Anxiety in Patients Who Have Had a Myocardial Infarction: The Maintaining Role of Perceived Physical Sensations and Causal Attributions

Abstract

This study investigated whether anxiety in patients who have had a myocardial infarction is maintained through similar processes to those proposed in the cognitive models of panic disorder (Clark, 1986) and health anxiety (Warwick and Salkovskis, 1990). Anxious (n = 22) and non-anxious (n = 29) patients, who all had an MI 3–12 months before testing, participated. The groups were compared on self-report measures of risk perception, bodily vigilance, illness perceptions the type of causal attributions (somatic, normalizing and psychological) generated for congruent and incongruent types of anxiety-related bodily sensations (cardiac, respiratory, gastro-intestinal and cognitive dyscontrol). Anxious, compared to non-anxious, MI participants perceived themselves to be at higher risk of a further MI, had higher levels of bodily vigilance and more negative emotional and cognitive representations of their MI. Anxious participants generated significantly more somatic attributions and fewer normalizing attributions, than non-anxious participants for cardiac sensations. There was also a trend for anxious participants to generate this pattern of attributions for respiratory items. The study provides evidence that the models of health anxiety (Warwick and Salkovskis, 1990) and panic disorder (Clark, 1986) are useful in understanding persistent anxiety following an MI.