Construct, concurrent and discriminant validity of Type D personality in the general population: Associations with anxiety, depression, stress and cardiac output

Abstract

The Type D personality, identified by high negative affectivity paired with high social inhibition, has been associated with a number of health-related outcomes in (mainly) cardiac populations. However, despite its prevalence in the health-related literature, how this personality construct fits within existing personality theory has not been directly tested. Using a sample of 134 healthy university students, the present study examined the Type D personality in terms of two well-established personality traits; introversion and neuroticism. Construct, concurrent, and discriminant validity of this personality type was established through examination of the associations between the Type D personality and psychometrically-assessed anxiety, depression, and stress, as well as measurement of resting cardiovascular function. Results showed that while the Type D personality was easily represented using alternative measures of both introversion and neuroticism, associations with anxiety, depression, and stress were mainly accounted for by neuroticism. Conversely, however, associations with resting cardiac output were attributable to the negative affectivity-social inhibition synergy, explicit within the Type D construct.Consequently, both the construct and concurrent validity of this personality type were confirmed, with discriminant validity evident on examination of physiological indices of well-being.Keywords: Type D personality, health, neuroticism, introversion, cardiac output Type D personality, neuroticism, extraversion 3 Theories of personality have an extensive history, with the human temperament long purported to be related to physical health. Personality theories have emanated from all areas of psychology, including cognitive psychology, psychoanalysis, and social psychology. However, perhaps the most productive source has been the psychometrically driven tradition of typologies and traits. Where typological theories of personality categorise individuals into discrete types, trait theories are based on the premise that all personalities can be identified on the basis of scores within a number of traits. Classically, the trait models of Eysenck (1991) and of Costa and McCrae (1992) are among those to have received the most research interest. Eysenck's threefactor approach posits that human personality can be encapsulated in the combination of neuroticism, extraversion, and psychoticism, while Costa and McCrae's "big five" swaps psychoticism for openness, agreeableness, and conscientiousness.Recently, however, a personality type known as Type D has shown strong and lasting links to a range of negative health outcomes following coronary events (Denollet, Sys, & Brutsaert, 1995), including death (Denollet et al., 1996), second myocardial infarction (Denollet, Vaes, & Brutsaert, 2000), poor quality of life (Pedersen, Holkamp et al., 2006), and higher rates of depression and anxiety (Denollet, 1998a;Pedersen, Ong et al., 2006). While some have argued that Type D and depression overlap, studies have shown the T...

Stress, health and illness: Four challenges for the future

“…For example, numerous traits such as alexithymia, Type D, cynical hostility, perfectionism and self-control have been found to moderate the effects of stress and/or have direct effects on various health-related outcomes (e.g., Boals, vanDellen, & Banks, 2011;Dittner, Rimes, & Thorpe, 2011;Howard & Hughes, 2012;O'Connor & Ashley, 2008;Ruthig, Hanson, Pedersen, Weber, & Chipperfield, 2011;Williams, O'Connor, Grubb, & O'Carroll, 2011). In the current issue, of particular note is the study by Howard and Hughes (2012) which explores the validity of Type D personality construct in the general population. Type D personality, defined as high negative affectivity coupled with high social inhibition, has been found to be associated with coronary heart disease and congestive heart failure (Denollet et al, 1996;Denollet, Schiffer, & Spek, 2010).…”

“…), coping (What and where is uncontrollability, negative emotion such as anger or anxiety and low perceived ability to cope. Appraisal models can be used in conjunction with stressor or eventfocused models (e.g., measuring perceived stress in the context of a stressor; Downing et al, 2012;Rinaldis et al, 2012) or in conjunction with distress models (e.g., measuring perceived stress along with distress; Howard & Hughes, 2012; see also Thoma, Scholz, Ehlert, & Nater, 2012). This approach may capture some of the cascade of stressors that arise from major events.…”

Type D personality and cardiovascular reactivity to an ecologically valid multitasking stressor

“…More recently, it has been argued that research investigating Type D personality as a predictor of cardiovascular disease endpoints should be abandoned altogether . For example, the strong positive relationship between NA and neuroticism, and the strong inverted relationship between SI and extraversion (De Fruyt & Denollet, 2002;Howard & Hughes, 2012) brings into question whether Type D personality is merely a re-conceptualisation of established personality traits. However, there is evidence for the discriminant validity of SI and extraversion, particularly with respect to the prediction of cardiovascular function (Howard & Hughes, 2012).…”

“…For example, the strong positive relationship between NA and neuroticism, and the strong inverted relationship between SI and extraversion (De Fruyt & Denollet, 2002;Howard & Hughes, 2012) brings into question whether Type D personality is merely a re-conceptualisation of established personality traits. However, there is evidence for the discriminant validity of SI and extraversion, particularly with respect to the prediction of cardiovascular function (Howard & Hughes, 2012). One of the main criticisms of Type D research is that Type D has previously been conceptualised using a dichotomous typology, whereby individuals with high scores on both NA and SI are categorised as 'Type D', with other participants being characterised as 'non-Type D' (Coyne et al, 2011;Ferguson et al, 2009).…”

A Critical Analysis of the Assumptions of Type D Personality: Comparing Prediction of Health-Related Variables with the Five Factor Model

“…The Type D personality construct implies that personality types are meaningful and useful, traits have interactive effects, and that the narrow traits of negative affectivity and social inhibition are more relevant than broad traits such as neuroticism and extraversion. While a few studies have challenged the assumptions of Type D personality regarding its status as a categorical variable (Ferguson et al, 2009;Howard & Hughes, 2012;Kelly-Hughes, Wetherell, & Smith, 2014) and its interactive effects (Horwood et al, 2016;Kelly-Hughes et al, 2014), almost no research has examined the ability of Type D personality to predict health-related variables in comparison to a comprehensive hierarchical framework of personality based on the Big Five. Thus, the present study sought to address these issues by comparing the predictive validity of various representations of Type D personality with the Five-Factor Model (Costa & McCrae, 1992).…”