Theses and Dissertations

Date of Award

2017

Document Type

Dissertation

Degree Name

Doctor of Psychology (PhD)

Department

College of Psychology

First Advisor

Jeffrey L. Kibler

Second Advisor

Steven N. Gold

Third Advisor

Mindy Ma

Keywords

Cardiovascular disease, Cardiovascular reactivity, Cognitive Appraisals, Depression subtype, Dissociation, PTSD subtype

Abstract

Both posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are related to an increased risk for cardiovascular disease (CVD), with links to ischemic heart disease, myocardial infarction, cardiac mortality, and other cardiac conditions. Given that these disorders are associated with increased medical costs, disability, and employer burden, research has investigated which factors increase the likelihood that one will develop CVD. While one hypothesis suggests that individuals who exhibit exaggerated responses to stress are at greater risk of developing CVD, individuals with PTSD/depression have been shown to exhibit both exaggerated and blunted stress responses. The purpose of the present study was to examine whether differing PTSD symptomatology, depressive presentation, dissociation, or cognitive appraisals of stressful events can predict the nature of one’s cardiovascular response to stress. It was hypothesized that: (1) PTSD arousal would be positively related to cardiac reactivity and PTSD avoidance negatively related to cardiac reactivity; (2) depressive activation would be positively related to cardiovascular reactivity and depressive withdrawal negatively related to cardiovascular reactivity; (3) dissociative symptoms would be negatively related to cardiovascular reactivity; and (4) challenge appraisals would be related to greater cardiac reactivity and threat appraisals to greater peripheral resistance. Female participants (N = 57) were administered the Clinician-Administered PTSD Scale (CAPS) and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) by graduate research assistants. Participants subsequently completed a demographic questionnaire and the Traumatic Life Events Questionnaire (TLEQ), Beck Depression Inventory-II (BDI-II), Dissociative Experiences Scale II (DES II), and Stress Appraisal Measure (SAM) to assess traumatic life events, depression, dissociation, and cognitive appraisals, respectively. Participants’ cardiovascular reactivity (HR, CO, SBP, DBP, and TPR) in response to two stress tasks‒mental arithmetic and public speaking‒were assessed via impedance cardiography and an automated blood pressure cuff. Multivariate regression revealed support for some hypotheses as significant relationships were found between reactivity and PTSD avoidance, PTSD arousal, and depressive withdrawal. No significant relationships were found between reactivity and dissociation, depressive activation, or threat appraisals. This study provides preliminary support for the idea that differing psychological presentations can predict the type of cardiovascular response one exhibits in response to stress.

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