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Główka AK, Kowalówka M, Burchardt P, Komosa A, Kruszyna Ł, Andrusiewicz M, Przysławski J, Karaźniewicz-Łada M. Selected Psychosocial Factors, Nutritional Behavior, and the Analysis of Concentrations of Selected Vitamins in Patients with Cardiovascular Diseases. Nutrients 2024; 16:1866. [PMID: 38931221 PMCID: PMC11206887 DOI: 10.3390/nu16121866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 06/11/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Cardiovascular diseases (CVD) are the leading cause of death worldwide, influenced by the interaction of factors, including age, sex, genetic conditions, overweight/obesity, hypertension, an abnormal lipid profile, vitamin deficiencies, diabetes, and psychological factors. This study aimed to assess the relationships between psychosocial and nutritional factors in a group of 61 patients with CVD (i.e., atherosclerosis, hypertension, ischemic heart disease, and myocardial infarction) and their possible impact on the course of the disease. The plasma concentrations of vitamins A, E, D, and β-carotene were determined using validated HPLC-MS/MS, while the lipid profile was analyzed enzymatically. Psychosocial factors and nutritional behaviors were assessed using author-designed questionnaires. Over 50% of patients had 25-OH-D3 and retinol deficiencies, while >85% of patients exhibited significant deficiencies in α-tocopherol and β-carotene. The lipid profile showed no specific relationship with any particular CVD. Dietary behavior minimally impacted biochemical parameters except for higher β-carotene concentrations in the group with higher fruit and vegetable intake. The negative impact of the CVD on selected parameters of quality of life was noticed. To increase the effectiveness of the prevention and treatment of CVD, the need for interdisciplinary cooperation observed between doctors, psychologists, and specialists in human nutrition seems to be justified.
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Affiliation(s)
- Anna Krystyna Główka
- Department of Bromatology, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (M.K.); (J.P.)
| | - Magdalena Kowalówka
- Department of Bromatology, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (M.K.); (J.P.)
| | - Paweł Burchardt
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznań, Poland; (P.B.); (A.K.)
- Department of Cardiology, Józef Struś Hospital, 61-285 Poznań, Poland
| | - Anna Komosa
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, 61-848 Poznań, Poland; (P.B.); (A.K.)
| | - Łukasz Kruszyna
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, 61-848 Poznań, Poland;
| | - Mirosław Andrusiewicz
- Department of Cell Biology, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
| | - Juliusz Przysławski
- Department of Bromatology, Poznan University of Medical Sciences, 60-806 Poznań, Poland; (M.K.); (J.P.)
| | - Marta Karaźniewicz-Łada
- Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, 60-806 Poznań, Poland;
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Ronat L, Rönnlund M, Adolfsson R, Hanganu A, Pudas S. Revised Temperament and Character Inventory factors predict neuropsychiatric symptoms and aging-related cognitive decline across 25 years. Front Aging Neurosci 2024; 16:1335336. [PMID: 38450380 PMCID: PMC10915205 DOI: 10.3389/fnagi.2024.1335336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/29/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Personality traits and neuropsychiatric symptoms such as neuroticism and depression share genetic overlap and have both been identified as risks factors for development of aging-related neurocognitive decline and Alzheimer's disease (AD). This study aimed to examine revised personality factors derived from the Temperament and Character Inventory, previously shown to be associated with psychiatric disorders, as predictors of neuropsychiatric, cognitive, and brain trajectories of participants from a population-based aging study. Methods Mixed-effect linear regression analyses were conducted on data for the full sample (Nmax = 1,286), and a healthy subsample not converting to AD-dementia during 25-year follow-up (Nmax = 1,145), complemented with Cox proportional regression models to determine risk factors for conversion to clinical AD. Results Two personality factors, Closeness to Experience (CE: avoidance of new stimuli, high anxiety, pessimistic anticipation, low reward seeking) and Tendence to Liabilities (TL: inability to change, low autonomy, unaware of the value of their existence) were associated with higher levels of depressive symptoms, stress (CE), sleep disturbance (TL), as well as greater decline in memory, vocabulary and verbal fluency in the full sample. Higher CE was additionally associated with greater memory decline across 25 years in the healthy subsample, and faster right hippocampal volume reduction across 8 years in a neuroimaging subsample (N = 216). Most, but not all, personality-cognition associations persisted after controlling for diabetes, hypertension and cardiovascular disease. Concerning risks for conversion to AD, higher age, and APOE-ε4, but none of the personality measures, were significant predictors. Conclusion The results indicate that personality traits associated with psychiatric symptoms predict accelerated age-related neurocognitive declines even in the absence of neurodegenerative disease. The attenuation of some personality effects on cognition after adjustment for health indicators suggests that those effects may be partly mediated by somatic health. Taken together, the results further emphasize the importance of personality traits in neurocognitive aging and underscore the need for an integrative (biopsychosocial) perspective of normal and pathological age-related cognitive decline.
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Affiliation(s)
- Lucas Ronat
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Neuroimaging of Emotions Lab, Montreal, QC, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
- Department of Medical and Translational Biology, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
| | | | - Rolf Adolfsson
- Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - Alexandru Hanganu
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Neuroimaging of Emotions Lab, Montreal, QC, Canada
- Department of Psychology, Faculty of Arts and Sciences, University of Montreal, Montreal, QC, Canada
| | - Sara Pudas
- Department of Medical and Translational Biology, Umeå University, Umeå, Sweden
- Umeå Center for Functional Brain Imaging, Umeå University, Umeå, Sweden
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O'Riordan A, Howard S, Keogh TM, Gallagher S. Type D personality is associated with lower cardiovascular reactivity to stress in women. Psychol Health 2023; 38:1515-1535. [PMID: 35007443 DOI: 10.1080/08870446.2021.2025239] [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: 08/23/2021] [Revised: 11/16/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This study examines if Type D personality is (1) associated with cardiovascular reactivity to acute stress in a healthy sample, and (2) has predictive utility for cardiovascular reactivity above its individual subcomponents (negative affect; NA, social inhibition; SI), as well as anxiety and depression. DESIGN Undergraduate students (n = 173) competed a standardised cardiovascular reactivity experimental protocol consisting of resting baseline and stressor phase (mental arithmetic), with systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) monitored throughout. MAIN OUTCOME MEASURES The main outcome measures were cardiovascular reactivity to the stressor, which was operationalised as the difference between resting baseline and the stressor phase for SBP, DBP and HR. RESULTS The continuous Type D interaction term (NA × SI) significantly predicted lower SBP reactivity to the mental arithmetic stressor amongst women, independent of NA, SI and confounding variables. Moreover, this remained significant after adjustment for anxiety and depressive symptoms. Depression, NA and SI were also significant independent predictors of SBP reactivity amongst women. CONCLUSION Type D personality is associated with lower SBP reactivity to acute stress in women, which may be indicative of blunted cardiovascular reactivity. This association was independent of NA, SI, Anxiety and Depression.
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Affiliation(s)
- Adam O'Riordan
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Siobhán Howard
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Tracey M Keogh
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Barakou I, Hackett KL, Finch T, Hettinga FJ. Self-regulation of effort for a better health-related quality of life: a multidimensional activity pacing model for chronic pain and fatigue management. Ann Med 2023; 55:2270688. [PMID: 37871249 PMCID: PMC10595396 DOI: 10.1080/07853890.2023.2270688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
PURPOSE To propose a comprehensive multidimensional model of activity pacing that improves health-related quality of life and promotes sustained physical activity engagement among adults with chronic conditions. MATERIALS AND METHODS A narrative review was conducted to examine the existing literature on activity pacing, health-related quality of life, pain and fatigue management, and physical activity promotion in chronic conditions. RESULTS The literature revealed a lack of a cohesive approach towards a multidimensional model for using activity pacing to improve health-related quality of life. A comprehensive multidimensional model of activity pacing was proposed, emphasizing the importance of considering all aspects of pacing for sustained physical activity engagement and improved health-related quality of life. The model incorporates elements such as rest breaks, self-regulatory skills, environmental factors, and effective coping strategies for depression/anxiety. It takes into account physical, psychological, and environmental factors, all of which contribute significantly to the enhancement of health-related quality of life, physical function, and overall well-being, reflecting a holistic approach. CONCLUSIONS The model offers guidance to researchers and clinicians in effectively educating patients on activity pacing acquisition and in developing effective interventions to enhance physical activity engagement and health outcomes among adults with chronic conditions. Additionally, it serves as a tool towards facilitating discussions on sustained physical activity and a healthy lifestyle for patients, which can eventually lead to improved quality of life.
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Affiliation(s)
- Ioulia Barakou
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
| | - Katie L. Hackett
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
- CRESTA Fatigue Clinic, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Tracy Finch
- Department of Nursing, Midwifery & Health, Northumbria University, Newcastle upon Tyne, UK
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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] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
Introduction Data 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. Methods We 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. Results In 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. Discussion Our 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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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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Allen MT, Shields MM, Myers CE. Distressed (Type D) personality is predicted by avoidance: evidence from a computer-based avatar task. PeerJ 2022; 10:e14302. [PMID: 36320564 PMCID: PMC9618263 DOI: 10.7717/peerj.14302] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/05/2022] [Indexed: 01/24/2023] Open
Abstract
Background One personality type associated with poor health outcomes is distressed (Type D) personality which involves high levels of both social inhibition (SI) and negative affectivity (NA). Type D is also linked to psychopathologies such as post-traumatic stress disorder (PTSD), anxiety disorders, and depression. One mechanism through which personality temperament may result in these psychopathologies is avoidance. Recently, a computer-based measure designed to assess avoidant behaviors, in which the participant guides the behavior of an avatar interacting with strangers in social situations, has been found to be related to various forms of avoidance. In the current study, we extended this work with the avatar avoidance task to determine its relationship to distressed (Type D) personality. We hypothesized that Type D personality, along with SI, but not NA, would be positively related to avatar avoidance scores. We also hypothesized that avatar avoidance scores would be higher in Type D individuals than non-Type D individuals. Methods A total of 302 undergraduates completed the Distressed Type D Personality Scale (DS-14), and a computer-based avatar avoidance task. Results Type D and SI, and NA to a lesser degree, were positively correlated with avoidance scores on the avatar task. Furthermore, regression analyses revealed that Type D and SI scores were best predicted by a model including avoidance scores and education level while NA scores were best predicted by a model including avoidance scores. Standard cut-off scores on the DS-14 scale resulted in four groups (i.e., low SI and NA, high SI, high NA, and Type D) which significantly differed in avoidance scores. Specifically, Type D individuals had higher avoidance scores than the other three groups. Taken together these findings support a role for avoidance in Type D personality. The computer-based avatar avoidance task may be particularly relevant as an ecologically valid measure to identify avoidance in a virtual setting for use with individuals expressing Type D personality who may be unwilling or unable to accurately self-report or describe their own avoidant tendencies.
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Affiliation(s)
- M. Todd Allen
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Michelle M. Shields
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, USA
| | - Catherine E. Myers
- Department of Pharmacology, Physiology & Neuroscience, Rutgers University—New Jersey Medical School, Newark, NJ, USA,Department of Veterans Affairs, VA Medical Center, East Orange, NJ, USA
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Wojciechowska I, Matkowski R, Pawłowski T. Type D Personality and Big Five Personality Traits and the Risk of Breast Cancer: A Case-Control Study. Front Psychiatry 2022; 13:723795. [PMID: 35273526 PMCID: PMC8902144 DOI: 10.3389/fpsyt.2022.723795] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The goal of this study is to establish the differences in Type D personality and Big five personality traits between a group of newly diagnosed breast cancer patients and a group of controls. METHODS A comparative study of breast cancer patients and women without previous history of cancer was carried out. We used Type D Scale-14 as an instrument for the assessment of the type-D personality pattern and NEO-FFI for the assessment of the Big Five personality traits. Conditional logistic regression models were used to estimate odds ratios and 95% confidence intervals were applied for breast cancer by personality trait factors. RESULTS Negative affectivity (NA) (OR = 4.45 95% CI: 1.96-10.61), neuroticism HIGH (OR = 3.97, 95% CI: 1.08-15.81), openness to experience HIGH (OR = 3.47 95% CI: 1.11-11.49), were associated factors significantly related to an increased risk of breast cancer, whereas Social Inhibition (SI) was associated factor with a decreased risk of breast cancer (OR = 0.40 95% CI: 0.16-0.92). CONCLUSIONS This was the first case-control study which analyzed NA and SI traits in breast cancer patients. SI as a breast-cancer risk decreasing factor might indicate that expressing negative emotions is not always a healthy mechanism of their regulation.
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Affiliation(s)
- Irena Wojciechowska
- Division of Psychotherapy and Psychosomatic Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - Rafał Matkowski
- Wroclaw Comprehensive Cancer Center, Wroclaw, Poland.,Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Pawłowski
- Division of Psychotherapy and Psychosomatic Medicine, Wroclaw Medical University, Wroclaw, Poland
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GÜRBÜZ M, GENİŞ B, KARAYTUĞ MO, COŞAR B. Bir psikiyatri kliniğinde Psikosomatik Araştırmalar için Tanı Ölçütleri (DCPR) ve D tipi kişiliğin değerlendirilmesi. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.840219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Durosini I, Mazzocco K, Triberti S, Russo GA, Pravettoni G. Personality Traits and Cardiotoxicity Arising From Cancer Treatments: An Hypothesized Relationship. Front Psychol 2021; 12:546636. [PMID: 34025489 PMCID: PMC8132872 DOI: 10.3389/fpsyg.2021.546636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 04/12/2021] [Indexed: 12/04/2022] Open
Abstract
Thanks to the evolution in medical and pharmaceutical research, to date, the number of cancer treatments is increasingly on the rise. Despite this, several side effects related to cancer treatments can exacerbate patients’ physical and psychological conditions, such as cardiotoxicity. Over the years, researchers have explored the possible relationship between psychological variables and physical diseases. Even though some authors examined the relationship between personality and specific diseases, no scientific attention has been paid to the role of personality in the development of cardiotoxicity arising from cancer treatments. Yet this is an important objective, given that determining whether personality influences cardiac toxicity of anticancer treatments could inform the processes by which stable psychological factors influence health. This contribution summarizes and analyzes the available scientific evidence about the association between personality and main cardiotoxicity-related-diseases of anticancer therapies, including cancer and cardiovascular diseases, in order to sketch a hypothetical model of the relationship between personality traits and cardiotoxicity.
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Affiliation(s)
- Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ketti Mazzocco
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Stefano Triberti
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | | | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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Alpsoy E, Polat M, Yavuz IH, Kartal P, Didar Balci D, Karadag AS, Bilgic A, Arca E, Karaman BF, Emre S, Adisen E, Sendur N, Bilgic O, Cordan Yazici A, Yalcin B, Koca R, Gunduz K, Borlu M, Ergun T, Dursun P, Bilgili SG, Surer Adanir A, Gulekon A, Yagcioglu G, Yilmaz E, Kavuzlu U, Senol Y. Internalized Stigma in Pediatric Psoriasis: A Comparative Multicenter Study. Ann Dermatol 2020; 32:181-188. [PMID: 33911736 PMCID: PMC7992623 DOI: 10.5021/ad.2020.32.3.181] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/30/2019] [Accepted: 12/13/2019] [Indexed: 11/08/2022] Open
Abstract
Background Internalized stigma, adoption of negative attitudes and stereotypes of the society regarding persons' illness, has not been studied previously in pediatric psoriasis patients. Objective We aimed to investigate the internalized stigma in pediatric psoriasis patients and to determine differences according to factors affecting internalized stigma compared to adult psoriasis patients. Methods This multicenter, cross-sectional, comparative study included 125 pediatric (55 female, 70 male; mean age±standard deviation [SD], 14.59±2.87 years) and 1,235 adult psoriasis patients (577 female, 658 male; mean age±SD, 43.3±13.7 years). Psoriasis Internalized Stigma Scale (PISS), Dermatology Life Quality Index (DLQI), Perceived Health Status (PHS), and the General Health Questionnaire (GHQ)-12 were the scales used in the study. Results The mean PISS was 58.48±14.9 in pediatric group. When PISS subscales of groups were compared, the pediatric group had significantly higher stigma resistance (p=0.01) whereas adult group had higher scores of alienation (p=0.01) and stereotype endorsement (p=0.04). There was a strong correlation between mean values of PISS and DLQI (r=0.423, p=0.001). High internalized stigma scores had no relation to either the severity or localization of disease in pediatric group. However, poor PHS (p=0.007) and low-income levels (p=0.03) in both groups, and body mass index (r=0.181, p=0.04) in the pediatric group were related to high PISS scores. Conclusion Internalized stigma in pediatric patients is as high as adults and is related to poor quality of life, general health, and psychological illnesses. Unlike adults, internalized stigma was mainly determined by psoriasis per se, rather than disease severity or involvement of visible body parts, genitalia or folds.
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Affiliation(s)
- Erkan Alpsoy
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Mualla Polat
- Department of Dermatology and Venereology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey
| | - Ibrahim Halil Yavuz
- Department of Dermatology and Venereology, Van Yuzuncu Yil University School of Medicine, Van, Turkey
| | - Pelin Kartal
- Department of Dermatology and Venereology, University of Health Sciences Ankara Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey
| | - Didem Didar Balci
- Department of Dermatology and Venereology, Izmir Tepecik Education and Research Hospital, Izmir, Turkey
| | - Ayse Serap Karadag
- Department of Dermatology and Venereology, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey
| | - Asli Bilgic
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ercan Arca
- Department of Dermatology and Venereology, Guven Hospital, Ankara, Turkey
| | | | - Selma Emre
- Department of Dermatology and Venereology, Yildirim Beyazit University Ankara Atatürk Education and Research Hospital, Ankara, Turkey
| | - Esra Adisen
- Department of Dermatology and Venereology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Neslihan Sendur
- Department of Dermatology and Venereology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ozlem Bilgic
- Department of Dermatology and Venereology, Selcuk University School of Medicine, Konya, Turkey
| | - Ayca Cordan Yazici
- Department of Dermatology and Venereology, Mersin University School of Medicine, Mersin, Turkey
| | - Basak Yalcin
- Department of Dermatology and Venereology, Ankara Numune Training and Research Hospital, Ankara, Turkey
| | - Rafet Koca
- Department of Dermatology and Venereology, Bulent Ecevit University School of Medicine, Zonguldak, Turkey
| | - Kamer Gunduz
- Department of Dermatology and Venereology, Celal Bayar University School of Medicine, Manisa, Turkey
| | - Murat Borlu
- Department of Dermatology and Venereology, Erciyes University School of Medicine, Kayseri, Turkey
| | - Tulin Ergun
- Department of Dermatology and Venereology, Marmara University School of Medicine, Istanbul, Turkey
| | - Pinar Dursun
- Department of Dermatology and Venereology, Mersin State Hospital, Mersin, Turkey
| | - Serap Gunes Bilgili
- Department of Dermatology and Venereology, Van Yuzuncu Yil University School of Medicine, Van, Turkey
| | - Asli Surer Adanir
- Department of Child and Adolescent Psychiatry, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ayla Gulekon
- Department of Dermatology and Venereology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Gizem Yagcioglu
- Department of Dermatology and Venereology, Adnan Menderes University School of Medicine, Aydın, Turkey
| | - Ertan Yilmaz
- Department of Dermatology and Venereology, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ufuk Kavuzlu
- Department of Dermatology and Venereology, Mersin University School of Medicine, Mersin, Turkey
| | - Yesim Senol
- Department of Medical Education, Akdeniz University School of Medicine, Antalya, Turkey
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12
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O'Riordan A, Howard S, Gallagher S. Type D personality and life event stress: the mediating effects of social support and negative social relationships. ANXIETY STRESS AND COPING 2020; 33:452-465. [PMID: 32223435 DOI: 10.1080/10615806.2020.1746284] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background and Objective: Type D personality has been associated with increased perceptions of stress. As Type D individuals have been noted to report lower social support and greater perceptions of negativity in social interactions, this study examined if the association between Type D personality and life events stress was mediated by these social relationships. Design: A cross-sectional design. Methods: Undergraduate students (N = 197) completed questionnaires assessing Type D personality, social support, negative social relationships, and life events stress. Results: Unadjusted analyses revealed that Type D individuals perceived their life events to be significantly more stressful than non-Type D individuals. Type D individuals also reported increased perceptions of negative social relationships and lower social support. Finally, the association between Type D personality and life events stress was mediated by perceptions of negative social relationships. However, when controlling for the main effects of negative affectivity and social inhibition, Type D was not significantly associated with social relationship or life events variables. Further, effects appeared to be primarily driven by negative affectivity. Conclusion: These results support recent findings in the Type D literature that have identified null effects of Type D when controlling for negative affectivity.
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Affiliation(s)
- Adam O'Riordan
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Siobhán Howard
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Department of Psychology, Centre for Social Issues Research, Study of Anxiety, Stress and Health Laboratory, University of Limerick, Limerick, Ireland.,Health Research Institute, University of Limerick, Limerick, Ireland
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13
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Kim JM, Stewart R, Kim SY, Kim JW, Kang HJ, Lee JY, Kim SW, Shin IS, Kim MC, Hong YJ, Ahn Y, Jeong MH, Yoon JS. Interaction between BDNF val66met polymorphism and personality on long-term cardiac outcomes in patients with acute coronary syndrome. PLoS One 2019; 14:e0226802. [PMID: 31887219 PMCID: PMC6936775 DOI: 10.1371/journal.pone.0226802] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Accepted: 11/25/2019] [Indexed: 12/12/2022] Open
Abstract
Background The prognostic role of BDNF val66met polymorphism on long-term cardiac outcomes in acute coronary syndrome (ACS) has been unclear. Environmental factors may modify the association, but these have not been investigated to date. This study aimed to investigate the potential interactive effects of BDNF val66met polymorphism and personality traits, one of the main environmental prognostic factors of ACS, on major adverse cardiac events (MACEs) in patients with ACS. Methods A total of 611 patients with recent ACS were recruited at a university hospital in Korea. Baseline evaluations from 2007 to 2012 assessed BDNF val66met polymorphism and personality using the Big Five Inventory, which yielded two personality clusters (resilient and vulnerable) and five dimensions (extraversion, agreeableness, conscientiousness, neuroticism, and openness). Over a 5~12 year follow-up after the index ACS, times to MACE were investigated using Cox regression models after adjustment for a range of covariates. Results The BDNF val66met polymorphism modified the associations between vulnerable personality type and worse long-term cardiac outcomes in ACS patients with significant interaction terms, in that the associations were statistically significant in the presence met allele. Similar findings were observed for the individual personality dimensions of agreeableness and neuroticism. Conclusions Gene (BDNF val66met polymorphism) x environment (personality traits) interactions on long-term cardiac outcomes were found in ACS.
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Affiliation(s)
- Jae-Min Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- * E-mail:
| | - Robert Stewart
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom, and South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Seon-Young Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Wan Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Hee-Ju Kang
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Ju-Yeon Lee
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Sung-Wan Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Il-Seon Shin
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Min Chul Kim
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Chonnam National University Medical School, Gwangju, Korea
| | - Jin-Sang Yoon
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
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14
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Ezzati D, Mashinchi Abbasi N, Namdar H, Khezerlou Aghdam N, Hashemi Nosrat-abad T, Shiri A, Sadeghi B, Salehi M. The Relationship between Sleep Quality and Happiness in Men with Coronary Artery Disease. INTERNATIONAL JOURNAL OF CARDIOVASCULAR PRACTICE 2019. [DOI: 10.29252/ijcp-28143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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15
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Bouwens E, van Lier F, Rouwet EV, Verhagen HJM, Stolker RJ, Hoeks SE. Type D Personality and Health-Related Quality of Life in Vascular Surgery Patients. Int J Behav Med 2019; 26:343-351. [PMID: 31264102 PMCID: PMC6652784 DOI: 10.1007/s12529-018-09762-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study evaluated the association of type D personality and health-related quality of life (HRQoL) and assessed the stability of type D personality in vascular surgery patients during the year after surgery. METHOD In a prospective cohort study between 2008 and 2014, 294 patients were assessed with validated questionnaires preoperatively and at 1, 6, and 12 months after surgery. Associations between type D personality, depression, and HRQoL were analyzed by generalized estimating equation models. Type D personality was analyzed in its standard dichotomous form as well as continuous (z) scores of its two components, negative affectivity (NA) and social inhibition (SI), and their interaction term. RESULTS Prevalence of type D personality varied between 18% and 25%. However, only 9% of the complete responders were classified as type D personality at all four assessments, whereas one third changed between type D classifications. Continuous scores showed greater stability over time. Dichotomized type D personality measured over time was significantly associated with impaired HRQoL, but this was not the case if measured once at baseline, like in general use. The continuous NA score and depression were also significantly associated with impaired HRQoL over time. CONCLUSION Type D personality was not a stable trait over time. Preoperative assessment of type D personality did not predict improvement in HRQoL after vascular surgery. However, the study revealed associations between the NA component of type D personality, depression, and lower HRQoL. This indicates that measures of overall negative affect should be taken into account when assessing HRQoL patient-reported outcomes in vascular surgery patients.
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Affiliation(s)
- Elke Bouwens
- Department of Anesthesiology, Erasmus MC University Medical Center Rotterdam, Erasmus MC, NA-1718, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
| | - Felix van Lier
- Department of Anesthesiology, Erasmus MC University Medical Center Rotterdam, Erasmus MC, NA-1718, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
| | - Ellen V Rouwet
- Department of Vascular Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Hence J M Verhagen
- Department of Vascular Surgery, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Robert Jan Stolker
- Department of Anesthesiology, Erasmus MC University Medical Center Rotterdam, Erasmus MC, NA-1718, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands
| | - Sanne E Hoeks
- Department of Anesthesiology, Erasmus MC University Medical Center Rotterdam, Erasmus MC, NA-1718, P.O. Box 2040, 3000 CA, Rotterdam, Netherlands.
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16
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Williams L, Ashford-Smith S, Cobban L, Fitzsimmons R, Sukhatme V, Hunter SC. The dyadic effects of Type D personality on health in romantic couples. Psychol Health 2019; 35:811-823. [PMID: 31637928 DOI: 10.1080/08870446.2019.1679371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: An individual's own personality traits are powerful predictors of their health outcomes (actor effects). However, the effect of personality on health may also occur at an interpersonal level, whereby the personalities of people close to the individual also affect his or her health outcomes (partner effects). Our objective was to examine the actor and partner effects of Type D personality on health in romantic couples for the first time.Design: Cross-sectional questionnaire-based study (N = 364), consisting of 182 romantic couples from the general population (mean age = 35.7 years).Main outcome measures: Each participant completed self-report measures of Type D personality (DS14), health behaviours (GPHB), mood (DASS-21) and quality of life (WHOQOL-BREF).Results: Data were analysed using the Actor-Partner Interdependence Model (APIM). The APIM showed no actor or partner effects of the overall Type D construct. However, there were actor effects of negative affect for both males and females on depression and quality of life, a male actor effect of social inhibition on quality of life, and a female partner effect of social inhibition on depression.Conclusions: These findings suggest that there are both actor and partner effects of the Type D components on some health outcomes.
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Affiliation(s)
- Lynn Williams
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Sarah Ashford-Smith
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Laura Cobban
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Rebecca Fitzsimmons
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Vedika Sukhatme
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK
| | - Simon C Hunter
- School of Psychological Sciences & Health, University of Strathclyde, Glasgow, UK.,Faculty of Education, University of Western Australia, Crawley, WA, Australia
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17
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Social Context and Sex Moderate the Association Between Type D Personality and Cardiovascular Reactivity. Appl Psychophysiol Biofeedback 2019; 44:321-330. [DOI: 10.1007/s10484-019-09447-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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Piña IL, Di Palo KE, Ventura HO. Psychopharmacology and Cardiovascular Disease. J Am Coll Cardiol 2019; 71:2346-2359. [PMID: 29773162 DOI: 10.1016/j.jacc.2018.03.458] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 03/07/2018] [Accepted: 03/09/2018] [Indexed: 11/25/2022]
Abstract
This review discusses common mental health disorders and their associations with cardiovascular disease risks. Commonly found mental health disorders include depression, anxiety, and personality types. The link between depression and cardiovascular disease mortality has been established. Depression is also common in patients with heart failure. In addition to discussing psychological disorders, a review of psychotropic drugs is also included. Drugs are described for therapy for depression and anxiety, as well as associations with cardiovascular drug-drug interactions. Drug-drug interactions are more common and potentially dangerous in elderly patients, in whom the conditions often coexist. The most common drug-drug interactions involve the P450 system of enzymes.
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Affiliation(s)
- Ileana L Piña
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York.
| | - Katherine E Di Palo
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
| | - Hector O Ventura
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, New Orleans, Louisiana; The University of Queensland School of Medicine, St. Lucia, Queensland, Australia
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19
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Association between Type D personality and outcomes in patients with non-ischemic heart failure. Qual Life Res 2019; 28:2901-2908. [DOI: 10.1007/s11136-019-02241-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2019] [Indexed: 10/26/2022]
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20
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Kato T, Mizutani S, Umezaki Y, Sugiyama S, Naito T. Relationship between Type D personality and dropout from dental treatment in middle-aged adults. J Oral Sci 2019; 61:264-269. [PMID: 31217375 DOI: 10.2334/josnusd.18-0068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Type D personality-the tendency toward combined negative affectivity and social inhibition-is a risk factor for coronary heart disease. Although Type D personality has been linked to low adherence to diabetic care, it is unclear whether it is related to adherence to dental therapy. Thus, study examined the relationship between Type D personality and withdrawal from dental therapy. A web-based questionnaire was used to compare a treatment dropout group (n = 225) and maintenance group(n = 236). The questionnaire was designed to assess Type D personality traits, reasons for dropout, and respondent sociodemographic characteristics and attitudes. There were no significant differences in the sociodemographic characteristics of the two groups. However, the proportion of respondents with a Type D personality was significantly larger in the dropout group than in the maintenance group (P = 0.04). The most common reasons for dental therapy dropout were "improvement of symptoms" (46.2%) and "busy with business or study" (30.7%). The most frequent attitude reported in the dropout group was negative feelings toward dental practice. In conclusion, Type D personality might be related to dropout from dental therapy.
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Affiliation(s)
- Tomotaka Kato
- Department of Oral Health Science, School of Dentistry, University of Washington.,Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College
| | - Shinsuke Mizutani
- Section of Geriatric Dentistry and Perioperative Medicine in Dentistry, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University.,OBT Research Center, Faculty of Dental Science, Kyushu University
| | - Yojiro Umezaki
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College
| | | | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College
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21
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Marzorati C, Monzani D, Mazzocco K, Pavan F, Cozzi G, De Cobelli O, Monturano M, Pravettoni G. Predicting trajectories of recovery in prostate cancer patients undergone Robot-Assisted Radical Prostatectomy (RARP). PLoS One 2019; 14:e0214682. [PMID: 30946773 PMCID: PMC6448842 DOI: 10.1371/journal.pone.0214682] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/18/2019] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To identify trends of patients' urinary and sexual dysfunctions from a clinical and psychological perspective and understand whether sociodemographic and medical predictors could differentiate among patients following different one-year longitudinal trajectories. METHODS An Italian sample of 478 prostate cancer patients undergone Robot-Assisted Radical Prostatectomy completed the EPIC-26 survey between July 2015 and July 2016 at the pre-hospitalization (T0), 45 days (T1) and 3 (T2), 6 (T3), 9 (T4), and 12 months (T5) after surgery. Sociodemographic and clinical characteristics (age, BMI, diabetes, nerve-sparing procedure) were also collected. Latent Class Growth Analysis was conducted separately for sexual dysfunction and urinary incontinence EPIC-26 subscales. The association between membership in the two longitudinal trajectories of urinary and sexual dysfunctions was assessed by considering Chi-square test and its related contingency table. RESULTS People who have a high level of urinary incontinence at T1 are likely to have a worse recovery. Age, BMI and pre-surgical continence may affect the level of incontinence at T1 and the recovery trajectories. Patients with low and moderate sexual problems at T1 can face a moderate linear recovery, while people with high level of impotence immediately after surgery may take a longer period to solve sexual dysfunctions. Age and the pre-surgical sexual condition may impact the recovery. Finally, a great proportion of patients reported both steady problems in sexual function and constant high levels of urinary incontinence over time. CONCLUSIONS This study highlights different categories of patients at risk who may be important to know in order to develop personalized medical pathways and predictive models in a value-based healthcare.
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Affiliation(s)
- Chiara Marzorati
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesca Pavan
- Patient Safety & Risk Management Service, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriele Cozzi
- Division of Urology, European Institute of Oncology IRCCS, Milan, Italy
| | - Ottavio De Cobelli
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Division of Urology, European Institute of Oncology IRCCS, Milan, Italy
| | - Massimo Monturano
- Patient Safety & Risk Management Service, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, European Institute of Oncology IRCCS, Milan, Italy
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22
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Symptom severity and quality of life in patients with atrial fibrillation: Psychological function outweighs clinical predictors. Int J Cardiol 2019; 279:84-89. [DOI: 10.1016/j.ijcard.2018.10.101] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/14/2018] [Accepted: 10/29/2018] [Indexed: 11/21/2022]
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23
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de Vroege L, de Heer EW, van der Thiel E, van den Broek KC, van Eck van der Sluijs JF, van der Feltz-Cornelis CM. Type D Personality, Concomitant Depressive and Anxiety Disorders, and Treatment Outcomes in Somatic Symptom and Related Disorders: An Observational Longitudinal Cohort Study. Front Psychiatry 2019; 10:417. [PMID: 31316400 PMCID: PMC6611395 DOI: 10.3389/fpsyt.2019.00417] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/24/2019] [Indexed: 11/13/2022] Open
Abstract
Objective: To establish the prevalence of Type D personality in patients with somatic symptoms and related disorders and to evaluate the association of Type D personality with treatment outcomes. This study explores the effect of Type D personality and its two traits, negative affectivity (NA) and social inhibition (SI). Methods: In this longitudinal observational cohort study, we assessed the prevalence of Type D in 212 patients presenting themselves at a clinic in Tilburg, the Netherlands. We explored psychological and physical treatment outcomes of a multimodal treatment tailored to patient needs in relation to Type D scores. We explored the differences with regard to physical symptoms, anxiety, and depression. We also explored the differences between patients with and without Type D personality who completed treatment with regard to the baseline scores of physical symptoms, anxiety, and depression. We explored the association between Type D personality and treatment outcome using the traditional dichotomous method and the dimensional method (with main effects of NA and SI, and the interaction of NA × SI). Results: Of the 212 patients with Somatic Symptom and Related Disorders (SSRD), those with Type D personality (181: 61.8%) had experienced significantly higher levels of depression [t = 4.404, p < .001] and anxiety [t = 3.757, p < .001]. Of the 212, 187 patients completed treatment. Mean scores improved significantly for the whole patient group after treatment with regard to depression (p < .001), anxiety (p < .001), and physical symptoms (p < .001). At baseline, patients with Type D personality had significantly higher scores in anxiety [F = 15.707, p < .001] and depression [F = 19.392] than patients without Type D personality who completed treatment. After controlling for the high baseline scores with regard to physical symptoms, anxiety, or depression, only the effect of Type D personality on remission of anxiety was significant (OR = .33, p = 0.39). Neither NA and SI nor the interaction of NA × SI was associated with the treatment outcome. Conclusions: This study shows that Type D personality occurs frequently in patients with SSRD. Type D personality only decreases the probability of remission of anxiety as a treatment outcome, and both NA and SI play a role in this. Type D personality did not decrease remission either of physical symptoms or of depression. Hence, both NA and SI factors may be expressions of anxiety mostly in type D.
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Affiliation(s)
- Lars de Vroege
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands
| | - Eric W de Heer
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands
| | - Eva van der Thiel
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands
| | - Krista C van den Broek
- Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands
| | - Jonna F van Eck van der Sluijs
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands
| | - Christina M van der Feltz-Cornelis
- Department Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands.,Clinical Centre of Excellence for Body, Mind and Health, GGz Breburg, Tilburg, Netherlands.,MHARG, Department of Health Sciences, Hull York Medical School, University of York, York, United Kingdom
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24
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Impacts of Type D Personality and Depression, Alone and in Combination, on Medication Non-Adherence Following Percutaneous Coronary Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102226. [PMID: 30314347 PMCID: PMC6209952 DOI: 10.3390/ijerph15102226] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 09/29/2018] [Accepted: 09/29/2018] [Indexed: 12/14/2022]
Abstract
Background: Medication adherence after percutaneous coronary intervention (PCI) is essential to preventing the risk of restenosis. Even though Type D personality and depression have been known to affect medication non-adherence, their combined influence on PCI patients remains unclear. Aim: We aimed to identify how both Type D personality and depression were associated with medication non-adherence for 3 months after successful PCI. Methods: This prospective cohort study included 257 PCI patients, who took 3 or more cardiac medications, at a university hospital. We measured sociodemographic and clinical variables, Type D personality, depression, and medication non-adherence using face-to-face interviews and medical record reviews. Results: The total prevalence of medication non-adherence at the one- and three-month follow-ups was 14% and 16%, respectively. At one month, the prevalence of those with a combination of Type D personality and depression (23.4%) and depression alone (24%) was significantly higher than other groups. At three months, the prevalence of the Type D personality-only group (39.1%) was the highest. Type D personality increased the risk of medication non-adherence 5.089 times at three months, while depression increased it 2.6 times at one month. However, the risk of medication non-adherence was not increased in patients with combined Type D personality and depression. Conclusions: Individual assessments of Type D personality and depression are required. Therefore, psychological interventions focusing on personality and depression are crucial. Longitudinal follow-up studies must explore the interaction or individual impact of Type D personality and depression on medication non-adherence and other negative outcomes.
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25
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Leu HB, Yin WH, Tseng WK, Wu YW, Lin TH, Yeh HI, Cheng Chang K, Wang JH, Wu CC, Chen JW. Impact of type D personality on clinical outcomes in Asian patients with stable coronary artery disease. J Formos Med Assoc 2018; 118:721-729. [PMID: 30243505 DOI: 10.1016/j.jfma.2018.08.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 08/16/2018] [Accepted: 08/24/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Some personality types are associated with cardiovascular (CV) diseases and may be related to clinical outcomes in coronary artery disease (CAD). This study investigates the association between type D personality and clinical outcomes in stable CAD patients in an Asian cohort. METHODS Stable CAD patients were enrolled and prospectively followed up for at least 1 year in Taiwan. The inclusion criteria were at least one successful percutaneous coronary intervention (PCI) and stable medical treatment for at least 1 month before enrollment. Vulnerability to psychological distress was measured by the Type D Personality Scale (DS14) after enrollment. The end point was the occurrence of total CV events. Cox regression models of CV events were used to investigate the role of type D personality in clinical outcomes. RESULTS The study included 777 patients, among which 122 (15.77%) had type D personality. Forty-two CV events were identified: 3 cardiac deaths, 5 nonfatal myocardial infarctions, 1 stroke, 4 congestive heart failures (CHF), 6 peripheral arterial occlusive disorder cases, and 23 readmissions for angina/revascularization treatment. Patients with type D personality had significantly higher incidence of future CV events (9.84% vs. 4.58%, p = 0.018%) and admission for angina/revascularization (5.74% vs. 2.44%, p = 0.049). Patients with subsequent CV events were more likely to have type D personality (28.57% vs. 14.97%, p=0.018). After proportional Cox regression analysis, type D personality remained an independent predictor of future CV events (HR: 3.21, 95% CI: 1.06-9.69). In subgroup analyses, type D personality was especially associated with higher risk of total CV events among females, the elderly, hypertension patients, diabetes patients, and non-smokers. CONCLUSION Type D personality was an independent predictor of CV outcomes in an Asian cohort of stable CAD patients. This personality type may be identified in risk stratification for secondary prevention after PCI.
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Affiliation(s)
- Hsin-Bang Leu
- Heath Care and Management Center, Taipei Veterans General Hospital, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
| | - Wei-Hsian Yin
- Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, and School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Kung Tseng
- Department of Medical Imaging and Radiological Sciences, I-Shou University and Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Yen-Wen Wu
- Cardiology Division of Cardiovascular Medical Center and Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Tsung-Hsien Lin
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hung-I Yeh
- Mackay Memorial Hospital, Mackay Medical College, New Taipei City, Taiwan
| | - Kuan- Cheng Chang
- Division of Cardiology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Taiwan Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Ji-Hung Wang
- Department of Cardiology, Buddhist Tzu-Chi General Hospital, Tzu-Chi University, Hualien, Taiwan
| | - Chau-Chung Wu
- Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Department of Primary Care Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jaw-Wen Chen
- Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan; Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan
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26
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Masafi S, Saadat SH, Tehranchi K, Olya R, Heidari M, Malihialzackerini S, Jafari M, Rajabi E. Effect of Stress, Depression and Type D Personality on Immune System in the Incidence of Coronary Artery Disease. Open Access Maced J Med Sci 2018; 6:1533-1544. [PMID: 30159090 PMCID: PMC6108813 DOI: 10.3889/oamjms.2018.217] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/08/2018] [Accepted: 07/18/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND: Psychoneuroimmunology (PNI) is the study of the interaction between psychological processes and the nervous and immune systems of the human body. The impact of psychological factors on the immune system and the role of this system in Coronary Artery Disease (CAD) are confirmed. Coronary Heart Disease (CHD) is arisen due to the failure of blood and oxygen to the heart tissues. AIM: The present study aimed to describe psychoneuroimmunological processes which contribute to CAD and CHD progression. METHOD: Such psychological risk factors like stress, depression and type D personality were investigated here. Psychoneuroimmunological pathways of all three mentioned risk factors were described for CAD. RESULTS: The studies review indicated that stress could be accompanied with myocardial ischemia and help to rupture. The depression involves in the transfer of stable atherosclerotic plaque to unstable, and type D personality is effective in the initial stages of a CAD. CONCLUSION: As more information on cardiovascular immunity becomes available, this will provide a better understanding and thus act as the foundation for the potential development of new treatment strategies for treatment of cardiovascular disorders.
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Affiliation(s)
- Saideh Masafi
- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | - Seyed Hassan Saadat
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Katayoun Tehranchi
- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | - Roohollah Olya
- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | - Mostafa Heidari
- Department of Psychology, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Saied Malihialzackerini
- Department of Psychology, Kish International Branch, Islamic Azad University, Kish Island, Iran
| | - Mahdi Jafari
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ehsan Rajabi
- Shahid Beheshty University of Medical Science, Tehran, Iran
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Allen MT, Handy JD, Blankenship MR, Servatius RJ. The distressed (Type D) personality factor of social inhibition, but not negative affectivity, enhances eyeblink conditioning. Behav Brain Res 2018; 345:93-103. [PMID: 29486267 DOI: 10.1016/j.bbr.2018.02.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/23/2018] [Accepted: 02/23/2018] [Indexed: 11/19/2022]
Abstract
Recent work has focused on a learning diathesis model in which specific personality factors such as behavioral inhibition (BI) may influence associative learning and in turn increase risk for the development of anxiety disorders. We have found in a series of studies that individuals self-reporting high levels of BI exhibit enhanced acquisition of conditioned eyeblinks. In the study reported here, hypotheses were extended to include distressed (Type D) personality which has been found to be related to BI. Type D personality is measured with the DS-14 scale which includes two subscales measuring negative affectivity (NA) and social inhibition (SI). We hypothesized that SI, which is similar to BI, would result in enhanced acquisition while the effect of NA is unclear. Eighty nine participants completed personality inventories including the Adult Measure of Behavioral Inhibition (AMBI) and DS-14. All participants received 60 acquisition trials with a 500 ms, 1000 Hz, tone CS and a co-terminating 50 ms, 5 psi corneal airpuff US. Participants received either 100% CS-US paired trials or a schedule of partial reinforcement where 50% US alone trials were intermixed into CS-US training. Acquisition of CRs did not differ between the two training protocols. Whereas BI was significantly related to Type D, SI, and NA, only BI and SI individuals exhibited enhanced acquisition of conditioned eyeblinks as compared to non-inhibited individuals. Personality factors now including social inhibition can be used to identify individuals who express enhanced associative learning which lends further support to a learning diathesis model of anxiety disorders.
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Affiliation(s)
- M T Allen
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, United States; Rutgers Biomedical Health Sciences, Stress and Motivated Behavior Institute, Rutgers University, Newark, NJ, United States; Central New York Research Corporation, Syracuse, NY, United States.
| | - J D Handy
- Central New York Research Corporation, Syracuse, NY, United States; Department of Veterans Affairs, Syracuse Veterans Affairs Medical Center, Syracuse NY, United States
| | - M R Blankenship
- Department of Psychology, Western Illinois University, Macomb, IL, United States
| | - R J Servatius
- Rutgers Biomedical Health Sciences, Stress and Motivated Behavior Institute, Rutgers University, Newark, NJ, United States; Department of Veterans Affairs, Syracuse Veterans Affairs Medical Center, Syracuse NY, United States; Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, NY, United States
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28
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Imbalzano E, Vatrano M, Quartuccio S, Ceravolo R, Ciconte VA, Rotella P, Pardeo R, Trapani G, De Fazio P, Segura-Garcia C, Costantino R, Saitta A, Mandraffino G. Effect of type D personality on smoking status and their combined impact on outcome after acute myocardial infarction. Clin Cardiol 2018; 41:321-325. [PMID: 29457844 DOI: 10.1002/clc.22865] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 10/23/2017] [Accepted: 11/24/2017] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Smoking cessation is correlated with several psychological, social, biological, and pharmacological aspects. The combined tendency to experience negative emotions and to inhibit the expression of these emotions is indicated as "type D personality," an independent risk marker for clinical outcome in cardiac disease. Despite this effect of type D personality on cardiovascular disease, it is still unclear whether this personality trait may influence smoking cessation after a myocardial infarction. HYPOTHESIS we hypothesized that there is a relationship between type D personality and smoking persistence in acute coronary syndrome patients, and this association may predict a worse long-term prognosis. METHODS The study enrolled 231 patients with ST-segment elevation myocardial infarction, treated with primary percutaneous coronary intervention. Type D scale 14 (ds 14) was administered upon admission to the hospital. RESULTS After controlling for demographic and clinical confounders, non-type D patients reported statistically significant higher frequencies of smoking cessation when compared with the type D group. In addition, the presence of this psychological factor anticipates significantly the onset of smoking during adolescence. Furthermore, current type D smokers had a higher incidence of cardiovascular events during long-term follow-up. CONCLUSIONS Type D personality and smoking status increase the risk of cardiac events. An emotionally stressed personality and persistence of smoking after the first cardiac event, and mostly their mutual influence, indicate a population at high cardiovascular risk.
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Affiliation(s)
- Egidio Imbalzano
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Marco Vatrano
- UTIC and Cardiology, Hospital "Pugliese-Ciaccio", Catanzaro, Italy
| | | | - Roberto Ceravolo
- UTIC and Cardiology, Hospital "Pugliese-Ciaccio", Catanzaro, Italy
| | | | - Paola Rotella
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Renato Pardeo
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Giovanni Trapani
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Pasquale De Fazio
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Cristina Segura-Garcia
- Department of Health Sciences, School of Specialization in Psychiatry, University "Magna Graecia", Catanzaro, Italy
| | - Rossella Costantino
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Antonino Saitta
- Department of Clinical and Experimental Medicine, University of Messina, Italy
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de Moor EL, Denollet J, Laceulle OM. Social inhibition, sense of belonging and vulnerability to internalizing problems. J Affect Disord 2018; 225:207-213. [PMID: 28837955 DOI: 10.1016/j.jad.2017.08.034] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 06/09/2017] [Accepted: 08/12/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND The aim of this study was to provide a conceptual test of how social inhibition, sense of belonging and internalizing problems are related, and whether sense of belonging moderates or mediates the relation between social inhibition and internalizing problems. METHODS Data were used from two waves of the Dutch internet cohort LISS (Longitudinal Internet Studies of the Social Sciences; N = 511, M age = 52.09 years). Social inhibition was measured using the DS14 in 2012, sense of belonging (i.e., feeling cut off and having people to really talk to) was measured with the General Social Exclusion Index in 2012 and internalizing problems with the MHI-5 in 2015. RESULTS Social inhibition was related to a lower sense of belonging and more internalizing problems. A low sense of belonging was related to more internalizing problems. Results indicated no moderation. However, evidence was found for partial mediation. That is, feeling cut off and having people to really talk to explained part of the link between social inhibition and internalizing problems. All analyses were controlled for sex, age and income. LIMITATIONS The items used to measure sense of belonging only cover part of the construct. The study was not fully prospective, as such, no conclusions can be drawn regarding causality. CONCLUSIONS Low sense of belonging is a key factor to consider when aiming at understanding individual differences in internalizing psychopathology related to social inhibition.
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Affiliation(s)
- Elisabeth L de Moor
- Department of Medical & Clinical Psychology, Tilburg University, The Netherlands.
| | - Johan Denollet
- Department of Medical & Clinical Psychology, Tilburg University, The Netherlands
| | - Odilia M Laceulle
- Department of Medical & Clinical Psychology, Tilburg University, The Netherlands; Department of Developmental Psychology, Utrecht University, The Netherlands
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Bekendam MT, Kop WJ, Barzilay S, Widdershoven JW, Aarnoudse W, Denollet J, Mommersteeg PMC. The predictive value of positive affect and Type D personality for adverse cardiovascular clinical outcomes in patients with non-obstructive coronary artery disease. J Psychosom Res 2018; 104:108-114. [PMID: 29275779 DOI: 10.1016/j.jpsychores.2017.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 10/25/2017] [Accepted: 11/05/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with non-obstructive coronary artery disease (NOCAD) continue to experience disabling symptoms. Positive affect (PA) has shown a cardioprotective potential. Type D personality has previously been shown to have a deleterious effect on adverse outcomes in diverse cardiac populations. Little is known about the predictive value of PA and Type D personality for long-term outcomes in NOCAD patients. The aim was to investigate the effect of PA and Type D personality on clinical outcomes. METHODS 547 patients (mean age 61 years±9, 48% male) who underwent a coronary angiography or CT-scan between January 2009 and February 2013 answered questionnaires concerning PA (GMS) and Type D personality (DS14). Cox proportional hazards analyses were performed. RESULTS When analyzed dichotomously, PA was a significant predictor of need for repeat cardiac testing (HR=0.64, 95% CI: 0.41-0.99), but not emergency department (ED) admissions (HR=0.83, 95% CI: 0.52-1.32) after adjustment for age, sex, education, diagnosis by group, BMI and hypertension. Analyzed continuously, the predictive value of PA was non-significant for both repeat testing (HR=0.85, 95% CI: 0.69-1.06) and ED admissions (HR=0.98, 95% CI: 0.77-1.23). Type D personality, both continuously and dichotomously, was not significantly associated with the outcomes. Findings were also examined for men and women separately. CONCLUSION Although Type D personality was not predictive of adverse events in this sample, PA is an interesting and important variable to take into account in NOCAD patients. Research on psychosocial factors in NOCAD patients should consider the importance of choices of endpoint, given the heterogeneity of NOCAD patients.
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Affiliation(s)
- Maria T Bekendam
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Willem J Kop
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Simone Barzilay
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Jos W Widdershoven
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; The Department of Cardiology, TweeSteden Hospital, Tilburg, The Netherlands
| | - Wilbert Aarnoudse
- The Department of Cardiology, TweeSteden Hospital, Tilburg, The Netherlands
| | - Johan Denollet
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Paula M C Mommersteeg
- Center of Research on Psychology in Somatic Diseases (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
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Talaei-Khoei M, Mohamadi A, Fischerauer SF, Ring D, Vranceanu AM. Type D personality in patients with upper extremity musculoskeletal illness: Internal consistency, structural validity and relationship to pain interference. Gen Hosp Psychiatry 2018; 50:38-44. [PMID: 28992609 DOI: 10.1016/j.genhosppsych.2017.09.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 09/01/2017] [Accepted: 09/22/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Type D personality - the joint tendency toward negative affectivity (NA) and social inhibition (SI) - is associated with greater symptom perception and negative health outcomes among various patient populations. We investigated Type D personality among patients with upper extremity musculoskeletal illness. METHOD In cross-sectional design, we estimated the prevalence of Type D personality in this population and explored the associations of two different Type D conceptualizations (i.e., categorical and dimensional as the NA×SI interaction) and the individual NA and SI traits with pain interference as well as structural-internal validity of DS14. RESULTS The categorical Type D personality and greater NA and SI were associated with pain interference above and beyond descriptive variables, but the interaction term between NA and SI was not. NA explained a larger proportion of the variance in pain interference than SI. DS14 showed a two-factor structure and high internal consistency in this sample. CONCLUSIONS The categorical Type D allows for identifying individuals who struggle with recovery from musculoskeletal injury. Although the dimensional conceptualization didn't prove to be associated with pain interference, NA and SI appear to have individual effects on pain interference, with most variance being accounted for by NA. Implications for clinical care are discussed.
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Affiliation(s)
- Mojtaba Talaei-Khoei
- Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Amin Mohamadi
- Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Stefan F Fischerauer
- Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Orthopedics and Traumatology, University Hospital Graz, Medical University of Graz, Graz, Austria
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, TX, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Behavioral Medicine Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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The Association of Type D personality with Heart Rate Variability and Lipid Profiles Among Patients with Coronary Artery Disease. Int J Behav Med 2017; 24:101-109. [PMID: 27229521 DOI: 10.1007/s12529-016-9571-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE Characteristics of the distressed (Type D) personality include negative affectivity (NA) and social inhibition (SI), which are associated with an increased risk of major adverse cardiac events and mortality among patients with coronary artery disease (CAD). The aims of this study were to examine: (1) the correlation of NA and SI with psychological characteristics, heart rate variability (HRV) indices, and lipids profiles and (2) the differences in psychological characteristics, HRV indices, and lipid profiles between patients with CAD with Type D personality and those with non-Type D personality. METHOD A cross-sectional study was conducted on 168 patients with CAD. The Taiwanese 14-item Type D Scale, Chinese Hostility Inventory-Short Form, Beck Depression Inventory-II, Beck Anxiety Inventory, and Anger Rumination Scale were administered to all of the participants. The raw signals of electrocardiograms were recorded over a 5-min baseline resting period and then transformed to HRV indices representing short-term cardiac autonomic activations. Lipid profiles were acquired from patients' medical records. RESULTS NA was positively correlated with hostility, depression, anxiety, and anger rumination. With respect to pathophysiological mechanisms for CAD with Type D personality, NA was negatively correlated with standard deviation of all normal-to-normal intervals (SDNN) and total power of HRV and positively correlated with total cholesterol. SI was positively correlated with suppressive hostility behavior and anger rumination; however, SI was not significantly correlated with expressive hostility behavior, or HRV indices and lipid profiles. CONCLUSION Pathophysiological mechanisms leading to higher rates of adverse outcomes in CAD in individuals with Type D personalities may involve cardiac autonomic imbalance and lipid dysregulation.
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33
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Donisan T, Bojincă VC, Dobrin MA, Bălănescu DV, Predețeanu D, Bojincă M, Berghea F, Opriș D, Groșeanu L, Borangiu A, Constantinescu CL, Ionescu R, Bălănescu AR. The relationship between disease activity, quality of life, and personality types in rheumatoid arthritis and ankylosing spondylitis patients. Clin Rheumatol 2017; 36:1511-1519. [PMID: 28451872 DOI: 10.1007/s10067-017-3654-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 04/07/2017] [Accepted: 04/20/2017] [Indexed: 01/26/2023]
Abstract
We hypothesized that clinical outcomes might be influenced by personality type (A, B, C, D) in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). One hundred ninety-four patients (104 with RA, 90 with AS) participated in a questionnaire study. We evaluated health-related quality of life (HRQoL) using the Medical Outcome Study Short-Form 36 (SF-36), personality type A/B with the Jenkins Activity Survey, type C with the State-Trait Anger Expression Inventory Anger-in Scale, type D with the Type D Personality Scale, and disease activity with Disease Activity Score with 28 joints for RA and Bath Ankylosing Spondylitis Disease Activity Index for AS. We used Pearson's correlation coefficient, independent samples t tests, and multivariate analyses of variance. In the RA group, type D personality was significantly correlated with 7/12 SF-36 components. AS patients with type D personality had deficits in all SF-36 subscales. Type D was related with higher disease activity in RA and AS. Both RA and AS type C patients had more active disease forms and negatively affected HRQoL subscales. In the RA group, type A personality did not correlate with HRQoL, but it positively influenced pain visual analog scale scores. In AS patients, type A personality was linked with higher HRQoL and with less active disease. Type C and type D personality types were correlated with decreased HRQoL and higher disease activity in RA and AS patients. Type A personality was associated with less active disease and higher HRQoL in AS patients and with less pain in RA patients.
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Affiliation(s)
- T Donisan
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - V C Bojincă
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania. .,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania.
| | - M A Dobrin
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania
| | - D V Bălănescu
- "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - D Predețeanu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - M Bojincă
- "Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania.,Department of Internal Medicine and Rheumatology "Dr. I. Cantacuzino" Hospital, 5-7 Ion Movilă Str, Bucharest, Romania
| | - F Berghea
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - D Opriș
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - L Groșeanu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - A Borangiu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - C L Constantinescu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - R Ionescu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
| | - A R Bălănescu
- Department of Internal Medicine and Rheumatology "Sf. Maria" Hospital, 37-39 Ion Mihalache Bd, Bucharest, Romania.,"Carol Davila" University of Medicine and Pharmacy, 37 Dionisie Lupu Str, Bucharest, Romania
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Huang IC, Lee JL, Ketheeswaran P, Jones CM, Revicki DA, Wu AW. Does personality affect health-related quality of life? A systematic review. PLoS One 2017; 12:e0173806. [PMID: 28355244 PMCID: PMC5371329 DOI: 10.1371/journal.pone.0173806] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/27/2017] [Indexed: 11/28/2022] Open
Abstract
Background Health-related quality of life (HRQOL) is increasingly measured as an outcome for clinical and health services research. However, relatively little is known about how non-health factors affect HRQOL. Personality is a potentially important factor, yet evidence regarding the effects of personality on HRQOL measures is unclear. Methods This systematic review examined the relationships among aspects of personality and HRQOL. Eligible studies were identified from Medline and PsycINFO. The review included 76 English-language studies with HRQOL as a primary outcome and that assessed personality from the psychological perspective. Individuals with various health states, including ill (e.g., cancer, cardiovascular disorders), aging, and healthy, were included in this review study. Results Some personality characteristics were consistently related to psychosocial aspects more often than physical aspects of HRQOL. Personality characteristics, especially neuroticism, mastery, optimism, and sense of coherence were most likely to be associated with psychosocial HRQOL. Personality explained varying proportions of variance in different domains of HRQOL. The range of variance explained in psychosocial HRQOL was 0 to 45% and the range of explained variance in physical HRQOL was 0 to 39%. Conclusions Personality characteristics are related to HRQOL. Systematic collection and analysis of personality data alongside HRQOL measures may be helpful in medical research, clinical practice, and health policy evaluation.
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Affiliation(s)
- I-Chan Huang
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
- * E-mail:
| | - Joy L. Lee
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, United States of America
| | - Pavinarmatha Ketheeswaran
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, United States of America
| | - Conor M. Jones
- Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, Tennessee, United States of America
| | - Dennis A. Revicki
- Outcomes Research, Evidera, Bethesda, Maryland, United States of America
| | - Albert W. Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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Condén E, Rosenblad A, Wagner P, Leppert J, Ekselius L, Åslund C. Is type D personality an independent risk factor for recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients? Eur J Prev Cardiol 2017; 24:522-533. [PMID: 28071958 DOI: 10.1177/2047487316687427] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Type D personality refers to a combination of simultaneously high levels of negative affectivity and social inhibition. The present study aimed to examine whether type D personality was independently associated with recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients, using any of the previously proposed methods for measuring type D personality. Design This was a prospective cohort study. Methods Utilising data from the Västmanland Myocardial Infarction Study, 946 post-acute myocardial infarction patients having data on the DS14 instrument used to measure type D personality were followed-up for recurrent myocardial infarction and all-cause mortality until 9 December 2015. Data were analysed using Cox regression, adjusted for established risk factors. Results In total, 133 (14.1%) patients suffered from type D personality. During a mean follow-up time for recurrent myocardial infarction of 5.7 (3.2) years, 166 (17.5%) patients were affected by recurrent myocardial infarction, of which 26 (15.7%) had type D personality, while during a mean follow-up time for all-cause mortality of 6.3 (2.9) years, 321 (33.9%) patients died, of which 42 (13.1%) had type D personality. After adjusting for established risk factors, type D personality was not significantly associated with recurrent myocardial infarction or all-cause mortality using any of the previously proposed methods for measuring type D personality. A weak association was found between the social inhibition part of type D personality and a decreased risk of all-cause mortality, but this association was not significant after taking missing data into account in a multiple imputation analysis. Conclusions No support was found for type D personality being independently associated with recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients, using any of the previously proposed methods for measuring type D personality.
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Affiliation(s)
- Emelie Condén
- 1 Centre for Clinical Research, Uppsala University, Sweden.,2 School of Health, Care and Social Welfare, Malardalen University, Sweden
| | | | | | - Jerzy Leppert
- 1 Centre for Clinical Research, Uppsala University, Sweden
| | - Lisa Ekselius
- 3 Department of Neuroscience, Uppsala University, Sweden
| | - Cecilia Åslund
- 1 Centre for Clinical Research, Uppsala University, Sweden
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Impact of a Type D Personality on Clinical and Psychometric Properties in a Sample of Turkish Patients With a First Myocardial Infarction. J Psychiatr Pract 2017; 23:3-10. [PMID: 28072640 DOI: 10.1097/pra.0000000000000201] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Recent studies have shown that a Type D personality is associated with an increased risk of cardiac mortality. OBJECTIVE This study aimed to examine the impact of a Type D personality on clinical and psychometric properties in a sample of Turkish patients with a first myocardial infarction (MI). METHOD The study included 131 patients who were admitted to the coronary care unit of a hospital. All of the patients underwent a psychiatric assessment within 2 to 6 months after their MI. Psychiatric interviews were conducted using the Structured Clinical Interview for DSM-IV (SCID-I). Patients also completed the Beck Depression Inventory, the Spielberger State-Trait Anxiety Inventory, the Health Anxiety Inventory, and the Type D personality scale. RESULTS The patients were divided into 2 groups on the basis of the presence or absence of Type D personality. There was a 38.2% prevalence of Type D personality in the patients with a first MI. Those with this type of personality had a significantly higher frequency of hypertension and stressful life events. The Type D patients also had more psychiatric disorders, including depressive and anxiety disorders, than the non-Type D patients. CONCLUSIONS Our findings suggest that Type D personality traits may increase the risk of hypertension and the risk of psychiatric morbidity in patients with a first MI. We suggest that this type of personality is a contributor to depression and anxiety disorders. These findings emphasize the importance of screening for Type D personality as both a cardiovascular and psychiatric risk marker in patients who have had an MI.
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Thomas CV, de Castro EK, Antonello ICF. Personality traits and clinical/biochemical course in the first year after kidney transplant. Ren Fail 2016; 38:1383-1390. [PMID: 27686135 DOI: 10.1080/0886022x.2016.1216712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND The relationship between personality and health is frequently studied in scientific research. This study investigated the clinical/biochemical course of kidney transplant patients based on personality traits. METHODS A longitudinal study assessed 114 kidney transplant patients (men = 68 and women = 46) with an average age of 47.72 years (SD = 11.4). Personality was evaluated using the Brazilian Factorial Personality Inventory (BFP/Big Five Model). Clinical variables were analyzed based on patient charts (estimated glomerular filtration rate (eGFR), hypertension, acute rejection, infection, graft loss, and death). Personality types were assessed by hierarchical cluster analysis. RESULTS Two groups with personality types were differentiated by psychological characteristics: Cluster 1 - average neuroticism, high surgency, agreeableness and conscientiousness, and low openness; Cluster 2 - high neuroticism, average surgency and agreeableness, average conscientiousness, and low openness. There was no statistically significant difference between the clusters in terms of hypertension, acute infection, graft loss, death, and Human Leukocyte Antigen (HLA) I and II panel reactive antibodies. eGFR was associated with the personality types. Cluster 2 was associated with a better renal function in the 9-month follow-up period after kidney transplantation. CONCLUSION In this study, patients from Cluster 2 exhibited higher eGFR 9 months after the transplant procedure compared to those from Cluster 1. Monitoring these patients over a longer period may provide a better understanding of the relationship between personality traits and clinical course during the post-transplant period.
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Affiliation(s)
- Caroline Venzon Thomas
- a Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande Do Sul , Porto Alegre , Brazil
| | - Elisa Kern de Castro
- b Graduate Program in Psychology, Vale Do Rio Dos Sinos University , São Leopoldo , Brazil
| | - Ivan Carlos Ferreira Antonello
- c Graduate Program in Medicine and Health Sciences, Pontifical Catholic University of Rio Grande Do Sul , Porto Alegre , Brazil
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Brain resting state functional magnetic resonance imaging in patients with takotsubo cardiomyopathy an inseparable pair of brain and heart. Int J Cardiol 2016; 224:376-381. [PMID: 27673694 DOI: 10.1016/j.ijcard.2016.09.067] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/25/2016] [Accepted: 09/15/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Takotsubo cardiomyopathy (TTC) is often triggered by emotional or physical stress factors. Psychological variables can have an impact on the physical manifestations of heart disease. TTC may reflect stunned myocardium from a neurogenic source. Anatomical connections between different parts of the brain can be visualized by diffusion tensor imaging (DTI) and thus, expressed by diffusion coefficient - fractional anisotropy (FA). A novel tool used to evaluate brain function in the absence of task is resting state functional magnetic resonance imaging (RS-fMRI). METHODS The study included both psychological tests and RS-fMRI examination, and was performed uniformly, in patients with takotsubo and healthy controls. The final group of patients consisted of 13 women, each who underwent a typical pattern of TTC triggered by emotionally stressful factors. The control group included thirteen healthy, age-matched women. RESULTS Psychological tests revealed that the Type D personality was not more likely to appear among studied patients with takotsubo cardiomyopathy than amongst the healthy population. However, the level of anxiety seen in patients with TTC was increased. There were no differences in FA values between patients and healthy controls. RS-fMRI showed that TTC patients had increased connectivity areas in the precuneus. The healthy controls, when compared to TTC patients had increased connectivity in the ventromedial prefrontal cortex. CONCLUSIONS Taking into account the RS-fMRI results, psychological testing may suggest that TTC patients place a greater focus on themselves (increased tendency to experience negative affectivity, greater conscientiousness) and might have problems with emotional control. Our findings lead to the hypothesis that there is a personality profile for TTC patients' reactions to stressful triggers.
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Kupper N, Denollet J. Explaining heterogeneity in the predictive value of Type D personality for cardiac events and mortality. Int J Cardiol 2016; 224:119-124. [PMID: 27648980 DOI: 10.1016/j.ijcard.2016.09.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/02/2016] [Accepted: 09/08/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Type D personality has been associated with adverse outcomes in patients with coronary artery disease (CAD). However, large heterogeneity exists between Type D studies, including some studies reporting null-findings. OBJECTIVES The aim of this study was to examine i) choice of endpoint and ii) age as two study characteristics that may partly explain this large heterogeneity in the Type D associated prognostic effect. METHODS We used four existing data cohorts of 1503 CAD patients (89% male, mean age=57.2±9.1) with baseline measures of Type D and endpoints >5years follow-up: major adverse cardiac events (MACE), cardiac death/MI, and non-cardiac death. Patients were classified in 4 age categories: <50y, 50-59y, 60-69y and ≥70y. Multiple logistic regression models included age, sex, and clinical covariates. RESULTS At follow-up, there were 295 events, including 116 cardiac death/MI, and 37 non-cardiac deaths. Both continuous and categorical measures of Type D predicted adverse events. Type D was independently associated with MACE (OR=1.82; 95%CI 1.33-2.50) and cardiac death/MI (OR=2.49; 95%CI 1.55-3.99). However, Type D was not associated with non-cardiac death (OR=1.23; 95%CI 0.57-2.69). Regarding age, Type D consistently predicted MACE in the lower age groups (all ORs≥2.20, all ps≤.004), but not in patients aged ≥70y (OR=1.43, p=.57). CONCLUSIONS Choice of endpoint and age modulated the risk conferred by Type D personality. Type D was associated with an increased risk of cardiac events, but not with non-cardiac death, or with events in patients aged ≥70y. Research on psychosocial risk in CAD should account for different sources of heterogeneity in study characteristics.
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Affiliation(s)
- Nina Kupper
- CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands.
| | - Johan Denollet
- CoRPS - Center of Research on Psychology in Somatic diseases, Tilburg University, The Netherlands
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Steca P, D’Addario M, Magrin ME, Miglioretti M, Monzani D, Pancani L, Sarini M, Scrignaro M, Vecchio L, Fattirolli F, Giannattasio C, Cesana F, Riccobono SP, Greco A. A Type A and Type D Combined Personality Typology in Essential Hypertension and Acute Coronary Syndrome Patients: Associations with Demographic, Psychological, Clinical, and Lifestyle Indicators. PLoS One 2016; 11:e0161840. [PMID: 27589065 PMCID: PMC5010181 DOI: 10.1371/journal.pone.0161840] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Accepted: 08/12/2016] [Indexed: 01/07/2023] Open
Abstract
Many studies have focused on Type A and Type D personality types in the context of cardiovascular diseases (CVDs), but nothing is known about how these personality types combine to create new profiles. The present study aimed to develop a typology of Type A and Type D personality in two groups of patients affected by and at risk for coronary disease. The study involved 711 patients: 51.6% with acute coronary syndrome, 48.4% with essential hypertension (mean age = 56.4 years; SD = 9.7 years; 70.7% men). Cluster analysis was applied. External variables, such as socio-demographic, psychological, lifestyle, and clinical parameters, were assessed. Six groups, each with its own unique combined personality profile scores, were identified: Type D, Type A-Negatively Affected, Not Type A-Negatively Affected, Socially Inhibited-Positively Affected, Not Socially Inhibited, and Not Type A-Not Type D. The Type A-Negatively Affected cluster and, to a lesser extent, the Type D cluster, displayed the worst profile: namely higher total cardiovascular risk index, physical inactivity, higher anxiety and depression, and lower self-esteem, optimism, and health status. Identifying combined personality profiles is important in clinical research and practice in cardiovascular diseases. Practical implications are discussed.
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Affiliation(s)
- Patrizia Steca
- Department of Psychology, University of Milan “Bicocca”, Milan, Italy
| | - Marco D’Addario
- Department of Psychology, University of Milan “Bicocca”, Milan, Italy
| | | | | | - Dario Monzani
- Department of Psychology, University of Milan “Bicocca”, Milan, Italy
| | - Luca Pancani
- Department of Psychology, University of Milan “Bicocca”, Milan, Italy
| | - Marcello Sarini
- Department of Psychology, University of Milan “Bicocca”, Milan, Italy
| | - Marta Scrignaro
- Department of Psychology, University of Milan “Bicocca”, Milan, Italy
| | - Luca Vecchio
- Department of Psychology, University of Milan “Bicocca”, Milan, Italy
| | - Francesco Fattirolli
- Department of Medical and Surgical Critical Care, Cardiac Rehabilitation Unit, University of Florence and Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Cristina Giannattasio
- Health Science Department, University of Milan “Bicocca”, Milan, Italy
- Cardiology IV, Cardiovascular “A.De Gasperis” Department, Niguarda Ca’ Granda Hospital, Milan, Italy
| | - Francesca Cesana
- Health Science Department, University of Milan “Bicocca”, Milan, Italy
- Cardiology IV, Cardiovascular “A.De Gasperis” Department, Niguarda Ca’ Granda Hospital, Milan, Italy
| | - Salvatore Pio Riccobono
- Cardiology IV, Cardiovascular “A.De Gasperis” Department, Niguarda Ca’ Granda Hospital, Milan, Italy
| | - Andrea Greco
- Department of Psychology, University of Milan “Bicocca”, Milan, Italy
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Type D Personality and Coronary Plaque Vulnerability in Patients With Coronary Artery Disease: An Optical Coherence Tomography Study. Psychosom Med 2016; 78:583-92. [PMID: 26867079 DOI: 10.1097/psy.0000000000000307] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate the association between Type D personality and higher incidence of major adverse cardiac events, we used in vivo optical coherence tomography (OCT) to evaluate the association between Type D with coronary plaque characteristics. METHODS A total of 109 patients who had culprit coronary plaque (s) were included in the study. The Type D construct was analyzed using both the categorized and the continuous approaches. Plaque vulnerability of culprit lesions was measured by OCT. RESULTS After adjusting for demographic and clinical factors, multivariate analysis demonstrated that Type D was associated with lipid plaque (odds ratio [OR] = 4.87, 95% confidence interval [CI] = 1.41-11.14, p = .025), thin cap fibroatheroma (OR = 3.84, 95% CI = 1.36-10.85, p = .011), and fibrous cap thickness (β = -1.43, standard error = 0.04, p = .001) analyzed by categorical approach. When analyzing Type D as continuous variable, the negative affectivity component was significantly related to plaque vulnerability, including lipid plaque (OR = 3.43, 95% CI = 1.23-9.52, p = .018), thin cap fibroatheroma (OR = 2.20, 95% CI = 1.10-4.40, p = .026), and fibrous cap thickness (β = -0.05, standard error = 0.02, p = .030), whereas no associations between the negative affectivity by social inhibition interaction term with OCT indices were found. CONCLUSIONS The results suggest that plaque characteristics in Type D have more features of plaque vulnerability. The negative affectivity component seems to drive the associations between Type D and vulnerable plaques. These findings provide new insights into the mechanism involved in the association between Type D and major adverse cardiac event.
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Garcia-Retamero R, Petrova D, Arrebola-Moreno A, Catena A, Ramírez-Hernández JA. Type D personality is related to severity of acute coronary syndrome in patients with recurrent cardiovascular disease. Br J Health Psychol 2016; 21:694-711. [PMID: 27222488 DOI: 10.1111/bjhp.12196] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 04/13/2016] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To investigate the relationship between Type D (distressed) personality and cardiac biomarkers of disease severity in patients with acute coronary syndrome. To identify potential mechanisms behind the effect of Type D personality on cardiovascular disease (CVD). DESIGN Cross-sectional. METHODS Patients (N = 215) with acute coronary syndrome completed a survey including a measure of Type D personality. Blood samples including a lipid profile and cardiac enzymes were taken within 3 days after the cardiovascular event. Data were analysed using simple correlations, multiple regressions, and mediation analyses. RESULTS Type D personality was more predictive of severity of the acute coronary syndrome among patients with previous CVD compared to patients without previous CVD. Among patients with previous CVD, Type D personality was associated with the presence of ST elevation (R(2) =.07) and more damage to the myocardium as indicated by higher troponin-I (R(2) = .05) and myoglobin (R(2) = .07) levels. These effects were independent from demographics, CV risk factors, and depression. Lower HDL cholesterol levels mediated the relationship between Type D personality and disease severity (Κ(2) = .12 [95% CI 0.02, 0.28]) for myoglobin and Κ(2) = .08 [95% CI 0.01, 0.21] for troponin-I). CONCLUSION Type D personality was related to a worse lipid profile and more severe acute coronary syndrome in patients with previous history of CVD. Given the strong relationship between disease severity and subsequent mortality, these results suggest that severity of the myocardial infarction may be a potential mechanism explaining increased mortality in Type D patients with recurrent CVD. Statement of contribution What is already known on this subject? Type D personality has been related to worse outcomes in cardiac patients. However, recent studies show mixed results, suggesting the need to clarify potential mechanisms. What does this study add? Type D personality is related to severity of acute coronary syndrome in patients with previous history of cardiovascular disease. This effect is partially accounted for by lower HDL levels in Type D patients. Disease severity is a potential mechanism by which Type D personality may affect cardiovascular health of patients with recurrent CVD.
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Affiliation(s)
- Rocio Garcia-Retamero
- Mind, Brain, and Behavior Research Center, University of Granada, Spain.,Center for Adaptive Behavior and Cognition, Max Plank Institute for Human Development, Berlin, Germany
| | - Dafina Petrova
- Mind, Brain, and Behavior Research Center, University of Granada, Spain
| | | | - Andrés Catena
- Mind, Brain, and Behavior Research Center, University of Granada, Spain
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Topp M, Vestbo J, Mortensen EL. Personality Traits and Mental Symptoms are Associated with Impact of Chronic Obstructive Pulmonary Disease on Patients' Daily Life. COPD 2016; 13:773-778. [PMID: 27089450 DOI: 10.3109/15412555.2016.1168793] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Previous research has shown that personality traits are associated with self-reported health status in the general population. COPD Assessment Test (CAT) is increasingly used to assess health status such as the impact of chronic obstructive pulmonary disease (COPD) on patients' daily life, but knowledge about the influence of personality traits on CAT score is lacking. The aim of this study was to examine the influence of Big Five personality traits on CAT score and the relation between personality traits and mental symptoms with respect to their influence on CAT score. A sample of 168 patients diagnosed with COPD was consecutively recruited in a secondary care outpatient clinic. All participants completed CAT, NEO Five-Factor Inventory, and Hospital Depression and Anxiety Scale. Multiple linear regression analysis was used to explore the association between personality traits and CAT scores and how this association was influenced by mental symptoms. The personality traits neuroticism, agreeableness and conscientiousness; and the mental symptoms depression and anxiety showed significant influence on CAT score when analysed in separate regression models. Identical R-square (R = 0.24) was found for personality traits and mental symptoms, but combining personality traits and mental symptoms in one regression model showed substantially reduced effect estimates of neuroticism, conscientiousness and anxiety, reflecting the strong correlations between personality traits and mental symptoms. We found that the impact of COPD on daily life measured by CAT was related to personality and mental symptoms, which illustrates the necessity of taking individual differences in personality and mental status into account in the management of COPD.
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Affiliation(s)
- Marie Topp
- a Section of Respiratory Medicine, Hvidovre Hospital , Hvidovre , Denmark
| | - Jørgen Vestbo
- b Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester and University Hospital of South Manchester NHS Foundation Trust , south Manchester , England
| | - Erik Lykke Mortensen
- c Department of Public Health and Center for Healthy Aging , University of Copenhagen , Copenhagen , Denmark
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Booth L, Williams L. Type D personality and dietary intake: The mediating effects of coping style. J Health Psychol 2016; 20:921-7. [PMID: 26032807 DOI: 10.1177/1359105315573433] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
This study aimed to investigate the relationship between Type D and dietary intake and to determine whether this relationship is mediated by coping. In a cross-sectional study, 187 healthy participants completed a self-report questionnaire measuring Type D personality, dietary intake and coping. Results showed that Type D was associated with maladaptive coping and significantly less healthy food intake, including more consumption of fat and sugar, and significantly less consumption of fruit and vegetables. Regression analyses showed that this relationship was partially mediated by coping. The results suggest that Type D personality may represent a risk factor for unhealthy eating.
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Li X, Zhang S, Xu H, Tang X, Zhou H, Yuan J, Wang X, Qu Z, Wang F, Zhu H, Guo S, Tian D, Zhang W. Type D Personality Predicts Poor Medication Adherence in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study. PLoS One 2016; 11:e0146892. [PMID: 26894925 PMCID: PMC4760773 DOI: 10.1371/journal.pone.0146892] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 12/24/2015] [Indexed: 01/19/2023] Open
Abstract
Background Type D personality and medication nonadherence have been shown to be associated with poor health outcomes. Type D personality is associated with poor medication adherence in patients with coronary artery disease, myocardial infarction, and heart failure. However, the relationship between type D personality and medication adherence in patients with Type 2 Diabetes Mellitus (T2DM) remains unknown. This study aims to examine whether type D personality was associated with medication adherence in patients with T2DM. Design and Settings A follow-up study was conducted in general hospital of the People's Liberation Army in Beijing. Methods 412 T2DM patients (205 females), who were recruited by circular systematic random sampling, provided demographic and baseline data about medical information and completed measures of Type D personality. Then, 330 patients went on to complete a self-report measure of medication adherence at the sixth month after baseline data collection. Chi-square test, t tests, and hierarchical multiple regression analyses were conducted, as needed. Results Patients with type D personality were significantly more likely to have poor medication adherence (p<0.001). Type D personality predicts poor medication adherence before and after controlling for covariates when it was analyzed as a categorical variable. However, the dimensional construct of type D personality was not associated with medication adherence when analyzed as a continuous variable. Conclusion Although, as a dimensional construct, type D personality may not reflect the components of the personality associated with poor medication adherence in patients with T2DM, screening for type D personality may help to identify those who are at higher risk of poor medication adherence. Interventions, aiming to improve medication adherence, should be launched for these high-risk patients.
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Affiliation(s)
- Xuemei Li
- Clinics of Cadre, Department of Outpatient, General Hospital of the People's Liberation Army (301 Hospital), Beijing, China
| | - Shengfa Zhang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Huiwen Xu
- Department of Public Health Sciences, University of Rochester School of Medicine & Dentistry, Rochester, NY, United States of America
| | - Xinfeng Tang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Huixuan Zhou
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Jiaqi Yuan
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Xiaohua Wang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Zhiyong Qu
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Fugang Wang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - He Zhu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University Medical Center, Durham, NC, United States of America
| | - Shuai Guo
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
| | - Donghua Tian
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
- * E-mail: (DT); (WZ)
| | - Weijun Zhang
- School of Social Development and Public Policy, China Institute of Health, Beijing Normal University, Beijing, China
- * E-mail: (DT); (WZ)
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Wiencierz S, Williams L. Type D personality and physical inactivity: The mediating effects of low self-efficacy. J Health Psychol 2016; 22:1025-1034. [PMID: 26837688 DOI: 10.1177/1359105315622557] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Type D personality is associated with health-damaging behaviours among the general population. This study assessed the relationship between Type D personality, physical activity and self-efficacy. A total of 189 participants completed measures of Type D personality, physical activity and self-efficacy. Type D individuals had significantly lower levels of self-efficacy and engaged in significantly less walking and total exercise compared to non-Type D's. Furthermore, self-efficacy fully mediated the relationship between Type D and physical activity. Low levels of self-efficacy may be one mechanism to help explain why Type D individuals engage in more disease-promoting behaviours.
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Bezgin CH, Bezgin T, Kesebir S. Temperament and Character Profiles and Psychiatric Comorbidities in Patients With Coronary Artery or Valvular Heart Disease: Relationship With Cardiac Disease Severity. J Clin Med Res 2016; 8:202-9. [PMID: 26858792 PMCID: PMC4737030 DOI: 10.14740/jocmr2440w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2016] [Indexed: 12/13/2022] Open
Abstract
Background We aimed to investigate whether the psychopathological symptoms and temperament-character dimensions observed in patients operated due to coronary artery disease (CAD) or valvular heart disease (VHD) differ among the patients and from healthy individuals. Methods Study population was composed of subjects with CAD, VHD and healthy controls (n = 50 in each group). Socio-demographic questionnaire, temperament and character inventory (TCI) and symptom check list-90-R (SCL-90-R) were applied to all groups. Groups were compared about temperament-character dimensions and scores of subscales of SCL-90-R. Results Harm avoidance was found to be higher in VHD group than those with CAD and, lower in healthy controls than both patient groups (P = 0.004). Reward dependence was similar among both patient groups and, was higher than healthy group (P = 0.015). Depression, anxiety, somatization, obsession and interpersonal sensitivity were found to be similar in both patient groups but they were higher than those in controls (P < 0.001, P < 0.001, P < 0.001, P = 0.002 and P = 0.003, respectively). Phobia was seen equally in CAD group and healthy controls and, was found to be lower in these than in VHD (P = 0.009). Anger score was in descending order in patients with VHD, CAD and healthy controls group (P = 0.010 and 0.001). Paranoia was in descending order in patients with VHD, CAD and controls (P = 0.015 and 0.001). A weak and inverse correlation was found between ejection fraction (EF) and the persistence dimension of temperament scaled by TCI in patients with VHD (r = -0.276, P = 0.052). An inverse correlation was observed between EF and the reward dependence dimension in CAD group (r = -0.195, P = 0.044). In patients with VHD, EF demonstrated an inversely weak (r = -0.289, P = 0.042), moderate (r = -0.360, P = 0.010) and strong (r = -0.649, P < 0.001) correlation with inter-personal sensitivity, phobia and paranoia, respectively. There was an inverse and weak correlation between EF and depression and anger in VHD group (r = -0.302, P = 0.033 and r = -0.240, P = 0.054). Conclusion VHD and CAD exhibit different psychopathological symptoms and temperament traits. There is a correlation between the aforementioned psychopathological symptoms and temperament traits, and EF.
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Affiliation(s)
- Cigdem Hazal Bezgin
- Department of Psychiatry, Erenkoy Psychiatry Training and Research Hospital, Goztepe, Istanbul, Turkey
| | - Tahir Bezgin
- Department of Cardiology, Kartal Kosuyolu Heart Research Hospital, Kartal, Istanbul, Turkey
| | - Sermin Kesebir
- Department of Psychiatry, Erenkoy Psychiatry Training and Research Hospital, Goztepe, Istanbul, Turkey
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Celano CM, Millstein RA, Bedoya CA, Healy BC, Roest AM, Huffman JC. Association between anxiety and mortality in patients with coronary artery disease: A meta-analysis. Am Heart J 2015; 170:1105-15. [PMID: 26678632 DOI: 10.1016/j.ahj.2015.09.013] [Citation(s) in RCA: 167] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 09/11/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression and anxiety are common in patients with coronary artery disease (CAD). Although depression clearly has been associated with mortality in this population, the relationship between anxiety and mortality is less clear. Accordingly, we performed a series of meta-analyses to (1) examine the relationship between anxiety and mortality in patients with established CAD and (2) determine if this relationship differs in patients with stable CAD compared to those who have just had an acute coronary syndrome (ACS). METHODS AND RESULTS Systematic literature searches identified 44 articles (total N = 30,527) evaluating the prospective relationship between anxiety and mortality in individuals with established CAD. A series of 8 adjusted and unadjusted meta-analyses were performed to examine this relationship across all patients, with sensitivity analyses completed in post-ACS and stable CAD cohorts. In unadjusted analyses, anxiety was associated with a moderate increase in mortality risk (odds ratio 1.21 per SD increase in anxiety). However, when adjusting for covariates, nearly all associations became nonsignificant. In sensitivity analyses, anxiety was associated with an increased risk of poor outcomes in the stable CAD-but not post-ACS-cohort. CONCLUSIONS These analyses confirm that anxiety is associated with increased risk of mortality in patients with CAD; however, this relationship is not as strong as that of depression and may be explained partly by other clinical factors. If anxiety screening is performed, it should be performed during a period of clinical stability and should target anxiety disorders rather than anxiety symptoms alone.
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Affiliation(s)
- Christopher M Celano
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
| | - Rachel A Millstein
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - C Andres Bedoya
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Brian C Healy
- Harvard Medical School, Boston, MA; Department of Neurology, Massachusetts General Hospital, Boston, MA
| | - Annelieke M Roest
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jeff C Huffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Department of Neurology, Massachusetts General Hospital, Boston, MA
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Meyer T, Hussein S, Lange HW, Herrmann-Lingen C. Type D personality is unrelated to major adverse cardiovascular events in patients with coronary artery disease treated by intracoronary stenting. Ann Behav Med 2015; 48:156-62. [PMID: 24481867 DOI: 10.1007/s12160-014-9590-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Previous research in cardiac patients suggested that type D personality, defined as a combination of negative affectivity (NA) and social inhibition (SI), was associated with adverse outcome. PURPOSE The objective of this prospective study was to examine the independent prognostic value of type D in patients with coronary artery disease (CAD). METHODS A total of 465 patients completed the Type D Scale (DS14) questionnaire before undergoing stent implantation and were followed up for 5 years. RESULTS In a Cox regression model adjusted for selected confounders, we found a trend towards NA for the prediction of nonfatal major adverse cardiovascular event (MACE, hazard ratio (HR) = 1.07, 95 % confidence intervals (CIs) = 0.99-1.14, p = 0.074), while, in contrast, SI was a significant and independent predictor of better outcome (HR = 0.92, 95 % CI = 0.86-0.99, p = 0.027). CONCLUSIONS In a cohort of CAD patients, the type D pattern was not linked to adverse outcome, whereas SI was negatively associated with MACE.
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Affiliation(s)
- Thomas Meyer
- Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen, Göttingen, Germany
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