Association Between Type D Personality and Cardiovascular Disease History: Cross-Sectional Study

Background: Type D personality, characterized by high negative affectivity and social inhibition, has been linked to poorer mental health and heightened risk for adverse cardiovascular outcomes. Although previous studies have examined associations between type D personality, psychological distress, and cardiovascular disease (CVD), many have assessed these factors independently, relied on clinical samples, or overlooked the simultaneous assessment of psychological distress and CVD history. Consequently, less is known about how type D traits relate to emotional distress and CVD history within the general population. Understanding these relationships may support early identification of at-risk individuals and strengthen the integration of psychological screening into cardiovascular care. Objective: This study aimed to (1) examine associations between type D personality, emotional distress (depression, anxiety, and stress), and self-reported CVD history; (2) compare distress levels among participants with and without CVD history; and (3) determine whether type D personality predicts emotional distress independent of demographic factors and CVD history. Methods: A cross-sectional online survey was completed by 146 adults aged 30 to 85 years, recruited through convenience and snowball sampling on social media. Type D personality was assessed using the Type D Scale-14, and emotional distress was measured using the Depression Anxiety and Stress Scale-21 items. CVD history was captured through a single self-report question regarding prior diagnosis of a cardiovascular condition. Descriptive statistics characterized the sample. Two-tailed independent samples t tests compared distress between individuals with and without type D personality and between participants with and without CVD history. Pearson correlation coefficients examined associations among key variables. Hierarchical multiple regression assessed whether type D personality predicted emotional distress beyond age, gender, education, and CVD history. Results: Of the 146 participants, 40 (27.4%) reported a history of CVD and 62 (42.5%) met criteria for type D personality. Individuals with type D personality exhibited significantly higher depression, anxiety, and stress levels than non-type D participants (all P<.001). Participants with CVD history also reported greater distress compared with those without CVD history. Hierarchical regression analyses showed that type D personality remained a strong independent predictor of emotional distress (β=.46; P<.001) after adjusting for demographics and CVD history. CVD history made an additional but smaller contribution to distress (β=.18; P=.008). These findings highlight the cumulative influence of personality traits and cardiovascular background on psychological well-being. Conclusions: Type D personality traits have been associated with higher levels of psychological distress and with a greater likelihood of self-reported CVD history in the general population. Type D personality remained a significant predictor of distress after accounting for demographic factors and cardiovascular history, underscoring its potential role in early psychological risk identification. Incorporating brief personality and mental health screening into cardiovascular assessment may support more comprehensive care.