Type D Personality as a Risk Factor in Coronary Heart Disease: A Review of Current Evidence

Curr Cardiol Rep. 2018 Sep 12;20(11):104. doi: 10.1007/s11886-018-1048-x.


Purpose of the review: This review article synthesizes recent research findings on the psychological context of Type D personality and the mechanisms through which Type D affects disease progression and prognosis among patients with coronary heart disease (CHD).

Recent findings: One in four patients with CHD has a Distressed (Type D) personality, which is characterized by two stable traits: social inhibition and negative affectivity. Type D personality predicts increased mortality and morbidity burden, and poorer health-related quality of life. Type D is part of a family of psychosocial risk factors that affect CHD prognosis. The pattern of co-occurrence of these psychosocial factors and intra-individual differences in psychosocial profiles may affect risk prediction accuracy. Multiple biological and behavioral processes have been associated with Type D personality. Identifying pathways explaining the observed associations between Type D personality and CHD is important to improve etiological and pathophysiological knowledge and to design personalized interventions, and targeting specific risk-associated pathways.

Keywords: Atherosclerosis; Biobehavioral mechanisms; Cardiac mortality; Coronary heart disease; Heterogeneity; Risk profiles; Stress; Type D personality.

Publication types

  • Review

MeSH terms

  • Coronary Disease / psychology*
  • Humans
  • Quality of Life / psychology*
  • Risk Factors
  • Type D Personality*