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Five-year follow-up for adverse outcomes in males with at least minimally positive angiograms: importance of “denial” in assessing psychosocial risk factors
Abstract
The purpose of this study was to test the role of "denial" (spouse/friend minus self-ratings on parallel versions of the same questionnaire) in diluting the predictive value of emotional distress for cardiac events (deaths, new MIs, and/or revascularizations). One hundred forty-four men with no history of prior revascularization who had at least minimally positive diagnostic coronary angiograms, and someone they selected as "someone who knows you well," completed parallel versions of the Ketterer Stress Symptom Frequency Checklist (KSSFC). They were followed up by phone an average of 59.7 months after recruitment. Length of follow-up, baseline cardiac risk factors, and a number of baseline-obtained psychosocial risk factors were tested as prospective predictors of combined events (death by any cause, new MIs, and/or revascularizations) and current anginal frequency. Only spouse/friend observed anxiety on the KSSFC predicted current anginal frequency (p = 0.001). On the self-report version of the KSSFC, patients with one or more events reported less anger (p = 0.031), depression (p = 0.008), and anxiety (p = 0.003). These results may be attributable to "denial" because there were no differences in spouse/friend ratings, and difference scores (spouse/friend minus patient) on the KSSFC scales, particularly anger, were also related to events: AIAI (p = 0.002); depression (p = 0.063); and anxiety (p = 0.010). Denial may be a major limiting factor in accurately assessing emotional distress in cardiac populations, and may help account for a number of the previous findings.
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From Personality and Longevity: Knowns, Unknowns, and Implications for Public Health and Personalized Medicine (2011) · cites this paper as [170]
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Dasa, O., Mahmoud, A. N., Kaufmann, P. G., Ketterer, M., Light, K. C., Raczynski, J. M., Sheps, D. S., Stone, P. H., Handberg, E. M., & Pepine, C. J. (2022) · PubMed · doi:10.1097/psy.0000000000001044 · Cited by 1
“, spouse/friend) are common and generally in the direction of more anger being reported by the spouse/friend (49).”
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Self-Regulation and Control in Personality Functioning
Carver, C. S., & Scheier, M. F. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.029 · Cited by 1
Personality in Nonhuman Animals
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Weiß, A., & Deary, I. J. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108264822.005 · Cited by 2
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Psychological distress as a predictor of coronary heart disease
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Dunne, S. K. (2012) · Arrow@dit (Dublin Institute of Technology)
D-tyypin persoonallisuus ja työkuormitus työtyytyväisyyden selittäjinä
Pekurinen, J. (2015) · Työväentutkimus Vuosikirja
Ketterer, M. W., Ketterer, E. A., Barthel, B. G., Hanbali, A. S., Kuriakose, P., Guo, Y., & Knysz, W. (2012) · Open Journal of Medical Psychology · doi:10.4236/ojmp.2012.12002
“the obfuscating impact of denial/minimization, several investigators have demonstrated superior cross-sectional and prospective predictive power of significant other ratings of emotional distress in several medical populations [12-19].”
BackgroundSelf-citation
Metadata
- Authors
- Ketterer, M. W., Huffman, J., Lumley, M. A., Wassef, S., Gray, L., Kenyon, L., Kraft, P., Brymer, J., Rhoads, K., Lovallo, W. R., & Goldberg, A. D.
- Affiliations
- Henry Ford Health (US)
- Wayne State University (US)
- Oklahoma City VA Medical Center (US)
- Corresponding author
- Ketterer, Mark W.
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 1998-02
- Volume
- 44
- Issue
- 2
- Pages
- 241-250
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2079791496
- Cited by
- 112
- References
- 38
- Citations by year
- 2024: 1 · 2023: 2 · 2022: 3 · 2020: 40 · 2018: 2 · 2015: 2 · 2012: 9
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- denial, emotional distress, psychosocial risk factors, coronary artery disease, cardiac events, myocardial infarction, revascularization, cardiac mortality, anxiety, depression, anger, self-report
- MeSH terms
- Angiography, Anxiety Disorders, Cross-Sectional Studies, Denial, Psychological, Depressive Disorder, Follow-Up Studies, Humans, Interview, Psychological, Male, Middle Aged, Predictive Value of Tests, Retrospective Studies, Risk Factors, Severity of Illness Index, Stress, Psychological, Videotape Recording, Myocardial Ischemia
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