Association of Trait Resilience With Peritraumatic and Posttraumatic Stress in Patients With Myocardial Infarction

Abstract

Objective: Acute myocardial infarction (MI) is a life-threatening condition, leading to immediate fear and distress in many patients. Approximately 18% of patients develop posttraumatic stress disorder in the aftermath of MI. Trait resilience has shown to be a protective factor for the development of posttraumatic stress disorder. However, whether this buffering effect has already an impact on peritraumatic distress and applies to patients with MI is elusive. Methods: We investigated 98 consecutive patients with acute MI within 48 hours after having reached stable circulatory conditions and 3 months thereafter. Peritraumatic distress was assessed retrospectively with three single-item questions about pain, fear, and helplessness during MI. All patients completed the Posttraumatic Diagnostic Scale (PDS) and the Resilience Scale to self-rate posttraumatic stress and trait resilience. Results: Multivariate models adjusting for sociodemographic and medical factors showed that trait resilience was not associated with peritraumatic distress, but significantly so with posttraumatic stress. Patients with greater trait resilience showed lower PDS scores (b = −0.06, p < .001). There was no significant relationship between peritraumatic distress scores and PDS scores; resilience did not emerge as a moderator of this relationship. Conclusions: The findings suggest that trait resilience does not buffer the perception of acute MI as stressful per se but may enhance better coping with the traumatic experience in the longer term, thus preventing the development of MI-associated posttraumatic stress. Trait resilience may play an important role in posttraumatic stress symptoms triggered by medical diseases such as acute MI. Trait resilience has shown to be a protective factor for the development of posttraumatic stress disorder. However, whether this buffering effect has already an impact on peritraumatic distress and applies to patients with MI is elusive. Methods: We investigated 98 consecutive patients with acute MI within 48 hours after having reached stable circulatory conditions and 3 months thereafter. Peritraumatic distress was assessed retrospectively with three single-item questions about pain, fear, and helplessness during MI. All patients completed the Posttraumatic Diagnostic Scale (PDS) and the Resilience Scale to self-rate posttraumatic stress and trait resilience. Results: Multivariate models adjusting for sociodemographic and medical factors showed that trait resilience was not associated with peritraumatic distress, but significantly so with posttraumatic stress. Patients with greater trait resilience showed lower PDS scores (b = −0.06, p < .001). There was no significant relationship between peritraumatic distress scores and PDS scores; resilience did not emerge as a moderator of this relationship. Conclusions: The findings suggest that trait resilience does not buffer the perception of acute MI as stressful per se but may enhance better coping with the traumatic experience in the longer term, thus pr...

Posttraumatic Stress Disorder Following Myocardial Infarction: A Systematic Review

“…Several of the included studies showed that younger people (Guler et al., 2009; Hari et al., 2010; Kronish et al., 2018; von Känel et al., 2011) and women (Fortin et al., 2013; Hari et al., 2010; Husain et al., 2017; Kronish et al., 2018; Meister, Princip, et al., 2016; Roberge et al., 2010; von Känel et al., 2011) are at higher risk of developing PTSD compared with older individuals and men, whereas several investigations could not confirm these results (Gao et al., 2015; Guler et al., 2009; Lima et al., 2018; Marke & Bennett, 2013; Sumner et al., 2015; Wikman et al., 2012). There is no research evidence to support the positive effect of socioeconomic status on an individual's risk of developing PTSD (Wikman et al., 2012).…”

“…Findings also demonstrated associations between PTSD secondary to MI and certain personality traits, such as anxious attachment (Gao et al., 2015) or alexithymia, which results in difficulty identifying and expressing emotions (Gao et al., 2015; Marke & Bennett, 2013). In contrast, personality traits such as resilience, characterized by a sense of personal competence and acceptance of self and existence, were shown to be a protective factor for PTSD after MI (Meister, Princip, et al., 2016).…”

Peritraumatic distress: A review and synthesis of 15 years of research

“…Still others have utilized the DSM-IV Criterion A2 by using three questions to assess peritraumatic fear, helplessness, and horror (Blix, Hansen, Birkeland, Nissen, & Heir, 2013;Boelen, 2015). In the myocardial infarction literature, multiple studies have assessed peritraumatic reactions using three questions about fear of dying, helplessness, and pain (Meister et al, 2016;von Känel, Hari, Schmid, Saner, & Begré, 2011;Wiedemar et al, 2008). However, we found the PDI to surpass other measures in terms of reliability and validity across populations and languages and in terms of frequency of use (the PDI was used in the majority of studies on peritraumatic distress in our literature search).…”

The Impact of Resilience, Alexithymia and Subjectively Perceived Helplessness of Myocardial Infarction on the Risk of Posttraumatic Stress

“…Despite this, not necessarily every patient develops PTSD after MI. A possible explanation for this observation could be individual protective factors, such as resilience (Meister et al, 2016 ). Resilience can be described as an optimal adaption process after critical life events or even as the positive outcome after traumatic events (Agaibi & Wilson, 2005 ; Meister et al, 2016 ).…”