Date of Award

2013

Degree Type

Thesis

Department

Psychology

First Advisor

Moravec, Christine

Subject Headings

Coronary heart disease -- Psychological aspects -- Research, Stress management, Biofeedback training, Psychology

Abstract

Heart disease is the leading cause of death in the United States for both men and women, and coronary artery disease (CAD) is the most common type of heart disease, often leading to heart attacks. Over a long period of time, CAD can weaken the heart muscle, causing heart failure and arrhythmias. Three well established events which occur in CAD are an over activation of the sympathetic nervous system, increased inflammation and psychological distress. Biofeedback assisted stress management (BFSM) is a form of stress management that allows one to see how their physiology changes, in real time, as they either become stressed or relaxed. The patient is coached by the biofeedback therapist on strategies for reducing stress while the patient can see how effective the strategies are by looking at a computer screen in front of them. We hypothesized that in patients with CAD, BFSM training could help positively affect an over activation of the sympathetic nervous system, increased inflammation and psychological distress. To test this hypothesis, 19 patients enrolled in the cardiac rehabilitation program at the Cleveland Clinic were separated into a biofeedback group (BF) and a usual care (UC) group. All 19 enrolled patients underwent a stress assessment in which they were tested for blood markers of sympathetic activity and inflammation and underwent a mental stress test. Both the BF and UC patients received their normal cardiac rehabilitation but the BF patients also received 8 weekly sessions of BFSM. After the 8 weekly sessions of BFSM were complete, the patients had a second stress assessment in which they had their blood tested for the same markers as the first stress assessment and also underwent the same mental stress test. We found that the BFSM was effective in teaching CAD patients to breathe at a lower rate, but saw little difference between the BF and UC groups in regards to other physiological markers of stress. We also saw little difference between the BF and UC groups in regard to the markers of

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