Clinical Psychology and Heart Disease (eBook)

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Foreword 5
Foreword 7
List of Contributors 12
About the Editors 15
Enrico Molinari, 15
Angelo Compare, 15
Gianfranco Parati, 16
Introduction: Heart Disease and Psychosocial Factors* 17
References 19
Chapter 1 Clinical Psychology for Cardiac Disease 21
ÏPsycho-CardiologyÓ Activities 23
International and Italian Guidelines 26
Psychologists in ÏPsycho-CardiologyÓ 27
Conclusion 31
References 31
Chapter 2 Psychological Risk Factors for Cardiac Disease and Pathophysiological Mechanisms: An Overview 36
Psychological Risk Factors for Coronary Heart Disease 36
Brief Overview of the Biological Mechanisms Underlying the Pathogenesis of Ischemic Heart Disease 38
How Does the Psyche Interact with Physical Health in CHD? 39
Type A Behavior Pattern 40
Depression 40
Anxiety 41
Post-Traumatic Stress Disorder (PTSD) 41
Mental Stress 41
Syndrome X: A Conceptual Framework for Discussing the Interaction Between Heart and Mind 43
Conclusion 44
References 45
Chapter 3 Psychophysiology of Heart Disease 49
Introduction 50
Assessing the Response to Stress in the Laboratory 51
Mental Stressors 51
Physical Stressors 52
Limitations of Laboratory Stress Tests 53
Mechanisms 65
Pathways 67
Baroreflex 70
Endothelial Dysfunction 70
Inflammation 71
Endocrinological and Metabolic Factors 71
Clinical Relevance 72
Conclusion 75
References 75
Chapter 4 Mental Stress Ischemia: Characteristics, Pathophysiology, Prognosis and Treatment 84
Mental Stress Ischemia: Recognition of a Phenomenon 84
Mental Stress Ischemia: Methods of Study 86
Mental Stress Ischemia: Characteristics 86
Mental Stress Ischemia: Pathophysiology 89
Mental Stress Ischemia: Prognosis and Treatment 91
Mental Stress Ischemia: Future Directions 93
References 94
Chapter 5 Depression and CHD: Prevalence, Prognosis, Pathophysiology and Treatment 97
Introduction 97
Depression and CHD 99
Depression and CHD: Clinical Implications 102
Conclusion 105
References 106
Chapter 6 Prevalence of Depression in Chronic Heart Failure 111
Background 111
Prevalence and Association with Outcomes 112
Treatment Considerations 117
Conclusions 118
References 118
Chapter 7 Depression in Coronary Artery Disease: Assessment and Treatment 121
Introduction 121
The Nature and Prevalence of Depression in Patients with Coronary Artery Disease 122
Etiology of Depression in Patients with Coronary Artery Disease 123
Risk of Future Cardiac Events as Related to Depression 125
Concluding Remarks and Future Directions 127
References 129
Chapter 8 Anxiety and Heart Disease 132
Anxiety 132
Anxiety in Individuals with CHD 133
Anxiety after Acute Myocardial Infarction 134
Relationship between Anxiety and Cardiac Outcomes in CHD 141
Physiological Mechanisms 146
Behavioral Mechanisms 150
Summary 150
References 151
Chapter 9 Anxiety, Depressive Symptoms and Heart Transplantation 159
Introduction 159
Psychiatric and Psychosocial Interventions in HTx-Patients 168
References 169
Chapter 10 Psychological Factors in Hypertension Development and Treatment 174
Introduction 174
Overview 174
Conclusions 188
Psychological Factors and Hypertension 188
Mechanisms 189
Treatment Considerations 189
Future Research Issues 190
References 190
Appendix A 193
Chapter 11 Type A, Type D, Anger-Prone Behavior and Risk of Relapse in CHD Patients 195
Introduction 195
CHD 198
The Type A Behavior Pattern 199
Instruments of Evaluation 201
Studies on the TABP 204
Pathophysiological Mechanisms 206
Hostility and Anger 208
Studies on Anger/Hostility 209
Instruments of Evaluation 212
Pathophysiological Mechanisms 213
Type D Personality 214
Instruments 215
Studies of Risk Factors for Cardiac Events 215
Pathophysiological Mechanisms 216
Conclusions 217
References 218
Chapter 12 Defensive Hostility and Cardiovascular Disease: Theoretical and Empirical Bases for an Interpersonal Approach- Avoidance Conflict Perspective 224
Hostility and Anger 225
Defensive Hostility: A Conflict Model 227
Conclusions 234
References 235
Chapter 13 In Sickness and In Health: Interpersonal Risk and Resilience in Cardiovascular Disease 240
A Primer on Interpersonal Theory and Concepts 241
Evidence of Interpersonal Risk in Cardiovascular Disease 249
In Closing 263
References 263
Chapter 14 Psychological Stress in Women: the Stockholm Female Coronary Risk Study 280
References 283
Chapter 15 Application of Neural Networks and Other Artificial Adaptive Systems in Prediction and Data Mining of Risk Psychological Profile for CHD 286
Introduction 286
Rationale for the Use of ANNs: Becoming Aware of the Non- Linearity of Clinical Data 288
Comparison Between Non-Linear and Linear Conventional Statistic Prospective on a Cardiac In- Patient Sample Study 291
PatientsÌCharacteristics at Baseline and Cardiac Risk Condition: Application of Non- Linear Mapping of Descriptors Through Ï EvolutionaryÓ Algorithms 298
Non-Linear Clustering of Records through Special Kinds of Unsupervised Neural Networks: Self- Organising Maps ( SOMs) 306
Prediction of Cardiac Rehabilitation Outcomes: Linear Conventional Statistic Prospective 310
Prediction of Cardiac Rehabilitation Outcomes Using a Non- Linear Prospective: Artificial Neural Networks 312
Discussion 316
Conclusion 318
References 318
Chapter 16 Person Measurement and Rehabilitation Outcome: the New Perspective of Rasch Analysis 323
Disability, Rehabilitation, Measurement 323
Biometry and Person-Metric 324
Person Measurement: the Proposal from the Georg Rasch Model 329
The Rasch Model: an Overview 330
Appendix 1 Ò Why just the Rasch Model? 333
Appendix 2 - Example of Application of Rasch Analysis to a Measurement Scale 335
References 339
The "Heart" of Cardiology: an Imaginary Conversation with Bernard Lown* 342
Conversation: 343
Chapter 17 The Art of Listening to Cardiac Patient and his Family: the Meanings of Suffering Along Temporal Dimension 351
Premise 351
Listening to the Patient 352
Listening to the Semantic Dimension in Narratives 357
Listening to the Temporal Dimension 362
Conclusion 367
References 368
Chapter 18 Interpersonal Psychotherapy for Depression in Patients with Coronary Heart Disease 371
Introduction 371
Overview of Interpersonal Psychotherapy for Depression 372
Interpersonal Psychotherapy for Coronary Heart Disease Patients with Co- Morbid Depression 376
Summary 388
References 389
Chapter 19 Hanging onto a Heartbeat: Emotionally Focused Therapy for Couples Dealing with the Trauma of Coronary Heart Disease 393
Introduction 393
The Couple Relationship and Physical Health 394
The Couple Relationship and Coronary Heart Disease 394
Impact of Coronary Heart Disease on Partner 395
Relationship Between Partner and Patient Distress in CHD 396
Impact of CHD on Couple Relationship 396
The Impact of Couple Relationship on CHD 396
Coronary Heart Disease as a Trauma 397
Why Couples Need Treatment 398
Trauma and Attachment 400
Emotionally Focused Therapy for Couples 400
Case History: Even Though and Especially Since 404
Conclusion 410
References 410
Chapter 20 Type A Behavior Pattern and Its Treatment 415
Type A Behavior and Coronary Heart Disease 415
Treatment of the Type A Behavior Pattern 420
Conclusion 431
References 431
Chapter 21 Relaxation Techniques and Hypnosis in the Treatment of CHD Patients 437
Introduction 437
Psychobiological Aspects 438
Relaxation Techniques 440
Autogenic Training 441
Biofeedback and Combined Relaxation Procedures 443
Progressive Muscle Relaxation 445
Hypnosis 446
Clinical Issues 447
References 449
Chapter 22 Cardiological and Psychological Mobile Care through Telematic Technologies for Heart Failure Patients: ICAROS Project 453
Introduction 453
The ICAROS - FIRB Project 454
System Description 456
Overall System Architecture 457
Medical and Psychological Monitoring 460
Final Considerations 469
References 470
Chapter 23 Functioning and Disability in Patients with Cardiovascular Disease within the ICF Classification Framework: Proposals for Using ICF to Classify Functioning and Disability in Patients with Cardiovascular Disease 473
Heart Disease: Functioning and Disability 474
ICF Description 476
Structure of ICF Classification 477
Use of ICF in Cardiological Rehabilitation 480
Using ICF in a Cardiopathic Patient: Application Example 482
References 486
Chapter 24 Coherence-Building Techniques and Heart Rhythm Coherence Feedback: New Tools for Stress Reduction, Disease Prevention and Rehabilitation 489
The Emotional Basis of Stress 491
Breaking the Stress Cycle: The Power of Positive Emotions 492
Positive Emotion-Focused Tools and Techniques 498
The Generation of Emotions: A Pattern-Matching Process 500
Revisiting the HeartMath Techniques: A Repatterning Process 503
Heart Rhythm Coherence Feedback Training: Facilitating Coherence 505
Clinical Applications 506
Conclusions and Implications 509
References 510