Anxiety and hypervigilance to cardiopulmonary sensations in non-cardiac chest pain patients with and without psychiatric disorders
Section snippets
Participants
Participants were 231 patients seeking evaluation in the cardiology department of a large, university-affiliated medical center. Patients were eligible based on these inclusion criteria: a) At least 18 years of age, b) Chief complaint of chest pain or discomfort, c) Completion of cardiac evaluation including general physical exam and exercise tolerance test, d) Tests indicated no abnormalities during an exercise tolerance test, and e) English language fluency. To enhance generalizability,
Response rate and attrition
A total of 229 patients participated in this study: 147 patients completed the clinical interview, 113 patients completed the questionnaire battery and the clinical interview, 83 patients completed the questionnaire only, and 34 patients completed the interview only. Parametric and nonparametric tests revealed no significant differences on age, sex, ethnicity, education level, employment status, and income between the group completing the questionnaire only and the group completing the
Discussion
Theories have posited a central role for body vigilance (i.e., conscious attention directed at internal physical sensations) in the development and persistence of NCCP (Eifert, 1992, Mayou, 1998, White and Raffa, 2004). In this study, we examined body vigilance by the rate and pattern of conscious monitoring and evaluation of internal sensations in patients with NCCP. We hypothesized that patients would be more vigilant to cardiac-congruent sensations (e.g., heart palpitations, chest
Acknowledgement
Grants from the National Institutes of Health, National Institute of Mental Health (MH63185) and the University of Missouri-Saint Louis (University Research Award, awarded to Kamila White) supported this research and the preparation of this manuscript. The contents herein are solely the responsibility of the author and do not necessarily represent the view of the funding sources.
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2018, Nursing Clinics of North AmericaCitation Excerpt :Depression and anxiety specifically have been associated with NCCP and can impact pain.3,47 In addition, NCCP patient tend to do more self-monitoring and had poorer coping skills.48,49 Lifestyle choices also potentially lead to the development of chest pain that requires investigating cardiac versus noncardiac sources.