J Korean Acad Nurs.  2008 Feb;38(1):19-28. 10.4040/jkan.2008.38.1.19.

The Analysis of Type D Personality Research as a Psychosocial Risk Factor in Cardiovascular Disease for Elders with a Chronic Disease

• Song EK
• Son YJ

• KMID: 1405635
• DOI: http://doi.org/10.4040/jkan.2008.38.1.19

Abstract

PURPOSE: The purpose of this paper was to examine the relationship between type D personality and cardiovascular disease, and to suggest future research directions. METHOD: A literature search was conducted from the following nine databases: 1) MEDLINE, 2) CINAHL, 3) Pubmed Unrestricted, 4) PsycINFO, 5) KISS, 6) RICHIS, 7) RISS4U, and 8) Nanet. The combinations of the words, "type D personality", "personality", "heart", "cardiovascular", and "coronary" were used for keyword searches to find relevant articles. Twenty eight studies were identified. RESULT: Type D personality has been associated with increased morbidity and mortality in patients with established cardiovascular disease. Type D patients are also at increased risk for impaired quality of life, and seem to benefit less from medical and invasive treatment. CONCLUSION: There is substantial evidence for a relationship between type D personality and clinical outcomes related to cardiovascular disease. Randomized clinical trials are needed to further evaluate the value of controlling type D personality to improve survival and reduce morbidity in patients with cardiovascular disease. Accumulating evidence from this analysis indicates the urgent need to adopt a personality approach in order to optimize the identification of patients at risk for stress related cardiac events.

Keyword

Personality; Risk factors; Cardiovascular disease

MeSH Terms

Aged
Cardiovascular Diseases/*psychology
Chronic Disease
Humans
Middle Aged
*Personality
Risk Factors
*Stress, Psychological

Figure

• 

  Figure 1 Literature & selective process.

Reference

1. Angerer P, Siehert V, Kothny W, Mühlbauer D, Mudra H, von Schacky C. Impact of social support, cynical hostility and anger expression on progression of coronary atherosclerosis. J Am Coll Cardiol. 2000. 36:1781–1788.

2. Aquarius AE, Denollet J, Hamming JF, De Vries J. Role of disease status and type D personality in outcomes in patients with peripheral arterial disease. Am J Cardiol. 2005. 96:996–1001.

3. Berkman LF, Leo-Summers L, Horwitz RI. Emotional support and survival after myocardial infarction. A prospective, population-based study of the elderly. Ann Intern Med. 1992. 117:1003–1009.

4. Bosma H, Peter R, Siegrist J, Marmot M. Two alternative job stress models and the risk of coronary heart diseas. Am J Public Health. 1998. 88(1):68–74.

5. Conraads VM, Denollet J, De Clerck LS, Stevens WJ, Bridts C, Vrints CJ. Type D personality is associated with increased levels of tumor necrosis factor (TNF)-alpha and TNFalpha receptors in chronic heart failure. Int J Cardiol. 2006. 113(1):34–38.

6. Dembroski TM, Costa PT Jr. Coronary prone behavior: components of the type A pattern and hostility. J Pers. 1987. 55:211–235.

7. Denollet J. Personality and coronary heart disease: the type-D scale-16 (DS 16). Ann Behav Med. 1998. 20:209–215.

8. Denollet J. Type D personality a potential risk factor refined. J Psychosom Res. 2000. 49:255–266.

9. Denollet J. DS 14: standard assessment of negative affectivity, social inhibition, and type D personality. Psychosom Med. 2005. 67:89–97.

10. Denollet J, Conraads VM, Brutsaert DL, De Clerck LS, Stevens WJ, Vrints CJ. Cytokines and immune activation in systolic heart failure: the role of Type D personality. Brain Behav Immun. 2003. 17:304–309.

11. Denollet J, De Potter B. Coping subtypes for men with coronary heart disease: relationship to well-being, stress and Type-A behavior. Psychol Med. 1992. 22:667–684.

12. Denollet J, Sys SU, Brutsaert DL. Personality and mortality after myocardial infarction. Psychosom Med. 1995. 57:582–591.

13. Erdam RA, Duivenvoorden HJ, Verhage F, Kazemier M, Hugenholtz PG. Predictability of beneficial effects in cardiac rehabilitation: a randomized clinical trial of psychosocial variables. J Cardiopulm Rehabil. 1986. 6:206–213.

14. Friedman M, Rosenman RH. Association of specific overt behavior pattern with blood and cardiovascular findings: blood cholesterol level, blood clotting time, incidence of arcus senilis, and clinical coronary artery disease. J Am Med Assoc. 1959. 169:1286–1296.

15. Habra ME, Linden W, Anderson JC, Weinberg J. Type D personality is related to cardiovascular and neuroendocrine reactivity to acute stress. J Psychosom Res. 2003. 55:235–245.

16. Hemingway H, Marmot M. Evidence based cardiology: psychosocial factors in the aetiology and prognosis of coronary heart disease. Systematic review of prospective cohort studies. BMJ. 1999. 318:1460–1467.

17. Jenkins CD. Epidemiology of cardiovascular disease. J Consult Clin Psychol. 1988. 56:324–332.

18. Lett HS, Blumenthal JA, Babyak MA, Sherwood A, Strauman T, Robins C, et al. Depression as a risk factor for coronary artery disease: evidence, mechanism and treatment. Psychosom Med. 2004. 66:305–315.

19. Linden W, Stossel C, Maurice J. Psychosocial interventions for patients with coronary artery disease: a meta-analysis. Arch Intern Med. 1996. 156:745–752.

20. Medina MA, Amores-Sánchez MI. Homocysteine: an emergent cardiovascular risk factor? Eur J Clin Invest. 2000. 30:754–762.

21. Moser DK, Dracup K. Is anxiety early after myocardial infarction associated with subsequent ischemic and arrhythmic events? Psychosom Med. 1996. 58:395–401.

22. Pedersen SS, Denollet J. Type D personality, cardiac events, and impaired quality of life: a review. Eur J Cardiovasc Prev Rehabil. 2003. 10:241–248.

23. Pedersen SS, Middel B. Increased vital exhaustion among type-D patients with ischemic heart disease. J Psychosom Res. 2001. 51:443–449.

24. Pedersen SS, van Domburg RT, Theuns DA, Jordaens L, Erdmanm RA. Type D personality is associated with increased anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator and their partner. Psychosom Med. 2004. 66:714–719.

25. Ravaja N, Kauppinen T, Keltikangas-Jarvinen L. Relationships between hostility and psychological coronary heart disease risk factors in young adults: the moderating influences of depressive tendencies. Psychol Med. 2000. 30:381–393.

26. Rozanski A, Blumenthal JA, Kaplan J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation. 1999. 99:2192–2217.

27. Schiffer AA, Pedersen SS, Widdershoven JW, Hendriks EH, Winter JB, Denollet J. The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure. Eur J Cardiovasc Prev Rehabil. 2005. 12:341–346.

28. Smith TW, Ruiz JM. Psychosocial influences on the development and course of coronary heart disease: current status and implications for research and practice. J Consult Clin Psychol. 2002. 70:548–568.

29. Spielberger CD, Van Der Ploeg HM, Defares PB. ZBV: A Dutch-Language adaptation of the Spielberger State-Trait Anxiety Inventory. 1980. Lisse, The Netherlands: Swets & Zeitlinger.

30. Watson D, Clark LA, Harkness AR. Structures of personality and their relevance to psychopathology. J Abnorm Psychol. 1994. 103:18–31.