Psychological and cardiovascular responses to stressful interpersonal encounters.

This thesis-by-publication investigates the psychological and cardiovascular (CV) effects of assertive and passive responses to stressful interpersonal provocations, and also the CV effects of repeatedly ruminating on a provocation. Also discussed, are the extensively researched effects of aggressive responding to provocation. A number of related post-provocation and response outcome variables are explored. These include anger, resentment, avoidance, and powerlessness, as well as participants’ appraisals in response to provocation. Following the literature reviews in Chapters 1 to 3, Chapter 4 details the research aims and rationale, and an overview of the studies. The thesis comprises nine chapters that include one published article and three articles submitted for publication. An extensive history of assertiveness training courses and clinical interventions since the 1970s, has led to studies suggesting that, for enhancing CV and emotional recovery, and for lowering stress and social anxiety, verbally assertive responding to interpersonal provocations is more efficacious than passive or aggressive responding. Specifically, a number of benefits have been associated with responding to anger-generating provocations in a verbally assertive manner. These are firstly, faster anger reduction and CV recovery - the latter leading to a decrease in angry rumination - and secondly, a lowering of social anxiety. These claims have limited empirical support. Furthermore, the claims regarding a lowering of social anxiety have been derived from cohorts extensively trained in assertiveness techniques. Study 2 examines the effects of assertive and passive responding to a provocation, to determine whether the purported emotional and CV benefits of assertive responding are evident within an untrained cohort. The rationale for this approach is provided in Chapter 6. Five related premises reported in the literature are examined in the thesis. The first, explored in Study 1, is that people tend to be passive rather than assertive in stressful interpersonal encounters; however, no research to date has explored whether this premise is congruent with individuals’ beliefs as to their predicted behaviour in such encounters. The second and third premises propose two polarised positions: that assertive responding is trait behaviour and that assertive responding is state behaviour - situationally driven. The fourth premise, as mentioned above, is that assertive responding has CV and psychological benefits, compared with passive or aggressive responding to provocation. The final premise is that distraction from ruminating on an anger-inducing interpersonal provocation benefits CV and emotional recovery, whereas chronic rumination tends to lead to negative psychological and CV outcomes. Whilst chronic rumination (discussed in Chapter 2) implies repeated rumination, to date, repeated angry rumination has received empirical attention from only one study. As mentioned, outcomes related to provocation, and to responses to provocation, are explored in this thesis. Of particular interest is the provocation-related and under-researched variable of resentment and resentful rumination (Chapter 3). Resentment is considered a more durable form of anger, and implicated in early death. However, whilst the domain has received limited attention in the forgiveness literature, it has received no attention in empirical psychophysiological studies. Lastly, whilst many researchers have explored the relationship between anger and blood pressure (BP) reactivity and recovery, heart rate (HR) recovery and resting HR have only very recently begun to receive prominence in the literature as independent markers of CV disease risk. The broad aims of this project were firstly, to explore participants’ predicted responses to a range of provocation scenarios with the aim of determining if responses tended to reflect trait or situationally determined behaviour and, if trait behaviour, whether responses would be largely passive. A further aim in this context was to elicit participants’ ratings as to what they considered the most preferable responses to provocations. The second broad aim was to test the psychological and CV impact of assertive and passive responses to a novel provocation. The third aim was to explore the emotional and CV effects of repeated rumination on a provocation, and distraction from rumination. Within the latter paradigm, a self-administered visuospatial (VS) suppression tool was tested for utility in diminishing participants’ provocation-related imagery, and the effects on associated emotionality and CV measures. The fourth broad aim was to investigate resentment, as a response to anger-inducing provocations. Specific research aims in relation to the studies are detailed in Section 4.3. Chapter 9 concludes the thesis and consists of a general discussion, which considers the overall implications of the findings in relation to psychological and CV health. The general discussion also addresses study limitations, and provides suggestions for future directions.