The tense, the hostile and the distressed: multidimensional psychosocial risk profiles based on the ESC interview in coronary artery disease patients - the THORESCI study

Eveline van Montfort; Johan Denollet; Jeroen K Vermunt; Jos Widdershoven; Nina Kupper

doi:10.1016/j.genhosppsych.2017.05.006

The tense, the hostile and the distressed: multidimensional psychosocial risk profiles based on the ESC interview in coronary artery disease patients - the THORESCI study

Gen Hosp Psychiatry. 2017 Jul:47:103-111. doi: 10.1016/j.genhosppsych.2017.05.006. Epub 2017 May 22.

Authors

Eveline van Montfort¹, Johan Denollet¹, Jeroen K Vermunt¹, Jos Widdershoven¹, Nina Kupper²

Affiliations

¹ Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders, Netherlands; Tilburg University, Department of Methodology & Statistics, Tilburg Netherlands; Elisabeth-TweeSteden Hospital Tilburg, Tilburg Netherlands.
² Tilburg University, Department of Medical and Clinical Psychology, Center of Research on Psychological and Somatic Disorders, Netherlands; Tilburg University, Department of Methodology & Statistics, Tilburg Netherlands; Elisabeth-TweeSteden Hospital Tilburg, Tilburg Netherlands. Electronic address: h.m.kupper@tilburguniversity.edu.

PMID: 28807133
DOI: 10.1016/j.genhosppsych.2017.05.006

Abstract

Background: While single psychosocial factors have been associated with cardiovascular outcomes, it is still unclear how they cluster. Therefore, we examined whether latent multidimensional psychosocial risk profiles could be identified in the European Society of Cardiology (ESC) psychosocial screening interview. Additionally we examined whether these profiles were associated with specific sociodemographic, clinical, and psychosocial characteristics.

Method: 681 coronary artery disease patients (age=64.9±10.6; 80% men) completed the ESC interview, comprising 15 items on 7 predefined components. Multiple self-report questionnaires focusing on demographics, mood symptoms, personality, coping, and life events were used. Clinical information was extracted from patients' medical records.

Results: Latent class analysis identified four psychological classes: 1. Low psychological distress (62%), 2. High hostility (19%), 3. High tension (11%), 4. High psychological distress (8%), and two social classes: Low chronic stress (81%), and High work stress (%19). Characteristics increasing the odds to belong to the "High hostility" class were male sex, negative affectivity, and psychiatric history. "High tension" membership was associated with female sex, being single, a sedentary lifestyle, seeking social support, NA, early adverse life-events, depression, anxiety, and psychiatric history. "High psychological stress" characteristics were younger age, smoking, a sedentary lifestyle, NA, depression, anxiety, early adverse life-events, psychiatric history. Being younger, alcohol use and avoidance-oriented coping increased the odds to be in the "High work stress" class.

Conclusions: This study characterized four psychological and two social latent risk profiles. Results indicate the importance of a multidimensional psychosocial screening, potentially uncovering differential mechanistic pathways, which also may prove beneficial in clinical practice and in risk prevention strategies.

Keywords: Cluster analysis; Coronary artery disease; Psychosocial factors; Psychosocial risk profiles; Screening.

MeSH terms

Aged
Anxiety / epidemiology
Anxiety / psychology*
Cluster Analysis
Coronary Artery Disease / classification*
Coronary Artery Disease / epidemiology
Coronary Artery Disease / psychology*
Female
Hostility*
Humans
Interview, Psychological
Male
Middle Aged
Netherlands / epidemiology
Risk Factors
Stress, Psychological / epidemiology
Stress, Psychological / psychology*