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Lodder P, Kupper N, Mols F, Emons WH, Wicherts JM. Assessing the temporal stability of psychological constructs: An illustration of Type D personality, anxiety and depression. JOURNAL OF RESEARCH IN PERSONALITY 2022. [DOI: 10.1016/j.jrp.2022.104299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Strauser DR, Brehmer CE, Rumrill P, Strauser DG, Phillips B, Kosciulek JF, Shen S. Development and validation of the Illinois brief functioning inventory. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Individuals with disabilities experience disruptions in life participation at the onset or exacerbation of a disability. The multiple dimensions of functioning impacted go beyond the symptoms of a disabling condition and assessing an individual’s level of functioning is a critical first step of a strengths-based rehabilitation approach. With functioning playing an important role in the vocational rehabilitation process, it would be important to have an assessment tool that can be used to measure an individual’s level of functioning. OBJECTIVE: The purpose of this study was to examine the psychometric properties of the Illinois Brief Functioning Inventory (IBFI), a scale developed to measure the multi-dimensional nature of functioning as it relates to vocational rehabilitation, career development, and employment of people with disabilities. METHODS: Factor analysis, including exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), was used to determine and validate the underlying dimension of IBFI. RESULTS: Overall, the study findings indicate strong psychometrics for a 26-item instrument comprised of five meaningful subscales identifying functioning across physical, cognitive, and emotional dimensions. CONCLUSION: The results of this study provide initial psychometric support regarding the IBFI as an instrument that can be used to identify an individual’s current level of functioning.
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Affiliation(s)
| | | | | | | | | | | | - Sa Shen
- Stanford University, Stanford, CA, USA
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Manoj MT, Joseph KA, Vijayaraghavan G. Type D Personality and Myocardial Infarction: A Case-Control Study. Indian J Psychol Med 2020; 42:555-559. [PMID: 33354082 PMCID: PMC7735234 DOI: 10.1177/0253717620941157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Coronary heart disease (CHD) is an impending global pandemic in developed countries as well as developing countries and economies in transition, such as India. A significant increase in the incidence of myocardial infarction (MI), one of the most common types of CHD, is being reported in India, and the incidence and severity of the disease are more among the youth in Kerala. Studies assessing the association between psychological factors and MI are few in India. METHODS We adopted a case-control study design. A total of 150 cases (with MI) and 150 controls (without MI and matched for age and gender) from a tertiary care hospital in Trivandrum, Kerala, India, were selected using convenient sampling method, between September 2016 and August 2017. RESULTS As compared to 33.3% of the controls, 50.7% of patients with MI had type D personality characteristics. Multivariate logistic regression analysis after adjusting for the confounders indicated a positive and statistically significant association between type D personality and MI: OR = 4.14, 95% CI = 2.19-8.85, P = 0.003. CONCLUSION Type D personality is associated with MI.
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Affiliation(s)
- M T Manoj
- Society for Continuing Medical Education and Research, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
| | - K A Joseph
- Loyola College of Social Sciences, Trivandrum, Kerala, India
| | - Govindan Vijayaraghavan
- Society for Continuing Medical Education and Research, Kerala Institute of Medical Sciences, Trivandrum, Kerala, India.,Kerala Institute of Medical Sciences, Trivandrum, Kerala, India
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Menon V, Pillai AG, Satheesh S, Kaliamoorthy C, Sarkar S. Factor structure and validity of Type D personality scale among Indian (Tamil-speaking) patients with acute myocardial infarction. Indian J Psychiatry 2019; 61:572-577. [PMID: 31896862 PMCID: PMC6862999 DOI: 10.4103/psychiatry.indianjpsychiatry_27_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Type D personality has been linked to negative outcomes following acute myocardial infarction (AMI). Our objective was to determine the factor structure, reliability, and validity of the Type D personality construct among people with AMI in the Indian clinical setting. MATERIALS AND METHODS In a cross-sectional study conducted between August 2016 and July 2017, 200 consecutive patients with AMI admitted to a tertiary care center completed the Tamil version of the Type D scale-14 (DS-14). The Eysenck Personality Questionnaire Revised-Short Form (EPQR-S) was also administered to check the convergent/divergent validity. RESULTS The prevalence of Type D personality was 24%. Results of the principal components analysis revealed a four-factor solution for the Tamil version of the DS-14 which explained more than 75% of the variability. Strong convergent validity with the neuroticism subscale of EPQR-S (r = 0.84, P < 0.001) and divergent validity with the extraversion subscale (r = -0.75, P < 0.001) was noted. The two subscales of the Type D scale, negative affectivity and social inhibition (SI), demonstrated good reliability (Cronbach's alpha of 0.85 and 0.76, respectively). Dropping item no 14 from the DS-14 led to significant increase in internal consistency (Cronbach's alpha 0.81) for the SI subconstruct. CONCLUSION Among an Indian Tamil-speaking clinical sample of patients with AMI, Type D is a valid construct and can be assessed using the regional version of the DS-14 which showed a four-factor structure and good psychometric properties. Item no. 14 of the DS-14 scale may need modification for the Indian setting.
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Affiliation(s)
- Vikas Menon
- Department of Psychiatry, JIPMER, Puducherry, India
| | | | | | | | - Siddharth Sarkar
- Department of Psychiatry and National Drug Dependence Treatment Center (NDDTC), AIIMS, New Delhi, India
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Type D personality is a predictor of prolonged acute brain dysfunction (delirium/coma) after cardiovascular surgery. BMC Psychol 2019; 7:27. [PMID: 31046844 PMCID: PMC6498670 DOI: 10.1186/s40359-019-0303-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Accepted: 04/16/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Previous studies have shown a relationship between delirium and depressive symptoms after cardiac surgery with distress personalities linking to negative surgical outcomes. The aim of the present study is to further investigate the association between patients with Type D (distressed) personality with regards to delirium after cardiac surgery. METHODS We conducted a consecutive-sample observational cohort pilot study with an estimated 142 patients needed. Enrollment criteria included patients aged ≥18 years who were undergoing planned cardiovascular, thoracic and abdominal artery surgery between October 2015 to August 2016 at the University of Tsukuba Hospital, Japan. All patients were screened by Type-D Personality Scale-14 (DS14) as well as the Hospital Anxiety and Depression Scale (HADS) the day before surgery. Following surgery, daily data was collected during recovery and included severity of organ dysfunction, sedative/analgesic exposure and other relevant information. We then evaluated the association between Type D personality and delirium/coma days (DCDs) during the 7-day study period. We applied regression and mediation modeling for this study. RESULTS A total of 142 patients were enrolled in the present study and the total prevalence of delirium was found to be 34% and 26% of the patients were Type D. Non-Type D personality patients experienced an average of 1.3 DCDs during the week after surgery while Type D patients experienced 2.1 days over the week after surgery. Multivariate analysis showed that Type D personality was significantly associated with increased DCDs (OR:2.8, 95%CI:1.3-6.1) after adjustment for depressive symptoms and clinical variables. Additionally, there was a significant Type D x depression interaction effect (OR:1.7, 95% CI:1.2-2.2), and depressive symptoms were associated with DCDs in Type D patients, but not in non-Type D patients. Mediation modeling showed that depressive symptoms partially mediated the association of Type D personality with DCDs (Aroian test =0.04). CONCLUSIONS Type D personality is a prognostic predictor for prolonged acute brain dysfunction (delirium/coma) in cardiovascular patients independent from depressive symptoms and Type D personality-associated depressive symptoms increase the magnitude of acute brain dysfunction.
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Miller JL, Thylén I, Elayi SC, Etaee F, Fleming S, Czarapata MM, Lennie TA, Moser DK. Multi-morbidity burden, psychological distress, and quality of life in implantable cardioverter defibrillator recipients: Results from a nationwide study. J Psychosom Res 2019; 120:39-45. [PMID: 30929706 DOI: 10.1016/j.jpsychores.2019.03.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/03/2019] [Accepted: 03/05/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND The prevalence of multi-morbidity in implantable cardioverter defibrillator (ICD) recipients is approximately 25%. Multi-morbidity is associated with poor health and psychological outcomes in this population and may affect ICD recipients' quality-of-life (QOL). The purpose of this study was to determine the prevalence of psychological distress (anxiety, depressive symptoms, and Type-D personality) in ICD recipients with varying levels of comorbidities, and to examine the association between multi-morbidity burden and QOL in this population. METHODS All adults listed in the Swedish ICD and Pacemaker Registry in 2012 with an ICD implanted for at least one year were invited to participate in this study. Binary logistic regression was used to predict QOL using the EQ-5D mean index dichotomized based on median QOL scores. Multi-morbidity burden scores were based on quartile groupings. RESULTS A total of 2658 ICD recipients participated in the study (with a mean age of 65, 20.6% female, mean implant duration of 4.7 years, with 35.4% implanted for primary prevention of sudden cardiac arrest). Greater multi-morbidity burden, female sex, not working outside the home, history of ICD shock, negative ICD experience, higher levels of ICD-related concerns, and the presence of anxiety, depression, or Type D personality were associated with worse QOL in ICD recipients. Predictors differed by multi-morbidity burden level. CONCLUSIONS Multi-morbidity burden and psychological distress is an essential factor related to QOL. This issue should be discussed with potential ICD recipients prior to implant. Further exploration of increased recognition and treatment of psychological distress in ICD recipients is warranted.
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Affiliation(s)
- Jennifer L Miller
- University of Kentucky College of Nursing, RICH Heart Program, Lexington, KY, United States
| | - Ingela Thylén
- Department of Cardiology, Department of Medical Health Sciences, Division of Nursing, Linköping University, Linköping, Sweden
| | - Samy C Elayi
- University of Florida, Jacksonville, FL, United States
| | - Farshid Etaee
- Division of Cardiology, University of Kentucky College of Medicine, Gill Heart Institute, 800 Rose St, Lexington, KY 40536, United States.
| | - Steve Fleming
- University of Kentucky College of Public Health, Lexington, KY, United States
| | - Mary M Czarapata
- Division of Cardiology, University of Kentucky College of Medicine, Gill Heart Institute, 800 Rose St, Lexington, KY 40536, United States
| | - Terry A Lennie
- University of Kentucky College of Nursing, RICH Heart Program, Lexington, KY, United States
| | - Debra K Moser
- University of Kentucky College of Nursing, RICH Heart Program, Lexington, KY, United States
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Aluja A, Malas O, Lucas I, Worner F, Bascompte R. Assessment of the Type D personality distress in coronary heart disease patients and healthy subjects in Spain. PERSONALITY AND INDIVIDUAL DIFFERENCES 2019. [DOI: 10.1016/j.paid.2018.08.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Pushkarev G, Denollet J, Kuznetsov V, Spek V, Yaroslavskaya E. Type D personality in Russian patients with cardiovascular disease: validity of the Russian DS14 (DS14-RU). BMC Cardiovasc Disord 2019; 19:78. [PMID: 30940075 PMCID: PMC6444517 DOI: 10.1186/s12872-019-1056-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 03/21/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Type D personality is associated with unfavorable outcomes in patients with cardiovascular diseases (CVD). However, there is no valid Type D Scale in Russian language. The purpose of the study was to examine the factor structure of a new Russian version of 14-item Type D Scale (DS14-RU), and to evaluate the reliability and construct validity of the DS14-RU in clinical research. METHODS The study included 929 participants, 496 (53.4%) of which had coronary artery disease, 195 (21.0%) congestive heart failure, 84 (9.0%) arterial hypertension and 154 (16.6%) were relatively healthy volunteers. The mean age was 57.5 years, 565 (60.8%) participants were males. The respondents filled out an extended Russian version of the Type D scale and new DS14-RU, as well as the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Reeder Stress Inventory, and State-Trait Personality Inventory. RESULTS The new Russian version of DS14-RU was internally consistent with Cronbach's α = .80 for both the negative affectivity and social inhibition subscales. The prevalence of Type D personality, as measured with the DS14-RU, was 21.4% among patients with CVD, and 20.0% among relatively healthy participants. The mean scores for anxiety, depression, psychosocial stress and anger were significantly higher in patients with Type D personality and they had significantly lower levels of social support and curiosity. CONCLUSIONS The new DS14-RU is consistent with the original DS14 in terms of reliability, factor structure and construct validity. The DS14-RU can be used for the reliable assessment of Type D in Russian-speaking respondents.
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Affiliation(s)
- Georgiy Pushkarev
- Laboratory of Instrumental Diagnostics, Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, 111, Melnikaite Str, 625026 Tyumen, Russia
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Johan Denollet
- Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
| | - Vadim Kuznetsov
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
| | - Viola Spek
- Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
| | - Elena Yaroslavskaya
- Laboratory of Instrumental Diagnostics, Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, 111, Melnikaite Str, 625026 Tyumen, Russia
- Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Russian Academy of Science, Tomsk, Russia
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Leu HB, Yin WH, Tseng WK, Wu YW, Lin TH, Yeh HI, Cheng Chang K, Wang JH, Wu CC, Chen JW. Impact of type D personality on clinical outcomes in Asian patients with stable coronary artery disease. J Formos Med Assoc 2018; 118:721-729. [PMID: 30243505 DOI: 10.1016/j.jfma.2018.08.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 08/16/2018] [Accepted: 08/24/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Some personality types are associated with cardiovascular (CV) diseases and may be related to clinical outcomes in coronary artery disease (CAD). This study investigates the association between type D personality and clinical outcomes in stable CAD patients in an Asian cohort. METHODS Stable CAD patients were enrolled and prospectively followed up for at least 1 year in Taiwan. The inclusion criteria were at least one successful percutaneous coronary intervention (PCI) and stable medical treatment for at least 1 month before enrollment. Vulnerability to psychological distress was measured by the Type D Personality Scale (DS14) after enrollment. The end point was the occurrence of total CV events. Cox regression models of CV events were used to investigate the role of type D personality in clinical outcomes. RESULTS The study included 777 patients, among which 122 (15.77%) had type D personality. Forty-two CV events were identified: 3 cardiac deaths, 5 nonfatal myocardial infarctions, 1 stroke, 4 congestive heart failures (CHF), 6 peripheral arterial occlusive disorder cases, and 23 readmissions for angina/revascularization treatment. Patients with type D personality had significantly higher incidence of future CV events (9.84% vs. 4.58%, p = 0.018%) and admission for angina/revascularization (5.74% vs. 2.44%, p = 0.049). Patients with subsequent CV events were more likely to have type D personality (28.57% vs. 14.97%, p=0.018). After proportional Cox regression analysis, type D personality remained an independent predictor of future CV events (HR: 3.21, 95% CI: 1.06-9.69). In subgroup analyses, type D personality was especially associated with higher risk of total CV events among females, the elderly, hypertension patients, diabetes patients, and non-smokers. CONCLUSION Type D personality was an independent predictor of CV outcomes in an Asian cohort of stable CAD patients. This personality type may be identified in risk stratification for secondary prevention after PCI.
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Affiliation(s)
- Hsin-Bang Leu
- Heath Care and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Wei-Hsian Yin
- Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, and School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Kung Tseng
- Department of Medical Imaging and Radiological Sciences, I-Shou University and Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Yen-Wen Wu
- Cardiology Division of Cardiovascular Medical Center and Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-I Yeh
- Mackay Memorial Hospital, Mackay Medical College, New Taipei City, Taiwan
| | - Kuan- Cheng Chang
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Taiwan Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Ji-Hung Wang
- Department of Cardiology, Buddhist Tzu-Chi General Hospital, Tzu-Chi University, Hualien, Taiwan
| | - Chau-Chung Wu
- Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Department of Primary Care Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jaw-Wen Chen
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan
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Epifanio MS, Ingoglia S, Alfano P, Lo Coco G, La Grutta S. Type D Personality and Alexithymia: Common Characteristics of Two Different Constructs. Implications for Research and Clinical Practice. Front Psychol 2018; 9:106. [PMID: 29479327 PMCID: PMC5811501 DOI: 10.3389/fpsyg.2018.00106] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 01/22/2018] [Indexed: 11/18/2022] Open
Abstract
In the last few decades, particular attention has been paid to the role of personality specific traits that can affect the loss of health, i.e., Type D personality and Alexithymia. They have been conceptualized in a different period, this means that they are different both for their theoretical positions and their empirical studies. Some authors have speculated that there is a potential conceptual overlap between Type D personality and alexithymia constructs but there is a shortcoming in the literature. The aim of the study was to examine the potential overlap between the constructs of type D personality and alexithymia, replicating previous two studies, to extend these findings to Italian population. The participants were 247 Italian adults (males = 43%), recruited in primary health care practices of Palermo. All participants did not have chronic diseases during tests administration. They ranged in age from 35 to 69 years old (M = 52.34 years, SD = 9.76). Participants were administered Type D Personality Scale (DS-14) and Toronto Alexithymia Scale (TAS-20). A series of confirmatory factor analyses was performed to evaluate the factorial structure underlying the TAS-20 and DS-14 items. Globally results showed that alexithymia and type D personality are distinct constructs, but they are also strictly positively related with each other. Negative affectivity (NA) was highly correlated with Difficulties in identifying feelings and Difficulties in describing feelings, while Social inhibition (SI) was highly correlated with Difficulties in describing feelings. These results are consistent with those of other studies conducted in this area. Future research should consider evaluating the relationship between a deficit of affect regulation and type D personality to improve the effectiveness of interventions of health cure.
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Affiliation(s)
- Maria S. Epifanio
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Sonia Ingoglia
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Pietro Alfano
- Consiglio Nazionale delle Ricerche, Institute of Biomedicine and Molecular Immunology, Rome, Italy
| | - Gianluca Lo Coco
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
| | - Sabina La Grutta
- Department of Psychology and Educational Sciences, University of Palermo, Palermo, Italy
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The Association of Type D personality with Heart Rate Variability and Lipid Profiles Among Patients with Coronary Artery Disease. Int J Behav Med 2017; 24:101-109. [PMID: 27229521 DOI: 10.1007/s12529-016-9571-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE Characteristics of the distressed (Type D) personality include negative affectivity (NA) and social inhibition (SI), which are associated with an increased risk of major adverse cardiac events and mortality among patients with coronary artery disease (CAD). The aims of this study were to examine: (1) the correlation of NA and SI with psychological characteristics, heart rate variability (HRV) indices, and lipids profiles and (2) the differences in psychological characteristics, HRV indices, and lipid profiles between patients with CAD with Type D personality and those with non-Type D personality. METHOD A cross-sectional study was conducted on 168 patients with CAD. The Taiwanese 14-item Type D Scale, Chinese Hostility Inventory-Short Form, Beck Depression Inventory-II, Beck Anxiety Inventory, and Anger Rumination Scale were administered to all of the participants. The raw signals of electrocardiograms were recorded over a 5-min baseline resting period and then transformed to HRV indices representing short-term cardiac autonomic activations. Lipid profiles were acquired from patients' medical records. RESULTS NA was positively correlated with hostility, depression, anxiety, and anger rumination. With respect to pathophysiological mechanisms for CAD with Type D personality, NA was negatively correlated with standard deviation of all normal-to-normal intervals (SDNN) and total power of HRV and positively correlated with total cholesterol. SI was positively correlated with suppressive hostility behavior and anger rumination; however, SI was not significantly correlated with expressive hostility behavior, or HRV indices and lipid profiles. CONCLUSION Pathophysiological mechanisms leading to higher rates of adverse outcomes in CAD in individuals with Type D personalities may involve cardiac autonomic imbalance and lipid dysregulation.
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Identification of new biosignatures for clinical outcomes in stable coronary artery disease - The study protocol and initial observations of a prospective follow-up study in Taiwan. BMC Cardiovasc Disord 2017; 17:42. [PMID: 28129736 PMCID: PMC5273790 DOI: 10.1186/s12872-017-0471-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/14/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Either classic or novel biomarkers have not been well investigated for clinical outcomes of coronary artery disease (CAD) in Asian people especially ethnic Chinese. We reported here a prospective national-based follow-up study that aims to elucidate the clinical profiles and to identify the new biosignatures (especially the non-lipid profile and inflammatory biomakers) for future clinical outcomes in a sizable cohort of stable CAD patients in Taiwan. METHODS A total of 2500 CAD patients under stable condition after successful percutaneous coronary intervention will be enrolled for clinical data collection and blood/urine sampling in northern, southern, western, or eastern part of Taiwan between 2012 and 2017. They will be regularly followed up at least annually for 5 years to assess all cause deaths, hard clinical events (including cardiovascular death, nonfatal myocardial infarction, nonfatal stroke), and total cardiovascular events (including hard events, unplanned revascularization procedures, unplanned hospitalization for refractory or unstable angina, and for other causes such as stroke, transient ischemic attack, heart failure, or peripheral arterial occlusive disease). The classic and newly defined biosignatures will be compared in patients with and without clinical events during follow-up. The novel biomarkers will be identified via metabolomics analyses. Additionally, psychological personality and lifestyle data will be incorporated to explore the new dimensional views of the complex mechanisms of the disease. Till December 2014, the initial 1663 patients have been successfully enrolled. Among them, 85.93% are male; 36.22% have type 2 diabetes; 64.82% have hypertension; 56.04% are smokers and 20.44% have a family history of CAD. Their lipid profiles are under contemporary medical control with a mean plasma total cholesterol level of 163.51 ± 36.99 mg/dL and a mean low-density lipoprotein cholesterol level of 95.21 ± 29.98 mg/dL. DISCUSSION This nationwide study has successfully started to update the contemporary information and to investigate the potential predictors for clinical outcomes of stable CAD patients in Taiwan. The identification of new biomarkers, lifestyle and psychological personality may help to elucidate the complex mechanisms and provide the novel rational to the individual treatment strategies in Asian especially ethnic Chinese patients with CAD.
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Impact of a Type D Personality on Clinical and Psychometric Properties in a Sample of Turkish Patients With a First Myocardial Infarction. J Psychiatr Pract 2017; 23:3-10. [PMID: 28072640 DOI: 10.1097/pra.0000000000000201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent studies have shown that a Type D personality is associated with an increased risk of cardiac mortality. OBJECTIVE This study aimed to examine the impact of a Type D personality on clinical and psychometric properties in a sample of Turkish patients with a first myocardial infarction (MI). METHOD The study included 131 patients who were admitted to the coronary care unit of a hospital. All of the patients underwent a psychiatric assessment within 2 to 6 months after their MI. Psychiatric interviews were conducted using the Structured Clinical Interview for DSM-IV (SCID-I). Patients also completed the Beck Depression Inventory, the Spielberger State-Trait Anxiety Inventory, the Health Anxiety Inventory, and the Type D personality scale. RESULTS The patients were divided into 2 groups on the basis of the presence or absence of Type D personality. There was a 38.2% prevalence of Type D personality in the patients with a first MI. Those with this type of personality had a significantly higher frequency of hypertension and stressful life events. The Type D patients also had more psychiatric disorders, including depressive and anxiety disorders, than the non-Type D patients. CONCLUSIONS Our findings suggest that Type D personality traits may increase the risk of hypertension and the risk of psychiatric morbidity in patients with a first MI. We suggest that this type of personality is a contributor to depression and anxiety disorders. These findings emphasize the importance of screening for Type D personality as both a cardiovascular and psychiatric risk marker in patients who have had an MI.
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Demirci K, Yıldız M, Selvi C, Akpınar A. The relationship between childhood trauma and type D personality in university students. Int J Soc Psychiatry 2016; 62:542-8. [PMID: 27288419 DOI: 10.1177/0020764016653774] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIM There has been increasing evidence that childhood traumas are related to reduced health-related quality of life, neurobiological changes and long-term adverse effects, such as an increase in the likelihood of psychiatric disorders in adulthoods. The aim of this study was to investigate the relationships between childhood traumas and type D personality. SUBJECTS AND METHODS In total, 187 university students (64 males and 123 females; mean age = 21.69 ± 2.00) were included in the study. All participants were evaluated using the Type D Personality Scale (DS-14), Childhood Trauma Questionnaire (CTQ-28) and Beck Depression Inventory (BDI). The participants were divided into the two groups according to the presence of type D personality. Then, statistical analyses were performed. RESULTS The frequency of type D personality in participants was 43.3% (n = 81). The emotional neglect, physical neglect, emotional abuse component of the CTQ-28, total CTQ-28 scores and BDI scores were higher in the group with type D personality than in the group without type D personality (p < .001, p = .003, p = .001, p < .001 and p < .001, respectively). There were significantly positive correlations between the type D personality scores and BDI scores, emotional neglect, physical neglect, emotional abuse and childhood trauma total scores (p < .05, for all). Linear regression analyses showed that the significant and independent predictors of the score of DS-14 were total score of CTQ-28 and BDI score. CONCLUSION Childhood trauma may be associated with type D personality, and there is predictive value of the childhood trauma on the scores of type D personality.
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Affiliation(s)
- Kadir Demirci
- Department of Psychiatry, School of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Mesut Yıldız
- Department of Psychiatry, School of Medicine, Gaziosmanpaşa University, Tokat, Turkey
| | - Cansu Selvi
- School of Medicine, Süleyman Demirel University, Isparta, Turkey
| | - Abdullah Akpınar
- Department of Psychiatry, School of Medicine, Süleyman Demirel University, Isparta, Turkey
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Zhang JK, Fang LL, Zhang DW, Jin Q, Wu XM, Liu JC, Zhang CD, Dai DQ. Type D Personality in Gastric Cancer Survivors: Association With Poor Quality of Life, Overall Survival, and Mental Health. J Pain Symptom Manage 2016; 52:81-91. [PMID: 27112312 DOI: 10.1016/j.jpainsymman.2015.12.342] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 12/10/2015] [Accepted: 12/23/2015] [Indexed: 12/17/2022]
Abstract
CONTEXT The associations between Type D personality and poor quality of life, overall survival, and mental health in gastric cancer survivors. OBJECTIVES The aim of this research was to explore quality of life (QoL), mental health status, Type D personality, symptom duration, and emergency admissions of Chinese gastric cancer patients, as well as the relationship between these factors. METHODS Eight hundred thirty eligible Chinese patients newly diagnosed with gastric cancer between July 2009 and July 2011 were enrolled in this prospective study. Type D personality was measured with the 14-item Type D Personality Scale (DS14). Mental health status was measured with the Hospital Anxiety and Depression Scale. The QoL outcomes were assessed longitudinally using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 and Quality of Life Questionnaire-STO22 at baseline and six months after diagnosis. RESULTS The proportion of patients with symptom duration of more than one month and who were diagnosed after emergency admissions in the Type D group was significantly higher than that in the non-Type D personality group. At both of the time points, Type D patients reported statistically significant lower scores on role, emotional, cognitive, and social functioning (all Ps < 0.001) functional scales, global health status/QoL scales (P < 0.001), and worse symptom scores compared to patients without a Type D personality. During the six-month time frame, a higher percentage of patients in the Type D group demonstrated a considerable QoL deterioration. Clinically elevated levels of anxiety and depression were more prevalent in Type D than in non-Type D survivors (both Ps < 0.001). There was a statistically significant difference in three-year overall survival between the patients in the Type D group and the non-Type D personality group. CONCLUSION Type D personality is associated with poor QoL, three-year overall survival and mental health status among survivors of gastric cancer, even after adjustment of confounding background variables. The Type D personality group experienced increased levels of pain and fatigue compared to non-Type D patients. Type D personality might be a general vulnerability factor to screen for subgroups at risk of longer symptom duration and emergency admissions in clinical practice.
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Affiliation(s)
- Jia-Kui Zhang
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Li-Li Fang
- Department of Anesthesiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | - De-Wei Zhang
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Qiu Jin
- Department of Psychiatry, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Xiao-Mei Wu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, China
| | - Ji-Chao Liu
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Chun-Dong Zhang
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China
| | - Dong-Qiu Dai
- Department of Gastroenterological Surgery, The Fourth Affiliated Hospital of China Medical University, Shenyang, China.
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van Middendorp H, Kool MB, van Beugen S, Denollet J, Lumley MA, Geenen R. Prevalence and relevance of Type D personality in fibromyalgia. Gen Hosp Psychiatry 2016; 39:66-72. [PMID: 26804772 DOI: 10.1016/j.genhosppsych.2015.11.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 10/30/2015] [Accepted: 11/16/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Distressed (Type D) personality, combining high negative affectivity and social inhibition, is linked to poor health in various populations. Because patients with fibromyalgia experience high negative affect and show signs of social inhibition, this study aimed to examine the prevalence of Type D's components and their associations with health in an additive (worse health with both components present) or synergistic way (components amplifying each other's effects). METHOD Type D personality and physical and mental health were assessed online by 558 patients with self-reported fibromyalgia (94% women, age 47 ± 11 (21-77)years) by the Type D Scale-14 and RAND-36 Health Status Inventory. RESULTS Using the standard cutscores, Type D personality was present in 56.5% of patients. Negative affectivity alone and combined with social inhibition was associated with worse mental and, more limited, physical health, but no interactive (synergistic) associations were found. CONCLUSIONS Type D personality in fibromyalgia exceeds prevalence estimates in general, cardiovascular and chronic pain populations. Some indication of an additive but not of a synergistic effect was found, particularly for mental health, with clearly the largest associations for negative affectivity. The high prevalence of Type D's components may have specific treatment implications.
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Affiliation(s)
- Henriët van Middendorp
- Health, Medical, and Neuropsychology Unit, Institute of Psychology, Leiden University, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, The Netherlands.
| | - Marianne B Kool
- Department of Clinical and Health Psychology, Utrecht University, The Netherlands.
| | - Sylvia van Beugen
- Health, Medical, and Neuropsychology Unit, Institute of Psychology, Leiden University, The Netherlands.
| | - Johan Denollet
- Department of Medical and Clinical Psychology, Tilburg University, The Netherlands.
| | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, USA.
| | - Rinie Geenen
- Department of Clinical and Health Psychology, Utrecht University, The Netherlands; Department of Rheumatology and Clinical Immunology, University Medical Center, Utrecht, The Netherlands.
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Zohar AH. Is type-D personality trait(s) or state? An examination of type-D temporal stability in older Israeli adults in the community. PeerJ 2016; 4:e1690. [PMID: 26893971 PMCID: PMC4756746 DOI: 10.7717/peerj.1690] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Accepted: 01/24/2016] [Indexed: 11/20/2022] Open
Abstract
Background. Type D personality was suggested as a marker of poorer prognosis for patients of cardiovascular disease. It is defined by having a score of 10 or more on both sub-scales of the DS14 questionnaire, Social Inhibition (SI) and Negative Affectivity (NA). As Type D was designed to predict risk, its temporal stability is of prime importance. Methods. Participants in the current study were 285 community volunteers, who completed the DS14, and other personality scales, at a mean interval of six years. Results. The prevalence of Type D did not change. The component traits of Type D showed rank order stability. Type D caseness temporal stability was improved by using the sub-scales product as a criterion. Logistic hierarchical regression predicting Type D classification from Time1 demonstrated that the best predictors were Time1 scores on NA and SI, with the character trait of Cooperation, and the alexithymia score adding some predictive power. Conclusions. The temporal stability of the component traits, and of the prevalence of Type D were excellent. Temporal stability of Type D caseness may be improved by using a product threshold, rather than the current rule. Research is required in order to formulate the optimal timing for Type D measurement for predictive purposes.
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Affiliation(s)
- Ada H Zohar
- Clinical Psychology, Ruppin Academic Center , Israel
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Zhang JK, Fang LL, Zhang DW, Jin Q, Wu XM, Liu JC, Zhang CD, Dai DQ. Type D personality is associated with delaying patients to medical assessment and poor quality of life among rectal cancer survivors. Int J Colorectal Dis 2016; 31:75-85. [PMID: 26243469 DOI: 10.1007/s00384-015-2333-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/26/2015] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this research was to explore quality of life (QoL), mental health status, type D personality, symptom duration, and emergency admissions of Chinese rectal cancer patients as well as the relationship between these factors. METHODS Type D personality was measured with the 14-item Type D Personality Scale (DS14). Mental health status was measured with the Hospital Anxiety and Depression Scale (HADS). The QoL outcomes were assessed longitudinally using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR38 questionnaires at the baseline and 6 months after diagnosis. RESULTS Of the 852 survivors who responded (94 %), 187 (22 %) had a type D personality. The proportion of patients with duration of symptoms >1 month and being diagnosed after emergency admissions in type D group is significantly higher than that in non-type D group. At both of the time points, type D patients reported statistically significant lower scores on most of the functional scales, global health status/QoL scales, and worse symptom scores compared to patients without a type D personality. At the 6-month time point, a higher percentage of patients in the type D group demonstrated QoL deterioration. Clinically elevated levels of anxiety and depression were more prevalent in type D than in non-type D survivors. CONCLUSIONS Type D personality was associated with poor QoL and mental health status among survivors of rectal cancer, even after adjustment for confounding background variables. Type D personality might be a general vulnerability factor to screen for subgroups at risk for longer symptom duration and emergency admissions in clinical practice.
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Affiliation(s)
- Jia-kui Zhang
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China
| | - Li-li Fang
- Department of Anesthesiology, The Second Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, 310009, People's Republic of China
| | - De-wei Zhang
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China
| | - Qiu Jin
- Department of Psychiatry, The Fourth Affiliated Hospital of China Medical University, Shenyang, 110032, People's Republic of China
| | - Xiao-mei Wu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, 110001, People's Republic of China
| | - Ji-chao Liu
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China
| | - Chun-dong Zhang
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China
| | - Dong-qiu Dai
- Department of Gastroenterological Surgery and Cancer Center, The Fourth Affiliated Hospital of China Medical University, 4 Chongshan Road, Shenyang, 110032, P. R. China.
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Erkol İnal E, Demirci K, Doğru A, Şahin M. Ankylosing Spondylitis patients with Type D personality have worse clinical status. Mod Rheumatol 2015; 26:138-45. [PMID: 26011439 DOI: 10.3109/14397595.2015.1054098] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Type D personality was identified as an important factor that can explain the differences in clinical outcomes in various diseases. The aim of this study is to clarify the relationships between Type D personality and clinical status of patients with Ankylosing Spondylitis (AS). METHODS The scores of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), the Bath Ankylosing Spondylitis Functional Index (BASFI), the 36-Item Short-Form Health Survey (SF-36), and 14-item Type D Scale (DS-14) were noted. RESULTS We found significantly higher levels of the BASDAI, the BASFI, and the SF-36 mental subscale scores in patients with Type D personalities compared to those who were Non-Type D (p < 0.05). The total DS-14 scores were found to be correlated with the scores of physical and mental subscales of SF-36, the BASDAI, the BASFI, ASDAS-CRP, and ESR (p < 0.05). In logistic regression analysis, the occurrence of Type D personality was found to be an independent predictor for disease activity of AS due to BASDAI and ASDAS-ESR (p = 0.016, OR, 95% CI = 2.98,1.23-7.22; p = 0.022, OR, 95% CI = 2.78,1.16-6.63 respectively). CONCLUSIONS Patients may over-rate self-reported measurements such as the BASDAI, BASFI, and SF-36 related to their interpersonal characteristics. Therefore, including the Type D personality, which is a stable construct in evaluating AS patients with brief and valid DS-14, may be noteworthy.
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Affiliation(s)
- Esra Erkol İnal
- a Süleyman Demirel University, Faculty of Medicine , Department of Physical Medicine and Rehabilitation , Isparta , Turkey
| | - Kadir Demirci
- b Süleyman Demirel University, Faculty of Medicine , Department of Psychiatry , Isparta , Turkey
| | - Atalay Doğru
- c Süleyman Demirel University, Faculty of Medicine , Department of Internal Medicine , Division of Rheumatology , Isparta , Turkey
| | - Mehmet Şahin
- c Süleyman Demirel University, Faculty of Medicine , Department of Internal Medicine , Division of Rheumatology , Isparta , Turkey
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Staniute M, Brozaitiene J, Burkauskas J, Kazukauskiene N, Mickuviene N, Bunevicius R. Type D personality, mental distress, social support and health-related quality of life in coronary artery disease patients with heart failure: a longitudinal observational study. Health Qual Life Outcomes 2015; 13:1. [PMID: 25608461 PMCID: PMC4311474 DOI: 10.1186/s12955-014-0204-2] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 12/26/2014] [Indexed: 12/21/2022] Open
Abstract
Background The relationship between Type D personality and health related quality of life (HRQoL) in coronary artery disease patients is becoming more established, however, the factors that may explain this association remain unclear. The objective of the study was to examine the mediating effects of mental distress and social support on the relationship between the Type D personality and HRQoL in CAD patients with heart failure. Methods A total of 855 CAD patients with heart failure were assessed on Type D personality, mental distress, perceived social support and HRQoL with the following self-administered questionnaires: the Type D personality scale - 14, the Hospital Anxiety and Depression scale, the Multidimensional Scale of Perceived Social Support and the Minnesota Living with Heart Failure Questionnaire. Results The prevalence of Type D personality within the study population was 33.5%. Type D personality, anxiety symptoms, depressive symptoms and social support were all found to be determinants of decreased HRQoL (p’s < 0.001), once age, gender, NYHA functional class and acute myocardial infarction were adjusted for. Anxiety, depressive symptoms and social support were found to mediate the relationship between Type D personality and HRQoL. Type D personality exerted a stable effect on HRQoL over 24 months follow-up period. Conclusions Type D personality has an independent significant effect on the HRQoL in CAD patients with heart failure, and this relation is mediated by anxiety and depressive symptoms, social support.
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Affiliation(s)
- Margarita Staniute
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Julija Brozaitiene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Julius Burkauskas
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Nijole Kazukauskiene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Narseta Mickuviene
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
| | - Robertas Bunevicius
- Behavioral Medicine Institute, Lithuanian University of Health Sciences, Palanga, Lithuania.
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Marchesi C, Ossola P, Scagnelli F, Paglia F, Aprile S, Monici A, Tonna M, Conte G, Masini F, De Panfilis C, Ardissino D. Type D personality in never depressed patients at their first acute coronary syndrome. PSYCHOTHERAPY AND PSYCHOSOMATICS 2014; 83:190-1. [PMID: 24752175 DOI: 10.1159/000358525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 01/11/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Carlo Marchesi
- Psychiatry Unit, Department of Neuroscience, University of Parma, Parma, Italy
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Samartzis L, Dimopoulos S, Manetos C, Agapitou V, Tasoulis A, Tseliou E, Pozios I, Kaldara E, Terrovitis J, Nanas S. Neuroticism personality trait is associated with Quality of Life in patients with Chronic Heart Failure. World J Cardiol 2014; 6:1113-1121. [PMID: 25349656 PMCID: PMC4209438 DOI: 10.4330/wjc.v6.i10.1113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/07/2014] [Accepted: 09/17/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate Quality of life (QoL) in chronic heart failure (CHF) in relation to Neuroticism personality trait and CHF severity.
METHODS: Thirty six consecutive, outpatients with Chronic Heart Failure (6 females and 30 males, mean age: 54 ± 12 years), with a left ventricular ejection fraction ≤ 45% at optimal medical treatment at the time of inclusion, were asked to answer the Kansas City Cardiomyopathy Questionnaire (KCCQ) for Quality of Life assessment and the NEO Five-Factor Personality Inventory for personality assessment. All patients underwent a symptom limited cardiopulmonary exercise testing on a cycle-ergometer, in order to access CHF severity. A multivariate linear regression analysis using simultaneous entry of predictors was performed to examine which of the CHF variables and of the personality variables were correlated independently to QoL scores in the two summary scales of the KCCQ, namely the Overall Summary Scale and the Clinical Summary Scale.
RESULTS: The Neuroticism personality trait score had a significant inverse correlation with the Clinical Summary Score and Overall Summary Score of the KCCQ (r = -0.621, P < 0.05 and r = -0.543, P < 0.001, respectively). KCCQ summary scales did not show significant correlations with the personality traits of Extraversion, Openness, Conscientiousness and Agreeableness. Multivariate linear regression analysis using simultaneous entry of predictors was also conducted to determine the best linear combination of statistically significant univariate predictors such as Neuroticism, VE/VCO2 slope and VO2 peak, for predicting KCCQ Clinical Summary Score. The results show Neuroticism (β = -0.37, P < 0.05), VE/VCO2 slope (β = -0.31, P < 0.05) and VO2 peak (β = 0.37, P < 0.05) to be independent predictors of QoL. In multivariate regression analysis Neuroticism (b = -0.37, P < 0.05), the slope of ventilatory equivalent for carbon dioxide output during exercise, (VE/VCO2 slope) (b = -0.31, P < 0.05) and peak oxygen uptake (VO2 peak), (b = 0.37, P < 0.05) were independent predictors of QoL (adjusted R2 = 0.64; F = 18.89, P < 0.001).
CONCLUSION: Neuroticism is independently associated with QoL in CHF. QoL in CHF is not only determined by disease severity but also by the Neuroticism personality trait.
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Condén E, Rosenblad A, Ekselius L, Åslund C. Prevalence of Type D personality and factorial and temporal stability of the DS14 after myocardial infarction in a Swedish population. Scand J Psychol 2014; 55:601-10. [DOI: 10.1111/sjop.12162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 07/30/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Emelie Condén
- Centre for Clinical Research; Uppsala University; Västmanland County Hospital; Västerås Sweden
| | - Andreas Rosenblad
- Centre for Clinical Research; Uppsala University; Västmanland County Hospital; Västerås Sweden
| | - Lisa Ekselius
- Department of Neuroscience; Uppsala University; Sweden
| | - Cecilia Åslund
- Centre for Clinical Research; Uppsala University; Västmanland County Hospital; Västerås Sweden
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Abstract
BACKGROUND Research on the emotional processes associated with Type D personality is important for its further conceptualization. We examined the associations of Type D personality with social and general anxiety symptoms in a large community sample. PURPOSE The aim of the current study was to disentangle the associations of Type D personality and its components with social anxiety and general anxiety in a large sample from the general population. METHODS A random sample of 2,475 adults from the general population filled out questionnaires to assess Type D personality (DS-14), social anxiety (SIAS(10), SPS(11), BFNE-II), and general anxiety (HADS-A, GAD-7). RESULTS Type D individuals were characterized by increased levels of both social and general anxiety. The social inhibition (SI) component of Type D personality was most strongly associated with social interaction anxiety (r = .63), while negative affectivity (NA) was strongly associated with general anxiety (GAD-7: r = .70; HADS-A: r = .66). Within social anxiety, SI was more strongly associated with facets of social interaction anxiety than with social phobia. Multiple regression analysis showed that the synergistic interaction of NA and SI was a predictor of social anxiety (SIAS(10): β = .32, p < .0005; SPS(11): β = .27, p < .0005; BFNE-II: β = .11, p = .007) independent of demographics and the scores on the individual Type D components. This interaction was not a significant predictor of general anxiety. Logistic regression using the dichotomous Type D classification demonstrated a 9.1-fold (95%CI, 7.0-11.8) increased odds of a score in the highest quartile of social interaction anxiety and a 7.6-fold (95%CI, 5.8-9.8) increased odds of high social phobia. Odds ratios for clinically relevant levels of general anxiety were 8.3 (95%CI, 5.5-12.5) for GAD-7 and 6.5 (95%CI, 3.4-12.6) for HADS-A. CONCLUSION In the general population, Type D individuals were characterized by both social and general anxiety. The SI component of Type D is strongly associated with social interaction anxiety and the synergistic interaction of NA and SI was associated with high social anxiety, above and beyond the main NA and SI effects.
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Park YM, Ko YH, Lee MS, Lee HJ, Kim L. Type-d personality can predict suicidality in patients with major depressive disorder. Psychiatry Investig 2014; 11:232-6. [PMID: 25110494 PMCID: PMC4124180 DOI: 10.4306/pi.2014.11.3.232] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/01/2014] [Accepted: 01/11/2014] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE This study investigated the putative association between type-D personality and suicidality, including the history of suicide attempt and suicidal ideation in patients with major depressive disorder (MDD). METHODS Eighty-six outpatients aged between 18 and 65 years with MDD were recruited for this study from Ilsan Paik Hospital. The cohort was stratified into two subgroups according to the presence of type-D personality and history of suicide attempt (yes vs. no). Depression severity was evaluated using the Hamilton Depression Rating Scale. The type-D Personality Scale-14 (DS-14), the Beck Hopelessness Scale (BHS), the Barratt Impulsiveness Scale (BIS), the Hamilton Anxiety Scale, and the Beck Scale for Suicidal Ideation (BSS) were also applied. RESULTS The total BSS, BHS, and BIS scores were higher for the group with type-D personality than for the group without this personality (p=0.004, 0.01, and 0.003, respectively). In addition, the total scores for the BSS, BHS, and social inhibition (SI; subscale of DS-14) were higher for the group with a history of suicide attempt than for the group without this history (p=0.0000004, 0.003, and 0.033, respectively). There were positive correlations between the total DS-14 score and the total BSS, BHS, and BIS scores (r=0.413 and p=0.000077, r=0.404 and p=0.00012, and r=0.245 and p=0.024, respectively). CONCLUSION Depressed patients with type-D personality are more vulnerable to suicidality than those without type-D personality, even when the MDD severity is identical. In addition, the SI score was higher in patients with a history of suicide attempt than in those without this history.
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Affiliation(s)
- Young-Min Park
- Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Republic of Korea
| | - Young-Hoon Ko
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Moon-Soo Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
| | - Leen Kim
- Department of Psychiatry, Korea University College of Medicine, Seoul, Republic of Korea
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Marchesi C, Ossola P, Scagnelli F, Paglia F, Aprile S, Monici A, Tonna M, Conte G, Masini F, De Panfilis C, Ardissino D. Type D personality in never-depressed patients and the development of major and minor depression after acute coronary syndrome. J Affect Disord 2014; 155:194-9. [PMID: 24274964 DOI: 10.1016/j.jad.2013.10.052] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Revised: 10/30/2013] [Accepted: 10/31/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Type D personality (TDP) has been proposed as a risk factor for the development of depressive symptoms after an acute coronary syndrome (ACS). However, contrasting findings emerged about its predicting power on the onset of depression, since an overlap between TDP and depressive symptoms has been proposed. The present study was aimed to verify whether TDP predicts the development of a depressive disorder in the 6 months after the discharge from hospital. METHODS Two hundred fifty consecutive patients were recruited, at the Coronary Intensive Care Unit at the University Hospital of Parma, who were both presenting their first ACS and had no history of depression. The presence and the severity of major (MD) and minor (md) depression were evaluated with the Primary Care Evaluation of Mental Disorders (PRIME-MD) and the Hospital Anxiety and Depression Scale (HADS) respectively. Type D Personality was assessed with the DS14, both at baseline and at 1, 2, 4 and 6 month follow ups. RESULTS Out of 250 subjects (81.2% males), MD was diagnosed in 12 patients (4.8%) and md in 18 patients (7.2%). At baseline risk factors for a post-ACS depressive disorder were HADS depression scores, whereas TDP, or its subscales, did not showed any effect. LIMITATION The small amount of patients with incidence of depression, due to highly selective inclusion criteria, tempers the reliability of our results. CONCLUSION Our data suggests that TDP does not predict the development of depressive disorders in never-depressed patients at their first ACS, when the baseline depression severity was controlled.
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Affiliation(s)
- Carlo Marchesi
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy.
| | - Paolo Ossola
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy
| | - Francesca Scagnelli
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy
| | - Francesca Paglia
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy
| | - Sonja Aprile
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy
| | | | | | - Giulio Conte
- Department of Cardiology, University Hospital, Parma, Italy
| | - Franco Masini
- Department of Cardiology, University Hospital, Parma, Italy
| | - Chiara De Panfilis
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy; Mental Health Department, AUSL, Parma, Italy
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Abstract
The interaction of negative affectivity (NA) and social inhibition (SI), known as the Type D personality, is associated with a worse prognosis in cardiac patients. Until now, causal models have been speculative, and this is partly due to a lack of clarity related to the validity of SI, its role in emotion regulation, and the postulated independence of social and emotional functioning. To examine the construct validity of the Type D personality, we analyzed associations of NA and SI with different measures of affectivity, social anxiety, and social competencies in a German population-based representative sample (n = 2,495). Both NA and SI were associated with all other measures of social functioning and negative affect (all rs > .30) and showed considerable cross-loadings (NA: a 1 = .39, a 2 = .63; SI: a1 = .73 and a2 = .34) in a two-factor solution with the factors labeled as Social Functioning and Negative Affectivity. The SI subscale did not properly differentiate between social fears and social competencies, which emerged as rather different aspects of social functioning. Further studies should examine the effect of broader dimensions of social orientation and competencies and their interaction with NA on cardiac prognosis.
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Affiliation(s)
- Gesine Grande
- Faculty of Applied Sciences, Leipzig University of Applied Sciences, Germany
| | - Matthias Romppel
- Faculty of Applied Sciences, Leipzig University of Applied Sciences, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotheraphy, University Medical Center, Mainz, Germany
| | - Elmar Brähler
- Department of Medical Psychology and Sociology, University Medical Center, Leipzig, Germany
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Christodoulou C, Douzenis A, Mommersteeg PM, Rallidis L, Poulios A, Efstathiou V, Bouras G, Varounis C, Korkoliakou P, Palios J, Kremastinos DT, Lykouras L. A case-control validation of Type D personality in Greek patients with stable coronary heart disease. Ann Gen Psychiatry 2013; 12:38. [PMID: 24283252 PMCID: PMC4175478 DOI: 10.1186/1744-859x-12-38] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 11/12/2013] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Type D personality has been associated with a variety of emotional and social difficulties as well as with poor prognosis in patients with established coronary heart disease (CHD). We examined the psychometric properties and validity of the Type D Scale-14 (DS14) and the prevalence of Type D personality among Greek patients with CHD while taking into account demographic; clinical, such as diabetes mellitus, hypertension, and hypercholesterolemia; as well as psychological variables such as depression, anxiety, and psychological stress. METHODS Ninety-six patients with stable coronary heart disease and 80 healthy participants from the general population completed the Greek version of the DS14 and the Hospital Anxiety and Depression Scale (HADS). RESULTS Cronbach's α coefficient for the negative affectivity (NA) and social inhibition (SI) subscales was 0.83 and 0.72 for the CHD and 0.88 and 0.76 for the control group, respectively. Internal-structural validity was assessed by a factor analysis (two-factor solution), and the factor structure of the original DS14 was replicated. Using the standardized cutoff point of NA ≥10 and SI ≥10, instead of the median scores, in order to have compatible results with the majority of studies, the prevalence of Type D personality was 51% for the CHD patients and 13% for the control group. Higher NA and SI were connected with higher anxiety, depression, and total psychological stress. Finally, more patients with CHD and Type D personality than those without were diagnosed with type 2 diabetes; however, no differences were observed in hypertension or hypercholesterolemia. CONCLUSIONS These results indicate that the Type D construct is reliable and valid in a Greek population. The prevalence of Type D personality was higher in patients with stable coronary heart disease than in people from the general population. The DS14 subscales were positively correlated with higher anxiety, depression, and total psychological stress. Regarding other CHD risk factors, only diabetes mellitus was found more frequently in CHD patients with Type D personality.
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Affiliation(s)
- Christos Christodoulou
- Second Department of Psychiatry, "Attikon" General Hospital, University of Athens Medical School, Athens 12462, Greece.
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Abstract
CONTEXT Academic pressure, though established, is an unavoidable cause of depression in medical students. Role of Type D personality as determinant of depression is a new approach to the problem. AIM Determination of relationship between Type D personality and Depression among medical students. SETTING AND DESIGN Undergraduate students (both male and female, total 150) of Midnapore Medical College. MATERIALS AND METHODS Beck Depression Inventory for depression and DS 14 for type D personality. STATISTICAL ANALYSIS The scores were expressed as mean + SD. The significance of difference between the scores was done by Fisher's 2 sample t test. RESULTS AND CONCLUSION Prevalence rate of depression was 45.3%, which was mostly of mild type (34%). Type D personality was present in 70% cases of which 15.3% had only negative affectivity, 23.3% had only social inhibition and 31% had both the components. Both depression & Type D personality were present in 36% cases. Negative affectivity component was significantly associated with depression which could be therapeutically controlled.
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Affiliation(s)
- Soma Gupta
- Department of Biochemistry and Psychiatry, Midnapore Medical College, Paschim Medinipur, West Bengal, India
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Compare A, Bigi R, Orrego PS, Proietti R, Grossi E, Steptoe A. Type D personality is associated with the development of stress cardiomyopathy following emotional triggers. Ann Behav Med 2013; 45:299-307. [PMID: 23494256 DOI: 10.1007/s12160-013-9474-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Stress cardiomyopathy (SCM) can be triggered by emotional events. Recently, type D personality has been established as an independent predictor of acute cardiac adverse events. PURPOSE We sought to examine whether type D personality can be identified in SCM patients. METHODS A case-control study with 37 SCM patients, 37 myocardial infarction (AMI) patients, who both experienced emotional triggering, and 37 SCM patients without emotional triggers was performed. The DS14 and Interview for Recent Life Events were administered. RESULTS Twenty-eight (76 %) SCM emotional trigger patients were categorized as type D compared with 13 (43 %) SCM patients without emotional trigger and 12 (32 %) AMI patients (p < 0.001). SCM patients with emotional triggers had higher scores on the social inhibition subscale than the other patient groups. CONCLUSIONS The present study highlights the possible link between type D, with a specific key role for social inhibition component, and increased biological reactivity to acute emotional stress.
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Weng CY, Denollet J, Lin CL, Lin TK, Wang WC, Lin JJ, Wong SS, Mols F. The validity of the Type D construct and its assessment in Taiwan. BMC Psychiatry 2013; 13:46. [PMID: 23379902 PMCID: PMC3598734 DOI: 10.1186/1471-244x-13-46] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 01/29/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Type D (distressed) personality, defined by negative affectivity and social inhibition, is related to cardiovascular outcomes. Little is known about Type D in non-Western cultures. We examined the validity of this construct and its assessment in Taiwanese patients with coronary artery disease (CAD) and adults from the general population. METHODS CAD patients (N = 87) and adults from the general population (N = 421) completed the 14-item Type D Scale- Taiwanese version (DS14-T), State-Trait Anxiety Inventory, Beck Depression Inventory-II, and Chinese Hostility Inventory Short-Form. RESULTS Based on the psychometric examination, item #3 of the original DS14, "I often talk to strangers" was replaced by "I don't like to have a lot of people around me" which comes from the "Withdrawal" facet of social inhibition of DS-24. The reliability of Type D assessment in Taiwan was good, with Cronbach's α for negative affectivity and social inhibition of .86 and .79. Factor analyses confirmed the two-factor model of the Type D construct. The prevalence rate of Type D personality in Taiwan was 20% in CAD patients and 16% in the general population. Negative affectivity was positively associated with anxiety, depression and hostility, and social inhibition was positively associated with suppressive hostility and negatively associated with expressive hostility after controlling for the total hostility. Furthermore, Taiwanese individuals with a Type D personality displayed elevated levels of anxiety, depression and hostility. CONCLUSIONS The Type D construct and its assessment with the DS14-T is generalizable to an Asian setting, Taiwan. The DS14-T showed good psychometric properties, and the prevalence of Type D personality in Taiwan was similar to the prevalence rates in Western countries and Mainland China, and Type D was associated with anxiety, depression and hostility.
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Affiliation(s)
- Chia-Ying Weng
- Department of Psychology, National Chung-Cheng University, Chia-Yi, Taiwan.
| | - Johan Denollet
- Center of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Chin-Lon Lin
- Division of Cardiology, Department of Internal Medicine, The Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan
| | - Tin-Kwang Lin
- Division of Cardiology, Department of Internal Medicine, The Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | | | - Jyun-Ji Lin
- Department of Psychology, National Chung-Cheng University, Chia-Yi, Taiwan
| | - Shu-Shu Wong
- Department of Child Development and Family Studies, Tzu Chi University, Hualien, Taiwan
| | - Floortje Mols
- Center of Research on Psychology in Somatic diseases (CoRPS), Tilburg University, Tilburg, The Netherlands
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Bunevicius A, Staniute M, Brozaitiene J, Stropute D, Bunevicius R, Denollet J. Type D (distressed) personality and its assessment with the DS14 in Lithuanian patients with coronary artery disease. J Health Psychol 2012; 18:1242-51. [PMID: 23129829 DOI: 10.1177/1359105312459098] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We examined Type D personality (combination of negative affectivity with social inhibition) and its assessment with the DS14 in 543 Lithuanian coronary patients. Psychometric analyses confirmed the two-factor structure, internal consistency (α = 0.84/α = 0.75), and test-retest reliability (r = 0.69/0.81) of the DS14 negative affectivity and inhibition components. Negative affectivity correlated (r = -0.58) with emotional stability and social inhibition (r = -0.46) with extraversion; correlations with other Big-Five traits ranged between r = -0.11 and -0.19. Type D patients (34%) had a ninefold increased odds of depression (95% confidence interval = 5.01-17.36) and a fivefold increased odds of anxiety (95% confidence interval = 3.47-7.97). These findings support the validity of the Type D construct in Lithuania.
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Affiliation(s)
- Adomas Bunevicius
- Department of Psychiatry, University of North Carolina at Chapel Hill, CB#7175, Medical School Wing D, Chapel Hill, NC 27599-7175, USA.
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Vilchinsky N, Yaakov M, Sigawi L, Leibowitz M, Reges O, Levit O, Khaskia A, Mosseri M. Preliminary evidence for the construct and concurrent validity of the DS14 in Hebrew. Int J Behav Med 2012; 19:234-40. [PMID: 21298499 DOI: 10.1007/s12529-011-9147-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Type D personality is a risk indicator in cardiac patients. While both the validity and reliability of the Type D scale (DS14) have been confirmed in Western Europe, less attention has been paid to the subject in other nations. PURPOSE The purpose of this study was to examine the validity of the Hebrew version of the DS14 among a sample of cardiac patients in Israel. METHOD Male patients (N = 94) hospitalized for a first acute coronary syndrome (ACS) completed the DS14 1 month after their ACS. The Brief Symptoms Inventory (BSI) scales for depression and anxiety and the Buss-Durkee Hostility Inventory-Dutch for measuring covert and overt aggressions were administered during the initial hospitalization (baseline). The BSI was administered again at the 6-month follow-up. At follow-up, patients were also asked about their participation in a formal cardiac rehabilitation program. RESULTS The two-factor structure of the DS14 was confirmed and the DS14 subscales were internally consistent (Cronbach's α = 0.79/0.80). Type D cardiac patients had a significantly higher mean score on anxiety, depression, and covert aggression at baseline compared to non-Type D patients. At the 6-month follow-up, Type D was associated with more anxiety, more depression, and less attendance at a formal cardiac rehabilitation program. The prevalence of Type D in the current sample (5.3%) was found to be significantly lower than elsewhere in Europe. CONCLUSION Preliminary evidence suggests that it is possible to use the Hebrew version of the DS14 among Hebrew-speaking cardiac patients in future studies. However, the prevalence of the Type D personality in Israel should be further assessed.
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Affiliation(s)
- Noa Vilchinsky
- Department of Psychology, Bar-Ilan University, Ramat Gan, 52900, Israel.
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Xia LX, Ding C, Hollon SD, Fan Q. The Relationship Between Interpersonal Self-Support and Depression: A Longitudinal Study. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2012. [DOI: 10.1521/jscp.2012.31.8.835] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Beutel ME, Wiltink J, Till Y, Wild PS, Münzel T, Ojeda FM, Zeller T, Schnabel RB, Lackner K, Blettner M, Zwiener I, Michal M. Type D personality as a cardiovascular risk marker in the general population: results from the Gutenberg health study. PSYCHOTHERAPY AND PSYCHOSOMATICS 2012; 81:108-17. [PMID: 22262039 DOI: 10.1159/000331776] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2011] [Accepted: 08/12/2011] [Indexed: 11/19/2022]
Abstract
BACKGROUND Type D personality is considered as an independent risk factor for morbidity and mortality in cardiovascular patients and a vulnerability factor for distress in the general population. Because representative community studies are rare, we sought to determine the prevalence of type D personality and its relationship with demographic characteristics, different features of mental disorders, cardiovascular risk factors, health behavior, endothelial function and cardiovascular biomarkers in the general population. METHODS The prevalence of type D personality and its correlates were analyzed cross-sectionally in a population-based sample of 5,000 Mid-Europeans aged 35-74 years from the Gutenberg Health Study. RESULTS The prevalence of type D personality was 22.2% without remarkable differences in sex distribution. Type D subjects were characterized by lower socioeconomic status, lack of a partnership, increased depression, anxiety, depersonalization and health care utilization. Despite its strong association with mental disorders, type D personality emerged as psychometrically distinct. Although type D personality was independently associated with coronary heart disease (OR = 1.54, p = 0.044), no associations with traditional cardiovascular risk factors were found independently from depression or anxiety. CONCLUSIONS Although type D personality is strongly associated with depression, anxiety, impaired mental and somatic health status, and increased health care utilization, the type D construct seems to comprise dysfunctional personality patterns not covered by depression and anxiety scales. Beyond these associations, the pathways of the cardiotoxic impact of type D personality remain to be elucidated. There is a need for prospective population studies on potential links between type D personality and cardiac disease.
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Affiliation(s)
- M E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Straat JH, van der Ark LA, Sijtsma K. Multi-method analysis of the internal structure of the Type D Scale-14 (DS14). J Psychosom Res 2012; 72:258-65. [PMID: 22405218 DOI: 10.1016/j.jpsychores.2012.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 01/02/2012] [Accepted: 01/04/2012] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The Type D Scale-14 (DS14) measures distressed (also, Type D) personality by assessing the medium-level trait negative affectivity that encompasses the low-level traits dysphoria, anxiety, and irritability, and the medium-level trait social inhibition that encompasses the low-level traits social discomfort, reticence, and lack of social poise. The literature discusses three different structural models of the DS14. The goal of this study was to investigate which of the three models best describes the internal structure of the DS14. METHOD We used three methods to investigate the internal structure of the DS14 items using data collected in representative samples from the Dutch general population (N=3,181). The methods were exploratory factor analysis, confirmatory factor analysis, and Mokken scale analysis. RESULTS Exploratory factor analysis suggested a two-factor structure without evidence of the low-level factors, and the other two methods showed evidence of a three-level structure including the low-level factors. CONCLUSIONS A two-factor model with correlated errors for items defining low-level traits adequately describes the data. The results support the three-level hierarchical model as a conceptual model for Type D personality, and support the interpretation of DS14 scores on item subsets representing medium-level traits and low-level traits.
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Affiliation(s)
- J Hendrik Straat
- Department of Methodology and Statistics TSB, Tilburg University, Tilburg, The Netherlands.
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Nefs G, Pouwer F, Pop V, Denollet J. Type D (distressed) personality in primary care patients with type 2 diabetes: validation and clinical correlates of the DS14 assessment. J Psychosom Res 2012; 72:251-7. [PMID: 22405217 DOI: 10.1016/j.jpsychores.2012.01.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Revised: 12/23/2011] [Accepted: 01/04/2012] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In cardiovascular research, Type D personality (high negative affectivity and social inhibition) has been associated with a more than 3-fold increased risk of adverse health outcomes. This study examined the validity and clinical correlates of the Type D construct as assessed by the Type D Scale-14 (DS14) in type 2 diabetes patients. METHODS 1553 primary care patients with type 2 diabetes were assessed for demographic, clinical, lifestyle and psychological characteristics in 2007. A subgroup (n=1012) completed the DS14 again 1 year later. RESULTS The two-factor model of the Type D construct was confirmed in exploratory and confirmatory factor analyses; results were stable across gender. The Negative Affectivity (NA) and Social Inhibition (SI) subscales had adequate reliability in both men and women, as measured by Cronbach's alpha (NA=0.87, SI=0.83), lambda2 (NA=0.87/0.88, SI=0.84), corrected item-total correlations (NA 0.47-0.77, SI 0.34-0.72) and mean inter-item correlations (NA=0.50/0.51, SI=0.42). One year test-retest reliability using intraclass correlation coefficients was 0.64/0.63 for NA and 0.73/0.65 for SI. Type D and non-Type D patients did not differ in vascular history or physiological risk factors, but Type D women had a more sedentary lifestyle (p=.003). Type D patients experienced less social support and more stressful life events, loneliness, and more depressed mood, anhedonia and anxiety (p<.001 for most variables). These differences were clinically significant (Cohen's d>0.60 for most variables). CONCLUSION Type D personality can be reliably assessed in primary care patients with type 2 diabetes, and is associated with increased loneliness, stress and emotional distress in these patients.
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Affiliation(s)
- Giesje Nefs
- Center of Research on Psychology in Somatic Diseases-CoRPS, Department of Medical Psychology and Neuropsychology, Tilburg University, Tilburg, The Netherlands
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Romppel M, Herrmann-Lingen C, Vesper JM, Grande G. Six year stability of Type-D personality in a German cohort of cardiac patients. J Psychosom Res 2012; 72:136-41. [PMID: 22281455 DOI: 10.1016/j.jpsychores.2011.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 10/05/2011] [Accepted: 11/23/2011] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of the study was to systematically analyze the stability of Type-D personality over a time span of several years in a clinical sample. METHODS In a prospective cohort study, cardiac patients from different medical settings in Germany were assessed using the DS14 questionnaire at baseline (n=1240) and at a mean follow-up time of six years (n=679). Different types of stability were examined and compared with the stability of the Hospital Anxiety and Depression Scale (HADS). RESULTS Rank-order stability was moderate (r=.61 for Negative Affectivity [NA] and r=.60 for Social Inhibition [SI]) and didn't differ from the rank-order stability of the HADS. Whereas the mean level of SI didn't change over time, the mean level of NA increased (d=0.08). On an individual level, approximately one quarter of the participants showed a significant increase or decrease. The factorial structure of the DS14 was stable over time. Finally, the agreement of Type-D classification between the two measurement points was moderate (κ=.42) with 22% of the participants changing their Type-D classification over time. CONCLUSION The stability of NA and SI didn't differ from the stability of measures of emotional distress that are generally considered to be less stable. In particular, the only moderate stability of the dichotomous Type-D classification raises some questions.
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Affiliation(s)
- Matthias Romppel
- Faculty of Applied Social Sciences, University of Applied Sciences Leipzig, Germany.
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Svansdottir E, van den Broek KC, Karlsson HD, Gudnason T, Denollet J. Type D personality is associated with impaired psychological status and unhealthy lifestyle in Icelandic cardiac patients: a cross-sectional study. BMC Public Health 2012; 12:42. [PMID: 22251667 PMCID: PMC3398279 DOI: 10.1186/1471-2458-12-42] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 01/18/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Type D (distressed) personality has been associated with adverse cardiac prognosis and poor emotional well-being in cardiac patients, but it is still unclear what mechanisms link Type D personality with poor clinical outcomes in cardiac patients. In the present cohort of Icelandic cardiac patients, we examined potential pathways that may explain this relationship. The objectives were to examine 1) the association between Type D personality and impaired psychological status, and to explore whether this association is independent of disease severity; and 2) the association between Type D personality and an unhealthy lifestyle. METHODS A sample of 268 Icelandic coronary angiography patients (74% males (N = 199); mean age 62.9 years (SD 10.5), range 28-85 years) completed the Type D Scale (DS14), Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS) at hospitalization. Health-related behaviors were assessed 4 months following angiography. Clinical data were collected from medical files. RESULTS Type D personality was associated with an increased risk of anxiety (OR 2.97, 95% CI:1.55-5.69), depression (OR 4.01, 95% CI:1.42-11.29), and stress (OR 5.99, 95% CI:3.08-11.63), independent of demographic variables and disease severity. Furthermore, fish consumption was lower among Type Ds, as 21% of Type Ds versus 5% of non-Type Ds consumed fish < 1 a week (p < 0.001). Type D patients were also more likely to smoke at follow-up (22% versus 10%, p = 0.024) and to use antidepressants (17% versus 9%, p = 0.049) and sleeping pills (49% versus 33%, p = 0.019) compared to non-Type Ds. Type D personality was not associated with other health-related behaviors, aside from trends towards less fruit and vegetable consumption, and more weight gain. CONCLUSION Type D personality was associated with psychological distress and an unhealthy lifestyle in Icelandic cardiac patients. Future studies should further investigate the association between Type D personality and health-related behaviors.
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Affiliation(s)
- Erla Svansdottir
- CoRPS--Center of Research on Psychology in Somatic diseases, Tilburg University, 5000 LE Tilburg, The Netherlands
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Type D (distressed) personality is associated with poor quality of life and mental health among 3080 cancer survivors. J Affect Disord 2012; 136:26-34. [PMID: 21943928 DOI: 10.1016/j.jad.2011.08.034] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2011] [Revised: 08/26/2011] [Accepted: 08/26/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND This study assessed the association between Type D personality (the conjoint effect of negative affectivity and social inhibition) and quality of life (QoL) and mental health of cancer survivors up to 10 years post-diagnosis. METHODS All currently alive individuals diagnosed with endometrial or colorectal cancer between 1998 and 2007, or with lymphoma or multiple myeloma between 1999 and 2008 as registered in the Eindhoven Cancer Registry received a questionnaire on Type D personality (DS14), QoL (SF-36 or EORTC-QLQ-C30) and mental health (HADS). RESULTS Of the 3080 survivors who responded (69%), 572 (19%) had a Type D personality. Type D survivors had clinically meaningful lower levels of general health, social functioning, role-function emotional, mental health and vitality compared to non-Type D's (SF-36: all P's<0.001). They also reported clinically meaningful worse emotional and social functioning, global health status/QoL, and more fatigue (EORTC-QLQ-C30: all P's<0.001). This was also confirmed by multivariate logistic regression analyses showing that cancer survivors with a Type D personality were more likely to experience a decreased QoL on all SF-36 and EORTC-QLQ-C30 scales (all ORs ranging between 1.88 and 5.56). The proportion of survivors reporting an impaired QoL was higher among Type D (35-64%) than non-Type D's (20-36%). Finally, Type D's were more likely to be depressed (44% vs. 13%; P<0.0001) or anxious (51% vs. 14%; P<0.0001). CONCLUSIONS Cancer survivors with a Type D personality are at increased risk of impaired QoL and mental health problems that cannot be explained by socio-demographic or clinical characteristics.
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Abstract
OBJECTIVE Type D personality has been established as a predictor of adverse clinical events in patients with cardiovascular diseases. To date, all studies except one have been conducted by a single research group. Thus, the aim of our study was to provide an independent replication of the results regarding the prognostic validity of Type D personality in a German sample of cardiac patients. METHODS Cardiac patients (n = 1040) were recruited from cardiac rehabilitation centers (n = 484), an outpatient clinic (n = 249), and a university hospital (n = 307). Main analyses were based on the combined data from these three subsamples. Cardiac health status, medical risk factors, sociodemographic characteristics, psychological symptoms, and Type D personality were assessed at baseline. The primary end point was all-cause mortality. The Cox proportional hazards regression model was used to estimate the relative risk of death. RESULTS Vital status was known for 977 patients (22.5% women; mean [standard deviation] = 63.3 [10.7] years). Within the follow-up time (mean [standard deviation] = 71.5 [3.6] months), 172 patients died. Type D personality was found in 25.2% of survivors and in 22.2% of nonsurvivors (χ²= 0.78, p = .38). Depressive symptoms (p = .13) and anxiety (p = .27) were also not predictive of mortality. In the multivariate analyses, neither Type D (p = .95) nor negative affectivity (p = .71) and social inhibition (p = .59), as well as their interaction (p = .88), were associated with all-cause mortality. CONCLUSIONS In the present study, Type D personality and its constituents are not associated with increased mortality in patients with heart disease. The discrepancies with previous results deserve further investigation.
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Wiltink J, Beutel ME, Till Y, Ojeda FM, Wild PS, Münzel T, Blankenberg S, Michal M. Prevalence of distress, comorbid conditions and well being in the general population. J Affect Disord 2011; 130:429-37. [PMID: 21106250 DOI: 10.1016/j.jad.2010.10.041] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2010] [Revised: 10/25/2010] [Accepted: 10/26/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND The purposes of this paper are to determine the prevalence of distress in the community, to identify its determinants and to assess its relationship to somatic conditions and subjective well being. METHODS Distress and associated factors were investigated in a random sample of 5000 participants (35-74 years) of a community-based, prospective, observational cohort study in western Mid-Germany ("Gutenberg Heart Study") between 04/2007 and 10/2008. The sample was stratified 1:1 for gender and residence and in equal strata for decades of age. Data were assessed by self-report instruments, interviews and medical examination. RESULTS We found a prevalence rate for depression of 7.2% (6.5-8.0%), social anxiety 7.0% (6.3-7.7%), panic 4.6% (4.0-5.2%), generalized anxiety 3.4% (2.9-3.9%), and Type D personality 22.1% (21.0-23.2%). Mental conditions declined by age. Depression was related to diabetes (OR=1.99, 95% CI=1.26-3.15), dyslipidemia (OR=1.35, 95% CI=1.02-1.79), coronary heart disease (CHD; OR=1.88, 95% CI=1.04-3.39), and the history of stroke (OR=2.43, 95% CI=1.02-5.76). Panic was related to the history of myocardial infarction (OR=2.46, 95% CI=1.15-5.25), and generalized anxiety to obesity (OR=1.65, 95% CI=1.11-2.44). Mental distress was unrelated to hypertension, atrial fibrillation and cancer. In ordinal logistic regression subjective physical and mental well being were associated with anxiety, depression and Type D personality. CONCLUSIONS While mental conditions are highly prevalent, especially depression is associated with several somatic conditions. Mental and physical well being are strongly related to mental conditions. Future work should take into account comorbid conditions when identifying the impact of depression on CHD.
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Affiliation(s)
- Jörg Wiltink
- Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Germany.
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Validity of Type D personality in Iceland: association with disease severity and risk markers in cardiac patients. J Behav Med 2011; 35:155-66. [PMID: 21533610 PMCID: PMC3305874 DOI: 10.1007/s10865-011-9337-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2010] [Accepted: 03/07/2011] [Indexed: 01/28/2023]
Abstract
Type D personality has been associated with poor prognosis in cardiac patients. This study investigated the validity of the Type D construct in Iceland and its association with disease severity and health-related risk markers in cardiac patients. A sample of 1,452 cardiac patients completed the Type D scale (DS14), and a subgroup of 161 patients completed measurements for the five-factor model of personality, emotional control, anxiety, depression, stress and lifestyle factors. The Icelandic DS14 had good psychometric properties and its construct validity was confirmed. Prevalence of Type D was 26–29%, and assessment of Type D personality was not confounded by severity of underlying coronary artery disease. Regarding risk markers, Type D patients reported more psychopharmacological medication use and smoking, but frequency of previous mental problems was similar across groups. Type D is a valid personality construct in Iceland, and is associated with health-related risk markers, but not cardiac disease severity.
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Type D personality is associated with increased metabolic syndrome prevalence and an unhealthy lifestyle in a cross-sectional Dutch community sample. BMC Public Health 2010; 10:714. [PMID: 21092104 PMCID: PMC3002331 DOI: 10.1186/1471-2458-10-714] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Accepted: 11/19/2010] [Indexed: 01/18/2023] Open
Abstract
Background People with Type D-Distressed-personality have a general tendency towards increased negative affectivity (NA), while at the same time inhibiting these emotions in social situations (SI). Type D personality is associated with an increased risk of adverse outcomes in patients with cardiovascular disease. Whether Type D personality is a cardiovascular risk factor in healthy populations remains to be investigated. In the present study, the relations between Type D personality and classical cardiovascular risk factors, i.e. metabolic syndrome and lifestyle were investigated in a Dutch community sample. Methods In a cross-sectional study 1592 participants were included, aged 20-80 years. Metabolic syndrome was defined by self-report, following the International Diabetes Federation-IDF-guidelines including an increased waist circumference, dyslipidemia, hypertension, and diabetes. In addition lifestyle factors smoking, alcohol use, exercise and dietary habits were examined. Metabolic syndrome prevalence was stratified by Type D personality (a high score on both NA and SI), lifestyle and confounders age, gender, having a partner, higher education level, cardiac history, family history of cardiovascular disease. Results Metabolic syndrome was more prevalent in persons with a Type D personality (13% vs. 6%). Persons with Type D personality made poorer lifestyle choices, adhered less to the physical activity norm (OR = 1.5, 95%CI = 1.1-2.0, p = .02), had a less varied diet (OR = 0.50, 95%CI = 0.40-0.70, p < .0005), and were less likely to restrict their fat intake (OR = 0.70, 95%CI = 0.50-0.90, p = .01). Type D personality was related to a twofold increased risk of metabolic syndrome (OR = 2.2, 95%CI = 1.2-4.0, p = .011), independent of lifestyle factors and confounders. Conclusions Type D personality is related to an increased prevalence of metabolic syndrome and unhealthy lifestyle, which suggests both behavioral and biological vulnerability for development of cardiovascular disorders and diabetes.
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Denollet J, Schiffer AA, Spek V. A General Propensity to Psychological Distress Affects Cardiovascular Outcomes. Circ Cardiovasc Qual Outcomes 2010; 3:546-57. [DOI: 10.1161/circoutcomes.109.934406] [Citation(s) in RCA: 251] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Johan Denollet
- From the CoRPS–Center of Research on Psychology in Somatic diseases (J.D., A.A.S., V.S.), Tilburg University, Tilburg, The Netherlands; and the Department of Medical Psychology and Neuropsychology (A.A.S.), TweeSteden Hospital, Tilburg, The Netherlands
| | - Angélique A. Schiffer
- From the CoRPS–Center of Research on Psychology in Somatic diseases (J.D., A.A.S., V.S.), Tilburg University, Tilburg, The Netherlands; and the Department of Medical Psychology and Neuropsychology (A.A.S.), TweeSteden Hospital, Tilburg, The Netherlands
| | - Viola Spek
- From the CoRPS–Center of Research on Psychology in Somatic diseases (J.D., A.A.S., V.S.), Tilburg University, Tilburg, The Netherlands; and the Department of Medical Psychology and Neuropsychology (A.A.S.), TweeSteden Hospital, Tilburg, The Netherlands
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Yu DSF, Thompson DR, Yu CM, Pedersen SS, Denollet J. Validating the Type D personality construct in Chinese patients with coronary heart disease. J Psychosom Res 2010; 69:111-8. [PMID: 20624509 DOI: 10.1016/j.jpsychores.2010.01.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Revised: 12/24/2009] [Accepted: 01/15/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Type D personality predicts poor prognosis in coronary heart disease (CHD) but little is known about Type D in non-Western cultures. We examined the (a) validity of the Type D construct and its assessment with the DS14 scale in the Chinese culture, (b) prevalence of Type D, and (c) gender vs. Type D discrepancies in depression/anxiety, among Chinese patients with CHD. METHOD Patients with CHD (N=326) completed the Chinese version of the DS14. The NEO Five Factor Inventory (NEO-FFI), Hospital Anxiety and Depression Scale (HADS), and Stress Symptom Checklist (SSC) were administered to subsamples to establish construct and discriminant validity. Administration of the DS14, HADS, and SSC was repeated at 1 month after hospital discharge in 66 patients, and stability of the DS14 was examined in another subsample of 100 patients. RESULTS The theoretical structure of the Type D construct in the Chinese culture was supported (chi(2)/df=2.89, root mean square error of approximation=0.08, normal fit index=0.91, non-normal fit index=0.91, comparative fit index=0.93). The Negative Affectivity (NA) and Social Inhibition (SI) subscales of the DS14 in the entire sample were internally consistent (Cronbach's alpha=0.89/0.81), measured stable traits (3-month test-retest ICC=0.76/0.74), and correlated significantly with the neuroticism (NA/neuroticism, r=0.78, P<.001) and extraversion subscales (SI/extraversion, r=-0.64, P<.001) of the NEO-FFI, respectively. The prevalence of Type D personality was 31%. Type D was not related to transient emotional states. However, Chinese patients with a Type D personality were at increased concurrent risk of anxiety (P=.002) and depression (P=.016). CONCLUSION Type D personality is a cross-culturally valid construct, is associated with an increased risk of anxiety and depression, and deserves prompt attention in estimating the prognostic risk of Chinese CHD patients.
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Affiliation(s)
- Doris S F Yu
- The Chinese University of Hong Kong, Hong Kong, China.
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Is type-D a stable construct? An examination of type-D personality in patients before and after cardiac surgery. J Psychosom Res 2010; 69:101-9. [PMID: 20624508 DOI: 10.1016/j.jpsychores.2010.02.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Revised: 02/16/2010] [Accepted: 02/18/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Type-D personality-negative affectivity and social inhibition-are related to poor prognosis in cardiovascular diseases. At present, little is known about type-D personality and its stability before and after cardiac surgery. METHODS One hundred twenty-six patients recommended for coronary bypass and/or valve surgery were examined at pre-surgery and 6 months post-surgery to investigate the stability of type-D (14-item Type-D Scale) and its relationship to anxiety, depression (Hospital Anxiety and Depression Scale) and quality of life (Short Form 12). RESULTS Preoperatively, 26% were assessed to have type-D, while only 11% fulfilled type-D criteria both pre- and post-surgery. Patients were assessed and identified as belonging to one of the four type-D groups: Stable type-D (11%), non-type-D (61%), type-D pre (15%), and type-D post (13%). In comparison to the stable non-type D group, the stable type-D reported more symptoms of anxiety, depression, lower physical quality of life post-surgery, and lower mental quality of life both pre- and post-surgery. When compared to the population at large, stable type-D had more symptoms of depression pre-surgery, and more anxiety as well as lower physical and mental quality of life pre- and post-surgery. CONCLUSION Type-D diagnosis changed in nearly 60% of the cases post-surgery. Only those patients with stable type-D exhibited a relationship to emotional distress, such as anxiety and depression and reduced quality of life. Additional research on the critical cut-off scores and stability of type-D as it relates to critical life events would likely enhance our ability to more effectively diagnose and treat patients who are at high risk for insufficient coping.
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Grande G, Romppel M, Glaesmer H, Petrowski K, Herrmann-Lingen C. The type-D scale (DS14) – Norms and prevalence of type-D personality in a population-based representative sample in Germany. PERSONALITY AND INDIVIDUAL DIFFERENCES 2010. [DOI: 10.1016/j.paid.2010.02.026] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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