HOSTILITY REDUCTION AND AUTONOMIC CONTROL OF THE HEART

减少敌意和心脏的自主控制

• 批准号: 6390569
• 负责人: Richard P SLOAN
• 金额: $ 50.72万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-06-01 至 2004-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6390569
• 关键词: adult human (21+); angers; anxiety; autogenic training; autonomic nervous system; baroreflex; behavioral /social science research tag; blood pressure; clinical research; cognitive behavior therapy; conflict; coronary disorder; depression; disease /disorder proneness /risk; electrocardiography; heart function; heart rate; human subject; human therapy evaluation; longitudinal human study; physical fitness; psychological stressor; psychophysiology

DESCRIPTION: (adapted from investigator's abstract): This is an application to study the impact of a cognitive-behavioral hostility-reducing intervention on autonomic control of the cardiovascular system. It is based on a research program which explores the relationships among physiological/behavioral characteristics such as anxiety, hostility, depression, and physical conditioning, the central and autonomic nervous systems and cardiovascular and respiratory systems. Considerable evidence, initially anecdotal and in the past several decades empirical, indicates that hostility and anger are risk factors for coronary artery disease (CAD). This risk applies not only to patients with CAD but also to healthy people. Evidence also indicates that hostility is associated with dysregulation of autonomic period variability (HPV), a noninvasive index of autonomic regulation of the heart. Moreover, convincing data demonstrate that low levels of heart period variability confer risk of recurrent myocardial infarction in patients with CAD and of cardiac morbidity and mortality in healthy subjects. Finally data demonstrate that cognitive behavioral treatment (CBT) of hostility and anger is effective in reducing these negative personality characteristics. Together, these bodies of data suggest 1) that a mechanism by which hostility promotes the development of CAD is through the ANS and 2) that a CBT intervention to reduce hostility may enhance autonomic control of the heart. In this study, healthy subjects with high levels of hostility, measured by standard questionnaires, and the interpersonal Hostility Assessment Technique, will be assigned randomly to a 12-week CBT intervention or a wait-list control condition. Subjects will be tested of 24-hour levels of HPV and short-term HPV responses to laboratory challenges prior to the intervention, immediately following the intervention, and at 6-month follow-up. The investigators will test the hypothesis that daytime/24 hour HPV will be increased by the CBT intervention and that the HPV fall in response to laboratory challenge, which in high hostile subjects is greater than that in controls, will be reduced.

描述：（改编自研究者的摘要）：这是一份申请 研究减少认知行为敌意干预措施对 心血管系统的自主控制。它基于一项研究 探索生理/行为之间关系的程序 诸如焦虑、敌意、抑郁和身体方面的特征 调节、中枢和自主神经系统以及心血管和 呼吸系统。大量证据，最初是轶事和过去的证据 几十年的经验表明，敌意和愤怒是危险因素 用于冠状动脉疾病（CAD）。这种风险不仅适用于患有以下疾病的患者 CAD也为了健康的人们。证据还表明，敌意是 与自主神经周期变异（HPV）失调有关， 心脏自主调节的无创指数。而且，令人信服 数据表明，低水平的心率变异性会带来以下风险： 冠心病患者复发性心肌梗死和心脏病发病率 和健康受试者的死亡率。最后数据表明认知 敌意和愤怒的行为治疗（CBT）可有效减少 这些消极的人格特征。这些数据体一起 提出 1) 敌意促进 CAD 发展的机制 是通过 ANS 进行的，并且 2) 减少敌意的 CBT 干预可能会 增强心脏的自主控制能力。 在这项研究中，具有高水平敌意的健康受试者，通过测量 标准问卷和人际敌意评估技术， 将被随机分配接受为期 12 周的 CBT 干预或等待名单对照 健康）状况。受试者将接受 24 小时 HPV 水平和短期 HPV 水平检测 在干预之前立即应对实验室挑战 干预后以及 6 个月随访时。调查人员将 检验 CBT 会增加白天/24 小时 HPV 的假设 干预措施以及 HPV 因实验室挑战而下降，这 在高敌意受试者中，该值大于对照，将减少。