Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center.
German Center for Cardiovascular Research (DZHK).
Health Psychol. 2021 Nov;40(11):754-763. doi: 10.1037/hea0001128.
Family history of premature myocardial infarction (FH-MI) increases the risk for coronary heart disease (CHD). Research has shown that this effect cannot be accounted for by increased genetic vulnerability alone. We tested the hypothesis that FH-MI is associated with psychological distress, which is known to increase CHD risk, and that this effect is sustained over years and mediated by personality traits and coping strategies.
Levels of distress (i.e., exhaustion, depression, and anxiety) were compared between patients with versus without FH-MI and those with versus without own history of myocardial infarction (MI) from the large observational Diagnostic trial on Prevalence and Clinical Course of Diastolic Dysfunction and Heart Failure (DIAST-CHF) study of patients with cardiovascular risk factors or manifest heart disease (N = 1,470).
FH-MI was associated with a range of personality traits and coping strategies and independently predicted psychological distress, whereas own MI did not. In mediation analysis, we found that sociotropy and avoidant coping serially mediated significant portions of the effect of FH-MI on distress. Proportions of explained variance ranged from R2 = .11 for depressive symptoms to R2 = .25 for anxiety. Effects remained stable at 1-year follow-up. Several alternative hypotheses were tested and found to be less well supported by the data.
Participants with cardiovascular risk factors and FH-MI report increased distress, even years after the event, which might be one component leading to their increased CHD risk. They should be offered support for dealing with distress and life events recurring on sociotropy and avoidant coping as important diathesis factors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
早发性心肌梗死家族史（FH-MI）增加了冠心病（CHD）的风险。研究表明，这种影响不能仅归因于遗传易感性的增加。我们检验了这样一个假设，即 FH-MI 与心理困扰有关，而心理困扰已知会增加 CHD 的风险，并且这种影响可以持续多年，并通过人格特质和应对策略来介导。
比较了心血管危险因素或显性心脏病患者大型观察性诊断试验（Prevalence and Clinical Course of Diastolic Dysfunction and Heart Failure [DIAST-CHF] 研究）中 FH-MI 患者与 FH-MI 患者和无 FH-MI 患者之间的心理困扰水平（即疲劳、抑郁和焦虑）。
FH-MI 与一系列人格特质和应对策略相关，并独立预测心理困扰，而自身 MI 则没有。在中介分析中，我们发现社交依赖和回避应对策略连续中介了 FH-MI 对困扰的部分影响。解释方差的比例范围从抑郁症状的 R2 =.11 到焦虑的 R2 =.25。在 1 年随访时，效果仍然稳定。测试了几种替代假设，发现数据对这些假设的支持较少。
有心血管危险因素和 FH-MI 的参与者报告了更多的困扰，甚至在事件发生多年后也是如此，这可能是导致他们 CHD 风险增加的一个因素。应提供支持，帮助他们应对与社交依赖和回避应对相关的困扰和生活事件，这些都是重要的素质因素。
