Skip to main content

Advertisement

SpringerLink
Log in

Parental Overprotection and Heart-Focused Anxiety in Adults with Congenital Heart Disease

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

The care of adult patients with congenital heart disease (CHD) is challenging from a mental health perspective, as these patients continue to face a variety of biopsychosocial issues that may impact emotional functioning. Despite these issues, there are limited data on the psychosocial functioning of adults with CHD, and there are no data on the impact of parental overprotection on heart-focused anxiety in this patient population.

Purpose

The aim of this study was to examine the relationships between patient recollections of parental overprotection and current heart-focused anxiety in adults with CHD.

Method

A cross-sectional sample of 190 adult patients with CHD (51% male; mean age = 32.28, SD = 11.86 years) completed validated measures of perceived parental overprotection (Parental Bonding Instrument) and heart-focused anxiety (Cardiac Anxiety Questionnaire).

Results

The results indicated that perceived parental overprotection (β = 0.19, p = 0.02) and heart defect complexity (β = 0.17, p = 0.03) were significantly related to heart-focused anxiety. Contrary to hypotheses, perceived parental overprotection did not vary as a function of heart defect complexity (F (2, 169) = 0.02, p = 0.98).

Conclusion

Perceived parental overprotection and heart defect complexity are associated with heart-focused anxiety in adults with congenital heart disease. These results can inform the development of clinical interventions aimed at improving the psychosocial adjustment of this patient population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Hoffman JI, Christianson R. Congenital heart disease in a cohort of 19,502 births with long-term follow-up. Am J Cardiol. 1978;42:641–7.

    Article  PubMed  CAS  Google Scholar 

  2. Botto LD, Correa A, Erickson JD. Racial and temporal variations in the prevalence of heart defects. Pediatrics. 2001;107:E32.

    Article  PubMed  CAS  Google Scholar 

  3. Warnes CA. The adult with congenital heart disease: born to be bad? J Am Coll Cardiol. 2005;46:1–8.

    Article  PubMed  Google Scholar 

  4. Webb G. Improving the care of Canadian adults with congenital heart disease. Can J Cardiol. 2005;21:833–8.

    PubMed  Google Scholar 

  5. Oechslin EN, Harrison DA, Connelly MS, Webb GD, Siu SC. Mode of death in adults with congenital heart disease. Am J Cardiol. 2000;86:1111–6.

    Article  PubMed  CAS  Google Scholar 

  6. Kovacs AH, Sears SF, Saidi AS. Biopsychosocial experiences of adults with congenital heart disease: review of the literature. Am Heart J. 2005;150:193–201.

    Article  PubMed  Google Scholar 

  7. Foster E, Graham JTP, Driscoll DJ, Reid GJ, Reiss JG, Russell IA, et al. Task force 2: special health care needs of adults with congenital heart disease. J Am Coll Cardiol. 2001;37:1161–98.

    Article  Google Scholar 

  8. Gledhill J, Rangel L, Garralda E. Surviving chronic physical illness: psychosocial outcome in adult life. Arch Dis Child. 2000;83:104–10.

    Article  PubMed  CAS  Google Scholar 

  9. Tayebjee MH, Lip GY. Psychosocial functioning of adults with congenital heart disease: a neglected area. Eur Heart J. 2003;24:2159.

    Article  PubMed  Google Scholar 

  10. Utens EM, Verhulst FC, Erdman RA, Meijboom FJ, Duivenvoorden HJ, Bos E, et al. Psychosocial functioning of young adults after surgical correction for congenital heart disease in childhood: a follow-up study. J Psychosom Res. 1994;38:745–58.

    Article  PubMed  CAS  Google Scholar 

  11. van Rijen EH, Utens EM, Roos-Hesselink JW, Meijboom FJ, van Domburg RT, Roelandt JR, et al. Psychosocial functioning of the adult with congenital heart disease: a 20-33 years follow-up. Eur Heart J. 2003;24:673–83.

    Article  PubMed  Google Scholar 

  12. Cox D, Lewis G, Stuart G, Murphy K. A cross-sectional study of the prevalence of psychopathology in adults with congenital heart disease. J Psychosom Res. 2002;52:65–8.

    Article  PubMed  Google Scholar 

  13. Utens EM, Bieman HJ, Verhulst FC, Meijboom FJ, Erdman RA, Hess J. Psychopathology in young adults with congenital heart disease. Follow-up results. Eur Heart J. 1998;19:647–51.

    Article  PubMed  CAS  Google Scholar 

  14. Popelova J, Slavik Z, Skovranek J. Are cyanosed adults with congenital cardiac malformations depressed? Cardiol Young. 2001;11:379–84.

    Article  PubMed  CAS  Google Scholar 

  15. Brandhagen DJ, Feldt RH, Williams DE. Long-term psychologic implications of congenital heart disease: a 25-year follow-up. Mayo Clin Proc. 1991;66:474–9.

    PubMed  CAS  Google Scholar 

  16. Bromberg JI, Beasley PJ, D'Angelo EJ, Landzberg M, DeMaso DR. Depression and anxiety in adults with congenital heart disease: a pilot study. Heart Lung. 2003;32:105–10.

    Article  PubMed  Google Scholar 

  17. Horner T, Liberthson R, Jellinek MS. Psychosocial profile of adults with complex congenital heart disease. Mayo Clin Proc. 2000;75:31–6.

    Article  PubMed  CAS  Google Scholar 

  18. Kovacs AH, Saidi AS, Kuhl EA, Sears SF, Silversides C, Harrison JL, et al. Depression and anxiety in adult congenital heart disease: predictors and prevalence. Int J Cardiol. 2009;137:158–64.

    Article  PubMed  Google Scholar 

  19. Eifert GH, Thompson RN, Zvolensky MJ, Edwards K, Frazer NL, Haddad JW, et al. The Cardiac Anxiety Questionnaire: development and preliminary validity. Behav Res Ther. 2000;38:1039–53.

    Article  PubMed  CAS  Google Scholar 

  20. Eifert GH, Hodson SE, Tracey DR, Seville JL, Gunawardane K. Heart-focused anxiety, illness beliefs, and behavioral impairment: comparing healthy heart-anxious patients with cardiac and surgical inpatients. J Behav Med. 1996;19:385–99.

    Article  PubMed  CAS  Google Scholar 

  21. Hoyer J, Eifert GH, Einsle F, Zimmermann K, Krauss S, Knaut M, et al. Heart-focused anxiety before and after cardiac surgery. J Psychosom Res. 2008;64:291–7.

    Article  PubMed  Google Scholar 

  22. Zvolensky MJ, Eifert GH, Feldner MT, Leen-Feldner E. Heart-focused anxiety and chest pain in postangiography medical patients. J Behav Med. 2003;26:197–209.

    Article  PubMed  Google Scholar 

  23. Rietveld S, Karsdorp PA, Mulder BJ. Heartbeat sensitivity in adults with congenital heart disease. Int J Behav Med. 2004;11:203–11.

    Article  PubMed  Google Scholar 

  24. Abramson LY, Seligman MEP, Teasdale JD. Learned helplessness in humans: critique and reformulation. Journal of Abnormal Psychology. 1978;87:49–74.

    Article  PubMed  CAS  Google Scholar 

  25. Beck AT. Depression: causes and treatment. Philadelphia: University of Pennsylvania Press; 1967.

    Google Scholar 

  26. Ainsworth MDS, Blehar MC, Waters E, Wall S. Patterns of attachment: a psychological study of the strange situation. Hillsdale: Lawrence Erlbaum Associates; 1978.

    Google Scholar 

  27. Bowlby J. Attachment and loss. New York: Basic Books; 1969.

    Google Scholar 

  28. Gantt LT. Growing up heartsick: the experiences of young women with congenital heart disease. Health Care Women Int. 1992;13:241–8.

    Article  PubMed  CAS  Google Scholar 

  29. Parker G, Tupling H, Brown LB. A parental bonding instrument. Br J Med Psychol. 1979;52:1–10.

    Article  Google Scholar 

  30. Linde LM, Rasof B, Dunn OJ, Rabb E. Attitudinal factors in congenital heart disease. Pediatrics. 1966;38:92–101.

    PubMed  CAS  Google Scholar 

  31. Linde LM, Rasof B, Dunn OJ. Longitudinal studies of intellectual and behavioral development in children with congenital heart disease. Acta Paediatr Scand. 1970;59:169–76.

    Article  PubMed  CAS  Google Scholar 

  32. Garson Jr A, Benson RS, Ivler L, Patton C. Parental reactions to children with congenital heart disease. Child Psychiatry Hum Dev. 1978;9:86–94.

    Article  PubMed  Google Scholar 

  33. Kokkonen J, Paavilainen T. Social adaptation of young adults with congenital heart disease. Int J Cardiol. 1992;36:23–9.

    Article  PubMed  CAS  Google Scholar 

  34. Turgeon L, O'Connor KP, Marchand A, Freeston MH. Recollections of parent–child relationships in patients with obsessive-compulsive disorder and panic disorder with agoraphobia. Acta Psychiatr Scand. 2002;105:310–6.

    Article  PubMed  CAS  Google Scholar 

  35. Bennet A, Stirling J. Vulnerability factors in the anxiety disorders. Br J Med Psychol. 1998;71:311–21.

    Article  PubMed  Google Scholar 

  36. Silove D, Parker G, Hadzi-Pavlovic D, Manicavasagar V, Blaszczynski A. Parental representations of patients with panic disorder and generalised anxiety disorder. Br J Psychiatry. 1991;159:835–41.

    Article  PubMed  CAS  Google Scholar 

  37. Lieb R, Wittchen HU, Hofler M, Fuetsch M, Stein MB, Merikangas KR. Parental psychopathology, parenting styles, and the risk of social phobia in offspring: a prospective-longitudinal community study. Arch Gen Psychiatry. 2000;57:859–66.

    Article  PubMed  CAS  Google Scholar 

  38. First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV-TR Axis I Disorders, Research Version, Non-patient Edition (SCID-I/NP). New York: Biometrics Research, New York State Psychiatric Institute; 2002.

    Google Scholar 

  39. Warnes CA, Liberthson R, Danielson GK, Dore A, Harris L, Hoffman JI, et al. Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol. 2001;37:1170–5.

    Article  PubMed  CAS  Google Scholar 

  40. Spielberger CD. Manual for the State-Trait Anxiety Inventory STAI (Form Y). Palo Alto: Mind Garden; 1983.

    Google Scholar 

  41. Wilhelm K, Niven H, Parker G, Hadzi-Pavlovic D. The stability of the Parental Bonding Instrument over a 20-year period. Psychol Med. 2005;35:387–93.

    Article  PubMed  Google Scholar 

  42. Tabachnick BG, Fidell LS. Using multivariate statistics. 4th ed. Boston: Allyn and Bacon; 2001.

    Google Scholar 

  43. Kovacs AH, Ong L, Lin J, Chessex C. Heart-focused anxiety: the role of socioeconomic status. J Card Rehabil. 2006;26:176–9.

    Article  Google Scholar 

  44. Parker G. Parental characteristics in relation to depressive disorders. Br J Psychiatry. 1979;134:138–47.

    Article  PubMed  CAS  Google Scholar 

  45. Claessens P, Moons P, de Casterle BD, Cannaerts N, Budts W, Gewillig M. What does it mean to live with a congenital heart disease? A qualitative study on the lived experiences of adult patients. Eur J Cardiovasc Nurs. 2005;4:3–10.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to acknowledge the patients, physicians, and staff at the Toronto Congenital Cardiac Centre for Adults for their support of this study. This study was funded in part by a Social Sciences and Humanities Research Council of Canada Doctoral Fellowship awarded to the first author.

Author information

Authors and Affiliations

  1. OrionHealth Services, 201-3150 E. 54th Ave, Vancouver, BC, V5S 1Z1, Canada

    Lephuong Ong

  2. Behavioural Cardiology, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada

    Robert P. Nolan

  3. Department of Psychology, York University, Toronto, ON, Canada

    Jane Irvine

  4. Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada

    Adrienne H. Kovacs

Authors
  1. Lephuong Ong
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert P. Nolan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jane Irvine
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Adrienne H. Kovacs
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lephuong Ong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ong, L., Nolan, R.P., Irvine, J. et al. Parental Overprotection and Heart-Focused Anxiety in Adults with Congenital Heart Disease. Int.J. Behav. Med. 18, 260–267 (2011). https://doi.org/10.1007/s12529-010-9112-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-010-9112-y

Keywords

Search

Navigation