Abstract Body (Do not enter title and authors here): Background: Each year, millions of people worldwide experience cardiovascular events, including acute myocardial infarctions (AMIs). Surviving an AMI can result in psychological sequelae, including negative illness perceptions, fear of recurrence, and perceived stress, that may interfere with survivors’ recovery, individually influencing their physical, emotional, and cognitive outcomes. Though influential, little is known about the individual relationships between these variables in persons who have experienced an AMI.

Purpose: This study examined the relationships between illness perceptions, fear of recurrence, and perceived stress in AMI survivors. Also examined were predictors of fear of recurrence and perceived stress, changes in fear of recurrence over time, and effects of anxiety or depression.

Methods: We used a repeated measures descriptive design to evaluate relationships with the brief illness perception questionnaire, the fear of progression questionnaire, perceived stress scale, and the depression, anxiety, and stress scale (N =171). Additionally, we examined the relationship between participant demographics and modifiable risk factors such as diet, exercise, and smoking. Our hypotheses were tested via multiple linear regression and mediation modeling.

Results: Fear of recurrence was a significant mediator of the relationship between illness perceptions and perceived stress in AMI survivors [F (2,168) =43.31, R²=0.34, p<0.001]. Fear of recurrence did not decrease over time (M=68.45, SD=21.72), and was still a significant mediator of illness perceptions and perceived stress, after controlling for depression and anxiety [B = 0.09, SE = 0.05, t (166) = 2.03, p = 0.044]. The regression models identified age and race as significant predictors of fear of recurrence. Alcoholic beverage intake was a significant predictor of both fear of recurrence and perceived stress.

Conclusions: Providers should be aware that fear of recurrence is a separate symptom from anxiety and/or depression and should be evaluated separately. Fear of recurrence and the relationships with illness perceptions and perceived stress suggest that psychological sequelae may interfere with adaptive coping and health behaviors and should be further explored.

Keywords: Fear of Recurrence, Acute myocardial infarction, illness perception, perceived stress