"D"istressed Personality Linked To Heart Attack Risk

January 20, 1998

DALLAS, Jan. 20 -- People who are negative, insecure and distressed -- a "type D" personality -- are four times more likely to suffer a second heart attack than "non-D types," according to a study reported today in Circulation: Journal of the American Heart Association.

The findings are the first to suggest that a personality trait may influence the risk of a repeat heart attack, says lead author Johan Denollet, Ph.D., of the University of Antwerp, in Edegem, Belgium.

In the study, psychological tests were given to 87 men who had a severe heart attack. The men were at high risk for second heart attacks because of a decreased left ventricular function, resulting in a less effective pumping of blood.

Six to 10 years later researchers determined that the rate of recurrent heart attack for "type D" personality types was 52 percent compared to 12 percent for "non-type D" individuals.

Previous investigations have found associations between increased heart attack risk and psychological characteristics such as anxiety and depression. But the Belgium team suspected that personality might be a third psychological factor influencing a person's risk.

"Type D" personality types were identified based on their scores of negative affectivity -- having ongoing feelings of worry and anxiety -- and social inhibition, or being insecure and lacking assertiveness.

Individuals who scored above average on negative affectivity and social inhibition were considered "type D."

In other research, "type A" behavior -- characterized by anger and hostility -- also has been implicated as a risk factor for heart attack, although "research has produced inconsistent findings," says Denollet. A second behavior type, called "type B," is the opposite of "type A" and is characterized by lower level of energy and arousal.

Denollet says the "type D" personality provides a "more accurate" approach to understanding psychological influences on heart disease because it looks at two personality traits, rather than a "hodgepodge" of signs and symptoms associated with the behavioral type "A" and "B" or mood states such as depression or anxiety.

Much like high blood pressure or elevated cholesterol, the "D" personality may help identify individuals at risk, says Denollet.

In an editorial accompanying the study, Robert M. Carney, Ph.D., comments that the study is important because it advances the understanding of psychological factors that may increase the risk of heart attack.

"Their study is the first to show that after a heart attack, the risk of having another cardiac event is higher in people who are both socially inhibited and psychologically distressed, compared to patients with only one of these problems or to those with neither problem," says Carney, a professor of medical psychology at Washington University School of Medicine in St. Louis, Missouri.

However, he cautions that personality traits such as "type D" tend to be much harder to change than other psychological risk factors such as depression, anger, or anxiety.

Thus, he says, we should continue to concentrate on helping patients overcome depression and other negative moods, as well as help shy or socially inhibited patients to improve their social life, instead of trying to change their personality.

"Even if it were easier for health care providers to screen their patients for a single personality trait than for several different negative mood states, this advantage would be outweighed by the difficulty of changing their patients' personalities," says Carney.

"It would be a mistake to abandon research on depression, anxiety, anger, and social support in favor of the "type D" personality trait," he says.
-end-


American Heart Association

Related Depression Articles from Brightsurf:

Children with social anxiety, maternal history of depression more likely to develop depression
Although researchers have known for decades that depression runs in families, new research from Binghamton University, State University of New York, suggests that children suffering from social anxiety may be at particular risk for depression in the future.

Depression and use of marijuana among US adults
This study examined the association of depression with cannabis use among US adults and the trends for this association from 2005 to 2016.

Maternal depression increases odds of depression in offspring, study shows
Depression in mothers during and after pregnancy increased the odds of depression in offspring during adolescence and adulthood by 70%.

Targeting depression: Researchers ID symptom-specific targets for treatment of depression
For the first time, physician-scientists at Beth Israel Deaconess Medical Center have identified two clusters of depressive symptoms that responded to two distinct neuroanatomical treatment targets in patients who underwent transcranial magnetic brain stimulation (TMS) for treatment of depression.

A biological mechanism for depression
Researchers report that in depressed individuals there are increased amounts of an unmodified structural protein, called tubulin, in lipid rafts compared with non-depressed individuals.

Depression in adults who are overweight or obese
In an analysis of primary care records of 519,513 UK adults who were overweight or obese between 2000-2016 and followed up until 2019, the incidence of new cases of depression was 92 per 10,000 people per year.

Why stress doesn't always cause depression
Rats susceptible to anhedonia, a core symptom of depression, possess more serotonin neurons after being exposed to chronic stress, but the effect can be reversed through amygdala activation, according to new research in JNeurosci.

Which comes first: Smartphone dependency or depression?
New research suggests a person's reliance on his or her smartphone predicts greater loneliness and depressive symptoms, as opposed to the other way around.

Depression breakthrough
Major depressive disorder -- referred to colloquially as the 'black dog' -- has been identified as a genetic cause for 20 distinct diseases, providing vital information to help detect and manage high rates of physical illnesses in people diagnosed with depression.

CPAP provides relief from depression
Researchers have found that continuous positive airway pressure (CPAP) treatment of obstructive sleep apnea (OSA) can improve depression symptoms in patients suffering from cardiovascular diseases.

Read More: Depression News and Depression Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.