臺灣臨床心理學在心血管疾病之研究與應用現況

The Research and Applications of Clinical Health Psychology for Cardiovascular Diseases in Taiwan

台灣臨床心理學在冠狀動脈心臟病之研究，肇始於吳英璋教授所領導的台大健康心理學研究團隊，並由中正大學健康心理學實驗室繼續耕耘與發展。在心理病理研究方面，確立敵意性格在國人罹患冠狀動脈心臟病之生理病理機制中所扮演的角色，包括（1）直接路徑：敵意與較高心血管反應、較高交感神經反應、較多阻塞程度超過75%的冠狀動脈數量、較高的三酸甘油酯、與較差的血管彈性有關；（2）間接路徑：敵意與憂鬱及焦慮皆達正相關，此外，表達敵意與負向健康行為（包括抽煙、喝酒、與食用高油脂食物）亦有關。在臨床應用方面，研究證實冠狀動脈心臟病患者經認知行為團體治療降低其敵意傾向後，凝血速率亦明顯降低。此一生理機制的調整，將有助於減少冠狀動脈心臟病患者血管阻塞之風險，降低冠狀動脈心臟病之復發率與再住院率。

The research and applications of clinical health psychology for cardiovascular diseases were built by the Health Psychology Research Team led by Professor En-Chang Wu. This team found that hostility personality is an important psychopathological factor for cardiovascular diseases. Empirical researches conducted in Taiwan demonstrated that hostility directly involving in the pathophysiological mechanism of cardiovascular diseases with the findings that hostility was correlated with higher cardiovascular responses, higher autonomic nervous system activities, higher blood lipids, and impaired endothelial functions. Additionally, hostility indirectly involved in the pathophysiological mechanism of cardiovascular diseases through the negative health behaviors including greater alcohol, cigarette, and high fatty food consuming. With respect to the clinical application, Weng et al. (2006) reported that the cognitive behavior group therapy could reduce the blood coagulant speed of coronary heart disease patients to decrease the recurrence and mortality rate of the disease by decreasing the hostility tendency of coronary artery heart disease patients.