METHOD

1
Autonomic reactivity in high and low trait worry

• Procedure
• Three task sets
• (1) Body position orthostatic stress supine
  rest
• (2) Active/passive stress mental arithmetic
  hand cold pressor
• (3) Imagery relaxation worry
• Three-minute CV recording periods baseline,
  task, and recovery plus initial anticipatory
  baseline upon arrival at lab
• Task order counterbalanced within, but not across
  task sets

INTRODUCTION

• Epidemiologic studies show anxiety to be an
  independent risk factor for cardiovascular
  disease (CVD) (Haines et al., 1987 Kawachi et
  al., 1994a,b)
• Anxiety in its clinical, trait, and state forms
  is associated with low cardiac vagal control, as
  indexed through heart rate variability (HRV)
  analysis (Friedman, 2007)
• Worry may be a risk factor for CVD via its
  relation with perseveration and delayed CV
  recovery (Brosschot et al., 2006)
• Longitudinal data indicate that social worry in
  men is associated with increased CVD risk
  (Kubzansky et al., 1997)
• Aim to examine the relation between trait worry
  and CV reactivity/recovery to a range of
  laboratory tasks
• Primary Hypotheses High worriers will have
• increased CV reactivity delayed recovery across
  tasks
• lower vagal tone increased sympathetic
  responding
• Exploratory Do specific tasks evoke particularly
  large CV reactivity/delayed recovery in high
  worriers?

PEP During Orthostatic Post-Task Period
RESULTS

• 2 (group low vs. high worry) x 18 (condition
  baseline, task, and recovery) repeated measures
  ANCOVAs with BMI group as covariate
• BMI groups 17.0-18.5 (underweight) 18.6-25.0
  (normal) 25.1-30.0 (overweight) and gt30.0
  (obese).
• High worriers had higher HR than low worriers
  across tasks (F(1,35)4.84, plt.05)
• No group X task interactions on HR no other
  significant main effects for group on any other
  CV variable than HR
• PEP (beta-adrenergic sympathetic index) longer in
  low worriers in recovery from orthostatic stress
  (F(1,33)6.09, plt.02)
• Low worriers showed greater PEP increases between
  the first and second halves of the recovery
  periods following hand cold pressor
  (F(1,33)6.10, plt.02) and worry imagery
  (F(1,33)5.193 plt.05)
• HR higher in the high (M 81.4 b.p.m., SD 2.4)
  than low (M 72.2 b.p.m., SD 2.3) worry group
  during anticipatory baseline (F (1, 35)
  7.282, plt.02)

PEP Change Between First and Second Epoch Halves
CONCLUSIONS

• High trait worry robust HR elevations across
  conditions
• Overall absence of (a) interactions (b)
  differences in autonomic measures
• Possible mechanism Elevation of intrinsic HR
• Limited evidence of delayed sympathetic recovery
  in the high worry group following certain
  stressors
• Limitations
• Fatigue effects may have diluted CV responses to
  imagery
• Findings applicable only to young adult women
• Low temporal sensitivity may mask recovery
  findings
• Implications future studies
• Chronic high HR is a risk factor for all-cause
  mortality (Palatini Julius, 1997) may mediate
  worry-CVD link
• Focus on individual task sets
• Use of clinical samples (Generalized anxiety
  disorder)
• Replication in men and other age groups

METHOD

• Recruitment phase
• 450 female undergraduates screened with the Penn
  State Worry Questionnaire (PSWQ 16 item
  validated trait measure of worry Meyer et al.
  1990)
• Of 330 eligible subjects, those scoring in the
  upper and lower third on the PSWQ classified as
  high and low worry
• 21 in the low worry group (M PSWQ 37.7), 17 in
  the high worry group (M PSWQ 67.3) selected for
  laboratory phase
• Laboratory phase
• Dependent CV measures HR, low (0.040.15 Hz) and
  high (0.150.40 Hz) frequency HR spectral power,
  pre-ejection period (PEP), systolic and diastolic
  blood pressure (BP)
• Electrocardiogram, Impedance cardiogram recorded
  with Ambulatory Monitoring System v4.4
• BP recorded with IBS SD-700A automated monitor

HR Across All Epochs
Correspondence to bhfriedm_at_vt.edu
Presented at the 66th Annual Meeting of the
American Psychosomatic Society, Baltimore, MD,
March 2008