Annals of Behavioral Medicine

, Volume 20, Issue 4, pp 317–325

The social construction of cardiovascular reactivity

  • Nicholas Christenfeld
  • Laura M. Glynn
  • James A. Kulik
  • William Gerin


One can view the “reactivity hypothesis” as having two basic forms: the individual difference or personality approach, which suggests that people who show exaggerated cardiovascular responses to stress are at increased risk of developing cardiovascular disease, and the situational or social psychological approach, which suggests that circumstances which give rise to unusually large responses are those that put people at risk of disease. Both versions rely on the generality of cardiovascular responses across situations. Evidence is presented from two studies which indicate that such generality may, however, be hard to come by. In the first study. examining the personality approach, we show that a simple change in setting dramatically attenuates the consistency of reactivity. In the second study, from the social psychological perspective, we show that subtle alterations in the situation have profound effects on group mean responses. In both cases, reactivity proved extremely sensitive to the context, suggesting that testing in arbitrary and artificial settings cannot be expected to generalize well to the real world. Instead, we argue, careful attention to psychological naturalism is essential, with the testing carefully matched to specific real-world phenomena of interest.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. (1).
    Pickering TG, Gerin W: Cardiovascular reactivity in the laboratory and the role of behavioral factors in hypertension.Annals of Behavioral Medicine. 1990,12: 3–16.CrossRefGoogle Scholar
  2. (2).
    Krantz DS, Manuck SB: Acute physiologic reactivity and risk of cardiovascular disease: A review and methodologic critique.Psychological Bulletin. 1984,96: 435–464.CrossRefPubMedGoogle Scholar
  3. (3).
    Manuck SB: Cardiovascular reactivity in cardiovascular disease: “Once more unto the breach”.International Journal of Behavioral Medicine. 1994,1: 4–31.CrossRefPubMedGoogle Scholar
  4. (4).
    Matthews KA, Weiss SM, Detre T, et al:Handbook of Stress, Reactivity, and Cardiovascular Disease. New York: Wiley, 1986.Google Scholar
  5. (5).
    Lovallo WR, Wilson MF: The role of cardiovascular reactivity in hypertension risk. In Turner JR, Sherwood A, Light KC (eds),Individual Differences in Cardiovascular Response to Stress. New York: Plenum, 1992, 165–186.CrossRefGoogle Scholar
  6. (6).
    Manuck SB, Kaplan JR, Clarkson TB: Behaviorally induced heart rate reactivity and atherosclerosis in cynomolgus monkeys.Psychosomatic Medicine. 1983,45: 95–108.CrossRefPubMedGoogle Scholar
  7. (7).
    Manuck SB, Kaplan JR, Adams MR, Clarkson TB: Behaviorally elicited heart rate reactivity and atherosclerosis in female cynomolgus monkeys (Macaca fascicularis).Psychosomatic Medicine. 1989,51: 306–318.CrossRefPubMedGoogle Scholar
  8. (8).
    Kaplan JR, Adams MR, Clarkson TB, Koritnik DR: Psychosocial influences on female ‘protection’ among cynomolgus macaques.Atherosclerosis. 1984,53: 283–295.CrossRefPubMedGoogle Scholar
  9. (9).
    Kaplan JR, Manuck SB, Clarkson TB, Lusso FM, Taub DM: Social status, environment, and atherosclerosis in cynomolgus monkeys.Arteriosclerosis. 1982,2: 359–368.CrossRefPubMedGoogle Scholar
  10. (10).
    Fredrikson M, Matthews KA: Cardiovascular responses to behavioral stress and hypertension: A meta-analytic review.Annals of Behavioral Medicine. 1990,12: 30–39.CrossRefGoogle Scholar
  11. (11).
    Barnett PA, Spence JD, Manuck SB, Jennings JR: Psychological stress and the progression of carotid artery disease.Journal of Hypertension. 1997,15: 49–55.CrossRefPubMedGoogle Scholar
  12. (12).
    Holroyd KA, Gorkin L: Young adults at risk for hypertension: Effects of family history and anger management in determining responses to interpersonal conflict.Journal of Psychosomatic Research. 1983,27: 131–138.CrossRefPubMedGoogle Scholar
  13. (13).
    Houston BK: Personality characteristics, reactivity, and cardiovascular disease. In Turner JR, Sherwood A, Light KC (eds),Individual Differences in Cardiovascular Response to Stress. New York: Plenum, 1992, 103–123.CrossRefGoogle Scholar
  14. (14).
    Matthews KA: CHD and Type A behaviors: Update on and alternative to the Booth-Kewley and Friedmann quantitative review.Psychological Bulletin. 1988,104: 373–380.CrossRefPubMedGoogle Scholar
  15. (15).
    Smith TW, Christensen AJ: Cardiovascular reactivity and interpersonal relations: Psychosomatic processes in social context.Journal of Social and Clinical Psychology. 1992,112: 79–301.Google Scholar
  16. (16).
    Hartshorne H, May MA:Studies in the Nature of Character, Vol I: Studies in Deceit. New York: Macmillan, 1928.Google Scholar
  17. (17).
    Mischel W:Personality and Assessment. New York: John Wiley & Sons. 1968.Google Scholar
  18. (18).
    Ross L, Nisbett RE:The Person and the Situation: Perspectives of Social Psychology. Philadelphia, PA: Temple University Press, 1991.Google Scholar
  19. (19).
    Epstein S: The stability of behavior: I. On predicting most of the people much of the time.Journal of Personality and Social Psychology. 1979,37: 1097–1126.CrossRefGoogle Scholar
  20. (20).
    Bem DJ, Allen A: On predicting some of the people some of the time: The search for cross-situational consistencies in behavior.Psychological Review. 1974,81: 506–520.CrossRefGoogle Scholar
  21. (21).
    Funder DC, Colvin CR: Explorations in behavioral consistency: Properties of persons, situations, and behaviors.Journal of Personality and Social Psychology. 1991,60: 773–794.CrossRefPubMedGoogle Scholar
  22. (22).
    Festinger L: A theory of social comparison processes.Human Relations. 1954,7: 117–140.CrossRefGoogle Scholar
  23. (23).
    Zajonc RB: Social facilitation.Science. 1965,149: 269–274.CrossRefPubMedGoogle Scholar
  24. (24).
    Gerin W, Rosofsky M, Pieper C, Pickering TG: A test of laboratory-to-life generalizability using a controlled ambulatory procedure.Psychosomatic Medicine. 1994,56: 360–368.CrossRefPubMedGoogle Scholar
  25. (25).
    Turner JR, Girdler SS, Sherwood A, Light KC: Laboratory-field generalization and intertask consistency.Journal of Psychosomatic Research. 1990,34: 581–589.CrossRefPubMedGoogle Scholar
  26. (26).
    Harshfield GA, James GD, Schlussel Y, et al: Do laboratory tests of blood pressure reactivity predict blood pressure variability in real life?Journal of Hypertension. 1988,1: 168–174.CrossRefGoogle Scholar
  27. (27).
    Ironson GH, Gellman MD, Sitzer SB, et al: Predicting home and work blood pressure measurements from resting baselines and laboratory reactivity in Black and White Americans.Psychophysiology. 1989,26: 174–184.CrossRefPubMedGoogle Scholar
  28. (28).
    Langewitz W, Ruddel H, Schachinger H, Schmeider R: Standardized stress testing in the cardiovascular laboratory: Has it any bearing on ambulatory blood pressure values?Journal of Hypertension. 1989,7: S41-S48.CrossRefPubMedGoogle Scholar
  29. (29).
    Linden W, Con A: Laboratory reactivity models as predictors of ambulatory blood pressure and heart rate.Journal of Psychosomatic Research. 1994,38: 217–228.CrossRefPubMedGoogle Scholar
  30. (30).
    Melville DI, Raftery EB: Blood pressure changes during acute mental stress in hypertensive patients using the Oxford intraarterial system.Journal of Psychosomatic Research. 1981,24: 487–497.CrossRefGoogle Scholar
  31. (31).
    Van Egeren LF, Sparrow AW: Laboratory stress testing to assess real life cardiovascular reactivity.Psychosomatic Medicine. 1989,5: 1–9.CrossRefGoogle Scholar
  32. (32).
    Parati G, Pomidossi G, Casadei R, et al: Limitations of laboratory stress-testing in the assessment of subjects' cardiovascular reactivity to stress.Journal of Hypertension. 1986,4: S51-S53.Google Scholar
  33. (33).
    Floras JS, Hassan MO, Jones JV, Sleight P: Pressor responses to laboratory stresses and daytime blood pressure variability.Journal of Hypertension. 1991,5: 715–719.CrossRefGoogle Scholar
  34. (34).
    Matthews KA, Manuck SB, Saab PG: Cardiovascular responses of adolescents during a naturally occurring stressor and their behavioral and psychophysiological predictors.Psychophysiology. 1986,23: 198–209.CrossRefPubMedGoogle Scholar
  35. (35).
    Smith TW, O'Keeffe JL: Cross-situational consistency of cardiovascular reactivity.Biological Psychology. 1988,27: 237–243.CrossRefPubMedGoogle Scholar
  36. (36).
    Gerin W, Christenfeld N, Pieper C: The application of generalizability theory to blood pressure resting levels and mental stress responses.Journal of Blood Pressure Monitoring. 1996,1: 485–494.PubMedGoogle Scholar
  37. (37).
    Glynn LM, Christenfeld N, Gerin W: Implications of alternative methods of computing blood pressure means.Journal of Blood Pressure Monitoring. 1997,2: 175–178.PubMedGoogle Scholar
  38. (38).
    Smith JJ, Kampine JP:Circulatory Physiology. London: Williams & Wilkins, 1990.Google Scholar
  39. (39).
    Wesseling KH: Finapres, continuous noninvasive finger arterial pressure based on the method of Penaz. In Meyer-Sabellek W, Anlauf M, Gotzen R, Steinfeld L (eds),Blood Pressure Measurement. Darmstadt, Germany: Steinkopff Verlag, 1990.Google Scholar
  40. (40).
    Kamarck TW, Manuck SB, Jennings JR: Social support reduces cardiovascular reactivity to psychological challenge: A laboratory model.Psychosomatic Medicine. 1990,52: 42–58.CrossRefPubMedGoogle Scholar
  41. (41).
    Gerin W, Levy R, Pieper C, Pickering TG: Social support in social interaction: A moderator of cardiovascular reactivity.Psychosomatic Medicine. 1992,54: 324–336.CrossRefPubMedGoogle Scholar
  42. (42).
    Lepore SJ, Allen KAM, Evens GW: Social support lowers cardiovascular reactivity to an acute stress.Psychosomatic Medicine. 1993,55: 518–524.CrossRefPubMedGoogle Scholar
  43. (43).
    Christenfeld N, Gerin W, Linden W, et al: Social support effects on cardiovascular reactivity: Is a stranger as effective as a friend?Psychosomatic Medicine. 1997,59: 388–398.CrossRefPubMedGoogle Scholar
  44. (44).
    Turner JR, Hewitt JK: Twin studies of cardiovascular response to psychological challenge: A review and suggested future directions.Annals of Behavioral Medicine. 1992,14: 12–20.Google Scholar
  45. (45).
    Berkman LF, Syme SL: Social networks, host resistance, and mortality: A nine-year follow-up study of Alameda County residents.American Journal of Epidemiology. 1979,109: 186–204.PubMedGoogle Scholar
  46. (46).
    Mischel W, Peake PK: Beyond deja vu in the search for cross-situational consistency.Psychological Review. 1982,89: 730–755.CrossRefGoogle Scholar
  47. (47).
    Pickering TG:Ambulatory Monitoring and Blood Pressure Variability. London: Science Press, 1991.Google Scholar
  48. (48).
    Pickering TG, James GD, Boddie C, et al: How common is white coat hypertension?Journal of the American Medical Association. 1988,259: 225–228.CrossRefPubMedGoogle Scholar
  49. (49).
    Devereaux RB, Pickering TG, Harshfield GA, et al: Left ventricular hypertrophy in patients with hypertension: Importance of blood pressure response to regularly occurring stress.Circulation. 1983,68: 470–476.CrossRefGoogle Scholar
  50. (50).
    Smith TW, Brown PC: Cynical hostility, attempts to exert social control, and cardiovascular reactivity in married couples.Journal of Behavioral Medicine. 1991,14: 581–592.CrossRefPubMedGoogle Scholar
  51. (51).
    Brown PC, Smith TW: Social influence, marriage, and the heart: Cardiovascular consequences of interpersonal control in husbands and wives.Health Psychology. 1992,11: 88–96.CrossRefPubMedGoogle Scholar
  52. (52).
    Kirschbaum C, Pirke KM, Hellhammer DH: The ‘Trier Social Stress Test’—A tool for investigating psychobiological stress responses in a laboratory setting.Neuropsychobiology. 1993,28: 76–81.CrossRefPubMedGoogle Scholar
  53. (53).
    Kamarck TW, Jennings JR, Debski TT, et al: Reliable measures of behaviorally-evoked cardiovascular reactivity from a PC-based test battery: Results from student and community samples.Psychophysiology. 1992,29: 17–28.CrossRefPubMedGoogle Scholar

Copyright information

© The Society of Behavioral Medicine 1998

Authors and Affiliations

  • Nicholas Christenfeld
    • 1
  • Laura M. Glynn
    • 1
  • James A. Kulik
    • 1
  • William Gerin
    • 2
  1. 1.Department of PsychologyUniversity of California, San DiegoLa Jolla
  2. 2.Cornell University Medical CollegeNew York cityUSA

Personalised recommendations