Prevention of Stress-Provoked Endothelial Injury by Values Affirmation: a Proof of Principle Study

Ann Behav Med. 2016 Jun;50(3):471-9. doi: 10.1007/s12160-015-9756-6.


Background: Few studies have tested whether cellular processes directly associated with cardiovascular disease risk can be influenced by a psychological inoculation.

Purpose: This study investigated whether values affirmation, a psychological procedure designed to reduce stress and threat perception, would prevent endothelial injury to social evaluative threat (SET).

Methods: Participants (N=32) were randomized to SET, SET with values affirmation, or Control. SET was induced with the Trier Social Stress Test, and participants performed values affirmation prior to SET induction. Using flow cytometry, endothelial injury was assessed by measuring circulating levels of endothelial cell-derived microparticles (EMPs) phenotypic for endothelial cell activation (CD62E+), apoptosis (CD31+) or both (CD51+).

Results: Social threat caused expected increases in circulating EMPs phenotypic of endothelial cell injury, a response completely attenuated in those receiving values affirmation.

Conclusions: This study, as proof of principle due to small sample size, shows cellular level, cardiovascular disease-relevant effects of social stress and provides the first evidence of inoculation against such effects by a psychological procedure.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Cell-Derived Microparticles / metabolism
  • E-Selectin / blood
  • Endothelial Cells / pathology*
  • Fear / psychology
  • Female
  • Flow Cytometry
  • Humans
  • Male
  • Platelet Endothelial Cell Adhesion Molecule-1 / blood
  • Proof of Concept Study
  • Psychotherapy / methods
  • Social Perception
  • Stress, Psychological / complications*
  • Stress, Psychological / prevention & control
  • Young Adult


  • E-Selectin
  • Platelet Endothelial Cell Adhesion Molecule-1