Blood Pressure, Blood Volume and Behavior

1
Blood Pressure, Blood Volume and Behavior

• By Mike, Drew Greg

2
Blood Pressure

• BP is one of the most frequently measured
  physiological variables
• Its measurement in the doctors office and
  exceed its use as a variable in psychological
  research
• due to the overall indication of general
  function and health

3
Blood Volume

• BV refers to the amount of blood in a certain
  portion of body tissue at a given time
• BV is effected by local metabolic requirements
  and the behavior in which the person is doing
• Shepard (1906) discovered that the expectation of
  a stimulus led to decrease in hand BV and
  increase in brain BV

4
Anatomy Physiological of the Blood Vessels

• Blood Vessels are divided into several categories
  on the basis of their size, function, and
  microscopic characteristics
• Categories include large elastic arteries,
  medium-sized arteries, small arteries,
  capillaries, veins venules
• Blood Vessels are composed of 3 layers
• 1.) inner tunica intima
• 2.) a middle tunica media
• 3.) an outer tunica

5
Arteries

• Arteries are tubes with thick walls, branching
  from the aorta to carry blood to all parts of the
  body
• Arteries are made up of smooth muscles fibers and
  elastic membrane tissues
• Because of elasticity they can stretch under
  pressure and then return to normal when you
  relax
• Arterioles are the smallest arteries in the body
  which enable blood to enter capillary beds

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Arteries (cont)

• The capillaries are tiny vessels that allow the
  actual exchange of carbon dioxide and oxygen
  throughout the body
• Blood leaves the capillary beds by small venules,
  which form into veins which then carry blood back
  to the heart
• Veins are not as muscular as arteries, their
  walls are thin and have valves that prevent the
  backflow of blood

7
Regulation of Blood Pressure

• Jacob Francone (1970) listed 5 factors that
  function to maintain arterial blood pressure
• 1.) Cardiac factor refers to the volume of blood
  expelled each time the left ventricle contracts
• 2.) Peripheral resistance this is produced
  primarily by the arterioles, which vary their
  diameter over wide range
• 3.) blood volume refers to the relatively
  constant volume of blood cells and plasma with
  the whole circulatory system
• 4.) Viscosity increased viscosity of blood
  causes a greater resistance to flow and therefore
  a higher arterial pressure
• 5.) Elasticity of arterial walls elasticity of
  the larger arteries decreases and the systolic
  pressure rises

8
Baroreceptors

• Baroreceptors in the caratid sinuses and in the
  aorta transmit signals to the vasomotor system of
  the brain stem according to arterial pressure
• They are spray-type nerve endings, lying in the
  walls of the arteries which are stimulated when
  stretched
• Heart rate BP are inversely related through the
  baroreceptors reflex
• A drop in arterial pressure quickly leads to an
  increase in HR
• However, under certain condtions such as exercise
  or umpleasnt stimuli HR BP may increase together

9
Measurement of Blood Pressure

• The methods are known as indirect techniques
• True measurement of blood pressure can only be
  achieved by penetrating an artery to insert a
  sensing device
• Obviously can not accomplish in lab setting due
  to ethical problems

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Measurement (cont)

• Most familiar method involves the use of a
  sphygmomanometer. Uses a pressure cuff, rubber
  bulb, and mercury manomotor, and a stethoscope
• Cuff is wrapped around upper arm inflated to a
  level well above the expected systolic pressure
• This is called auscultary method

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Measurement (cont)

• Pulse pressure- determined by the difference
  between systolic and diastolic
• Mean arterial pressure (MAP) refers to the
  average pressure during the cardiac cycle is
  established as MAP 1/3 (SBP-DBP) DBP
• Some commercial BP measuring equipment provides
  digital readouts of MAP, systolic and diastolic
  pressure
• Gunn, Wolf, Black, Person (1972) described a
  portable device for the automatic measurement of
  blood pressure

12
Measurement of Blood Volume

• 3 basic types of devices for recording BV changes
• Hydraulic or pneumatic system- fluids or air
  detect a volume change in an observed part and
  transmit to a recording device
• Electrical impedances- reflects changes in
  impedance by tissue to the passage of
  high-frequency alternating current, as a function
  of change
• Photoelectric transducers- measure changes in the
  intensity of a light passing through a tissue
  segment, such as a finger tip or earlobe

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Emotional Reactions, Stress and BP

• By Drew

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Outline

• Emotional Reactions, Stress and BP
• Frustration and Aggression
• Emotional Imagery
• Naturalistic Stress
• Job Strain
• Active and Passive Coping
• Social-Environmental Factors and BP
• Social Communication
• Effects of Sociotropy
• Crowding
• Pets
• Social Support
• Competition, Auditory Stimulation and Aerobic
  Fitness
• Personality Factors Affecting BP

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Frustration and Aggression

• Generally, BP increases with both frustration and
  anger (Gentry, 1970)
• Participants 30 males and 30 females
• Conditions Frustration (interrupted and not
  allowed to complete intelligence task), attack
  (personal insults by the experimenter) or the
  control conditions
• Most males had a higher increase in systolic than
  females
• No differences in Diastolic

16
Frustration and Aggression

• Electric Shocks
• Geen and Stonner (1974) Higher BP for those who
  were shocked and told they were watching an
  aggressive movie vs. those not shocked and told
  they were watching an altruistic movie
• Conclusion The shock lowered inhibitions and
  raised arousal levels which led to higher BP for
  those who were shocked
• Geen (1975) Follow-up Study Subjects either
  shocked and shown real violence or not shocked
  and shown fictional violence
• Conclusion In conjunction with the prior study
  violence facilitates the expression of aggression
  by raising emotional arousal
• The highest BPs in the study were for people who
  were shocked and shown the real violence

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Emotional Imagery

• Schwartz, Weinberger and Singer (1981)
• Participants College Students
• Design Participants were asked to produce
  mental imagery for happiness, sadness, anger,
  fear, relaxation and a control state. They did
  those both while seated and then while
  exercising.
• Results Anger produced the greatest change in
  BP, and occurred while seated and exercising
• Roberts and Weerts (1982) also found anger raises
  BP more than fear

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Naturalistic Stress

• Example Giving a 5-minute speech in High school.
• Matthews, Manuck and Saab (1986)
• Anxious and Angry high school students
• Anxious students showed elevated BP and HR, while
  Angry students had elevated DBP
• Findings suggest that, for this type of study,
  laboratory settings will extrapolate to real life
  setting easily.
• Supported McKinney et al (1985) who showed lab
  measures of BP using standard stressors were
  similar to those BPs taken at home or work in
  similar situations.

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Job Strain

• Job strain can produce work-related stress
• May have health consequences
• Job Strain combination of high psychological
  demands and low decision latitude (little
  control) on the job (Carels et al, 1998).
• Conclusions from studies Stressful work settings
  lead to higher BPs

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Active and Passive Coping

• Active Coping the ability of a person to have
  an influence on the outcome of an event through
  performance (ex shock avoidance)
• Passive Coping the person has little or no
  control on the outcomes (ex hand in ice)
• Light and Oberist (1983) persons with high
  cardiovascular reactivity show larger increases
  in BP and HR during active coping tasks
• Sherwood, Dolan and Light (1990) findings
  indicate that active coping produced less of an
  increase in cardiac activity, but constricted
  peripheral blood vessels.
• It was then hypothesized that active coping leads
  to greater heart activity passive coping leads
  to greater changes in peripheral blood vessels

21
Social Communication

• Elevations in BP have been observed in both
  normotensive and hypertensive persons while
  talking to others (Lynch, Long, Thomas, Malinow,
  and Katcher (1981)). People with higher BP
  showed greater increases talking than those with
  lower BP
• Some hypertensives showed increases of 25-40
  within 30sec. of talking
• Talking to a higher-status person led to greater
  increases than talking to persons of equal
  status.
• Conclusion BP increases are related to the
  process of verbally communicating and show
  social-status differences

22
Effects of Sociotropy

• Sociotropic cognition is a heightened
  preoccupation with being accepted by others
• Edwart, Jorgensen, and Kolodner (1998)
  hypothesize and found data to support the
  hypothesis that adolescent girls who scored high
  in a measure of sociotropic cognition would show
  elevated BP in reaction to interpersonal stress
• Both SBP and DBP were significantly higher for
  high scorers, but only for socially relevant
  social competence interview
• For social competence and tracing tasks, all
  girls, even those who did not place high in
  sociotropic cognition, had similar BPs
• However, those girls who had a high need for
  social acceptance did have increased
  cardiovascular reactivity to the task with an
  interpersonal focus

23
Crowding

• DAtri, Fitzgerald, Kasl and Malinow (1981)
• Participants 568 male inmates (avg. age 25)
• Significant increase in BP for those in
  not-single cell housing although threat to life
  and safety may also lead to increases
• Rao, Inbarah, and Subramaniam (1984)
• Participants Random sample of 961 rural and
  1,073 urban women in India
• Results both systolic and diastolic were sig.
  higher in urban women. But again, other
  lifestyle and environment difference may have an
  affect on the results.

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Pets

• Presence of a dog lowers BP in humans (Friedmann,
  Katcher, Thomas, Lynch, and Messent, 1983)
• Participants group of 9-16 year olds
• Design measured BP while resting or reading in
  presence of a friendly animal
• BP and HR was lowered in all conditions in the
  presence of the animal, greatest when it was a dog

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Social Support

• Spitzer, Ironson, Gellman, and Schneiderman
  (1992)
• Effects of social situations with family,
  friends, and strangers on BP responses
• SBP and DBP were significantly lower in the
  presence of family members
• Job strain can also lead to elevated BP
• Schnall, Landsbergis, and Baker (1994)
• Conclusion supportive work relationships also
  lead to lower BP
• Depression and Cardiovascular Response
• Light, Kothandapani, and Allen (1998)
• Conclusion healthy young women with sub clinical
  depression evidence an increase in SNS
  (Sympathetic) activity and elevated SNS
  responsivity to behavioral stress.
• They also found a high correlation between Beck
  scores (for Depression) and a lack of perceived
  social support. Leading the researchers to
  believe in a link between social isolation and
  depressive symptoms.

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Social Support

• Thomas Friedman, Lottes, Gresty, Miller, and
  Lynch 1984
• Participants 30 nurses
• Measured Cardiovascular responses before and
  after they spoke to a nurse or group of nurses
• BP and HR were higher when speaking than when at
  rest and even higher when in front of a group
• Factors in social increases in BP other than just
  talking status of individuals, number of people,
  and pre-social BP

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Competition

• Dembroski, Macdougall, Slaats, Eliot, and Buell
  (1981)
• Participants Male College students playing TV
  tennis (i.e. PONG)
• Measurements BP and Heart Rate
• Findings The researchers reviewed medical
  records for prior illnesses of the participants.
  Those students whose HR and BP increased the most
  during TV Tennis were also more likely to have
  frequent minor illnesses than the rest

28
Auditory Stimulation

• Ray Brady, and Emurian (1984)
• Design Synthetic work task for 3 days
• Measurements HR, BP, and pulse amplitude
• Stimulation 93Db noise for 10min during each
  30min task
• Results
• Performance alone increased BP and HR, and
  dropped pulse amplitude
• Noise further increased BP and decreased pulse
  amplitude

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Auditory Stimulation

• Also observed by Carter and Beh (1989) in similar
  task
• Findings similar to that of Jonsson and Hansson
  (1977) with work and noisy vs. relatively quiet
  factories settings

30
Aerobic Fitness

• Conflicting results regarding training on BP
  during rest and exercise
• Light, Orbrist, James and Strogatz (1987)
• Participants 174 men (age 18-22)
• Divided into low, moderate, or high exercise
  groups based on self-report
• The low group showed greater cardiovascular
  response to stressful reaction task and exercise
  than those in the high group. Shown by SBP and
  HR.
• Results argue for the cardiovascular benefits of
  being physically fit (Studies continue to agree)

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Personality Factors Affecting BP

• 1970s and 80s Type A vs. Type B
• Type A Created by two cardiologists
• Person is Competitive, Impatient and Hostile
  Achievers (Friedman and Rosenman, 1974)
• Type B People mostly lacking Type A
  characteristics
• Type As are 3x more likely to suffer from
  cardiovascular disorders (Coronary Heart Disease
  and atherosclerosis Jenkins, 1976)

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Atherosclerosis

• Comes from the Greek words athero (meaning gruel
  or paste) and sclerosis (hardness).
• The process in which deposits of fatty
  substances, cholesterol, cellular waste products,
  calcium and other substances build up in the
  inner lining of an artery. This buildup is called
  plaque.
• It usually affects large and medium-sized
  arteries.  Some hardening of arteries often
  occurs when people grow older.
• Plaques can grow large enough to significantly
  reduce the blood's flow through an artery or
  they become fragile and rupture.
• Plaques that rupture cause blood clots to form
  that can block blood flow or break off and travel
  to another part of the body. If either happens
  and blocks a blood vessel that feeds the heart,
  it causes a heart attack. If it blocks a blood
  vessel that feeds the brain, it causes a stroke.
  And if blood supply to the arms or legs is
  reduced, it can cause difficulty walking and
  eventually lead to gangrene

From the American Heart Association
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Personality Factors Affecting BP

• Logic These disorders may be caused, to some
  extent, by the greater cardiovascular and
  neuro-endicrine reactivity of Type As.
• Type As have shown differential reactivity in
  studies compared to Type Bs.
• Harassment
• Competition
• Uncontrolled Noise
• Presence of a Hostile Individual
• Task Difficulty
• Incentives

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Personality Factors Affecting BP

• Study by Dembroski, Macdougall, Heard, and
  Shields (1979)
• Participants 80 Randomly assigned Type A and B
  males
• Conditions put into high or low challenge groups
  while engaged in Reaction Time and cold pressor
  activities
• Results Type As had a higher systolic rate than
  Type Bs

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Other Studies

• Harassment during competition Increased BP and
  Heart Rate for Type As but not Bs (Glass et al.
  1980)
• Incentive (Money) Higher BP for Type As even
  before the study began (Contrada, Wright and
  Glass, 1984)
• Short Term Memory Task Systolic increased more
  for Type As than Bs, but only when the task was
  difficult (no difference for moderate or easy
  tasks).

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Personality Factors Affecting Blood PressureBy
Mike Roth
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Children Teens

• 3-6 year old boys (type A)-
• Increased systolic BP than type Bs
• BP reactivity in children found reactivity to be
  predictable of later BP levels.
• Hines 1937 study-
• 300 participants (7-17 years old)
• 27 years later, 4 in 40 were hypertensive (207
  subjects)
• 45 years later 71 of the hypertensive subjects
  were still hypertensive
• Conclusion BP reactivity in childhood a strong
  predictor of high blood pressure in later
  adulthood

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Children Teens Cont.d

• McCann Mathews (1988)
• Studied effects of parental hypertension on
  cardiovascular responses to stressors in children
• 171 participants, grades 6-12
• Participants with a hypertensive parent had
  larger DBP during the stressors (stressors-
  arithmetic, 2 min. hand grip, and star tracing)
• The inc. in DBP even more pronounced in those
  with type A personality
• Hand grip hostility and inc. in DBP SBP have
  been linked to cardiovascular disease

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Women and Type A B personalities

• Females and males do differ with respect to
  cardiovascular responses
• MacDougal, Dembroski, and Krantz (1981)
• Type A and Bs no difference in DBP or SBP with
  respect to cold pressor tasks
• Did show elevated SBP with a structure interview
  an oral history given by another female.
• Types As show inc. with cardiovascular response
  with an interpersonal exchange than Type B women

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Women Contd

• Lane White and Williams (1984)
• Type A and B women have the same inc. in BP and
  HR to mental arithmetic.
• Type A women with a family history of high BP
  have larger cardiovascular response to
  challenging tasks
• Lawler, Schmeid, Mitchell, and Rixse (1984)
• College age Type A B women experience no
  difference in cardiovascular response to
  cognitive tasks

41
Women Cont.d

• Lawler Schmeid (1986)
• Type A and B women with a positive family history
  have inc. levels of SBP when faced with
  competitive stressors such as the oral quiz and
  Stroop color task
• Type Bs showed Type A cardiovascular responses
  due to a family history of hypertension.
• Concluded- Type A behavior in young adult women
  is not related to cardiovascular responses,
  therefore the cardiovascular A/B relationship
  must be further investigated

42
Women Contd

• Coronary heart disease leading cause of death for
  women
• Type A women have a higher SBP then type B when
  faced with realistic stressors
• Type As have higher HRs
• Types As have a desire to control, and thereby
  have higher HRs
• Desire to control may be the link in type A
  people with cardiovascular reactivity

43
Women Contd

• Lawler et al. (1990)
• Older women have observed increased activity for
  Type A personality, especially if they feel that
  they lack control
• Type A women have higher BP than type B when
  facing behavioral stressors
• (classified as type A B based on Jenkins
  Activity Survey)

44
Cardiovascular Reactivity, Hostility, and Anger

• Hostility and anger
• new focuses on type A that leads to CHD (coronary
  heart disease).
• Popular hypothesis
• Reactivity might be a predictive of
  Cardiovascular disease (including CHD and
  hypertension)
• Measures of hostility/anger
• Cook-Medley Hostility scale
• State-Trait-Anger Expression Inventory
  (Speilberger, 1985))

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Cardiovascular Reactivity, Hostility, and Anger
contd

• Cook-Medley Hostility Scale
• High scores associated with cardiovascular
  disease in men
• A 50 item scale
• Derived from the MMPI (Minnesota Multiphasic
  Personality Inventory)
• Measures anger proneness, suspicion, resentment,
  and distrust.
• Investigators use scale to asses cynical
  hostility or mistrust

46
Cardiovascular Reactivity, Hostility, and Anger
contd

• Suarez and Williams (1989)
• Study of cardiovascular reactivity of young men
  with high vs. low hostility scores while they
  tried to solve anagrams with or without
  harassment
• Harassment increased HR and BP for those w/ high
  hostility
• Harassment led to increased anger and higher
  cardiovascular activity

47
Cardiovascular Reactivity, Hostility, and Anger
contd

• Suarez and Williams (1990)
• Looked at antagonistic hostility (outward
  expression of anger) and neurotic hostility
  (anger suppressed)
• People that expressed anger outwardly had higher
  BP and higher forearm blood flow (when harassed)
• People that suppressed anger only experienced
  higher forearm blood flow (when harassed)
• Men and women with high hostility have higher
  levels of SBP and DBP during typical working day
  and giving presentations

48
Cardiovascular Reactivity, Hostility, and Anger
contd

• Bongard, alAbsi and Lovallo (1998)
• 4 groups
• High anger out, and low hostility generates the
  greatest increase in HR and BP.
• Hypothesized it occurred because of an inner
  conflict having low hostility, but an ability
  to outwardly express anger
• Low anger out and low hostility, and High anger
  out and high hostility were least reactive due to
  emotional and cognitive elements being compatible
• Low anger out and high hostility was the second
  highest with regards to HR and BP.
• In general a social task (4 minutes speech)
  resulted in more reactivity than mental
  arithmetic in all groups

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Heredity as a Factor in Cardiovascular Reactivity

• A family history of hypertension usually lead to
  an increase of cardiovascular reactivity to
  stress
• The sympathetic nervous system (SNS) exaggerates
  the cardiovascular responses of individuals w/ a
  family history of hypertension
• Lamensdorf and Linden (1992)
• Those that are not hypertensive but have a family
  history of hypertension have a greater DBP and HR
  reactivity than those without a family history

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Heredity as a Factor in Cardiovascular Reactivity
contd

• Lawler et al. (1998)
• Anger recall stressor when related to a family
  member during an interview resulted in large
  increases in SBP and DBP.
• Family tension/anger recall resulted in vascular
  tension
• Math arithmetic only produced large increases in
  HR (heart rate).
• Arithmetic anger resulted in a myocardial response

51
Heredity as a Factor in Cardiovascular Reactivity
contd

• Miller, Dogloy, Friese, and Sita (1998)
• Men w/ family history of hypertension, who scored
  high in hostility showed high cardiovascular
  response during interpersonal conflict
• Higher cardiac output and forearm blood flow
• Supports that too much cardiac output and
  peripheral blood flow could cause hypertension
  due to pressure on the arterial walls.

52
Conditioning of Blood Pressure

• Much of BP conditioning research is done with
  hypertensive individuals
• As hypertension is elevated BP without a specific
  cause and can lead to serious biological failure
  (i.e. stroke, heart disease)
• DiCara and Miller (1968)
• Rat models
• Shapiro, Tursky, Gershon and Stern (1969)
• Human models
• Reinforced males that increased or decreased SBP,
  with use of feedback techniques

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Conditioning of Blood Pressure contd

• Shapiro, Tursky, Gershon and Stern (1969)
• Gave feedback on every heart beat, in either
  upward or downward directions
• Lights and tones were signals for feedback that
  the heat beat was in heading in the right
  direction
• Reinforcement was a nude centerfold from Playboy
  magazine put on a screen for 5 sec.
• Indicated that SBP could be changed by feedback
  and conditioning (operant)

54
Conditioning of Blood Pressure contd

• Fey and Lindholm (1975)
• Had 4 groups
• 2 received reinforcement, 2 did not
• Reinforcement was visual
• Experimental period 3 days
• 1 hour each day
• Concluded-
• Visual feedback helpful in lowering BP, and
  improved each day it was practiced

55
Conditioning of Blood Pressure contd

• Shapiro, Redmond, McDonald, and Gaylor (1975)
• Can hypertensive individuals detect increases or
  decrease in BP?
• Yes, but changes in BP had to be large
• Still, researchers did not know how people could
  tell the difference, or make the discrimination
  in BP difference
• Could be related to the pressure of the cuff, or
  internal sources- more research needed

56

• Blood Volume and Behavior

57
Blood Volume and Sexual Response

• Studies
• Vasocongestion of vaginal,clitoral, and penile
  tissue
• Sexual arousal in various situations
• Includes blood flow, genital temp., and blood
  volume
• Geer (1975)
• Measuring other areas rather than genital areas
  does not help research in the sexual responses
  category

58
Blood Volume and Sexual Response contd

• Masters and Johnson (1966)
• Blood volume and muscle tension is seen in pelvic
  area during sexual arousal
• Geer (1944/1974/1975)
• Developed instruments that could measure blood
  flow and blood volume in male and female genitalia

59
Blood Volume and Sexual Response contd

• Rubinsky, Hoon, Eckerman, and Amberson (1985)
• Male and females experience the same increase in
  genitalia temperature, blood flow, pulse
  amplitude, and blood volume during erotic film
  viewing
• Geer, ODonohue, and Schorman (1986)
• Disproved studies that stated women were less
  stimulated by erotic stimuli than men.
• Women are stimulated even when there is no
  romantic content to the sexual stimuli

60
Blood Volume and Sexual Response contd

• Geer Quartararo (1976)
• Found that the during female orgasm
• Pulse increases
• Blood volume increased during and after orgasm,
  but at onset and during orgasm blood vol.
  Decreased
• Lead researchers to support that drop in blood
  vol. is an SNS response, and sexual arousal is a
  PNS response
• Hoon, Buche, and Klinchloe (1982)
• Discovered that female arousability was the same
  at any point in the female menstrual cycle.
• Measured premenstrual, menstrual, follicular,
  ovulatory, and luteal stages of the cycle.
• Used a self-arousal rating scale w/ response to
  erotic stimuli

61
Blood Volume and Sexual Response contd

• Geer Fuhr (1976)
• Cognitive factors
• Males distracted during a sexual arousal have
  lower arousal rates to erotic stimuli
• Effects on Women were found to be similar
• Vaginal blood flow, and pulse amplitude decreased
  during the listening to an erotic audio tape when
  an additional task was presented

62
Blood Volume and the Orienting Response

• Sokolov (1963)
• Blood flow increased in forehead when stimulus is
  novel or unexpected.
• Blood flow decreased in forehead when stimulus is
  painful or is threatening
• Blood flow in the head related to the orienting
  response (OR) and OR can lead to better
  perceptual skills (can be habituated)
• Decreases in blood flow is associated to the DR
  (defense response)- threatening or painful
  stimuli (immune to habituation)

63
Blood Volume and the Orienting Response contd

• Leveander, Lidberg, and Schalling (1974)
• OR and speed of habituation study
• Use tones at 100 db for 1 sec. At rates varying
  from 35-610 sec.
• Found that with each successive tone the
  participant habituated, resulting in a decrease
  in both pulse volume, blood volume responses.
• However, Pulse vol. response habituated much
  faster than blood vol. Responses (independent of
  each other)

64
Blood Volume and the Orienting Response contd

• Hare (1973)
• Used spiders as a stimulus with female
  participants
• Decreased blood volume (forehead) were seen in
  fearful women, whereas the opposite was seen in
  the non-fearful group.
• Vasoconstriction suggested DR, and vasodilation
  would suggest OR- supported Sokolovs theory

65
Conditioning of Blood Volume

• Shean (1968)
• Could decrease finger blood volume (classical
  conditioning)
• CS -gt word boat
• UCS -gt electric shock
• After several pairing of the CS with the UCS the
  participants acquisition and extinction of
  vasoconstriction was observed as participants
  were aware of the relationship between the word
  boat and the electric shock.

66
Works Cited

• Andreassi, John L. Psychophysiology Human
  Behavior Physiological Response.
• Fourth Ed. Mahwah New Jersey. pp.316-326.
• American Heart Association. Definition of
  Atheroschlerosis. Updated 2006. Accessed
  November 2, 2006. http//www.americanheart.org/pr
  esenter.jhtml?identifier4440

67
References

• Andreassi, J. L. (2000). Psychophysiology Human
  Behavior Physiological Response.Hillsdale, New
  Jersey Earlbaum.
• American Heart Association. Definition of
  Atheroschlerosis. Updated 2006. Accessed
  November 2, 2006. http//www.americanheart.org/pr
  esenter.jhtml?identifier4440