Beyond Type D personality: reduced positive affect (anhedonia) predicts impaired health status in chronic heart failure.
OBJECTIVE
Type D personality has been associated with impaired health status in chronic heart failure (CHF), but other psychological factors may also be important.


OBJECTIVE
To determine whether non-Type D patients with low positive affect and Type D patients report lower health status, compared with non-Type D patients with high positive affect at 12-month follow-up in chronic heart failure.


METHODS
Consecutive CHF outpatients (n = 276) filled out the Short Form-12 (health status) and Health Complaints Scale (disease-specific complaints) at inclusion and 12-month follow-up, and the DS14 (Type D personality) and positive affect (Global Mood Scale) at inclusion. Three groups were composed: non-Type D patients without anhedonia, non-Type D patients with anhedonia, and Type D patients.


RESULTS
After controlling for demographic and clinical confounders, and scores at inclusion, anhedonic non-Type D patients reported lower mental health status (beta = -.19, P < .004), and more feelings of disability (beta = .10, P = .04), marginally lower physical health status (beta = -.11, P = .07), and equal levels of cardiac symptoms (beta = .04, P = .43), when compared with non-Type D's without anhedonia. Type D patients reported lower levels of impaired mental health status, more cardiac symptoms and feelings of disability (-.31 < beta < .17, all Ps < .05). A trend was shown for physical health status (beta = -.11, P = .09).


CONCLUSIONS
Non-Type D patients low on positive affect and Type D patients report lower levels of health status in CHF, compared with non-Type D patients with high positive affect. Future studies need to determine whether lack of positive affect is associated with impaired clinical outcome.
Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
Aline J
AJ
Pelle
Susanne S
SS
Pedersen
Balázs M
BM
Szabó
Johan
J
Denollet
D000368:Aged; D005260:Female; D005544:Forecasting; D006304:Health Status; D006333:Heart Failure / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010551:Personality / Q000145:classification*; D011795:Surveys and Questionnaires