Negative Affect and Cardiovascular Health
Fogel, Joshua, Journal of Evidence-Based Psychotherapies
This article reviews a potentially key article integrating an understanding of negative affect states and cardiovascular health. Definitions, descriptions, and physiology of five negative affect states of depression, learned helplessness, hopelessness, vital exhaustion, and grief are critiqued. The relationship of these affect states to cardiovascular health are discussed from the perspective of the original article. Lastly, evidence regarding updating the original theory of conservation-withdrawal to include a modern addition of a giving up complex is reviewed. It is concluded that although the article had potential to significantly contribute to the literature, there are a number of areas that are lacking and unclear.
Key words: depression, negative affect, cardiovascular, hopelessness, vital exhaustion.
In the mental health area, affective disorders such as depression are areas of common focus for assessment and treatment. In the physical health area, cardiovascular disorders are quite prevalent health conditions. How does one integrate these two? In an article published in 2005 (Buerki & Adler, 2005), the authors review how negative affect states relate to cardiovascular disorders. They approach this concept in a multi-faceted way. They describe different types of negative affective disorders and review the literature showing evidence for the relationship of negative affective disorders to cardiovascular morbidity and mortality. They explain the physiology of these reviewed negative affective disorders. They then integrate existing theories along with the latest developments in this area and propose a new unified biopsychosocial concept. Although initially viewed by myself as a best article topic of the year, after reviewing the article I conclude that more work is necessary in order to improve the article and for further understanding of this potentially important topic.
In the Introduction to this article, the authors discuss the folklore belief that negative affect, disease, and death are interrelated. A stimulating example is provided about a tribal society that practices voodoo. In these societies, individuals believe that the voodoo practitioner has specialized magical powers. The example mentions that a powerful tribal member magically deprived individuals from the tribe's support system. This resulted in the individuals feeling very despondent and isolated and they died within 24 hours.
Now, many readers of this article are most likely not voodoo followers. However, we all have times where we have negative beliefs about something. The cognitive psychological approach is to believe that negative beliefs often result in negative affect. Besides scientific evidence to substantiate this concept, intuitively one can understand that chronic negative affect can result in syndromes or formal disorders that are debilitating. Also, there is an American idiomatic expression of, "He died of a broken heart." This expression suggests a link between negative affect and cardiovascular health. What scientific evidence exists to demonstrate this link between negative affect and cardiovascular health? The authors of this article start by defining negative affect in order to address this question.
NEGATIVE AFFECT AND CARDIOVASCULAR HEALTH
Negative Affect States Description
The authors describe five different negative affect states of 1) depression, 2) learned helplessness, 3) hopelessness, 4) vital exhaustion, and 5) grief. Depression is mentioned to include a variety of possible terms including major depression, depressive mood disorder, dysthymia, exogenous depression, endogenous depression, anaclitic depression, neurotic depression, and psychotic depression. It is unclear to me why the authors mention some of the more antiquated terms for depression. The terms of exogenous depression, endogenous depression, anaclitic depression, and neurotic depression are not formal diagnoses and to my knowledge are not used in the American clinical practice or research areas. …