Transcript Type D personality as a risk factor for adverse vascular

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Type D personality as a risk factor for adverse vascular outcomes
in diabetes patients:
A role for poor health behaviors and inadequate consultation behavior?
Center of Research
on Psychology
in Somatic diseases
Giesje Nefs, MSc
Tilburg University
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CoRPS
Center of Research on Psychology in Somatic diseases
Tilburg University
Giesje Nefs, MSc
PhD Student
Frans Pouwer, PhD
Victor Pop, PhD, MD
Johan Denollet, PhD
Program leader
Diabetes & Hypertension
Professor of Primary Care
Professor of Medical
Psychology
http://www.tilburguniversity.edu/nl/
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Emotional distress & vascular risk
Most common cause of morbidity and mortality in diabetes:
- Cardiovascular and microvascular complications
 Role for emotional distress?
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Type D personality
TYPE D PERSONALITY
Negative
Affectivity
“BINNENVETTER”
Social
Inhibition
Cardiovascular patients & Type D:
More than 3-fold increased risk of:
-non-fatal myocardial infarction
- revascularization
- (cardiac) mortality
Denollet, Psychosom Med, 2005;
Denollet et al., Circ Cardiovasc Qual Outcomes, 2010
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Why are Type D persons at increased risk?
INADEQUATE SELF-CARE BEHAVIORS?
Studies in healthy samples and cardiac patients
HEALTH BEHAVIORS
CONSULTATION BEHAVIORS
Type D personality associated with...
Type D personality associated with...
↓Exercise
↓Regular medical check-ups
↓Healthy diet
↓Consultations in case of symptoms
↓Adherence to medication regimen(s)
Consequences for self-management in diabetes?
Pedersen et al., J Am Coll Cardiol, 2004; Williams et al., J Psychosom Res, 2008; Hausteiner et al.,
Psychosom Med, 2010; Borkoles et al, Body Image, 2010; Williams et al., Psychol Health, in press;
Schiffer et al., Heart, 2007; Pelle et al., Int J Cardiol, 2010
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Research questions
Are type 1 and type 2 diabetes patients with a Type D
personality less likely to...
(1) ... engage in adequate self-care activities...
(diet, physical activity, medication adherence, disease monitoring,
smoking, alcohol consumption)
(2)... attend medical appointments or consult health provider...
(in case of symptoms / problems with self-management)
… compared to non-Type D patients?
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Methods and design
Cross-sectional study
- In close cooperation with the Dutch Diabetes Association (DVN)
- Random sample of approximately 900 DVN members
- Inclusion criteria: age ≥ 18, self-reported physician diagnosis of type 1 / type 2 DM
- Questionnaire booklet sent along with Diabc, the monthly DVN magazine
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Thank you for your attention!
[email protected]