Abstract
The Implications of White Coat Hypertension by Spruill et al. (2007) are multiple and extend well beyond the domain of hypertension and cardiovascular risk. First, their excellent study indicates that theory and research need to treat emotional reactions as situation-specific events. Although traits such as Anxiety can be easily and reliably measured, their assessment may not detect the situation-specific mechanisms that link emotional responses to health risks. Second, patients-self perceptions, whether they label themselves as having a chronic disease, give meaning to the situational cues that elicit emotional reactions. Third, as Spruill et al. indicate, health behavioral research needs to examine how the clinical setting and social and cultural frameworks affect self-labeling. We add to their clinical concerns by questioning whether a clinician’s words, i.e., whether they suggest a condition is related to stress, can in our contemporary culture, lead patients to treat a condition as acute rather than chronic, and how the clinicians-behavior, e.g., attention to specific areas of the body during a clinical examination, may shape the perceived cause of symptoms. The implications of this excellent study extend well beyond its focus on white coat hypertension.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Spruill TM, Pickering TG, Schwartz JE, et al.: The impact of perceived hypertension status on anxiety and the white coat hypertension effect.Annals of Behavioral Medicine. 2007,34:1-.
Shoda Y, Mischel W, Wright JC: Intraindividual stability in the organization and patterning of behavior: Incorporating psychological situations into the idiographic analysis of personality.Journal of Personality and Social Psychology. 1994,67:674-87.
Guyll M, Contrada RJ: Trait hostility and ambulatory cardiovascular activity in males and females.Health Psychology. 1998,17:30-9.
Kemeny MA: The psychobiology of stress.Current Directions in Psychological Science. 2003,12:124-29.
Newton TL, Contrada RJ: Verbal-autonomic response dissociation in repressive coping: The influence of social context.Journal of Personality and Social Psychology. 1992,62:159-67.
Wells A: A multidimensional measure of worry: Development and preliminary validation of the Anxious Thoughts Inventory.Anxiety Stress and Coping. 1994,6:289-99.
Diefenbach MA, Miller SM, Daly MB: Specific worry about breast cancer predicts mammography use in women at risk for breast and ovarian cancer.Health Psychology. 1999,18:532-36.
Reiss S: Expectancy theory of fear, anxiety, and panic.Clinical Psychology Review. 1991,11:141-53.
Leventhal H, Benyamini Y, Brownlee S, et al.: Illness representations: Theoretical Foundations. In Petrie KJ, Weinman J (eds),Perceptions of Health and Illness: Current Research and Applications. Amsterdam: Harwood Academic, 1997, 19-5.
Quirk GJ, Gehlert DR: Inhibition of the amygdala: Key to pathological states?Annals of the New York Academy of Sciences. 2003,985:263-72.
Cuthbert BN, Lang PJ, Strauss C, et al.: The psychophysiology of anxiety disorder: Fear memory imagery.Psychophysiology. 2003,40:407-22.
Lespérance F, Frasure-Smith N, Koszycki D, et al.: Effects of citalopram and interpersonal psychotherapy on depression in patients with coronary artery disease: The Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacy (CREATE) trial.Journal of the American Medical Association. 2007,297:367-79.
Garro LC: Remembering what one knows and the construction of the past: A comparison of cultural consensus theory and cultural schema theory.Ethos. 2000,28:275-19.
Christensen AJ, Ehlers SL, Wiebe JS, et al.: Patient personality and mortality: A 4-year prospective examination of chronic renal insufficiency.Health Psychology. 2002,21:315-20.
Heurtin-Roberts S, Reisin E: Health beliefs and compliance with prescribed medication among black women—New Orleans, 1985-986.Morbidity and Mortality Weekly Report. 1990,39:701-03.
Blumhagen D: Hyper-tension: A folk illness with a medical name.Culture, Medicine, and Psychiatry. 1980,4:197-27.
Brown CM, Segel R: Ethnic differences in temporal orientation and its implications for hypertension management.Journal of Health and Social Behavior. 1996,37:350-61.
Croyle RT, Jemmott JB: Psychological reactions to risk factor testing. In Skelton JA, Croyle RT (eds),Mental Representation in Health and Illness. New York: Springer-Verlag, 1991, 85-07.
Halm EA, Mora P, Leventhal H: No symptoms, no asthma: The acute episodic disease belief is associated with poor self-management among inner-city adults with persistent asthma.Chest. 2006,129:573-80.
Parsons T:The Social System. New York: Free Press, 1951.
Musumeci TJ: Expanding the chronic model: The impact of illness and treatment representations upon treatment adherence and health outcomes for adults with asthma. Doctoral dissertation, Rutgers, The State University of New Jersey, New Brunswick: 2007.
Eifert GH, Thompson RN, Zvolensky MJ, et al.: The cardiac anxiety questionnaire: Development and preliminary validity.Behaviour Research & Therapy. 2000,38:1039-053.
Aikens JE, Zvolensky MJ, Eifert GH: Fear of cardiopulmonary sensations in emergency room noncardiac chest pain patients.Journal of Behavioral Medicine. 2001,24:155-67.
Horowitz CR, Rein SB, Leventhal H: A story of maladies, misconceptions and mishaps: Effective management of heart failure.Social Science & Medicine. 2004,58:631-43.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Leventhal, H., Contrada, R.J. & Leventhal, E.A. Lessons from white coat hypertension: Comment on Spruill et al. “The impact of perceived hypertension status on anxiety and the white coat effect”. ann. behav. med. 34, 10–13 (2007). https://doi.org/10.1007/BF02879916
Issue Date:
DOI: https://doi.org/10.1007/BF02879916