• Logo
  • SBMUJournals

Effectiveness of Transdiagnostic Treatment on Health Locus of Control and Emotional Regulation in Patients with Coronary Heart Disease

Farnoosh Rafei, Mohammad Hatami, Anita Baghdassarians, Amin Rafieipour



Introduction: Coronary heart disease (CHD) is one of the main death causes in the world. Therefore, it is necessary to identify the psychological disorders in these patients and to apply the necessary interventions to reduce them. The purpose of the present research was to examine the effectiveness of transdiagnostic treatment on health locus of control and emotional regulation in patients with CHD.
Methods: This research was a quasi-experimental one with the plan of pretest posttest control group. The statistical population included all patients with coronary heart disease 40-65 years old who were treated in Kasra hospital of Tehran in 2019. The sample included 90 patients assigned to the two groups experimental and control group randomly. Data were collected using the Multidimensional Health Locus of Control Scale and Emotional Regulation Scale. The data were analyzed using the methods of multivariate analysis of covariance (MANCOVA).
Results: The result showed that the transdiagnostic therapy significantly increases the internal health locus of control and emotional regulation in the experimental group (p<0.01).
Discussion: This finding has important implications as regards the education and mental health of patients with coronary heart disease. Based on the results, it is necessary to pay more attention to two variables health locus of control and emotional regulation in the design of interventions to reduce the psychological problems, patients with CHD.
Declaration of Interest: None



Transdiagnostic treatment, Health locus of control, Emotional regulation, Coronary artery. Disease.


- Mohamadpour S, Pouyanfar A, Najar Z, Jafari H, Rahmani S. The Effectiveness of Mindfulness-Based Cognitive Group Therapy on the Quality Of Life and Hope in the Patients with Coronary Heart Disease. The International Journal of Indian Psychology, Volume 3, Issue 3, No. 9. 2016 Jun 27:6.

- Mohsenzadeh Y, Sarokhani D, Hemmati F, Sarokhani M, Baghban AA, Sayehmiri K. Quality of life in heart patients in Iran: A systematic review and meta-analysis method. Der Pharma Chemica. 2016;8(18):27-34.

- Shields GE, Wells A, Doherty P, Heagerty A, Buck D, Davies LM. Cost-effectiveness of cardiac rehabilitation: a systematic review. Heart. 2018 Sep 1;104(17):1403-10.

- Huber D, Henriksson R, Jakobsson S, Mooe T. Nurse-led telephone-based follow-up of secondary prevention after acute coronary syndrome: One-year results from the randomized controlled NAILED-ACS trial. PloS one. 2017 Sep 8;12(9):e0183963.

- Boehm JK, Chen Y, Williams DR, Ryff CD, Kubzansky LD. Subjective well-being and cardiometabolic health: An 8–11 year study of midlife adults. Journal of psychosomatic research. 2016 Jun 1;85:1-8.

- Du J, Zhang D, Yin Y, Zhang X, Li J, Liu D, Pan F, Chen W. The personality and psychological stress predict major adverse cardiovascular events in patients with coronary heart disease after percutaneous coronary intervention for five years. Medicine. 2016;95(15).

- Fan JL, Kong Y, Shi SH, Cheng YH. Positive correlations between the health locus of control and self-management behaviors in hemodialysis patients in Xiamen. International journal of nursing sciences. 2016;3(1):96-101.

- Gupta A, Wani MA. Locus of control and big five personality factors among lovely professional university students. Indian Journal of Positive Psychology. 2018;9(4):473-6.

- Nazareth M, Richards J, Javalkar K, Haberman C, Zhong Y, Rak E, Jain N, Ferris M. Relating Health Locus of Control to Health Care Use, Adherence, and Transition Readiness Among Youths With Chronic Conditions, North Carolina, 2015. Preventing chronic disease. 2016 Jul;13:E93-.

- Wallston KA. The validity of the multidimensional health locus of control scales. Journal of health psychology. 2005 Sep;10(5):623-31.

- Rideout A, Tolmie E, Lindsay G. Health locus of control in patients undergoing coronary artery surgery–changes and associated outcomes: a seven-year cohort study. European Journal of Cardiovascular Nursing. 2017 Jan;16(1):46-56.

- Nafradi L, Nakamoto K, Schulz PJ. Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence. PloS one. 2017 Oct 17;12(10):e0186458.

- Tabernero C. Comparative Study of Positivity and Self-Efficacy for the Regulation of Negative Emotions in Persons with and without Cardiovascular Disease. EC Psychology and Psychiatry (ECPP). 2017;4:247-63.

- Cavanagh M, Quinn D, Duncan D, Graham T, Balbuena L. Oppositional defiant disorder is better conceptualized as a disorder of emotional regulation. Journal of attention disorders. 2017 Mar;21(5):381-9.

- Lebel RD. Moving beyond fight and flight: A contingent model of how the emotional regulation of anger and fear sparks proactivity. Academy of Management Review. 2017 Apr;42(2):190-206.

- Bahremand M, Alikhani M, Zakiei A, Janjani P, Aghaei A. Emotion Risk-Factor in Patients with Cardiac Diseases: The Role of Cognitive Emotion Regulation Strategies, Positive Affect and Negative Affect (A Case-Control Study). Global journal of health science. 2016 Jan;8(1):173.

- Besharat MA, Ramesh S. The relationship between worry and anger rumination with adjustment problems to heart disease: The mediating role of difficulties in emotion regulation. Heart and Mind. 2017 Oct 1;1(4):141.

- Barlow DH, Ellard KK, Fairholme CP, Farchione CP, Boisseau CL, Allen LB, Ehrenreich-May J. The unified protocol for transdiagnostic treatment of emotional disorders: Client workbook.

- Norton PJ, Roberge P. Transdiagnostic therapy. Psychiatric Clinics. 2017 Dec 1;40(4):675-87.

- Barlow DH, Farchione TJ, Bullis JR, Gallagher MW, Murray-Latin H, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Conklin LR, Boswell JF, Ametaj A. The unified protocol for transdiagnostic treatment of emotional disorders compared with diagnosis-specific protocols for anxiety disorders: A randomized clinical trial. JAMA psychiatry. 2017 Sep 1;74(9):875-84.

- Capobianco L, Reeves D, Morrison AP, Wells A. Group metacognitive therapy vs. mindfulness meditation therapy in a transdiagnostic patient sample: a randomised feasibility trial. Psychiatry research. 2018 Jan 1;259:554-61.

- Ellard KK, Bernstein EE, Hearing C, Baek JH, Sylvia LG, Nierenberg AA, Barlow DH, Deckersbach T. Transdiagnostic treatment of bipolar disorder and comorbid anxiety using the Unified Protocol for Emotional Disorders: A pilot feasibility and acceptability trial. Journal of affective disorders. 2017 Sep 1;219:209-21.

- Gianaros PJ, Marsland AL, Kuan DC, Schirda BL, Jennings JR, Sheu LK, Hariri AR, Gross JJ, Manuck SB. An inflammatory pathway links atherosclerotic cardiovascular disease risk to neural activity evoked by the cognitive regulation of emotion. Biological psychiatry. 2014 May 1;75(9):738-45.

- Roberge P, Provencher MD, Gosselin P, Vasiliadis HM, Gaboury I, Benoit A, Antony MM, Chaillet N, Houle J, Hudon C, Norton PJ. A pragmatic randomized controlled trial of group transdiagnostic cognitive-behaviour therapy for anxiety disorders in primary care: study protocol. BMC psychiatry. 2018 Dec;18(1):320.

- Maddahi, M.E., Nikpajouh, A., Khalatbari, J., Malihia Zakerini, S. and Hashemi, S., 2018. Effects of metacognitive training and mindfulness-based cognitive therapy on couple communication patterns with the mediation of perceived stress, perceived social support, and emotion regulation in patients with coronary heart disease. Iranian Heart Journal, 19(1), pp.6-14.

- Rideout A, Tolmie E, Lindsay G. Health locus of control in patients undergoing coronary artery surgery–changes and associated outcomes: a seven-year cohort study. European Journal of Cardiovascular Nursing. 2017 Jan;16(1):46-56.

- Moshki M, Ghofranipour F, Hajizadeh E, Azadfallah P. Validity and reliability of the multidimensional health locus of control scale for college students. BMC Public health. 2007 Dec;7(1):295.

- Gross JJ, John OP. Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. Journal of personality and social psychology. 2003 Aug;85(2):348.

- Hasani J. Persian version of the emotion regulation questionnaire: Factor structure, reliability and validity. International Journal of Behavioral Sciences. 2016 Nov 1;10(3):156-61.

- Kashdan TB, Morina N, Priebe S. Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo War: Experiential avoidance as a contributor to distress and quality of life. Journal of anxiety disorders. 2009 Mar 1;23(2):185-96.

DOI: https://doi.org/10.22037/ijabs.v6i3.28276


  • There are currently no refbacks.