The association of friedman's pathogenic emotions (AIAI) with current smoking, but not smoking history, in males suspected of coronary artery disease (CAD)

Abstract

The role of Friedman's pathogenic emotions (aggravation, irritation, anger and impatience or AIAI) in the initiation or aggravation of ischemic coronary heart disease (ICHD) may be due to direct neural/neuroendocrine factors or to indirect influences on other risk factors, such as smoking. In two studies of independent samples, data collected during an initial interview with male patients undergoing coronary angiography included (a) packyears of smoking and (b) current smoking status. The Jenkins Activity Survey (JAS), Life Change Scale (LCS) and Ketterer Stress Symptom Frequency Checklist (KSSFC) were administered during the first study. A mean split comparing high versus low groupings on each of the psychometric scales demonstrated that patients displaying Type B (44 per cent versus 22 per cent), depressive (53 per cent versus 22 per cent), anxious (44 per cent versus 26 per cent) and AIAI (51 per cent versus 23 per cent) characteristics were more likely to be current smokers ( JJ < 0.05) while not being any different from their counterparts in smoking history. In a second sample of 149 male angiography patients who were better educated and from a different region of the country, the KSSFC, Framingham Type A Scale, Cooke-Medley Hostility Scale (CMHS) and Perceived Social Support Scale were used. Only the AIAI Scale (25 per cent versus 12 per cent) and CMHS (26 per cent versus 12 per cent) were positively associated with current smoking, again independent of any baseline difference in smoking history. Present results are most parsimoniously explained by the thesis that high levels of AIAI interfere with smoking cessation or relapse avoidance.

Psychosocial and Traditional Risk Factors in Early Ischaemic Heart Disease: Cross-Sectional Correlates

“…It is probable that emotional distress adversely influences the other risk factors. For example, smoking cessation and relapse prevention [19], the development of hypertension [20][21][22], medication compliance [23], adherence to exercise regimens [24] and compliance in diabetes [25] all appear to be adversely influenced by emotional distress. Thus, distress may represent a common aggravating pathway for many of the traditional risk factors, as well as having a direct 'psychophysiological' impact on disease onset or aggravation [26][27][28].…”

Psychological Correlates of Mental Stress-induced Ischemia in the Laboratory

“…The ability of such stressors to induce ischemia is impressive given that the mental stressors used in laboratory studies are shorter and less intense than many real-life psychosocial stressors. The role of mental stress in prospective epidemiological studies of ischemic heart disease endpoints (Dembroski et al, 1989;Frasure-Smith et al, 1995b;Kawachi et al, 1994b) may be mediated at least in part by direct neural or neuroendocrine mechanisms, in addition to any impact such stress has on behavioral mechanisms such as smoking cessation/maintenance and medication/exercise/dietary compliance (Carney, Freedland, Eisen, Rich, & Jaffe, 1995;Ketterer & Maercklein, 1992).…”

Effects of Personality Style, Anxiety, and Depression on Reported Reasons for Smoking1

“…They do not experience the sense of urgency that is characteristic of the Type A style. Although Ketterer and Maercklein (1992) found no differences in the smoking histories of Type A and Type B personalities, the possibility that each of these personality styles is associated with different reasons for smoking has not been investigated.…”