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Psychosocial Factors in Patients With Noncardiac Chest Pain

From Division of Social Science, Hong Kong University of Science and Technology (C.C.) and the University Department of Medicine, University of Hong Kong (W.W., K.L., B.C.W., W.H.C.H., W.H., S.L.), Hong Kong.

Address reprint requests to: Cecilia Cheng, PhD, Division of Social Science, Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong. Email: c.cheng{at}ust.hk

OBJECTIVE: This study sought to explore some psychosocial factors that distinguished individuals with noncardiac chest pain (NCCP) from those without NCCP, and whether these psychosocial factors were associated with anxiety and depression that are co-morbid factors of NCCP.

METHODS: A matched case-control design was adopted to compare differences in psychosocial factors among a target group of patients with NCCP (N = 70), a pain control group of patients with rheumatism (N = 70), and a community control group of healthy individuals (N = 70).

RESULTS: Compared with subjects from the two control groups, NCCP patients tended to monitor more, use more problem-focused coping, display a coping pattern with a poorer strategy-situation fit, and receive less emotional support in times of stress. Moreover, monitoring perceptual style and problem-focused coping were associated with higher levels of anxiety and depression. Coping pattern with a strategy-situation fit and emotional support were related to lower levels of anxiety and depression.

CONCLUSIONS: The present new findings suggest that monitoring perceptual style and inflexible coping style are risk factors that enhance one’s vulnerability to NCCP. Emotional support may be a resource factor that reduces one’s susceptibility to NCCP.

Key Words: atypical chest pain, • coping, • noncardiac chest pain, • psychosocial factors, • stress.

Abbreviations: ANOVA = analysis of variance;; EMBSS-SF = Extended Miller Behavioral Style Scale–Short Form;; ISSB-SF = Inventory of Socially Supportive Behaviors–Short Form;; MAAC-R = Multiple Affect Adjective Checklist–Revised;; MANOVA = multivariate analysis of variance;; NCCP = noncardiac chest pain;; PFCI = problem-focused coping index;; SES = socioeconomic status;; SSFI = strategy-situation fit index

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