Burg Matthew M, Lampert Rachel, Joska Tammy, Batsford William, Jain Diwakar
VA Connecticut Healthcare System, West Haven Campus, West Haven, CT, USA.
Psychosom Med. 2004 Nov-Dec;66(6):898-902. doi: 10.1097/01.psy.0000145822.15967.15.
We have previously reported on the triggering of arrhythmia and hence, implanted cardioverter-defibrillators (ICD) shock by strong emotion. The purpose of the present study was to examine whether concordant psychological traits distinguish patients who experience emotion-triggered ICD shock.
Two hundred forty ICD patients completed the Speilberger Trait Anxiety and Anger Inventories and Anger Expression Scale, and the abridged Cook-Medley Hostility Scale approximately 2 months after ICD implantation. Patients were also given a structured diary to record mood states retrospectively for the period 0 to 15 minutes preceding ICD shock and for a period corresponding to the same time of day 1 week later. Patients who reported emotion-triggered ICD shock were compared on concordant psychological measures to patients who did not.
Patients who reported at least moderate anger in the 0 to 15 minutes before ICD shock scored significantly higher on Speilberger Trait Anger (24.18 +/- 3.97 vs. 17.04 +/- 2.17, p < .0001), and Cook-Medley Aggressive Responding (5.76 +/- 0.75 vs. 3.96 +/- 1.30, p < .0001) and Hostile Affect (3.59 +/- 0.80 vs. 2.04 +/- 1.02, p < .0001), and lower on Speilberger Anger Control (7.94 +/- 1.43 vs. 10.64 +/- 1.19, p < .001) than those who did not. In multivariate analysis, only Trait Anger remained a significant predictor of anger-triggered shock (chi2 = 7.10, p < .008). Patients who reported at least moderate anxiety in the 0 to 15 minutes before ICD shock scored significantly higher on Speilberger Anxiety (22.43 +/- 1.65 vs. 19.96 +/- 1.71, p < .0001) than those who did not.
Stable psychological factors are associated with risk for ICD-shock triggered by concordant strong emotion.
我们之前曾报道过强烈情绪会引发心律失常，进而导致植入式心脏复律除颤器（ICD）电击。本研究的目的是检验一致的心理特征是否能区分经历情绪引发ICD电击的患者。
240名ICD患者在ICD植入后约2个月完成了斯皮尔伯格特质焦虑和愤怒量表、愤怒表达量表以及简化的库克-梅德利敌意量表。患者还被给予一本结构化日记，用于回顾性记录ICD电击前0至15分钟的情绪状态以及1周后同一天同一时间的情绪状态。将报告情绪引发ICD电击的患者与未报告的患者在一致的心理测量指标上进行比较。
报告在ICD电击前0至15分钟至少有中度愤怒的患者，在斯皮尔伯格特质愤怒量表（24.18±3.97对17.04±2.17，p<.0001）、库克-梅德利攻击性反应量表（5.76±0.75对3.96±1.30，p<.0001）和敌意情感量表（3.59±0.80对2.04±1.02，p<.0001）上的得分显著更高，而在斯皮尔伯格愤怒控制量表上的得分（7.94±1.43对10.64±1.19，p<.001）显著更低。在多变量分析中，只有特质愤怒仍然是愤怒引发电击的显著预测因素（χ2 = 7.10，p<.008）。报告在ICD电击前0至15分钟至少有中度焦虑的患者，在斯皮尔伯格焦虑量表上的得分（22.43±1.65对19.96±1.71，p<.0001）显著高于未报告的患者。
稳定的心理因素与由一致的强烈情绪引发ICD电击的风险相关。
