Factor structure and construct validity of the Anxiety Sensitivity Index among island Puerto Ricans

The factor structure and convergent and discriminant validity of the Anxiety Sensitivity Index (ASI) were examined among a sample of 275 island Puerto Ricans. Results from a confirmatory factor analysis (CFA) comparing our data to factor solutions commonly reported as representative of European American and Spanish populations indicated a poor fit. A subsequent exploratory factor analysis (EFA) indicated that a two-factor solution (Factor 1, Anxiety Sensitivity; Factor 2, Emotional Concerns) provided the best fit. Correlations between the ASI and anxiety measures were moderately high providing evidence of convergent validity, while correlations between the ASI and BDI were significantly lower providing evidence of discriminant validity. Scores on all measures were positively correlated with acculturation, suggesting that those who ascribe to more traditional Hispanic culture report elevated anxiety

Anger expression and its relation to coronary heart disease.

The purpose of this study was to determine if subjects\u27 preferred modes of anger expression were related to their behavioral, cognitive, affective, and physiological responses to interpersonal conflict. Subjects identified as being anger-in or anger-out based on responses to the Spielberger Anger Expression Scales were asked to participate in two conflict oriented role plays, one in which they were instructed to express their anger and and the other in which they were asked to suppress their anger. Results showed that for all subjects anger expression was associated with increased frequency of negative verbal behaviors, greater experience of affect as determined by self-reported state anger, arousal, and anxiety, greater systolic blood pressure and heart rate reactivity than anger suppression. Anger suppression was associated with greater repression-oriented and rational coping cognitive responding and more problem solving behaviors than anger expression. Anger-in individuals used significantly more repression statements compared to anger-out individuals across both role play interactions. Anger-out persons showed exaggerated DBP response in contrast to anger-in subjects but only during the anger expression role play. Additionally, if the anger expression scene followed anger suppression in contrast to the reverse order, a more intense response was observed on a number of variables including a greater experience of verbal negative behaviors, thoughts of victimization, self-reported anger, self-reported arousal, resting diastolic blood pressure, and diastolic blood pressure reactivity

A qualitative assessment of barriers and facilitators to achieving behavior goals among obese inner-city adolescents in a weight management program

Purpose: The purpose of this study was (1) to examine the reasons for managing weight, (2) to investigate the barriers and facilitators to achieving behavior goals, and (3) to assess how a behavior coach affects the goal-setting process of obese inner-city adolescents in a weight management program.Methods: Obese adolescents participating in a pilot study assessing the role of a behavior coach on successful weight management (n = 18) were interviewed to identify barriers and facilitators to reaching behavior goals. Data were analyzed using descriptive statistics and the constant comparative method of qualitative analysis.Results: In the rationale for weight control, adolescent girls and boys reported a desire to improve physical appearance and physical conditioning, respectively. Barriers to reaching physical activity goals among girls included unsafe neighborhoods and a negative body image. Maintaining unrealistic behavior and weight goals hindered satisfaction with behavior change and weight loss in both genders. Overall, coaching provided support that helped the obese teens feel more successful in the goal-setting process and address issues related to their disruptive environments.Conclusions: Diabetes educators can include a behavior coach as part of a weight management program to help teens set behavior goals and overcome barriers to reaching behavior goals

Effects of Acute Mental Stress and Exercise on T-Wave Alternans in Patients with Implantable Cardioverter Defibrillators and Controls

Background - Malignant cardiac arrhythmias can be triggered by exercise and by mental stress in vulnerable patients. Exercise-induced T-wave alternans (TWA) is an established marker of cardiac electrical instability. However, the effects of acute mental stress on TWA have not been investigated as a vulnerability marker in humans. Methods and Results - TWA responses to mental stress (anger recall and mental arithmetic) and bicycle ergometry were evaluated in patients with implantable cardioverter defibrillators (ICDs) and documented coronary artery disease (n=23, age 62.1±12.3 years) and controls (n=17, age 54.2±12.1 years). TWA was assessed from digitized ECGs by modified moving average analysis. Dual-isotope single photon emission computed tomography was used to assess myocardial ischemia. TWA increased during mental stress and exercise (P values \u3c0.001), and TWA responses were higher in ICD patients than in controls (arithmetic Δ=8.9±1.4 versus 4.3±2.2 μV, P=0.043; exercise Δ=21.4±2.8 versus 13.8±3.2 μV, P=0.038). TWA increases with mental stress occurred at substantially lower heart rates (anger recall Δ=9.7±7.7 bpm, arithmetic Δ=14.3±133 bpm) versus exercise (Δ=53.7± 22.7 bpm; P values \u3c0.001). After adjustment for heart rate increases, mental stress and exercise provoked increased TWA in ICD patients (P values \u3c0.05), but not in controls (P values \u3e0.2). Ejection fraction and stress-induced myocardial ischemia were not associated with TWA. Conclusions - Mental stress can induce cardiac electrical instability, as assessed via TWA, among patients with arrhythmic vulnerability and occurs at lower heart rates than with exercise. Pathophysiological mechanisms of mental stress-induced arrhythmias may therefore involve central and autonomic nervous system pathways that differ from exercise-induced arrhythmias