Antecedents of the Type A Behavior Pattern

This study has been completed.
Sponsor:
Collaborator:
Information provided by (Responsible Party):
Karen Matthews, University of Pittsburgh
ClinicalTrials.gov Identifier:
NCT00005328
First received: May 25, 2000
Last updated: January 16, 2013
Last verified: January 2013
  Purpose

To identify the early emergence and stability of children's hostile behaviors and their associated psychophysiological responses to behavioral challenges, which are possible risk factors for cardiovascular diseases in adulthood; and to specify their determinants and consequences.


Condition
Cardiovascular Diseases
Heart Diseases

Study Type: Observational
Study Design: Observational Model: Ecologic or Community
Time Perspective: Cross-Sectional

Further study details as provided by University of Pittsburgh:

Primary Outcome Measures:
  • Development of hostility, anxiety, and heightened cardiovascular responsivity to stress affect the early development of vascular stiffness and left ventricular mass. [ Time Frame: 3 years ] [ Designated as safety issue: No ]
    Adolescents' socioeconomic status and ethnicity affect their exposure to psychological stress, including discrimination, which, in turn, is thought to lead to the development of the propensity to be vigilant for possible threat, to view ambiguous situations as potentially harmful, and to mistrust others. These cognitive propensities may become more automatic with development and lead to stable traits of hostility, anxiety, and heightened cardiovascular responsivity to stress. These traits may then affect the early development of vascular stiffness and left ventricular mass.


Enrollment: 184
Study Start Date: April 1980
Study Completion Date: August 2008
Primary Completion Date: August 2008 (Final data collection date for primary outcome measure)
Detailed Description:

DESIGN NARRATIVE:

Beginning in 1980, the longitudinal study examined the Type A behavior pattern, hostility, physiological responses and family interactive behaviors in primarily white, upper-middle class children and parents. The study was renewed several times. In the fiscal year 1992 renewal, the research was extended to include the study of Black children and those from lower-middle to middle class families. The inclusion of these groups is important not only because these they have been understudied, but also because an examination is needed of developmental factors that may be important in accounting for the much higher incidence of hypertension and related disorders in Blacks and in lower and lower-middle class groups. The current study examines the patterns of cardiovascular responses exhibited by Black and white children in order to better assess hemodynamic and autonomic nervous system mechanisms that underlie these responses. It also examines how these hemodynamic patterns relate to cardiovascular risk factors such as body fat distribution, left ventricular geometry (via echocardiography), as well as insulin, glucose, and lipid levels and it explores a new conceptualization of hostility indices and cardiovascular risk factors.

A total of 184 Black and white children and adolescents of both genders are recruited for participation, half being pre-pubescent (9-10 years old) and half being post-pubescent (15-16 years old). The first laboratory session consists of a fasting venous blood draw, collection of anthropomorphic data, a psychophysiological stress protocol involving four tasks selected to elicit different autonomic nervous system responses, and completion of standardized questionnaires to assess hostility and social support. A second session involves an echocardiographic assessment of left ventricular geometry and cardiac performance variables, the Type A Structured Interview, and an interview examining how subjects process information about hostile intentions and actions of others.

The study has been extended through August 2007 to re-assess adolescents enrolled in Project Pressure three years after their initial assessment to address key hypotheses regarding the early emergence of behavioral risk factors for cardiovascular disease (CVD) in adolescence and their antecedents and consequences. In the initial phase of Project Pressure, the investigators collected data from 217 black and white, male and female high school students to test cross-sectionally a model of the development of CVD risk factors. Their model suggests that adolescents' socioeconomic status and ethnicity affect their exposure to psychological stress, including discrimination, which, in turn, is thought to lead to the development of the propensity to be vigilant for possible threat, to view ambiguous situations as potentially harmful, and to mistrust others. These cognitive propensities may become more automatic with development and lead to stable traits of hostility, anxiety, and heightened cardiovascular responsivity to stress. These traits may then affect the early development of vascular stiffness and left ventricular mass. They now propose to test the model longitudinally using the same measures as in the initial assessment, plus adding some new measures that take advantage of recent technological and conceptual advances: (a) endothelial dysfunction and carotid intima medial thickness; (b) coping with discrimination and ethnic identity; and (c) depression. They anticipate that 165 of the previous adolescents will be reassessed, which is adequate in terms of power to test our key hypotheses. The longitudinal design will be a stronger test of the model than the previous cross-sectional study.

  Eligibility

Ages Eligible for Study:   9 Years to 16 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population

Adolescents from one high school in Pittsburgh

Criteria

No eligibility criteria

  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00005328

Sponsors and Collaborators
University of Pittsburgh
Investigators
Principal Investigator: Karen Matthews, PhD University of Pittsburgh
  More Information

Publications:

Responsible Party: Karen Matthews, Distinguished Professor, University of Pittsburgh
ClinicalTrials.gov Identifier: NCT00005328     History of Changes
Other Study ID Numbers: 4124, R01HL025767
Study First Received: May 25, 2000
Last Updated: January 16, 2013
Health Authority: United States: Federal Government

Additional relevant MeSH terms:
Cardiovascular Diseases
Heart Diseases

ClinicalTrials.gov processed this record on October 01, 2014