Type D personality. A potential risk factor refined - PubMed
There is an urgent need to adopt a personality approach in the identification of patients at risk for cardiac events. NA and SI are broad and stable personality traits that may be of special interest not only in CHD, but in other chronic medical conditions as well.
pubmed.ncbi.nlm.nih.gov
Negative affectivity (NA) denotes the stable tendency to experience negative emotions [56,57], i.e., high-NA individuals are more likely to experience negative affect across time and regardless of the situation. This trait has also been conceptualized as neuroticism [53,54]. NA correlates 0.68 with the neuroticism scale from the NEO-FFI in healthy subjects [58] and 0.64 with the neuroticism scale from the Eysenck Personality Questionnaire in patients with CHD [59]. Hence, these personality constructs share about 40± 50% common variance, implying that they are closely related but not identical. Neuroticism may have negative connotations (i.e., ``neurotic'' disorder) that I prefer to avoid. Because both NA and neuroticism are centrally defined by the tendency to experience negative affect [57], the label NA is used here to designate dysphoric individual differences that are stable over time. High-NA individuals not only experience more feelings of dysphoria and tension, but have a negative view of self, report more somatic symptoms, and have an attention bias towards adverse stimuli [57]. Overall, they seem to scan the world for signs of impending trouble: neuroticism or NA has been associated with more exposure to and reactivity to stressful events [60] and with more negative appraisals of interpersonal stressors [61]. In women with breast cancer, for example, NA is associated with heightened sensitivity to treatment-induced symptoms [62] and a self-defeating way of comparing one's own situation with that of other breast cancer patients [63]. Likewise, evidence suggests that NA is an important determinant of subjective well-being and emotional distress in CHD patients [64]. NA has been associated with chest pain in the absence of CHD [65] but also with actual CHD [66]. Hence, NA may act both as a nuisance variable and as an actual risk factor. In any case, it is premature to write off associations between NA and physical health [67]. NA is assessed well by the Trait Anxiety Inventory [68]; therefore, the Dutch form of this scale [69] was used to assess dysphoric individual differences in previous research on type D. Social inhibition (SI) denotes the stable tendency to inhibit the expression of emotions and behaviors in social interaction [70], i.e., high-SI individuals are more likely to feel inhibited, tense and insecure when with others. SI correlates ÿ 0.52 with the extraversion scale from the NEO-FFI in healthy subjects [58] and ÿ 0.65 with the extraversion scale from the Eysenck Personality Questionnaire in patients with CHD [59]. Hence, these personality constructs share about 25± 45% common variance, implying that they are closely related but not identical. SI is more closely related to the interpersonal than to the intrapsychic (i.e., positive affect, energy, excitement seeking) dimension of introversion/extraversion [59].
High-NA individuals not only experience more feelings of dysphoria and tension, but have a negative view of self, report more somatic symptoms, and have an attention bias towards adverse stimuli [57]. Overall, they seem to scan the world for signs of impending trouble: neuroticism or NA has been associated with more exposure to and reactivity to stressful events [60] and with more negative appraisals of interpersonal stressors [61]. In women with breast cancer, for example, NA is associated with heightened sensitivity to treatment-induced symptoms [62] and a self-defeating way of comparing one's own situation with that of other breast cancer patients [63]. Likewise, evidence suggests that NA is an important determinant of subjective w
