Biomedical subjects

J Denollet

Publications and source records attributed to J Denollet.

22 records · Page 2Linked to original sources

PubMedDate not supplied

Negative affectivity and repressive coping: pervasive influence on self-reported mood, health, and coronary-prone behavior.

Negative affectivity (NA) and repressive coping (REP) are coping styles characterized by a disposition to either experience or avoid distress. This study investigated the potential influence of NA and REP on self-reported distress and coronary-prone behavior among 178 male cardiac patients undergoing rehabilitation. Based on their STAI-Trait and Marlowe-Crowne Scale scores, subjects were categorized as high NA (N = 72), low NA (N = 44), or REP (N = 62) individuals. With respect to subjective distress, high-NA individuals reported more negative mood states and health complaints than both low-NA and REP individuals (p less than 0.0001). In contrast, no association was found between coping style and cardiovascular fitness as measured by exercise stress testing (p = 0.87). Hence, it seems that (a) high-NA individuals overreacted to physical problems and (b) REP individuals warded off distress. These differences in coping style were stable over a period of 3 months. With respect to coronary-prone behavior, the current findings were largely inconsistent with previous research. NA was associated with Type A interview-rating (p less than 0.001), but not with Type A self-rating. REP individuals, however, had a significantly lower score on the Jenkins Activity Survey and the Cook-Medley Hostility Scale than both high-NA and low-NA individuals (p less than 0.0001). Supposed associations, therefore, between NA and self-rated coronary-prone behavior may in fact originate from the repressive coping style that characterizes some individuals low in NA. In summary, it may be stated that the findings of the current study suggest the use of NA and REP markers in research, so that the potential influence of these coping styles can be identified in the study of stress-health relationships.

Adaptation, Psychological↗

PubMedDate not supplied

Health complaints and outcome assessment in coronary heart disease.

Research on coronary heart disease (CHD) lacks sensitive outcome measures. Health complaints, although subjective in nature, may provide information on the degree of recovery from CHD. The purpose of Study 1 was to identify common health complaints in a group of 535 men (mean age, 57.5 years) with CHD. In the weeks after a coronary event, they frequently reported somatic (e.g., chest pain, dyspnea, fatigue, sleep problems) and cognitive (e.g., concern about health and functional status) health complaints. Statistical analyses produced the Health Complaints Scale (HCS), which comprises 12 somatic and 12 cognitive complaints. Confirmatory factor analysis provided evidence for the model undergirding the HCS, and the somatic and cognitive scales of the HCS were found to have high internal consistency (alpha > or = .89), adequate test-retest reliability (r > or = .69), and good construct validity. Study 2 provided evidence for the idea that the HCS can be distinguished from standard scales of psychopathology. Statistical analyses in 266 men with CHD indicated that, compared to symptoms of psychopathology, the HCS scales displayed discrete factor loadings as well as higher scores at baseline and a normal clustering of scores. Important to note, HCS scores decreased in 60 subjects participating in cardiac rehabilitation (p < .0001) but not in 60 control subjects. Although research should not disregard psychological biases on symptom reporting, it is argued that health complaints need to be accurately assessed in CHD patients.

Adaptation, Psychological↗

PubMedDate not supplied

Personality and mortality after myocardial infarction.

Previous research showed: a) emotional distress is a risk factor for mortality after myocardial infarction (MI) and b) emotional distress is linked to stable personality traits. In this study, we examined the role of these personality traits in mortality after MI. Subjects were 105 men, 45 to 60 years of age, who survived a recent MI. Baseline assessment included biomedical and psychosocial risk factors, as well as each patient's personality type. After 2 to 5 (mean, 3.8) years of follow-up, 15 patients (14%) had died. Rate of death for patients with a distressed personality type (11/28 = 39%) was significantly greater than that for patients with other personality types (4/77 = 5%) (p < .0001). Patients with this personality type tend simultaneously to experience distress and inhibit expression of emotions. Low exercise tolerance, previous MI (p < .005), anterior MI, smoking, and age (p < .05) were also associated with mortality. A logistic regression model including these biomedical factors had a sensitivity for mortality of only 27%. The addition of distressed personality type in this model more than doubled its sensitivity. Of note, among patients with poor physical health, those with a distressed personality type had a five-fold mortality risk (p < .005). Consistent with the findings of other investigators, depression (p < .005), life stress, use of benzodiazepines (p < .01), and somatization (p < .05) were also related to post-MI mortality. These psychosocial risk factors were more prevalent in the distressed personality type than in the other personality types (p < .001-.05). Multiple logistic regression indicated that these psychosocial factors did not add to the predictive value of the distressed personality type. Hence, an important personality effect was observed despite the low power. This suggests that personality traits may play a role in the detrimental effect of emotional distress in MI patients.

Adaptation, Psychological↗

PubMedDate not supplied

Sensitivity and specificity of observer and self-report questionnaires in major and minor depression following myocardial infarction.

This study evaluated screening abilities of self-report questionnaires for depression in first myocardial infarction (MI) patients. One month post-MI, 206 patients with first MI were screened for major and minor depression using the 90-item Symptom Check List (SCL-90), the Beck Depression Inventory (BDI), the Hospital Anxiety and Depression Scale (HADS), and the 17-item Hamilton Depression Rating Scale (Ham-D). The Structured Clinical Interview for DSM-IV criteria was used as the gold standard. Sensitivity and specificity for different cutoff points, using relative operating characteristics curves, were assessed. The internal consistency for all scales was good. When screening for major and minor depression, the optimal cutoff scores are lower than those for screening major depression only. The SCL-90, BDI, HADS, and Ham-D proved to have acceptable abilities for screening post-MI major and minor depression.

Adult↗