Multimodal treatment of women with mitral valve prolapse syndrome

No Thumbnail Available
Nevin, Doris Eileen Jacobs
Nicholas, Donald R.
Issue Date
Thesis (Ph. D.)
Department of Counseling Psychology and Guidance Services
Other Identifiers

Mitral valve prolapse is the most commonly occurring cardiac condition. It is a benign condition which affects as many as 10% of the population. Some patients have symptomatic mitral valve prolapse. This condition is referred to as mitral valve prolapse syndrome. Symptoms include: chest pain, tachycardia, palpitations, fatigue, dizziness, shortness of breath, headaches, low exercise tolerance, feelings of anxiety, panic attacks, and mood swings. These symptoms adversely effect the patient's quality of life.The purpose of this study was to investigate the response of patients with mitral valve prolapse syndrome to treatment that includes the accepted treatment for panic disorder, and to determine the roles of self-efficacy and of level of spousal support in enhancing the ability of identified patients to cope with mitral valve prolapse syndrome.Thirty-one subjects initially agreed to participate in this study. Of these subjects, fifteen left the study. The leading causes of dropout were lack of spousal support and multiple role stress. The remaining sixteen subjects completed the study. Subjects were randomly divided into three treatment conditions, individual multimodal therapy, couples multimodal therapy, and a waiting list/control group. Treatment consisted of attending a five session psychoeducational program and completing prescribed exercises at home between sessions. The first two sessions examined self-care lifestyle changes that patients could make to alleviate symptoms. The remaining three sessions focused on the over reactiveness of the autonomic nervous system for these patients and the efficacy of learned relaxation procedures. Dependent measures included a Symptom Checklist, Anxiety Sensitivity, Strength and Magnitude of Self-Efficacy and Strength and Magnitude of Interactive Efficacy.Data was analyzed in a two-step process. First, it was analyzed using a multiple single case design format. This was followed by a quantitative analysis of grouped data. In general, the multiple single case design complemented the quantitative analysis. Individual findings in the multiple single case design indicated issues for future research.Participation in treatment was found to aid in decreasing global physical symptoms, decreasing anxiety sensitivity symptoms, and increasing the subject's confidence in her ability to manage her symptoms. The increased level of self-confidence was related significantly to decreasing global physical symptoms. There was a weak, non-statistically significant correlation between increased confidence of self-efficacy and decreased anxiety sensitivity symptoms. Participation in couples multimodal treatment or any treatment was not significantly linked to increased interactive efficacy. Increased interactive efficacy was correlated with increased self-efficacy and decreased global physical symptoms.