Personality and heart disease

Heart (British Cardiac Society) (Impact Factor: 5.6). 08/2007; 93(7):783-4. DOI: 10.1136/hrt.2006.109355
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Available from: Gerard J Molloy
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    • "Negative mood and affectivity traits have been intensively studied as risk indicators of cardiovascular diseases since 1960s, when the concept of type A behavior characterized by hostility, impatience, competitiveness, and dominance was established as a risk factor (Friedman and Rosenman, 1960). Thereafter, the findings have not been consistent across the negative affective traits, and the conceptual debate has continued (Steptoe and Molloy, 2007; Tindle et al., 2010). Of the psychosocial factors, the strongest evidence has emerged for depression, which seems to be both an independent predictor of future cardiovascular diseases, and an important determinant of outcome (Barefoot and Schroll, 1996; Everson et al., 1998; Ford et al., 1998; Schulz et al., 2002; Strik et al., 2003; Buerki and Adler, 2005) as well as associates with unhealthy behaviors in persons suffering from cardiovascular disorders (Ziegelstein et al., 2000). "
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    ABSTRACT: The purpose of this study is to investigate the value of life orientation as a screening tool and survival indicator in old age. A postal questionnaire answered by 2490 random older people (>75 years) included six questions concerning satisfaction with life, feeling needed, plans for future, zest for life, lack of feelings of depression and loneliness. The vital status was followed for 57 months. All-cause mortality rate was 19.1% and 30.3% among elderly with (22%) and without (78%) positive life orientation, respectively (p<0.001). The difference in mortality increased over time. After controlling for age, gender, and subjective health, the protective value of positive life orientation remained significant (hazard ratio, HR=0.78, 95%CI=0.63-0.98, p<0.03). Feeling needed was the strongest independent predictor (HR=0.72, p<0.001). A six-question life orientation identifies old people at risk. Positive life orientation predicts good survival prognosis independently of subjective health.
    Preview · Article · Jul 2011 · Archives of gerontology and geriatrics
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    • "In addition, in patients who survived a myocardial infarction, Type D personality was found to predict post-traumatic stress disorder (PTSD) above and beyond other risk factors such as age, gender, neuroticism, and extroversion [3]. It has been suggested that the presence of Type D may be affected by the state of illness, as “the knowledge of having a serious illness affects people’s moods and confidence in social interactions” [4]. In this respect, one could argue that Type D is disease state specific rather than a stable trait. "
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    ABSTRACT: The Type D (distressed) personality refers to a general propensity to psychological distress defined by the combination of negative affectivity and social inhibition. Type D personality predicts poor mental and physical health in cardiac patients, but it has been argued that its assessment is affected by the state of illness. Therefore, validation of the Type D construct in healthy adults remains essential. The objectives of this study were (1) to validate Type D personality against temperament and character dimensions in young, healthy adults and (2) to investigate the association between Type D personality and pre-deployment mental health. Type D personality, temperament, and questionnaires on mental health were filled out by 86 healthy male Dutch military personnel before UN deployment to Afghanistan. Type D personality was present in 16% of healthy military personnel before deployment. The Type D components social inhibition (α = 0.89) and negative affectivity (α = 0.85) correlated positively with harm avoidant temperament (r = 0.66 and 0.46) and negatively with self-directed character (r = -0.33 and -0.57). In addition, these four traits loaded on the same broad personality dimension. Military men with a Type D personality not only reported significantly less self-directedness and more harm avoidance as compared to non-Type D men (p < 0.001) but also more symptoms of PTSD, general emotional distress, and hostility (all p < 0.012). Type D personality was associated with harm avoidance, low self-directedness, and increased symptoms of PTSD and hostility in men awaiting deployment. This association was not caused by any somatic confounding in these young, healthy men.
    Full-text · Article · Jun 2011 · International Journal of Behavioral Medicine
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    • "Recent evidence also indicates that Type D personality is distinctly different from depression in terms of predictive power (Denollet and Pedersen, in press; Schiffer et al., 2007), cortisol secretion (Whitehead et al., 2007) and somatic confounding (de Jonge et al., 2007). Hence, it is important to identify mechanisms that may explain the link between Type D and cardiac outcomes (Steptoe and Molloy, 2007). The current study suggests that the presence of Type D personality in CHF, irrespective of age, identifies a subgroup with a particularly stimulated inflammatory profile that may warrant special attention. "
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    ABSTRACT: Tumor necrosis factor-alpha (TNF-alpha) and its soluble receptors 1 (sTNFR1) and 2 (sTNFR2) have been shown to be implicated in the pathogenesis of chronic heart failure (CHF). Ageing is accompanied by increased plasma levels of pro-inflammatory cytokines. We hypothesized that Type D personality (joint tendency to experience negative emotions and to inhibit self-expression) and age may have similar pro-inflammatory effects in the context of CHF. Participants in this study were 130 consecutive outpatients with CHF (76% men); there were 70 relatively younger (<or=59 years) and 60 relatively older (>or=60 years) patients. They all completed the 14-item Type D Scale (DS14); 43 patients (33%) had a Type D personality. A multivariate model of cytokine levels indicated an independent overall effect of both older age [F(1,128)=9.11, p=.003] and Type D personality [F(1,128)=8.28, p=.005]. Stratifying patients in age/personality subgroups showed that younger non-Type D patients had the lowest and older Type D patients the highest sTNFR1 and sTNFR2 levels (986+/-318 vs 1661+/-1128 pg/ml and 1838+/-777 vs 2823+/-1439 pg/ml, p<.0001). Importantly, the mean sTNFR1 level in younger Type D patients (1359+/-660 pg/ml) was equivalent to that in older non-Type D patients (1360+/-440 pg/ml, p=.99) who were on average 18 years older. Younger Type D and older non-Type D patients also had similar sTNFR2 levels (2406+/-1329 vs 2448+/-812 pg/ml, p=.88). Only older Type D patients had a higher mean TNF-alpha level as compared to patients who were younger or who were not Type D (5.4+/-2.9 vs 3.9+/-2.4 pg/ml, p=.008). A logistic regression model including sex, severity of CHF, systolic heart failure and ischemic etiology indicated that the combined risk category of older age or Type D was independently associated with substantially increased sTNFR1 and sTNFR2 levels. Hence, Type D personality was associated with increased TNF-alpha activity. This disease-promoting effect of Type D matched the pro-inflammatory effect of ageing.
    Full-text · Article · Jul 2008 · Brain Behavior and Immunity
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