Hypertension and Neuroticism

Abstract

324 normo- and hypertensive subjects were investigated for neurotic symptoms during outpatient screening for arterial hypertension. The patients were randomly selected and subdivided into three groups: ‘new’ hypertensives, ‘old’ hypertensives and normotensives. Neurotic symptoms were evaluated using the Kellner and Sheffield Symptom Rating Test. The mean values thus obtained were adjusted using covariance analysis, with age and sex as the covariants. The ‘new’ hypertensives scored significantly lower for total neuroticism, depression and inadequacy than the normotensives. They also differed from the ‘old’ hypertensives, scoring significantly lower for total neuroticism, anxiety, somatization and inadequacy. However, no differences were revealed between the ‘old’ hypertensives and the normotensives. The significance and implications of these psychological differences are discussed.

The Relationship between Neuroticism and Blood Pressure Reexamined

“…Given the small sample sizes (18 and 20) this finding would in fact indicate differences between normotensive and hypertensive populations. No correlation between neuroticism and blood pressure was observed in the study by Santonastoso et al [8], whereas Cuelho et al [9] found that hypertensives exhibited higher neuroticism scores than normotensive pa tients in the same practice. On the other hand, in the Western Electric Study neuroticism showed no association with systolic blood pressure [10].…”

The under-reporting tendency of hypertensives: An analysis of potential psychological and physiological mechanisms

“…Relevant in this context is the view of Lacey and Lacey (1970), who have suggested that cardiovascular pressor responses--which are stronger in hypertensives--may go along with rejection of or non-responsiveness to the external environment. Santonastaso et al (1984) reported that recently diagnosed hypertensives scored significantly lower on neuroticism, depression, and inadequacy than normotensives. They also had lower scores for neuroticism, anxiety, somatization and inadequacy than aware hypertensives.…”

“…A considerable amount of literature has been devoted to this theme, but we would like to call attention to specifically one intriguing and counter-intuitive phenomenon that has been repeatedly found in this research field. When potential confounders, such as awareness of one's blood pressure level, have been taken into account, hypertensives and persons with elevated blood pressure have been found to have diminished self-report rates of negative life events (Linden & Feuerstein, 1983;Svensson & Theorell, 1983;Theorell, Svensson, Knox, Waller, & Alvarez, 1986), occupational stressors (Jenkins, Hurst, & Rose, 1985;Winkleby, Ragland, & Syme, 1988), physical symptoms, such as headaches and dizziness (Davies, 1970;Kidson, 1973;Tibblin & Lindström, 1972), negative psychological characteristics, such as neuroticism, anxiety, and depression (Davies, 1970;Santonastaso, Canton, Ambrosio, & Zamboni, 1984), and painfulness of laboratory aversive stimulation Zamir & Shuber, 1980) in comparison with normotensives. In some studies, continuous inverse associations have been found between blood pressure level and stress(or) report rates, even in normotensive samples (Winkleby et al, 1988;Tibblin & Lindström, 1972;Bruehl, Carlson, & McCubbin, 1992;McCubbin & Bruehl, 1994).…”

“…Selection bias occurs when the hypertensive sample consists of patients treated for the disorder. Hypertensive patients may differ on a number of psychological characteristics from persons which are unaware of their elevated blood pressure, such as neuroticism and anxiety (Irvine et al, 1989;Santonastaso et al, 1984). A relatively elevated level of these characteristics, which may have enhanced the probability of hypertension diagnosis in patient samples, may influence several other variables of interest, in particular those assessed by self-reports (Irvine et al, 1989;Monk, 1980;Soghikian, Fallick-Hunkeler, Ury, & Fisher, 1981).…”

Elevated blood pressure and self-reported symptom complaints, daily hassles, and defensiveness

“…Given the fact that a conceptual confusion exists in the application of the various defensive constructs (Santonastaso et al, 1984;Tomaka, Blascovich, & Kelsey, 1992), defensiveness was measured in two ways. First, a shortened version (15 items) of the Marlowe-Crowne Social Desirability Scale (SDS; Crowne & Marlowe, 1964) was used, based on the results of an item analysis by Hermans (1971).…”