LEADER 00000nam  2200313   4500 
001    AAI3202569 
005    20081217100426.5 
008    081217s2006    ||||||||||||||||| ||eng d 
020    9780542506727 
035    (UMI)AAI3202569 
040    UMI|cUMI 
100 1  Raffa, Susan Driscoll 
245 10 Applying a triple vulnerabilities theory of emotional 
       disorders to noncardiac chest pain 
300    126 p 
500    Source: Dissertation Abstracts International, Volume: 67-
       01, Section: B, page: 0557 
500    Adviser: David H. Barlow 
502    Thesis (Ph.D.)--Boston University, 2006 
520    The term noncardiac chest pain is used to describe the 
       experience of chest pain in the absence of coronary artery
       disease or other medical explanations. It is a 
       multidisciplinary problem and is associated with 
       significant health care utilization, disability, and 
       psychiatric morbidity. Current theories of the etiology 
       and maintenance of the syndrome are based on cognitive-
       behavioral theories, specifically empirically supported 
       models of panic and anxiety. In the current study, a 
       triple vulnerabilities theory of the development and 
       maintenance of emotional disorders was applied. 
       Specifically, behavioral inhibition, perceived emotional 
       control, and anxiety sensitivity were hypothesized to be 
       significant contributors to chest pain symptoms. In 
       addition, it was hypothesized that the relationship 
       between behavioral inhibition and chest pain symptoms 
       would be moderated by anxiety sensitivity and by perceived
       emotional control. The current study also evaluated 
       psychiatric morbidity and explored the nature of previous 
       learning history related to cardiac and life-threatening 
       medical events 
520    A total of 222 individuals with chest pain without history
       of cardiac disease were recruited for participation 
       subsequent to negative findings on exercise tolerance 
       testing. Participants completed a questionnaire battery 
       and 133 participants completed a semi-structured interview
       used to diagnose anxiety and mood disorders, as well as 
       somatoform and substance-use disorders. Results indicated 
       that nearly half of the participants completing the 
       diagnostic interview were diagnosed with one or more 
       psychiatric disorders. Psychiatric morbidity was 
       significantly associated with chest pain that was more 
       frequent, intense, and associated with more interference 
       and distress. Application of the triple vulnerabilities 
       theory revealed a significant relationship between anxiety
       sensitivity and chest pain symptoms. In addition, there 
       was a significant moderating effect of perceived emotional
       control on the relationship between behavioral inhibition 
       and chest pain symptoms. Analysis of learning history 
       related to cardiac and life threatening events revealed 
       high frequencies of both witnessing and having knowledge 
       of such events in others. Contrary to prediction, positive
       learning history for such events was not significantly 
       associated with impairment or distress related to chest 
       pain. Results of the study suggest significant psychiatric
       morbidity related to noncardiac chest pain, as well as a 
       significant emotional component 
590    School code: 0017 
590    DDC 
650  4 Psychology, Clinical 
690    0622 
710 2  Boston University 
773 0  |tDissertation Abstracts International|g67-01B 
856 40 |uhttp://pqdd.sinica.edu.tw/twdaoapp/servlet/