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      Psychosocial perspectives in cardiovascular disease

      1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10

      European Journal of Preventive Cardiology

      SAGE Publications

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          Most cited references 29

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          DS14: standard assessment of negative affectivity, social inhibition, and Type D personality.

          Type D personality-a joint tendency toward negative affectivity (NA) and social inhibition (SI)-is related to poor cardiac prognosis, but there is no standard for assessing Type D. This study reports on the Type D Scale-14 (DS14) as a standard measure of NA, SI, and Type D. The study included 3813 participants (2508 from the general population, 573 cardiac patients, 732 hypertension patients). They all filled out the DS14, containing 7-item NA and SI subscales; 275 subjects also completed the NEO-FFI, and 121 patients filled out the DS14 twice. Factor analysis of the DS14 yielded 2 dominant traits; all of the NA and SI items loaded between 0.62 to 0.82 on their corresponding factor (N = 3678). The NA scale covered dysphoria, worry, and irritability; the SI scale covered discomfort in social interactions, reticence, and lack of social poise. The NA and SI scales were internally consistent (alpha = 0.88/0.86; N = 3678), stable over a 3-month period (test-retest r = 0.72/0.82) and not dependent on mood and health status (N = 121). NA correlated positively with neuroticism (r = 0.68); SI correlated negatively with extraversion (r = -0.59/-0.65). Scale-level factor analysis confirmed the construct validity of the DS14 against the NEO-FFI. Using a cutoff of 10 (NA > or =10 and SI > or =10), 1027 subjects (28%) were classified as Type D, 21% in the general population versus 28% in coronary heart disease and 53% in hypertension (p < or = .001). Age, sex, and Type D (odds ratio, 3.98; 95% confidence interval, 3.2-4.6; p <.0001) were independently associated with cardiovascular morbidity. The DS14 is a brief, psychometrically sound measure of negative affectivity and social inhibition that could readily be incorporated in epidemiologic and clinical research.
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            Depression and Coronary Heart Disease

            Circulation, 118(17), 1768-1775
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              Stress and Cardiovascular Disease: An Update on Current Knowledge

              Considerable progress has been made during the past decade in research on cardiovascular effects of stress. Early-life stressors, such as childhood abuse and early socioeconomic adversity, are linked to increased cardiovascular morbidity in adulthood. Our updated meta-analyses of prospective studies published until 2011 show a 1.5-fold (95% confidence interval 1.2–1.9) increased risk of coronary heart disease among adults experiencing social isolation and a 1.3-fold (1.2–1.5) excess risk for workplace stress; adverse metabolic changes are one of the underlying plausible mechanisms. Stress, anger, and depressed mood can act as acute triggers of major cardiac events; the pooled relative risk of acute coronary syndrome onset being preceded by stress is 2.5 (1.8–3.5) in case-crossover studies. Stress is also implicated in the prognosis of cardiovascular disease and in the development of stress (takotsubo) cardiomyopathy. A major challenge over the next decade is to incorporate stress processes into the mainstream of cardiovascular pathophysiological research and understanding.
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                Author and article information

                Journal
                European Journal of Preventive Cardiology
                Eur J Prev Cardiolog
                SAGE Publications
                2047-4873
                2047-4881
                June 16 2017
                June 2017
                June 16 2017
                June 2017
                : 24
                : 3_suppl
                : 108-115
                Affiliations
                [1 ]Department of Psychology, University of Southern Denmark, Denmark
                [2 ]Department of Cardiology, Odense University Hospital, Denmark
                [3 ]Department of Neurology, Inselspital Bern University Hospital and University of Bern, Switzerland
                [4 ]Department of Clinical Research, University of Bern, Switzerland
                [5 ]Department of Psychosomatic Medicine, Clinic Barmelweid, Switzerland
                [6 ]Hypertension in Africa Research Team, Potchefstroom, North-West University, South Africa
                [7 ]Bordeaux Population Health, University of Bordeaux, France
                [8 ]Freemasons Foundation Centre for Men’s Health, The University of Adelaide, Australia
                [9 ]CoRPS – Department of Medical and Clinical Psychology, Tilburg University, the Netherlands
                [10 ]Department of Cardiology, Antwerp University Hospital, Belgium
                Article
                10.1177/2047487317703827
                © 2017

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