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Author Raffa, Susan Driscoll
Title Applying a triple vulnerabilities theory of emotional disorders to noncardiac chest pain
book jacket
Descript 126 p
Note Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0557
Adviser: David H. Barlow
Thesis (Ph.D.)--Boston University, 2006
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
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
School code: 0017
Host Item Dissertation Abstracts International 67-01B
Subject Psychology, Clinical
Alt Author Boston University
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