Gholam Reza Nikrahan1, Johannes A C Laferton2, Karim Asgari3, Mehrdad Kalantari3, Mohammad Reza Abedi4, Ali Etesampour5, Abbas Rezaei6, Laura Suarez7, Jeff C Huffman7. 1. Department of Psychology, University of Isfahan, Isfahan, Iran; Department of Psychology, Islamic Azad University of Borujen, Borujen, Iran. Electronic address: rezanikrahan@yahoo.com. 2. Department of Psychiatry, Brigham and Women's Hospital, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA. 3. Department of Psychology, University of Isfahan, Isfahan, Iran. 4. Department of Consulting, University of Isfahan, Isfahan, Iran. 5. Department of Internal Medicine, Najafabad Islamic Azad University, Najafabad, Iran. 6. Department of Immunology, Isfahan University of Medical Sciences, Isfahan, Iran. 7. Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, Massachusetts General HospitalBoston, MA.
Abstract
BACKGROUND: Among cardiac patients, positive psychologic factors are consistently linked with superior clinical outcomes and improvement in key markers of inflammation and hypothalamic-pituitary-adrenal axis functioning. Further, positive psychology interventions (PPI) have effectively increased psychologic well-being in a wide variety of populations. However, there has been minimal study of PPIs in cardiac patients, and no prior study has evaluated their effect on key prognostic biomarkers of cardiac outcome. Accordingly, we investigated the effect of 3 distinct PPIs on risk biomarkers in cardiac patients. METHODS: In an exploratory trial, 69 patients with recent coronary artery bypass graft surgery or percutaneous intervention were randomized to (1) one of three 6-week in-person PPIs (based on the work of Seligman, Lyubomirsky, or Fordyce) or (2) a wait-list control group. Risk biomarkers were assessed at baseline, postintervention (7 weeks), and at 15-week follow-up. Between-group differences in change from baseline biomarker levels were examined via random effects models. RESULTS: Compared with the control group, participants randomized to the Seligman (B = -2.06; p = 0.02) and Fordyce PPI (B = -1.54; p = 0.04) had significantly lower high-sensitivity C-reactive protein levels at 7 weeks. Further, the Lyubomirsky PPI (B = -245.86; p = 0.04) was associated with a significantly lower cortisol awakening response at 7 weeks when compared with control participants. There were no other significant between-group differences. CONCLUSION: Despite being an exploratory pilot study with multiple between-group comparisons, this initial trial offers the first suggestion that PPIs might be effective in reducing risk biomarkers in high-risk cardiac patients.
RCT Entities:
BACKGROUND: Among cardiac patients, positive psychologic factors are consistently linked with superior clinical outcomes and improvement in key markers of inflammation and hypothalamic-pituitary-adrenal axis functioning. Further, positive psychology interventions (PPI) have effectively increased psychologic well-being in a wide variety of populations. However, there has been minimal study of PPIs in cardiac patients, and no prior study has evaluated their effect on key prognostic biomarkers of cardiac outcome. Accordingly, we investigated the effect of 3 distinct PPIs on risk biomarkers in cardiac patients. METHODS: In an exploratory trial, 69 patients with recent coronary artery bypass graft surgery or percutaneous intervention were randomized to (1) one of three 6-week in-person PPIs (based on the work of Seligman, Lyubomirsky, or Fordyce) or (2) a wait-list control group. Risk biomarkers were assessed at baseline, postintervention (7 weeks), and at 15-week follow-up. Between-group differences in change from baseline biomarker levels were examined via random effects models. RESULTS: Compared with the control group, participants randomized to the Seligman (B = -2.06; p = 0.02) and Fordyce PPI (B = -1.54; p = 0.04) had significantly lower high-sensitivity C-reactive protein levels at 7 weeks. Further, the Lyubomirsky PPI (B = -245.86; p = 0.04) was associated with a significantly lower cortisol awakening response at 7 weeks when compared with control participants. There were no other significant between-group differences. CONCLUSION: Despite being an exploratory pilot study with multiple between-group comparisons, this initial trial offers the first suggestion that PPIs might be effective in reducing risk biomarkers in high-risk cardiac patients.
Authors: Christina M Dubois; Scott R Beach; Todd B Kashdan; Maren B Nyer; Elyse R Park; Christopher M Celano; Jeff C Huffman Journal: Psychosomatics Date: 2012 Jul-Aug Impact factor: 2.386
Authors: Lana L Watkins; Gary G Koch; Andrew Sherwood; James A Blumenthal; Jonathan R T Davidson; Christopher O'Connor; Michael H Sketch Journal: J Am Heart Assoc Date: 2013-03-19 Impact factor: 5.501
Authors: Laura D Kubzansky; Jeff C Huffman; Julia K Boehm; Rosalba Hernandez; Eric S Kim; Hayami K Koga; Emily H Feig; Donald M Lloyd-Jones; Martin E P Seligman; Darwin R Labarthe Journal: J Am Coll Cardiol Date: 2018-09-18 Impact factor: 24.094
Authors: Janice Hegewald; Uta E Wegewitz; Ulrike Euler; Jaap L van Dijk; Jenny Adams; Alba Fishta; Philipp Heinrich; Andreas Seidler Journal: Cochrane Database Syst Rev Date: 2019-03-14