Can being self-aware help you beat the UK's biggest killer?

With heart disease one of the world's very biggest killers, new approaches to prevention and treatment are always welcome. In fact, most heart disease can be prevented by changes in people's behaviour and attitudes. The same holds true for the effective treatment of those who have already developed the disease.

Many health psychologists have focused on developing effective ways to change behaviours that increase the risk of heart disease, such as smoking. But there's also growing interest in the relationship between health and particular aspects of self-awareness and illness. A recent study in the International Journal of Psychology explores what the effects of mindfulness – which has its roots in Buddhist and Hindu meditation – and integrated self-knowledge might be in preventing or treating heart disease.

But what do these two concepts mean? "Mindfulness" involves having an enhanced awareness about experience in the here and now, and being fully present in the moment. The focus is on perception of what is going on inside and outside our bodies, rather than on the analysis of those perceptions. "Integrative self-knowledge" (ISK) combines living in the present with reflection on changes in experience over time, our own standards about our functioning, and our goals. It identifies inconsistencies between experiences as well as conflicts between what we experience and what we want to experience. ISK can also motivate us to bring our present experience and the experience we desire into line by changing our behaviour or attitudes.

Past health studies have tended to focus on the effects of one or other of these types of self-awareness. The team behind the International Journal of Psychology report measured both. They looked at whether mindfulness and ISK were related to mental health (perceived level of stress, and symptoms of anxiety and depression) and to an angry and hostile way of reacting to other people that has previously been shown to be a risk factor for the development of heart disease.

The authors studied two groups of men: those who had not been diagnosed with a serious illness (who would be a good target for heart-disease prevention interventions) and those who were about to undergo surgery for heart disease (a good target for treatment and management interventions).

As the researchers expected, the men with heart disease had lower levels of mindfulness and integrative self-knowledge, higher levels of anger and hostility towards others, felt more stressed, and reported more symptoms of anxiety and depression than men who did not have a serious-disease diagnosis.

But within both groups, men with higher levels of mindfulness had lower anger and hostility towards others, felt less stressed, and reported fewer symptoms of anxiety and depression. When the authors looked at ISK, exactly the same pattern of results was found in both groups of men. But of the two aspects of self-awareness, statistical tests showed that ISK was the most important. The results of this ground-breaking study suggest that while mindfulness is good for your health, integrative self-knowledge is even better.

Related research suggests that it's possible to teach people to become more mindful, and that this has a range of health benefits. What's now needed is research into whether it's also possible to teach people how to have greater integrative self-knowledge, and if so, whether practising these skills can bring long-term health benefits for those hoping to recover from, or at risk of developing, heart disease.