Richard J. Contrada - US grants

Strategies used to cope with psychological stress appear to play a major role in, determining stress-related outcomes such as physical and subjectiv well-being. Coping may involve approach strategies, in which attention is directed toward the source of stress and its effects on the person, or avoidant strategies, in which attention is directed away from stress. Whereas the approach/avoidance distinction is captured by a number of existing paper-and-pencil instruments, these measures suffer from a variety of conceptual and methodological problems. This project examines a novel approach for assessing approach/avoidant coping as it pertains to the individual's orientation toward negative affect associated with stress. The approach involves quantification of the degree to which the individual's self-report of emotional distress is concordant with physiologic responses to stress. It is hypothesized that effective coping is associated with concordance between these two aspects of the stress response, and that less effective coping is associated with a lack of concordance characterized either by an exaggeration (approach) or minimization (avoidance) of subjective distress relative to physiologic activity. This hypothesis is derived from a control systems framework in which negative affect is seen as feedback that guides the selection of cognitive and instrumental coping responses. This line of reasoning will be evaluated in two studies, each of which will be conducted using independent samples of 60 college students an 60 community residents. The first is a laboratory study in which variation in self-report and physiologic responses to stress will be created through administration of a battery of standard psychological stressors. The second study will be conducted in the naturalistic setting where an ambulatory blood pressure monitor will be used to measure physiologic activity and a diary to acquire self-reports of affect. It is hypothesized that (1) stress-response concordance measures will show modest associations with conceptually similar, traditional coping measures; (2) stress-response concordance measures will contribute to the prediction of physical health after controlling for traditional coping measures; (3) these effects will be stronger for within-subject as compared with between-subject assessments of stress-response concordance. This research should lay the groundwork for subsequent research in which assessments of stress-response concordance may be used to determine the effects of approach and avoidant coping styles on physical and mental health.

Despite a major downturn in the 1960s and 1970s, cardiovascular disease remains the most common source of morbidity and mortality in the United States. As a result, many individuals can expect to develop diseases of the heart and blood vessels and to undergo invasive treatments such as valve surgery (VS) and coronary artery bypass graft surgery (CABG). Notwithstanding the high level of safety and clear benefits experienced on average among patients receiving these treatments, there is substantial variability in both medical and psychosocial outcomes. The ability of biomedical variables to account fully for this variability has stimulated interest in psychological and social factors that may influence the course of recovery from invasive cardiovascular treatments such as VS and CABG. Research in this area has examined the role of person factors, such as personality characteristics and depression, as well as social characteristics, such as extent and quality of patients' social support networks. However, very little attention has been given to the role of religiousness in recovery to cardiac surgery. Religiousness is a major personal and social resource for many people, yet it has only recently become a topic of systematic study as a predictor of health outcomes in individuals faced with major life stressors. In the proposed study, religiousness and spirituality will be examined as predictors of psychological well-being, physical health, and mortality in 80 patients undergoing VS or CABG at UMDNJ-RWJ Medical School. Psychosocial assessments will be conducted prior to surgery on the day of pre-admission testing, and at 1-month and 6-month follow-ups. Hypotheses to be addressed concern the construct validity of measures of religiousness and spirituality, the association between religiousness/spirituality and outcomes of surgery, the effects of surviving surgery on religiousness/spirituality, and the role of psychological and social mechanisms that may explain associations between religiousness/spirituality and surgical recovery.

DESCRIPTION (Adapted from the Applicant's Abstract): This is an application for support for a two-day conference entitled, "Self, Social Identity, and Physical Health: Interdisciplinary Explorations." The purpose of the conference is to examine constructs related to self and identity as a framework for conceptualizing psychosocial aspects of physical health. These concepts have recently come to the forefront of social and behavioral sciences, but their application to problems of physical health and disease has received limited attention. We propose that self/identity constructs can form the basis of a new paradigm for conceptualizing psychosocial aspects of the biopsychosocial paradigm that has gained widespread acceptance in the health sciences over the past few decades. To evaluate this proposition, leading researchers working in the areas of self/identity and/or physical health/disease will examine the following issues: (1)Self, Sickness, and Systems concerns (a) individual-level systems involved in sickness, including the self-regulation model posited by health researchers and various self structures and processes posited by self researchers, and (b) the role of cultural systems in shaping the individual's experiences with illness and its treatment; (2)Self and Identity in Stress, Emotion, and Coping will examine (a) social identity factors (including treatment by others and the individual's own ethnic identity) as a source of stress and ultimately as contributing to disease, and (b) the utility of self and identity constructs in conceptualizing the processes whereby health is affected by the private experience of stress and by the inhibition or social expression of stress emotions; (3) Illness-Promoting Behavior Patterns as a Consequence of Social Identity and Self-Related Personality Structures will examine (a) the effects of social identity on the acquisition of health-damaging behavior patterns, and (b) the utility of self and identity constructs in the conceptualization of personality structures that have been associated with disease-promoting or health-enhancing behavior patterns; (4) Impact of Physical Illness on Identity will consider, from both a psychological and a sociological perspective, the changes in self-related processes, structures, and roles that occur as the individual copes with sickness and interacts with the health-care system. The conference will conclude with a round table discussion of all the talks. An edited volume based on the conference presentations will be published by Oxford University Press.

psychological aspect of aging; postoperative state; religion; heart surgery; psychological adaptation; outcomes research; belief; human old age (65+); human middle age (35-64); aging; health behavior; age difference; behavioral /social science research tag; human subject; clinical research;