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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(Brown et al. 1998 ; Brown unpublished data).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1998 ; Brown unpublished data)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

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