Dimensions of hostility in japanese undergraduate students

Japanese undergraduate students (N = 512) completed the Japanese versions of 4 hostility questionnaires: Aggression Questionnaire (Ando et al., 1999); State-Trait Anger Expression Inventory (Suzuki & Haruki, 1994); Müller Anger Coping Questionnaire (Otake et al., 2000); and Cynicism Questionnaire (Izawa & Nomura, 2004). Dimensions of hostility, determined by factor analysis for the 12 subscales of the 4 questionnaires, revealed a 4-factor solution: Expressive Hostility, Inhibitive Hostility, Assertiveness, and Hostile Cognition. Prior studies with Western participants had suggested a 2-factor solution of Expression and Experience dimensions of hostility. However, our results forcing a 2-factor solution showed a different pattern: The first factor included Expressive Hostility and Hostile Cognition, and the second factor included Inhibitive Hostility. These results indicate that the dimensions of hostility in Japanese students differed from those in American and European participants. This may be related to characteristics of Japanese society that emphasize cooperative behavior and not expressing angry emotions.     

Hostility,coronary heart disease,and total mortality: A 33-year follow-up study of university students

Hostility as measured by the Cook-Medley Hostility (HO) Scale on the Minnesota Multiphasic Personality Inventory has been suggested as a risk factor for coronary heart disease (CHD) and total mortality. This study tested the HO-CHD hypothesis in a sample of 1399 men who entered the University of Minnesota in 1953 and, as part of freshman orientation, completed the MMPI. Current health status was ascertained for 94% of the sample through telephone interviews 33 years later. Higher HO scores did not predict CHD mortality, CHD morbidity, or total mortality either before or after adjustment for baseline risk factors. Among the plausible explanations for these results are that (1) hostility is not a risk factor in all populations, (2) the HO scale at age 19 does not assess a stable psychological characteristic, or (3) the HO scale is not an adequate measure of hostility.This research was supported by a University of Minnesota, School of Public Health, Biomedical Research Support Grant (2S07-RR05448) and the National Heart, Lung, and Blood Institute (2T32-HL07328).     

Hostility,coronary heart disease (CHD) incidence,and total mortality: Lack of association in a 25-year follow-up study of 478 physicians

Higher levels of hostility, assessed by a Minnesota Multiphasic Personality Inventory (MMPI) scale (Ho), have been associated with the incidence of coronary disease and mortality from coronary disease and other causes in two prospective studies. In this study we examined the relationship between hostility and health status 25 years later in 478 physicians who completed the MMPI at the time of their medical-school admission interview. In contrast to earlier studies, higher Ho scores were not predictive of coronary disease incidence or total mortality. The implications of this finding for current research on the hostility component of the Type A behavior pattern are discussed.     

冠心病患者介入治疗后血浆新型气体信号分子硫化氢及一氧化氮变化的临床研究

目的研究新型气体信号分子硫化氢（H2S）及一氧化氮（NO）在冠心病患者和冠脉造影正常者血浆中含量的差异及介入治疗对其的影响,探讨其在冠心病发病及介入治疗中的病理生理意义。方法冠心病组40例,造影正常组17例,采用硫敏感法测定术前血浆H2S含量并用Greiss法测定血浆中NO含量,动态监测冠心病患者冠状动脉造影前后、介入治疗后即刻、术后24h和72h血浆H2S、NO含量,分析冠心病组和造影正常组患者血浆H2S、NO含量的差异及介入治疗后血浆H2S和NO的变化。结果冠心病患者血浆H2S、NO含量远低于造影正常组（P均〈0.01）;冠脉双支和多支病变组血浆H2S含量差异无统计学意义（P〉0.05）,但均明显低于单支病变组（P〈0.05和P〈0.01）。不同支数病变冠心病患者血浆NO含量差异无统计学意义。冠脉血管有闭塞组其血浆H2S、NO含量明显低于单纯狭窄组（P均〈0.05）;支架植入术后复查狭窄者NO含量明显低于无狭窄者（P〈0.05）,H2S含量也低于无狭窄者,但差异无统计学意义（P〉0.05）。冠状动脉造影术对血浆H2S、NO含量无影响,但PCI治疗术后即刻H2S、NO含量显著降低;H2S含量术后24h恢复至术前水平,NO含量术后24h降至最低水平,72h仍未恢复至术前水平。结论 H2S和NO可能参与了冠心病的发病过程及介入治疗后急性血管闭塞及再狭窄的发生,血浆H2S含量的高低与冠脉血管病变严重程度相关。     

Increasing constructive anger verbal behavior decreases resting blood pressure: A secondary analysis of a randomized controlled hostility intervention

We hypothesized that increasing anger verbal behavior in an assertive, constructively motivated style should decrease resting blood pressure (BP) and that this behavior may be one mechanism through which hostility relates to BP. We tested this hypothesis by conducting secondary analyses on a single-blind, matched, randomized controlled study of hostility modification and BP. A total of 22 high-hostile male patients with coronary heart disease were matched on age and hostility level and were randomly assigned to either an 8-week cognitive-behavioral hostility treatment (n = 10) or an information-control group (n = 12). Patients were reassessed after treatment and at 2-month follow-up on hostility, observed anger expression, and resting BP. We found that decreases in hostility predicted increases in constructive anger behavior-verbal component, which in turn predicted decreases in resting BP at follow-up. Thus, one of the mechanisms underlying the hostility-BP association may be the lack of constructive anger expression.     

Rehabilitation training improves exercise tolerance after percutaneous coronary intervention

The aim of this present study was to investigate the effects of training on exercise tolerance of patients with coronary heart disease after percutaneous coronary intervention.Fifty-seven cases of coronary heart disease after percutaneous coronary intervention were divided randomly into the rehabilitation training group(26 cases) and control group(31 cases).Patients in the rehabilitation training group received rehabilitation training at different stages and exercise intensities 3 d after percutaneous coronary intervention for 3 months.The heart rate,blood pressure,ECG changes in treadmill exercise test,and the frequency of anginal episodes were observed.The results showed that NST and ΣST of ECG and the frequency of anginal episodes were significantly reduced in the rehabilitation training group.In addition,exercise tolerance was improved and the total exercise time was lengthened in these patients.Moreover,ST segment depression time and emergence time of angina with exercise were also lengthened compared with controls(P < 0.05,or 0.01).However,the heart rate and blood pressure before and after exercise of the two groups were similar.The study indicated that rehabilitation training could significantly relieve angina,amend ischemic features of ECG,and improve exercise tolerance of coronary heart disease patients after percutaneous coronary intervention.     

老年冠心病慢性闭塞病变的介入治疗探讨

目的探讨老年冠心病患者采用经皮冠状动脉介入(PCI)治疗的中短期疗效。方法对102例住院老年患者采用股动脉穿刺后,行球囊扩张,造影显示扩张满意后植入合适支架。术后随访6-32个月。结果102例患者术后临床症状均完全或基本完全缓解。本组患者有19例多支病变患者至少有一支慢性完全闭塞血管经努力而未能开通,无法植入支架。102例患者通过随访6-32个月,其中32例患者接受了冠脉造影复查,有17例患者分别于术后6个月至16个月又出现胸痛、胸闷症状。超声心动图检查射血分数(EF),心功能术后较术前明显改善,P<0.05。结论对冠状动脉慢性完全闭塞的老年患者,无论核素或超声检查是否存在存活心肌,均应尽量进行闭塞病变的介入治疗,以期改善患者的远期预后。     

Cynical Hostility,Anger Expression Style,and Acute Myocardial Infarction in Middle-aged Japanese Men

Studies using American and European populations have demonstrated that high levels of anger/ hostility are predictive of coronary heart disease (CHD) mortality. However, Japanese studies did not show consistent relationship between anger/hostility and CHD. This study examines the association of cynical hostility and anger expression style with acute myocardial infarction (AMI) in middle-aged Japanese men through a case-control study. The patients with acute myocardial infarction (N = 96, mean age = 50.8 years) and the healthy participants in a health check-up program (N = 77, mean age = 50.3 years) were studied. Both groups completed the Cynicism Questionnaire (CQ) and the State-Trait Anger Expression Inventory (STAXI). The patients exhibited higher scores on CQ than the healthy controls. Logistic regression analyses controlling for biological risk factors revealed that the CQ score was associated with increased risk of AMI (OR = 1.11 [95% CI 1.00–1.22]). In addition, the score of Anger-control, a subscale of STAXI, was associated with decreased risk of AMI (OR = 0.75 [95% CI 0.62–0.92]). These results indicated that higher levels of cynical hostility increased the risk of AMI and that anger-control strategies could have some benefit in reducing the risk of AMI in middle-aged Japanese men.     

The impact of smoking status on 9.3 years incidence of cardiovascular and all-cause mortality among Iranian men

Aim: To examine the association of different smoking groups with cardiovascular disease (CVD), coronary heart diseases (CHD) and CVD attributed death and death due to all causes in a male Tehranian population.

Methods: From a population-based study 3059 male individuals, aged ≥30 years, free of CVD at baseline were evaluated for a median of 9.3 years. The adjusted hazard ratios (HRs) for incident CVD/CHD, total and CVD mortality regarding their smoking status were calculated using Cox proportional regression analysis, considering never smoking as reference.

Results: A total of 158 deaths, in which 78 were CVD attributable, occurred. Considering CVD and CHD events, this study identified 299 and 257 events, respectively. Being a past smoker significantly increased the risk of CVD events (HR?=?2.42, CI?=?1.28–0.56), however, it has no effect on CHD events, total and CVD mortality. Being a current smoker (more than 10 cigarettes a day) dramatically increased the risk of CVD/CHD events and total/CVD mortality. However, smoking less than 10 cigarettes per day only increased the risk of CVD (HR?=?2.12, CI?=?1.14–3.95) and its mortality (HR?=?4.57, CI?=?1.32–15.79).

Conclusion: The findings indicate that smoking increases the risk of incident CVD/CHD, total and CVD mortality, particularly CVD mortality. These outcomes were attributable to the daily amount of cigarettes smoked. Past smokers still had higher risk for CVD events, which cessation may not reduce.     

Challenges in reducing depression-related mortality in cardiac populations: cognition,emotion, fatigue or personality?

Abstract

Depression is associated with increased morbidity and mortality in cardiac patients post-event; however treatment of psychological symptoms has failed to reduce cardiovascular risk. We explore depression and related constructs in terms of construct overlap and intervention potential. Certain depressive symptoms may be more important than others for increasing risk. Depressive cognitions may have lesser importance than somatic symptoms, but there is potential for designing interventions based on distorted illness perceptions. Somatic depressive symptoms and vital exhaustion are associated with increased risk. However, these symptoms may be more indicative of cardiovascular disease severity. A global tendency towards negative affectivity could account for the associations seen with negative affect states, with those of Type D personality demonstrating especially high levels of risk for morbidity/mortality. Positive emotion is associated with better outcomes, and could provide clues of how to intervene with negative emotion. Construct overlap and a dearth of theoretically based studies remain significant challenges. Future research needs to encompass all relevant variables to identify the key symptoms or symptom constellations that increase cardiovascular risk. A more sophisticated understanding of these issues can lead to more precise pinpointing of the ‘cardiotoxic’ aspects of psychological status, and ultimately to more refined interventions.     

Feasibility and preliminary outcomes from a pilot study of a brief psychological intervention for families of children newly diagnosed with cancer

OBJECTIVE: To report initial feasibility and outcome from a pilot study of a new three-session intervention for caregivers of children newly diagnosed with cancer, Surviving Cancer Competently Intervention Program-Newly Diagnosed (SCCIP-ND). METHOD: Nineteen families (38 caregivers) were randomly assigned to SCCIP-ND or treatment as usual subsequent to learning of their child's illness. The study design included pre- and 2-month postintervention assessments, with state anxiety and posttraumatic stress symptoms as outcomes. Feasibility was based on therapist feedback and supervision, program evaluations, and data from study-tracking procedures. RESULTS: SCCIP-ND appears to be an acceptable intervention that can be used successfully with caregivers over the first few months after diagnosis. Recruitment and retention data document feasibility but also highlight challenges. Preliminary outcome data show changes in the desired direction [e.g., reduced anxiety and parental posttraumatic stress symptoms (PTSS)]. CONCLUSIONS: The pilot data are supportive of the value and challenges of developing evidence-based family interventions in pediatric psychology.     

Harassment,hostility, and Type A as determinants of cardiovascular reactivity during competition

Anger/hostility and Type A behavior have been implicated in elevated cardiovascular reactivity and disease. In the present experiment systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were monitored during conditions of competition alone or in conjunction with goal blocking or harassment. Cardiovascular reactivity was examined as a function of conditions, Type A or B pattern, and various measures of anger/hostility. Harassment elicited significantly elevated SBP and HR changes relative to goal-blocking and control conditions. Type As reliably exceeded Type Bs in magnitude of SBP change during the harassment condition only. However, exploratory analyses correlating anger/hostility measures and cardiovascular reactivity indicated that only subjects scoring high on the Buss-Durkee Hostility Inventory showed significantly elevated SBP reactivity as a function of Type A behavior pattern, rated hostility during the A-B interview, or outward expression of anger assessed by the Framingham Anger-In vs Anger-Out Scale.This study was supported in part by National Heart, Lung and Blood Institute (NHLBI) Training Grant HL07426 to the University of Miami. We thank Professor T. Dembroski for his overall consultation during the study and for providing training in the administration and scoring of the Type A structured interview and components.     

Association of Sleep Duration with Mortality from Cardiovascular Disease and Other Causes for Japanese Men and Women: the JACC Study

Study Objectives:

To examine sex-specific associations between sleep duration and mortality from cardiovascular disease and other causes.

Design:

Cohort study.

Setting:

Community-based study.

Participants:

A total of 98,634 subjects (41,489 men and 57,145 women) aged 40 to 79 years from 1988 to 1990 and were followed until 2003.

Interventions:

N/A.

Measurements and Results:

During a median follow-up of 14.3 years, there were 1964 deaths (men and women: 1038 and 926) from stroke, 881 (508 and 373) from coronary heart disease, 4287 (2297 and 1990) from cardiovascular disease, 5465 (3432 and 2033) from cancer, and 14,540 (8548 and 5992) from all causes. Compared with a sleep duration of 7 hours, sleep duration of 4 hours or less was associated with increased mortality from coronary heart disease for women and noncardiovascular disease/noncancer and all causes in both sexes. The respective multivariable hazard ratios were 2.32 (1.19–4.50) for coronary heart disease in women, 1.49 (1.02–2.18) and 1.47 (1.01–2.15) for noncardiovascular disease/noncancer, and 1.29 (1.02–1.64) and 1.28 (1.03–1.60) for all causes in men and women, respectively. Long sleep duration of 10 hours or longer was associated with 1.5- to 2-fold increased mortality from total and ischemic stroke, total cardiovascular disease, noncardiovascular disease/noncancer, and all causes for men and women, compared with 7 hours of sleep in both sexes. There was no association between sleep duration and cancer mortality in either sex.

Conclusions:

Both short and long sleep duration were associated with increased mortality from cardiovascular disease, noncardiovascular disease/noncancer, and all causes for both sexes, yielding a U-shaped relationship with total mortality with a nadir at 7 hours of sleep.

Citation:

Ikehara S; Iso H; Date C; Kikuchi S; Watanabe Y; Wada Y; Inaba Y; Tamakoshi A. Association of sleep duration with mortality from cardiovascular disease and other causes for Japanese men and women: the JACC study. SLEEP 2009;32(3):259–301.     

Independent and Mediated Contributions of Personality, Coping, Social Support, and Depressive Symptoms to Physical Functioning Outcome Among Patients in Cardiac Rehabilitation

This study examined the direct and mediated contributions of psychosocial variables to posttreatment physical functioning among 142 patients receiving cardiac rehabilitation. Two models were proposed and tested. In the first model, psychosocial factors were correlated and made to predict baseline and 6-week physical functioning. The results showed that after controlling for age, illness severity, baseline physical functioning, and other psychosocial correlates, optimism and social support still significantly predicted better posttreatment physical functioning. In the second model, we explored both the direct and mediational relationships between psychosocial factors and physical health outcomes. Optimism and social support were found to contribute to health outcomes not only directly but also indirectly through the mediation of less engagement in detrimental coping and lower depressive symptoms, whereas hostility and negative coping only predicted outcomes indirectly through mediators. These findings highlighted the importance of addressing psychosocial issues and their interrelationships in cardiac rehabilitation.     

Measurement of the type a behavior pattern in adolescents and young adults: Cross-cultural development of AATAB

This paper reports psychometric development of a new scale, the AATAB, a 19-item questionnaire which attempts to measure the Type A behavior pattern in the adolescent and in the young adult. Initial studies were accomplished with Polish secondary-school students. Test-retest and internal consistency reliability estimates were very adequate, as was concurrent validity. Construct validity information is scant but in the desired direction. Factor analytical studies reveal only a single-factor structure on these adolescent subjects. The AATAB was given to university students of both sexes in Poland, Italy, and the United States. Students from all three countries scored at about the same level and concurrent validity was acceptable. Factor analysis of these data revealed meaningful factors for both sexes across all three cultures. While similar factors were found, the order of them was different by sex and by culture. These results are discussed and further reliability and validity research with the AATAB is outlined.Support of this research by a grant to D.G.F. and P.B. from the NATO Scientific Affairs Division is gratefully acknowledged. This research also benefited from awards to K.W. and D.G.F. from the Health Science Exchange programs of the National Institutes of Health and the Polish Ministry of Health and Social Welfare. Important contributions were made to this project by Dr. Anna Maria Giannini, Dr. Marino Bonaiuto, Mark Stevens, Miki Pudvah, Suzanne Nyitray, and Melissa Roya.     

Introducing genetic testing for cardiovascular disease in primary care: a qualitative study

Background

While primary care systematically offers conventional cardiovascular risk assessment, genetic tests for coronary heart disease (CHD) are increasingly commercially available to patients. It is unclear how individuals may respond to these new sources of risk information.

Aim

To explore how patients who have had a recent conventional cardiovascular risk assessment, perceive additional information from genetic testing for CHD.

Design and setting

Qualitative interview study in 12 practices in Nottinghamshire from both urban and rural settings.

Method

Interviews were conducted with 29 adults, who consented to genetic testing after having had a conventional cardiovascular risk assessment.

Results

Individuals’ principal motivation for genetic testing was their family history of CHD and a desire to convey the results to their children. After testing, however, there was limited recall of genetic test results and scepticism about the value of informing their children. Participants dealt with conflicting findings from the genetic test, family history, and conventional assessment by either focusing on genetic risk or environmental lifestyle factors. In some participants, genetic test results appeared to reinforce healthy behaviour but others were falsely reassured, despite having an ‘above-average’ conventional cardiovascular risk score.

Conclusion

Although genetic testing was acceptable, participants were unclear how to interpret genetic risk results. To facilitate healthy behaviour, health professionals should explore patients’ understanding of genetic test results in light of their family history and conventional risk assessment.     

Preparing for Parenthood: background and development of a risk modifying intervention to prevent postnatal depression

Summary Risk and protective factor modification has been proposed as a rational approach to developing mental health improvement interventions by prevention. The intervention "Preparing for Parenthood" (PFP) was developed embodying theoretical and evidence based predictors of symptom inception and alleviation as a real world set of tasks. A manual describing and directing the operational procedures of PFP is outlined. Course leaders trained in its application endeavoured to implement PFP with women at risk of developing postnatal depression during pregnancy before the birth of their first child. Also described are an initial market research survey, the outcome of three pilot courses and the final design of the PFP course. The lack of clinical efficacy of PFP, demonstrated in a subsequent randomised evaluation, is discussed in relation to concurrent research in the field and lessons and implications for more effective preventive intervention development and evaluation.     

经皮冠状动脉介入治疗患者围手术期焦虑对术后不良心血管事件的预测作用

目的:探讨择期经皮冠状动脉介入治疗(PCI)围手术期焦虑对术后不良心血管事件的预测价值。方法:选取2019年6月-2019年12月在苏州市某三甲医院221例择期介入治疗的冠心病患者为研究对象,收集各时间点焦虑水平。采用Logistic回归模型评价术后主要不良心血管事件的独立危险因素;采用受试者工作特征曲线(ROC)下面积(AUC)评估焦虑各时间点对不良心血管事件的预测效能。结果:本研究随访期间共40例(19%)发生不良心血管事件。在家等候期焦虑水平、术前1天焦虑水平是择期PCI患者术后发生不良心血管事件的独立危险因素,且对不良心血管事件具有良好的预测效果,截断值分别为58.50分、55.50分,灵敏度分别为80.0%、85.0%,特异度分别为90.4%、80.0%。结论:围手术期焦虑能够较为高效、简便地识别高危患者以及预测不良心血管事件的发生。     

心理社会因素与冠心病相关的综合研究（1）：单因素分析

本文为社会心理危险因素与冠心病相关的综合研究报告之一。99例冠心病(CHD)患者,经冠状动脉选择性造影(CAG),A 型人格、生活事件、社会支持,情绪反应有关量表评定,与99例正常人对照组比较,结果显示:CAG 阳性者(69例) A 型行为所占比例明显高于对照组,A 型行为与冠状动脉病变程度呈正相关,A 型行为中 CH (竞争性,敌意,不耐心)是 CHD 主要危险因子,生活应激事件,社会支持差,负性情绪反应等与 CHD 发病有关。提示社会心理因素通过一定中介与冠心病存在肯定关系。