Academic journal article International Journal of Psychology and Psychological Therapy

Factors That Moderate the Effect of Laboratory-Based Social Support on Cardiovascular Reactivity to Stress

Academic journal article International Journal of Psychology and Psychological Therapy

Factors That Moderate the Effect of Laboratory-Based Social Support on Cardiovascular Reactivity to Stress

Article excerpt

Epidemiological research suggests that social support is inversely related to cardiovascular morbidity and mortality (Cohen, 1988; Eriksen, 1994), and is associated with the course of coronary heart disease (CHD) even after its onset (Berkman, LeoSummers, & Horwitz, 1992; Case, Moss, Case, McDermott, & Elberly, 1992). One recent review concluded that various types of low social support confer a risk of 1 .5 to 2.0 of negative CVD events in both healthy populations and in patients with CVD (Lett, et al, 2005).

The specific mechanisms or processes through which social support influences cardiovascular health remain unclear. Kamarck, Manuck, and Jennings (1990) suggested that social support operates at a physiological level as a moderator of cardiovascular reactivity to stress (CVR). This suggestion is derived from the reactivity hypothesis, which states that excessive cardiovascular response to episodic stress contributes to the development of hypertension and coronary heart disease (Krantz & Manuck, 1984; Manuck, Kasprowicz, & Mulddon, 1990).

A number of researchers have examined the effects of social support on cardiovascular health from the perspective of the reactivity hypothesis. One approach adopted in this research involves the study of the effects of laboratory analogues of social support on CVR. Studies adopting this approach have yielded some conflicting findings. Although a number of researchers found that social support attenuated CVR to laboratory stressors (e.g., Kamarck, Manuck, & Jennings, 1990; Lepore, Mata Allen & Evans, 1993), others have found increased CVR when social support analogues are provided (e.g., Allen, Blascovich, Tomaka & Kelsey, 1991; Anthony & O'Brien, 1999), and that social support analogues had no effect on CVR (e.g., Sheffield & Carroll, 1994). Social support-CVR studies vary with respect to their treatment of methodological and individual difference variables that may moderate the effects of social support on CVR. A systematic review of methodological and individual difference variables in the social support-CVR literature has not been published.

METHOD

A computer-based search using Psyclnfo, Medline, Ebsco and PubMed was undertaken to search for relevant articles published since 1990. Combinations of the following key words were entered into the search engines: cardiovascular, reactivity, activity, blood pressure (BP), heart rate (HR), stress, laboratory, support, social support, and affiliation. In addition, pertinent references were identified and titles relevant to the current review were obtained.

Inclusion and Exclusion Criteria

Published literature examining the effects of laboratory analogues of social support on CVR to acute stress was included. Only manipulations of conspecific social support were included. For example, while Allen et al. (1991) used pet dogs as support providers in one of their conditions, this condition will not be discussed in the review (although the other conditions of their study will be). Only studies of adult, non-clinical populations, which examined any of the various measures of CVR in laboratory settings, were considered. As such, studies that examined ambulatory BP (e.g., Steptoe, 2000) were excluded. The effect of adult attachment and social support provided by a romantic partner on CVR was examined in one study (Feeney & Kirkpatrick, 1996). Given that all of the other studies used either a supportive confederate or non-romantic friend in the social support condition, Feeney and Kirkpatrick's study was excluded.

A summary table of the 21 studies that fitted the inclusion criteria can be seen in Table 1. The table summarises the design of the 21 studies and includes a column of additional factors examined in each study. It can be seen from this table that while 15 studies found that some operationalisation of social support attenuated CVR (e.g., Kamarck et al, 1990), the remaining 6 experiments report either that social support increased CVR (e. …

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