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Journal of Clinical Psychology in Medical Settings

Erschienen in:

12.06.2018

The Role of Disease Conviction: Exploring Its Effects on Chest Pain and Anxiety-Related Models of Non-cardiac Chest Pain

verfasst von: Caleb M. Pardue, Kamila S. White, Ernest V. Gervino

Erschienen in: Journal of Clinical Psychology in Medical Settings | Ausgabe 2/2019

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Abstract

The aim of this study was to investigate the role of disease conviction in the chest pain and life interference of patients with non-cardiac chest pain (NCCP), after controlling for anxiety sensitivity and body vigilance. While all three psychological constructs are theoretically implicated and empirically associated with the experience of NCCP, no research has examined the influence of disease conviction in the context of other relevant constructs. The sample included 229 participants with NCCP who were recruited after a medical evaluation failed to elicit an organic explanation for their chest pain. Hierarchical regression analyses revealed that while anxiety sensitivity significantly predicted chest pain severity and interference, only body vigilance contributed significant additional variance to chest pain severity, and only disease conviction contributed significant additional variance to chest pain interference. While anxiety sensitivity, body vigilance, and disease conviction all appear to affect those with NCCP, it seems that their impact is manifest in different domains (i.e., pain perception vs. psychosocial impairment).

Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P. (2007). The short health anxiety inventory in an undergraduate sample: Implications for a cognitive-behavioral model of hypochondriasis. Cognitive Therapy and Research, 31, 871–883. https://doi.org/10.1007/s10608-006-9058-1.CrossRef

Aikens, J. E., Michael, E., Levin, T., & Lowry, E. (1999). The role of cardioprotective avoidance beliefs in noncardiac chest pain and associated emergency department utilization. Journal of Clinical Psychology in Medical Settings, 6, 317–332. https://doi.org/10.1023/A:1026267113458.CrossRef

Aikens, J. E., Zvolensky, M. J., & Eifert, G. H. (2001). Differential fear of cardiopulmonary sensations in emergency room noncardiac chest pain patients. Journal of Behavioural Medicine, 24, 155–167. https://doi.org/10.1023/A:1010710614626.CrossRef

American Heart Association. (2006). Heart and stroke statistical update. Dallas, TX: American Heart Association.

Arntz, A., Dreessen, L., & Merckelbach, H. (1991). Attention, not anxiety, influences pain. Behaviour Research and Therapy, 29, 41–50. https://doi.org/10.1016/S0005-7967(09)80006-5.CrossRefPubMed

Barsky, A. J. (1992). Hypochondriasis and obsessive-compulsive disorder. Psychiatric Clinics in North America, 15, 791–801.CrossRef

Beitman, B. D., Basha, I., Flaker, G., DeRosear, L., Mukerji, V., Trombka, L., & Katon, W. (1987). Atypical or nonanginal chest pain. Panic disorder or coronary artery disease? Archives of Internal Medicine, 147, 1548–1552. https://doi.org/10.1001/archinte.1987.00370090028005.CrossRefPubMed

Beitman, B. D., Mukerji, V., Lamberti, J. W., Schmid, L., DeRosear, L., Kushner, M., … Basha, I. (1989). Panic disorder in patients with chest pain and angiographically normal coronary arteries. American Journal of Cardiology, 63, 1399–1403. https://doi.org/10.1016/0002-9149(89)91056-4.CrossRefPubMed

Bradley, L. A., Scarinci, I. C., & Richter, J. E. (1991). Pain threshold levels and coping strategies among patients who have chest pain and normal coronary arteries. Medical Clinics of North America, 75, 1189–1202.CrossRefPubMed

Chambers, J., & Bass, C. (1990). Chest pain and normal coronary anatomy: Review of natural history and possible etiologic factors. Progress in Cardiovascular Diseases, 33, 161–184. https://doi.org/10.1016/0033-0620(90)90007-O.CrossRefPubMed

Deacon, B., & Abramowitz, J. S. (2006a). A pilot study of two-day cognitive–behavioral therapy for panic disorder. Behaviour Research and Therapy, 44, 807–817. https://doi.org/10.1016/j.brat.2005.05.008.CrossRefPubMed

Deacon, B., & Abramowitz, J. S. (2008). Is hypochondriasis related to obsessive-compulsive disorder, panic disorder, or both? An empirical evaluation. Journal of Cognitive Psychotherapy: An Internal Quarterly, 22, 115–127. https://doi.org/10.1891/0889-8391.22.2.115.CrossRef

Deacon, B. J., & Abramowitz, J. S. (2006b). Anxiety sensitivity and its dimensions across the anxiety disorders. Journal of Anxiety Disorders, 20, 837–857. https://doi.org/10.1016/j.janxdis.2006.01.003.CrossRefPubMed

Di Nardo, P. A., Brown, T. A., & Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV: Life time version (ADIS-IV-L). New York: Oxford University Press.

Eifert, G. H. (1991). Cardiophobia: An anxiety disorder in its own right? Behaviour Change, 8, 100–116.CrossRef

Eifert, G. H., Hodson, S. E., Tracey, D. R., Seville, J. L., & Gunawardane, K. (1996). Heart-focused anxiety, illness beliefs, and behavioral impairment: Comparing healthy heart-anxious patients with cardiac and surgical inpatients. Journal of Behavioral Medicine, 19, 385–399. https://doi.org/10.1007/BF01904764.CrossRefPubMed

Eifert, G. H., Zvolensky, M. J., & Lejuez, C. W. (2000). Heart-focused anxiety and chest pain: A conceptual and clinical review. Clinical Psychology: Science and Practice, 7, 403–417. https://doi.org/10.1093/clipsy.7.4.403.CrossRef

Esler, J. L., Barlow, D. H., Woolard, R. H., Nicholson, R. A., Nash, J. M., & Erogul, M. H. (2003). A brief cognitive-behavioral intervention for patients with noncardiac chest pain. Behavior Therapy, 34, 2. https://doi.org/10.1016/S0005-7894(03)80009-6.CrossRef

Eslick, G. D., Coulshed, D. S., & Talley, N. J. (2002). The burden of illness of non-cardiac chest pain. Alimentary Pharmacology and Therapeutics, 16, 1217–1223.CrossRefPubMed

Eslick, G. D., Jones, M. P., & Talley, N. J. (2003). Non-cardiac chest pain: Prevalence, risk factors, impact and consulting—A population-based study. Alimentary Pharmacology and Therapeutics, 17, 1115–1124. https://doi.org/10.1046/j.1365-2036.2003.01557.x.CrossRefPubMed

Eslick, G. D., & Talley, N. J. (2008). Natural history and predictors of outcome for non-cardiac chest pain: A prospective 4-year cohort study. Neurogastroenterology and Motility, 20, 989–997. https://doi.org/10.1111/j.1365-2982.2008.01133.x.CrossRefPubMed

Fass, R., & Eslick, G. (2007). Noncardiac chest pain: A growing medical problem. San Diego: Plural Publishing.

Fergus, T. A., & Valentiner, D. P. (2010). Disease phobia and disease conviction are separate dimensions underlying hypochondriasis. Journal of Behavior Therapy and Experimental Psychiatry, 41, 438–444. https://doi.org/10.1016/j.jbtep.2010.05.002.CrossRefPubMed

Finegold, J. A., Asaria, P., & Francis, D. P. (2012). Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations. International Journal of Cardiology, 168, 93445. https://doi.org/10.1016/j.ijcard.2012.10.046.CrossRef

Fleet, R. P., & Beitman, B. D. (1997). Unexplained chest pain: When is it panic disorder? Clinical Cardiology, 20, 187–194. https://doi.org/10.1002/clc.4960200303.CrossRefPubMed

Gibbons, R. J., Balady, G. J., Beasley, J. W., Bricker, J. T., Duvernoy, W. F., Froelicher, V. F., … Winters, W. L. (1997). ACC/AHA guidelines for exercise testing. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee of Exercise Testing). Journal of the American College of Cardiology, 30, 260–311.CrossRefPubMed

Goldschlager, N., Selzer, A., & Cohn, K. (1976). Treadmill stress tests as indicators of presence and severity of coronary artery disease. Annals of Internal Medicine, 85, 277–286. https://doi.org/10.7326/0003-4819-85-3-277.CrossRefPubMed

Hadjistavropoulos, H. D., Frombach, I. K., & Asmundson, G. J. G. (1999). Exploratory and confirmatory factor analytic investigations of the Illness Attitudes Scale in a nonclinical sample. Behaviour Research and Therapy, 37, 671–684. https://doi.org/10.1016/S0005-7967(98)00159-4.CrossRefPubMed

Hadlandsmyth, K., White, K. S., & Krone, R. J. (2013). Quality of life in patients with non-CAD chest pain: Associations to fear of pain and psychiatric disorder severity. Journal of Clinical Psychology in Medical Settings, 20, 284–293. https://doi.org/10.1007/s10880-012-9347-7.CrossRefPubMed

Hiller, W., Leibbrand, R., Rief, W., & Fichter, M. M. (2005). Differentiating hypochondriasis from panic disorder. Journal of Anxiety Disorders, 19, 29–49. https://doi.org/10.1016/j.janxdis.2003.10.006.CrossRefPubMed

Israel, J. I., White, K. S., & Gervino, E. V. (2015). Illness perceptions, negative emotions, and pain in patients with noncardiac chest pain. Journal of Clinical Psychology in Medical Settings, 22, 77–89. https://doi.org/10.1007/s10880-015-9419-6.CrossRefPubMed

Johnson, J. W. (2000). A heuristic method for estimating the relative weight of predictor variables in multiple regression. Multivariate Behavioral Research, 35, 1–19.CrossRefPubMed

Kellner, R. (1986). Somatization and hypochondriasis. New York: Praeger Publishers.

Kellner, R., Abbott, P., Winslow, W. W., & Pathak, D. (1987). Fears, beliefs and attitudes in DSM–III hypochondriasis. Journal of Nervous and Mental Disease, 175, 20–25. https://doi.org/10.1097/00005053-198701000-00004.CrossRefPubMed

Kerns, R. D., Turk, D. C., & Rudy, T. E. (1985). The west haven-yale multidimensional pain inventory (WHYMPI). Pain, 23, 345–356. https://doi.org/10.1016/0304-3959(85)90004-1.CrossRefPubMed

Kroenke, K., & Mangelsdorff, A. D. (1989). Common symptoms in ambulatory care: Incidence, evaluation, therapy and outcome. American Journal of Medicine, 86, 262–266. https://doi.org/10.1016/0002-9343(89)90293-3.CrossRefPubMed

Lampe, F. C., Whincup, P. H., Wannamethee, S. G., Ebrahim, S., Walker, M., & Shaper, A. G. (1998). Chest pain on questionnaire and prediction of major ischaemic heart disease events in men. European Heart Journal, 19, 63–73. https://doi.org/10.1053/euhj.1997.0729.CrossRefPubMed

Lipsitz, J. D., Masia-Warner, C., Apfel, H., Marans, Z., Hellstern, B., Forand, N., & Fyer, A. J. (2004). Anxiety and depressive symptoms and anxiety sensitivity in youngster with noncardiac chest pain and benign heart murmurs. Journal of Pediatric Psychology, 29, 607–612. https://doi.org/10.1093/jpepsy/jsh062.CrossRefPubMed

Locke, G. R. 3rd, Talley, N. J., Fett, S. L., Zinsmeister, A. R., & Melton, L. J. 3rd (1997). Prevalence and clinical spectrum of gastroesophageal reflux: A population-based study in Olmsted County, Minnesota. Gastroenterology, 112, 1448–1456. https://doi.org/10.1016/S0016-5085(97)70025-8.CrossRefPubMed

Maller, R. G., & Reiss, S. (1992). Anxiety sensitivity in 1984 and panic attacks in 1987. Journal of Anxiety Disorders, 6, 241–247. https://doi.org/10.1016/0887-6185(92)90036-7.CrossRef

Mayou, R. (1998). Chest pain, palpitations and panic. Journal of Psychosomatic Research, 44, 53–70. https://doi.org/10.1016/S0022-3999(97)00209-2.CrossRefPubMed

McNally, R. J. (1994). Panic disorder: A critical analysis. New York: Guilford.

McNally, R. J. (2002). Anxiety sensitivity and panic disorder. Biological Psychiatry, 52, 938–946. https://doi.org/10.1016/S0006-3223(02)01475-0.CrossRefPubMed

Noto, T. J., Jr., Johnson, L. W., Krone, R., Weaver, W. F., Clark, D. A., Kramer, J. R., Jr., & Vetrovec, G. W. (1991). Cardiac catheterization 1990: A report of the Registry of the Society for Cardiac Angiography and Interventions (SCA&I). Catheterization and Cardiovascular Diagnosis, 24, 75–83. https://doi.org/10.1002/ccd.1810240202.CrossRefPubMed

Olatunji, B. O., Deacon, B. J., & Abramowitz, J. S. (2009). Is Hypochondriasis an anxiety disorder? The British Journal of Psychiatry, 194, 481–482. https://doi.org/10.1192/bjp.bp.108.061085.CrossRefPubMed

Olatunji, B. O., Deacon, B. J., Abramowitz, J. S., & Valentiner, D. P. (2007). Body vigilance in non-clinical and anxiety disorder samples: Structure, correlates, and prediction of health concerns. Behavior Therapy, 38, 392–401. https://doi.org/10.1016/j.beth.2006.09.002.CrossRefPubMed

Otto, M., Demopulos, C., McLean, N., Pollack, M., & Fava, M. (1998). Additional findings on the association between anxiety sensitivity and hypochondriacal concerns: Examination of patients with major depression. Journal of Anxiety Disorders, 12, 225–232. https://doi.org/10.1016/S0887-6185(98)00011-5.CrossRefPubMed

Otto, M., Pollack, M., Sachs, G., & Rosenbaum, J. (1992). Hypochondriacal concerns, anxiety sensitivity, and panic disorder. Journal of Anxiety Disorders, 6, 93–104. https://doi.org/10.1016/0887-6185(92)90008-U.CrossRef

Peterson, R. A., & Reiss, S. (1992). Anxiety sensitivity index manual (2nd ed.). Worthington, OH: International Diagnostic Systems.

Plehn, K., & Peterson, R. A. (2002). Anxiety sensitivity as a predictor of the development of panic symptoms, panic attacks, and panic disorder: A prospective study. Journal of Anxiety Disorders, 16, 455–474. https://doi.org/10.1016/S0887-6185(02)00129-9.CrossRefPubMed

Pope, J. H., Ruthazer, R., Beshansky, J. R., Griffith, J. L., & Selker, H. P. (1998). Clinical features of emergency department patients presenting with symptoms suggestive of acute cardiac ischemia: A multicenter study. Journal of Thrombosis and Thrombolysis, 6, 63–74. https://doi.org/10.1023/A:1008876322599.CrossRefPubMed

Reiss, S. (1980). Pavlovian conditioning and human fear—An expectancy model. Behavior Therapy, 11, 380–396. https://doi.org/10.1016/S0005-7894(80)80054-2.CrossRef

Reiss, S. (1991). Expectancy model of fear, anxiety, and panic. Clinical Psychology Review, 11, 141–153. https://doi.org/10.1016/0272-7358(91)90092-9.CrossRef

Reiss, S., Peterson, R. A., Gursky, D. M., & McNally, R. J. (1986). Anxiety sensitivity, anxiety frequency, and the prediction of fearfulness. Behaviour Research and Therapy, 24, 1–8. https://doi.org/10.1016/0005-7967(86)90143-9.CrossRefPubMed

Richter, J. E., Beitman, B. D., & Cannon, R. O. (1991). Unexplained chest pain: Differential diagnosis of chest pain with normal cardiac studies. In J. E. Richter & B. D. Beitman (Eds.), Medical Clinics of North America (pp. 1045–1223). Philadelphia: WB Saunders.

Schmidt, N. B., Lerew, D. R., & Jackson, R. J. (1999). Prospective evaluation of anxiety sensitivity in the pathogenesis of panic: Replication and extension. Journal of Abnormal Psychology, 108, 532–537. https://doi.org/10.1037/0021-843X.108.3.532.CrossRefPubMed

Schmidt, N. B., Lerew, D. R., & Trakowski, J. H. (1997). Body vigilance in panic disorder: Evaluating attention to bodily perturbations. Journal of Consulting and Clinical Psychology, 65, 214–220. https://doi.org/10.1037/0022-006X.65.2.214.CrossRefPubMed

Schmidt, N. B., & Trakowski, J. H. (1999). Attentional focus and fearful responding in patients with panic disorder during a 35% CO₂ challenge. Behavior Therapy, 30, 623–640. https://doi.org/10.1016/S0005-7894(99)80029-X.CrossRef

Schroeder, S., Gerlach, A. L., Achenbach, S., & Martin, A. (2015). The relevance of accuracy of heartbeat perception in noncardiac and cardiac chest pain. International Journal of Behavioral Medicine, 22, 258–267. https://doi.org/10.1007/s12529-014-9433-3.CrossRefPubMed

Taylor, S., Koch, W. J., & McNally, R. J. (1992). How does anxiety sensitivity vary across the anxiety disorders? Journal of Anxiety Disorders, 6, 249–259.CrossRef

Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., … Coles, M. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety Sensitivity Index-3. Psychological Assessment, 19, 176–188. https://doi.org/10.1037/1040-3590.19.2.176.CrossRefPubMed

Turk, D. C., & Rudy, T. E. (1990). The robustness of an empirically derived taxonomy of chronic pain patients. Pain, 43, 27–35. https://doi.org/10.1016/0304-3959(90)90047-H.CrossRefPubMed

Tyrer, P., Tyrer, H., Morriss, R., Crawford, M., Cooper, S., Yang, M., … Barrett, B. (2017). Clinical and cost-effectiveness of adapted cognitive behaviour therapy for non-cardiac chest pain: A multicentre, randomised controlled trial. Open Heart, 4. https://doi.org/10.1136/openhrt-2016-000582.

White, K. S. (2007). Cardiovascular disease and anxiety disorders. In M. J. Zvolensky & J. A. S. Smits (Eds.), Health behaviors and physical illness in anxiety and its disorders: Contemporary theory and research (pp. 279–315). New York: Springer.

White, K. S., & Barlow, D. H. (2002). Panic disorder and agoraphobia. In D. H. Barlow (Ed.), Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed., pp. 328–379). New York: Guilford.

White, K. S., Craft, J. M., & Gervino, E. V. (2010). Anxiety and hypervigilance to cardiopulmonary sensations in non-cardiac chest pain patients with and without psychiatric disorders. Behaviour Research and Therapy, 48, 394–401. https://doi.org/10.1016/j.brat.2010.01.001.CrossRefPubMedPubMedCentral

White, K. S., McDonnell, C. J., & Gervino, E. V. (2011). Alexithymia and anxiety sensitivity in patients with non-cardiac chest pain. Journal of Behavior Therapy and Experimental Psychiatry, 42, 432–439. https://doi.org/10.1016/j.jbtep.2011.04.001.CrossRefPubMedPubMedCentral

White, K. S., & Raffa, S. D. (2004). Anxiety and other emotional factors in noncardiac chest pain. Mental Fitness, 3, 60–67.

White, K. S., Raffa, S. D., Jakle, K. R., Stoddard, J. A., Barlow, D. H., Brown, T. A., … Gervino, E. V. (2008). Morbidity of DSM-IV Axis I disorders in patients with noncardiac chest pain: Psychiatric morbidity linked with increased pain and health care utilization. Journal of Consulting and Clinical Psychology, 76, 422–430. https://doi.org/10.1037/0022-006X.76.3.422.CrossRefPubMed

Wong, W. M., Lai, K. C., Lau, C. P., Hu, W. H. C., Chen, W. H., Wong, B. C. Y., … Lam, S. K. (2002). Upper gastrointestinal evaluation of Chinese patients with non-cardiac chest pain. Alimentary Pharmacology and Therapeutics, 16, 465–471. https://doi.org/10.1046/j.1365-2036.2002.01217.x.CrossRefPubMed

Zinbarg, R. E., Brown, T. A., Barlow, D. H., & Rapee, R. M. (2001). Anxiety sensitivity, panic, and depressed mood: A re-analysis teasing apart the contributions of the two levels in the hierarchical structure of the anxiety sensitivity index. Journal of Abnormal Psychology, 110, 372–377. https://doi.org/10.1037/0021-843X.110.3.372.CrossRefPubMed

Titel: The Role of Disease Conviction: Exploring Its Effects on Chest Pain and Anxiety-Related Models of Non-cardiac Chest Pain
verfasst von: Caleb M. Pardue
Kamila S. White
Ernest V. Gervino
Publikationsdatum: 12.06.2018
Verlag: Springer US
Erschienen in: Journal of Clinical Psychology in Medical Settings / Ausgabe 2/2019
Print ISSN: 1068-9583
Elektronische ISSN: 1573-3572
DOI: https://doi.org/10.1007/s10880-018-9572-9

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