Abstract
The Serial Color Word Test was administered at baseline to 253 hypertensive men participating in the prospective cohort study of cardiovascular diseases “Men born in 1914” in Malmö, Sweden. This test of psychological adaptation to a stressful encounter was used to investigate whether susceptibility to stress moderates the risk of a cardiac event in association with hypertension. Adaptive behavior, as measured by test performance, can be categorized in two dimensions. The regression dimension refers to linear change of time spent in the test session whereas the variability dimension refers to nonlinear change. Both dimensions consist of four different patterns. At follow-up (mean time = 8.2 ±3.5 years), the risk of a cardiac event varied between men with different adaptive patterns. One pattern, the Curnulative- Dissociative pattern of the variability dimension, characterized by a discontinuous and fluctuating time-consumption, was associated to an almost three-fold risk of a cardiac event during follow-up (relative risk [RR], 2.99; 95% confidence interval [CI], 1.33 - 6.70, p = .010) after adjustment for medical-, socioeconomic-, and lifestyle-related factors. No association existed between adaptive patterns and overall mortality.
Similar content being viewed by others
References
Andersson, A. L. (1967). Adaptive visual after effect processes as related to patterns of color-word interference serials. Percephcal and Motor Skills, 25,437–453.
Andersson, A. L., Nilsson, A., & Henriksson, N.-G. (1970). Personality differences between accident-loaded and accident-free young car drivers. British Journal of Psychology, 61, 409–421.
Barnett, P. A., Spence, J. D., Manuck, S. B., & Jennings, J. K. (1996). Psychological stress and the progression of carotid artery disease. Journal of Hypertension., 15, 49–55.
Boutcher, S. H., & Stocker, D. (1996). Cardiovascular response of young and older males to mental challenge. Journal of Gerontology Psychological Sciences. 51B, 261–267.
Doehrman, S., Landau, R., & O’Connell, D. (1978). The Stroop phenomenon: Perceptual conflict or response competition? Perceptual and Motor Skills, 47, 1127–1131.
Eberhard, G., Johnson, G., Nilsson, L. K., & Smith, G. J. W. (1965). Clinical and experimental approaches to the desciption of depression and anti-depressive therapy. Acta Psychiatrica Scandinavica, 41, suppl. 186.
Eberhard, G., & Ljunghill-Andersson, J. (1968). Results of experimental part of the main investigation. In G. Eberhard (Ed.), Peptic ulcer in twins. A study in personality, heredity and environment. Acta Psychiatrica Scandinavia, suppl. 205, pp. 46–54.
Harris, T., Cook, E. F., Kannel, W. B., & Goldman, L. (1988). Proportional hazards analysis of risk factors for coronary heart disease in individuals aged 65 or older. The Framingham Study. Journal of the American Geriatric Society, 36, 1023–1028.
Haynes, S. G., Feinleib, M., & Kannel, W. B. (1980). The relationship of psychosocial factors to coronary heart disease in the Framingham study. iii. Eight-year incidence of coronary heart disease. American Journal of Epidemiology, 111, 37–58.
Hippisley-Cox, J., Fielding, K., & Pringle, M. (1998). Depression as a risk factor for ischaemic heart disease in men: Population based case-control study. British Medical Journal, 316, 1714–1719.
Janzon, L., Hanson, B. S., Isacsson, S. -O., Lindell, S.-E., & Steen, B. (1986). Factors influencmg participation in health surveys. Results from prospective population study “Men born in 1914” in Malmø, Sweden. Journal of Epidemiological Community Health, 40, 174–177.
Jennings, J. R., Kamarck, T., Manuck, S., Everson, S. A., Kaplan, G., & Salonen, J. T. (1997). Aging or disease? Cardiovascular reactivity in Finnish men over the middle years. Psychologv of Aging, 12, 225–238.
Kamarck, T. W., Jennings, J. R, Pogue-Geile, M., & Manuck, S. B. (1994). A multidimensional measurement model for cardiovascular reactivity: Stability and cross validation in two adult samples. Health Psychology, 13, 471–478.
Karasek, R. A., Jr. (1979). Job demands, job decision latitude, and mental strain: Implications for job redesign. Administrntive Science Quarterly, 24, 285–308.
Kragh, U., & Smith, G. J. W. (1970). Percept-genetic analysis. Lund, Sweden: Gleerups.
Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.
Lezak, M. D. (1995). Neuropsychological assessment, 3rd ed. New York: Oxford University Press.
Marmot, M. (1996). Ischaemic heart disease. In S. Ebrahim & A. Kalache (Eds.), Epidemiology in old age (pp. 253–261). London: BMJ Publishing Group.
McCrae, R. R., & Costa, P. T., Jr. (1986). Personality, coping, and coping effectiveness in an adult sample. Journal of Personality, 54, 385–405.
McEwen, B. S., & Stellar, E. (1993). Stress and the individual. Mechanisms leading to disease. Archives of Internal Medicine, 153, 2093–2101.
Nilsson, A, & Almgren, P.-E. (1970). Para-natal emotional adjustment. A prospective investigation of 165 women. Part II. The influence of background factors, psychiatric history, parental relations, and personality characteristics. Acta Psychiatrica Scandinavia (Suppl. 220), 65–141.
Öhman, A., & Bohlin, G. (1989). The role of controllability in cardiovascular activation and cardiovascular disease: Help or hindrance? In A. Steptoe & A. Appels (Eds.), Stress, personal control and health. (pp. 257–276). Chichester, England: Wiley.
Ornish, D., Brown, S. E., Scherwitz, L. W., Binnings, J. H., Armstrong, W. T., Ports, T. A.,, McLanahan, S. M., Kirkeeide, R. L., Brand, R. J., & Gould, K. L. (1990). Can lifestyle changes reverse coronary heart disease? Lancet, 336, 129–133.
Rose, G. A., & Blackburn, H. (1968). Cardiovascular survey methods. World Health Organization Monographic Series, 56,l-188.
Rozanski, A., Bairey, N., Krantz, D. S., Friedman, J., Resser, K. J., Morell, M., Hilton-Chalfen, S., Hestrin, L., Bietendorf, J., & Berrnan, D. S. (1988). Mental stress and the induction of silent myocardial ischemia in patients with coronary artery disease. The New England Journal of Medicine, 318, 1005–1012.
Rubino, I. A., Del Monaco, E., Rocchi, M. T., & Pezzarossa, B. (1994). Microgenetic styles of regulation in schizophrenia. Perceptual and Motor Skills, 79,451–457.
Rubino, I. A., Fedeli, B., Zanna, V., & Fortuna, E. (1997). A multivariate study of the Serial Color-Word Test. Perceptual and Motor Skills, 84, 275–282.
Rubino, I. A., Grasso, S., & Pezzarossa, B. (1990). Microgenetic patterns of adaptation on the Stroop task by patients with bronchial asthma and duodenal peptic ulcer. Perceptual and Motor Skills, 71, 19–31.
Rubino, I. A., Greco, E., Zanna, V., & Pezzarossa, B. (1994). Microgenetic styles in histrionic and obsessive-compulsive personality disorders. Perceptual and Motor Skills, 78, 51–60.
Rubino, I. A., Verucci, M., & Fortuna, E. (1993). Microgenetic styles of regulation among two nonpsychotic psychiatric groups. Perceptual and Motor Skills, 76, 1059–1069.
Sjöberg, L. (1974). Psychometric properties of the serial color word test. Scandinavian Journal of Psychology, 15, 15–20.
Smith, G. J. W., Nilsson, L., & Johnson, G. (1964). Differentiation of character neurosis and symptom neurosis on the basis of differences between two serial experiments. Scandinavian Journal of Psychology, 5,234–238.
Smith, G. J. W., & Nyman, G. E. (1970). A study of psychotic patterns with the Serial Color Word Test. In U. Kragh & G. J. W. Smith (Eds.), Percept-genetic analysis (pp. 263–272). Lund, Sweden: Gleerups.
Smith, G. J. W., & Nyman, G. E. (1974). The validity of the serial color word-test A reply to Lennart Sjöberg. Scandinavian Journal of Psychologv, 15, 238–240.
Smith, G. J. W., Nyman, G. E., & Hentschel, U. (1986). Manual till CWT -Serialt färgordtest. Stockholm: Psykologiförlaget AB.
Smith, G. J. W., Nyman, G. E., Hentschel, U., & Rubino, I. A. (in press). The serial Color-Word Test (s-CWT). Leyden: Swets & Zeitlinger.
SPSS advanced statistics 6.1 [Computer program]. (1994). Chicago: SPSS Inc.
Steen, G., Hagberg, B., Johnson, G., & Steen, B. (1987). Cognitive function, cognitive style and life satisfaction in a 68-year-old male population. Comprehensive Gerontolology B, 1, 54–61.
Steptoe, A. (1991). Psychological coping, individual differences and physiological stress responses. In C. L. Cooper & R. Payne (Eds.), Personality and stress. Individual differences in the stress process. (pp. 205–233). West Sussex, England: Wiley.
Stroop, J. R. (1935) Studies of interference in serial verbal reactions. Journal of Experimenta1 Psychology, 18, 643–662.
Theander, S. (1970). Anorexia nervosa. Acta Psychiatrica Scandinavia, Suppl. 214.
Vita, J. A., Ganz, P., & Selwyn, A. P. (1991). Interactions between mental stress and coronary heart disease. In A. P. Shapiro & A. Baum (Eds.), Behavioral aspects of cardiovascular disease. (pp. 3–9). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.
World Health Organization. (1969). Manual of the international statistical classification of diseases, injuries, and causes of death, based on the recommendations of the Eighth Revision Conference 1965 and adopted by the 19th World Health Assembly. Geneva: Author.
Author information
Authors and Affiliations
Corresponding author
Additional information
Preparation of this article was supported by the Ribbing Memorial Foundation and Swedish Medical Research Committee grants B95-27X-11262-01A and B96-27X-11263-02A.
The authors thank Professor Emeritus Gudmund Smith of Lund University, Sweden, for valuable support.
Rights and permissions
About this article
Cite this article
André-Petersson, L., Hagberg, B., Hedblad, B. et al. Incidence of cardiac events in hypertensive men related to adaptive behavior in stressful encounters. Int. J. Behav. Med. 6, 331–355 (1999). https://doi.org/10.1207/s15327558ijbm0604_3
Issue Date:
DOI: https://doi.org/10.1207/s15327558ijbm0604_3