Identification of stressful event mediators of pain in the cardias patitent
The relationship between self-reported anginal pain and self-reported stressful events was investigated, using the Psychiatric Epidemiology Research Interview Scale (PERI), the Hassles and Uplifts Scales, a Frequency of Anginal Pain Checklist, and a Demographic Data Questionnaire. The subjects were men between the ages of 45 and 64 who experienced angina pectoris. Fifty-eight questionnaires were returned and analyzed.
Frequency counts of the categorical variables were calculated. Pearson correlation coefficients were used to test the null hyptheses which hypothesized no relationship existed between self-reported yearly anginal pain and self-reported desirable or undesirable major life events nor a relationship between self-reported 24-hour frequency and perceived intensity of anginal pain and stressful minor daily events.
Results of the correlations were non-significant and the hypotheses were not rejected. A correlational matrix of eight variables was constructed demonstrating a strong correlation (0.5889, p = 0.000) between undesirable major life events (PERI) and the frequency of hassles, desirable major life events (PERI) and the frequency of hassles (0.2170, p = 0.051), PERI undesirable and hassles intensity (0.3801, p = 0.002), PERI desirable and the frequency of uplifts (0.3459, p = 0.004), and PERI undesirable and the frequency of uplifts (0.3150, p = 0.008).
Significant findings of a one-way analysis of variance were that subjects who were veterans reported more pain within a 24-hour period and a higher frequency of uplifts than non-veteran subjects; subjects with more education reported a higher incidence of pain during the previous year, and employed subjects reported greater amounts of undesirable stress.
A multiple regression analysis identified that participation in a cardiac rehabilitation program was predictive of decreased frequency of pain and that both employment and increased educational level were predictive of increased pain.
It was recommended that future studies of the relationship between life events and anginal pain be conducted utilizing a larger sample size and more precise research instruments. Studies of the roles of psychosocial stressors, defense mechanisms, and the endogenous opiate system are also recommended.