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Annals of Behavioral Medicine

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01-10-2014 | Original Article

Divergent Associations of Antecedent- and Response-Focused Emotion Regulation Strategies with Midlife Cardiovascular Disease Risk

Authors: Allison A. Appleton, ScD, MPH, Eric B. Loucks, PhD, Stephen L. Buka, ScD, Laura D. Kubzansky, PhD, MPH

Published in: Annals of Behavioral Medicine | Issue 2/2014

Abstract

Background

It is not known whether various forms of emotion regulation are differentially related to cardiovascular disease risk.

Purpose

The purpose of this study is to assess whether antecedent and response-focused emotion regulation would have divergent associations with likelihood of developing cardiovascular disease.

Methods

Two emotion regulation strategies were examined: reappraisal (antecedent-focused) and suppression (response-focused). Cardiovascular disease risk was assessed with a validated Framingham algorithm that estimates the likelihood of developing CVD in 10 years. Associations were assessed among 373 adults via multiple linear regression. Pathways and gender-specific associations were also considered.

Results

One standard deviation increases in reappraisal and suppression were associated with 5.9 % lower and 10.0 % higher 10-year cardiovascular disease risk, respectively, in adjusted analyses.

Conclusions

Divergent associations of antecedent and response-focused emotion regulation with cardiovascular disease risk were observed. Effective emotion regulation may promote cardiovascular health.

Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics—2011 update: A report from the American Heart Association. Circulation. 2011; 123: e18-e209.PubMedCrossRef

Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart disease and stroke statistics-2010 update: A report from the American Heart Association. Circulation. 2010; 121: e46-e215.PubMedCrossRef

Miller G, Chen E, Cole SW. Health psychology: Developing biologically plausible models linking the social world to physical health. Annu Rev Psychol. 2009; 60: 501-524.PubMedCrossRef

Everson-Rose SA, Lewis TT. Psychosocial factors and cardiovascular disease. Annu Rev Public Health. 2005; 26: 469-500.PubMedCrossRef

Kobau R, Seligman MEP, Peterson C, et al. Mental health promotion in public health: Perspectives and strategies from positive psychology. Am J Public Health. 2011; 101: e1-e9.PubMedCentralPubMedCrossRef

Boehm JK, Kubzansky LD. The heart’s content: The association between positive psychological well-being and cardiovascular health. Psychol Bull. 2012. doi:10.1037/a0027448.PubMed

Gross JJ, John OP. Individual differences in two emotion regulation processes: Implications for affect, relationships and well-being. J Pers Soc Psychol. 2003; 85: 348-362.PubMedCrossRef

John OP, Gross JJ. Healthy and unhealthy emotion regulation: Personality processes, individual differences, and life span development. J Pers. 2004; 72: 1301-1334.PubMedCrossRef

Gross JJ. Emotion regulation in adulthood: Timing is everything. Curr Dir Psychol Sci. 2001; 10: 214-219.CrossRef

10.

Appleton AA, Kubzansky LD. Emotion regulation and cardiovascular disease risk. In: Gross JJ, ed. Hanbook of Emotion Regulation. 2nd ed. New York: The Guilford Press; 2014.

11.

Consedine NS, Magai C, Bonanno GA. Moderators of the emotion inhibition-health relationship: A review and research agenda. Rev Gen Psychol. 2002; 6: 204-228.CrossRef

12.

Appleton AA, Buka SL, Loucks EB, Gilman SE, Kubzansky LD. Divergent associations of adaptive and maladaptive emotion regulation strategies with inflammation. Health Psychol. 2013; 13: 748-756.CrossRef

13.

Rozanski A, Kubzansky LD. Psychologic functioning and physical health: A paradigm of flexibility. Psychosom Med. 2005; 67: S47-S53.PubMedCrossRef

14.

Kubzansky LD, Park N, Peterson C, Vokonas P, Sparrow D. Healthy psychological functioning and incident coronary heart disease: The importance of self-regulation. Arch Gen Psychiatr. 2011; 68: 400-408.PubMedCrossRef

15.

Kinnunen M, Kokkonen M, Kaprio J, Pulkkinen L. The associations of emotion regulation and dysregulation with the metabolic syndrome factor. J Psychosom Res. 2005; 58: 513-521.PubMedCrossRef

16.

C Reactive Protein Coronary Heart Disease Genetics Collaboration. Association between C reactive protein and coronary heart disease: Mendelian randomisation analysis based on individual participant data. BMJ. 2011; 342: 1-8.CrossRef

17.

Danesh D, Wheeler JG, Hirschfield GM, et al. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. New Engl J Med. 2004; 350: 1387-1397.PubMedCrossRef

18.

Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease: Application to clinical and public health practice. A statement for healthcare professionals from the Centers for Disease Control and Prevention and the American Heart Association. Circulation. 2003; 107: 499-511.PubMedCrossRef

19.

Elliott P, Chambers JC, Zhang W, et al. Genetic loci associated with c-reactive protein levels and risk of coronary heart disease. JAMA. 2009; 302: 37-48.PubMedCentralPubMedCrossRef

20.

Appleton AA, Loucks EB, Buka SL, Rimm E, Kubzansky LD. Childhood emotional functioning and the developmental origins of cardiovascular disease risk. J Epidemiol Community Health. 2013; 67: 405-411.PubMedCentralPubMedCrossRef

21.

Thurston RC, Kubzansky LD. Multiple sources of psychosocial disadvantage and risk of coronary heart disease. Psychosom Med. 2007; 69: 748-755.PubMedCrossRef

22.

Moller-Leimkuhler A. Higher comorbidity of depression and cardiovascular disease in women: A biopsychosocial perspective. World J Biol Psychiatry. 2010; 11: 922-933.PubMedCrossRef

23.

Lazarus RS. Emotion and Adaptation. New York: Oxford University Press; 1991.

24.

Calkins SD, Hill A. Caregiver influences on emerging emotion regulation: Biological and environmental transactions in early development. In: Gross JJ, ed. Handbook of Emotion Regulation. New York: The Guilford Press; 2007: 229-248.

25.

Thompson R. Family influences on emotion regulation. In: Gross JJ, ed. Handbook of Emotion Regulation. 2nd ed. New York: The Guilford Press; 2014.

26.

Rothbart M, Posner M. Temperament and emotion regulation. In: Gross JJ, ed. Handbook of Emotion Regulation. 2nd ed. New York: The Guilford Press; 2014.

27.

Shonkoff JP, Phillips DA, eds. From Neurons to Neighborhoods: The Science of Early Childhood Development. Washington, DC: National Academy Press; 2000.

28.

Hart CL, Taylor MD, Davey Smith G, et al. Childhood IQ and cardiovascular disease in adulthood: Prospective observational study linking the Scottish Mental Survey 1932 and the Midspan studies. Soc Sci Med. 2004; 59: 2131-2138.PubMedCrossRef

29.

Pollitt RA, Rose KM, Kaufman JS. Evaluating the evidence for models of life course socioeconomic factors and cardiovascular outcomes: A systematic review. BMC Public Health. 2005; 5: 7.PubMedCentralPubMedCrossRef

30.

Berenson GS, Srnivasan SR. Cardiovascular risk factors in youth with implications for aging: The Bogalusa heart study. Neurobiol Aging. 2005; 26: 303-307.PubMedCrossRef

31.

D’Agostino RB, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: The Framingham Heart Study. Circulation. 2008; 117: 742-753.

32.

Broman SH, Nichols PI, Kennedy WA. Preschool IQ: Prenatal and Early Developmental Correlates. New York: Hallstead Press; 1975.

33.

Niswander KR, Gordon M. The Women and Their Pregnancies. Washington, DC: US Government Printing Office; 1972.

34.

Almeida ND, Loucks EB, Kubzansky LD, et al. Quality of parental emotional care and calculated risk for coronary heart disease. Psychosom Med. 2010; 72: 148-155.PubMedCentralPubMedCrossRef

35.

Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974; 20: 470-475.PubMed

36.

Rafai N, Cole TG, Iannotti E, et al. Assessment of interlaboratory performance in external proficiency testing programs with a direct HDL-cholesterol assay. Clin Chem. 1998; 44: 1452-1458.

37.

Mattu GS, Heran BS, Wright JM. Overall accuracy of the BpTRU - an automated electronic blood pressure device. Blood Press Monit. 2004; 9: 47-52.PubMedCrossRef

38.

Wechsler D. Wechsler Intelligence Scale for Children. New York: The Psychological Corporation; 1949.

39.

Myrianthopoulos N, French K. An application of the U.S. Bureau of the Census socioeconomic index to a large, diversified patient population. Soc Sci Med. 1968; 2: 283-299.PubMedCrossRef

40.

CDC: Fact Sheets - Alcohol Use and Health. Retrieved 9/12/13, 2013 from http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm.

41.

Willett WC. Nutritional Epidemiology. 2nd ed. New York: Oxford University Press; 1998.CrossRef

42.

Michaud DS, Skinner HG, Wu K, et al. Dietary patterns and pancreatic cancer risk in men and women. J Natl Cancer Inst. 2005; 97: 518-524.PubMedCrossRef

43.

UCLA Academic Technology Services Statistical Consulting Group: Introduction to SAS. 2011.

44.

Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986; 51: 1173-1182.PubMedCrossRef

45.

Kramer HC, Kiernan M, Essex M. How and why criteria defining moderators and mediators differ between the Baron & Kenny and MacArthur approachs. Health Psychol. 2008; 27: S101-S108.CrossRef

46.

Gross JJ, Levenson RW. Emotion suppression: Physiology, self-report, and expressive behavior. J Pers Soc Psychol. 1993; 64: 970-986.PubMedCrossRef

47.

Gross JJ, Levenson RW. Hiding feelings: The acute effects of inhibiting negative and positive emotion. J Abnorm Psychol. 1997; 106: 95-103.PubMedCrossRef

48.

Black PH, Garbutt LD. Stress, inflammation and cardiovascular disease. J Psychosom Res. 2002; 52: 1-23.PubMedCrossRef

49.

Suls J, Bunde J. Anger, anxiety, and depression as risk factors for cardiovascular disease: The problems and implications of overlapping affective dispositions. Psychol Bull. 2005; 131: 260-300.PubMedCrossRef

Title: Divergent Associations of Antecedent- and Response-Focused Emotion Regulation Strategies with Midlife Cardiovascular Disease Risk
Authors: Allison A. Appleton, ScD, MPH
Eric B. Loucks, PhD
Stephen L. Buka, ScD
Laura D. Kubzansky, PhD, MPH
Publication date: 01-10-2014
Publisher: Springer US
Published in: Annals of Behavioral Medicine / Issue 2/2014
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI: https://doi.org/10.1007/s12160-014-9600-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Divergent Associations of Antecedent- and Response-Focused Emotion Regulation Strategies with Midlife Cardiovascular Disease Risk

Abstract

Background

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Purpose

Methods

Results

Conclusions

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