The Influence of Personality Traits on Specific Coping Styles and the Development of Posttraumatic Stress Symptoms following Acute Coronary Syndrome: A Cluster Analytic Approach

Abstract

Objective: A growing body of literature suggests a relationship between personality traits and posttraumatic stress disorder (PTSD) symptoms after acute coronary events (ACS). However, specific personality profiles have not been examined in patients after ACS. Thus, the aim of the present study was to examine personality profiles created from response patterns on the resilience, alexithymia and type D personality (TDP) scales and to examine associations with PTSD symptoms, symptom clusters and coping styles among a sample of ACS patients. Methods: A cluster analytic approach was utilized to identify risk profiles based on personality variables and a series of ANOVAs in 154 patients. Post hoc analyses were conducted to examine the relationship between each profile, and interviewer-rated PTSD symptoms and different coping styles. Results: The analyses indicated a three-cluster solution, including low- (high resilience, low alexithymia and non-TDP), medium- (average resilience, average alexithymia and non-TDP) and high-risk (low resilience, high alexithymia and TDP) profiles. Clusters differed significantly in all three coping subscales. At 3-month follow up, clusters differed significantly in all three PTSD subscales (re-experiencing, avoidance and hyperarousal). At 12-month follow up, the differences remained significant for the hyperarousal subscale only. Conclusions: The personality profiles identified and the respective associations to PTSD symptoms and coping strategies highlight the potential impact for the psychological adjustment following ACS.

Posttraumatic Stress Disorder as a Consequence of Acute Cardiovascular Disease

“…In contrast, objective parameters of cardiac injury (e.g., troponin T level in ACS) show little correlation with PTSD symptoms [ 45 ]. Various other risk factors for the development of CDI-PTSD symptoms relate to the environment and treatment of the disease (e.g., a hectic hospital admission, treatment complications, statements made by staff, use of benzodiazepines) [ 46 , 47 •], sociodemographic factors (younger age, female sex) [ 44 ], comorbidities (depression, anxiety disorders, ASD) [ 48 ], personality factors (type D, neuroticism, hostility, alexithymia) [ 49 , 50 ], and a patient’s biopsychosocial history (stressful life events, previous heart disease, and other somatic diseases) [ 51 ]. In addition, even patients with suspected ACS that are ultimately ruled out can show PTSD symptoms and have a comparable risk to develop PTSD related to the acute event as patients with confirmed ACS [ 52 ].…”

“…Other treatment options such as online therapies could also be valuable for the treatment of CDI-PTSD. Alexithymia, particularly a lack of “identifying feelings” has been associated with the development of CDI-PTSD [ 49 ]. Therefore, it may be worthwhile to put a greater focus on emotion regulation and strategies to improve emotion awareness in the treatment of CDI-PTSD.…”