Cardiac autonomic control and treatment of hostility: a randomized controlled trial.
Cardiac autonomic control and treatment of hostility: a randomized controlled trial.
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DOI：
10.1097/psy.0b013e3181c8a529
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发表时间：
2010-01
影响因子：
3.3
通讯作者：
Bigger JT Jr
中科院分区：
文献类型：
--
作者：
Sloan RP;Shapiro PA;Gorenstein EE;Tager FA;Monk CE;McKinley PS;Myers MM;Bagiella E;Chen I;Steinman R;Bigger JT Jr
To test whether reduction in hostility increases autonomic regulation of the heart. In this randomized controlled trial, participants were 158 healthy adults, 20–45 years of age, who were one SD above national norms on the Cook-Medley Hostility and the Spielberger Trait Anger Indices. Participants also were interviewed using the Interpersonal Hostility Assessment Technique (IHAT). They were randomly assigned to a 12-week cognitive behavior therapy (CBT) program for hostility reduction or a wait list control condition. The main outcome measure was cardiac autonomic modulation, measured as RR interval variability (RRV) derived from 24-ECG recordings. In a MANOVA assessing psychological outcomes of hostility, anger, and IHAT scores, there was a significant treatment effect with an average reduction across the three outcomes that was approximately .7 SD (ES=.685, se=.184, p<.001) greater for the intervention group than for the control group. In contrast, the change in HR was −0.14 bpm (95%CI= −2.43, 2.14) in treatment participants and −1.36 bpm (95%CI= −3.28, 0.61) in wait list participants. HF RRV, an index of cardiac parasympathetic modulation, increased by 0.07 ln msec2 (95%CI= −0.10, 0.24) for participants in the treatment condition and decreased by 0.04 ln msec2 (95%CI= −0.18, 0.10) for participants in the wait list condition. These differences were not significant. The findings for other indices of RRV were similar. Reduction of hostility and anger was not accompanied by increases in cardiac autonomic modulation. These findings raise questions about the status of disordered ANS regulation of the heart as a pathophysiological mechanism underlying the hostility – heart disease relationship and about whether hostility itself is a mechanism or merely a marker of elevated risk of heart disease. clinicaltrials.gov NCT00365196
