Type D personality has been associated with poor prognosis in cardiac patients. This study investigated the validity of the Type D construct in Iceland and its association with disease severity and health-related risk markers in cardiac patients. A sample of 1,452 cardiac patients completed the Type D scale (DS14), and a subgroup of 161 patients completed measurements for the five-factor model of personality, emotional control, anxiety, depression, stress and lifestyle factors. The Icelandic DS14 had good psychometric properties and its construct validity was confirmed. Prevalence of Type D was 26–29%, and assessment of Type D personality was not confounded by severity of underlying coronary artery disease. Regarding risk markers, Type D patients reported more psychopharmacological medication use and smoking, but frequency of previous mental problems was similar across groups. Type D is a valid personality construct in Iceland, and is associated with health-related risk markers, but not cardiac disease severity.

In the general Icelandic population, Type D personality was associated with differences in lifestyle-related CAD risk factors, a higher estimated risk of developing CAD, and higher incidence of previous cardiac events. Unhealthy lifestyles may partly explain the adverse cardiovascular effect of Type D personality.

BackgroundType D (distressed) personality has been associated with adverse cardiac prognosis and poor emotional well-being in cardiac patients, but it is still unclear what mechanisms link Type D personality with poor clinical outcomes in cardiac patients. In the present cohort of Icelandic cardiac patients, we examined potential pathways that may explain this relationship. The objectives were to examine 1) the association between Type D personality and impaired psychological status, and to explore whether this association is independent of disease severity; and 2) the association between Type D personality and an unhealthy lifestyle.MethodsA sample of 268 Icelandic coronary angiography patients (74% males (N = 199); mean age 62.9 years (SD 10.5), range 28-85 years) completed the Type D Scale (DS14), Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS) at hospitalization. Health-related behaviors were assessed 4 months following angiography. Clinical data were collected from medical files.ResultsType D personality was associated with an increased risk of anxiety (OR 2.97, 95% CI:1.55-5.69), depression (OR 4.01, 95% CI:1.42-11.29), and stress (OR 5.99, 95% CI:3.08-11.63), independent of demographic variables and disease severity. Furthermore, fish consumption was lower among Type Ds, as 21% of Type Ds versus 5% of non-Type Ds consumed fish < 1 a week (p < 0.001). Type D patients were also more likely to smoke at follow-up (22% versus 10%, p = 0.024) and to use antidepressants (17% versus 9%, p = 0.049) and sleeping pills (49% versus 33%, p = 0.019) compared to non-Type Ds. Type D personality was not associated with other health-related behaviors, aside from trends towards less fruit and vegetable consumption, and more weight gain.ConclusionType D personality was associated with psychological distress and an unhealthy lifestyle in Icelandic cardiac patients. Future studies should further investigate the association between Type D personality and health-related behaviors.

health psychology report • volume 6(1), 8 original article background Body image dissatisfaction has been linked with a range of adverse psychosocial outcomes in both genders and has become an important public health issue. Across all ages, women have reported being more dissatisfied with their bodies than men. The aim of the current study was to examine if fitness and physical activity associate with body image satisfaction differently across gender and age, measured in the same participants. participants and procedure Participants were measured initially at age 15 years (N = 385) and again at age 23 years (N = 201). Structural equation modelling was used to examine the association between body image satisfaction, fitness, and physical activity. Covariates included skinfold thickness, body mass index, socioeconomic status, anxiety, and depression. results Fitness and physical activity declined during the study period, body mass index increased, but no changes were found in body image satisfaction, depression, anxiety, or skinfold thickness. For women at ages 15 and 23 years, self-reported fitness and depression were found to be related to body image satisfaction, including body mass index at the age of 23 years. For 15-year-old men, skinfold thickness and aerobic fitness related to body image satisfaction, whereas skinfold thickness, depression, body mass index, and self-reported fitness did so at age 23 years. conclusions Results suggest that different approaches are needed across gender to improve body image in adolescence whereas more similar ones can be used in emerging adulthood.