By Annie Murphy Paul, published on May 1, 1998 - last reviewed on August 30, 2004
We all know a Type A personality when we see one: aggressive,
overbearing, impatient. But see the unlucky soul who happens to get in
his way? Timid, insecure, and anxious, her personality is as different
from his as can be--yet she may face a greater danger of heart disease
than her Type A tormentor.
Call her Type D, a high-risk category recently recognized by
heart-disease researchers in Belgium. Such people are tense and unhappy,
"always looking for upcoming problems," says Johan Denollet, Ph.D., of
the University of Antwerp.
They combine this tendency toward negative feelings with social
inhibition, an uneasiness in their interactions with other people.
Together, these traits quadruple their risk of a second heart
Though scientists aren't sure how particular personalities create
disease, they speculate that the reserved natures of Type Ds prevent them
from seeking the support of others, which is known to be critical to
The chronic anxiety that these people experience, especially in
social situations, may also be a direct culprit, because stress
constricts arteries to the heart, increases platelet activity in the
blood (making dangerous clots more likely), and keeps the heart beating
at a constantly high rate, which eventually wears it down.
The problem is that Type D describes a personality type that is
usually stable over a lifetime (as opposed to Type A, which is simply a
hodgepodge of behavioral signs). It's therefore very difficult to
change--but Denollet says a personality overhaul isn't necessary
"Type D is not the condition we seek to change, but a marker that
tells us which patients to pay special attention to," he says. Once
patients are identified as Type D, says Denollet, they could be offered
additional treatments--counseling, behavioral therapy, social skills
coaching--designed to help wallflowers bloom.