• Korean Journal of Psychosomatic Medicine
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• v.15 no.2
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• pp.81-87
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• 2007

Objectives : The distressed personality (type-D) pattern, consisting of negative affectivity and social inhibition, has been shown by Denollet et al. For measuring the Type D characteristics, Denollet has devised the 14 item Type D scale (DS14). In the present study, this instrument was translated into Korean. The reliability and validity of the Korean DS14 was pilot tested. Methods : Preliminary version of the total 17-item DS14 scale was translated into Korean. 372 controls that did not have any coronary heart diseases (CHD) were randomly sampled in Seoul and Gyeonggi province. Preliminary Korean version was applied to controls and 14 items were finally selected to maximize reliability of the scale. We compared the distribution of type-D personality among the normal controls, hypertensive patients, and the CHD patients. Results : 7 of 10 items in social inhibition were selected and final 14-item version was made. The internal consistency of negative affectivity (0.817) and social inhibition (0.797) were high. In addition, the prevalence of type-D personality in the CHD patients group was significantly higher than normal controls. Conclusion : These findings suggest that Korean version of DS14 is a valid tool for measuring the type D characteristics. Type-D characteristics can be suggested to predict adverse prognosis in patients with CHD.

• Korean Journal of Adult Nursing
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• v.19 no.4
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• pp.644-655
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• 2007

Purpose: The purposes of this study were to describe the pattern of type D personality, to compare the life style and quality of life between type D personality and non-type D personality patients, and to investigate the factors influencing quality of life in patients with hypertension. Methods: A cross sectional, descriptive study was used. The participants in this study were 193 outpatients who were diagnosed with hypertension at two university hospitals in urban area, Korea. The data was collected from December, 2006 to January, 2007. Type D personality was measured by the DS-14 scale. Results: The prevalence of type D personality was 83.9%. Patients of type D personality were significantly different in educational status, monthly income, fat intake and exercise, and had a lower overall quality of life than patients of non-type D personality. Under controlled general characteristics and life style factors, multiple linear regression analysis was performed. The most significant factor influencing quality of life in hypertensive patients was type D personality, and this factor explained their quality of life with a variance of 14.8%. Conclusions: Various programs for psychological intervention are required to control for the distressed personality of patients with hypertension. Further studies should be conducted prospectively on a larger patient population.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.3
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• pp.312-320
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• 2008

Purpose: The purpose of this study was to verify the validity and reliability of the Type D Scale-14 (DS14). Methods: The participants were 288 patients who were diagnosed with angina pectoris, myocardial infarction, and hypertension. DS14 was developed by Denollet(2005) and consists of two domains, 7 items on negative affectivity (NA) and 7 items on social inhibition (SI). The Korean version of DS14 was developed through translation-reversed translation and a preliminary test. Data were collected using a self-report questionnaire. Cronbach $\alpha$ and Guttman split-half were used to test reliability and item analysis and factor analysis for validity. The SPSS program was used. Results: 35.8% of the participants were classified as Type D. Mean score for NA was 16.80 and for SI, 14.10 in Type D participants. For reliability of NA, Cronbach $\alpha$=0.771, and for SI, 0.707. Factor analysis on 12 items(numbers 1 & 3 were excluded as the corrected item-total correlations were below r=0.3) yielded two factors for NA (6 items) and SI (6 items). Number 7 in the NA domain was sorted into the SI domain. Conclusion: The results indicate, the cultural differences were between Europeans and Koreans. Repetition of the research is needed for generalization of DS14.

• The Journal of the Korea Contents Association
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• v.13 no.5
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• pp.286-294
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• 2013

The purpose of this study was to confirm the mental health and quality of life by type-D personality of the patients with coronary artery disease (CAD). The participants in the study were 111 hospitalized patients with CAD at a hospital in Gyeonggi-do. The type-D personality was assessed by the Type-D Personality Scale (DS14). The mental health was measured with Symptom Checklist-90-Revision (SCL-90R) while quality of life was assessed with World Health Quality of Life Assessment Instrument (WHOQOL-BREF). The data analysis revealed that 36.1% of CAD patients were identified as having type-D personality traits. Non type-D personality patients have shown better mental health state than type-D personality patients (p<.001) have. The level of quality of life in the type D personality patients were significantly lower than that of non type-D counterparts (p<.001). It is necessary for type-D personality to be considered, when the nursing intervention programs for improving the mental health and quality of life of the patients with CAD are developed.

• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.349-356
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• 2009

Purpose: The purpose of this study was to identify the influence of the type-D personality on quality of life and illness intrusiveness. Methods: This study was a cross-sectional study. Data were collected using self-reported questionnaire from 200 patients with coronary artery disease(CAD). Variables were measured with the Type-D Scale-14(DS14), Korean Health Related Quality of Life Scale(KoQoLS), and the Illness Intrusiveness Rating Scale(ILRS). Results: Of the patients, 38% were classified as type-D personality. Among the 10 subcategories of quality of life, the highest mean score was bodily pain($5.84{\pm}2.85$) and the lowest was role limitation($1.52{\pm}1.20$). Among 13 item of illness intrusiveness, the highest mean score was health($3.78{\pm}1.73$) and the lowest was family relationships($2.14{\pm}1.58$). There were significant differences in all the subcategories of quality of life between type-D and non type-D except for subcategories of bodily pain and role limitation. However, there were no significant differences in illness intrusiveness between type-D and non type-D. Conclusion: Type-D is an important factor in quality of life in patients with CAD, but no correlations between type-D and illness intrusiveness were found. These results can be used as basic data for developing cardiac rehabilitation programs to improve quality of life in type-D patients.

• Korean Journal of Psychosomatic Medicine
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• v.21 no.1
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• pp.18-26
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• 2013

Objectives : Type D personality was originally introduced to study the role of personality in predicting outcomes of heart disease. However, researches showed that other medical conditions are also affected by this personality. The purpose of this study was to evaluate the relationship between type D personality and somatic symptom complaints in depressive patients. Methods : Eighty-two individuals diagnosed with depressive disorder were included. Type D personality was measured with DS14. Patient Health Questionnaire(PHQ) 9 and 15 were used to measure depression severity and somatization tendencies. For alexithymia, TAS-20 was used. Student T-test and linear regression analysis were performed. The best regression model was determined by stepwise variable selection. Results : More than half of the subjects(56%) complained at least medium degree somatic symptoms according to PHQ-15 criteria. Two-thirds of the subjects were classified as Type D personality(63.4%). The mean PHQ-15 score of the Type D individuals was significantly higher than the remaining subjects(PHQ-15 mean=12.7, $p=8.2{\times}10^{-7}$). The best regression model included age, PHQ-9 score and NA subscale score as predictor variables. Among these, only the coefficients of age($p=1.5{\times}10^{-3}$) and NA score($p=1.5{\times}10^{-7}$) were found to be statistically significant. Conclusions : The result showed that Type D personality was one of the strong predictors of somatic complaints among depressive individuals. The finding that negative affectivity rather than social inhibition was more closely associated with somatization tendencies does not fully agree with the traditional explanation that inability to express negative emotion predispose the individuals to somatic symptoms. The finding that alexithymia was not shown to be a significant predictors also substantiated this discrepancy. However, it might be possible that the high correlation between NA and SI subscore(r=0.65) and between NA and TAS-20 score(r=0.44) hid the additional effects of social inhibition and alexithymia. Further research with a larger sample would be needed to investigate the effects of the latter two components over and above the effect of negative affectivity on the somatic complaints in depressive patients.

• Korean Journal of Health Psychology
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• v.14 no.2
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• pp.277-292
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• 2009

This study investigated the responses of the autonomic nervous system of individuals with Type D personality during an acute stressful situation. Twenty-three female students of Type D personality and 23 female students with non-Type D personality. Stroop Color-Word Task was used to induce a stressful situation, heart rate variability (HRV) was used to measure the responses of the autonomic nervous system during the baseline, acute stress, recovery periods. To analyze the data, the repeated measures analysis of variance was used to compare the autonomic nervous system of the Type D group to that of the non-Type D group. Regression analysis is used to determine if the Type D scale and stress vulnerability predicted the activities of the autonomic nervous system during the baseline period. The results of this study demonstrated that the Type D group's normalized low frequency (LF norm) and ratio of low frequency to high frequency (LF/HF ratio) were higher than those for the non-Type D group, while its normalized high frequency (HF norm) was lower than that for the non-Type D group in all three periods. There were no statistically significant differences among the three periods in terms of LF norm, HF norm, and LF/HF ratio in the Type D group. The study demonstrated that the total scores of the Type DS-14 and scores of social inhibition and negative affect were independent predictors of LF norm and HF norm during the baseline. The Type D group showed increased activation of the sympathetic nervous system and/or decreased activation of the parasympathetic nervous system. These results support the hypothesis that the Type D personality is vulnerable to the stress. Also, the highly activated sympathetic and/or lowly activated parasympathetic nervous systems, which were observed in the Type D group during the baseline, indicated that the Type D individual is susceptible to psychosomatic disorders.