Personality, emotional distress and coronary heart disease

Abstract

Hostility, depression, and anxiety have been associated with coronary heart disease (CHD), but the role of emotional distress in the development of CHD is still a controversial issue. Evidence shows, however, that emotional distress plays a key role in the progression of CHD: (i) emotional distress is associated with pathophysiological mechanisms and cardiac events in coronary patients, (ii) psychosocial treatments of emotional stress may reduce mortality and morbidity in these patients, and (iii) inhibition of negative emotions may accelerate CHD. Evidence also shows that emotional stress as a risk factor for CHD is a chronic characteristic; research has, however, largely ignored the role of personality in this context. The approach to personality and CHD that is presented in this paper revisits the tradition of global personality traits, and is based on the notion that the interaction between negative affectivity (the tendency to experience negative emotions) and social inhibition (the tendency to inhibit self-expression in social interaction) has potential explanatory power in coronary patients. The construct of type-D personality is introduced to designate those coronary patients who experience difficulties in the areas of negative emotions and self-expression. Type-D patients typically report high levels of depressive symptoms and poor levels of social support. Evidence is presented which suggests that, eventually, the emotional difficulties of type-D patients may result in hard endpoints such as increased risk for long-term mortality. It is concluded that, in addition to assessing specific psychosocial factors, it is equally important to assess the effect of global traits and their interaction on prognosis in patients with CHD.

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

“…With the introduction of ''the distressed personality'' (type-D), belief in the role of personality factors in IHD may be restored [7,8]. Studies show that personality type-D is related to depression, social alienation, a higher number of reinfarctions and higher mortality rates independent of established biomedical risk factors and disease severity [7,9,10].…”

“…The inhibition of expression of emotions is conscious in order to avoid the disapproval of others. Social inhibition appears to be a moderator, such that prevalence of cardiac events for individuals high in negative affectivity but low in social inhibition is less than for individuals high in both components [9]. Thus, it is the interaction rather than the two individual components that characterises personality type-D [10].…”

Dependência tabágica, assertividade e alexitimia em doentes cardíacos

“…Porém, Denollet (1997) identificou a personalidade tipo D que se caracteriza por altos níveis de ansiedade, tensão crônica, emoções negativas e inibição social, aumentando o estresse emocional e levando a um baixo nível de bem-estar psicológico. No estudo desenvolvido por Denollet (2005), a personalidade tipo D foi mais prevalente entre pacientes cardíacos e hipertensos comparativamente com indivíduos da população geral.…”

Psychometric characteristics of type-D personality scale and comparision type-D personality among uniersity students

“…Denollet [6] compared the results of two factors of negative affect and social inhibition in males and females, and reported a higher level of negative affect in females than in males, and a higher level of social inhibition in males than in females. As noted in this study and other studies [1,2,5] emotional stress has a relationship with coronary heart disease and other health damaging factors, so DS14 factors and its components were analyzed in males and females to investigate the differences between males and females in terms of coronary heart disease and other health damaging factors.…”

“…In regard to the relationship between stress and health, studies show that psychological factors have a relationship with previous events and progress of cardiovascular diseases [1]. One of the factors proposed in recent years is the moderating role between health and stress is type-D personality or distressed type [2].…”