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Psychosocial factors have always been considered important causes of heart disease. Because of its extraordinary epidemiological and political relevance, coronary heart disease (CHD) has received Special scientific attention in this field. However, the abundance of literature dealing with its biological, psychological and social precursors is in sharp contrast with a lack of comprehensive modeis trying to integrate the results of different scientific traditions. This paper gives a brief overview of the present State of psychosocial research on etiological factors in CHD. Instead of solely relying on attempts to identify supposedly independent risk factors, it emphasizes the importance of dynamic biopsychosocial processes, which finally lead to manifest coronary disease. The paper outlines an approach which integrates clinical and empirical findings in a bio-psycho-sociodynamic model. This model is open to future extension. It may be helpful for better understanding individual patients as well as scientific findings. By providing hypotheses, which are suggested to go beyond the still predominating reductionistic, linear modeis, it may furthermore be a basis for future research in psychosocial cardiology.
Herrmann-Lingen
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Universität Göttingen, Klinik für Psychosomatik und Psychotherapie, von-Siebold- Str. 5, 37075 Göttingen.