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Physical and psychological correlates of severe heart disease in men

Published online by Cambridge University Press:  09 July 2009

Christopher Bass  and
Fawaz Akhras
Christopher Bass*
Affiliation:
Academic Department of Psychological Medicine and Department of Cardiology, King's College School of Medicine and Dentistry, London
Fawaz Akhras
Affiliation:
Academic Department of Psychological Medicine and Department of Cardiology, King's College School of Medicine and Dentistry, London
*
1Address for correspondence: Dr C. Bass, Academic Department of Psychological Medicine, King's College School of Medicine and Dentistry, Denmark Hill, London SE5 9RS.
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Synopsis

Seventy eight men were assessed one month before coronary artery bypass graft surgery using standardized measures of psychiatric morbidity and personality as well as a measure of emotional expression (the CECS). All patients had at least one coronary vessel occluded by 75% or more of its diameter, and functional capacity was assessed by calculating the exercise treadmill time (in seconds) for each patient.

Most of the variance in exercise treadmill time was accounted for by the following variables: young age, short duration of symptoms, and less severe angina. Only one in five men was designated a psychiatric ‘case’. The only psychological measure significantly associated with atherosclerosis was expression of fear (on the CECS). A measure of Type A behaviour (Bortner score) was related to exercise treadmill time, but not to any of the angiographic or clinical indices of coronary heart disease (CHD).

Like other measures of Type A behaviour, the Bortner scale is psychometrically impure and has doubtful validity. More valid behavioural variables (such as those measured by the CECS) require further investigation. Future studies on the relation between psychological factors and the extent of CHD should take account of not only sex differences but also patients without significant CHD: high rates of psychiatric morbidity in such patients confound the relation between psychological trait measures and atherosclerosis.

Type
Research Article
Information
Psychological Medicine , Volume 17 , Issue 3 , August 1987 , pp. 695 - 703
Copyright
Copyright © Cambridge University Press 1987

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References

Ahnve, S., De Faire, U., Orth-Gomer, K. & Theorell, T. (1979). Type A behaviour in patients with non-coronary chest pain admitted to a coronary care unit. Journal of Psychosomatic Research 23, 219–223.CrossRefGoogle ScholarPubMed
Barefoot, J. C., Dahlstrom, G. & Williams, R. B. (1983). Hostility, CHD incidence, and total mortality: a 25–year follow-up study of 255 physicians. Psychosomatic Medicine 45, 59–63.CrossRefGoogle ScholarPubMed
Bass, C. (1984). Type A behaviour in patients with chest pain: test-retest reliability and psychometric correlates of Bortner scale. Journal of Psychosomatic Research 28, 289–300.CrossRefGoogle ScholarPubMed
Bass, C. & Wade, C. (1982). Type A behaviour: not specifically pathogenic? Lancet ii, 1147–1150.CrossRefGoogle Scholar
Bass, C. & Wade, C. (1984). Chest pain with normal coronary arteries: a comparative study of psychiatric and social morbidity. Psychological Medicine 14, 41–51.CrossRefGoogle ScholarPubMed
Bass, C., Cawley, R. H., Wade, C., Gardner, W. N., Hutchinson, D. C., Ryan, K. & Jackson, G. (1983). Unexplained breathlessness and psychiatric morbidity in patients with normal and abnormal coronary arteries. Lancet i, 605–609.CrossRefGoogle Scholar
Blumenthal, J. A., Williams, R. B., Kong, Y., Schanberg, S. M. & Thompson, L. W. (1978). Type A behaviour pattern and coronary atherosclerosis. Circulation 58, 634–639.CrossRefGoogle Scholar
Blumenthal, J. A., Herman, S., O'Toole, L. C., Haney, T. L., Williams, R. B. & Barefoot, J. C. (1985). Development of a brief self-report measure of the Type A (coronary prone) behaviour pattern. Journal of Psychosomatic Research 29, 265–274.CrossRefGoogle Scholar
Bortner, R. W. (1969). A short rating scale as a potential measure of Pattern A behavior. Journal of Chronic Disease 22, 87–91.CrossRefGoogle Scholar
Bruce, R. A. (1971). Exercise testing of patients with coronary heart disease: principles and normal standards for evaluation. Annals of Clinical Research 3, 323–332.Google ScholarPubMed
Byrne, D. G. & Roseman, R. H. (1986). Type A behaviour and the experience of affective discomfort. Journal of Psychosomatic Research 30, 663–672.CrossRefGoogle ScholarPubMed
Dembroski, T. M., Macdougal, J. M., Williams, R. B., Haney, T. L. & Blumenthal, J. A. (1985). Components of Type A, hostility, and anger in relationship to angiographic findings. Psychosomatic Medicine 47, 219–233.CrossRefGoogle ScholarPubMed
Dimsdale, J. E., Hackett, T. P., Hutter, A. M., Block, P. C. & Catanzano, D. (1978). Type A personality and the extent of coronary atherosclerosis. American Journal of Cardiology 42, 583–586.CrossRefGoogle ScholarPubMed
Elias, M. F., Robbins, M. A., Blow, F. C., Rice, A. P. & Edgecomb, J. L. (1982). A behavioural study of middle-aged chest pain patients: physical symptom reporting, anxiety, and depression. Experimental Ageing Research 8, 45–51.CrossRefGoogle Scholar
Eysenck, H. J. & Eysenck, S. B. G. (1975). Manual of the Eysenck Personality Questionnaire. Hodder and Stoughton: London.Google Scholar
Eysenck, H. & Fulker, D. (1983). The components of Type A behaviour and its genetic determinants. Personality and Individual Differences 4, 499–505.CrossRefGoogle Scholar
Friedman, M. & Powell, L. H. (1984). The diagnosis and quantitative assessment of Type A behaviour: introduction and description of the videotaped structured interview. Integrative Psychiatry 2, 123–129.Google Scholar
Gensini, G. G. (1980). Coronary arteriography. In Heart Disease. A Textbook of Cardiovascular Medicine, (ed. Braunwald, E.), pp. 308–362. WB Saunders: Philadelphia.Google Scholar
Goldberg, D. P., Cooper, B., Eastwood, M. R., Kedward, H. B. & Shepherd, M. (1970). A standardized psychiatric interview for use in the community surveys. British Journal of Preventative and Social Medicine 24, 18–23.Google ScholarPubMed
Heller, R. F. (1979). Type A behaviour and coronary heart disease. British Medical Journal ii, 368.CrossRefGoogle Scholar
Johnstone, D. W. & Shaper, A. G. (1983). Type A behaviour in British men: reliability and intercorrelation of two measures. Journal of Chronic Disease 36, 203–207.CrossRefGoogle Scholar
Maguire, G. P., Julier, D. L., Hawton, K. E. & Bancroft, J. (1974). Psychiatric morbidity and referral on two general medical wards. British Medical Journal i, 268–270.CrossRefGoogle Scholar
Matthews, K. A. & Bronson, B. I. (1979). Allocation of attention and the Type A coronary-prone behaviour pattern. Journal of Personal and Social Psychology 37, 2081–2090.CrossRefGoogle Scholar
Pettingale, K. W., Watson, M. & Greer, S. (1984). The validity of emotional control as a trait in breast cancer patients. Journal of Psychosocial Oncology 2, 21–30.CrossRefGoogle Scholar
Proudfit, W. L., Shirley, E K. & Sones, P. M. (1966). Selective cinecoronary arteriography. Correlation with clinical findings in 1000 patients. Circulation 33, 901–910.CrossRefGoogle Scholar
Scherwitz, L., McKelvain, R., Laman, C., Patterson, J., Dutton, L., Yusim, S., Lester, J., Kraft, L., Rochelle, D. & Leachman, R. (1983). Type A behaviour, self-involvement, and coronary atherosclerosis. Psychosomatic Medicine 45, 47–57.CrossRefGoogle ScholarPubMed
Silver, L., Jenkins, C. D., Ryan, T. J. & Melidossian, C. (1980). Sex differences in the psychological correlates of cardiovascular diagnosis and coronary angiographic findings. Journal of Psychosomatic Research 24, 327–334.CrossRefGoogle ScholarPubMed
Spielberger, C. D., Johnson, E. H., Russell, S. F., Crane, R. J., Jacobs, G. A. & Worden, T. J. (1985). The experience and expression of anger: construction and validation of an anger expression scale. In Anger and hostility in cardiovascular and behavioral disorders (ed. Chesney, M. A. and Rosenman, R. H.), pp. 5–30. Hemisphere (McGraw-Hill): Washington DC.Google Scholar
Tennant, C C. & Langeluddecke, P. M. (1985). Psychological correlates of coronary heart disease. Psychological Medicine 15, 581–588.CrossRefGoogle ScholarPubMed
Watson, M. & Greer, S. (1983). Development of a questionnaire measure of emotional control. Journal of Psychosomatic Research 27, 299–305.CrossRefGoogle ScholarPubMed
Wielgosz, A. T., Fletcher, R. H., McCants, C. B., McKinnis, R. A., Haney, T. L. & Williams, R. B. (1984). Unimproved chest pain in patients with minimal or no coronary disease: a behavioural phenomenon. American Heart Journal 108, 67–72.CrossRefGoogle ScholarPubMed
Williams, R. B., Haney, T. L., Lee, K. I., Kong, Y. H., Blumenthal, J. A. & Whalen, R. E. (1980). Type A behaviour, hostility, and coronary atherosclerosis. Psychosomatic Medicine 42, 539–550.CrossRefGoogle ScholarPubMed
Williams, R. B., Barefoot, J. C. & Shekelle, R. B. (1985). The health consequences of hostility. In Anger and hostility in cardiovascular and behavioral disorders (ed. Chesney, M. A., and Rosenman, R. H.), pp. 173–185Hemisphere (McGraw-Hill): Washington DC.Google Scholar