Gender differences in psychophysiological responses to speech stress amongolder social phobics: Congruence and incongruence between self-evaluative and cardiovascular reactions

Objective: Evidence suggests increased cardiovascular risk and autonomic im pairment among individuals with chronic anxiety. Little attention, however, has been paid to the anxiety disorder of social phobia despite its high pr evalence. Additionally, gender- and age-related cardiovascular profiles hav e not been examined in relation to social phobia. This study investigated c ardiovascular responses to a socially threatening situation among older men and women with social phobia and control subjects. Methods: Thirty subject s with social phobia and 30 control subjects (mean age = 65 years) were ass essed during baseline, paced breathing, speech preparation, and speech pres entation. Electrocardiographic variables, blood pressure, respiration, and emotional state (self-reported) were monitored. Hemodynamic variables inclu ded heart rate, blood pressure, cardiac output, and systemic vascular resis tance; autonomic measures were respiratory sinus arrhythmia and baroreflex sensitivity, both markers of cardiac vagal control, and 0.10-Hz systolic bl ood pressure variability, an index of sympathetic vasomotor tone. Results: Subjects with social phobia, in contrast to nonanxious control subjects, ma nifested more anxiety, embarrassment, and somatic complaints in response to stress; however, physiological measures generally did not distinguish grou ps. Interaction effects indicated that socially phobic women were hyperresp onsive to the stressor with respect to self-reported, hemodynamic, and auto nomic parameters. Socially phobic men manifested no physiological differenc es in comparison with control subjects, but they reported more psychologica l and somatic complaints. Conclusions: Gender differences in subjective and physiological responses to a socially threatening situation indicate congr uence between perceived social anxiety and physiological responses in older women but not men. We found no evidence of impaired cardiovascular autonom ic regulation among socially phobic men despite other reports that phobical ly anxious men are at greater cardiovascular risk.