title: Evaluative threat and ambulatory blood pressure: cardiovascular effects of social stress in daily experience.
abstract: OBJECTIVE
  Physiological effects of social evaluation are central in models of psychosocial influences on physical health. Experimental manipulations of evaluative threat evoke substantial cardiovascular and neuroendocrine responses in laboratory studies, but only preliminary evidence is available regarding naturally occurring evaluative threats in daily life. In such nonexperimental ambulatory studies, it is essential to distinguish effects of evaluative threat from related constructs known to alter stress, such as ability perceptions and concerns about appearance.
  
  
  METHODS
  94 married, working couples (mean age 29.2 years) completed a 1-day (8 a.m. to 10 p.m.) ambulatory blood pressure protocol with random interval-contingent measurements using a Suntech monitor and Palm Pilot-based measures of control variables and momentary experiences of social-evaluative threat, concerns about appearance, and perceived ability.
  
  
  RESULTS
  In hierarchical analyses for couples and multiple measurement occasions (Proc Mixed; SAS) and controlling individual differences (BMI, age, income) and potential confounds (e.g., posture, activity), higher reports of social-evaluative threat were associated with higher concurrent systolic (estimate = .87, SE = .34) and diastolic blood pressure (estimate = 1.06; SE = .26), both p < .02. Effects of social-evaluative threat remained significant when perceived ability and appearance concerns were controlled.
  
  
  CONCLUSIONS
  Naturally occurring social-evaluative threat during daily activity is associated with increased systolic and diastolic blood pressure. Given associations between ambulatory blood pressure and risk of cardiovascular disease, the findings support conceptual models of threats to the social self as a potentially important influence on physical health.
authors.affiliation: Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA. tim.smith@psych.utah.edu
authors.forename: Timothy W
authors.initials: TW
authors.lastname: Smith
authors.forename: Wendy
authors.initials: W
authors.lastname: Birmingham
authors.forename: Bert N
authors.initials: BN
authors.lastname: Uchino
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012649:Self Concept; D018454:Spouses / Q000523:psychology* / Q000706:statistics & numerical data; D013315:Stress, Psychological / Q000503:physiopathology*; D014937:Work / Q000523:psychology*; D055815:Young Adult