Type D Personality as a Risk Factor for Adverse Outcome in Patients With Cardiovascular Disease: An Individual
Paul Lodder1, Jelte M Wicherts, Marijn Antens
1From the Department of Methodology and Statistics (Lodder, Wicherts), and Center of Research on Psychology in Somatic diseases (CoRPS) (Lodder, Antens, Kupper), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands;Department of Psychosomatics and Psychotherapy (Albus), University of Cologne, Medical Faculty and University Hospital, Cologne, Germany; Tyumen Cardiology Research Center (Bessonov, Pushkarev), Tomsk National Research Medical Center, Russian Academy of Science, Tyumen, Russia; Uppsala University, Centre for Clinical Research (Condén), Hospital of Västmanland, Västmanland, Sweden; Intensive Care Unit, Department of Pediatrics and Pediatric Surgery (Dulfer), Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Psychology (Gostoli, Rafanelli), University of Bologna, Bologna, Italy; Brandenburgische Technische Universität Cottbus-Senftenberg (Grande), Cottbus, Germany; Department of Clinical Physiology and Centre for Clinical Research (Hedberg), Uppsala University, Västmanland County Hospital, Västerås, Sweden; Department of Psychosomatic Medicine and Psychotherapy (Herrmann-Lingen, Meyer), University of Göttingen Medical Center and German Center for Cardiovascular Research (DZHK), partner site Göttingen, Germany; Department of Health, Medicine and Caring Sciences (Jaarsma), Linköping University, Linköping, Sweden; Graduate Institute of Long-term Care (Koo), Tzu Chi University of Science and Technology, Hualien City, Hualien, Taiwan;Dalla Lana School of Public Health (Koo), University of Toronto, Toronto, Ontario, Canada;College of Nursing of Harbin Medical University (P. Lin), The Second Affiliated Hospital of Harbin Medical University, Harbin, China; Division of Cardiology, Department of Internal Medicine (T.-K. Lin), Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi; School of Medicine, Tzu Chi University (T.-K. Lin), Hualien City, Hualien, Taiwan; Laboratory of Comorbidity in Cardiovascular Diseases (Raykh, Sumin), Federal State Budgetary Scientific Institution "Research Institute for Complex Issues of Cardiovascular Diseases", Moscow, Russian Federation; Institute of Cardiology (Schaan de Quadros, Schmidt), University Foundation of Cardiology, Porto Alegre, Rio Grande do Sul, Brazil; Research Institute of Child Development and Education (Utens), Amsterdam UMC/ Level, Amsterdam; Department of Cardiology, University of Groningen (van Veldhuisen), University Medical Center Groningen, Groningen, the Netherlands; and Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University (Wang), Harbin, China.
Objective:
Type D personality, a joint tendency toward negative affectivity and social inhibition, has been linked to adverse events in patients with heart disease, although with inconsistent findings. Here, we apply an individual patient-data meta-analysis to data from 19 prospective cohort studies ( N = 11,151) to investigate the prediction of adverse outcomes by type D personality in patients with acquired cardiovascular disease.
Method:
For each outcome (all-cause mortality, cardiac mortality, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, major adverse cardiac event, any adverse event), we estimated type D's prognostic influence and the moderation by age, sex, and disease type.
Results:
In patients with cardiovascular disease, evidence for a type D effect in terms of the Bayes factor (BF) was strong for major adverse cardiac event (BF = 42.5; odds ratio [OR] = 1.14) and any adverse event (BF = 129.4; OR = 1.15). Evidence for the null hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03), cardiac mortality (BF = 23.7; OR = 0.99), and myocardial infarction (BF = 16.9; OR = 1.12), suggesting that type D had no effect on these outcomes. This evidence was similar in the subset of patients with coronary artery disease (CAD), but inconclusive for patients with heart failure (HF). Positive effects were found for negative affectivity on cardiac and all-cause mortality, with the latter being more pronounced in male than female patients.
Conclusion:
Across 19 prospective cohort studies, type D predicts adverse events in patients with CAD, whereas evidence in patients with HF was inconclusive. In both patients with CAD and HF, we found evidence for a null effect of type D on cardiac and all-cause mortality.
Related Concept Videos
01:27Psychoneuroimmunology: Cardiovascular Disease
A key area of focus in PNI is the relationship between stress and coronary...
01:30Coronary Artery Disease I: Introduction
01:23Stress Prevention and Stress Management Techniques II
Type A Personality: Driven and Easily Stressed
Individuals with Type A personalities are often highly competitive and ambitious and operate with a strong sense of urgency. Commonly labeled as...
01:29Personality Theory by Eysenck and Eysenck
In the extroversion/introversion dimension, highly extroverted people are sociable, outgoing, and easily connect with others. In contrast,...
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:25Borderline Personality Disorder
Genetic and Environmental Contributions
Borderline Personality...