Araştırma Makalesi
BibTex RIS Kaynak Göster

Esansiyel Hipertansiyon Tanılı Hastaların Üstbilişler, Bilişsel Dikkat Kilitlenmesi ve Anksiyete Belirtilerinin İncelenmesi: Vaka-Kontrol Çalışması

Yıl 2023, Cilt: 18 Sayı: 1, 28 - 34, 16.03.2023
https://doi.org/10.17517/ksutfd.1039089

Öz

Amaç: Üstbilişsel değişkenlere odaklanan bu araştırma, hipertansiyon hastaları ve sağlıklı kontrol grubu arasında üstbilişsel inançlar, bilişsel dikkat kilitlenmesi ve anksiyete belirtilerini karşılaştırmayı amaçlamaktadır.
Gereç ve Yöntemler: Vaka-kontrol çalışması şeklinde dizayn edilen mevcut çalışmanın örneklemini kardiyoloji polikliniğine ardışık başvuran 128 hipertansiyon hastası ve 231 sağlıklı kontrol oluşturmaktadır. Çalışmaya dahil edilen gönüllülere sosyodemografik veri formu, Beck Anksiyete Envanteri (BAE), Üstbilişler-30 ölçeği (ÜBÖ-30) ve Bilişsel Dikkat Kilitlenmesi Ölçeği (CAS-1) uygulanmıştır. Elde edilen veriler usulüne uygun hesaplanarak istatistiki işleme tabi tutulmuştur.
Bulgular: Çalışmaya dahil edilen katılımcıların yaş ortalaması 51.81±8.07 yıldı ve %75.5’i (n=271) kadındı. İki çalışma grubu arasında sosyodemografik verilerin karşılaştırılmasında istatiksel olarak fark saptanmamıştır (p>0.05). Esansiyel hipertansiyon ve sağlıklı kontrol grubu arasında BAE (t=-3.700, p<0.001), ÜBÖ-30 kontrol edilemezlik ve tehlike (t=-3.587, p<0.001) ve düşünceleri kontrol ihtiyacı (t=-2.233, p=0.020) alt boyutları, CAS-1 bilişsel dikkat
(t=-3.543, p<0.001), inanç (t=-2.454, p=0.015) ve toplam (t=-3.364, p<0.001) skorlarında istatiksel olarak anlamlı farklılık saptanmıştır.
Sonuçlar: Mevcut çalışma, esansiyel hipertansiyon hastalarının anksiyete ve üstbiliş aktivasyonlarının daha yüksek olduğunu ortaya koymuştur. Bu sonuçların üstbilişsel süreçler ile fiziksel sorunlar arasındaki ilişkiyi ortaya koyması nedeniyle önemli olduğunu düşünüyoruz. Bununla birlikte esansiyel hipertansiyon hastalarına yönelik planlanacak terapotik müdahaleler için çalışmamızın sonuçlarının ışık tutacağı düşünülebilir.

Kaynakça

  • Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2224-2260.
  • World Health Organization. Global Health Observatory (GHO) data. Raised blood pressure situation and trends. Website: https:// www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/Accessed May 31, 2019.
  • Rabi DM, Daskalopoulou SS, Padwal RS, Khan NA, Grover SA, Hackam DG et al. The 2011 Canadian Hypertension Education Program recommendations for the management of hypertension: blood pressure measurement, diagnosis, assessment of risk, and therapy. Can J Cardiol 2011;27:415-433.
  • Bacon SL, Campbell TS, Arsenault A, Lavoie KL. The impact of mood and anxiety disorders on incident hypertension at one year. Int J Hypertens 2014;2014:1-7.
  • Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci 2015;17:327-335.
  • World Health Organization. Depression and other common mental disorders: global health estimates. Geneva:World Health Organization, 2017:1-24
  • Sherbourne CD, Wells KB, Meredith LS, Jackson CA, Camp P. Comorbid anxiety disorder and the functioning and well-being of chronically ill patients of general medical providers. Arch Gen Psychiatry 1996;53:889-895.
  • Wallace K, Zhao X, Misra R, Sambamoorthi U. The humanistic and economic burden associated with anxiety and depression among adults with comorbid diabetes and hypertension. J Diabetes Res 2018;2018:1-9.
  • Gündüz A, Gündoğmuş İ. The relationship of adverse childhood events on automatic thoughts, intermediate beliefs, schemas, anxiety and depressive symptoms and quality of life in university students (tur). Journal of Clinical Psychiatry 2019;22:424-435.
  • Dressler WW, dos Santos JE, Viteri FE. Blood pressure, ethnicity, and psychosocial resources. Psychosom Med 1986;48:509-519.
  • Rutledge T, Hogan BE. A quantitative review of prospective evidence linking psychological factors with hypertension development. Psychosom Med 2002;64:758-66.
  • Hildrum B, Mykletun A, Holmen J, Dahl AA. Effect of anxiety and depression on blood pressure: 11-year longitudinal population study. Br J Psychiatry 2008;193:108-113.
  • Chien I-C, Lin C-H. Increased risk of hyperlipidemia in patients with anxiety disorders: A population-based study. J Psychosom Res 2016;86:47-52.
  • Cuffee Y, Ogedegbe C, Williams NJ, Ogedegbe G, Schoenthaler A. Psychosocial risk factors for hypertension: an update of the literature. Curr Hypertens Rep 2014;16:483.
  • Kaliyaperumal S, Hari SB, Siddela PK, Yadala S. Assessment of quality of life in hypertensive patients. J Appl Pharm Sci 2016;6:143-147.
  • Player MS, Peterson LE. Anxiety disorders, hypertension, and cardiovascular risk: A review. Int J Psychiatry Med 2011;41:365-377.
  • Bhat SK, Beilin LJ, Robinson M, Burrows S, Mori TA. Relationships between depression and anxiety symptoms scores and blood pressure in young adults. J Hypertens 2017;35:1983-1991.
  • Markovitz JH, Matthews KA, Wing RR, Kuller LH, Meilahn EN. Psychological, biological and health behavior predictors of blood pressure changes in middle-aged women. J Hypertens 1991;9:399-406.
  • Cartwright S, Panchal S. The stressful effects of mergers and acquisitions. Stress in the workplace: Past, present and future 2001:67-89.
  • Lazarus RS. Stress and emotion: A new synthesis: Springer publishing company; 2006.
  • Haji-Mirsaeidi Z, Kazemi-Zahrani H, Sadeghi M. Comparison of the Mindfulness Skills, Metacognitive Beliefs and Perceived Stress in Hypertension Patients and Control Group. Global Journal of Health Science 2017;9:138-138.
  • Lobban F, Haddock G, Kinderman P, Wells A. The role of metacognitive beliefs in auditory hallucinations. Pers Individ Differ 2002;32:1351-1363.
  • Matthews G, Wells A. Attention and emotion: A clinical perspective. 1 st ed. London. Taylor and Francis; 2016.
  • Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J 2018;39:3021-3104.
  • Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175-191.
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893.
  • Ulusoy M. Beck anksiyete ölçeğinin psikometrik özellikleri. Uzmanlık Tezi, Bakırköy Ruh ve Sinir Hastalıkları Hastanesi, İstanbul 1993.
  • Wells A, Cartwright-Hatton S. A short form of the metacognitions questionnaire: properties of the MCQ-30. Behav Res Ther 2004;42:385-396.
  • Tosun A, Irak M. Üstbiliş Ölçeği-30'un Türkçe Uyarlaması, Geçerliği, Güvenirliği, Kaygı ve Obsesif-Kompülsif Belirtilerle İlişkisi. Turk Psikiyatri Derg 2008;19:67-80.
  • Wells A. Metacognitive therapy for anxiety and depression. 1 st ed. New York: Guilford press; 2011.
  • Gündüz A, Gündoğmus İ, Sertçelik S, Engin BH, İşler A, Çipil A et al. Validity and reliability of cognitive attentional syndrome-1 questionnaire. Psychiatry Investig 2019;16:355-362.
  • Fisher PL, Wells A. Experimental modification of beliefs in obsessive–compulsive disorder: a test of the metacognitive model. Behav Res Ther 2005;43:821-829.
  • Davydov DM, Stewart R, Ritchie K, Chaudieu I. Depressed mood and blood pressure: The moderating effect of situation-specific arousal levels. Int J Psychophysiol 2012;85:212-223.
  • Purdon C, Clark DA. Metacognition and obsessions. Clin Psychol Psychother 1999;6:102-110.
  • Wells A. Detached mindfulness in cognitive therapy: A metacognitive analysis and ten techniques. J Ration Emot Cogn Behav Ther 2005;23:337-355.
  • Morrison AP, Wells A. A comparison of metacognitions in patients with hallucinations, delusions, panic disorder, and non-patient controls. Behav Res Ther 2003;41:251-256.
  • Seldenrijk A, Vogelzangs N, Batelaan NM, Wieman I, van Schaik DJ, Penninx BJ. Depression, anxiety and 6-year risk of cardiovascular disease. J Psychosom Res 2015;78:123-129.
  • Johnson HM. Anxiety and hypertension: is there a link? A literature review of the comorbidity relationship between anxiety and hypertension. Curr Hypertens Rep 2019;21:1-7.

Investigation of Metacognitions, Cognitive Attentional and Anxiety Symptoms in Patients Diagnosed with Essential Hypertension: A Case-Control Study

Yıl 2023, Cilt: 18 Sayı: 1, 28 - 34, 16.03.2023
https://doi.org/10.17517/ksutfd.1039089

Öz

Objective: Focusing on metacognitive processes, this study aims to compare metacognitive beliefs, cognitive attention syndrome, and anxiety symptoms between hypertension patients and healthy control group.
Materials and Methods: The sample of the present study, which was designed as a case-control study, consists of 128 consecutive patients with essential hypertension who applied to the cardiology outpatient clinic and 231 healthy controls. Sociodemographic data form, Beck Anxiety Inventory (BAI), Metacognition Questionnaire 30 (MCQ-30), and Cognitive Attentional Syndrome-1 Questionnaire (CAS-1) were applied to the volunteers included in the study. The obtained data were duly calculated and subjected to statistical processing.
Results: The mean age of the participants included in the study was 51.81±8.07 years, and 75.5% (n=271) were female. No statistical difference was found between the two study groups in the comparison of sociodemographic data (p>0.05). A statistically significant difference was found in BAI (t=-3.700, p<0.001), MCQ-30 Uncontrollability and danger (t=-3.587, p<0.001), need to control thoughts (t=-2.233, p=0.020), CAS-1 cognitive attention (t=-3.543, p<0.001), belief (t=-2.454, p=0.015) and total (t=-3.364, p<0.001) scores between essential hypertension and the healthy control group.
Conclusion: The present study revealed that patients with essential hypertension have higher activation of anxiety and metacognition. We think that these results are important because they reveal the relationship between metacognitive processes and physical problems. However, it can be thought that the results of our study will shed light on the therapeutic interventions to be planned for essential hypertension patients.

Kaynakça

  • Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2224-2260.
  • World Health Organization. Global Health Observatory (GHO) data. Raised blood pressure situation and trends. Website: https:// www.who.int/gho/ncd/risk_factors/blood_pressure_prevalence_text/en/Accessed May 31, 2019.
  • Rabi DM, Daskalopoulou SS, Padwal RS, Khan NA, Grover SA, Hackam DG et al. The 2011 Canadian Hypertension Education Program recommendations for the management of hypertension: blood pressure measurement, diagnosis, assessment of risk, and therapy. Can J Cardiol 2011;27:415-433.
  • Bacon SL, Campbell TS, Arsenault A, Lavoie KL. The impact of mood and anxiety disorders on incident hypertension at one year. Int J Hypertens 2014;2014:1-7.
  • Bandelow B, Michaelis S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci 2015;17:327-335.
  • World Health Organization. Depression and other common mental disorders: global health estimates. Geneva:World Health Organization, 2017:1-24
  • Sherbourne CD, Wells KB, Meredith LS, Jackson CA, Camp P. Comorbid anxiety disorder and the functioning and well-being of chronically ill patients of general medical providers. Arch Gen Psychiatry 1996;53:889-895.
  • Wallace K, Zhao X, Misra R, Sambamoorthi U. The humanistic and economic burden associated with anxiety and depression among adults with comorbid diabetes and hypertension. J Diabetes Res 2018;2018:1-9.
  • Gündüz A, Gündoğmuş İ. The relationship of adverse childhood events on automatic thoughts, intermediate beliefs, schemas, anxiety and depressive symptoms and quality of life in university students (tur). Journal of Clinical Psychiatry 2019;22:424-435.
  • Dressler WW, dos Santos JE, Viteri FE. Blood pressure, ethnicity, and psychosocial resources. Psychosom Med 1986;48:509-519.
  • Rutledge T, Hogan BE. A quantitative review of prospective evidence linking psychological factors with hypertension development. Psychosom Med 2002;64:758-66.
  • Hildrum B, Mykletun A, Holmen J, Dahl AA. Effect of anxiety and depression on blood pressure: 11-year longitudinal population study. Br J Psychiatry 2008;193:108-113.
  • Chien I-C, Lin C-H. Increased risk of hyperlipidemia in patients with anxiety disorders: A population-based study. J Psychosom Res 2016;86:47-52.
  • Cuffee Y, Ogedegbe C, Williams NJ, Ogedegbe G, Schoenthaler A. Psychosocial risk factors for hypertension: an update of the literature. Curr Hypertens Rep 2014;16:483.
  • Kaliyaperumal S, Hari SB, Siddela PK, Yadala S. Assessment of quality of life in hypertensive patients. J Appl Pharm Sci 2016;6:143-147.
  • Player MS, Peterson LE. Anxiety disorders, hypertension, and cardiovascular risk: A review. Int J Psychiatry Med 2011;41:365-377.
  • Bhat SK, Beilin LJ, Robinson M, Burrows S, Mori TA. Relationships between depression and anxiety symptoms scores and blood pressure in young adults. J Hypertens 2017;35:1983-1991.
  • Markovitz JH, Matthews KA, Wing RR, Kuller LH, Meilahn EN. Psychological, biological and health behavior predictors of blood pressure changes in middle-aged women. J Hypertens 1991;9:399-406.
  • Cartwright S, Panchal S. The stressful effects of mergers and acquisitions. Stress in the workplace: Past, present and future 2001:67-89.
  • Lazarus RS. Stress and emotion: A new synthesis: Springer publishing company; 2006.
  • Haji-Mirsaeidi Z, Kazemi-Zahrani H, Sadeghi M. Comparison of the Mindfulness Skills, Metacognitive Beliefs and Perceived Stress in Hypertension Patients and Control Group. Global Journal of Health Science 2017;9:138-138.
  • Lobban F, Haddock G, Kinderman P, Wells A. The role of metacognitive beliefs in auditory hallucinations. Pers Individ Differ 2002;32:1351-1363.
  • Matthews G, Wells A. Attention and emotion: A clinical perspective. 1 st ed. London. Taylor and Francis; 2016.
  • Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH). Eur Heart J 2018;39:3021-3104.
  • Faul F, Erdfelder E, Lang A-G, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175-191.
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893.
  • Ulusoy M. Beck anksiyete ölçeğinin psikometrik özellikleri. Uzmanlık Tezi, Bakırköy Ruh ve Sinir Hastalıkları Hastanesi, İstanbul 1993.
  • Wells A, Cartwright-Hatton S. A short form of the metacognitions questionnaire: properties of the MCQ-30. Behav Res Ther 2004;42:385-396.
  • Tosun A, Irak M. Üstbiliş Ölçeği-30'un Türkçe Uyarlaması, Geçerliği, Güvenirliği, Kaygı ve Obsesif-Kompülsif Belirtilerle İlişkisi. Turk Psikiyatri Derg 2008;19:67-80.
  • Wells A. Metacognitive therapy for anxiety and depression. 1 st ed. New York: Guilford press; 2011.
  • Gündüz A, Gündoğmus İ, Sertçelik S, Engin BH, İşler A, Çipil A et al. Validity and reliability of cognitive attentional syndrome-1 questionnaire. Psychiatry Investig 2019;16:355-362.
  • Fisher PL, Wells A. Experimental modification of beliefs in obsessive–compulsive disorder: a test of the metacognitive model. Behav Res Ther 2005;43:821-829.
  • Davydov DM, Stewart R, Ritchie K, Chaudieu I. Depressed mood and blood pressure: The moderating effect of situation-specific arousal levels. Int J Psychophysiol 2012;85:212-223.
  • Purdon C, Clark DA. Metacognition and obsessions. Clin Psychol Psychother 1999;6:102-110.
  • Wells A. Detached mindfulness in cognitive therapy: A metacognitive analysis and ten techniques. J Ration Emot Cogn Behav Ther 2005;23:337-355.
  • Morrison AP, Wells A. A comparison of metacognitions in patients with hallucinations, delusions, panic disorder, and non-patient controls. Behav Res Ther 2003;41:251-256.
  • Seldenrijk A, Vogelzangs N, Batelaan NM, Wieman I, van Schaik DJ, Penninx BJ. Depression, anxiety and 6-year risk of cardiovascular disease. J Psychosom Res 2015;78:123-129.
  • Johnson HM. Anxiety and hypertension: is there a link? A literature review of the comorbidity relationship between anxiety and hypertension. Curr Hypertens Rep 2019;21:1-7.
Toplam 38 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Pınar Demir Gündoğmuş 0000-0001-8042-189X

İbrahim Gündoğmuş 0000-0002-1921-1495

Yayımlanma Tarihi 16 Mart 2023
Gönderilme Tarihi 20 Aralık 2021
Kabul Tarihi 24 Şubat 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 18 Sayı: 1

Kaynak Göster

AMA Demir Gündoğmuş P, Gündoğmuş İ. Esansiyel Hipertansiyon Tanılı Hastaların Üstbilişler, Bilişsel Dikkat Kilitlenmesi ve Anksiyete Belirtilerinin İncelenmesi: Vaka-Kontrol Çalışması. KSÜ Tıp Fak Der. Mart 2023;18(1):28-34. doi:10.17517/ksutfd.1039089