Does dissociation of emotional and physiological reactivity predict blood pressure change over 10 years?

One of the major theories of psychosomatic medicine is that pervasive dissociations between physiological reactivity and simultaneous emotion awareness may be an important marker for the long term development of cardiac problems. For example, a defensive coping style is characterized by high physiological reactivity to a stressor, paired with simultaneous low subjective emotional awareness of that stressor. The numerous different factors that have been identified as predictive of later cardiac states have lead to conceptual confusion in the field. Subjective Autonomic Discrepancy (SAD) scores computed by subtracting standardized subjective stress response scores from standardized reactivity scores, are proposed as a simplified method of capturing the dissociation between physiological and emotional reactivity, and thus increasing the explanatory power of predictive models of cardiac health outcomes. Data from a ten-year longitudinal study were used to evaluate the reliability and predictive validity of this phenomenon. It was found that discrepancy scores for blood pressure indices show trait-like stability over a period of 3 years (r= .53, p<.001 for SBP and r= .69, p<.001 for DBP, n=117). However SADS for heart rate showed only moderate 3 year stability (r= .16, p= .06). Encouraged by these results, two different predictor models for blood pressure change were tested. Although linear prediction of systolic blood pressure did come close to traditional definitions of significance, neither a linear nor a quadratic model was found to show significant prospective validity in predicting ambulatory blood pressure change over a 3 or 10 year period. All regression analyses controlled for initial ambulatory blood pressure means and other relevant control variables. Dissociation between physiological arousal and emotional awareness does not appear to be an important variable in the identification of individuals at risk for later cardiovascular health problems.Arts, Faculty ofPsychology, Department ofGraduat