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The Stability of Type D Personality in Dialysis Patients

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Abstract

Purpose

Type D personality has been identified as an independent risk factor for survival in cardiovascular disease (CVD) patients. As CVD is present in about 50% of dialysis patients, it is of clinical interest to assess the prevalence of type D personality, the association with depressive and anxiety symptoms, and stability of type D personality in dialysis patients.

Methods

Data was used from two consecutive measurements of the DIVERS study, a prospective cohort study among chronic dialysis patients in the Netherlands. Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and the Type D Scale-14 (DS14) were used to assess depressive and anxiety symptoms and type D personality, respectively. The association of type D personality was assessed with analysis of variance F test. Stability of type D personality, depressive, and anxiety symptoms were determined by calculating Cohen’s κ, and by determining the positive agreement.

Results

In total, 349 patients were included of which 249 patients had two measurement points. The prevalence of type D personality was 21% and type D personality was associated with depressive and anxiety symptoms (P < 0.01). Over a 6-month period, Cohen’s κ was 0.52, 0.56, and 0.61 for type D personality, depressive, and anxiety symptoms, respectively. Sixty-one, 73, and 73% had a stable type-D personality, depressive, and anxiety symptoms, respectively.

Conclusion

The presence of type D personality varies over time in dialysis patients. Therefore, type D personality is possibly more a state instead of a trait phenomenon.

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References

  1. Grande G, Romppel M, Barth J. Association between type D personality and prognosis in patients with cardiovascular diseases: a systematic review and meta-analysis. Ann Behav Med. 2012;43:299–310.

    Article  PubMed  Google Scholar 

  2. Denollet J. DS14: standard assessment of negative affectivity, social inhibition, and Type D personality. Psychosom Med. 2005;67:89–97.

    Article  PubMed  Google Scholar 

  3. Mols F, Thong MSY, De Poll-Franse LVV, Roukema JA, Denollet J. Type D (distressed) personality is associated with poor quality of life and mental health among 3080 cancer survivors. J Affective Disord. 2012;136:26–34.

    Article  Google Scholar 

  4. Denollet J, De Jonge P, Kuyper A, Schene AH, Van Melle JP, Ormel J, et al. Depression and type D personality represent different forms of distress in the Myocardial INfarction and Depression-Intervention Trial (MIND-IT). Psychol Med. 2009;39:749–56.

    Article  CAS  PubMed  Google Scholar 

  5. Pedersen SS, van Domburg RT, Theuns DA, Jordaens L, Erdman RA. Type D personality is associated with increased anxiety and depressive symptoms in patients with an implantable cardioverter defibrillator and their partners. Psychosom Med. 2004;66:714–9.

    Article  PubMed  Google Scholar 

  6. Versteeg H, Roest AM, Denollet J. Persistent and fluctuating anxiety levels in the 18 months following acute myocardial infarction: the role of personality. Gen Hosp Psychiatry. 2015;37:1–6.

    Article  PubMed  Google Scholar 

  7. Martens EJ, Mols F, Burg MM, Denollet J. Type D personality predicts clinical events after myocardial infarction, above and beyond disease severity and depression. J Clin Psychiatry. 2010;71:778–83.

    Article  PubMed  Google Scholar 

  8. Son YJ, You MA, Song EK. Influence of Type D personality on health-related quality of life among Korean patients with end-stage renal disease. Int J Nurs Pract. 2012;18:260–7.

    Article  PubMed  Google Scholar 

  9. Alçelik A, Yildirim O, Canan F, Eroglu M, Aktas G, Savli H. Preliminary psychometric evaluation of the type D personality construct in Turkish hemodialysis patients. Journal of Mood Disorders. 2012;2:1–5.

    Article  Google Scholar 

  10. Conden E, Rosenblad A, Ekselius L, Aslund C. Prevalence of type D personality and factorial and temporal stability of the DS14 after myocardial infarction in a Swedish population. Scand J Psychol. 2014;55:601–10.

    Article  PubMed  Google Scholar 

  11. Romppel M, Herrmann-Lingen C, Vesper JM, Grande G. Six year stability of Type-D personality in a German cohort of cardiac patients. J Psychosom Res. 2012;72:136–41.

    Article  PubMed  Google Scholar 

  12. Martens EJ, Kupper N, Pedersen S, Aquarius AE, Denollet J. Type-D personality is a stable taxonomy in post-MI patients over an 18-month period. J Psychosom Res. 2007;63:545–50.

    Article  PubMed  Google Scholar 

  13. Kupper N, Boomsma DI, De Geus EJC, Denollet J, Willemsen G. Nine-year stability of type D personality: contributions of genes and environment. Psychosom Med. 2011;73:75–82.

    Article  PubMed  Google Scholar 

  14. Spindler H, Kruse C, Zwisler AD, Pedersen S. Increased anxiety and depression in Danish cardiac patients with a type D personality: cross-validation of the type D scale (DS14). Int J Behav Med. 2009;16:98–107.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Dannemann S, Matschke K, Einsle F, Smucker MR, Zimmermann K, Joraschky P, et al. Is type-D a stable construct? An examination of type-D personality in patients before and after cardiac surgery. J Psychosom Res. 2010;69:101–9.

    Article  PubMed  Google Scholar 

  16. Caspi A, Roberts BW, Shiner RL. Personality development: stability and change. Annu Rev Psychol. 2005;56:453–84.

    Article  PubMed  Google Scholar 

  17. Lee HS, Lee SK, Lee HP, Kim YK. State effect of traumatic experience on personality structure. Psychiatry Investig. 2012;9:361–7.

    Article  PubMed  PubMed Central  Google Scholar 

  18. van Dijk PC, Jager KJ, de CF, Collart F, Cornet R, Dekker FW et al. Renal replacement therapy in Europe: the results of a collaborative effort by the ERA-EDTA registry and six national or regional registries. Nephrol Dial Transplant 2001; 16:1120–1129.

  19. Davies SJ, Russell L, Bryan J, Phillips L, Russell GI. Comorbidity, urea kinetics, and appetite in continuous ambulatory peritoneal dialysis patients: their interrelationship and prediction of survival. Am J Kidney Dis. 1995;26:353–61.

    Article  CAS  PubMed  Google Scholar 

  20. Statistics Netherlands. Someone with a foreign background. http://www.cbs.nl/en-GB/menu/methoden/begrippen/default.htm?Languageswitch=on&ConceptID=37 . 26–6-2014.

  21. Stronks K, Kulu-Glasgow I, Agyemang C. The utility of ‘country of birth’ for the classification of ethnic groups in health research: the Dutch experience. Ethn Health. 2009;14:255–69.

    Article  PubMed  Google Scholar 

  22. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–71.

    Article  CAS  PubMed  Google Scholar 

  23. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56:893–7.

    Article  CAS  PubMed  Google Scholar 

  24. Loosman WL, Siegert CE, Korzec A. Validity of the Hospital Anxiety and Depression Scale and the Beck Depression Inventory for use in end-stage renal disease patients. Br J Clin Psychol. 2010;49:507–16.

    Article  CAS  PubMed  Google Scholar 

  25. Wang MY, Chan SF, Chang LI, Chen TH, Tsai PS. Better sleep quality in chronic haemodialyzed patients is associated with morning-shift dialysis: a cross-sectional observational study. Int J Nurs Stud. 2013;50:1468–73.

    Article  PubMed  Google Scholar 

  26. Che HH, Lu ML, Chen HC, Chang S.W., Lee YJ. Validation of the Chinese version of the Beck Anxiety Inventory. Formosan Journal of Medicine 2006; 10:447–454.

  27. Loosman WL, Hoekstra T, van Dijk S, Terwee CB, Honig A, Siegert CE, et al. Short-Form 12 or Short-Form 36 to measure quality-of-life changes in dialysis patients? Nephrol Dial Transplant. 2015;

  28. de Vet HC, Mokkink LB, Terwee CB, Hoekstra OS, Knol DL. Clinicians are right not to like Cohen's kappa. BMJ. 2013;346:f2125.

    Article  PubMed  Google Scholar 

  29. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986;1:307–10.

    Article  CAS  PubMed  Google Scholar 

  30. Mols F, Denollet J. Type D personality in the general population: a systematic review of health status, mechanisms of disease, and work-related problems. Health Qual Life Outcomes. 2010;8:9.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Denollet J, Pedersen S, Vrints CJ, Conraads VM. Predictive value of social inhibition and negative affectivity for cardiovascular events and mortality in patients with coronary artery disease: the type D personality construct. Psychosom Med. 2013;75:873–81.

    Article  PubMed  Google Scholar 

  32. Bergvik S, Sorlie T, Wynn R, Sexton H. Psychometric properties of the Type D scale (DS14) in Norwegian cardiac patients. Scand J Psychol. 2010;51:334–40.

    PubMed  Google Scholar 

  33. Yu XN, Zhang J, Liu X. Application of the Type D Scale (DS14) in Chinese coronary heart disease patients and healthy controls. J Psychosom Res. 2008;65:595–601.

    Article  PubMed  Google Scholar 

  34. Bunevicius A, Staniute M, Brozaitiene J, Stropute D, Bunevicius R, Denollet J. Type D (distressed) personality and its assessment with the DS14 in Lithuanian patients with coronary artery disease. J Health Psychol. 2013;18:1242–51.

    Article  PubMed  Google Scholar 

  35. Starrenburg AH, Kraaier K, Pedersen S, van HM, Scholten M, van der PJ. Association of Psychiatric History and Type D Personality with symptoms of anxiety, depression, and health status prior to ICD implantation. Int J Behav Med. 2013; 20:425–433.

  36. Tully PJ, Pedersen SS, Winefield HR, Baker RA, Turnbull DA, Denollet J. Cardiac morbidity risk and depression and anxiety: a disorder, symptom and trait analysis among cardiac surgery patients. Psychol Health Med. 2011;16:333–45.

    Article  PubMed  Google Scholar 

  37. Romppel M, Herrmann-Lingen C, Vesper JM, Grande G. Type D personality and persistence of depressive symptoms in a German cohort of cardiac patients. J Affective Disord. 2012;136:1183–7.

    Article  Google Scholar 

  38. Denollet J, Schiffer AA, Spek V. A general propensity to psychological distress affects cardiovascular outcomes: evidence from research on the type D (distressed) personality profile. Circ Cardiovasc Qual Outcomes. 2010;3:546–57.

    Article  PubMed  Google Scholar 

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Acknowledgements

This study was funded by the Kidney Foundation of the Netherlands (SB 174). The Kidney Foundation had no influence in study design whatsoever. We thank the nurses and participating dialysis centers of the DIVERS study for collection and management of the data. We gratefully thank all patients who participated in the DIVERS study.

Author information

Authors and Affiliations

  1. Department of Nephrology, Onze LieveVrouwe Gasthuis, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands

    Wim L. Loosman, Rianne W. de Jong, Gertrud L. G. Haverkamp & Carl E. H. Siegert

  2. Department of Psychiatry, Onze Lieve Vrouwe Gasthuis, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands

    Wim L. Loosman, Rianne W. de Jong, Gertrud L. G. Haverkamp & Adriaan Honig

  3. Department of Internal Medicine, VU University Medical Center, De Boelelaan 1118, 1081 HZ, Amsterdam, the Netherlands

    Tessa O. van den Beukel

  4. Department of Clinical Epidemiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, the Netherlands

    Friedo W. Dekker

  5. Department of Psychiatry, VU University Medical Center, De Boelelaan 1118, 1081 HZ, Amsterdam, the Netherlands

    Adriaan Honig

Authors
  1. Wim L. Loosman
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  2. Rianne W. de Jong
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Corresponding author

Correspondence to Wim L. Loosman.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Loosman, W.L., de Jong, R.W., Haverkamp, G.L.G. et al. The Stability of Type D Personality in Dialysis Patients. Int.J. Behav. Med. 25, 85–92 (2018). https://doi.org/10.1007/s12529-017-9667-y

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  • DOI: https://doi.org/10.1007/s12529-017-9667-y

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