Feasibility, Acceptability, and Preliminary Efficacy of a Positive Psychology Intervention for Patients with Coronary Heart Disease: A Randomized Pilot Trial

Alexandra Rojas, MD

Massachusetts General Hospital – Fellow

Scientific Abstract

Background. Psychological distress is associated with an increased risk of major cardiac adverse events and coronary heart disease- (CHD-) related mortality. In contrast, positive psychological constructs (e.g., optimism) are associated with reduced risk of CHD incidence and fewer cardiac readmissions. Positive psychology interventions (PPIs) can cultivate positive psychological constructs, reduce depressive symptoms, and enhance psychological well-being; these effects could impact cardiovascular outcomes. However, there have been few studies of PPIs in CHD patients. The aim of this study was to assess the use of a novel PPI among patients with CHD.

Methods. This three-arm, randomized pilot study assessed the feasibility, acceptability and preliminary efficacy of an 8-week, group-based PPI, compared to both cognitive-behavioral therapy (CBT) and treatment as usual (TAU) in CHD patients. Efficacy outcomes, measured at baseline, 9 weeks, and 15 weeks, included optimism, happiness, psychological distress, depressive symptoms, and C-reactive protein (CRP).

Results. Eighty-four patients with CHD (mean age=57.6±8.3;13.1% female) were enrolled and analyzed. Regarding feasibility and acceptability, participants in the PPI group completed 6.8 (SD 1.3) out of 8 sessions (85%), and 96% of PPI participants completed at least 5 of 8. Participants rated PPI exercises as easy to complete and useful, and reported a high likelihood of continuing them post-intervention. In preliminary efficacy analyses, compared to CBT and TAU, the PPI was associated with non-significant, small- to large-sized greater improvements in psychological outcomes but did not significantly impact CRP levels.

Conclusions. PPI was feasible and acceptable in patients with CHD, and it was associated with promising improvements in psychological outcomes when compared to TAU or CBT.

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research Areas


Alexandra Rojas, MD, Monika Sadlonova, MD, Maryam B. Kermani, PhD candidate, Jeff C. Huffman, MD, Gholam Reza Nikrahan, PhD, Masoumeh Sadeghi, MD, Christopher M. Celano, MD

Principal Investigator

Monika Sadlonova, MD