Predictive value of social inhibition and negative affectivity for cardiovascular events and mortality in patients with coronary artery disease: The Type D personality construct

J. Denollet, S.S. Pedersen, C.J. Vrints, V. Conraads

Research output: Contribution to journalArticleScientificpeer-review

Abstract

Objective:
Methodological considerations and selected null findings indicate the need to reexamine the Type D construct. We investigated whether associations with cardiac events in patients with coronary artery disease (CAD) involve the specific combination of negative affectivity (NA) and social inhibition (SI), or rather the main effect of either trait alone.
Methods:
In this 5-year follow-up of 541 patients with CAD, the Type D construct (14-item Type D Scale) was tested by examining a) the interaction of continuous NA and SI z scores and b) a four-group classification defined by low/high trait scores. End points were major adverse cardiac events (MACEs; death, myocardial infarction [MI], coronary revascularization) and cardiac death/MI.
Results:
At follow-up, 113 patients had a MACE, including 47 patients with cardiac death/MI. After adjustment for disease severity, age, sex, and main trait effects, the interaction of NA and SI z scores was associated with MACE (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.11–1.67). This continuous measure of Type D was also associated with cardiac death/MI (OR = 1.48, 95% CI = 1.11–1.96) and remained an independent predictor of events after adjustment for depressive symptoms. Using a cutoff of 10 on both NA and SI scales, Type D was associated with an adjusted OR of 1.74 (95% CI = 1.11–2.73) for MACE and an OR of 2.35 (95% CI = 1.26–4.38) for death/MI but was unrelated to noncardiac death. Patients with high NA or SI alone were not at increased risk.
Conclusions:
Continuous (NA × SI interaction) and dichotomized measures of Type D were associated with cardiovascular events in patients with CAD. Research is needed to explore moderating factors that may alter this association.
Original languageEnglish
Pages (from-to)873-881
JournalPsychosomatic Medicine
Volume75
Issue number9
DOIs
Publication statusPublished - 2013

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Odds Ratio
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Depression

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@article{60f5e251f6614819b64868a19c8366dd,
title = "Predictive value of social inhibition and negative affectivity for cardiovascular events and mortality in patients with coronary artery disease: The Type D personality construct",
abstract = "Objective: Methodological considerations and selected null findings indicate the need to reexamine the Type D construct. We investigated whether associations with cardiac events in patients with coronary artery disease (CAD) involve the specific combination of negative affectivity (NA) and social inhibition (SI), or rather the main effect of either trait alone.Methods: In this 5-year follow-up of 541 patients with CAD, the Type D construct (14-item Type D Scale) was tested by examining a) the interaction of continuous NA and SI z scores and b) a four-group classification defined by low/high trait scores. End points were major adverse cardiac events (MACEs; death, myocardial infarction [MI], coronary revascularization) and cardiac death/MI.Results: At follow-up, 113 patients had a MACE, including 47 patients with cardiac death/MI. After adjustment for disease severity, age, sex, and main trait effects, the interaction of NA and SI z scores was associated with MACE (odds ratio [OR] = 1.36, 95{\%} confidence interval [CI] = 1.11–1.67). This continuous measure of Type D was also associated with cardiac death/MI (OR = 1.48, 95{\%} CI = 1.11–1.96) and remained an independent predictor of events after adjustment for depressive symptoms. Using a cutoff of 10 on both NA and SI scales, Type D was associated with an adjusted OR of 1.74 (95{\%} CI = 1.11–2.73) for MACE and an OR of 2.35 (95{\%} CI = 1.26–4.38) for death/MI but was unrelated to noncardiac death. Patients with high NA or SI alone were not at increased risk.Conclusions: Continuous (NA × SI interaction) and dichotomized measures of Type D were associated with cardiovascular events in patients with CAD. Research is needed to explore moderating factors that may alter this association.",
author = "J. Denollet and S.S. Pedersen and C.J. Vrints and V. Conraads",
year = "2013",
doi = "10.1097/psy.0000000000000001",
language = "English",
volume = "75",
pages = "873--881",
journal = "Psychosomatic Medicine",
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}

Predictive value of social inhibition and negative affectivity for cardiovascular events and mortality in patients with coronary artery disease : The Type D personality construct. / Denollet, J.; Pedersen, S.S.; Vrints, C.J.; Conraads, V.

In: Psychosomatic Medicine, Vol. 75, No. 9, 2013, p. 873-881.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Predictive value of social inhibition and negative affectivity for cardiovascular events and mortality in patients with coronary artery disease

T2 - The Type D personality construct

AU - Denollet, J.

AU - Pedersen, S.S.

AU - Vrints, C.J.

AU - Conraads, V.

PY - 2013

Y1 - 2013

N2 - Objective: Methodological considerations and selected null findings indicate the need to reexamine the Type D construct. We investigated whether associations with cardiac events in patients with coronary artery disease (CAD) involve the specific combination of negative affectivity (NA) and social inhibition (SI), or rather the main effect of either trait alone.Methods: In this 5-year follow-up of 541 patients with CAD, the Type D construct (14-item Type D Scale) was tested by examining a) the interaction of continuous NA and SI z scores and b) a four-group classification defined by low/high trait scores. End points were major adverse cardiac events (MACEs; death, myocardial infarction [MI], coronary revascularization) and cardiac death/MI.Results: At follow-up, 113 patients had a MACE, including 47 patients with cardiac death/MI. After adjustment for disease severity, age, sex, and main trait effects, the interaction of NA and SI z scores was associated with MACE (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.11–1.67). This continuous measure of Type D was also associated with cardiac death/MI (OR = 1.48, 95% CI = 1.11–1.96) and remained an independent predictor of events after adjustment for depressive symptoms. Using a cutoff of 10 on both NA and SI scales, Type D was associated with an adjusted OR of 1.74 (95% CI = 1.11–2.73) for MACE and an OR of 2.35 (95% CI = 1.26–4.38) for death/MI but was unrelated to noncardiac death. Patients with high NA or SI alone were not at increased risk.Conclusions: Continuous (NA × SI interaction) and dichotomized measures of Type D were associated with cardiovascular events in patients with CAD. Research is needed to explore moderating factors that may alter this association.

AB - Objective: Methodological considerations and selected null findings indicate the need to reexamine the Type D construct. We investigated whether associations with cardiac events in patients with coronary artery disease (CAD) involve the specific combination of negative affectivity (NA) and social inhibition (SI), or rather the main effect of either trait alone.Methods: In this 5-year follow-up of 541 patients with CAD, the Type D construct (14-item Type D Scale) was tested by examining a) the interaction of continuous NA and SI z scores and b) a four-group classification defined by low/high trait scores. End points were major adverse cardiac events (MACEs; death, myocardial infarction [MI], coronary revascularization) and cardiac death/MI.Results: At follow-up, 113 patients had a MACE, including 47 patients with cardiac death/MI. After adjustment for disease severity, age, sex, and main trait effects, the interaction of NA and SI z scores was associated with MACE (odds ratio [OR] = 1.36, 95% confidence interval [CI] = 1.11–1.67). This continuous measure of Type D was also associated with cardiac death/MI (OR = 1.48, 95% CI = 1.11–1.96) and remained an independent predictor of events after adjustment for depressive symptoms. Using a cutoff of 10 on both NA and SI scales, Type D was associated with an adjusted OR of 1.74 (95% CI = 1.11–2.73) for MACE and an OR of 2.35 (95% CI = 1.26–4.38) for death/MI but was unrelated to noncardiac death. Patients with high NA or SI alone were not at increased risk.Conclusions: Continuous (NA × SI interaction) and dichotomized measures of Type D were associated with cardiovascular events in patients with CAD. Research is needed to explore moderating factors that may alter this association.

U2 - 10.1097/psy.0000000000000001

DO - 10.1097/psy.0000000000000001

M3 - Article

VL - 75

SP - 873

EP - 881

JO - Psychosomatic Medicine

JF - Psychosomatic Medicine

SN - 0033-3174

IS - 9

ER -