Selection of social comparison standards in cardiac patients with and without experienced defibrillator shock

Abstract

Patients with an implantable cardioverter-defibrillator (ICD) often report psychological distress. However, both physical disease severity and psychological adjustment are variable. The role of social comparison in illness coping has not been studied in these patients yet. We theorize that relative to patients without experienced shock (ICD-), those with experienced ICD shocks (ICD+) display higher levels of psychological distress and thereby compare more frequently with fellow patients with more severe disease, but better disease coping and identify more strongly with these comparison standards. We recruited 92 patients with (ICD+, n = 38) and without an experienced ICD shock (ICD-, n = 54), who selected one of four comparison standards varying in disease severity and coping capacity. Relative to ICD-, ICD + patients reported higher levels of device-related distress, but there were no significant differences in anxiety, depression, or quality of life. ICD + patients selected more often comparison standards with poor coping. Irrespective of standard choice, ICD + patients displayed more negative mood following comparison. Our results support the view that ICD patients suffer from elevated levels of psychological distress, whereby ICD + patients tend to compare unfavorably to fellow patients. Altogether, the findings warrant further research into social comparison as a relevant coping mechanism in ICD patients.