The Role of Type D Personality in Acute Coronary Syndrome

Introduction: Acute Coronary Syndrome (ACS) is one of the most common causes of death in patients with Cardiovascular Diseases (CVD). In addition to the known physical factors influencing the incidence of CVD, some psychologists have pointed to the role of psychological factors such as personality type. Objective: This study aimed to determine the role of type D personality in ACS patients in Iran in 2019. Materials and Methods: In a case-control study, 112 participants were included. A total of 56 patients with ACS were compared with 56 matched people without ACS. They were selected by the convenience sampling method. Type D scale 14 (DS14) was used to assess the type D personality. The Chi-squared test, independent t-test, and multivariate logistic regression were used to analyze the obtained data. Results: The Mean±SD age in the case group was 57.23±8.562 years, and in the Mean±SD age in the control group was 57.25±8.529 years. Also, most participants in both groups were men (71.4%). The result showed that type D personality was more prevalent in patients with ACS (26% vs 7.1%; P=0.006). Based on multivariate regression analysis and after controlling for demographic and clinical risk factors, type D personality was independently associated with ACS (OR=5.323, 95% CI; 0.987-28/712, P=0.052). Also, after investigating subscales, only social inhibition had a significant association with ACS (P=0.008). Conclusion: Type D personality is an independent risk factor of the ACS. Thus, type D personality may make people vulnerable to the ACS. Therefore, besides medical interventions, clinicians must consider behavioral interventions to reduce the incidence of ACS.

Association between Type-D Personality and Affective (Anxiety, Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study

Background: Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients. Objective: The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up). Aims: The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients. Methods: 145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1. Results: One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of Type-D personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1. Conclusion: Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology.

Relationship of Type D Personality to Adverse Health Outcomes in People with Type 2 Diabetes: Parallel Mediating Effects of Diabetes Distress and Social Isolation

Background: This study aims to investigate the relationship of Type D personality to glycated hemoglobin (HbA1c) and health-related quality of life (HRQOL) directly, and also indirectly via diabetes distress and social isolation in people with type 2 diabetes.Methods: Secondary data analysis of a cross-sectional survey was used. Data on 524 people with type 2 diabetes from outpatient clinics were obtained from June 2020 to February 2021. The hypotheses of this study were tested using the PROCESS macro with 10,000 bootstrapping iterations to estimate 95% confidence intervals (CIs) for indirect (mediating) effects.Results: Type D personality was present in 31.3% of the participants, and exerted a significant direct effect on HRQOL but not on HbA1c. Type D personality exerted a significant indirect effects on HbA1c via diabetes distress and social isolation (95% CI = 0.014 to 0.163 and 0.007 to 0.121, respectively), and on HRQOL via diabetes distress and social isolation (95% CI = -0.335 to -0.178 and -0.056 to -0.008, respectively). The indirect effects of Type D personality on HRQOL via diabetes distress had a greater magnitude than that via social isolation.Conclusion: It is necessary for health professionals to monitor people with type 2 diabetes to determine whether Type D personality is present. Those with Type D personality should be provided with interventions to reduce diabetes distress and alleviate social isolation in order to improve their glycemic control and HRQOL.

The Importance of Type D Personality in the Development of Temporomandibular Disorders (TMDs) and Depression in Students during the COVID-19 Pandemic

Background: a type D personality is a factor in a person’s susceptibility to general mental stress, especially during the COVID-19 pandemic. Although many studies were conducted on the relationships among stressful situations, an individual’s personality, depression, and the occurrence of various diseases, e.g., cardiovascular disease or cancer, there are no analogous data on people with temporomandibular disorders (TMDs). Aim: the assessment of TMDs and depression symptoms in students with type D personality. Material and Methods: the research was carried out with the participation of 240 physiotherapy students. The study group (G1) consisted of 120 participants with type D personalities, the control group (G2) consisted of the same number of participants, without “stress” personalities. All subjects were assessed for the occurrence of TMD symptoms, as well as for depression and anxiety symptoms, using the Beck Depression Inventory (BDI), based on the proprietary questionnaire. Results: in students with type D personality symptoms, TMDs occurred significantly more often and in greater number (p = 0.00) than in those without stress personalities. The exception was the symptom of increased muscle tension, which showed no statistical difference (p = 0.22). Among the 240 respondents, depression was found in 128 people (53.3%). In the group of students with type D personalities, depression was significantly more frequent than in the group without type D personalities (p = 0.00). In participants with depression, TMD symptoms were more common, i.e., headaches, neck, and shoulder girdle pain, TMJ acoustic symptoms, increased masticatory muscle tension, teeth clenching, and teeth grinding. There was no significant difference between the incidence of depression and TMJ pain and jaw locking. There was a significant interaction between the occurrence of headaches and acoustic symptoms and the occurrence of depression. For headache and depression interactions, the OR was >1; based on the results, we may assume that a headache depends more on the occurrence of depression rather than it being a symptom of a TMJ disorder in people with type D personalities. Conclusion: type D personality and depression may contribute to the development of TMD symptoms.

Tobacco Profile and Evaluation of the DS14 Scale in Patients with Coronary Syndrome

Background: the prevalence of current smokers in patients with coronary syndrome is high. This risk behaviour significantly increases the risk of cardiovascular complications. In the recommendations for the management of cardiovascular diseases, psychosocial and psychological factors are still neglected in practice. The aim of study was to verify the prevalence of tobacco use in hospitalized patients with coronary syndrome, notably to verify the type-D personality and tobacco use in the groups obtained from the evaluation of the DS14 scale. Methods: in this cross-sectional study, we addressed 100 hospitalized patients with coronary syndrome. Results: in the cohort, 48% patient were current smokers, 21% were never smokers, 24% were former smokers, 4% were occasional smokers, and 3% were quitters. Based on the evaluation of DS14, 21% of patients were classified as type-D personality and 38% as non-type-D; we identified two subtypes: the NA group at 23% and the SI group at 18%. In the group of the current smokers, 81% declared that they wanted to quit smoking, 15% of the patients were undecided, and 4% of current smokers did not want to quit. Conclusions: cardiac patients are aware that their disease is related to smoking; despite the severity of their disease, patients’ motivation to change their risky behaviour is low.

Prediction of Emotional Repression based on Alexithymia and Type D Personality in Cardiovascular Patients

Introduction: Cardiovascular disease is one of the causes of mortality in the world, which psychological factors play an important role in its occurrence and exacerbation. This study aimed to investigate the prediction of emotional repression based on alexithymia and type D personality in cardiovascular patients. Methods: Participants were 100 patients with coronary artery disease selected through accidental sampling from the patients undergoing treatment at Rajaee Heart Hospital in Karaj City and completed TAS-20, DS14 and ECQ questionnaires. The validity and reliability of all three questionnaires have been confirmed in domestic and foreign studies. Data were analyzed using SPSS version 16 Software and Pearson correlation, Multiple regressions. Results: The correlation results showed that there was a significant relationship between alexithymia and personality type D with emotional repression in the cardiac patients at the level of 0.05, and the results of multivariate regression results showed that alexityymia and personality type D did not predict emotional repression. Conclusion: Alexithymia, personality type D, and emotional repression are risk factors for the development and exacerbation of cardiovascular disease.