Stephanie Dannemann, Klaus Matschke, Franziska Einslec, Mervin Smucker, Katrin Zimmermann, Peter Joraschky, Kerstin Weidner, & Volker Köllner (2010). Is type-D a stable construct? An examination of type-D personality in patients before and after cardiac surgery. Journal of Psychosomatic Research, 69, 101-109.
Objective: Type-D personality—negative affectivity and social inhibition—are related to poor prognosis in cardiovascular diseases. At present, little is known about type-D personality and its stability before and after cardiac surgery. Methods: One hundred twenty-six patients recommended for coronary bypass and/or valve surgery were examined at pre-surgery and 6 months post-surgery to investigate the stability of type-D 14-item Type-D Scale) and its relationship to anxiety, depression (Hospital Anxiety and Depression Scale) and quality of life (Short Form 12). Results: Preoperatively, 26% were assessed to have type-D, while only 11% fulfilled type-D criteria both pre-and post-surgery. Patients were assessed and identified as belonging to one of the four type-D groups: Stable type-D (11%), non-type-D (61%), type-D pre (15%), and type-D post (13%). In comparison to the stable nontype D group, the stable type-D reported more symptoms of anxiety, depression, lower physical quality of life post-surgery, and lower mental quality of life both pre-and post-surgery. When compared to the population at large, stable type-D had more symptoms of depression pre-surgery, and more anxiety as well as lower physical and mental quality of life pre-and post-surgery. Conclusion: Type-D diagnosis changed in nearly 60% of the cases post-surgery. Only those patients with stable type-D exhibited a relationship to emotional distress, such as anxiety and depression and reduced quality of life. Additional research on the critical cutoff scores and stability of type-D as it relates to critical life events would likely enhance our ability to more effectively diagnose and treat patients who are at high risk for insufficient coping.