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Cardiac Psychology: An overview of theoretical considerations and empirical evidence from an interdisciplinary perspective

Helle Spindler 


Cardiac psychology is an emerging interdisciplinary area that emphasises the need to bring together cardiology and psychology in daily clinical practice with the aim of providing for the medical as well as the psychological needs of cardiac patients.

This thesis presents an overview of the theoretical considerations and empirical evidence that forms the basis of this perspective. The introduction serves as a general presentation of the psychological factors that have been linked to cardiac prognosis and patient-centred health outcomes, e.g. health-related quality of life (HRQL) in cardiovascular disease (CVD). In addition, it discusses the ramifications of the cardiac psychology perspective for our understanding of the interplay between patients and health personnel.
Chapter 2 presents a review examining the risk of developing PTSD following cardiac disease, and what factors may be associated with an increased risk of PTSD. In chapters 3-5 empirical studies examining the association between chronic risk factors, i.e. type-D personality and increased psychological distress in the form of anxiety and depression, as well as between type-D personality and impaired HRQL are presented.
Studies examining episodic risk factors, such as anxiety and depression, and their association with impaired HRQL are presented in chapters 6-7. Finally, chapters 8-9 present two studies examining two buffering factors, positive affect and social support.

Chapter 10 discusses the presented studies in the context of existing knowledge concerning CVD and psychological factors and emphasizes the need to incorporate the complexity of the associations between risk and buffering factors, mediating and moderating factors, and various outcomes in future research and theoretical conceptualisations. In relation to chapters 2, 5, and 8 that also report on the psychometric properties of the Danish versions of the type-D personality scale (DS14), the Hospital Anxiety and Depression Scale (HADS), and the Global Mood Scale (GMS) chapter 10 also discusses methodological and statistical issues associated with the incorporation and use of psychological measures in CVD research.

The conclusion sums up the methodological and theoretical challenges that face psychosomatic research and cardiac psychology in future. In addition, it briefly touches on the need to incorporate an interdisciplinary approach to CVD patients, and how we may use existing knowledge to guide contemporary daily clinical practice.