title: Anger, depression and anxiety associated with endothelial function in childhood and adolescence.
abstract: OBJECTIVE
  Psychosocial adversity is a risk factor for cardiovascular disease (CVD) in adults. The authors assessed associations of reactive hyperaemia peripheral arterial tonometry (RH-PAT), a measure of endothelial function predictive of CVD, with self-assessed psychological health among school children.
  
  
  METHODS
  A total of 248 healthy school children (mean (SD) age 14.0 (1.0); 136 girls and 112 boys) underwent RH-PAT testing. They completed the Beck Youth Inventories (BYI) of emotional and social impairment scales, which is used to screen for depression, anxiety, anger and disruptive behaviour.
  
  
  RESULTS
  No sex differences were observed for the RH-PAT score. Statistically significant differences were observed for the BYI scores; girls had higher scores for depression, anger and anxiety. Among the girls, there were statistically significant associations between lower RH-PAT scores and higher scores for anger (B coefficient=-0.100, p=0.040), depression (-0.108, p=0.009) and anxiety (-0.138, p=0.039) after adjustment for age. Among the boys, disruptive behaviour was associated with higher RH-PAT scores (0.09, p=0.006).
  
  
  CONCLUSIONS
  The girls have higher levels of self-assessed anger; depression and anxiety compared with the boys, and these characteristics are associated with lower RH-PAT scores, indicating attenuated endothelial function. Among the boys, disruptive behaviour was associated with better endothelial function. Although psychological ill-health is associated with impaired endothelial function and CVD among adults, such processes may also be relevant to children. Psychosocial adversity in childhood might be a risk factor for subsequent CVD.
authors.affiliation: Department of Metabolism and Cardiovascular Research/Clinical Physiology, Sahlgrenska University Hospital, Göteborg, Sweden. walter.osika@stressforskning.su.se
authors.forename: W
authors.initials: W
authors.lastname: Osika
authors.forename: S M
authors.initials: SM
authors.lastname: Montgomery
authors.forename: F
authors.initials: F
authors.lastname: Dangardt
authors.forename: P
authors.initials: P
authors.lastname: Währborg
authors.forename: L M
authors.initials: LM
authors.lastname: Gan
authors.forename: E
authors.initials: E
authors.lastname: Tideman
authors.forename: P
authors.initials: P
authors.lastname: Friberg
mesh_terms: D000293:Adolescent; D000786:Anger / Q000502:physiology*; D000886:Anthropometry / Q000379:methods; D001007:Anxiety / Q000503:physiopathology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000503:physiopathology; D002648:Child; D003863:Depression / Q000503:physiopathology*; D004522:Educational Status; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008297:Male; D011569:Psychiatric Status Rating Scales; D012737:Sex Factors