Siobhán Howard

A Taxometric Analysis of Type-D Personality

Objective: To test the dimensionality of Type-D personality, using taxometric procedures, to assess if Type-D personality is taxonic or dimensional. Type-D personality is treated as a categorical variable and caseness has been shown to be a risk factor for poor prognosis in coronary heart disease. However, at present, there is no direct evidence to support the assumption that Type D is categorical and able to differentiate true cases from noncases. Methods: In total, 1012 healthy young adults from across the United Kingdom and Ireland completed the DS14, the standard index of Type D, and scores were submitted to two taxometric procedures MAMBAC and MAXCOV. Results: Graphical representations (comparing actual with simulated data) and fit indices indicated that Type D is more accurately represented as a dimensional rather than categorical construct. Conclusion: Type D is better represented as a dimensional construct. Implications for theory development and clinical practice with respect to Type D are examined as well as the wider use of taxometrics within psychosomatic medicine (e.g., to investigate if there are medically unexplained syndrome taxons, such as a Gulf War Syndrome taxon). NA = negative affectivity; SI = social inhibition; MAMBAC = mean above minus below a cut; MAXCOV = maximum covariance; MAXEIG = maximum Eigenvalue; L-MODE = L-mode factor analysis; CCFI = curve comparison fit index.

Construct, concurrent and discriminant validity of Type D personality in the general population: Associations with anxiety, depression, stress and cardiac output

The Type D personality, identified by high negative affectivity paired with high social inhibition, has been associated with a number of health-related outcomes in (mainly) cardiac populations. However, despite its prevalence in the health-related literature, how this personality construct fits within existing personality theory has not been directly tested. Using a sample of 134 healthy university students, this study examined the Type D personality in terms of two well-established personality traits; introversion and neuroticism. Construct, concurrent and discriminant validity of this personality type was established through examination of the associations between the Type D personality and psychometrically assessed anxiety, depression and stress, as well as measurement of resting cardiovascular function. Results showed that while the Type D personality was easily represented using alternative measures of both introversion and neuroticism, associations with anxiety, depression and stress were mainly accounted for by neuroticism. Conversely, however, associations with resting cardiac output were attributable to the negative affectivity–social inhibition synergy, explicit within the Type D construct. Consequently, both the construct and concurrent validity of this personality type were confirmed, with discriminant validity evident on examination of physiological indices of well-being.

Individual differences in adaptation of cardiovascular responses to stress

Previous research has described patterns of adaptation of cardiovascular responses across prolonged or recurring stress. However, despite important implications for the study of reactivity, relatively little research has directly examined the antecedents or consequences of this adaptation. We present data showing that neuroticism, a personality trait associated with dispositional appraisals of stress, is associated with reductions in HR, CO, and TPR responses across stress exposures. Comparisons of reactivity curves suggest blunted initial stress responses among persons with high neuroticism, and higher initial responses followed by greater decreases among persons with low neuroticism. The data also suggest an association between adaptation of cardiovascular responses and myocardial hemodynamic responding. Such findings shed new light on previous studies detecting healthful correlates of short-term stress responding, and highlight the relevance of adaptation to future cardiovascular reactivity research.

Type D personality is associated with a sensitized cardiovascular response to recurrent stress in men.

The present study sought to examine the role of gender and Type D personality on cardiovascular reactivity to stress, by examining patterns of cardiovascular adaptation to recurrent laboratory-based stress. Cardiovascular data were collected from 76 students who, following an initial 10-min baseline period, underwent two cognitive stress tasks. Type D personality was assessed using the 16-item Type D scale. Adaptation of cardiovascular response to recurrent stress was examined by scrutinizing the changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) across the procedure. Female participants and non-Type D males showed cardiovascular habituation to recurrent stress. For Type D males, however, cardiovascular sensitization was evident. The results implicate Type D personality in maladaptive cardiovascular responses, particularly in men, highlighting a possible direct mechanism of psychosomatic cardiovascular pathogenesis.

Stress reactivity and the Hemodynamic Profile-Compensation Deficit (HP-CD) Model of blood pressure regulation.

Considering the central role of the concept of blood pressure reactivity to explanations of the influence of life stress in the pathogenesis of cardiovascular disease, it is important that the underlying psychophysiological determinants of blood pressure change are elucidated. Empirical evidence is reviewed concerning the utility of the Hemodynamic Profile-Compensation Deficit (HP-CD) Model (Gregg et al., 2002), which draws on physiological theory that explains blood pressure regulation as a dynamic compensatory relation between cardiac output and total peripheral resistance. Core constructs and quantitative features of the Model are explained, accompanied by a focussed review of the Models application in reactivity studies of stress, lifestyle behaviours, laboratory-to-field generalisability, and personality differences. Although the available studies are relatively few in number, evidence of the Models utility is promising. Application of the Model in further research could help to elucidate cardiovascular pathogenesis in ways not achievable through the study of blood pressure reactivity alone.

Benefit of social support for resilience-building is contingent on social context: examining cardiovascular adaptation to recurrent stress in women

Previous work on social support and stress tolerance using laboratory-based cardiovascular stress response paradigms has suggested that perceived social support may be effective in building resilience in recipients. However, such paradigms are often socially de-contextualized insofar as they fail to take account of the social aspects of stress itself. Using 90 healthy college women, the present study sought to examine the association between self-reported perceived social support and cardiovascular stress tolerance. Participants underwent two consecutive exposures to a mental arithmetic task. On second exposure to the stressor, participants completed the task under either social threat or control conditions. Social threat was manipulated using socially salient instructions, to create a high social context. Adaptation to stress was established in terms of comparisons between cardiovascular responses to successive exposures. Results showed that cardiovascular responses tended to habituate across time, with perceived social support associated with the degree of habituation, but only under certain contextual conditions; high perceived support was associated with effective habituation under control conditions only. This response pattern is consistent with the view that high perceived social support buffers against stress in healthful ways, but only in asocial contexts.

An experimental test of blunting using sleep-restriction as an acute stressor in Type D and non-Type D women.

Recent years have seen a growing interest in evidence indicating that a low, or blunted, cardiovascular response to stress may predict increased risk for a range of adverse health outcomes. Type D personality has been associated with poor health in cardiac patients, and more recently, has been associated with lower reactivity to laboratory stress in healthy individuals, underpinned by an increase in vascular responding. Previous findings have also demonstrated that partial sleep restriction is characterised by a robust vascular profile. However, despite the fact that a vascular response profile underpins both reactivity in sleep restricted adults and blunted reactivity in healthy Type D adults, limited empirical work has examined the correlates of sleep restriction and Type D. The present study sought to investigate if manipulation of sleep duration in healthy Type D and non-Type D individuals would alter cardiovascular reactivity to stress, and in particular whether such manipulation could elucidate the comparative nature of blunting. Seventy female university students completed a laboratory social stress task while undergoing continuous hemodynamic monitoring, after either a night of partial sleep restriction or a full nights rest. In both groups, Type D participants exhibited relatively low SBP stress responses, consistent with the view that at-risk groups show blunting in (some indices of) cardiovascular reactivity. For non-Type D participants, low SBP responses were observed only in participants who had undergone sleep restriction, suggesting that sleep-restriction served as an environmental stressor which precipitated in non-Type D persons a cardiovascular stress response resembling that ordinarily seen in Type D persons. This blunted response was associated with an increase in vascular responding. Thus, the findings suggest that blunting is characterised not only by reductions in some (frequently studied) cardiovascular parameters, but also by increases in others.

Attention focus, trait anxiety and pain perception in patients undergoing colposcopy.

Few studies have compared the relative efficacy of attention‐focus strategies in reducing clinical pain. Colposcopy, a medical diagnostic examination performed to identify premalignant cervical cell changes, elicits both anxiety and pain in patients, while allowing little or no behavioural control over the event. Employing a multi‐group experimental design, the present study sought to investigate how different types of attention‐focus strategies impacted upon pain perception, state anxiety and affect, in a sample of 123 colposcopy patients. Patients were randomly assigned to one of three groups: sensory focusing, active distraction and undirected control. Psychometric measures of pre‐colposcopy pain expectancy and dispositional trait anxiety were also taken, in order to assess whether these factors further contributed to outcomes. Overall, when controlling for pain expectancy and trait anxiety, self‐reported pain intensity, sensory pain and affective pain did not differ across groups. Further, there were no significant between‐group differences in colposcopy‐related state anxiety or affect. However, pre‐colposcopy psychometric measures were found to be predictive of a range of outcomes. Pre‐colposcopy pain expectancy, but not trait anxiety, was found to be positively related to colposcopy‐related pain. It was further demonstrated that heightened state anxiety following colposcopy was due to experienced pain and pain unpleasantness, rather than to aspects of the pre‐colposcopy prediction of pain. The results have implications for management of acute clinical pain.

Social support reduces resting cardiovascular function in women

Abstract Social support is believed to benefit cardiovascular health in part by buffering recipients from life stress. Classically, this has been investigated by exploring the relationship between support and cardiovascular reactivity to laboratory stress. Such research customarily emphasizes stress responses and downplays the relevance of resting cardiovascular levels. However, it is now appreciated that resting cardiovascular function is associated with disease risk independently of reactivity. Moreover, such mechanisms are known to be relevant to female members of the population, despite the fact that much previous research has focused on males. Reactivity research rests on the assumption that stress promotes gradual hypertension over time. As such, it is important to establish the relationship between psychosocial factors and resting blood pressure. In a cross-sectional biopsychosocial screening study, we examined resting cardiovascular levels in 211 healthy non-smoking women, using regression to assess associations with psychometric indices of social support (namely, perceived network size and perceived satisfaction with support) while controlling for a range of potential biometric and psychometric confounds. Overall, social support was found to be associated with reduced resting cardiovascular function independently of, and to a greater extent than, biometric variables, anxiety, and depression. Benchmarking these effects against the differences in cardiovascular function between the present sample and a group of 92 similarly aged males revealed that social support accounted for as much variance as gender, which is widely assumed to be an important biomedical determinant of blood pressure. Such findings corroborate assertions that social support influences disease risk in ways that involve direct psychosomatic mechanisms.

Conscientiousness and mindfulness in midlife coping: An assessment based on MIDUS II

Research has demonstrated that conscientious individuals tend to engage in planful problem solving to cope with stressful situations. Likewise, mindful individuals tend to favour approach-based coping and are less likely to engage in avoidant coping strategies. To examine whether conscientiousness and mindfulness determined agentic coping behaviour, hierarchical linear regressions were conducted using data from 602 participants drawn from the National Survey of Midlife Development in the United States (MIDUS) Study II and MIDUS II Biomarker Project. Personality responses were derived from the five-factor model inventory, gathered at a single time-point. Results revealed that conscientiousness predicted problem-focused coping (p < 0.001; β = 0.23) and inversely predicted emotion-focused coping respectively (p < 0.001; β = -0.14), even after controlling for remaining Big Five and confounding variables. Mindfulness also predicted problem-focused coping (p < 0.001; β = 0.21). Neuroticism predicted emotion-focused coping (p < 0.001; β = 0.40). These findings suggest that conscientiousness and mindfulness may contribute to coping responses in potentially healthful ways, highlighting new evidence regarding the potential protective role of conscientiousness.