Type D Personality Is Associated with Psychological Distress and Poor Self-Rated Health among the Elderly: A Population-Based Study in Japan

Despite accumulating evidence, previous studies have not clearly separated the contribution of community-level social capital on mental health from that of individual-level social support. We examined the association between community-level social capital and psychological distress in a sample of older Japanese individuals, taking into account the effects of individual-level social capital and social support. We collected data via a cross-sectional survey among all residents aged ≥65 in three rural municipalities in Okayama Prefecture. We measured two components of social capital in the questionnaire: perceptions of trust and reciprocity in the community. Community-level social capital was obtained by aggregating individual responses and calculating the proportion of subjects reporting mistrust and lack of reciprocity. Psychological distress was assessed by the Kessler Psychological Distress scale. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for psychological distress using two-level Poisson regression models (9,761 individuals nested within 35 communities). The prevalence of psychological distress was 39.8%. Low community-level social capital was associated with psychological distress, even after controlling for individual-level social support, age, sex, educational attainment, frequency of alcohol consumption, smoking status, body mass index, marital status, socioeconomic status, and number of cohabiters. The adjusted RRs per 10% increase of the proportion of mistrust and lack of reciprocity in the communities were 1.23 (95% CI: 1.01–1.51) and 1.12 (95% CI: 1.02–1.24), respectively. Lower levels of community-level social capital are associated with psychological distress among the Japanese elderly population, even after adjusting for individual-level perceptions of social capital and social support.

Abstract. Background and purpose. Type D personality is characterized by negative affectivity and social inhibition. This personality construct is linked to cardiovascular diseases and is considered as stable. However, there has been little research on prevalence in non-clinical samples and on stability of this construct. The main aim of this study was to evaluate the prevalence and retrospective perception of stability of Type D personality in patients and general population. Methods. This was a cross-sectional study with a sample from general population (n=304) and cardiovascular patients (n=154). Type D was evaluated using DS14 questionnaire. Respondents were asked to assess their personal characteristics at the moment and how they felt 5 years ago. Items about health condition, lifestyle and sociodemographic characteristics were also included into questionnaire. Results. Type D personality was similarly prevalent in both study groups -33.1% in cardiovascular patients and 35.9% in general population (p =.561). The prevalence of Type D based on retrospective assessment: during the last 5 years increased by 8.4% points in patients (p =.015) and by 0.4% points in comparison group (p =.472). In addition, Type D personality was associated with less healthy lifestyle in both study groups (p<.05) and also with a worse perceived health in comparison group (p<.001). Conclusions. Type D personality is similarly prevalent in general population and cardiovascular patients. However, this construct is considered as less stable among the patients. Type D personality was associated with less healthy lifestyle and in part with worse perceived health.

Home visits by commissioned welfare volunteers are significantly associated with a lower risk of psychological distress among older people.