title: Type D personality, self-efficacy, and medication adherence following an acute coronary syndrome.
abstract: OBJECTIVE
  To assess the relationship among Type D personality, self-efficacy, and medication adherence in patients with coronary heart disease.
  
  
  METHODS
  The study design was prospective and observational. Type D personality, self-efficacy for illness management behaviors, and medication adherence were measured 3 weeks after hospitalization for acute coronary syndrome in 165 patients (mean [standard deviation] age = 61.62 [10.61] years, 16% women). Self-reported medication adherence was measured 6 months later in 118 of these patients. Multiple linear regression and mediation analyses were used to address the study research questions.
  
  
  RESULTS
  Using the original categorical classification, 30% of patients with acute coronary syndrome were classified as having Type D personality. Categorically defined patients with Type D personality had significantly poorer medication adherence at 6 months (r = -0.29, p < .01). Negative affectivity (NA; r = -0.25, p = .01) and social inhibition (r = -0.19, p = .04), the components of Type D personality, were associated with medication adherence 6 months after discharge in bivariate analyses. There was no evidence for the interaction of NA and social inhibition, that is, Type D personality, in the prediction of medication adherence 6 months after discharge in multivariate analysis. The observed association between NA and medication adherence 6 months after discharge could be partly explained by indirect effects through self-efficacy in mediation analysis (coefficient = -0.012; 95% bias-corrected and accelerated confidence interval = -0.036 to -0.001).
  
  
  CONCLUSIONS
  The present data suggest the primacy of NA over the Type D personality construct in predicting medication adherence. Lower levels of self-efficacy may be a mediator between higher levels of NA and poor adherence to medication in patients with coronary heart disease.
authors.affiliation: Division of Psychology, School of Natural Sciences, Cottrell Bldg, University of Stirling, Stirling FK9 4LA, Scotland. g.j.molloy@stir.ac.uk
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Molloy
authors.forename: Gemma
authors.initials: G
authors.lastname: Randall
authors.forename: Anna
authors.initials: A
authors.lastname: Wikman
authors.forename: Linda
authors.initials: L
authors.lastname: Perkins-Porras
authors.forename: Nadine
authors.initials: N
authors.lastname: Messerli-Bürgy
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D003327:Coronary Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007266:Inhibition, Psychological; D016014:Linear Models; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D015999:Multivariate Analysis; D009341:Negativism; D010551:Personality; D011446:Prospective Studies; D012648:Self Care / Q000523:psychology / Q000706:statistics & numerical data*; D020377:Self Efficacy; D057566:Self Report; D016903:Drug Monitoring