혈압자료 분석을 통한 심혈관 질환 위험성격(A형, D형)과 정상집단의 변별†
Discriminating High Risk Personality for Coronary Heart Disease(type A and type D) from a Normal Group by Analyzing Blood Pressure Data
신영숙 (조선대학교)
초록
본 논문은 우선 문헌고찰을 통해 그간 심혈관 질환(CHD: coronary heart disease)의 성격적 위험인자로 지목되어 오던 A형 성격 및 D형 성격에 대하여 비일관된 연구 결과들이 도출된 원인 중의 하나를 생리적 지표에 대한 측정방법들 간의 이질성이나 타당성의 문제에 기인할 수 있다고 가정하였다. 이에 심혈관 질환과 밀접한 관련이 있는 생리적 지표인 혈압측정 방법의 차이에 의해 각 집단(A형, D형, 정상집단)이 구별될 수 있는지 알아보고자 하였다. 이를 위해 148명의 남녀 대학생(남자 45%)을 대상으로 사전에 A형 성격(MMPI-2의 TPA척도)과 D형 성격(DS14) 경향을 측정하는 자기보고형 설문지를 실시하여 A형 D형, 그리고 정상집단으로 구분한 후 혈압이 측정되었다. 먼저 전통적인 혈압측정방법에 의한 혈압수치(수축기/이완기 혈압)를 통해 각 집단이 구분될 수 있는지 살펴본 결과 집단별로 유의한 차이가 나타나지 않았다. 다음 단계로, 측정된 혈압 자료에 대한 패턴분석 방법을 적용했을 때, A형과 D형 성격이 정상인들과 얼마나 잘 구별될 수 있는지 알아보았다. 측정된 혈압 자료는 컴퓨터에 입력되어 커프 압력을 통해 측정된 혈압의 진동패턴은 먼저 정규화 시키고, 이 정규화 된 개인의 혈압 패턴은 국소 퓨리에 변환(STFT)을 사용하여 세 성격 유형간의 시간영역대별 주파수 변이에 대한 특징을 추출한 후 선형판별 분석(LDA)을 통해 분석해 보았다. 그 결과 세 집단을 구별할 수 있는 인식률은 88.8%로 상당히 높은 수준을 보였다. 이러한 결과는 A형 혹은 D형 성격과 심혈관 질환과의 관계에 대한 연구 결과는 심장활동을 충실히 반영하는 다양한 측정 지표나 그 분석방법의 차이에 의해 달라질 수 있으며, 특히 수축기와 이완기 이외의 혈압 진동패턴을 고려하는 것이 더 타당한 방법일 수 있다는 점을 시사하며, 향후 이러한 방법에 의해 심혈관 질환 위험 성격의 구성개념에 대한 새로운 측면에서의 탐색가능성을 제시했다는 의의를 지닌다.
- keywords
- Coronary Heart Disease, personality, blood pressure, 심혈관질환, A형 성격, D형 성격, 혈압
Abstract
The objective of this study was to test the validity of two different measuring methods of discriminating between type A and type D, which were known as the psychological risk factors for coronary heart disease(CHD), from that of normal people. Before measuring blood pressure, 148 college students(male 45%) participated and were classified as type A , B, and the normal group using the TPA scale of MMPI-2 and DS14. The first analysis was conducted with the data of systolic and diastoloic blood pressure, and we found no significant differences between these three groups. Next, a newly developed analyzing method was applied to the qualitative data of the blood pressure wave to examine the possibility of discriminating between a CHD-prone personality group and those of persons in the normal group. For this analysis, the blood pressure wave was measured with a computer program through cuff pressure. Then, the pressure wave patterns were normalized and transformed by STFT(short-time Fourier transformation). Finally, the wave features of the three groups were extracted from the STFT data, and then was analyzed by using LDA(linear discriminant analysis). The recognition rate was 88.8%, which represents a fairy robust result. The results of our analysis showed the utility of qualitative data of heart functions. Our study also suggests that the relationship between a CHD-prone personality and CHD could be varied by the different aspects of biological features or analyzing method for measuring heart functions.
- keywords
- Coronary Heart Disease, personality, blood pressure, 심혈관질환, A형 성격, D형 성격, 혈압
참고문헌
이문수, 박영민, 임홍의, 송우혁, 안정천, 김성환, ... 고영훈 (2007). D형 인격 척도의 표준화 예비연구: 내적 일치도 및 구성타당도. 정신신체의학, 15, 81-87.
이해영 (2014). 고혈압: 순환기 분야에서 최근 개정된새로운 가이드라인, 대한내과학회지, 87(2), 127-130.
한경희, 김중술, 임지영, 이정흠, 민병배, 문경주. (2005). 다면적인성검사II 매뉴얼. 서울: 마음사랑.
Al-Asadi, J. N. (2010). Type A behavior pattern:is it a risk factor for hypertension? Eastern Mediterranean Health Journal, 16(7), 740-745.
Blumenthal, J. A., Williams, R. B., Kong, Y., Schanberg, S. M., & Thompson, L. W. (1978). Type A behavior patter and coronary atherosclerosis. Circulation, 58(4), 634-639.
Booth-Kewley, S., & Friedman, H. S. (1987). Psychological predictors of heart disease: a quantitative review. Psychological Bulletin, 101(3), 343– 362.
Butcher, J. N., Graham, J. R., Williams, C. L., & Ben-Porath, Y. S. (1990). Development and use of the MMPI-2 content scales. Minneapolis:University of Minnesota Press.
Byrne, D. G. (1996). Type A Behavior, anxiety and neuroticism: reconceptualizing the pathophysiological path and boundaries of coronary-prone behavior. Stress Medication, 12(4), 227-238.
Chida, Y., & Steptoe, A. (2009). The association of anger and hostility with future coronary heart disease: a meta-analytic review of prospective evidence. Journal of the American College of Cardiology, 53, 936–946.
Denollet, J., Sys, S. U., & Brutsaert, D. L. (1995). Personality and mortality after myocardial infarction. Psychosomatic Medicine, 57, 582-591.
Denollet, J., Sys, S. U., Stroobant, N., Rombouts, H., Gillebert, T., & Brutsaert, D. L. (1996). Personality as independent predictor of long-term mortality in patients with coronary heart disease. Lancet, 347, 417-421.
Denollet, J. (1998). Personality and coronary heart disease: the type D scale-16(DS16). Annals of Behavioral Medicine, 20(3), 209-215.
Denollet, J. (2000). Type D personality:a potential risk factor refined. Journal of Psychosomatic Research, 49, 255-266.
Denollet, J., & Van Heck, G. L. (2001). Psychological risk factor in heart disease: what type D personality is (not) about. Journal of Psychosomatic Research, 51, 465-468.
Denollet, J. (2005). DS14:standard assessment of negative affectivity, social inhibition, and type D personality. Psychosomatic Medicine, 67, 89-97.
Denollet, J., Pedersen, S. S., Vrints, C. J., & Conraads, V. M. (2013). Predictive value of social inhibition and negative affectivity for cardiovascular events and mortality in patients with coronary artery disease: the type D personality construct. Psychosomatic Medecine, 75(9), 873-881.
Dimsdale, J. E. (1988). Aperspective on typeA behavior and coronary disease. The New England Journal of Medicine, 318, 110–112.
Dobson, A. J., Alexander, H. M., Malcolm, J. A., Steele, P. L., & Miles, T. A. (1991). Heart attacks and the Newcastle earthquake. The Medical Journal of Austalia, 155, 757-761.
Espnes, G. A. (2002). The type A behavior pattern and coronary heart disease: a critical and personal look at the type A behavior pattern at the turn of the century. International Congress Series, 1241, 99-104.
Fang, C. Y., & Myers, H. F. (2001). The effects of racial stressors and hostility on cardiovascular reactivity in African and Caucasian men. Health Psychology, 20(1), 64-70.
Franklin, S. S., Larson, M. G., Khan, S. A., Wong, N. D., Leip, E. P., Kannel, W. B., & Levy, D. (2001). Does the relation of blood pressure to coronary heart disease risk change with aging? Circulation, 103, 1245-1249.
Friedman, M., & Rosenman, R. H. (1959). Association of specific overt behavior pattern with blood and cardiovascular findings; blood cholesterol level, blood clotting time, incidence of arcus senilis, and clinical coronary artery disease. Journal of the American Medical Association, 169, 1286-1296.
Fukunaga, K. (1990) Introduction to Statistical Pattern Recognition(2nd Ed), (pp. 445-459). San Diego:Academic Press.
Gabor, D. (1946). Theory of communication. Journal of the Institution of Electrical Engineers, 93, 429-431.
Grande, G., Romppel, M., & Barth, J. (2012). Association between type D personality and prognosis in patients with cardiovascular diseases: a systematic review and meta-analysis. Annals of Behavioral Medicine, 43(3), 299-310.
Griffiths, M. D., & Dancaster, I. (1995). The effect of type a personality on physiological arousal while playing computer games. Addictive Behaviors 20(4), 543-548.
Hemingway, H., Kuper, H., & Marmot, M. (2003). Evidence based cardiology(2nd Ed): Psychosocial factors in the primary and secondary prevention of coronary heart disease: an updated systematic review of prospective cohort studies. (pp181-218). London: BMJ books.
Howard, S., & Hughes, B. M. (2013). Type D personality is associated with a sensitized cardiovascular response to recurrent stress in men. Biological Psychology, 94, 450-455.
Irvine, J., Garner, D. M., Craig, H. M., & Logan, A. G. (1991), Prevalence of type A behavior in untreated hypertensive individuals. Hypertension, 18, 72-78.
Jones, K. V. (1985), The thrill of victory:blood-pressure varalbility and the type A behavior pattern. Journal of Behavioral Medicine, 8(3), 277-285.
Kawachi, I., Sparrow, D., Kubzansky, L. D., Laura, D., Spiro, A., Vokonas, P., ... Weiss, S. T. (1998). Prospective study of a self-report Type A scale and risk of coronary heart disease: Test of the MMPI-2 Type A Scale. Circulation, 98, 405-412.
Kuper, H., Marmot, M., & Hemingway, H. (2002). Systematic review of prospective cohort studies of psychosocial factors in the etiology and prognosis of coronary heart disease. Seminars in Vascular Medicine, 2, 267–314.
Lee, D. J., Gomez-Marin, O., & Prineas, R. J. (1996). Type A behavior pattern and change in blood pressure from childhood to adolescence. The Minneapolis Children's Blood Pressure Study. American Journal of Epidemiology, 143(1), 63-72.
Lyness, S. A. (1993). Predictors of differences between Type A and B individuals in heart rate and blood pressure reactivity. Psychological Bulletin, 114(2), 266-95.
MacMahon, S., Peto, R., Cutler, J., Collins, R., Sorlie, P., Neaton, J., ... Stamler, J. (1990). Blood pressure, stroke, and coronary heart disease. Part 1, Prolonged differences in blood pressure:prospective observational studies corrected for the regression dilution bias. Lancet, 31, 765-774.
Mols, F., & Denollet, J. (2010). Type D personality among noncardiovascular patient populations:a systematic review. General Hospital Psychiatry, 32(1), 66-72.
Myrtek, M. (1995). Type A behavior pattern, personality factors, disease, and physiological reactivity: A meta-analysitc update. Personality and Individiual. Differences, 18(4), 491-502.
Myrtek, M. (2001). Meta-analyses of prospective studies on coronary heart disease, type A personality and hostility. International Journal of Cardiology 79, 245-251.
Nyklicek, I., Vorselaars, A., & Denollet, J. (2011). Type D personality and cardiovascular function in daily life of people without documented cardiovascular disease. International Journal of Psychophysiology, 80, 139-142.
O'Dell, K. R., Masters, K. S., Spielmans, G. I., & Maisto, S. A. (2011). Does type-D personality predict outcomes among patients with cardiovascular disease? A meta-analytic review. Journal of Psychosomatic Research, 71(4), 199-206.
Rozanski, A., Blumenthal, J. A., & Kaplan, J. (1999). Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation, 99(16), 2192-2217.
Rosenman, R. H., Brand, R. J., Jenkins, D., Friedman, M., Straus, R., & Wurm, M. (1975). Coronary heart disease in western collaborative group study:final follow-up experience of 8 1/2years. Journal of the American Medical Association, 233, 872–877.
Rosenman, R. H. (1997). Lecture given at 14th World Congress on Psychosomatic Medicine: Towards the years 2000. 31st August–5th September, Cairns, Australia.
Schnall, P. L., Schwartz, J. E., Landbergis, P. A., Warren, K., & Pickering, T. G. (1992). Relation between job strain, alcohol, and ambulatory blood pressure. Hypertension, 19, 488-494.
Schulman, J. K., & Stromberg, S. (2007). On the value of doing nothing. Cardiology in Review, 15, 123-132.
Shin, Y. S. (2011). Estimation of blood pressure measurements for hypertension diagnosis using oscillometric method. Communications and Computer sciences, E94-A(2), 806-812.
Siegel, J. M., Matthews, K. A., & Leitch, C. J. (1983). Blood pressure variability and the type a behavior pattern in adolescence. Journal of Psychosomatic Reserch, 27(4), 265-272.
Spence, J. T., Helmreich, R. L., & Pred, R. S. (1987). Impatience versus achievement strivings in the Type A pattern: Differential effects on students'health and academic achievement. Journal of Applied Psychology, 72(4), 522-528.
Suzuki, S., Sakamoto, S., Koide, M., Fujita, H., Sakuramoto, H., Kuroda. T., ... Matuso, T. (1997). Hanshin-Awaji earthquake as a trigger for acute myocardial infarction. American Heart Journal, 134, 974-977.
de Voogd, J. N., Sanderman, R., & Coyne, J. C. (2012) A meta-analysis of spurious associations between type D personality and cardiovascular disease endpoints. Annals of Behavioral Medicine, 44(1), 136-137.
Wilson, P. W., D'Agostino, R. B., Levy, D., Belanger, A. M., Silbershatz, H., & Kannel, W. B. (1998), Predicton of coronary heart disease using risk factor categories, Circulation, 97, 1837-1847.
Yan, L. L., Liu, K., Matthews, K. A., Daviglus, M. L., Ferguson, T. F., & Kiefe, C. I. (2003). Psychosocial factors and risk of hypertension:The coronary artery risk development in young adults (CARDIA) study. Journal of American Medical Association, 290, 2138-2148.
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수