Sex and gender differences in psychosocial risk profiles in patients with coronary artery disease: The THORESCI study

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Separate psychosocial risk factors tend to cluster together, complicating risk assessment. Additionally, sex differences in within-person psychosocial risk clusters have been established, but gender differences remain rather unexplored. The current study explored the clustering of the psychosocial risk factors as identified by the European Society of Cardiology (ESC) prevention guidelines
among patients with coronary artery disease (CAD). Furthermore, we
examined how sex and gender differences characterize these withinperson psychosocial risk clusters, adjusted for age.


440 CAD patients (Mage = 68.48, SD = 9.04; 83.9% male) completed the ESC screening instrument and a validated questionnaire for gender traits (BSRI), one item on gender identity and several demographic variables, used to compose a gender norm score. Latent Class Analysis (LCA) was used to identify
psychosocial risk clusters.


LCA revealed five psychosocial risk clusters: 1. Emotional distress, anger, and Type D Personality (27%), 2. Low levels of general distress, moderate anger and hostility (25%), 3. Low levels of distress (21%), 4. Social and emotional distress (18%) and 5. High overall distress and trauma (9%). Masculine traits and older age were associated with class membership to the lower distress risk profiles
and a lowered odds to belong to cluster 5. Additionally, female sex
characterized class membership to the emotional and social distress risk profile. Furthermore, the effect of masculine and feminine traits was dependent on sex.


The results of the current study explain levels of heterogeneity among patients with CAD by considering the joint occurrence of psychosocial risk factors, as well as the role of sex, age, and gender traits within psychosocial risk profiles.
Original languageEnglish
Article number1392
Pages (from-to)A8-A8
JournalPsychosomatic Medicine
Issue number5
Publication statusPublished - 2022


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