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A Randomized-Controlled Minimal Early Behavioral Intervention Trial to Prevent the Development of Posttraumatic Stress Caused by Acute Myocardial Infarction

English title A Randomized-Controlled Minimal Early Behavioral Intervention Trial to Prevent the Development of Posttraumatic Stress Caused by Acute Myocardial Infarction
Applicant von Känel Roland
Number 140960
Funding scheme Project funding (Div. I-III)
Research institution Klinik und Poliklinik für Allgemeine Innere Medizin Inselspital
Institution of higher education University of Berne - BE
Main discipline Mental Disorders, Psychosomatic Diseases
Start/End 01.10.2012 - 31.01.2016
Approved amount 325'234.00
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All Disciplines (2)

Discipline
Mental Disorders, Psychosomatic Diseases
Clinical Cardiovascular Research

Keywords (7)

Posttraumatic stress disorder; Myocardial infarction; Randomized controlled trial; Behavioral intervention; Atherosclerosis; Cardiovascular disease; Psychological stress

Lay Summary (German)

Lead
Mit dieser Studie soll untersucht werden, ob ein einmaliges und früh nach dem Herzinfarkt durchgeführtes Beratungsgespräch nach notfallpsychologischen Prinzipien die Entwicklung von posttraumatischem Stress bezogen auf das Infarkterleben, gemessen 3 Monate nach dem Infarkt, zu reduzieren vermag.
Lay summary

Inhalt und Ziele des Forschungsprojekts

Nach einem Herzinfarkt entwickelt einer von sechs Patienten eine posttraumatische Belastungsstörung (PTBS), welche durch verschiedene Symptome charakterisiert ist. Dazu gehören das Wiedererinnern an den Infarkt (z.B. das automatische Ablaufen eines inneren Films), Handlungen, die das Wiedererinnern vermeiden sollen (z.B. nicht über den Infarkt sprechen wollen) und Beschwerden von erhöhter psychischer Anspannung wie Gereiztheit und gestörter Schlaf. Posttraumatische Stresssymptome verschlechtern die Prognose des Herzinfarkts und erhöhen das Risiko für eine erneute Hospitalisierung wegen einem Herzkreislauf-Problem. In der Notfallpsychologie werden nach Verkehrsunfällen und anderen Katastrophen früh sogenannte „Care Teams“ eingesetzt, welche die Betroffenen bei der Bewältigung traumatisierender Erlebnisse unterstützen, damit diese möglichst keine PTBS entwickeln. Das Hauptziel unserer Studie ist mit einem 45-min Beratungsgespräch am Patientenbett, innerhalb von 48 Stunden nach dem Infarkt, die Entwicklung von posttraumatischen Stresssymptomen, die 3 Monate später gemessen werden, zu vermindern. Weitere Ziele sind die Verbesserung des Funktionsniveaus im Alltag, sowie der körperlichen und psychischen Gesundheit der Patienten, welche ein Beratungsgespräch nach notfallpsychologischen Vorgaben erhielten. Die Wirksamkeit der notfallpsychologischen Beratung wird verglichen mit derjenigen einer allgemeinen Intervention zur Stressreduktion.

Wissenschaftlicher Kontext

Sollte sich diese einfache Form eines notfallpsychologischen Beratungsgesprächs als wirksam erweisen, so könnte sie prinzipiell Eins-zu-Eins auf Herznotfallstationen umgesetzt werden, um die Lebensqualität und eventuell sogar die Prognose von Infarktpatienten zu verbessen.

Direct link to Lay Summary Last update: 18.12.2013

Responsible applicant and co-applicants

Employees

Publications

Publication
The Role of Illness Perception and Its Association With Posttraumatic Stress at 3 Months Following Acute Myocardial Infarction
Znoj Hansjörg, Barth Jürgen, Schmid Jean-Paul, von Känel Roland, Princip Mary, Gattlen Christina, Meister-Langraf Rebecca E., Schnyder Ulrich (2018), The Role of Illness Perception and Its Association With Posttraumatic Stress at 3 Months Following Acute Myocardial Infarction, in Frontiers in Psychology, 9, 941.
C-reactive protein as a predictor of posttraumatic stress induced by acute myocardial infarction
Bielas Hannes, Meister Rebecca, Schmid Jean-Paul, Barth Jürgen, Znoj Hansjörg, Schnyder Ulrich, Princip Mary, von Känel Roland (2018), C-reactive protein as a predictor of posttraumatic stress induced by acute myocardial infarction, in General Hospital Psychiatry, 1.
Early Psychological Counseling for the Prevention of Posttraumatic Stress Induced by Acute Coronary Syndrome: The MI-SPRINT Randomized Controlled Trial.
von Känel Roland, Barth Jürgen, Princip Mary, Meister-Langraf Rebecca E., Schmid Jean-Paul, Znoj Hansjörg, Herbert Claudia, Schnyder Ulrich (2018), Early Psychological Counseling for the Prevention of Posttraumatic Stress Induced by Acute Coronary Syndrome: The MI-SPRINT Randomized Controlled Trial., in Psychotherapy and Psychosomatics, 87(2), 75-84.
Low Self-rated Health Is Related to Blood Hypercoagulability in Patients Admitted with Acute Myocardial Infarction.
von Känel Roland, Meister-Langraf Rebecca E., Schmid Jean-Paul, Barth Jürgen, Znoj Hansjörg, Schnyder Ulrich, Princip Mary (2018), Low Self-rated Health Is Related to Blood Hypercoagulability in Patients Admitted with Acute Myocardial Infarction., in Thrombosis and Haemostasis, 118(1), 54-62.
Acute stress disorder and C-reactive protein in patients with acute myocardial infarction.
Bielas Hannes, Meister-Langraf Rebecca E., Schmid Jean-Paul, Barth Jürgen, Znoj Hansjörg, Schnyder Ulrich, Princip Mary (2017), Acute stress disorder and C-reactive protein in patients with acute myocardial infarction., in European Journal of Preventive Cardiology, 25(3), 298-305.
Are Inflammatory Cytokines Associated with Pain during Acute Myocardial Infarction?
Imholz Laurin, Meister-Langraf Rebecca E., Princip Mary, Fux Michaela, Schnyder Ulrich, Barth Jürgen, Znoj Hansjörg, Schmid Jean-Paul, von Känel Roland (2017), Are Inflammatory Cytokines Associated with Pain during Acute Myocardial Infarction?, in Neuroimmunomodulation, 24(3), 154-161.
Post-traumatic stress disorder and cardiovascular disease
Edmondson Donald, von Känel Roland (2017), Post-traumatic stress disorder and cardiovascular disease, in The Lancet Psychiatry, 4(4), 320-329.
Can Illness Perceptions Predict Lower Heart Rate Variability following Acute Myocardial Infarction?
Princip Mary, Scholz Marco, Meister Langraf Rebecca E., Barth Jürgen, Schnyder Ulrich, Znoj Hansjörg, Schmid Jean-Paul, von Känel Roland (2016), Can Illness Perceptions Predict Lower Heart Rate Variability following Acute Myocardial Infarction?, in Frontiers in Psychology, 7(1801), 1-9.
Association of Trait Resilience With Peritraumatic and Posttraumatic Stress in Patients With Myocardial Infarction.
Meister Rebecca Elisabeth, Princip Mary, Schnyder Ulrich, Barth Jürgen, Znoj Hansjörg, Schmid Jean-Paul, Wittmann Lutz, von Känel Roland (2016), Association of Trait Resilience With Peritraumatic and Posttraumatic Stress in Patients With Myocardial Infarction., in Psychosomatic Medicine, 78(3), 327-334.
Perception of a hectic hospital environment at admission relates to acute stress disorder symptoms in myocardial infarction patients.
Meister Rebecca Elisabeth, Weber Tania, Princip Mary, Schnyder Ulrich, Barth Jürgen, Znoj Hansjörg, Schmid Jean-Paul, von Känel Roland (2016), Perception of a hectic hospital environment at admission relates to acute stress disorder symptoms in myocardial infarction patients., in General Hospital Psychiatry, 39, 8-14.
A picture paints a thousand words – heart drawings reflect acute distress, illness perception and predict posttraumatic stress symptoms after acute myocardial infarction
Princip Mary, Koemeda Miriam, Meister Rebecca E., Barth Jürgen, Schnyder Ulrich, Znoj Hansjörg, Schmid Jean-Paul, von Känel Roland (2015), A picture paints a thousand words – heart drawings reflect acute distress, illness perception and predict posttraumatic stress symptoms after acute myocardial infarction, in Health Psychology Open, 2(1), 1-10.
Resilience as a correlate of acute stress disorder symptoms in patients with acute myocardial infarction.
Meister Rebecca E, Weber Tania, Princip Mary, Schnyder Ulrich, Barth Jürgen, Znoj Hansjörg, Schmid Jean-Paul, von Känel Roland (2015), Resilience as a correlate of acute stress disorder symptoms in patients with acute myocardial infarction., in Open Heart, 2(1), 000261-000261.
Myocardial Infarction - Stress PRevention INTervention (MI-SPRINT) to reduce the incidence of posttraumatic stress after acute myocardial infarction through trauma-focused psychological counseling: study protocol for a randomized controlled trial.
Meister Rebecca, Princip Mary, Schmid Jean-Paul, Schnyder Ulrich, Barth Jürgen, Znoj Hansjörg, Herbert Claudia, von Känel Roland (2013), Myocardial Infarction - Stress PRevention INTervention (MI-SPRINT) to reduce the incidence of posttraumatic stress after acute myocardial infarction through trauma-focused psychological counseling: study protocol for a randomized controlled trial., in Trials, 14(1), 329-329.

Collaboration

Group / person Country
Types of collaboration
Dr. med. Hannes Bielas, Abteilung für Kinder- und Jugendpsychosomatik, Fontane-Klinik, Berlin Germany (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof. Dr. med. et phil. Karl-Heinz Ladwig, Helmholtz Zentrum München Germany (Europe)
- in-depth/constructive exchanges on approaches, methods or results
Prof. Dr. Jean-Paul Schmid, Kardiologie, Spital Tiefenau Bern Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
- Research Infrastructure
PD. Dr. phil. Jürgen Barth, Institut für komplementäre und integrative Medizin Unispital Zürich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof. Dr. phil. Hansjörg Znoj, Clinical Psychology and Psychotherapy, University of Bern Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Donald Edmondson, PhD, Center for Behavioral Cardiovascular Health, Columbia University United States of America (North America)
- in-depth/constructive exchanges on approaches, methods or results
- Publication
Prof. Dr. med. Ulrich Schnyder, Department of Psychiatry and Psychotherapy, University of Zurich Switzerland (Europe)
- in-depth/constructive exchanges on approaches, methods or results
- Publication

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
6th Annual Scientific Conference of the European Association of Psychosomatic Medicine (EAPM) Talk given at a conference Early psychological counseling to prevent posttraumatic stress induced by acute coronary syndrome: The MI-SPRINT randomized controlled trial. 28.06.2018 Verona, Italy von Känel Roland;
84. Jahrestagung der Deutschen Gesellschaft für Kardiologie Talk given at a conference Welche klinische Relevanz hat posttraumatischer Stress für kardiovaskuläre Ereignisse? 05.04.2018 Mannheim, Germany von Känel Roland;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie Talk given at a conference Sleep quality and neuroendocrine and coagulation activity in patients referred with acute coronary syndrome 23.03.2018 Berlin, Germany von Känel Roland;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie Talk given at a conference Acute stress disorder and C-reactive protein in patients admitted with acute myocardial infarction 22.03.2018 Berlin, Germany von Känel Roland;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie Talk given at a conference Early psychological counseling for the prevention of posttraumatic stress induced by acute coronary syndrome: the Myocardial Infarction – Stress Prevention Intervention (MI-SPRINT) randomized controlled trial 22.03.2018 Berlin, France von Känel Roland;
47th Annual Conference of the International Sociecty of Psychoneuroendocrinology (ISPNE) Talk given at a conference Relation of sleep disturbances to neuroendocrine and coagulation activity in patients with acute myocardial infarction 09.09.2017 Zurich, Switzerland von Känel Roland;
5th Annual Scientific Conference of the European Association of Psychosomatic Medicine (EAPM) Talk given at a conference Associations among sleep problems, neuroendocrine and coagulation activity in patients admitted with acute coronary syndrome 01.07.2017 Barcelona, Spain von Känel Roland;
Joint Annual Meeting Swiss Society of Cardiology (SSC) Swiss Society of Cardiac Surgery (SSCS) Talk given at a conference Psychocardiologic care after acute cardiac events 09.06.2017 Baden, Switzerland Schmid Jean-Paul; von Känel Roland;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie Talk given at a conference Self-rated health and hemostatic factors in patients with acute myocardial infarction 22.03.2017 Berlin, Germany von Känel Roland;
5th BENESCO Winter Research Meeting Talk given at a conference Sleep problems, neuroendocrine and coagulation activity in acute coronary syndrome 10.03.2017 Wengen, Switzerland von Känel Roland;
74th Annual Scientific Meeting of the American Psychosomatic Society Talk given at a conference Prevention of Posttraumatic Stress Attributable to Acute Myocardial Infarction: Data from the MI SPRINT Randomized Controlled Trial 11.03.2016 Denver, United States of America von Känel Roland;
74th Annual Scientific Meeting of the American Psychosomatic Society Talk given at a conference Prevention of posttraumatic stress attributable to acute myocardial infarction: Data from the MI-SPRINT randomized controlled trial 11.03.2016 Denver (CO), United States of America Schnyder Ulrich; Meister Rebecca; Znoj Hansjörg; von Känel Roland; Schmid Jean-Paul; Barth Jürgen; Princip Mary;
Lunchmeeting der Klink Barmelweid Individual talk Bedeutung von Stress und Depression für Herzkreislauf-Krankheiten 29.01.2016 Klinik Barmelweid, Switzerland von Känel Roland;
Kongress der Deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde 2015 Poster Association of prior health-related quality of life and acute stress disorder symptoms after myocardial infarction 26.11.2015 Berlin, Germany Barth Jürgen; Schnyder Ulrich; Meister Rebecca; Princip Mary; Schmid Jean-Paul; Znoj Hansjörg; von Känel Roland;
Kongress der Deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde 2015 Poster The relationship between heart rate variability and negative affect following an acute myocardial infarction 26.11.2015 Berlin, Germany Meister Rebecca; Schnyder Ulrich; Schmid Jean-Paul; Princip Mary; Barth Jürgen; Znoj Hansjörg; von Känel Roland;
Kongress der Deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde 2015 Poster Association of social support with posttraumatic stress three months after an acute myocardial infarction 26.11.2015 Berlin, Germany Znoj Hansjörg; Barth Jürgen; Meister Rebecca; Princip Mary; Schmid Jean-Paul; von Känel Roland; Schnyder Ulrich;
Kongress der Deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde 2015 Poster Impact of illness perception in heart rate variability following acute myocardial infarction 26.11.2015 Berlin, Germany Znoj Hansjörg; von Känel Roland; Princip Mary; Schmid Jean-Paul; Meister Rebecca; Barth Jürgen; Schnyder Ulrich;
Kongress der Deutschen Gesellschaft für Psychiatrie und Psychotherapie, Psychosomatik und Nervenheilkunde 2015 Poster Pictures speak volumes - prospective value of drawings of the amount of damage from patients and their health-related quality of life. 26.11.2015 Berlin, Germany Barth Jürgen; Schnyder Ulrich; Schmid Jean-Paul; von Känel Roland; Princip Mary; Znoj Hansjörg; Meister Rebecca;
Fortbildung der Medizinischen Klinik Kantonsspital Olten Individual talk Stress und Herz 13.11.2015 Kantonsspital Olten, Switzerland von Känel Roland;
Abendveranstaltung Qualitätszirkel Arzt-Apotheker der Regionen Aarau Individual talk Psychosomatik des Herz-Kreislauf-Systems: Gestern und Heute 10.11.2015 Seminarhotel Aarauerhof, Aarau, Switzerland von Känel Roland;
83. Jahresversammlung der Schweizerischen Gesellschaft für Allgemeine Innere Medizin Talk given at a conference Stress, Depression und Koronare Herzkrankheit - ein Update 21.05.2015 Congress Center Basel, Switzerland von Känel Roland;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2015 Talk given at a conference Krankheitswahrnehmung bei Patienten mit akutem Herzinfarkt 25.03.2015 Berlin, Germany Princip Mary;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2015 Poster Association of resilience with psychophysiological stress reaction to acute myocardial infarction 25.03.2015 Berlin, Germany Princip Mary; Barth Jürgen; Schnyder Ulrich; Znoj Hansjörg; von Känel Roland; Meister Rebecca; Schmid Jean-Paul;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2015 Poster Differences in psychophysiological stress reaction to acute myocardial infarction depend upon the perception of hecticness at hospital admission 25.03.2015 Berlin, Germany Schmid Jean-Paul; Znoj Hansjörg; von Känel Roland; Meister Rebecca; Schnyder Ulrich; Barth Jürgen; Princip Mary;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2015 Poster The role of initial illness perception in predicting posttraumatic stress levels at three months after acute myocardial infarction 25.03.2015 Berlin, Germany Meister Rebecca; von Känel Roland; Schmid Jean-Paul; Barth Jürgen; Znoj Hansjörg; Schnyder Ulrich; Princip Mary;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2015 Poster A picture paints a thousand words – association between the percentage of the drawn heart perceived as damaged and levels of posttraumatic stress three months after discharge 25.03.2015 Berlin, Germany Meister Rebecca; Barth Jürgen; von Känel Roland; Schmid Jean-Paul; Schnyder Ulrich; Znoj Hansjörg; Princip Mary;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2015 Talk given at a conference Akute Stressreaktion auf einen Myokardinfarkt 25.03.2015 Berlin, Germany Meister Rebecca;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2015 Poster Negative illness perceptions are associated with decreased heart rate variability following acute myocardial infarction. 25.03.2015 Berlin, Germany Znoj Hansjörg; Barth Jürgen; Schnyder Ulrich; Schmid Jean-Paul; Meister Rebecca; von Känel Roland; Princip Mary;
Symposium Psychosomatische Medizin - Nur mit beiden Augen sieht man scharf. Schweizerische Gesellschaft für Psychiatrie und Psychotherapie Jahreskongress Talk given at a conference Der Herzinfarkt als Psychotrauma: Klinische Bedeutung und Prävention 11.09.2014 Congress Center Basel, Switzerland von Känel Roland;
Barmelweid-Kolloquium Herausforderungen in der Psychosomatik - damals wie heute Talk given at a conference Psychotraumatisierung durch körperliche Krankheiten. 04.09.2014 Klinik Barmelweid, Switzerland von Känel Roland;
Fortbildung Klinik und Poliklinik für Innere Medizin UniversitätsSpital Zürich Individual talk Traumatisierung durch körperliche Krankheiten am Beispiel akuter Myokardinfarkt. 05.06.2014 UniversitätsSpital Zürich, Switzerland von Känel Roland;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2014 Poster Association of blood coagulation activation in acute myocardial infarction patients and posttraumatic stress levels after 3 months 28.03.2014 Berlin, Germany Znoj Hansjörg; Schmid Jean-Paul; Meister Rebecca; von Känel Roland; Schnyder Ulrich; Princip Mary; Barth Jürgen;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2014 Poster Association between social support and posttraumatic stress levels three months after acute myocardial infarction 28.03.2014 Berlin, Germany Znoj Hansjörg; Meister Rebecca; Schnyder Ulrich; Barth Jürgen; von Känel Roland; Princip Mary; Schmid Jean-Paul;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2014 Poster Association between overall psychological distress and posttraumatic stress levels three months after acute myocardial infarction 28.03.2014 Berlin, Germany Barth Jürgen; Schnyder Ulrich; von Känel Roland; Schmid Jean-Paul; Princip Mary; Meister Rebecca; Znoj Hansjörg;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2014 Poster Speaking in images - association between the percentage of the drawn heart perceived as damaged and subjective distress level after myocardial infarction 28.03.2014 Berlin, Germany Schmid Jean-Paul; Schnyder Ulrich; von Känel Roland; Barth Jürgen; Princip Mary; Znoj Hansjörg; Meister Rebecca;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2014 Poster Association between cognitive depressive symptoms and blood coagulation activation in patients with acute myocardial infarction patients 28.03.2014 Berlin, Germany Schnyder Ulrich; Znoj Hansjörg; Schmid Jean-Paul; von Känel Roland; Barth Jürgen;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2014 Poster Association of social support with psychophysiological reactions in acute myocardial infarction patients 28.03.2014 Berlin, Germany von Känel Roland; Znoj Hansjörg; Barth Jürgen; Schmid Jean-Paul; Meister Rebecca; Princip Mary; Schnyder Ulrich;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2014 Poster Association of heart rate variability with plasma cortisol in patients with acute myocardial infarction 28.03.2014 Berlin, Germany von Känel Roland; Schmid Jean-Paul; Schnyder Ulrich; Princip Mary; Meister Rebecca; Znoj Hansjörg; Barth Jürgen;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2014 Talk given at a conference Myocardial Infarction – Stress Prevention INTervention (MI-SPRINT) to reduce the incidence of posttraumatic stress after acute myocatrdial infarction through trauma-focused psychological counseling: study protocol for a randomized controlled trial 27.03.2014 Berlin, Germany Schmid Jean-Paul; Meister Rebecca; Schnyder Ulrich; Znoj Hansjörg; von Känel Roland; Barth Jürgen; Princip Mary;
Deutscher Kongress für Psychosomatische Medizin und Psychotherapie 2014 Talk given at a conference Association of heart rate variability with cardiovascular risk factors in patients with acute myocardial infarction 27.03.2014 Berlin, Germany Barth Jürgen; von Känel Roland; Meister Rebecca; Znoj Hansjörg; Princip Mary; Schnyder Ulrich; Schmid Jean-Paul;
72nd Annual Scientific Meeting of the American Psychosomatic Society Poster Association between cognitive depressive symptoms and blood coagulation activation in patients with acute myocardial infarction patient 15.03.2014 San Francisco (CA), United States of America Schnyder Ulrich; von Känel Roland; Schmid Jean-Paul; Princip Mary; Barth Jürgen; Znoj Hansjörg; Meister Rebecca;
72nd Annual Scientific Meeting of the American Psychosomatic Society Poster Association between social support and posttraumatic stress levels three months after acute myocardial infarction 15.03.2014 San Francisco (CA), United States of America Schnyder Ulrich; Princip Mary; Barth Jürgen; Meister Rebecca; Schmid Jean-Paul; Znoj Hansjörg; von Känel Roland;
72nd Annual Scientific Meeting of the American Psychosomatic Society Poster Speaking in images – association between the percentage of the drawn heart perceived as damaged and subjective distress level after myocardial infarction 14.03.2014 San Francisco (CA), United States of America Princip Mary; Barth Jürgen; Meister Rebecca; Schnyder Ulrich; Znoj Hansjörg; von Känel Roland; Schmid Jean-Paul;
72nd Annual Scientific Meeting of the American Psychosomatic Society Poster Association of heart rate variability with plasma cortisol in patients with acute myocardial infarction 14.03.2014 San Francisco (CA), United States of America Princip Mary; Schnyder Ulrich; Meister Rebecca; Znoj Hansjörg; Schmid Jean-Paul; Barth Jürgen; von Känel Roland;
72nd Annual Scientific Meeting of the American Psychosomatic Society Poster Association of social support with psychophysiological reactions in acute myocardial infarction patients 14.03.2014 San Francisco (CA), United States of America Barth Jürgen; Schnyder Ulrich; Meister Rebecca; von Känel Roland; Princip Mary; Znoj Hansjörg; Schmid Jean-Paul;
72nd Annual Scientific Meeting of the American Psychosomatic Society Poster Differences in physiological stress reaction to acute myocardial infarction depending on the context of hospital referrals 13.03.2014 San Francisco (CA), United States of America Barth Jürgen; Schmid Jean-Paul; Schnyder Ulrich; Meister Rebecca; Princip Mary; Znoj Hansjörg; von Känel Roland;
72nd Annual Scientific Meeting of the American Psychosomatic Society Poster Association of blood coagulation activation in acute myocardial infarction patients and posttraumatic stress levels after 3 months 13.03.2014 San Francisco (CA), United States of America Znoj Hansjörg; von Känel Roland; Barth Jürgen; Schmid Jean-Paul; Princip Mary; Schnyder Ulrich; Meister Rebecca;
72nd Annual Scientific Meeting of the American Psychosomatic Society Poster Association of heart rate variability with cardiovascular risk factors in patients with acute myocardial infarction 13.03.2014 San Francisco (CA), United States of America Barth Jürgen; von Känel Roland; Schmid Jean-Paul; Znoj Hansjörg; Princip Mary; Schnyder Ulrich; Meister Rebecca;
72nd Annual Scientific Meeting of the American Psychosomatic Society Poster Association between overall psychological distress and posttraumatic stress levels three months after acute myocardial infarction 13.03.2014 San Francisco (CA), United States of America Meister Rebecca; von Känel Roland; Barth Jürgen; Schnyder Ulrich; Znoj Hansjörg; Schmid Jean-Paul; Princip Mary;
Dienstagmittagfortbildung Psychosomatik Basel Individual talk Der Herzinfarkt als Psychotrauma: ein unterschätztes klinisches Phänomen 18.02.2014 Zentrum für Lehre und Forschung, Universitätsspital Basel, Switzerland von Känel Roland;
Interdisziplinäres Psychosomatisches Kolloquium Universität Freiburg i.B. Individual talk Stress und Herzinfarkt: Die Bedeutung der Psychosomatischen Medizin in der Kardiologie 14.01.2014 Auditorium Maximum, Universitätsklinikum Freiburg i.B., Germany von Känel Roland;
Cardiovascular Prevention and Rehabilitation Training Course, European Association for Cardiovascular Prevention and Rehabilitation Talk given at a conference Post-traumatic stress syndrome after myocardial infarction: How to assess and how to address 21.09.2013 Inselspital Bern, Switzerland von Känel Roland;
Weiterbildung Pflege Departement Herz und Gefässe. Inselspital Bern Individual talk Posttraumatische Belastungsstörung nach akutem Myokardinfarkt 02.09.2013 Inselspital Bern, Switzerland von Känel Roland;
Weiterbildung Pflege Departement Herz und Gefässe Inselspital Bern Individual talk Posttraumatische Belastungsstörung nach akutem Myokardinfarkt. 02.09.2013 Inselspital Bern, Switzerland von Känel Roland;
15. Symposium Perspektiven der psychiatrischen Therapie Talk given at a conference Angst und Herz 07.12.2012 Universitätsspital Zürich, Switzerland von Känel Roland;
Studienvorstellung Pflege Departement Herz und Gefässe Inselspital Bern Individual talk MI-SPRINT Myocardial Infarction–Stress PRevention INTervention 30.11.2012 Inselspital Bern, Switzerland von Känel Roland;


Communication with the public

Communication Title Media Place Year
Talks/events/exhibitions Herzinfarkt und Stress: Zwei, die zusammengehören. Themenabend Gehirn- u. Traumastiftung Graubünden German-speaking Switzerland 2015
Media relations: radio, television Krankes Herz und Psyche. Herzinfarkt – Herz und Seele gemeinsam heilen SRF 1; PULS, die Gesundheitssendung des Schweizer Fernsehens, 9. Februar 2015. Auftritt als Experte German-speaking Switzerland 2015
Talks/events/exhibitions Stress und Herz - eine gegenseitige Beziehung. Öffentlichkeitsveranstaltung TRION Kongresshaus Aarau German-speaking Switzerland 2014
Media relations: radio, television Nach dem Herzinfarkt auch den Geist heilen SRF 2 Wissenschaftsmagazin German-speaking Switzerland 2013
Media relations: print media, online media Der Albtraum danach. Warum ein Herzinfarkt die Patienten in eine schwere Krise stürzen kann. Gesundheitstipp German-speaking Switzerland 2012

Awards

Title Year
Posterpreis des Deutschen Kollegiums für Psychosomatische Medizin (DKPM) anlässlich des Deutschen Kongresses für Psychosomatische Medizin und Psychotherapie in Berlin; für das Poster "Speaking in images – association between the percentage of the drawn heart perceived as damaged and subjective distress level after myocardial infarction“ 2014

Associated projects

Number Title Start Funding scheme
139468 Cardiovascular diseases and psychiatric disorders in the general population: a prospective follow-up study 01.04.2012 Cohort Studies Large
122406 The effects of alpha- adrenergic blockade on norepinephrine-induced changes in blood lipids, procoagulant activity, and inflammatory cytokines in essential hypertension:associations with psychological factors? 01.08.2009 Project funding (Div. I-III)
68277 The effect of beta-blockers, aspirin and natural habituation on procoagulant activity, expression of cellular adhesion molecules and endothelial activation in response to acute mental stress. 01.11.2002 Project funding (Div. I-III)
56155 Auswirkungen von mentalem Stress auf die Hämostase. 01.05.1999 Fellowships for prospective researchers

Abstract

Background: Posttraumatic Stress Disorder (PTSD) is a mental disorder that may occur after someone experiences a traumatic event. PTSD is associated with impaired quality of life, social functioning, and high economic burden to the society. Between 10-20% of patients may develop PTSD in response to the traumatic experience of a myocardial infarction. Sociodemographic and psychosocial variables, including perceived distress during myocardial infarction (MI), have been identified as “risk factors” for the development of posttraumatic stress in the aftermath of MI. Posttraumatic stress attributable to MI has also been shown to be predictive of poor cardiovascular prognosis, whereby this link might relate to atherothrombotic processes like endothelial dysfunction, dyslipidemia, inflammation, and coagulation. Guidelines have been published for early interventions to prevent the development of posttraumatic stress after different types of trauma but not in terms of acute MI as a traumatic event. Main Aim: The overarching aim of the planned project is to test whether a minimal behavioral intervention performed shortly after acute MI in patients at a high risk to develop PTSD and in the setting of a coronary care unit (CCU) reduces the development of posttraumatic stress.Study Hypotheses: Our primary hypothesis is that posttraumatic stress levels at the 3-month follow-up (primary outcome) will be at least 20% lower in the intervention group than in the control group, and that this effect will last up to 12 months after the intervention. Our secondary hypothesis is that, at follow-up visits, the intervention group will show better psychosocial functioning, and a more favourable cardiometabolic biomarker profile (i.e. metabolic factors, biomarkers of endothelial dysfunction, inflammation and coagulation) (all secondary outcomes) than the control group.Study Design and Methods: The project will run for a period of 36 months (06/2012- 05/2015). We will enroll 426 patients between 18 and 80 years of age with a first-time MI at high risk to develop PTSD (i.e., those scoring on numeric rating scales (range 0-10) with at least 5 for chest pain plus at least 5 for fear of dying and/or helplessness/loss of control, all assessed at admission). Patients will be randomized to one single session of 45 min of either a behavioral intervention specifically targeting MI-triggered traumatic reactions (intervention group, n=213) or to receive general information about the role of psychological stress in coronary heart disease and how to deal with it (control group, n=213), both to be performed by the study therapist in the CCU within 48 h after patients have reached stable circulatory conditions. All patients will additionally receive written study material. The focus of the behavioral intervention is educational and resource-oriented targeting at individual resources and cognitive (re)structuring with regard to MI-related trauma stress. All patients will be assessed for previously identified “risk factors” of post-MI PTSD. Cardiac variables will be abstracted from hospital charts. Circulating levels of cardiometabolic biomarkers will also be determined. At the 3-month and 12-month follow-up all patients will be assessed for interviewer-rated posttraumatic stress levels, psychosocial functioning, and biomarkers. To identify adverse reactions, interim analyses will be performed after subgroups of 130 and 260 patients on “posttraumatic stress” at three months after the intervention. Expected Values: If effective, the planned project will be the first to show that the development of posttraumatic stress can successfully be prevented in post-MI patients at high risk to develop PTSD through a minimal behavioral intervention that is feasible (e.g. little-time consuming) to be administered in a busy CCU setting. A favorable cardiometabolic risk profile in the intervention group might inform a larger intervention trial to possibly improve cardiac prognosis in patients with PTSD attributable to MI, as biologically plausible atherothrombotic mechanisms would seem to be responsive to an early behavioral intervention.
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