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Higher Heart Disease Risk for “Distressed” Personalities

Most people are relatively familiar with the concepts of Type A and Type B personalities and have probably tried to identify their match. But what if your personality is characteristic of the lesser known Type D?

A new study suggests that if a person is profiled as a Type D personality from a psychologist’s standpoint, the risk of future heart disease and cardiovascular issues becomes higher.

Recently published in the American Heart Association’s Circulation: Cardiovascular Quality and Outcomes, the summary article said that a review of more than 6,000 patients revealed a link between Type D personality characteristics and heart disease.

Also known as “distressed” personality, Type D people typically are characterized by negativity and often exhibit low self-esteem and a tendency toward depression. A “distressed” personality may display common characteristics such as stress, anger, worry, hostility and tension.

“Type D patients tend to experience increased levels of anxiety, irritation and depressed mood across situations and time, while not sharing these emotions with others because of fear of disapproval,” said Viola Spek, Ph.D., senior author of the study and a researcher at Tiburg University in the Netherlands. “We found that Type D personality predicts mortality and morbidity in these patients, independent of traditional medical risk factors.”

An analysis of 49 different studies involving Type D patients was conducted and statistically compared to the presence of future heart conditions and psychological health.

A threefold increase in risk was found for “distressed personalities” as it related to peripheral artery disease, angioplasty or bypass procedures, heart failure, heart transplantation, heart attack or death. The same increase in risk was identified for psychological conditions including clinical depression, anxiety and overall poorly framed mental health.

“Type D personality and depression are distinct manifestations of psychological distress, with independent cardiovascular effects,” said Johan Denollet, Ph.D., lead author of the study. “Our findings support the simultaneous use of depression and Type D measures to flag high-risk patients.”

Researchers suggested that better screening could be completed on heart patients to determine if they have characteristics that align with “distressed” personalities. Once identified, appropriate psychological counseling interventions could be undertaken to potentially improve heart health and future outcomes.

Type D personality was introduced in the 1990s, decades after the original personality classification system was implemented. It is identified by using a 14-item questionnaire that measures social inhibitions and mood.

Other research points to Type A personalities—characterized by a focus on achievement, urgency and competitiveness—as being at a higher risk for heart disease, but findings have not been conclusive.

There are a growing number of studies underway tracking Type D personalities and overall health. This study conducted by the group in the Netherlands was pooled from the researchers’ own previous studies due to lack of other data in the industry.

Some studies have connected biological and behavioral pathways as a source contributing to the negative effects of Type D traits.

Denollet suggests that psychological intervention could help the future outlook of Type D patients but adds that it’s difficult for this population to express concerns about stresses or negative feelings. Primary care providers will often have to be the catalysts for identifying “distressed” personalities and drawing them out.

The study was funded by the Netherlands Organization for Scientific Research.

Source: American Heart Association

Higher Heart Disease Risk for “Distressed” Personalities

Selena Chavis

APA Reference
Chavis, S. (2018). Higher Heart Disease Risk for “Distressed” Personalities. Psych Central. Retrieved on September 26, 2020, from
Scientifically Reviewed
Last updated: 8 Aug 2018 (Originally: 15 Sep 2010)
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
Published on Psych All rights reserved.