Type D personality is associated with psychological distress and poor self-rated health among the elderly: a population-based study in Japan

Association between personality traits and psychological distress among postmenopausal women with coronary heart disease: A cross-sectional survey and mediation analysis

Postmenopausal women with negative personality characteristics are at an increased risk of psychological disorders, yet little is known about the mechanism underlying the relationship between type D personality and psychological distress in postmenopausal women with coronary disease. This study assessed the mediating roles of perceived social support and self-perceived burden in the relationship between type D and psychological distress based on the equity theory and stress-buffering model. Demographic characteristics, type D, psychological distress, perceived social support, and self-perceived burden were completed by 335 participants with self-reported questionnaires using a cross-sectional design in Southeast China. The results revealed that perceived social support and self-perceived burden both separately and serially mediated the relationship between type D personality and psychological distress. Effective intervention strategies aimed at improving perceived social support or reducing self-perceived burden may be beneficial in reducing psychological distress.

The association of Type D personality with functional outcomes, quality of life and neuropathic pain in persons with spinal cord injury

STUDY DESIGN

Cross-sectional study.

OBJECTIVES

This study aimed to investigate the association of Type D personality (TDP) with functional outcomes, health-related quality of life (HRQoL) and neuropathic pain in persons with spinal cord injury (SCI), using dichotomous and continuous analysis methods.

SETTING

Tertiary rehabilitation center.

METHODS

This study included 105 persons with SCI. Independence level was determined using the Functional Independence Measure (FIM)-motor subscale. The Short Form-36 questionnaire (SF-36) was used to assess HRQoL. TDP (combined existence of negative affectivity and social inhibition) was assessed using Type D Scale-14 (DS-14). Presence of chronic pain was questioned and the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) Pain Scale was used to distinguish neuropathic pain from others.

RESULTS

In dichotomous method, the FIM-motor score was significantly lower in persons with TDP (41 persons, 39%) (p = 0.025). Persons with TDP had significantly lower scores in vitality, emotional role and mental health. There was no significant difference between the groups, regarding neuropathic pain and LANSS scores (p > 0.05 for all). Negative affectivity and total DS-14 scores had negative correlation with mental health and vitality. In continuous interaction method, TDP predicted mainly the mental health components of SF-36 (particularly, vitality and mental health). Negative affectivity was the driving factor. TDP was not associated with FIM-motor, VAS pain or LANSS scores.

CONCLUSIONS

Mental component of HRQoL is associated with Type D in persons with SCI in both analyses. Assessment of potential differences related with TDP may be beneficial to develop and apply person-specific goals in SCI rehabilitation.

Cross-cultural adaptation and validation of the 15-item Geriatric Depression Scale (GDS-15) into Igbo language: a validation study

Background

Late-life experiences such as protracted and indisposing medical disorders can negatively impact older adults’ psychological and mental health, making them vulnerable to depression. Majority of the assessment tools for depression were developed for use in western countries. There is therefore the need for availability of culture- and environment-specific tools for assessment of depression in low-and-middle-income countries. This study was designed to cross-culturally adapt and validate the Geriatric Depression Scale-15 (GDS-15) into Igbo language and culture.

Methods

The English version of the GDS-15 was translated into Igbo language; synthesized, back-translated, and underwent expert panel review, pretesting and cognitive debriefing interview, according to the American Academy of Orthopedic Surgeons’ guidelines. The Igbo version of the GDS-15 was tested for concurrent and structural validities, and internal consistency among consecutively recruited 140 consenting older adults (62.9% females) in Enugu North Senatorial District at 0.05 level of significance.

Results

The English version of the GDS-15 was successfully cross-culturally adapted to Igbo with all the 15 items still retained on the Igbo version of the GDS-15. The Igbo version of the GDS-15 exhibited the same structure as the English version, and displayed a Cronbach’s alpha value of 0.53 with no significant ceiling (0%) and floor (0%) effects. The correlation between the participants’ total scores on the Igbo and the English versions of the GDS-15 (ρ = 0.86) was adequate. There was no significant difference between corresponding scores in the English and Igbo versions of the GDS-15 (p = 0.89).

Conclusions

The Igbo version of the GDS-15 is a valid and culturally specific instrument, and can be used for assessing depression among Igbo older adults in Nigeria.

Competitive Anxiety, and Guilt and Shame Proneness From Perspective Type D and Non-type D Football Players

The precompetitive, competitive, and postcompetitive mental states of athletes are currently not sufficiently researched. Long-term exposure to stressors contributes to the formation of mental blocks and leads to various health problems. One of the factors that can explain the variability of athletes' reactions to stress is their personality. This study is the first to examine competitive anxiety, and guilt and shame proneness in the context of the reaction of football players to distress in sports. The study consists of 112 male football players aged 16–24 (21.00 ± 1.90) who were divided into type D and non-type D football players according to scoring on the Denollet Scale (DS14). Football players also filled out the Sport Anxiety Scale (SAS-2) and the Guilt and Shame Proneness Scale (GASP). The taxonomic approach was conducted to test and to examine differences in stressor intensity as a function of type D personality. A correlation, multivariate analysis of variance, and regression analysis were performed in the study. We found that type D football players were more afraid of failures in sports (worry), felt more often autonomous excitement concentrated in the stomach and muscles (somatic anxiety), and showed more frequent concentration disruption than did non-type D football players. We also found that although type D football players were more likely to rate their behavior as negative and inappropriate, they showed a much greater effort to correct it than did non-type D football players. Negative affectivity and social inhibition of type D football players were positively correlated with competitive anxiety. In addition, we noted lower levels of somatic anxiety and lower concentration disruption for football players who used escape strategies to manage stress. The shame proneness subscale monitoring negative self-evaluation was also closely related to the concentration disruption of football players. We found that the examination of athletes by type D personality is necessary due to the fact that negative affectivity and social inhibition are significant predictors of competitive anxiety of football players, which explains their worries at 24.0%, somatic anxiety at 8.2%, and concentration disruption at 10.6%.

New Factor Structure of the Tampa Scale for Kinesiophobia in Older Japanese Adults After Lumbar Surgery

Purpose

The Tampa Scale for Kinesiophobia (TSK) has been used worldwide as a measure of kinesiophobia, but its factor structure in older Japanese adults after lumbar surgery is unknown. The purpose of this study was to fill this research gap by identifying the factors that comprise TSK in older Japanese adults after lumbar surgery.

Patients and Methods

Participants were older Japanese adults who had undergone surgery for lumbar spinal stenosis. Clinicodemographic data, TSK, intensity of low back pain and leg pain, dysesthesia (using an 11-point numerical rating scale), and HRQOL (using the EQ-5D-5L) were collected. After supplementing the missing values by the multiple assignment method, the hypothetical model of TSK was developed by categorical exploratory factor analysis (weighted least squares method, promax rotation). Confirmatory factor analysis (WLSMV method, promax rotation) was used to compare the hypothetical model and the traditional one-factor and two-factor models. Furthermore, we confirmed the relationship between factors extracted from the hypothetical model and HRQOL, pain, and dysesthesia.

Results

Questionnaires were mailed to 302 individuals, and responses were obtained from 211 (72.4±4.2 years [range: 65–88]; 115 men and 96 women; 804±343.1 [380–1531] days after surgery; 137 who had undergone decompression and fixation surgery, 74 who had undergone decompression surgery) (response rate: 69.9%). The hypothesized model consisted of “somatic focus,” “activity avoidance,” and “efficacy of physical activities,” all of which were highly consistent. The fit of the hypothetical model was slightly inferior to that of the traditional two-factor model, but the hypothetical model met the criteria for fit. Somatic focus in the hypothetical model was significantly associated with HRQOL, pain, and dysesthesia.

Conclusion

In older Japanese adults after lumbar surgery, the goodness of fit of the TSK model was maintained by adding efficacy of physical activities as a third factor to the traditional two factors.

Association between Satisfaction with Life and Personality Types A and D in Young Women with Acne Vulgaris

People with acne vulgaris report a lower level of satisfaction with life and are more frequently classified as having Type D personalities than those without acne. This research examined, for the first time, the moderating and mediating role of personality type in the relationship between acne severity and satisfaction with life. Among 300 female nursing and cosmetology students ranging in age from 19 to 24 years (M = 21.28, SD = 1.39), 150 individuals (50%) presented with symptoms of acne vulgaris (AV group), while the other 150 (50%) were categorized as controls without acne vulgaris (WAV sample). A cross-sectional study was conducted using three self-report questionnaires: The Satisfaction with Life Scale (SWLS), the Framingham Type A Scale (FTAS), and the Type D Scale (DS14). Acne vulgaris was clinically diagnosed using the Hellgren–Vincent Scale (HVS). The AV group scored significantly higher on the FTAS and DS14 and lower on the SWLS than the WAV sample. Life satisfaction correlated negatively with both the negative affectivity (NA) and social inhibition (SI) subscales of the DS14. The moderating role of the Type A behavioral pattern (TABP) and the mediating role of both NA and SI subscales of the DS14 were observed in the relationship between acne severity and satisfaction with life. The type of personality may explain the mechanism of the relationship between acne disease and subjective well-being. Therefore, psychological interventions and strategies focused on managing stress and mood may effectively improve satisfaction with life in people with acne.

Type D personality is a predictor of prolonged acute brain dysfunction (delirium/coma) after cardiovascular surgery

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.

Type D Personality, Social Support, and Depression Among Ethnic Chinese Coronary Artery Disease Patients Undergoing a Percutaneous Coronary Intervention: An Exploratory Study

This study investigated the relationships between Type D personality, depression, and social support among ethnic Chinese coronary artery disease (CAD) patients undergoing percutaneous coronary interventions. Type D personality is associated with CAD, and may increase patients' depression and mortality rate. However, very few studies have explored the relationships between depression and social support among ethnic Chinese Type D CAD patients. A longitudinal, repeated-measures design was used; 105 Taiwanese CAD patients undergoing a percutaneous coronary intervention were recruited between January and December 2015. A demographic questionnaire, Type D Scale, ENRICHD Social Support Inventory, and Patient Health Questionnaire-9 were completed by 102 participants (mean age = 64.42, SD = 13.67 years) at hospitalization, and at the second week and third month after discharge. Data were analyzed using t tests and a generalized estimating equation. Results indicated that 46.7% of participants who had Type D personality had lower social support and higher depression than did the remaining (non-Type D) participants. At two weeks after discharge, the improvement in social support was higher among Type D patients than non-Type D participants; the same was true for depression at two weeks and three months after discharge each. Type D Taiwanese CAD patients showed lower perceived social support and higher depression during hospitalization than did non-Type D participants. Furthermore, the more social support patients received at home, the lower was their depression. Health-care providers should provide continuous mental health care, conduct early screening of mental health issues, and ensure that patients receive sufficient social support to reduce depression.

Type D personality and periodontal disease in university students: A prospective cohort study

The purpose of this prospective cohort study was to investigate whether Type D personality was related to periodontal disease in Japanese university students. Among students ( n = 600) who were interested in receiving oral health examinations, logistic regression analysis showed that the risk of developing periodontal disease during a 3-year period was associated with body mass index ⩾ 25 (odds ratio: 2.543; 95% confidence interval: 1.297-4.989; p = 0.007) and Type D personality (odds ratio: 1.473; 95% confidence interval: 1.027-2.111; p = 0.035). In this short-term prospective cohort study, a significant association between periodontal disease and Type D personality was observed in Japanese university students.

Home visits by commissioned welfare volunteers and psychological distress: a population-based study of 11,312 community-dwelling older people in Japan

OBJECTIVE

Novel countermeasures to increase healthcare expenditures should be explored in rapidly aging societies, including Japan. Social support is a resource for the older people that effectively reduces psychological distress, with or without specialized health service provision. This cross-sectional study was conducted to determine whether home visits by commissioned welfare volunteers (organizations of community residents assigned by national or local governments) are associated with a lower risk of psychological distress among the older people.

METHODS

Questionnaires were sent in August 2010 to all residents aged ≥65 years in three municipalities (n = 21,232) in Okayama Prefecture in Japan; 13,929 were returned (response rate = 65.6%). The final sample size for the analysis was 11,312 participants. Home visits, psychological distress (Kessler Psychological Distress Scale: K6 > 5), and severe psychological distress (K6 > 13) were measured by the questionnaire. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for psychological distress, adjusting for age, gender, education, marital status, and qualification for long-term care insurance.

RESULTS

The prevalence was 41.4% for psychological distress and 6.5% for severe psychological distress among all participants. Home visits were significantly associated with a lower risk of psychological distress after adjusting for the covariates (OR: 0.71, 95% CI: 0.65-0.77). These associations were comparable for men and women. The association was clearer for severe psychological distress (OR: 0.51, 95% CI: 0.43-0.61).

CONCLUSIONS

Home visits by commissioned welfare volunteers are significantly associated with a lower risk of psychological distress among older people.

Community-Level Social Capital and Psychological Distress among the Elderly in Japan: A Population-Based Study

Despite accumulating evidence, previous studies have not clearly separated the contribution of community-level social capital on mental health from that of individual-level social support. We examined the association between community-level social capital and psychological distress in a sample of older Japanese individuals, taking into account the effects of individual-level social capital and social support. We collected data via a cross-sectional survey among all residents aged ≥65 in three rural municipalities in Okayama Prefecture. We measured two components of social capital in the questionnaire: perceptions of trust and reciprocity in the community. Community-level social capital was obtained by aggregating individual responses and calculating the proportion of subjects reporting mistrust and lack of reciprocity. Psychological distress was assessed by the Kessler Psychological Distress scale. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for psychological distress using two-level Poisson regression models (9,761 individuals nested within 35 communities). The prevalence of psychological distress was 39.8%. Low community-level social capital was associated with psychological distress, even after controlling for individual-level social support, age, sex, educational attainment, frequency of alcohol consumption, smoking status, body mass index, marital status, socioeconomic status, and number of cohabiters. The adjusted RRs per 10% increase of the proportion of mistrust and lack of reciprocity in the communities were 1.23 (95% CI: 1.01–1.51) and 1.12 (95% CI: 1.02–1.24), respectively. Lower levels of community-level social capital are associated with psychological distress among the Japanese elderly population, even after adjusting for individual-level perceptions of social capital and social support.

Type-d personality can predict suicidality in patients with major depressive disorder

OBJECTIVE

This study investigated the putative association between type-D personality and suicidality, including the history of suicide attempt and suicidal ideation in patients with major depressive disorder (MDD).

METHODS

Eighty-six outpatients aged between 18 and 65 years with MDD were recruited for this study from Ilsan Paik Hospital. The cohort was stratified into two subgroups according to the presence of type-D personality and history of suicide attempt (yes vs. no). Depression severity was evaluated using the Hamilton Depression Rating Scale. The type-D Personality Scale-14 (DS-14), the Beck Hopelessness Scale (BHS), the Barratt Impulsiveness Scale (BIS), the Hamilton Anxiety Scale, and the Beck Scale for Suicidal Ideation (BSS) were also applied.

RESULTS

The total BSS, BHS, and BIS scores were higher for the group with type-D personality than for the group without this personality (p=0.004, 0.01, and 0.003, respectively). In addition, the total scores for the BSS, BHS, and social inhibition (SI; subscale of DS-14) were higher for the group with a history of suicide attempt than for the group without this history (p=0.0000004, 0.003, and 0.033, respectively). There were positive correlations between the total DS-14 score and the total BSS, BHS, and BIS scores (r=0.413 and p=0.000077, r=0.404 and p=0.00012, and r=0.245 and p=0.024, respectively).

CONCLUSION

Depressed patients with type-D personality are more vulnerable to suicidality than those without type-D personality, even when the MDD severity is identical. In addition, the SI score was higher in patients with a history of suicide attempt than in those without this history.

Group involvement and self-rated health among the Japanese elderly: an examination of bonding and bridging social capital

Background

To date, only a small amount of research on bonding/bridging social capital has separately examined their effects on health though they have been thought to have differential effects on health outcomes. By using a large population-based sample of elderly Japanese people, we sought to investigate the association between bonding and bridging social capital and self-rated health for men and women separately.

Methods

In August 2010, questionnaires were sent to all residents aged ≥65 years in three municipalities in Okayama prefecture (n = 21232), and 13929 questionnaires were returned (response rate: 65.6%). Social capital was measured from survey responses to questions on participation in six different types of groups: a) the elderly club or sports/hobby/culture circle; b) alumni association; c) political campaign club; d) citizen’s group or environmental preservation activity; e) community association; and f) religious organization. Participant perception of group homogeneity (gender, age, and previous occupation) was used to divide social capital into bonding or bridging. Odds ratios (ORs) and 95% confidence intervals (CIs) for poor self-rated health were calculated.

Results

A total of 11146 subjects (4441 men and 6705 women) were available for the analysis. Among men, bonding and bridging social capital were inversely associated with poor self-rated health (high bonding social capital; OR: 0.55, 95% CI: 0.31–0.99; high bridging social capital; OR: 0.62, 95% CI: 0.48–0.81) after adjusting for age, educational attainment, smoking status, frequency of alcohol consumption, overweight, living arrangements, and type-D personality. The beneficial effect among women was more likely limited to bonding social capital (high bonding social capital; OR: 0.34, 95% CI: 0.12–1.00), and the association between bridging social capital and self-rated health was less clear (high bridging social capital; OR: 0.69, 95% CI: 0.44–1.07).

Conclusions

Bonding/bridging social capital could have differential associations with self-rated health among the Japanese elderly depending on the individual’s sex. Considering the lack of consensus on how to measure bonding and bridging social capital, however, we need to carefully assess the generalizability of our findings. Further research is warranted to identify health-relevant dimensions of social capital in different cultural or economic settings.