We are watching you: type D personality is associated with exaggerated cardiovascular stress reactivity but only under high social evaluative threat

The Type D personality has been associated with a range of negative health
outcomes including cardiovascular disease. A potential mechanism is large
magnitude cardiovascular reactivity to stress. However, the studies on reactivity to acute psychological stress in Type D individuals have reported equivocal findings, potentially due to the varying social aspects of the stressor employed. The present study, examined whether cardiovascular reactivity in Type D and Non-Type D undergraduate students differed according to an asocial (31 Type D , 30 Non-Type D: 52% female) or social (35 Type D, 34 Non-Type D: 55% female) version of the stress task. Type D personality was assessed using the DS14 questionnaire, with participant’s blood pressure and heart rate recorded at rest and during a 15-minute stress protocol comprising the Stroop and a mental arithmetic task. With adjustment for age, cardiovascular fitness, perceived stressfulness (which differed between the groups) and baseline levels (which did not differ between groups), there were significant group x condition interactions for systolic (p = .010) and diastolic (p = .029) blood pressure, and heart rate (p = .033) reactivity. Under the social condition, Type D individuals exhibited significantly greater systolic blood pressure (p = .010), and heart rate (p = .009) reactivity, with no group differences under the asocial condition. Diastolic blood pressure reactivity did not significantly vary according to Type D status within either condition. Interestingly, Type D individuals’ responses were somewhat lower than non-Type D individuals for all reactivity measures in the asocial condition, although this was not significant. This study highlights that Type D individuals only exhibit exaggerated haemodynamic reactions under conditions of high social evaluative threat. This suggests that the possible mechanism underlying the association between Type D personality and increased cardiovascular disease risk is via stress responses in highly social situations.