Type D Personality and Alexithymia: Common Characteristics of Two Different Constructs. Implications for Research and Clinical Practice

Background Type D personality (TDP) is a sign of tapered stress and compromises treatment outcomes including those of hip arthroplasty. The common dissatisfaction with total knee arthroplasty (TKA) is predicted by fear avoidance, pain catastrophizing and emotional lability, with poor quality of life (QoL) reflecting these strains. This study is the first to investigate the influence of TDP on TKA assuming (1) negative affect (NA) to be linked to fear avoidance and to increased dissatisfaction with TKA and (2) the expression of NA and social inhibition (SI) to not be stable over time. Method We studied 79 participants using the brief symptom inventory-18, the pain-catastrophizing scale, the Tampa scale of kinesiophobia, the SF-36, and the WOMAC preoperatively and 12 months postoperatively. T-test and regression were used to compare the variables of interest between groups built based upon outcome severity. Result NA at follow-up predicted knee pain (p=0.02) and knee function (p < 0.01) at follow-up. Contrarily, increased expressions of NA/SI at follow-up were predicted by NA (p=0.04) and rumination (p=0.05) at the baseline. Conclusion The present results suggest the postoperative increase of NA to be linked to dysfunctional outcomes of TKA due to an interaction with pain catastrophizing. Baseline self-rated physical health did not connect to the dissatisfaction with TKA 1-year postoperatively.

Nearly 30 years after typeD personality was proposed as a psychological risk factor for cardiovascular disease, issues have been raised in the aspects of its validity. By reviewing the results of the existing major studies, this paper first outlined and summarized what the issues have been raised regarding the validity of typeD personality, and then proposed the future direction of research to resolve them. As a result of reviewing the main studies on the validity of the typeD personality, it can be concluded that the main issues raised so far converged in two aspects. One issue was about the validity of the psychological construct itself, whether the construct of typeD personality itself has its own sound ground. The other issue was whether the construct of typeD is really directly related to cardiovascular disease or whether it is an independent variable that can significantly predict the onset or prognosis of the disease. Although these two aspects of the issue exist, for now, the crucial rationale for the typeD personality to deny its validity appears to be weak. It is also expected that many of the current issues could be resolved if key factors in mediating(or moderating) between typeD personality and cardiovascular disease are identified in the future.

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