Lack of Prognostic Value of Type D Personality for Mortality in a Large Sample of Heart Failure Patients
2011 (English)In: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 73, no 7, 557-562 p.Article in journal (Refereed) Published
Background: Type D personality has been proposed as a prognostic indicator for mortality in cardiovascular disease. Most research examining this construct originates from one research group, and it is critical that the predictive value of Type D personality for adverse outcomes is independently cross-validated. This study examined its prognostic value in heart failure, relative to B-type natriuretic peptide (BNP) and depressive symptoms. Methods: We studied 706 patients with complete BNP, depressive symptom, and Type D personality and mortality data from 958 patients with heart failure enrolled after hospitalization for a multisite study of a disease management program. Multivariable models were adjusted for BNP and depression. Results: At 18 months, there were 192 deaths (27.2%). No evidence was found for a prognostic value of Type D personality in the unadjusted model (hazard ratio [HR] = 0.893, 95% confidence interval [CI] = 0.582-1.370). In contrast, BNP was significantly predictive of mortality (HR = 1.588, 95% CI = 1.391-1.812), whereas depression was not (HR = 1.011, 95% CI = 0.998-1.024). Type D was also not predictive in covariate-adjusted models (HR = 0.779, 95% CI = 0.489-1.242). Similar results were obtained when analyzing Type D as the interaction between continuous z scores of its two components, negative affectivity and social inhibition (p = .144). Conclusions: In the largest study to date, Type D does not predict mortality. Future research should construe Type D as the interaction of continuous negative affectivity and social inhibition z scores, rather than as a typology, and consider analyses replacing negative affectivity with depression.
Place, publisher, year, edition, pages
Lippincott, Williams and Wilkins , 2011. Vol. 73, no 7, 557-562 p.
Type D personality, heart failure, survival, B-type natriuretic peptide, depression
National CategoryMedical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-71220DOI: 10.1097/PSY.0b013e318227ac75ISI: 000295122300006OAI: oai:DiVA.org:liu-71220DiVA: diva2:446347