Cardiac Threat Appraisal and Depression after First Myocardial Infarction

Abstract

The present study investigated cardiac threat appraisal and its association with depression after first myocardial infarction (MI). A semi-structured interview allowing for DSM-IV-axis I diagnoses was administered to 36 patients after first MI. Patients completed self-reports 5–15 days after the MI (time 1), 6–8 weeks later (time 2), and again 6 months later (time 3). Assessments at time 1 included indices of cardiac threat appraisal, locus of control, coping, and depression while at time 2 and time 3 only measures of depression were obtained. Cardiac threat appraisal was significantly correlated with depression at time 1, but was unrelated to depression scores at time 2 and time 3. Furthermore, there was a significant inverse association between cardiac threat appraisal and the subscales “search for affiliation” and “threat minimization” of the coping questionnaire. Additionally, “search for affiliation” correlated negatively with depression scores at time 1 and time 3, and “threat minimization” negatively with depression scores at time 1 and time 2. These results suggest a significant association between cardiac threat appraisal and depressive symptoms shortly after MI. Practical implications for treatment are discussed.

Cardiac Disease, Coping with

“…Recent studies did find support for the relevance of rumination both for self-reported cardiac symptoms such as fatigue or sleep problems (León et al, 2010) and for depressive symptoms (e.g., Garnefski and Kraaji, 2010), although not consistently. However, Vögele et al (2012) did not observe any associations of rumination with future depression (self-reported and clinically diagnosed according DSM-IV) in patients after an MI. However, Vögele et al (2012) did not observe any associations of rumination with future depression (self-reported and clinically diagnosed according DSM-IV) in patients after an MI.…”

“…This might be particularly relevant for those patients who perceive their health condition as controllable (Park et al, 2012). Interestingly, patients who perceived higher threat reported to make less use of these strategies (Vögele et al, 2012). In the study by Vögele et al (2012), the coping strategies 'threat minimization' and 'search for affiliation' were associated with lower depression scores immediately after the MI and up to 6 months later (Vögele et al, 2012).…”

“…Threat appraisals, i.e., appraising disease-related stressors as harmful to one's physical and emotional well-being, have been cross-sectionally linked to a diagnosis and to symptoms of depression in patients hospitalized because of an MI (e.g., Vögele et al, 2012). Longitudinally, threat appraisal contributed to the development of depressive symptoms after 6 months in patients with chronic HF, whereas challenge appraisal was unrelated to depression (Park et al, 2006).…”

“…A composite labeled 'active coping' also helped to counter depressive symptoms assessed after 6 months in patients with chronic HF (Park et al, 2006). In the study by Vögele et al (2012), the coping strategies 'threat minimization' and 'search for affiliation' were associated with lower depression scores immediately after the MI and up to 6 months later (Vögele et al, 2012). Garnefski and Kraaji (2010) emphasized that approaching the stressor 'cardiac disease' by finding new goals in one's life (goal reengagement) contributes to a stable low level of depressive symptoms.…”

Behavioral Medicine

“…In a longitudinal study on cardiac patients, for example, 'threat minimization' and 'search for affiliation' assessed only days after a MI both predicted lower depression scores 2 and 6 months after the MI, respectively, suggesting an important prognostic role for cognitive appraisal processes in the early period after a cardiac event (Vögele et al, 2012). In a longitudinal study on cardiac patients, for example, 'threat minimization' and 'search for affiliation' assessed only days after a MI both predicted lower depression scores 2 and 6 months after the MI, respectively, suggesting an important prognostic role for cognitive appraisal processes in the early period after a cardiac event (Vögele et al, 2012).…”