Increased vital exhaustion among type-D patients with ischemic heart disease

Abstract

Increased vital exhaustion among type-D patients with ischemic heart diseasePedersen, S.S.; Middel, B. General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.-Users may download and print one copy of any publication from the public portal for the purpose of private study or research -You may not further distribute the material or use it for any profit-making activity or commercial gain -You may freely distribute the URL identifying the publication in the public portal Take down policy If you believe that this document breaches copyright, please contact us providing details, and we will remove access to the work immediately and investigate your claim. Abstract Objective: To investigate the prevalence of the ''distressed personality'' (type-D) in cardiac patients and to explore the relationships between type-D, gender, vital exhaustion and angina pectoris. Methods: A questionnaire was completed by 171 patients scheduled for coronary angiography (CAG) at baseline and again at 6 weeks following implementation of treatment with invasive procedures or medication. Results: Women were more vitally exhausted at baseline and more likely to be classified as type-D. Type-D patients scored higher on vital exhaustion independent of all other variables. Angina was related to vital exhaustion, but improvement in angina following intervention was not associated with improvement in vital exhaustion scores. Conclusion: Although medical interventions reduced angina, a concomitant decrease in vital exhaustion scores was not found. It is suggested that type-D may explain gender differences on distress. Clinical implications are discussed, including the importance of including personality factors in future research, as they have been shown to have independent prognostic value. D

Type D personality and hemodynamic reactivity to laboratory stress in women

“…Conventionally, a median split on both scales is used to identify Type D (e.g., Denollet, 1998;Denollet et al, 2000;Pedersen and Middel, 2001), and good internal reliability has been reported (Denollet, 1998). In the present sample, Cronbach's α for the NA and SI scales was .87 and .75, respectively, indicating acceptable internal consistency.…”

“…Although the present study used a singlegender sample, thereby reducing its ecological validity, it succeeded in demonstrating that possible maladaptive effects of the Type D personality are not confined to males as could Type D personality and hemodynamic reactivity 19 previously have been surmised. This is important, as due to gender differences in base rates of cardiac disease, male participants far outweigh female participants in the clinical samples on which much Type D research has been conducted (e.g., Denollet et al, 1995;Denollet et al, 1996;Pedersen and Middel, 2001). If it were the case that only male Type D individuals showed a maladaptive cardiovascular response to stress, the context of the epidemiological findings would need to be re-examined.…”

Psychological risk factors in heart disease

“…The investigation by Pedersen and Middel [9] published in this issue contributes to the evaluation of two potentially relevant concepts. This study investigated the relationship between Type D personality and vital exhaustion in patients with angiographically documented coronary artery disease.…”

“…Pedersen and Middel [9] investigated whether Type D was a predictor of vital exhaustion in 217 coronary patients who were scheduled for coronary angioplasty (33%), bypass surgery (29%), or conservative medical treatment (38%). As predicted by theory [12], Type D patients were at a substantially increased risk of suffering from vital exhaustion at baseline (OR 6.35).…”

“…Let's consider for one moment the effect of gender versus the effect of Type D in the Pedersen and Middel study [9]. Using Cohen's criteria for effect size [13], the gender effect on vital exhaustion changed from moderate at baseline (effect size= .48) to small following intervention (effect size= .20).…”