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ORIGINAL ARTICLES |
From the University of California, Los Angeles, Los Angeles, CA (T.L.G., N.A., J.L.F.); and the University of California, San Francisco, San Francisco, CA (M.E.K.).
Address correspondence and reprint requests to Tara L. Gruenewald, Department of Medicine/Geriatrics, UCLA David Geffen School of Medicine, 10945 LeConte Ave, Suite 2339, Los Angeles, CA, 90095-1687. E-mail: tlgruen{at}ucla.edu or tgruenewald@mednet.ucla.edu
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ABSTRACT |
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 TOP ABSTRACT INTRODUCTIONMETHODSRESULTSDISCUSSIONNOTESACKNOWLEDGMENTSREFERENCES |
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METHODS: Pre- and poststressor emotion, self-esteem, heart rate, blood pressure, and salivary cortisol were compared in 81 participants randomly assigned to complete speech and mental arithmetic stress tasks with social evaluation present (n = 41) or absent (n = 40).
RESULTS: As hypothesized, participants in the social evaluation condition exhibited greater increases in shame and greater decrements in social self-esteem. Other psychological states (eg, anxiety, performance self-esteem) did not show differential changes as a function of the social context. Salivary cortisol increased in social evaluation condition participants but did not increase in participants who performed the same tasks in the absence of social evaluation. Cortisol increases were greater in participants who experienced greater increases in shame and greater decreases in social self-esteem under social-self threat.
CONCLUSION: Threat to the social self is an important elicitor of shame experience, decreases in social self-esteem and cortisol increases under demanding performance conditions. Cortisol changes may be specifically tied to the experience of emotions and cognitions reflecting low self-worth in this context.
Key Words: stress, • cortisol, • shame, • emotion, • self-esteem.
Abbreviations: DBP = diastolic blood pressure;; SBP = systolic blood pressure;; HR = heart rate;; SOC-EVAL = social evaluation condition;; NON-EVAL = non-evaluation condition;; ABS = Affect Balance Scale;; SSGS = State Shame and Guilt Scale
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INTRODUCTION |
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TOPABSTRACTINTRODUCTIONMETHODSRESULTSDISCUSSIONNOTESACKNOWLEDGMENTSREFERENCES |
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Humans are argued to be social animals that possess fundamental motivations to belong and be accepted by others (2–4), and the status of one’s social self is argued to be an important determinant of the distribution of social and physical resources (5,6). Thus, concerns with achieving or maintaining a positive social self may be an important human motive that is supported by specific psychological and physiological systems that provide signaling (ie, "the social self is under threat") and mobilizing (ie, initiation of psychobiological activity to help deal with the threat) functions.
Psychological Responses to Social-Self Threats
Numerous social psychological, evolutionary, and emotion theories converge to suggest that situations which threaten the social self should elicit the experience of a specific class of emotions, those that can broadly be referred to as feelings of low social worth: shame, humiliation, embarrassment, etc (7–11). A number of theorists have asserted that shame is the prototypical emotion experienced in response to devaluations of the social self (6–8,12–14). Phenomenological studies also support this hypothesis, as people have reported that previous experience of shame was characterized by a sense of social isolation, feeling small and inferior, and a pressure to hide from others (15,16). To date, however, there is little experimental research on this topic; most of the previous research employed imagined scenarios thought to elicit shame emotions or recall of past situations in which these emotions were experienced (15–18).
Acute threats to the social self are also likely to affect one’s thoughts and opinions of oneself. This may be especially true for the social component of state self-esteem: thoughts regarding the positive or negative state of the social self (eg, feeling inferior, feeling as if one has made a poor social impression). Leary and associates (19,20) have demonstrated that imagined or actual social rejection in the laboratory leads to lowered overall state self-esteem and more negative ratings on a number of emotions (eg, anxious, upset, happy, calm, ashamed) and self-relevant adjectives (eg, self-confident, superior, effective, smart). However, their postrejection assessments have not clearly distinguished shame from other emotional responses or effects on social vs. nonsocial (eg, performance, appearance) dimensions of self-esteem, which are goals of the present investigation.
Physiological Responses to Social-Self Threats
One physiological system that we believe may be provoked by threats to the social self is the HPA axis, a hormonal system that regulates metabolism and energy production and is thought to be centrally involved in regulating physiological responses to stress (21–24). A large body of human and animal literature indicates increased levels of HPA hormones (eg, corticotrophin releasing hormone, adrenocorticotrophic hormone, and cortisol/corticosterone) under physically and psychologically threatening conditions. Narrative reviews suggest that certain characteristics of situations may be more likely to activate the HPA system, including situations characterized by novelty, uncontrollability, unpredictability, and ego involvement (24–27).
Threat to the social self as an important elicitor of the HPA axis has received less attention in the stress literature, but social challenges, especially those marked by negative evaluations from others and loss of status, have been identified as important elicitors of HPA stress responses (see 27). Acute and chronic social rejection, important forms of social-self threat, have been found to correlate with cortisol levels. Stroud and associates (28) demonstrated that a social rejection experience in the laboratory led to short-term increases in salivary cortisol, especially in females. Similar associations are also found in more naturalistic environments; children socially rejected at school have higher basal cortisol levels than their accepted or even neglected peers (29). Negative, unsupportive social environments are argued to contribute to alterations in HPA functioning (30); however, threat to the social self as an important component of this association has received less attention. Nonhuman animal research also indicates that levels of and changes in HPA hormones are sensitive to social threats, including subordinate social status or the threat of status loss (important nonhuman animal forms of threat to the "social self;" eg, 31–34).
Threat to the social self may also play an important role in short-term cortisol elevations witnessed in response to acute stressor experience in the laboratory. Public speaking tasks and activities that tax cognitive resources, such as the combination of speech and mental arithmetic tasks included in the well-known Trier Social Stress Test (TSST; 35), have been shown to elicit transient elevations in cortisol in the laboratory. However, the specific characteristics of acute stressor paradigms that engage the HPA axis are unclear. In a meta-analytic review of 208 laboratory acute stress studies, Dickerson and Kemeny (36) demonstrated that stressor paradigms characterized by social-evaluative threat, such as stressful situations in which an evaluative audience was present or in which the participant was the target of a negative social comparison, led to greater cortisol reactivity as compared with paradigms in which social-evaluative threat was absent or minimized. This meta-analytic review provides strong support for the hypothesis that factors that threaten the social self within laboratory stressor paradigms may be potent elicitors of HPA responses. To date, however, we know of no acute stress investigation that has compared cortisol reactivity to a stressor task that manipulated the presence or absence of social-evaluative threat. The present investigation provides an opportunity to experimentally validate the conclusions drawn by the meta-analysis and our theoretical premise that the HPA system will be activated by threat to the social self.
The Present Investigation
In the present investigation, we tested the hypothesis that a situation that had the potential to threaten the social self would be more likely to elicit increases in shame, decrements in social self-esteem, and increases in cortisol, than a situation in which threat to the social self was minimized. To do this, we manipulated participants’ performance of "stressful" activities (speech and math tasks) so that half of the individuals performed these activities in the presence of an unfriendly, evaluative audience ("social-evaluative condition," SOC-EVAL), to create a situation in which participants’ social selves might be threatened, whereas the other half performed the demanding tasks in private ("nonevaluative condition," NON-EVAL) so that potential threat to the social self was minimized. Engaging in the tasks in either condition required cognitive resources (participants had to prepare their speech, solve difficult math problems), demanded active performance (oral delivery of speech, solve math problems under time pressure), and was characterized by uncontrollability (math problems became increasingly difficult and impossible to solve),1 characteristics of situations typically thought to be "stressful" (25–28). The manipulated factor that differed between the two stress conditions was the presence or absence of direct social-evaluative threat.
We were interested in whether increases in cortisol would be more likely to occur in the social-evaluative as compared with the nonevaluative stressor; however, we also included measures of heart rate (HR) and blood pressure to assess changes in arousal that we believed would occur in both stress conditions.
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METHODS |
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All participants were screened for and excluded from participation if they possessed health conditions or engaged in behaviors that might affect the biological measures assessed in this study, including a number of health conditions (eg, Cushing’s disease, high blood pressure) and use of prescription (eg, oral contraceptives) and nonprescription (eg, marijuana, regular tobacco use) drugs. Participants were asked not to engage in strenuous exercise, drink alcohol, or smoke on the day of their appointment,2 and to not consume dairy products, caffeine, or eat 1 hour before the session.
Participants were paid $20 or given psychology course experimental credit, whichever they preferred, for their participation in the study.
Measures
Questionnaire Measures
Measures of emotion and self-esteem were administered before and after the stress tasks (see below). For the prestress administration participants were asked to answer each question in response to how they felt during the last few minutes, and for the poststress administration how they felt during last ten minutes, including during the speech and math tasks.
The Affects Balance Scale (ABS; 37), a 40-item measure of positive and negative state emotion experience (1 = never to 5 = always), was used to measure state emotion. Three additional emotion items (humiliated, self-conscious, embarrassed) were added to more carefully assess shame-related emotions. Pre- and poststress mean scores for the anxiety (nervous, timid, tense, anxious, afraid; internal reliability coefficient Cronbach’s 
pre = 0.80, post = 0.80) and shame (ashamed, humiliated, self-conscious, and embarrassed; pre = 0.86, post = 0.86) subscales were examined in analyses. The shame subscale of the State Shame and Guilt Scale (SSGS; 38) was used as a second measure of pre- and poststress shame experience. Participants responded to five statements (eg, "I want to sink into the floor and disappear") on a five-point scale (1 = not feeling this way at all to 5 = feeling this way very strongly; pre = 0.69, post = 0.83).
The social and performance subscales of the State Self-Esteem Scale (39) were also administered before and after the performance tasks. Respondents rated their agreement with 14 statements on a five-point scale (1 = not at all to 5 = extremely; performance pre = 0.85, post = 0.88; social pre = 0.86, post = 0.91).
A task rating questionnaire consisting of three questions assessing feelings of difficulty, threat, and challenge felt during the activities (seven-point scale, 1 = extremely poor/not at all true to 7 = extremely well/very true) was administered after the performance tasks. Participants in the social stress condition were also asked to rate how much they liked the panel of evaluators, how much they thought the panelists liked and accepted them, how effective they believed they were in convincing panelists that they should get the job during the speech portion of the activity, and how well they thought the panelists would rate their performance overall (see below for protocol description), using a 7-point scale (1 = not at all/very poor to 7 = very much/very excellent).
Physiological Measures
Measures of HR, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were assessed with a Critikon automatic sphygmomanometer (Dinamap Model 8146, Critikon Corporation, Tampa, FL). Measurements were taken oscillometrically by placing an occluding cuff over the brachial artery of the participant’s nondominant arm. Readings were taken every 2 minutes during specific phases of the experimental session (see below) and averaged to produce a single value for each phase.
Salivary cortisol was assessed at four points throughout the experimental session (see below) with the Salivette device (Sartstedt, Rommelsdorf, Germany). This device is essentially a cotton roll which participants were asked to place under their tongue for 3 minutes. The saturated roll was placed into a sealed, plastic container, refrigerated for no longer than 16 hours, and then centrifuged to extract saliva. Samples were frozen at –80°C until assayed. Cortisol was measured using a high sensitivity salivary cortisol immunoassay kit (Salimetrics, State College, PA; sensitivity <0.007 µg/dl). Values are reported in µg/dl.
Design and Procedure
Participants reported individually for a 90-minute laboratory session scheduled between the hours of 2:30 and 7:00 PM to control for diurnal variations in cortisol. A timeline of major study activities is provided in Figure 1. During the first 20 minutes, participants provided informed consent, completed prestress questionnaires, and rested quietly. Baseline HR and BP readings were taken during the last 10 minutes of the rest period, and the first saliva sample was taken immediately after ("baseline" measures).
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In the SOC-EVAL condition of the study, participants were informed that they would perform the activities in front of a panel of evaluators who would judge their performance, while participants in the nonevaluative (NON-EVAL) condition were informed that they would perform these activities while alone in the room.
HR and BP readings were taken while the participants listened to task instructions ("task instruction" measure). The participants then had 10 minutes to mentally prepare their speech. A second saliva sample was taken at the end of this preparation period ("stress anticipation" measure).
The participant was then taken to a second area of the room and asked to stand in front of a microphone. In the SOC-EVAL condition, the panel of evaluators was already seated behind a table facing the microphone. The panel of evaluators consisted of two individuals of approximately the same age as the participant who were trained to respond in a nonaccepting and critical manner (eg, nonsmiling, stony faces, writing comments on their clipboard). The participant was told that the panelists were present to judge his/her performance and ability to communicate ideas successfully in a social situation. The experimenter introduced the participant to the panelists, turned on an audiotape recorder,3 demonstrated how the experimenter would monitor sound from the other room to ensure they spoke for the entire 5 minutes,4 and then asked the participant to wait until she left the room to begin his/her speech. The experimenter was not present during the speech so that she would not act as an additional source of social evaluation. When an alarm signaled the end of the speech segment, the experimenter reentered the room and moved the participant to the computer terminal in order to begin the math task. Once the experimenter left the room, the participant then completed the math activity on the computer within the view of the panel. HR and BP were monitored during the speech and math tasks.
In the NON-EVAL stressor condition, the participant was asked to perform these same tasks while alone in the room. The participant was asked to give his or her speech facing the table that the evaluators sat at in the SOC-EVAL condition and to complete the same computerized math task; however, no evaluators were present. As in the SOC-EVAL condition, the speech was audiotaped and sound was monitored.
After the stressor tasks, participants in both conditions were taken to another area of the room where they were asked to sit and complete poststress questionnaire measures. Five minutes after the cessation of the stressor, participants were asked to provide another saliva sample ("poststress" measure). After the saliva sample, participants were asked to rest quietly for 5 minutes. HR and BP were monitored during this resting period, and the last saliva sample was taken at the end of the rest period ("resting recovery" measures). Finally, participants were fully debriefed and paid or awarded experiment credit.
Statistical Analysis
Possible baseline differences between SOC-EVAL and NON-EVAL condition participants on all dependent variables were examined with t tests to ensure success of random assignment. Possible gender differences in levels and stress reactivity of cardiovascular and salivary measures, and possible time of day of laboratory appointment effects for salivary cortisol were assessed with repeated-measures ANOVAs.
Repeated-measures ANOVAs with stress condition (SOC-EVAL vs. NON-EVAL) as a between-subjects factor and time of measurement of psychological and physiological measures as within-subjects variables were performed to assess hypotheses of differential psychobiological stress responses in SOC-EVAL and NON-EVAL stress condition participants. Within-subjects psychological variables were pre- and poststress levels of (a) anxiety (ABS) and shame (ABS and SSGS) emotions and (b) performance and social self-esteem. Physiological within-subjects variables were (a) average HR, SBP, and DBP for the resting baseline, stress task instruction, task preparation, speech, mental arithmetic, and resting recovery periods; and (b) salivary cortisol levels for the resting baseline, stress anticipation, poststress and resting recovery time points. Greenhouse-Geisser adjusted degrees of freedom were used when appropriate.
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RESULTS |
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There was a significant main effect of gender for SBP and significant gender by time interactions for SBP and DBP in repeated-measures ANOVAs, with males having higher BP levels. However, gender did not interact with stress condition to affect BP levels. There were no baseline or reactivity gender differences for HR, cortisol, or any of the psychological variables. Time of day analyses indicated that there was a marginally significant trend for lower baseline cortisol levels during the last timeslot of the day (5:30–7:00 PM), as compared with the preceding timeslots (2:30–4:00 and 4:00–5:30). However, time of day did not predict differential patterns of cortisol responses across the session or interact with experimental condition in analyses.
Manipulation Checks
There was not a significant difference in ratings of task difficulty for participants in the social and nonsocial stress conditions (SOC-EVAL M = 5.05, SEM = 0.21; NON-EVAL M = 4.80, SEM = 0.22, t(79) = 0.82, p = .42). SOC-EVAL condition participants rated the tasks as more threatening (SOC-EVAL M = 2.80, SEM = 0.28, NON-EVAL M = 2.03, SEM = 0.21, t(79) = 2.21, p = .03), and marginally more challenging (SOC-EVAL M = 5.66, SEM = 0.18; NON-EVAL M = 5.20, SEM = 0.18, t(79) = 1.80, p = .08). Mean scores for all five ratings of the panel of evaluators for participants in the social condition were significantly lower than the scale midpoint of 4 (all p’s < .05), indicating that participants in the social condition did not like the panelists or feel that the panelists would judge them or their performance favorably.
Psychological Responses
Between- and within-subjects results from repeated-measures ANCOVAs for emotion and self-esteem variables are presented in Table 1, and pre- and poststress means for each variable in each condition are depicted in Figure 2. There was a significant effect of time for each variable (SSGS shame effect marginally significant), such that negative emotion poststress scores were higher and poststress self-esteem scores were lower than prestress scores. As hypothesized, only the shame emotion subscales and the social self-esteem measure showed significant stress condition by time effects (SSGS shame effect marginally significant).6 Poststress shame scores were higher (ABS shame Mdifference = 0.59, p = .01; SSGS shame Mdifference = 0.28, p = .12), and social self-esteem scores lower (mean difference = –0.56, p = .01), for SOC-EVAL stress condition participants as compared with NON-EVAL stress condition participants.
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DISCUSSION |
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Implications for Stress Research
The pattern of responses in the emotion, self-esteem and task rating measures indicates that both stressor condition groups found the tasks to be "stressful" in accordance with standards typically used in acute stress research (eg, perceived task difficulty, increased anxiety). However, performance of these demanding tasks in the presence of an evaluative social audience led to greater responses in the specific set of psychological states that we believe are indicative of a threat to the social self: increases in shame emotions and decreases in the social component of self-esteem. Greater cortisol increases were observed in participants who experienced greater increases in shame and greater decreases in social self-esteem, but cortisol increases did not significantly differ as a function of the magnitude of increases in anxiety or decreases in performance self-esteem. The lack of an association between increases in cortisol and anxiety conflicts with other investigations that have found associations between stress-induced increases in these parameters (41,42); however, these associations are not always found in acute stress research (43,44), nor are such associations always examined. The finding of greater concordance between large stress-induced increases in cortisol and shame complements findings of a previous investigation which documented greater cortisol increases in response to task failure in children who experienced more postfailure shame, embarrassment, and negative self-evaluation (45). Thus, threats to the social self and the emotions and cognitions that derive from such threats may be important elicitors of this critical physiological system. More research will be needed to thoroughly elucidate whether other cognitive and emotional processes not examined in the present investigation may underlie greater cortisol increases witnessed under social-evaluative threat, including psychological factors thought to be linked to HPA activity, such as perceived control, novelty, unpredictability, and ego involvement, and to more clearly delineate links between cortisol reactivity and changes in shame and social self-esteem.
In this investigation, we employed a version of the TSST developed by Kirschbaum and his colleagues (35,40), a paradigm that has been employed in many acute stress investigations and is known to reliably elicit cortisol increases. Our results indicate that threat to the social self inherent in this paradigm may be an important "active ingredient" in the elicitation of a cortisol increase. This investigation also experimentally confirms the results of Dickerson and Kemeny’s meta-analysis (36), which demonstrated that social-evaluative threat within stressor paradigms was associated with cortisol reactivity. A long history of theoretical and empirical research has documented the types of threats likely to activate the HPA axis, such as threats to physical integrity, fear-provoking events, and events characterized by unpredictability, novelty, and loss of control (24–27). Our goal in formulating the Social Self Preservation Theory is to encourage attention to threat to the social self as an additional important elicitor of this system, as maintaining the integrity of the social self may also be important for survival and well-being. Chronic exposure to social self threats, such as that which occurs in those with a stigmatizing condition or those consistently subjected to or particularly sensitive to rejection, might provide a consistent trigger to this system, resulting in increased risk for diseases linked to this system (see 22,46).
Implications for Emotion Research
Negative emotional and cognitive responses are hypothesized to be important pathways between stressor experience and adverse physiological and health states. However, the majority of research in this area has focused on the physiological correlates and health consequences of negative mood (a composite of a number of negative moods) or depressed mood. Less attention has been given to specific emotions in this research (with the exception of anger and cardiovascular activity). The present findings support the utility of examining specific emotional and cognitive responses to different characteristics of stressful situations; such efforts may help to clarify our understanding of associations between stressor experience and health outcomes (47).
Many theories of the etiology of shame emotions and social self-esteem hypothesize that these states are particularly likely to occur in social situations in which the self is devalued (6,8,14); however, little empirical work in which aspects of the social environment are manipulated to test this hypothesis exists. The present investigation provides experimental support for the differential experience of shame and social self-esteem as a function of the social context of stressful situations. Future research further delineating changes in specific feelings of low social worth (eg, shame, embarrassment, humiliation) and other categories of negative emotion, as well as concomitant changes in different physiological parameters, to different types of social and nonsocial stressors is needed.
Limitations and Future Directions
We included HR and blood pressure measures to assess increases in general levels of arousal that we thought would result from performance of tasks equally in both stress conditions. The finding of marginally higher HR and SBP responses in evaluative condition participants during the speech portion of the stress activities does indicate that these parameters are sensitive to social-evaluative characteristics of stressor performance, a finding consistent with an investigation that found greater SBP increases to a public speaking stressor in a condition in which social evaluation was emphasized compared with one in which it was not (48). Perhaps if we had employed additional and more comprehensive measures of cardiovascular activity, such as impedance cardiography and electrocardiographic techniques, we might have been better able to detect differences in autonomic response between our two stress conditions. Research with such techniques has indicated differential effects of social evaluation during performance of learned and unlearned tasks on cardiac and vascular components of autonomic reactivity (49) and differential effects of the introduction of evaluative observation on cardiac and vascular response adaptation to repeated performance stressor exposure (50). Thus, future investigations that include such techniques will be useful in clarifying our understanding of the activity of these systems under conditions of threat to the social self. Future research will also be needed to clarify the factors that account for the larger cardiovascular responses witnessed during the speech as compared with the math task in both conditions, which is an outcome that has been demonstrated in a previous investigation (41). Probable candidates include differences in physical activity (eg, participants stood during speech task and sat during math task) and psychosocial factors (eg, perhaps speech task more ego involving). The more pronounced differences in HR and SBP at the speech time point between the two stress conditions also suggests that speaking tasks may elicit greater concerns regarding others’ evaluations of the social self.
We chose to test our theory in this first investigation by manipulating the presence or absence of social-evaluative threat within a commonly used performance stress paradigm, so that our findings could be compared with previous acute stress investigations and so that the role of the social context of stressor experience in the elicitation of specific emotional, cognitive, and physiological responses would be highlighted. It could be argued, however, that manipulating the presence or absence of social-evaluative threat while holding all other activities constant may have produced two experimental conditions that varied in intensity (ie, the social-evaluative condition simply "adds" social-evaluation to a performance stressor, yielding "more stress") rather than in nature (ie, the presence or absence of social-evaluative threat). Although we cannot rule out this alternative explanation for our results, we do feel it is important to highlight that only certain psychological and physiological responses varied significantly across the two stress conditions. If our social-evaluative condition was simply more intense, it might be expected that most of the psychological and physiological stress response measures (eg, anxiety, performance self-esteem) would have shown greater changes in this condition. It will be important to address this issue of difference in intensity versus difference in the nature of a stressor in future research.
Although we believe that performance of speech and math tasks under social-evaluative threat is a provocative situation, capable of eliciting concerns about the status of one’s social self, it will be important to examine psychological and physiological responses to other forms of threat to the social self, including those outside the laboratory and those that may be common outside the college environment. Given the potential ubiquity of acute and chronic social self threats in our environment, a greater understanding of the psychobiological consequences of such threats is an important aim of future research.
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ACKNOWLEDGMENTS |
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We thank Sally Dickerson, Shelley Taylor, Teresa Seeman, and Neil Malamuth for their helpful comments on the rationale and design of this research. We are indebted to Julie Bower, Roberta Mancuso, and Shelley Taylor’s 421 Research Group for their comments and suggestions on previous versions of this manuscript. We thank Dennis Montoya for his assistance with the assays for salivary cortisol.
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NOTES |
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2Although habitual smokers were excluded from participation, participants were directed not to smoke on the day of their appointment in the event that an occasional smoker might smoke on the day of the appointment. All participants indicated that they did not smoke on the day of their appointment.
3In both conditions, participants’ speeches were audiotaped. NON-EVAL condition participants were told that this audiorecording would only be used to ensure that the speeches given were on the correct topic but would not be evaluated in any way. SOC-EVAL participants were told it would serve as an additional source for evaluation. Audiorecording was used in order to encourage and confirm that participants spoke on the assigned topic.
4In both conditions, sound vocalizations (but not actual spoken content) were monitored to ensure that the participants spoke for the entire speech period. The participant was warned that if he ceased speaking for a period of more than 30 seconds, the experimenter would send a sound alert (via a two-way radio) from the next room to signal the participant that he needed to continue speaking. Sound monitoring was instituted to ensure that all participants spoke for the full period in both stress conditions, so that there would not be an imbalance of activity between participants or stress conditions. In actuality, the alerting procedure was used for only 2 of the 81 participants, one from each experimental condition (one subject alerted two times, one subject alerted three times). The remainder of the 81 participants never ceased speaking for longer than a 30-second period.
5Analyses for psychological and physiological variables not including baseline anxiety as a covariate produced a similar pattern of results to those reported here.
6Results for other subscales of the Affect Balance Scale are not discussed here. However, there were significant effects of time for depressed emotion, affection, and contentment (poststress negative emotion higher and positive emotions lower), but not for anger, joy, or vigor. There were no significant stress condition by time interactions for any of these other emotion subscales.
Tara L. Gruenewald is currently in the Department of Medicine/Geriatrics, Najib Aziz is in the Department of Pathology and Laboratory Medicine, and John L. Fahey is in the Department of Microbiology and Immunology, at the UCLA David Geffen School of Medicine, University of California, Los Angeles. Margaret E. Kemeny is in the Health Psychology Program at the University of California, San Francisco.
Received for publication December 23, 2003.
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