Are You a Type D?

The Dangers of Chronic Distress

Are you worried, irritable and socially inhibited?

A simple test may help predict the health effects.

BY MICHAEL CRAIG MILLER, M.D.

YEARS AGO, WHEN THE psychologistJohan Denollet was first working with cardiac patients at a university hospital in Antwerp, Belgium, he noticed a paradox. Some heart-attack survivors remained cheerful and optimistic, even though they had suffered extensive cardiac damage. They joined eagerly in rehabilitation programs and adhered to them. Others, though, grew discouraged. They tended to resist rehab, even after milder heart arracks, and spent most of their energy complaining. Denollet, began to suspect that there was something fundamentally different about these two groups of patients. So he set out to find a way of measuring it. The tool he developed–a simple, 14-question personality test known as the DS14 –is now opening a new frontier in cardiology.

The test, defines overall distress in terms of two emotional states:“negative affectivity”(worry, irritability, gloom) and“social inhibition” (reticence and a lack of self -assurance). High distress scores are strongly associated with both hypertension and coronary heart disease. And among people who already have heart conditions, those with the highest distress scores – the so-calledType D personalities– are less responsive to treatment and have a poorer quality of life. They are also more likely to die prematurely.

Denollet’s DS14 isn’t the first attempt to link personality to medical risk. During the 1960s and ‘70s, psychologists devised a short alphabet to describe the different tendencies.Type A’s – the perfectionists and strives who worked weekends– were deemed to be the most likely candidates for heart disease. Relaxed, non-competitiveType B’s were supposed to be the models of health. AndType C’s– outwardly pleasant people who avoid conflict by suppressing their feelings– were said to be cancer-prone.

How strongly could your distress score affect your health? The study found that Type D patients were more than four times as likely as others to experience heart attack or death within six to nine mouths of the procedure.

The DS14 is looking more and more like a parlor game worth playing. But don’t panic if you score at the high end of the scale.Type D personality itself is not a mental illness. It is a collection of normal human traits. And as Denollet is quick to point out, “there are many Type D individuals who are living healthy lives and functioning quite well.” A good marriage can be an antidote to social inhibition, especially if your partner's ease with people compensates for your own discomfort. And even the most distress – prone person can learn through psychotherapy to cope with stress and beat back anxious thoughts. Many Type D people have trouble seeking help – by definition; they’re ill at ease and afraid to open up to others – but physicians. Family members and friends can help them over those hurdles. And the test itself can help Type D people own up to their fears and frustrations, since it doesn’t require any embarrassing social interaction.

EVEN IF YOU NEVER FULLYconquer your distress; you can take practical steps to make it less toxic to your health. Daily exercise and a wholesome diet will reduce almost anyone’s risk of a heart arrack. And lifestyle changes that protect your heart can improve your emotional state as well. In a 2001 study, Denollet found that comprehensive cardiac-rehab programs had the effect of boosting people’s moods as well as their survival rates, making their lives both richer and longer.

Test

The social and emotional problems associated with Type D personality can increase your chances of developing heart disease. Read each statement and circle the appropriate number to indicate your answer.

There are no rights or wrong answers: your own impression is the only thing that matters.

Circle your answers:

	False	Less False	Neutral	Less True	True
1. I make contact easily when I meet people	4	3	2	1	0
2. I often make a fuss about unimportant things	0	1	2	3	4
3. I often talk to strangers	4	3	2	1	0
4. I often feel unhappy	0	1	2	3	4
5. I am often irritated	0	1	2	3	4
6. I often feel inhibited in social interactions	0	1	2	3	4
7. I take a gloomy view of things	0	1	2	3	4
8. I find it hard to start a conversation	0	1	2	3	4
9. I am often in a bad mood	0	1	2	3	4
10. I am a closed kind of person	0	1	2	3	4
11- I would rather keep people at a distance	0	1	2	3	4
12. I often find myself worrying about something	0	1	2	3	4
13. I am often down in the dumps	0	1	2	3	4
14. When socializing,  I don’t find the right things to talk about	0	1	2	3	4

ADD YOUR ANSWERS

Negative Affectivity:

Add scores for questions 2, 4, 5, 7, 9, 12 and 13

Social Inhibition:

Add scores for questions 1, 3, 6, 8, 19, 11 and 14

SCORE THE RESULTS

You qualify as a Type D personality if your Negative Affectivity is 10 or higher and your Social Inhibition is 10 or higher.

Source: Newsweek Magazine