Association between Type-D Personality and Affective (Anxiety, Depression, Post-traumatic Stress) Symptoms and Maladaptive Coping in Breast Cancer Patients: A Longitudinal Study

Abstract

Background: Type-D (distressed) personality has not been prospectively explored for its association with psychosocial distress symptoms in breast cancer patients. Objective: The objective of the study was to test the hypothesis that Type-D personality can be associated with psychosocial distress variables in cancer over a 2-point period (6 month-follow-up). Aims: The aim of the study was to analyze the role of Type-D personality in relation to anxiety, depression, post-traumatic stress symptoms, general distress, and maladaptive coping among cancer patients. Methods: 145 breast cancer patients were assessed within 6 months from diagnosis (T0) and again 6 months later (T1). The Type-D personality Scale, the Hospital Anxiety and Depression Scale, Depression subscale (HAD-D), the Brief Symptom Inventory (BSI-18) Anxiety subscale, the Distress Thermometer (DT), the Post-traumatic Symptoms (PTS) Impact of Event Scale (IES), and the Mini Mental Adjustment to Cancer (Mini-MAC) Anxious Preoccupation and Hopelessness scales were individually administered at T0 and T1. Results: One-quarter of cancer patients met the criteria for Type-D personality, which was stable over the follow-up time. The two main constructs of Type-D personality, namely social inhibition (SI) and negative affectivity (NA), were related to anxiety, depression, PTS, BSI-general distress and maladaptive coping (Mini-MAC anxious preoccupation and hopelessness). In regression analysis, Type-D SI was the most significant factor associated with the above-mentioned psychosocial variables, both at T0 and T1. Conclusion: Likewise other medical disorders (especially cardiology), Type-D personality has been confirmed to be a construct significantly related to psychosocial distress conditions and maladaptive coping that are usually part of assessment and intervention in cancer care. More attention to personality issues is important in oncology.

Type D Personality as a Marker of Poorer Quality of Life and Mood Status Disturbances in Patients with Skin Diseases: A Systematic Review

“…Mood status disturbances, such as anxiety or depression, seem to be more frequent among patients with type D personality compared with those without type D personality, regardless of the disease in question. These associations also seem to be comparable for other diseases, such as breast cancer (36). This could be of great interest because the detection of type D personality in patients with skin diseases could be an interesting way of detecting patients who are at a higher risk of having psychological disorders regardless of the disease severity.…”

An update on Takotsubo syndrome

“…23 This translates into experiencing anxiety, negative thoughts, and emotions, alongside suppressing these emotions from others. 24 As a result, TDP has been associated with not just TTS, but cardiovascular disease in general. 25 The increased risk of TTS in TDP individuals may be attributed to their raised inflammatory markers and dysregulated autonomic nervous system.…”

“…15 Furthermore, TDP is itself associated with maladaptive coping. 24 Likewise, individuals with preexisting mental health problems such as depression and anxiety were more prone to TTS compared with their counterparts. 27 This highlights how a patient's personality, psyche, and biology may cause TTS, each exclusively or collectively.…”

An Educational Intervention for Coronary Heart Disease Patients With Type D Personality: A Randomized Controlled Trial

“…Psychophysiological and behavioral pathways have been proposed to elucidate the link between type D personality and adverse health outcomes (Enatescu et al, 2021; Kupper & Denollet, 2018), with the former focused on physiological responses elicited by a range of psychological disorders experienced by individuals with type D personality (Enatescu et al, 2021; Kupper & Denollet, 2018) and the latter focused on the predisposing, negative effects of type D personality on various health-related behaviors such as lifestyle modification and adherence to medication or cardiac rehabilitation that lead to poor cardiac prognoses (Kupper & Denollet, 2018). In addition, patients with type D personalities typically cope less effectively with their illness than their non-type-D counterparts (Grassi et al, 2022). Thus, these two pathways suggest potentially efficacious targets to improve health outcomes in patients with type D personalities.…”

“…Empirical evidence indicates that cardiac patients with type D personality face an increased risk of adverse health outcomes (Grassi et al, 2022;Manoj et al, 2020). For example, patients with CHD who have a type D personality face an up to 3 times higher risk of experiencing a cardiovascular event than those with other personality types (Leu et al, 2019).…”