DS14: Standard Assessment of Negative Affectivity, Social Inhibition, and Type D Personality

Objective: 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. Methods: 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. Results: 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 ( 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 (r0.59/0.65). Scale-level factor analysis confirmed the construct validity of the DS14 against the NEO-FFI. Using a cutoff of 10 (NA 10 and SI 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 .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. Conclusion: The DS14 is a brief, psychometrically sound measure of negative affectivity and social inhibition that could readily be incorporated in epidemiologic and clinical research. Key words: negative affectivity, social inhibition, Type D personality, heart disease, hypertension, heart failure, depression. CHD coronary heart disease; DS14 Type D Scale-14; GM