title: A case-control validation of Type D personality in Greek patients with stable coronary heart disease.
abstract: BACKGROUND
  Type D personality has been associated with a variety of emotional and social difficulties as well as with poor prognosis in patients with established coronary heart disease (CHD). We examined the psychometric properties and validity of the Type D Scale-14 (DS14) and the prevalence of Type D personality among Greek patients with CHD while taking into account demographic; clinical, such as diabetes mellitus, hypertension, and hypercholesterolemia; as well as psychological variables such as depression, anxiety, and psychological stress.
  
  
  METHODS
  Ninety-six patients with stable coronary heart disease and 80 healthy participants from the general population completed the Greek version of the DS14 and the Hospital Anxiety and Depression Scale (HADS).
  
  
  RESULTS
  Cronbach's α coefficient for the negative affectivity (NA) and social inhibition (SI) subscales was 0.83 and 0.72 for the CHD and 0.88 and 0.76 for the control group, respectively. Internal-structural validity was assessed by a factor analysis (two-factor solution), and the factor structure of the original DS14 was replicated. Using the standardized cutoff point of NA ≥10 and SI ≥10, instead of the median scores, in order to have compatible results with the majority of studies, the prevalence of Type D personality was 51% for the CHD patients and 13% for the control group. Higher NA and SI were connected with higher anxiety, depression, and total psychological stress. Finally, more patients with CHD and Type D personality than those without were diagnosed with type 2 diabetes; however, no differences were observed in hypertension or hypercholesterolemia.
  
  
  CONCLUSIONS
  These results indicate that the Type D construct is reliable and valid in a Greek population. The prevalence of Type D personality was higher in patients with stable coronary heart disease than in people from the general population. The DS14 subscales were positively correlated with higher anxiety, depression, and total psychological stress. Regarding other CHD risk factors, only diabetes mellitus was found more frequently in CHD patients with Type D personality.
authors.affiliation: Second Department of Psychiatry, "Attikon" General Hospital, University of Athens Medical School, Athens 12462, Greece. christo.christodoulou@gmail.com.
authors.forename: Christos
authors.initials: C
authors.lastname: Christodoulou
authors.forename: Athanasios
authors.initials: A
authors.lastname: Douzenis
authors.forename: Paula Mc
authors.initials: PM
authors.lastname: Mommersteeg
authors.forename: Loukianos
authors.initials: L
authors.lastname: Rallidis
authors.forename: Antonis
authors.initials: A
authors.lastname: Poulios
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Efstathiou
authors.forename: Georgios
authors.initials: G
authors.lastname: Bouras
authors.forename: Christos
authors.initials: C
authors.lastname: Varounis
authors.forename: Panagiota
authors.initials: P
authors.lastname: Korkoliakou
authors.forename: John
authors.initials: J
authors.lastname: Palios
authors.forename: Dimitrios Th
authors.initials: DT
authors.lastname: Kremastinos
authors.forename: Lefteris
authors.initials: L
authors.lastname: Lykouras