Matters of the Heart: Self-regulation of Negative Emotions to Reduce Coronary Heart Disease Risk

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Negative emotions increase coronary heart disease risk (Harris, Luskin, Norman, Standard, Buring, Evans & Thoresen, 2006; Sadovsky, 2004; Tibbits, Ellis, Piramelli, Luskin, & Lukman, 2006; Todara, Shen, Niaura, Spiro & Ward, 2003; Warner, 2006). Over the last decade, researchers in a variety of disciplines have been investigating the impact of negative emotions, hostility, anger, stress, anxiety and depression on coronary heart disease. In general, stress and the inability to cope with stress results in increased sympathetic nervous system activity which results in increased vascular resistance, subsequently raising blood pressure. Strong negative emotions that accompany unforgiving responses typically initiate sympathetic reactivity, thus raising blood pressure, and have been linked with other markers signaling increased inflammation like C-reactive protein, interleukin-1, and tumor necrosis factors. Increased inflammatory markers are of particular interest because of the important roles they play in artery-clogging atherosclerosis (Boyle, Jackson & Suarez, 2007; Hemingway, et al., 2003; Tibbits, Ellis, Piramelli, Luskin, & Lukman, 2006; Todara, Shen, Niaura, Spiro & Ward, 2003; Warner, 2007). Forgiving responses have been shown to reverse these negative emotions (Doyle, 1999; Hebl & Enright, 1993; Luskin, 2001; McCullough, 2007; Orcutt, 2006; Tibbits, Ellis, Piramelli, Luskin & Lukman, 2006; Wade & Worthington, 2005; Wade, Bailey & Shaffer, 2005; Williamson & Gonzales, 2007). The purpose of this preliminary study was to determine the effectiveness of a 6 week forgiveness intervention adapted from the Stanford Forgiveness Project on blood pressure, perceived stress, anxiety, depression and anger in patients with Stage 1 hypertension. This pilot study focused on refining the forgiveness intervention strategy, provided essential information about intervention effectiveness, and established measures of efficacy for future research.


Keywords: Forgiveness, Cardiovascular Risk Factor Reduction Anger, Stress, Depression, Hypertension
Stream: Natural, Environmental and Health Sciences
Presentation Type: Paper Presentation in English
Paper: A paper has not yet been submitted.


Dr. Kandy Smith

Associate Professor, College of Nursing, University of South Alabama
Mobile, Alabama, USA

Kandy Smith is an Associate Professor in the College of Nursing at the University of South Alabama in Mobile, Alabama. Her nursing career spans 24 years and includes practice in the ICU as a nurse and clinical nurse specialist, and in staff development before joining academia 14 years ago. Kandy received a Bachelor of Science in Nursing from the University of Southern Mississippi, a Masters in Nursing from Emory University and a Doctorate of Nursing Science from Louisiana State University Health Sciences Center. Having taught across the curriculum in both undergraduate and graduate nursing programs, Dr. Smith is passionate about developing emotional competencies in nursing students and nurses in practice. She participated as a Fellow in the Helene Fuld Leadership Initiative in Nursing Education Fellowship, and has presented numerous workshops, papers and posters on the subject of developing social and emotional competencies. Research interests include leadership development and implications for social and emotional competency development in nurses and patients.

Robin Lawson

Clinical Assistant Professor, College of Nursing, University of South Alabama
Mobile, Alabama, USA

Robin Lawson is a Clinical Assistant Professor in the College of Nursing at the University of South Alabama in Mobile, Alabama. Her nursing career of 14 years includes practice in the intensive care unit as a staff nurse and as a critical care educator. Robin joined academia seven years ago and established a successful faculty practice as a nurse practitioner at a community-based health care clinic where she manages the health care of acutely and chronically ill patients with multiple, complex health problems and co-morbid illnesses such as hypertension, cardiovascular disease, and diabetes. Her work includes a therapeutic lifestyle intervention project shown to decrease cardiovascular risk reduction through a healthy diet and physical activity. Robin received a Bachelor of Science in Nursing and a Masters of Science in Nursing from the University of South Alabama. She will complete her Doctor of Nursing Practice degree from the University of South Alabama in December 2007.

Dr. Robert Lightfoot

Founder and Executive Medical Director, Victory Health Partners
Mobile, Alabama, USA

Dr. Robert Lightfoot is the founder and Executive Medical Director for Victory Health Partners, a nonprofit healthcare organization providing a continuum of affordable quality care for the low income uninsured population. Victory is truly a community partnership of people from diverse backgrounds banding together in friendship and love to provide healthcare to fellow citizens of the community. Dr. Lightfoot joins with physicians, dentists, nurse practitioners and psychologists to provide health care services in a clinic setting and collaborates with a network of over 150 physicians and dentists who donate their services in their offices to the Clinic’s patients at little or no cost. His work has met a critical need for medical care in the local community. Dr. Lightfoot received his medical education at the University of Alabama, completed his surgical internship and residency in General and Vascular Surgery at the University of Kentucky Medical Center. He is certified by the American Board of Surgery. He is a member of many professional organizations, is a Fellow in the American College of Surgeons, and has held many distinctive positions, including President of the Medical Staff at Knollwood Park Hospital.

Dr. Anthony Guarino

Clinical Therapist, Victory Health Partners
Mobile, Alabama, USA

Dr. Anthony Guarino’s distinguished career spans research, academia and clinical practice. After graduating with a B. S. in Chemistry from Boston College, he resumed his scientific training at the University of Rhode Island, receiving an M.S. in Chemistry and a Ph.D. in Pharmacology with a minor in Medicinal Chemistry. The next 26 years of his professional life were equally divided between the National Institutes of Health (NIH) and the Food and Drug Administration (FDA). During most of his time at NIH, Dr. Guarino was involved with the drug development program of the National Cancer Institute (NCI). Much of his FDA time involved the review of applications for drug approvals. Dr. Guarino was granted the credentials of Licensed Professional Counselor (1995) after returning to graduate school to obtain a M. S. in Counseling from Liberty University (1993). Dr. Guarino has spent the last 14 years specializing in Marriage & Family Counseling for Catholic Social Services, Castlebrook Counseling, Inc. and Carpenters House, PC in Mobile, AL. Currently he maintains a full practice as a Clinical Therapist at the Carpenter’s House and Victory Health Partners as a Clinical Therapist and serves as an adjunct professor in the Department of Pharmacology, College of Medicine, University of South Alabama.

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