آیا تیپ شخصیت نوع دی نتایج در بیماران مبتلا به بیماری های قلبی عروقی را پیش بینی می کند؟ بررسی فراتحلیلی

Objective Research generally indicates that psychological variables are stronger predictors of cardiovascular outcomes in healthy populations than in those with preexisting illness. Studies of Type-D personality, however, suggest that it may also be predictive of negative health outcomes in cardiovascular patient populations. To date, no independent, comprehensive meta-analysis centered specifically on Type-D has integrated this literature and provided quantitative estimates of these relationships. The present meta-analysis investigated the associations between Type-D personality and (a) major adverse cardiac events (MACE), (b) health-related quality of life (HRQOL) and (c) biochemical markers of cardiovascular disease among cardiovascular patients. Method Two independent reviewers abstracted data from 15 separate studies. A random effects meta-analytic model was utilized to calculate omnibus effect sizes for each set of related studies, i.e., for the MACE (N of patients=2903), HRQOL (N of patients=1263) and biochemical marker (N of patients=305) measures. Results A positive association was found between Type-D personality and MACE, whereas a negative association was observed between Type-D personality and HRQOL. There was a trend toward significance in the association between Type-D personality and cardiovascular disease biomarkers. Conclusion Type-D personality is a promising construct for understanding psychological relationships with important outcomes among cardiovascular patients. Subsequent investigations undertaken by a more diverse group of unaffiliated scientists are important for further development in this line of research. .

Type-D or “distressed” personality is characterized by the combination of two stable personality constructs: negative affectivity (NA) and social inhibition (SI). Negative affectivity is the tendency to consistently experience negative emotions such as dysphoria, anxious apprehension and irritability across time or situation, whereas SI is the tendency to inhibit the expression of emotions, experience high levels of insecurity in social situations and excessively control self-expression for fear of disapproval by others [1] and ⁎[2]. Type-D theorists suggest that it is the synergistic effect of high NA in combination with high SI that is most predictive of poor health and particularly poor cardiac prognosis [3]. The relationship between Type-D personality and depression has been a source of some discussion. Briefly, Type-D is posited as a personality trait or disposition and as such does not connote the presence of pathology, as is the case with depression, but Type-D does connote temporal stability, which is not necessarily the case for depression. Furthermore, Type-D not only includes NA, a construct that is broader than depression, but also centrally includes SI, which is not a core characteristic of depression. Denollet and colleagues [4] provide further evidence for the construct validity and distinctiveness of Type-D in relation to depression among cardiac patients. Thus, though the construct of NA carries with it some overlap with depression, Type-D and depression are significantly different in important ways. Evidence exists for the stability of Type-D personality. For example, acute myocardial infarction patients were assessed for Type-D, depression and anxiety multiple times over 18 months. Variability in mood status and disease severity did not have an association with change in Type-D classification [5], which remained relatively stable. Current controversy regarding whether Type-D is a dimensional or taxonic construct [6] and [7] continues but is not central to this project and will not be further addressed here.