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Validity of a German Comprehensive Psychosocial Screening Instrument based on the ESC Cardiovascular Prevention Guidelines. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2023; 69:76-97. [PMID: 36927319 DOI: 10.13109/zptm.2023.69.1.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background: Following guidelines for cardiovascular disease prevention of the European Society for Cardiology (ESC), the current study validated the German Comprehensive Psychosocial Screening Instrument in participants who underwent coronary angiography. Methods: 314 participants (Mage = 69.7 ± 12.0; 69 % male) completed the German Comprehensive Psychosocial Screening Instrument and validated comparison scales to measure depression (PHQ-9), anxiety (GAD-7), Type D personality (DS14), work stress (ERI), family stress (SMSS), trauma (PC-PTSD), and anger and hostility (Z-scale of MMPI-2). Results: Confirmatory factor analysis (CFA) confirmed that the psychosocial risk factors were separate entities rather than a signs or symptoms of a single broad indication of distress (CFI = .872, RMSEA = .056, SRMR = .058). Intraclass coefficients (ICC), kappa and diagnostic accuracy indicators (receiver operator characteristic [ROC] curves, sensitivity, specificity, and the positive and negative predictive values [PPV; NPV]) indicated that most screener scales were sufficient to good. We also compared patients with established coronary heart disease (CHD; n = 213) to those with no current CHD (n = 100) and found overall similar results. Discussion: The German version of the Comprehensive Psychosocial Screening Instrument has an acceptable performance. Aside from minor improvements, the screening instrument could be implemented in the cardiological practice to screen patients on multidimensional psychosocial risk.
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van den Houdt S, Albus C, Herrmann-Lingen C, Widdershoven J, Kupper N. Validity of a multidimensional comprehensive psychosocial screening instrument based on the ESC cardiovascular prevention guidelines - Evidence from the general and cardiovascular patient population. J Psychosom Res 2022; 157:110791. [PMID: 35398675 DOI: 10.1016/j.jpsychores.2022.110791] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 02/24/2022] [Accepted: 03/18/2022] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the psychometric properties and validity of the updated version of the Dutch multidimensional Comprehensive Psychosocial Screening Instrument in patients with coronary heart disease and the general population, based upon guideline recommendations from the European Society for Cardiology. METHOD 678 participants (Mage = 48.2, SD = 16.8; 46% male) of the Dutch general population and 312 cardiac patients (Mage = 65.9, SD = 9.9; 77% male) who recently received percutaneous coronary intervention completed the Comprehensive Psychosocial Screening Instrument and validated questionnaires for depression (PHQ-9), anxiety (GAD-7), Type D personality (DS14), hostility (CMHS), anger (STAS-T), trauma (SRIP), and chronic work and family stress (ERI, MMQ-6). RESULTS Confirmatory factor analysis (CFA) confirmed that the eight screened risk factors were best measured as separate entities, rather than broader indications of distress. Inter-instrument agreement, assessed with the intraclass coefficient (ICC) and the screening accuracy indicators (receiving operator characteristic [ROC] curves, sensitivity, specificity, and the positive and negative predictive values [PPV; NPV]) were good for most screened risk factors. PPV was low in low prevalence risk factors like anxiety, trauma, and depression. CONCLUSION Overall, the current version of the Comprehensive Psychosocial Screening Instrument has an acceptable performance in both populations, with a fair to excellent level of agreement with established full questionnaires. Besides a few suggestions for further refinement, the screener may be implemented in primary care and cardiological practice.
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Affiliation(s)
- Sophie van den Houdt
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands.
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, Medical Faculty and University Hospital of Cologne, Germany.
| | - Christoph Herrmann-Lingen
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center and German Center for Cardiovascular Research (DZHK), partner site Göttingen, Germany.
| | - Jos Widdershoven
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands; Department of Cardiology, Elisabeth-TweeSteden Hospital, the Netherlands
| | - Nina Kupper
- Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical & Clinical Psychology, Tilburg University, the Netherlands.
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Andreeva GF, Gorbunov VM. Hostility, Anger, Psycho-emotional Factors and Cardiovascular Disease. RATIONAL PHARMACOTHERAPY IN CARDIOLOGY 2022. [DOI: 10.20996/1819-6446-2022-04-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The review presents the main aspects of the relationship between psychoemotional factors, hostility, anger and cardiovascular diseases. The first chapter describes the main historical stages in the study of this problem, starting from the Middle Ages and ending with fundamental research of the 19-20 centuries. In the second part, the authors demonstrated that hostility/anger are a risk factor for the CVD development and affect the prognosis and course of CVD (hypertension, ischemic heart disease, various cardiac arrhythmias, etc.). In the third chapter, there were studies that found that high rates of hostility/ anger reduced the effectiveness of cardiovascular therapy. In the fourth part, there are the main correlation mechanisms of negative emotions, hostility/anger and the cardiovascular system, carried out through the relationships with the activation of the hypothalamic-pituitary-adrenal, autonomic nervous system, platelet activation, with the changes in the risk factors characteristics etc. In the final chapter, the authors suggested prospects for further study of the problem, probably associated with the assessment of behavioral interventions, pharmacological or complex effects on the severity of hostility/anger to reduce CVD mortality in individuals with high rates of hostility / anger.
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Affiliation(s)
- G. F. Andreeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. M. Gorbunov
- National Medical Research Center for Therapy and Preventive Medicine
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Vitori TK, Frazier SK, Biddle MJ, Mudd-Martin G, Pelter MM, Dracup K, Moser DK. Hostility predicts mortality but not recurrent acute coronary syndrome. Eur J Cardiovasc Nurs 2021; 20:132–137. [PMID: 33611360 DOI: 10.1177/1474515120950913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 07/28/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hostility is associated with greater risk for cardiac disease, cardiac events and dysrhythmias. Investigators have reported equivocal findings regarding the association of hostility with acute coronary syndrome (ACS) recurrence and mortality. Given mixed results on the relationship between hostility and cardiovascular outcomes, further research is critical. AIMS The aim of our study was to determine whether hostility was a predictor of ACS recurrence and mortality. METHODS We performed a secondary analysis of data (N = 2321) from a large randomized clinical trial of an intervention designed to reduce pre-hospital delay among patients who were experiencing ACS. Hostility was measured at baseline with the Multiple Adjective Affect Checklist (MAACL) and patients were followed for 24 months for evaluation of ACS recurrence and all-cause mortality. We used Cox proportional hazards modeling to determine whether hostility was predictive of time to ACS recurrence or all-cause mortality. RESULTS The majority of patients were married (73%), Caucasian (97%), men (68%), and had a mean age of 67 ± 11 years. Fifty-seven percent of participants scored as hostile based on the established MAACL cut point (mean score = 7.56 ± 3.8). Hostility was an independent predictor of all-cause mortality (p = < 0.039), but was not a predictor of ACS recurrence (p = 0.792). CONCLUSION Hostility is common in patients with ACS and its relationship to clinical outcomes is important to the design of future interventions to improve long-term ACS mortality.
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Fonagy P, Yakeley J, Gardner T, Simes E, McMurran M, Moran P, Crawford M, Frater A, Barrett B, Cameron A, Wason J, Pilling S, Butler S, Bateman A. Mentalization for Offending Adult Males (MOAM): study protocol for a randomized controlled trial to evaluate mentalization-based treatment for antisocial personality disorder in male offenders on community probation. Trials 2020; 21:1001. [PMID: 33287865 PMCID: PMC7720544 DOI: 10.1186/s13063-020-04896-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/12/2020] [Indexed: 11/10/2022] Open
Abstract
Background Antisocial personality disorder (ASPD), although associated with very significant health and social burden, is an under-researched mental disorder for which clinically effective and cost-effective treatment methods are urgently needed. No intervention has been established for prevention or as the treatment of choice for this disorder. Mentalization-based treatment (MBT) is a psychotherapeutic treatment that has shown some promising preliminary results for reducing personality disorder symptomatology by specifically targeting the ability to recognize and understand the mental states of oneself and others, an ability that is compromised in people with ASPD. This paper describes the protocol of a multi-site RCT designed to test the effectiveness and cost-effectiveness of MBT for reducing aggression and alleviating the wider symptoms of ASPD in male offenders subject to probation supervision who fulfil diagnostic criteria for ASPD. Methods Three hundred and two participants recruited from a pool of offenders subject to statutory supervision by the National Probation Service at 13 sites across the UK will be randomized on a 1:1 basis to 12 months of probation plus MBT or standard probation as usual, with follow-up to 24 months post-randomization. The primary outcome is frequency of aggressive antisocial behaviour as assessed by the Overt Aggression Scale – Modified. Secondary outcomes include violence, offending rates, alcohol use, drug use, mental health status, quality of life, and total service use costs. Data will be gathered from police and criminal justice databases, NHS record linkage, and interviews and self-report measures administered to participants. Primary analysis will be on an intent-to-treat basis; per-protocol analysis will be undertaken as secondary analysis. The primary outcome will be analysed using hierarchical mixed-effects linear regression. Secondary outcomes will be analysed using mixed-effects linear regression, mixed-effects logistic regression, and mixed-effects Poisson models for secondary outcomes depending on whether the outcome is continuous, binary, or count data. A cost-effectiveness and cost-utility analysis will be undertaken. Discussion This definitive, national, multi-site trial is of sufficient size to evaluate MBT to inform policymakers, service commissioners, clinicians, and service users about its potential to treat offenders with ASPD and the likely impact on the population at risk. Trial registration ISRCTN 32309003. Registered on 8 April 2016.
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Affiliation(s)
- Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK. .,Anna Freud National Centre for Children and Families, London, UK.
| | - Jessica Yakeley
- Portman Clinic, Tavistock and Portman NHS Foundation Trust, London, UK
| | - Tessa Gardner
- Anna Freud National Centre for Children and Families, London, UK
| | - Elizabeth Simes
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Anna Freud National Centre for Children and Families, London, UK
| | - Mary McMurran
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, UK
| | - Mike Crawford
- Centre for Mental Health, Imperial College, London, UK
| | - Alison Frater
- School of Law, Royal Holloway, University of London, London, UK
| | - Barbara Barrett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Angus Cameron
- National Probation Service London Division, London, UK
| | - James Wason
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Stephen Pilling
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Stephen Butler
- Psychology Department, University of Prince Edward Island, Charlottetown, Canada
| | - Anthony Bateman
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Anna Freud National Centre for Children and Families, London, UK
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Tyra AT, Brindle RC, Hughes BM, Ginty AT. Cynical hostility relates to a lack of habituation of the cardiovascular response to repeated acute stress. Psychophysiology 2020; 57:e13681. [DOI: 10.1111/psyp.13681] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 07/13/2020] [Accepted: 08/08/2020] [Indexed: 01/23/2023]
Affiliation(s)
- Alexandra T. Tyra
- Department of Psychology and Neuroscience Baylor University Waco TX USA
| | - Ryan C. Brindle
- Department of Cognitive and Behavioral Science and Neuroscience Program Washington and Lee University Lexington VA USA
| | - Brian M. Hughes
- School of Psychology National University of Ireland Galway Ireland
| | - Annie T. Ginty
- Department of Psychology and Neuroscience Baylor University Waco TX USA
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Abstract
A low resting heart rate across development from infancy to young adulthood relates to greater aggression/hostility. Adult aggression and a high heart rate relate to health risk. Do some aggressive individuals retain low heart rate and less health risk across development while others show high heart rate and more risk? A longitudinal sample of 203 men assessed as teens (age 16.1) and adults (mean age 32.0) permitted us to assess (a) stability of heart rate levels and reactivity, (b) stability of aggression/hostility, and (c) whether change or stability related to health risk. Adults were assessed with Buss-Perry measures of aggression/hostility; teens with the Zuckerman aggression/hostility measure. Mean resting heart rate, heart rate reactivity to speech preparation, and aggression/hostility were moderately stable across development. Within age periods, mean heart rate level, but not reactivity, was negatively related to hostility/aggression. Maintaining low heart rate into adulthood was related to better health among aggressive individuals relative to those with increasing heart rate into adulthood. Analyses controlled for weight gain, socioeconomic status, race, health habits, and medication. Low heart rate as a characteristic of hostile/aggressive individuals may continue to relate to better health indices in adulthood, despite possible reversal of this relationship with aging.
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Kim J, Kim O. A Health Behavior Prediction Model for Patients With Coronary Artery Disease. Clin Nurs Res 2017; 28:217-234. [DOI: 10.1177/1054773817725868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The aim of this study was to determine the relationships among functional status, hostility, social support, illness perceptions, and health behaviors in patients with coronary artery disease using structural equation modeling. Participants comprised 215 patients with coronary artery disease who had received percutaneous coronary artery intervention or a coronary artery bypass graft in two general hospitals in Seoul, Korea. Using structured interviews with questionnaires, data accrued from July to August, 2015. Fitness of the model was verified with AMOS 21.0. As social support increased, it negatively aligned with cognitive-illness perceptions. Higher levels of hostility and greater negative cognitive-illness perceptions aligned with negative emotional-illness perceptions. Social support indirectly affected emotional-illness perceptions. Lower levels of functional status, greater social support, and more positive cognitive-illness perceptions aligned with health behaviors. Social support indirectly affected health behaviors. In conclusion, nurses should focus on coronary artery disease patients’ physical functions and cognitive-illness perceptions to provide support.
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Affiliation(s)
- Jiyoung Kim
- Dong-eui University, Busan, Republic of Korea
| | - Oksoo Kim
- Ewha Womans University, Seoul, Republic of Korea
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Ruiz JM, Taylor DJ, Uchino BN, Smith TW, Allison M, Ahn C, Johnson JJ, Smyth JM. Evaluating the longitudinal risk of social vigilance on atherosclerosis: study protocol for the North Texas Heart Study. BMJ Open 2017; 7:e017345. [PMID: 28808040 PMCID: PMC5791551 DOI: 10.1136/bmjopen-2017-017345] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 04/24/2017] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Psychosocial factors are increasingly recognised as important determinants of cardiovascular disease risk. The North Texas Heart Study aims to understand the mechanisms responsible for this association with a focus on social vigilance (ie, scanning the environment for social threats). There is also growing interest in supplementing traditional methods (eg, survey assessment of psychosocial risk paired with cross-sectional and longitudinal health outcomes) with daily or repeated momentary assessment of psychosocial factors. However, there are relatively few longitudinal studies directly comparing these approaches with hard endpoints. METHODS AND ANALYSIS The North Texas Heart Study proposes a longitudinal measurement burst design to examine psychosocial determinants of subclinical atherosclerosis. A sample of 300 healthy community participants, stratified by age and gender, will complete survey measures, as well as 2 days of ecological momentary assessment at baseline and at a 2-year follow-up. A range of psychosocial and behavioural factors, objective biomarkers, as well as carotid intima-media thickness (cIMT) will be assessed at both time points. Unadjusted and adjusted models will evaluate cross-sectional associations and determinants of change in the cIMT. ETHICS AND DISSEMINATION The Institutional Review Board at the study coordinating institute (University of North Texas) has approved this study. Positive, negative or inconclusive primary and ancillary findings will be disseminated in scientific journals and conferences.
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Affiliation(s)
- John M Ruiz
- Department of Psychology, University of Arizona, Tucson, Arizona, USA
| | - Daniel J Taylor
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Bert N Uchino
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Timothy W Smith
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Matthew Allison
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California, San Diego, California, USA
| | - Chul Ahn
- Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jillian J Johnson
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Joshua M Smyth
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, USA
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Keith F, Krantz DS, Chen R, Harris KM, Ware CM, Lee AK, Bellini PG, Gottlieb SS. Anger, hostility, and hospitalizations in patients with heart failure. Health Psychol 2017. [PMID: 28650197 DOI: 10.1037/hea0000519] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Heart failure patients have a high hospitalization rate, and anger and hostility are associated with coronary heart disease morbidity and mortality. Using structural equation modeling, this prospective study assessed the predictive validity of anger and hostility traits for cardiovascular and all-cause rehospitalizations in patients with heart failure. METHOD 146 heart failure patients were administered the STAXI and Cook-Medley Hostility Inventory to measure anger, hostility, and their component traits. Hospitalizations were recorded for up to 3 years following baseline. Causes of hospitalizations were categorized as heart failure, total cardiac, noncardiac, and all-cause (sum of cardiac and noncardiac). RESULTS Measurement models were separately fit for Anger and Hostility, followed by a Confirmatory Factor Analysis to estimate the relationship between the Anger and Hostility constructs. An Anger model consisted of State Anger, Trait Anger, Anger Expression Out, and Anger Expression In, and a Hostility model included Cynicism, Hostile Affect, Aggressive Responding, and Hostile Attribution. The latent construct of Anger did not predict any of the hospitalization outcomes, but Hostility significantly predicted all-cause hospitalizations. Analyses of individual trait components of each of the 2 models indicated that Anger Expression Out predicted all-cause and noncardiac hospitalizations, and Trait Anger predicted noncardiac hospitalizations. None of the individual components of Hostility were related to rehospitalizations or death. CONCLUSION The construct of Hostility and several components of Anger are predictive of hospitalizations that were not specific to cardiac causes. Mechanisms common to a variety of health problems, such as self-care and risky health behaviors, may be involved in these associations. (PsycINFO Database Record
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Affiliation(s)
- Felicia Keith
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - David S Krantz
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Rusan Chen
- Center for New Designs in Learning and Scholarship, Georgetown University
| | | | - Catherine M Ware
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Amy K Lee
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Paula G Bellini
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences
| | - Stephen S Gottlieb
- Department of Medicine, Division of Cardiology, University of Maryland School of Medicine
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Validity of the European Society of Cardiology's Psychosocial Screening Interview in Patients With Coronary Artery Disease-The THORESCI Study. Psychosom Med 2017; 79:404-415. [PMID: 27922567 DOI: 10.1097/psy.0000000000000433] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to examine the validity of the European Society of Cardiology (ESC) psychosocial screening instrument. METHODS A total of 508 acute (67%) or elective (33%) percutaneous coronary intervention patients (mean [standard deviation]age = 63 [10] years, 81% male) completed the ESC screening interview and established questionnaires for psychosocial risk markers, that is, depression (Patient Health Questionnaire 9), anxiety (Generalized Anxiety Disorder Questionnaire 7), type D personality (Type D Scale 14), hostility (Cook-Medley Hostility Scale 7), and marital/work stress (Maudsley Marital Quality Questionnaire 6, Effort-Reward Imbalance Scale) during or close after hospital admission. At 1-year follow-up, angina and cardiopulmonary symptoms were assessed. RESULTS Prevalence estimates of psychosocial factors based on the ESC screener were as follows: depression (18%), anxiety (33%), negative affectivity (11%), social inhibition (41%), work stress (17%), marital stress (2%), and hostility (38%). Analysis of correspondence with validated questionnaires revealed fair to moderate agreement (depression [κ = .39], anxiety [κ = .23], type D personality [κ = .21]), regardless of percutaneous coronary intervention indication. For work and marital stress, there was poor to fair performance (κ range = .04-.24); agreement for hostility was poor (κ = -.27). A positive ESC screen for depression, anxious tension, and type D personality was associated with more angina and cardiopulmonary symptoms at follow-up (odds ratios ranging between 1.85 (95% confidence interval = 0.84-4.08) and 8.01 (95% confidence interval = 2.35-27.35). CONCLUSIONS The ESC screener contributes to the search for a multidimensional and easy-to-use psychosocial screening instrument for cardiac patients. Although the screener, in its current form, may not be sufficiently valid to reliably detect all predefined psychosocial factors, screening scores for depression and anxiety might be useful in clinical practice. Our findings can be used for further refinement and validation of the screener.
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Jennings JR, Pardini DA, Matthews KA. Heart rate, health, and hurtful behavior. Psychophysiology 2016; 54:399-408. [PMID: 28026867 DOI: 10.1111/psyp.12802] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 11/02/2016] [Indexed: 01/02/2023]
Abstract
Hostility is a risk factor for cardiovascular events. When challenged, individuals high on hostility exhibit a hyperreactive psychophysiological response to stressors, thereby increasing risk for developing cardiovascular disease. However, low resting heart rate (HR) is associated with physical aggression and hostility in children, adolescents, and adults. Based on a community sample of 296 men (mean age = 32.0), we (a) address whether aggression/hostility relates to physical health through relationships with cardiovascular levels at rest and in response to stressors, and (b) determine how relations between aggression and health are altered by including psychophysiological indices in statistical models. The Cook-Medley cynical/hostile attitudes and the Buss-Perry physical aggression and hostility measures assessed aggression. Health was assessed as systolic blood pressure (SBP), report of medical conditions, and a metabolic composite. Reactivity to stressors was assessed with HR, SBP, and diastolic blood pressure. Aggression was negatively related to both resting HR and reactivity. High resting HR and reactivity were, however, positively related to poor health. Thus, the relationship between aggression and HR and reactivity suppressed an overall relationship between high aggression/hostility and poor health. In the presence of covariates for socioeconomic status, race, health behaviors, and medications, the relationship between aggression and health was significantly strengthened when HR level and reactivity were included in models. In sum, at early midlife, low HR among aggressive and hostile individuals is related to less health risk. Aggression and hostility have a deleterious influence on health, but primarily among individuals with higher HR and possibly greater cardiovascular reactivity.
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Affiliation(s)
- J Richard Jennings
- Departments of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dustin A Pardini
- School of Criminology and Criminal Justice, Arizona State University, Phoenix, Arizona, USA
| | - Karen A Matthews
- Departments of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Silarova B, Nagyova I, Rosenberger J, van Dijk JP, Reijneveld SA. Sense of coherence as a mediator between hostility and health-related quality of life among coronary heart disease patients. Heart Lung 2016; 45:126-31. [DOI: 10.1016/j.hrtlng.2015.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 11/12/2015] [Accepted: 11/15/2015] [Indexed: 11/16/2022]
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Sanjuán P, Montalbetti T, Pérez-García AM, Bermúdez J, Arranz H, Castro A. A Randomised Trial of a Positive Intervention to Promote Well-Being in Cardiac Patients. Appl Psychol Health Well Being 2016; 8:64-84. [PMID: 26876425 DOI: 10.1111/aphw.12062] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Negative emotions are linked to the onset and development of coronary heart diseases (CHD), whereas positive emotions are associated with better health and lower mortality rates among patients with these diseases. The objective of this randomised trial was to improve cardiac patients' emotional states using a Programme to Improve Well-being (PIW) based exclusively on positive interventions (those that promote intentional behaviours and thoughts to improve well-being). METHODS Cardiac patients (n = 108) were randomly assigned to two parallel groups. In the control group, they participated in only a Cardiac Rehabilitation Programme (CRP group), whereas the intervention group also participated in the PIW (CRP+PIW group). Physical functional capacity, depressive symptoms, hostility, and negative and positive affect were assessed at T1 (baseline) and T2 (8 weeks later). RESULTS At T2, after controlling for functional capacity, the CRP+PIW group reported a significantly less negative affect than the CRP group. Moreover, the CRP group did not change from T1 to T2, whereas the CRP+PIW group reported more positive emotions and fewer negative emotions and hostility at T2 than at T1. CONCLUSIONS Positive interventions effectively improve the emotional state of cardiac patients. We suggest that specific modules should be included in the CRP to improve well-being.
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Affiliation(s)
- Pilar Sanjuán
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | | | - José Bermúdez
- Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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