Document Type



Doctor of Philosophy



Date of Defense


Graduate Advisor

Kamila S. White, PhD


Barbara Bucur

Zoe D. Peterson

Ann M. Steffen


Non-cardiac chest pain (NCCP) describes angina-like pain suffered by patients who lack a cardiac diagnosis (Fleet & Beitman, 1997). Despite a benign diagnosis, some NCCP patients continue to experience persistent pain, cardiac worry, impaired quality of life (Eifert, Hodson, Tracey, Seville, & Gunawardane, 1996), elevated rates of psychiatric disorders (Bass & Wade, 1984; White, et al., 2008), and negative health consequences (Eslick & Talley, 2008). Consistent with theory, research indicates that NCCP patients differentially fear cardiac sensations (Aikens, Zvolensky, & Eifert, 2001; White, Craft, & Gervino, 2010). It may be that NCCP patients avoid physical activity, which elicits feared cardiorespiratory cues; however, physical activity rates have not previously been identified. In the current study, physical activity was indexed in a NCCP sample and associations between interoceptive fear, anxiety about pain, and physical activity were examined. It was hypothesized that interoceptive fear and pain anxiety would be associated with lower physical activity after controlling for key demographic variables. NCCP patients (N = 29) who completed cardiac catheterization with <30% luminal diameter narrowing participated in the study. These results show that many NCCP are inactive (37%) or insufficiently active (41%) for cardiovascular benefits. Few patients (22%) are sufficiently physically active to minimally impact cardiovascular health. More NCCP patients are inactive compared to the general population. Initial correlations did not yield the expected relationships; physical activity, pain anxiety, and interoceptive fear were not associated. Results show that rates of a cardioprotective behavior, physical activity, are low in NCCP patients. Clinical implications, strengths and limitations of this study, and future directions in NCCP research are discussed.

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