International Journal of Behavioral Medicine

, Volume 21, Issue 1, pp 149–159 | Cite as

Trajectories of Perceived Emotional and Physical Distress in Patients with an Implantable Cardioverter Defibrillator

  • Krista C. van den Broek
  • Nina Kupper
  • Pepijn H. van der Voort
  • Marco Alings
  • Johan Denollet
  • Ivan Nyklíček



Little is known about the course of emotional and physical distress in patients with an implantable cardioverter defibrillator (ICD).


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.


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.


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.


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.


Implantable cardioverter defibrillator Anxiety Depression Health Status Personality 



We would like to thank Ms. Eefje Postelmans and Mr. Hidde Weetink for inclusion of the patients into the study. This study was supported by the Netherlands Organization for Scientific Research, The Hague, The Netherlands with a VICI grant (453-04-004) to Prof. Dr. Johan Denollet.

Conflict of Interest



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Copyright information

© International Society of Behavioral Medicine 2012

Authors and Affiliations

  • Krista C. van den Broek
    • 1
  • Nina Kupper
    • 1
  • Pepijn H. van der Voort
    • 2
  • Marco Alings
    • 3
  • Johan Denollet
    • 1
  • Ivan Nyklíček
    • 1
  1. 1.Department of Medical Psychology, CoRPS - Center of Research on Psychology in Somatic diseasesTilburg UniversityTilburgThe Netherlands
  2. 2.Department of CardiologyCatharina HospitalEindhovenThe Netherlands
  3. 3.Department of CardiologyAmphia HospitalBredaThe Netherlands

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