Type A personality and anger analysis in heart failure patients

Title: Type A Personality And Anger Analysis In Heart Failure PatientsHealth is traditionally equated to the absence of disease but can be considered as biopsychosocial Wellbeing in the wider scope of the public health paradigm. The Biopsychosocial (BPS) Model of Health and Illness accounts for biological, psychological, and sociological interconnected spectrums, each as systems of the body. Studies suggest that both body and mental disease arise from each other. There are personality variables that are linked to certain health outcomes. Stress seems to be a factor in these personality types and specifically how a person responds to stress. Stress is a biological and psychological response experienced on encountering a threat that we feel we do not have the resources to deal which lead to the arousal of the sympathetic nervous system and reduced activity in the parasympathetic nervous system. The hostility component of Type A personality, a high level of expressed anger and hostility is a significant independant risk factor for coronary disease that may interact synergistically with other risk factors, such as smoking and heredity. The addition of psychosocial treatments to standard cardiac rehabilitation regimens reduces mortality and morbidity in coronary disease,Aim of the study: The first goal of this study was the evaluation of the rate of occurrence of A and B type personality among the patients referred to our clinic for heart failure and the relation of personality types with heart failure. The second goal was to define which components of the anger were more common in the heart failure group compared to normal subjects. The third goal was to compare the patients and healthy controls according to personality type and compare the components of anger in each group. The fourth goal was to investigate the anger profiles and type A personality. Material and methodsPatient group and study designThe protocol of the study had been approved by the ethic comity of the University of Celal Bayar. 50 patients(38 male and 12 females) with documented heart failure on echocardiography and 50(32 male 18 females) subjects with normal cardiac function had given consent to participate in our study. Patients with severe hepatic disease renal failure and advenced pulmonary disease were not enrolled in the study. We used the Turkish adaptation of ERTCTA scale to identify the individuals with A type personality among patients and the control group. Anger profiles of both groups were assessed using the Turkish adaptation of STAXI2 index, the STAXI 2 TR index. Statistical evaluation:A chi-squared test, also referred to as chi-square test or ?² test, had been used to evaluate the occurrence of A type personality among patients and controls. (Independest Samples "t" test) One-way,ANOVA ve Post-hoc test had been used to compare the anger profiles 83between groups and non parametric Mann-Whitney test had been used when the number of patients were too low fort he previous tests. All statistical analysis were made using SPSS.20 program.Results:The income of heart failure patients was higher compared to individuals in the control group.Our results fit with previous study results on developping countries where higher income is related to higher risk of cardiac disease. Patients with heart failure had more often type and and high type A personality compared to control group (respectively %78,%38; p<0,001).There was no correlation between personality types and the existance of coronary disease (p>0,05). Similary there was no significant difference of personality type between genders (p>0,05). On comparison of clinical anger scores, S-Ang/F and AX-Con-In scores were higher in patients compared to normal cases(p<0,05). On comparison of anger scores among women, S-Ang/F, AX/Con-Out ve AX/Con-In anger scores were higher in HF patients compared to control group individuals but no significant difference was observed among male individuals (p<0,05). The anger scores of personality types were compared among all groups.High type A personality individuals had higher S-Ang/F, S-Ang, T-Ang/R, T-Ang/T, T-Ang scorlares compared to B type personality individuals. (p values respectively: 0,001, 0,007, 0,042, 0,042, 0,014). AX/Con-In, AX/Con-Out scores were higher in Type A personality compared to type B personality individuals (p= 0,030, 0,035). Non parametric tests did not reveal any significant difference on comparison of patients and controls concerning the anger scores of type A and type B personalities. When considering the group of type A personality, S- Ang/V was higher in heart failure patients compared to controls (p=0,05). There was no significant difference on anger scores when comparring the patients with or without coronary artery disease (p>0.05).Conclusion: The increase of income increases the risk of heart failure in our country in a similar way to the developping countries. A type and high type A personality may be a risk factor for heart failure.Anger can be considered as a separate risk factor for heart failure independant of the presence or not of the coronary disease, larger scale studies are necessary to elucidate this issue. Our study suggest that anger may be more predictive in women compared to men for the development of heart failure.Our results suggest that ERCTA.TR and STAXI-2.TR tests may be beneficial in the risk assessment for heart failure patients in addition to personality type analysis. Our study support the importance of personality and anger as a risk factor just like the classic risk factors.Keywords: A type personality, ERCTA.TR, STAXI-2.TR, Heart failure