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14 Ways to Tell if Your Personality Is Working Against You

New research shows how having a certain personality type can be bad for your heart.

Key points

  • The Type A personality was found to be an invalid concept based on retractions of the original research.
  • Type D personality remains a valid concept, and as shown in new research, can help explain heart health.
  • By tuning into your emotional reactivity, you can keep your stress levels, and your heart, in shape.

When the Type A personality research was revealed to be based on fraudulent research, its retraction caused shock waves to reverberate throughout the behavioral medicine community. After all, doesn’t it make sense that people whose personality leads them to be hard-driving, competitive, and impatient would be heart attacks just waiting to happen? Although they may not be pleasant to be with, these people formerly known as Type A don’t seem to be any worse off than their counterparts, the so-called Type B. What’s more, the Type C personality also proposed by behavioral health researchers is based on just as flawed a set of studies.

The tendency to type people by letters ended in the alphabet with Type D, which remains the only personality style standing amidst all the retractions and controversy. According to a new systematic review of the literature, it still appears to hold up.

What Is Type D, and Why Does It Matter?

The “D” in Type D stands for “distressed.” Baylor University’s Adam O’Riordan and colleagues (2023), who conducted the review, further define people with Type D as exhibiting the two components of negative affectivity, or sadness and anxiety, and social inhibition, the tendency to push aside the emotions they feel when they’re with other people.

Type D was originally identified in cardiac patients, and in prior reviews of the literature, stood up to scientific scrutiny. Cardiac patients with this personality, in at least a majority of studies conducted, had twice the risk of dying, and as a result, European Guidelines for Cardiovascular Disease Prevention, as cited by O’Riordan et al., include Type D as a “psychosocial risk factor to be assessed in clinical practice.”

People with Type D personalities, prior researchers find, have poorer lifestyle habits such as less frequent physical activity and unhealthy eating. However, this would not be enough to predispose them to higher mortality risk. Because they perceive life events to be more stressful than do the non-Type D people, their bodies release more stress hormones. This “cardiovascular reactivity” hypothesis proposes that this chronic overarousal causes such conditions as hypertension.

Another counter-proposal suggests that it’s the opposite, an under-reactivity, which contributes to Type D’s negative effects on the body. This tendency, a blunted way of dealing with stress, shows up in other research on the ways that Type D people respond to experimentally induced stress. Perhaps it is what the Baylor U. researchers call “homeostatic dysregulation” that accounts for Type D’s harmful health effects.

Testing Type D’s Link to Health

Using standard methods of conducting systematic reviews, O’Riordan et al. began with a set of 401 studies, which, after eliminating those that didn’t make the grade, led to a final collection of 14 studies averaging 99 participants each. The authors rated each study on its methodological quality on a 1 to 9 scale; the final studies included in the review received scores of 5.64 for those reporting significant effects, and 5 for those reporting null effects.

The physiological criteria included measures such as systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), cardiac output (CO), or total peripheral resistance reactivity (changes in the arteries).

You can test yourself on your own Type D tendencies with these items (0=False, 4=True).

Negative affectivity:

  1. I often make a fuss about unimportant things.
  2. I often feel unhappy.
  3. I am often irritated.
  4. I take a gloomy view of things.
  5. I often find myself worrying about something.
  6. I am often down in the dumps.

Social inhibition:

  1. I make contact easily when I meet people (R).
  2. I often talk to strangers (R).
  3. I often feel inhibited in social interactions.
  4. I find it hard to start a conversation.
  5. I am a closed kind of person.
  6. I would rather keep other people at a distance.
  7. When socializing, I don't find the right things to talk about.

Individuals who obtain a score of 10 or more on both scales are classified as Type D.

The Baylor U. review sought to examine the contributions of sex and the importance of a social stressor to the Type D-cardiac reactivity equation. High social stressors included experimental manipulations requiring direct and reciprocal communication between the participant and another person, such as giving a speech, and/or receiving negative social feedback or evaluation after an experimental task.

Overall, Type D personality was associated with lower blood pressure and HR reactivity across studies, which would support the “blunted” hypothesis about Type D’s effect on cardiovascular functioning. However, consistent with the prior literature, sex and the nature of the social situation did make a difference in this overall effect.

The authors go on to explain how blunting could be just as bad as hyperarousal, depending on the nature of the stress. As they note, this is a “suboptimal” response in the parts of the brain responsible for “motivational and behavioral regulation.” When engaging in stressful tasks, you want these brain regions to be performing, not dampening. Otherwise, you will experience “withdrawal and disengagement.”

There may be, however, a bright side to this form of withdrawal. Might it not be healthy to settle down if there’s no social pressure on you to perform? Now, though, sex might come into play. Women may be more likely to internalize their feelings of stress than men due to differing socialization in confrontations with stress. However, women are also more likely to express their emotions than men, particularly in social situations.

All in all, the differences across study findings led the authors to conclude that future studies should investigate prospectively, rather than through correlational studies, whether being Type D and having blunted responses to social stressors is healthy or pathological, and whether this varies by sex.

Paying Attention to Your Emotions

The strength of this comprehensive review was its attention to nuanced detail and experimental rigor. Rather than make a blanket statement that it’s always good or always bad to be Type D, the Baylor U. researchers show that the answer is “It depends.” Unlike the Type A researchers, who tended to make broad (and unsubstantiated) claims, O’Riordan et al. showed that Type D’s effects depended on which situations and for whom the cardiovascular responses were observed.

There are practical implications of these findings. By identifying your own Type D tendencies, you can use the “data” you collect across your own daily interactions. If someone is evaluating you, are you able to mobilize and rise to the occasion, or do you retreat and let your emotions eat away at you? On the other hand, when there’s no pressure, do you allow yourself to relax and focus on doing your best?

To sum up, personality can affect your health, but not in a direct and necessarily obvious way. Learning to tune into your own reactivity can help you find ways to keep stress at bay and focus instead on your ability to thrive.


Denollet, J. (2005). DS14: Standard Assessment of Negative Affectivity, Social Inhibition, and Type D Personality. Psychosomatic Medicine, 67(1), 89–97. doi:10.1097/01.psy.0000149256.81953.49

O'Riordan, A., Gallagher, S., & Howard, S. (2023). Type D personality and cardiovascular reactivity to acute psychological stress: A systematic review and meta-analysis. Health Psychology, 42(9), 628–641.

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