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Sumin AN, Shcheglova AV. Pathogenetic Mechanisms Underlying Major Adverse Cardiac Events in Personality Type D Patients after Percutaneous Coronary Intervention: The Roles of Cognitive Appraisal and Coping Strategies. Diagnostics (Basel) 2023; 13:3374. [PMID: 37958270 PMCID: PMC10648350 DOI: 10.3390/diagnostics13213374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND This paper aimed to study the association of type D personality, coping strategies, and cognitive appraisal with annual prognosis after a percutaneous coronary intervention (PCI) in patients with coronary artery disease (CAD). METHODS The prospective study included 111 CAD patients who underwent a PCI. All participants, before the PCI, completed questionnaires designed to collect information about type D personality, cognitive appraisal, and coping styles. Information was also collected on the clinical and demographic characteristics of the patients. After 1 year of follow-up, the presence of major adverse cardiac events (MACEs) was assessed. RESULTS The presence of a MACE was noted in 38 patients, and the absence of a MACE was noted in 53 patients. In patients with type D personality, higher incidences of MACEs (54.1% versus 33.3%; p = 0.0489) and hospitalization rates (29.7% versus 7.4%; p = 0.004) were revealed. Patients with poor prognoses preferred a moderate use of the confrontation strategy than patients without a MACE (78.4% vs. 50.9%; p = 0.0082). Patients with MACEs had statistically significantly lower indicators of strong emotions (11.92 ± 5.32 versus 14.62 ± 4.83 points; p = 0.005) and future prospects (11.36 ± 3.81 versus 13.21 ± 3.41 points; p = 0.015) than patients without a MACE. In a multiple binary logistic regression model, the following factors had significant associations with MACE development: type D, moderate use of confrontation coping, moderate use of self-control coping, and strong emotions in cognitive appraisal. CONCLUSION This study showed that not only personality type D, but also certain coping strategies and cognitive appraisals increase the likelihood of developing a MACE after a PCI. This provides a theoretical basis for understanding the mechanism underlying type D personality and MACEs in patients after a PCI.
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Affiliation(s)
- Alexey N. Sumin
- Laboratory of Comorbidity in Cardiovascular Diseases, Department of Clinical Cardiology, Research Institute of Complex Problems of Cardiovascular Diseases, 6, Sosnovy Blvd., 650002 Kemerovo, Russia;
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Yin S, Li N, Wang Y. Prognostic value of Type D personality for post-stroke depression in ischemic stroke patients. J Affect Disord 2023; 333:172-176. [PMID: 37086794 DOI: 10.1016/j.jad.2023.04.064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Depression in patients with stroke has been a risk factor for adverse outcomes. Type D personality as a significant predictor of negative psychological status. However, the relationship with post-stroke depression (PSD) is still unclear. METHODS A prospective observational study of 533 patients with first-ever ischemic stroke was conducted between November 2020 and March 2021. Type D personality was assessed at baseline. The presence of depression was measured 3-month after discharge. RESULTS During 3-month follow-up, a total of 141 patients developed PSD. On multivariate logistic analysis, the main effect of negative affectivity (OR = 1.28, 95%CI = 1.03-1.61, p = 0.030) and social inhibition (OR = 1.25, 95%CI = 1.01-1.54, p = 0.039) showed significant correlation with PSD when Type D analyzed as continuous variables. Furthermore, positive effects were found for the negative affectivity and social inhibition interaction (OR = 1.31, 95 % CI =1.11-1.55, p = 0.001) on PSD. CONCLUSIONS Our findings suggest that Type D personality is high risk group of PSD. These findings highlight the importance of personalized interventions management in Type D individuals.
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Affiliation(s)
- Shi Yin
- Department of neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Na Li
- Office of administration of the Public Health Institute of Harbin Medical University, Harbin, China
| | - Yini Wang
- Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
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Torgersen KS, Sverre ECB, Weedon-Fekjær H, Andreassen OA, Munkhaugen J, Dammen T. Risk of recurrent cardiovascular events in coronary artery disease patients with Type D personality. Front Psychol 2023; 14:1119146. [PMID: 37057178 PMCID: PMC10088369 DOI: 10.3389/fpsyg.2023.1119146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
IntroductionData on the association between Type D personality, its traits negative affectivity (NA) and social inhibition (SI), and risk of major adverse cardiac events (MACE) in coronary outpatients is sparse. Furthermore, the associations between Type D subgroups and cardiovascular risk factors are largely unknown.MethodsWe investigated i) Type D personality, NA and SI and risk of recurrent MACE, and ii) the relationship between Type D subgroups and risk factors in a coronary population. This prospective cohort study included 1083 patients` median 16 months after a myocardial infarction and/or a revascularization procedure who were followed-up for 4.2 (SD 0.4) years. Type D personality was assessed by DS14. Anxiety and depression, statin adherence, and risk factors were assessed by patients’ self-report and a clinical examination with blood samples. MACE, defined as cardiovascular death, myocardial infarction, revascularization, stroke or heart failure, were obtained from hospital records from index event to end of study lasting 5.7 years. Data were analyzed by Cox proportional hazard regression.ResultsIn all, 352 MACE occurred in 230 patients after average 4.2 years follow-up. Higher NA score was associated with MACE after adjustment for age, risk factors and comorbidity (HR 1.02 per unit increase, 95% CI 1.00-1.05), whereas we found a weaker, not statistically significant estimated effect of higher SI score. After additional adjustment for symptoms of anxiety and depression, we found a weaker, not statistically significant association between NA and MACE (HR 1.01 per unit increase, 95% CI 0.98-1.05). Low statin adherence and smoking were more prevalent in the Type D and high NA group.DiscussionOur results indicate that the NA trait is related to worse prognosis in outpatients with coronary artery disease.
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Affiliation(s)
- Kristin Stensland Torgersen
- Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elise Christine Bjørkholen Sverre
- Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Drammen Hospital, Drammen, Norway
| | - Harald Weedon-Fekjær
- Oslo Center for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Ole A Andreassen
- NORMENT: Norwegian Centre for Mental Disorders Research, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - John Munkhaugen
- Department of Behavioural Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Medicine, Drammen Hospital, Drammen, Norway
| | - Toril Dammen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Section of Psychiatric Treatment Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Wang X, Ding L, Fu S, Zhang Q. Cognitive Appraisal, Dispositional Coping, and Posttraumatic Growth among Patient-Caregiver Dyads Undergoing Hemodialysis. West J Nurs Res 2023; 45:528-538. [PMID: 36744635 DOI: 10.1177/01939459231151387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The present study aims to investigate the mediating effect of dispositional coping on the relationship between cognitive appraisal (which includes areas of threat, challenge, harm/loss, and benign/irrelevant appraisals) and posttraumatic growth (PTG) among patient-caregiver dyads undergoing hemodialysis. In total, 237 dyads of patients undergoing hemodialysis and their family caregivers were recruited from a tertiary hospital in Tianjin, China. Dyadic data were analyzed using the Actor-Partner Interdependence Mediation Model (APIMeM). The final APIMeM model examining dyadic effects of challenge appraisal and dispositional coping on PTG demonstrated an excellent model fit. The challenge appraisal of family caregivers was directly associated with the PTG of patients undergoing hemodialysis. Dispositional coping mediated the pathways between challenge appraisal and PTG for both patients undergoing hemodialysis and family caregivers. By exploring the cognitive appraisal and dispositional coping of patient-caregiver dyads undergoing hemodialysis may help both partners foster PTG.
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Affiliation(s)
- Xiaoxu Wang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Lan Ding
- Tianjin Medical University General Hospital, Tianjin, China
| | - Shenghui Fu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Qing Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
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Type D Personality as a Risk Factor for Adverse Outcome in Patients With Cardiovascular Disease: An Individual Patient-Data Meta-analysis. Psychosom Med 2023; 85:188-202. [PMID: 36640440 DOI: 10.1097/psy.0000000000001164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
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.
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Sumin AN, Prokashko IY, Shcheglova AV. Coping Strategies In Young Healthy Individuals With Type D Personality. RUSSIAN OPEN MEDICAL JOURNAL 2022. [DOI: 10.15275/rusomj.2022.0408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective — To study the choice of coping strategies and coping intensity in healthy individuals with type D personality. Material and methods — The study included 98 students of Kemerovo State Medical University (KemSMU), 68 women and 30 men (their mean age was 19.1±2.0 years). All subjects filled out psychological questionnaires to identify type D personality (DS-14) and the choice of coping strategies (Ways of Coping Questionnaire (WCQ) and Coping Strategy Indicator (CSI)). Results — The participants were divided into a group with type D personality (n=44) and without it (n=54). Individuals with type D personality had higher scores on the Escape-Avoidance (p<0.001), Accepting Responsibility (p=0.009) and Distancing (p=0.05) scales of the WSQ questionnaire, and Avoidance strategy scale of the CSI questionnaire (p=0.007). Students with type D personality were characterized by a pronounced preference for the Escape-Avoidance strategy (p=0.000018). An increase of 1 point in the values on the Escape-Avoidance scale improved the chance of identifying type D personality by 1.15 times (p<0.001). An increase in scores on the Positive Reappraisal scale reduced the likelihood of identifying type D personality (OR 0.98; p=0.005). The Escape-Avoidance coping strategy was rather strongly associated with type D personality (AUC=0.779). Conclusion — In healthy young people with type D personality, inadequate coping strategies were notably prevalent: the Escape-Avoidance strategy identified by WCQ, and the Avoidance strategy marked by the CSI. The Escape-Avoidance strategy was independently associated with type D personality, and the Positive Reappraisal strategy was associated with the non-D type.
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Affiliation(s)
- Aleksei N. Sumin
- esearch Institute for Complex Issues of Cardiovascular Disease, Kemerovo, Russia
| | | | - Anna V. Shcheglova
- Research Institute for Complex Issues of Cardiovascular Disease, Kemerovo, Russia
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The negative affectivity dimension of Type D personality associated with increased risk for acute ischemic stroke and white matter hyperintensity. J Psychosom Res 2022; 160:110973. [PMID: 35749831 DOI: 10.1016/j.jpsychores.2022.110973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 05/24/2022] [Accepted: 06/13/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study was conducted to examine the relationship among type D personality, acute ischemic stroke (AIS), and white matter hyperintensity (WMH). METHODS In a cross-sectional study conducted between September 2020 and June 2021, 235 patients aged 50-85 years with first-ever ischemic cerebrovascular disease, including 146 males and 89 females, were enrolled. All participants underwent the Type D Scale-14 test containing negative affectivity (NA) and social inhibition (SI) subscales. Clinical and laboratory data were also collected for analysis. The patients were divided into the AIS group (n = 148) and the transient ischemic attack (TIA) group (n = 87) according to whether there was an acute lesion. RESULTS Patients with type D personality had a higher frequency of AIS and LAA and a higher level of WMH. Multiple logistic regression showed that the NA score was related to a 1.11-fold increase in the odds of AIS (95% CI: 1.03-1.19). Neither NA nor SI showed a clear association with a higher frequency of LAA. Higher scores of NA (OR = 1.07, 95% CI: 1.01-1.15), SI (OR = 1.11, 95% CI: 1.03-1.19), and the interaction between the two dimensions (OR = 1.03, 95% CI: 1.01-1.05) were independently associated with an increased load of WMH. CONCLUSION Type D personality was related to AIS and WMH. In particular, it was NA, not SI, affected the occurrence of AIS. Our findings may provide new insights regarding behavioral vulnerability for the development of cerebrovascular disorders.
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Sumin AN, Prokashko IY, Shcheglova AV. Evaluation of Coping Strategies among Students with Type D Personality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084918. [PMID: 35457785 PMCID: PMC9029841 DOI: 10.3390/ijerph19084918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 04/15/2022] [Accepted: 04/16/2022] [Indexed: 12/04/2022]
Abstract
Objective: Personality type D may be associated with a predisposition to develop stress under external adverse influences, for example, in the COVID-19 pandemic. Likewise, type D personality is associated with higher burnout levels; thus, it may contribute to the development of diseases symptoms. The current study was designed to examine the coping strategies in young healthy persons with personality type D. Methods: The study included 98 medical students, with 30 being males. The participants completed questionnaires to identify personality type D (DS-14) and the coping strategies. Depending on the results of the DS-14 questionnaire, four subgroups were distinguished with different levels of points on the NA and SI subscales. Results: For persons with type D personality, the escape–avoidance strategy was used more often, the accepting responsibility and self-controlling strategies were less common compared with non-type-D individuals. When type D was adjusted for the NA and SI subscales, the correlation remained only with escape–avoidance strategy. We did not find a synergistic effect of the NA and SI subscales in regard to coping. Conclusions: This study demonstrated a link between personality type D and maladaptive coping strategies. The predominance of the maladaptive coping strategy in type D is a possible point of application for psychosocial training in such individuals that requires further research.
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Affiliation(s)
- Alexey N. Sumin
- Laboratory of Comorbidity in Cardiovascular Deseases, Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovy Blvd., 6, 650002 Kemerovo, Russia;
- Correspondence: ; Tel.: +7-(3842)-64-44-61 or +7-903940-8668
| | - Ingrid Yu. Prokashko
- Federal State-Funded Educational Institution of Higher Education “Kemerovo State Medical University”, Voroshilova Str., 22a, 650029 Kemerovo, Russia;
| | - Anna V. Shcheglova
- Laboratory of Comorbidity in Cardiovascular Deseases, Federal State Budgetary Scientific Institution “Research Institute for Complex Issues of Cardiovascular Disease”, Sosnovy Blvd., 6, 650002 Kemerovo, Russia;
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Yang W, Hou Y, Chen Y, Liu W, Fang F, Xiao J, Wang J. Personality Characteristics and Emotional Distress Among Chinese Pregnant Women: A Moderated Mediation Model. Front Psychiatry 2021; 12:645391. [PMID: 34867496 PMCID: PMC8636932 DOI: 10.3389/fpsyt.2021.645391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 10/15/2021] [Indexed: 11/13/2022] Open
Abstract
Previous studies have suggested that certain personality characteristics are associated with emotional distress during pregnancy. However, the underlying mechanism of this association is rarely understood. The current study investigated the links between personality and pregnant women's emotional distress (depressive and anxiety symptoms), tested the chain mediating effects of two resilience factors-social support and positive coping, and explored whether socioeconomic status (SES) could moderate the effects (including direct and/or indirect effects) of personality on their emotional distress. Results of a relatively large sample of pregnant women in China (N = 1157) showed positive associations for psychoticism and neuroticism with depressive and anxiety symptoms as well as negative associations for extraversion with depression and anxiety. After controlling for four important variables (the first pregnancy or not, having adverse pregnancy experience or not, being pregnant as planned or not, and number of weeks of pregnancy), social support and positive coping acted as chain mediators on the associations of personality with depressive symptoms as well as of personality with anxiety. Overall, the association of personality and depressive symptoms demonstrated invariance across socioeconomic status (SES). However, SES moderated the relationship between personality and anxiety. Specifically, the negative association of positive coping with anxiety symptoms was weaker for low SES women than for high SES ones. Results highlight the importance of social support and positive coping to decrease personality-related depressive and anxiety symptom among pregnant women. Furthermore, identifying other resilience factors that alleviate anxiety in women with low SES is urgently called for.
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Affiliation(s)
| | | | - Yu Chen
- School of Nursing, Southern Medical University, Guangzhou, China
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