DS14 is more likely to measure depression rather than a personality disposition in patients with acute coronary syndrome

Abstract

It has been suggested that Type D Personality is a risk factor for acute coronary syndrome (ACS) and the DS14 has been developed for its assessment. However, some of the items on the DS14 seem to evaluate depressive symptoms rather than personality features. Therefore, the present study aims to verify whether an overlap exists between the constructs of Type D Personality and depression. Three-hundred-and-four consecutive patients who were both presenting their first ACS and had no history of major depression completed the Hospital Anxiety and Depression Scale (HADS) and the DS14 to assess Type D personality at baseline and have been re-evaluated at 1, 2, 4, 6, 9 and 12-month follow-ups. Out of 304 subjects (80.6% males), 40 were diagnosed as depressed. An exploratory factor analysis of HADS and the DS14 in the second month revealed that four out of seven items on the depressive subscale of HADS (HADS-D) and six out of seven items on the Negative Affectivity (NA) subscale of the DS14 segregated on the same factor. Results were verified by a Partial Confirmatory Factor Analysis performed at the twelfth month when most of the patients achieved complete remission from the depressive episode. Temporal stability was poor for NA and Type D Personality and these construct co-vary with HADS-D over time. Our data suggests that NA and depression are overlapping constructs, supporting the idea that the DS14 measures depressed features, rather than a personality disposition.

Negative Affectivity, Aging, and Depression: Results From the Neurobiology of Late-Life Depression (NBOLD) Study

“…In addition, our use of the seven-item NA component of the DS-14 might be seen as a limitation. Whereas early evidence demonstrated that the DS-14 highly correlated with neuroticism and other measures of negative affect [25], a more recent factor analysis suggests the measure considerably overlaps with symptoms of major depression [53]. This may explain why there was little overlap in the distribution of the DS-14 between our depressed and non-depressed subjects.…”

Type D personality in cardiovascular patients and general population: prevalence and retrospective perception of stability

“…The previous research in patients with acute coronary syndrome showed low stability for negative affectivity and Type D personality and suggested that DS14 questionnaire does not describe the fundamental and permanent personality traits but shows emotional instability (Ossola et al, 2015). Loosman et al (2017) study with dialysis patients also support that Type D personality is possibly more a state instead of a trait phenomenon.…”

“…This was demonstrated in samples with coronary syndrome (Ossola, De Panfilis, Tonna, Ardissino, & Marchesi, 2015), myocardial infarction (Conden, Rosenblad, Ekselius, & Åslund, 2014) and in CVD patients before and after cardiac surgery (Dannemman et al, 2010) with follow-up up to 12 months. Such ambiguous results suggest that the stability of Type D personality is not clear.…”

Temperament and Depression After a First Acute Coronary Syndrome

“…The present study is part of a more extensive investigation on never-depressed patients at their first ACS (Marchesi et al, 2014a(Marchesi et al, , 2014bMarchesi et al, 2015;Ossola et al, 2015aOssola et al, , 2015bOssola et al, , 2018.…”