Skip to main content

Advertisement

Log in

Comparison of the effectiveness of cognitive-behavioral group intervention for coronary heart disease and cognitive therapy in groups on type D personality and psychological distress on coronary heart patients- a randomized clinical trial

  • Published:
Current Psychology Aims and scope Submit manuscript

Abstract

In contemporary medicine, researchers in the behavioral sciences emphasize the relationship between psychosocial characteristics, personality traits and behavioral patterns in patients with Coronary Heart Diseases (CHD). The purpose of this study was to compare the efficacy of Cognitive-Behavioral Group Intervention for Coronary Heart Disease (CBGI-CHD) and Cognitive Therapy in Groups (CTG) of Type D Personality (TDP) and stress, anxiety, and depression. The present study was a semi-experimental study in which the pretest-posttest with the control group was utilized. Patients (51) randomly allocated to three equal groups. Of these, 17 (13 men and 4 women) in the first experimental group (CTG), 17 (10 men and 7 women) in the second experimental group (CBGI-CHD) and 17 (12 men and 5 women) were randomly assigned to the control group. The first and second experimental groups, along with regular medical care, received CTG and CBGI-CHD for 12 weekly sessions of 2 h and 12 weekly sessions of 2.5 h, respectively (from April up to the end of June 2016) in private clinics of cardiologists of Mashhad. The control group received only regular medical care in this period. Patients in all groups responded to the DS14, DASS21 and BDI-II scales before intervention (pretest) and immediately after the intervention (posttest). It included diagnostic criteria for the diagnosis of CHD in the patient’s medical records by a cardiologist. According to the results, there was a significant difference between the two experimental groups compared to the control group and the effectiveness of CBGI-CHD and CTG interventions on the variables. The results showed that there was no statistically significant difference in TDP and depression variables between CTG and GBGI-CHD treatments (P > 0.05). But there was a significant difference in anxiety and stress between CTG and CBGI-CHD Treatments (P ≤ 0.05). CTG is more effective in reducing anxiety and stress than GBGI-CHD. Finally, it’s possible to conclude that both CTG and GBGI-CHD are useful interventions in patients with CHD. However, the effect of CTG was more important than GBGI-CHD in anxiety and stress variables.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.

    Book  Google Scholar 

  • Aquarius, A. E., Denollet, J., De Vries, J., & Hamming, J. F. (2007). Poor health-related quality of life in patients with peripheral arterial disease: Type D personality and severity of peripheral arterial disease as independent predictors. Journal of Vascular Surgery, 46(3), 507–512. https://doi.org/10.1016/j.jvs.2007.04.039.

    Article  PubMed  Google Scholar 

  • Bayazi, M. H., Ahadi, H., Fata, L., & Danesh Sani, S. H. (2012). The effectiveness of a short cognitive-behavioral group intervention on depression, anxiety, and stress in patients with chronic coronary heart disease: A randomized controlled trial. Journal of Fundamentals of Mental Health, 14(1), 110–121.

    Google Scholar 

  • Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.

    Article  Google Scholar 

  • Beck, A.T., Emery, G., Greenberg, R. L. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.

  • Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck depression inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8(1), 77–110. https://doi.org/10.1016/0272-7358(88)90050-5.

    Article  Google Scholar 

  • Chauvet-Gelinier, J. C., & Bonin, B. (2017). Stress, anxiety and depression in heart disease patients: A major challenge for cardiac rehabilitation. Annals of Physical and Rehabilitation Medicine, 60(1), 6–12. https://doi.org/10.1016/j.rehab.2016.09.002.

    Article  PubMed  Google Scholar 

  • Carney, R. M., & Freedland, K. E. (2017). Depression in patients with coronary artery disease: A more significant problem than previously recognized? European Heart Journal - Quality of Care and Clinical Outcomes, 3(4), 262–263. https://doi.org/10.1093/ehjqcco/qcx019.

    Article  PubMed  Google Scholar 

  • Celano, C. M., Daunis, D. J., Lokko, H. N., Campbell, K. A., & Huffman, J. C. (2016). Anxiety disorders and cardiovascular disease. Current Psychiatry Reports, 18(11), 101. https://doi.org/10.1007/s11920-016-0739-5.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cowan, M. J., Freedland, K. E., Burg, M. M., Saab, P. G., Youngblood, M. E., Cornell, C. E., Powell, L. H., Czajkowski, S. M., & ENRICHD Investigators. (2008). Predictors of treatment response for depression and inadequate social support- the ENRICHD randomized clinical trial. Psychotherapy and Psychosomatics, 77(1), 27–37. https://doi.org/10.1159/000110057.

    Article  PubMed  Google Scholar 

  • Cully, J. A., Paukert, A., Falco, J., & Stanley, M. (2009). Cognitive-behavioral therapy: Innovations for cardiopulmonary patients with depression and anxiety. Cognitive and Behavioral Practice, 16(4), 394–407. https://doi.org/10.1016/j.cbpra.2009.04.004.

    Article  Google Scholar 

  • Dalili, Z., & Bayazi, M. H. (2019). The effectiveness of mindfulness-based cognitive therapy on the illness perception and psychological symptoms in patients with rheumatoid arthritis. Complementary Therapies in Clinical Practice, 34, 139–144. https://doi.org/10.1016/j.ctcp.2018.11.012.

    Article  PubMed  Google Scholar 

  • Denollet, J. (2002). Type D personality and vulnerability to chronic disease, impaired quality of life, and depressive symptoms. Psychosomatic Medicine, 64(1), 101–101.

    Google Scholar 

  • Denollet, J. (2005). DS14: Standard assessment of negative affectivity, social inhibition, and type D personality. Psychosomatic Medicine, 67(1), 89–97. https://doi.org/10.1097/01.psy.0000149256.81953.49.

    Article  PubMed  Google Scholar 

  • Denollet, J., Pedersen, S. S., Ong, A. T., Erdman, R. A., Serruys, P. W., & Van Domburg, R. T. (2006). Social inhibition modulates the effect of negative emotions on cardiac prognosis following percutaneous coronary intervention in the drug-eluting stent era. European Heart Journal, 27(2), 171–177. https://doi.org/10.1093/eurheartj/ehi616.

    Article  PubMed  Google Scholar 

  • DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: A meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160, 2101–2107.

    Article  Google Scholar 

  • Dusseldorp, E., Van Elderen, T., Maes, S., Meulman, J., & Kraaij, V. (1999). A meta-analysis of psychoeducational programs for coronary heart disease patients. Health Psychology, 18(5), 506–519. https://doi.org/10.1037//0278-6133.18.5.506.

    Article  PubMed  Google Scholar 

  • Free, M.L. (1999). Cognitive therapy in groups; guidelines and resources for practice. Second Edition. School of Applied Psychology, Griffith University, Australia, John Wiley and Sons, Ltd.

  • Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62, 617–627. https://doi.org/10.1001/archpsyc.62.6.617.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kivimäki, M., Virtanen, M., Elovainio, M., Kouvonen, A., Väänänen, A., & Vahtera, J. (2006). Work stress in the etiology of coronary heart disease—A meta-analysis. Scandinavian Journal of Work, Environment & Health, 32(6), 431–442. https://doi.org/10.5271/sjweh.1049.

    Article  Google Scholar 

  • Kozela, M., Bobak, M., Besala, A., Micek, A., Kubinova, R., Malyutina, S., Denisova, D., Richards, M., Pikhart, H., Peasey, A., Marmot, M., & Pająk, A. (2016). The association of depressive symptoms with cardiovascular and all-cause mortality in central and Eastern Europe: Prospective results of the HAPIEE study. European Journal of Preventive Cardiology, 23(17), 1839–1847. https://doi.org/10.1177/2047487316649493.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kupper, N., & Denollet, J. (2018). Type D personality as a risk factor in coronary heart disease. Current Cardiology Reports, 20(11), 104. https://doi.org/10.1007/s11886-018-1048-x.

    Article  PubMed  PubMed Central  Google Scholar 

  • Leu, H. B., Yin, W. H., Tseng, W. K., Wu, Y. W., Lin, T. H., Yeh, H. I., Cheng Chang, K., Wang, J. H., Wu, C. C., & Chen, J. W. (2018). Impact of type D personality on clinical outcomes in Asian patients with stable coronary artery disease. Journal of the Formosan Medical Association, xx, 118, 1–9. https://doi.org/10.1016/j.jfma.2018.08.021.

    Article  Google Scholar 

  • Lovibond, P. F., Lovibond, S.H. (1995). The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U.

  • McPhillips, R., Salmon, P., Wells, A., & Fisher, P. (2019). Qualitative analysis of emotional distress in cardiac patients from the perspectives of cognitive behavioral and metacognitive theories: Why might cognitive behavioral therapy have limited benefit, and might metacognitive therapy be more effective? Frontiers in Psychology, 9, 2288. https://doi.org/10.3389/fpsyg.2018.02288.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mohammadi, F., Bagheri, M., Sadat Hashemi, M., & Komeili Sani, H. K. (2018). The effects of cognitive behavioral therapy on depression and anxiety among patients with thalassemia: A randomized controlled trial. Journal of Caring Sciences, 7(4), 219–224. https://doi.org/10.15171/jcs.2018.033.

    Article  Google Scholar 

  • Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., et al. (2010). CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. Research Methods & Reporting, 1-28. https://doi.org/10.1136/bmj.c869.

  • Partovi, T., & Razavi, M. R. (2019). The effect of game-based learning on academic achievement motivation of elementary school students. Learning and Motivation, 68, 101592. https://doi.org/10.1016/j.lmot.2019.101592.

    Article  Google Scholar 

  • Razavi, M.R. (2013). Conditions influencing faculty Members' stages of concern and levels of implementation of online learning technology at E-learning Centres in Iranian universities, Universiti Putra Malaysia.

  • Richards, S. H., Anderson, L., Jenkinson, G. E., Whalley, B., Rees, K., et al. (2018). Psychological interventions for coronary heart disease: Cochrane systematic review and meta-analysis. European Journal of Preventive Cardiology, 25(3), 247–259. https://doi.org/10.1177/2047487317739978.

    Article  PubMed  Google Scholar 

  • Roest, A. M., Martens, E. J., de Jonge, P., & Denollet, J. (2010). Anxiety and risk of incident coronary heart disease: A meta-analysis. Journal of the American College of Cardiology, 56(1), 38–46. https://doi.org/10.1016/j.jacc.2010.03.034.

    Article  PubMed  Google Scholar 

  • Tully, P. J., Turnbull, D. A., Beltrame, J., Horowitz, J., Cosh, S., Baumeister, H., & Wittert, G. A. (2015). Panic disorder and incident coronary heart disease: A systematic review and meta-regression in 1 131 612 persons and 58 111 cardiac events. Psychological Medicine, 45(14), 2909–2920. https://doi.org/10.1017/S0033291715000963.

    Article  PubMed  Google Scholar 

  • Saab, P. G., Bang, H., Williams, R. B., Powell, L. H., Schneiderman, N., Thoresen, C., Burg, M., Keefe, F., & ENRICHD Investigators. (2009). The impact of cognitive-behavioral group training on event-free survival in patients with myocardial infarction: The ENRICHD experience. Journal of Psychosomatic Research, 67, 45–56. https://doi.org/10.1016/j.jpsychores.2009.01.015.

    Article  PubMed  PubMed Central  Google Scholar 

  • Schacter, D. L., Gilbert, D. T., & Wehner, D. M. (2010). Psychology (2nd ed.). New York, NY: Worth Publishers.

    Google Scholar 

  • Sharma, V., Doobay, M., & Baczynski, C. (2017). Bipolar postpartum depression: an update and recommendations. Journal of Affective Disorders, 219, 105–111. https://doi.org/10.1016/j.jad.2017.05.014.

    Article  PubMed  Google Scholar 

  • Stefan-Dabson, K., Mohammadkhani, P., & Massah-Choulabi, O. (2007). Psychometrics characteristic of Beck depression inventory-II in patients with major depressive disorder. Archives of Rehabilitation, 8, 82-90. [Persian].

  • Steptoe, A., & Kivimäki, M. (2013). Stress and cardiovascular disease: An update on current knowledge. Annual Review of Public Health, 34, 337–354. https://doi.org/10.1146/annurev-publhealth-031912-114452.

    Article  PubMed  Google Scholar 

  • Taylor, S.E., & Fiske, S.T. (2019). Interview with Shelley E. Taylor. Annual Review of Psychology, 70, 1–8. https://doi.org/10.1146/annurev-psych-041818-040645.

  • Vaccarino, V., Badimon, L., Bremner, J.D., Cenko, E., Cubedo, J., Dorobantu, M., Duncker D.J., Koller A., Manfrini O., Milicic D., Padro T., Pries A.R., Quyyumi A.A., Tousoulis D., Trifunovic D., Vasiljevic Z., de Wit C., Bugiardini R., ESC Scientific Document Group Reviewers, Lancellotti P., Carneiro A.V. (2019). Depression and coronary heart disease: 2018 ESC position paper of the working group on coronary pathophysiology and microcirculation developed under the auspices of the ESC Committee for practice guidelines. European Heart Journal, 0, 1–15. https://doi.org/10.1093/eurheartj/ehy913, 41.

Download references

Acknowledgments

I sincerely appreciate the Imam Reza Hospital of Mashhad for allowing me to carry out this research; I am also thankful to all patients with CHD referring to doctor Dargah’s office, for making the data available for this study.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mohammad Hossein Bayazi.

Ethics declarations

Conflict of Interest

The author declares that he has no competing interests.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nejati, M., Sharifinia, A., Maleki, M. et al. Comparison of the effectiveness of cognitive-behavioral group intervention for coronary heart disease and cognitive therapy in groups on type D personality and psychological distress on coronary heart patients- a randomized clinical trial. Curr Psychol 41, 4001–4011 (2022). https://doi.org/10.1007/s12144-020-00917-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12144-020-00917-8

Keywords

Navigation