Psychohematological Research
Laboratory
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Contents
Current Projects
Stress-Hemoconcentration
The goal
of my initial studies within this area was to establish the reproducibility
of stress-hemoconcentration phenomenon under a variety of psychological
and physical stressors. I have been able to demonstrate that acute
laboratory stressors such as mental arithmetic (Patterson, Gottdiener,
Vargot, Hecht, Goldstein, & Krantz), public speaking (Patterson,
Marsland, Manuck, Kameneva, & Muldoon; Muldoon, Herbert, Patterson,
Kameneva, Raible, & Manuck), and cold pressor tests (Patterson,
Krantz, Vargot, Hecht, & Gottdiener) produced acute decreases
in plasma volume and subsequent increase in lipid and plasma protein
hemoconcentration in healthy individuals. More importantly, these
early studies were among the first to indicate blood pressure-induced
transvascular fluid movement as a possible mechanism for the plasma
volume changes due to a consistent finding of negative correlations
between changes in plasma volume and blood pressure.
The blood pressure – hemoconcentration relationship became the
impetus for the next step in my research, which was to identify the
underlying mechanism(s) of stress-hemoconcentration. A transvascular
fluid movement mechanism has been supported by data from two studies
conducted in my laboratory. These studies revealed negative relationships
between blood pressure and hematologic measures of hemoconcentration
(i.e., plasma volume, blood and plasma density) (Patterson, Matthews,
Allen, & Owens), and a distinct time lag between peak increases
in blood pressure and peak decreases in plasma volume in which blood
pressure peaked 3-4 minutes before plasma volume during 10-minute
stressors (Patterson, Jochum, & Krantz). These results provide
direct evidence that acute psychological stress can produce significant
changes in hemorheology and hemoconcentration and strongly suggest
acute changes in blood pressure as the most likely mechanism for the
stress-induced hemoconcentration effect.
Although laboratory assessments of stress-hemoconcentration had been
exclusively obtained in a seated position, it was recognized that
real-world stressors are be equally encountered in a standing position.
Therefore, another logical step for my research was to assess the
influence of posture and stressful experiences on hemoconcentration
as a representation of real-world standing stressors. Recently, my
lab completed a study designed to investigate the effects of real-world
posture on assessments of 'lab-to-life' stress-hemoconcentration with
attention focused on the two postures, supine and standing (Patterson,
VanderKaay, & Arnott). What we found was that posture has an overall
effect on mental stress-induced changes in blood pressure and plasma
volume, in that greater hemoconcentration and increases in blood pressure
occurred during the supine condition compared to the standing condition.
Members of my lab have become interested in assessing other factors
that are known to influence daily plasma volume levels, such as smoking
and nicotine, and their effect on stress-induced hemoconcentration
(VanderKaay, Patterson, & Tulodzieski). In using a within-subject
design, what we have found that, among smokers, resting blood pressure
and plasma volume levels were significantly higher during a laboratory
session in which they wore an active transdermal nicotine patch as
compared to wearing a placebo patch. However, greater stress-induced
changes in blood pressure and plasma volume occurred during the placebo
patch session as compared to the nicotine patch session, which may
reflect nicotine withdrawal effects.
Along with establishing the reliability of the stress-hemoconcentration
effect across various types and duration of stressors, the test-retest
reliability of these changes over time was the next fundamental factor
that needed to be established. In a manuscript currently under review,
colleagues at the University of Birmingham and I found stress-hemoconcentration
during three different tasks (mental arithmetic, cold pressor, and
exercise) to be highly reliable over a four-week period using a test-retest
design (Patterson, Bacon, Ring, Willemsen, & Carroll).
In summary, I believe that this phase of my programmatic research
has consistently demonstrated that psychological stress reliably produces
increased blood cell, lipid, and protein concentrations and promotes
a thrombogenic environment that may contribute to the development
of cardiovascular disease, as well as, acute angina or myocardial
infarction.
Acute Hydration, Hydration
Status, and Stress-Hemoconcentration
During the
past 3 years of my quest to establish Psychohematology, I have become
increasing interested in the possibility of using fluid loading or
hyperhydration as a means for attenuating stress-hemoconcentration
or cardiovascular reactivity. In the field of physiology, a number
of studies have reported positive therapeutic effects of fluid hyperhydration
in reducing acute hemoconcentration during strenuous exercise. Physiological
research in this area has repeatedly found significant decreases in
hemoconcentration and increases in plasma volume when high ionic content
fluids are consumed before extended strenuous exercise. Given these
reported beneficial effects of hydration on exercise-induced hemoconcentration,
it seemed reasonable to examine the possible beneficial effects of
hyperhydration on psychological stress-induced hemoconcentration.
In a series of recent studies conducted in my laboratory, my research
team sought to assess and compare the magnitude of stress-induced
hemoconcentration during hypo- and hyper-hydrated states during different
laboratory stressors. We have also begun to examine the possible differential
effects of oral fluid hyper-hydration with various fluids (e.g., water,
6%, and 8% carbohydrate sports drinks) on hemorheologic changes during
psychological stress. The initial study in this area was designed
to assess the effects of acute fluid loading on hemorheologic and
hemodynamic factors during a 6-minute math task using an 8% carbohydrate
sports drink (Performance) as the hyperhydration fluid (Patterson,
VanderKaay, & Arnott). The results of this study indicate that
although fluid loading does influence overall hemorheology profiles,
hyperhydration does not appear to attenuate the stress-hemoconcentration
effects that accompany acute psychological stress. However, this study
did demonstrate that cardiovascular reactivity does appear to be influenced
by hydration status in that hyper-hydration produces lower resting
vascular resistance (less blood flow resistance from the blood vessels)
and seems to attenuate the typical stress-induced increase in vascular
resistance. To follow-up our first hydration assessment study, we
decided to assess the hyper-hydration effect using two other rehydration
fluids that are more commercially available to everyday consumers:
Gatorade (6% carbohydrate sports drink) and water (no carbohydrates)
(Patterson, VanderKaay, Shanholtzer, & Tulodzieski). Using the
same paradigm as the Performance study, the results from this study
were similar to the Performance study in that there was a significant
difference between the hyperhydration and hypohydration conditions,
with hyperhydration produced a significant decrease in vascular constriction
and hypohydration producing a significant increase in vascular resistance
during stress. Further analysis also revealed that hyperhydration
with Gatorade producing the greatest decrease in vascular resistance
in comparison with water.
Based on the finding from our acute fluid-loading paradigm, we designed
a study to determine if long-term hydration enhancement produces beneficial
cardiovascular effects on normal resting blood pressure levels and
during acute laboratory stress (Patterson & Spinks). In this study,
blood pressure was recorded and total body water was assessed via
electrical bio-impedance in undergraduate students during two laboratory
sessions: An initial hydration assessment session and during a follow-up
session 3 days later. During the initial session, all participants
were given six 1-liter bottles of water and instructed to consume
two of the bottles per day in addition to their normal daily fluid
intake. Correlational analyses revealed significant inverse relationships
between follow-up blood pressure and changes in total body water,
therefore suggest that long-term hydration enhancement may facilitate
a reduction in resting blood pressure. Finally, in our most recent
pilot study, my research group in collaboration with Dr. Chris France
assessed the effects of a 3-day hyperhydration regimen on cardiovascular
reactivity during posture change and psychological stress in eight
individuals who were assigned to either an enhanced hydration group
or a normal hydration group (Prause, Patterson, France, & Spinks).
Before the experimental session, the enhance hydration group consumed
2 liters of water per day in addition to their normal fluid intake.
During the experimental session, blood pressure and heart rate were
assessed during consecutive four 5 min periods: supine baseline, standing,
surgery video, and a final standing baseline. Results revealed significant
group difference for blood pressure reactivity during the first standing
period, with the normal hydration group being more reactive than the
enhanced hydration group. Results also revealed a significant group
difference for HR reactivity during the surgery video, with HR reactivity
being greater in the enhance hydration group. Despite the small number
of participants, the results of this pilot study suggest that hyperhydration
attenuates BP reactivity during postural challenge, but enhances HR
reactivity during passive stress.
The information generated from these studies on stress-hemoconcentration,
fluid loading, and hydration status will hopefully lead to important
new insights regarding processes that lead to and control excessive
stress-induced decreases in plasma volume (e.g., plasma osmolality
or systemic hydration) or excessive increases in blood pressure and
help health psychologists and the public understand the importance
of proper fluid balance in buffering the cardiovascular system from
potentially atherogenic daily stressors.
Dehydration and Neuropsychological
Performance in the Elderly
Dehydration
is a common health problem for older adults, and a common area of
neglect for institutionalized elderly. In studies of institutionalized
elderly patients, researchers have found that patients who were cognitively
impaired or incontinent received significantly less fluid intake than
other patients. Therefore, it has been suggested that for those who
are cognitively impaired, inadequate hydration might be adding to
or even causing their confusion. Elderly people are particularly vulnerable
to dehydration due to age related changes in the kidney, altered response
to antidiuretic hormone, changes to thirst sensation, and changes
in the body’s ability to react to loss of fluid. There are also
behavioral issues that may lead to changes in fluid intake as we age,
including fear of incontinence, desire to avoid nocturia, lack of
accessibility of fluids, or inability to obtain/drink fluids due to
medical/mental condition.
Although it is well known that severe dehydration can cause these
acute and serious cognitive problems, less is known about mild dehydration.
Mild dehydration can lead to headache, fatigue, and lightheadedness,
and dehydration that is more advanced can make you physically clumsy.
Dehydration of as little as 1% decrease in body weight results in
impaired physical performance. However, the effect of mild to moderate
dehydration on mental performance has not been adequately studied
in any age group. Dehydration may be one cause of cognitive difficulties
seen in elderly persons, and may contribute to further cognitive decline.
For example, mild cognitive problems may lead to further dehydration,
poor nutrition, and misuse of medications, causing further cognitive
difficulties, and eventually resulting in hospitalization and/or severe
cognitive impairment as well as significant health risk. Julie Suhr
and I just finished a pilot study investigated the effects of dehydration
on cognition in older adults. A sample of 31 community-dwelling relatively
healthy older adults (mean age 62.9 years) completed several cognitive
tests, including the Repeatable Battery for the Assessment of Neuropsychological
Status, the Grooved Pegboard Test, and the Trailmaking Test, and also
had their level of hydration measured using bioelectrical impedance.
Percent total body water by weight: (%TBW) ranged from 34 to 58% in
the sample. Thus, even in this relatively small sample, a wide range
of hydration was apparent, with many individuals falling well below
normal expectations for this age range. In the whole sample, better
hydration tended to be related to improved psychomotor speed (r’s
= -.27 to -.31, p<.05 to <.10) and to better performance on
some aspects of attention and memory processing (r=.23 to .29, p<.01
to <.05). In addition, hydration was related to visuospatial skills
(r=.33, p<.05). In just the females, there were strong and significant
relationships between good hydration and improved psychomotor speed
(r=-.35 to -.50, all p<.05), better attention (r=.51, p<.05),
and improved immediate memory (r=.35, p<.05).Thus, our pilot data
strongly suggests that cognitive status is related to even mild dehydration
in a community-dwelling sample of relatively healthy older adults.
Based upon the results of the pilot study, I have developed and submitted
a NIH grant proposal, along with Julie Suhr, that is designed to assess
the relationship between hydration status and cognitive performance
in a representative sample of healthy, non-institutionalized elderly
adults n=1000) living in Southeastern Ohio. Our main hypothesis is
that mild levels of dehydration will lead to poorer performance in
attention, memory, and psychomotor speed task performance.
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Snapshots
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Personnel
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Recent Publications
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VanderKaay, M.M.,
Patterson, S.M,, Shanholtzer, B.A., & Farrell, C.A., (under
review). Effects of acute fluid hydration stress-induced
hemoconcentration and cardiovascular reactivity. |
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VanderKaay, M.M.,
& Patterson, S.M. (under review). Effects of nicotine
on stress-induced hemoconcentration and cardiovascular reactivity. |
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Patterson, S.M.,
Bacon, S.L., Ring, C.R., Willemsen, G., & Carroll, D. (under
review). Effects of Mental, Cold and Exercise Stress on
Hemoconcentration: 4-Week Test-Restest Reliability. |
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Patterson, S.M.,
VanderKaay, M.M., & Arnott, L.F. (under review). Psychohematology:
Relationships between hemodynamic and hematologic factors during
individual and combined acute stress and posture manipulations.. |
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Patterson, S.M.,
VanderKaay, M.M., & Arnott, L.F. (under review). Effects
of oral fluid loading on hemorheologic and hemodynamic reactivity. |
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Prause, L.A.,
& Patterson, S.M., (In Press). Hydration and cardiovascular
function: Effects of hydration enhancement on cardiovascular function
at rest and during psychological stress. International
Journal of Psychophysiological Research. |
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Suhr, J.A., Hall,
J., Patterson, S.M., Tong-Niinistro, R., (2004). The Relation
of Hydration Status to Cognitive Performance in Healthy Older Adults.
International Journal of Psychophysiological Research,
53, 121-125. |
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Shanholtzer,
B.A., & Patterson, S.M., (2003). Use of bioelectrical
impedance in hydration status assessment: Reliability of a new tool
in psychophysiological research. International Journal
of Psychophysiology, 49, 217-226. |
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Ey, S., Klesges,
L.M., Patterson, S.M., Hadley, W., Barnard, M., Alpert, B.S. (2000).
Racial differences in adolescents' perceived vulnerability
to disease and injury. Journal of Behavioral Medicine,
23, 421-435. |
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Kelsey, R.M.,
Patterson, S.M., Alpert, B.S., Barnard, M. (2000). Consistency
of hemodynamic responses to cold stress in adolescents.
Hypertension, 36, 1013-1017. |
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Kelsey, R.M.,
Alpert, B.S., Patterson, S.M., Barnard, M. (2000). Racial
Differences in Cardiovascular Hemodynamic Responses to Naturalistic
Environmental Stress among Adolescents. Circulation,
101, 2284-2289. |
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Kop, W.J., Gottdiener,
J.S., Patterson, S.M., Krantz, D.S. (2000). Independent
prediction of left ventricular mass by ambulatory blood pressure
and hemodynamic responses to physical and mental stress: Evidence
for gender differences. Journal of Psychosomatic Research,
48, 79-88. |
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Patterson, S.M.,
Marsland, A., Manuck, S.B., Kameneva, M., Muldoon, M.F. (1998).
Acute hemoconcentration during psychological stress: Assessment
of hemorheologic factors. International Journal of
Behavioral Medicine, 5, 24-31. |
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Marsland, A.,
Herbert, T.B., Muldoon, M.F., Bachen, E.A., Patterson, S.M., Cohen,
S., Rabin, B., & Manuck, S.B. (1997). Lymphocyte redistribution
during acute laboratory stress: Mediating effects of hemoconcentration.
Health Psychology, 16, 341-348. |
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Patterson, S.M.,
Jochum, S., & Krantz, D.S. (1995). Mechanisms of decreased
plasma volume during psychological stress and postural change.
Psychophysiology, 32, 538-545. |
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Patterson, S.M.,
Krantz, D.S., Vargot, S., Hecht, G.M., & Gottdiener, J.S. (1995).
Prothrombotic effects of acute mental and physical stress:
Changes in platelet function, blood viscosity, and plasma volume.
Psychosomatic Medicine, 57, 592-599. |
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Recent Presentations
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Rochette, L.M.
& Patterson, S.M. (2005) Effects of hydration on cardiovasculasr
psychophysiology, 63rd Annual Scientific Meeting of
the American Psychosomatic Society, Vancouver, B.C. |
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Patterson, S.M.,
France, C.R., & France, J.L. (2005) Acute hydration
and applied muscle tension promote physiological changes that can
attenuate vasovagal reactions to blood donation, 63rd
Annual Scientific Meeting of the American Psychosomatic Society,
Vancouver, B.C. |
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Hall, J.A. &
Patterson, S.M. (2005) Weekend alcohol use and early week
hydration measurement, 63rd Annual Scientific Meeting
of the American Psychosomatic Society, Vancouver, B.C. |
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Shanholtzer,
B.A. & Patterson, S.M. (2005) Hydration status is a
factor related to changes in resting systolic blood pressure during
the menstrual cycle, 63rd Annual Scientific Meeting
of the American Psychosomatic Society, Vancouver, B.C. |
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France, C.R.,
France, J.L., & Patterson, S.M. (2005) Applied muscle
tension may attenuate vasovagal reactions to blood donation,
63rd Annual Scientific Meeting of the American Psychosomatic
Society, Vancouver, B.C. |
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Shanholtzer,
B.A. & Patterson, S.M. (2004) Bioelectrical Impedance
Technology: Non-invasive Assessment of Stress-Hemoconcentration?
62nd Annual Scientific Meeting of the American Psychosomatic
Society, Orlando. |
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VanderKaay,
M. M., Patterson, S. M., & Chester, L. A. (2004). Cardiovascular
reactivity and nicotine: A comparison between cigarette smokers
and chippers. 62nd Annual Scientific Meeting of the
American Psychosomatic Society, Orlando. |
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Shanholtzer,
B.A., & Patterson, S.M., (2003). Division 38 (Health
Psychology), American Psychological Association,
Toronto, Canada |
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Prause L.A.,
& Patterson, S.M., (2003). Division 38 (Health Psychology),
American Psychological Association, Toronto, Canada |
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Patterson, S.M.,
Heckman, T.G., Silverthorn, M., Waltje, A., & Meyers, M. (2003).
Psychosocial factors associated with disease progression
in rural people living with HIV disease: A prospective analysis.
Psychosomatic Medicine, 65, 174. |
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Reid, A.A.,
Gonzalez-Vallejo, C., Patterson, S.M. (2002). Emotion as
a value determinant and attribute importance weight. Annual
Meeting of the Society for Judgment and Decision Making, Kansas
City, MO. |
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VanderKaay,
M.M., & Patterson, S.M. (2002). The effects of nicotine
on stress-induced hemoconcentration and cardiovascular reactivity.
Society for Psychophysiological Research, Washington D.C.
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Shanholtzer,
B.A., & Patterson, S.M. (2002). Effects of dietary and
fluid intake on fluid hydration status. Society for
Psychophysiological Research, Washington D.C. |
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Prause, L.M.,
Patterson, S.M., France, C.R., & Spinks, D.E. (2002). Effects
of chronic fluid loading on posture and stress-induced cardiovascular
reactivity. Society for Psychophysiological Research,
Washington D.C. |
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Patterson, S.M.,
Vancouver, J.B., & Krantz, D.S. (2002). Relationships
among 24-hour activity diary recordings, Holter monitor heart rate,
and Actigraph activity monitoring. Society for Psychophysiological
Research, Washington D.C. |
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Patterson, S.M.,
& Spinks, D.E. (2002). Relationship between hydration
enhancement and blood pressure: More is better. Society
for Psychophysiological Research, Washington D.C. |
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Patterson, S.M.,
France, C.R., Prause, L.M., & Gill, M. (2002). Hydration
status and cardiovascular psychophysiology. Society
for Psychophysiological Research, Washington D.C. |
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Carson, K.L.,
& Patterson, S.M. (2002). Individual differences in
behavioral activation and inhibition and EEG response to reward
and punishment. Society for Psychophysiological Research,
Washington D.C. |
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VanderKaay,
M.M., Patterson, S.M., Shanholtzer, B.A., Tulodzieski, B.A., Arnott,
L.F., & Sutherland, M.T. (2002). Relationships between
fluid hydration status and cardiovascular reactivity. American
Psychological Society, New Orleans. |
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Shanholtzer,
B.A., & Patterson, S.M. (2002). Fluid Hydration Status
Assessment in Behavioral Medicine Research: Seven-Day Test-Retest
Reliability. Society of Behavioral Medicine, Washington
D.C. |
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Patterson, S.M.,
VanderKaay, M.M., Shanholtzer, B.A., & Tulodzieski, B., (2002).
Effects of fluid hydration on stress-hemoconcentration and
serum lipid responses during mental stress. Psychosomatic
Medicine, 64, 114. (Citation Paper) |
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VanderKaay,
M.M., Patterson, S.M., & Tulodzieski, B. (2002). Attenuation
of hemorheologic and hemodynamic responses during acute stress by
hyperhydration. Society of Behavioral Medicine,
Washington D.C. (Citation Paper) |
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Updated:
November 1, 2007
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