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Type D Personality and Illness

19381623_sMany of us have heard about the Type A personality, which describes a person who tends to be competitive and self-critical. People with this pattern of behavior also tend to live life with a strong sense of urgency and experience high levels of anger and frustration (McLeod, 2014). Given this profile, we can understand that those with this type of behavior pattern tend to experience more stress and as a result have more health problems including a greater prevalence of high blood pressure and heart disease. However, findings indicate that this personality type does not predict outcome very well (Bianchi et al., 2008). Therefore, researchers began to develop new studies to look at the types of personality and behavioral features that lead to stress-related cardiac events.

It has become clear that psychological distress is associated with the development of conditions that may lead to heart attacks. In fact, depression, anxiety and hostility have all been linked to the development of coronary artery disease (Chida & Steptoe, 2009; van Melle et al., 2004; Roest, Martens, de Jonge, & Denollet, 2010). However, researchers have also learned that psychological distress does not take place in a vacuum where patients experience only one problem such as depression at a time. Instead, patients at an elevated risk for coronary artery disease and heart attack tend to experience a cluster of problems that lead to distress. Therefore, researchers have begun to look at the concept of a Type D (distressed) personality that is characterized by the experience of a high level of negative emotions and social inhibition.

Signs you may have a Type D Personality (Denollet & Pedersen, 2012):

  • You experience sadness, worry and tension more days than not or at a level that impacts how you function in your daily life.
  • You often view yourself in a negative light, which often includes a lot of negative self-talk.
  • You scanning the world around you looking for bad things to happen.
  • You tend to inhibit the expression of feelings in social situations or change your behavior frequently out of fear of rejection and disapproval from others.
  • You feel tense and insecure in social situations.

If you find that these signs describe you then there are some things you can do to change these patterns and experiences to keep your heart healthy:

  • Manage your stress. Engaging in relaxation exercises, physical exercise, and healthy eating can help you to feel better and prevent illness.
  • Begin a meditation practice. Transcendental meditation has been found to be very helpful for people at risk for heart disease. Mindfulness meditation is another type of practice that can help. To learn more about mindfulness meditation, check out our blog for some simple and easy to use techniques.
  • Monitor your sleep. Inadequate rest has been linked with increases in both anxiety and depression.
  • Seek treatment from a therapist for social anxiety.
  • Track your moods. If you find that you are consistently experiencing sadness and/or anxiety more days than not that impacts your relationships or daily functions then get help from a mental health professional.

DSC_0170_2Dr. Stephanie Davidson is a licensed, clinical health psychologist at the Rowan Center for Behavioral Medicine. She specializes in the use of cognitive-behavioralhumanistic and existential approaches to treat patients with a range of medical and mental health challenges. She has a strong interest in mindfulness-based interventions to heal the body and mind. Her focus is on collaboration with the goal of assisting patients in adjusting to difficult experiences and achieving a greater sense of well-being, balance and peace in their lives.


Bianchi, F., Leo, R. Fortunately, E., Sirasusano, A. & Romeo, F. (2008). Correlations between personality factors and coronary artery disease: from Type A behavior pattern to Type D personality. Journal of Cardiovascular Medicine, 9, 761-768.

Chida, Y. & Steptoe, A. (2009). The association of anger and hostility with future coronary heart disease. Journal of the American College Cardiology, 53, 936-946.

Denollet, J. & Pedersen, S. S. (2012). Heart and mind: the practice of cardiac psychology (2nd ed.). Allan, R. & Fisher, J. (Eds.). American Psychological Association: Washington, DC.

McLeod, S. A. (2014). Type A Personality. Retrieved from www.simplypsychology.org/personality-a.html

Roest, A. M., Martens, E. J. de Jonge, P., Denollet, J. (2010). Anxiety and risk of incident coronary heart disease: a meta-analysis. Journal of the American College of Cardiology, 56, 38-46.

van Melle, J. P., Tijessen, J. G., Ormel, J., van Veldhuisen, D. J…. van den Berg, M. P. (2004). Prognostic association of depression following myocardial infarction with mortality and cardiovascular events: a meta-analysis. Psychsomatic Medicine, 66, 814-822.

Type D Personality and Illness

Rowan Center For Behavioral Medicine

At Rowan Center for Behavioral Medicine, we help people get the most out of life by using evidence-based therapy and partnering with a range of health professionals to provide integrated care. We have had success working with common concerns such as depression, anxiety, stress-management, relationship problems and phase-of-life issues. In addition, we specialize in health and rehabilitation psychology providing assistance to patients with medical illnesses and disabilities.

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APA Reference
Williams, A. (2015). Type D Personality and Illness. Psych Central. Retrieved on July 20, 2018, from https://blogs.psychcentral.com/live-thrive/2015/06/type-d-personality-and-illness/


Last updated: 14 Jul 2015
Last reviewed: By John M. Grohol, Psy.D. on 14 Jul 2015
Published on PsychCentral.com. All rights reserved.