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Clinical Psychology and Special Education
2026. Vol. 15, no. 1, 113–133
doi:10.17759/cpse.2026150108
ISSN: 2304-0394 (online)

Psychological factors of adherence to treatment in patients with cardiovascular diseases in a situation of risking social status change

 
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Abstract

Context and relevance. The diagnosis of cardiac disease in transport workers may be a reason for dismissal from work duties, becoming a source of frustration and imbuing the situation of illness with additional personal meaning for the patient. Understanding the role of psychological factors, particularly the patient`s personality, in the formation of adherence to treatment aims to solve the issue of insufficient effectiveness of cardiovascular therapy and encouraging health behavior. Objective: to study the role of psychological factors in adherence to treatment in patients with cardiovascular diseases. Hypothesis. The level of adherence to treatment in patients with cardiovascular diseases depends on psychological factors mediating the treatment process. Methods and materials. The sample consisted of 43 male patients hospitalised with various cardiac pathologies in “RZD-Medicine” Central Clinical Hospital (М = 49,40; SD = 7,71). To provide a complex assessment of psychological factors the Hospital Anxiety and Depression Scale (HADS), the Short Health Anxiety Inventory, the Brief Illness Perception Questionnaire, the Defense Mechanisms Rating Scales (DMRS-SR-30), as well as the Picture Frustration Test were used. Adherence was measured using the Questionnaire for Comprehensive Assessment of Treatment Adherence. Structural equation modeling according to the path analysis procedure was used to determine the influence of psychological factors on adherence to treatment. Results. The results showed that adherence to treatment in patients with cardiovascular disease is associated with greater vigilance to bodily sensations, defense maturity and use of need-persistent and intropunitive frustration reactions. New data on the relationship between treatment adherence and frustration reactions and patient’s mechanisms of psychological defense were obtained. Using structural modeling, we inferred a model of the indirect influence of the maturity of patient’s defense mechanisms on the adherence to treatment for cardiovascular diseases, mediated by the type of frustration reactions. Conclusions. Maturity of defenses can serve as a reliable predictor for the type of frustration reaction: mature defenses predetermine the response to frustration by seeking a solution to the problem, which in turn increases the likelihood of high adherence to treatment. Therefore, the results highlight the need for further research on the role of personality in forming adherence to treatment using a larger sample size.

General Information

Keywords: adherence to treatment, cardiovascular diseases, defense mechanisms, frustration re-actions

Journal rubric: Empirical Research

Article type: scientific article

DOI: https://doi.org/10.17759/cpse.2026150108

Acknowledgements. The authors are grateful for assistance in data collection to the staff of Central Clinical Hospital “RZD-Medicine”.

Received 07.11.2025

Revised 23.12.2025

Accepted

Published

For citation: Pervichko, E.I., Deshchenko, E.V., Mitina, O.V., Akatova, E.V., Shikina, M.A. (2026). Psychological factors of adherence to treatment in patients with cardiovascular diseases in a situation of risking social status change. Clinical Psychology and Special Education, 15(1), 113–133. (In Russ.). https://doi.org/10.17759/cpse.2026150108

© Pervichko E.I., Deshchenko E.V., Mitina O.V., Akatova E.V., Shikina M.A., 2026

License: CC BY-NC 4.0

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Information About the Authors

Elena I. Pervichko, Doctor of Psychology, Associate Professor of Department of Neuro- and Pathopsychology, Faculty of Psychology, Lomonosov Moscow State University, Moscow, Russian Federation, ORCID: https://orcid.org/0000-0001-8721-7656, e-mail: elena_pervichko@mail.ru

Elizaveta V. Deshchenko, Postgraduate Student, Faculty of Psychology, Lomonosov Moscow State University, Moscow, Russian Federation, ORCID: https://orcid.org/0009-0006-5102-1989, e-mail: elizaveta17022001@mail.ru

Olga V. Mitina, Candidate of Science (Psychology), Leading Researcher of the Laboratory of Communication Psychology, Faculty of Psychology, Lomonosov Moscow State University, Moscow, Russian Federation, ORCID: https://orcid.org/0000-0002-2237-4404, e-mail: omitina@inbox.ru

Evgenia V. Akatova, Doctor of Medicine, Professor of Department of Hospital Therapy No. 1, Russian University of Medicine of the Ministry of Health of Russia, Moscow, Russian Federation, ORCID: https://orcid.org/0009-0006-1219-1272, e-mail: akev@list.ru

Maria A. Shikina, Resident of Department of Hospital Therapy No. 1, Russian University of Medicine of the Ministry of Health of Russia, Moscow, Russian Federation, ORCID: https://orcid.org/0009-0004-9212-6598, e-mail: maria.med11@yandex.ru

Contribution of the authors

Elena I. Pervichko — ideas and research design; planning of the research; control over the research; annotation and editing of the manuscript.

Elizaveta V. Deshchenko — research design; preparation of theoretical review; collection and analy-sis of empiric data; application of statistical methods for data analysis; writing and design of the manuscript.

Olga V. Mitina — application of statistical methods for data analysis; annotation of the manuscript.

Evgenia V. Akatova — ideas; organization of collaboration with the clinical base of the research; control over the research.

Maria A. Shikina — organization of collaboration with the clinical base of the research; recruitment of respondents for the research.

All authors participated in the discussion of the results and approved the final text of the manu-script.

Conflict of interest

The authors declare no conflict of interest.

Ethics statement

The study was reviewed and approved by the Interuniversity Ethics Committee (report no. 12, 2023/12/14).

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