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June 25, 2026Scientific Reports0 citationsOpen Access

The mediating role of depression, anxiety, and sleep in the relationship between type D personality and asthma control: a cross-sectional study

ŞŞŞaban Melih ŞimşekMŞMeltem Hazel ŞimşekRCRuhsel CORUT

Key Result

Type D personality was indirectly associated with poorer asthma control through depression (β = -0.088), anxiety (β = -0.115), and impaired sleep quality (β = -0.057).

Key Points

  • To explore how depression, anxiety, and sleep quality mediate the relationship between type D personality and asthma control in patients.
  • Cross-sectional design, involving 150 adult asthma patients from a tertiary outpatient clinic.
  • Participants completed assessments including the Asthma Control Test, Type D Personality Scale, Beck Depression Inventory, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index.
  • Statistical mediation analyses were performed using bootstrapping with 5,000 resamples.
  • 39.3% of the sample displayed Type D personality traits.
  • Patients with Type D personality scored higher in depression and anxiety, and had poorer sleep quality (all p < 0.05).
  • Significant indirect effects of Type D on asthma control through depression (β = -0.088), anxiety (β = -0.115), and sleep quality (β = -0.057), all retained significance after adjustments.

Study Design

Type

Cross-Sectional (n=150)

Multicenter

No

Structured PICO

Does Type D personality affect asthma control through depression, anxiety, and sleep quality in adult asthma patients?

P
Population
150 adult patients aged 18-65 years with asthma, free of recent exacerbations and psychiatric disorders, evaluated in a cross-sectional study.
E
Exposure
Type D personality (exposure)
C
Comparator
Non-Type D personality
O
Outcome
Asthma control measured by the Asthma Control Test (ACT)patient reported

Type D personality is indirectly associated with poorer asthma control through increased psychological symptom burden and impaired sleep quality.

Main Result

Effect estimate: β = -0.088 (95% CI -0.132, -0.047)

Limitations

  • Cross-sectional design precludes determining temporal and causal direction of associations.
  • Tertiary care setting may limit generalizability to community-based populations.
  • Item-level data for the BDI, BAI, and PSQI were not retained in the database.
  • Cross-sectional design precludes causal inference
  • All measures were based on self-report instruments, and objective markers of asthma severity were not included
  • Tertiary hospital setting may limit generalizability
  • Modest internal consistency observed for the Social Inhibition subscale
  • Psychiatric exclusion was based on self-report and available medical records, and no structured psychiatric interview was performed

Abstract

Abstract Type D personality, defined by the co-occurrence of negative affectivity and social inhibition, has been associated with poorer health outcomes in chronic diseases, including asthma. However, the psychological mechanisms underlying the relationship between Type D personality and asthma control remain unclear. This cross-sectional study included 150 adult patients with asthma recruited from a tertiary outpatient clinic. Participants completed the Asthma Control Test (ACT), Type D Personality Scale (DS-14), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI). Type D personality traits were identified in 39.3% of the sample. Compared with non–Type D individuals, patients with Type D personality had higher depressive and anxiety symptom scores and poorer sleep quality (all p < 0.05). Mediation analyses using bootstrapping (5,000 resamples) revealed significant indirect effects of Type D personality on asthma control through depression (β = -0.088, 95% CI -0.132, -0.047), anxiety (β = -0.115, 95% CI -0.158, -0.078), and sleep quality (β = -0.057, 95% CI -0.091, -0.029). These indirect effects remained statistically significant after adjustment for age, sex, smoking status, and FEV1 (% predicted). These findings suggest that Type D personality is indirectly associated with poorer asthma control through increased psychological symptom burden and impaired sleep quality.

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Cite This Study

Şimşek et al. (2026) conducted a cross-sectional in Asthma (n=150). Type D personality vs. Non-Type D personality was evaluated on Indirect effect of Type D personality on asthma control through depression (β = -0.088, 95% CI -0.132, -0.047). Type D personality was indirectly associated with poorer asthma control through depression (β = -0.088), anxiety (β = -0.115), and impaired sleep quality (β = -0.057).

synapsesocial.com/papers/6a3d91bf408ebb922448b14bhttps://doi.org/10.1038/s41598-026-58701-w
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