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Psychosomatic Medicine 65:9-21 (2003)
© 2003 American Psychosomatic Society


REACTIVITY SPECIAL SECTION

Cardiovascular Reactivity to Psychological Challenge: Conceptual and Measurement Considerations

Thomas W. Kamarck, PhD and William R. Lovallo, PhD

From the Department of Psychology, University of Pittsburgh (T.W.K.), Pittsburgh, Pennsylvania; and the Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center (W.R.L.), Oklahoma City, Oklahoma.

Address correspondence to: Thomas W. Kamarck, Department of Psychology, University of Pittsburgh, 4403 Sennott Square, 210 S. Bouquet Street, Pittsburgh, PA 15260. Email: tkam{at}pitt.edu

ABSTRACT

OBJECTIVE AND METHODS: This article is a selective review of recent findings bearing on the conceptualization and measurement of cardiovascular reactivity to psychological challenge, with a focus on several issues relevant to the reliability, content validity, construct validity, and criterion validity of these measures.

RESULTS AND CONCLUSIONS: With respect to reliability, use of standardized task demands and aggregated scores are associated with enhanced short-term reliability, but the long-term reliability of cardiovascular reactivity has not been sufficiently documented. With respect to content validity, existing evidence suggests that "vascular" or "cardiac" tasks may evoke responses that reflect similar distributions of individual difference, whereas associations between responses to "physical" and "psychological" tasks are modest. The evidence is not clear at present with respect to the importance of including affective or interpersonal stimuli as part of trait reactivity assessments. With respect to construct validity, existing data show that cardiovascular reactivity to psychological challenge is largely independent of standard measures of autonomic function. With respect to criterion validity, recent studies point to a number of methodological limitations that may have restricted our ability to detect lab-to-life generalizability of reactivity measures in the past. Continued progress in understanding and measuring reactivity as an individual difference dimension is essential in helping us to evaluate emerging evidence examining the relationship between reactivity and disease risk.

Key Words: cardiovascular reactivity • measurement • biopsychology • cardiovascular disease.

Abbreviations: BP = blood pressure; CNS = central nervous system; CVR = cardiovascular reactivity; DBP = diastolic blood pressure; HR = heart rate; RSA = respiratory sinus arrhythmia; SBP = systolic blood pressure; SNS = sympathetic nervous system.




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