Type D personality

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Type-D personality [1][2] is defined as the joint tendency towards negative affectivity (worry, irritability, gloom) and social inhibition (reticence and a lack of self-assurance). The letter 'D' stands for 'distressed'. Johan Denollet, a Dutch professor of medical psychology, is the founder of this concept. Research has shown that CHD patients with a type-D personality have a worse prognosis after a myocardial infarction (MI) as compared to patients without a type-D personality. Type-D is associated with a 4- to 8-times increased risk of mortality, recurrent MI, or sudden death. The effect of type-D is independent from traditional risk factors in CHD [3],[4][5][6]. Type-D personality can be assessed by means of a valid and reliable 14-item questionnaire, the DS14 [7]. One half of the items refer to negative affectivity, and the other half of the items refer to social inhibition. People who score 10 points or more on both dimensions are classified as type-D. In the general population Type D personality has a prevalence of between 20 and 35%, while in cardiac populations prevalence may be higher [8]. The DS14 can be applied in clinical practice for risk stratification in post-MI patients.

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  1. DS14: standard assessment of negative affectivity, social inhibition, and Type D personality (Psychosomatic Medicine, 2005).
  2. Website Type-D research
  3. Personality as independent predictor of long-term mortality in patients with coronary heart disease (Lancet, 1996)
  4. Personality, disease severity, and the risk of long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction (Circulation, 1998).
  5. Inadequate response to treatment in coronary heart disease : adverse effects of type D personality and younger age on 5-year prognosis and quality of life (Circulation, 2000).
  6. Type-D personality mechanisms of effect: The role of health-related behavior and social support. J Psychosom Res. 2008 Jan;64(1):63-9.
  7. DS14: standard assessment of negative affectivity, social inhibition, and Type D personality (Psychosomatic Medicine, 2005).
  8. Type D personality as a prognostic factor in heart disease: assessment and mediating mechanisms. J Pers Assess. 2007 Dec;89(3):265-76.
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