Abstract
Type D (Distressed) personality combines negative affectivity (NA) and social inhibition (SI) and is associated with an increased risk of cardiovascular disease. We aimed to (1) validate a new proxy based on the Achenbach System of Empirically Based Assessment (ASEBA) for Type D personality and its NA and SI subcomponents and (2) estimate the heritability of the Type D proxy in an extended twin-pedigree design in the Netherlands Twin Register (NTR). Proxies for the dichotomous Type D classification, and continuous NA, SI, and NAxSI (the continuous measure of Type D) scales were created based on 12 ASEBA items for 30,433 NTR participants (16,449 twins and 13,984 relatives from 11,106 pedigrees) and sources of variation were analyzed in the ‘Mendel’ software package. We estimated additive and non-additive genetic variance components, shared household and unique environmental variance components and ran bivariate models to estimate the genetic and non-genetic covariance between NA and SI. The Type D proxy showed good reliability and construct validity. The best fitting genetic model included additive and non-additive genetic effects with broad-sense heritabilities for NA, SI and NAxSI estimated at 49%, 50% and 49%, respectively. Household effects showed small contributions (4–9%) to the total phenotypic variation. The genetic correlation between NA and SI was .66 (reflecting both additive and non-additive genetic components). Thus, Type D personality and its NA and SI subcomponents are heritable, with a shared genetic basis for the two subcomponents.
Highlights
Type D or Distressed personality is an established risk factor for the development and poor prognosis of coronary artery disease (Beutel et al 2012; Denollet et al 2013; Grande et al 2012; Kupper and Denollet 2018; Wang et al 2016)
The studies were approved by the Central Ethics Committee on Research Involving Human Subjects of the VU University Medical Center, Amsterdam, an Institutional Review Board certified by the U.S Office of Human Research Protections (IRB Number IRB-2991 under Federal-wide Assurance-3703; IRB/Institute Codes, Netherlands Twin Register (NTR) 03-180)
Reliability analysis in multiple validation samples showed that the Achenbach System of Empirically Based Assessment (ASEBA) derived scales were internally consistent
Summary
Type D or Distressed personality is an established risk factor for the development and poor prognosis of coronary artery disease (Beutel et al 2012; Denollet et al 2013; Grande et al 2012; Kupper and Denollet 2018; Wang et al 2016). Type D personality has been identified as a vulnerability factor for mental disorders such as anxiety and depression in cardiac patients (Kupper et al 2013; Martens et al 2008) and in the general population (Kupper and Denollet 2014; Svansdottir et al 2012; van Dooren et al 2016). Type D personality can be described as a continuous trait, using the multiplicative interaction of SI by NA. Multiple biological (e.g., systemic inflammation, endothelial dysfunction, autonomic nervous dysregulation, telomere shortening) and behavioural (e.g., sleep problems, poor social support, poorer self-management skills) pathways are associated with Type D personality and may explain its adverse effects (Denollet et al 2018; Jandackova et al 2017; Kupper and Denollet 2018; Schoormans et al 2018)
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