The Relationship Between theTendency for Negative Emotions and the Risk of Coronary Heart Disease
Abstract
Goals: The main aimof the research was to determine the possible relationship between the tendency for negative emotions (operationalised through the traits of depression, anxiety and anger) and the risk of coronary heart disease. The secondaimwas to identify the combination of the examined emotional traits which best differentiates the persons with different states of health in the context of coronary heart disease. Method: The study sample consisted of 150 subjects divided into three groups: the personsdiagnosed with coronary heart disease, the personswith specific risk for coronary heart disease but without a diagnosis of coronary heart disease, and the personswith neither diagnosis nor risk of coronary heart disease. The following measurement instruments were applied: the Depressive Personality Scale, the Spielberger State-Trait Anxiety Inventory and the SpielbergerState-Trait Anger Expression Inventory. Results: The coronary heart disease group scored higher onall applied instruments compared to the group without specific risks. The subjects under the specific risk of coronary heart disease scored higher on the anxiety and depression inventory compared with the persons without specific risks. Canonical discriminant analysis revealed that the anxiety trait best differentiatesthe three groups, while the other two emotional traits proved to beredundant when it comes to prediction. Conclusions: The study results have shown a correlation between the traits of anxiety, anger and depression with the risk of coronary heart disease. The effects of the depression and anger traits can be almost completely explained by the correlation between the anxiety trait and the health status related to the coronary disease.
References
Appels, A., Bär, F.W., Bär, J., Bruggeman, C., & de Baets, (. (2000). Inflammation, Depressive Symptomatology, and Coronary Artery Disease. Psychosomatic Medicine, 62(5), 601-605. doi:10.1097/00006842-200009000-00001
Bonnet, F., Irving, K., Terra, J., Nony, P., Berthezène, F., & Moulin, P. (2005). Anxiety and depression are associated with unhealthy lifestyle in patients at risk of cardiovascular disease. Atherosclerosis, 178(2), 339-344. doi:10.1016/j.atherosclerosis.2004.08.035
Camatta, C.D., & Nagoshi, C.T. (1995). Stress, Depression, Irrational Beliefs, and Alcohol Use and Problems in a College Student Sample. Alcoholism: Clinical and Experimental Research, 19(1), 142-146. doi:10.1111/j.1530-0277.1995.tb01482.x
Castillo, M.I., Cooke, M.L., Macfarlane, B., & Aitken, L.M. (2016). Trait Anxiety But Not State Anxiety During Critical Illness Was Associated With Anxiety and Depression Over 6 Months After ICU. Critical Care Medicine, 44(1), 100-110. doi:10.1097/ccm.0000000000001356
Chida, Y., & Steptoe, A. (2009). The association of anger and hostility with future coronary heart disease: a meta-analytic review of prospective evidence. Journal of the American College of Cardiology, 53(11), 936-946. doi:10.1016/j.jacc.2008.11.044
Davidson, K.W., & Mostofsky, E. (2010). Anger expression and risk of coronary heart disease: Evidence from the Nova Scotia Health Survey. American Heart Journal, 159(2), 199-206. doi:10.1016/j.ahj.2009.11.007
Denollet, J. (2005). DS14: Standard Assessment of Negative Affectivity, Social Inhibition, and Type D Personality. Psychosomatic Medicine, 67(1), 89-97. doi:10.1097/01.psy.0000149256.81953.49
Denollet, J., Pedersen, S.S., Vrints, C.J., & Conraads, V.M. (2006). Usefulness of Type D Personality in Predicting Five-Year Cardiac Events Above and Beyond Concurrent Symptoms of Stress in Patients With Coronary Heart Disease. The American Journal of Cardiology, 97(7), 970-973. doi:10.1016/j.amjcard.2005.10.035
Denollet, J., Rombouts, H., Gillebert, T., Brutsaert, D., Sys, S., Brutsaert, D., & Stroobant, N. (1996). Personality as independent predictor of long-term mortality in patients with coronary heart disease. The Lancet, 347(8999), 417-421. doi:10.1016/s0140-6736(96)90007-0
Friedman, M., & Rosenman, R.H. (1959). Association of specific overt behavior pattern with blood and cardiovascular findings: blood cholesterol level, blood clotting time, incidence of arcus senilis, and clinical coronary artery disease. Journal of the American Medical Association, 169(12), doi:10.1001/jama.1959.03000290012005
Gallo, L.C., Ghaed, S.G., & Bracken, W.S. (2004). Emotions and Cognitions in Coronary Heart Disease: Risk, Resilience, and Social Context. Cognitive Therapy and Research, 28(5), 669-694. doi:10.1023/b:cotr.0000045571.11566.19
Institut za javno zdravlje Srbije ,,Dr Milan Jovanović Batut”. (2015). Incidencija i mortalitet od akutnog koronarnog sindroma u Srbiji. http://www.batut.org.rs/download/publikacije/2014AkutniKoronarniSindrom.pdf.
Katiyar, M., Gupta, S.C., & Singh, H. (1989). Role of neuroticism and extraversion in patients of acute myocardial infraction. Indian J Clin Psychol, 15, 18-20.
Kawachi, I., Colditz, G.A., Ascherio, A., Rimm, E.B., Giovannucci, E., Stampfer, M.J., & Willett, W.C. (1994). Prospective study of phobic anxiety and risk of coronary heart disease in men. Circulation, 89(5), 1992-1997. doi:10.1161/01.cir.89.5.1992
Kawachi, I., Sparrow, D., Spiro, A., Vokonas, P., & Weiss, S.T. (1996). A prospective study of anger and coronary heart disease: The Normative Aging Study. Circulation, 94(9), 2090-2095. doi:10.1161/01.cir.94.9.2090
Khan, A.A., Hassan, M., Kumar, P., Mishra, D., & Kumar, R. (2012). Personality Profile and Coping Skills among Coronary Heart Disease Patients and Non-Patient Groups. Delhi Psychiatry Journal, 15(2), 352-358.
Knaus, W.J. (1983). How To Conquer Your Frustrations. New Jersey: Prentice Hall Trade.
Kubzansky, L.D., Cole, S.R., Kawachi, I., Vokonas, P., & Sparrow, D. (2006). Shared and unique contributions of anger, anxiety, and depression to coronary heart disease: A prospective study in the normative aging study. Annals of Behavioral Medicine, 31(1), 21-29. doi:10.1207/s15324796abm3101_5
Marić, Z. (2002). Kognitivni činioci emocije i emocionalnog poremećaja iz ugla REBT. Beograd: Filozofski fakultet. Magistarski rad.
Eng, P.M., Fitzmaurice, G., Kubzansky, L.D., Rimm, E.B., & Kawachi, I. (2003). Anger Expression and Risk of Stroke and Coronary Heart Disease Among Male Health Professionals. Psychosomatic Medicine, 65(1), 100-110. doi:10.1097/01.psy.0000040949.22044.c6
Mook, J., Van, D.P.H.M., & Chr. Kleijn, W. (1990). Anxiety, anger and depression: Relationships at the trait level. Anxiety Research, 3(1), 17-31. doi:10.1080/08917779008248738
Myrtek, M. (2001). Meta-analyses of prospective studies on coronary heart disease, type A personality, and hostility. International Journal of Cardiology, 79(2-3), 245-251. doi:10.1016/s0167-5273(01)00441-7
Nekouei, Z.K., Yousefy, A., Doost, H.T., Manshaee, G., & Sadeghei, M. (2014). Structural Model of psychological risk and protective factors affecting on quality of life in patients with coronary heart disease: A psychocardiology model. Journal of research in medical sciences: The official journal of Isfahan University of Medical Sciences, 19(2), 90.
Novović, Z., Mihić, (., & Tovilović, S. (2010). Procena depresivnog poremećaja ličnosti. U M. Biro, S. Smederevac, & Z. Novović (Ur.), Procena psiholoških i psihopatoloških fenomena. Beograd: CPP.
Papageorgiou, C., Panagiotakos, D.B., Pitsavos, C., Tsetsekou, E., Kontoangelos, K., Stefanadis, C., & Soldatos, C. (2006). Association between plasma inflammatory markers and irrational beliefs; the ATTICA epidemiological study. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 30(8), 1496-1503. doi:10.1016/j.pnpbp.2006.05.018
Player, M.S., & Peterson, L.E. (2011). Anxiety Disorders, Hypertension, and Cardiovascular Risk: A Review. The International Journal of Psychiatry in Medicine, 41(4), 365-377. doi:10.2190/pm.41.4.f
Puterman, E., Epel, E.S., O’Donovan, A., Prather, A.A., Aschbacher, K., & Dhabhar, F.S. (2014). Anger Is Associated with Increased IL-6 Stress Reactivity in Women, But Only Among Those Low in Social Support. International Journal of Behavioral Medicine, 21(6), 936-945. doi:10.1007/s12529-013-9368-0
Rozanski, A., Blumenthal, J.A., & Kaplan, J. (1999). Impact of Psychological Factors on the Pathogenesis of Cardiovascular Disease and Implications for Therapy. Circulation, 99(16), 2192-2217. doi:10.1161/01.cir.99.16.2192
Rugulies, R. (2002). Depression as a predictor for coronary heart disease: a review and meta-analysis. American Journal of Preventive Medicine, 23(1), 51-61. doi:10.1016/s0749-3797(02)00439-7
Sirois, B.C., & Burg, M.M. (2003). Negative emotion and coronary heart disease: A review. Behavior Modification, 27(1), 83-102. doi:10.1177/0145445502238695
Smith, P.J., & Blumenthal, J.A. (2011). Psychiatric and Behavioral Aspects of Cardiovascular Disease: Epidemiology, Mechanisms, and Treatment. Revista Española de Cardiología (English Edition), 64(10), 924-933. doi:10.1016/j.rec.2011.06.003
Spielberger, C.D. (1983). Manual for the State-Trait Anxiety Inventory (Form Y). Palo Alto, CA: Mind Garden.
Spielberger, C.D. (1999). State-trait anger expression inventory-2: Professional manual. Odessa, Fla.: Psychological Assessment Resources, Inc..
Stanković, S., & Vukosavljević-Gvozden, T. (2011). The Relationship of a Measure of Frustration Intolerance with Emotional Dysfunction in a Student Sample. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 29(1), 17-34. doi:10.1007/s10942-011-0128-2
Steptoe, A., & Molloy, G.J. (2007). Personality and heart disease. Heart, 93(7), 783-784. doi:10.1136/hrt.2006.109355
Vasan, R.S., Larson, M.G., Leip, E.P., Kannel, W.B., & Levy, D. (2001). Assessment of frequency of progression to hypertension in non-hypertensive participants in the Framingham Heart Study: a cohort study. The Lancet, 358(9294), 1682-1686. doi:10.1016/s0140-6736(01)06710-1
Vasiljević, Z. (2011). Akutni koronarni sindrom. U: M. Ostojić, V. Kanjuh, & B. Beleslin (Ur.), Kardiologija. 424-462.
von Känel, R., Mills, P.J., Fainman, C., & Dimsdale, J.E. (2001). Effects of Psychological Stress and Psychiatric Disorders on Blood Coagulation and Fibrinolysis: A Biobehavioral Pathway to Coronary Artery Disease. Psychosomatic Medicine, 63(4), 531-544. doi:10.1097/00006842-200107000-00003
Williams, J.E., Paton, C.C., Siegler, I.C., Eigenbrodt, M.L., Nieto, F.J., & Tyroler, H.A. (2000). Anger proneness predicts coronary heart disease risk: prospective analysis from the Atherosclerosis Risk in Communities (ARIC) study. Circulation, 101(17), 2034-2039. doi:10.1161/01.cir.101.17.2034
World Health Organization. (1992). International statistical classification of diseases and related health problems. Geneva: WHO. 10th revision.
Poirier, P., Giles, T.D., & Bray, G.A. (2006). Obesity and cardiovascular disease. Circulatio, 113, 898-918.
Kannel, W.B., Dawber, T.R., Kagan, A., Revotskie, N., & Stokes, J. (1961). Factors of risk in the development of coronary heart disease -- six-year follow-up experience: the Framingham Study. Annals of Internal Medicine, 55, 33-50.
Phillips, A.C., Batty, G.D., Gale, C.R., Deary, I.J., Osborn, D., & MacIntyre, K. (2009). Generalized anxiety disorder, major depressive disorder, and their comorbidity as predictors of all-cause and cardiovascular mortality: the Vietnam experience study. Psychosomatic Medicine, 71, 395-403.
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