The World Health Organization (1969) has declared that heart
disease is the largest plague that ever faced humanity. Myocardial
Infarction (MD, in addition to causing more deaths than all other
diseases of the heart combined, is responsible for changes, and in
many cases deterioration, in the quality of life of survivors. Intervention
programs tend to focus on preventing re-occurrence of MI. At
the same time there is an urgent need for sophisticated rehabilitation
programs that aim to improve quality of life after MI. It is speculated
here that identification of the personality factors that relate to
the different adjustment patterms of different subgroups of post-MI
patients will assist in the design of an efficient rehabilitation
program. Accordingly, the present study focuses on the inquiry of the
psychological mechanisms that mediate between the Type A behavior pattern
(TABP) and adjustment style. An integrated crisis and developmental
theory based on psychoanalytical, attachment and social learning
theories is proposed. The Thesis put forward is that TABP is not a
homogeneous pattern and that interpersonal dependency is an underlying
personality factor that subdivides Type A patients to subgroups with
different developmental and adjustment patterns. It is claimed here
that dependent Type A patients have a dependent-independent developmental
psychodynamic conflict, and that for them, TABP is an adopted
defense mechanism. They are expected to have more adjustment difficulties
to the specific characteristics of the post-MI crisis than inde pendent Type A patients for whom TABP is a socially learned developmental
process in an urban Western environment. Type B patients, who
also lack the psychodynamic conflict, are expected to adjust as a
group better than dependent Type A patients.
Seventy-nine white urban South African males aged 30-60
years, after clinical MI, were tested. A combination of qualitative
and quantitative methods of assessment was used in order to test the
relationships between personality factors and adjustment, which was
defined by multi-dimensional criteria (32 indices of adjustment) that
related to various aspects of life in the post-MI period.
The results confirmed the heterogeneity of TABP, dependent
Type A patients adjusted less well than independent Type A patients to
16 out of 32 indices of adjustment. As expected for the same 16 indices,
the behavior of Type B patients was better adjusted than dependent
Type A patients. The outcomes of the adjustment of post-MI
patients to all 32 indices is discussed. On the basis of the study's
results and the crisis and developmental theory set out here, a differential
rehabilitation program is proposed that relates to the different
needs of the subgroups of post-MI patients. / Thesis (Ph.D.)-University of Natal, Durban, 1986.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:ukzn/oai:http://researchspace.ukzn.ac.za:10413/7719 |
| Date | January 1986 |
| Creators | Segev, Uri. |
| Contributors | Strydom, J., Schlebusch, Lourens. |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
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