1. CoRPS Center of Research on Psychology in Somatic diseases Type D personality as a risk factor for adverse vascular outcomes in diabetes patients: A role for poor health behaviors and inadequate consultation behavior? Giesje Nefs, MSc Tilburg University

2. CoRPS CoRPS Center of Research on Psychology in Somatic diseases Tilburg University Giesje Nefs, MSc PhD Student Frans Pouwer, PhD Program leader Diabetes & Hypertension Victor Pop, PhD, MD Professor of Primary Care Johan Denollet, PhD Professor of Medical Psychology http://www.tilburguniversity.edu/nl/

3. CoRPS Emotional distress & vascular risk Most common cause of morbidity and mortality in diabetes: - Cardiovascular and microvascular complications  Role for emotional distress?

4. CoRPS Type D personality TYPE D PERSONALITY Negative Affectivity Social Inhibition Cardiovascular patients & Type D: More than 3-fold increased risk of: -non-fatal myocardial infarction - revascularization - (cardiac) mortality “BINNENVETTER” Denollet, Psychosom Med, 2005; Denollet et al., Circ Cardiovasc Qual Outcomes, 2010

5. CoRPS Why are Type D persons at increased risk? INADEQUATE SELF-CARE BEHAVIORS? HEALTH BEHAVIORS Type D personality associated with... ↓Exercise ↓Healthy diet ↓Adherence to medication regimen(s) CONSULTATION BEHAVIORS Type D personality associated with... ↓Regular medical check-ups ↓Consultations in case of symptoms Studies in healthy samples and cardiac patients Consequences for self-management in diabetes? Pedersen et al., J Am Coll Cardiol, 2004; Williams et al., J Psychosom Res, 2008; Hausteiner et al., Psychosom Med, 2010; Borkoles et al, Body Image, 2010; Williams et al., Psychol Health, in press; Schiffer et al., Heart, 2007; Pelle et al., Int J Cardiol, 2010

6. CoRPS Research questions Are type 1 and type 2 diabetes patients with a Type D personality less likely to... (1)... engage in adequate self-care activities... (diet, physical activity, medication adherence, disease monitoring, smoking, alcohol consumption) (2)... attend medical appointments or consult health provider... (in case of symptoms / problems with self-management) … compared to non-Type D patients?

7. CoRPS Methods and design Cross-sectional study - In close cooperation with the Dutch Diabetes Association (DVN) - Random sample of approximately 900 DVN members - Inclusion criteria: age ≥ 18, self-reported physician diagnosis of type 1 / type 2 DM - Questionnaire booklet sent along with Diabc, the monthly DVN magazine

8. CoRPS

9. Thank you for your attention! g.m.nefs@uvt.nl