Developmental, Gender, and Ethnic Group Differences in Moods and Ambulatory Blood Pressure in Adolescents Janet C. Meininger, M.S.N., Ph.D. School of Nursing and School of Public Health The University of Texas Health Science Center at Houston Patricia Liehr, M.S.N., Ph.D. School of Nursing The University of Texas Health Science Center at Houston Wenyaw Chan, Ph.D. School of Public Health The University of Texas Health Science Center at Houston Glenda Smith, M.S.N., D.S.N. School of Nursing The University of Texas Health Science Center at Houston William H. Mueller, Ph.D. School of Public Health The University of Texas Health Science Center at Houston ABSTRACT Background: Adolescence is characterized by profound changes in physical, psychological, and social functioning thought to be accompanied by intense and varying moods. Pur- pose: Within a psychophysiological framework, this study exam- ined the prevalence of 12 self-reported mood states of adoles- cents; investigated associations between specific mood states and ambulatory blood pressure readings; and explored effects of interactions among moods, gender, ethnic group, and matura- tion on ambulatory blood pressures. Methods: The sample in- cluded 371 African American, European American, and His- panic American adolescents 11 to 16 years old. Systolic (SBP) and diastolic (DBP) blood pressures were measured every 30 min with an ambulatory monitor and were synchronized with electronic activity monitoring and moods self-recorded during waking hours in a checklist diary. Results: Moods differed sig- nificantly by gender, ethnic group, and maturation. Controlling for height, maturation, gender, ethnic group, mother’s educa- tion, position, location, activity, other moods, and interactions of moods with other variables in a multilevel, random coeffi- cients regression model, both positive and negative mood states were associated with higher levels of SBP and DBP; being re- laxed or bored, or having a feeling of accomplishing things were associated with lower SBP and DBP. There were significant in- teraction effects of moods with physical maturity, gender, and ethnic group on ambulatory SBP and DBP. Conclusions: Fur- ther study of the modifying effects of gender, ethnic group, and stage of development on reports of moods, and their associa- tions with cardiovascular responses is recommended. (Ann Behav Med 2004, 28(1):10–19) INTRODUCTION Psychosocial and physiological phenomena interact to in- crease the risk of adverse cardiovascular outcomes; however, the pathways through which they act are not fully understood. A psychophysiological model that links moment-to-moment changes in cardiovascular indicators such as blood pressure and heart rate with long-term cardiovascular outcomes was pro- posed by Sloan et al. (1). In this model, physical factors (aging and neuropathy), psychosocial and emotional factors (depres- sion, anxiety, anger, and work stress), and health behaviors (spe- cifically, physical deconditioning) may operate to decrease au- tonomic control, leading to an increase in blood pressure variability in response to challenge. Chronic increases in blood pressure variability over the long term may increase the risk of cardiovascular diseases through endothelial damage, athero- sclerosis, plaque disruption, and thrombosis. On the basis of this framework, it is purported that cardiac control, which is medi- ated autonomically, serves to buffer blood pressure fluctuations, especially in response to challenge. Those who are less able to buffer blood pressure responses to challenge are presumably at higher risk for adverse cardiovascular outcomes. The design of this study is consistent with this theoretical framework. It examined frequent, intermittent assessments of blood pressures and moods of adolescents under natural condi- tions. This, combined with a means to assess the respondents’ physical activity and psychosocial experiences, enabled an ex- amination of individual and group differences in cardiovascular responses to challenges encountered during daily activities. 10 This study was funded by the National Institute of Nursing Research NR03052. We thank Thong Nguyen for data management and Candace Ayars, Brenda Binder, Lisa Brown, Danielle Ellsworth, Lisa Reyes, Dee Stonebreaker, Shelley Swafford, and Amy Woll for data collection. Reprint Address: J. C. Meininger, M.S.N, Ph.D., The University of Texas Health Science Center–Houston, 1100 Holcombe Boulevard, HMB Suite 5.518, Houston, TX 77030. © 2004 by The Society of Behavioral Medicine. Downloaded from https://academic.oup.com/abm/article/28/1/10/4633671 by guest on 24 January 2023