Psychopathophysiology and compassion-based cognitive-behavior group therapy for patients with coronary artery disease

Metaanalyses of longitudinal studies validated psychosocial factors play an important role for the occurrence and prognosis of coronary artery disease (CAD). Hostility and anxiety personality trait, depression, and stress affect cardiovascular functions, and these psychosocial risk factors impact the progression of coronary artery atherosclerosis through autonomic nervous system, HPA axis, and unhealthy behaviors. The mechanisms include enhanced heart rate, blood pressure, inflammation, coagulation response, and endothelial dysfunction. Cognitive-behavioral therapy could significantly reduce psychological risk factors and prognosis related to CAD. Weng et al. (2016) and Lin et al. (2018) developed the compassion-based cognitive-behavioral group therapy (CBGT) protocol for CAD patients. The effect of this protocol to reduce hostility and anxiety was supported, as well as improve vasomotor and ANS regulation for patients with CAD. Motivation is increased by providing psychoeducation of CAD psychopathology, along with personal psychophysiological stress profile illustrating enhanced heart rate, blood pressure, and vasoconstriction under emotional disturbance. This CBGT program increases motivations to attend psychotherapy session and adhere to medical advices, thus improving psychological and even cardiovascular health.