با همکاری مشترک دانشگاه پیام نور و انجمن روانشناسی سلامت

نوع مقاله : علمی- پژوهشی

نویسندگان

1 دانشگاه تهران

2 دانشگاه علوم پزشکی تهران

3 عضو هیات علمی دانشگاه تهران

چکیده

هدف: پژوهش حاضر با هدف بررسی نقش واسطه ای خشم در رابطه بین عاطفه منفی و بازداری اجتماعی با شدت تنگی عروق کرونری انجام گرفت.
روش: این پژوهش یک پژوهش اکتشافی از نوع طرح های همبستگی است. تعداد 200 بیمار مبتلا به تنگی عروق کرونری (112 مرد ، 88 زن) با تکمیل مقیاس خشم چند بعدی (MAI) و مقیاس شخصیتی نوع D (DS14) در این پژوهش شرکت کردند.
یافته ها: نتایج پژوهش نشان دادد که متغیرهای خشم، عاطفه منفی و بازداری اجتماعی با شدت تنگی عروق در سطح 01/0 p < رابطه مثبت معنادار دارند. نتایج تحلیل مسیر نیز نشان داد که خشم در رابطه بین عاطفه منفی و بازداری اجتماعی با شدت تنگی عروق کرونری نقش واسطه ای ایفا می‌کند.
نتیجه گیری: بر اساس یافته های این پژوهش نتیجه گرفته می شود که خشم، عاطفه منفی و بازداری اجتماعی می توانند شدت تنگی عروق کرونری را پیش بینی کنند.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Main Title: The mediating role of anger on the relationship between negative affect and social inhibition with severity of coronary artery stenosis

نویسندگان [English]

  • Mohammad Ali Besharat 1
  • Masomeh Darvishi Lord 1
  • Ali Zahed Mehr 2
  • Masoud Gholamali Lavasani 3

1 University of Tehran

2 Tehran University of Medical Sciences

3 University of Tehran

چکیده [English]

Aim: The present study aimed to examine the mediating role of anger on the relationship between negative affect and social inhibition with severity of coronary artery stenosis in a sample of patients with coronary artery disease.

Method: Method of the present exploratory study was correlational. A total of 200 patients with coronary artery disease (112 men, 88 women) participated in this study. The patients were asked to complete the Multidimensional Anger Inventory (MAI) and Type D Personality Scale (DS14).

Results: The results demonstrated that anger, negative affect, and social inhibition had a meaningful association with severity of coronary artery stenosis (p < .01). The results of path analysis also showed that the relationship between negative affect and social inhibition with severity of coronary artery stenosis is mediated by anger.

Conclusion: It can be concluded that severity of coronary artery stenosis might be predicted by anger, negative affect, and social inhibition.

کلیدواژه‌ها [English]

  • Anger
  • Negative Affect
  • social inhibition
  • coronary artery disease
آقایوسفی، علیرضا؛ شاهنده، مریم (1391)، رابطه علی خشم و سرسختی روانشناختی با کیفیت زندگی در بیماران عروق کرونری. روانشناسی سلامت، 3، 49-39.
اکبری، مهدی؛ علیلو، مجید؛ اصلان آبادی، ناصر (1387)، بررسی تأثیر هیجان‌های منفی، بازداری اجتماعی و نقش عامل جنسیت در بروز بیماری کرونری قلبی. مطالعات روانشناختی، 1، 71-86.
بشارت، محمد علی (1382)، بررسی پایایی، روایی و تحلیل عاملی مقیاس شخصیت نوع D در نمونه‌ای از جمعیت عمومی. گزارش پژوهشی، دانشگاه تهران.
بشارت، محمد علی (1386)، ویژگی­های روانسنجی مقیاس خشم چند بعدی. گزارش پژوهشی. دانشگاه تهران.
بشارت، محمدعلی (1389)، کمال‌گرایی و خشم. فصلنامه علمی- پژوهشی روانشناسی دانشگاه تبریز، 17، 33-52.
بشارت، محمد علی و پورنگ، پریسا (1386)، بررسی ویژگی­های روانسنجی مقیاس شخصیت نوع D در نمونه‌ای از مبتلابان به بیماری عروق کرونر قلب. گزارش پژوهشی، دانشگاه تهران.
بشارت، محمد علی و شمسی‌پور، حمید (1383)، بررسی پایایی و روایی مقیاس شخصیت نوع D در نمونه‌ای از مبتلایان به بیماری عروق کرونر قلب. گزارش پژوهشی، دانشگاه تهران.
حیدری پهلویان، احمد؛ قراخانی، محسن؛ محجوب، حسین (1387)، خصومت، تیپ شخصیتی و بیماری عروق کرونر قلب. مجله علمی دانشگاه علوم پزشکی و خدمات بهداشتی درمانی همدان، 4، 44-47.
مرادی، بهیه؛ معصومی، معصومعلی؛ نعلینی، مهدی؛ ناطق، شوکت (1384)، بررسی وضعیت عوامل خطرساز در بیماران پس از جراحی بای پس عروق کرونر. مجله پزشکی کوثر، 4، 280-271.
مسعودنیا، ابراهیم (1388)، خشومت، خشم و خطر بروز آترواسکلروز عروق کرونر. مجله علمی- پژوهشی دانشگاه علوم پزشکی شهید صدوقی یزد، 6، 551-540.
    مسعودنیا، ابراهیم (1389)، رابطه بین تیپ شخصیتی D و مؤلفه های آن با سلامت عمومی در دانشجویان. مجله علوم رفتاری، 2، 149-143.
هاشمی نصرت آباد، تورج؛ ماشینچی عباسی، نعیمه؛ عدل نسب، لادن و بهادری خسروشاهی، جعفر (1391)، مقایسه تیپ شخصیتی D و فرسودگی حیاتی در بیماران قلبی و افراد عادی. روانشناسی سلامت، 3، 68-60.
American Heart Association (2002), Heart and Stroke Statistical Update, Dallas, TX.
Boyle, S. H., Williams, R. B., Mark, D. B., Brummett, B. H., Siegler, I. C., Barefoot, J. C. (2005), Hostility, age, and mortality in a sample of cardiac patients. American Journal of Cardiology, 96, 64-66.
Burg, M. M., Lampert, R, Joska, T., Batsford, W., Jain, D. (2004), Psychological traits and emotion-triggering of ICD shock-terminated arrhythmias. Psychosomatic Medicine, 66, 898-902.
Chida, Y., & Steptoe, A. (2009), The Association of Anger and Hostility with future Coronary Heart Disease: a Meta- Analytic Review of Prospective Evidence. Journal of the American College of Cardiology, 53, 936-946.
Costa, P. T., & McCrae, R. R. (1985), The NEO Personality Inventory manual. Odessa (Fla): Psychology Assessment Resources.
Denollet, J. (1998), DS14: Personality and coronary heart disease: The type D Scale-16 (DS16). Annual Behavioral Medicine, 20, 209-215.
Denollet, J. (2005), DS14: Standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosomatic Medicine, 67, 89-97.
Denollet, J., & Brutsaert, D. L. (1998), Personality, Disease severity and the risk of long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction. Circulation, 97, 167-173.
Denollet, J., Pedersen, S. S., Vrints, C.J., & Conraads, V. M. (2006), Usefulness of Type D personality in predicting five-year cardiac events above and beyond concurrent symptoms of stress in patients with coronary heart disease. American Journal of Cardiology, 97, 970-973.
Denollet, J., Schiffer, A. A., & Spek, V. (2010), A general propensity to psychological distress affects cardiovascular outcomes: evidence from research on the type D (distressed) personality profile. Circulation Cardiovascular Quality and Outcomes, 3, 546-557.
Denollet, J., Sys, S. U., Stroobant, N., Rombouts, H., Gillebert, T. C., & Brutsaert, D. L. (1996), Personality as independent predictor of long-term mortality in patients with coronary heart disease. Lancet, 34, 417-21.
Denollet, J., Vaes, J., & Brutsaert, D. L. (2000), Inadequate response to treatment in coronary heart disease: adverse effects of Type D personality and younger age on 5-year prognosis and quality of life. Circulation, 102, 630-635.
Everson, S. A., Kauhanen, J., Kaplan, G. A., Goldberg, D. E., Julkunen, J., Tuomilehto, J., & Salonen, J. T. (1997), Hostility and increased risk of mortality and acute myocardial infarction: the mediating role of behavior risk factors. American Journal of Epidemiology, 146, 142-152.
Eysenck, H. J., & Eysenck, S. B. G. (1985), Eysenck Personality Question- naire. London: Hodder & Stoughton.
Friedman, H. S., & Booth-kewley, S. (1987), The “disease-prone personality”: a meta-analytic view of the construct. American Psychologist, 42, 539-555.
Ghashghaei, E. F., Sadeghi, M., Marandi, S. M., & Ghashghaei, S. E. (2012), Exercise-based cardiac rehabilitation improves hemodynamic responses after coronary artery bypass graft surgery. ARYA Atherosclerosis, 7, 151-156.
Glynn, L. M., Christenfeild, N., & Grein, W. (2007), Recreating cardiovascular responses with rumination: The effecta of delay between harassment and its recall. International Journal of Psychophysiology, 66, 135-140.
Hamer, M., O Donnell, K., Lahiri, A.&  Steptoe, A. (2010), Salivary cortisol responses to mental stress are associated with coronary artery calcification in healthy men and women. European Heart Journal, 31, 424-429.
Harburg, E., Julius, M., Kaciroti, N., Gleiberman, L., Schork, M. A. (2003), Expressive/suppressive anger- coping responses, gender, and type of mortality: a 17- year follow-up (Tecumseh, Michigan, 1971-1988), Psychosomatic Medicine, 65, 588- 597.
Kassinove, H., Suckhodolsky, D. G. (1995), Anger disorders: basic science and practice issues. Issues in Comprehensive Pediatric Nursing, 18, 173-205.
Key, B. L., Campbell, T. S., Bacon, S. L., & Gerin, W. (2008), The influence of trait and state rumination on cardiovascular recovery from a negative emotional stressor. Journal of Behavioral Medicine, 31, 237-248.
Kop, W. J., Krantz, D. S., Nearing, B. D., Gottdiener, J. S., Quigley, J. F., O'Callahan, M., et al. (2004), Effects of acute mental stress and exercise on T-wave alternans in patients with implantable cardioverter defibrillators and controls. Circulation, 109, 1864-1869.
Koula, G., Asimakopouliu, T., Skinner, C., Spimpolo, J., Marsh, S., & Fox, C. (2008), Unrealistic Pessimism about risk of coronary heart disease and stroke in patients with type D personality. Patient Education and Counseling, 71, 95-101.
Kupper, N., Pedersen, S. S., Höfer, S., Saner, H., Oldridge, N., & Denollet, J. (2013), Cross-cultural analysis of Type D (distressed) personality in 6222 patients with ischemic heart disease: A study from the International HeartQoL Project. International Journal of Cardiology, 166, 327-333.
Lampert, R., Shusterman, V., Burg, M., McPherson, C., Batsford, W., Gold-berg, A., et al. (2009), Anger-induced T-wave alternans predicts future ventricular arrhythmias in patients with implantable cardioverter-defibrillators. Journal of the American College of Cardiology, 53, 774-778.

Lett, H. S., Blumenthal, J.  A., Babyak, M. A.,  Strauman, T.  J., Robins, C., & Sherwood, A. (2005), Social support and coronary heart disease: epidemiologic evidence and implications for treatment. Psychosomatic Medicine, 67, 869-878.

Lichtman, J. H., Bigger, J. T., Blumenthal, J. A., Frasure-Smith, N., Kaufmann, P. G. et al. (2008). Depression and Coronary Heart Disease: Recommendations for Screening, Referral, and Treatment. Circulation,118, 1768-1775.
Miller, M. C. (2005), Questions & answers: What is type D personality? Harvard Health Letter, 22, 8.
Mols, F., & Denollet, J. (2010a). Type D personality among noncardiovascular patient populations: A systematic review. General Hospital Psychiatry, 32, 66-72.
Mols, F., & Denollet, J. (2010b), Type D personality in the general population: asystematic review of health status, mechanisms of disease, and work related problems. Health and Quality of Life Outcomes, 8, 9.
Musselman, D. L., Evans, D. L., & Nemeroff, C. B. (1998), The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Archive of General Psychiatry, 55, 580-592.
O'Dell, K. R., Masters, K. S., Spielmans, G. I., & Maisto, S. A. (2011),  Does type-D personality predict outcomes among patients with cardiovascular disease? A meta-analytic review. Journal of Psychosomatic Research, 71, 199-206.
Pedersen, S. S., & denollet, J. (2006), Is Type D personality here to stay?emerging evidence across cardiovascular-disease patient groups. Current Cardiolog Reviews, 2, 205-213.
Pedersen, S. S., & Middel, B. (2001), Increased vital exhaustion among Type-D patients with ischaemic heart disease. Journal of  Psychosomatic Research, 51, 443-449
Rompple, M., Herrmann-Lingen, C., Vesper, J. M., & Grande, G. (2012), Type D personality and persistence of depressive symptoms in a German cohort of cardia patients. Journal of Affective disorders, 136, 1183-1187.
Rosamond, W., Flegal, K., Friday, G., Furie, K., Greenlund, K., et al. (2007), Heart disease and stroke statistics. Update: A report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 115, 69-171.
Rosengren, A., Wilhelmsen, L., Orth-Gomér, K. (2004), Coronary disease in relation to social support and social class in Swedish men: a 15 year follow-up in the study of men born in 1933. Eurpean Heart Journal, 25, 56-63.
Rusting, C. L., & Nolen-Hoeksema, S. (1998), are regulating responses to anger: Effects of rumination and distraction on angry mood. Journal of Personality and Social Psychology, 74, 790-803.
Schiffer, A. A., Pedersen, S. S., Widdershoven, J. W., Hendriks, E. H., Winter, J. B., & Denollet, J. (2005), The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure. European Journal of Cardiovascular Prevention and Rehabilitation, 12, 341-346.
Seeman, T. E. (1996), Social ties and health: the benefits of social integration. Annals of Epidemiology, 6, 442-451.
Segerstrom, S. C., Stanton, A. L., & Shortidge, B. E. (2003), A multidimensional structure for repetitive thought: what's on your mind, and how, and how much? Journal of Personality and Social Psychology, 85, 909-921.
Sher, L. (1999), Effects of psychological factors on the development of cardiovascular pathology: Role of the immune system and infection. Journal of Mededica Hypotheses. 53, 112-13.
Sher, L. (2005), Type D personality: the heart, stress, and cortisol. Quarterly Journal of Medicine, 98, 323-329.
Siegel, J. (1986), the multidimensional anger inventory. Journal of Personality and Social Psychology, 51, 191-200.
Sinokki, M., Hinkka,  K., Ahola, K., Koskinen, S., Kivimaki, M., Honkonen, T. et al. (2009),  The association of social support at work and in private life with mental health and antidepressant use: the Health 2000 Study. Journal of Affective Disorders, 115, 36-45.
Smith, T. W., & Ruiz, J. M. (2002), psychosocial influences on the development and course of coronary heart disease: current status and implications for research and practice. Journal of Consultant and Clinical Psychology, 70, 548-568.
Svansdottir, E., van den Broek, K. C., Karlsson, H. D., Olason, D. T., Thorgilsson, H., & Denollet, J. (2013), The distressed (Type D) and Five-Factor Models of personality in young, healthy adults and their association with emotional inhibition and distress. Personality and Individual Differences, 55, 123-128.
Thomas, S. P., Groer, M., Davis, M., Droppleman, P., Mozingo, J., & Pierce, M. (2000), Anger and cancer. Cancer Nursing, 23, 344-349.
Ursano. R. J., Epstein, R. S., & Lazar, S. G. (2002), Behavioral responses to illness: personality and disorders. In: Wise, M. G., Rundell, J. R. (Eds). The American Psychiatric Publishing Text-book of Consultation- Liaison Psychiatry. Psychiatry in the Medically III. 2nd edn. Washington DC, American Psychiatric Publishing, 107-25.
Videbeck, S. L. (2006). Psychiatric Mental Health Nursing (3rd Ed.). Lippincott Williams & Wilkins.
Watson, D., Clarke, L. A., & Tellegen, A. (1988), Development and validation of brief measures of positive and negative affect: The PANAS Scales. Journal of Personality and Social Psychology, 54, 1063-1070.
Williams, L., O'Connor, R., Grubb, N., & O'Carroll, R.­(2012),­Type D personality and­ three-month­psychosocial outcomes among patients post-myocardial infarction. Journal of Psychosomatic Research, 72, 422-426.
World Health Organization (2008), Life course perspectives on coronary heart disease, stroke and diabetes: Key issues and implication for policy and research. Available from: URL: http://www.who.int.
Yu, X. N., Chen, Z., Zhang, J., & Liu, X. (2010), ­Coping­ Mediates the Association between Type D
Personality and Perceived Health in Chinese Patients with Coronary Heart Disease.­International Journal of Behavioral Medicine, 18, 277-284.
Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F., et al. (2004), Effect of potentially modifiable risk factors associated with myocardial infarction in 52­countries (the interheart study): case-control study. Lancet, 364, 937-952.