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(Brown et al. 1998 ; Brown unpublished data).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1998 ; Brown unpublished data)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