Iris Publishers-Open access Journal of Cardiovascular Research | Cross-Cultural Confirmation of the Type D Personality Construct

Authored by Les Rodriguez

The Type D personality construct is characterized by negative affectivity and social inhibition and is a predictor of poor outcomes in cardiovascular health [1]. Patients with coronary artery disease and Type D personality have a higher rate of mortality and nonfatal myocardial infarction [2]. They also have a four to six times higher risk for anxiety and depression [3], five times higher risk for poor mental health [4] and four times higher risk of recurrent cardiac episodes [5] compared to individuals who are not Type D personality. They are at a significantly higher risk of myocardial infarction, a poorer prognosis following a myocardial infarction [6], and more cardiovascular-related health problems compared to individuals who are not Type D personality [7].

Type D personality is a known risk factor for premature, cardiac-related death [8]. The Type D personality construct has been linked to a number of cardiovascular conditions that strain, weaken and debilitate and ultimately damage the heart muscle as well as serious cardiac outcomes; heart arrhythmias [9], chronic heart failure [10], coronary artery disease [11], hypertension [12], myocardial infarction [4], and peripheral arterial disease [13].

The cross-cultural confirmation of the Type D personality construct is well documented in research literature. The Type D personality construct has been researched and generalized in a number of different cross cultural contexts and populations and its relationship with a number of health conditions examined; Dutch military personnel deployed to Afghanistan [14], Dutch military personnel awaiting deployment [15], domestic violence victims [16], patients with chronic heart failure and peripheral artery disease [17], healthy patients [5], Chinese patients with heart disease [18], Danish patients with heart disease [3], Scottish patients with heart disease [4], work-related problems [6], development of posttraumatic stress disorder [14], irritable bowel syndrome [19], development of stress cardiomyopathy [20], and poor medication adherence [21] among many others.

Some researchers argue that the Type D personality construct does not generalize across all cultures because studies have had limited coverage in countries in Africa, Asia and South America, therefore, generalization of the Type D personality construct to these countries cannot be made [10]. In contrast, Kupper, Pedersen, Hofer, Saner, Oldridge & Denollet (2013), concluded that their study’s ability to establish cross-cultural equivalence in a large sample size, a strength of their study through the HeartQoL project, was a promising outcome because it included many different cultures, countries and languages [10].

The study from the International HeartQoL project conducted a cross-cultural analysis of 6,222 patients with ischemic heart disease from 22 countries to examine the prevalence and validity of the Type D personality construct and demonstrated cross-cultural equivalence [10]. The study included countries from Western Europe (Netherlands, Belgium, Austria, Germany, Switzerland, and France), Southern Europe (Italy, Spain, and Portugal), Northern Europe (Denmark, Sweden, and Norway), Eastern Europe (Ukraine, Poland, Hungary, and Russia), as well as English speaking countries (Australia, Canada, Ireland, United Kingdom, United States [10]. The Type D personality construct has been the subject of research at a global level with studies conducted in many countries such as: Belgium, Iceland, Norway, Ukarine, Korea [22], Canada [23], China [24], Denmark [25], England [26], Germany [27], India [28], Israel [29], Hungary [30], Italy [31], Netherlands [12], Poland [32], Sweden [33], Turkey [34], and Greece [35].

The results of the study from the International HearQoL project of the Type D personality construct showed consistency between countries in Western Europe, Southern Europe, Eastern Europe, Northern Europe, and the United States thus demonstrating that the cross-cultural validity and reliability of the Type D personality construct.

Author contributions

The author confirms being the sole contributor of this work and approved it for publication.

Acknowledgement

None.

Conflict of Interest Statement

The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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