chapter  9
32 Pages

The Diary of Ambulatory Behavioral States: A New Approach to the Assessment of Psychosocial Influences on Ambulatory Cardiovascular Activity

Recent evidence supports the utility of ambulatory blood pressure monitoring for improving our understanding of cardiovascular disease risk. For example, measures of blood pressure taken in the ambulatory setting have been shown to predict cardiovascular events or mortality in hypertensive patients, provid-ing prognostic information independent of that provided by clinic manometry readings (Mann, Millar-Craig, & Raftery, 1985; Perloff, Sokolow, & Cowan, 1983). The value of ambulatory measures is assumed to stem from their ability to capture the unique

effects of psychosocial influences on cardiovascular activity during daily living-influences that are not present in the laboratory or clinic (Devereux et al., 1983). If this assumption is valid, identifying the types of psychosocial influences that affect cardiovascular activity during daily life should be critical for helping us understand the unique predictive influence of ambulatory monitoring. We devised the Diary of Ambulatory Behavioral States (DABS) as a means of assessing some of the behavioral influences suspected to be important determinants of cardiovascular activity and disease risk.