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Lack of Prognostic Value of Type D Personality for Mortality in a Large Sample of Heart Failure Patients
University of Groningen.
Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
University of Groningen.
University of Groningen.
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2011 (English)In: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 73, no 7, 557-562 p.Article in journal (Refereed) Published
Abstract [en]

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.
Keyword [en]
Type D personality, heart failure, survival, B-type natriuretic peptide, depression
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-71220DOI: 10.1097/PSY.0b013e318227ac75ISI: 000295122300006OAI: diva2:446347
|Available from: 2011-10-07 Created: 2011-10-07 Last updated: 2011-10-12

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Jaarsma, Tiny
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