Six year stability of Type-D personality in a German cohort of cardiac patients

Objective: The aim of the study was to systematically analyze the stability of Type-D personality over a time span of several years in a clinical sample. Methods: In a prospective cohort study, cardiac patients from different medical settings in Germany were assessed using the DS14 questionnaire at baseline (n = 1240) and at a mean follow-up time of six years (n = 679). Different types of stability were examined and compared with the stability of the Hospital Anxiety and Depression Scale (HADS). Results: Rank-order stability was moderate (r = .61 for Negative Affectivity [NA] and r = .60 for Social Inhibition [SI]) and didn't differ from the rank-order stability of the HADS. Whereas the mean level of SI didn't change over time, the mean level of NA increased (d = 0.08). On an individual level, approximately one quarter of the participants showed a significant increase or decrease. The factorial structure of the DS14 was stable over time. Finally, the agreement of Type-D classification between the two measurement points was moderate (kappa = .42) with 22% of the participants changing their Type-D classification over time. Conclusion: The stability of NA and SI didn't differ from the stability of measures of emotional distress that are generally considered to be less stable. In particular, the only moderate stability of the dichotomous Type-D classification raises some questions. (C) 2011 Elsevier Inc. All rights reserved.