ثبات شش ساله شخصیت نوع-D در یک گروه از بیماران قلبی آلمانی
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|37068||2012||6 صفحه PDF||سفارش دهید||5464 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Journal of Psychosomatic Research, Volume 72, Issue 2, February 2012, Pages 136–141
Abstract Objective The aim of the study was to systematically analyze the stability of Type-D personality over a time span of several years in a clinical sample. Methods In a prospective cohort study, cardiac patients from different medical settings in Germany were assessed using the DS14 questionnaire at baseline (n = 1240) and at a mean follow-up time of six years (n = 679). Different types of stability were examined and compared with the stability of the Hospital Anxiety and Depression Scale (HADS). Results Rank-order stability was moderate (r = .61 for Negative Affectivity [NA] and r = .60 for Social Inhibition [SI]) and didn't differ from the rank-order stability of the HADS. Whereas the mean level of SI didn't change over time, the mean level of NA increased (d = 0.08). On an individual level, approximately one quarter of the participants showed a significant increase or decrease. The factorial structure of the DS14 was stable over time. Finally, the agreement of Type-D classification between the two measurement points was moderate (κ = .42) with 22% of the participants changing their Type-D classification over time. Conclusion The stability of NA and SI didn't differ from the stability of measures of emotional distress that are generally considered to be less stable. In particular, the only moderate stability of the dichotomous Type-D classification raises some questions.
In recent years, Type-D personality, characterized by the coincidence of a high level of negative affectivity (NA) and a high level of social inhibition (SI)  and , has been established as a predictor of poor prognosis and adverse clinical events in patients with cardiovascular diseases. A recent meta-analysis concluded that patients with Type D have more than a 3-fold increased risk for mortality and recurrent myocardial infarction as well as for psychological distress, even after controlling for sociodemographic variables, medical risk factors, and different indicators of psychological distress, especially depression . In considering potential causal mechanisms of the Type-D personality and the strength of the effects compared to other concepts of negative affectivity, the stability of the Type-D construct as well as its constituents - negative affectivity and social inhibition - has been pointed out as a salient aspect. In contrast to episodic or transient states of depressive mood and anxiety, the pathogenetic mechanisms of the Type-D personality are seen as affecting a person continuously across time  and .
نتیجه گیری انگلیسی
The stabilities of the NA and SI dimensions are comparable to other personality traits, although for widely recognized traits such as extraversion or neuroticism, higher reliability estimates have been reported. However, the stability characteristics are comparable to the scales of the HADS as well, an instrument created to assess more transient or episodic distress. This weakens the theoretical assumption of Type D as a chronic risk marker and the proposed causal mechanisms that rely on a continuous impact of Type D. Future research should focus on longitudinal studies of possible mechanisms that relate Type D to the prognosis of cardiovascular diseases. For clinical practice, the low stability of the dichotomous Type-D classification raises questions about the usefulness of Type D as a screening tool. The use of a two-step screening procedure  might be more appropriate. To limit the impact of the low stability of the dichotomous classification, the Type-D construct should be represented as a latent class or an interaction between latent variables.