The relationship between mindfulness and enduring somatic threat severity in long-term cardiac arrest survivors.
Cardiac arrest
Enduring somatic threat
Mindfulness
Trauma
Journal
Journal of behavioral medicine
ISSN: 1573-3521
Titre abrégé: J Behav Med
Pays: United States
ID NLM: 7807105
Informations de publication
Date de publication:
10 2023
10 2023
Historique:
received:
07
12
2022
accepted:
21
02
2023
medline:
23
10
2023
pubmed:
10
3
2023
entrez:
9
3
2023
Statut:
ppublish
Résumé
Cardiac arrest (CA) survivors experience continuous exposures to potential traumas though chronic cognitive, physical and emotional sequelae and enduring somatic threats (ESTs) (i.e., recurring somatic traumatic reminders of the event). Sources of ESTs can include the daily sensation of an implantable cardioverter defibrillator (ICD), ICD-delivered shocks, pain from rescue compressions, fatigue, weakness, and changes in physical function. Mindfulness, defined as non-judgmental present-moment awareness, is a teachable skill that might help CA survivors cope with ESTs. Here we describe the severity of ESTs in a sample of long-term CA survivors and explore the cross-sectional relationship between mindfulness and severity of ESTs. We analyzed survey data of long-term CA survivors who were members of the Sudden Cardiac Arrest Foundation (collected 10-11/2020). We assessed ESTs using 4 cardiac threat items from the Anxiety Sensitivity Index-revised (items range from 0 "very little" to 4 "very much") which we summed to create a score reflecting total EST burden (range 0-16). We assessed mindfulness using the Cognitive and Affective Mindfulness Scale-Revised. First, we summarized the distribution of EST scores. Second, we used linear regression to describe the relationship between mindfulness and EST severity adjusting for age, gender, time since arrest, COVID-19-related stress, and loss of income due to COVID. We included 145 CA survivors (mean age: 51 years, 52% male, 93.8% white, mean time since arrest: 6 years, 24.1% scored in the upper quarter of EST severity). Greater mindfulness (β: -30, p = 0.002), older age (β: -0.30, p = 0.01) and longer time since CA (β: -0.23, p = 0.005) were associated with lower EST severity. Male sex was also associated with greater EST severity (β: 0.21, p = 0.009). ESTs are common among CA survivors. Mindfulness may be a protective skill that CA survivors use to cope with ESTs. Future psychosocial interventions for the CA population should consider using mindfulness as a core skill to reduce ESTs.
Sections du résumé
BACKGROUND
Cardiac arrest (CA) survivors experience continuous exposures to potential traumas though chronic cognitive, physical and emotional sequelae and enduring somatic threats (ESTs) (i.e., recurring somatic traumatic reminders of the event). Sources of ESTs can include the daily sensation of an implantable cardioverter defibrillator (ICD), ICD-delivered shocks, pain from rescue compressions, fatigue, weakness, and changes in physical function. Mindfulness, defined as non-judgmental present-moment awareness, is a teachable skill that might help CA survivors cope with ESTs. Here we describe the severity of ESTs in a sample of long-term CA survivors and explore the cross-sectional relationship between mindfulness and severity of ESTs.
METHODS
We analyzed survey data of long-term CA survivors who were members of the Sudden Cardiac Arrest Foundation (collected 10-11/2020). We assessed ESTs using 4 cardiac threat items from the Anxiety Sensitivity Index-revised (items range from 0 "very little" to 4 "very much") which we summed to create a score reflecting total EST burden (range 0-16). We assessed mindfulness using the Cognitive and Affective Mindfulness Scale-Revised. First, we summarized the distribution of EST scores. Second, we used linear regression to describe the relationship between mindfulness and EST severity adjusting for age, gender, time since arrest, COVID-19-related stress, and loss of income due to COVID.
RESULTS
We included 145 CA survivors (mean age: 51 years, 52% male, 93.8% white, mean time since arrest: 6 years, 24.1% scored in the upper quarter of EST severity). Greater mindfulness (β: -30, p = 0.002), older age (β: -0.30, p = 0.01) and longer time since CA (β: -0.23, p = 0.005) were associated with lower EST severity. Male sex was also associated with greater EST severity (β: 0.21, p = 0.009).
CONCLUSION
ESTs are common among CA survivors. Mindfulness may be a protective skill that CA survivors use to cope with ESTs. Future psychosocial interventions for the CA population should consider using mindfulness as a core skill to reduce ESTs.
Identifiants
pubmed: 36892781
doi: 10.1007/s10865-023-00405-x
pii: 10.1007/s10865-023-00405-x
pmc: PMC9995732
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
890-896Subventions
Organisme : NHLBI NIH HHS
ID : T32 HL155020
Pays : United States
Organisme : NCATS NIH HHS
ID : TL1 TR002533
Pays : United States
Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Références
Berg, S. K., Rasmussen, T. B., Herning, M., et al. (2020). Cognitive behavioural therapy significantly reduces anxiety in patients with implanted cardioverter defibrillator compared with usual care: Findings from the Screen-ICD randomised controlled trial. European Journal of Preventive Cardiology, 27(3), 258–268.
doi: 10.1177/2047487319874147
pubmed: 31575299
Bremer, A., Dahne, T., Stureson, L., et al. (2019). Lived experiences of surviving in-hospital cardiac arrest. Scandinavian Journal of Caring Sciences, 33, 156–164.
doi: 10.1111/scs.12616
pubmed: 30329171
Charlson, M. E., Pompei, P., Ales, K. L., et al. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373–383.
doi: 10.1016/0021-9681(87)90171-8
pubmed: 3558716
Choi, K. W., Shaffer, K. M., Zale, E. L., et al. (2018). Early risk and resiliency factors predict chronic posttraumatic stress disorder in caregivers of patients admitted to a neuroscience ICU. Critical Care Medicine, 46, 713–719.
doi: 10.1097/CCM.0000000000002988
pubmed: 29384786
Edmondson, D. (2014). An enduring somatic threat model of posttraumatic stress disorder due to acute life-threatening medical events. Soc Personal Psychol Compas, 8,118 – 34.
Edmondson, D., Birk, J. L., Ho, V. T., et al. (2018). A challenge for psychocardiology: Addressing the causes and consequences of patients’ perceptions of enduring somatic threat. The American Psychologist, 73(9), 1160–1171.
doi: 10.1037/amp0000418
pubmed: 30525797
pmcid: 6619434
Feldman, G., Hayes, A., Kumar, S., et al. (2007). Mindfulness and emotion regulation: The development and initial validation of the cognitive and affective mindfulness scale-revised (CAMS-R). Journal of Psychopathological and Behavioral Assessment, 29, 177.
doi: 10.1007/s10862-006-9035-8
Gamper, G., Willeit, M., Sterz, F., et al. (2004). Life after death: Posttraumatic stress disorder in survivors of cardiac arrest–prevalence, associated factors, and the influence of sedation and analgesia. Critical Care Medicine, 32(2), 378–383.
doi: 10.1097/01.CCM.0000108880.97967.C0
pubmed: 14758151
Greenberg, J., Popok, P. J., Lin, A., et al. (2020). A mind-body physical activity program for chronic pain with or without a digital monitoring device: Proof-of-concept feasibility randomized controlled trial. JMIR Form Res, 4, e18703.
doi: 10.2196/18703
pubmed: 32348281
pmcid: 7308894
Harrod, M., Kamphuis, L. A., Hauschildt, K., et al. (2021). Getting better or getting by?: A qualitative study of in-hospital cardiac arrest survivors long-term recovery experiences. SSM Qualitative research in health, 1, 100002.
doi: 10.1016/j.ssmqr.2021.100002
pubmed: 36089989
pmcid: 9453782
Huang, F., Wei-Ti, C., Cheng-Shi, S., et al. (2021). Adaptation and validation of the cognitive and affective mindfulness scale-revised (CAMS-R) in people living with HIV in Myanmar. Mindfulness, 13, 188–197.
doi: 10.1007/s12671-021-01784-5
pubmed: 34777622
pmcid: 8576082
Irvine, J., Firestone, J., Ong, L., et al. (2011). A randomized controlled trial of cognitive behavior therapy tailored to psychological adaptation to an implantable cardioverter defibrillator. Psychosomatic Medicine, 73(3), 226–233.
doi: 10.1097/PSY.0b013e31820afc63
pubmed: 21321256
Kabat-Zinn, J. (2003). Mindfulness-based interventions in context: Past, present, and future. Clinical Psychology: Science and Practice, 10, 144–156.
Lawton, M. P., & Brody, E. M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179–186.
doi: 10.1093/geront/9.3_Part_1.179
pubmed: 5349366
Mace, R. A., Doorley, J., Bakhshaie, J., et al. (2021). Psychological resiliency explains the relationship between emotional distress and quality of life in neurofibromatosis. Journal of Neuro-Oncology, 155, 125–132.
doi: 10.1007/s11060-021-03852-1
pubmed: 34570301
Meli, L., Alcántara, C., Sumner, J. A., et al. (2019). Enduring somatic threat perceptions and post-traumatic stress disorder symptoms in survivors of cardiac events. Journal of Health Psychology, 24, 1817–1827.
doi: 10.1177/1359105317705982
pubmed: 28810445
Meyers, E. E., Presciutti, A., Shaffer, K. A., et al. (2020). The impact of resilience factors and anxiety during hospital admission on longitudinal anxiety among dyads of neurocritical care patients without major cognitive impairment and their family caregivers. Neurocritical Care, 33, 468–478.
doi: 10.1007/s12028-020-00913-7
pubmed: 31997141
Morrison, V., Pollard, B., Johnston, M., & MacWalter, R. (2005). Anxiety and depression 3 years following stroke: Demographic, clinical, and psychological predictors. Journal of psychosomatic research, 59(4), 209–213.
doi: 10.1016/j.jpsychores.2005.02.019
pubmed: 16223623
Moulaert, V., Verbunt, J. A., van Heugten, C. A., & Wade, D. T. (2009). Cognitive impairments in survivors of out-of-hospital cardiac arrest: A systematic review. Resuscitation, 80, 297–305.
doi: 10.1016/j.resuscitation.2008.10.034
pubmed: 19117659
Naber, D., & Bullinger, M. (2018). Psychiatric sequelae of cardiac arrest. Dialogues in Clinical Neuroscience, 20(1), 73–77.
doi: 10.31887/DCNS.2018.20.1/dnaber
pubmed: 29946214
pmcid: 6016050
Pedersen, S. S., van Domburg, R. T., Theuns, D. A., et al. (2005). Concerns about the implantable cardioverter defibrillator: A determinant of anxiety and depressive symptoms independent of experienced shocks. American Heart Journal, 149(4), 664–669.
doi: 10.1016/j.ahj.2004.06.031
pubmed: 15990750
Peterson, R. A., & Reiss, S. (1993). Anxiety sensitivity index revised test manual. IDS Publ.
Presciutti, A., Shaffer, J. A., Newman, M. M., et al. (2020). Modifiable provider-patient relationship factors and illness perceptions are associated with quality of life in survivors of cardiac arrest with good neurologic recovery. Resuscitation Plus, 3, 100008.
doi: 10.1016/j.resplu.2020.100008
pubmed: 34223295
pmcid: 8244500
Presciutti, A., Newman, M. M., Grigsby, J., et al. (2021). Associations between posttraumatic stress symptoms and quality of life in cardiac arrest survivors and informal caregivers: A pilot survey study. Resuscitation Plus, 5, 100085.
doi: 10.1016/j.resplu.2021.100085
pubmed: 34223351
pmcid: 8244463
Presciutti, A., Siry-Bove, B., Newman, M. M. (2022a). Qualitative study of long-term cardiac arrest survivors’ challenges and recommendations for improving survivorship. JAHA, 11(14), e025713.
Presciutti, A., Greenberg, J., Lester, E., et al. (2022b). Mindfulness is inversely associated with psychological symptoms in long-term cardiac arrest survivors. Journal of Behavioral Medicine, 45(4), 643–648.
doi: 10.1007/s10865-022-00295-5
pubmed: 35157171
pmcid: 8853140
Qintar, M., George, J. J., Panko, et al. (2015). A prospective study of anxiety in ICD patients with a pilot randomized controlled trial of cognitive behavioral therapy for patients with moderate to severe anxiety. Journal of interventional cardiac electrophysiology: an international journal of arrhythmias and pacing, 43(1), 65–75.
doi: 10.1007/s10840-015-9990-7
pubmed: 25779222
Rosman, L., Whited, A., Lampert, R., Mosesso, V. N., Lawless, C., & Sears, S. F. (2015). Cardiac anxiety after sudden cardiac arrest: Severity, predictors and clinical implications. Int J of Card, 181, 73–76.
doi: 10.1016/j.ijcard.2014.11.115
Sawyer, K. N., Brown, F., Christensen, R., et al. (2016). Surviving sudden cardiac arrest: A pilot qualitative survey study of survivors. Therapeutic Hypothermia Temperature Management, 6, 76–84.
doi: 10.1089/ther.2015.0031
pubmed: 26950703
Sawyer, K. N., Camp-Rogers, T. R., Kotini-Shah, P., et al. (2020). Sudden cardiac arrest survivorship: A scientific statement from the American Heart Association. Circulation, 141(12), e654–e685.
doi: 10.1161/CIR.0000000000000747
pubmed: 32078390
Sekhon, M. S., Ainslie, P. N., & Griesdale, D. E. (2017). Clinical pathophysiology of hypoxic ischemic brain injury after cardiac arrest: A “two-hit” model. Critical care, 21(1), 90.
doi: 10.1186/s13054-017-1670-9
pubmed: 28403909
pmcid: 5390465
Shaffer, K. M., Riklin, E., Jacobs, J. M., et al. (2016). Mindfulness and coping are inversely related to psychiatric symptoms in patients and informal caregivers in the neuroscience ICU: Implications for clinical care. Critical Care Medicine, 44, 2028–2036.
doi: 10.1097/CCM.0000000000001855
pubmed: 27513536
Spindler, H., Johansen, J. B., Andersen, K., et al. (2009). Gender differences in anxiety and concerns about the cardioverter defibrillator. Pacing and clinical electrophysiology:PACE, 32(5), 614–621.
doi: 10.1111/j.1540-8159.2009.02334.x
pubmed: 19422582
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., et al. (2022). Heart disease and stroke statistics-2022 update: A report from the American Heart Association. Circulation, 145(8), e153–e639.
doi: 10.1161/CIR.0000000000001052
pubmed: 35078371
Vranceanu, A. M., Bannon, S., Mace, R. (2020). Feasibility and efficacy of a resiliency intervention for the prevention of chronic emotional distress among survivor-caregiver dyads admitted to the neuroscience intensive care unit: A randomized clinical trial. JAMA Network Open, 3(10), e2020807.
Wilder Schaaf, K. P., Artman, L. K., Peberdy, M. A., et al. (2013). Anxiety, depression, and PTSD following cardiac arrest: A systematic review of the literature. Resuscitation, 84(7), 873–877.
doi: 10.1016/j.resuscitation.2012.11.021
pubmed: 23200996