Type D personality
Type D personality, short for distressed personality, describes a stable pattern of two things: feeling worried or irritable (negative affectivity) and avoiding social interaction or keeping feelings secret (social inhibition). People with Type D tend to experience more negative emotions and are less likely to share them because they fear rejection or disapproval.
The concept was developed by Johan Denollet in the 1990s after observing heart patients. About 1 in 5 people in the general population have Type D, and the rate can be higher among people with heart disease.
Type D is not a psychiatric disorder like clinical depression. It’s a normal but enduring personality style, and someone with Type D does not automatically have depression, though the two can occur together.
Early studies suggested that Type D might be linked to worse outcomes after a heart attack, including a higher risk of death. However, larger, more comprehensive studies did not consistently confirm an increased mortality risk. They did find that Type D can be associated with more adverse events over time in people with cardiovascular disease.
Type D is measured with a 14-item questionnaire called the Type D Scale (DS14). Seven items assess negative affectivity and seven assess social inhibition. A score of 10 or more on both scales classifies someone as Type D. These traits tend to remain fairly stable over several years and can help doctors assess risk in cardiac patients.
Research methods have evolved. Simply splitting people into Type D vs not (two groups) or into four groups can mislead about what’s really driving outcomes. A better approach treats negative affectivity and social inhibition as continuous traits and looks at how they interact. If both traits are high, they may repeatedly increase risk in a synergistic way. Modern analyses use models that test this interaction and account for measurement errors.
This page was last edited on 3 February 2026, at 02:50 (CET).