See

discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/15919263

Cardiovascular Differentiation of Happiness,

Sadness, Anger, and Fear Following Imagery
and Exercise1

Article in Psychosomatic Medicine · September 1981

DOI: 10.1097/00006842-198108000-00007 · Source: PubMed

CITATIONS READS

237 1,963

3 authors, including:

Jefferson A Singer
Connecticut College
64 PUBLICATIONS 2,661 CITATIONS

SEE PROFILE

All content following this page was uploaded by Jefferson A Singer on 23 December 2013.

The user has requested enhancement of the downloaded file. All in-text references underlined in blue are added to the original document
and are linked to publications on ResearchGate, letting you access and read them immediately.
Cardiovascular Differentiation of Happiness,
Sadness, Anger, and Fear Following Imagery and
Exercise1

GARY E. SCHWARTZ, PHD, DANIEL A. WEINBERGER, MPHIL, AND

JEFFERSON A. SINGER, BA

This study examined cardiovascular patterns following happiness, sadness, anger, fear,
relaxation, and control imagery in 32 subjects while they were seated and while they exercised.
Affective imagery was an effective strategy for inducing reliable patterns of systolic and
diastolic blood pressure and heart rate associated with particular emotional states. Anger, rather
than fear, produced the greatest overall increases in cardiovascular measures and was distinctly
opposite from relaxation. Anger differed from fear and all other conditions in terms of greater
increases in diastolic pressure following imagery and greater increases in heart rate and slower
recovery of systolic pressure following exercise. Sadness was unique in that systolic pressure
and heart rate were virtually as high when subjects were still as when they were actually
moving. Furthermore, sadness was the one emotional state that seemed to interfere with the
cardiovascular adjustments normally associated with exercise. Implications of these findings
for current biobehavioral models of emotion, including the role that specific emotions may play
in the pathogenesis and treatment of cardiovascular disease, are considered.

INTRODUCTION Webster (cited in ref. 5, p. 17) that emo-

Amid the diversity of human lan-
guages, cultures, and values, the subjec-
tive experiences and facial expressions
associated with fundamental emotions
such as happiness or fear are remarkably
universal (1, 2). Emotions are largely co-
ordinated in the limbic system or "vis-
ceral brain" (3). Thus, they are more com-
plex than simple reflexes but not as varied
or readily modifiable as reactions of
the cerebral hemispheres (4, p. 244). Most
psychophysiologists, would agree with
'Presented at the American Psychosomatic Soci-
ety meeting March 29, 1980, New York, New York.
From the Department of Psychology, Yale Univer-
sity, New Haven, Connecticut.
Address requests for reprints to: Dr. Gary E.
Schwartz, Department of Psychology, Yale Univer-
sity, Box 11A Yale Station, New Haven, CT 06520.
Received for publication October 4,1980; revision
received February 5, 1981.
tional reactions are characterized, in part,
by integrated "neuromuscular, respira-
tory, cardiovascular, hormonal, and other
bodily changes" in anticipation of re-
sponding to significant environmental
challenges.
Not surprisingly, since the inception of
psychosomatic medicine, individuals' au-
tonomic emotional responses have been
considered primary links between psy-
chosocial functioning and proneness to
various physical diseases. However, for
numerous theoretical and pragmatic rea-
sons (6, 7), the requisite basic research on
the psychophysiology of emotion has had
an uneven and problematic history.
In the early part of this century, Cannon
(4) described visceral emotional responses
in terms of a basic emergency reaction of
"fight" or "flight." Many prominent in-
vestigators (e.g., refs. 8-10) continue to

Psychosomatic Medicine Vol. 43, No. 4 (August 1981) 343

Copyright © 1981 by the American Psychosomatic Society, Inc. 0033-3174/81/04034322$02 50
Published by Elsevier North Holland, Inc.
52 Vanderbilt Ave., New York; NY 10017

believe that autonomic emotional reac-
tions are best thought of in terms of un-
idimensional arousal.
There is currently little doubt that Can-
non accurately described a basic "flight"
response that corresponds in many ways
to preparation for isotonic exercise
(11-13). The pattern represents general
"arousal" primarily in the sense that it
includes the wide variety of changes
which are reinforced by the release of
adrenaline (epinephrine) (14, 15). Within
the cardiovascular system, heart rate, sys-
tolic blood pressure, and muscular blood
flow all increase. However, net peripheral
vascular resistance declines, keeping
diastolic blood pressure relatively low.
In humans, this pattern is not only
connected to fear of physical harm but to
the more general (see ref. 16) reaction of
anxiety or apprehension. Contributing to
the view that the "flight" response is the
only major autonomic reaction to emo-
tional stimuli, fear and anxiety are readily
produced in the laboratory and, therefore,
widely studied. The mere threat of shock
can produce 15 beat per minute increases
in heart rate (17), while mildly threaten-
ing mental arithmetic can produce 300
percent increases in muscular blood flow
(18).
Most current discussions of "stress-
related" disorders implicitly, if not
explicitly, consider fear and anxiety to be
principal mediators. However, there is a
growing body of literature suggesting that
an individual's regulation of other emo-
tions, such as anger (19-21) and sadness
and depression (22, 23), may play unique
and possibly primary roles in cardiovas-
cular and other diseases. Thus, it remains
of major clinical as well as theoretical
significance whether various emotions af-
fect bodily functioning in ways similar to
344 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
GARY E. SCHWARTZ et al.
or qualitatively different from fear and
anxiety.
Unfortunately, merely participating in
a psychophysiological experiment often
elicits moderate fear and anxiety, making
it difficult to study other emotions in
relatively pure form. Indeed, it is quite a
feat to make someone covered with elec-
trodes and unable to move distinctly
happy. In addition, most methods of reli-
ably instigating sadness or anger in the
laboratory are unethical by current stan-
dards.
Studies in the 1050s by Ax (24), Fun-
kenstein et al. (25), and Schachter (26)
remain the major references on the au-
tonomic differentiation of fear and anger.
Using such strategies as malfunctioning
polygraphs and abusive confederates,
these researchers found that anger is im-
portantly different from fear. For example,
Ax (24) found significant differences in
seven of fourteen physiological measures,
including indices of cardiovascular, elec-
trodermal, respiratory, and muscular ac-
tivity.
The most well-documented findings
across studies are differences in car-
diovascular response. While fear primar-
ily resembles an epinephrine-like re-
sponse, anger more resembles a combined
epinephrine- and norepinephrine-like re-
sponse. Heart rate and systolic blood pres-
sure tend to increase equally, but diastolic
blood pressure increases more during
anger. While fear conditions uniformly
produce considerable dilation of periph-
eral arteries, anger conditions tend to
produce net vasoconstriction in major
muscle groups, differentially elevating
diastolic pressure (26). Peripheral norepi-
nephrine, whose primary effect is vas-
oconstriction, may actually partially
mediate these differences. Endocrine
CARDIOVASCULAR DIFFERENTIATION OF EMOTION
studies of urinary and plasma levels of
catecholamines have suggested an associ-
ation between norepinephrine secretion
and aggressive behavior (27-29).
Even relative to anger, there has been
little study of the autonomic concomitants
of happiness and sadness. Two investiga-
tions have explicitly compared these
emotions, both using films as stimuli.
Sternbach (30) recorded six physiological
measures while ten 8-year-olds watched
"Bambi." Unfortunately, the study con-
tains a number of methodological difficul-
ties. The hour-long film was shown un-
edited, and the children were individu-
ally asked to remember which scene was
"saddest," "scariest," "nicest" ("hap-
piest"), and "funniest." Prestimulus
levels used to determine autonomic re-
sponse were arbitrarily determined 30 to
60 seconds before each child's designated
scenes with no explicit control for what
they were responding to at that time. This
may explain why the largest relative in-
crease in heart rate was reported to be 0.35
beats per minute, even though mean heart
rate was 81.4 during the "happy" scene,
86.3 during "sad," 88.4 during "funny,"
and 91.6 during "scary."
Especially when prestimulus level is
considered, there was a clear tendency in
the Sternbach study for skin resistance
level to increase and for eye blinks to
decrease during sadness. Both of these
changes indicate an inhibition rather than
activation of sympathetic activity. Al-
though appropriate statistics are not
available, respiration and finger pulse
volume were also lower during sadness
than during the other three conditions.
Averill (31), using three independent
groups of college students, found a dif-
ferent pattern of response for sadness in
comparison to "mirth" and control. How-
Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
ever, recent data (16) suggest that sadness
situations elicit particularly complex pat-
terns of emotion, making sadness rela-
tively difficult to study in a pure form.
Averill's sad stimulus, a film on John F.
Kennedy including the aftermath of the
assassination, was clearly emotionally
complex. Four of the eighteen subjects
actually reported higher anger or anxiety
than sadness. Ratings of sadness corre-
lated 0.51 (p<0.05) with anger and 0.58
(p<0.05) with excitement. Averill seemed
to be measuring what Ekman and Friesen
(32) call "distress," which tends to in-
volve more anger and active protest than
does the resignation of sadness.
Interestingly, Averill (31) found that
the film about Kennedy produced signifi-
cant increases in blood pressure with a
larger mean increase in diastolic pressure,
which is similar to an anger pattern. Mirth
did not differ from control on any car-
diovascular measure except phasic in-
creases in heart rate that seemed related to
laughter.
As an alternative to the deceptions of
confederates and complicated films, the
use of affective imagery has recently
emerged as a means of reliably generating
emotional states. Humans not only have
the capacity to visualize an affect-
arousing situation but also to respond to
this internal image as an emotionally sig-
nificant event. Thus, as Lang (6) has re-
cently indicated, the whole psychophysi-
ological experience can be created in
miniature as an integrated "perceptual-
motor set."
Schwartz et al. (33, 34) have demon-
strated one major component of this pro-
cess in that subjects imagining happy,
sad, or angry scenes recreate correspond-
ing facial expressions. These facial mus-
cle changes are typically too small to be
345

seen by observers but produce distinct
patterns of electromyographic (EMG) ac-
tivity. Hence, these expressions do not
seem related to communication, but
rather to the recreation of the experience.
Weerts and Roberts (35), using pre-
selected subjects and individually tai-
lored anger and fear imagery scenes, re-
plicated the cardiovascular patterns found
by Ax and others. As in response to act-
ual environmental manipulation, dias-
tolic pressure increased significantly
more during anger than fear imagery;
heart rate and systolic pressure increased
equally.
Although not all subjects have vivid
imagery (36), there is no evidence to
suggest that the patterns of physiological
response to affective imagery differs qual-
itatively from those in the actual situation.
Indeed, psychophysiological research
suggests that clinical methods such as
systematic desensitization may be effec-
tive precisely because of this isomorph-
ism (37).
All of the studies of emotion mentioned
in this review have required subjects to
remain still. However, as the word 'e-
motion' suggests, there often is a tendency
to want to move when expressing happi-
ness, anger, or fear. Interestingly, in sad-
ness there is an equally distinct desire not
to move (38).
At a neurophysiological level, it re-
mains unclear whether exercise and emo-
tional behavior actually utilize distinct
neural pathways and produce qualita-
tively different cardiovascular ad-
justments (12). In other words, when one
is exercising, are the cardiovascular ef-
fects of emotional state redundant, addi-
tive, or, in some cases, genuinely interac-
tive? Why is cardiovascular activation
during exercise used to ameliorate
stress-related disease, while supposedly
346 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
GARY E. SCHWARTZ et al.
similar emotional activation is considered
pathogenic? Is it possible that exercising
in an angry state has very different conse-
quences for health than exercising in a
normal or relaxed state?
The present study was designed to
examine cardiovascular patterns follow-
ing happiness, sadness, fear, anger, relax-
ation, and control imagery while subjects
were seated and while they exercised in
the standard one-step test. To maximize
perceptual-motor coupling (6) and com-
parability of the imagery and exercise
conditions, subjects in the seated imagery
conditions imagined expressing the des-
ignated emotional state while exercising
on the step; they then proceeded to actu-
ally exercise while continuing to generate
the desired emotion. To highlight the
practical as well as theoretical signifi-
cance of cardiovascular patterning in
emotion, blood pressure and heart rate
assessed by standard clinical procedures
were chosen as dependent measures.
METHODS
Subjects
Thirty-two healthy, college-aged, paid volunteers
participated in the study. Eight males and eight
females each were recruited from both Amherst
College and Hampshire College. The only require-
ment for participation in the study was some high
school or college acting experience. This criterion
was chosen to increase the likelihood that subjects
would be relatively comfortable in the otherwise
novel task of publicly self-generating emotional
states. On the other hand, it was hypothesized that
this criterion would only minimally restrict the
generalizability of findings concerning within sub-
ject differences.
Design
Each subject participated in six trials, one for
each condition (happiness, sadness, anger, fear, con-
CARDIOVASCULAR DIFFERENTIATION OF EMOTION

trol, and relaxation). The order of conditions was ily would. After each of the six exercise periods,
counterbalanced across subjects. Each trial included subjects returned to their seats and resumed a nor-
a 4-minute rest period, a 2-minute imagery period, a mal state.
60-second or 25-step exercise period, and a 6-minute
postexercise recovery period.
To avoid interference in the natural expression of Dependent Measures
emotion during exercise, subjects' pace was not Systolic and diastolic blood pressure was rec-
rigidly controlled. Pretesting determined that during orded from subjects' nondominant arm using a
a minute of normal exercise, subjects tended to take Lumi-tronics II electronic sphygmomanometer. The
approximately 25 steps. To investigate the relative brachial artery was palpated and marked to increase
effects of length of time exercising versus the consistency of readings within subjects. Im-
amount of physical movement (number of steps), mediately prior to each blood pressure reading, heart
half of the subjects exercised for 25 steps and half forrate was recorded manually by counting the number
60 seconds. Thus, for example, if subjects walked of pulses in 15 seconds. For each trial, heart rate
unusually slowly during relaxation, one could inves- systolic and diastolic blood pressure readings were
tigate whether the cardiovascular response of sub- taken: 1) in the middle of the rest period, 2) at the
jects who exercised for 60 seconds was comparable end of rest period, 3) at the end of the imagery
to those exercising for a longer period of time in period, 4) immediately following the exercise
order to move a fixed distance. period, 5) midway through the exercise recovery
period, and 6) at the end of the exercise recovery
Procedure period.
At the end of each trial, subjects rated how happy,
Two male undergraduates unfamiliar with the sad, angry, fearful, and relaxed they felt on a 1 to 5
specific hypotheses of the study each ran half of the scale, separately for the imagery and exercise
males and females from each college. Except during periods. Subjects were instructed to rate each condi-
exercise, subjects sat in a straight-backed chair next tion as honestly as possible on all five feelings. They
to a desk in a moderately sized laboratory room. The were also encouraged to use decimals if the 1 to 5
experimenter sat in front of the desk in easy reach of scale did not provide them with sufficient dif-
the subjects' nondominant arm to obtain the car- ferentiation.
diovascular measures. A wooden platform about 40
Subjects were informed that the experimenter was
cm high, similar to the one used in the Harvard Step
completing the same scales based on his observa-
Test, was situated a few feet in front of the subjects'
tions of their behavior. The experimenter estimated
chair.
how intensely subjects were experiencing each feel-
For the happiness, sadness, anger, fear, and relax-
ing based on relative facial expressions and body
ation conditions, subjects were asked, after the ini-
postures (see ref, 7). This procedure may have
tial rest period, to close their eyes and to select a
further encouraged subjects' honest reporting.
particular situation from their past or future that
Finally, for the 60-second exercise conditions, the
would evoke the desired state. Then, during the
number of steps taken per trial was recorded. For the
imagery phase, subjects were asked to recreate as
25-step conditions, the number of seconds taken to
vividly as possible the feelings and physical sensa-
complete the task was recorded.
tions associated with that scene while imagining
expressing themselves walking up and down the
step. For the control imagery condition, subjects Data Analysis
were asked to imagine walking up and down the step
as they normally would without creating any par- The two resting values per trial for each car-
ticular emotion. diovascular measure were separately averaged to
At the end of the 2 minutes of imagery, subjects produce indices of baseline activity. All analyses of
opened their eyes and following a brief measurement the cardiovascular data were performed on change
period, proceeded to actually walk up and down the scores with the appropriate baseline value sub-
step. During the relaxation and the four emotion tracted from each measurement. Analysis of var-
conditions, subjects nonverbally (facially and post- iance, multiple regression, and discriminant func-
urally) expressed the feelings appropriate to the tion analysis were each used to answer specific
imagined situations. For the neutral, control condi- questions about the patterns of changes in the car-
tion, subjects performed the step test as they ordinar- diovascular measures.

Psychosomatic Medicine Vol. 43, No. 4 (August 1981) 347


The analyses of the cardiovascular data may be
summarized as follows:
1. To examine mean changes in the cardiovascular
measures, two sets of analyses were performed—
one for the six imagery conditions and one for the
three measurements of the comparable six exercise
conditions. In each case, a multivariate analysis of
variance of systolic pressure, diastolic pressure,
and heart rate was followed by separate univariate
analyses of each cardiovascular measure. In turn,
the Newman-Keuls procedure was used to assess
specific comparisons within the univariate
analyses.
2. Correlational and regression analyses of the
cardiovascular data were then performed sepa-
rately for imagery and for the first measurement of
exercise. The other two measurements of exercise
were not included in these and subsequent
analyses because questions concerning patterns of
response rather than recovery were being ad-
dressed. The correlational analyses assessed rela-
tions among the cardiovascular measures within
each condition. The regression analyses directly
investigated the ways in which interactions of
various emotional conditions with diastolic pres-
sure or heart rate diverged from a linear "arousal"
model in the prediction of systolic pressure. Un-
like analysis of variance techniques, these
analyses allowed a number of conclusions to be
drawn about the hemodynamics underlying the
various cardiovascular patterns.
3. Discriminant analysis was employed to address
a number of additional questions. This was the
only analysis in which the cardiovascular changes
during imagery and exercise were directly com-
pared. The procedure was used to assess what
patterns of relative changes in the three cardiovas-
cular measures during imagery and the first mea-
surement of exercise allowed maximal discrimina-
tion among the six conditions. This analysis could
determine, for example, that levels of heart rate
and diastolic pressure during imagery relative to
levels of heart rate and systolic pressure during
exercise most effectively differentiated among the
various conditions.
The data analysis was performed using standard
computer packages. Statistical Analysis System
(SAS) was used for the multivariate analyses of
variance, Statistical Package for the Social Sciences
(SPSS) for the discriminant and regression analyses,
and Data-Text for the repeated measures analyses of
variance including those with slightly unbalanced
cell sizes.
Due to equipment difficulties, one subject's dias-
348 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
GARY E. SCHWARTZ et al.
tolic pressure for control imagery and another's for
anger during exercise were missing, and the
analyses were adjusted accordingly.
It should be noted that all of the significance
levels reported for the multivariate analyses of var-
iance and discriminant analyses in this study are
conservatively biased because standard multivariate
computer programs do not readily handle within-
subjects designs. However, since all of the affected
statistics were highly significant, there was no need
to adjust the values. Each statistical procedure will
be discussed in more detail within the context of the
specific analyses.
RESULTS
Analyses of Variance of the
Cardiovascular Changes
Imagery Conditions. The cardiovas-
cular measures were first analyzed using
analysis of variance techniques to
examine the effects of condition on mean
changes. For the imagery conditions, a
one-way multivariate analysis of variance
of condition (happiness, sadness, anger,
fear, relaxation, control) was performed
with diastolic blood pressure (DBP), sys-
tolic blood pressure (SBP), and heart rate
(HR) as dependent measures. A Wilks' A
(lambda) of 0.636 (approximate F (15,
502.8 = 6.0, p <0.001) clearly revealed
that imagery conditions differentially af-
fected patterns of cardiovascular activity.
The results are illustrated in Figure 1.
As a follow-up procedure, one-way re-
peated measures analyses of variance
were used to investigate each cardiovas-
cular measure separately. Each analysis
was significant, and the Newman-Keuls
procedure was employed to compare in-
dividual means (see Table 1).
For diastolic blood pressure (omnibus F
(5, 1550) = 3.60, p = 0.005), the mean
increase during anger was significantly
higher than during any of the five other
CARDIOVASCULAR DIFFERENTIATION OF EMOTION

Increases during fear were similar to those

during happiness; changes during both
conditions were not significantly different
from the normal control, although they
were different from relaxation. Contrary to
Averill's (31) findings, diastolic changes
in sadness were virtually identical to
those in the control condition and not
significantly different from relaxation.
As expected, systolic pressure was not
as differentiating. Although the anger
condition produced the highest mean in-
crease, it was not significantly different
from fear, sadness, or happiness. All four
of the emotion conditions raised systolic
pressure above the level of the two control
conditions (omnibus F (5,155) = 6.99, p
Fig. 1. Mean changes in heart rate (HR) and in <0.001).
systolic (SBP) and diastolic (DBP) blood Increases in heart rate were also higher
pressure separately for the happiness
(HAP), sadness (SAD), anger (ANG), fear
during the four emotion conditions than
(FEAR), control (CON), and relaxation during relaxation and the control (om-
(REL) conditions following seated imagery. nibus F (5,155) = 15.23, p <0.001). How-
ever, unlike systolic pressure, fear and
anger produced significantly larger in-
conditions (see Table 1). Consistent with creases than happiness, while sadness fell
previous research, 25 of 32 subjects had in between (see Table 1).
greater increases in diastolic pressure dur-
ing anger than during fear (t(31) = 2.56, p Exercise Conditions. As an initial
<0.02). Mean arterial pressure (DBP global assessment, the exercise data were
+ (SBP -DBP) 13) was also higher in anger analyzed in a two-way multivariate
than in fear (t(31) = 2.04, p = 0.05). analysis of variance with condition (hap-

TABLE 1 Newman-Keuls Analysis of Mean Changes in Cardiovascular Measures During Imagery

Condition*

Measure HAP SAD ANG FEAR CON REL

Diastolic
blood pressure (N=31) 3.58a 1.68a'6 6.94 3.44a 1.53a'b -0.896
Systolic
blood pressure (N = 32) 4.98a 6.42a 7.31 a 6.72a 0.45b 0.55b
6 C
Heart rate (N = 32) 5.63 a fa
7.13 ' 10.50" 10.22" 0.19 0.03c
*AII values in a given row without a common superscript letter are signmcanuy airrerem at oeiow me u.ua level.
Abbreviations refer to happiness (HAP), sadness (SAD), anger (ANG), fear (FEAR), control (CON), and relaxation
(REL).

Psychosomatic Medicine Vol. 43, No. 4 (August 1981) 349


piness, sadness, anger, fear, control, re-
laxation) and measurement (first, second,
third) as factors and DBP, SBP, and HR as
dependent measures. The Wilks' criteria
for condition (A = 0.804, approximate F
(15, 1524) = 8.36, p <0.001), measure-
ment (A = 0.567, approximate F (6, 1104)
= 60.34, p <0.001), and their interaction
(A = 0.817, approximate F (30, 1620) =
3.84, p <0.001) were all highly signifi-
cant. Univariate analyses to be discussed
in greater depth indicated that these ef-
fects were primarily due to the differential
influence of condition on the response
and recovery of systolic pressure and
heart rate.
For each cardiovascular measure, a
three-way Exercise Type (60 seconds, 25
steps) x Condition x Measurement
analysis of variance was assessed with
repeated measures on the last two factors.
In none of the analyses were main effects
or interactions involving Exercise Type
significant. Therefore, the quality of the
exercise rather than the literal amount
was determining the physiological pat-
terning. Cardiovascular changes during
relaxation, for example, were virtually
identical between groups on each mea-
sure even though one group took an aver-
age of 12.6 steps in 60 seconds while the
other group took 25 steps in 87.9 seconds
(17.1 steps in 60 seconds).
As expected, in both exercise types, the
nature of the condition systematically af-
fected how rapidly subjects moved. For
subjects exercising for 25 steps, anger
(45.4), fear (51.4) and happiness (49.6)
conditions took significantly fewer sec-
onds than the control (63.9), while sad-
ness (85.1) and relaxation (87.9) took sig-
nificantly longer (one-way analysis: F
(5,65) = 13.13, p <0.001). Similarly, sub-
jects exercising for 60 seconds took more
350 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
GARY E. SCHWARTZ et al.
steps during anger (29.5), fear (26.9), and
happiness (24.7) than during control
(20.9) and fewer during sadness (15.3)
and relaxation (13.1) (one-way analysis:
F (5, 60) = 14.88, p <0.001).
In sharp contrast to the imagery condi-
tions, during exercise, diastolic blood
pressure was similar across conditions (F
<1). In all conditions, mean diastolic
pressure was lower than during rest, rang-
ing from -0.67 for control to -2.13 for
happiness. This tendency was stable
across the three measurements (see Table
2) and is consistent with the literature on
the physiology of isotonic exercise (11,
13).
For systolic pressure, the effects of con-
dition (F (5, 150) = 13.10, p <0.001),
measurement (F (2, 60) = 73.45, p
<0.001, and Condition X Measurement (F
(10, 300) = 8.50, p <0.001) were all highly
significant. Although systolic pressure
recovered across measurements and
recovered more in the more activating
conditions, there remained a significant
condition effect during each of the three
measurements (see Fig. 2 and Table 2).
Although the rate of exercise during
anger, fear, and happiness did not signifi-
cantly differ, at the first measurement
anger produced higher systolic pressure
than happiness with fear falling in-
between. Control, sadness, and relaxation
all produced substantially smaller in-
creases (omnibus F (5, 155) = 16.65, p
<0.001). By the second measurement, sys-
tolic pressure during fear had recovered
faster than during anger. At this reading,
systolic pressure was significantly higher
in anger than in any of the other condi-
tions (omnibus F (5, 155) = 9.05, p
<0.001).
By the third measurement, only anger
(5.16) and relaxation (0.55) were signifi-
CARDIOVASCULAR DIFFERENTIATION OF EMOTION

TABLE 2 Newman-Keuls Analysis of Mean Changes in Cardiovascular Measures During Exercise

Condition*

Measure HAP SAD ANC FEAR CON REL

Diastolic
blood pressure (N = 31)
Measurement 1 -2.41" -0.83" -1.44 a -1.52 a -1.13" -1.45"
Measurement 2 -2.24" - 0 95" -1.00" -0.53" -0.91" - .92"
Measurement 3 -1.72" -0.67" -2.28" -1.05" 0.03" -1.62 a
Systolic
blood pressure (N = 32)
Measurement 1 14.896 7.58C 19.53a 18.06"'6 5.92C 4.30c
Measurement 2 6.17" 3.33b 10.41 6.91" 3.026 0.806
Measurement 3 4.11"' 6 1.45"'h 5.16" 4.63"' b 1.77""b o.ss1'
Heart rate (N=32)
Measurement 1 26.75" 7.63fa 33.38 26 56" 14.13 5.41 b
Measurement 2 -0.94" -1.88" 1 25" -1.44 s -0.81a -1.34"
Measurement 3 0.31" 0.13" -0.19" -1.69" -0.69" 0.28"
•All values in a given row without a common superscript letter are significantly different at below the 0.05 level.
Abbreviations refer to happiness (HAP), sadness (SAD), anger (ANC), fear (FEAR), control (CON), and relaxation
(REL).

cantly different as systolic pressure re-
turned to baseline (omnibus F (5, 155) =
3.41, p = 0.006).
Heart rate was also significantly af-
fected by condition (F (5, 150) = 13.40, p
<0.001), measurement (F (2, 260) = 86.58,
p <0.001), and their interaction (F (10,
300) = 22.49, p <0.001). Most of the
condition main effect was contributed by
the first measurement (F (5, 155) = 24.90,
p <0.001). At this point, exercising in
anger raised heart rate an average of more
than 33 beats per minute. This change was
significantly greater than during fear and
the other conditions, including a more
than double increase over normal exer-
cise. On the other hand, both sadness and
relaxation produced less than half the
mean increase of normal exercise. Unlike
systolic pressure, there were no dif-
ferences among conditions at the second
and third readings. Interestingly, heart
rate rebounded slightly below resting
baseline (X = —0.86) by the second mea-
surement and more closely approached
baseline by the third (X = -0.31).
Correlational and Regression
Analyses of the Cardiovascular
Changes
Correlations among Cardiovascular
Measures. Although the analyses of var-
iance revealed important differential ef-
fects of emotional condition on levels of
cardiovascular response, they provided
little information regarding changes in
the relations among the cardiovascular
measures. Table 3 includes the correla-
tions among the cardiovascular measures
within the various conditions for imagery
and for the first measurement of exercise.
Although subjects were visualizing exer-
cising while they were seated, the pat-
terns of correlations clearly differed be-
tween the two phases. In general, during

Psychosomatic Medicine Vol. 43, No. 4 (August 1981) 351

 GARY E. SCHWARTZ et al.

sure. A major exception was sadness in

which the coupling between the diastolic
and systolic pressure actually increased
slightly. Also of note, systolic pressure
and heart rate, in general, became sub-
stantially more coupled during exercise
than they were during imagery, suggest-
ing an inhibition of the baroreceptor
mechanism. Among the imagery condi-
tions, fear most resembled the exercise
pattern.

Multiple Regression Analyses Predict-

Fig. 2. Mean changes in heart rate (HR) and in
systolic (SBP) and diastolic (DBP) blood
pressure separately for the happiness
(HAP), sadness (SAD), anger (ANG), fear
(FEAR), control (CON), and relaxation
(REL) conditions during the first measure-
ment following exercise.
imagery, systolic and diastolic pressure
tended to increase together. On the other
hand, the major vasodilation associated
with isotonic exercise reversed this pat-
tern, producing small negative correla-
tions between systolic and diastolic pres-
ing Systolic BJood Pressure. Multiple
regression analyses were employed to
examine these cardiovascular patterns
more closely. If the cardiovascular system
responds along a linear, undimensional
arousal continuum, the best predictor of
one cardiovascular measure should be a
second cardiovascular measure. Theoreti-
cally, emotional state should not substan-
tially alter that relation or independently
contribute unique information. To test
this hypothesis, four comparable regres-
sion analyses were performed. Because
systolic pressure is importantly related to
both diastolic pressure and heart rate, it
was chosen as the most potentially infor-
mative dependent measure.
For both imagery and exercise, the
question was separately asked: How does

TABLE 3 Pearson Correlations among the Cardiovascular Measures during Imagery and Exercise0
r
'SBP, DBP 'SBP, HR DBP, HR

Condition Imagery Exercise Imagery Exercise Imagery Exercise

Happiness 0.18 -0.05 0.22 0.53* 0.00 -0.02
Sadness 0.35* 0.46* 0.15 0.34* -0.14 0.09
Anger 0.57* -0.22 -0.21 0.43* -0.20 -0.38
+
Fear 0.49* -0.10 0.29 0.40* 0.28 -0.38
Control 0.19 -0.19 0.15 0.41* 0.43* -0.05
Relaxation
Relaxation 0.00
0.00 -0.10
-0.10 -0.03
-0.03 0.36* -0.23
-0.23 -0.20
-0.20
The correlations are between systolic (SBP) and diastolic blood pressure (DBP), systolic pressure and heart rate (HR),
+
and diastolic pressure and heart rate. p <0.10; *p <0.05; **p <0.01; ***p <0.001.

352 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)

CARDIOVASCULAR DIFFERENTIATION OF EMOTION

emotional state interact with diastolic ticularly related to levels of diastolic pres-
pressure and how does it interact with sure. Thus, although the mean increases
heart rate in predicting systolic pressure? in systolic pressure during happiness,
Thus, for example, diastolic pressure, sadness, anger, and fear were equal, the
condition, and Diastolic Pressure x Con- hemodynamics of those increases were
dition (i.e., the products of the measures different.3 Especially during anger, rela-
with the main effects partialled out) were tive increases in peripheral resistance
used to predict systolic pressure in sepa- seem to have contributed to increases in
rate analyses of imagery and exercise. systolic pressure as a by-product of in-
Identical analyses were performed for creases in diastolic pressure. On the other
heart rate. hand, during sadness the increases in sys-
Condition and its interaction with the tolic pressure were particularly unrelated
cardiovascular measure were each entered to diastolic pressure, indicating that they
into the regression as a set of five effect were primarily mediated by cardiac out-
coded contrast variables representing the put.
five noncontrol conditions. In each con- As indicated in Table 3, heart rate dur-
trast, the designated condition was as- ing imagery provided little information
signed a " 1 " , the control condition a about systolic blood pressure. The slight
" — 1", and all other conditions a "0". This link between the measures did seem
procedure, like a standard analysis of var- primarily related to arousal. When emo-
iance, resulted in F tests comparing each tional condition was included along with
condition to the mean of all conditions.2 heart rate in the regression, the unique
The regression analyses are presented in information provided by heart rate be-
Table 4. came nonsignificant.
The results concerning diastolic pres- Only two conditions provided informa-
sure during imagery indicate, as tion about systolic pressure which did not
suggested before, that there was a moder- overlap with that provided by heart rate.
ate coupling of diastolic and systolic pres- During relaxation, systolic pressure was
sure during this phase. However, happi- significantly lower than average, inde-
ness and fear were the only conditions in pendent of heart rate. Anger, once again,
which diastolic pressure alone was the involved a particularly unusual pattern.
best predictor of systolic pressure. During The anger condition produced the highest
sad imagery, systolic pressure was signif- mean increase in both heart rate and sys-
icantly higher than expected, while dur- tolic blood pressure (see Table lj. How-
ing relaxation it was significantly lower. ever, unlike fear, happiness, and sadness,
During anger, systolic pressure was par- the correlation between systolic pressure
and heart rate during anger was actually

2
The regression analyses are based on Cohen and
Cohen (39). The significance tests for the condition
and interaction effects are adjusted for a within-
subjects design by removing between-subjects var-
iance from the error terms. Heart rate and diastolic
pressure were not simultaneously entered into these
regressions because complex suppressor effects
made interpretation questionable.
3
Blood pressure is determined by the product of
cardiac output and peripheral vascular resistance.
Cardiac output is determined jointly by heart rate
and stroke volume. Systolic pressure equals diastolic
pressure plus the pulse pressure of a stroke of the
heart. Peripheral resistance primarily influences sys-
tolic pressure through its effect on diastolic pressure.

Psychosomatic Medicine Vol. 43, No. 4 (August 1981) 353

 GARY E. SCHWARTZ et al.

TABLE 4 Multiple Regression Analyses Predicting Systolic Blood

Pressure during Imagery and Exercise"
Imagery Exercise

Predictors Beta r Beta r

Diastolic Blood Pressure 0.32"* 0.40"* -0.03 -0.07
(DBP)
Condition
Happiness 0.15* 9-0.2T"
Sadness 0.20" 0.21*** -0.16* 0.04
Anger 0.33"* 0.32*"
Fear 0.30"* 0.30*"
Relaxation -0.16* 0.00 -0.34"* -0.03
Condition x DBP
Anger 0.19* 0.26*"
Sadness 0.23*** 0.12*

Heart Rate 0.09 0.25*" 0.53"* 0.60"*

Condition
Anger 0.43*" 0.24*" 0.26** 0.33*"
Relaxation -0.23** 0.00 -0.15* -0.03
Condition x Heart Rate
Anger -0.24" 0.047
a
Systolic pressure was separately predicted from diastolic pressure (DBP) and from heart rate. Condition or its
interaction with the cardiovascular measure are reported only when the Beta weight significantly contributed to
prediction. The corresponding zero-order correlation (r) between the designated variable and systolic pressure is
also reported. Significant levels for the Beta weights are adjusted for a within-subjects design. The analysis of
diastolic blood pressure is based on 191 observations and of heart rate on 192 (i.e., 32 subjects x 6 conditions). *p
<0.05; " p <0.01; * " p <0.001.

negative (-0.21; see Table 3). Thus, the
regression analysis revealed that being in
the anger condition is especially predic-
tive of high systolic blood pressure when
one adjusts for the fact that high heart rate
is predictive of lower systolic pressure.
Linking the two regression analyses
during imagery, one finds that high dia-
stolic pressure is uniquely associated with
high systolic pressure during anger and,
in turn, high systolic pressure during
anger is uniquely associated with lowered
pulse rate. These relations may suggest
that during anger the increases in systolic
pressure mediated by increases in periph-
eral resistance may particularly activate
inhibition of heart rate through barorecep-
tor mechanisms.
Although the imagery task included
imagining exercising, the actual exercise
task produced qualitatively different
emotion-cardiovascular interactions. As
mentioned earlier, compensatory vasodi-
lation during exercise resulted in diastolic
pressure having no relation to systolic
pressure. However, independent of dia-
stolic pressure, systolic pressure was sig-
nificantly higher than average during
anger, fear, and happiness, and signifi-
cantly lower than average during sadness

354 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)

CARDIOVASCULAR DIFFERENTIATION OF EMOTION
and relaxation. As noted earlier (see Table
3), although sadness was associated with
lower than average systolic pressure, it
was the one condition in which diastolic
pressure remained predictive of systolic
pressure. This pattern suggests that sad-
ness produced a psychobiological state
which was incompatible with the normal
adjustments of exercise.
Unlike imagery, during exercise heart
rate and systolic pressure were highly
correlated. However, as in imagery, relax-
ation and anger were notably different
from the average. Independent of any rela-
tion to heart rate, systolic pressure was
particularly high in anger and low during
relaxation. Because these changes were
also virtually independent of diastolic
pressure, one can infer that they resulted
primarily from differences in stroke vol-
Discriminant Analysis of the
Cardiovascular Changes
A major question that has not been
addressed in the preceding analyses is
how well can simple measures of heart
rate and blood pressure discriminate
among emotional states during imagery
and exercise? A stepwise discriminant
analysis was employed to reveal both 1]
what linear combinations of the car-
diovascular measures maximally distin-
guish among the six conditions and 2)
how these functions tend to classify and
misclassify individual observations. Wal-
ter and Porges (40) have described a simi-
lar use of discriminant analysis in
physiologically differentiating among
various experimental conditions.
The three cardiovascular measures dur-
ing imagery and exercise were simultane-
ously entered into a stepwise analysis to
discriminate among the six trials of the
Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
experimental design. As expected, all
measures contributed unique information
to the discriminant functions except dia-
stolic presure during exercise. To discrim-
inate among the six conditions, five or-
thogonal linear functions were produced.
However, only the first two functions
were significant, accounting for 96.3 % of
the variance explained by the five func-
tions.
As a whole, the discriminant analysis
produced a highly significant Wilks ' A of
0.478 (x2 (25) = 135.48, p <0.001). The
first linear combination of cardiovascular
measures had a canonical correlation of
0.65 with identification of condition, in-
dicating that it could account for about
42% of the variance. This first function
was a general measure of how consis-
tently all aspects of the cardiovascular
system were activated. Heart rate (0.48)
and systolic pressure (0.30) during exer-
cise and heart rate (0.51) and diastolic
pressure (0.33) during imagery all had
sizable discriminant weights in the same
direction. The composite of these weights
correlated with the weighting of anger
(1.20) at one end and relaxation (-1.16) at
the other. On this dimension of activation,
fear (0.77), happiness (0.36), sadness
(-0.35), and control (-0.80) were quite
symmetrically spaced between the ex-
tremes of anger and relaxation.
When this first function was removed,
the relation between cardiovascular mea-
sures and the designation of condition
remained significant (Wilks' A = 0.829, x2
(16) = 34.32, p = 0.005). The second
discriminant function had a canonical
correlation of 0.38, explaining an addi-
tional 14 % of the variance in condition.
Interestingly, this function revealed that
fear (0.21) and especially sadness (0.75),
unlike happiness (-0.31) and control
(-0.46), had a pattern of relatively low
355

heart rate (-0.63) during exercise and low
diastolic pressure (-0.35) during imagery
compared with changes in heart rate
(0.64) and systolic pressure (0.48) during
imagery.
With six conditions, one would expect
to correctly identify an observation by
chance about one-sixth of the time. Due to
missing data, 31 subjects had observations
for anger and control conditions, and all
32 subjects had complete data for the
remaining conditions. Therefore, without
any additional information, one would
assign a prior probability of 16.3% for
correctly classifying an observation as
anger or control by chance and a probabil-
ity of 16.8% for the remaining four condi-
tions.
Overall, the cardiovascular measures
correctly identified the condition from
which an observation was taken 42.6% of
the time. Interestingly, fear (5 of 32) was
the only condition that could not be iden-
tified at above chance levels. Fear was
about equally confused with sadness,
anger, and happiness, although these
conditions were not nearly as likely to be
confused with each other. Anger (15 of 31)
and sadness (15 of 32) could be correctly
identified in about half of the subjects.
Happiness (10 of 32) could be distin-
guished about a third of the time and
control (17 of 31) and relaxation (19 of 32)
more than half the time.
On the basis of cardiovascular activity,
control and relaxation were identified as
one of the two control conditions about
80% of the time. In none of the subjects
was anger confused with relaxation; in
only two individuals was anger confused
with sadness, even though these emotions
tend to co-occur in a variety of situations
(16). Although sadness and relaxation in-
volved a similar amount of physical
356 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
GARY E. SCHWARTZ et al.
movement during exercise, these condi-
tions were confused only at the level ex-
pected by chance (i.e., about 20% of the
time).
Self-Reports of Emotional
Intensity
In the context of this report, it is impor-
tant to know whether subjects were
generating emotional states of comparable
intensities. In other words, were subjects
feeling as sad during the sadness condi-
tion as they were feeling angry during the
anger condition? In addition, were levels
of happiness during imagery comparable
to levels of happiness during exercise?
To answer these questions, ratings (on
comparable 1-5 scales) of happiness,
sadness, anger, fear, and relaxation during
their respective conditions were
evaluated in a two-way repeated
measures analysis of Phase (imagery,
exercise ) x Emotional Condition (happi-
ness, sadness, anger, fear, relaxation). The
overall intensity of ratings during imagery
(4.20) and exercise (4.21) were virtually
identical (F< 1). in both phases subjects
reported being quite successful in
generating the desired states. In addition,
there was no main effect for emotional
condition (F (4,120) = 1.44, ns). Across
phases, ratings of the predominant emo-
tions were similar, ranging from 4.10 for
ratings of sadness in the sadness condi-
tions to 4.33 for ratings of anger in the
anger conditions.
Importantly, there was a highly signifi-
cant Phase x Emotional Condition in-
teraction (F (4,120) = 7.92, p <0.001).
Subjects reported being better able to gen-
erate states of happiness (4.35 vs. 4.24),
anger (4.53 vs. 4.14), and fear (4.20 vs.
4.08) while exercising. On the other hand,
CARDIOVASCULAR DIFFERENTIATION OF EMOTION
they reported that movement reduced
their ability to create states of sadness
(4.03 vs. 4.18) and relaxation (3.96 vs.
4.36).
The control condition was not included
in this analysis. During control imagery,
subjects reported that they were fairly
relaxed (3.55) and moderately happy
(2.29). During exercise, they became
somewhat less relaxed (3.03) and slightly
more happy (2.41).
Although the emotions reported during
the happiness, sadness, anger, fear, and
relaxation conditions were relatively
pure, some of the ratings of the nondo-
minant emotions were notable. For exam-
ple, especially during imagery, ratings of
happiness (2.88 vs. 2.60) during the relax-
ation conditions and ratings of relaxation
during the happiness conditions (2.75 vs.
2.19) were moderately high. In addition,
given the association between sadness
and a lack of movement, it was notable
that ratings of sadness during the anger
(2.21 vs. 1.94) and fear (2.01 vs. 1.65)
conditions were particularly high when
subjects were still. The only other non-
dominant rating above 2.0 during imagery
was the rating of relaxation (2.10) during
sadness. In contrast, the only other rating
above 2.0 during exercise was anger (2.09)
during the fear condition.
SUMMARY
The complex findings in this report
may be summarized as follows.
1. The use of affective imagery was an
effective strategy for inducing patterns
of cardiovascular change associated
with particular emotional states.
2. Contrary to the view of emotional
Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
"stress" (41) producing undif-
ferentiated physiological arousal, the
three cardiovascular measures (dias-
tolic blood pressure, systolic blood
pressure, and heart rate) responded to
the same set of specific emotions in two
circumstances (movement vs non-
movement) with six different patterns
of change (the six lines in Figs. 1 and 2).
3. Anger clearly produced the greatest
overall activation of the cardiovascular
measures and was distinctly opposite
from relaxation. The "fight" response of
anger differed from the "flight" re-
sponse of fear as well as from all other
conditions in terms of greater increases
in diastolic pressure during imagery
and greater increases in heart rate and
slower recovery of systolic pressure fol-
lowing exercise. Anger in the absence
of expression (i.e., movement) pro-
duced a unique pressor response in-
cluding indirect evidence of relatively
high peripheral resistance concurrent
with activated baroreceptor mechanisms.
4. Unlike anger, fear had no clearly
unique cardiovascular effects. Discrim-
inant analysis often confused it with the
happiness, anger, and sadness patterns.
Happiness produced changes quite
similar to those in fear except happiness
elicited less increase in heart rate dur-
ing imagery.
5. Sadness, like relaxation and unlike
happiness, anger, and fear, could not be
interpreted as a preparation for move-
ment as the word "emotion" (5) im-
plies. In sadness as well as relaxation,
subjects moved slowly and reported
being somewhat better able to generate
the desired state while stationary. Un-
like relaxation and all other states, heart
rate and systolic blood pressure in sad-
ness were virtually as high when sub-
357

jects were still as when they were actu-
ally exercising. In addition, sadness
was the one case in which emotional
state seemed to interfere with the car-
diovascular adjustments normally as-
sociated with exercise.
DISCUSSION
Based on the work of Cannon (4), Freud
(42), MacLean (3), and Plutchik (43),
among others (e.g., refs. 44 and 45), one
might summarize that emotions function-
ally (and anatomically) serve to link per-
ceptions of the status of the environment
to the status of internal needs and drives
(e.g., for survival, food, sex, comfort, af-
filiation). Humans do not merely pas-
sively respond to the environment with
pain or pleasure. "Paleomammalian"
structures (3) have evolved that anticipate
whether situational cues require, for
example, preparation for flight (experi-
enced as fear), physical combat (i.e.,
anger), loss and deprivation (i.e., sad-
ness), or satisfaction (i.e., happiness) (cf.
ref. 43).
The present study provides evidence
that emotional responses of happiness,
sadness, anger, and fear each evoke
specific, biologically meaningful, patterns
of cardiovascular adjustment. The current
experimental design capitalized on sub-
jects' ability to respond emotionally to
recalled or imagined situations. In this
experiment, as in similar ones (33-35), it
was not essential to standardize stimuli
across subjects. The findings support the
view that emotions are triggered by struc-
tural factors that are common to a variety
of specific contents (46-47). It was not
relevant to this study whether individuals
were sad because they imagined a relative
dying or a girlfriend or boyfriend leaving
358 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
GARY E. SCHWARTZ et al.
for the summer. In addition, the findings
were robust without major effects of sex.4
Consistent with evidence of the special
role of hostility in hypertension (19, 48)
and cardiovascular disease (21), the
"fight" response of anger had a more
profound effect on cardiovascular func-
tioning than any other emotion. For
example, in comparison to fear, anger
produced significantly greater increases
in diastolic and mean arterial pressure
during imagery and significantly greater
increases in pulse rate and slower recov-
ery of systolic pressure during exercise.
The evidence suggests that the de-
mands of fighting in anger are substan-
tially different from those of running in
fear. The present study is at least the fifth
replication (24-26, 35) of the phenome-
non of greater mean increase in diastolic
pressure in anger relative to fear in con-
strained (seated) subjects. The correla-
tional and regression analyses indicated
that increases in systolic pressure in anger
are particularly related to increases in
diastolic pressure. This finding is consis-
tent with previous research emphasizing
the role of peripheral vasoconstriction in
the pressor response in anger.
Although the biological function of this
pattern may at first seem mysterious (49),
vasoconstriction and increased diastolic
blood pressure are associated with in-
creased isometric muscle strength (4, 13,
50), vigilant sensory intake (51), and pro-
tection against the acute effects of hemor-
rhage (52)—all of which may be necessary
during a physical fight. These cardiovas-
4
Differences between males and females were as-
sessed in additional analyses of variance of each
cardiovascular measure separately for the imagery
and exercise conditions. None of the main effects or
interactions were significant.
CARDIOVASCULAR DIFFERENTIATION OF EMOTION
cular preparations for fighting as opposed
to fleeing are not unique to humans. For
example, Baccelli et al. (53) found that the
same cats that produced muscular vasodi-
lation when scared by a dog reliably pro-
duced vasoconstriction when confronted
by an attacking cat.
Interestingly, Ax (24) found that anger
produced higher overall muscle tension,
while fear produced a larger number of
intermittent bursts of tension. This pat-
tern is also consistent with the differential
demands of isometric versus isotonic
exercise. The ability to fight in anger
requires mustering maximal strength,
while the ability tofleeprimarily requires
speed and endurance. Given the nature of
cardiosomatic coupling (49), it is not sur-
prising that the sustained muscle tension
in anger may have more profound car-
diovascular consequences than more in-
termittent contractions in fear.
The comparisons of means, regression
weights, and discriminant functions all
highlighted anger as the opposite of re-
laxation. Although relaxation therapies
are virtually always discussed as counters
for anxiety, they may actually be more
related to alleviating the isometric tension
of anger.
It is also notable that the peripheral
vasoconstriction associated with anger is
antithetical to the major vasodilation as-
sociated with exercise (11). Adams et al.
(54) actually found in fighting cats simul-
taneous vasodilation in moving limbs and
vasoconstriction in stationary ones. In the
present study, although subjects were im-
agining exercising while seated, the anger
pattern definitely dominated during im-
agery. However, when subjects were actu-
ally moving, the exercise pattern pre-
vailed. The anger condition generated the
highest positive correlation (0.57) be-
tween systolic and diastolic pressure
Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
when subjects were stationary but the
highest negative correlation (-0.22) when
subjects were expressing themselves
motorically. These findings may be con-
sistent with considerable evidence that
inhibited rather than expressed anger is
correlated with phasic high blood pres-
sure and chronic hypertension (19, 20, 48,
55).
An important characteristic of anger in
the absence of movement is the tendency
for high systolic blood pressure to be
associated with relatively low heart rate as
well as with high diastolic pressure (see
Tables 2 and 3). This pattern suggests that
anger may especially elicit baroreceptor
inhibition of heart rate even though other,
possibly humoral (15, 27) and more
central mechanisms, seem to maintain
vasoconstriction. Anokhin's (56) work
indicates that baroreceptors can only fire
continuously for about 25 minutes before
they fatigue and adjust to a higher level of
pressure. Thus, as Meyer (20) has
suggested, anger that is maintained but
suppressed beyond this period may play a
special role in eliciting the "resetting"
mechanism observed in essential hyper-
tension (57).
The condition of simultaneous high
systolic pressure, high heart rate, and vas-
odilation seen in fear, exercise, and stimu-
lation of the "defense center" in the
hypothalamus seems less likely to over-
load the barorecptors. There is evidence
that in these states baroreceptor suppres-
sion of heart rate may be temporarily
deactivated through central inhibition
(58). Consistent with this phenomenon,
systolic pressure and heart rate were most
highly correlated during fear imagery and
during exercise (see Table 3).
Although the fear pattern during imag-
ery resembled the exercise pattern in
terms of high heart rate and systolic pres-
359

sure relative to diastolic pressure, the pat-
terns were not identical. For example,
during fear imagery, systolic and diastolic
pressure maintained a considerable posi-
tive correlation, whereas during exercise
they did not.
Given that the fear pattern is the one
usually studied as "emotional arousal," it
is striking that it was the only condition
which the discriminant analysis had diffi-
culty identifying. In terms of overall car-
diovascular activation, fear fell about
midway between anger and happiness.
However, fear resembled sadness in that
systolic pressure and heart rate during
imagery were high relative to diastolic
pressure during imagery and heart rate
during exercise. Although the current de-
sign only measured emotional states at the
point of recovery, one might speculate
that exercising in fear initially produced a
cardiovascular response equal to that in
anger, while more consistent exertion in
anger may have eventually led to the
differential response. The experimenters
informally reported that fearful subjects
were light-footed and that some would
intermittently cower as well as run. How-
ever, angry subjects tended to move
rhythmically and pound the step.
In the regression analyses, fear and
happiness were notable in that they most
often resembled the average cardiovascu-
lar pattern. During imagery, happiness
produced a considerably smaller mean
increase in heart rate than fear but during
exercise the mean responses were almost
identical. Like fear (and anger), subjects
tended to generate greater happiness
when they were moving. At one level,
running away from someone in fear
produces similar isotonic demands as
running towards them in happiness.
However, not surprisingly, imagining
360 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
GARY E. SCHWARTZ et al.
escaping from harm generated a larger
preparatory response than imagining
expressing satisfaction. It is also possible
that other measures, such as cardiovascu-
lar variability or humoral changes, will
eventually reveal that running when
happy is importantly different from run-
ning when afraid.
Of all the emotions, sadness had par-
ticularly unusual cardiovascular effects.
In contrast to happiness, anger, and fear,
sadness curiously seems to involve a rec-
ognition that there is "nothing to be
done." Sad subjects moved more slowly
than normal (the control condition) and
reported being somewhat better able to
generate sadness while stationary.
Quite dramatically, sadness was the
one condition in which movement did not
produce the cardiovascular adjustments
normally associated with exercise (see
Tables 3 and 4). Subjects moved an equal
amount during sadness and relaxation
and generated similar moderate increases
in systolic pressure and heart rate; how-
ever, systolic and diastolic pressure re-
mained significantly positively coupled
in sadness while negatively correlated in
relaxation and in all other conditions.
Sadness and rapid movement seem to be
very incompatible. In this study, subjects
moved slowly in a way that allowed the
sadness pattern to persist. More strenuous
running may have interfered with this
pattern and the subjective experience of
sadness (59). Interestingly, Griest et al.
(60) have reported that running is quite
effective in reducing patients' depressed
mood.
Somewhat paradoxically, during sad-
ness increases in systolic blood pressure
and heart rate were as large when subjects
were stationary as when they were actu-
ally exercising (see Table 1). Although
CARDIOVASCULAR DIFFERENTIATION OF EMOTION
sadness clearly does not entail a prepara-
tion for movement, sad imagery resulted
in increases in systolic pressure and heart
rate that were not significantly different
from those in fear and anger imagery.
Sadness in relatively pure form pro-
totypically requires an acceptance of and
adjustment to the loss of a significant
relationship (38, 61). Intense sadness
seems literally to include physiological
preparation for a loss of nurturance. Espe-
cially in contrast to anger, sadness is as-
sociated with considerable inhibition of
gastrointestinal activity, including saliva-
tion, gastric secretion, and motility as
well as hunger (38).
The current data, including the regres-
sion analysis, suggest that sadness pro-
duces a notable increase in cardiac out-
put, as is the case in anemia and other
systemic distress in which bodily tissue
experiences deprivation (62). As Hamburg
(63, p. 316) observed, "serious threat to a
key relationship may be as much
emergency in psychophysiological terms
as threat of attack by a predator." The
"disruption of interindividual bonds may
have profound consequences in car-
bohydrate, protein, fat, electrolyte, and
water metabolism and on crucial func-
tions of circulation" (63, p. 316). The
increase in cardiac output, decrease in
movement and digestion, and the other
selective changes in sympathetic and
parasympathetic activity (30, 38) as-
sociated with sadness may all be consis-
tent with its role in recuperation after the
loss of someone or something of major
significance.
It is important to recognize that the
present study was designed to maximize
subjects' psychophysiological responses
in the laboratory without the use of
ethically questionable manipulations.
Psychosomatic Medicine Vol. 43, No. 4 (August 1981)
Subjects were chosen to be relatively un-
inhibited about publicly generating fairly
intense emotion. In addition, they were
encouraged to create as intense emotional
states as possible. Subjects seemed to be
quite successful at the task in that they
reported average intensity ratings of 4.2
on a 5 point scale. Subjects were also
encouraged to maximize peripheral
physiological involvement by imagining
bodily expressing the emotions even
while seated (6).
Although subjects were not explicitly
asked, it had probably been quite a while
since they were as intensely angry, sad, or
afraid in their personal lives as they were
in imagination in this experiment. Even
though imagery has not traditionally been
considered a powerful stimulus, observers
could readily discriminate subjects' emo-
tional state (see Schwartz (7) for further
discussion). For example, according to the
experimenters, some subjects' blood ves-
sels clearly protruded on their necks dur-
ing anger. As Zajonc (64) has recently
reiterated, emotions are inherently subjec-
tive experiences. Thus, for example, hav-
ing subjects' imagine their own mothers'
deaths may be a more powerful stimulus
than showing all subjects the same film of
someone else's mother's death.
The present study may be the first evi-
dence of the effects of mental imagery and
emotional expression during exercise.
Exercising in an angry state produced
overwhelmingly different cardiovascular
demands than exercising in a normal or
relaxed state. These findings may be rele-
vant to why jogging seems to be deleteri-
ous for some with cardiovascular disease
while recuperative for others. For exam-
ple, Type A running may be quite dif-
ferent from Type B running (65). Emo-
tional state affected more than the mere
361
 GARY E. SCHWARTZ et al.

rate of movement. Anger differed in car-
diovascular response from fear and hap-
piness, and sadness differed from relaxa-
tion even though the respective rates of
movement were comparable.
Although many of the specific findings
in this report will require replication, the
data, as a whole, compellingly indicate
that physiological responses of sadness,
anger, and happiness depart in important
ways from the often studied "arousal"
pattern of fear. These fundamental emo-
tions seem to have such basic links to the
cardiovascular system that they can
genuinely interact with as well as aug-
ment the massive adjustments associated
with exercise. Emotions such as anger and
sadness are difficult to study using tradi-
tional laboratory procedures; neverthe-
less, they seem to be unique, integral parts
of human psychobiology. Specific emo-
tions seem to differentially mediate the
relation between environmental stress
and cardiovascular responses in ways that
may be consequential in the pathogenesis
and treatment of cardiovascular and re-
lated diseases.
The first two authors contributed
equally to this research and are listed in
alphabetical order. The research was
supported in part by National Science
Foundation Grant 81045. The authors
thank D. Blackmer, P. Crits-Christoph,
and I. Roseman for their contributions to
the implementation of this research
and/or the improvement of the final man-
uscript.

REFERENCES

1. Ekman P, Friesen WV, Ellsworth P: Emotion in the Human Face. New York, Pergamon Press, 1972
2. Izard CE: The Face of Emotion. New York, Appleton-Century-Crofts, 1971
3. MacLean PD: Sensory and perceptive factors in emotional functions in the triune brain, in Emotions:
Their Parameters and Measurement. Edited by L. Levi. New York, Raven Press, 1975
4. Cannon WB: Bodily Changes in Pain, Hunger, Fear and Rage, 2nd ed. (1929). Boston, CT Branford, 1953
5. Hassett J: A Primer of Psychophysiology. San Francisco, WH Freeman, 1978
6. Lang PJ: A bio-informational theory of emotional imagery. Psychophysiology 16:495-512, 1979
7. Schwartz GE: Psychophysiological patterning and emotion revisited: a systems perspective, in
Measuring Emotions in Infants and Children. Edited by C. Izard. Cambridge University Press, 1981
8. Benson H: The Relaxation Response. New York, Avon Books, 1975
9. Mandler G: Mind and Emotion. New York, Wiley, 1975
10. Schachter S: The assumption of identity and peripheralist-centralist controversies in motivation and
emotion, in Feelings and Emotions. Edited by MB Arnold. New York, Academic Press, 1970
11. Bullard RW: Physiology of exercise, in Physiology. Edited by EE Selkurt. Boston, Little, Brown, and Co.,
1971, pp. 651-668
12. Cohen DH, Obrist PA: Interactions between behavior and the cardiovascular system. Circ Res
37:693-706, 1975
13. Tuttle WW, Horvath SM: Comparison of effects of static and dynamic work on blood pressure and heart
rate. J Appl Physiol 10:294-296, 1957
14. Martin B: The assessment of anxiety by physiological behavioral measures. Psychol Bull 58:234-255,
1961
15. Wenger MA, Clemens TL, Darsie ML, Engel BT et al: Autonomic response patterns during intravenous
infusion of epinephrine and nor-epinephrine. Psychosom Med 22:294-307, 1960
16. Schwartz GE, Weinberger DA: Patterns of emotional responses to affective situations: relations among
happiness, sadness, anger, fear, depression, and anxiety. Motivation Emotion 4:175 — 191, 1980

362 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)

CARDIOVASCULAR DIFFERENTIATION OF EMOTION

17. Hodges WF, Spielberger CD: The effects of threat of shock on heart rate for subjects who differ in
manifest anxiety and fear of shock. Psychophysiology 2:287-294, 1966
18. Blair DA, Glover WE, Greenfield ADM, Roddie IC: Excitation of cholinergic vasodilator nerves to
human skeletal muscles during emotional stress. J Physiol 148:633—647, 1959
19. Esler M, Julius S, Zweifler A et al: Mild high-renin essential hypertension. N Engl J Med 296:405-411,
1977
20. Meyer RG: Chronic high blood pressure, essential hypertension, and the inhibition of aggression
(Summary). Proceedings of the 76th Annual Convention of the American Psychological Association
7:401-402, 1972
21. Williams RB, Haney PL, Lee KL, Kong Y, Blumenthal JA, Whalen RE: Type A behavior, hostility, and
coronary atherosclerosis. Psychosom Med 42:539-549, 1980
22. Jacobs S, Ostfeld A: An epidemiological review of the mortality of bereavement. Psychosom Med
39:344-357, 1977
23. Schmale AH: Relationship of separation and depression to disease. Psychosom Med 20:259-277,1958
24. Ax AF: The physiological differentiation between fear and anger in humans. Psychosom Med
15:433-442, 1953
25. Funkenstein DH, King SH, Drolette M: The direction of anger during a laboratory stress-inducing
situation. Psychosom Med 16:404-413, 1954
26. SchachterJ:Pain, fear, and anger in hypertensives and normotensives. Psychosom Med 19:17-29,1957
27. Cohen SI, Silverman AJ: Psychophysiological investigations of vascular response variability. J
Psychosom Res 3:185-210, 1959
28. Elmadjian F, Hope JM, Lamson ET: Excretion of epinephrine and norepinephrine in various emotional
states. Arch Neurol Psychiatry 77:608-620, 1957
29. Fine BJ, Sweeney DR: Personality traits, and situational factors, and catecholamine excretion. J Exper
Res Pers 3:15-27, 1968
30. Sternbach RA: Assessing differential autonomic patterns in emotions. J Psychosom Res 6:87—91, 1962
31. Averill JR: Autonomic response patterns during sadness and mirth. Psychophysiology 5:399-414,1969
32. Ekman P, Friesen WV: Unmasking the Face. Englewood Cliffs, NJ, Prentice-Hall, 1975
33. Schwartz GE, Fair PL, Salt P, Mandel MR, Klerman GL: Facial muscle patterning to affective imagery in
depressed and nondepressed subjects. Science 192:489-491, 1976
34. Schwartz GE, Fair PL, Salt P, Mandel MR, Klerman GL: Facial expression and imagery in depression: an
electromyographic study. Psychosom Med 38:337-347, 1976
35. Weerts TC, Roberts R: The physiological effects of imagining anger-provoking and fear-provoking
scenes (abstr). Psychophysiology 13:174, 1976
36. Marks DF: Visual imagery differences in the recall of pictures. Br J Psychol 64:17-24, 1973
37. Lang PJ, Melamed BG, Hart J: A psychophysiological analysis of fear modification using an automated
desensitization procedure. J Abnorm Psychol 76:229-234, 1970
38. Averill JR: Grief: its nature and significance. Psychol Bull 70:721-748, 1968
39. Cohen J, Cohen P: Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences.
Hillsdale, NJ, L Erlbaum, 1975
40. Walter GF, Porges SW: Heart rate and respiratory responses as a function of task difficulty: the use of
discriminant analysis in the selection of psychologically sensitive physiological responses.
Psychophysiology 13:563-571, 1976
41. Selye H: Confusion and controversy in the stress field. J Hum Stress 1:37-44, 1975
42. Freud S: Inhibitions, Symptoms and Anxiety (1926), in The Standard Edition of the Complete
Psychological Works of Sigmund Freud, vol 20. Edited by J Strachey. London, Hogarth Press, 1959
43. Plutchik R: Emotion: A Psychoevolutionary Synthesis. New York, Harper & Row, 1980
44. Tomkins SS: Affect as the primary motivational system, in Feelings and Emotions. Edited by MB
Arnold. New York, Academic Press, 1970
45. Arnold MB: Perennial problems in the field of emotion, in Feelings and Emotions. Edited by MB
Arnold. New York, Academic Press, 1970
46. de Rivera J: A structural theory of the emotions. Psychol Issues 10 (Monograph 40), 1977
47. Roseman IJ: Cognitive aspects of emotion and emotional behavior. Paper presented at the meeting of the
American Psychological Association, New York, NY, September 1979

Psychosomatic Medicine Vol. 43, No. 4 (August 1981) 363

 GARY E. SCHWARTZ et al.

48. Harburg E, Erfurt JC, Hauenstein LS et al: Socio-ecological stress, suppressed hostility, skin color, and
black-white male blood pressure: Detroit. Psychosom Med 35:276-296, 1973
49. Obrist PA: The cardiovascular-behavioral interaction—As it appears today. Psychophysiology
13:95-107, 1976
50. Humphreys PW, Lind AR: The blood flow through active and inactive muscles of the forearm during
sustained hand-grip contractions. J Physiol 166:120-135, 1963
51. Williams RB, Bittker TE, Buchsbaum MS, Wynne LC: Cardiovascular and neurophysiologic correlates
of sensory intake and rejection. I. Effect of cognitive tasks. Psychophysiology 12:427-433, 1975
52. Kety SS: Psychoendocrine systems and emotion: biological aspects, in Neurophysiology and Emotion.
Edited by DC Glass. New York, Rockefeller University Press, 1967, pp. 103-116
53. Baccelli G, Ellison GD, Mancia G, Zanchetti A: Opposite responses of muscle circulation to different
emotional stimuli. Experientia 27: 1183-1184, 1971
54. Adams DB, Baccelli G, Mancia G, Zanchetti A: Relation of cardiovascular changes in fighting to
emotion and exercise. J Physiol 212: 321-335, 1971
55. Hokanson JE, Burgess M: The effect of status, type of frustration, and aggression on vascular processes. J
Abnorm Soc Psychol 65:232-237, 1962
56. Anokhin P: The physiological basis of the pathogenesis of hypertensive states, in Symposium on the
Pathogenesis of Essential Hypertension. Edited by J Cort, V Fencl, Z Hejl, J Jirka. Prague, State Medical
Publishing House, 1961, pp. 199-222
57. Gribbin B, Pickering TG, Sleight P, Peto R: Effects of age and high blood pressure on baroreflex
sensitivity in man. Circ Res 29:424-430, 1971
58. Coote JH, Hilton SM, Perez-Gonzalez JF: Inhibition of the baroreceptor reflex on stimulation in the brain
stem defence centre. J Physiol 288:549-560, 1979
59. Nowlis DP, Greenberg N: Empirical description of effects of exercise on mood. Percept Mot Skills
49:1001-1002, 1979
60. Greist JH, Klein MH, Eischens RR, Faris J, Gurman AS, Morgan WP: Running as treatment for
depression. Comprehensive Psychiatry 20:41-54, 1979
61. Pollock GH: Process and affect: mourning and grief. Int J Psycho-Anal 59:255-276, 1978
62. Hoffbrand BI, Forsyth RP: The hemodynamic consequences of moderate postoperative anemia in
monkeys. Surg Gynecol Obstet 132:61-66, 1971
63. Hamburg DA: Emotions in the perspective of human evolution, in Expression of the Emotions in Man.
Edited by PH Knapp. New York, International Universities Press, 1963, pp. 300-317
64. Zajonc RB: Feeling and thinking: preferences need no inferences. Am Psychol 35:151-175, 1980
65. Friedman M, Rosenman RH: Type A behavior and your heart. Greenwich, CT, Fawcett Crest, 1974

364 Psychosomatic Medicine Vol. 43, No. 4 (August 1981)

View publication stats