o u l d no l o n g e r f a l I when t h e same t o n e o r s t i m u l u s was p r e s e n t e d . T h i s c a p a c i t y t o h a b i t u a t e t o n o v e l s t i m u l i makes i t p o s s i b l e f o r a l l a n i m a l s and humans t o a d a p t t o t h e i r e n v i r o n m e n t . L y n c h ( 1 7 8 5 ) r e p o r t e d t h a t t h e s e o b s e r v a t i o n s c o u l d be e x t e n d e d t o human d i a l o g u e . L y n c h wondered w h e t h e r h y p e r t e n s i v e s s p e n d l e s s t i m e o r i e n t i n g or I i s t e n i n g t o o t h e r s * and t h u s a r e u n a b l e t o a v a i l t h e m s e l v e s o f a n a t u r a l way of l o w e r i n g h e a r t r a t e and b l o o d p r e s s u r e . L y n c h o b s e r v e d t h a t h y p e r t e n s i v e s f r e q u e n t l y a p p e a r e d t o d e f e n d a g a i n s t a message and t h a t words t h a t o u g h t t o l e a d them t o pay a t t e n t i o n or o r i e n t a r e r e s p o n d e d t o as i f t o a t h r e a t . Thus i t i s a r g u e d ? h y p e r t e n s i v e s may have l o s t t h e a b i l i t y t o a t t e n d t o n o v e l s t i m u l i i n an o r i e n t i n g way* and seem n o t t o I i s t e n when s p o k e n t o . I f t h i s i s t h e c a s e ? t h e n h y p e r t e n s i v e s have l o s t a n a t u r a l way o f r e d u c i n g b l o o d p r e s s u r e l e v e l s a f t e r s p e e c h o r d u r i n g a c o m f o r t a b l e d i a l o g u e . A l s o * s i n c e b l o o d p r e s s u r e l e v e l s d u r i n g s p e e c h a r e s t r o n g l y l i n k e d w i t h b a s e - l i n e v a l u e s ? t h e h i g h e r t h e b l o o d p r e s s u r e l e v e l s a r e between s p e e c h p h a s e s * t h e h i g h e r l e v e l s w i l l go d u r i n g s u b s e q u e n t s p e e c h p h a s e s * t h u s t r a p p i n g h y p e r t e n s i v e s i n a v i c i o u s s p i r a l I i ng eye Ie. T h i s o b s e r v a t i o n i s q u i t e s t a r t l i n g . I t s i m p o r t a n c e i s see n i n t h e new p e r s p e c t i v e i t p r o v i d e s f o r non-p h a r m a c o l o g i c a l t r e a t m e n t s f o r h y p e r t e n s i o n . S u c h methods u s u a l l y i n v o l v e t h e r e l a x a t i o n r e s p o n s e * b i o f e e d b a c k o r m e d i t a t i o n . Thus t h e r e a p p e a r s t o be an e m p h a s i s t h a t t h e i n d i v i d u a l o u g h t t o f o c u s a t t e n t i o n on some o b j e c t o u t s i d e o f h i m s e l f i n o r d e r t o r e d u c e b l o o d p r e s s u r e . 19 From t h e I i m i t e d body o f r e s e a r c h o n what happens when a p e r s o n e n g a g e s i n c o n v e r s a t i o n ; i t a p p e a r s t h a t d u r i n g a c o m f o r t a b l e d i a l o g u e ; b l o o d p r e s s u r e r i s e s d u r i n g s p e e c h b u t q u i c k l y f a l I s back t o b a s e - l i n e or b e l o w q u i c k l y when he or she l i s t e n s a t t e n t i v e l y . T h i s r e a c t i o n has been l i k e n e d t o t h e o r i e n t i n g r e f l e x where t h e r e i s a s l o w i n g o f t h e h e a r t r a t e and l o w e r i n g o f b l o o d p r e s s u r e t o a n o v e l s t i m u l u s . The o r i e n t i n g r e f l e x however does no t l a s t v e r y l o n g and t h e r e i s a r e t u r n t o b a s e - l i n e l e v e l s . I n h y p e r t e n s i v e s ; i t has been o b s e r v e d t h a t b I D o d p r e s s u r e and h e a r t r a t e l e v e l s do n o t d r o p as q u i c k l y a f t e r s p e e c h . When l i s t e n i n g t o c o n v e r s a t i o n ; h y p e r t e n s i v e s a p p e a r t o have l o s t t h i s o r i e n t i n g r e f l e x and t h e a b i I i t y t o a t t e n d t o n o v e l s t i m u I i . A l t h o u g h t h i s o b s e r v a t i o n makes s e n s e and c o n c e p t u a l l y a p p e a r s t o f i t t h e p e r s o n a l i t y a s c r i b e d t o h y p e r t e n s i v e s as v i g i l a n t and d e f e n s i v e ; i t has not been t e s t e d e m p i r i c a l l y i n a c o n t r o l l e d s t u d y . In t h i s r e s e a r c h t h e r e f o r e ; t h e d e s i g n wi I I i n c l u d e b o t h s p e e c h and I i s t e n i n g p h a s e s o n a t o p i c o f p e r s o n a l r e l e v a n c e and on a n e u t r a l t o p i c t o t e s t t h i s o b s e r v a t i o n . From L y n c h e s work; i t i s p o s t u l a t e d t h a t +FH s u b j e c t s wi I I have d i f f e r e n t p a t t e r n s o f CV r e s p o n s e s f r o m p a t t e r n s m a n i f e s t e d by -FH s u b j e c t s when t h e y I i s t e n . 2D O v e r a l I Summary of L i t e r a t u r e R e v i e w and H y p o t h e s e s The r e v i e w o f I i t e r a t u r e may be summed up i n t h i s way • H a v i n g a fami l y h i s t o r y o f e s s e n t i a l h y p e r t e n s i o n p r e d i s p o s e s one t o h i g h a c u t e c a r d i o v a s c u l a r r e a c t i v i t y . T h i s r e a c t i v i t y p a t t e r n i s p r e s e n t d u r i n g s p e e c h J e s p e c i a l l y s p e e c h w i t h a f f e c t i v e c o n t e n t . P o s s i b l y * t h i s d i f f e r e n t i a l r e a c t i v i t y may a l s o be m a n i f e s t e d i n a u t o n o m i c r e s p o n s e s d u r i n g l i s t e n i n g p h a s e s o f a c o n v e r s a t i o n . I t i s p o s t u l a t e d t h a t = 1. +FH i n d i v i d u a l s wi I I show g r e a t e r a u t o n o m i c r e s p o n s e s t o a l I t a s k s t h a n -FH i n d i v i d u a l s * 2. +FH i n d i v i d a l s w i l l show a d i f f e r e n t p a t t e r n of a u t o n o m i c a c t i v i t y d u r i n g l i s t e n i n g p h a s e s t h a n w i l l -FH i n d i v i d u a l s * 3. S u b j e c t s wi I I d i s p l a y g e n e r a l l y g r e a t e r a u t o n o m i c r e s p o n s e s t o s p e e c h t a s k s t h a n t o I i s t e n i n g t a s k s * 4. S p e e c h D f p e r s o n a l l y r e l e v a n t c o n t e n t wi I I y i e l d g r e a t e r a u t o n o m i c r e a c t i v i t y t h a n n e u t r a l s p e e c h * 5. and* f i n a l l y * i n o r d e r t o f u r t h e r v a l i d a t e t h e n a t u r e o f t h e s e l e c t e d s p e e c h t a s k s * i t i s p r o p o s e d t h a t when compared w i t h a s t a n d a r d m e n t a l a r i t h m e t i c l a b o r a t o r y s t r e s s o r t a s k * t h e h i g h a f f e c t s p e e c h t a s k w i l l y i e l d p a r t i c u l a r l y h i g h l e v e l s o f a u t o n o m i c a r o u s a l . MethodoIggy 21 In us ing speech as a task for autonomic a r o u s a l ) i t is important to separate n e u t r a l content from a f f e c t i v e content (May and Johnson 1773) L inden) 1787). It is a l s o important to be ab le to s t a n d a r d i z e speech content for every s u b j e c t ) b e a r i n g in mind the i d i o s y n c r a t i c nature of p e r c e p t i o n of a f f e c t t r i g g e r s (Linden* 1785). Thus in s t r i v i n g for a ba lance between e x t e r n a l ( i . e personal r e l e v a n c e ) * and i n t e r n a l v a l i d i t y ( i . e . s t a n d a r d i z a t i o n ) ) two pi lot s t u d i e s were conducted to he lp choose t o p i c s of n e u t r a l and a f f e c t i v e content and f u r t h e r * to val idate these as to the presumed d i f f e r e n t i a l l e v e l s of CV arousa l a s s o c i a t e d with them. For the main study* the two speech tasks chosen were those r a t e d by s u b j e c t s in the f i r s t p i l o t as the most and l eas t a f f e c t - p r o v o k i n g . These were then compared for f u r t h e r val i d a t i o n with a s tandard mental a r i t h m e t i c t e s t for which there are r e l i a b l e norms (Linden* 1787). P i l o t Study 1 1. The C o n v e r s a t i o n R a t i n g S c a l e S u b j e c t s lb male and 13 female second year undergraduate s tudents r a t e d a 26 - i t em q u e s t i o n n a i r e on t o p i c s for conversa t i on. 22 Method 28 i t e m s were g e n e r a t e d t h r o u g h b r a i n s t o r m i n g i n s e a r c h of n e u t r a l and a f f e c t i v e t o p i c s f o r d i s c u s s i o n f o r an e x p e r i m e n t . The i t e m s i n c l u d e d t h e w e a t h e r * t h e c o u r s e s you s t u d y * c o l o r s * a d e s p i s e d or l o v e d p e r s o n * a f r u s t r a t i n g e v e n t o r p e r s o n * d e a t h * an e m b a r r a s s i n g moment* e t c ( s e e A p p e n d i x A ) . S u b j e c t s were a s k e d t o r a t e t h e s e t o p i c s on a 6 - p o i n t ' s c a l e (D-5) a c c o r d i n g t o how e m o t i o n a l l y a r o u s i n g t h e y w o u l d f i n d i t t o t a l k t o a male or f e m a l e e x p e r i m e n t e r r e s p e c t i v e l y on e a c h o f t h e i t e m s . The c r i t e r i o n f o r t h e c h o i c e o f an i t e m as a n e u t r a l o r a f f e c t i v e t o p i c o f c o n v e r s a t i o n was t h a t t h e i t e m s h o u l d have t h e l o w e s t o r h i g h e s t r a t i n g s o f a r o u s a b i I i t y . T h ese t o p i c s s h o u l d a l s o y i e l d t h e l e a s t w i t h i n - i t e m s p r e a d o r v a r i a t i o n o f a r o u s a b i I i t y r a t i n g . A l s o c o n s i d e r e d was t h e i n t e r a c t i o n o f r a t i n g s b e t ween sex of r a t e r ( t e r m e d ' r e s p o n d e n t ' ) and sex of t h e e x p e r i m e n t e r ( t e r m e d ' o t h e r ' ) i n o r d e r t o p r e v e n t c o n f o u n d i n g . R e s u l t s The i t e m w h i c h had t h e l o w e s t r a t i n g s on a r o u s a b i I i t y by b o t h men and women was 'The W e a t h e r ' . T h e r e were no s i g n i f i c a n t d i f f e r e n c e s b e t ween mean r a t i n g s by b o t h men and women and no i n t e r a c t i o n e f f e c t s b etween r e s p o n d e n t and sex of o t h e r . 23 T a b l e 1. Mean a r o u s a b i 1 i t y r a t i n g s on t h e t o p i c o f Weather ( S c a l e o f 0-5) sex o f o t h e r ma I e f e m a l e Sex of ma I e D.50 0.69 r e s p o n d e n t female 0.38 0 .31 A n a l y s i s o f v a r i a n c e showed no main e f f e c t s f o r sex and n D two-way i n t e r a c t i o n b e t ween sex of o t h e r and sex of r e s p o n d e n t a t t h e .05 l e v e l . On t o p i c s r a t e d as v e r y e m o t i o n a l l y - l a d e n s u c h as D e a t h and S u i c i d e * (mean r a t i n g s g r e a t e r t h a n 4 . 0 ) * t h e r e were many two way i n t e r a c t i o n s b e t ween sex of r e s p o n d e n t and se x o f o t h e r * i n d i c a t i n g t h a t men w o u l d f e e l more a r o u s e d when t a l k i n g t o women t h a n t o o t h e r men and v i c e v e r s a * s i n c e f o r p r a c t i c a l r e a s o n s i t had been d e c i d e d t o use one e x p e r i m e n t e r t o i n t e r v i e w b o t h male and f e m a l e s u b j e c t s * t h e t o p i c o f d i s c u s s i o n w o u l d have t o be one w h i c h had been e q u a l l y r a t e d f o r d i s c u s s i o n w i t h a f e m a l e e x p e r i m e n t e r by b o t h male and f e m a l e r a t e r s . F o r t h i s r e a s o n i t e m 12 was s e l e c t e d as t h e p r i m a r y e m o t i o n a l l y - l a d e n t o p i c : 'The p e r s o n you d e s p i s e t h e most' 24 T a b l e 2. Mean r a t i n g s for- 'The person you desp i se the most •* sex of other ma I e f ema I e  sex of male 3.38 3.00 respondent female 3.88 3 .69 Al though there were s i g n i f i c a n t d i f f e r e n c e s between male and female r a t i n g s of how e m o t i o n a l l y - l a d e n the item was as a t o p i c for d i s c u s s i o n F ( l ? 57)=5.1? p_=.03? there was no d i f f e r e n c e in t h e i r r a t i n g s on sex of other F ( l ? 57)=1.1? p_=. 29. In other words? they would f i n d i t e q u a l l y e m o t i o n a l l y a r o u s i n g to t a l k to a male or female e x p e r i m e n t e r . However d u r i n g p i l o t t e s t i n g ? i t was d i s c o v e r e d that s u b j e c t s found i t d i f f i c u l t at t imes to r e c a l I a person they d e s p i s e d . For such subjec t s? another t o p i c was found: The most f r u s t r a t i n g event or p e r s o n . T h i s t o p i c had s i m i l a r r a t i n g s to the above item and in a d d i t i o n ? i t had the mer i t that i n v a r i a b l y the c o n v e r s a t i o n centered around i ssues of c o n t r o l ? anger and power which were i s sues tha t a l s o came up when other s u b j e c t s spoke about a person they d e s p i s e d . A d l e r et a l . ( 1 9 7 2 ) a l s o r e p o r t e d s i m i l a r themes in content a n a l y s e s of the speech of h y p e r t e n s i v e s u b j e c t s d u r i n g an exper iment . A f i n a l reason for i t s s e l e c t i o n was i t s 25 r a t i n g as arousing* with l i t t l e d i f f e r e n c e between male and female r a t i n g s * F ( l * 57) = 1.7* £.= .20 and no i n t e r a c t i o n e f f e c t s between sex of respondent and sex of other F ( l * 57)=.08 £ >.05. Table 3 Mean r a t i n g s for 'The most f r u s t r a t i n g person or event.' Sex of other, ma I e Fema I e Sex of male 3.31 3.23 respondent female 3.56 3.63 2. v a l i d a t i o n of tasks ( p i l o t study II)  Subjects S u b j e c t s for t h i s experiment were twelve graduate students. Method Subjec t s were shown around the laboratory to get them comfortable with the surroundings. They were then comfortably seated and t o l d that the experiment was a c a r d i o v a s c u l a r r e a c t i v i t y study* that alI that was expected of them was to hold a d i s c o u r s e with the experimenter* for 5 minutes at a time* an c e r t a i n s e l e c t e d t o p i c s while measurements were taken of t h e i r blood p r e s s u r e and heart r a t e . They were t o l d that t h e i r base I ine measures would be taken as they read Herman Cartoons ta make them fee l more r e l a x e d . They were asked to remain q u i e t at such t imes and to move as I i t t l e as p a s s i b l e . The b lood p r e s s u r e c u f f of a Dinamap monitor was then f i t t e d around the l e f t arm of s u b j e c t s and they were g i v e n a book af Herman Cartoons and t o l d to r e l a x for ID minutes with the exper imenter s i t t i n g q u i e t l y w r i t i n g or r e a d i n g . Reading has been found ta f a c i l i t a t e a d a p t a t i o n to the l a b o r a t o r y whi le I i m i t i n g the e f f e c t of a n t i c i p a t i o n an p h y s i o l o g i c a l a r o u s a l ? (L inden and McEachern>1985). A f t e r t h i s ? s u b j e c t s were asked to t a l k on e i t h e r the a f f e c t i v e or the n e u t r a l t o p i c . The tasks were c o u n t e r b a l a n c e d to c o n t r o l for s e r i a l e f f e c t s so that h a l f the s u b j e c t s spoke f i r s t an the a f f e c t i v e and then on the n e u t r a l t o p i c s and v i c e - v e r s a . If they stopped before 3 minutes were up? the exper imenter asked q u e s t i o n s to he lp them (See method s e c t i o n be low) . S u b j e c t s then r e s t e d for 5 minutes and spoke on the other t o p i c for 5 minutes . They then r e l a x e d for another 5 minutes . Each s u b j e c t was i n d i v i d u a l l y t e s t e d . At the end? s u b j e c t s were shown the read ings of t h e i r b lood p r e s s u r e and heart ra t e and how i t v a r i e d with speech and speech c o n t e n t . 27 R e s u I t s B I O D C I p r e s s u r e and h e a r t r a t e r e s p o n s e s m e a s u r e d d u r i n g s p e e c h and r e s t i n g p e r i o d s were c o n v e r t e d i n t o c hange s c o r e s by s u b t r a c t i n g t h e a v e r a g e r e a d i n g s o f e a c h r e s t p e r i o d f r o m t h e a v e r a g e o f t h e s u b s e q u e n t s p e e c h t a s k . T a b l e 4. Mean Change s c o r e s on p h y s i o l o g i c a l m e a s u r e s  f r o m b a s e I i n e t o s p e e c h t a s k s . Task Neu t r a I A f f e c t i v e H e a r t R a t e ( b p m ) 6.8 10.• S y s t o l ic(mm Hg) 2.3 5.4 D i a s t o l i c ( m m Hg) 2.3 6.6 A R e p e a t e d M e a s u r e s MANOVA i n d i c a t e d t h a t t h e d i f f e r e n c e s b e t ween t h e means on t h e two d i f f e r e n t t e s t s were s i g n i f i c a n t on b o t h s y s t o l i c and d i a s t o l i c b l o o d p r e s s u r e m e a s ures b u t n o t on h e a r t r a t e . These e f f e c t s were r e a s o n a b l y l a r g e ? F ( l ) 12)=7.5» £=.02 f o r D i a s t o l i c ) and F<1) 12)=8.8) £=.01) and i n d i c a t e t h a t t h e two t a s k s y i e l d e d d i f f e r e n t l e v e l s of CV a r o u s a l . D i s c u s s i o n The above r e s u l t s s t r o n g l y s u g g e s t t h a t t h e two t o p i c s of c o n v e r s a t i o n w i l l y i e l d d i f f e r e n t l e v e l s o f CV a r o u s a l on s y s t o l i c and d i a s t o l i c b l D D d p r e s s u r e . These r e s u l t s 28 are a l s o in l i n e with o thers such as L i n d e n (1987)* and Baker et al (1975). T h i s suggests that with the p a r t i c i p a t i o n of undergraduate s tudents unfami I iar to the exper imenter in the main s t u d y J the observed d i f f e r e n c e s between tasks may be even g r e a t e r . Main Study  Exper imenta l des ign A repeated measures des ign was used with one between and two w i t h i n group f a c t o r s . The between groups f a c t o r was fami ly h i s t o r y of E s s e n t i a l H y p e r t e n s i o n and the w i t h i n s u b j e c t v a r i a b l e s were • a f f e c t i v e content of task ( a f f e c t i v e v s . n e u t r a l ) * and phase of c o n v e r s a t i o n ( speech versus l i s t e n i n g p h a s e s ) . M u l t i p l e dependent measures were c o l l e c t e d d u r i n g each task p e r i o d . S u b j e c t s Seventy-one male and female undergraduates who v o l u n t e e r e d to p a r t i c i p a t e in a study of t h e i r p h y s i o l o g i c a l responses to s t r e s s were i n v i t e d to take p a r t in the exper iment . The r e s u l t s of s i x s u b j e c t s were d i s c a r d e d for the f o l l o w i n g reasons ' (a) incomplete p h y s i o l o g i c a l r ead ings due to e x c e s s i v e motor a c t i v i t y of subjec t* (b) unavai Iabi I i t y of c o n f i r m a t i o n of fami ly h i s t o r y data and (c) s u b j e c t on med ica t ion which would a f f e c t b lood p r e s s u r e e . g . * s l e e p i n g medicat ion* or a f f e c t e . g . * l i t h i u m c a r b o n a t e . In format ion of f ami ly h i s t o r y of h y p e r t e n s i o n was col l e c t ed by mai I from parents* (see appendix B ) . Of the seventy-one p a i r s of q u e s t i o n n a i r e s sent out* (see Appendix C)> f i f t y - s i x p a i r s were r e t u r n e d by mai I. The remain ing f i f t e e n were o b t a i n e d v i a te lephone* with s u b j e c t s ' consent . S u b j e c t s were c l a s s i f i e d as +FH i f at l eas t one of t h e i r parents had E s s e n t i a l H y p e r t e n s i o n and - F H i f n e i t h e r parent was h y p e r t e n s i v e . Parents u n c e r t a i n of t h e i r bIood pres sure l e v e l s were asked to seek c o n f i r m a t i o n through t h e i r fami ly p h y s i c i a n s . T h i s procedure has been used o f t en in the l i t e r a t u r e ( e . g . * Stoney and Matthews* 1788) and is r e p o r t e d to be the most r e l i a b l e index of FH ( b a r r i n g d i r e c t p h y s i c a l e x a m i n a t i o n ) . The f i n a l sample was made up of 36 - F H and 26 +FH s u b j e c t s . The groups were not of equal numbers because o f t en s u b j e c t s would v o l u n t e e r as +FH but c o n f i r m a t i o n from parents would be to the c o n t r a r y . Parents c o n f i r m a t i o n was always the b a s i s of g r o u p i n g . Exper imenta l Tasks Each s u b j e c t had to do two speech tasks with I i s t e n i n g phases (see Appendix D)* and one mental a r i t h m e t i c ta sk . The ta sks were* 1. Speech task of personal r e l evan ce to the s u b j e c t / I i s t e n i n g to experimenter t a l k on t o p i c of r e l e v a n c e to h e r s e l f . 3D 2. Speech task of non-personal r e I e v a n c e / I i s t e n i n g to experimenter t a l k on s i m i l a r t o p i c . 3. Mental A r i t h m e t i c task performed out loud . 1. P e r s o n a l l y Re levant Task Based on the r e s u l t s o b t a i n e d from the p i l o t study? the s e l e c t e d t o p i c of personal r e l e v a n c e was 'The most f r u s t r a t i n g person or e v e n t ' . S u b j e c t s were asked to speak for f i v e minutes about the most f r u s t r a t i n g person or event in t h e i r l i v e s ? s i m u l a t i n g as c l o s e l y as p o s s i b l e ? a c o n v e r s a t i o n with the e x p e r i m e n t e r . They were t o l d to c o n t i n u e speaking for as long as they c o u l d f i n d something to say or unt i I the f i v e minutes were up and i t was the e x p e r i m e n t e r ' s t u r n to speak. They were t o l d not to worry about running out of t h i n g s to say because the exper imenter would he lp them with prompts . They were a l s o asked to I i s t en q u i e t l y when the exper imenter spoke and were t o l d to save a lI q u e s t i o n s and comments unt i I the very end of the exper iment . Prompts which were use fu l in the pi lot study for m a i n t a i n i n g the flow of c o n v e r s a t i o n were used aga in as we I I as q u e s t i o n s germane to the flow of each i n d i v i d u a l c o n v e r s a t i o n . Examples were: 1 C D U I d y D u d e s c r i b e t h i s person /event in some d e t a i l ? . 2. Why w a s / i s t h i s p e r s o n / e v e n t f r u s t r a t i n g to you? 3. What l a s t i n g impress ion d i d / d o e s t h i s per son /event have on your I i fe? 4. What did you d i s l ike most about the event or person? 5. What were your f e e l ings toward t h i s event or person? L.How much c o n t r o l d i d the person/event have over you? 2.Task of L i t t l e Personal Relevance Subje c t s were asked to speak on 'The Weather'. This t o p i c was s e l e c t e d on the b a s i s that i t was unanimously rated as the most neutral t o p i c by su b j e c t s in the pi lot study. Subjects were asked to simply d e s c r i b e the four seasons i n Vancouver. They were asked to speak for 5 minutes and then to I i s t e n to the experimenter t a l k . The experimenter t a l k e d about the weather in t r o p i c a l West A f r i c a for 5 minutes. Again su b j e c t s were asked not to i n t e r r u p t t h i s u n t i l the end of the experiment. Examples of the prompts used to maintain the flow of c o n v e r s a t i o n were : 1. How d i f f e r e n t has t h i s year's weather p a t t e r n been from normal Vancouver weather? 2. What kind of winter/fal I/spring/summer do you think we w i l l have? 3. What d i f f e r e n t kinds of c l o t h i n g does one need for the d i f f e r e n t seasons? 4. Describe the d i f f e r e n t c o l o r s which accompany the d i f f e r e n t seasons. 32 3 .Menta l A r i t h m e t i c Task S u b j e c t s were asked to execute a s tandard mental a r i t h m e t i c t e s t with vocal speech. Tasks were presented on a v ideo screen at ID second i n t e r v a l s for a t o t a l of 5 minutes . The ra te of p r e s e n t a t i o n was c o n t r o l l e d and was the same for every s u b j e c t . The p h y s i o l o g i c a l r e a c t i o n s to t h i s t e s t were used to check the v a l i d i t y of the a f f e c t i v e t o p i c as a s t r e s s f u l t a s k . The study a l s o r e p r e s e n t e d an attempt to r e p l i c a t e work done by L inden (1985). The exact procedure is o u t l i n e d in L inden (1987). The Buss-Durkee H o s t i l i t y S c a l e The Buss-Durkee Host i I i t y s c a l e was a l s o completed by s u b j e c t s . It is a s c a l e des igned to g ive a measure of h o s t i l i t y (see Appendix E ) . It is composed Df seven s u b s c a l e s as we I I as a gui It s c a l e . Items were generated from r a t i o n a l ana lyse s of h o s t i le behav ior as manifes ted in c l i n i c a l s e t t i n g s . The 75 items on the s c a l e were cuI led from the o r i g i n a l 105 through a s e r i e s of item a n a l y s e s and r e v i s i o n s ) (Buss and Durkee* 1957). F a c t o r a n a l y s i s ? has? however i n d i c a t e d that the items c l u s t e r around two main f a c t o r s : o v e r t and c o v e r t h o s t i l i t y . Bendig (1962)) l i s t e d 14 items that c l u s t e r e d around the o v e r t f a c t o r and 22 items that c l u s t e r e d around the c o v e r t f a c t o r . The o v e r t f a c t o r items were mostly found in the a s s a u l t and verba l h o s t i I i t y s c a l e s whi le the 33 c o v e r t f a c t o r items came mostly from the gu i It and i r r i tab i I i ty s e a l e s . Mathews (1985) reviewed severa l s t u d i e s and r e p o r t e d that i n t e r n a l c o n s i s t e n c y of the o v e r t and c o v e r t h o s t i I i t y s c a l e s were .76 and .72 r e s p e c t i v e l y ? and that over a 2-week i n t e r v a l ? r e l iab i I i t y c o e f f i c i e n t s for the s u b s c a l e s ranged from .64 to .78. The r e l iab i I i t y of G l o b a l H o s t i l i t y was .82. Mathews-1 review f u r t h e r i n d i c a t e d that the Buss-Durkee s cares were n e g a t i v e l y c o r r e l a t e d with s o c i a l d e s i r a b i l i t y and p o s i t i v e l y with such i n v e n t o r i e s as the Anger S e l f Report (r=.66)? and the R e a c t i o n Inventory (r=.45) J which measure anger and h o s t i I i t y . The B r i e f H y p e r t e n s i o n S e l f Report Instrument c o r r e l a t e d p o s i t i v e l y with the i r r i t a t i o n ? resentment and verba l h o s t i l i t y s u b s c a l e s of the Buss -Durkee . Al though s y s t o l i c and d i a s t o l ic b lood p r e s s u r e of e s s e n t i a l h y p e r t e n s i v e s were found to be u n r e l a t e d to Buss-Durkee scares? ather r e s u l t s i n d i c a t e d that h y p e r t e n s i v e s s cared h igher on the suppressed anger? gui It and i r r i t a b i I i t y s u b s c a l e s of the Buss-Dur kee. The Buss-Durkee was g iven to determine whether or not i t c o u l d d i s c r i m i n a t e between the two groups on the b a s i s of expressed h o s t i I i t y . It was ana lyzed in two s tages . F i r s t ? the means of each group on the d i f f e r e n t s u b s c a l e s were c o n t r a s t e d for s i g n i f i c a n t d i f f e r e n c e s . Then the 14 items making up the o v e r t s c a l e and 20 items making up 34 the c o v e r t s c a l e were used in a 2(FH) X 2 ( o v e r t vs c o v e r t ) u n i v a r i a t e ANOVA to t e s t for p o s s i b l e d i f f e r e n c e s in the e x p r e s s i o n of h o s t i I i t y between the two groups . See Appendix E for the items of the two s c a l e s . Procedure S u b j e c t s were shown around the l a b o r a t o r y and a b r i e f e x p l a n a t i o n was g iven about the apparatus i n v o l v e d . They were seated and read an out I ine of the exper imenta l procedure (see Appendix F ) . They were then t o l d that they c o u l d leave the experiment i f they wished not to p a r t i c i p a t e (none l e f t ) and then s igned the consent form (see Appendix G ) . A c u f f from the automated sphygmomanometer was p l a c e d an the nan-dominant arm of the s u b j e c t . The s u b j e c t was reques ted ta r e l a x * and to keep as comfor tab le a p o s i t i o n as was p o s s i b l e with very l i t t l e movement. A 15-minute a d a p t a t i o n p e r i o d was al lowed for each s u b j e c t d u r i n g which time s u b j e c t s were encouraged to r e l a x and read a book of c a r t o o n s . P h y s i o l o g i c a l read ings were taken at minute 1> 13 and 15 of t h i s time p e r i o d . Only the r e c o r d i n g s taken at minute 15 were used as a measure af base I ine . Immediately f o l l o w i n g t h i s * s u b j e c t s were g iven i n s t r u c t i o n s as ta what to do for the f i r s t t a s k . Each s u b j e c t was asked to t a l k for f i v e minutes on e i t h e r the a f f e c t i v e ? or n e u t r a l t o p i c or to do a mental a r i t h m e t i c 35 task f i r s t . Each of the speaking tasks were fo l l owed by the s u b j e c t I i s t e n i n g to the experimenter t a l k on the same t o p i c ? except for the a r i t h m e t i c t a s k . Each I i s t e n i n g phase was fo l l owed by a r e s t p e r i o d of f i v e minutes where s u b j e c t s c o n t i n u e d to read Herman C a r t o o n s . T h i s was to a l low a r e t u r n to base! ine measures before the next task was i n t r o d u c e d . P h y s i o l o g i c a l responses recorded d u r i n g r e s t p e r i o d s were used as basel ine va lues for the tasks which fo l lowed immediate ly . D i f f e r e n t sequences of order of task p r e s e n t a t i o n were randomly as s igned w i t h i n each group. However? these sequences were matched a c r o s s groups and gender to c o n t r o l for p o s s i b l e s e r i a l e f f e c t s . S u b j e c t s were asked at the end of each recovery per iod? to ra t e an a s c a l e of 1-1D how p e r s o n a l l y r e l e v a n t they f e l t each speech task was and to ra te the tasks on how a n x i e t y p r o v o k i n g they had found them to be. (See A p p e n d i x ) . Apparatus An e l e c t r o n i c sphygmomanometer with p r e s s u r e cu f f? automat ic e l e c t r i c a l pump? a microproces sor? and d i g i t a l d i s p l a y (Dinamap 845 V i t a l S igns Moni tor? C r i t i k o n ) was employed to monitor hear t ra t e and blood p r e s s u r e . T h i s f u l l y automated monitor g ive s read ings which are comparable with i n t r a - a r t e r i a I measurements (Borow & Newburger 1982? S i l a s ? Barker & Ramsay 1980). 36 Far r e s p i r a t o r y a c t i v i t y r e s p i r a t i o n ra te was monitored us ing H a i t and L i n d e n ' s (1787) method. A Bel lows s t r a i n gauge was a t tached around the chest at the leve l of the armpits* and another around the upper abdomen to act as a c o n t r o l measure. R e s i s t a n c e changes in the s t r a i n gauge were fed into a SensDrmedics v o I t a g e / p u I s e / p r e s s u r e c o u p l e r . Amp I i f i e d and f i I tered r e s i s t a n c e s were g r a p h i c a l l y d i s p l a y e d on c h a r t paper of the R611 Sensormedics Dynograph. Outcome Measures For each task > the dependent v a r i a b l e s were heart r a t e ; s y s t a l ic and d i a s t o I ic b lood pressure* and r a t e of r e s p i r a t i o n . Each s u b j e c t a l s o completed the Buss-Durkee Hast i I i ty sea Ie. 37 38 RESULTS A s e r i e s of repeated measures MANOVAS and MANCOVAS were used ta t e s t far s i g n i f i c a n c e of r e s u l t s . S tandard procedure was MANOVA f i r s t * with a c r i t e r i o n of p=.10* where necessary* fo l lowed up by s imple e f f e c t s t e s t s and T u k e y ; s and S c h e f f e ' s pos t -hoc comparisons with j= l e v e l s set at .05 . In each case there were t e s t s for homogeneity of c o v a r i a n c e s . The r e s u l t s of these ana lyse s are presented in s tepwise f a s h i o n below to answer the f a l l o w i n g q u e s t i o n s in the order g i v e n ! 1. Da the twa groups d i f f e r an t h e i r p e r c e p t i o n of task d i f f i c u l t y and personal r e l e v a n c e ? 2. Are the two c o n v e r s a t i o n a l t o p i c s p e r c e i v e d to be d i f f e r e n t ? 3. Do the two groups d i f f e r on t h e i r e x p r e s s i o n of host i I i ty? 4. Do the two groups d i f f e r in t h e i r p h y s i o l o g i c a l responses to two d i f f e r e n t t o p i c s of c o n v e r s a t i o n with speech and l i s t e n i n g phases? ( I n v e s t i g a t e d by a 2(FH> X 2 ( t o p i c of c o n v e r s a t i o n ) X 2(phases of c o n v e r s a t i o n ) MANOVA). 5. Are there d i f f e r e n t responses to the three d i f f e r e n t ta sks? ( I n v e s t i g a t e d by a 2(FH) X 3 ( t a s k s ) MANCOVA) 6. Do these r e s u l t s rep I i cate those of Dimsdale e t . a l . ' s work when peak va lues are used as dependent measures? 3? S u b j e c t i v e task e v a l u a t i o n s Houi a n x i e t y provok ing? Did s u b j e c t s exper i ence d i f f e r e n t l e v e l s of d i s t r e s s on the three d i f f e r e n t " t a l k " ta sks? And d i d p e r c e i v e d d i s t r e s s vary with having a p o s i t i v e or nega t ive f a m i l y h i s t o r y of h y p e r t e n s i o n ? To answer these ques t ions* s u b j e c t s were asked to ra te the tasks on an a n x i e t y s c a l e of 1 to 3* with "3" s i g n i f y i n g the most a n x i e t y - p r o v o k i n g task and "1" the l e a s t . A n a l y s i s of v a r i a n c e (2(FH) x 3(tasks>> showed that the tasks e l i c i t e d d i f f e r e n t l e v e l s of s u b j e c t i v e d i s t r e s s * F (1* 62)=26.56> & <.DD1. Having a p o s i t i v e f a m i l y h i s t o r y of e s s e n t i a l h y p e r t e n s i o n d i d not a f f e c t the p e r c e p t i o n of how d i s t r e s s p r o v o k i n g the tasks were* F (1* 62) = .05* p_ =.82* nor was there any i n t e r a c t i o n of f a m i l y h i s t o r y with s u b j e c t i v e r a t i n g of d i s t r e s s . Pos t -hoc S c h e f f e J c o n t r a s t s with a lpha l e v e l s set at p = .05 i n d i c a t e d that both a f f e c t and math tasks were r a t e d as s i g n i f i c a n t l y more d i s t r e s s provok ing than was the weather t a s k . However* the as s igned r a t i n g for Math d i d not d i f f e r s i g n i f i c a n t l y from that for the a f f e c t i v e task . 40 Tab le 5. Mean a n x i e t y r a t i n g of tasks by +FH and - F H s u b j e c t s . Fam i Iy Hi s t o r y  +FH - F H Top i c Mean ( sd) Mean (sd) a f f e c t 2.1 ( .7) 2 .2 ( .6) weather 1.5 ( .8) 1.3 ( .6) math 2 .4 ( .7) 2 .5 ( .7) How p e r s o n a l l y r e l e v a n t ? Did s u b j e c t s p e r c e i v e c o n v e r s i n g about a f r u s t r a t i n g event or person to have more personal r e l e v a n c e than c o n v e r s i n g about the weather? S u b j e c t s r a t e d c o n v e r s a t i o n s on a s c a l e of "1" to on haw p e r s o n a l l y r e l e v a n t they found the c o n v e r s a t i o n s to be. T a l k i n g about a f r u s t r a t i n g event was found to be much more p e r s o n a l l y r e l e v a n t than t a l k i n g about the weather? F (1?60) = 122.11? £ <.001. S u b j e c t s found the l i s t e n i n g phases of the c o n v e r s a t i o n to be j u s t as r e l e v a n t as the t a l k i n g phases? F (l?ca0) =3.71? p_ > . 05. There was? however? an i n t e r a c t i o n between c o n v e r s a t i o n task phase and t o p i c of c o n v e r s a t i o n ? F (1? 60) = 21.21? p. < .001. Dur ing the a f f e c t i v e c o n v e r s a t i o n ? s tudents r a t e d as more p e r s o n a l l y r e l e v a n t ? what they t a l k e d about? than what they I i s t ened t o . Dur ing the weather c o n v e r s a t i o n ? they 41 r a t e d as more p e r s o n a l l y r e l e v a n t * what they heard* than what they t a l k e d about . There was na s i g n i f i c a n t main e f f e c t for f a m i l y h i s t o r y * F (1* 60)=.09* £ > . 05 * and no i n t e r a c t i o n between fami ly h i s t o r y and t o p i c of c o n v e r s a t i o n * F (1* 60) = .72* p_>.05. There was a l s o no i n t e r a c t i o n between the phase of c o n v e r s a t i o n and f a m i l y h i s t o r y * F (1* 60)=.1* £ > .05 . These r e s u l t s i n d i c a t e tha t the two t o p i c s of c o n v e r s a t i o n were p e r c e i v e d to be d i f f e r e n t in terms of l eve l of personal re l evance* and show that the m a n i p u l a t i o n of the w i t h i n v a r i a b l e ( t o p i c of c o n v e r s a t i o n ) was s u c c e s s f u l . Tab le 6= Mean r a t i n g s of personal r e l e v a n c e d u r i n g a f f e c t i v e and n e u t r a l c o n v e r s a t i o n s . FH+ FH-AFFECT speech 7 .9 (1 .9) 8.D (1 .8) I i s ten 6 .8 (2 .4) 6.3 (2 .7) WEATHER speech 3 .2 (1.61) 3 .5 (2 .4) I i s ten 3 . 4 ( 2 . 1 ) 3 .9 (2 .2) Fami ly H i s t o r y and Hos t i I i t y . Did +FH s u b j e c t s score the BDHI any d i f f e r e n t l y from -FH s u b j e c t s ? R e s u l t s from a Hote l I i n g J s T - t e s t showed that there were no s i g n i f i c a n t d i f f e r e n c e s between the two groups on any of the s u b s c a l e s of the BDHI or on the t o t a l score ( £ > . 0 5 ) . 42 Tab le 7. Mean scares an the BDHI for +FH and - F H  s u b j e c t s .  Sea 1es +FH - F H Mean (SD) Mean (SD) A s s a u 1 t 4. 2 (2. 5) 4. 4 (2 .2) I n d i r e c t H o s t i l i t y 5. 5 (2. 3) 5. a ( 1.8) Negat i v i sm 2. 4 (1. 5) 2. 4 (1 .3) Ir r i tab i 1 i ty 6. 2 (2. 1) 6. • (3.D) Resentment 2. 7 (1 . 7) 2. 1 (1 .7) S u s p i c i o n 2. 6 (1 . 7) 2. 8 (1 .8) Verba 1 Host i 1 i ty 6. 6 (2. 5) 7. 4 (2 .7) G u i l t 4. 4 (2. 3) 3 . (2 .2) T o t a l score 33 1.7 (11 .3) 33 .7 (7 .5) Over t 7. 2 (2. 6,3) 7. S (3 .0) Covert IE 1.8 (4. D) 7 . 6 (3 .8) An ANOVA of conceptual s c a l e s ( 2(FH) X 2 ( D v e r t vs c o v e r t h o s t i I i t y ) ) i n d i c a t e d that there were no main e f f e c t s for FH (p> .05) and no i n t e r a c t i o n between FH and the response an the two s u b s c a l e s (p = . 1 7 ) . T h i s i n d i c a t e s that responses on the BDHI do not d i s c r i m i n a t e between +FH and - F H s u b j e c t s . 43 PHYSIOLOGICAL FINDINGS Did p o s i t i v e fami ly h i s t o r y of e s s e n t i a l h y p e r t e n s i o n increase r e s p o n s i v i t y to ta sks? Did a f f e c t i v e c o n v e r s a t i o n e l i c i t g r e a t e r p h y s i o l o g i c a l responses than n e u t r a l c o n v e r s a t i o n ? And d i d speech tasks always r a i s e p h y s i o l o g i c a l a c t i v i t y ? To t e s t these hypotheses* a m u l t i v a r i a t e a n a l y s i s of v a r i a n c e was conducted with one between group v a r i a b l e : f a m i l y h i s t o r y * and two w i t h i n - g r o u p v a r i a b l e s ! t o p i c of c o n v e r s a t i o n ( n e u t r a l * Dr af personal r e l e v a n c e ) * and phase of c o n v e r s a t i o n (speech vs l i s t e n i n g ) . There were 4 p h y s i o l o g i c a l dependent v a r i a b l e s . HR* SBP* DBP and RR. F i n d i n g s i n d i c a t e d that +FH s u b j e c t s d i s p l a y e d h igher DBP and SBP throughout* but there were no d i f f e r e n c e s between groups on RR and HR. T a l k i n g about a t o p i c of persona l r e l e v a n c e (high a f f e c t ) y i e l d e d g r e a t e r autonomic responses than n e u t r a l speech on al I p h y s i o l o g i c a l i n d i c e s except RR. S u b j e c t s d i s p l a y e d g r e a t e r autonomic responses to speech tasks than to I i s t e n i n g ta sks on a l I p h y s i o l o g i c a l i n d i c e s . There was an i n t e r a c t i o n between t o p i c of c o n v e r s a t i o n and phase of c o n v e r s a t i o n . For t h i s a n a l y s i s * the p h y s i o l o g i c a l r e a d i n g s were averaged a c r o s s minutes 1* 3* and 5 of each c o n v e r s a t i o n phase. Detai led r e s u l t s are g iven below. Tab le 8 shows the F va lues for the MANOVA of 2<FH) x 2 ( top ics= a f f e c t / w e a t h e r ) x 2(phases: s p e e c h / I i s t e n ) . T a b l e 8 Manama summary t a b l e o f e f f e c t o f f a m i l y h i s t o r y (FH) on HR, SBP > DBP and RR. (2FH X 2 TOPICS X 2  PHASES OF CONVERSATION) E f f e c t v a r i a t e MS F df P FH GRAND MEAN 13.8 3.28 4* 57 * HR 727.2 1 .66 1 , 62 SBP 1778.0 5.04 1 , 62 DBP 2037.7 11 .56 1 , 62 RR 38.0 2. 16 1 , 62 TOPIC GRAND MEAN 44. 1 10 .48 4 , 57 *** HR 85.0 7.27 1 > 62 ** SBP 637.4 24.7 1 , 62 **# DBP 614.3 27. 1 1 > 62 *** RR 4.5 2.2 1 , 62 FH X TOPIC GRAND MEAN 3.4 .81 4, 57 PHASE GRAND MEAN 504.77 120.14 4; 57 *** HR 4607.73 138.87 1 > 62 #*K SBP 4631.66 240.24 1, 62 *** DBP 5634.87 261.08 1, 62 *** RR 1176.28 147.31 1, 62 *** TOPIC X PHASE GRANDMEAN 30 .36 7.34 4, 57 *** HR 73.24 10 .85 1 , 62 K * SBP 82.53 7.36 1 , 62 #K DBP 156.53 13. 17 1 , 62 *** RR 1 .57 .65 1 , 62 FH X TOPIC X PHASE GRAND MEAN .63 . 15 4 , 57 SIGN I F I C A N C E * < E<.05) ** (p_'<. 01) *** < £ < • 001 ) 45 T a b l e 9 Mean SBP v a l u e s f a r +FH and -FH s u b j e c t s a t .d J j L i J L L i L E L ^ PHASE TOPIC +FH (N=26) -FH (N=36) BASELINE AFFECT WEATHER 124.2 122.6 ( 1 2 . 3 0 ) ( 1 2 . 6 0 ) 119.6 ( 9.75) 119.B ( 1 1 . 0 6 ) TALK AFFECT WEATHER 136.9 132.2 ( 1 0 . 5 4 ) ( 1 1 . 4 7 ) 130.1 ( 9.72) 126.0 ( 9.53) LI S T E N AFFECT WEATHER 126.4 123. B < 9.73) ( 9.79) 121.2 ( 9.B5) 119.7 ( I D . 6 8 ) RECOVER AFFECT WEATHER 124.2 123.3 ( 9.65) ( 9.00) 118.2 < 9.02) 118.3 ( 1 0 . 6 0 ) 46 T a b l e 10 = Mean DBP v a l u e s o f +FH and -FH s u b j e c t s a t  d i f f e r e n t c o n v e r s a t i o n p e r i o d s . PHASE TOPIC +FH (N=26) -FH (N=36) AFFECT 73.96 ( 7 . 2 7 ) 68.44 ( 7 . 5 1 ) BASELINE WEATHER 72.23 ( 7 . 8 8 ) 68.39 ( 8 . 0 8 ) AFFECT 88.15 ( 6 . 1 9 ) 80.65 ( 7 . 7 2 ) TALK WEATHER 81.82 ( 7 . 2 2 ) 76.61 ( 8 . 2 2 ) AFFECT 75.76 ( 6 . 2 3 ) 70.46 ( 7 . 5 6 ) L I S T E N WEATHER 73.82 ( 7 . 5 0 ) 69.02 ( 8 . 6 5 ) AFFECT 74.21 ( 7 . 7 9 ) 68.14 ( 7 . 2 8 ) RECOVER WEATHER 72.32 ( 7 . 0 1 ) 68.09 ( 7 . 1 4 ) 47 T a b l e 11 Mean H e a r t r a t e v a l u e s o f +FH and -FH s u b j e c t s  d u r i n g d i f f e r e n t p h a s e s of c o n v e r s a t i o n . PHASE TOPIC +FH <N=26) -FH (N=36) AFFECT 73, .00 ( ? . • 70) 71 , .56 (1 3 , .44) WEATHER 72, .85 (10 .43) 71 , . 13 (11 . ,29) AFFECT 82 .40 (11 . 11) 80 .33 (12, •701 WEATHER 80 .35 ( 9 .85) 77 .69 (12, . 00) AFFECT 72 .50 ( 8 .78) 70 .57 (11 , .01) WEATHER 72, .88 ( 8 .84) 70, . 05 (10, .66) AFFECT 72 .31 ( 9 .40) 70 . 09 (10 , .43) WEATHER 72, .4? ( 9 .95) 70, .06 (11 . ,32) BASELINE TALK L I S T E N RECOVER 48 T a b l e 12= Mean r a t e o f r e s p i r a t i o n v a l u e s o f +FH and -FH  s u b j e c t s d u r i n g d i f f e r e n t p h a s e s o f c o n v e r s a t i o n . PHASE TOPIC +FH (N=26) -FH (N=36) BASELINE AFFECT WEATHER 16.62 16. 04 (2 . 6 4 ) (3.4D) 16.19 ( 2 . 8 5 ) 16.17 ( 2 . 8 9 ) TALK AFFECT 12.61 ( 2 . 4 5 ) WEATHER 12.62 ( 2 . 2 4 ) 11.84 (2.D8) 12.D6 ( 2 . 2 6 ) L I S T E N AFFECT 16.87 (3.2D) WEATHER 17.10 ( 3 . 6 3 ) 16.D8 ( 2 . 2 8 ) 16.67 ( 3 . 3 7 ) RECOVER AFFECT 16.44 ( 2 . 4 3 ) WEATHER 16.22 ( 2 . 8 5 ) 15.88 ( 2 . 6 0 ) 16.37 ( 2 . 7 8 ) i 4<? There were no i n t e r a c t i o n e f f e c t s between (1) FH and phase of c o n v e r s a t i o n * and (2) FH and t o p i c of c o n v e r s a t i o n . Because of t h i s lack of i n t e r a c t i o n between the between-groups f a c t o r and the two w i t h i n - g r o u p f a c t o r s * i t was unnecessary to conduct f u r t h e r p o s t - h o c a n a l y s e s . However* one other f a c t o r was c o n s i d e r e d a p o s s i b l e cause of the d i f f e r e n c e between the +FH and - F H groups • age. The e f f e c t of age. +FH s u b j e c t s turned out to be s i ightIy o l d e r than - F H s u b j e c t s . Table 13 shows the age d i s t r i b u t i o n . Table 13 ' Age d i s t r i b u t i o n of s u b j e c t s mean age SQ max m i n +FH 22.7 (S.6) 36 18 - F H 20.4 (2 .8) 35 18 Al though the d i f f e r e n c e in age between the two groups was very smal l* 2 .3 years* i t was s i g n i f i c a n t * F (1 >63) - 1.21) p_ <D1. T h i s posed a p o t e n t i a l problem to the f i n d i n g tha t FH+ s u b j e c t s had h igher b lood p r e s s u r e than F H - s u b j e c t s . Ulou I d t h i s s imply be a t t r i b u t a b l e to age? To answer t h i s q u e s t i o n a MANCOVA was performed with age as a c o v a r i a t e . Regres s ion s lopes were found not to be s i g n i f i c a n t l y d i f f e r e n t for the two groups . R e s u l t s 5D i n d i c a t e d that age was not a s i g n i f i c a n t covar i a t e i F (4> 56)= . 94 J p_ >.D5. Concerns over age d i f f e r e n c e s t h e r e f o r e d i d not appear n e c e s s a r y . For t h i s MANCOvA; the p h y s i o l o g i c a l r ead ings used were those taken d u r i n g b a s e l i n e (minute 3)> and the average of three read ings ( minute l>3>and 5) taken d u r i n g the speech) I i s t en and recovery phases of the a f f e c t and n e u t r a l c o n v e r s a t i o n s . v i s u a l i n s p e c t i o n of f i g u r e s 1 and 2 support the s t a t i s t i c a l f i n d i n g that +FH s u b j e c t s had c o n s i s t e n t l y h igher l e v e l s of b lood p r e s s u r e d u r i n g a l I phases of c o n v e r s a t i o n ) and t o p i c s of c o n v e r s a t i o n . But do +FH s u b j e c t s show g r e a t e r r e s p o n s i v i t y to the d i f f e r e n t phases of c o n v e r s a t i o n ? T h i s was not c o n s i s t e n t l y supported by the above data? because there were no s i g n i f i c a n t FH by phase i n t e r a c t i o n s for mean autonomic a c t i v i t y l e v e l s ! but when peak va lues for each task phase are c o n s i d e r e d ) there is an i n t e r a c t i o n between f a m i l y h i s t o r y and t o p i c of c o n v e r s a t i o n on DBP) F (1) 62)=7.24> P_<.01. T h i s suggests that with re spec t to peak va lues ) +FH s u b j e c t s were more h i g h l y r e a c t i v e on the a f f e c t i v e t a s k . (See f i g u r e 3) T a b l e s 14) 15) and 16 g ive the mean peak va lues for each group at the d i f f e r e n t phases of conver sat i an . 51 Figure 1 MEAN SBP VALUES AT DIFFERENT TASK PHASES 52 Figure 2 MEAN DBP VALUES AT DIFFERENT TASK PHASES 65-1 BASELINE TALK LISTEN RECOVER 53 Figure 3 +FH VS - F H ON PEAK DBP MEASURES USING CHANGE SCORES 54 T a b l e 14'Mean ( a n d s t a n d a r d d e v i a t i o n s o f ) Peak v a l u e s o f e a c h c o n v e r s a t i o n p h a s e on HR (bpm) PHASE TOPIC +JFH ^FH BASELINE AFFECT 73.00 ( 7 . 7 2 ) 71.42 ( 1 3 . 6 ) WEATHER 72.85 ( 1 0 . 4 3 ) 71.05 ( 1 1 . 3 6 ) TALK L I S T E N AFFECT WEATHER AFFECT WEATHER 87.27 84. 12 75.00 75.31 ( 1 3 . 1 4 ) ( 1 0 . 4 1 ) ( 7 . 1 3 ) ( 7 . 4 5 ) 85.66 81 .55 73. 11 72.03 ( 1 5 . 2 8 ) ( 1 3 . 1 7 ) ( 1 1 . 7 4 ) ( 1 1 . 0 7 ) RECOVER AFFECT WEATHER 74.65 ( 8 . 7 6 ) 74.81 ( 1 0 . 3 0 ) 72.26 ( 1 0 . 5 7 ) 72.42 ( 1 2 . 2 1 ) 55 T a b l e 15=Mean ( a n d s t a n d a r d d e v i a t i o n s o f ) peak v a l u e s of e a c h c o n v e r s a t i o n p h a s e SBP ( i n mm Hg)  PHASE TOPIC +FH -FH BASELINE AFFECT WEATHER 124.2 ( 1 2 . 3 0 ) .122.6 ( 1 2 . 6 0 ) 117.4 ( 7 . 5 1 ) 117.7 ( 1 1 . 5 6 ) TALK AFFECT WEATHER 142.7 ( 1 2 . 0 0 ) 136.4 ( 1 1 . 4 8 ) 135.7 ( 1 1 . 4 ) 130.7 ( 1 0 . 6 3 ) L I S T E N AFFECT WEATHER 130.8 ( 7 . 7 7 ) 127.7 ( 7 . 7 5 ) 124.4 ( 1 0 . 1 1 ) 123.1 ( 1 0 . 7 6 ) RECOVER AFFECT WEATHER 128.5 ( 1 0 . 5 3 ) 128.0 ( 1 0 . 2 1 ) 121.7 ( 7 . 6 6 ) 122.2 ( 1 0 . 2 1 ) 56 T a b l e 16= Mean ( a n d s t a n d a r d d e v i a t i o n s o f ) peak v a l u e s o f  DBF t a k e n a t e a c h c o n v e r s a t i o n p h a s e i n mm Hg. PHASE TOPIC +FH -FH BASELINE AFFECT WEATHER 73.96 (7.27) 72.23 (7.88) 68.39 (7.33) 67.87 (8.31) TALK AFFECT WEATHER 93.5D (7.97) 85.31 (6.98) 84.71 (8.91) 80.50 (8.91) L I S T E N AFFECT WEATHER 79.77 (5.82) 76.92 (7.61) 73.29 (7.57) 71.45 (8.28) RECOVER AFFECT WEATHER 77.12 (8.87) 75.23 (7.08) 70.68 (7.76) 71.39 (7.17) 57 T o p i c of C o n v e r s a t i o n . O v e r a l I , the main e f f e c t of t o p i c of conversa t i o n * ( a f f e c t i ve vs n e u t r a l ) , was s i g n i f i c a n t . U n i v a r i a t e F t e s t s showed t h i s to be t r u e on HR, SBP, DBP and RR. (See t a b l e 8 for F v a l u e s ) The d i f f e r e n t phases of c o n v e r s a t i o n Dur ing the exper iment , each s u b j e c t was r e q u i r e d to t a l k , I i s t e n and r e l a x for both a f f e c t i v e and n e u t r a l t o p i c s of c o n v e r s a t i o n . The r e s u l t s of a 2 ( t a s k s ) X 4(phases of c o n v e r s a t i o n ) MANOVA i n d i c a t e d that s u b j e c t s were d i f f e r e n t l y aroused at d i f f e r e n t phases of each t o p i c of c o n v e r s a t i o n , F (12, 4&9)=45.12, p_ <.D01. There was a s i g n i f i c a n t i n t e r a c t i o n between the t o p i c of c o n v e r s a t i o n and the phase of the c o n v e r s a t i o n , F (12, 469)=13.79, £ < . • • ! . Table 13 d i s p l a y s these means. P o s t -hoc S c h e f f e ; c o n t r a s t s with a lpha l e v e l s set at .05 i n d i c a t e d that only on the t a l k i n g phase of each c o n v e r s a t i o n , d i d va lues d i f f e r on a l l CV v a r i a t e s . There were no s i g n i f i c a n t d i f f e r e n c e s between the e f f e c t s of the two tasks at basel ine , I i s t e n i n g and recovery phases with one e x c e p t i o n ; SBP d i s c r i m i n a t e d between the two tasks Dn the I i s t e n i n g phase , with a f f e c t i v e I i s t e n i n g h igher than n e u t r a l I i s t e n i n g . + 58 Tab le 17 Mean phy 5 i • I og i ca I i n d i c e s o-f arpusa l on two d i f f e r e n t  t o p i c s of c o n v e r s a t i o n at d i f f e r e n t phases of c o n v e r s a t i o n . var i ate Phase a f f e c t weather HR base i i ne 72 . 3 72 . 1 t a l k 81.4 77.Q I i s ten 71.5 71 .5 recover 71.2 71.3 SBP base I i ne 121.7 121.2 t a l k 135.5 127.0 I i s ten 123.8 121.8 recover 121.2 120.8 DBP base I i ne 68.4 70.3 t a l k 84.4 77.2 I i s ten 73.1 72.4 recover 71.2 71.2 RR base I i ne 16.6 16.1 t a l k 12.2 12.3 I i s ten 16.5 17.0 recover 16.2 16.3 F i g u r e s 1 and 2 a l s o show of c o n v e r s a t i o n and phase Df the i n t e r a c t i o n between t o p i c c o n v e r s a t i o n on DBP and SBP. 5<? E v a l u a t i o n of p h y s i o l o g i c a l responses to the Math t a s k . Does a mental a r i t h m e t i c task y i e l d more p h y s i o l o g i c a l arousa l than t a l k i n g about the weather or a f r u s t r a t i n g event? R e s u l t s of a 2(FH> X 3 ( t a s k s : weather? a f f e c t ) and math) MANCOVA) with base I ine as a c o v a r i a t e i n d i c a t e d an o v e r a l I s i g n i f i c a n t main e f f e c t for type of task) F (8) 222)=11.83) £ <.DD1. Posthoc S c h e f f e J t e s t s on b a s e l i n e - a d j u s t e d means with a lpha l e v e l s set at p = .05 i n d i c a t e d that both the math task) and t a l k i n g about a f r u s t r a t i n g p e r s o n / e v e n t y i e l d e d h igher l e v e l s of b lood p r e s s u r e and heart ra t e than t a l k i n g about the weather) but that the two (math and a f f e c t ) d i d not d i f f e r s i g n i f i c a n t l y from each other on SBP or RR. On DBP) a f f e c t y i e l d e d s i g n i f i c a n t l y h igher arousa l than math) whi le on heart ra t e the reverse was t r u e . The 2 X 3 MANCOVA model was chosen because i t a l lowed a symmetrical and ba lanced f a c t o r i a l a n a l y s i s s i n c e u n l i k e the c o n v e r s a t i o n tasks J the math task d i d not have a I i s t e n i n g phase. Bes ide t h i s ? there were no e f f e c t s of task on I i s t e n i n g and recovery phases) and i t was unnecessary to inc lude them in t h i s a n a l y s i s . Tab le 11 g ive s the average read ings d u r i n g the t a l k phase of these t a s k s . F i g u r e s 4) 5) and 6 show the d i f f e r e n t e f f e c t s of the ta sks on HR) SBP and DBP r e s p e c t i v e l y . T a b l e 18. Mean ( s t a n d a r d d e v i a t i o n ) p h y s i • I p g i c a I r e a d i n g s t a k e n  d u r i n g s p e e c h t a s k s and math. VAR 1 ATE FH AFFECT WEATHER MATH HR (bpm) +FH 82.4 80 . 4 85.3 (11.1) ( 9 . 8) 14.4) -FH 8D.2 77. 6 83.8 ( 1 2 . 7 ) < 12 :.2) ( 1 5 . • ) SBP (mm Hg) +FH 136.9 132 .0 135.5 ( 1 0 . 5 ) (11 .5) <ID.8) -FH 129.6 125 .4 129. D ( 9 . 2 ) ( 9 . • ) ( I D . 8 ) DBP(mm Hg) +FH 88.2 81 . 8 84.7 ( 6 . 2 ) ( 7 . 2) ( 7 . 4 ) -FH 80.5 76. 3 78. D ( 7 . 8 ) ( 8 . 2) ( 7 . 8 ) RR (bpm) +FH 12.6 12. 6 13.7 ( 2 . 4 ) ( 2 . 2) ( 2 . 7 ) -FH 11.8 12. 0 13.3 ( 2 . 1 ) ( 2 . 3) ( 2 . 1 ) Figure 4 THE EFFECTS OF DIFFERENT TASKS ON HR 80 H Legend TZ2 + F H MATH AFFECT WEATHER L2 Figure 5 THE EFFECTS OF DIFFERENT TASKS ON SBP MATH AFFECT WEATHER 63 Figure 6 THE EFFECTS OF DIFFERENT TASKS ON DBP DISCUSSION 64 Fam i Iy H i s t o r y . The r e s u l t s of the study i n d i c a t e that s u b j e c t s who had a p o s i t i v e fami ly h i s t o r y of EH showed g r e a t e r c a r d i o v a s c u l a r responses to a l I the exper imenta l s t r e s s o r s in troduced in the s tudy . Whether the t o p i c of c o n v e r s a t i o n was the weather or a f r u s t r a t i n g e v e n t / p e r s o n ; or a mental a r i t h m e t i c t a s k J +FH s u b j e c t s showed g r e a t e r l e v e l s of arousa l on d i a s t o l ic and s y s t o l i c b lood p r e s s u r e . +FH i n d i v i d u a l s began with s i g n i f i c a n t l y h igher r e s t i n g l e v e l s of b lood p r e s s u r e and mainta ined t h i s throughout the experiment? i n d i c a t i n g that +FH i n d i v i d u a l s were not more r e s p o n s i v e to the tasks than -FH i n d i v i d u a l s . However? in a d d i t i o n to t h i s o v e r a l l h igher arousa l l e v e l ? +FH s u b j e c t s a l s o had g r e a t e r DBP response l e v e l s to the a f f e c t r a t h e r than the math task or the low a f f e c t p r o v o c a t i o n . S i n c e the h igh a f f e c t t o p i c a l s o provoked the g r e a t e s t DBP responses? the h i g h e s t response l e v e l s on DBP were evoked by the a f f e c t i v e t o p i c in +FH s u b j e c t s . When peak DBP measures were cons idered? +FH i n d i v i d u a l s showed g r e a t e r r e s p o n s i v i t y to the a f f e c t i v e task than - F H i n d i v i d u a l s . Why the a f f e c t i v e and not the Math task? The a f f e c t i v e task el i c i t e d the g r e a t e s t responses on DBP? which is c o n s i d e r e d an a I p h a - a d r e n e r g i c v a s o - c o n s t r i c t i v e 65 response . +FH i n d i v i d u a l s are more quick to g ive t h i s response (Stoney and Matthews? 1788). Bes ides t h i s ? the task p r o b a b l y in troduced more i n d i r e c t response f l u c t u a t i o n s than the Math task which is presumed to have a s teady demand on the Cv system with l i t t l e v a r i a b i l i t y over t ime . Al though the s tandard d e v i a t i o n s (see t a b l e 18) do not i n d i c a t e d i f f e r e n t i a l v a r i a b i l i t y of responses to the d i f f e r e n t tasks? t h i s is probab ly because the s tandard d e v i a t i o n r e f l e c t s v a r i a b i I i t y a c r o s s s u b j e c t s and not w i t h i n s u b j e c t s . F a m i l y h i s t o r y and p e r c e i v e d s t r e s s f u I n e s s of t a s k . The r e s u l t s i n d i c a t e d tha t both +FH and - F H s u b j e c t groups ranked the tasks e q u a l l y provoking? i n d i c a t i n g tha t the +FH f a c t o r d i d not a f f e c t p e r c e p t i o n of s t r e s s f u I n e s s of t a s k . T h i s f i n d i n g is i n t e r e s t i n g because i t p r o v i d e s f u r t h e r support for other f i n d i n g s in the i i t e r a t u r e that there is g r e a t e r desynchrony between f e e l i n g s expressed by +FH i n d i v i d u a l s and leve l of autonomic a r o u s a l ? than there is with - F H i n d i v i d u a l s ? (Jorgensen and Houston? 1786). That is? a l though both groups s u b j e c t i v e l y r e p o r t e d equal l e v e l s of anx ie ty? the +FH group showed h igher l e v e l s of autonomic a c t i v i t y through out the study? presumably r e f l e c t i n g d e n i a l of d i s t r e s s on the p a r t of +FH s u b j e c t s (Jorgensen and Houston ? 1786) . 6,6, F a m i l y H i s t o r y and H o s t i l i t y . The Buss-Durkee H o s t i l i t y Inventory p r o v i d e s a g l o b a l impress ion of h o s t i l e f e e l i n g s and a tendency to act out anger . A c c o r d i n g to B i a g g i o (1780) however? the s u b s c a l e s do not seem to possess a h igh degree of d i s c r i m i n a n t val i d i t y . In t h i s study? n e i t h e r the s u b s c a l e s nor the t o t a l h o s t i l i t y score d i s c r i m i n a t e d between the +FH and -FH groups . Nor were the scores s i g n i f i c a n t l y d i f f e r e n t from the norms p r o v i d e d by the B i a g g i o study? except that the t o t a l scores of both +FH and - F H groups d e v i a t e d .5 SD from the mean of the normative group. A t rend was observed however? with r e s p e c t to the o v e r t and cover t e x p r e s s i o n of hos t i I i t y . - F H s u b j e c t s scared s i i g h t l y h igher than +FH s u b j e c t s on the over t sca le? whi le +FH s u b j e c t s scored s l i g h t l y h igher than - F H s u b j e c t s on the c o v e r t s c a l e . T h i s is in l i n e with the a n g e r - i n l i t e r a t u r e ? which suggests that e s s e n t i a l h y p e r t e n s i v e s d i s p l a y more a n g e r - i n t e n d e n c i e s than normotensives? (Jensen? 1788). T h i s t rend is a l s o in l i n e with the o b s e r v a t i o n that +FH s u b j e c t s tend to g ive s i i g h t l y lower r a t i n g s of a n x i e t y to the s t r e s s r e l a t e d tasks than - F H s u b j e c t s ? perhaps i n d i c a t i n g an unwi I I ingness to admit openly to negat ive fee l ings? aga in s u p p o r t i n g Jorgensen and Houston ' s (1786) assumption of h igh d e n i a l . It must be emphasized though that these r e s u l t s show i n t e r e s t i n g trends? and not c o n c l u s i o n s based an s t a t i s t i c a l s i g n i f i c a n c e . 67 A f f e c t and neutral speech. Subjects showed greater responses when conversing about a f r u s t r a t i n g person/event than they showed when t a l k i n g about the weather. Using the same interview format for the c o n t r o l task (neutral speech or speech of nan-personal relevance) provided an excel lent means of comparison between s t r e s s f u l and n o n - s t r e s s f u l t a s k s i a comparison u s u a l l y l a c k i n g in p s y c h o p h y s i o l o g i c a l studies? which instead u t i I ize base I ine measures as the only means of comparison. This method allowed monitoring of the e f f e c t s of speech content on blood pressure. T a l k i n g about the weather had been rated as the le a s t arousing t o p i c to d i s c u s s with a stranger in a laboratory s i t u a t i o n during the pi lot study. It was thus p o s t u l a t e d that i t would lead to lower l e v e l s of Cv arousal than d i s c u s s i n g a f r u s t r a t i n g event or person. This was found to be the case both in the pi lot and actual study. On average? the d i f f e r e n c e between the two t o p i c s during speech was 6.5 mm Hg on s y s t o l ic and 5.2 mm Hg on d i a s t o l i c blood pressure. These s i g n i f i c a n t d i f f e r e n c e s i n d i c a t e d that the two t o p i c s of c o n v e r s a t i o n e l i c i t e d d i f f e r e n t l e v e l s of s t r e s s . These r e s u l t s support the co n c l u s i o n s of s t u d i e s by Linden (1987)? and Dimsdale et al (1?87)> that speech content is an important p r e d i c t o r of blood pressure change. 68 How v a l i d are c o n v e r s a t i o n a l ta sks? . Inc luded in the des ign of t h i s experiment was a mental a r i t h m e t i c t e s t which was to serve as a f u r t h e r comparison for the c o n v e r s a t i o n a l t a s k s . The procedure and the observed p h y s i o l o g i c a l r e a c t i o n s to the math task were simi Iar to those observed by L i n d e n (1987). S u b j e c t i v e r a t i n g of tasks showed that the math task was r a t e d as e q u a l l y d i s t r e s s i n g as was t a l k i n g about a f r u s t r a t i n g person or event* and that the two were s u b j e c t i v e l y p e r c e i v e d as more s t r e s s f u l than d i s c u s s i n g the weather. The l a t t e r r e s u l t s were rep I i c a t e d by the p h y s i o l o g i c a l r e a c t i o n s to the r e s p e c t i v e tasks and suggest that the c o n v e r s a t i o n a l tasks employed in t h i s study have h igh i n t e r n a l val i d i t y . Furthermore* the p o s t -hoc t e s t s i n d i c a t e d that the a f f e c t i v e c o n v e r s a t i o n a l task y i e l d e d h igher d i a s t o l i c b lood p r e s s u r e l e v e l s than d i d the math t a s k . T h i s is important because in most s t u d i e s on fami ly h i s t o r y of e s s e n t i a l h y p e r t e n s i o n * ( e . g . Stoney and Matthews (1988)* O b r i s t et a l . * ( 1 9 8 7 ) ) * i t is DBP tha t has most c o n s i s t e n t l y been found to d i f f e r e n t i a t e between o f f s p r i n g of h y p e r t e n s i v e s and non-hypertens i ves . These f i n d i n g s are e x c i t i n g because c o n v e r s a t i o n a l tasks c o n c e p t u a l l y have g r e a t e r e x t e r n a l v a l i d i t y than mental a r i t h m e t i c tasks* c o l d - p r e s s o r and other i s o m e t r i c t e s t s . They can be used with non-s tudent p o p u l a t i o n s such as o l d e r people* without g e n e r a t i n g the sense of 69 inadequacy so o f t en evoked with mental a r i t h m e t i c in s u b j e c t s who have not done math for ages. C o n v e r s a t i o n a l tasks a l s o have the advantage of a l l o w i n g room for i d i o s y n c r a s i e s in the events which s u b j e c t s may f i n d f r u s t r a t i n g . The task does not r e q u i r e s p e c i a l equipment? and i t is s i m p l e . Comparison with Stoney and Matthews? (1988) To which p o p u l a t i o n s do the r e s u l t s of t h i s study app ly? Is +FH r e a l l y a r i s k f a c t o r for E s s e n t i a l H y p e r t e n s i o n ? These q u e s t i o n s are addressed by Stoney and Matthews (1988). The b lood p r e s s u r e and hear t ra t e of middle -aged o f f s p r i n g of h y p e r t e n s i v e s and myocardia l i n f a r c t i o n p a t i e n t s were monitored at r e s t and d u r i n g s e r i a l s u b t r a c t i o n ? m i r r o r image t r a c i n g ? and i s o m e t r i c h a n d g r i p . The r e s u l t s showed that middle -aged men and women with a p a r e n t a l h i s t o r y of h y p e r t e n s i o n e x h i b i t e d exaggerated DBP responses d u r i n g a lI s t r e s s o r s . T h e i r r e s u l t s a l s o i n d i c a t e d that men with a p a r e n t a l h i s t o r y of myocardia l i n f a r c t i o n with or without a p a r e n t a l h i s t o r y of hyper tens ion? e x h i b i t e d exaggerated SBP responses . The authors r e l a t e d t h i s increased SBP response in s u b j e c t s with a p o s i t i v e p a r e n t a l h i s t o r y of myocardia l i n f a r c t i o n ? to an exaggerated b e t a - a d r e n e r g i c c a r d i a c output response? whereas the g r e a t e r DBP response d u r i n g i s o m e t r i c e x e r c i s e of men with a +FH Df h y p e r t e n s i o n was p o s t u l a t e d to be r e l a t e d to an 70 exaggerated a I p h a - a d r e n e r g i c p e r i p h e r a l r e s i s t a n c e response . As Stoney and Matthews s ta t ed ) these r e s u l t s are important because they p r o v i d e i n d i r e c t support for the h y p o t h e s i s that i n d i v i d u a l d i f f e r e n c e s in CV responses d u r i n g b e h a v i o r a I s t r e s s are a r i s k f a c t o r for EH and CHD and that these d i f f e r e n c e s may be t r a c e d to s p e c i f i c p a r e n t a l h i s t o r y of e s s e n t i a l h y p e r t e n s i o n or myocardia l i n f a r c t i o n . The r e s u l t s of the present study support the Stoney and Matthews f i n d i n g s that i n d i v i d u a l s with the +FH f a c t o r have increased DBP responses to b e h a v i o r a l s t r e s s e s p e c i a l l y when peak DBP responses are c o n s i d e r e d . Furthermore) the Stoney and Matthews r e s u l t s i n d i c a t e that the r e s u l t s of the c u r r e n t study are general i z a b l e to o l d e r p o p u l a t i o n s . For the f u t u r e ) l o n g i t u d i n a l s t u d i e s us ing simi Iar methods to the one used here) with p o p u l a t i o n s at r i s k such as the r i s k group d e f i n e d here) would f u r t h e r c l a r i f y the issue of general i zab i I i t y . Comparison with D i m s d a l e ' s work. Very recent work in psychosomat ic medic ine has focussed an the r e - i n t r o d u c t i o n of the s t r e s s in t erv i ew into l a b o r a t o r y work as a s t i m u l u s for autonomic a r o u s a l . Dimsdale) S t e r n ) and Di I Ion (1788)) r e p o r t e d a study in which 24 normotensive and 19 h y p e r t e n s i v e s u b j e c t s performed a s tandard l a b o r a t o r y math task) a c o l d pres sor t e s t and took p a r t in a s t r e s s in terv iew in that o r d e r . 71 The f i r s t three tasks were 3 minutes each with a minimum • f 5 minutes r e s t p e r i o d between t a s k s . The s t r e s s i n t e r v i e w on average l a s t e d 16 minutes . The r e s u l t s i n d i c a t e d that the h y p e r t e n s i v e s u b j e c t s had h igher peak b lood p r e s s u r e responses to each task (38/32 mm Hg over basel ine) than mormotensives (31/24 mm Hg over b a s e l i n e ) ? and that the s t r e s s i n t e r v i e w el i c i t e d about twice as much b lood p r e s s u r e increase s as the other three t a s k s . The authors argued for the s t r e s s in terv iew as a use fu l l a b o r a t o r y too l with g r e a t e r e x t e r n a l v a l i d i t y and t e s t -r e t e s t r e l iab i I i t y than the other s tandard l a b o r a t o r y s t r e s s o r s . They a l s o argued that peak bIODd p r e s s u r e responses o c c u r r e d at p o i n t s in the in terv iew when speech content was of g r e a t e s t emotional r e l e v a n c e to the s u b j e c t s . The r e s u l t s of Dimsdale et a I . ? were r e p l i c a t e d by the present study? the outcome of which i n d i c a t e d g r e a t e r increased r e s p o n s i v i t y of +FH s u b j e c t s to a f f e c t i v e speech content on peak DBP. The present study moreover c o n t r o l led the p o t e n t i a l sequencing confound of ta sks apparent in the Dimsdale et al work. In that study? the i n v a r i a n t order of task p r e s e n t a t i o n c o u l d account for the s tepwise increase in autonomic responses from one task to the next . In the c u r r e n t study? the order of task p r e s e n t a t i o n was c o u n t e r b a l a n c e d and each task l a s t e d f i v e minutes . Thus the tasks were more e q u i v a l e n t in t h i s study than in the Dimsdale s tudy . 72 Loss of the o r i e n t i n g r e f l e x in +FH s u b j e c t s ? Based on L y n c h ; s (1785) c l i n i c a l o b s e r v a t i o n s ? i t was p r e d i c t e d that +FH i n d i v i d u a l s would show a d i f f e r e n t p a t t e r n of r e s p o n s i v i t y on I i s t e n i n g tasks than - F H i n d i v i d u a l s . No such d i f f e r e n c e s between groups were observed . T h i s e x p e c t a t i o n of a d i f f e r e n c e was based on the assumptions that (a) Lynches comparison of the o r i e n t i n g r e f l e x to the a r t of l i s t e n i n g was j u s t i f i e d ? and (b) h y p e r t e n s i v e s and t h e i r o f f s p r i n g I i s t en "defensively-'-' to r e l e v a n t m a t e r i a l as Lynch p o s t u l a t e d . To examine the r e s u l t s c l o s e l y ? le t us choose the non-s t r e s s f u l c o n v e r s a t i o n task as our p o i n t of f o c u s . A f t e r the experiment? some s u b j e c t s r e p o r t e d be ing t o t a l l y immersed and i n t e r e s t e d in the experimenters ' 1 n a r r a t i v e of the weather in West A f r i c a ? whi le o thers wandered r e p e a t e d l y whether they had "performed" wel l? hence the s u r p r i s i n g l y h igh r e l e v a n c e r a t i n g s far t h i s t a s k . They worr i ed about be ing assessed? and i f they would be examined an what the exper imenter was s a y i n g . T h i s was in s p i t e of having been r e a s s u r e d at the beg inn ing of the experiment that no such assessment would be made. If one goes by the I i t e r a t u r e ? one would expect +FH s u b j e c t s to be the ones ta worry about be ing a s s e s s e d . There was u n f o r t u n a t e l y no d i r e c t check of t h i s in the present s tudy . If such thought p a t t e r n s should have an e f f e c t on arousa l ? i t should do so when s u b j e c t s I i s t en to the exper imenter? when they have the o p p o r t u n i t y to 73 compare the speech they have j u s t made with that which the exper imenter is making. However when asked to ra te the degree of personal r e l e v a n c e of I i s t e n i n g tasks? f a m i l y h i s t o r y d i d not d i f f e r e n t i a t e between the two groups . Nor were there any d i f f e r e n c e s in p h y s i o l o g i c a l i n d i c e s of arousa l between +FH and - F H on the I i s t e n i n g t a s k s . In fac t? the i n d i c e s of arousa l d u r i n g I i s t e n i n g d i d not d i f f e r s i g n i f i c a n t l y from b a s e l i n e l e v e l s . In t h i s study? the +FH f a c t o r d i d not c o n t r i b u t e to d i f f e r e n c e s in I i s t e n i n g p a t t e r n s . For a number of reasons however? these f i n d i n g s should not be taken as d i s c o n f i r m a t i o n D f L y n c h ' s hypotheses . The h y p o t h e s i s that autonomic responses d u r i n g l i s t e n i n g would d i f f e r in +FH s u b j e c t s is based on the assumption that they have l o s t the o r i e n t i n g r e f l e x to navel s t imul i ? and t h e r e f o r e r e a c t with increased autonomic re sponses . The o r i e n t i n g r e f l e x occurs w i t h i n seconds of the p r e s e n t a t i o n of a new s t i m u l u s . Dur ing t h i s study however? p h y s i o l o g i c a l measurements were recorded in the f i r s t ? t h i r d and f i f t h minutes? thus p o s s i b l y mi s s ing the acute s h o r t - t e r m r e f l e x i f i t was p r e s e n t . From the r e s u l t s of Dimsdale et al (1988) and L y n c h ' s (1985) work? i t is c l e a r that a s tepwise increase of BP might occur with time d u r i n g a c o n v e r s a t i o n un le s s there were Iong enough pauses for r e f l e c t i o n to a l low r e t u r n of BP to r e s t i n g l e v e l s . In that case one would expect that d u r i n g our c o n v e r s a t i o n ? I i s t e n i n g and recovery phases would be a s s o c i a t e d with 74 higher l e v e l s of autonomic arousa l than the b a s e l i n e v a l u e s . T h i s was not so . L i s t e n i n g and recovery va lues d i d not d i f f e r s i g n i f i c a n t l y from b a s e l i n e values? thus sugges t ing that there c o u l d have been a moderat ing i n f l u e n c e : perhaps the o r i e n t i n g r e f l e x ? Bes ides the methodology? there is a l s o the q u e s t i o n of s u b j e c t s . S u b j e c t s in the experiment were young? h e a l t h y normotens ives whi le Lynches, o b s e r v a t i o n s r e f e r r e d mostly to h y p e r t e n s i v e i n d i v i d u a l s . Hi s p a t i e n t s were in a therapy s i t u a t i o n and were engaged in h i g h l y p e r s o n a l l y r e l e v a n t c o n v e r s a t i o n . The c u r r e n t study d i d not produce such a l i s t e n i n g s i t u a t i o n s i n c e the exper imenter t a l k e d about a t o p i c of personal r e l e v a n c e to h e r s e l f and not to the s u b j e c t . What the c u r r e n t f i n d i n g s do is p r o v i d e " c o n t r o l " i n f o r m a t i o n for how s u b j e c t s respond a u t o n o m i c a l l y d u r i n g n e u t r a l I i s t e n i n g . F u r t h e r t e s t i n g of Lynches model cou ld now proceed to c o n t r a s t responses to n e u t r a l l i s t e n i n g (as done in t h i s s tudy) with a h i g h l y r e l e v a n t l i s t e n i n g p r o t o c o l . The l a t t e r task however would be d i f f i c u l t to s t a n d a r d i z e and has been avo ided in t h i s study for t h i s very r e a s o n . Issues r e l a t e d to Methodology 75 1. C o n v e r s a t i o n as a l a b o r a t o r y t o o l . The s t r e s s in terv iew as a too l has been s i m p l i f i e d in t h i s s tudy . A s k i n g a s u b j e c t to t a l k about a f r u s t r a t i n g event or person a l lows s u b j e c t s to p ick i s sues of persona l r e l e v a n c e . The chosen i ssues may not always be the most f r u s t r a t i n g p o s s i b l e but q u i t e l i k e l y they a r e . The task may be repeated without becoming inval id unl ike S c h a c h t e r J s (1757)* or Ax and F u n k e n s t e i n ' s (1753) d e c e i t f u l a f f e c t m a n i p u l a t i o n s which can be used only once . What is d i f f i c u l t to s t a n d a r d i z e about such i n t e r v i e w s is the number of q u e s t i o n s needed to keep s u b j e c t s t a l k i n g for the fuI I f i v e minutes . For some s u b j e c t s few probes were needed whi le for o thers* there would be no c o n v e r s a t i o n at a l I without s evera l i n t e r j e c t i o n s on the p a r t of the e x p e r i m e n t e r . Thus a l though each speech phase l a s t e d f i v e minutes* some s u b j e c t s t a l k e d more than o t h e r s . Thus r a t e of speech c o u l d not be c o n t r o l led e a s i l y in t h i s method. Rate of speech may be a p r e d i c t o r of CV a c t i v a t i o n * Friedmann et a l . * (1782)* Baker et a l . * (1775) . Could ra te of speech have c o n t r i b u t e d to the d i f f e r e n c e in a c t i v i t y between the two groups? T h i s does not seem I i k e l y . R e s u l t s from the math task i n d i c a t e that the +FH group always had h igher l e v e l s of autonomic 1L a c t i v i t y and yet the r a t e of p r e s e n t a t i o n of the math problems were the same for the two FH groups . Cv responses d u r i n g I i s t e n i n g were h igher for the a f f e c t i v e task than the n e u t r a l task on SBP. T h i s might be i n d i c a t i v e of slower a d a p t a t i o n r a t e s a f t e r an a f f e c t -provok ing c o n v e r s a t i o n than a f t e r a n e u t r a l c o n v e r s a t i o n . T h i s d i f f e r e n c e in responses to the two tasks w i t h i n s u b j e c t s g ives f u r t h e r support that the m a n i p u l a t i o n of the w i t h i n v a r i a b l e was s u c c e s s f u l and that the tasks have i n t e r n a l v a l i d i t y . 2. S u b j e c t s . The c h o i c e of c r i t e r i a for d i f f e r e n t i a t i n g between the two groups was based on Hastrup et a l . ' s (1985) r e s u l t s of accuracy of r e p o r t i n g of h i s t o r y of e s s e n t i a l h y p e r t e n s i o n and coronary hear t d i s e a s e . In that a r t i c l e ? Hastrup et al e s t imated the e r r o r of r e p o r t s at 1D% for col lege s tudents? and g r e a t e r for p a r e n t s ' r e p o r t of t h e i r parents? i . e . ? of g r a n d p a r e n t s ' h e a l t h . S i x t e e n percent of the s tudents in t h i s study e r r e d in t h e i r e s t i m a t i o n of p a r e n t a l h i s t o r y of e s s e n t i a l h y p e r t e n s i o n . S i x t y - t h r e e of those who e r r e d s a i d parents were h y p e r t e n s i v e whi le p a r e n t a l c o n f i r m a t i o n was n e g a t i v e . These s u b j e c t s may not have known what h igh b lood p r e s s u r e was and may have been bas ing t h e i r judgments on b e h a v i o r a l c h a r a c t e r i s t i c s of parents? such as the type A behav ior p a t t e r n . S i n c e p a r e n t a l c o n f i r m a t i o n was the 7 7 c r i t e r i o n on which group membership was made* t h i s d id not pose a problem in the c u r r e n t study and in f a c t the above data on erroneous r e p o r t i n g of p a r e n t a l FH s t r o n g l y conf i rms the advantage of our method. T h i s s t i I I leaves another p o t e n t i a l problem: were the parents of some of the - F H s u b j e c t s s t i I I too young to show high blood p r e s s u r e ? How many of them would l a t e r become h y p e r t e n s i v e ? So then how many of the - F H s u b j e c t s should r e a l l y be in the +FH group? Would t h i s change the r e s u l t s of t h i s s tudy? From the r e s u l t s of Stoney and Matthews' 1 (1988) study of middle -aged men and women o f f s p r i n g of h y p e r t e n s i v e s * the r e p l y to the l a s t q u e s t i o n would be negat ive* and i t is f a i r to p r e d i c t that the r e s u l t s would remain much the same except that the e f f e c t of FH would be even g r e a t e r than demonstrated here and there might be a s t ranger i n t e r a c t i o n e f f e c t between FH and t a s k . Thus* in s p i t e of the d i f f i c u l t y of d e t e r m i n i n g FH and the inherent e r r o r t h i s might in troduce into the r e s u l t s * the e f f e c t s are S t r a n g and o v e r r i d e a p o t e n t i a l e x c l u s i o n error for the +FH group. The Stoney and Matthews' data a l s o suggest that these r e s u l t s are genera I izabIe to a l d e r o f f s p r i n g of e s s e n t i a l h y p e r t e n s i v e s and suggest s t r o n g l y that +FH is a r i s k for f u t u r e development of e s s e n t i a l hypertens i o n . 78 3. Rate of r e s p i r a t i o n . As a dependent v a r i a b l e * ra t e D f r e s p i r a t i o n d i d not d i f f e r e n t i a t e between the two groups on any t a s k . It W D u l d seem t h a t +FH i n d i v i d u a l s s h o w i n c r e a s e d r e a c t i v i t y o n l y on CV m e a s u r e s . On the other h a n d * there were problems with s c o r i n g D f the RR v a r i a b l e . There were d i f f i c u l t i e s in d e c i d i n g sometimes when a b r e a t h i n g c y c l e was complete a n d when i t was not* e s p e c i a l l y when s u b j e c t s were t a l k i n g . The score o f t en became a judgement c a l I a n d was at t imes s u b j e c t i v e . Bes ides t h i s problem* the experiment was run in the la te f a l I a n d w i n t e r . Dur ing mid February* a lo t of s u b j e c t s came in with c o l d s . A few breathed q u i t e sha I lowly and with d i f f i c u l t y * i n t r o d u c i n g another source of u n r e l i a b i l i t y . 4.Improvements in Methodology D e s i g n . Through out the experiment* the exper imenter was in the same room as the s u b j e c t . The i n t e r a c t i o n was s t a n d a r d i z e d as far as i t was p o s s i b l e . However i t r e q u i r e d another person to take the measurements in the a d j o i n i n g room. To save time* labour (having to repeat to 70 s u b j e c t s the same d e s c r i p t i o n of weather and f r u s t r a t i n g event) *and increase s t a n d a r d i z a t i o n of task* c o u l d the method have been des igned without the i n t e r a c t i o n of exper imenter and s u b j e c t ? Could s u b j e c t s have been g iven i n s t r u c t i o n s by tape* and have been asked to t a l k to a tape about the 79 weather and a f r u s t r a t i n g e v e n t / p e r s o n far f i v e minutes without prompts? Or c o u l d prompts have been g iven by tapes? Yes* a l I that c o u l d have been done but at a cos t to the e x t e r n a l v a l i d i t y of the r e s u l t s . It was a small p r i c e to pay for s e t t i n g up as n a t u r a l an environment of c o n v e r s a t i o n as p o s s i b l e ) with a s t r a n g e r in the l a b o r a t o r y . One aspect of the des ign c o u l d be changed to b e t t e r t e s t the h y p o t h e s i s on d i f f e r e n c e s of r e a c t i v i t y between the two groups on I i s t e n i n g . If speech and I i s t e n i n g c o u l d be a l t e r n a t e d ) so that the s u b j e c t sometimes I i s t ened f i r s t r a t h e r than always a f t e r speech) one might then adequate ly t e s t t h i s h y p o t h e s i s . A l s o ) as mentioned e a r l i e r ) i f s u b j e c t s l i s t e n e d to c o n v e r s a t i o n which was very s e I f - r e I e v a n t ) as would occur in a therapy s i t u a t i o n ) then L y n c h J s h y p o t h e s i s would be more adequate ly t e s t e d . Summary and C o n c l u s i o n s  T h i s study was des igned to t e s t the i n t e r a c t i v e e f f e c t s of fami ly h i s t o r y with autonomic responses to a f f e c t -p r o v o k i n g and menta l ly c h a l l e n g i n g tasks d u r i n g speech as we I I as I i s t e n i n g phases and secondly ) to t e s t responses a c r o s s d i f f e r e n t k inds of l a b o r a t o r y t a s k s . To i n v e s t i g a t e t h i s ? 62 normotens ives ) 2L of whom had at l eas t one h y p e r t e n s i v e parent ) p a r t i c i p a t e d in a repeated measures des ign in which they he ld a negat ive a f f e c t -8D laden and a n e u t r a l c o n v e r s a t i o n with the e x p e r i m e n t e r . They a l s o worked at a mental a r i t h m e t i c task v e r b a l l y . R e s u l t s i n d i c a t e d : 1. tha t there was g r e a t e r CV arousa l for +FH i n d i v i d u a l s on a l l t a s k s . 2. that g r e a t e r s p e c i f i c r e a c t i v i t y to tasks for +FH i n d i v i d u a l s was observed only i f peak DBP measures were cons i d e r e d . 3 . that a f f e c t - l a d e n c o n v e r s a t i o n s lead to h igher arousa l than n e u t r a l speech and mental a r i t h m e t i c on DBP. 4. that +FH s u b j e c t s reached t h e i r h ighes t mean DBP l e v e l s d u r i n g a f f e c t - p r o v o c a t i o n t a s k s . In c o n c l u s i o n ? the r e s u l t s of the study do support the Ghanaian proverbs quoted e a r l i e r ; a crab does indeed b r i n g f o r t h a crab and sweet c o n v e r s a t i o n ( s o o t h i n g ! ) may we I I be worth a bawl of del i c i a u s soup. F u t u r e d i r e c t i o n s As L i n d e n (19B1) e a r l ier recommended? i t is time to develop r e p l i c a b l e ? s t a n d a r d i z e d l a b o r a t o r y tasks that e l i c i t a I p h a - a d r e n e r g i c responses in CV r e s e a r c h . T h i s is because i t has become e v i d e n t that h y p e r t e n s i v e s and t h e i r o f f s p r i n g are more s e n s i t i v e an DBP which is under a I p h a - a d r e n e r g i c c o n t r o l . The r e s u l t s of t h i s study i n d i c a t e that a f f e c t i v e ta sks such as the a f f e c t - l a d e n c o n v e r s a t i o n e l i c i t such responses whi le the s tandard 81 math task? I ike the c o l d pres sor t e s t and o t h e r s I ike i t ; p r i m a r i ly el i c i t SBP and HR responses which are thought to be b e t a - a d r e n e r g i c . Tasks l i k e the c o n v e r s a t i o n task used here possess i n h e r e n t l y more e c o l o g i c a l v a l i d i t y and are easy to use. T h e i r s t a n d a r d i z a t i o n would go a long way to he lp f u t u r e r e s e a r c h on mechanisms I i n k i n g a f f e c t and hear t d i s e a s e . 8 2 REFERENCES Acller R . J Herman J . M . ; S c h a f f e r N . ; Schmidt T . J Schonecke O . U . J Uexkul l T . V . ( 1 9 7 7 ) . A context study of p s y c h o l o g i c a l c o n d i t i o n s p r i o r to s h i f t s in b lood p r e s s u r e . Psychotherapy and Fsychosomat ics 2 7 1 7 8 - 2 0 4 . A t k i n s o n R . L . J A t k i n s o n R . C . ; Smith E . E . ; & H i l g a r d E . R . ( 1 7 8 7 ) . I n t r o d u c t i o n to P s y c h o l o g y . H a r c a u r t Brace Jauanouich) P u b l i s h e r s . T o r o n t o . Alexander F . ( 1 7 3 7 ) . P s y c h o a n a l y t i c Study of a case of E s s e n t i a l H y p e r t e n s i o n . Psychosomatic Med ic ine 1_> 1 3 7 - 1 5 2 . Baker U . M . J Sandman C . A . J Pepinsky H . B . ( 1 7 7 5 ) . A f f e c t i v i t y of task > r e h e a r s a l time and p h y s i o l o g i c a l re sponse . Journa l of Abnormal P s y c h o l o g y . 8 4 > 5 3 7 - 5 4 4 Bendig A . U . J ( 1 7 6 2 ) . F a c t o r a n a l y t i c s c a l e s of c o v e r t and over t h o s t i l i t y . _ J o u r n a l of C o n s u l t i n g P s y c h o l o g y . 2 6 = 2 0 0 B i a g g i o M . K . J Sup Iee K . J C u r t i s N. ( 1 7 8 1 ) . R e l i a b i l i t y and VaI i d i t y of four anger s c a l e s . Journa l of Personal i t y Assessment . 4 5 J 6 3 7 - 6 4 8 . Buss A . H . J 8> Durkee A. ( 1 7 5 7 ) . An inventory for a s s e s s i n g d i f f e r e n t k inds of h o s t i l i t - y . Journa l of C o n s u l t i n g  Psycho I o g y , 2 1 , 3 4 3 - 4 7 . Dimsdale J . J S t e r n M . J & D i l l o n E . ( 1 7 8 8 ) . The s t r e s s in t erv i ew as a too l for examining p h y s i o l o g i c a l r e a c t i v i t y . Psychosomat ic M e d i c i n e j 5 0 > 6 4 - 7 1 . Dimsdale J . J Young D . J Moore R . J & S t r a u s s H . U . ( 1 7 8 7 ) . Do plasma n o r e p i n e p h r i n e l e v e l s r e f l e c t b e h a v i o r a l s t r e s s ? Psychosomat ic M e d i c i n e ; 4 7 J 3 7 5 - 3 8 2 . Fo I k I ow B . J H a l l b a c k M . J L i n d g r e n Y . J S i l v e s t s s o n R . J 8, Ue i I I L . ( 1 7 7 4 ) . Importance of a d a p t i v e changes in v a s c u l a r des ign for e s t a b I ishment of pr imary h y p e r t e n s i o n in man and spontaneous ly h y p e r t e n s i v e r a t s . C i r c u l a t i o n  Research j 3 2 - 3 3 - (Suppl 1 ) = 2 - 1 6 Freidmann E . J Thomas S . A . J KuI i c k - C i u f f o D . J Lynch J . J . J & Sugimohara M. ( 1 7 8 2 ) . The e f f e c t s of normal and r a p i d speech on b lood p r e s s u r e . Psychosomatic M e d i c i n e J 4 4 J 5 4 3 - 5 5 3 Graham F . K . J & C l i f t o n R . , K . , ( 1 7 6 6 ) . Hear t ra t e changes as a component of the o r i e n t i n g r e f l e x . P s y c h o l o g i c a l B u l l e t i n . 6 5 J 3 0 5 - 3 2 0 83 Hasrup J . L . * Hatchk i ss A . P . * 8> Johnson C A . (1785) . Accuracy of knowledge of f a m i l y h i s t o r y of c a r d i o v a s c u l a r d i s o r d e r s . H e a l t h P s y c h o l o g y . 4> 271-306. Jorgensen R . S . * 8, Houston B . K . (1781). Fami ly h i s t o r y of h y p e r t e n s i o n * gender* and c a r d i o v a s c u l a r r e a c t i v i t y and s t e r e o t y p y d u r i n g s t r e s s . Journa l of Behav ior  Med Ic i ne. 4* 175-187 Jorgensen R. S. * 8. Houston B . K . (1786) Fami ly h i s t o r y of h y p e r t e n s i o n * personal i t y p a t t e r n s * and c a r d i o v a s c u l a r r e a c t i v i t y to s t r e s s . Psychosomatic Medic ine* 48* 102-115. Kaplan S . M . * G o t t s c h a l k L . A . * M a g l i o c c o B . * R o h o v i t t D .* 8. Ross Ul. D. * (1760). H o s t i l i t y in verba l p r o d u c t i o n s and h y p n o t i c dreams of h y p e r t e n s i v e p a t i e n t s , (an a b s t r a c t ) Psychosomat ic Medic ine* 22 * (176)=320. Lawler K . A . * 8< Schme i d L . A . (1786). C a r d i o v a s c u l a r r e s p o n s i v i t y * type A behaviour and p a r e n t a l h i s t o r y of hear t d i s e a s e in young women. Psychophys i oIogy * 23*28-32. L a z a r u s R . S . (1766). P s y c h o l o g i c a l S t r e s s and the coping  process . New York McGraw-Hi I I . Long J . M . * Lynch J . J . * Machiran N . M . * Thomas S . A . * 8, Malinaw K . L . (1782) . The e f f e c t of s t a t u s on blood p r e s s u r e d u r i n g verba l communicat ion . Journa l of  B e h a v i o u r a l Medic ine* 5* 165-172. L i n d e n U). (1785) C a r d i o v a s c u l a r response as a f u n c t i o n of p r e d i s p o s i t i o n * cop ing behaviour and s t i m u l u s t y p e . Journa l of Psychosomatic Research * 27 * 611-620 L i n d e n U. (1787) . A M i c r o a n a l y s i s of autonomic a c t i v i t y d u r i n g human speech. Psychosomatic Medic ine* L i n d e n W. (1787) . E f f e c t of no ise d i s t r a c t i o n d u r i n g mental a r i t h m e t i c on p h a s i c c a r d i o v a s c u l a r a c t i v i t y . Psychophys i o Iogy * 24* 328-333. L i n d e n W.* 8> F e u r s t e i n M. (1781) . E s s e n t i a l h y p e r t e n s i o n and s o c i a l cop ing b e h a v i o u r . Journa l of Human S t r e s s * 3* 28-34 L i n d e n U. * 8> McEachern H. (1785) . A rewiew of P h y s i o l o g i c a l p r e s t r e s s a d a p t a t i o n : e f f e c t s of d u r a t i o n and c o n t e x t . I n t e r n a t i o n a l Journal of Psychophys io Iogy* 2 > 237-245. Lynch J . J . (1767) . The c a r d i a c o r i e n t i n g response and i t s r e l a t i o n s h i p to the c o n d i t i o n e d response in dogs. C o n d i t i o n a l Ref lex* 2* 138-52 8 4 L y n c h J . J . ( 1 7 8 5 ) . The l a n g u a g e o f t h e h e a r t ' The bo d y ' s  r e s p o n s e t o human d i a l o g u e . New Y o r k : B a s i c B o o k s . Manuk S . B . J & P r o i e t t i J.M. ( 1 7 8 2 ) . P a r e n t a l h y p e r t e n s i o n and c a r d i o v a s c u l a r r e s p o n s e t o c o g n i t i v e and i s o m e t r i c c h a l l e n g e . P s y c h o p h y s i o I o g y > 1 7 , 4 8 1 - 4 8 7 M a t t h e w s K . A . ( 1 7 8 5 ) . A s s e s s m e n t o f t y p e A b e h a v i o r > a n g e r ? and h o s t i l i t y i n e p i d e m i o l o g i c a l s t u d i e s i n c a r d i o v a s c u l a r d i s e a s e . I n A.M. O s f f e l d and E.D. E a k e r . ( E d s ) . M e a s u r i n g p s y c h o s o c i a l v a r i a b l e s i n e p i d e m i o l o g i c s t u d i e s o f c a r d i o v a s c u l a r d i s e a s e . U.S. De p a r t m e n t o f H e a l t h and Human s e r v i c e s . NIH P u b l i c a t i o n No. 8 5 - 2 2 7 0 . 2 3 3 - 2 3 8 . May J.R.? 8. J o h n s o n H.J. ( 1 7 7 3 ) . P h y s i o l o g i c a l a c t i v i t y t o i n t e r n a l l y e l i c i t e d a r o u s a l and i n h i b i t o r y t h o u g h t s . J o u r n a l o f Abnormal P s y c h o l o g y . 8 2 > 2 3 7 - 2 4 5 . O b r i s t P.A.) L i g h t K . C . J James S . A . J 8, S t r o g a t z D.S. ( 1 7 8 7 ) C a r d i o v a s c u l a r r e s p o n s e s t o s t r e s s ! M e a s u r e s o f m y o c a r d i a l r e s p o n s e and r e l a t i o n s h i p t o h i g h r e s t i n g s y s t o l i c p r e s s u r e and p a r e n t a l h y p e r t e n s i o n . P s y c h o p h y s i o l o g y ) 2 4 > 6 5 - 7 8 . Rose R . J . J & Che s n e y M.A. ( 1 7 8 6 ) . C a r d i o v a s c u l a r s t r e s s r e a c t i v i t y : A b e h a v i o r a l g e n e t i c p e r s p e c t i v e . B e h a v i o r  T h e r a p y , 17> 3 1 4 - 3 2 3 . S a r a s o n I.G. ( 1 7 6 1 ) . I n t e r c o r r e l a t i o n s among m e a s u r e s o f h o s t i l i t y . J o u r n a l o f C l i n i c a l P s y c h o l o g y . 1 7 ) 1 8 7 - 1 7 2 . S i l a s J . H . J B a r k e r A.T., 8> Ramsay L.E. ( 1 7 8 0 ) . C l i n i c a l E v a l u a t i o n o f Dinamap 8 4 5 a u t o m a t e d b l o o d p r e s s u r e r e c o r d e r . B r i t i s h H e a r t J o u r n a l ) 4 3 ) 2 0 2 - 2 0 5 S t o n e y C M . ) & M a t t h e w s K . A . ( 1 7 8 8 ) . P a r e n t a l h i s t o r y of h y p e r t e n s i o n and m y o c a r d i a l i n f a r c t i o n p r e d i c t s c a r d i o v a s c u l a r r e s p o n s e s t o b e h a v i o r a l s t r e s s o r s i n m i d d l e - a g e d men and women. P s y c h o p h y s i o l o g y ) 2 5 ) 2 6 7 - 2 7 7 . WaI I i n B . J . ( 1 7 8 1 ) S y m p a t h e t i c n e r v e a c t i v i t y u n d e r l y i n g e I e c t r o d e r m a I and c a r d i o v a s c u l a r r e a c t i o n s i n man. P s y c h o p h y s i o I o g y > 1 8 ) 4 7 0 - 4 7 6 U e i p e r t D.) S h a p i r o D.) & S u t e r T. ( 1 7 8 7 ) . F a m i l y h i s t o r y o f H y p e r t e n s i o n and c a r d i o v a s c u l a r r e s p o n s e s t o o r t h o s t a t i c s t r e s s . P s y c h o p h y s i o l o g y ) 2 4 ) 2 5 1 - 2 5 7 . 85 W i l l i a m s R . B . J B a r e f o o t J . C . J & S c h e k e l l e R . B . ( 1 7 8 2 ) . H e a l t h Consequences of Hos t i I i t y . In Chesney M . A . > & Rosenman R . H . (Eds) Anger and Host i I i t y in  C a r d i o v a s c u l a r and B e h a v i o u r a l D i s o r d e r s . New York Hemisphere Pub I . Co. W i l l i a m R . B . J K i m b a l l C . P . J & W i l l a r d H . N . ( 1 7 7 2 ) . The i n f l u e n c e of i n t e r p e r s o n a l i n t e r a c t i o n on d i a s t o l i c b lood p r e s s u r e . Psychosomatic M e d i c i n e . 34. A P P E N D I C E S . APPENDIX A 87 C o n v e r s a t i o n R a t i n g S c a l e P lease c i r c l e • Male /Female P lease ra te how emot ionaly laden you would f i n d each of the f a l l o w i n g t o p i c s i f yau had ta d i s c u s s them with (1) a man? (2) woman in an exper imenta l s i t u a t i o n on a s c a l e of 0 to 5 J where Q means "not at a l I e m o t i o n a l l y laden" and 5 means "very e m o t i o n a l l y laden". Rat i ng with Top i c a man a woman E g . my f a v o u r i t e s p o r t . 3 3 1. the weather today 2. casual sex 3. should magazines l i k e p layboy be banned? 4. your s t r e n g t h s and weaknesses 5. The courses you study 6 . your f i r s t date 7. death of a c l o s e f r i e n d or r e l a t i v e 8. d e s c r i b e your dai ly r o u t i n e 9. be ing dumped by a g i r l / b D y f r i e n d 10. your f a v o r i t e c o l o u r s 11. d e s c r i b e a person yau lave 12. d e s c r i b e a person you desp i se 13. an embarrass ing moment for you 14. what's your f a v o r i t e form of b i r t h c o n t r a I 15. g i v i n g d i r e c t i o n s an haw to get ta the sub 16. a c u r r e n t r e l a t i o n s h i p of personal re Ievance 17. f a m i l y 18. argument with a c u r r e n t or ex-par tner 19. the worst exam in your I i f e 20. best hoi iday ever 21. most f r u s t r a t i n g e v e n t / p e r s o n 22. cos t of u n i v e r s i t y e d u c a t i o n 23. s u i c i d e 24. pros & cans of p r e - m a r i t a l sex 25. e a t i n g p l a c e s an campus 26. the government of B . C . 88 APPENDIX B=  L e t t e r to parents Dear Parent ? Your son /daughter ; ? has k i n d l y agreed ta p a r t i c i p a t e in r e s e a r c h an bIaad p r e s s u r e changes. T h i s r e s e a r c h is be ing conducted in the Department of Psychology? at the U n i v e r s i t y of B r i t i s h Columbia where your son /daughter is p r e s e n t l y a s t u d e n t . The p r i n c i p a l i n v e s t i g a t o r is Dr . W. L i n d e n . In order to i n v e s t i g a t e whether or not having a fami ly h i s t o r y of E s s e n t i a l H y p e r t e n s i o n ( c h r o n i c a l l y e l e v a t e d b lood p r e s s u r e ) wi I I p r e d i s p o s e one to d i f f e r e n t l a b o r a t o r y responses? a la t of r e s e a r c h such as the one we are conduct ing? has to be under taken . Thus we need your c o n f i r m a t i o n about whether or not you and / o r your spouse have e l e v a t e d b lood p r e s s u r e . P lease be assured that whatever i n f o r m a t i o n you g ive in your answers to the q u e s t i o n s on the a t tached sheet w i l l be kept s t r i c t l y c o n f i d e n t i a l and not d i s c u s s e d even with your s o n / d a u g h t e r . Any i n f o r m a t i o n used when the work is pub I ished w i l l be recorded in group form and so w i l l daub Iy assure your anonymity . We would l i k e to assure you that i f you do not wish to p a r t i c i p a t e for whatever reasons? your son/daughter wi I I not be in any way a f f e c t e d in h i s / h e r academic c a r e e r . If however you do wish to he lp in t h i s very important r e s e a r c h then p lease f i n d enc losed a s e I f - a d d r e s s e d and stamped enve lope . We would be g r a t e f u l i f you c o u l d enc lo se your responses i n s i d e t h i s envelope and past i t ta us . Thank you for your c o - o p e r a t i o n . Your p a r t i c i p a t i o n is very much apprec i ated . yours s i n c e r e l y ? APPENDIX C:  P a r e n t s ' Q u e s t i o n n a i r e P lease f i l l in your answers to the f a l l o w i n g q u e s t i o n s : 1. Do yDu have h igh b lood p r e s s u r e ? Y B S / N D . 2. The l a s t r e a d i n g of your b lood p r e s s u r e was 3. It was taken on (date) 4. Do you have any of the f o l l o w i n g h e a l t h problems: (p lease c i r c l e the r e l e v a n t problem) a. kidney problems b. s u f f e r e d a s t r o k e c. any other c a r d i o v a s c u l a r problems? 5. Did any of your parents have e l e v a t e d b laad p r e s s u r e ? a. mother? b. f a t h e r ? b. P lease s p e c i f y i f they had any of the problems mentioned in q u e s t i o n 4 above. T h a n k - y o u for yDur time and for p a r t i c i p a t i n g in our r e s e a r c h . We wi I I be g lad to answer any q u e s t i o n s c o n c e r n i n g the r e s e a r c h . 90 APPENDIX D:  Exper imenta l T a s k s . 1. The c o n v e r s a t i o n of personal r e l e v a n c e . I n s t r u c t i o n to s u b j e c t : Could you t e l I me about a most f r u s t r a t i n g person or event i n your l i f e ? L i s t e n i n g ta sk : I remember q u i t e c l e a r l y the most f r u s t r a t i n g event and person in my I i f e . the i n c i d e n t o c c u r r e d when I was in the second year of my undergraduate degree . My country had j u s t had a r e v o l u t i o n and the r u l ing c i v i I ian government had been overthrown by a m i l i t a r y j u n t a which had the support of the masses and the u n i v e r s i t y s t u d e n t s . For s t a t e s e c u r i t y ? the u n i v e r s i t i e s were c losed? ( s tudents were c o n s i d e r e d very voI a t i Ie and eas i ly switched to the s ide of any o p p o s i t i o n that might s p r i n g u p . ) . The s tudent body t h e r e f o r e dec ided to j o i n the r e v o l u t i o n in a very p r a c t i c a l way. We were formed into groups some of which c a r r i e d bags of Cocoa onto w a i t i n g sh ips? dug i r r i g a t i o n cana l s? p l a n t e d crops? p a t r o l led borders to prevent smuggI ing? e t c . These were d u t i e s that we c o n s i d e r e d needed doing to keep our economy r o I I i n g . At the end of three months however? most of us wanted to r e t u r n to school to f i n i s h the academic y e a r . But there was a subgroup of s tudents? e s p e c i a l l y the leaders? who were r e a l l y committed to the i d e a l s of the r e v o l u t i o n and who f e l t that we would be r e n d e r i n g a v a l u a b l e s e r v i c e to our n a t i o n by remain ing out of school and c o n t i n u i n g our program of economic rehabi I i t a t i o n . We on the other hand be I ieved that the government was spending much too much money on our programs as we I I as paying s t a f f at the U n i v e r s i t i e s whi le we were not a t t e n d i n g . We f e l t our country c o u l d not r e a l l y a f f o r d t h i s unnecessary e x p e n d i t u r e . So we asked for a c o n f e r e n c e . At t h i s conference? I presented our views backed by f i g u r e s and f a c t s which we had c a r e f u l l y campi led from a s e r i e s of i n t e r v i e w s with people in the m i n i s t r i e s which were i n v o l v e d with our p r o j e c t s . To round i t o f f? I mentioned that we had a l s o in terv i ewed a couple government o f f i c i a l s whose names we c o u l d not mention? and who were of the o p i n i o n that the ru l ing mi I i t a r y j u n t a wouId a l low the U n i v e r s i t i e s to reopen i f s tudents wanted to go back. They were l eav ing i t up to us to d e c i d e . As I f i n i s h e d my p r e s e n t a t i o n ? t h i s b r i I I iant law s tudent gat up and s a i d that s i n c e I c o u l d not quote my sources? I must be l y i n g . He comple te ly ignored the r e p o r t that I had presented e a r l ier and focussed on the f a c t that I c o u l d not quote my s o u r c e s . I c o u l d not r e f u t e h i s s u b t l e a c c u s a t i o n s because he had used such b i g wards and legal j a r g o n . A l s o my time was up and the chairman would not a l low me to respond. 91 I remember fee l ing very humi I i a ted before the people p r e s e n t ; my p e e r s . ? and f r i e n d s ? t h i n k i n g how u n f a i r i t was that he had focussed only on that l a s t statement about i n t e r v i e w i n g the o f f i c i a l s and not on the other f a c t s we had t o i l e d so hard to g a t h e r . I th ink I was angry with myself because I f e l t that I had in a way brought t h i s on myse l f . Perhaps we had not needed to mention the i n t e r v i e w s and then he would have had to r e p l y to the economic f a c t s o n l y . In the long run? we d i d win the debate and r e t u r n e d to school . However the memory of that i n c i d e n t s t i I I haunts me to t h i s day. 2. The n e u t r a l c o n v e r s a t i o n  I n s t r u c t i o n to s u b j e c t D e s c r i b e to me the weather in Vancouver? b e g i n n i n g with winter? and then spr ing? summer and the f a l I . L i s t e n i n g Task I am going to t e I I you about the weather a long the coast of West A f r i c a which is where I come from. S ince the temperature does not vary much throughout the year? i t is d i f f i c u l t to t e I I the seasons apart? except for the presence or absence of r a i n . So I w i l l d e s c r i b e the seasons with r e s p e c t to the movement of the sun? and I wi I I begin? as you began? with a •"winter"1''. The coas t of West A f r i c a I ies j u s t 4 degrees north of the Equator and so in December the sun is in the Southern Hemisphere? and we have our f i r s t W i n t e r . At t h i s time? a cool dry wind blows from the Sahara D e s e r t . T h i s is c a I led the Harmattan . It is very dry and c a r r i e s f i n e p a r t i c l e s of dust from the Desert which get d e p o s i t e d on t r e e s and f u r n i t u r e and c a r s e t c . So every t h i n g gets a f i n e coat of I ight brown d u s t . We t h e r e f o r e have a I ight brown C h r i s t m a s I It is dry and the temperature is u s u a l l y about 19 degrees at n igh t and 24 d u r i n g the day. That is w i n t e r ! When the sun begins i t s Nor thern journey in February? we get the f i r s t r a i n s from the A t l a n t i c ocean which c l e a r the dust from the a i r . At f i r s t i t is s t i l l r e l a t i v e l y dry and f r e s h a f t e r these r a i n s ? and then as the sun gets c l o s e r ? the weather gets h a t t e r and more humid unt i I by March temperatures are unbearably hat? 28 - 3D? and uncomfortably humid. W i t h i n 10 minutes of a shower? one is comple te ly covered in sweat and you fee l very s t i c k y . But t h i s is the wet summer? and the farmers begin p l a n t i n g and so there is a good s ide to i t . By June i t s t a r t s g e t t i n g c o o l e r and a second winter b e g i n s . T h i s is a wet and t r o p i c a l "winter" . The r a i n s now are t o r r e n t i a l and temperatures are in the lower 2 0 ; s . The sun is in the Nor thern Hemisphere and i t is your summer! T h i s is our second r a i n y season. Then as the sun begins i t s Southern journey? we have g l o r i o u s sunny weather for weeks on end which r i p e n s the c o r n . T h i s is the season for harves t f e s t i v a l s ? a b i t I ike your t h a n k s g i v i n g . So August? September? O c t o b e r ; are in a way a second summer Our t r e e s are evergreen and so I guess we do not r e a l l y hav a f a l I . Then winter begins in la te November. So you see; we have two w i n t e r s : a dry one which begins in November; and a wet one which begins in June. These seasons correspond to the p e r i o d when the sun is at i t s most d i s t a n t from the e q u a t o r . We a l s o have two summers: A wet one in F e b r u a r y - A p r i l ; and a dry one in A u g u s t - O c t o b e r ; c o r r e s p o n d i n g tD the two p e r i o d s in the year when the sun moves a c r o s s the E q u a t o r . We dress very much the same the year round because the temperatures do not change very much We have two p l a n t i n g seasons (the wet summer and wet winter and two h a r v e s t seasons; (the s h o r t s p e l I between the wet summer and wet w i n t e r ; and the dry summer). In f a c t ; the words summer and winter do not mean any t h i n g to us . We s imply r e f e r to the seasons as the r a i n y or dry season or the Harmattan . The weather r e p o r t h a r d l y mentions t emperatures ; u s u a l l y j u s t the amount of r a i n because r a i n is very important for a g r i c u l t u r e . APPENDIX F = BDHI To each of these s ta tements ; answer true (T) or f a l s e ( F ) . Sometimes n e i t h e r t rue nor f a l s e appears to be the p e r f e c t answer; in t h i s case choose the one which comes c l o s e r to how you would fee l or behave. 1. I seldom s t r i k e back; even i f someone h i t s me f i r s t . 2.1 sometimes spread gos s ip about people I don ' t I ike . 3. Un le s s somebody asks me in a n i ce way; I won't do what they want. 4. I lose my temper easi ly but over i t q u i c k l y . 5. I d o n ' t seem to get what's coming to me. 6. I know that people tend to t a l k about me behind my back. 7. Ulhen I d i s a p p r o v e of my f r i e n d s b e h a v i o r ; I l e t them now i t . 8. The few times I have chea ted; I have s u f f e r e d unbearable fee l ings of remorse. 9. Once in a whi le I cannot c o n t r o l my urge to harm o t h e r s . 10. I never get mad enough to throw t h i n g s . 11. Sometimes people bother me j u s t by being around. 12. When someone makes a r u l e I don ' t I ike I am tempted to break i t . 14. I tend to be on my guard with people who are somewhat more f r i e n d l y than I expec ted . 15. I o f t en f i n d myself d i s a g r e i n g with p e o p l e . 16. I sometimes have bad thoughts which make me fee l ashame of myse If . 17. I can th ink of no good reason for ever h i t t i n g anyone. 18. When I am angry; I sometimes s u l k . 19. When someone is bossy; I do the o p p o s i t e of what he a sks . 94 20. I am i r r i t a t e d a great deal more than people are aware of . 21. I d o n ' t know any people that I downright ha te . 22. There are a number of people who seem to d i s l ike me very much . 23. I c a n ' t he lp g e t t i n g into arguments when people d i s a g r e e with me. 24. People who s h i r k on the job must fee l very gui I ty . 25. If somebody h i t s me f i r s t ) I l e t him have i t . 26. When I am mad) I sometimes slam doors . 27. I am always p a t i e n t with o t h e r s . 28. O c c a s i o n a l l y when I am mad at someone I w i l l g ive him the " s i l e n t t reatment" . 29. When I look back on what's happened to me> I c a n ' t he lp f e e l i n g m i l d l y r e s e n t f u l . 30. There are a number of people who seem to be j e a l o u s of me . 31. I demand that people r e s p e c t my r i g h t s . 32. It depresses me that I d i d not do more for my p a r e n t s . 33. Whoever i n s u l t s me or my fami ly is a s k i n g for a f i g h t . 34. I never p l a y p r a c t i c a l j o k e s . 35. It makes my blood boi I tD have somebody make fun of me. 36. When people are bossy) I take my time j u s t to show them. 37. Almost every week I see someone I d i s l i k e . 38. I sometimes have the fee l ing that o thers are laughing at me . 39. Even when my anger is aroused) I don ' t use "s trong language". 40. I am concerned about be ing f o r g i v e n for my s i n s . 41 . People who c o n t i n u a l l y pes ter you are a sk ing for a punch in the nose. 42. I sometimes pout when I d o n ' t get my own way. 95 43. If somebody annoys me> I am apt to teI I him what I th ink of him. 44. I o f t en fee l I ike a powder keg ready to exp lode . 45. A l though I don ' t show i t ) I am sometimes eaten up with j e a l o u s y . 46. My motto is "never t r u s t s t r a n g e r s " . 47. When people ye I I at me) I yel I back. 48. I do many t h i n g s that make me fee l remorseful a f t e r w a r d . 49. When I r e a l l y lose my temper) I am capable of s l a p p i n g someone. 50. S i n c e the age of ten) I have never had a temper tantrum. 51. When I get mad) I say nasty t h i n g s . 52. I sometimes c a r r y a c h i p on my s h o u l d e r . 53. If I l e t people see the way I f e e l ) I 'd be c o n s i d e r e d a hard person to get a long w i t h . 54. I commonly wander what hidden reason another person may have for doing something n i ce for me. 55. I c o u l d not put someone in h i s p l a c e ) even i f he needed i t . 56. Fa i lure g ive s me a fee l ing of remorse. 57. I get into f i g h t s about as o f t en as the next p e r s o n . 58. I can remember be ing so angry that I p i c k e d up the neares t t h i n g and broke i t . 59. I o f t en make t h r e a t s I don ' t r e a l l y mean to carry out . 60. I c a n ' t he lp be ing a l i t t l e rude to people I d o n ' t l i k e . 61. At t imes I fee l I get a raw deal out of I i f e . 62. I used to th ink that mast people t o l d the t r u t h but now I know otherw i se. 63. I g e n e r a l l y cover up my poor o p i n i o n of o t h e r s . 64. When I do wrong) my consc i ence punishes me s e v e r e l y . 96 65. If I have to r e s o r t to p h y s i c a l v i o l e n c e to defend my r i ghts J I w i l l . 66. If someone doesn ' t t r e a t me r i g h t ? I d o n ' t l e t i t annoy me . j 67. I have no enemies who r e a l l y wish to harm me. 68. Uhen arguing? I tend to r a i s e my v o i c e . 69. I o f t en fee l that I have not I ived the r i g h t k ind of l i f e . 70. I have known people who pushed me so far that we came to blows. 71. I don ' t le t a lo t of unimportant t h i n g s i r r i t a t e me. 72. I seldom fee l that people are t r y i n g to anger or i n s u l t me . 73. L a t e l y ? I have been k ind of grouchy. 74. I would r a t h e r concede a p o i n t than get into an argument about i t . 75. I sometimes show my anger by banging on the t a b l e . 97 S c a r i ng of t h e BDHI The A s s a u I t S e a Ie 1 ( F ) , 9, 17(F), 2 5 , 3 3 , 4 1 , 4 9 , 5 7 , 6 5 , 7D. I n d i r e c t H o s t i I i t y S c a l e 2, ID, 18, 2 6 , 3 4 ( F ) , 4 2 , 5 0 ( F ) , 5 8 , 75. N e g a t i v i sm 3, 12, 19, 2 8 , 36. I r r i t a b i I i t y 4, 11, 2 0 , 2 7 ( F ) , 3 5 , 44, 5 2 , 6 0 , 6 6 ( F ) , 7 1 ( F ) , 7 3 . R e s e n t m e n t S c a l e 5, 13, 2 1 ( F ) , 2 9 , 3 7 , 4 5 , 5 3 , 6 1 . Susp i c i on 6, 14, 2 2 , 3 0 , 3 8 , 4 6 , 54, 6 2 , 6 7 ( F ) , 7 2 ( F ) . v e r b a l H o s t i l i t y 7, 15, 2 3 , 3 1 , 3 9 ( F ) , 4 3 , 4 7 , 5 1 , 5 5 , ( F ) , 5 9 , 6 3 ( F ) , 6 8 , 74. Gu i I t 8,16, 24, 3 2 , 4 0 , 4 8 , 5 6 , 64, 69. ( A d a p t e d f r o m B u s s and D u r k e e , 1 9 5 7 ) . The O v e r t Sea Ie 1 ( F ) , 7, 15, 1 7 ( F ) , 2 5 , 2 7 ( F ) , 3 9 ( F ) , 4 3 , 4 9 , 5 1 , 5 7 , 6 3 ( F ) , 6 5 , 70. The C o v e r t S c a l e 1 1 , 16, 18, 19, 2 0 , 2 1 ( F ) , 2 8 , 3 2 , 3 6 , 44, 4 5 , 4 8 , 5 2 , 5 3 , 5 4 , 5 6 , 6 0 , 6 6 ( F ) , 6 9 , 7 1 ( F ) ( A d a p t e d f r o m S a r a s D n , 1961) 9B APPENDIX F :  R a t i o n a l e g iven for the experiment The r e s e a r c h aims at f i n d i n g out i f there are any r e l a t i o n s h i p s between f a m i l y h i s t o r y of h y p e r t e n s i o n and p h y s i o l o g i c a l r e a c t i o n s d u r i n g c o n v e r s a t i o n . If such r e l a t i o n s h i p s e x i s t ? we hope that in the fu ture? r e s e a r c h l i k e t h i s w i l l help to i d e n t i f y young people who are at r i s k for h y p e r t e n s i o n so that e a r l y i n t e r v e n t i o n programs may be i n s t i t u t e d . I n s t r u c t i o n to S u b j e c t The e s t imated time for t h i s experiment is 7D minutes . During that time you wi I I remain seated whi le cont inuous measures are taken of h e a r t - r a t e ? blood p r e s s u r e and r a t e of r e s p i r a t i o n . A l l these measures are a u t o m a t i c a l l y recorded by the computer in the adjacent room. C o n v e r s a t i o n s wi I I a l s o be recorded . The experiment is d i v i d e d into 4 p a r t s . During the f i r s t part? we would I ike you to get used to our l a b o r a t o r y and to f ee l c o m f o r t a b l e . LJe t h e r e f o r e ask you to r e l a x for a p e r i o d of 15 minutes . Dur ing that time? we w i l l monitor your blood p r e s s u r e and heart ra t e and ra te of r e s p i r a t i o n ? j u s t as we wi I I con t inue to do throughout the exper iment . A f t e r the 15 minutes are up? you w i l l be asked to t a l k to the exper imenter on a s p e c i f i c t o p i c . It wi I I be a t o p i c on which you can converse q u i t e easi l y . U)e would I ike you to 99 fee l very much at ease and assure you that what ever you say w i l l be kept in the s t r i c t e s t c o n f i d e n c e . We would I ike you to th ink of t h i s s i t u a t i o n as a s i m u l a t e d c o n v e r s a t i o n with a s t ranger? as c l o s e to rea l i t y as p o s s i b l e . You wi I I speak for only 5 minutes) and I i s t e n to the experimenter for 5 minutes . You then s i t q u i e t l y for 5 minutes and read the car toons on the t a b l e bes ides you. You w i l l be asked to t a l k about another t o p i c for 5 minutes and so w i l l the exper imenter a f t e r you have f i n i s h e d . Then fo l lows a r e s t p e r i o d . You wi I I a l s o asked tD do a mental a r i t h m e t i c task a l o u d . The tasks w i l l be presented to you on the s c r e e n . At the end of the experiment) we ask you to s i t for a shor t 5- minute p e r i o d so we can take the f i n a l p h y s i o l o g i c a l measures. P lease t r y not to t a l k at a l I except at the t imes when the exper imenter asks you t o . At each stage of the experiment? you w i l l be t o l d what is to come next . P lease do not worry that you are be ing a s s e s s e d . The only assessment is that of the p h y s i o l o g i c a l measures we are t a k i n g . 100 APPENDIX G• Consent Form I ; agree to p a r t i c i p a t e in a r e s e a r c h p r o j e c t e n t i t l e d " C a r d i o v a s c u l a r Risk and Autonomic Changes Dur ing High and Low A f f e c t . " which is to be conducted in the c a r d i o v a s c u l a r p s y c h o p h y s i o l o g y lab in the psychology Department with Dr . Wolfgang L i n d e n as the P r i n c i p a l I n v e s t i g a t o r . The study i n v o l v e s a 1 - s e s s i o n experiment of 7D minutes (+ 5 to ID minutes for e x p l a n a t i o n s ) . The procedures to be fo l l owed and t h e i r purposes have been e x p l a i n e d to me. As I unders tand i t? the study r e q u i r e s me t o r e l a x for 15 minutes and then to p a r t i c i p a t e in three exper imenta l tasks which i n v o l v e some amount of c o n v e r s a t i o n with an exper imenter? and a mental a r i t h m e t i c t a s k . Dur ing the experiment m u l t i p l e c a r d i o v a s c u l a r f u n c t i o n s w i l l be moni tored . A l l monitors are n a n - i n v a s i v e in nature? are harmless and lead tD no s i g n i f i c a n t d i s c o m f o r t . I have agreed to have my p a r e n t s / c l o s e r e l a t i v e c o n t a c t e d by l e t t e r for c o n f i r m a t i o n Df h i s t o r y Df e s s e n t i a l h y p e r t e n s i o n which I r ea l ize is an important aspect of t h i s r e s e a r c h . I unders tand tha t there are no f o r e s e e a b l e r i s k s to my h e a l t h or s a f e t y . I understand that I may re fuse to p a r t i c i p a t e or withdraw at any time without i n f l u e n c e an my c l a s s s t a n d i n g . A l l i n f o r m a t i o n is s t r i c t l y c o n f i d e n t i a l . Whi le f i n d i n g s may be used in f u t u r e s t u d i e s ? there w i l l be no i d e n t i f i c a t i o n of me p e r s o n a l l y on any permanent r e c o r d s . Al I i n f o r m a t i o n w i l l be recorded in group farm and wi I I remain s t r i c t l y anonymous. I am aware that I have the r i g h t to ask and r e c e i v e answers on any q u e s t i o n s r e l a t e d to the exper iment . Quest ions? i f any? have been answered to my s a t i s f a c t i o n . I have read and understood the content of t h i s farm. I have r e c e i v e d a copy of t h i s consent farm. Research P a r t i c i p a n t Witness Date APPENDIX H= Task V a l i d a t i o n Q u e s t i o n n a i r e s On a s c a l e at 1-10 where 10 means g i v i n g or r e c e i v i n g i n f o r m a t i o n of very personal r e l e v a n c e , and 1 means g i v i n g or r e c e i v i n g i n f o r m a t i o n of no personal r e l e v a n c e , p l ease ra te by c i rc I i ng the appropr i ate number a. the f i r s t speech task 1 2 3 4 5 6 7 8 8 10 p lease s t a t e what t o p i c i t was. b. L i s t e n i n g to the exper imenter on the same t o p i c as above 1 2 3 4 5 6 7 8 9 10 c. the second speech task 1 2 3 4 5 L 7 8 9 10 p l ease s t a t e the t o p i c d. L i s t e n i n g to the exper imenter 1 2 3 4 5 6 7 8 9 10 2. On a s c a l e on 1 to 3 , where 3 means most d i s t r e s s -p r o v o k i n g , and 1 means l eas t d i s t r e s s - p r o v o k i n g , how would you ra te the f o l l o w i n g ? T a l k i n g about a f r u s t r a t i n g event or person Mental A r i t h m e t i c T a l k i n g about the weather 3 How important would you ra te the r e l a t i o n s h i p / e v e n t which you d e s c r i b e d on a s c a l e of 1 - 10? 102 APPENDIX 1=  Personal Data Q u e s t i o n n a i r e . P lease f i l l in t h i s q u e s t i o n n a i r e as a c c u r a t e l y as you can . 1 How o l d are yau? 2 Haw much da yau weigh? ( lbs or kgs) 3 How t a l I are you? 4 Uhat is your sex? <M/F) 5 Do you smoke c i g a r e t t e s or tobacco or any other drug? 6 If yes , haw o f t en and how much? Eg how many s t i c k s per day 7 Are you on any med i cat i on? 8 If yes? p l ease w r i t e down the name and what i t is for ? Are there any i n c i d e n c e s of d i s e a s e in yDur fami ly such as 1. h y p e r t e n s i o n ? (h igh l e v e l s of b lood p r e s s u r e ) 2. k idney d i s e a s e 3. Any o t h e r ? (p lease s p e c i f y ) 10 If yau have answered yes to any of the items in q u e s t i o n 9 above? p l ease s t a t e what r e l a t i o n s h i p you have with t h i s fami ly member(s) Eg fa ther? mother? etc 11 Da yau take par t in any s p o r t s ? 12 If yes? how o f ten per week on average? 13 Wh i ch s p a r t ( s ) ? 

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