Related Experiment Video

Updated: Jul 16, 2026

Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment
08:25

Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment

Published on: December 6, 2024

Cortisol awakening response is elevated in acute coronary syndrome patients with type-D personality

Daisy L Whitehead1, Linda Perkins-Porras, Philip C Strike

  • 1Department of Epidemiology and Public Health, Psychobiology Group, University College London, London, United Kingdom.

Journal of Psychosomatic Research
|March 27, 2007
PubMed

Insights

Distressed (Type-D) personality in acute coronary syndrome (ACS) patients is linked to altered hypothalamic-pituitary-adrenocortical (HPA) axis function. This personality type may disrupt cortisol patterns, potentially impacting future cardiac health.

Area of Science:

  • Endocrinology
  • Psychocardiology
  • Psychoneuroimmunology

Background:

  • Type-D personality and depression are linked to adverse outcomes in acute coronary syndrome (ACS) patients.
  • The hypothalamic-pituitary-adrenocortical (HPA) axis may mediate the relationship between psychological distress and cardiac events.
  • Understanding cortisol patterns in ACS survivors with Type-D personality is crucial for predicting clinical outcomes.

Purpose of the Study:

  • To investigate salivary cortisol output in patients recently admitted for ACS.
  • To examine the association between Type-D personality, depressive symptoms, and HPA axis function (specifically cortisol awakening response [CAR]).
  • To determine if Type-D personality influences cortisol patterns independently of other clinical factors.

Main Methods:

  • Salivary cortisol was measured eight times over 24 hours in 72 ACS patients within 5 days of admission.
  • Depressive symptoms were assessed using the Beck Depression Inventory (BDI).
  • Type-D personality was measured using the Type-D Scale-16, with a focus on the cortisol awakening response (CAR).

Main Results:

  • Cortisol exhibited a typical diurnal pattern, with an average CAR of 7.58 nmol/l.
  • Cortisol levels and CAR were not significantly related to ACS severity or BDI scores.
  • Type-D personality was positively associated with CAR, independent of age, gender, and body mass, accounting for 7.9% of CAR variance.

Conclusions:

  • Type-D personality may be associated with disrupted HPA axis function in acute cardiac event survivors.
  • Altered HPA axis function in Type-D individuals could contribute to heightened inflammatory responses.
  • These findings suggest a potential pathway linking Type-D personality to increased future cardiac morbidity.
Abstract

More Related Videos

Eye Tracking, Cortisol, and a Sleep vs. Wake Consolidation Delay: Combining Methods to Uncover an Interactive Effect of Sleep and Cortisol on Memory08:08

Eye Tracking, Cortisol, and a Sleep vs. Wake Consolidation Delay: Combining Methods to Uncover an Interactive Effect of Sleep and Cortisol on Memory

Published on: June 18, 2014

Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder09:55

Use of a Psychophysiological Script-driven Imagery Experiment to Study Trauma-related Dissociation in Borderline Personality Disorder

Published on: March 8, 2018

Related Concept Videos

Introduction to Stress and Lifestyle01:27

Introduction to Stress and Lifestyle

Stress is a multifaceted response to events perceived as challenging or threatening, highlighting physical, emotional, cognitive, and behavioral reactions. Physically, stress can lead to fatigue, sleep disruptions, and various health issues such as frequent colds, chest pains, and nausea. Emotionally, it can manifest as anxiety, depression, irritability, and anger triggered by both minor and major life events. Cognitively, it may result in difficulty in concentration, memory, and...
Psychoneuroimmunology: Cardiovascular Disease01:27

Psychoneuroimmunology: Cardiovascular Disease

Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...
Hypothalamic-Pituitary Axis01:37

Hypothalamic-Pituitary Axis

The response to stress—be it physical or psychological, acute or chronic—involves activation of the Hypothalamic-Pituitary-Adrenal (HPA) axis. The HPA axis is part of the neuroendocrine system because it involves both neuronal and hormonal communication. Its function is to regulate homeostatic systems—metabolic, cardiovascular, and immune—providing the necessary means to respond to a stressor.
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
Cushing Syndrome II: Pathophysiology01:19

Cushing Syndrome II: Pathophysiology

Cortisol production is normally governed by the hypothalamic–pituitary–adrenal (HPA) axis, which maintains hormonal balance through tightly regulated feedback mechanisms. Disruption of this regulatory system is central to the development of Cushing syndrome, whether the excess cortisol originates from external medications or internal pathology. Persistent cortisol elevation alters metabolism, immune function, and endocrine signaling, producing the characteristic clinical features of the...