title: Toward a more complete understanding of the effects of personal mastery on cardiometabolic health.
abstract: OBJECTIVE
  A great deal of research has been devoted to identifying the psychological factors that might be associated with reduced risk for cardiovascular diseases. In particular, coping resources such as personal mastery might attenuate stress-related pathophysiology. The purpose of the present review was to examine the existing literature reporting associations between personal mastery and cardiometabolic health outcomes to determine which outcomes have been studied to date, investigate the extent of inconsistency in the literature, and propose new directions for research.
  
  
  METHODS
  Systematic review of articles examining the associations between personal mastery and cardiometabolic health.
  
  
  METHODS
  Studies were included if they examined objective measures of cardiometabolic function, cardiovascular events, and/or mortality.
  
  
  RESULTS
  Thirty-two studies were identified examining the effect of mastery on the following outcomes: mortality and/or cardiovascular events, psychoneuroendocrine stress systems, cardiovascular reactivity to acute stress, metabolic dysregulation, inflammation/coagulation, and evidence of large vessel disease from imaging methods.
  
  
  CONCLUSIONS
  Overall, mastery was associated with better cardiometabolic health and reduced risk for disease and/or death, typically with a small-medium effect size. A relatively small proportion of studies reported contradictory findings that higher mastery was associated with poorer cardiometabolic outcomes. The state of the current research suggests that future investigations should focus on 1) clarifying the mediators and moderators most relevant in the association between mastery and downstream disease, 2) testing the association between mastery and biological outcomes longitudinally, 3) examining the physiological impact of mastery-increasing interventions, and 4) studying the relationship between mastery and disease risk in diverse ethnic or sociocultural groups.
authors.affiliation: Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, La Jolla, CA 92093-0680, USA.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Roepke
authors.forename: Igor
authors.initials: I
authors.lastname: Grant
mesh_terms: D000223:Adaptation, Psychological; D002318:Cardiovascular Diseases / Q000523:psychology*; D006801:Humans; D007389:Internal-External Control; D008659:Metabolic Diseases / Q000523:psychology*; D017063:Outcome Assessment, Health Care; D012307:Risk Factors; D013315:Stress, Psychological / Q000523:psychology*; D016896:Treatment Outcome