Cruciani Gianluca, Liotti Marianna, Tanzilli Annalisa, Lo Buglio Gabriele, Guarino Davide, Carone Nicola, Casali Matteo, Galli Federica, Lingiardi Vittorio
Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.
Front Psychol. 2025 May 22;16:1587747. doi: 10.3389/fpsyg.2025.1587747. eCollection 2025.
Myocardial infarction (MI) is a major cause of mortality worldwide. Psychopathological symptoms play a bidirectional role in MI prognosis, both increasing cardiovascular risk and being exacerbated by cardiac events, leading to further complications. Personality impairments and disruptions in epistemic trust-the ability to assess social communications as trustworthy and relevant-strongly affect psychopathology levels and may worsen MI clinical outcomes by impeding health behaviors and treatment adherence. This is the first study examining the interplay between psychopathological symptoms, personality dysfunction, and epistemic dimensions in MI patients compared to healthy controls.
A sample of 67 MI patients and 80 age- and gender-matched healthy controls completed self-report measures to assess levels of general psychopathology (DSM-5 self-rated Level 1 Cross-Cutting Symptom Measure), personality functioning (Personality Inventory for DSM-5 Short Form), and epistemic stances (Epistemic Trust, Mistrust, and Credulity Questionnaire). Multivariate analyses were used to compare the groups, while correlations and moderation models were employed to evaluate associations among variables within the MI group.
MI patients showed significantly higher psychopathological symptoms, more severe personality impairments, and greater epistemic mistrust than controls. Within the MI group, psychopathological symptoms were associated with specific maladaptive personality traits (especially, negative affectivity) and epistemic mistrust and credulity. The relationship between worse personality functioning and severe psychopathological symptoms was moderated by epistemic mistrust.
The study emphasizes the importance of addressing psychopathology and epistemic disruptions in clinical settings to improve the treatment's adherence and recovery. The development of targeted interventions to mitigate psychological vulnerabilities in MI patients is recommended.
心肌梗死(MI)是全球范围内主要的死亡原因。心理病理症状在心肌梗死预后中起双向作用,既增加心血管风险,又因心脏事件而加重,进而导致更多并发症。人格障碍和认知信任(即评估社会交往是否可信及相关的能力)的破坏会强烈影响心理病理水平,并可能通过阻碍健康行为和治疗依从性而使心肌梗死的临床结局恶化。这是第一项比较心肌梗死患者与健康对照者心理病理症状、人格功能障碍和认知维度之间相互作用的研究。
67名心肌梗死患者和80名年龄及性别匹配的健康对照者完成了自我报告测量,以评估一般心理病理水平(《精神疾病诊断与统计手册》第5版自评一级交叉症状测量)、人格功能(《精神疾病诊断与统计手册》第5版简式人格量表)和认知立场(认知信任、不信任和轻信问卷)。采用多变量分析比较两组,同时使用相关性和调节模型评估心肌梗死组内变量之间的关联。
与对照组相比,心肌梗死患者表现出明显更高的心理病理症状、更严重的人格障碍和更强的认知不信任。在心肌梗死组内,心理病理症状与特定的适应不良人格特质(尤其是消极情感性)以及认知不信任和轻信相关。认知不信任调节了较差的人格功能与严重心理病理症状之间的关系。
该研究强调在临床环境中解决心理病理和认知障碍对于提高治疗依从性和促进康复的重要性。建议制定有针对性的干预措施以减轻心肌梗死患者的心理脆弱性。