Effects of Positive Psychology Interventions on Risk Biomarkers in Coronary Patients: A Randomized, Wait-List Controlled Pilot Trial
Open accessAbstract
Background Among cardiac patients, positive psychologic factors are consistently linked with superior clinical outcomes and improvement in key markers of inflammation and hypothalamic-pituitary-adrenal axis functioning. Further, positive psychology interventions (PPI) have effectively increased psychologic well-being in a wide variety of populations. However, there has been minimal study of PPIs in cardiac patients, and no prior study has evaluated their effect on key prognostic biomarkers of cardiac outcome. Accordingly, we investigated the effect of 3 distinct PPIs on risk biomarkers in cardiac patients.Methods In an exploratory trial, 69 patients with recent coronary artery bypass graft surgery or percutaneous intervention were randomized to (1) one of three 6-week in-person PPIs (based on the work of Seligman, Lyubomirsky, or Fordyce) or (2) a wait-list control group. Risk biomarkers were assessed at baseline, postintervention (7 weeks), and at 15-week follow-up. Between-group differences in change from baseline biomarker levels were examined via random effects models.Results Compared with the control group, participants randomized to the Seligman (B = -2.06; p = 0.02) and Fordyce PPI (B = -1.54; p = 0.04) had significantly lower high-sensitivity C-reactive protein levels at 7 weeks. Further, the Lyubomirsky PPI (B = -245.86; p = 0.04) was associated with a significantly lower cortisol awakening response at 7 weeks when compared with control participants. There were no other significant between-group differences.Conclusion Despite being an exploratory pilot study with multiple between-group comparisons, this initial trial offers the first suggestion that PPIs might be effective in reducing risk biomarkers in high-risk cardiac patients.
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After a positive psychotherapy-type intervention, a significant decrease in reactive protein and an increase in interleukin 6 and interleukin 1 were observed in 55 adults with CVD.
“After the intervention, a significant decrease in reactive protein and an increase in interleukin 6 and interleukin 1 were observed [35].”
From The effects of nurse-led spiritual care on psychological well-being in the healthcare services of patients with cardiovascular diseases in Iran: a systematic review (2024) · cites this paper as [35]
The Results (Primary study outcome: hs-CRP, Table 3; page unavailable) report significantly greater post-intervention reductions in hs-CRP for the Seligman and Fordyce groups versus controls. But the Results (Secondary outcome: IL-1, IL-6, CARg, Table 3; page unavailable) report no significant between-group change in either interleukin, not significant increases. The Methods (page unavailable) state that 69 patients were randomized, rather than 55. (LLM, conf=0.91)
Experimental — accuracy not yet measuredEffects of positive psychology-based programs on cardiac biomarkers or other disease markers have been mixed, with some observed effects on markers of inflammation in small trials in patients with heart failure or coronary artery disease, modest effects on glycosylated hemoglobin in small studies in diabetes, but minimal effects on other markers.
“Effects of such programs on cardiac biomarkers (eg, inflammatory markers, heart rate variability) or other disease markers have been mixed, with some observed effects on markers of inflammation in small trials in patients with heart failure 209 or coronary artery disease, 210 modest effects on glycosylated hemoglobin in small studies in diabetes, 206,207 but minimal effects on other”
From Psychological Health, Well-Being, and the Mind-Heart-Body Connection: A Scientific Statement From the American Heart Association (2021) · cites this paper as [210]
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Cites
Yusuf, S., Hawken, S., Ôunpuu, S., Dans, T., Avezum, A., Lanas, F., McQueen, M., Budaj, A., Pais, P., Varigos, J., et al. (2004) · The Lancet · doi:10.1016/s0140-6736(04)17018-9 · Cited by 12,026 · see citing works
Positive Psychology Progress: Empirical Validation of Interventions.
Seligman, M. E. P., Steen, T. A., Park, N., & Peterson, C. (2005) · American Psychologist · doi:10.1037/0003-066x.60.5.410 · Cited by 5,947 · see citing works
Ridker, P. M., Hennekens, C. H., Buring, J. E., & Rifai, N. (2000) · New England Journal of Medicine · doi:10.1056/nejm200003233421202 · Cited by 5,850 · see citing works
Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00108-7 · Cited by 3,638 · see citing works
Psychological Well-Being Revisited: Advances in the Science and Practice of Eudaimonia
Ryff, C. D. (2014) · Psychotherapy and Psychosomatics · doi:10.1159/000353263 · Cited by 2,976 · see citing works
Sin, N. L., & Lyubomirsky, S. (2009) · Journal of Clinical Psychology · doi:10.1002/jclp.20593 · Cited by 2,955 · see citing works
Positive psychology interventions: a meta-analysis of randomized controlled studies
Bolier, L., Haverman, M., Westerhof, G. J., Riper, H., Smit, F., & Bohlmeijer, E. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-119 · Cited by 1,996 · see citing works
Ridker, P. M., Buring, J. E., Shih, J., Matias, M., & Hennekens, C. H. (1998) · Circulation · doi:10.1161/01.cir.98.8.731 · Cited by 1,642 · see citing works
Seligman, M. E. P., Rashid, T., & Parks, A. C. (2006) · American Psychologist · doi:10.1037/0003-066x.61.8.774 · Cited by 1,560 · see citing works
Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis
Barth, J., Schumacher, M., & Herrmann-Lingen, C. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000146332.53619.b2 · Cited by 1,358 · see citing works
Inflammation as a Cardiovascular Risk Factor
Willerson, J. T., & Ridker, P. M. (2004) · Circulation · doi:10.1161/01.cir.0000129535.04194.38 · Cited by 1,304 · see citing works
van Melle, J. P., de Jonge, P., Spijkerman, T. A., Tijssen, J. G. P., Ormel, J., van Veldhuisen, D. J., van den Brink, R. H. S., & van den Berg, M. P. (2004) · Psychosomatic Medicine · doi:10.1097/01.psy.0000146294.82810.9c · Cited by 1,034 · see citing works
Sheldon, K. M., & Lyubomirsky, S. (2006) · The Journal of Positive Psychology · doi:10.1080/17439760500510676 · Cited by 925 · see citing works
Boehm, J. K., & Kubzansky, L. D. (2012) · Psychological Bulletin · doi:10.1037/a0027448 · Cited by 909 · see citing works
Ghassemzadeh, H., Mojtabai, R., Karamghadiri, N., & Ebrahimkhani, N. (2005) · Depression and Anxiety · doi:10.1002/da.20070 · Cited by 813 · see citing works
Positive affect and health-related neuroendocrine, cardiovascular, and inflammatory processes
Steptoe, A., Wardle, J., & Marmot, M. (2005) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0409174102 · Cited by 763 · see citing works
Lyubomirsky, S., Dickerhoof, R., Boehm, J. K., & Sheldon, K. M. (2011) · Emotion · doi:10.1037/a0022575 · Cited by 720 · see citing works
Positive Affect and Psychobiological Processes Relevant to Health
Steptoe, A., Dockray, S., & Wardle, J. (2009) · Journal of Personality · doi:10.1111/j.1467-6494.2009.00599.x · Cited by 520 · see citing works
Tindle, H. A., Chang, Y.-F., Kuller, L. H., Manson, J. E., Robinson, J. G., Rosal, M. C., Siegle, G. J., & Matthews, K. A. (2009) · Circulation · doi:10.1161/circulationaha.108.827642 · Cited by 483 · see citing works
Advances in Analysis of Longitudinal Data
Gibbons, R. D., Hedeker, D., & DuToit, S. (2010) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.032408.153550 · Cited by 452 · see citing works
Development of a program to increase personal happiness.
Fordyce, M. W. (1977) · Journal of Counseling Psychology · doi:10.1037/0022-0167.24.6.511 · Cited by 411 · see citing works
A program to increase happiness: Further studies.
Fordyce, M. W. (1983) · Journal of Counseling Psychology · doi:10.1037/0022-0167.30.4.483 · Cited by 363 · see citing works
Januzzi, J. L., Rehman, S., Mohammed, A. A., Bhardwaj, A., Barajas, L. J., Barajas, J. A., Kim, H.-N., Baggish, A. L., Weiner, R. B., Chen‐Tournoux, A., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.03.072 · Cited by 360 · see citing works
Depression and Cardiac Disease
Celano, C. M., & Huffman, J. C. (2011) · Cardiology in Review · doi:10.1097/crd.0b013e31820e8106 · Cited by 320 · see citing works
Self-citationPsychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis
Richards, S. H., Anderson, L., Jenkinson, C. E., Whalley, B., Rees, K., Davies, P., Bennett, P., Liu, Z., West, R., Thompson, D. R., et al. (2018) · European Journal of Preventive Cardiology · doi:10.1177/2047487317739978 · Cited by 319 · see citing works
Watkins, L. L., Koch, G. G., Sherwood, A., Blumenthal, J. A., Davidson, J. R. T., O’Connor, C. J., & Sketch, M. H. (2013) · Journal of the American Heart Association · doi:10.1161/jaha.112.000068 · Cited by 293 · see citing works
Positive affect and psychobiological processes
Dockray, S., & Steptoe, A. (2010) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2010.01.006 · Cited by 263 · see citing works
Kubzansky, L. D., & Thurston, R. C. (2007) · Archives of General Psychiatry · doi:10.1001/archpsyc.64.12.1393 · Cited by 252 · see citing works
Designing positive psychology: taking stock and moving forward
(2011) · Choice Reviews Online · doi:10.5860/choice.48-6592 · Cited by 240 · see citing works
Goldston, K., & Baillie, A. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.05.005 · Cited by 237 · see citing works
Martens, E. J., de Jonge, P., Na, B., Cohen, B. E., Lett, H. S., & Whooley, M. A. (2010) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2010.74 · Cited by 235 · see citing works
Baumeister, H., Hutter, N., & Bengel, J. (2011) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008012.pub3 · Cited by 220 · see citing works
A prospective study of positive psychological well-being and coronary heart disease.
Boehm, J. K., Peterson, C., Mika Kivimaki, B., & Kubzansky, L. D. (2011) · Health Psychology · doi:10.1037/a0023124 · Cited by 203 · see citing works
Depressive Symptoms and Survival of Patients With Coronary Artery Disease
Barefoot, J. C., Brummett, B. H., Helms, M. J., Mark, D. B., Siegler, I. C., & Williams, R. B. (2000) · Psychosomatic Medicine · doi:10.1097/00006842-200011000-00008 · Cited by 200 · see citing works
DuBois, C. M., Lopez, O. V., Beale, E. E., Healy, B. C., Boehm, J. K., & Huffman, J. C. (2015) · International Journal of Cardiology · doi:10.1016/j.ijcard.2015.05.121 · Cited by 187 · see citing works
Self-citationPeterson, J. C. (2012) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.1311 · Cited by 178 · see citing works
Heart health when life is satisfying: evidence from the Whitehall II cohort study
Boehm, J. K., Peterson, C., Mika Kivimaki, B., & Kubzansky, L. D. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr203 · Cited by 157 · see citing works
Positive psychological attributes and cardiac outcomes: associations, mechanisms, and interventions
DuBois, C. M., Beach, S. R., Kashdan, T. B., Nyer, M. B., Park, E. R., Celano, C. M., & Huffman, J. C. (2012) · Psychosomatics · doi:10.1016/j.psym.2012.04.004 · Cited by 152 · see citing works
Psychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis
Whalley, B., Thompson, D. R., & Taylor, R. S. (2014) · International Journal of Behavioral Medicine · doi:10.1007/s12529-012-9282-x · Cited by 149 · see citing works
Development of a positive psychology intervention for patients with acute cardiovascular disease
Huffman, J. C., Mastromauro, C. A., Boehm, J. K., Seabrook, R., Fricchione, G. L., Denninger, J. W., & Lyubomirsky, S. (2011) · Heart International · doi:10.4081/hi.2011.e14 · Cited by 148 · see citing works
Self-citationDispositional Optimism and the Risk of Cardiovascular Death: The Zutphen Elderly Study
Giltay, E. J. (2006) · Archives of Internal Medicine · doi:10.1001/.431 · Cited by 132 · see citing works
Surtees, P. G., Wainwright, N. W. J., Luben, R., Khaw, K.-T., & Day, N. E. (2006) · Health Psychology · doi:10.1037/0278-6133.25.1.102 · Cited by 115 · see citing works
Denollet, J., Pedersen, S. S., Daemen, J., de Jaegere, P. P. T., Serruys, P. W. J. C., & van Domburg, R. T. (2007) · Journal of Internal Medicine · doi:10.1111/j.1365-2796.2007.01870.x · Cited by 89 · see citing works
Baumeister, H., Hutter, N., & Bengel, J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008012.pub2 · Cited by 78 · see citing works
Ratings of positive and depressive emotion as predictors of mortality in coronary patients
Brummett, B. H., Boyle, S. H., Siegler, I. C., Williams, R. B., Mark, D. B., & Barefoot, J. C. (2005) · International Journal of Cardiology · doi:10.1016/j.ijcard.2004.06.016 · Cited by 60 · see citing works
Dispositional Optimism and the Risk of Cardiovascular Death
Giltay, E. J., Kamphuis, M. H., Kalmijn, S., Zitman, F. G., & Kromhout, D. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.4.431 · Cited by 9 · see citing works
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Self-citationPositive Psychological Well-Being and Cardiovascular Disease
Kubzansky, L. D., Huffman, J. C., Boehm, J. K., Hernandez, R., Kim, E. S., Koga, H. K., Feig, E. H., Lloyd-Jones, D. M., Seligman, M. E. P., & Labarthe, D. R. (2018) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2018.07.042 · Cited by 429 · see citing works
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Magán, I., Jurado-Barba, R., Casado, L., Barnum, H., Jeon, A., Hernandez, A. V., & Bueno, H. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2021.110710 · Cited by 39 · see citing works
Mousavizadeh, S. N., & Jandaghian-Bidgoli, M. (2024) · BMC Cardiovascular Disorders · doi:10.1186/s12872-024-04076-7 · Cited by 16 · see citing works
“After the intervention, a significant decrease in reactive protein and an increase in interleukin 6 and interleukin 1 were observed [35].”
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- Authors
- Nikrahan, G. R., Laferton, J. A. C., Asgari, K., Kalantari, M., Abedi, M. R., Etesampour, A., Rezaei, A., Suarez, L., & Huffman, J. C.
- Affiliations
- University of Isfahan (IR)
- Brigham and Women's Hospital (US)
- Islamic Azad University of Najafabad (IR)
- Isfahan University of Medical Sciences (IR)
- Harvard University (US)
- Corresponding author
- Nikrahan, Gholam Reza
- ORCID
- Venue
- Psychosomatics
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 57
- Issue
- 4
- Pages
- 359-368
- ISSN
- 0033-3182 (ISSN-L)
- PMC
- PMC4902729
- OpenAlex
- W2278605548
- Cited by
- 84
- References
- 48
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 6 · 2023: 5 · 2022: 5 · 2021: 10 · 2020: 8 · 2019: 5 · 2018: 34 · 2017: 4 · 2016: 2
- FWCI
- 12.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01HL113272)
- University of Isfahan (R01HL113272)
- Deutscher Akademischer Austauschdienst (R01HL113272)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- positive psychology interventions, coronary artery disease, risk biomarkers, C-reactive protein, inflammation, cortisol awakening response, hypothalamic-pituitary-adrenal axis, coronary artery bypass grafting, percutaneous coronary intervention, psychosocial interventions
- MeSH terms
- Aged, Coronary Artery Bypass, C-Reactive Protein, Coronary Artery Disease, Depression, Female, Humans, Hydrocortisone, Hypothalamo-Hypophyseal System, Interleukin-1, Male, Middle Aged, Pilot Projects, Pituitary-Adrenal System, Risk, Saliva, Waiting Lists, Biomarkers, Interleukin-6, Percutaneous Coronary Intervention
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