Attitude does affect one's health - Be Happy!!

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Too negative for your own good?

Penny Wark

 

(Timesonline Health Bulletin)

 

Take two patients who have each had a similarly damaging heart attack. One is

cheerful, outgoing and optimistic, and seizes every possibility of

rehabilitation. The other is withdrawn, gloomy, grumbles a lot and resists any

talk of getting better. One of them recovers. Which one?

 

 

It is not difficult to guess that Mr Happy is likely to do better than Mr Grumpy

— doctors have long believed that personality is associated with medical risk.

Johan Denollet was one of them when he found himself working as a psychologist

in coronary rehabilitation and noticed that patients who had been through the

same medical experiences had different ways of responding. “In dealing with

these patients I had the impression that two distinct personality traits were of

importance, ” he recalls. “But to move on you have to have empirical data.”

 

NI_MPU('middle');Denollet, professor of medical psychology at Tilburg University

in the Netherlands, has now conducted research with cardiovascular patients —

they include coronary patients, and those with hypertension, peripheral arterial

disease, heart failure, and cardiac arrhythmias — which shows that his instincts

were right. Through this he has been able to identify the Type D personality —

the patient who is inclined to build up a form of chronic stress that may be

harmful to their health. This suggests that psychological state is as key to a

healthy heart as diet, exercise and external stress.

The two major characteristics Professor Denollet had spotted are: “negative

affectivity”, a tendency to experience negative emotions — worry, sadness and

pessimism; and “social inhibition, a tendency to inhibit the expression of

emotions, to be reticent and to lack self-esteem. But he stresses that

classification is not a simple matter of happy versus grumpy.

“The combined presence of both negative affectivity and social inhibition is

important,” he explains. “You can have someone who tends to be very negative —

but if they talk about how they feel they can do something about it and are not

at increased risk.”

To pinpoint those patients who match Type D’s characteristics Professor Denollet

has devised a 14-question personality test known as the DS14, which has proved

to be an effective predicitor of cardiovascular health.

 

High scores are strongly associated with both hypertension and coronary heart

disease, and among coronary patients the highest scores equate with people who

are less responsive to treatment, have a poorer quality of life and are likely

to die prematurely. “If Type D is present in a cardiac patient he has a

four-fold increased risk of getting a heart attack or dying too soon,” Denollet

says. Using an earlier version of the test, he worked with 300 people undergoing

cardiac rehabilitation in Antwerp. Within ten years 27 per cent of the Type D

patients had died, mostly of heart disease or stroke, compared with 7 per cent

of the others.

The identification of the Type D personality follows well-known work by

psychologists in the 1960s and 1970s which equated specific characteristics with

risk of poor health. Ambitious, goal-orientated workaholics were called Type As

and said to be prone to stress and anger and at risk of high blood pressure and

heart disease. Type Bs, non-competitive, easygoing and contemplative, were

thought to carry no significant health risks. Type Cs, reliable copers who avoid

conflict by suppressing their feelings, were said to be prone to cancer. The

link between Type A and heart disease was undermined by mixed research in the

1980s, though later studies confirmed that negative emotions can be harmful to

health.

The value of Denollet’s work is that it enables doctors — both GPs and

cardiologists — and individuals to measure a person’s susceptibility to

experience some harmful emotions. This is especially useful for people who are

embarrassed by the notion of talking openly to others.

“Paradoxically, Type D patients are well aware of what’s going on in their lives

— if they are feeling more tired or breathless,” Denollet says. “But they’re not

likely to contact their cardiologist to do something about it. If the

cardiologist knows they’re Type D he can arrange more appointments for these

patients, and he can probe more to find out what’s really going on.”

Does this mean that you should be concerned if you are a Type D? Not

necessarily, he says. “There are quite healthy Type Ds who can talk about things

that are going on in their lives. It’s like smoking is a serious risk for heart

disease — but this doesn’t mean that you’re bound to have a heart attack if you

smoke. If you are Type D and don’t have any significant health problems you

don’t have to worry too much provided you have good social resources, or are

happily married, and have plenty of friends. If you are Type D and do have a

chronic condition then you need to make changes in your life that will make you

happier.”

Denollet is now seeking an explanation for his link between specific personality

traits and a greater risk of cardiovascular difficulties, and he is testing the

concept in non-Western cultures.

As debate about the role of personality traits in the development and

progression of coronary artery disease continues, the Texas Heart Institute has

said that “evidence suggests that Type D has displaced Type A as the dominant

personality risk factor”.

http://www.timesonline.co.uk/article/0,,8123-1826792,00.html

 

 

 

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