Document Detail


Cardiac autonomic control and treatment of hostility: a randomized controlled trial.
MedLine Citation:
PMID:  20028833     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
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:
Title:  Psychosomatic medicine     Volume:  72     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-08     Completed Date:  2010-03-09     Revised Date:  2013-05-31    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1-8     Citation Subset:  IM    
Affiliation:
Division of Behavioral Medicine, Department of Psychiatry, Columbia University Medical Center, New York, NY 10032, USA. rps7@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
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:
K02 MH01491/MH/NIMH NIH HHS; R01 HL063872/HL/NHLBI NIH HHS; R01 HL63872/HL/NHLBI NIH HHS
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