عاطفه منفی و بازداری اجتماعی در بیماری های قلبی عروقی: بررسی تیپ شخصیتی نوع D و نظریه واکنش با استفاده از آیتم ارزیابی آن

Objective Individuals with increased levels of both negative affectivity (NA) and social inhibition (SI)—referred to as type-D personality—are at increased risk of adverse cardiac events. We used item response theory (IRT) to evaluate NA, SI, and type-D personality as measured by the DS14. The objectives of this study were (a) to evaluate the relative contribution of individual items to the measurement precision at the cutoff to distinguish type-D from non-type-D personality and (b) to investigate the comparability of NA, SI, and type-D constructs across the general population and clinical populations. Methods Data from representative samples including 1316 respondents from the general population, 427 respondents diagnosed with coronary heart disease, and 732 persons suffering from hypertension were analyzed using the graded response IRT model. Results In Study 1, the information functions obtained in the IRT analysis showed that (a) all items had highest measurement precision around the cutoff and (b) items are most informative at the higher end of the scale. In Study 2, the IRT analysis showed that measurements were fairly comparable across the general population and clinical populations. Conclusions The DS14 adequately measures NA and SI, with highest reliability in the trait range around the cutoff. The DS14 is a valid instrument to assess and compare type-D personality across clinical groups.

Early identification of cardiovascular patients who are characterized by an unfavorable clustering of psychological risk factors [1] is important in order to improve their prognosis and quality of life. A recent report of the National Heart, Lung, and Blood Institute working group on outcomes research in cardiovascular disease also recommended studies to identify the key determinants of patient-centered outcomes such as quality of life and functional status [2]. In recent years, we have argued that the personality traits of Negative Affectivity (NA) and Social Inhibition (SI) are of special interest in this context [3]. NA denotes the stable tendency to experience negative emotions [4]; high-NA individuals experience more feelings of dysphoria, anxious apprehension, and irritability across time and situations. SI denotes the stable tendency to inhibit the expression of emotions and behaviors in social interaction [5]; high-SI individuals tend to feel inhibited, tense, and insecure when with others. Individuals who are characterized by high NA as well as SI seem to scan the world for signs of impending trouble [6] and avoid negative reactions from others through excessive control over self-expression [7].