| Cardiac autonomic control and treatment of hostility: a randomized controlled trial. | |
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MedLine Citation:
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PMID: 20028833 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To test whether reduction in hostility increases autonomic regulation of the heart. METHODS: In this randomized controlled trial, participants were 158 healthy adults, aged 20 years to 45 years, who were 1 standard deviation (SD) above national norms on the Cook-Medley Hostility and the Spielberger Trait Anger Indices. Participants also were interviewed, using the Interpersonal Hostility Assessment Technique (IHAT). They were randomly assigned to a 12-week cognitive behavior therapy program for hostility reduction or a wait-list control condition. The main outcome measure was cardiac autonomic modulation, measured as RR interval variability (RRV) derived from 24-electrocardiographic recordings. RESULTS: In a multivariate analysis of variance assessing psychological outcomes of hostility, anger, and IHAT scores, there was a significant treatment effect with an average reduction across the three outcomes that was approximately 0.7 SD (ES = 0.685, SE = 0.184, p < .001) greater for the intervention group than for the control group. In contrast, the change in heart rate was -0.14 beat/min (95% Confidence Interval [CI] = -2.43, 2.14) in treatment participants and -1.36 beat/min (95% CI = -3.28, 0.61) in wait-list participants. High-frequency RRV, an index of cardiac parasympathetic modulation, increased by 0.07 ln ms(2) (95% CI = -0.10, 0.24) for participants in the treatment condition and decreased by 0.04 ln ms(2) (95% CI = -0.18, 0.10) for participants in the wait-list condition. These differences were not significant. The findings for other indices of RRV were similar. CONCLUSIONS: Reduction of hostility and anger was not accompanied by increases in cardiac autonomic modulation. These findings raise questions about the status of disordered autonomic nervous system regulation of the heart as a pathophysiological mechanism underlying the hostility-heart disease relationship and about whether hostility itself is a mechanism or merely a marker of elevated risk of heart disease. |
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Authors:
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Richard P Sloan; Peter A Shapiro; Ethan E Gorenstein; Felice A Tager; Catherine E Monk; Paula S McKinley; Michael M Myers; Emilia Bagiella; Ivy Chen; Richard Steinman; J Thomas Bigger |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Date: 2009-12-22 |
Journal Detail:
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Title: Psychosomatic medicine Volume: 72 ISSN: 1534-7796 ISO Abbreviation: Psychosom Med Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-08 Completed Date: 2010-03-09 Revised Date: 2013-05-13 |
Medline Journal Info:
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Nlm Unique ID: 0376505 Medline TA: Psychosom Med Country: United States |
Other Details:
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Languages: eng Pagination: 1-8 Citation Subset: IM |
Affiliation:
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Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA. rps7@columbia.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Analysis of Variance Anger Autonomic Nervous System / physiology*, physiopathology Autonomic Nervous System Diseases / physiopathology Blood Pressure / physiology Cognitive Therapy / methods* Coronary Disease / epidemiology, physiopathology Electrocardiography, Ambulatory / methods, statistics & numerical data* Female Heart / innervation*, physiopathology Heart Rate / physiology Hostility* Humans Male Middle Aged Outcome Assessment (Health Care) Personality Inventory Questionnaires Risk Factors Waiting Lists |
| Grant Support | |
ID/Acronym/Agency:
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K02 MH01491/MH/NIMH NIH HHS; R01 HL063872/HL/NHLBI NIH HHS; R01 HL63872/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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