Overprotection during childhood leads to heart-focused anxiety in adults with congenital heart disease: Study

Independence and medically appropriate activities should be urged for young people with congenital heart disease

Adults with congenital heart disease are more likely to suffer heart-focused anxiety - a fear of heart-related symptoms and sensations - if their parents were overprotective during their childhood and adolescence. Dr. Lephuong Ong from Orion Health Services in Vancouver, and colleagues from University Health Network and York University in Toronto, Canada, suggest that health care professionals could encourage greater independence for adolescents and adults with congenital heart disease to improve their psychosocial adjustment. Dr. Ong's work1 is published online in Springer's International Journal of Behavioral Medicine.

Approximately one percent of all infants are born with congenital heart defects and over 90 percent of these children survive into adulthood, thanks to recent medical advances. As well as their medical condition, these patients face mental health issues including anxiety, neurocognitive deficits, body image concerns and difficulties with relationships. Research suggests that levels of parental protection are likely to be higher in children with congenital heart disease compared with healthy children.

Ong and team investigated the relationship between patient recollections of parental overprotection - defined as intrusion, excessive contact, infantilization and prevention of independent behavior - and heart-focused anxiety in adults with congenital heart disease. The researchers assessed heart defect severity, heart-focused anxiety and perceived parental overprotection during childhood for a sub-sample of 192 adults participating in the study.

Their analyses showed that levels of heart-focused anxiety rose as levels of parental overprotection increased. Disease severity was also linked to higher anxiety levels. Surprisingly, levels of parental overprotection did not vary with disease severity.

The authors conclude: "Adults with congenital heart disease, who report their parents as being overprotective, might have learned to form negative interpretations of their symptoms and use maladaptive coping behaviors, like avoidance and fearful responding, when experiencing cardiac symptoms or when faced with situations that trigger cardiac-related sensations. Clinicians could consider providing recommended activity guidelines for parents and their children to reduce limitations on activities that are deemed medically appropriate, to encourage independence among adolescents and young adults with congenital heart defects."