Psychological response styles and cardiovascular health : confound or independent risk factor?

We used the results from two large scale cardiovascular investigations as a platform for examining ways in which psychological response style measures could improve the prediction of cardiovascular health outcomes. Of particular focus was the long-standing conceptual controversy over whether response styles are better treated as confounds to the self-report of stress-related personality characteristics or as separate personality traits. Study 1 consisted of a 3-year prospective study of ambulatory blood pressure levels in a healthy adult sample of males and females (N=T25). Study 2 comprised a pharmacological treatment study among ischemic heart disease patients (N=95). Questionnaire batteries completed in each study included self-report measures of depression, anger expression, daily stress, and hostility, along with self-deception and impression management response style scales. In each study, we investigated direct relationships between the response style measures and cardiovascular outcomes, moderator relationships between response style x psychological risk factor interactions and cardiovascular endpoints, and finally between the psychological risk factors and cardiovascular measures after statistically extracting response style variance from the p sychological risk factor scores. Results most strongly supported the main effects model. Higher self-deception scores predicted elevated 3-year diastolic and systolic blood pressure means in study 1, and poorer treatment outcomes in study 2. In both investigations these relationships proved stable after controlling for baseline cardiovascular standing. Importantly, efforts to statistically control for response style effects within the psychological risk factors did not improve predictive power with these measures. The above findings favor efforts to treat response styles as potentially independent psychological contributors to cardiovascular health outcomes, and support ongoing attempts to identify biobehavioral mechanisms through which personality dispositions may impact the appearance or progression of disease.Arts, Faculty ofPsychology, Department ofGraduat