The Impact of Type D Personality Traits on Quality of Life, Sleep, Anxiety, and Depression in Fibromyalgia Patients: A Comparative Study with Healthy Controls.

BACKGROUND Type D personality has been associated with adverse clinical outcomes and poor quality of life in many diseases. This study aimed to evaluate the effects of type D personality on pain, anxiety and depression, sleep quality, and quality of life in 50 patients with fibromyalgia syndrome. MATERIAL AND METHODS Fifty patients with fibromyalgia and 50 healthy controls were included in the study. Baseline and post-treatment evaluations encompassed a comprehensive battery of assessment tools: socio-demographic questionnaire, visual analog scale for pain, Beck Anxiety Inventory, Beck Depression Inventory, Fibromyalgia Impact Questionnaire, SF-36 Short Form Questionnaire, and Pittsburgh Sleep Quality Index. The effects of type D personality traits on clinical parameters were determined by evaluating the participants with the D-Type Personality Scale (DS-14). RESULTS Twelve participants (24%) in the control group and 30 patients (60%) in the fibromyalgia group had type D personality traits, and the difference was significant (P<0.001). The Beck Anxiety Inventory and Beck Depression Inventory scores were significantly higher, and the SF-36 domains of vitality and mental health were significantly lower in fibromyalgia patients with type D personality (P=0.023, P=0.036, P=0.002, P>0.001). CONCLUSIONS This study draws attention to the high prevalence of type D personality in patients with fibromyalgia and demonstrates that this personality trait has a negative impact on patients' clinical parameters.

Association between type D personality and supportive care needs in elderly patients with breast cancer: a prospective longitudinal observational study.

BACKGROUND: Elderly patients with breast cancer often have more unmet needs after receiving common treatments such as surgery and chemotherapy. Type D personality has been related to supportive care needs in the general population. However, its association with supportive care needs in elderly breast cancer patients has not been prospectively explored. This study aimed to address this gap. OBJECTIVES: The aim was to understand the impact of Type D personality on the supportive care needs of elderly breast cancer patients at diagnosis, 2 weeks postoperatively, 3 months postoperatively, and 6 months postoperatively and to analyse the impact of Type D personality on the changing trajectory of supportive care needs after controlling for confounding factors such as demographics, symptom distress and social support. METHODS: A total of 122 elderly patients (≥ 65 years) with breast cancer in Ruijin Hospital, Shanghai, China, were included from September 2021 until August 2022. Supportive care needs were measured by the Supportive Care Needs Survey Short Form and tracked at diagnosis, 2 weeks postoperatively, 3 months postoperatively, and 6 months postoperatively. To investigate changes in the supportive care needs of elderly breast cancer patients and the effect of Type D personality on these needs, a linear mixed model was applied. RESULTS: A total of 122 elderly patients participated. There was an overall decreasing trend in supportive care needs, with Type D personality patients having significantly higher levels of supportive care needs than the non-Type D personality patients at all stages. Through linear mixed models, it was found that the Type D personality group had a lower overall downward trend than the non-Type D personality group, with need levels remaining consistently higher. This difference persisted after controlling for demographic information, symptom burden, social support. CONCLUSIONS: Elderly breast cancer patients with Type D personality had higher levels of supportive care needs and a slower rate of decline that was maintained over a longer period than those with non-Type D personality.

Predictive value of type D personality for cardiac events in Chinese patients with acute myocardial infarction.

BACKGROUND: Our study aimed to investigate the association between type D personality and adverse cardiac events in chinese patients after acute myocardial infarction (AMI). METHODS: Patients with AMI admitted to cardiac care unit (CCU) of China-Japan Friendship Hospital, Beijing, China between January 2016 and December 2017 were enrolled. 257 patients completed psychological questionnaires at enrollment. Type D personality was assessed with 14-item Type D Scale-14 (DS14). Anxiety and depression were quantified using Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regression analysis was used to determine the independent predictors of in-hospital major adverse cardiac events (MACEs), while cox regression analysis was used to evaluate post-discharge endpoints. RESULTS: 54 patients (21%) were classified as Type D personality defined by the combination of a negative affectivity (NA) score ≥ 10 and a social inhibition (SI) score ≥ 10 on the DS14. Patients with Type D personality displayed significantly higher scores of anxiety (7.4 ± 3.1 vs. 4.2 ± 3.1, p < .001) and depression (7.2 ± 3.8 vs. 4.0 ± 3.4, p < .001). AMI patients with Type D personality had higher prevalence rates of anxiety (χ2 = 30.095, P < .001) and depression (χ2 = 27.082, P < .001). Type D group also displayed a significantly higher level of blood lipoprotein(a) (177.2 ± 200.7 vs. 118.1 ± 255.7 mg/L, P = .048). The incidence of in-hospital MACEs was higher in type D than in non-Type D patients (24.1% vs. 11.3%, χ2 = 5.751, P = .026). Multivariable logistic regression showed three significant independent predictors of in-hospital MACEs: age [odds ratio(OR) = 1.055; 95%CI 1.016-1.095, p = .004], type-D personality(OR 3.332; 95% CI 1.149-9.661, p = .014) and killip classification(OR 2.275, 95% CI 1.506-3.437, p < .001). The average follow-up time was 31 (23-37.5) months. Type D patients had higher incidences of post-discharge events(23.1% vs. 11.5%, p = .032). In the analysis of post-discharge events by Cox regression, χ2 of the Cox regression equation was 16.795 (P = .032). Smoking (HR 2.602; 95% CI1.266-5.347, p = .009) and type-D personality (HR 2.265; 95%CI 1.028-4.988, p = .042) were independent predictors of long-term cardiac events. Kaplan-Meier curves showed significant difference in event-free survival between type D and non-type D group (p = .043). CONCLUSIONS: Type D personality is an independent predictor of in-hospital and post-discharge cardiac events after AMI in Chinese patients.

The relationship between results of coronary angiography, Mediterranean-type lifestyle, type D personality, and healthy life expectancy.

AIM: The aim of this study was to determine the relationship between coronary angiography results and Mediterranean-type lifestyle and type D personality. METHODS: Mediterranean-type lifestyle index and type D personality scale were administered to 230 participants. RESULTS: In univariate analysis according to coronary angiography results, a statistically significant effect was determined between the decision for treatment with percutaneous coronary intervention (PCI) and diabetes mellitus, and total and subscale points of Mediterranean lifestyle index, and between the decision for treatment with bypass and body mass index, Mediterranean diet, physical activity, and total points. In multivariate analysis, there was determined to be an effect between the PCI and systolic pressure, and between bypass and body mass index and subscale of physical activity. When disease-free life expectancy was examined, there was seen to be a negative effect of smoking and low Mediterranean diet points for participants with PCI, and of smoking, presence of hypertension, family history, and high type D personal characteristics score for those with bypass decision. CONCLUSION: The evidence-based recommendations for a Mediterranean-type lifestyle stated in cardiovascular disease (CVD) preventative guidelines may have a positive effect on the prevention of CVD, disability-free life, and mortality.

OBJETIVO: Este estudio se llevó a cabo para determinar la relación entre los resultados la angiografía coronaria y el estilo vida mediterráneo y los rasgos personalidad tipo D. MÉTODO: El índice de estilo de vida de tipo mediterráneo y la escala de personalidad de tipo D se administraron a 230 participantes. RESULTADOS: Según el resultado angiografía coronaria, subdimensiones intervención coronaria percutánea y diabetes y estilo de vida mediterráneo y puntajes totales en análisis univariante, circunvalación, cuanto a índice masa corporal, dieta estilo mediterráneo, actividad física y puntuación total; en análisis multivariado, se encontró que la intervención coronaria percutánea se asoció con la presión arterial sistólica, circunvalación con el índice masa corporal y subdimensión actividad física. Mirando la esperanza vida libre enfermedades, el tabaquismo y la baja puntuación la dieta tipo mediterránea del participante para el que se tomó la intervención coronaria percutánea, el índice masa corporal bajo, tabaquismo, hipertensión, los antecedentes familiares y los rasgos de personalidad tipo D altos del participante con la circunvalación afectan negativamente la esperanza de vida libre enfermedades. CONCLUSIÓN: Como se indica en las pautas de prevención enfermedades cardiovasculares, el estilo vida mediterráneo puede tener efectos positivos en la prevención enfermedades cardiovasculares, discapacidad y mortalidad.

Type D personality and cardiovascular reactivity to acute psychological stress: A systematic review and meta-analysis.

OBJECTIVES: Type D personality has been associated with adverse cardiovascular health, with atypical cardiovascular reactions to psychological stress considered a possible mechanism of effect. However, studies examining Type D personality and cardiovascular reactions to acute stress have yielded mixed findings. Here, we conducted a systematic review and meta-analyses to examine if, and under what conditions, Type D personality is associated with cardiovascular reactivity to stress; a particular focus was placed on sex and the social salience of the stressor as potential moderators of effects. METHOD: Electronic databases (Medline, PsycArticles, PsycInfo, CINAHL, PubMed, Web of Science) were searched for relevant publications. A total of 401 articles were retrieved and screened for eligibility. Inclusion criteria included studies with nonclinical samples employing a resting baseline period followed by a psychological stress task period and measurement of cardiovascular reactivity. Following screening and removal of irrelevant articles, 17 peer-reviewed studies were included in the review. RESULT: Type D personality was associated with lower blood pressure reactivity to acute psychological stress. Subgroup analyses revealed an association between Type D personality and lower cardiovascular reactivity among females, but not males. Additionally, Type D personality was primarily associated with lower cardiovascular reactivity in response to nonsocial stressors. CONCLUSIONS: Type D personality is associated with lower blood pressure reactivity to acute psychological stress, particularly among females and in response to nonsocial stressors. This lower response may be indicative of blunted cardiovascular reactivity and therefore signals an increased risk of adverse health outcomes. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

An Educational Intervention for Coronary Heart Disease Patients With Type D Personality: A Randomized Controlled Trial.

BACKGROUND: Type D personality, a newly specified personality type defined as the interaction of high levels of negative affectivity and social inhibition, is associated with poor health outcomes. Few interventional studies have been performed to improve health outcomes in this subpopulation. PURPOSE: This study was developed to examine the effects of an educational intervention on psychological health, health-promoting behaviors, and quality of life in coronary heart disease (CHD) patients with type D personality in China. METHODS: A randomized controlled trial was adopted. One hundred twenty-eight patients with CHD and type D personality were randomly assigned. The intervention group received the 12-week educational intervention in addition to usual care, whereas the control group received usual care only. Data on anxiety and depression, health-promoting behaviors, and quality of life were collected at baseline and at 1 and 3 months after enrollment. After controlling for the covariates, the generalized estimating equation model was used to examine the intervention effects. RESULTS: The mean age of the participants was 61.02 years, and more than 70% were male. Results of the generalized estimating equation analysis showed significantly greater improvements in anxiety, depression, and health-promoting behaviors in the intervention group than in the control group. In addition, quality of life, the domains of angina limitation, angina stability, and treatment satisfaction were found to have improved more significantly in the intervention group than the control group, whereas the posttest changes in angina frequency and disease perception were found to be similar in both groups. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The educational intervention was shown to be effective in improving psychological health, health-promoting behaviors, and certain domains of quality of life in patients with CHD and type D personality. Nurses should identify patients with this personality type and provide tailored care to improve their health outcomes in clinical practice.

Psychiatric disorders, rumination, and metacognitions in patients with type D personality and coronary heart disease.

BACKGROUND: Little is known regarding the prevalence of psychiatric disorders in patients with both coronary heart disease (CHD) and type D personality, and whether these patients may benefit from psychotherapy that modifies metacognitive beliefs implicated in disorder maintenance. This study explored prevalence rates among these patients and associations between type D characteristics, rumination and metacognitions. METHODS: Forty-seven consecutive patients with CHD who scored positive for type D personality were included in this pre-planned study. Participants underwent structured clinical interviews for mental and personality disorders and completed questionnaires assessing rumination and metacognitions. RESULTS: Mean age was 53.8 (SD 8.1) years and 21.3% were female. At least one mood disorder or anxiety disorder was found in 70.2% and 61.7% of the patients. The most common disorders were major depressive disorder (59.6%), social phobia (40.4%), and generalized anxiety disorder (29.8%). At least one personality disorder was detected in 42.6%. Only 21% reported ongoing treatment with psychotropic medication whereas none had psychotherapy. Metacognitions and rumination were significantly associated with negative affectivity (0.53-0.72, p < .001) but not social inhibition. CONCLUSION: Mood and anxiety disorders were highly prevalent and relatively untreated among these patients. Future studies should test the metacognitive model for type D personality.

Prognostic value of Type D personality for post-stroke depression in ischemic stroke patients.

BACKGROUND: Depression in patients with stroke has been a risk factor for adverse outcomes. Type D personality as a significant predictor of negative psychological status. However, the relationship with post-stroke depression (PSD) is still unclear. METHODS: A prospective observational study of 533 patients with first-ever ischemic stroke was conducted between November 2020 and March 2021. Type D personality was assessed at baseline. The presence of depression was measured 3-month after discharge. RESULTS: During 3-month follow-up, a total of 141 patients developed PSD. On multivariate logistic analysis, the main effect of negative affectivity (OR = 1.28, 95%CI = 1.03-1.61, p = 0.030) and social inhibition (OR = 1.25, 95%CI = 1.01-1.54, p = 0.039) showed significant correlation with PSD when Type D analyzed as continuous variables. Furthermore, positive effects were found for the negative affectivity and social inhibition interaction (OR = 1.31, 95 % CI =1.11-1.55, p = 0.001) on PSD. CONCLUSIONS: Our findings suggest that Type D personality is high risk group of PSD. These findings highlight the importance of personalized interventions management in Type D individuals.

Impact of Type D Personality, Role Strain, and Diabetes Distress on Depression in Women With Type 2 Diabetes: A Cross-Sectional Study.

BACKGROUND: Women with diabetes face a significantly elevated risk of developing depression. Clarifying the factors associated with depression is critical to designing more timely interventions for this vulnerable population. PURPOSE: This study was developed to examine the impact of Type D personality, diabetes-care-related role strain, and diabetes-related distress on depression in women with Type 2 diabetes. METHODS: A cross-sectional design was used. Convenience sampling was used to recruit 298 women aged 20-64 years who had been diagnosed with Type 2 diabetes for over 6 months from three outpatient endocrine clinics in Taiwan. Demographic and disease characteristics and Type D personality (negative affectivity and social inhibition), diabetes-care-related role strain, and diabetes-related distress and depression status information were collected using self-reported questionnaires and medical records. The important factors of influence on depression were examined using hierarchical multiple regression. RESULTS: On the basis of the results of the hierarchical multiple regression analysis, age, negative affectivity, diabetes-care-related role strain, and diabetes-related distress were identified as significantly associated with depression, with negative affectivity explaining most (43.4%) of the variance in depression, followed by diabetes-care-related role strain and diabetes-related distress, which respectively explained 3% and 2.5% of the variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The negative affectivity associated with the Type D personality was shown to be more significantly associated with depression than diabetes-related psychosocial factors such as diabetes-related distress and diabetes-care-related role strain. Timely assessment of negative affectivity and the provision of brief mindfulness intervention to reduce negative affectivity may be useful in preventing depression in women with Type 2 diabetes, whereas addressing diabetes-related distress and diabetes-care-related role strain should not be neglected when providing comprehensive depression-preventing interventions to young women with diabetes.

Type D Personality as a Marker of Poorer Quality of Life and Mood Status Disturbances in Patients with Skin Diseases: A Systematic Review.

Type D personality is characterized by social inhibition and negative affectivity. Poorer outcomes and worse quality of life have been linked to type D personality in patients with a variety of non-dermatological diseases. Despite increasing evidence of the importance of type D personality in skin diseases, there are no reviews on this subject. The aim of this review is to summarize the current evidence regarding type D personality and skin diseases. A systematic search was performed using Medline and Web of Science databases from inception to 11 October 2022. Studies addressing the presence of type D personality, its associated factors, its impact on the outcomes of the disease or the quality of life of the patients were included in the systematic review. A total of 20 studies, including 3,124 participants, met the eligibility criteria and were included in the review. Acne, hidradenitis suppurativa, psoriasis, melanoma, atopic dermatitis, chronic spontaneous urticaria and pruritic disorders were the main diseases assessed. Type D personality was more frequent among patients with skin diseases than among controls. Type D personality was found to be associated with poorer quality of life and higher rates of psychological comorbidities in patients with skin diseases. In conclusion, type D personality appears to be a marker of patients with increased risk of poorer quality of life and higher rates of psychological comorbidities. Screening for type D personality in specialized dermatology units might be beneficial to identify patients who are more psychologically vulnerable to the consequences of chronic skin diseases.

Type D Personality as a Risk Factor for Adverse Outcome in Patients With Cardiovascular Disease: An Individual Patient-Data Meta-analysis.

OBJECTIVE: Type D personality, a joint tendency toward negative affectivity and social inhibition, has been linked to adverse events in patients with heart disease, although with inconsistent findings. Here, we apply an individual patient-data meta-analysis to data from 19 prospective cohort studies ( N = 11,151) to investigate the prediction of adverse outcomes by type D personality in patients with acquired cardiovascular disease. METHOD: For each outcome (all-cause mortality, cardiac mortality, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, major adverse cardiac event, any adverse event), we estimated type D's prognostic influence and the moderation by age, sex, and disease type. RESULTS: In patients with cardiovascular disease, evidence for a type D effect in terms of the Bayes factor (BF) was strong for major adverse cardiac event (BF = 42.5; odds ratio [OR] = 1.14) and any adverse event (BF = 129.4; OR = 1.15). Evidence for the null hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03), cardiac mortality (BF = 23.7; OR = 0.99), and myocardial infarction (BF = 16.9; OR = 1.12), suggesting that type D had no effect on these outcomes. This evidence was similar in the subset of patients with coronary artery disease (CAD), but inconclusive for patients with heart failure (HF). Positive effects were found for negative affectivity on cardiac and all-cause mortality, with the latter being more pronounced in male than female patients. CONCLUSION: Across 19 prospective cohort studies, type D predicts adverse events in patients with CAD, whereas evidence in patients with HF was inconclusive. In both patients with CAD and HF, we found evidence for a null effect of type D on cardiac and all-cause mortality.

Relationships among Symptoms, Disability, Type D Personality, and Quality of Life in Patients with Migraine: A Cross-Sectional Study in South Korea.

BACKGROUND: Type D personality as a personality vulnerable to stress consists of negative affectivity and social inhibition, and it is related to symptoms and decreased quality of life in patients with chronic illness. AIM: This study aimed to explore the relationships among migraine symptoms, disability, type D personality, and quality of life in patients with migraine. METHODS: A convenience sample of 135 patients with migraine was collected at the neurologic outpatient clinics of two tertiary hospitals in South Korea. Frequency and severity of migraine symptoms, Migraine Disability Assessment, type D personality, and quality of life were investigated using a structured questionnaire. A descriptive cross-sectional design was used. RESULTS: Sixty-one (45.2%) were classified as type D personality. The intensity of the most severe migraine and Migraine Disability Assessment scores in subjects with type D personality were significantly higher than those in subjects without type D personality. In addition, the quality of life score of subjects with type D personality was significantly lower than in subjects without type D personality. The intensity of the migraine, Migraine Disability Assessment score, and type D personality were significant factors influencing quality of life on stepwise multiple regression analysis. CONCLUSIONS: Type D personality was related to migraine symptoms, disability, and quality of life in patients with migraine.

The combined impact of Type D personality and depression on cardiovascular events after acute myocardial infarction.

BACKGROUND: Type D personality and depression are the independent psychological risk factors for adverse outcomes in cardiovascular patients. The aim of this study was to examine the combined effect of Type D personality and depression on clinical outcomes in patients suffering from acute myocardial infarction (AMI). METHODS: This prospective cohort study included 3568 patients diagnosed with AMI between February 2017 and September 2018. Type D personality and depression were assessed at baseline, while the major adverse cardiac event (MACE) rate (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) and in-stent restenosis (ISR) rate were analyzed after a 2-year follow-up period. RESULTS: A total of 437 patients developed MACEs and 185 had ISR during the follow-up period. The Type D (+) depression (+) and Type D (+) depression (-) groups had a higher risk of MACE [95% confidence interval (CI) 1.74-6.07] (95% CI 1.25-2.96) and ISR (95% CI 3.09-8.28) (95% CI 1.85-6.22). Analysis of Type D and depression as continuous variables indicated that the main effect of Type D, depression and their combined effect were significantly associated with MACE and ISR. Moreover, Type D (+) depression (+) and Type D (+) depression (-) emerged as significant risk factors for MACE and ISR in males, while only Type D (+) depression (+) was associated with MACE and ISR in female patients. CONCLUSIONS: These findings suggest that patients complicated with depression and Type D personality are at a higher risk of adverse cardiovascular outcomes. Individual assessments of Type D personality and depression, and comprehensive interventions are required.

Relationship between Type D personality and adverse health outcomes in people with type 2 diabetes: The parallel mediating roles of diabetes distress and social isolation.

AIM: To investigate the relationship between Type D personality and adverse health outcomes [glycated haemoglobin (HbA1c) and health-related quality of life (HRQOL)] directly, and indirectly via diabetes distress and social isolation in people with type 2 diabetes. DESIGN: A secondary analysis of 524 participant's data derived from a cross-sectional, correlational study with people with type 2 diabetes. METHODS: Data were analysed using the PROCESS macro of SPSS. RESULTS: Type D personality was present in 31.3% of the participants, and exerted a direct effect on HRQOL but not on HbA1c. Type D personality indirectly affected both HbA1c and HRQOL via the mediators of diabetes distress and social isolation. Nurses need to monitor people with type 2 diabetes to determine whether Type D personality is present. Those with Type D personality should be provided with interventions to reduce diabetes distress and alleviate social isolation in order to improve HbA1c and HRQOL.

Sex differences in the course of implantable cardioverter defibrillator concerns (Results from the Danish national DEFIB-WOMEN study).

OBJECTIVE: The implantable cardioverter defibrillator (ICD) is used to treat malignant ventricular arrhythmias. Since 33% of patients experience ICD-related concerns, we examined sex differences in ICD concerns and correlates of ICD concerns during 24 months of follow-up after implantation of an ICD. METHODS: Patients from the DEFIB-WOMEN study (n = 1515; 81.6% male patients) completed questionnaires on ICD concerns, anxiety, depression, and Type D personality at five measure points (baseline, 3-, 6-, 12- and 24-months post-implantation). RESULTS: Male patients scored on average 7.0 (6.8) points on ICD concerns at the time of implantation and female patients scored on average 10.5 (8.2) points. We found statistically significant sex differences in ICD concerns at all measurement points, with female patients scoring 2.77 points (8.7% of the maximum score of 32) higher than male patients. ICD concerns decreased in both sexes the first 6 months and then levelled out. For both sexes, ICD concerns at baseline were significantly correlated with ICD concerns at 24-months follow-up. Anxiety at baseline was correlated with ICD concerns in female patients, while depression at baseline and at least one experienced shock correlated with ICD concerns in male patients. CONCLUSION: Female patients reported more ICD concerns at all measurement points compared to male patients, but for both sexes ICD concerns decreased in the first 6 months. ICD shock, anxiety, depression, and ICD concerns at baseline were correlates of ICD concerns at 24-months follow-up.

Prevalence and implications of type D personality in patients with alopecia areata: A marker of quality-of-life impairment and mood status disturbances, a comparative study.

INTRODUCTION: Distressed personality (or Type D personality, TDp) is a personality trait that has been associated with poor quality of life in patients suffering from a variety of skin diseases such as psoriasis or urticaria. To date the potential association between Alopecia areata (AA) and TDp has not been studied. The aim of this study was to compare the prevalence of TDp between patients with AA and controls, and to analyse the impact of TDp on patients with AA regarding mood status disturbances, quality of life and sexuality. METHODS: Cross-sectional study includes patients suffering from mild-to-severe AA and sex- and age-matched healthy controls. Socio-demographic and clinical variables, quality of life, sexual disfunction, anxiety, depression and TDp were collected using validated questionnaires. RESULTS: A total of 120 participants (60 patients and 60 controls) were included. Patients with AA showed higher prevalence of TDp than controls (35% vs. 15% p = 0.01), as well as higher rates of anxiety, depression and sexual dysfunction (p < 0.05). TDp was found to be linked to disease severity (p = 0.04), anxiety and depression scores (p < 0.001) and worse quality of life (p = 0.001). No relationship was found between TDp and sexual dysfunction. DISCUSSION: Type D personality prevalence is higher in patients with AA than in controls. It is associated with higher rates of anxiety, depression and worse quality of life. Screening for this type of personality could be useful to detect patients who could benefit from additional psychological support as a complement to their medical treatment.

Type D Personality and Health Behaviors in People Living with Obesity.

BACKGROUND: Considering that health behaviors and personality traits play an important role in the formation of health attitudes, the main objective of this study was to evaluate the relations that occur between type D personality and health behaviors in a group of obese patients. METHODS: 443 adult patients with BMI ≥ 30 kg/m2, who had been hospitalized in selected hospital facilities in the Silesian Voivodeship (Poland), participated in the study. Respondents completed three standardized questionnaires-the Multidimensional Health Locus of Control Scale, version A (MHLC-A), the Inventory of Health Behaviors (IZZ), and the Type D Scale (DS-14). RESULTS: Patients with type D personality were characterized by the least effective mental attitudes and preventive behaviors, and differed significantly from the other personality types (intermediate and non-type D). Type D personality increased the risk of initiating improper health behaviors by more than five times. Regarding the sense of health control, patients with type D personality had significantly lower scores for the Internal Dimension subscale (21.3 ± 3.1) and higher for the Powerful Others Dimension subscale (24.0 ± 2.6), compared to patients with intermediate and non-type D personality. Proper health behaviors correlated with an internal sense of health control; the strongest correlation, defined as a medium, was with Preventive Behaviors (R = 0.42; p < 0.0001). CONCLUSIONS: Type D personality was associated with poorer attitudes towards health. Among obese respondents with a type D personality, there was a significantly higher prevalence of those who believed that their health status was a consequence of chance events.

Type D personality, cognitive illness perception, depression, approach coping, and self-management among older adults in long-term care hospitals: Structural equation modeling.

This study aimed to construct a structural equation model to explore the relationship between Type D personality, cognitive illness perception, depression, approach-coping, and self-management. The study was conducted at two long-term care hospitals with 300 or more beds in Korea. Participants were 287 older patients from whom data were collected from February 17 to March 10, 2021, using a structured questionnaire comprising items on the following variables: Type D personality, cognitive illness perception, depression, approach coping, and self-management. Type D personality (ß=-.601, p=.001), cognitive illness perception (ß =.692, p <.001), depression (ß =-.204, p =.011), and approach-coping (ß =.326, p <.001) explained 78.8% of the total variance of self-management, highlighting their impact on how patients accept and manage a disease and their relevance to the self-management of older adults in long-term care hospitals.

Evolution of Type D Personality Traits After Cochlear Implantation in Severely Hearing Impaired Adults 55 Years and Older: An Exploratory Prospective, Longitudinal, Controlled, Multicenter Study.

PURPOSE: To study the evolution of type D personality traits in older adults after cochlear implantation compared with a control group of severely hearing impaired older adults who did not receive a cochlear implant (CI). The influence of COVID-19 on this evolution was also explored. Type D personality combines a high degree of negative affectivity (NA) and social inhibition (SI). METHODS: In this prospective, longitudinal, controlled multicenter exploratory study, 76 older CI users and 21 severely hearing impaired controls without CI were included. The CI group and the control group did not differ significantly regarding age, formal education, residual hearing, Type D Scale-14 (DS14) total score, NA, and SI at baseline. Type D personality traits were assessed with the DS14 at baseline (T0) and 14 months later (T14). RESULTS: Type D personality traits differed significantly over time between the CI group and the control group (p < 0.001). In the CI group, the DS14 total score (mean delta T = -6.63; p < 0.001), NA (mean delta T = -3.26; p < 0.001), and SI (mean delta T = -3.37; p < 0.001) improved significantly over time (delta T = T14-T0), whereas no significant difference was found in the control group. Significantly fewer subjects were categorized as type D personalities in the CI group (delta T = -12; p = 0.023) at T14, whereas no significant change was found in the control group (delta T = 3; p = 0.250). COVID-19 did not influence the evolution of type D personality traits significantly in the CI group. CONCLUSION: Cochlear implantation has a positive effect on type D personality traits in older adults with a severe-to-profound hearing impairment.

Type D Personality Independently Predicts Erectile Dysfunction in Taiwanese Young Men.

BACKGROUND: Studies have demonstrated that erectile dysfunction has a well-established bidirectional relationship with depression and have indicated an independent association of type D personality (TDP) with depression. Nevertheless, the relationship of erectile dysfunction with TDP has not been sufficiently examined. AIM: To examine the associations among depression symptoms, TDP, and erectile dysfunction. METHODS: The cross-sectional study recruited 1740 sexually active Taiwanese men (age: 20-40 years) with erectile dysfunction. Participants completed an online questionnaire collecting general demographic information and containing the International Index of Erectile Function-5, Type D Scale-14, and Depression and Somatic Symptom Scale. Pearson's chi squared or Student's t'test was conducted for comparisons between participants with vs without TDP. We conducted multivariate and univariate logistic regression analysis to investigate the predictors of moderate/severe erectile dysfunction. OUTCOMES: The prevalence of TDP and moderate/severe erectile dysfunction, the associations between TDP and the severities of depression symptoms and erectile dysfunction, and independent risk factors for moderate/severe erectile dysfunction. RESULTS: A total of 360 (15.9%) and 941 (54.08%) men had moderate/severe erectile dysfunction and TDP, respectively. Men with TDP reported significantly higher total and subscale scores in the International Index of Erectile Function-5 and the Depression and Somatic Symptom Scale; this group also exhibited higher prevalence of moderate or severe erectile dysfunction. According to the univariate analysis, all variables significantly predicted moderate or severe erectile dysfunction except for age and body mass index. A multivariate analysis revealed TDP status and depression symptoms to be independent predictors of moderate or severe erectile dysfunction. With regard to subscales of the Type D Scale-14, we discovered that social inhibition had a greater influence on moderate or severe erectile dysfunction than had negative affectivity. A mediation analysis indicated that the relationship between TDP and erectile dysfunction was mediated by depressive symptoms. CLINICAL IMPLICATIONS: Research has suggested that compared with the general population, individuals with TDP are less willing to seek medical consultation, have lower medication adherence, and have heightened risk of depression; urologists should strive to identify patients with TDP. STRENGTHS & LIMITATIONS: This study is the first to investigate the association of TDP with erectile dysfunction in a large population of young men by using validated instruments. Conclusions on causality cannot be drawn due to the study's cross-sectional nature. CONCLUSION: This research revealed relationships among TDP, depression symptoms, and erectile dysfunction in Taiwanese young men. Fan Y-H, Liou Y-J, Cheng W-M. Type D Personality Independently Predicts Erectile Dysfunction in Taiwanese Young Men. J Sex Med 2022;19:1397-1403.