Association Between Type D Personality and Prognosis in Patients with Cardiovascular Diseases: a Systematic Review and Meta-analysis

Grande, Gesine; Romppel, Matthias; Barth, Jürgen

doi:10.1007/s12160-011-9339-0

Cited by 198 publications

(157 citation statements)

References 63 publications

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“…This adds to the growing literature on negative findings for Type D and prognosis (Coyne et al, 2011;Grande et al, 2012), and while a full discussion of potential reasons is beyond the scope of this literature, it may be due to cultural differences among countries.…”

Section: Tale 4 About Here Discussionmentioning

confidence: 84%

Longitudinal modelling of theory-based depressive vulnerabilities, depression trajectories and poor outcomes post-ACS

Keegan

Conroy

Doyle

2016

Journal of Affective Disorders

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Section: Tale 4 About Here Discussionmentioning

confidence: 84%

Longitudinal modelling of theory-based depressive vulnerabilities, depression trajectories and poor outcomes post-ACS

Keegan

Conroy

Doyle

2016

Journal of Affective Disorders

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“…Grande and colleagues [35] performed such a meta-analysis of available studies and the resulting forest plot (Fig. 5 in [35]), offered a striking graphic representation of what was already known.…”

Section: Meta-analysis To the Rescue?mentioning

confidence: 99%

Are we witnessing the decline effect in the Type D personality literature? What can be learned?

Coyne¹,

Voogd²

2012

Journal of Psychosomatic Research

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a b s t r a c t a r t i c l e i n f oAfter an unbroken series of positive, but underpowered studies seemed to demonstrate Type D personality predicting mortality in cardiovascular disease patients, initial claims now appear at least exaggerated and probably false. Larger studies with consistently null findings are accumulating. Conceptual, methodological, and statistical issues can be raised concerning the construction of Type D personality as a categorical variable, whether Type D is sufficiently distinct from other negative affect variables, and if it could be plausibly assumed to predict mortality independent of depressive symptoms and known biomedical factors, including disease severity. The existing literature concerning negative affect and health suggests a low likelihood of discovering a new negative affect variable that independently predicts mortality better than its many rivals. The apparent decline effect in the Type D literature is discussed in terms of the need to reduce the persistence of false positive findings in the psychosomatic medicine literature, even while preserving a context allowing risk-taking and discovery. Recommendations include greater transparency concerning research design and analytic strategy; insistence on replication with larger samples before accepting "discoveries" from small samples; reduced confirmatory bias; and availability of all relevant data. Such changes would take time to implement, face practical difficulties, and run counter to established practices. An interim solution is for readers to maintain a sense of pre-discovery probabilities, to be sensitized to the pervasiveness of the decline effect, and to be skeptical of claims based on findings reaching significance in small-scale studies that have not been independently replicated.© 2012 Elsevier Inc. All rights reserved. IntroductionMany "discoveries" turn out to be exaggerated or simply false across diverse research areas and disciplines. John Ioannidis [1] provoked concern with his demonstration that of the 49 most cited clinical research studies in major journals, replications of 34 had been attempted, and 41% of key findings had been refuted or shown to be substantially diminished. In a subsequent paper [2] he offered evidence that "most claimed research findings are false" and he and others [3-6] have since identified some mechanisms by which discoveries appear in the literature and then undergo a decline or refutation. Claims of breakthrough discoveries frequently arise in small positive studies that would seem to be too underpowered to detect an effect, and the inadequate sample size makes findings all the more attention grabbing.Yet, portrayals in the literature of such "discoveries" ignore the larger context of a strong confirmatory bias in published research papers, with unknown numbers of negative findings not being published and findings being declared discoveries simply because of having achieved an arbitrary level of significance. Moreover, statistically significant findings in small studies are nece...

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“…However, these studies have cast doubt on the association between Type D and mortality in cardiac patients. Furthermore, a recent meta-analysis [17] has suggested that the early studies on Type D may have overestimated the prognostic effect of Type D. Although the authors identified a significant association between Type D and mortality and non-fatal MI, they found that the identified odds ratios have decreased over time.…”

Section: Introductionmentioning

confidence: 98%

Type D personality and three-month psychosocial outcomes among patients post-myocardial infarction

Williams

O’Connor

Grubb

et al. 2012

Journal of Psychosomatic Research

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Objective: Type D personality has been proposed as a risk factor for poor prognosis in cardiac patients. Recent studies which have adopted a dimensional approach to Type D (negative affectivity × social inhibition) found no effect of Type D on mortality, after controlling for its constituent elements. To-date, no study has determined if Type D is associated with psychosocial outcomes in post-myocardial infarction (MI) patients when conceptualised as a dimensional variable. Methods: Participants were 192 MI patients (138 males, 54 females, mean age 66.0 years) who provided demographic and clinical information, and completed measures of Type D one-week post-MI. Three months later, 131 of these MI patients completed measures of disability and quality of life. Results: Using regression analyses, adjusted for demographic and clinical data, Type D emerged as a significant predictor of disability and quality of life in MI patients, when analysed using the traditional categorical approach. However, Type D did not predict disability and quality of life when it was analysed using the interaction of negative affectivity and social inhibition. Negative affect emerged as a significant predictor of both disability (β=.433, t(130) = 3.53, p b .01), and quality of life (β= − .624, t(130) = − 5.68, p b .001). Conclusions:The results suggest that Type D is not associated with short-term psychosocial outcome in MI patients, after controlling for its constituent elements. However, negative affect was significantly associated with both disability and quality of life. Future research should conceptualise Type D as the interaction between negative affectivity and social inhibition, rather than as a typology.© 2012 Elsevier Inc. All rights reserved. IntroductionThe Type D construct describes individuals who simultaneously experience high levels of negative affectivity and high levels of social inhibition [1]. Type D individuals are, therefore, thought to experience negative emotions (such as anxiety, sadness, anger etc.) across time and situations and inhibit the expression of these emotions in social interactions due to fears of how others may react. Crucially, it is the synergistic effect of high scores on both stable personality traits, negative affectivity and social inhibition, which has been proposed as the key feature of the Type D construct, suggesting that it is not merely the presence of negative emotions that should be considered as a risk factor but also how an individual copes with these negative emotions [2].The first studies carried out on the Type D construct [1,3,4] demonstrated that Type D is associated with a four-fold increased risk of mortality in coronary heart disease (CHD) patients, independent of traditional biomedical risk factors. In addition, a further study demonstrated that Type D CHD patients had a four-fold risk of major cardiac events over five years, independent of disease severity [5]. Similar findings were demonstrated in recent studies which demonstrated a comparable relationship between Type D and ...

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Association Between Type D Personality and Prognosis in Patients with Cardiovascular Diseases: a Systematic Review and Meta-analysis

Abstract: More recent methodologically sound studies suggest that early type D studies had overestimated the prognostic relevance.

Cited by 198 publications

References 63 publications

Longitudinal modelling of theory-based depressive vulnerabilities, depression trajectories and poor outcomes post-ACS

Longitudinal modelling of theory-based depressive vulnerabilities, depression trajectories and poor outcomes post-ACS

Are we witnessing the decline effect in the Type D personality literature? What can be learned?

Type D personality and three-month psychosocial outcomes among patients post-myocardial infarction

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