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Distressed personality type

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Type-D personality is defined as the joint tendency towards negative affectivity (worry, irritability, gloom) and social inhibition (reticence and a lack of self-assurance). The letter 'D' stands for 'distressed'. Johan Denollet (1), a Dutch professor of medical psychology, is the founder of this concept. Research has shown that CHD patients with a type-D personality have a worse prognosis after a myocardial infarction (MI) as compared to patients without a type-D personality. Type-D is associated with a 4- to 8-times increased risk of mortality, recurrent MI, or sudden death. The effect of type-D is independent from traditional risk factors in CHD (2,3,4). Type-D personality can be assessed by means of a valid and reliable 14-item questionnaire, the DS14 (5). One half of the items refer to negative affectivity, and the other half of the items refer to social inhibition. People who score 10 points or more on both dimensions are classified as type-D. The DS14 can be applied in clinical practice for risk stratification in post-MI patients.


  1. Website Type-D research
  2. Personality as independent predictor of long-term mortality in patients with coronary heart disease (Lancet, 1996)
  3. Personality, disease severity, and the risk of long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction (Circulation, 1998).
  4. Inadequate response to treatment in coronary heart disease : adverse effects of type D personality and younger age on 5-year prognosis and quality of life (Circulation, 2000).
  5. DS14: standard assessment of negative affectivity, social inhibition, and Type D personality (Psychosomatic Medicine, 2005).
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