Abstract
Cardiac patients’beliefs about the causes of their illness may influence their receptivity to psychosocial interventions. The purpose of this study was to determine whether depression or anxiety influence patients’ attributions about the causes of their heart disease. The primary hypothesis was that depressed or anxious patients are more likely to endorse negative emotions as among the causes of their heart disease than are patients who are not depressed or anxious. Sixty-nine patients with documented ischemic heart disease recruited from an exercise stress testing laboratory completed the Beck Depression and Anxiety Inventories and a heart disease attribution checklist. Univariate analyses confirmed that patients who are depressed or anxious are more likely than other patients to endorse negative emotions as causes of their heart disease. Anxiety but not depression was retained as an independent predictor of negative emotion attributions in a logistic regression analysis. We conclude that mood state influences cardiac patients’ beliefs about the causes of their heart disease.
Similar content being viewed by others
References
Ahern, D., Gorkin, L., Anderson, J., Tierney, C., Hallstrom, A., Ewart, C., et al. (1990). Biobehavioral variables and mortality or cardiac arrest in the Cardiac Arrhythmia Pilot Study (CAPS). American Journal of Cardiology, 66, 59–62.
Beck, A. T., & Emery, G. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988). An inventory for measuring clinical anxiety: Psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893–897.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. E., & Erbaugh, J. K. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 561–571.
Berkman, L. F., Leo-Summer, L., & Horwitz, R. I. (1992). Emotional support and survival after myocardial infarction. Annals of Behavioral Medicine, 117, 1003–1009.
Cameron, L., Leventhal, E. A., & Leventhal, H. (1995). Seeking medical care in response to symptoms and life stress. Psychosomatic Medicine, 57, 37–47.
Carney, R. M., Freedland, K. E., & Jaffe, A. S. (2001). Depression as a risk factor for coronary heart disease mortality. Archives of General Psychiatry, 58, 229–230.
Carney, R. M., Freedland, K. E., Veith, R. C., & Jaffe, A. S. (1999). Can treating depression reduce mortality after an acute myocardial infarction? Psychosomatic Medicine, 61, 666–675.
Carney, R. M., Rich, M. W., Freedland, K. E., Saini, J., teVelde, A., Simeone, C., et al. (1988). Major depressive disorder predicts cardiac events in patients with coronary artery disease. Psychosomatic Medicine, 50, 627–633.
Cox, D. R., & Snell, E. J. (1989). The analysis of binary data (2nd ed.). London: Chapman & Hall.
ENRICHD Investigators. (2000). Enhancing recovery in coronary heart disease patients (ENRICHD): Study design and methods. American Heart Journal, 139, 1–9.
Fava, M., Bless, E., Otto, M. W., Pava, J. A., & Rosenbaum, J. F. (1994). Dysfunctional attitudes in major depression: Changes with pharmacotherapy. Journal of Nervous & Mental Disease, 182, 45–49.
Frasure-Smith, N., Lespérance, F., & Talajic, M. (1993). Depression following myocardial infarction: Impact on 6-month survival. Journal of the American Medical Association, 270, 1819–1825.
Frasure-Smith, N., Lespérance, F., & Talajic, M. (1995). Depression and 18-month prognosis after myocardial infarction. Circulation, 91, 999–1005.
French, D. P., Senior, V., Weinman, J., & Marteau, T. (2001). Causal attributions for heart disease: A systematic review. Psychology and Health, 16, 77–98.
Gemar, M. C., Segal, Z. V., Sagrati, S., & Kennedy, S. J. (2001). Mood-induced changes on the Implicit Association Test in recovered depressed patients. Journal of Abnormal Psychology, 110, 282–289.
Mechanic, D. (1986). Illness behavior: An overview. In S. McHugh & T. M. Vallis (Eds.), Illness behavior: A multidisciplinary model (pp. 101–109). New York: Plenum.
Nagelkerke, N. J. D. (1991). A note on a general definition of the coefficient of determination. Biometrika, 78, 691–692.
Penninx, B. W. J. H., Beekman, A. T. F., Honig, A., Deeg, D. J. H., Schoevers, R. A., van Eijk, J. T. M., et al. (2001). Depression and cardiac mortality: Results from a community-based longitudinal study. Archives of General Psychiatry, 58, 221–227.
Petrie K. J., Weinman, J., Sharpe, N., & Buckley, J. (1996). Role of patients’ view of their illness in predicting return to work and functioning after myocardial infarction: Longitudinal study. British Medical Journal, 312, 1191–1194.
Robertson, R. M. (2001). Women and cardiovascular disease: The risks of misperception and the need for action. Circulation, 103, 2318–2320.
Safer, M. A., Tharps, Q. J., Jackson, T. C., & Leventhal, H. (1979). Determinants of three stages of delay in seeking care at a medical clinic. Medical Care, 17, 11–29.
Segal, Z. V., Gemar, M., & Williams, S. (1999). Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression. Journal of Abnormal Psychology, 108, 3–10.
Sensky, T. (1997). Causal attributions in physical illness. Journal of Psychosomatic Research, 43, 565–573.
Shores, M. M., Pascualy, M., & Veith, R. C. (1998). Major depression and heart disease: Treatment trials. Seminars in Clinical Neuropsychiatry, 3, 87–101.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Day, R.C., Freedland, K.E. & Carney, R.M. Effects of anxiety and depression on heart disease attributions. Int. J. Behav. Med. 12, 24–29 (2005). https://doi.org/10.1207/s15327558ijbm1201_4
Issue Date:
DOI: https://doi.org/10.1207/s15327558ijbm1201_4