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Psychology

<OpenstaxParagraph>
	For centuries, poets and folklore have asserted that there is a connection between moods and the heart (Glassman &amp; Shapiro, 1998). You are no doubt familiar with the notion of a broken heart following a disappointing or depressing event and have encountered that notion in songs, films, and literature.
</OpenstaxParagraph>
<OpenstaxParagraph>
	Perhaps the first to recognize the link between <OpenstaxTerm>depression</OpenstaxTerm> and <OpenstaxTerm>heart disease</OpenstaxTerm> was Benjamin Malzberg (1937), who found that the death rate among institutionalized patients with melancholia (an archaic term for depression) was six times higher than that of the population. A classic study in the late 1970s looked at over 8,000 people diagnosed with manic-depressive disorder (now classified as bipolar disorder) in Denmark, finding a nearly 50% increase in deaths from heart disease among these patients compared with the general Danish population (Weeke, 1979). By the early 1990s, evidence began to accumulate showing that depressed individuals who were followed for long periods of time were at increased risk for heart disease and cardiac death (Glassman, 2007). In one investigation of over 700 Denmark residents, those with the highest depression scores were 71% more likely to have experienced a heart attack than were those with lower depression scores (Barefoot &amp; Schroll, 1996). <a href="#CNX_Psych_14_03_HeartAtt">Figure 14.20</a> illustrates the gradation in risk of heart attacks for both men and women.
</OpenstaxParagraph>
<OpenstaxFigure id="CNX_Psych_14_03_HeartAtt" src="https://openstax.org/apps/archive/20240226.174525/resources/9166d64d857cb753f981a0abd20dc08ecf4a7aee" alt="A bar graph shows the relationship between depression score quartiles for men and women on the x-axis and heart attacks per 1000 on the y-axis. In the 1st depression score quartile, 3 out of 1000 women experienced heart attacks compared to 8 out of 1000 men. In the 2nd depression score quartile, 4 out of 1000 women experienced heart attacks compared to 11 out of 1000 men. In the 3rd depression score quartile, 5 out of 1000 women experienced heart attacks compared to 9 out of 1000 men. In the 4th depression score quartile, 5 out of 1000 women experienced heart attacks compared to 15 out of 1000 men." mediaType="image/jpeg" width="649" height="356" />
<OpenstaxFigureText width="649">
	<strong>Figure 14.20</strong> This graph shows the incidence of heart attacks among men and women by depression score quartile (adapted from Barefoot &amp; Schroll, 1996).
</OpenstaxFigureText>
<OpenstaxParagraph>
	After more than two decades of research, it is now clear that a relationship exists: Patients with heart disease have more depression than the general population, and people with depression are more likely to eventually develop heart disease and experience higher mortality than those who do not have depression (Hare, Toukhsati, Johansson, &amp; Jaarsma, 2013); the more severe the depression, the higher the risk (Glassman, 2007). Consider the following: 
</OpenstaxParagraph>
<OpenstaxUl>
	<OpenstaxLi>
		In one study, death rates from cardiovascular problems was substantially higher in depressed people; depressed men were 50% more likely to have died from cardiovascular problems, and depressed women were 70% more likely (Ösby, Brandt, Correia, Ekbom, &amp; Sparén, 2001).
	</OpenstaxLi>
	<OpenstaxLi>
		A statistical review of 10 longitudinal studies involving initially healthy individuals revealed that those with elevated depressive symptoms have, on average, a 64% greater risk of developing heart disease than do those with fewer symptoms (Wulsin &amp; Singal, 2003).
	</OpenstaxLi>
	<OpenstaxLi>
		A study of over 63,000 registered nurses found that those with more depressed symptoms when the study began were 49% more likely to experience fatal heart disease over a 12-year period (Whang et al., 2009).
	</OpenstaxLi>
</OpenstaxUl>
<OpenstaxParagraph>
	The American Heart Association, fully aware of the established importance of depression in cardiovascular diseases, several years ago recommended routine depression screening for all heart disease patients (Lichtman et al., 2008). Recently, they have recommended including depression as a risk factor for heart disease patients (AHA, 2014).
</OpenstaxParagraph>
<OpenstaxParagraph>
	Although the exact mechanisms through which depression might produce heart problems have not been fully clarified, a recent investigation examining this connection in early life has shed some light. In an ongoing study of childhood depression, adolescents who had been diagnosed with depression as children were more likely to be obese, smoke, and be physically inactive than were those who had not received this diagnosis (Rottenberg et al., 2014). One implication of this study is that depression, especially if it occurs early in life, may increase the likelihood of living an unhealthy lifestyle, thereby predisposing people to an unfavorable cardiovascular disease risk profile.
</OpenstaxParagraph>
<OpenstaxParagraph>
	It is important to point out that depression may be just one piece of the emotional puzzle in elevating the risk for heart disease, and that chronically experiencing several negative emotional states may be especially important. A longitudinal investigation of Vietnam War veterans found that depression, anxiety, hostility, and trait anger each independently predicted the onset of heart disease (Boyle, Michalek, &amp; Suarez, 2006). However, when each of these negative psychological attributes was combined into a single variable, this new variable (which researchers called psychological risk factor) predicted heart disease more strongly than any of the individual variables. Thus, rather than examining the predictive power of isolated psychological risk factors, it seems crucial for future researchers to examine the effects of combined and more general negative emotional and psychological traits in the development of cardiovascular illnesses.
</OpenstaxParagraph>

14.3.5 Depression and the Heart

1 Introduction to Psychology

1.1 What Is Psychology?

1.1.1 Why Study Psychology?

1.2 History of Psychology

1.2.1 Wundt and Structuralism

1.2.2 Functionalism

1.2.3 Freud and Psychoanalytic Theory

1.2.4 Wertheimer, Koffka, Köhler, and Gestalt Psychology

1.2.5 Pavlov, Watson, Skinner, and Behaviorism

1.2.6 Maslow, Rogers, and Humanism

1.2.7 The Cognitive Revolution

1.2.8 Multicultural And Cross-Cultural Psychology

1.2.9 Women in Psychology

1.3 Contemporary Psychology

1.3.1 Biopsychology and Evolutionary Psychology

1.3.2 Sensation and Perception

1.3.3 Cognitive Psychology

1.3.4 Developmental Psychology

1.3.5 Personality Psychology

1.3.6 Social Psychology

1.3.7 Industrial-Organizational Psychology

1.3.8 Health Psychology

1.3.9 Sport and Exercise Psychology

1.3.10 Clinical Psychology

1.3.11 Forensic Psychology

1.4 Careers in Psychology

1.4.1 Other Careers in Academic Settings

1.4.2 Career Options Outside of Academic Settings

2 Psychological Research

2.1 Why Is Research Important?

2.1.1 Use of Research Information

2.1.2 NOTABLE RESEARCHERS

2.1.3 The Process of Scientific Research

2.2 Approaches to Research

2.2.1 Clinical or Case Studies

2.2.2 Naturalistic Observation

2.2.3 Surveys

2.2.4 Archival Research

2.2.5 Longitudinal and Cross-Sectional Research

2.3 Analyzing Findings

2.3.1 Correlational Research

2.3.2 Causality: Conducting Experiments and Using the Data

2.3.3 Reliability and Validity

2.4 Ethics

2.4.1 Research Involving Human Participants

2.4.2 Research Involving Animal Subjects

3 Biopsychology

3.1 Human Genetics

3.1.1 Genetic Variation

3.1.2 Gene-Environment Interactions

3.2 Cells of the Nervous System

3.2.1 Neuron Structure

3.2.2 Neuronal Communication

3.2.3 Neurotransmitters and Drugs

3.3 Parts of the Nervous System

3.3.1 Peripheral Nervous System

3.4 The Brain and Spinal Cord

3.4.1 The Spinal Cord

3.4.2 The Two Hemispheres

3.4.3 Forebrain Structures

3.4.4 Midbrain and Hindbrain Structures

3.4.5 Brain Imaging

3.5 The Endocrine System

3.5.1 Major Glands

4 States of Consciousness

4.1 What Is Consciousness?

4.1.1 Biological Rhythms

4.1.2 Problems With Circadian Rhythms

4.2 Sleep and Why We Sleep

4.2.1 What is Sleep?

4.2.2 Why Do We Sleep?

4.3 Stages of Sleep

4.3.1 NREM Stages of Sleep

4.3.2 REM Sleep

4.4 Sleep Problems and Disorders

4.4.1 Insomnia

4.4.2 Parasomnias

4.4.3 Sleep Apnea

4.4.4 Narcolepsy

4.5 Substance Use and Abuse

4.5.1 Substance Use Disorders

4.5.2 Drug Categories

4.6 Other States of Consciousness

4.6.1 Hypnosis

4.6.2 Meditation

5 Sensation and Perception

5.1 Sensation versus Perception

5.1.1 Sensation

5.1.2 Perception

5.2 Waves and Wavelengths

5.2.1 Amplitude and Wavelength

5.2.2 Light Waves

5.2.3 Sound Waves

5.3 Vision

5.3.1 Anatomy of the Visual System

5.3.2 Color and Depth Perception

5.4 Hearing

5.4.1 Anatomy of the Auditory System

5.4.2 Pitch Perception