This article reviews literature regarding the influence of negative emotions, specifically depression, anger/hostility, and anxiety on coronary heart disease (CHD). For each domain, evidence is presented demonstrating the deleterious effects of negative affect on health outcomes in patients with CHD. This is followed by a discussion of the manner in which emotional factors are transduced into cardiac health risk factors. The pathophysiological mechanisms by which negative emotions have been found to exert an influence on CHD are highlighted. Finally, a general overview of the outcomes of interventions designed to ameliorate the effects of these negative emotional states on cardiovascular health are reviewed. Several treatment studies are described in detail for the purpose of elaborating the types of multicomponent interventions that attempt to address negative emotions in populations with CHD.

The implantable cardioverter defibrillator (ICD) provides a survival advantage over antiarrhythmic medications for patients with life-threatening ventricular arrhythmias. However, the effect of ICD therapy on quality-of-life and psychosocial functioning are not as well understood. Health care providers (e.g., physicians, nurses) can serve as a valuable source of information related to these ICD outcomes. The purpose of this study was to investigate health care provider perceptions regarding: (1) the quality-of-life and psychosocial functioning of their ICD recipients, (2) the concerns or problems reported by ICD recipients, and (3) the degree of provider comfort in managing these concerns. The final sample of health care providers (n = 261) rated ICD recipients' global quality-of-life and psychosocial functioning, and specific concerns about health care, lifestyle, special population adjustment, marital and family adjustment, and emotional well-being. With regard to quality-of-life, health care providers reported that the majority of ICD recipients were functioning better (38%) or about the same (47%) than before implantation. However, health care providers reported that 15% of recipients experienced worse quality-of-life postimplantation. Similarly, health care providers indicated that 10%-20% of ICD recipients experienced worse emotional functioning and strained family relationships. Moreover, issues related to driving, dealing with ICD shocks, and depression were the most common ICD recipient concerns. Significant differences were noted between physicians and nurses/other health care professionals on a wide range of psychosocial issues. Health care providers generally reported the most comfort dealing with traditional medical issues (i.e., patient adherence), and the least comfort in managing emotional well-being issues (e.g., depression and anxiety). These results suggest that routine attention to ICD quality-of-life and psychosocial outcomes is indicated for health care providers who care for ICD recipients.

No abstract

Adolescent and parent organ donation attitudes, knowledge, communications, and donor card signing rates were assessed. Parent-adolescent dyads (N = 137) were recruited at a Department of Motor Vehicles (DMV). Using discriminant analysis, attitude, knowledge, and communication variables adequately classified adolescent donor status. Overall, adolescent positive attitude toward donation was the most powerful variable discriminating between donors and nondonors. Examining only participants who had discussed donation with parents, the nature of parent-adolescent discussions about organ donation became the most important variable in donor classification. Adolescent donors reported significantly more positive and less negative attitudes, had parents with more positive and less negative attitudes, and had engaged in more frequent and more positive communications with parents about organ donation.