Outcomes of psychological interventions designed to change unhelpful illness perceptions in people with coronary heart disease (CHD): A Meta-analysis

Background Previous research demonstrated that maladaptive illness perceptions contribute to poor psychological outcomes in CHD. Cardiac interventions are effective in changing illness perceptions. However, it is unclear whether interventions targeting illness perceptions can also contribute to positive changes in symptoms of depression and anxiety. It is unclear whether interventions with psychological components lead to more reduction in inaccurate illness perceptions. Objective The current thesis aims to determine if psychological interventions are more efficacious in changing illness perceptions compared to interventions without these components. Another goal is to assess whether cardiac interventions can also contribute to positive changes in anxiety and depression. Finally, the present investigation assesses the impact of type of illness and age on the efficacy of cardiac interventions. Methods Using meta-analytic design English databases, relevant journals and references lists were searched for randomised controlled trials of interventions designed to change illness perceptions. The outcomes included illness perceptions, and symptoms of depression and anxiety. Participants with CHD were included in the current meta-analysis. Effect sizes were expressed as Hedges’s g. Results All cardiac interventions yield a small but consistent effect in reduction of maladaptive illnesses perceptions. However, interventions with psychological component are not significantly more efficacious in changing maladaptive illness perception (Hedges’s g = .248) compared to interventions that do not contained psychological components (Hedges’s g = .224). Interventions designed to change illness perceptions contribute to significant positive change in symptoms of anxiety (Hedges’s g = .204), but not symptoms of depression (Hedges’s g = - .089). Participants with chronic illness report larger reduction in inaccurate illness representations compared to participants with acute illness. Conclusions All components (psychological and non-psychological) of cardiac interventions can lead to small but positive reduction in maladaptive illness perceptions and symptoms of anxiety. While some interventions components (e.g. information giving) might work on the cognitive level, other techniques (e.g. active listening) might be more efficacious in addressing issues in emotional processing of CHD. Further, depressive symptoms and acute nature of illness might complicate process of change because of higher levels of emotional distress