Type D folks, watch out. - D
It's all about personality: its impact on health, coping, psychological well-being and quality of life
L. Strober, A. Costanzo, J. DeLuca, N. Chiaravalloti
Kessler Foundation, West Orange, NJ, United States
Background: It is well appreciated that personality plays a role on one's health, well-being, and perceptions and management of their illness. Previously, the concept of a “Type D or Distressed” Personality has been described as a combination of higher levels of neuroticism and lower levels of extraversion/social discomfort. Medical patients with a Type D Personality have been found to have poorer health outcomes, greater psychological difficulties, greater reports of fatigue, and overall reduced quality of life.
Objective: The purpose of the present study was to determine the incidence of Type D Personality and examine its impact on health, coping, psychological functioning, and overall quality of life in a multiple sclerosis (MS) sample.
Method: Two hundred and thirty individuals with MS were administered measures of personality. Thirty seven (16%) were found to be “Type D+.” Participants completed measures of disease symptoms, disease management, psychological functioning, self-efficacy, locus of control (LOC), and quality of life.
Results: “Type D” individuals reported greater levels of fatigue (p < .001) and pain (p = .001). They reported lower levels of provider relationship and communication (p = .026), perceived self-efficacy in managing their MS (p < .001), and poorer adherence (p =.030). They also employed maladaptive coping styles such as mental disengagement (p = .007), behavioral disengagement (p < .001), denial (p = .002), venting emotions (p < .001), and substance use (p < .001). In contrast, they were less likely to use adaptive coping such as planning (p = .015), active coping (p = .018), and positive interpretation and growth (p = .002). “Type D +” individuals reported a lower sense of general self-efficacy (p < .001) and LOC (p < .001) and greater depression (p < .001) and anxiety (p < .001). They also reported a lower satisfaction with life (p < .001) and greater perceived stress (p < .001). Finally, with regard to functional outcomes, a greater percentage of those considering leaving the workforce were found to be “Type D.”
(χ2 = 4.22, p = .040).
Conclusions: Consistent with the literature in other medical populations, the existence of Type D Personality is associated with several negative outcomes in MS. Given this, consideration and assessment of personality traits appears warranted in hopes of assuring optimal outcomes and tailoring one's interventions.