Falger P R
Int J Aging Hum Dev. 1983;16(1):7-27. doi: 10.2190/D8UL-32XA-4KM4-GP9R.
Empirical evidence is reviewed about the contributions of life changes and the coronary-prone behavior pattern in the development of myocardial infarction in middle adulthood. Since established clinical risk factors account for about half of the total variance, it is necessary to explore in more detail the crucial developmental role that distressing psychologic and social parameters should play. Because of the generally prolonged incubation period of the effects of psychosocial risk factors, it is proposed that they should be studied from a life-span developmental perspective. Two metamodels seem appropriate in this respect: a mechanistic model by Dohrenwend and Dohrenwend, and an organismic model by Levinson. After scrutinizing some properties of these models, including their potential explanatory power, it is argued that an organismic model may predict better the pathogenic development of distressing psychosocial risk constellations over consecutive phases in the life course of the heart patient.
本文回顾了关于生活变化和冠心病易发行为模式在中年人心肌梗死发病过程中的作用的实证证据。由于已确定的临床风险因素约占总变异的一半，因此有必要更详细地探讨令人痛苦的心理和社会参数应发挥的关键发展作用。由于心理社会风险因素的影响通常具有较长的潜伏期，因此建议从生命历程发展的角度对其进行研究。在这方面，有两种元模型似乎是合适的：多赫伦温德和多赫伦温德提出的机械模型，以及莱文森提出的有机模型。在审视了这些模型的一些特性，包括它们潜在的解释力之后，有人认为有机模型可能能更好地预测心脏病患者生命历程中连续阶段令人痛苦的心理社会风险组合的致病发展。
