INTRODUCTION Type D, Optimism, Cognitive Organization, and EsteemThe “Type D” (Distressed) Personality tends to experience increased negative distress and does not express these negative emotions in social interactions (Erdman, Jordaens, Pedersen, & van Domburg, 2004). They are characterized by high levels of negative affectivity (NA) and social inhibition (SI), which are also the two subscales used in Type D assessment. The NA subscale measures tendencies towards: dysphoria (feelings of emotional/mental discomfort, the opposite of euphoria), anxious apprehension, and irritability. The other subscale, SI, measures tendencies towards: social discomfort, reticence (shyness/quitness, reluctance to assert oneself in social settings), and a general lack social poise.Anxiety, pessimism, limited social assertion, and low levels of self-assurance typify the Type D who, research indicates, is at greater risk for an array of physical and psychological problems. Type D negative outcomes, as reported by Denollet (2005), include increased risk for physiological concerns such as: mortality, morbidity, vital exhaustion; and psychological concerns such as posttraumatic stress, depression, anxiety, irritability, and low levels of positive affect. Denollet’s study used Belgian cardiac patients (specifically coronary heart disease, and hypertension patients) and a sample from the general population. He found the occurrence of Type D personalities among the groups to be 28%, 53%, and 21% respectively. Subjects included both males and females, and ranged in ages from 16 to 101 (M = 45.6).In a recent MWSU study (Oshel & Waller, 2005) more associations were found for Type D negative outcomes. From 41 students in an introductory psychology class (16 male, 25 female, with an average age of 22.2) data were obtained using both physiological and psychological measures. Type D individuals had significantly higher loneliness and isolation scores, higher stress scores, exhibited fewer healthy behaviors, recalled fewer words on an immediate word recall test, and had lower performance scores on a story recall test.Type D construct exploration has been limited to heart patients. The construct was developed with Belgian cardiac patients (Denollet & Pederson, 2004) and few have explored it outside of Belgium. Due to the construct originating as an attempt to identify those at risk for cardiac problems, little exploration has been conducted in other groups within the general population (non-cardiac patients). Research is needed to explore this construct with other populations such as college students, older non-cardiac patients, etc. Correlations between sychological traits and Type D also needs to be reinforced empirically, as most associated traits were attached initially to be descriptors, not concrete characteristics backed by data.This study is an Ex Posto Facto study, aimed at exploring the theoretical validity of the Type D construct in relation to more specific psychological constructs, such as positive thinking and cognition. Further fleshing out Type D traits will provide ways of effectively isolating cardiac risk personalities. Those constructs being explored here are: optimism, the degree of generally positive expectations (Scheier & Carver, 1985); cognitive disorganization, the degree that one’s overall cognitive functioning lacks in the coherence, structure, and guidance essential to task completion and goal attainment (Dean, 2004); and esteem, the degree of one’s self-acceptance/assessment of personal adequacy (Rosenberg, 1965). Given the base descriptors of the Type D personality, the study was conducted with the hypothesis that Type D’s (as compared to NonD’s) will have more unfavorable scores on assessments of the constructs: lower on optimism, higher on cognitive disorganization, and lower on esteem.
The participants for this study were 102 college students from an introductory psychology class. Subjects were both male and female, and ranged in ages from 18 to 50, with a mean age of 22.17. There were 28 male (61% Type D) and 74 female (43% Type D) participants.
The materials employed were paper forms of four psychological assessment scales. Which were the DS14, Life Orientation Test (LOT), Sense of Personal Disorganization Scale (SPDS), and the Self-Esteem Scale. Each scale is described below. The DS14 (Type D Personality Scale) was used to assess Type D (Denollet, 2005). It is comprised of fourteen items (ex: “I often feel inhibited in social interactions”), scored on a five point scale (0-4). There are two subscales, each consisting or seven items: negative affectivity, and social inhibition. Individuals who score a ten or higher on both the NA & SI subscales are classified as having Type D personality. Cronbach’s Alpha (.88 and.86) for the NA and SI subscales indicates the scale has good internal reliability. SI and NA correlate (r = -.59 and r = .68) with extraversion and neuroticism, respectively supporting the scale’s construct validity.The Life Orientation Test (LOT) was used to assess optimism (Scheier, & Carver, 1985). It consists of twelve items (ex: “In uncertain times, I usually expect the best.”) with eight optimism focused items and four filler items. Items are scored on a five point scale (0-4). Results are based on total scores. Cronbach’s Alpha (.76) for the LOT indicates the scale has good internal reliability. The scale correlates negatively (r = -.47) with hopelessness supporting the scale’s construct validity.The Sense of Personal Disorganization Scale (SPDS) was used to assess cognitive disorganization (Dean, & Mirels, 2001). It consists of ten items (ex: “Forgetting to do things has caused problems for me.”) that are scored on a five point scale (1-5). The results are based on total score. The SPDS has a Cronbach’s Alpha of .85 and it correlates as would be expected with several other constructs including anxiety, and esteem.The Self-Esteem Scale which assess esteem (Rosenberg, 1965). It is comprised of ten items (ex: “I feel that I have a number of good qualities.”) that are scored on a four point scale (1-4). The results are based on total score. A Guttman scale reproducibility coefficient of .92 for the scale indicates good internal reliability. The scale correlates (r = .59) with Coopersmith’s Self-esteem Inventory, supporting convergent validity of the scale.
The aforementioned students were administered the four scales as part of a packet. These scales, along with an informed consent form and several other assessment scales, were completed during one of the fifty minute lecture sessions as part of regular in-class participation. The packets were then collected by the instructor, and the results compiled for analysis.
RESULTSSeparate Independent Samples T-Tests were run against Type-D for optimism, cognitive dysorganiztion, and esteem. Significant differences between Type-D (n = 49) and Non-D (n = 53) were found for all three (see Figure 1). There was a significant difference in optimism t(2, 100) = 3.97, p < .05, with the mean of the Type-D personality group being significantly lower (M = 17.35, sd = 5.93) than the Non-D group (M = 21.60, sd = 4.89). There was a significant difference in cognitive dysorganization t(2, 100) = -2.67, p < .05, with the mean of the Type-D group being significantly higher (M = 29.61, sd = 8.06) than the Non-D group (M = 24.85, sd = 1.34). And, there was a significant difference in esteem t(2, 100) = 4.54, p < .05, with the mean of the Type-D group being significantly lower (M = 29.76, sd = 6.25) than the Non-D group (M = 34.47, sd = 4.09).Pearson correlation coefficients were calculated for the relationships between subjects’ total Type-D score (sum of the social inhibition and negative affect subscales) and optimism, cognitive dysorganization, and esteem. A significant and negative correlation was found r(2,100) = -.57, p < .001, suggesting that higher Type-D scorers tend to be less optimistic. A significant and positive correlation was found r(2,100) = .32, p < .001, indicating that higher Type-D scorers tend to be more cognitively dysorganized. A significant and negative correlation was found r(2,100) = -.61, p < .001, implying that higher Type-D scorers tend to have lower esteem.
DISCUSSIONThe T-test results evidence significant mean differences between the Type D personality and NonD personalities on all three of the studied constructs. The correlational results provide discriminate validity for the DS14 measure. The results are in the predicted direction for positive functioning (i.e., negative correlations with optimism and esteem) and for negative psychological functions (i.e., positive correlations with cognitive disorganization). The correlations are also not too strong, that is, they are between .32 and .61 instead of .80 and .90 which supports the DS14 as being a unique measure, hence necessary. The findings of this study support the hypothesis and the initial outlines of the Type D personality proposed by Denollett (2005). By further establishing the trait package of the Type D, perhaps easier trait package recognition in general population individuals will lead to earlier cardiac risk assessment. The fact that the DS14`s validity holds up with a sample of college students (and a substantially different mean age, 22.4 vs. 45.6) is quite encouraging for its gereralizability. Hopefully that generalizability will pay off in longitudinal studies evidencing the DS14 an effective predictor (thus potential preventer) of cardiac difficulties.Possible limitations of the study seem to revolve around the college setting. The students sampled in this study yielded a much higher percentage of Type D personalities than did the general population sample in Denollett`s work (48% vs. 21%, respectively). Perhaps the circumstances surrounding college life amplify perceived severity of the SI and NA traits in students. The scales being administered as part of a larger battery may have resulted in some lack completion on the part of the students. Also the classes being introductory psychology classes may have caused some subject expectancy confounds to creep in. Future studies using different intro courses may lead to some interesting contrasts in results. Other future studies using different subgroups seem worthwhile. And a look at Type D success rates in academic, professional, and personal relationship settings could harvest some important predictive/preventative info for negative outcomes aside from those directly health related.
REFERENCESDean, J. B. (2004). Cognitive disorganization, prospective memory, and planning. Dissertation Abstracts International: Section B: The Sciences and Engineering, 65, 1025-1185.Dean, J. B., & Mirels, H. J. (2001, June). “Cognitive disorganization” impares prospective memory. Poster session presented at the annual convention of the American Psychological Society, Toronto, Canada.Denollet, J. (2005). DS14: Standard assessment of negative affectivity, social inhibition, and type D personality. Psychosomatic Medicine, 67, 89-97.Denollet, J., & Pedersen, S. S. (2004). Validity of the type D personality construct in Danish post-mi patients and controls. Journal of Psychosomatic Research, 57, 265-272.Oshel, L., & Waller, J. (2006, March). Loneliness, type D personality, and orthostatic blood pressure regulation. Poster session presented at the annual Great Plains Conference, Warrensburg, MO.Rosenberg, M. (1965). Society and the adolescent self-image. Princeton, NJ: Princeton University Press.Scheier, M., & Carver, C. (1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology, 4, 219-247.
FIGURE CAPTION Figure 1. Mean scores of Type D versus NonD personalities.