Type D personality

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Type D personality, a concept used in the field of medical psychology, is defined as the joint tendency towards negative affectivity (e.g. worry, irritability, gloom) and social inhibition (e.g. reticence and a lack of self-assurance).[1] The letter D stands for "distressed".[2]


Individuals with a Type D personality have the tendency to experience increased negative emotions across time and situations and tend not to share these emotions with others, because of fear of rejection or disapproval. Johan Denollet, professor of Medical Psychology at Tilburg University, Tilburg, The Netherlands, developed the construct based on clinical observations in cardiac patients, empirical evidence, and existing theories of personality.[3] The prevalence of Type D personality is 21% in the general population[4] and ranges between 18% to 53% in cardiac patients.[2]

Some early studies found that coronary artery disease (CAD) patients with a Type D personality have a worse prognosis following a myocardial infarction (MI) as compared to patients without a Type D personality. In some of these studies, Type D was associated with a 4-fold increased risk of mortality, recurrent MI, or sudden cardiac death, independently of traditional risk factors, such as disease severity.[1][5][6] However, a number of subsequent, larger scale studies have failed to replicate these findings.[7][8][9][10] Consequently, some researchers have argued that these earlier, small (and therefore potentially statistically underpowered) studies that appeared to link Type D personality to mortality in CHD and CVD patients may have inadvertently reached exaggerated or false conclusions.[11]


Type D personality can be assessed by means of a valid and reliable 14-item questionnaire, the Type D Scale (DS14).[4] Seven items refer to negative affectivity, and seven items refer to social inhibition. People who score 10 points or more on both dimensions are classified as Type D. The DS14 can be applied in clinical practice for the risk stratification of cardiac patients.[citation needed]

Type D has also been addressed with respect to common somatic complaints in childhood.[12]

See also[edit]


  1. ^ a b Denollet, J., Sys, S. U., Stroobant, N., Rombouts, H., Gillebert, T. C., & Brutsaert, D. L. (February 1996). "Personality as independent predictor of long-term mortality in patients with coronary heart disease". Lancet. 347 (8999): 417–21. doi:10.1016/S0140-6736(96)90007-0. PMID 8618481.
  2. ^ a b Pedersen, S. S., & Denollet, J. (2006). "Is Type D Personality Here to Stay? Emerging Evidence Across Cardiovascular Disease Patient Groups" (PDF). Current Cardiology Reviews. 2 (3): 205. doi:10.2174/157340306778019441. Archived from the original (PDF) on 2010-06-15.
  3. ^ Author unknown (date unknown). Center of Research on Psychology in Somatic diseases. Tilburg University. Retrieved from http://www.tilburguniversity.nl/corps/.
  4. ^ a b Denollet, J. (2005). "DS14: standard assessment of negative affectivity, social inhibition, and Type D personality". Psychosomatic Medicine. 67 (1): 89–97. doi:10.1097/01.psy.0000149256.81953.49. PMID 15673629.
  5. ^ Denollet, J., & Brutsaert, D. L. (January 1998). "Personality, disease severity, and the risk of long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction". Circulation. 97 (2): 167–73. doi:10.1161/01.cir.97.2.167. PMID 9445169.
  6. ^ Denollet, J., Vaes, J., & Brutsaert, D. L. (August 2000). "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. 102 (6): 630–5. doi:10.1161/01.cir.102.6.630. PMID 10931802.
  7. ^ Grande, G; Romppel, M; Vesper, JM; Schubmann, R; Glaesmer, H; Herrmann-Lingen, C (September 2011). "Type D personality and all-cause mortality in cardiac patients--data from a German cohort study". Psychosomatic medicine. 73 (7): 548–56. doi:10.1097/psy.0b013e318227a9bc. PMID 21862827.
  8. ^ Coyne, JC; Jaarsma, T; Luttik, ML; van Sonderen, E; van Veldhuisen, DJ; Sanderman, R (September 2011). "Lack of prognostic value of type D personality for mortality in a large sample of heart failure patients". Psychosomatic medicine. 73 (7): 557–62. doi:10.1097/psy.0b013e318227ac75. PMID 21862826.
  9. ^ Pelle, AJ; Pedersen, SS; Schiffer, AA; Szabó, B; Widdershoven, JW; Denollet, J (March 2010). "Psychological distress and mortality in systolic heart failure". Circulation: Heart Failure. 3 (2): 261–7. doi:10.1161/circheartfailure.109.871483. PMID 20071656.
  10. ^ Meyer, T; Hussein, S; Lange, HW; Herrmann-Lingen, C (October 2014). "Type D personality is unrelated to major adverse cardiovascular events in patients with coronary artery disease treated by intracoronary stenting". Annals of Behavioral Medicine. 48 (2): 156–62. doi:10.1007/s12160-014-9590-2. PMID 24481867.
  11. ^ Coyne, J.C., & de Voogd, J.N. (December 2012). "Are we witnessing the decline effect in the Type D personality literature? What can be learned?" (PDF). Journal of Psychosomatic Research. 73 (6): 401–07. doi:10.1016/j.jpsychores.2012.09.016. PMID 23148805.
  12. ^ Jellesma, F. C. (April 2008). "Health in young people: social inhibition and negative affect and their relationship with self-reported somatic complaints". Journal of Developmental and Behavioral Pediatrics : JDBP. 29 (2): 94–100. doi:10.1097/DBP.0b013e31815f24e1. PMID 18285719.

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