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Type D Personality: Psychometric Properties of the DS14 and Associations with Ill Health and Coronary Heart Disease in General and Clinical Populations
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Clinical Research, County of Västmanland.
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Type D personality, or distressed personality, refers to the joint tendency to experience negative emotions and to inhibit self-expression in social interactions. The overall aims of this thesis were to examine the impact of Type D personality on adolescents’ self-perceived health, to examine the factorial and temporal stability of the Type D personality construct DS14, and to clarify whether type D personality is an independent risk factor for recurrent myocardial infarction and all-cause mortality among patients with myocardial infarction.

The prevalence of Type D personality in the adolescent population was 10.4% for boys and 14.6% for girls. Boys and girls with Type D personality were approximately twice as likely to report musculoskeletal pain and five times as likely to report psychosomatic symptoms.

Adolescents with Type D personality were four times more likely to have sleep disturbances and to sleep fewer hours, especially on school nights.

Among patients with myocardial infarction, the Swedish DS14 had stable structural validity. Our measurements confirmed the two-factor model of the DS14. However, the DS14 exhibited low temporal stability, especially when comparing the measurement obtained during hospitalization with the 1- and 12-month follow-up measurements.

Among patients with myocardial infarction, the Framingham risk score had a strong predictive value for recurrent myocardial infarction, and a somewhat weaker predictive value for all-cause mortality. However, none of the previously proposed methods for the analysis of the DS14 Type D personality measurement predicted recurrent myocardial infarction or all-cause mortality, either in univariable analyses or in addition to the Framingham risk score.

In conclusion, the present thesis found significant associations between the DS14 and psychosomatic symptoms in adolescents. However, the measurement exhibited a low stability over time and no predictive value for recurrent myocardial infarction and mortality among patients with myocardial infarction. Taken together, these results raise the question of whether the Swedish DS14 really is a measure of personality. An alternative explanation for the strong cross-sectional associations observed between the DS14 and psychosomatic symptoms might be that the DS14 functions as a pseudo-measure of ill health, or co-varies with depressive or psychosomatic characteristics.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. , 74 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1034
Keyword [en]
adolescence, ill health, mortality, myocardial infarction, sleep, stability, Type D personality
National Category
Neurosciences
Research subject
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-233041ISBN: 978-91-554-9052-2 (print)OAI: oai:DiVA.org:uu-233041DiVA: diva2:750471
Public defence
2014-11-14, Aulan, Ingång 21, Västmanlands sjukhus, Västerås, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2014-10-23 Created: 2014-09-29 Last updated: 2015-01-23Bibliographically approved
List of papers
1. Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents
Open this publication in new window or tab >>Type D personality is a risk factor for psychosomatic symptoms and musculoskeletal pain among adolescents: a cross-sectional study of a large population-based cohort of Swedish adolescents
2013 (English)In: BMC Pediatrics, ISSN 1471-2431, E-ISSN 1471-2431, Vol. 13, 11- p.Article in journal (Refereed) Published
Abstract [en]

Background: Type D personality, or the "distressed personality", is a psychosocial factor associated with negative health outcomes, although its impact in younger populations is unclear. The purpose of this study was to investigate the prevalence of Type D personality and the associations between Type D personality and psychosomatic symptoms and musculoskeletal pain among adolescences. Methods: A population-based, self-reported cross-sectional study conducted in Vastmanland, Sweden with a cohort of 5012 students in the age between 15-18 years old. The participants completed the anonymous questionnaire Survey of Adolescent Life in Vastmanland 2008 during class hour. Psychosomatic symptoms and musculoskeletal pain were measured through index measuring the presence of symptoms and how common they were. DS14 and its two component subscales of negative affectivity (NA) and social inhibition (SI) were measured as well. Results: There was a difference depending on sex, where 10.4% among boys and 14.6% among girls (p = < 0.001) were defined as Type D personality. Boys and girls with a Type D personality had an approximately 2-fold increased odds of musculoskeletal pain and a 5-fold increased odds of psychosomatic symptoms. The subscale NA explained most of the relationship between Type D personality and psychosomatic symptoms and musculoskeletal pain. No interaction effect of NA and SI was found. Conclusions: There was a strong association between Type D personality and both psychosomatic symptoms and musculoskeletal pain where adolescent with a type D personality reported more symptoms. The present study contributes to the mapping of the influence of Type D on psychosomatic symptoms and musculoskeletal pain among adolescents.

Keyword
Adolescents, Musculoskeletal pain, Negative affectivity, Psychosomatic symptoms, Social inhibition, Type D personality
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-197125 (URN)10.1186/1471-2431-13-11 (DOI)000314838500001 ()
Available from: 2013-03-19 Created: 2013-03-18 Last updated: 2017-12-06Bibliographically approved
2. Type D personality is associated with sleep problems in adolescents. Results from a population-based cohort study of Swedish adolescents
Open this publication in new window or tab >>Type D personality is associated with sleep problems in adolescents. Results from a population-based cohort study of Swedish adolescents
2013 (English)In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 74, no 4, 290-295 p.Article in journal (Refereed) Published
Abstract [en]

Objective: Sleep problems are associated with an increased risk of psychiatric and somatic diseases. Type D personality, or the distressed personality, refers to the joint tendency to experience negative emotions and to inhibit self-expression in social interaction. Type D personality is associated with an increased number of health complaints including cardiovascular diseases. The present study investigated whether Type D personality was associated with sleep problems among adolescents. Methods: The study was part of the Survey of Adolescent Life in Vastmanland 2008 (SALVe 2008). A total of 5012 adolescents (age 15-18 years old) completed a questionnaire including the Type D measurement DS14 and questions on sleep disturbances, sleep hours during school nights, and sleep hours during weekend nights. Results: Adolescents with a Type D personality had an approximately four times increased risk of having sleep disturbances. Moreover, Type D personality was associated with sleeping fewer hours. Conclusion: As adolescence represents a formative period for development it is critical to identify sleep disorders early. The presence of Type D personality associated with poor sleep demands attention because sleep problems may be an early stage in the development of later diseases.

Keyword
Adolescents, Sleep behaviours, Sleep disturbances, Sleep hours, Type D personality
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-198608 (URN)10.1016/j.jpsychores.2012.11.011 (DOI)000316586600004 ()
Available from: 2013-04-22 Created: 2013-04-22 Last updated: 2017-12-06Bibliographically approved
3. Prevalence of Type D Personality and Factorial and Temporal Stability of the DS14 after Myocardial Infarction in a Swedish Population
Open this publication in new window or tab >>Prevalence of Type D Personality and Factorial and Temporal Stability of the DS14 after Myocardial Infarction in a Swedish Population
2014 (English)In: Scandinavian Journal of Psychology, ISSN 0036-5564, E-ISSN 1467-9450, Vol. 55, no 6, 601-610 p.Article in journal (Refereed) Published
Abstract [en]

This study examined the prevalence of Type D personality and the temporal stability, internal consistency, and construct validity of the DS14 at three time points after myocardial infarction. The prevalence of Type D personality was 14.0% during hospitalization, 25.1% at 1 month, and 19.2% at 12 months. A total of 6.1% of patients were classified as Type D personality at all three assessments, whereas 68.4% were stable non-Type D and 25.6% changed between personality classifications. The DS14 had stable structural validity, but low temporal stability over time, especially from hospitalization to the 1-month and 12-month follow-ups (k = 0.365 and 0.397, respectively).

National Category
Psychiatry
Identifiers
urn:nbn:se:uu:diva-232467 (URN)10.1111/sjop.12162 (DOI)000345219900012 ()25243796 (PubMedID)
Available from: 2014-09-19 Created: 2014-09-18 Last updated: 2017-12-05Bibliographically approved
4. Type D personality as an independent risk factor for recurrent myocardial infarction and all-cause mortality in addition to theFramingham risk score: a prospective cohort-study
Open this publication in new window or tab >>Type D personality as an independent risk factor for recurrent myocardial infarction and all-cause mortality in addition to theFramingham risk score: a prospective cohort-study
Show others...
2014 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754Article in journal (Refereed) Submitted
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:uu:diva-232533 (URN)
Available from: 2014-09-19 Created: 2014-09-19 Last updated: 2017-12-05Bibliographically approved

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