Affective Outcomes in the SUPRIM Stress Management Program for Post-Myocardial Infarction Patients

• BackgroundThe Interheart Study showed that psychosocial stress increased the risk of myocardial infarction (OR 2.67). The Secondary Prevention in Uppsala Primary healthcare project (SUPRIM) tested whether stress management after myocardial infarction could decrease risk of recurrent cardiovascular events. SUPRIM was a randomized controlled trial in which CHD patients attended a CBT group stress management program. During 94 months of follow-up there was a 45% reduction of recurrent myocardial infarctions (MI) in the intervention group. There were no differences between intervention and control patientes in standard risk factors. Thus, we assumed that psychological mechanisms could explain the effects on hard endpoints.Method362 MI patients were assessed by a package of self-rating psychometric instrument, and this paper examined whether hostility, time urgency, depression, somatic anxiety, and vital exhaustion decreased more in the intervention group than in the control group. Data collected from 5 points of measurement over 24 months were analyzed with multi-linear regression.ResultsThe intervention had a significant effect on hostility, time urgency, and somatic anxiety. Vital exhaustion and depression scores showed no differences. There was a significant relationship between attendance rate and decrease of hostility, but no association between attendance rate and levels of vital exhaustion or depression.ConclusionsTreatment effects were demonstrated in measures that assessed emotional reactivity. These changes are possibly linked to physiological and hormonal mechanisms. However, it is to a considerable degree still unknown why and how the stress management intervention impacts disease endpoints.

Ämnesord

SAMHÄLLSVETENSKAP  -- Psykologi -- Tillämpad psykologi (hsv//swe)

SOCIAL SCIENCES  -- Psychology -- Applied Psychology (hsv//eng)

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