Self-Efficacy and Recovery from Heart Attack

Implications for a Social Cognitive Analysis of Exercise and Emotion
  • Craig K. Ewart
Part of the The Plenum Series in Social/Clinical Psychology book series (SSSC)


Coronary heart disease continues to be the leading health threat to citizens of developed nations; in the United States alone, diseases of the heart and vasculature cause over a half-million premature deaths annually while contributing to nearly as many cases of preventable disability (Gunby, 1992). One’s chances of surviving a heart attack (acute myocardial infarction, AMI) have increased in recent years due to important innovations in emergency and postcoronary care. Yet survivors still face disabling difficulties that most health care providers are ill-prepared to detect and poorly equipped to treat (Ben-Sira & Eliezer, 1990; Fontana, Kerns, Rosenberg, & Colonese, 1989).


Exercise Training Heart Attack Aerobic Power Cardiac Rehabilitation Program Coronary Artery Bypass Graft Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  2. Bandura, A. (1990). Perceived self-efficacy in the exercise of personal agency. Applied Sports Psychology, 2, 128–163.CrossRefGoogle Scholar
  3. Bandura, A., & Cervone, D. (1983). Self-evaluative and self-efficacy mechanisms governing the motivational effects of goal systems. Journal of Personality and Social Psychology, 45, 1017–1028.CrossRefGoogle Scholar
  4. Ben-Sira, Z., & Eliezer, R. (1990). The structure of readjustment after heart attack. Social Science and Medicine, 30, 523–536.PubMedCrossRefGoogle Scholar
  5. Bersheid, E. (1983). Emotion. In H. Kelley, E. Bersheid, A. Christensen, J. H. Harvey, T. L. Huston, G. Levinger, E. McClintock, L. A. Peplau, & D. R. Peterson (Eds.), Close relationships (pp. 110–168 ). New York: Freeman.Google Scholar
  6. Boutcher, S. H., & Landers, D. M. (1988). The effects of vigorous exercise on anxiety, heart rate, and alpha activity of runners and nonrunners. Psychophysiology, 25, 696–702.PubMedCrossRefGoogle Scholar
  7. Bower, G. H. (1981). Mood and memory. American Psychologist, 36, 129–148.PubMedCrossRefGoogle Scholar
  8. Brown, J. D. (1991). Staying fit and staying well: Physical fitness as a moderator of life stress. Journal of Personality and Social Psychology, 60, 555–561.PubMedCrossRefGoogle Scholar
  9. Cioffi, D. (1991). Beyond attentional strategies: A cognitive-perceptual model of somatic interpretation. Psychological Bulletin, 109, 25–41.PubMedCrossRefGoogle Scholar
  10. Coyne, J. C., & Smith, D. A. E (1991). Couples coping with a myocardial infarction: A contextual perspective on wives’ distress. Journal of Personality and Social Psychology, 61, 404–412.PubMedCrossRefGoogle Scholar
  11. Davidson, R. J., Ekman, P., Saron, C. D., Senulis, J. A., & Friesen, W. V. (1990). Approach-withdrawal and cerebral asymmetry: Emotional expression and brain physiology I. Journal of Personality and Social Psychology, 58, 330–341.Google Scholar
  12. DeBusk, R. E, Blomqvist, C. G., Kouchoukous, N. T., Luepker, R. V., Miller, H. S., Moss, A. J., Pollock, M. L., Reeves, T. J., Selvester, R. H., Stason, W. B., Wagner, G. S., & Willman, V. L. (1986). Identification and treatment of low-risk patients after acute myocardial infarction and coronary-artery bypass graft surgery. New England Journal of Medicine, 314, 161–166.PubMedCrossRefGoogle Scholar
  13. Desharnais, R., Jobin, J., Cote, C., Levesque, L., & Godin, G. (1993). Aerobic exercise and the placebo effect: A controlled study. Psychosomatic Medicine, 55, 149–154.PubMedGoogle Scholar
  14. Ekman, P., Levenson, R. W., & Friesen, W. V. (1983). Autonomic nervous system activity distinguishes among emotions. Science, 221, 1208–1210.PubMedCrossRefGoogle Scholar
  15. Emmons, R. A. (1986). Personal strivings: An approach to personality and subjective wellbeing. Journal of Personality and Social Psychology, 51, 1058–1068.CrossRefGoogle Scholar
  16. Ewart, C. K. (1989). Psychological effects of resistive weight training: Implications for cardiac patients. Medicine and Science in Sports and Exercise, 21, 683–688.PubMedGoogle Scholar
  17. Ewart, C. K. (1990). A social problem-solving approach to behavior change in coronary heart disease. In S. Schumaker, E. Schron, & J. Ockene (Eds.), Handbook of health behavior change (pp. 153–190 ). New York: Springer.Google Scholar
  18. Ewart, C. K. (1991). Social action theory for a public health psychology. American Psychologist, 46, 931–946.PubMedCrossRefGoogle Scholar
  19. Ewart, C. K. (1992). Self-efficacy and recovery from acute myocardial infarction. In R. Schwarzer (Ed.), Self-efficacy: Thought control of action (pp. 287–304 ). New York: Springer.Google Scholar
  20. Ewart, C. K. (1993). Editorial: Marital interaction-The context for psychosomatic research. Psychosomatic Medicine, 55, 410–412.PubMedGoogle Scholar
  21. Ewart, C. K., Stewart, K. J., Gillilan, R. E., & Kelemen, M. H. (1986). Self-efficacy mediates strength gains during circuit weight training in men with coronary artery disease. Medicine and Science in Sports and Exercise, 18, 531–540.PubMedGoogle Scholar
  22. Ewart, C. K., Stewart, K. J., Gillilan, R. E., Kelemen, M. H., Valenti, S. A., Manley, J. D., & Kelemen, M. D. (1986). Usefulness of self-efficacy in predicting overexertion during programmed exercise in coronary artery disease. American Journal of Cardiology, 57, 557–561.PubMedCrossRefGoogle Scholar
  23. Ewart, C. K., & Taylor, C. B. (1985). The effects of early postmyocardial infarction exercise testing on subsequent quality of life. Quality of Life and Cardiovascular Care, 1, 162–175.Google Scholar
  24. Ewart, C. K., Taylor, C. B., Reese, L. B., & DeBusk, R. F. (1983). Effects of early postmyocardial infarction exercise testing on self-perception and subsequent physical activity. American Journal of Cardiology, 51, 1076–1080.PubMedCrossRefGoogle Scholar
  25. Folkins, C. H., & Sime, W. E. (1981). Physical fitness training and mental health. American Psychologist, 36, 373–389.PubMedCrossRefGoogle Scholar
  26. Fontana, A. F., Kerns, R. D., Rosenberg, R. L., & Colonese, K. L. (1989). Support, stress, and recovery from coronary heart disease: A longitudinal causal model. Health Psychology, 8, 175–193.PubMedCrossRefGoogle Scholar
  27. Frijda, N. H., Kuipers, P., & Ter Schure, E. (1989). Relations among emotion, appraisal, and emotional action readiness. Journal of Personality and Social Psychology, 57, 212–228.CrossRefGoogle Scholar
  28. Gunby, P. (1992). Cardiovascular diseases remain nation’s leading cause of death. Journal of the American Medical Association, 267, 335–336.PubMedCrossRefGoogle Scholar
  29. Hackett, T. P., Cassem, N. H., & Wishnie, H. A. (1968). The coronary care unit: An appraisal of its psychologic hazards. New England Journal of Medicine, 279, 1365–1370.PubMedCrossRefGoogle Scholar
  30. Kavanagh, D. J., & Bower, G. H. (1985). Mood and self-efficacy: Impact of joy and sadness on perceived capabilities. Cognitive Therapy and Research, 9, 507–525.Google Scholar
  31. Kiecolt-Glaser, J. K., Malarkey, W. B., Chee, M. A., Newton, T., Cacioppo, J. T., Mao, J. Y., & Glaser, R. (1993). Negative behavior during marital conflict is associated with immunological down-regulation. Psychosomatic Medicine, 55, 395–409.PubMedGoogle Scholar
  32. Lazarus, R. S. (1991a). Progress on a cognitive-motivational-relational theory of emotion. American Psychologist, 46, 819–834.PubMedCrossRefGoogle Scholar
  33. Lazarus, R. S. (1991b). Emotion and adaptation. New York: Oxford University Press.Google Scholar
  34. Levenson, R. W. (1988). Emotion and the autonomic nervous system: A prospectus for research on autonomic specificity. In H. Wagner (Ed.), Social psychophysiology and emotion: 17–42 ). London: Wiley.Google Scholar
  35. Martin, J. E., Dubbert, P. M., Katell, A. D., Thompson, J. K., Raczynski, J. R., Lake, M., Smith, P. O., Webster, J. S., Sikora, T., & Cohen, R. E. (1984). Behavioral control of exercise in sedentary adults: Studies 1 through 6. Journal of Consulting and Clinical Psychology, 52, 795–811.PubMedCrossRefGoogle Scholar
  36. McNair, D. M., Lorr, M., & Droppleman, L. F. (1981). Manual for the Profile of Mood States. San Diego, CA: Educational and Industrial Testing Service.Google Scholar
  37. Miller, N. H., Haskell, W. L., Berra, K., & DeBusk, R. F. (1984). Home versus group exercise training for increasing functional capacity after myocardial infarction. Circulation, 70, 645–649.PubMedCrossRefGoogle Scholar
  38. Morgan, W. P. (1985). Affective beneficence of vigorous physical activity. Medicine and Science in Sports and Exercise, 6, 422–425.Google Scholar
  39. O’Connor, G. T., Buring, J. E., Yusuf, S., Goldhaber, S. Z., Olmstead, E. M., Paffenbarger, R. S., & Hennekens, C. H. (1989). An overview of randomized trials of rehabilitation with exercise after myocardial infarction. Circulation, 80, 234–244.Google Scholar
  40. Pennebaker, J. W. (1982). The psychology of physical symptoms. New York: Springer-Verlag.CrossRefGoogle Scholar
  41. Pickering, T. G. (1989). Ambulatory monitoring: Applications and limitations. In N. Schnei-derman, S. Weiss, & P. Kaufman (Eds.), Handbook of research methods in cardiovascular behavioral medicine (pp. 261–272 ), New York: Plenum Press.Google Scholar
  42. Ross, C. E., & Hayes, D. (1988). Exercise and psychologic well-being in the community. American Journal of Epidemiology127, 762–761. Google Scholar
  43. Salazar, W., Petruzzello, S. J., Landers, D. M., Etnier, J. L., & Kubitz, K. A. (1993). Meta-analytic techniques in exercise psychology. In P. Seraganian (Ed.) Exercise psychology: The influence of physical exercise on psychological processes (pp. 122–145). New York: Wiley. Google Scholar
  44. Schachter, S. (1966). The interaction of cognitive and physiological determinants of emotional state. In C. D. Spielberger (Ed.), Anxiety and behavior (pp. 193–224 ). New York: Academic Press.Google Scholar
  45. Steptoe, A., & Cox, S. (1988). Acute effects of aerobic exercise on mood. Health Psychology 7329–340. Google Scholar
  46. Stewart, K. J., Kelemen, M. H., & Ewart, C. K. (1993). Relationships between self-efficacy and mood before and after exercise training. Journal of Cardiopulmonary Rehabilitation, 14, 35–42.CrossRefGoogle Scholar
  47. Taylor, C. B., Bandura, A., Ewart, C. K., Miller, N. H., & DeBusk, R. F. (1985). Exercise testing to enhance wives’ confidence in their husband’s capability soon after clinically uncomplicated myocardial infarction. American Journal of Cardiology, 55, 636–628.CrossRefGoogle Scholar
  48. Taylor, C. B., Sallis, J. E, & Needle, R. (1985). The relation of physical activity and exercise to mental health. Public Health Reports, 100, 195–202.PubMedGoogle Scholar
  49. Tellegen, A. (1985). Structures of mood and personality and their relevance to assessing anxiety, with an emphasis on self-report. In A. H. Tuma & J. D. Maser (Eds.), Anxiety and the anxiety disorders (pp. 681–706 ). Hillsdale, NJ: Erlbaum.Google Scholar
  50. Tuson, K. M., & Sinyor, D. (1993). On the affective benefits of acute aerobic exercise: Taking stock after twenty years of research. In P. Seraganian (Ed.) Exercise psychology: The influence of physical exercise on psychological processes (pp. 80–121). New York: Wiley. Google Scholar
  51. Watson, D. W., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology 541063–1070. Google Scholar
  52. Watson, D. W., & Pennebaker, J. W. (1989). Health complaints, stress, and distress: Exploring the central role of negative affectivity. Psychological Review, 96, 234–254.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Craig K. Ewart
    • 1
  1. 1.School of Public HealthJohns Hopkins UniversityBaltimoreUSA

Personalised recommendations