Van den Broek Krista C, Nyklícek Ivan, Van der Voort Pepijn H, Alings Marco, Denollet Johan
CoRPS-Center of Research on Psychology in Somatic diseases, Tilburg University, Tilburg, the Netherlands.
Pacing Clin Electrophysiol. 2008 Jul;31(7):850-7. doi: 10.1111/j.1540-8159.2008.01099.x.
Studies have examined the relationship between shocks and anxiety, but little is known about the role of personality. Our aim was to examine the determinants of self-reported and interviewer-rated anxiety following implantable cardioverter defibrillator (ICD) implantation.
At baseline, that is, 0-3 weeks following ICD implantation, 308 ICD patients (82% men, mean age = 62.6 years) completed the DS14 (Type D personality) and ASI (anxiety sensitivity). The STAI (self-reported symptoms of state-anxiety) was assessed at baseline and follow-up, which was 2 months following ICD implantation. At this follow-up, the HAM-A interview (interviewer-rated anxiety) was assessed in a subsample (57%); the occurrence of ICD shocks was deduced from medical records.
Analysis of covariance (ANCOVA) for repeated measures showed a significant interaction effect between time and shocks (F = 9.27, P = 0.003) with patients who had experienced a shock experiencing higher levels of self-reported anxiety at follow-up. The main effects of Type D personality (F = 33.42, P < 0.0001) and anxiety sensitivity (F = 66.31, P < 0.0001) were significant, indicating that these patients scored higher on self-reported anxiety across time points. Multivariable linear regression analyses yielded Type D personality (beta= 0.18, P = 0.021) and anxiety sensitivity (beta= 0.19, P = 0.016), but not shocks, as independent predictors of interviewer-rated anxiety. Covariates included gender, marital status, education, age, ICD indication, cardiac history, and comorbidity.
Type D personality and anxiety sensitivity were independent predictors of both self-reported and interviewer-rated anxiety outcomes while ICD shocks were related to an increase in levels of self-reported anxiety only. Identification and support of ICD patients with Type D personality, increased anxiety sensitivity, or shocks is important.
已有研究探讨了电击与焦虑之间的关系，但对于人格特质的作用却知之甚少。我们的目的是研究植入式心律转复除颤器（ICD）植入后自我报告的焦虑和访谈者评定的焦虑的决定因素。
在基线期，即ICD植入后0 - 3周，308例ICD患者（82%为男性，平均年龄 = 62.6岁）完成了DS14（D型人格）和ASI（焦虑敏感性）测评。在基线期和随访期（ICD植入后2个月）评估状态焦虑自评量表（STAI）。在此次随访中，对一个子样本（57%）进行了汉密尔顿焦虑量表（HAM - A）访谈（访谈者评定的焦虑）；从医疗记录中推断ICD电击的发生情况。
重复测量的协方差分析（ANCOVA）显示时间和电击之间存在显著的交互作用（F = 9.27，P = 0.003），经历过电击的患者在随访时自我报告的焦虑水平更高。D型人格（F = 33.42，P < 0.0001）和焦虑敏感性（F = 66.31，P < 0.0001）的主效应显著，表明这些患者在各个时间点的自我报告焦虑得分更高。多变量线性回归分析得出，D型人格（β = 0.18，P = 0.021）和焦虑敏感性（β = 0.19，P = 0.016）是访谈者评定焦虑的独立预测因素，而电击不是。协变量包括性别、婚姻状况、教育程度、年龄、ICD适应症、心脏病史和合并症。
D型人格和焦虑敏感性是自我报告的焦虑和访谈者评定的焦虑结果的独立预测因素，而ICD电击仅与自我报告的焦虑水平升高有关。识别并支持具有D型人格、焦虑敏感性增加或经历过电击的ICD患者很重要。
