Cardiovascular Responses and their Psychological Correlates

Abstract

A technique for parallel study of the psychological interaction between subject and experimenter and specified measurements of cardiovascular function during a standardized interview procedure is described. It was demonstrated that the physiological responses in the subject (changes in heart rate, arterial blood pressure, and ballistocardiogram) were related primarily to the interaction of subject and examiner and indeed, that the development of the circulator changes appeared to be dependent upon the establishment of a meaningful relationship with the interviewer. This technique has now been applied to 39 healthy young adults, 31 patients with hypertension, and 28 patients with peptic ulcer. Patients with essential hypertension, despite their capacity for physiological hyperreactivity, were found to be hyporeactive in comparison to the healthy young men, and no more active than the non-depressed ulcer patients in the same age group. These patients with hypertension demonstrated in the interview "insulating" defensive techniques, similar to those seen in healthy subjects who were hypo-reactors. With the development of a close relationship to the examiner (which occurred in a few patients with hypertension) there was seen a display of physiological hyperreaction in the interview situation. Non-depressed patients with peptic ulcer, on the other hand, related more easily and did not demonstrate either physiological hyperreactivity when the relationship was intense, nor a tendency toward psychological "insulation." Patients with peptic ulcer who were depressed withdrew from the relationship and demonstrated a relative lack of physiological responsiveness. It is interesting to speculate that the (inherent?) vascular hyperreactivity of the patients with hypertension is, under these circumstances, held in check through psychological mechanism of setting up an "insulated" object relationship with the examiner.