CASE STUDY: Compassion-based cognitive-behavior group therapy for patients with coronary artery disease

Purpose: Using a compassion-based cognitive-behavior group therapy (CBGT) program to reduce the hostility levels and examine the therapeutic effect on the autonomic nervous system (ANS) function of coronary artery heart disease (CAD) patients. Method: Forty-three documented CAD patients (mean age = 58.42 ± 7.54, male 69.8%) recruited from cardiology outpatients participated in the study. All the participants attended eight 2-h weekly sessions. They completed the multidimensional hostility, anxiety, depression, and perceived stress inventories and ANS examinations pre and post the CBGT treatment. The anger recall task was adopted to examine the ANS activities, respiration rate, and blood volume pulse (BVP). Results: After treatment, there were significant reductions in multidimensional hostility (ES = 0.22–0.43, t(41) = 3.41–5.51, ps < .001); depression (ES = 0.26, t(41) = 3.39, P < .001); anxiety (ES = 0.48, t(39) = 6.03, P < .001); and perceived stress (ES = 0.23, t(38) = 3.39, P < .01). Furthermore, there was a significant reduction in respiration rate (η2 = 0.30, F(1, 37) = 17.56, P < .001) and an increase in BVP (η2 = 0.10, F(1, 35) = 4.43, P < .05). The Pearson correlation showed that reduced (pre-post) expressive hostility (anger-out) behavior was correlated with increased (pre-post) Ln high-frequency power of heart rate variability, an index of cardiac parasympathetic modulation, during the four stages (r = − .32 to − .46, ps < .05) of the anger recall task. Conclusion: The result indicated that the increased parasympathetic modulation concurred with the decreased expressive hostility (anger-out) behavior after the compassion-based CBGT. This effect might be helpful to the disease prognosis.