There are numerous physical and mental health implications associated with burnout and Type D personality (TDP). TDP is defined by the presence of specific levels of both negative affectivity and social inhibition. The purpose of this research was to examine the severity and prevalence of burnout in working adults with TDP in comparison to those without TDP. Social cognitive theory was the theoretical foundation for this study. Online surveys were used to gather responses to the Type D Scale-14 (DS14), the standard for measure for assessing TDP, and the Burnout Measure, Short Version (BMS) from 333 participants. Quantitative analyses included the use of t tests, chi square tests, correlation, and regression analysis to determine (a) if there is a disparity in the severity and prevalence of burnout in individuals with and without TDP; (b) if levels of burnout correlate with levels of TDP; and (c) whether age, gender, or both moderate the relationship between burnout and TDP. According to study results, there was a difference in the prevalence of burnout between groups, as 25.5% of the 143 participants with TDP had burnout compared to 9.3% of the 190 participants without TDP. Mean scores on the BMS were also higher, indicating a significantly greater level of burnout severity for participants with TDP. A positive correlation was found between severity of TDP and severity of burnout. Age was found to moderate the relationship between burnout severity and TDP, but did not affect the relationship between burnout prevalence and TDP. Gender did not have any impact on burnout in individuals with TDP. Neither age nor gender affected the prevalence or severity of burnout in individuals without TDP. These results can be beneficial in healthcare environments for the development of treatments and preventative measures for patients, as well as used by businesses, which have increased expenditures associated with employee burnout.

There are numerous physical and mental health implications associated with burnout and Type D personality (TDP). TDP is defined by the presence of specific levels of both negative affectivity and social inhibition. The purpose of this research was to examine the severity and prevalence of burnout in working adults with TDP in comparison to those without TDP. Social cognitive theory was the theoretical foundation for this study. Online surveys were used to gather responses to the Type D Scale-14 (DS14), the standard for measure for assessing TDP, and the Burnout Measure, Short Version (BMS) from 333 participants. Quantitative analyses included the use of t tests, chi square tests, correlation, and regression analysis to determine (a) if there is a disparity in the severity and prevalence of burnout in individuals with and without TDP; (b) if levels of burnout correlate with levels of TDP; and (c) whether age, gender, or both moderate the relationship between burnout and TDP. According to study results, there was a difference in the prevalence of burnout between groups, as 25.5% of the 143 participants with TDP had burnout compared to 9.3% of the 190 participants without TDP. Mean scores on the BMS were also higher, indicating a significantly greater level of burnout severity for participants with TDP. A positive correlation was found between severity of TDP and severity of burnout. Age was found to moderate the relationship between burnout severity and TDP, but did not affect the relationship between burnout prevalence and TDP. Gender did not have any impact on burnout in individuals with TDP. Neither age nor gender affected the prevalence or severity of burnout in individuals without TDP. These results can be beneficial in healthcare environments for the development of treatments and preventative measures for patients, as well as used by businesses, which have increased expenditures associated with employee burnout.

There are numerous physical and mental health implications associated with burnout and Type D personality (TDP). TDP is defined by the presence of specific levels of both negative affectivity and social inhibition. The purpose of this research was to examine the severity and prevalence of burnout in working adults with TDP in comparison to those without TDP. Social cognitive theory was the theoretical foundation for this study. Online surveys were used to gather responses to the Type D Scale-14 (DS14), the standard for measure for assessing TDP, and the Burnout Measure, Short Version (BMS) from 333 participants. Quantitative analyses included the use of t tests, chi square tests, correlation, and regression analysis to determine (a) if there is a disparity in the severity and prevalence of burnout in individuals with and without TDP; (b) if levels of burnout correlate with levels of TDP; and (c) whether age, gender, or both moderate the relationship between burnout and TDP. According to study results, there was a difference in the prevalence of burnout between groups, as 25.5% of the 143 participants with TDP had burnout compared to 9.3% of the 190 participants without TDP. Mean scores on the BMS were also higher, indicating a significantly greater level of burnout severity for participants with TDP. A positive correlation was found between severity of TDP and severity of burnout. Age was found to moderate the relationship between burnout severity and TDP, but did not affect the relationship between burnout prevalence and TDP. Gender did not have any impact on burnout in individuals with TDP. Neither age nor gender affected the prevalence or severity of burnout in individuals without TDP. These results can be beneficial in healthcare environments for the development of treatments and preventative measures for patients, as well as used by businesses, which have increased expenditures associated with employee burnout.

Although cardiovascular disease (CVD) does not occur until mid to late life for most adults, the presence of risk factors for CVD, such as high blood pressure (BP) and high cholesterol, has increased dramatically in young adults. Type D personality consists of two personality traits, negative affectivity (NA) and social inhibition (SI), and has repeatedly been shown to be an independent predictor of hard medical outcomes (e.g. morbidity and mortality) in cardiac patients. The present study examined the relationships between Type D personality (high NA and high SI), coping strategies, and physiological markers of cardiovascular health in a sample of non-medical, university students. Measures of cardiovascular risk included high frequency heart rate variability (HF HRV), calculated LDL cholesterol, and systolic blood pressure (SBP). Regression analyses revealed that higher use of social supportive coping was a significant predictor of calculated LDL cholesterol. Social supportive coping was also shown to moderate the relationship between Type D personality and HF HRV. Interventions that target psychological and physiological mechanisms associated with CVD are well developed. Clear identification of young adults who are at risk of developing CVD is necessary to intervene in a manner that could potentially save lives. Additional systematic research, especially if it is longitudinal, will help to clarify the ability of Type D personality and coping to predict CVD.

Background: Type D personality, or the "distressed personality", is a psychosocial factor associated with negative health outcomes, although its impact in younger populations is unclear. The purpose of this study was to investigate the prevalence of Type D personality and the associations between Type D personality and psychosomatic symptoms and musculoskeletal pain among adolescences. Methods: A population-based, self-reported cross-sectional study conducted in Vastmanland, Sweden with a cohort of 5012 students in the age between 15-18 years old. The participants completed the anonymous questionnaire Survey of Adolescent Life in Vastmanland 2008 during class hour. Psychosomatic symptoms and musculoskeletal pain were measured through index measuring the presence of symptoms and how common they were. DS14 and its two component subscales of negative affectivity (NA) and social inhibition (SI) were measured as well. Results: There was a difference depending on sex, where 10.4% among boys and 14.6% among girls (p = < 0.001) were defined as Type D personality. Boys and girls with a Type D personality had an approximately 2-fold increased odds of musculoskeletal pain and a 5-fold increased odds of psychosomatic symptoms. The subscale NA explained most of the relationship between Type D personality and psychosomatic symptoms and musculoskeletal pain. No interaction effect of NA and SI was found. Conclusions: There was a strong association between Type D personality and both psychosomatic symptoms and musculoskeletal pain where adolescent with a type D personality reported more symptoms. The present study contributes to the mapping of the influence of Type D on psychosomatic symptoms and musculoskeletal pain among adolescents.

Type D personality, or distressed personality, refers to the joint tendency to experience negative emotions and to inhibit self-expression in social interactions. The overall aims of this thesis were to examine the impact of Type D personality on adolescents’ self-perceived health, to examine the factorial and temporal stability of the Type D personality construct DS14, and to clarify whether type D personality is an independent risk factor for recurrent myocardial infarction and all-cause mortality among patients with myocardial infarction. The prevalence of Type D personality in the adolescent population was 10.4% for boys and 14.6% for girls. Boys and girls with Type D personality were approximately twice as likely to report musculoskeletal pain and five times as likely to report psychosomatic symptoms. Adolescents with Type D personality were four times more likely to have sleep disturbances and to sleep fewer hours, especially on school nights. Among patients with myocardial infarction, the Swedish DS14 had stable structural validity. Our measurements confirmed the two-factor model of the DS14. However, the DS14 exhibited low temporal stability, especially when comparing the measurement obtained during hospitalization with the 1- and 12-month follow-up measurements. Among patients with myocardial infarction, the Framingham risk score had a strong predictive value for recurrent myocardial infarction, and a somewhat weaker predictive value for all-cause mortality. However, none of the previously proposed methods for the analysis of the DS14 Type D personality measurement predicted recurrent myocardial infarction or all-cause mortality, either in univariable analyses or in addition to the Framingham risk score. In conclusion, the present thesis found significant associations between the DS14 and psychosomatic symptoms in adolescents. However, the measurement exhibited a low stability over time and no predictive value for recurrent myocardial infarction and mortality among patients with myocardial infarction. Taken together, these results raise the question of whether the Swedish DS14 really is a measure of personality. An alternative explanation for the strong cross-sectional associations observed between the DS14 and psychosomatic symptoms might be that the DS14 functions as a pseudo-measure of ill health, or co-varies with depressive or psychosomatic characteristics.

HINTERGRUND: Die Typ-D-Persönlichkeit (von distressed personality) etablierte sich in den letzten Jahren als ein Risikofaktor für den Verlauf kardiovaskulärer Erkrankungen. Die bisherigen Studien waren in den Niederlanden oder Belgien durchgeführt worden. Das Ziel der hier vorliegenden Arbeit war eine unabhängige Überprüfung der Ergebnisse an einer Stichprobe deutscher kardiologischer Patienten. Zusätzlich sollte untersucht werden, ob die Typ-D-Persönlichkeit und ihre Dimensionen der negativen Affektivität (NA) und der sozialen Inhibition (SI) über den Untersuchungszeitraum stabil blieben. METHODEN: Hierzu wurden 1040 stationär oder ambulant kardiologisch behandelte Patienten rekrutiert. Mithilfe der Typ-D-Skala (DS14) und der Hospital Anxiety and Depression Scale (HADS) wurden die Merkmale einer Typ-D-Persönlichkeit sowie Depressivität und Ängstlichkeit erhoben. Zusätzlich wurden klinisch relevante Daten, wie z. B. Geschlecht, Alter und kardiale Vorerkrankungen, erfasst. Endpunkt der Studie war die Gesamtmortalität. Mit Cox-Regressionsanalysen wurde das relative Sterblichkeitsrisiko der Probanden ermittelt. ERGEBNISSE: Hinsichtlich der Stabilität von Typ-D, NA und SI ergaben sich über einen Zeitraum von 5,9 Jahren Re-Test Stabilitäten an der unteren Grenze des Erwarteten. Es gab also eine gewisse Stabilität der Typ-D-Persönlichkeit, diese war aber nicht wesentlich höher als beispielsweise die von Angst und Depressivität, und auf Ebene des individuellen Patienten kam es häufig zu Veränderungen. Der Überlebensstatus ließ sich für 977 Studienteilnehmer ermitteln, hiervon waren 172 im Beobachtungszeitraum verstorben. In univariater und multivariater Analyse waren weder Typ-D noch NA oder SI Prädiktionsfaktoren einer höheren Gesamtmortalität. Im Gegensatz zu anderen Studien wies unsere Stichprobe ein heterogenes kardiales Erkrankungsprofil auf. Eine hierdurch bedingte Verschleierung eines Einflusses des Typ-D-Musters konnten wir durch separate Untersuchung der KHK-Patienten ausschließen. SCHLUSSFOLGERUNG: Zusammenfassend lässt sich sagen, dass unsere Studie zu den größten zählt, die bisher zur Evaluation des Einflusses der Typ-D-Persönlichkeit auf die Gesamtmortalität kardiologischer Patienten durch-geführt worden ist. Nach mehr als 5 Jahren Beobachtungszeit, mit 5764 Menschenjahren und 172 beobachteten Todesfällen hat sie suffiziente Ausdruckskraft, relevante Effekte der Typ-D-Persönlichkeit auf die Mortalität aufzudecken. Die klare Abwesenheit dieses Effektes in univariater und multivariater Analyse legt den Schluss nahe, dass die Typ-D-Persönlichkeit und ihre Dimensionen NA und SI bei deutschen kardiologischen Patienten nicht mit einer erhöhten Mortalität assoziiert sind. Die Diskrepanz zwischen unseren Ergebnissen und den Ergebnissen von Denollet und seiner Arbeitsgruppe macht weitere Forschung an anderen Stichproben nötig. Kulturelle Unterschiede in der Verarbeitung negativer Affekte sind als mögliche Ursache unserer abweichenden Ergebnisse zu diskutieren und sollten in zukünftigen Studien weiter untersucht werden.

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Background: Compliance with CPAP treatment for OSA is not reliably predicted by the severity of symptoms or physiological variables. I conducted a series of studies to examine a range of factors that may affect compliance with CPAP. Methods: I performed a retrospective study examining association of demographic factors and OSA severity with long-term CPAP compliance. In a prospective study, I looked at the correlation of short and long-term CPAP compliance with socio-economic status, education, type D personality, demographics, disease severity, mood and clinician's prediction. I undertook a prospective, cross-over trial comparing the impact of Bi-level PAP therapy in individuals with low tolerance of CPAP. Results: In a retrospective analysis, an improvement in subjective daytime somnolence was correlated with optimal compliance. In the prospective study, median compliance with CPAP at 6 months was 5.6 (3.4- 7.1) hours/night with 73% of subjects using CPAP ≥ 4 hours/night. Compliance with CPAP was not found to be associated with socio-economic class for people in work, type D personality, education, sex, age, baseline sleepiness (ESS score) or disease severity (ODI). The clinician's initial impression had no predictive value for individual patients. Subjects who were long-term unemployed or reporting mood disorders (High Beck's Depression Index scores) were likely to have poor compliance and sub-optimal CPAP usage (OR 4.6, p = 0.011 and OR 1.4. p=0.04 respectively). Subjects experiencing side effects after the first night on treatment showed lower acceptance and subsequent compliance. In the cross-over trial, changing to Bi-level PAP in individuals with suboptimal compliance due to pressure related intolerance, did not lead to an improvement in CPAP compliance. In post-hoc analysis, compliance and comfort were better in the subgroup that complained of difficulty with exhalation on CPAP. Conclusion: My research as presented in this thesis, did not find an association between disease severity (ODI), socio-economic status (for people in employment), education or personality type and CPAP compliance. My research demonstrated that subjects with long-term unemployment, mood disorders and those experiencing side effects on the first night of treatment were likely to have sub-optimal compliance. Changing to Bi-level PAP is only likely to be useful for a sub-group of subjects experiencing pressure related intolerance. More research is needed to explore whether intensive support to individuals with OSA and long term unemployment, as well as mood disorders, may improve compliance.

This thesis researches psychological aspects in adult patients undergoing heart surgery. The thesis is divided into theoretical and empirical part. The theoretical part discusses depressive and anxiety symptomatology, quality of life and type D personality, in the context of cardiac surgery. Basic characteristics, possible relations, impacts of occurrence of these aspects and possible related interventions, which seem to be beneficial for cardiac surgery, are presented for each topic. In the empirical part, the symptoms of depression, anxiety and health-related quality of life were examined using a sample of (N = 47) patients undergoing valve surgery. BDI-II, BAI and SF-36 methods were used. The research was conducted in three measurements. The first measurement took place before the surgery, the second before the end of hospitalization and the third took place 30 days after being discharged from the hospital. It was discovered that the depressive symptomatology of our sample differed significantly from the normative sample in the first and second measurements. In the first measurement, the respondents of our sample differed significantly from the norm in the symptomatology of anxiety. In both cases it was an increased symptomatology of depression or anxiety over the norm. In the dimensions of...