Trajectories of perceived emotional and physical distress in patients with an implantable cardioverter defibrillator

K.C. van den Broek, N. Kupper, P.H.J. van der Voort, M. Alings, J. Denollet, I. Nyklicek

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Background
Little is known about the course of emotional and physical distress in patients with an implantable cardioverter defibrillator (ICD).
Purpose
We examined (1) trajectories of emotional and physical distress in the first 18 months postimplantation and (2) predictors of these trajectories, including demographical, clinical, and personality factors.
Methods
Dutch patients with an ICD (N = 645) completed measures on anxiety, depression, somatic symptoms, and perceived disability at the time of implantation, and 2, 12, and 18 months postimplantation. Measures on Type D personality (tendency to inhibit the expression of negative emotions) and anxiety sensitivity (tendency to fear anxiety-related sensations) were also completed at baseline.
Results
Latent class analysis (LatentGOLD) identified six to seven distinct trajectories, varying largely in overall levels of distress, and remaining relatively stable after a small initial decline. Multinomial regression showed that Type D personality and anxiety sensitivity were the most prominent predictors, particularly of trajectories that reflected higher distress levels. Cardiac resynchronization therapy and coronary artery disease also increased the risk for distress, whereas ICD indication and shocks did not.
Conclusions
The course of emotional and physical distress may be relatively stable after ICD implantation. In clinical practice, identification of patients with high risk of higher levels of emotional and physical distress may be warranted; as such, patients with high levels of anxiety sensitivity or a Type D personality should be identified and offered behavioral support.
Original languageEnglish
Pages (from-to)149-159
JournalInternational Journal of Behavioral Medicine
Volume21
Issue number1
DOIs
Publication statusPublished - 2014

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Implantable Defibrillators
Depression

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@article{e4baf341b7744e4590a6990528c3a140,
title = "Trajectories of perceived emotional and physical distress in patients with an implantable cardioverter defibrillator",
abstract = "BackgroundLittle is known about the course of emotional and physical distress in patients with an implantable cardioverter defibrillator (ICD).PurposeWe examined (1) trajectories of emotional and physical distress in the first 18 months postimplantation and (2) predictors of these trajectories, including demographical, clinical, and personality factors.MethodsDutch patients with an ICD (N = 645) completed measures on anxiety, depression, somatic symptoms, and perceived disability at the time of implantation, and 2, 12, and 18 months postimplantation. Measures on Type D personality (tendency to inhibit the expression of negative emotions) and anxiety sensitivity (tendency to fear anxiety-related sensations) were also completed at baseline.ResultsLatent class analysis (LatentGOLD) identified six to seven distinct trajectories, varying largely in overall levels of distress, and remaining relatively stable after a small initial decline. Multinomial regression showed that Type D personality and anxiety sensitivity were the most prominent predictors, particularly of trajectories that reflected higher distress levels. Cardiac resynchronization therapy and coronary artery disease also increased the risk for distress, whereas ICD indication and shocks did not.ConclusionsThe course of emotional and physical distress may be relatively stable after ICD implantation. In clinical practice, identification of patients with high risk of higher levels of emotional and physical distress may be warranted; as such, patients with high levels of anxiety sensitivity or a Type D personality should be identified and offered behavioral support.",
author = "{van den Broek}, K.C. and N. Kupper and {van der Voort}, P.H.J. and M. Alings and J. Denollet and I. Nyklicek",
year = "2014",
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Trajectories of perceived emotional and physical distress in patients with an implantable cardioverter defibrillator. / van den Broek, K.C.; Kupper, N.; van der Voort, P.H.J.; Alings, M.; Denollet, J.; Nyklicek, I.

In: International Journal of Behavioral Medicine, Vol. 21, No. 1, 2014, p. 149-159.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Trajectories of perceived emotional and physical distress in patients with an implantable cardioverter defibrillator

AU - van den Broek, K.C.

AU - Kupper, N.

AU - van der Voort, P.H.J.

AU - Alings, M.

AU - Denollet, J.

AU - Nyklicek, I.

PY - 2014

Y1 - 2014

N2 - BackgroundLittle is known about the course of emotional and physical distress in patients with an implantable cardioverter defibrillator (ICD).PurposeWe examined (1) trajectories of emotional and physical distress in the first 18 months postimplantation and (2) predictors of these trajectories, including demographical, clinical, and personality factors.MethodsDutch patients with an ICD (N = 645) completed measures on anxiety, depression, somatic symptoms, and perceived disability at the time of implantation, and 2, 12, and 18 months postimplantation. Measures on Type D personality (tendency to inhibit the expression of negative emotions) and anxiety sensitivity (tendency to fear anxiety-related sensations) were also completed at baseline.ResultsLatent class analysis (LatentGOLD) identified six to seven distinct trajectories, varying largely in overall levels of distress, and remaining relatively stable after a small initial decline. Multinomial regression showed that Type D personality and anxiety sensitivity were the most prominent predictors, particularly of trajectories that reflected higher distress levels. Cardiac resynchronization therapy and coronary artery disease also increased the risk for distress, whereas ICD indication and shocks did not.ConclusionsThe course of emotional and physical distress may be relatively stable after ICD implantation. In clinical practice, identification of patients with high risk of higher levels of emotional and physical distress may be warranted; as such, patients with high levels of anxiety sensitivity or a Type D personality should be identified and offered behavioral support.

AB - BackgroundLittle is known about the course of emotional and physical distress in patients with an implantable cardioverter defibrillator (ICD).PurposeWe examined (1) trajectories of emotional and physical distress in the first 18 months postimplantation and (2) predictors of these trajectories, including demographical, clinical, and personality factors.MethodsDutch patients with an ICD (N = 645) completed measures on anxiety, depression, somatic symptoms, and perceived disability at the time of implantation, and 2, 12, and 18 months postimplantation. Measures on Type D personality (tendency to inhibit the expression of negative emotions) and anxiety sensitivity (tendency to fear anxiety-related sensations) were also completed at baseline.ResultsLatent class analysis (LatentGOLD) identified six to seven distinct trajectories, varying largely in overall levels of distress, and remaining relatively stable after a small initial decline. Multinomial regression showed that Type D personality and anxiety sensitivity were the most prominent predictors, particularly of trajectories that reflected higher distress levels. Cardiac resynchronization therapy and coronary artery disease also increased the risk for distress, whereas ICD indication and shocks did not.ConclusionsThe course of emotional and physical distress may be relatively stable after ICD implantation. In clinical practice, identification of patients with high risk of higher levels of emotional and physical distress may be warranted; as such, patients with high levels of anxiety sensitivity or a Type D personality should be identified and offered behavioral support.

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