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Psychosocial Risk Factors, Airborne Pollution, Hypertension and Cardiovascular Diseases
Published in Giuseppe Mancia, Guido Grassi, Konstantinos P. Tsioufis, Anna F. Dominiczak, Enrico Agabiti Rosei, Manual of Hypertension of the European Society of Hypertension, 2019
Subjects who present depressive symptoms or, worse, who demonstrate clinical depression, are also at higher risk of coronary heart disease, and this translates into an impaired recovery and a poorer prognosis after the event (12–14). This is improved by social support (6,7). The opposite condition further enhances the negative effects of depression on cardiovascular prognosis (14–17). Remarkably, the sizable effects of these conditions suggest that depression and social isolation are often associated with a cluster of other cardiovascular risk factors, which may account for the link between depression and cardiovascular prognosis. This assumption is supported by the evidence that the pharmacological therapy of depression does not improve cardiovascular prognosis (14–18). The patient who hosts a large array of negative emotions for prolonged periods of time, which are not shared with others as a result of a reluctance to engage in social contacts, resulting in social inhibition, discloses a type D personality. This condition is related to a poorer prognosis in patients with established cardiovascular disease, even after multiple adjustments (19,20). In mitigation, however, it is difficult to normalize for confounding factors such as depression (12–18), which encompasses also the negative emotions of the type D personality (19,20). Moreover, this condition is often associated with social isolation (6,7), a less healthy lifestyle, and perhaps a poorer socioeconomic status (1–5).
Understanding Tinnitus: A Psychological Perspective
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Laurence McKenna, Elizabeth Marks, David J. Scott
Establishing a causal relationship between personality variables and tinnitus distress is challenging. These studies assume such traits were present through most of the person’s life, and that anxious or depressed dispositions are not the product of tinnitus. Anxious traits identified in people soon after the onset of tinnitus have been found to predict greater tinnitus distress 6 months later.19 These observations suggest that, when tinnitus arises in people who are already emotionally strained, it is more likely to lead to distress. Another study20 examined the relationship between type D personality (a generally gloomy view of life and social inhibition), tinnitus distress and quality of life and found that the impact of type D personality on tinnitus severity was in part mediated by the presence of anxiety and depression. Additional evidence supports the idea that the relationship between personality variables and distress is not direct but is mediated by cognitive variables such as dysfunctional thoughts,21 particularly catastrophization,22 and tinnitus-specific illness perceptions.23
The Multifactorial Model of Cardiovascular Pathology: Is Caffeine Pathogenic in Coronary Heart Disease?
Published in Barry D. Smith, Uma Gupta, B.S. Gupta, Caffeine and Activation Theory, 2006
Barry D. Smith, Radha Gholkar, Mark Mann, Nancy Toward
Another proposed cardiovascular risk factor is stress, which may contribute in two ways: (a) as a short-term factor that leads to an MI; and (b) as a long-term factor contributing to the gradual development of CHD over many years. First, myocardial infarction is associated with the occurrence of stressful life events in the year preceding the MI (Rafanelli et al., 2005). Tension and anxiety were also recently shown to be strong, independent factors in CHD incidence and mortality in men from the Framingham Offspring Study (Eaker, Sullivan, Kelly–Hayes, D’Agostino, & Benjamin, 2005). Stress indicators are also higher in people with metabolic syndrome, a precursor to CHD (Vitaliano et al., 2002). Activation of the sympathetic nervous system may thus be hypothesized as a cause of CHD and MI (Brunner et al., 2002). One recent theoretical model proposes that a type D personality, involving social avoidance and internalization of stress, results in higher cortisol levels and could contribute to CHD (Sher, 2005). Caffeine often interacts with stress to affect cardiovascular parameters (see later discussion).
Psychiatric disorders, rumination, and metacognitions in patients with type D personality and coronary heart disease
Published in Nordic Journal of Psychiatry, 2023
Toril Dammen, John Munkhaugen, Elise Sverre, Torbjørn Moum, Costas Papageorgiou
Given the definition of Type D personality, it is not surprising that it has been associated with symptoms of emotional disorders such as depression and anxiety. Most previous studies examining the associations between Type D personality and emotional disorders have used self-report questionnaires [7]. To date, only three studies have relied on psychiatric diagnostic interviews to explore the link between Type D personality and psychiatric disorders in CHD patients [7–9]. One such study reported a 26% prevalence of depression in a group of patients experiencing myocardial-infarction (MI) who also had Type D personality [8]. In another similar study among patients with MI, psychiatric disorders were significantly more prevalent in patients with Type D compared to those without type D personality, with 40% of the Type D patients identified as suffering from depressive disorders as opposed to 6% among those without type D personality [9]. The association between Type D personality and a broader spectrum of mental disorders was also investigated in 570 patients with depression and CHD. In this study, there was a prevalence of at least one mental disorder in 85% of patients with both type D and CHD, with affective disorders (54%) being the most common cluster of disorders [7]. Finally, at least one personality disorder or dysthymia was found in 30% of this patient group [7]. Despite the high prevalence of mental disorders, we do not know if these patients are identified and offered treatment for their mental disorders.
An experimental investigation into cardiovascular, haemodynamic and salivary alpha amylase reactivity to acute stress in Type D individuals
Published in Stress, 2019
Sarah F. Allen, Mark A. Wetherell, Michael A. Smith
Type D personality is characterized by high levels of social inhibition (SI) and negative affectivity (NA) (Denollet, et al., 1996). Research has demonstrated associations between Type D and negative health outcomes in both cardiac (e.g. Schiffer et al., 2005) and other clinical populations (Mols & Denollet, 2010a); and more recently in the general population (Smith et al., 2018). Type D is related to increased physical symptoms and poorer perceived health (Allen, Wetherell & Smith, 2019; Smith et al., 2018; Stevenson & Williams, 2014; Williams & Wingate, 2012), in addition to anxiety, depression, somatization (Michal, Wiltink, Grande, Beutel & Brähler, 2011); maladaptive stress reactivity (e.g. Habra et al., 2003; Howard & Hughes, 2013; Kelly-Hughes, Wetherell & Smith, 2014); and poor coping, social support and health behaviors (Williams & Wingate, 2012; Booth & Williams, 2015). It is suggested that these factors may mediate the relationship between Type D personality and physical health.
Does negative affectivity have an association with achieving target values in hypertensive patients: primary care perspective
Published in Postgraduate Medicine, 2023
Yusuf Cetin Doganer, Ebru Esra Yalcın, Umit Aydogan, Halil Dogrul, Muhammet Bereket, Melih Karamuk
Our study has some limitations. First, we completed the study with fewer patients than we planned to include. We believe some participants among 54 patients who refused to participate in the study may exhibit Type D personality traits. Secondly, Type D personality traits were screened using a questionnaire. It may be misleading to determine these personality traits with a structured survey filled with the patients’ responses instead of a clinical interview. Finally, the results cannot be generalized to all hypertensive patients as the study was conducted in three family health-care centers. Multicenter studies with more participants are needed.