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Title: Psychosocial predictors of symptoms of posttraumatic stress disorder and emotional distress in first admission acute coronary syndrome (ACS) patients
Author: Marke, Victoria M. T.
ISNI:       0000 0004 2751 9830
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2011
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Building upon Joseph et al's (1997) psychosocial model, the current thesis presents a framework for understanding the development of symptoms PTSD in patients with acute coronary syndrome (ACS). This framework identified personality (measured as alexithymia), cardiac threat (subjective and objective), peritraumatic reactions (fear and dissociation), appraisals (measured as illness beliefs), perceived social support (qualitative, confidant and affective) and use of coping (problem-focused, emotion-focused and support seeking) which were tested for their ability to predict the development and maintenance of symptoms of PTSD. In addition, due to high levels of co-morbidity between PTSD and other psychopathologies, these psychosocial variables were tested for their ability to predict more general distress (i.e. anxiety and depression).This thesis used a longitudinal, repeated measures questionnaire design methodology with 97 first-time ACS patients, across three different time points (hospital, 4-6 weeks and 6 months post-event). Alexithymia was found to be the strongest and most consistent predictor of PTSD, anxiety and depression. Many of the psychosocial variables overlapped for predicting distress however peritruamtic fear was uniquely predictive of PTSD, while subjective threat and affective support uniquely predicted depression. Overall, the study provided some support for the current framework as a model for PTSD. An additional aim of the thesis was the development of a new cardiac specific measure of patient concerns and concurrent coping during post-event adjustment. Results indicated that participants' most reported concerns related to the results of their angiogram, discovering their cardiac symptoms and fear about further heart problems during hospitalisation. At discharge, patients reported concern about further heart problems, the effect of their condition upon their family, their future and returning to 'themselves'. The most frequently used strategy was emotion-focused (try and think positively) followed by problem-focused (ask health-care professionals). Use of coping strategies varied in accordance with the specific concern and generally decreased over time. The current results were discussed in relation to clinical practice and patient care.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available