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Moriarity DP, Grehl MM, Walsh RFL, Roos LG, Slavich GM, Alloy LB. A systematic review of associations between emotion regulation characteristics and inflammation. Neurosci Biobehav Rev 2023; 150:105162. [PMID: 37028579 PMCID: PMC10425218 DOI: 10.1016/j.neubiorev.2023.105162] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/22/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023]
Abstract
Elevated inflammation is a risk factor for many psychiatric (e.g., depression) and somatic conditions (e.g., rheumatoid arthritis). Inflammation is influenced by psychosocial processes such as emotion regulation. Characterization of which emotion regulation characteristics impact inflammation could help refine psychosocial interventions aimed at normalizing health-harming inflammatory activity for individuals with psychiatric and somatic illnesses. To investigate this issue, we systematically reviewed the literature on associations between a variety of emotion regulation traits and inflammation. Out of 2816 articles identified, 38 were included in the final review. 28 (74%) found that (a) poor emotion regulation is associated with higher inflammation and/or (b) strong emotion regulation skills are associated with lower inflammation. Consistency of results differed as a function of the emotion regulation construct investigated and methodological characteristics. Results were most consistent for studies testing positive coping/social support seeking or broadly defined emotion regulation/dysregulation. Methodologically, studies testing reactivity to a stressor, adopting a vulnerability-stress framework, or using longitudinal data were most consistent. Implications for integrated, transdiagnostic psychoimmunological theories are discussed, as well as recommendations for clinical research.
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Affiliation(s)
- Daniel P Moriarity
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
| | - Mora M Grehl
- Department of Psychology & Neuroscience, Temple University, USA
| | | | - Lydia G Roos
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - George M Slavich
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Lauren B Alloy
- Department of Psychology & Neuroscience, Temple University, USA
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The negative affectivity dimension of Type D personality associated with increased risk for acute ischemic stroke and white matter hyperintensity. J Psychosom Res 2022; 160:110973. [PMID: 35749831 DOI: 10.1016/j.jpsychores.2022.110973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/24/2022] [Accepted: 06/13/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study was conducted to examine the relationship among type D personality, acute ischemic stroke (AIS), and white matter hyperintensity (WMH). METHODS In a cross-sectional study conducted between September 2020 and June 2021, 235 patients aged 50-85 years with first-ever ischemic cerebrovascular disease, including 146 males and 89 females, were enrolled. All participants underwent the Type D Scale-14 test containing negative affectivity (NA) and social inhibition (SI) subscales. Clinical and laboratory data were also collected for analysis. The patients were divided into the AIS group (n = 148) and the transient ischemic attack (TIA) group (n = 87) according to whether there was an acute lesion. RESULTS Patients with type D personality had a higher frequency of AIS and LAA and a higher level of WMH. Multiple logistic regression showed that the NA score was related to a 1.11-fold increase in the odds of AIS (95% CI: 1.03-1.19). Neither NA nor SI showed a clear association with a higher frequency of LAA. Higher scores of NA (OR = 1.07, 95% CI: 1.01-1.15), SI (OR = 1.11, 95% CI: 1.03-1.19), and the interaction between the two dimensions (OR = 1.03, 95% CI: 1.01-1.05) were independently associated with an increased load of WMH. CONCLUSION Type D personality was related to AIS and WMH. In particular, it was NA, not SI, affected the occurrence of AIS. Our findings may provide new insights regarding behavioral vulnerability for the development of cerebrovascular disorders.
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The Potential Mediating Effects of Inflammation on the Association Between Type D Personality and Coronary Plaque Vulnerability in Patients With Coronary Artery Disease: An Optical Coherence Tomography Study. Psychosom Med 2022; 84:468-477. [PMID: 35311805 DOI: 10.1097/psy.0000000000001068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Type D personality involves the interaction between negative affectivity with social inhibition and has been associated with an increased risk of coronary artery disease (CAD) progression and coronary plaque vulnerability. However, the underlying mechanisms in the relationship between type D personality and coronary plaque vulnerability remain indeterminate. The present study examined the potential mediating effects of inflammation biomarkers on the association between type D personality and coronary plaque vulnerability in patients with CAD. METHODS A total of 347 patients (mean [standard deviation] age = 56.6 [11.2] years; 29.3% women) with CAD who had culprit coronary plaques were examined for type D personality. The inflammation biomarkers (high-sensitivity C-reactive protein, interleukin 6 [IL-6], and tumor necrosis factor α [TNF-α]) were evaluated. Each individual inflammation biomarker was standardized using z scores to calculate inflammation standardized sumscores. Plaque vulnerability of culprit lesions was measured in vivo using optical coherence tomography. RESULTS The presence of type D personality (38%) was associated with TNF-α, IL-6, and inflammation standardized sumscores (t = 2.74, Cohen d = 0.32, p = .006; t = 4.03, Cohen d = 0.44, p ≤. 001; t = 4.16, Cohen d = 0.11, p = .001, respectively). In addition, the standardized inflammation sumscore was a mediator of the relationship between type D personality and lipid-rich plaques (effect sizes = 0.12, 95% confidence interval = 0.007-0.286, p = .064) and plaque rupture vulnerability (effect sizes = 0.16, 95% confidence interval = 0.043-0.365, p = .024). Analysis of continuous type D scores revealed that TNF-α, IL-6, and inflammation standardized sumscores also mediate the relationship between the primary effect of negative affectivity and plaque vulnerability. CONCLUSIONS Inflammation activation is a potential mediator of the association between type D personality and plaque vulnerability. The negative affectivity component of type D personality might be particularly relevant to the inflammatory aspects of plaque vulnerability.
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The Distressed personality type: replicability and general health associations. EUROPEAN JOURNAL OF PERSONALITY 2020. [DOI: 10.1002/per.645] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The Distressed personality type, identified in a cardiac population, confers risk for worse cardiac outcomes. Whether such a class of persons is identifiable in general patient populations, as well as its health correlates, remains unknown. We investigated these questions in a sample of 482 older primary care patients. Mixture structural equation modelling revealed that a Distressed Type was identifiable in Five Factor Model (FFM) personality data and associated with higher levels of medically documented multimorbidity, and worse subjective health ratings, physician assessed physical functioning and interviewer rated psychosocial functioning. In models including paths from outcomes to both traits and types, traits and types were independently associated with health outcomes, pointing towards the value of considering both approaches in epidemiologic personology research. Copyright © 2007 John Wiley & Sons, Ltd.
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Sun J, Zhang X, Wang Y, Wang J, Li J, Cao F. The associations of interpersonal sensitivity with mental distress and trait aggression in early adulthood: a prospective cohort study. J Affect Disord 2020; 272:50-57. [PMID: 32379620 DOI: 10.1016/j.jad.2020.03.161] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/20/2020] [Accepted: 03/29/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND To explore the longitudinal associations of interpersonal sensitivity (IS) with mental distress and trait aggression among participants passing through adolescence into adulthood. METHODS A total of 306 participants were recruited at baseline and received a 24-month follow-up. Questionnaires investigating sociodemographics; IS; depression, anxiety, and stress; and trait aggression were used. Univariable and multivariable logistic regression and cross-lagged analyses were also performed. RESULTS At base, 22.5%, 18.3%, 24.2%, and 9.2% of the participants reported higher levels of IS, depressive, anxious, and stressful symptoms. IS at baseline was a partial risk factor for new problems, including anxiety, stress, and anger at follow-up. Newly developed or persistent IS was significantly associated with ongoing symptoms. Discontinued IS, however, only resolved the association with stress and anxiety symptoms. Similarly, newly developed or persistent IS was significantly associated with increased persistence of some problems (anxiety symptoms and physical aggression), while the discontinuation of IS was associated with a lessening of these outcomes. Cross-lagged analyses revealed bidirectional associations of IS with anxiety symptom and stress symptom. LIMITATIONS All subjects were recruited from one medical college, which could limit applicability. This study had a relatively small sample size. Self-reported questionnaires can lead to recall bias. Further research is needed to test causality. CONCLUSIONS IS can predict adolescents' newly developed partial mental distress and aggression. Our findings highlight the crucial role of early recognition of both higher levels of interpersonal sensitivity and associated behavioral problems.
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Affiliation(s)
- Jiwei Sun
- School of Nursing, Shandong University, No.44 Wenhua Xi Road, Jinan, China.
| | - Xuan Zhang
- School of Nursing, Shandong University, No.44 Wenhua Xi Road, Jinan, China.
| | - Ying Wang
- School of Nursing, Shandong University, No.44 Wenhua Xi Road, Jinan, China.
| | - Juan Wang
- School of Nursing, Shandong University, No.44 Wenhua Xi Road, Jinan, China.
| | - Jiahuan Li
- School of Nursing, Shandong University, No.44 Wenhua Xi Road, Jinan, China.
| | - Fenglin Cao
- School of Nursing, Shandong University, No.44 Wenhua Xi Road, Jinan, China.
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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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Saghazadeh A, Rezaei N. The Physical Burden of Immunoperception. BIOPHYSICS AND NEUROPHYSIOLOGY OF THE SIXTH SENSE 2019. [PMCID: PMC7123546 DOI: 10.1007/978-3-030-10620-1_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
The previous chapter introduced the ImmunoEmotional Regulatory System (IMMERS). Also, there was a brief discussion about psychological states/psychiatric disorders that so far have been linked to the IMMERS. The present chapter considers another aspect of the IMMERS in which physiological states/physical diseases can be fit to the IMMERS.
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Sahoo S, Padhy SK, Padhee B, Singla N, Sarkar S. Role of personality in cardiovascular diseases: An issue that needs to be focused too! Indian Heart J 2018; 70 Suppl 3:S471-S477. [PMID: 30595309 PMCID: PMC6310178 DOI: 10.1016/j.ihj.2018.11.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/31/2018] [Accepted: 11/02/2018] [Indexed: 01/02/2023] Open
Abstract
This review provides a broad overview of the relationship of personality with cardiovascular diseases (CVDs). There has been a sustained interest over the last half a century on the issue of relationship between personality traits and CVDs. Type A behavior was the initial focus of inquiry as it was observed that individuals who were competitive, hostile, and excessively driven were overrepresented among patients seeking treatment for CVDs and also were prone to develop coronary artery disease/syndrome. However, the research gradually expanded to assess the relationship of cardiac morbidity with various other personality facets. Furthermore, studies found out that negative effects (including anger and hostility) were also associated with adverse cardiovascular outcomes. Subsequently, a new personality entity named as the type D ‘distressed’ personality, which combined negative affectivity and social inhibition. type D personality then became the area of research and was demonstrated to be related with poorer cardiac outcomes. Interestingly, the results of various research studies are not equivocal, and hence, there are several critiques related to the current understanding of the link between personality construct and the risk of development as well as the outcome of CVDs. Furthermore, few personality traits such as optimism, conscientiousness, openness to experience, and curiosity have been found to be protective factors against development of CVDs and therefore are called ‘cardioprotective’ personality traits. A detailed discussion on the various aspects of personality in relation to CVDs along with a critical appraisal has been presented in this review.
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Affiliation(s)
- Swapnajeet Sahoo
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar-751019, India.
| | - Susanta Kumar Padhy
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar-751019, India.
| | - Binayananda Padhee
- Department of Cardiology, Hi-Tech Medical College and Hospital, Bhubaneswar 751025, India.
| | - Neha Singla
- National Health Mission, Kavaratti 682555, India.
| | - Siddharth Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi 110029, India.
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Dehghani F. Type D personality and life satisfaction: The mediating role of social support. PERSONALITY AND INDIVIDUAL DIFFERENCES 2018. [DOI: 10.1016/j.paid.2018.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Psychological Profile in Coronary Artery By-Pass Graft Patients vs. Valve Replacement Patients Entering Cardiac Rehabilitation after Surgery. Sci Rep 2018; 8:14381. [PMID: 30258180 PMCID: PMC6158272 DOI: 10.1038/s41598-018-32696-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 09/13/2018] [Indexed: 11/16/2022] Open
Abstract
Anxiety and depression are thought to influence the genesis of ischemic diseases and not of valvular diseases, but little is known on the psychological profile of cardiac patients after surgery. Aim of this study was to investigate differences in disease experience and mood between patients undergoing cardiac rehabilitation after coronary artery by-pass graft (CABG) or after valve replacement (VR). We studied 1,179 CABG and 737 VR patients who completed the Illness Behaviour Questionnaire and the Hospital Anxiety and Depression Scale after surgery. We tested the independent effect of the type of surgery by multivariate analysis and between-group differences in prevalence of clinically relevant scores. Relevant scores in the psychosomatic concern scale were more frequent in CABG than in VR patients. After correction by age, sex, education and marital status, scores of disease conviction and psychosomatic concern were higher in CABG patients, scores of denial were higher in VR patients. Unexpectedly, anxiety and depression scores did not differ between groups. Results suggest providing psychological support for anxiety and depression to both VR and CABG patients during cardiac rehabilitation, and planning differentiated interventions of cardiac rehabilitation and secondary prevention tailored to the specific psychological reactions of CABG and VR patients.
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Masafi S, Saadat SH, Tehranchi K, Olya R, Heidari M, Malihialzackerini S, Jafari M, Rajabi E. Effect of Stress, Depression and Type D Personality on Immune System in the Incidence of Coronary Artery Disease. Open Access Maced J Med Sci 2018; 6:1533-1544. [PMID: 30159090 PMCID: PMC6108813 DOI: 10.3889/oamjms.2018.217] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/08/2018] [Accepted: 07/18/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND: Psychoneuroimmunology (PNI) is the study of the interaction between psychological processes and the nervous and immune systems of the human body. The impact of psychological factors on the immune system and the role of this system in Coronary Artery Disease (CAD) are confirmed. Coronary Heart Disease (CHD) is arisen due to the failure of blood and oxygen to the heart tissues. AIM: The present study aimed to describe psychoneuroimmunological processes which contribute to CAD and CHD progression. METHOD: Such psychological risk factors like stress, depression and type D personality were investigated here. Psychoneuroimmunological pathways of all three mentioned risk factors were described for CAD. RESULTS: The studies review indicated that stress could be accompanied with myocardial ischemia and help to rupture. The depression involves in the transfer of stable atherosclerotic plaque to unstable, and type D personality is effective in the initial stages of a CAD. CONCLUSION: As more information on cardiovascular immunity becomes available, this will provide a better understanding and thus act as the foundation for the potential development of new treatment strategies for treatment of cardiovascular disorders.
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Affiliation(s)
- Saideh Masafi
- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | - Seyed Hassan Saadat
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Katayoun Tehranchi
- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | - Roohollah Olya
- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | - Mostafa Heidari
- Department of Psychology, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Saied Malihialzackerini
- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | - Mahdi Jafari
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Rajabi
- Shahid Beheshty University of Medical Science, Tehran, Iran
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Imbalzano E, Vatrano M, Quartuccio S, Ceravolo R, Ciconte VA, Rotella P, Pardeo R, Trapani G, De Fazio P, Segura-Garcia C, Costantino R, Saitta A, Mandraffino G. Effect of type D personality on smoking status and their combined impact on outcome after acute myocardial infarction. Clin Cardiol 2018; 41:321-325. [PMID: 29457844 DOI: 10.1002/clc.22865] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 10/23/2017] [Accepted: 11/24/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Smoking cessation is correlated with several psychological, social, biological, and pharmacological aspects. The combined tendency to experience negative emotions and to inhibit the expression of these emotions is indicated as "type D personality," an independent risk marker for clinical outcome in cardiac disease. Despite this effect of type D personality on cardiovascular disease, it is still unclear whether this personality trait may influence smoking cessation after a myocardial infarction. HYPOTHESIS we hypothesized that there is a relationship between type D personality and smoking persistence in acute coronary syndrome patients, and this association may predict a worse long-term prognosis. METHODS The study enrolled 231 patients with ST-segment elevation myocardial infarction, treated with primary percutaneous coronary intervention. Type D scale 14 (ds 14) was administered upon admission to the hospital. RESULTS After controlling for demographic and clinical confounders, non-type D patients reported statistically significant higher frequencies of smoking cessation when compared with the type D group. In addition, the presence of this psychological factor anticipates significantly the onset of smoking during adolescence. Furthermore, current type D smokers had a higher incidence of cardiovascular events during long-term follow-up. CONCLUSIONS Type D personality and smoking status increase the risk of cardiac events. An emotionally stressed personality and persistence of smoking after the first cardiac event, and mostly their mutual influence, indicate a population at high cardiovascular risk.
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Affiliation(s)
- Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Marco Vatrano
- UTIC and Cardiology, Hospital "Pugliese-Ciaccio", Catanzaro, Italy
| | | | - Roberto Ceravolo
- UTIC and Cardiology, Hospital "Pugliese-Ciaccio", Catanzaro, Italy
| | | | - Paola Rotella
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Renato Pardeo
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Giovanni Trapani
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Rossella Costantino
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Antonino Saitta
- Department of Clinical and Experimental Medicine, University of Messina, Italy
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Muscatello MRA, Bruno A, Mento C, Pandolfo G, Zoccali RA. Personality traits and emotional patterns in irritable bowel syndrome. World J Gastroenterol 2016; 22:6402-15. [PMID: 27605876 PMCID: PMC4968122 DOI: 10.3748/wjg.v22.i28.6402] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 05/26/2016] [Accepted: 06/15/2016] [Indexed: 02/06/2023] Open
Abstract
The review focuses on those personality traits (neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness), constructs (alexithymia and distressed - Type D personality) and emotional patterns (negative and positive) that are of particular concern in health psychology, with the aim to highlight their potential role on the pathogenesis, onset, symptom clusters, clinical course, and outcome of irritable bowel syndrome (IBS). Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing not only to IBS clinical expression and symptomatic burden, but also to disease physiopathology. In this sense, psychological treatments should address those personality traits and emotional features that are constitutive of, and integral to IBS. The biopsychosocial model of illness applied to IBS acknowledges the interaction between biological, psychological, environmental, and social factors in relation to pain and functional disability. A holistic approach to IBS should take into account the heterogeneous nature of the disorder, and differentiate treatments for different types of IBS, also considering the marked individual differences in prevalent personality traits and emotional patterns. Beyond medications, and lifestyle/dietary interventions, psychological and educational treatments may provide the optimal chance of addressing clinical symptoms, comorbid conditions, and quality of life in IBS patients.
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Abstract
Great advances have been made in our understanding of Takotsubo syndrome in the past decade, but the aetiology of the condition remains incompletely understood. The most established theory, that catecholamine-mediated myocardial stunning is provoked by emotional or physiological stress, is supported by the presence of supraphysiological levels of plasma catecholamines in patients with Takotsubo syndrome. For this reason, the hyperexcitability of the autonomic nervous system under conditions of physical and emotional stress is often assessed in these patients. Observational studies have indicated that a predisposing influence of chronic or traumatic stress, anxiodepressive disorders, and maladaptive personality traits are linked to the pathogenesis of Takotsubo syndrome. Chronic stress can influence autonomic function through dysregulation of the hypothalamic-pituitary-adrenal axis and contribute to the development of cardiovascular disorders. In this Perspectives article, we discuss the current knowledge of the psychoneuroendocrinological and psychosocial mechanisms underlying the pathophysiology of Takotsubo syndrome.
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Zuccarella-Hackl C, von Känel R, Thomas L, Kuebler P, Schmid JP, Mattle HP, Mono ML, Rieben R, Wiest R, Wirtz PH. Higher macrophage superoxide anion production in coronary artery disease (CAD) patients with Type D personality. Psychoneuroendocrinology 2016; 68:186-93. [PMID: 26994482 DOI: 10.1016/j.psyneuen.2016.02.031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 02/28/2016] [Accepted: 02/29/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND Type D personality (Type D) is an independent psychosocial risk factor for poor cardiac prognosis and increased mortality in patients with cardiovascular disease (CVD), but the involved mechanisms are poorly understood. Macrophages play a pivotal role in atherosclerosis, the process underlying coronary artery disease (CAD). We investigated macrophage superoxide anion production in production in CAD patients with and without Type D. METHODS AND RESULTS We studied 20 male CAD patients with Type D (M:66.7±9.9years) and 20 age-matched male CAD patients without Type D (M:67.7±8.5years). Type D was measured using the DS14 questionnaire with the two subscales 'negative affectivity' and 'social inhibition'. We assessed macrophage superoxide anion production using the WST-1 assay. All analyses were controlled for potential confounders. CAD patients with Type D showed higher superoxide anion production compared to CAD patients without Type D (F(1,38)=15.57, p<0.001). Complementary analyses using the Type D subscales 'negative affectivity' and 'social inhibition', and their interaction as continuous measures, showed that both Type D subscales (negative affectivity: (ß=0.48, p=0.002, R(2)=0.227); social inhibition: (ß=0.46, p=0.003, R(2)=0.208)) and their interaction (ß=0.36, p=0.022, R(2)=0.130) were associated with higher WST-1 reduction scores. Results remained significant when controlling for classical CVD risk factors (i.e. body mass index, mean arterial blood pressure), atherosclerosis severity (i.e. intima media thickness, presence of carotid plaques), and psychological factors (depressive symptom severity, chronic stress). CONCLUSIONS Our results indicate higher macrophage superoxide anion production in CAD patients with Type D compared to those without Type D. This may suggest a mechanism contributing to increased morbidity and mortality in CAD patients with Type D.
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Affiliation(s)
- Claudia Zuccarella-Hackl
- Biological and Health Psychology, University of Bern, Bern, Switzerland; Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Roland von Känel
- Department of Clinical Research, University of Bern, Bern, Switzerland; Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland; Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland
| | - Livia Thomas
- Biological and Health Psychology, University of Bern, Bern, Switzerland; Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany
| | - Peggy Kuebler
- Biological and Health Psychology, University of Bern, Bern, Switzerland
| | - Jean-Paul Schmid
- Cardiology Clinic, Tiefenauspital, Bern University Hospital, Bern, Switzerland
| | - Heinrich P Mattle
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Marie-Louise Mono
- Department of Neurology, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Robert Rieben
- Department of Clinical Research, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Institute of Diagnostic and Interventional Neuroradiology, Bern University Hospital, and University of Bern, Bern, Switzerland
| | - Petra H Wirtz
- Biological and Health Psychology, University of Bern, Bern, Switzerland; Biological Work and Health Psychology, University of Konstanz, Konstanz, Germany.
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Type D Personality and Coronary Plaque Vulnerability in Patients With Coronary Artery Disease: An Optical Coherence Tomography Study. Psychosom Med 2016; 78:583-92. [PMID: 26867079 DOI: 10.1097/psy.0000000000000307] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate the association between Type D personality and higher incidence of major adverse cardiac events, we used in vivo optical coherence tomography (OCT) to evaluate the association between Type D with coronary plaque characteristics. METHODS A total of 109 patients who had culprit coronary plaque (s) were included in the study. The Type D construct was analyzed using both the categorized and the continuous approaches. Plaque vulnerability of culprit lesions was measured by OCT. RESULTS After adjusting for demographic and clinical factors, multivariate analysis demonstrated that Type D was associated with lipid plaque (odds ratio [OR] = 4.87, 95% confidence interval [CI] = 1.41-11.14, p = .025), thin cap fibroatheroma (OR = 3.84, 95% CI = 1.36-10.85, p = .011), and fibrous cap thickness (β = -1.43, standard error = 0.04, p = .001) analyzed by categorical approach. When analyzing Type D as continuous variable, the negative affectivity component was significantly related to plaque vulnerability, including lipid plaque (OR = 3.43, 95% CI = 1.23-9.52, p = .018), thin cap fibroatheroma (OR = 2.20, 95% CI = 1.10-4.40, p = .026), and fibrous cap thickness (β = -0.05, standard error = 0.02, p = .030), whereas no associations between the negative affectivity by social inhibition interaction term with OCT indices were found. CONCLUSIONS The results suggest that plaque characteristics in Type D have more features of plaque vulnerability. The negative affectivity component seems to drive the associations between Type D and vulnerable plaques. These findings provide new insights into the mechanism involved in the association between Type D and major adverse cardiac event.
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Strober LB. Personality in multiple sclerosis (MS): impact on health, psychological well-being, coping, and overall quality of life. PSYCHOL HEALTH MED 2016; 22:152-161. [PMID: 26987417 DOI: 10.1080/13548506.2016.1164321] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Personality has long been considered a factor that can account for differences in health, well-being, and overall quality of life (QOL). A 'Distressed or Type D Personality' has been studied in medical populations as a predictor of several outcomes. The purpose of the present investigation was to determine the presence of Type D Personality in multiple sclerosis (MS) and its role on disease symptoms, disease management, health-related behaviors, coping, psychological well-being, and overall QOL and functioning. Two hundred and thirty (230) individuals with MS completed a survey assessing personality, disease symptoms, disease management, coping, self-efficacy, locus of control (LOC), psychological well-being, and QOL. Thirty-seven (16%) individuals were found to be 'Type D+.' Such individuals reported greater fatigue, pain, depression, and anxiety and worse disease management and adherence. They also reported engaging in maladaptive means of coping. Compared to 'Type D-' they reported lower self-efficacy, LOC, QOL and greater perceived stress. Finally, 'Type D+' individuals were more likely to be considering leaving the workforce. Findings suggest that 'Type D' Personality is associated with various negative outcomes in MS. Consideration of the routine assessment of personality in MS seems warranted and may better inform interventions and ward off poor outcomes.
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Affiliation(s)
- L B Strober
- a Kessler Foundation , West Orange , NJ , USA.,b Department of Physical Medicine & Rehabilitation, New Jersey Medical School , Rutgers - State University of New Jersey , Newark , NJ , USA
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Li X, Zhang S, Xu H, Tang X, Zhou H, Yuan J, Wang X, Qu Z, Wang F, Zhu H, Guo S, Tian D, Zhang W. Type D Personality Predicts Poor Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study. PLoS One 2016; 11:e0146892. [PMID: 26894925 PMCID: PMC4760773 DOI: 10.1371/journal.pone.0146892] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 12/24/2015] [Indexed: 01/19/2023] Open
Abstract
Background Type D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM) remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM. Design and Settings A follow-up study was conducted in general hospital of the People's Liberation Army in Beijing. Methods 412 T2DM patients (205 females), who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed. Results Patients with type D personality were significantly more likely to have poor medication adherence (p<0.001). Type D personality predicts poor medication adherence before and after controlling for covariates when it was analyzed as a categorical variable. However, the dimensional construct of type D personality was not associated with medication adherence when analyzed as a continuous variable. Conclusion Although, as a dimensional construct, type D personality may not reflect the components of the personality associated with poor medication adherence in patients with T2DM, screening for type D personality may help to identify those who are at higher risk of poor medication adherence. Interventions, aiming to improve medication adherence, should be launched for these high-risk patients.
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Affiliation(s)
- Xuemei Li
- Clinics of Cadre, Department of Outpatient, General Hospital of the People's Liberation Army (301 Hospital), Beijing, China
| | - Shengfa Zhang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Huiwen Xu
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States of America
| | - Xinfeng Tang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Huixuan Zhou
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Jiaqi Yuan
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Xiaohua Wang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Zhiyong Qu
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Fugang Wang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - He Zhu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, United States of America
| | - Shuai Guo
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Donghua Tian
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
- * E-mail: (DT); (WZ)
| | - Weijun Zhang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
- * E-mail: (DT); (WZ)
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Wu JR, Moser DK. Type D personality predicts poor medication adherence in patients with heart failure in the USA. Int J Behav Med 2015; 21:833-42. [PMID: 24198039 DOI: 10.1007/s12529-013-9366-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Type D (distressed) personality and medication nonadherence have been associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease. However, the relationship between type D personality and medication adherence in patients with heart failure (HF) remains unknown. PURPOSE Therefore, the goal of this study was to examine the association between type D personality and medication adherence in patients with HF. METHOD This was a sub-analysis of baseline data from a randomized controlled trial with 84 patients with HF in the USA. Demographic, clinical, and psychological data were collected at baseline by interview, questionnaires, and medical record review. Type D personality was assessed using the Type D Personality Scale (DS14). Medication adherence was measured using both objective (Medication Event Monitoring System, MEMS) and self-reported (Morisky Medication Adherence Scale, MMAS-4) measures. Patients started medication adherence monitoring with the MEMS bottle at baseline and is used continuously for a month. Multiple regressions were used to explore the relationships between type D personality and medication adherence while adjusting for demographic, clinical, and psychological factors. RESULTS Patients with type D personality were more likely to have poor medication adherence. Type D personality was associated with medication adherence before and after adjusting for covariates when it was analyzed as a categorical variable. However, type D personality was not associated with medication adherence when analyzed as a dimensional construct. Negative affectivity, a component of type D personality, was associated with medication adherence. CONCLUSION As a dimensional construct, type D personality may not reflect the components of the personality associated with poor outcomes. Negative affectivity was associated with medication adherence in patients with HF. Interventions aiming to improving/enhancing medication adherence need to take into account patients with the negative affectivity component of type D personality who are at higher risk for poor medication adherence, which may lead to adverse health outcomes.
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Affiliation(s)
- Jia-Rong Wu
- School of Nursing, University of North Carolina at Chapel Hill, 435 Carrington Hall, CB# 7460, Chapel Hill, NC, 27599-7460, USA,
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Molina-Leyva A, Caparros-delMoral I, Ruiz-Carrascosa J, Naranjo-Sintes R, Jimenez-Moleon J. Elevated prevalence of Type D (distressed) personality in moderate to severe psoriasis is associated with mood status and quality of life impairment: a comparative pilot study. J Eur Acad Dermatol Venereol 2015; 29:1710-7. [DOI: 10.1111/jdv.12960] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/09/2014] [Indexed: 01/09/2023]
Affiliation(s)
- A. Molina-Leyva
- Department of Dermatology; Hospital Torrecardenas; Almería Spain
| | | | | | | | - J.J. Jimenez-Moleon
- CIBER de Epidemiología y Salud Pública (CIBERESP); Granada Spain
- Dpto. de Medicina Preventiva y Salud Pública; Instituto de Investigación Biosanitaria ibs; Hospitales Universitarios de Granada/Universidad de Granada; Granada Spain
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Hur S, Han GS, Cho BJ. Changes in Glucose, TNF-α and IL-6 Blood Levels in Middle-aged Women Associated with Aerobic Exercise and Meditation Training. J Phys Ther Sci 2014; 26:1933-6. [PMID: 25540501 PMCID: PMC4273061 DOI: 10.1589/jpts.26.1933] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 06/17/2014] [Indexed: 01/05/2023] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of exercise therapy on
glucose, TNF-α and IL-6 blood levels in middle-aged women. [Subjects] A total of 46
participants were assigned to four groups: Type D personality+Exercise
(n=12), Type D+no-Exercise (n=12), not-Type D+Exercise
(n=12), and not-Type D+no-Exercise (n=10). [Methods]
Blood glucose was measured by the hexokinase method. An enzyme-linked immunosorbent assay
(ELISA) was used to measure the circulating plasma levels of TNF-α and
IL-6 (Quantikine HS, R&D Systems, Minneapolis, USA). An aerobic exercise program and
meditation were conducted in parallel by the Exercise groups for 10 months. Stretching was
performed for 10 min as a warm-up, and then walking and running on a treadmill at 60 to
70% of HRmax were performed for 40 min three times a week. Blood samples were processed
according to standard laboratory procedures. [Results] Fasting glucose showed a
significant interaction effect among groups, group×time, and post-test.
TNF-α showed a significant difference among groups, and was lower in
the not-Type D personality+Exercise group than in the other three groups. IL-6 showed a
significant difference among the groups. [Conclusion] In conclusion, personality may
affect the established effect of exercise on cytokine activity. Type D personality was
independently associated with significant immune activation, and increase in
TNF-α activity was observed among Type D participants.
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Affiliation(s)
- Sun Hur
- Division of Sport Science, Kangwon National University, Republic of Korea
| | - Gun-Soo Han
- Department of Sports and Leisure Studies, College of Humanity, Daegu University, Republic of Korea
| | - Byung-Jun Cho
- Department of Emergency Medical Technology, Kangwon National University, Republic of Korea
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Hur S, Cho BJ, Kim SR. Comparison of the effects of exercise participation on psychosocial risk factors and cardiovascular disease in women. J Phys Ther Sci 2014; 26:1795-8. [PMID: 25435703 PMCID: PMC4242958 DOI: 10.1589/jpts.26.1795] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 05/19/2014] [Indexed: 12/22/2022] Open
Abstract
[Purpose] The aim of this study was to research the association of Type D personality
with CVD risk factors and psychology through comparison of the association of exercise
participation with CVD risk factors and psychological risk factors in women with Type D.
[Subjects] This study included 416 middle-aged women. All participants completed the
14-item Type D Scale (DS14) to assess Type D personality. The DS14 consists of two
subscales, NA and SI, both of which comprise 7 items. The research subjects were randomly
assigned to four groups: Type D+Exercise (n=12), Type D+non-Exercise (n=12), non-Type
D+Exercise (n=12), non-Type D+non-Exercise (n=10). The study consisted of 46 participants.
[Methods] An aerobic exercise program and meditation were conducted in parallel for 10
months. Stretching was performed for 10 min as a warm-up, and then walking and running
were performed on a treadmill at the HRmax 60–70% level for 40 min; this was done three
times a week. Blood samples were processed according to standard laboratory procedures.
The concentrations of TG and HDL-cholesterol were determined enzymatically on a clinical
chemistry analyzer. Blood glucose was measured by the hexokinase method. [Results] Weight,
percent fat, social support, and waist circumference showed a significant difference
between times in the Exercise groups, and the values were significantly lower than those
of the non-Exercise groups. Anxiety and depression showed a significant interaction effect
between groups. The average number of CVD risk factors in subjects showed a significant
difference between groups. [Conclusion] In conclusion, there were significant differences
between groups in terms of CVD risk factors and psychological risk factors in women with
Type D personality.
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Affiliation(s)
- Sun Hur
- Division of Sport Science, Kangwon National University, Republic of Korea
| | - Byung-Jun Cho
- College of Pharmacy, Chungnam National University, Republic of Korea
| | - Seon-Rye Kim
- Department of Emergency Medical Technology, Kangwon National University, Republic of Korea
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Brouwers C, Kupper N, Pelle AJ, Szabó BM, Westerhuis BL, Denollet J. Depressive symptoms in outpatients with heart failure: Importance of inflammatory biomarkers, disease severity and personality. Psychol Health 2014; 29:564-82. [DOI: 10.1080/08870446.2013.869813] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Tabary SZ, Rezaii M, Nia ZJ, Goodarzy P, Izanloo M. A Comparative Study of Quality of Family, Social Relationships and Type D Personality in Cardiovascular Patients and Non-Patients. Health (London) 2014. [DOI: 10.4236/health.2014.616248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Damen NL, Versteeg H, van Helmondt SJ, de Jaegere PP, van Geuns RJM, Meine MM, van Domburg RT, Pedersen SS. The distressed (Type D) personality mediates the relationship between remembered parenting and psychological distress in cardiac patients. Psychol Health 2013; 29:318-33. [PMID: 24131060 DOI: 10.1080/08870446.2013.845889] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Both the distressed (Type D) personality (i.e. the combination of negative affectivity and social inhibition traits) and dysfunctional parenting styles are associated with anxiety and depression. As parenting styles have been related to personality development, dysfunctional parenting styles may also be associated with Type D personality. We examined whether remembered parenting was associated with anxiety and depression in cardiac patients and whether Type D personality mediated this relationship. METHODS Our sample comprised 435 patients treated with percutaneous coronary intervention (PCI) and 123 patients with congestive heart failure (CHF). Patients completed the Hospital Anxiety and Depression Scale, Type D Scale (DS14), and Remembered Relationship with Parents (RRP(10)) scale. RESULTS Remembered parenting was significantly associated with higher anxiety and depression levels and Type D personality. In multivariable linear regression analyses, Type D personality accounted for 25-29% of the variance in anxiety and 23-46% of the variance in depression, while remembered parenting was no longer significantly associated with these domains. Sobel tests and bootstrapping indicated that Type D personality mediated the relationship between remembered parenting and anxiety and depression. CONCLUSION Type D personality mediated the relationship between remembered parenting and anxiety and depression in both PCI and CHF patients.
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Affiliation(s)
- Nikki L Damen
- a Department of Medical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS) , Tilburg University , Tilburg , The Netherlands
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Ferguson E. Personality is of central concern to understand health: towards a theoretical model for health psychology. Health Psychol Rev 2013; 7:S32-S70. [PMID: 23772230 PMCID: PMC3678852 DOI: 10.1080/17437199.2010.547985] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Revised: 12/11/2010] [Indexed: 12/15/2022]
Abstract
This paper sets out the case that personality traits are central to health psychology. To achieve this, three aims need to be addressed. First, it is necessary to show that personality influences a broad range of health outcomes and mechanisms. Second, the simple descriptive account of Aim 1 is not sufficient, and a theoretical specification needs to be developed to explain the personality-health link and allow for future hypothesis generation. Third, once Aims 1 and 2 are met, it is necessary to demonstrate the clinical utility of personality. In this review I make the case that all three Aims are met. I develop a theoretical framework to understand the links between personality and health drawing on current theorising in the biology, evolution, and neuroscience of personality. I identify traits (i.e., alexithymia, Type D, hypochondriasis, and empathy) that are of particular concern to health psychology and set these within evolutionary cost-benefit analysis. The literature is reviewed within a three-level hierarchical model (individual, group, and organisational) and it is argued that health psychology needs to move from its traditional focus on the individual level to engage group and organisational levels.
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Affiliation(s)
- Eamonn Ferguson
- Department of Psychology, University of Nottingham, Nottingham, NG7 2RD, UK
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27
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Sumin AN, Sumina LY, Barbarash NA. Stress-related hemodynamic response in healthy young individuals with Type D personality. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2012. [DOI: 10.15829/1728-8800-2012-3-70-76] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To investigate the association between the stress-related hemodynamic response during the mental calculation test (MCT) and the presence of Type D personality in healthy young individuals. Material and methods. The study included 80 healthy individuals (19 men and 61 women; mean age 18,8±0,2 years). Psychological status examination included the DS-14 scale, depression scale, and Spielberger-Khanin scale. MCT was performed with simultaneous assessment of hemodynamic response. Results. Type D personality (distressed type) was observed in 32,5% of the participants. Among young students, Type D personality was associated with higher levels of trait and state anxiety (TA and SA), as well as higher depression scale scores, compared to students without Type D personality. Type D personality was also linked to a more pronounced response of systolic blood pressure (SBP) during MCT (p=0,05). There was a strong correlation between social inhibition levels and maximal heart rate (HR) during MCT (r=-0,238; p=0,034). Young men demonstrated a moderate correlation between Type D personality and HR response (r=-0,508; p=0,026), as well as between negative affectivity levels and HR response during MCT (r=0,469; p=0,043). Conclusion. Distressed personality type was observed in one-third of healthy young participants of the study. Type D personality and its subscales correlated with the hemodynamic response during MCT, with some gender-specific features observed. These findings clarify potential mechanisms of Type D personality effects on the development and prognosis of cardiovascular disease.
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Affiliation(s)
- A. N. Sumin
- Research Institute of Complex Cardiovascular Problems, Siberian Branch, Russian Academy of Medical Sciences
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Son YJ, Song EK. The impact of type D personality and high-sensitivity C-reactive protein on health-related quality of life in patients with atrial fibrillation. Eur J Cardiovasc Nurs 2012; 11:304-12. [PMID: 21601531 DOI: 10.1016/j.ejcnurse.2011.04.004] [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] [Indexed: 10/18/2022]
Abstract
BACKGROUND Anxiety or depressive symptoms are known to be predictors of impaired health-related quality of life (HRQoL). However, little research has focused on the impact of type D personality as chronic psychological distress on HRQoL in atrial fibrillation (AF) patients. Increased high-sensitivity C-reactive protein (hsCRP) is likely to be associated with anxiety or depressive symptoms, whereas the relation of hsCRP to Type D personality was unexplored, and the impact of hsCRP on HRQoL was undetermined in AF patients. AIM To determine whether type D personality and hsCRP are independently associated with impaired HRQoL. METHODS A cross-sectional study design was used among a total of 114 patients with chronic AF. Patients underwent measurements of serum levels of hsCRP. Type D personality, anxiety and depressive symptoms, and HRQoL were assessed by the type D scale, the hospital anxiety and depression scale, and the short-form medical outcomes survey, respectively. Hierarchical linear regression was used to determine the impact of Type D personality and hsCRP on HRQoL. RESULTS Thirty-two percent of patients had Type D personality. Patients with type D personality had higher hsCRP than those with non-type D personality (1.4 ± 1.9 vs. 0.6 ± 2.2, p = 0.046). In hierarchical linear regression, type D personality (β = - 0.28; p = 0.005) and hsCRP (β = -0.21; p = 0.034) were independently associated with HRQoL controlling for clinical risk factors, anxiety, and depression symptoms. CONCLUSIONS Type D personality and hsCRP are independent predictors of impaired HRQoL. Clinicians need to pay attention to patients with Type D personality and monitor serum levels of hsCRP to prevent impaired HRQoL in AF patient.
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Affiliation(s)
- Youn-Jung Son
- Department of Nursing, College of Medicine, Soonchunhyang University 366-1, Ssangyong-dong, Cheonan 330-946, South Korea
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Mommersteeg PMC, Pelle AJ, Ramakers C, Szabó BM, Denollet J, Kupper N. Type D personality and course of health status over 18 months in outpatients with heart failure: multiple mediating inflammatory biomarkers. Brain Behav Immun 2012; 26:301-10. [PMID: 21983280 DOI: 10.1016/j.bbi.2011.09.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 09/21/2011] [Accepted: 09/22/2011] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The distressed (Type D) personality is associated with poor health status (HS) and increased inflammatory activation in heart failure (HF). We tested whether multiple inflammatory biomarkers mediated the association between Type D personality and the course of self-reported HS over 18 months. METHODS HF outpatients (n=228, 80% male, mean age 67.0±8.7 years), filled out the Type D questionnaire (DS14) at inclusion and the Short Form-12 (SF12) and the Kansas City Cardiomyopathy Questionnaire (KCCQ) at 0, 6, 12, and 18 months. Blood samples at inclusion were analyzed for high sensitive C-reactive protein (hsCRP), interleukin (IL)-6, tumor necrosis factor (TNF)-α, and its soluble receptors (sTNFr1, sTNFr2). A multiple mediation latent growth model was tested using structural equation modeling. RESULTS Type D personality (prevalence=21%) was associated with poorer HS (all scales p<0.001), deterioration of mental HS (p<0.001), and higher TNF-α and sTNFr2 levels in the full mediation model. A higher inflammatory burden was associated with a poorer baseline level and a deterioration of generic physical, mental and disease-specific HS. No mediating effects were found for the multiple inflammatory biomarkers on the association between Type D and baseline self-reported HS, whereas change in physical HS was significantly mediated by the group of five inflammatory biomarkers (p=0.026). CONCLUSIONS Only the association between Type D personality and change in self-reported physical health status was significantly mediated by inflammatory biomarkers. Future research should investigate whether the association between Type D personality and poor health status may be explained by other biological or behavioral factors.
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Affiliation(s)
- Paula M C Mommersteeg
- Center of Research on Psychology in Somatic diseases, Department of Medical Psychology and Neuropsychology, Tilburg University, Tilburg, The Netherlands.
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van Bon-Martens MJH, Denollet J, Kiemeney LALM, Droomers M, de Beer MJA, van de Goor IAM, van Oers HAM. Health inequalities in the Netherlands: a cross-sectional study of the role of Type D (distressed) personality. BMC Public Health 2012; 12:46. [PMID: 22257675 PMCID: PMC3293707 DOI: 10.1186/1471-2458-12-46] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Accepted: 01/18/2012] [Indexed: 11/16/2022] Open
Abstract
Background In the Netherlands, as in many European countries, inequalities in health exist between people with a high and a low socioeconomic status (SES). From the perspective of the 'indirect selection hypothesis', this study was designed to expand our understanding of the role of Type D personality as an explanation of health inequalities. Methods Data came from two cross-sectional Dutch surveys among the general population (aged between 19 and 64 years, response 53.7%, n = 12,090). We analyzed the relative risks of low SES, assessed using education and income, and Type D personality, assessed using the Type D Scale-14 (DS14), for different outcomes regarding lifestyle-related risk factors and health, using multivariate Generalized Linear Models. Results Results showed that Type D personality was significantly associated with low SES (OR = 1.7 for both low education and low income). Moreover, the relative risks of Type D personality and low SES were significantly elevated for most adverse health outcomes, unconditionally as well as conditionally. Conclusion The cross-sectional design hinders the making of definite etiological inferences. Nevertheless, our findings suggest that Type D personality does not explain the socioeconomic health inequalities, but is a risk factor in addition to low SES. Prevention of adverse health outcomes in low SES populations may have more effect when it takes into account that persons with a low SES in combination with a Type D personality are at highest risk.
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Affiliation(s)
- Marja J H van Bon-Martens
- Academic Collaborative Centre Public Health Brabant, Tranzo, Tilburg School of Social and Behavioral Sciences, University of Tilburg, Tilburg, the Netherlands.
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Distressed personality is associated with lower psychological well-being and life satisfaction, but not disability or disease activity in rheumatoid arthritis patients. Clin Rheumatol 2011; 31:661-7. [PMID: 22190069 PMCID: PMC3314814 DOI: 10.1007/s10067-011-1905-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Revised: 12/05/2011] [Accepted: 12/05/2011] [Indexed: 12/11/2022]
Abstract
The distressed personality type ("type D personality") has been shown to be associated with low quality of life and higher morbidity and mortality in various patient groups. Because the role of type D personality is unknown in patients with rheumatoid arthritis (RA), the aim of the present study was to investigate the association of type D personality with aspects of quality of life and disease activity in RA patients. In addition, a potential buffering effect by accepting mindfulness was examined. Participants were 147 patients between 22 and 87 years of age. Patients completed relevant questionnaires at home and the disease activity score was determined. After controlling for potentially confounding variables, multivariate analyses of covariance showed an association of type D personality with a lower satisfaction with life (p < 0.001) and a lower psychological well-being (p < 0.001), but not disease activity in RA patients. Although mindfulness was associated with a higher satisfaction with life (p = 0.02) and positive mood (p = 0.01), it did not diminish the unfavourable associations between type D and well-being. In conclusion, although type D personality is related with lower well-being, it does not seem to be associated with disability or disease activity in RA patients.
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Yu XN, Chen Z, Zhang J, Liu X. Coping mediates the association between Type D personality and perceived health in Chinese patients with coronary heart disease. Int J Behav Med 2011; 18:277-84. [PMID: 20941651 PMCID: PMC3145899 DOI: 10.1007/s12529-010-9120-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Increasing evidence show that Type D personality is a risk factor for morbidity, mortality, and quality of life of patients with coronary vascular disease. Few studies examined coping as a potential behavioral mechanism to explain the harmful effect of Type D personality. PURPOSE This study examined the association between Type D personality, coping, and perceived health among Chinese patients with coronary heart disease (CHD). METHODS One hundred seventeen CHD patients completed the assessments on Type D personality, coping, perceived severity of CHD, and morale. RESULTS There was no difference on severity of coronary artery stenosis between Type D and non-Type D patients. Compared to the non-Type D patients, the Type D patients perceived higher severity of CHD (5.31 ± 2.41 versus 4.45 ± 2.17, p < 0.05) and lower morale (12.67 ± 4.71 versus 15.00 ± 4.43, p < 0.05), and used less confrontation (16.90 ± 5.39 versus 20.88 ± 4.95, p < 0.001) and more acceptance-resignation coping (10.16 ± 3.50 versus 8.35 ± 3.48, p < 0.05). Mediation analyses showed that confrontation coping mediated the association between Type D personality and perceived severity of disease, and acceptance-resignation coping mediated the association between Type D personality and morale after controlling for age, gender, and clinical variables. CONCLUSION The Type D patients used maladaptive coping in response to disease. These coping strategies fully mediated the association between Type D personality and perceived health. Implications for integrating coping training into the intervention for patients with a Type D personality are discussed.
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Affiliation(s)
- Xiao-nan Yu
- School of Public Health, Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
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Mommersteeg PMC, Herr R, Bosch J, Fischer JE, Loerbroks A. Type D personality and metabolic syndrome in a 7-year prospective occupational cohort. J Psychosom Res 2011; 71:357-63. [PMID: 21999980 DOI: 10.1016/j.jpsychores.2011.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 05/09/2011] [Accepted: 05/10/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Type D personality is a combination of high negative affectivity (NA) and high social inhibition (SI). This trait is related to increased mortality and poor health outcomes in patients with cardiovascular diseases, although it is less well-established if Type D personality also poses an increased risk in healthy populations. A potential underlying pathway could include the metabolic syndrome and the combination of abdominal obesity, subnormal levels of triglycerides and HDL-cholesterol, elevated blood pressure, and increased plasma glucose levels. We investigated if Type D personality shows a cross-sectional and longitudinal association with metabolic syndrome in a working population. METHODS Poisson regression and linear regression were used to estimate the association between Type D personality and its subscales (NA) and (SI) with objectively established metabolic syndrome markers in cross-sectional (n=458) and prospective (n=268, 6.3 years follow-up) analyses of data from an occupational cohort (mean age=35.9 years, SD=11.7; 80% male). RESULTS Type D personality was neither associated with the metabolic syndrome nor with any of its subcomponents. CONCLUSION The present study does not support a role for metabolic syndrome as a mediating mechanism. More research is needed that examines potential pathways linking Type D personality with cardiovascular disease outcomes.
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Affiliation(s)
- Paula M C Mommersteeg
- CoRPS, Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands.
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Does type-D personality predict outcomes among patients with cardiovascular disease? A meta-analytic review. J Psychosom Res 2011; 71:199-206. [PMID: 21911096 DOI: 10.1016/j.jpsychores.2011.01.009] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 01/07/2011] [Accepted: 01/10/2011] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Research generally indicates that psychological variables are stronger predictors of cardiovascular outcomes in healthy populations than in those with preexisting illness. Studies of Type-D personality, however, suggest that it may also be predictive of negative health outcomes in cardiovascular patient populations. To date, no independent, comprehensive meta-analysis centered specifically on Type-D has integrated this literature and provided quantitative estimates of these relationships. The present meta-analysis investigated the associations between Type-D personality and (a) major adverse cardiac events (MACE), (b) health-related quality of life (HRQOL) and (c) biochemical markers of cardiovascular disease among cardiovascular patients. METHOD Two independent reviewers abstracted data from 15 separate studies. A random effects meta-analytic model was utilized to calculate omnibus effect sizes for each set of related studies, i.e., for the MACE (N of patients=2903), HRQOL (N of patients=1263) and biochemical marker (N of patients=305) measures. RESULTS A positive association was found between Type-D personality and MACE, whereas a negative association was observed between Type-D personality and HRQOL. There was a trend toward significance in the association between Type-D personality and cardiovascular disease biomarkers. CONCLUSION Type-D personality is a promising construct for understanding psychological relationships with important outcomes among cardiovascular patients. Subsequent investigations undertaken by a more diverse group of unaffiliated scientists are important for further development in this line of research.
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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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Chapman BP, Roberts B, Duberstein P. Personality and longevity: knowns, unknowns, and implications for public health and personalized medicine. J Aging Res 2011; 2011:759170. [PMID: 21766032 PMCID: PMC3134197 DOI: 10.4061/2011/759170] [Citation(s) in RCA: 134] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 05/19/2011] [Indexed: 11/23/2022] Open
Abstract
We review evidence for links between personality traits and longevity. We provide an overview of personality for health scientists, using the primary organizing framework used in the study of personality and longevity. We then review data on various aspects of personality linked to longevity. In general, there is good evidence that higher level of conscientiousness and lower levels of hostility and Type D or "distressed" personality are associated with greater longevity. Limited evidence suggests that extraversion, openness, perceived control, and low levels of emotional suppression may be associated with longer lifespan. Findings regarding neuroticism are mixed, supporting the notion that many component(s) of neuroticism detract from life expectancy, but some components at some levels may be healthy or protective. Overall, evidence suggests various personality traits are significant predictors of longevity and points to several promising directions for further study. We conclude by discussing the implications of these links for epidemiologic research and personalized medicine and lay out a translational research agenda for integrating the psychology of individual differences into public health and medicine.
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Affiliation(s)
- Benjamin P. Chapman
- Laboratory of Personality and Development and Rochester Health Decision Making Group, Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden, Rochester, NY 14607, USA
| | - Brent Roberts
- Personality Interest Group, Department of Psychology, University of Illinoi, Rochester, NY 14607, USA
| | - Paul Duberstein
- Laboratory of Personality and Development and Rochester Health Decision Making Group, Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden, Rochester, NY 14607, USA
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Abstract
Community studies conducted over the past decade have greatly increased our knowledge of the epidemiology of personality disorders. Here, we review the prevalence, distribution, and consequences of personality disorders, and potential risk factors for their development. An estimated 6-10% of individuals in the community have a personality disorder. The prevalence of personality disorders varies across sociodemographic groups, being higher, for example, in those who are separated or divorced and those who have dropped out of high school. Personality disorders are strongly associated with Axis I disorders in the community, including mood disorders, anxiety disorders, and alcohol and other substance use disorders, as well as with functional impairment. Personality disorders also are associated with medical service use and medical morbidity and mortality, especially related to cardiovascular disease. Individuals in the community with personality disorders are more likely to have a history of criminal arrest, interpersonal violence, and suicidal behaviours. Childhood adversities, especially abuse and neglect, are potential risk factors for the development of personality disorders. Additional prospective studies are needed to elucidate potential precursors and consequences of personality disorders. Furthermore, primary and secondary prevention strategies are needed to reduce the individual and societal burdens from personality disorders in the community.
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Affiliation(s)
- Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Evidence for a cognitive bias of interpretation toward threat in individuals with a Type D personality. J Behav Med 2011; 35:95-102. [DOI: 10.1007/s10865-011-9351-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Accepted: 04/25/2011] [Indexed: 10/18/2022]
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Chapman BP, van Wingaarden E, Seplaki CL, Talbot N, Duberstein P, Moynihan J. Openness and conscientiousness predict 34-week patterns of Interleukin-6 in older persons. Brain Behav Immun 2011; 25:667-73. [PMID: 21241793 PMCID: PMC3358819 DOI: 10.1016/j.bbi.2011.01.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 12/20/2010] [Accepted: 01/10/2011] [Indexed: 11/25/2022] Open
Abstract
Studies have indicated that personality may be associated with inflammatory markers such as Interleukin (IL)-6. One pathway between personality and IL-6 may be health behaviors and conditions resulting in inflammation, while an alternate pathway involves activation of stress-response systems. In a clinical trial sample of 200 older adults, we examined associations between personality traits at baseline and three measures of IL-6 spanning 34 weeks of follow-up. Results indicate that IL-6 remained very stable over time, and that higher Conscientiousness and Openness were associated with lower IL-6 across the entire 34 week period. Goal striving was the active subcomponent of Conscientiousness, while aesthetic interests was the active subcomponent of Openness in IL-6 associations. Common health behaviors and chronic illness accounted for only a portion of these effects, suggesting that other behavioral and/or physiological processes may also predispose some persons to inflammation. Personality phenotype may provide useful prognostic information for inflammation. Older adults lower in Conscientiousness and Openness constitute a target population for anti-inflammatory interventions. Openness and Conscientiousness predicts 32-week patterns of Interleukin-6 in older persons.
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Affiliation(s)
- Benjamin P. Chapman
- Center for Mind-Body Research, Department of Psychiatry, University of Rochester Medical Center
| | - Edwin van Wingaarden
- Department of Community and Preventive Medicine, University of Rochester Medical Center
| | | | - Nancy Talbot
- Center for Mind-Body Research, Department of Psychiatry, University of Rochester Medical Center
| | - Paul Duberstein
- Center for Mind-Body Research, Department of Psychiatry, University of Rochester Medical Center
| | - Jan Moynihan
- Center for Mind-Body Research, Department of Psychiatry, University of Rochester Medical Center
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Type D personality and hemodynamic reactivity to laboratory stress in women. Int J Psychophysiol 2011; 80:96-102. [DOI: 10.1016/j.ijpsycho.2011.02.006] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 01/31/2011] [Accepted: 02/07/2011] [Indexed: 11/20/2022]
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Tziallas D, Kostapanos MS, Skapinakis P, Milionis HJ, Athanasiou T, S Elisaf M, Mavreas V. The association between Type D personality and the metabolic syndrome: a cross-sectional study in a University-based outpatient lipid clinic. BMC Res Notes 2011; 4:105. [PMID: 21466680 PMCID: PMC3080309 DOI: 10.1186/1756-0500-4-105] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2010] [Accepted: 04/05/2011] [Indexed: 11/10/2022] Open
Abstract
Background Type D personality has been associated in the past with increased cardiovascular mortality among patients with established coronary heart disease. Very few studies have investigated the association of type D personality with traditional cardiovascular risk factors. In this study, we assessed the association between type D personality and the metabolic syndrome. Findings New consecutive patients referred to an outpatient lipid clinic for evaluation of possible metabolic syndrome were eligible for inclusion in the study. The metabolic syndrome was defined according to the International Diabetes Federation (IDF) diagnostic criteria. Type D personality was assessed with the DS-14 scale. Multivariate regression techniques were used to investigate the association between personality and metabolic syndromes adjusting for a number of medical and psychiatric confounders. Three hundred and fifty-nine persons were screened of whom 206 met the diagnostic criteria for the metabolic syndrome ("cases") and 153 did not ("control group"). The prevalence of type D personality was significantly higher in the cases as compared to the control group (44% versus 15% respectively, p < 0.001). In multivariate logistic regression analysis the presence of Type D personality was significantly associated with metabolic syndrome independently of other clinical factors, anxiety and depressive symptoms (odds ratio 3.47; 95% Confidence Interval: 1.90 - 6.33). Conclusions Type D personality was independently associated with the metabolic syndrome in this cross-sectional study. The potential implications of this finding, especially from a clinical or preventive perspective, should be examined in future research.
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Affiliation(s)
- Dimitrios Tziallas
- Department of Psychiatry, University of Ioannina School of Medicine, Ioannina, Greece.
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Abstract
The etiology, predictive value, and biobehavioral aspects of depression in heart failure (HF) are described in this article. Clinically elevated levels of depressive symptoms are present in approximately 1 out of 5 patients with HF. Depression is associated with poor quality of life and a greater than 2-fold risk of clinical HF progression and mortality. The biobehavioral mechanisms accounting for these adverse outcomes include biological processes (elevated neurohormones, autonomic nervous system dysregulation, and inflammation) and adverse health behaviors (physical inactivity, medication nonadherence, poor dietary control, and smoking). Depression often remains undetected because of its partial overlap with HF-related symptoms and lack of systematic screening. Behavioral and pharmacologic antidepressive interventions commonly result in statistically significant but clinically modest improvements in depression and quality of life in HF, but not consistently better clinical HF or cardiovascular disease outcomes. Documentation of the biobehavioral pathways by which depression affects HF progression will be important to identify potential targets for novel integrative behavioral and pharmacologic interventions.
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Affiliation(s)
- Willem J Kop
- Division of Cardiology, Department of Medicine, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201, USA.
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Finnegan L, Shaver JL, Zenk SN, Wilkie DJ, Ferrans CE. The symptom cluster experience profile framework. Oncol Nurs Forum 2011; 37:E377-86. [PMID: 21059571 DOI: 10.1188/10.onf.e377-e386] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To present the novel Symptom Cluster Experience Profile (SCEP) framework for guiding symptom research in adult survivors of childhood cancers and other subgroups at risk for high symptom burden. DATA SOURCES Empirically derived model of symptom cluster experience profiles, existing theoretical frameworks, and data-based literature on symptoms and quality of life in adult survivors of childhood cancers. DATA SYNTHESIS In a previous study, the authors generated a preliminary model to characterize subgroups of adult survivors of childhood cancers with high-risk symptom cluster profiles. The authors developed the SCEP framework, which depicts symptom cluster experiences as subgroup-specific profiles that are driven by multiple sets of risk and protective factors. The risk and protective factors may directly and indirectly contribute to or alleviate symptoms through their effects on systemic stress. Systemic stress instigates and sustains the symptom experience that, in turn, is expressed through negative diffusion into other components of quality of life, such as functional status, general health perceptions, and overall quality of life. CONCLUSIONS The SCEP framework is an initial approach to unbundle the complex heterogeneity that underlies the clustering of symptoms. By measuring a wide range of risk and protective factors in future studies of adult survivors of childhood cancers and other subgroups at risk for high symptom burden, further development and validation of the SCEP framework will occur. IMPLICATIONS FOR NURSING The SCEP framework can be used to specify mechanisms underlying symptom cluster profiles and derive interventions targeted to high-risk symptom profiles. Findings from future studies can be translated to risk-based surveillance and symptom management clinical practice guidelines.
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Affiliation(s)
- Lorna Finnegan
- College of Nursing, University of Illinois at Chicago, USA
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Einvik G, Dammen T, Hrubos-Strøm H, Namtvedt SK, Randby A, Kristiansen HA, Somers VK, Nordhus IH, Omland T. Prevalence of cardiovascular risk factors and concentration of C-reactive protein in Type D personality persons without cardiovascular disease. ACTA ACUST UNITED AC 2011; 18:504-9. [DOI: 10.1177/1741826710389383] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Gunnar Einvik
- Division of Medicine, Akershus University Hospital and University of Oslo, Norway
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Toril Dammen
- Division of Medicine, Akershus University Hospital and University of Oslo, Norway
- Department of Psychiatry, Oslo University Hospital, Norway
| | - Harald Hrubos-Strøm
- Division of Medicine, Akershus University Hospital and University of Oslo, Norway
- Centre for Clinical Research, Akershus University Hospital, Norway
| | - Silje K Namtvedt
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Anna Randby
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Håvard A Kristiansen
- Head and Neck Research Group, Akershus University Hospital and University of Oslo, Norway
| | | | - Inger H Nordhus
- Department of Clinical Psychology, University of Bergen, Norway
| | - Torbjørn Omland
- Department of Behavioral Medicine, Institute of Basic Medical Sciences, University of Oslo, Norway
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Kopp MS, Thege BK, Balog P, Stauder A, Salavecz G, Rózsa S, Purebl G, Adám S. Measures of stress in epidemiological research. J Psychosom Res 2010; 69:211-25. [PMID: 20624521 DOI: 10.1016/j.jpsychores.2009.09.006] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2009] [Revised: 08/17/2009] [Accepted: 09/10/2009] [Indexed: 11/18/2022]
Abstract
A comprehensive assessment of psychosocial stress often poses significant challenges due to diversity in conceptualization of stress. Consequently, a number of instruments that measure psychosocial stress, its stressors, and its impact at the individual, organizational, and societal levels have been developed. This article aims to provide a brief review of such instruments, focusing on established questionnaire and interview measures in line with the environmentalist and psychological conceptualizations of stress. This includes measures of major life events; work, marital, and social stress; the individual's coping abilities; and psychological and somatic outcomes of stress. We provide a general description of selected instruments and discuss their administration, scoring, and psychometric properties. Appropriate application of these instruments in epidemiological and clinical research, as well as in inpatient care, can aid the detection of psychosocial stress, support thorough assessment and management of the individual's illness, and ensure accurate identification of individuals who would benefit from specific behavioral (psychotherapeutic) interventions.
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Affiliation(s)
- Mária S Kopp
- Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
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Elevated Serum Levels of Interleukin-10 and Tumor Necrosis Factor Are Both Associated With Vital Exhaustion in Patients With Cardiovascular Risk Factors. PSYCHOSOMATICS 2010. [DOI: 10.1016/s0033-3182(10)70692-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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van den Broek KC, Smolderen KG, Pedersen SS, Denollet J. Type D Personality Mediates the Relationship Between Remembered Parenting and Perceived Health. PSYCHOSOMATICS 2010. [DOI: 10.1016/s0033-3182(10)70688-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Jerant A, Chapman B, Duberstein P, Franks P. Effects of personality on self-rated health in a 1-year randomized controlled trial of chronic illness self-management. Br J Health Psychol 2010; 15:321-35. [PMID: 19594988 PMCID: PMC3013621 DOI: 10.1348/135910709x464353] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Personality factors moderate self-efficacy enhancing effects of some illness self-management interventions, but their influence on self-rated health is unclear. This study examined whether high neuroticism and low conscientiousness, extraversion, and agreeableness (the distressed personality profile) moderated the effects of the homing in on health (HIOH) illness self-management intervention on mental and physical health status. DESIGN Analysis of data from 384 subjects completing a randomized controlled trial of HIOH. METHODS Regression analyses examined effects of NEO-five factor inventory scores on SF-36 mental component summary (MCS-36) and physical component summary (PCS-36) scores (baseline; 2, 4, and 6 weeks; 6 months; 1 year), adjusting for age, gender, and study group. RESULTS Baseline MCS-36 scores were worse in those with the distressed personality profile relative to others: high neuroticism (13.3 points worse, 95% confidence interval (CI)=11.0, 15.7) and low conscientiousness (6.6 points worse, 95% CI=4.1, 9.2), extraversion (10.1 points worse, 95% CI=7.7, 12.5) and agreeableness (4.2 points worse, 95% CI=1.6, 6.8). Intervention subjects had better MCS-36 scores at 4 and 6 weeks, and benefits were confined to participants with low conscientiousness (4 weeks - 3.7 points better, 95% CI=0.2, 71; 6 weeks - 5.0 points better, 95% CI=1.57, 8.4). There were no intervention or personality effects on PCS-36 scores. CONCLUSIONS Chronically ill self-management intervention recipients with the distressed personality profile had worse self-rated mental health, and conscientiousness moderated the short-term effects of the intervention on self-rated mental health. Measuring personality may help identify individuals more likely to benefit from self-management interventions.
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Affiliation(s)
- Anthony Jerant
- Department of Family and Community Medicine, Center for Healthcare Policy and Research, University of California Davis School of Medicine, Sacramento, California 95817, USA.
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Health-related quality of life is related to cytokine levels at 12 months in patients with chronic heart failure. Brain Behav Immun 2010; 24:615-22. [PMID: 20074634 DOI: 10.1016/j.bbi.2010.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2009] [Revised: 01/05/2010] [Accepted: 01/07/2010] [Indexed: 11/22/2022] Open
Abstract
Chronic heart failure (CHF) is a condition with a high mortality risk. Besides traditional risk factors, poor health-related quality of life (HRQoL) is also associated with poor prognosis in CHF. Immunological functioning might serve as a biological pathway underlying this association, since pro and anti-inflammatory cytokines are independent predictors of prognosis. The aim of this study was to examine the association between HRQoL at inclusion (baseline) and pro and anti-inflammatory cytokine levels both at baseline and 12months, using a prospective study design. CHF outpatients completed the Minnesota Living with Heart Failure Questionnaire (MLHFQ) and the Short Form Health Survey 36 (SF-36). Blood samples were drawn at baseline (n=111) and 12months (n=127) to measure pro (IL-6, TNFalpha, sTNFR1, sTNFR2) and anti- (IL1ra, IL-10) inflammatory markers. Linear regression analysis were run for the MLHFQ, the SF-36 mental component summary (MCS) and the physical component summary (PCS), controlling for age, sex, BMI, smoking, co morbidity, NYHA-class and 6min walk test. Baseline MLHFQ was associated with increased levels of baseline sTNFR2, and 12-month sTNFR1 12month sTNFR2. Baseline MCS and change in MCS were related to increased 12-month sTNFR1 levels. All significant findings relate a worse HRQoL at baseline or a deterioration over time to increased sTNFR1/2 levels. These findings suggest that immune activation may be one of the pathways underlying the relationship between poor HRQoL and mortality and morbidity in CHF patients. Future studies are warranted to replicate these findings in larger samples.
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Biopsychosocial impact of the voice in relation to the psychological features in female student teachers. J Psychosom Res 2010; 68:379-84. [PMID: 20307705 DOI: 10.1016/j.jpsychores.2009.10.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2009] [Revised: 09/24/2009] [Accepted: 10/01/2009] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The aim of the study was to assess biopsychosocial impact of the voice in relation to the psychological features in female student teachers. METHODS This research was a cross-sectional study in 755 student teachers using general questionnaires, the Voice Handicap Inventory (VHI), Type D Scale-16, Symptom Check List (SCL-90), and Utrecht Coping List (UCL). Student teachers with a relative high score on the VHI (>75th percentile) and students with a relative low score (<25th percentile) were compared. RESULTS Type D student teachers had a 4x greater risk of a high VHI-score (OR 4.23) than the non-type-D group. The student teachers with relative high VHI scores scored significantly higher (P<.001) on the SCL-90 total and all subscales, compared to the student teachers with relative low VHI scores. Furthermore, the students with a relative high VHI score had significant high scores on the subscales passive attitude (P<.001), palliative reactions (P<.001), avoidance and a waiting attitude (P<.001), and expression of emotions (P=.003) of the UCL. CONCLUSION This study showed that a relative high biopsychosocial impact of the voice is related to the personality trait Type D, psychosomatic well-being and coping strategies in female student teachers. These features should be implemented in screening and training programs for students for a voice demanding profession. The students have to be prepared to cope with psychological, physical and vocal demands of the teaching profession. The speech therapist (of the vocational university) has to be aware of an important role in coaching the students into a more active coping attitude.
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