Liljeroos Thea, Humphries Sophia, Puthoopparambil Soorej Jose, Norlund Fredrika, Olsson Erik M G
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Cogn Behav Ther. 2023 Jan;52(1):47-64. doi: 10.1080/16506073.2022.2135591. Epub 2022 Nov 28.
Myocardial infarction (MI) is one of the leading causes of mortality and disability worldwide. Emotional distress, such as anxiety and depression, are common among MI patients. The aim of this study was to investigate emotional reactions following MI and to explore how MI patients self-manage their emotional distress using the perspective of an explanatory behavioural model of depression and anxiety. Written testimonies from 92 MI patients starting an internet-based cognitive behavioural therapy (iCBT) were analysed using qualitative content analysis with a mixed deductive and inductive approach. Six themes were identified. The first three highlight the emotional reactions post-MI: Hypoarousal reactions and low mood; Hyperarousal reactions; and A changed sense of self and outlook on life. The following three themes describe strategies for managing emotional distress: Avoidance of potentially rewarding situations; Avoidance of heart relevant stimuli triggering anxiety; and Engaging in potentially positive activities and acceptance. The MI experience may trigger emotional reactions, with a particular emphasis on heart-focused anxiety, depression and a shift in the perception of one's identity. Patients tend to manage emotional distress through social withdrawal and experiential avoidance which likely maintains the distress. Applying a behavioural model to the management of emotional distress following MI is suited.
心肌梗死（MI）是全球范围内导致死亡和残疾的主要原因之一。焦虑和抑郁等情绪困扰在心肌梗死患者中很常见。本研究的目的是调查心肌梗死后的情绪反应，并从抑郁和焦虑的解释性行为模型的角度探讨心肌梗死患者如何自我管理情绪困扰。采用定性内容分析法，运用演绎和归纳相结合的方法，对92名开始接受基于互联网的认知行为疗法（iCBT）的心肌梗死患者的书面证词进行了分析。确定了六个主题。前三个主题突出了心肌梗死后的情绪反应：低唤醒反应和情绪低落；高唤醒反应；以及自我认知和人生观的改变。以下三个主题描述了管理情绪困扰的策略：避免潜在的有益情境；避免触发焦虑的与心脏相关的刺激；以及参与潜在的积极活动和接受。心肌梗死经历可能会引发情绪反应，尤其强调以心脏为中心的焦虑、抑郁以及自我认知的转变。患者倾向于通过社交退缩和经验性回避来管理情绪困扰，而这可能会使困扰持续存在。将行为模型应用于心肌梗死后情绪困扰的管理是合适的。
