The relationship of optimism, self-efficacy, self-esteem, sense of coherence, locus of control, hostility, and depression to health status and to acute, stress-induced cardiovascular responses

Within the psychological literature, particularly in the case of research investigations of the psychological correlates of cardiovascular disease, there has been a tendency for researchers to become preoccupied with determining the characteristics of the "disease-prone" personality, while relatively little attention has been given to the equally important possibility that certain psychological characteristics may be "healthy" or "disease-resistant." Cardiovascular reactivity has been proposed as a risk factor for coronary heart disease. Furthermore, it is frequently suggested as a mechanism whereby psychological factors, such as hostility, may lead to pathology. Conversely, based on this "reactivity hypothesis", one would expect psychological correlates of good health to be associated with decreased reactivity. However, reactivity could also be viewed as an indication of engagement or effort, not necessary predictive of illness. To address this issue, the physiological correlates of psychological factors varying in their predictive relationship to health (optimism, self-efficacy, self-esteem, internal locus of control, and sense of coherence) and illness (hostility, depression, and external locus of control) were examined in a sample of 41 undergraduate students. Heart rate, blood pressure, cardiac output, and total peripheral resistance were measured while subjects rested and participated in two stressful laboratory tasks: mental arithmetic and handgrip. The aforementioned psychological variables, as well as subjects' perceived health status were assessed via self-report measures. In general, findings seemed to weigh in favor of the traditional view of reactivity as pathological, the most consistent trend in this regard involving heart rate, with heart rate decreases generally being associated with psychological factors noted for their relationship to good health, and increases being related to "disease-prone" traits and lower self-reported health status. However, considerable evidence inconsistent with the reactivity hypothesis leaves an unclear picture of the relationship between personality, reactivity, and health, and warrants further investigation. Alternative interpretations are offered for inconsistent findings, as well as for the observation that results pertaining to absolute levels of physiological measures were generally more robust than those for task-reactivity change scores.