Schema Therapy on Personality Type D, Working and Prospective Memory and Adherence to Treatment in Patients with Coronary Artery Disease

Many studies have provided the combination and incorporation of the fields of psychology and Cardiology. Using science of psychology has been suggested to prevention and treatment of diseases related to the heart. Type D personality is recognized as a risk factor for a wide range of diseases. Type D personality is the inter action of two stable personality traits: negative affectivity (NA), which is the tendency to negative emotions experience across time and situations, and social inhibition (SI), which is the tendency to inhibit the expression of emotions. Patients who have high score in NA, frequently report feelings of dys phoria, worry, tension and patients who have high score in SI tend to avoid negative reactions from others. Adherence to medication is defined as a degree to the patient who is in accordance with the interval and dose regimen prescribed. Adherence to medication refers to the degree or extent of compliance to the health care provider’s recommendations for day–to–day treatment. Cognitive function disturbances in patients with cardiovascular disease (CVD) occur relatively often. This fact can have significant influence on physiological, psychological and social aspects of a patient’s life. A recent study found that although heart doctors do cognitive problems test, but many of them miss memory loss in their patients. However, some heart doctors do not believe that diagnose of cognitive problems is not their duty, and they are mainly trained to focus on heart problems. They feel that check for memory problems should be done by primary care physicians. However, if you care someone with heart disease, make sure that one of their doctors tests them for memory loss, as it could be the difference in the success or failure of their treatment. Working memory is a cognitive system with a limited capacity that is responsible for temporarily holding information available for processing. Working memory is important for reasoning and the guidance of decision–making and behavior. Prospective memory is a form of memory that involves remembering to perform a planned action or recall a planned intention at some future point in time. Prospective memory tasks are common in daily life and range from the relatively simple to extreme life or death situations. This study aimed to evaluate schema therapy on personality type D, working and prospective memory and adherence to treatment in patients with cardiovascular disease.

Five man with heart disease were selected from patients referred to Mashhad (Northeast of Iran) Razavi hospital along with using purposeful sampling method. The statistical population of all cardiac patients was Razavi Specialist Hospital in Mashhad. Patients participated in this study after obtaining treatment requirements. The efficacy of treatment protocol was evaluated in three phase (Baseline, 6 session treatment and 6 weeks follow–up) by using the Type D personality questionnaire (DS14), prospective memory questionnaire, Wechsler working memory test and Morisky Medication Adherence Scale (MMAS–8–Item). The data were analyzed using visual analysis using Excel software, calculating the permanent change index (RCI), and calculating recovery percentages.

The results showed that cognitive, experimental, interpersonal and behavioral techniques in the D character was (p=0.033), working memory was (p=0.085), prospective memory was (p=0.042), and follow–up therapy medicine was (p=0.003). Cardiovascular patients were statistically and clinically significant.

According to the results, schema therapy waseffective in reducing personality type D, increasing working memory, reducing prospective memory defects and increasing the medication adherence to treatment.