{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T21:49:10Z","timestamp":1790718550645,"version":"4.1.0"},"reference-count":59,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T00:00:00Z","timestamp":1663113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005366","name":"Universitetet i Oslo","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005366","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p>Psychological distress, including depression and anxiety, and Type-D personality are prevalent in patients with coronary heart disease (CHD) and associated with poor cardiovascular outcomes. Worry and rumination may be among the core features responsible for driving psychological distress in these patients. However, the nature of associations between these constructs remains to be delineated, yet they may have implications for the assessment and treatment of CHD patients. This study aimed to (1) explore the factorial structure and potential overlap between measures of depression, anxiety and the Type-D personality factors known as negative affectivity and social inhibition, and (2) examine how these constructs relate to worry and rumination in a sample of 1,042 CHD outpatients who participated in the in the cross-sectional NORwegian CORonary Prevention study. We conducted confirmatory factor analyses (<jats:italic>n<\/jats:italic> = 1,042) and regression analyses (<jats:italic>n<\/jats:italic> = 904) within a structural equation modeling framework. Results showed all constructs to have acceptable factor structure and indicated an overlap between the constructs of depression and negative affectivity. Worry was most strongly associated with anxiety, whereas rumination was most strongly associated with depression and negative affectivity. The results suggest conceptual similarities across the measures of depression and negative affectivity. They further suggest that intervention efforts could benefit from targeting worry and\/or rumination in the treatment of CHD outpatients presenting with symptoms of psychological distress.<\/jats:p>","DOI":"10.3389\/fpsyg.2022.929410","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T12:58:16Z","timestamp":1663160296000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Relationships between depression, anxiety, type D personality, and worry and rumination in patients with coronary heart disease"],"prefix":"10.3389","volume":"13","author":[{"given":"Kristoffer","family":"Tunheim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toril","family":"Dammen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silje","family":"Baardstu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torbj\u00f8rn","family":"Moum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Munkhaugen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costas","family":"Papageorgiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"B1","first-page":"267","article-title":"Information theory and an extension of the maximum likelihood principle","author":"Aikake","year":"1973","journal-title":"Second international symposium on information theory"},{"key":"B2","doi-asserted-by":"publisher","first-page":"334","DOI":"10.1111\/j.1467-9450.2009.00793.x","article-title":"Psychometric properties of the Type D scale (DS14) in Norwegian cardiac patients.","volume":"51","author":"Bergvik","year":"2010","journal-title":"Scand. J. Psychol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1016\/0005-7967(83)90121-3","article-title":"Preliminary exploration of worry: Some characteristics and processes.","volume":"21","author":"Borkovec","year":"1983","journal-title":"Behav. Res. Ther."},{"key":"B4","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation.","volume":"40","author":"Charlson","year":"1987","journal-title":"J. Chronic. Dis."},{"key":"B5","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1207\/s15327906mbr4102_5","article-title":"A comparison of bifactor and second-order models of quality of life.","volume":"41","author":"Chen","year":"2006","journal-title":"Multivar. Behav. Res."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1186\/1744-859X-12-38","article-title":"A case-control validation of Type D personality in Greek patients with stable coronary heart disease.","volume":"12","author":"Christodoulou","year":"2013","journal-title":"Ann. Gen. Psychiatry"},{"key":"B7","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1037\/\/0021-843x.100.3.316","article-title":"Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications.","volume":"100","author":"Clark","year":"1991","journal-title":"J. Abnorm. Psychol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1111\/sjop.12162","article-title":"Prevalence of type D personality and factorial and temporal stability of the DS14 after myocardial infarction in a Swedish population.","volume":"55","author":"Conden","year":"2014","journal-title":"Scand. J. Psychol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"522","DOI":"10.1177\/2047487316687427","article-title":"Is type D personality an independent risk factor for recurrent myocardial infarction or all-cause mortality in post-acute myocardial infarction patients?","volume":"24","author":"Conden","year":"2017","journal-title":"Eur. J. Prev. Cardiol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1097\/01.psy.0000149256.81953.49","article-title":"DS14: Standard assessment of negative affectivity, social inhibition, and Type D personality.","volume":"67","author":"Denollet","year":"2005","journal-title":"Psychosom Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1161\/01.cir.97.2.167","article-title":"Personality, disease severity, and the risk of long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction.","volume":"97","author":"Denollet","year":"1998","journal-title":"Circulation"},{"key":"B12","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1001\/archinternmed.2007.120","article-title":"Prognostic value of Type D personality compared with depressive symptoms.","volume":"168","author":"Denollet","year":"2008","journal-title":"Arch. Int. Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1017\/S0033291708004157","article-title":"Depression and Type D personality represent different forms of distress in the Myocardial INfarction and Depression - Intervention Trial (MIND-IT).","volume":"39","author":"Denollet","year":"2009","journal-title":"Psychol. Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1080\/08870441003624398","article-title":"What predicts depression in cardiac patients: Sociodemographic factors, disease severity or theoretical vulnerabilities?","volume":"26","author":"Doyle","year":"2011","journal-title":"Psychol. Health"},{"key":"B15","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1680\/ijct.2008.1.3.192","article-title":"Repetitive negative thinking as a transdiagnostic pro-cess.","volume":"1","author":"Ehring","year":"2008","journal-title":"Int. J. Cogn. Ther."},{"key":"B16","doi-asserted-by":"publisher","first-page":"934","DOI":"10.1016\/j.ijcard.2012.10.046","article-title":"Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations.","volume":"168","author":"Finegold","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1007\/s10608-007-9146-x","article-title":"Rumination and worry: Factor analysis of self-report measures in depressed participants.","volume":"32","author":"Goring","year":"2007","journal-title":"Cogn. Ther. Res."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078493","article-title":"Detecting depression in patients with coronary heart disease: A diagnostic evaluation of the PHQ-9 and HADS-D in primary care, findings from the UPBEAT-UK study.","volume":"8","author":"Haddad","year":"2013","journal-title":"PLoS One"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives.","volume":"6","author":"Hu","year":"1999","journal-title":"Struct. Equ. Modeling"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1001\/archpsyc.64.12.1393","article-title":"Emotional vitality and incident coronary heart disease: Benefits of healthy psychological functioning.","volume":"64","author":"Kubzansky","year":"2007","journal-title":"Arch. Gen. Psychiatry"},{"key":"B21","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3200\/BMED.30.1.35-44","article-title":"The interrelationship of psychosocial risk factors for coronary artery disease in a working population: Do we measure distinct or overlapping psychological concepts?","volume":"30","author":"Kudielka","year":"2004","journal-title":"Behav. Med."},{"key":"B22","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1007\/s12529-013-9350-x","article-title":"Type D personality is associated with social anxiety in the general population.","volume":"21","author":"Kupper","year":"2014","journal-title":"Int. J. Behav. Med."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s11886-018-1048-x","article-title":"Type D personality as a risk factor in coronary heart disease: A review of current evidence.","volume":"20","author":"Kupper","year":"2018","journal-title":"Curr. Cardiol. Rep."},{"key":"B24","author":"Leiknes","year":"2016","journal-title":"Psychometric assessment of the norwegian version of the hospital anxiety and depression scale (HADS). Rapport 2016."},{"key":"B25","doi-asserted-by":"publisher","first-page":"414","DOI":"10.1016\/s0140-6736(96)90004-5","article-title":"Negative emotions and coronary heart disease: Getting to the heart of the matter.","volume":"347","author":"Lesp\u00e9rance","year":"1996","journal-title":"Lancet"},{"key":"B26","doi-asserted-by":"publisher","first-page":"285","DOI":"10.1037\/a0033266","article-title":"Why the items versus parcels controversy needn\u2019t be one.","volume":"18","author":"Little","year":"2013","journal-title":"Psychol. Methods"},{"key":"B27","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/0005-7967(90)90135-6","article-title":"Development and validation of the Penn State Worry Questionnaire.","volume":"28","author":"Meyer","year":"1990","journal-title":"Behav. Res. Ther."},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1037\/h0101777","article-title":"The effects of different types of treatment for anxiety on repetitive negative thinking: A meta-analysis.","volume":"27","author":"Monteregge","year":"2020","journal-title":"Clin. Psychol. Sci. Pract."},{"key":"B29","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1080\/14017431.2016.1202445","article-title":"Patient characteristics and risk factors of participants and non-participants in the NOR-COR study.","volume":"50","author":"Munkhaugen","year":"2016","journal-title":"Scand. Cardiovasc. J."},{"key":"B30","author":"Muth\u00e9n","year":"2017","journal-title":"Mplus User\u2019s Guide"},{"key":"B31","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1037\/\/0021-843x.100.4.569","article-title":"Responses to depression and their effects on the duration of depressive episodes.","volume":"100","author":"Nolen-Hoeksema","year":"1991","journal-title":"J. Abnorm. Psychol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1192\/bjo.2018.54","article-title":"Metacognitive therapy versus cognitive-behavioural therapy in adults with generalised anxiety disorder.","volume":"4","author":"Nordahl","year":"2018","journal-title":"BJPsych. Open"},{"key":"B33","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1111\/sjop.12244","article-title":"DS14 is more likely to measure depression rather than a personality disposition in patients with acute coronary syndrome.","volume":"56","author":"Ossola","year":"2015","journal-title":"Scand. J. Psychol."},{"key":"B34","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1002\/(SICI)1099-0879(199905)6:2<156::AID-CPP196<3.0.CO;2-A","article-title":"Process and metacognitive dimensions of depressive and anxious thoughts and relationships with emotional intensity.","volume":"6","author":"Papageorgiou","year":"1999","journal-title":"Clin. Psychol. Psychother."},{"key":"B35","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1177\/1403494816688375","article-title":"Reproducibility of an extensive self-report questionnaire used in secondary coronary prevention.","volume":"45","author":"Peersen","year":"2017","journal-title":"Scand. J. Public Health"},{"key":"B36","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1016\/j.jad.2008.05.017","article-title":"Overlap and distinctiveness of psychological risk factors in patients with ischemic heart disease and chronic heart failure: Are we there yet?","volume":"113","author":"Pelle","year":"2009","journal-title":"J. Affect. Disord."},{"key":"B37","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1016\/j.cpr.2013.08.004","article-title":"Assessing treatments used to reduce rumination and\/or worry: A systematic review.","volume":"33","author":"Querstret","year":"2013","journal-title":"Clin. Psychol. Rev."},{"key":"B38","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1007\/s12529-021-09992-y","article-title":"The influence of personality type d on cardiovascular prognosis in patients after coronary artery bypass grafting: Data from a 5-year-follow-up study.","volume":"29","author":"Raykh","year":"2022","journal-title":"Int. J. Behav. Med."},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0073459","article-title":"Psychological interventions for patients with coronary heart disease and their partners: A systematic review.","volume":"8","author":"Reid","year":"2013","journal-title":"PLoS One"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD002902.pub4","article-title":"Psychological interventions for coronary heart disease.","volume":"4","author":"Richards","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"B41","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.jacc.2010.03.034","article-title":"Anxiety and risk of incident coronary heart disease: A meta-analysis.","volume":"56","author":"Roest","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"B42","first-page":"399","article-title":"Corrections to test statistics and standard errors in covariance structure analysis","author":"Satorra","year":"1994","journal-title":"Latent variables analysis: Applications for developmental research"},{"key":"B43","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/978-3-319-10470-6_18","article-title":"Estimating the Dimension of a Model.","volume":"6","author":"Schwarz","year":"1978","journal-title":"Ann. Stat."},{"key":"B44","doi-asserted-by":"publisher","first-page":"671","DOI":"10.1023\/A:1005587311498","article-title":"Worry and rumination: Repetitive thought as a concomitant and predictor of negative mood.","volume":"24","author":"Segerstrom","year":"2000","journal-title":"Cogn. Ther. Res."},{"key":"B45","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.ijcard.2019.12.014","article-title":"Sex and gender-stratified risks of psychological factors for adverse clinical outcomes in patients with ischemic heart disease: A systematic review and meta-analysis.","volume":"302","author":"Smaardijk","year":"2020","journal-title":"Int. J. Cardiol."},{"key":"B46","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.02908","article-title":"Metacognitive therapy for depression: A 3-year follow-up study assessing recovery, relapse, work force participation, and quality of life.","volume":"10","author":"Solem","year":"2019","journal-title":"Front. Psychol."},{"key":"B47","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s12529-012-9244-3","article-title":"Association of psychiatric history and type D personality with symptoms of anxiety, depression, and health status prior to ICD implantation.","volume":"20","author":"Starrenburg","year":"2013","journal-title":"Int. J. Behav. Med."},{"key":"B48","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1002\/9780470713143.ch7","article-title":"The Penn State Worry Questionnaire (PSWQ)","author":"Startup","year":"2006","journal-title":"Worry and its psychological disorders: Theory, assessment and treatment"},{"key":"B49","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1177\/1754073917692863","article-title":"Toxic affect: Are anger, anxiety, and depression independent risk factors for cardiovascular disease?","volume":"10","author":"Suls","year":"2018","journal-title":"Emot. Rev."},{"key":"B50","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1007\/s10865-011-9337-5","article-title":"Validity of Type D personality in Iceland: Association with disease severity and risk markers in cardiac patients.","volume":"35","author":"Svansdottir","year":"2012","journal-title":"J. Behav. Med."},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011913","article-title":"Diagnostic accuracy of the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) for detecting major depression: Protocol for a systematic review and individual patient data meta-analyses.","volume":"6","author":"Thombs","year":"2016","journal-title":"BMJ. Open"},{"key":"B52","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1023\/A:1023910315561","article-title":"Rumination reconsidered: A psychometric analysis.","volume":"27","author":"Treynor","year":"2003","journal-title":"Cogn. Ther. Res."},{"key":"B53","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.jpsychores.2014.10.001","article-title":"The anxious heart in whose mind? A systematic review and meta-regression of factors associated with anxiety disorder diagnosis, treatment and morbidity risk in coronary heart disease.","volume":"77","author":"Tully","year":"2014","journal-title":"J. Psychosom. Res."},{"key":"B54","doi-asserted-by":"publisher","first-page":"3227","DOI":"10.1093\/eurjpc\/zwab154","article-title":"2021 ESC Guidelines on cardiovascular disease prevention in clinical practice.","volume":"42","author":"Visseren","year":"2021","journal-title":"Eur. J. Prev. Cardiol."},{"key":"B55","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/j.jbtep.2019.02.006","article-title":"Is repetitive negative thinking a transdiagnostic process? A comparison of key processes of RNT in depression, generalized anxiety disorder, obsessive-compulsive disorder, and community controls.","volume":"64","author":"Wahl","year":"2019","journal-title":"J. Behav. Ther. Exp. Psychiatry"},{"key":"B56","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.copsyc.2015.01.020","article-title":"Psychological treatment of depressive rumination.","volume":"4","author":"Watkins","year":"2015","journal-title":"Curr. Opin. Psychol."},{"key":"B57","author":"Wells","year":"2009","journal-title":"Metacognitive therapy for anxiety and depression."},{"key":"B58","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1161\/CIRCULATIONAHA.120.052428","article-title":"Improving the effectiveness of psychological interventions for depression and anxiety in cardiac rehabilitation: PATHWAY-A single-blind, parallel, randomized, controlled trial of group metacognitive therapy.","volume":"144","author":"Wells","year":"2021","journal-title":"Circulation"},{"key":"B59","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The hospital anxiety and depression scale.","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."}],"container-title":["Frontiers in Psychology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2022.929410\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T12:58:27Z","timestamp":1663160307000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyg.2022.929410\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,14]]},"references-count":59,"alternative-id":["10.3389\/fpsyg.2022.929410"],"URL":"https:\/\/doi.org\/10.3389\/fpsyg.2022.929410","relation":{},"ISSN":["1664-1078"],"issn-type":[{"value":"1664-1078","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,14]]},"article-number":"929410"}}