朝向对个人掌控力对心血代谢健康的影响有更完整的理解。
Toward a more complete understanding of the effects of personal mastery on cardiometabolic health.
机构信息
Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, La Jolla, CA 92093-0680, USA.
出版信息
Health Psychol. 2011 Sep;30(5):615-32. doi: 10.1037/a0023480.
OBJECTIVE
A great deal of research has been devoted to identifying the psychological factors that might be associated with reduced risk for cardiovascular diseases. In particular, coping resources such as personal mastery might attenuate stress-related pathophysiology. The purpose of the present review was to examine the existing literature reporting associations between personal mastery and cardiometabolic health outcomes to determine which outcomes have been studied to date, investigate the extent of inconsistency in the literature, and propose new directions for research.
DESIGN
Systematic review of articles examining the associations between personal mastery and cardiometabolic health.
MAIN OUTCOME MEASURES
Studies were included if they examined objective measures of cardiometabolic function, cardiovascular events, and/or mortality.
RESULTS
Thirty-two studies were identified examining the effect of mastery on the following outcomes: mortality and/or cardiovascular events, psychoneuroendocrine stress systems, cardiovascular reactivity to acute stress, metabolic dysregulation, inflammation/coagulation, and evidence of large vessel disease from imaging methods.
CONCLUSIONS
Overall, mastery was associated with better cardiometabolic health and reduced risk for disease and/or death, typically with a small-medium effect size. A relatively small proportion of studies reported contradictory findings that higher mastery was associated with poorer cardiometabolic outcomes. The state of the current research suggests that future investigations should focus on 1) clarifying the mediators and moderators most relevant in the association between mastery and downstream disease, 2) testing the association between mastery and biological outcomes longitudinally, 3) examining the physiological impact of mastery-increasing interventions, and 4) studying the relationship between mastery and disease risk in diverse ethnic or sociocultural groups.
目的
大量研究致力于识别可能与降低心血管疾病风险相关的心理因素。特别是，应对资源（如个人掌控力）可能会减轻与压力相关的病理生理学变化。本综述的目的是检查现有文献中关于个人掌控力与心脏代谢健康结果之间的关联，以确定迄今为止研究了哪些结果，调查文献中的不一致程度，并为研究提出新的方向。
设计
对检查个人掌控力与心脏代谢健康之间关联的文章进行系统回顾。
主要观察指标
如果研究检查了心脏代谢功能、心血管事件和/或死亡率的客观测量指标，则纳入研究。
结果
确定了 32 项研究，这些研究考察了掌握力对以下结果的影响：死亡率和/或心血管事件、心理神经内分泌应激系统、急性应激下的心血管反应性、代谢失调、炎症/凝血、以及影像学方法检测到的大血管疾病证据。
结论
总体而言，掌握力与更好的心脏代谢健康和降低疾病风险/死亡风险相关，通常具有中等至较小的效应大小。相对较少的研究报告了相反的发现，即较高的掌握力与较差的心脏代谢结果相关。目前研究的状况表明，未来的研究应集中于 1）阐明在掌握力与下游疾病之间的关联中最相关的中介和调节因素，2）纵向测试掌握力与生物学结果之间的关联，3）检验掌握力增强干预的生理影响，以及 4）研究掌握力与不同种族或社会文化群体中疾病风险的关系。
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