Various forms of disease-related anxiety (DRA) have shown to correlate with negative mental health outcomes in cardiovascular (CVD) patients. The aim of this article was to provide a systematic...Show moreVarious forms of disease-related anxiety (DRA) have shown to correlate with negative mental health outcomes in cardiovascular (CVD) patients. The aim of this article was to provide a systematic review and meta-analysis of the relationship between DRA and psychological outcomes in patients with CVD. A systematic literature search was performed on the 16th of April, 2021. A random-effect model meta-analyses were conducted on cross-sectional data assessing the correlations between various DRA types and psychological outcomes. Study results which were eligible for inclusion but could not be analysed statistically were described in a summary of findings. We found 20 eligible studies of mostly cross-sectional design. Twelve of these studies were included in the meta-analysis. The performed meta-analyses showed that higher levels of cardiac anxiety (CAQ total) were correlated with higher levels of general anxiety (r= 0.47, p<.001) and depression (r= 0.34, p<.001) (HADS). The same relationship was found between the three susbcales of cardiac anxiety (CAQ fear, CAQ avoidance, CAQ attention) and general anxiety (rfear= 0.50, p <.001; ravoidance= 0.19, p <.001; rattention= 0.38,p<.001) and depression (rfear= 0.40, p <.001; ravoidance= 0.32, p <.001; rattention= .31,p <.001) (HADS). Fear of movement (FactS-HF 15) was significantly, positively correlated with state anxiety (r= 0.38, p<.001) and depression (r= 0.28, p<.001) (STADI) and trait anxiety (r= 0.51, p<.001) and depression (r= 0.45, p<.001) (STADI). Finally, correlation between kinesiophobia (TSK-Heart) and general anxiety (HADS-A) was non-significant (r= 0.36, p=.224). Our findings show a connection between various types of DRA and a higher risk of psychopathology in CVD patients. While the underlying pathway cannot be seen from our results, multiple processes have been proposed in previous studies. We believe that regular DRA screening and development of disease-specific treatment may be beneficial for this patient population. However, more research is needed in order to understand this relationship as well as to assess the effectiveness of a disease-specific approach.Show less
Cardiovascular Disease (CVD) constitutes the single leading cause of death and disability worldwide. Although mortality rates have been declining in recent decades, CVD still represents a severe...Show moreCardiovascular Disease (CVD) constitutes the single leading cause of death and disability worldwide. Although mortality rates have been declining in recent decades, CVD still represents a severe threat to patients’ health and health-related quality of life (HRQoL). Patients who develop comorbid disease-related anxiety are at increased risk for worse disease progression and impaired HRQoL. The purpose of this paper was to review the current scientific evidence and to perform a meta-analysis on the relationship between disease-related anxiety and clinical health outcomes in patients with CVD. Due to an insufficient number of studies, our analysis focused on the relationship between cardiac anxiety and HRQoL. The literature was searched for eligible articles published by September 2021 on eight online databases. Data extraction revealed 12 observational studies eligible for inclusion in the systematic review. Of those, 4 articles (including 985 patients) fulfilled the criteria to be included in the meta-analyses, which examined the association between cardiac anxiety and both physical and mental HRQoL, respectively. Under the random-effects model, we found a significant and negative correlation between cardiac anxiety and physical HRQoL (r = -0.53: 95% CI [-0.57, -0.48; p < .001]). Additionally, we found a significant and negative correlation of small-to-moderate strength between cardiac anxiety and mental HRQoL (r = -0.43: 95% CI [-0.50, -0.35; p < .001]). These results implicate that, on average, patients with CVD experience lower levels of both physical and mental HRQoL with increasing levels of cardiac anxiety. Our findings further suggest that routine screenings should be implemented in clinical practice to identify and potentially treat at-risk patients. Future research on the cause-and-effect of these relationships is warranted.Show less
Research on the neural processing of reward and punishment thus far has indicated the complex and constant role it plays in decision making and behaviour. Current findings suggest that an action...Show moreResearch on the neural processing of reward and punishment thus far has indicated the complex and constant role it plays in decision making and behaviour. Current findings suggest that an action can be incentivised by the desire to avoid punishment as well to gain reward. A means of gauging how effective a financial incentive is to motivate behaviour is via the neural response it elicits using EEG data. This study uses the Monetary Incentive Delay task (MIDt) to examine financial incentive-driven behavior. Due to loss aversion, we expected a greater neural response (feedback related negatively; FRN), in punishing conditions where money is lost compared to reward or control where it is not. We investigate how reward and punishment sensitivity of the participant could moderate this relationship between FRN and the type of incentive, assuming that higher punishment sensitivity will predict an increased FRN amplitude generated in the punishment compared to reward conditions. This thesis is a preliminary analysis, involving university students with no substance abuse or problematic gambling histories (N = 21) that complete the MIDt while EEG was being recorded. The short Sensitivity to Punishment and Sensitivity to Reward Questionnaire was administered pre-experiment and all money earned during the MIDt was awarded to the participants upon completion. Data was analyzed using repeated measures ANOVA, with contrasts as follows: control vs gain; control vs loss; gain vs loss. A moderation analysis was run of punishment/reward sensitivity (SP/SR) on gain versus loss with FRN amplitude as outcome using PROCESS in SPSS. Data is still being obtained at this point in time to achieve necessary power for this study. This is potentially why our preliminary results were non-significant for our hypotheses. However, the trends shown in the FRN absolute values indicate a greater neural response in punishment conditions where money is lost compared to either the reward or neutral counterparts. Additional analysis is required to fully ascertain how punishment and reward sensitivity impact the neural correlates of financial incentives and how this finding can be applied when using such incentives practically.Show less
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. Research has shown that cardiac rehabilitation (CR) reduces morbidity, mortality, and unplanned hospital...Show moreCardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. Research has shown that cardiac rehabilitation (CR) reduces morbidity, mortality, and unplanned hospital admissions. In addition, improvements in exercise capacity, quality of life, and mental health were reported. However, women are substantially less likely to be referred to CR and are additionally less likely to enroll when they are referred. The aim of this study was to conduct a systematic literature review about potential barriers which women face when entering CR. Underlying factors causing underrepresentation of women in CR are multifactorial and consist of individual-, healthcare provider- , and system-level factors. Individual-level factors which negatively influence enrollment rates are, for example, disease related factors and demographics, including older age. On a systemic level, for instance, a lack of health insurance financial coverage for the CR program deterred women from enrolling. One healthcare provider factor is the characteristics of CR programs, since some women were reluctant to enroll in CR due to the high intensity exercising. A meta-analysis about the effectiveness of strategies aiming to improve enrolment rates of women was performed. The risk ratio analysis did not yield clear evidence for suitable referral strategies for women to improve enrollment rates. However, two studies showed that coaching and motivational interviewing strategies can increase enrolment rates among female CVD patients. According to an event rate analysis, implementing an adequate referral strategy such as peer navigation, in combination with coaching as well as the combined peer navigation, automatic, and coaching strategy could facilitate overcoming barriers which are particularly challenging for female patients. An examination of current standards of care in each health care system or country is needed, followed by addressing the aforementioned multifactorial level barriers and the implementation of suitable referral strategies.Show less
Recent research proposes that psychological factors might influence individuals’ pain experiences via descending endogenous pain modulation. This can be studied using the experimental paradigm of...Show moreRecent research proposes that psychological factors might influence individuals’ pain experiences via descending endogenous pain modulation. This can be studied using the experimental paradigm of conditioned pain modulation (CPM). Two types of psychological variables suggested to influence individuals’ pain experience are self-efficacy beliefs and dispositional optimism. It is further proposed that self-efficacy might predict dispositional optimism. The present study aims to investigate whether self-efficacy and dispositional optimism affect individuals’ CPM response. The primary research question asks whether the influence of self-efficacy on CPM is mediated by dispositional optimism. This is investigated by three hypotheses: First, self-efficacy affects CPM; second, dispositional optimism affects CPM; third, dispositional optimism mediates the effect of self-efficacy on CPM. The provisional research question asks whether verbal suggestions are effective in changing self-efficacy beliefs and is tested with a hypothesis stating that verbally manipulation self-efficacy is successful. Participants (N = 17) are university students or adults, randomly grouped into a high versus low self-efficacy condition in which they are accordingly manipulated. The Life Orientation Test-Revised (LOT-R) is administered to measure dispositional optimism. The CPM paradigm is executed using an algometer and the cold-pressor test as stimuli. The primary hypotheses are analysed using linear regression and the PROCESS macro procedure. The results were not statistically significant at p ≤ .05 and, followingly, neither of the hypotheses could be confirmed. However, secondary findings might potentially point towards an effect of self-efficacy on CPM (β = .17) and dispositional optimism on CPM (β = .15). The provisional hypothesis, tested using a one-way ANOVA, revealed non-significant results at p ≤ .05. Thus, the manipulation of self-efficacy was not successful. The present research represents one of the first studies investigating the role of self-efficacy and dispositional optimism in CPM. The current findings suggest that future research into this field is highly needed. This would help to uncover the impact of self-efficacy and dispositional optimism on CPM or to show that a different approach including other psychological variables is more suitable. Investigating the field of CPM further could help to improve pain treatments and prevent the development of persistent pain conditions.Show less
