Type D personality and cardiovascular reactivity to acute stress

A research paper on personality, social relationships and cardiovascular reactivity to stress by Adam O’ Riordan, Dr Eoin Brown, Prof. Stephen Gallagher and Dr Siobhán Howard was published in the Journal of Psychophysiology (August 2020). This paper was supported by funding from the Irish Research Council and the John and Pauline Ryan PhD Scholarship.


O’Riordan, A., Howard, S., Brown, E., & Gallagher, S. (2020). Type D personality and cardiovascular reactivity to acute stress: The mediating effects of social support and negative social relationships. Psychophysiology, 57(11), e13660.


Type D (distressed) personality is characterized by increased levels of both negative affectivity (NA) and social inhibition (SI). The NA facet of Type D refers to the tendency to experience an array of negative emotions across time, while the SI facet refers to the tendency to inhibit the expression of these negative emotions during social interactions. Therefore, although Type D individuals experience these negative emotions, they tend to “bottle up” these emotions in order to avoid disapproval from others.


Over the past two-decades, Type D has received considerable research attention due to its association with adverse cardiovascular health. In fact, a range of longitudinal studies have found that cardiovascular patients with Type D personality are twice as likely to experience negative cardiovascular events (e.g. reoccurring heart attacks) and to die from cardiovascular disease in comparison to individuals without Type D personality.


When confronted with psychological stress, the tendency to exhibit atypical cardiovascular reactions has been consistently associated with poorer health outcomes. Thus, our study aimed to examine how atypical cardiovascular reactions to psychological stress may be a mechanism facilitating the association between Type D personality and adverse cardiovascular health. A sample of 195 undergraduate students (138 female) participated in this observational study, where they completed measures assessing Type D personality (DS14) and a stress testing protocol consisting of a maths task and speech task.


Furthermore, social relationships are imperative for stress appraisal and coping. While positive social relationships decrease perceptions of stress, negative social relationships increase perceptions of stress. Given the socially inhibited nature of Type D personality, a second aim of our study was to examine if these social relationships were causing the atypical cardiovascular reactions to stress amongst Type D individuals. Thus, we also assessed self-reported social support and negative social relationships.


The results showed that Type D individuals reported having lower levels of social support and greater perceptions of negative social relationships (hostile and rejectful relationships). Secondly, Type D individuals exhibited blunted (atypically low) blood pressure reactivity to acute psychological stress. Furthermore, mediation analyses indicated that the relationship between Type D personality and cardiovascular reactivity was mediated via increased perceptions of negative social relationships, as well as lower levels of social support.


Our results suggest that atypical cardiovascular reactions to stress is a likely mechanism promoting adverse cardiovascular health amongst Type D individuals, and that these stress responses are caused by a greater perception of negative social relationships and lower levels of social support.



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