Anna C. Whittaker (previously Phillips) | The University of Birmingham (original) (raw)

Papers by Anna C. Whittaker (previously Phillips)

Objective: Psychological factors such as the stress of caregiving are emerging as predictors of t... more Objective: Psychological factors such as the stress of caregiving are emerging as predictors of telomere length, an index of biological ageing. However, although lifetime major depressive disorder is associated with shorter telomeres, less is known about depression symptoms.

Objective: This study addressed the issue of whether frequent exposure to life events is associat... more Objective: This study addressed the issue of whether frequent exposure to life events is associated with aggravation or blunting of cardiovascular reactions to acute mental stress. Methods: In a substantial cohort of 585 healthy young adults, systolic and diastolic blood pressure and pulse rate were recorded at rest and in response to a mental arithmetic stress task. Participants indicated, from a list of 50 events, those they had experienced in the last year. Results: There was an overall association between life events and blunted cardiovascular reactivity that was driven by variations in the frequency of exposure to desirable events. The total number of events and the number of personal events were negatively associated with systolic blood pressure and pulse rate reactions to acute stress, whereas the number of work-related events was negatively associated with diastolic blood pressure and pulse rate reactivity. The negative association between total events and systolic blood pressure reactivity was stronger for women than men, whereas men exposed to frequent undesirable events showed enhanced diastolic blood pressure reactivity. The blunting of pulse rate reactivity associated with frequent personal life events was evident particularly for those who had a relatively large number of close friends. Conclusion: The nature and extent of the association between life events exposure and stress reactivity in young adults depends on the valence of the events together with the sex of the individual and their social network size.

The presence of supportive others has been associated with attenuated cardiovascular reactivity i... more The presence of supportive others has been associated with attenuated cardiovascular reactivity in the laboratory. The effects of the presence of a spouse and others in a more naturalistic setting have received little attention. Blood pressure and heart rate reactions to mental stress were recorded at home in 1028 married/partnered individuals. For 112 participants, their spouse/partner was present; for 78, at least one other person was present. Women tested with a spouse/partner present showed lower magnitude systolic blood pressure and heart rate reactivity than those tested without. Individuals tested with at least one nonspousal other present also displayed attenuated reactivity. This extends the results of laboratory studies and indicates that the spontaneous presence of others is associated with a reduction in cardiovascular reactivity in an everyday environment; spouse/partner presence would appear to be especially effective for women.

The relationship between cardiovascular reactions to acute mental challenge in the laboratory and... more The relationship between cardiovascular reactions to acute mental challenge in the laboratory and cognitive ability has received scant attention. The present study examined the association between reactivity and future cognitive ability. Heart rate and blood pressure reactions to a mental stress task were measured in 1647 participants comprising three distinct age cohorts. Cognitive ability was assessed using the Alice Heim-4 test of general intelligence and choice reaction time 5 and 12 years later. High heart rate reactivity was related to higher general intelligence scores and faster choice reaction times at both follow-ups. High heart rate reactivity was also associated with a smaller decline in cognitive ability between assessments. These associations were still evident following adjustment for a wide range of potentially confounding variables. The present results are consistent with the notion that high reactivity may not always be a maladaptive response and that low or blunted reactivity may also have negative corollaries.

Exaggerated haemodynamic reactions to acute psychological stress have been implicated in a number... more Exaggerated haemodynamic reactions to acute psychological stress have been implicated in a number of adverse health outcomes. This study examined, in a large community sample, the cross-sectional associations between haemodynamic reactivity and self-reported smoking status.

Immunoglobulins are essential for combating infectious disease although very high levels can indi... more Immunoglobulins are essential for combating infectious disease although very high levels can indicate underlying pathology. The present study examined associations between secretory immunoglobulin A (sIgA) in saliva and mortality rates in the general population. Participants were 639 adults from the eldest cohort of the West of Scotland Twenty-07 Study aged 63 years at the time of saliva sampling in 1995. From unstimulated 2-minute saliva samples, saliva volume and S-IgA concentration were measured, and S-IgA secretion rate determined as their product. Mortality data were tracked for 19 years. Cox proportional hazard models were applied to compute hazard ratios (HR) for all-cause mortality from sIgA secretion rate. Associations were adjusted for gender, assay batch, household occupational group, smoking, medication usage, and self-reported health. There was a negative association between log sIgA secretion rate and all-cause mortality, HR = 0.81, 95% CI = 0.73-0.91, p < .001. Further analysis of specific causes of mortality revealed that the all-cause association was due to an underlying association with cancer mortality and in particular with cancers other than lung cancer. The HR for non-lung cancer was 0.68 (95%CI = 0.54 to 0.85) implying a 32% reduction in mortality risk per standard deviation rise in log sIgA secretion rate. Effects were stronger for men than women. For deaths from respiratory diseases, sIgA secretion had a non-linear relationship with mortality risk whereby only the very lowest levels of secretion were associated with elevated risk. SIgA concentration revealed a similar but weaker pattern of association. In the present study, higher secretion rates of sIgA were associated with a decreased risk of death from cancer, specifically non-lung cancer, as well as from respiratory disease. Thus, it appears that sIgA plays a protective role among older adults, and could serve as a marker of mortality risk, specifically cancer mortality.

Exaggerated cardiovascular reactions to acute psychological stress have been implicated in a numb... more Exaggerated cardiovascular reactions to acute psychological stress have been implicated in a number of adverse health outcomes. This study examined, in a large community sample, the crosssectional and prospective associations between reactivity and self-reported health. Blood pressure and heart rate were measured at rest and in response to an arithmetic stress task. Self-reported health was assessed concurrently and five years later. In cross-sectional analyses, those with excellent/good self-reported health exhibited larger cardiovascular reactions than those with fair/poor subjective health. In prospective analyses, participants who had larger cardiovascular reactions to stress were more likely to report excellent/good health five years later, taking into account their reported health status at the earlier assessment. The findings suggest that greater cardiovascular reactivity may not always be associated with negative health outcomes.

Recent versions of the reactivity hypothesis, which consider it to be the product of stress expos... more Recent versions of the reactivity hypothesis, which consider it to be the product of stress exposure and exaggerated hemodynamic reactions to stress that confers cardiovascular disease risk, assume that reactivity is independent of the experience of stressful life events. This assumption was tested in two substantial cohorts, one middle-aged and one elderly. Participants had to indicate from a list of major stressful life events up to six they had experienced in the previous 2 years. They were also asked to rate how disruptive and stressful they were, at the time of occurrence and now. Blood pressure and pulse rate were measured at rest and in response to acute mental stress. Those who rated the events as highly disruptive at the time of exposure and now exhibited blunted systolic blood pressure reactions to acute stress. The present results suggest that acute stress reactivity may not be independent of stressful life events experience.

Exaggerated cardiovascular reactions to acute psychological stress may be involved in the etiolog... more Exaggerated cardiovascular reactions to acute psychological stress may be involved in the etiology of cardiovascular pathology. The present analysis examined the association between the magnitude of systolic and diastolic blood pressure reactions to stress and cardiovascular disease mortality. Participants were 431 (229 women) from the West of Scotland Twenty-07 Study, aged 63 years at the time of stress testing, where blood pressure was measured during resting baseline and mental arithmetic stress. Participants' vital status was tracked for the next 16 years, during which time 38 had died of cardiovascular disease. Both systolic and diastolic blood pressure reactions were positively associated with cardio-vascular disease mortality. This association could reflect the long-term erosive effects of exaggerated reactivity on the vasculature as well as its short-term capacity to trigger acute cardiovascular events.

Carroll, D., Phillips, A.C., & Der, G. (2008). Body mass index, obesity, abdominal adiposity and cardiovascular reactions to psychological stress in a large community sample. Psychosomatic Medicine, 70, 653-660. http://dx.doi.org/10.1097/PSY.0b013e31817b9382

Whether chronic stress experience is related to down-regulation of secretory immunoglobulin A (S-... more Whether chronic stress experience is related to down-regulation of secretory immunoglobulin A (S-IgA) was tested in two substantial cohorts, one middle-aged (N = 640) and one elderly (N = 582), comprising similar numbers of men (N = 556) and women (N = 666) and manual (N = 606) and non-manual (N = 602) workers. Participants indicated from a list of major stressful life events up to six they had experienced in the previous two years.

Objective: The reactivity hypothesis was tested using data from a 12 year follow-up of blood pres... more Objective: The reactivity hypothesis was tested using data from a 12 year follow-up of blood pressure. It was examined whether blood pressure reactions to acute mental stress predicted future blood pressure resting levels, as well as the temporal drift in resting blood pressure, and whether the prediction was affected by sex, age, and socioeconomic status. Methods: Resting blood pressure was recorded at an initial baseline and in response to a mental stress task. Twelve years later resting blood pressure was again assessed. Data were available for 1196 participants, comprising, at the time of stress testing, 437 24-year olds, 503 44-year olds, and 254 63-year olds, 645 women and 551 men, and 531 were from manual socioeconomic households and 661 non-manual socioeconomic households. Results: In multivariate linear regression models, adjusting for a number of potential confounders, systolic blood pressure reactivity positively predicted future resting systolic blood pressure, as well as the upward drift in systolic blood pressure over the 12 years, β = .10, p < .001 in both cases. The effect sizes were smaller than those reported from an earlier 5-year follow-up. The analogous associations for diastolic blood pressure reactivity were not statistically significant. In multivariate logistic regression, high systolic blood pressure reactivity was associated with an increased risk of being hypertensive 12 years later, OR = 1.03, 95%CI 1.01 -1.04, p < .

Depression and exaggerated cardiovascular reactivity are considered risk factors for cardiovascul... more Depression and exaggerated cardiovascular reactivity are considered risk factors for cardiovascular disease, possibly as a result of common antecedents, such as altered autonomic nervous system function. We examined the association between depressive symptomatology and cardiovascular reactions to psychological stress in 1608 adults (875 women) comprising 3 distinct age cohorts: 24-, 44-, and 63-year olds. Depression was assessed using the Hospital Anxiety and Depression Scale. Blood pressure and heart rate were measured at baseline and during the paced auditory serial arithmetic test. Depression scores were negatively associated with systolic blood pressure and heart rate reactions, after adjustment for likely confounders such as sex, cohort, occupational status, body mass index, stress task performance score, baseline cardiovascular activity, antidepressant, and antihypertensive medication. The direction of association was opposite to that which would be expected if excessive reactivity were to mediate the association between depression and cardiovascular disease outcomes or if they shared common antecedents. #

The foetal origins of disease hypothesis contends that an unfavourable intra-uterine environment,... more The foetal origins of disease hypothesis contends that an unfavourable intra-uterine environment, as evidenced by low birth-weight, increases vulnerability to chronic illness in adulthood . There is now reasonably consistent evidence of a negative association between birth-weight and adult blood pressure . However, the mechanisms underlying this relationship remain unclear. It has been suggested that individual differences in susceptibility to stress may play a role . One way of assessing this susceptibility is by measuring blood pressure reactions to an acute psychological stress task. There is evidence that large magnitude blood pressure reactions to such exposures predict elevated resting blood pressure at subsequent follow up . The present analyses revisited the issue of birth-weight and adult blood pressure and examined whether any association was mediated by individual differences in blood pressure reactions to acute stress.