Cardiac-disease-induced PTSD and Fear of illness progression: Capturing the unique nature of disease-related PTSD

Abstract

According to Edmondson's Enduring Somatic Threat (EST) Model of PTSD Due to Acute Life-Threatening Medical Events, the nature of PTSD in the context of illness may differ from the nature of "traditional" PTSD in that it includes future-oriented alongside past-related intrusive thoughts. Yet almost no empirical studies to date have assessed the putative future-oriented quality of cardiac-disease-induced PTSD (CDI-PTSD). In the current study, we assessed the hypothesized associations between CDI-PTSD and fear of illness progression (FoP) - a novel theoretical conceptualization of patients' future-related anxieties. We hypothesized that FoP would be positively associated with CDI-PTSD, and especially with its specific items of intrusive thoughts. Patients (N = 112) were interviewed three months post-hospitalization for an acute coronary event via use of the PSS-SR-5 (to assess PTSD symptomatology), the FoP-Q-SF (to assess fear of illness progression), and the HADS (to assess anxiety and depression levels). Results indicated a strong positive association between CDI-PTSD and FoP, even when controlling for anxiety and depression. As hypothesized, the concepts of CDI-PTSD and fear of illness progression were strongly associated both at the level of the clusters as well as at the level of the specific items. The current study provides an initial empirical validation of the EST Model, especially regarding the future-oriented nature of PTSD resulting from acute cardiovascular disease.

Keywords: CDI-PTSD; Cardiovascular disease; EST model; Fear of illness progression; PTSD.