The body ' s response to health care provider

Participant responses were compared for cancer genetic counselor provision of information provided in a dominant versus facilitative communication style. Participants watched two different segments of genetic counseling while heart rate (HR) and respiratory sinus arrhythmia were assessed. Communication style was determined by coding with the Roter interaction analysis system. Results supported a consistent contrast effect across measures, which was not moderated by trait emotional control. Individuals presented with the dominant style first exhibited a reduced HR for the facilitative segment as compared with participants who saw the facilitative style first. When viewing the dominant style first, participants rated the subsequent facilitative counselor as more friendly, submissive, and receptive and were more satisfied. An explanation for the findings is supported by positive and negative evaluative processes literature. The stress response is being increasingly examined within the context of social interactions. The interpersonal contexts of hostility and of low social support are now accepted determinants of both laboratory and naturalistic-induced stress responses and contribute to the development of coronary heart disease (e.g., Gallo, Smith, & Kircher, 2000; Uchino, 2004). A specific interpersonal context that has been less widely examined in the social psychophysiological literature is the autonomic correlates of interpersonal responses to social constraint or social dominance. According to the Social Cognitive Processing Model (SCPM; Lepore, 1992; Lepore, Evans, & Schneider, 1991; Lepore, Silver, Wortman, & Wayment, 1996), experiencing a stressful, controlling social interaction can lead to inhibition of emotions and has implications for health and psychological adjustment. From this perspective, health care providers, through their communication about a client's health or disease risk, have the potential to facilitate or hinder a client's emotional experience and response. In this analogue study, we compare acute autonomic responses to cancer genetic counselor provision of genetic risk information provided in two ways: social constraining and dominant style versus psychosocially and emotionally facilitative style. We suggest that acute cardiovascular reactivity associated with socially imposed emotional inhibition could impact the patient in two ways. First, acute cardiovascular reactivity, in the present study, is a marker for the distress associated with socially imposed emotional inhibition, which may or may not have consequences for long-term health. Second, we suggest that the acute effects may interfere with information processing and thus undermine the intended purpose of the provision of health information. genetic counseling | cancer patients | health providers | health education |