Person centered analysis of psychological traits to explain heterogeneity in patient reported outcomes of coronary artery disease: The THORESCI study

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Heterogeneity in the prognosis of coronary artery disease (CAD) patients may be explained by relatively stable individual psychological differences. Therefore, we studied multiple personality and coping traits using a person-centered approach, and examined the predictive value of this approach for patient-reported outcomes.
Method
657 CAD patients (age = 66.39 ± 10.6; 79% men) completed multiple self-report questionnaires focusing on demographics, negative affectivity and social inhibition (DS14), neuroticism and extraversion (EPQ), resilience (DRS-15), and coping styles (CISS) after undergoing percutaneous coronary intervention.Depressive symptoms (PHQ-9), anxiety (GAD-7), and treatment adherence (MOS) were assessed at 6 months follow-up. Clinical information was extracted from patients’ medical records.
Results
A step-3 latent class analysis identified four subgroup profiles: Low distress (31%), Passive coping (21%), Active coping (20%), and High distress (28%). For all patient-reported outcomes, overall significant differences between the subgroups were observed (p-values < .05). The High distress profile was associated with the highest levels of emotional distress (d’s > .94), and lowest levels of positive mood (d = −1.02) and treatment adherence (d = −2.75) at follow-up. Patients with an Active coping profile also experienced increased emotional distress (d’s > .50), but participated in cardiac rehabilitation most often (d = .13), and reported high levels of positive mood (d = −1.02). Patients with a Passive coping profile displayed few emotional problems after sixmonths (d’s < .30), but participation to cardiac rehabilitation was relatively low (d = .04).
Conclusions
This study revealed four distinct psychological latent subgroups, which were predictive of patientreported outcomes. The results indicate that a person-centered approach is useful in explaining heterogeneity in recovery from PCI, and may enhance personalized medicine in patients with CAD.
Original languageEnglish
Pages (from-to)14-22
JournalJournal of Affective Disorders
Volume236
DOIs
Publication statusPublished - 2018

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Multiple Personality Disorder
Precision Medicine
Individuality
Self Report
Medical Records
Depression
Cardiac Rehabilitation
Neuroticism
Extraversion (Psychology)
Surveys and Questionnaires

Keywords

  • Personality
  • Coping styles
  • Psychological profiles
  • Variable-centered
  • Person-centered
  • Latent class analysis
  • Coronary artery disease
  • AMERICAN-HEART-ASSOCIATION
  • MYOCARDIAL-INFARCTION
  • SCIENTIFIC STATEMENT
  • SOCIAL INHIBITION
  • PREDICTIVE-VALUE
  • POSITIVE AFFECT
  • NEGATIVE AFFECT
  • CARDIAC EVENTS
  • RISK-FACTORS
  • DEPRESSION

Cite this

@article{9c6ced20d4c74b9c9d2504777492288a,
title = "Person centered analysis of psychological traits to explain heterogeneity in patient reported outcomes of coronary artery disease: The THORESCI study",
abstract = "BackgroundHeterogeneity in the prognosis of coronary artery disease (CAD) patients may be explained by relatively stable individual psychological differences. Therefore, we studied multiple personality and coping traits using a person-centered approach, and examined the predictive value of this approach for patient-reported outcomes.Method657 CAD patients (age = 66.39 ± 10.6; 79{\%} men) completed multiple self-report questionnaires focusing on demographics, negative affectivity and social inhibition (DS14), neuroticism and extraversion (EPQ), resilience (DRS-15), and coping styles (CISS) after undergoing percutaneous coronary intervention.Depressive symptoms (PHQ-9), anxiety (GAD-7), and treatment adherence (MOS) were assessed at 6 months follow-up. Clinical information was extracted from patients’ medical records.ResultsA step-3 latent class analysis identified four subgroup profiles: Low distress (31{\%}), Passive coping (21{\%}), Active coping (20{\%}), and High distress (28{\%}). For all patient-reported outcomes, overall significant differences between the subgroups were observed (p-values < .05). The High distress profile was associated with the highest levels of emotional distress (d’s > .94), and lowest levels of positive mood (d = −1.02) and treatment adherence (d = −2.75) at follow-up. Patients with an Active coping profile also experienced increased emotional distress (d’s > .50), but participated in cardiac rehabilitation most often (d = .13), and reported high levels of positive mood (d = −1.02). Patients with a Passive coping profile displayed few emotional problems after sixmonths (d’s < .30), but participation to cardiac rehabilitation was relatively low (d = .04).ConclusionsThis study revealed four distinct psychological latent subgroups, which were predictive of patientreported outcomes. The results indicate that a person-centered approach is useful in explaining heterogeneity in recovery from PCI, and may enhance personalized medicine in patients with CAD.",
keywords = "Personality, Coping styles, Psychological profiles, Variable-centered, Person-centered, Latent class analysis, Coronary artery disease, AMERICAN-HEART-ASSOCIATION, MYOCARDIAL-INFARCTION, SCIENTIFIC STATEMENT, SOCIAL INHIBITION, PREDICTIVE-VALUE, POSITIVE AFFECT, NEGATIVE AFFECT, CARDIAC EVENTS, RISK-FACTORS, DEPRESSION",
author = "{van Montfort}, E.M.J. and N. Kupper and J.W.M.G. Widdershoven and J. Denollet",
year = "2018",
doi = "10.1016/j.jad.2018.04.072",
language = "English",
volume = "236",
pages = "14--22",
journal = "Journal of Affective Disorders",
issn = "0165-0327",
publisher = "Elsevier",

}

TY - JOUR

T1 - Person centered analysis of psychological traits to explain heterogeneity in patient reported outcomes of coronary artery disease

T2 - The THORESCI study

AU - van Montfort, E.M.J.

AU - Kupper, N.

AU - Widdershoven, J.W.M.G.

AU - Denollet, J.

PY - 2018

Y1 - 2018

N2 - BackgroundHeterogeneity in the prognosis of coronary artery disease (CAD) patients may be explained by relatively stable individual psychological differences. Therefore, we studied multiple personality and coping traits using a person-centered approach, and examined the predictive value of this approach for patient-reported outcomes.Method657 CAD patients (age = 66.39 ± 10.6; 79% men) completed multiple self-report questionnaires focusing on demographics, negative affectivity and social inhibition (DS14), neuroticism and extraversion (EPQ), resilience (DRS-15), and coping styles (CISS) after undergoing percutaneous coronary intervention.Depressive symptoms (PHQ-9), anxiety (GAD-7), and treatment adherence (MOS) were assessed at 6 months follow-up. Clinical information was extracted from patients’ medical records.ResultsA step-3 latent class analysis identified four subgroup profiles: Low distress (31%), Passive coping (21%), Active coping (20%), and High distress (28%). For all patient-reported outcomes, overall significant differences between the subgroups were observed (p-values < .05). The High distress profile was associated with the highest levels of emotional distress (d’s > .94), and lowest levels of positive mood (d = −1.02) and treatment adherence (d = −2.75) at follow-up. Patients with an Active coping profile also experienced increased emotional distress (d’s > .50), but participated in cardiac rehabilitation most often (d = .13), and reported high levels of positive mood (d = −1.02). Patients with a Passive coping profile displayed few emotional problems after sixmonths (d’s < .30), but participation to cardiac rehabilitation was relatively low (d = .04).ConclusionsThis study revealed four distinct psychological latent subgroups, which were predictive of patientreported outcomes. The results indicate that a person-centered approach is useful in explaining heterogeneity in recovery from PCI, and may enhance personalized medicine in patients with CAD.

AB - BackgroundHeterogeneity in the prognosis of coronary artery disease (CAD) patients may be explained by relatively stable individual psychological differences. Therefore, we studied multiple personality and coping traits using a person-centered approach, and examined the predictive value of this approach for patient-reported outcomes.Method657 CAD patients (age = 66.39 ± 10.6; 79% men) completed multiple self-report questionnaires focusing on demographics, negative affectivity and social inhibition (DS14), neuroticism and extraversion (EPQ), resilience (DRS-15), and coping styles (CISS) after undergoing percutaneous coronary intervention.Depressive symptoms (PHQ-9), anxiety (GAD-7), and treatment adherence (MOS) were assessed at 6 months follow-up. Clinical information was extracted from patients’ medical records.ResultsA step-3 latent class analysis identified four subgroup profiles: Low distress (31%), Passive coping (21%), Active coping (20%), and High distress (28%). For all patient-reported outcomes, overall significant differences between the subgroups were observed (p-values < .05). The High distress profile was associated with the highest levels of emotional distress (d’s > .94), and lowest levels of positive mood (d = −1.02) and treatment adherence (d = −2.75) at follow-up. Patients with an Active coping profile also experienced increased emotional distress (d’s > .50), but participated in cardiac rehabilitation most often (d = .13), and reported high levels of positive mood (d = −1.02). Patients with a Passive coping profile displayed few emotional problems after sixmonths (d’s < .30), but participation to cardiac rehabilitation was relatively low (d = .04).ConclusionsThis study revealed four distinct psychological latent subgroups, which were predictive of patientreported outcomes. The results indicate that a person-centered approach is useful in explaining heterogeneity in recovery from PCI, and may enhance personalized medicine in patients with CAD.

KW - Personality

KW - Coping styles

KW - Psychological profiles

KW - Variable-centered

KW - Person-centered

KW - Latent class analysis

KW - Coronary artery disease

KW - AMERICAN-HEART-ASSOCIATION

KW - MYOCARDIAL-INFARCTION

KW - SCIENTIFIC STATEMENT

KW - SOCIAL INHIBITION

KW - PREDICTIVE-VALUE

KW - POSITIVE AFFECT

KW - NEGATIVE AFFECT

KW - CARDIAC EVENTS

KW - RISK-FACTORS

KW - DEPRESSION

U2 - 10.1016/j.jad.2018.04.072

DO - 10.1016/j.jad.2018.04.072

M3 - Article

VL - 236

SP - 14

EP - 22

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -