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was a cultural difference in what was appropriate to report on the questionnaire, and

therefore that the biological markers were a better representation of the lack of a

significant ethnic difference in stress levels.

There are subtleties in how ethnic groups differ in stress responses, including

how they respond to specific circumstances. For example, in a study of female

nurses and nurse’s aides in Hawaii, Brown and colleagues noted that Filipino

Americans (mostly Ilocanos) were significantly more likely to report being anxious

than were European American women in diaries that they kept for a full day (Brown

et al. 1998 ). However, whenZ-scores of ambulatory blood pressure were computed

to control for between-subject effects, at times when the European American nurses

reported anxiety, they had higher elevations in their ambulatory blood pressureZ-

scores than was the case for the Filipino American women, as shown in Fig.7.4

(Brown et al. 1998 ; Brown unpublished data). This may represent a reporting bias,

with European American women less likely to report being anxious under low

stress conditions. Looking at specific circumstances, group differences in how

people perceive a situation as being stressful can be discerned. In the study of

nurses, ethnic differences were found in responses of women while doing house-

hold chores: Filipino American women were more likely to report being anxious

during these chores than European Americans, but the European American women

had higher diastolic blood pressureZ-scores than the Filipino Americans during
these times (Brown et al. 1998 ), shown in Fig.7.5.

Stress responses can also be used to better understand how individuals, and

populations, respond to social phenomena. Schmitt and coworkers studied three

communities of aboriginal Australians and found that mean epinephrine excretion

Z-score of blood pressure

0.0

0.2

0.4

0.6

0.8

1.0

Anxiety Report

No Anxiety Report

FilAm: Systolic BP EurAm Systolic BPFilAm Diastolic BP EurAm Diastolic BP

Fig. 7.4 Ethnic differences between European Americans and Filipino Americans inZ-scores of
ambulatory BP during times of reported anxiety versus when no anxiety reported (Brown et al.
1998 ; Brown unpublished data)

7 Stress Biomarkers as an Objective Window on Experience 131