Cross-cultural analysis of Type D (distressed) personality in 6222 patients with ischemic heart disease

A study from the International HeartQoL Project

N. Kupper, S.S. Pedersen, S. Höfer, H. Saner, N. Oldridge, J. Denollet

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Abstract

Background
Type D (distressed) personality, the conjoint effect of negative affectivity (NA) and social inhibition (SI), predicts adverse cardiovascular outcomes, and is assessed with the 14-item Type D Scale (DS14). However, potential cross-cultural differences in Type D have not been examined yet in a direct comparison of countries.
Aim
To examine the cross-cultural validity of the Type D construct and its relation with cardiovascular risk factors, cardiac symptom severity, and depression/anxiety.
Methods
In 22 countries, 6222 patients with ischemic heart disease (angina, 33%; myocardial infarction, 37%; or heart failure, 30%) completed the DS14 as part of the International HeartQoL Project.ResultsType D personality was assessed reliably across countries (αNA > .80; αSI > .74; except Russia, which was excluded from further analysis). Cross-cultural measurement equivalence was established for Type D personality at all measurement levels, as the factor-item configuration, factor loadings, and error structure were not different across countries (fit: CFI = .91; NFI = .88; RMSEA = .018), as well as across gender and diagnostic subgroups. Type D personality was more prevalent in Southern (37%) and Eastern (35%) European countries compared to Northern (24%) and Western European and English-speaking (both 27%) countries (p < .001). Type D was not confounded by cardiac symptom severity, but was associated with a higher prevalence of hypertension, smoking, sedentary lifestyle, and depression.
Conclusion
Cross-cultural measurement equivalence was demonstrated for the Type D scale in 21 countries. There is a pan-cultural relationship between Type D personality and some cardiovascular risk factors, supporting the role of Type D personality across countries and cardiac conditions.
Original languageEnglish
Pages (from-to)327-333
JournalInternational Journal of Cardiology
Volume166
Issue number2
DOIs
Publication statusPublished - 2013

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Depression
Sedentary Lifestyle
chemotactic factor inactivator

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@article{c879c2df424f4c4fb82aef1a6968e51e,
title = "Cross-cultural analysis of Type D (distressed) personality in 6222 patients with ischemic heart disease: A study from the International HeartQoL Project",
abstract = "BackgroundType D (distressed) personality, the conjoint effect of negative affectivity (NA) and social inhibition (SI), predicts adverse cardiovascular outcomes, and is assessed with the 14-item Type D Scale (DS14). However, potential cross-cultural differences in Type D have not been examined yet in a direct comparison of countries.AimTo examine the cross-cultural validity of the Type D construct and its relation with cardiovascular risk factors, cardiac symptom severity, and depression/anxiety.MethodsIn 22 countries, 6222 patients with ischemic heart disease (angina, 33{\%}; myocardial infarction, 37{\%}; or heart failure, 30{\%}) completed the DS14 as part of the International HeartQoL Project.ResultsType D personality was assessed reliably across countries (αNA > .80; αSI > .74; except Russia, which was excluded from further analysis). Cross-cultural measurement equivalence was established for Type D personality at all measurement levels, as the factor-item configuration, factor loadings, and error structure were not different across countries (fit: CFI = .91; NFI = .88; RMSEA = .018), as well as across gender and diagnostic subgroups. Type D personality was more prevalent in Southern (37{\%}) and Eastern (35{\%}) European countries compared to Northern (24{\%}) and Western European and English-speaking (both 27{\%}) countries (p < .001). Type D was not confounded by cardiac symptom severity, but was associated with a higher prevalence of hypertension, smoking, sedentary lifestyle, and depression.ConclusionCross-cultural measurement equivalence was demonstrated for the Type D scale in 21 countries. There is a pan-cultural relationship between Type D personality and some cardiovascular risk factors, supporting the role of Type D personality across countries and cardiac conditions.",
author = "N. Kupper and S.S. Pedersen and S. H{\"o}fer and H. Saner and N. Oldridge and J. Denollet",
year = "2013",
doi = "10.1016/j.ijcard.2011.10.084",
language = "English",
volume = "166",
pages = "327--333",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "2",

}

Cross-cultural analysis of Type D (distressed) personality in 6222 patients with ischemic heart disease : A study from the International HeartQoL Project. / Kupper, N.; Pedersen, S.S.; Höfer, S.; Saner, H.; Oldridge, N.; Denollet, J.

In: International Journal of Cardiology, Vol. 166, No. 2, 2013, p. 327-333.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Cross-cultural analysis of Type D (distressed) personality in 6222 patients with ischemic heart disease

T2 - A study from the International HeartQoL Project

AU - Kupper, N.

AU - Pedersen, S.S.

AU - Höfer, S.

AU - Saner, H.

AU - Oldridge, N.

AU - Denollet, J.

PY - 2013

Y1 - 2013

N2 - BackgroundType D (distressed) personality, the conjoint effect of negative affectivity (NA) and social inhibition (SI), predicts adverse cardiovascular outcomes, and is assessed with the 14-item Type D Scale (DS14). However, potential cross-cultural differences in Type D have not been examined yet in a direct comparison of countries.AimTo examine the cross-cultural validity of the Type D construct and its relation with cardiovascular risk factors, cardiac symptom severity, and depression/anxiety.MethodsIn 22 countries, 6222 patients with ischemic heart disease (angina, 33%; myocardial infarction, 37%; or heart failure, 30%) completed the DS14 as part of the International HeartQoL Project.ResultsType D personality was assessed reliably across countries (αNA > .80; αSI > .74; except Russia, which was excluded from further analysis). Cross-cultural measurement equivalence was established for Type D personality at all measurement levels, as the factor-item configuration, factor loadings, and error structure were not different across countries (fit: CFI = .91; NFI = .88; RMSEA = .018), as well as across gender and diagnostic subgroups. Type D personality was more prevalent in Southern (37%) and Eastern (35%) European countries compared to Northern (24%) and Western European and English-speaking (both 27%) countries (p < .001). Type D was not confounded by cardiac symptom severity, but was associated with a higher prevalence of hypertension, smoking, sedentary lifestyle, and depression.ConclusionCross-cultural measurement equivalence was demonstrated for the Type D scale in 21 countries. There is a pan-cultural relationship between Type D personality and some cardiovascular risk factors, supporting the role of Type D personality across countries and cardiac conditions.

AB - BackgroundType D (distressed) personality, the conjoint effect of negative affectivity (NA) and social inhibition (SI), predicts adverse cardiovascular outcomes, and is assessed with the 14-item Type D Scale (DS14). However, potential cross-cultural differences in Type D have not been examined yet in a direct comparison of countries.AimTo examine the cross-cultural validity of the Type D construct and its relation with cardiovascular risk factors, cardiac symptom severity, and depression/anxiety.MethodsIn 22 countries, 6222 patients with ischemic heart disease (angina, 33%; myocardial infarction, 37%; or heart failure, 30%) completed the DS14 as part of the International HeartQoL Project.ResultsType D personality was assessed reliably across countries (αNA > .80; αSI > .74; except Russia, which was excluded from further analysis). Cross-cultural measurement equivalence was established for Type D personality at all measurement levels, as the factor-item configuration, factor loadings, and error structure were not different across countries (fit: CFI = .91; NFI = .88; RMSEA = .018), as well as across gender and diagnostic subgroups. Type D personality was more prevalent in Southern (37%) and Eastern (35%) European countries compared to Northern (24%) and Western European and English-speaking (both 27%) countries (p < .001). Type D was not confounded by cardiac symptom severity, but was associated with a higher prevalence of hypertension, smoking, sedentary lifestyle, and depression.ConclusionCross-cultural measurement equivalence was demonstrated for the Type D scale in 21 countries. There is a pan-cultural relationship between Type D personality and some cardiovascular risk factors, supporting the role of Type D personality across countries and cardiac conditions.

U2 - 10.1016/j.ijcard.2011.10.084

DO - 10.1016/j.ijcard.2011.10.084

M3 - Article

VL - 166

SP - 327

EP - 333

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 2

ER -