The Attention Training Technique Reduces Anxiety and Depression in Patients With Coronary Heart Disease: A Pilot Feasibility Study

Dammen, Toril; Tunheim, Kristoffer; Munkhaugen, John; Papageorgiou, Costas

doi:10.3389/fpsyg.2022.948081

Cited by 5 publications

(9 citation statements)

References 52 publications

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“…This is interesting because Type D personality has been highly correlated with neuroticism ( De Fruyt and Denollet, 2002 ). Together with our results, suggesting a potential overlap between depression, anxiety and NA, further studies on the treatment for depression and anxiety in patients with CAD may also assess the effectiveness on NA and SI as well as Type D. Recently, the attention training technique—a component of metacognitive therapy—showed effect on anxiety, depression and NA in these patients ( Dammen et al, 2022 ). Whether the attention training technique also influences the presence of Type D as well as the risk for recurrent adverse events in CAD patients remains to be investigated.…”

Section: Discussionsupporting

confidence: 72%

“…This may be due to the NA construct overlapping with depression and anxiety or an underlying dimension between depression, anxiety and NA. A recent study indicated that there may be such an underlying dimension, particularly between HADS-D and NA (Tunheim et al, 2022). Moreover, Type D personality may render the person vulnerable to experiencing higher levels of anxiety and depression, which may be a consequence to being diagnosed with CAD.…”

Section: Discussionmentioning

confidence: 99%

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Risk of recurrent cardiovascular events in coronary artery disease patients with Type D personality

et al. 2023

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IntroductionData on the association between Type D personality, its traits negative affectivity (NA) and social inhibition (SI), and risk of major adverse cardiac events (MACE) in coronary outpatients is sparse. Furthermore, the associations between Type D subgroups and cardiovascular risk factors are largely unknown.MethodsWe investigated i) Type D personality, NA and SI and risk of recurrent MACE, and ii) the relationship between Type D subgroups and risk factors in a coronary population. This prospective cohort study included 1083 patients` median 16 months after a myocardial infarction and/or a revascularization procedure who were followed-up for 4.2 (SD 0.4) years. Type D personality was assessed by DS14. Anxiety and depression, statin adherence, and risk factors were assessed by patients’ self-report and a clinical examination with blood samples. MACE, defined as cardiovascular death, myocardial infarction, revascularization, stroke or heart failure, were obtained from hospital records from index event to end of study lasting 5.7 years. Data were analyzed by Cox proportional hazard regression.ResultsIn all, 352 MACE occurred in 230 patients after average 4.2 years follow-up. Higher NA score was associated with MACE after adjustment for age, risk factors and comorbidity (HR 1.02 per unit increase, 95% CI 1.00-1.05), whereas we found a weaker, not statistically significant estimated effect of higher SI score. After additional adjustment for symptoms of anxiety and depression, we found a weaker, not statistically significant association between NA and MACE (HR 1.01 per unit increase, 95% CI 0.98-1.05). Low statin adherence and smoking were more prevalent in the Type D and high NA group.DiscussionOur results indicate that the NA trait is related to worse prognosis in outpatients with coronary artery disease.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Risk of recurrent cardiovascular events in coronary artery disease patients with Type D personality

et al. 2023

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“…However, the effect of MCT results from the confluence of learning and practice together, suggesting that practice must be adequate and regular. Dammen et al ( 51 ) demonstrated that ATT exercise, which is also a part of our web app in particular leads to significant improvement in anxiety and depression symptoms. The exercise area was introduced in a module in the middle of the training program where the participants were instructed to practice regularly.…”

Section: Discussionmentioning

confidence: 97%

Improving mental well-being in psychocardiology—a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients

Larionov,

Petrova,

Demirbuga

et al. 2023

Front. Psychiatry

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BackgroundMany patients with cardiovascular disease also show a high comorbidity of mental disorders, especially such as anxiety and depression. This is, in turn, associated with a decrease in the quality of life. Psychocardiological treatment options are currently limited. Hence, there is a need for novel and accessible psychological help. Recently, we demonstrated that a brief face-to-face metacognitive therapy (MCT) based intervention is promising in treating anxiety and depression. Here, we aim to translate the face-to-face approach into digital application and explore the feasibility of this approach.MethodsWe translated a validated brief psychocardiological intervention into a novel non-blended web app. The data of 18 patients suffering from various cardiac conditions but without diagnosed mental illness were analyzed after using the web app over a two-week period in a feasibility trial. The aim was whether a non-blended web app based MCT approach is feasible in the group of cardiovascular patients with cardiovascular disease.ResultsOverall, patients were able to use the web app and rated it as satisfactory and beneficial. In addition, there was first indication that using the app improved the cardiac patients’ subjectively perceived health and reduced their anxiety. Therefore, the approach seems feasible for a future randomized controlled trial.ConclusionApplying a metacognitive-based brief intervention via a non-blended web app seems to show good acceptance and feasibility in a small target group of patients with CVD. Future studies should further develop, improve and validate digital psychotherapy approaches, especially in patient groups with a lack of access to standard psychotherapeutic care.

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“…This makes it particularly well suited to CHD patients who often present with mixed anxiety and depression. Finally, in a recent open study, we found ATT delivered face-to-face in a 6- session group format to be feasible and potentially effective for improving depression and anxiety symptoms in CHD patients ( Dammen et al, 2022 ), which holds considerable appeal for use in increasingly busy cardiac follow-up clinics. The next progressive step is to test the effectiveness of ATT in a randomized controlled clinical trial.…”

Section: Introductionmentioning

confidence: 97%

“…Recently, RCTs have reported ATT delivered in group formats to be effective in reducing symptoms of anxiety and depression among a student population ( Haukaas et al, 2018 ). There is also preliminary evidence from an open study that ATT is feasible and potentially effective in treating symptoms of anxiety and depression in CHD patients ( Dammen et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Attention training technique delivered in groups as treatment for anxiety and depression in patients with coronary heart disease: study protocol for a waiting-list randomized controlled trial

Dammen,

Tunheim,

Munkhaugen

et al. 2023

Front. Psychol.

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IntroductionClinically significant symptoms of depression and anxiety in coronary heart disease (CHD) patients are common and associated with adverse outcomes. Psychological treatments have shown limited effectiveness and more effective treatments have been requested. Attention training technique (ATT), a component of metacognitive therapy, can potentially be effective as a stand-alone treatment for anxiety and depression. In an open study, ATT delivered face-to-face in a group format was feasible and potentially effective for improving depression and anxiety symptoms in CHD patients. The next progressive step is to test the effectiveness of ATT in a randomized controlled trial. This paper describes the methodology of this trial.MethodsATT-CHD is a randomized wait-list (WL) controlled study. Eligible CHD patients from two hospitals with Hospital Anxiety and Depression Scale (HADS)-Anxiety and/or HADS-Depression subscales scores ≥8 will be randomized into ATT (n = 32) or WL control (n = 32). After 6–8 weeks, WL patients will be allocated to ATT. Participants will be evaluated pre-, mid- and post-treatment, and at 6-months follow-up using changes in HADS as primary outcome. Secondary outcomes will be changes in psychiatric disorders, rumination, worry, type D-personality, metacognitions, insomnia, quality of life, and C-Reactive protein (CRP).DiscussionTo our knowledge, this will be the first WL-controlled randomized study testing the effectiveness of group-based ATT as treatment of symptoms of anxiety and depression in CHD patients. It will also explore correlations between changes in psychological distress and CRP. A qualitative analysis will reveal patients’ experience with ATT including processes that may facilitate or serve as barriers to effectiveness. Recruitment into the study commenced in December 2022.Ethics and disseminationThe Regional Committees for Medical and Health Research Ethics (REK), Norway has granted approval for the study (ID 52002). The trial results will be published in peer-reviewed journals. According to Norwegian legislation, the Norwegian Data Protection Authority, and the Committee of Ethics, we are not allowed to share original study data publicly.Clinical trial registrationClinicalTrials.gov, identifier NCT05621408 pre-inclusion. There were no significant changes of methods or outcomes after study start.

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The Attention Training Technique Reduces Anxiety and Depression in Patients With Coronary Heart Disease: A Pilot Feasibility Study

Cited by 5 publications

References 52 publications

Risk of recurrent cardiovascular events in coronary artery disease patients with Type D personality

Risk of recurrent cardiovascular events in coronary artery disease patients with Type D personality

Improving mental well-being in psychocardiology—a feasibility trial for a non-blended web application as a brief metacognitive-based intervention in cardiovascular disease patients

Attention training technique delivered in groups as treatment for anxiety and depression in patients with coronary heart disease: study protocol for a waiting-list randomized controlled trial

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