From the Department of Human and Social Sciences (Compare, Brugnera, Zarbo), Human Factors and Technologies (Compare, Brugnera, Zarbo), University of Bergamo, Italy; Division of Psychology, School of Applied Sciences (Spada, Caselli), London South Bank University, United Kingdom; School of Psychology (Tasca), University of Ottawa, Ontario, Canada; Sigmund Freud University (Sassaroli, Caselli, Ruggiero); Studi Cognitivi (Caselli, Ruggiero), Milan, Italy; Division of Cardiology (Wittstein), Department of Medicine, Johns Hopkins University School of Medicine; and Division of Cardiology (Wittstein), Johns Hopkins Hospital, Baltimore, Maryland.
Psychosom Med. 2018 May;80(4):377-384. doi: 10.1097/PSY.0000000000000564.
The current study examined the role of emotional competences and depression in takotsubo cardiomyopathy (TTC).
We compared 37 TTC patients who experienced emotion triggers (TTC-t: M (SD) age = 66.4 (12.8) years, 33 women) with 37 TTC patients who did not experience emotion triggers (TTC-nt: M (SD) age = 65.8 (11.1) years, 33 women) and 37 patients with acute myocardial infarction who experienced an emotion trigger (AMI-t: M (SD) age = 66.1 (10.1) years, 33 women). Three aspects of emotional competence (emotional intelligence, metacognitive beliefs, and emotional processing deficits) were assessed using the Trait Meta-Mood Scale (TMMS), the Meta-Cognitions Questionnaire 30, and the Emotional Processing Scale. Differences between-group means were evaluated using multivariate analysis of covariance, adjusting for depressive symptom (Hamilton Rating Scale for Depression).
Compared with the TTC-nt and AMI-t comparison groups, TTC-t patients had low scores on emotional intelligence (TMMS Attention: F(2, 184) = 23.10, p < .001; TMMS Repair: F(2, 184) = 11.98, p < .001) and high scores in metacognitive beliefs and emotional processing deficits (e.g., Meta-Cognitions Questionnaire 30 Negative Beliefs about Thoughts: F(2, 184) = 56.93, p < .001), independent of the levels of depressive symptom. TTC-nt patients also had significantly lower scores on the Hamilton Rating Scale for Depression scale compared with AMI-t (p = .021) and TTC-t (p = .004) patients.
TTC-t patients showed a specific dysfunctional profile of emotional competence, even after adjusting for depressive symptom. These results provided a better understanding of the psychological factors that contribute to TTC.
本研究旨在探讨情绪能力和抑郁在应激性心肌病(TTC)中的作用。
我们比较了 37 例经历情绪触发的 TTC 患者(TTC-t:M(SD)年龄=66.4(12.8)岁,33 名女性)、37 例未经历情绪触发的 TTC 患者(TTC-nt:M(SD)年龄=65.8(11.1)岁,33 名女性)和 37 例经历情绪触发的急性心肌梗死患者(AMI-t:M(SD)年龄=66.1(10.1)岁,33 名女性)。使用特质元情绪量表(TMMS)、元认知问卷 30 项和情绪加工量表评估情绪能力的三个方面(情绪智力、元认知信念和情绪加工缺陷)。使用协方差的多变量分析,调整抑郁症状(汉密尔顿抑郁评定量表),评估组间差异。
与 TTC-nt 和 AMI-t 对照组相比,TTC-t 患者在情绪智力方面得分较低(TMMS 注意力:F(2,184)=23.10,p<.001;TMMS 修复:F(2,184)=11.98,p<.001),元认知信念和情绪加工缺陷得分较高(例如,元认知问卷 30 项负性思维:F(2,184)=56.93,p<.001),独立于抑郁症状水平。TTC-nt 患者的汉密尔顿抑郁评定量表得分也明显低于 AMI-t(p=.021)和 TTC-t(p=.004)患者。
即使调整了抑郁症状,TTC-t 患者仍表现出特定的情绪能力功能障碍特征。这些结果提供了对导致 TTC 的心理因素的更好理解。