Arch Iran Med March. 2020;23(3): 175-180.
  Abstract View: 226
  PDF Download: 328

Original Article

Relationship between Worry, and Anger Rumination with Cardiovascular Disease Severity: Social Loneliness as a Moderator

Somayeh Ramesh 1 * ORCID logo, Mohammad Ali Besharat 1, Hossein Nogh 2

1 Department of Psychology, University of Tehran, Tehran, Iran
2 Department of Cardiovascular Diseases, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran


Background: Biological and psychological factors contribute to cardiovascular disease (CVD). This study aimed to test the moderating effect of social loneliness in the relationship between worry and anger rumination, and CVD severity.

Methods: A total of 327 patients with CVD (138 women, 189 men) participated in this study. The Penn State Worry Questionnaire (PSWQ), Anger Rumination Scale (ARS), Social Loneliness Scale (SLS), and Gensini score as an indicator of CVD severity were used to collect data. Data were analyzed using Pearson correlation and stepwise regression.

Results: The results of this study showed a significant positive correlation between worry (54.44 ± 12.31, r = 0.59, P<0.01), anger rumination (46.54±12.47; r = 0.36; P<0.01), and social loneliness (28.22 ± 9.13, r = 0.65, P<0.01) with CVD severity (15.07 ± 5.13). In other words, higher levels of worry, anger rumination, and social loneliness are associated with exacerbation of CVD. Social loneliness was a moderator in the relationship between worry and CVD severity (ΔR2 = 0.007, F= 4.2870, P<0.05), suggesting the importance of worry in CVD severity, especially in lonely people. The main effects of worry and social loneliness on CVD severity were β = 0.32, SE = 0.04, 95% CI = 0.2289, 0.4222, P<0.001 and β = 0.46, SE = 0.04, 95% CI = 0.3649, 0.5572, P<0.001, respectively. The moderating effect of social loneliness on the relationship between worry and CVD severity was β = 0.07; SE = 0.03; 95% CI = 0.0074, 0.1522; P<0.001. Social loneliness was not a moderator in the relationship between anger rumination and CVD severity (ΔR2 = 0.006, F= 3.10, P>0.05).

Conclusion: Based on the findings of this research, it can be concluded that along with biological factors, attention to the role of psychological factors of worry, anger rumination, and loneliness in preventive and therapeutic interventions related to CVD is a special necessity

Keywords: Anger Rumination Scale, Cardiovascular disease, Loneliness, Test Anxiety Scale
Cite this article as: Ramesh S, Besharat MA, Nogh H. Relationship between worry, and anger rumination with cardiovascular disease severity: social loneliness as a moderator. Arch Iran Med. 2020;23(3):175–180.
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Submitted: 28 Aug 2019
Accepted: 07 Dec 2019
ePublished: 01 Mar 2020
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