ارتباط بین شخصیت نوع D و برداشت بیماری در بازماندگان سرطان روده بزرگ: مطالعه استفاده از رجیستری مشخصات مبتنی بر جمعیت

Abstract Objective To examine the association between Type D personality and illness perceptions among colorectal cancer survivors 1–10 years post-diagnosis. Methods Data from two population-based surveys on colorectal cancer survivors was used. Patients diagnosed between 1998 and 2009, as registered in the Eindhoven Cancer Registry, received a questionnaire on Type D personality (DS14) and illness perceptions (B-IPQ); 81% (n = 3977) responded. Results 750 (19%) patients had a Type D personality. They believe their illness has significantly more serious consequences, will last significantly longer, and experience significantly more symptoms that they attribute to their illness. Also, they are more concerned about their illness, and their disease more often influences them emotionally. Differences regarding ‘consequences’, ‘concern’ and ‘emotional response’ were also clinically relevant. The majority of patients stated that the cause of their disease was unknown (23.3%), hereditary (20.3%), lifestyle (15.1%), psychological distress (11.9%) or other (11.6%). Significant differences in perceptions on cause of disease between Type Ds and non-Type Ds were found for psychological distress (16.2 vs. 10.9%; p < 0.01), randomness (1.7 vs. 5.3%; p < 0.01) and unknown (18.8 vs. 24.4%; p < 0.01). Multivariate analyses showed that Type D was negatively associated with ‘coherence’ and positively with ‘consequences’, ‘timeline’, ‘identity’, ‘concern’, and ‘emotional representation’. Conclusions These results elucidate the associations between personality and illness perceptions, demonstrating their close interrelatedness. Our study may be helpful in further developing theoretical models regarding giving meaning to illness and the illness perceptions that the illness elicits. Future studies should investigate whether interventions can positively impact illness perceptions of Type D cancer patients. Abbreviations (ECR), Eindhoven Cancer Registry; (NA), Negative affectivity; (SI), Social inhibition

Type D (distressed) personality has become an important research topic in the field of medical psychology in recent years. It has been described as the tendency to experience a high joint occurrence of negative affectivity and social inhibition [1]. People who score high on negative affectivity have the tendency to experience negative emotions, while people who score high on social inhibition have the tendency not to express these emotions, because of fear of rejection or disapproval by others. Those with high levels on both personality traits are classified as having a Type D personality [1]. Systematic reviews among various patient groups [2] and [3] and healthy individuals [4] have shown that Type D personality is a stable [1] and [5] and powerful predictor of impaired quality of life and mental health status, above and beyond clinical characteristics. Also, studies have shown that individuals with a Type D personality reported higher rates of medically documented comorbidity [6] and [7], more somatic complaints [8], [9], [10] and [11], and report to feel more bothered by their illness [7], [12] and [13] compared to those without this personality type. Findings on health care utilization among those with a Type D personality are mixed. While some studies have shown that patients with a Type D personality are less likely to seek appropriate medical care [9], [12], [14] and [15], a recent publication among cancer survivors concluded the opposite [7].