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Adjusting to Congenital Heart Disease in Adolescence: The Role of Patients’ Personality and Self

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Clinical Psychology and Congenital Heart Disease

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Abstract

In this chapter, two key issues are addressed. First of all, we examine whether adolescents with congenital heart disease (conHD) have an increased risk for developing certain self-related vulnerabilities due to the additional stressors that they are facing. Although previous research identified some minor differences between adolescents with and without conHD (i.e., patients had lower extraversion scores and explored future possibilities less broadly as compared to healthy controls), patients seem to be as competent as their peers in addressing the developmental task of identity formation and in establishing a mature sense of self.

Second, we explore the role of patients’ personality and self-concept for their physical and psychological health. Although extensive research has linked Type A and Type D personality to mortality and adverse health outcomes in patient groups with acquired cardiovascular pathologies, the personality and self-concept of individuals with conHD has received little to no attention in the literature. In this chapter, the findings of three recent studies are discussed in which patients’ personality and identity status were found to predict a variety of outcomes including quality of life, self-rated health, and healthcare utilization, even after controlling for the effects of sex, age, and illness complexity. Hence, these findings suggest that patients’ personality and self-concept might be important targets for future intervention and prevention efforts aimed at improving patients’ physical and psychological health. However, more research is needed before such interventions can be implemented into clinical practice.

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References

  1. Moons P, Bovijn L, Budts W, Belmans A, Gewillig M (2010) Temporal trends in survival to adulthood among patients born with congenital heart disease from 1970 to 1992 in Belgium. Circulation 122:2264–2272

    Article  PubMed  Google Scholar 

  2. Karsdorp PA, Everaerd W, Kindt M, Mulder BJM (2007) Psychological and cognitive functioning in children and adolescents with congenital heart disease: a meta-analysis. J Pediatr Psychol 32:527–541

    Article  PubMed  Google Scholar 

  3. Erikson EH (1950) Childhood and society. Norton, New York

    Google Scholar 

  4. Klimstra TA, Hale WW, Raaijmakers QAW, Branje SJT, Meeus WHJ (2009) Maturation of personality in adolescence. J Pers Soc Psychol 96:898–912

    Article  PubMed  Google Scholar 

  5. Kovacs AH, Sears SF, Saidi AS (2005) Biopsychosocial experiences of adults with congenital heart disease: review of the literature. Am Heart J 150:193–201

    Article  PubMed  Google Scholar 

  6. Benyamini Y (2011) Why does self-rated health predict mortality? An update on current knowledge and a research agenda for psychologists. Psychol Health 26:1407–1413

    Article  PubMed  Google Scholar 

  7. Miller TQ, Guijarro ML, Hallet A, Smith TW, Turner CW (1996) A meta-analytic review of research on hostility and physical health. Psychol Bull 119:322–348

    Article  PubMed  Google Scholar 

  8. Denollet J, Sys SU, Stroobant N, Rombouts H, Gillebert TC, Brutsaert DL (1996) Personality as independent predictor of long-term mortality in patients with coronary heart disease. Lancet 347:417–421

    Article  PubMed  Google Scholar 

  9. Denollet J, Pedersen SS, Vrints CJ, Conraads VM (2006) Usefulness of Type D personality in predicting five-year cardiac events above and beyond concurrent symptoms of stress in patients with coronary heart disease. Am J Cardiol 97:970–973

    Article  PubMed  Google Scholar 

  10. McAdams DP, Olson BD (2009) Personality development: continuity and change over the life course. Annu Rev Clin Psychol 61:517–542

    Article  Google Scholar 

  11. McCrae RR, Costa PT (1999) A five-factor theory of personality. In: Pervin LA, John OP (eds) Handbook of personality: theory and research. The Guilford Press, New York, pp 139–153

    Google Scholar 

  12. Klimstra T, Akse J, Hale W, Raaijmakers Q, Meeus W (2010) Longitudinal associations between personality traits and problem behavior symptoms in adolescence. J Res Pers 44:273–284

    Article  Google Scholar 

  13. Letzring TD, Edmonds GW, Hampson SE (2014) Personality change at mid-life is associated with changes in self-rated health: evidence from the Hawaii personality and health cohort. Pers Individ Dif 58:60–64

    Google Scholar 

  14. Van De Ven MOM, Engels RCME (2011) Quality of life of adolescents with asthma: the role of personality, coping strategies, and symptom reporting. J Psychosom Res 71:166–173

    Article  Google Scholar 

  15. Rassart J, Luyckx K, Klimstra T, Moons P, Groven C, Weets I (2014) Personality and illness adaptation in young adults with Type 1 diabetes: the intervening role of illness coping and perceptions. J Clin Psychol Med Settings 21:41–55

    Google Scholar 

  16. Hampson SE, Friedman HS (2008) Personality and health: a lifespan perspective. In: John OP, Robins RW, Pervin LA (eds) Handbook of personality: theory and research, 3rd edn. Guilford Press, New York, pp 770–794

    Google Scholar 

  17. Wheeler K, Wagaman A, McCord D (2012) Personality traits as predictors of adherence in adolescents with Type 1 diabetes. J Child Adolesc Psychiatr Nurs 25:66–74

    Article  PubMed  Google Scholar 

  18. Kroger J, Marcia JE (2011) Identity statuses: origins, meanings, and interpretations. In: Schwartz SJ, Luyckx K, Vignoles VL (eds) Handbook of identity theory and research. Springer, New York, pp 31–53

    Chapter  Google Scholar 

  19. Luyckx K, Schwartz S, Goossens L, Beyers W, Missotten L (2011) Processes of personal identity formation and evaluation. In: Schwartz S, Luyckx K, Vignoles V (eds) Handbook of identity theory and research. Springer, New York, pp 77–98

    Chapter  Google Scholar 

  20. Luyckx K, Seiffge-Krenke I, Schwartz S, Goossens L, Weets I, Hendrieckx C, Groven C (2008) Identity development, coping, and adjustment in emerging adults with a chronic illness: the sample case of Type 1 diabetes. J Adolesc Health 43:451–458

    Article  PubMed  Google Scholar 

  21. Schwartz S, Luyckx K, Beyers W, Soenens B, Zamboanga B, Forthun L, Hardy S, Vazsonyi A, Ham L, Kim S, Whitbourne S, Waterman A (2010) Examining the light and ark sides of emerging adults’ identity: a study of identity status differences in positive and negative psychosocial functioning. J Youth Adolesc 40:839–859

    Article  PubMed  Google Scholar 

  22. Rassart J, Luyckx K, Goossens E, Apers S, Klimstra T, Moons P (2013) Personality traits, quality of life, and perceived health in adolescents with congenital heart disease. Psychol Health 28:319–335

    Article  PubMed  Google Scholar 

  23. Luyckx K, Goossens E, Van Damme C, Moons P (2011) Identity formation in adolescents with congenital cardiac disease: a forgotten issue in the transition to adulthood. Cardiol Young 21:411–420

    Article  PubMed  Google Scholar 

  24. Roberts BW, Wood D, Caspi A (2008) The development of personality traits in adulthood. In: John OP, Robins RW, Pervin LA (eds) Handbook of personality: theory and research, 3rd edn. The Guilford Press, New York, pp 375–398

    Google Scholar 

  25. Specht J, Egloff B, Schmukle SC (2011) Stability and change of personality across the life course: the impact of age and major life events on mean-level and rank-order stability of the Big Five. J Pers Soc Psychol 101:862–882

    Article  PubMed  Google Scholar 

  26. Williams SJ (2000) Chronic illness as biographical disruption or biographical disruption as chronic illness? Reflections on a core concept. Sociol Health Illn 22:40–67

    Article  Google Scholar 

  27. Schoormans D, Mulder BJ, van Melle JP, Pieper EG, van Dijk AP, Sieswerda GJT, Hulsbergen-Zwarts MS, Plokker TH, Brunninkhuis LG, Vliegen HW, Sprangers MA (2012) Patients with a congenital heart defect and type D personality feel functionally more impaired, report a poorer health status and quality of life, but use less healthcare. Eur J Cardiovasc Nurs 11:349–355

    Article  PubMed  Google Scholar 

  28. van den Broek KC, Smolderen KG, Pedersen SS, Denollet J (2010) Type D personality mediates the relationship between remembered parenting and perceived health. Psychosomatics 51:216–224

    Article  PubMed  Google Scholar 

  29. Pedersen SS, Denollet J (2004) Validity of the Type D personality construct in Danish post-MI patients and healthy controls. J Psychosom Res 57:265–272

    Article  PubMed  Google Scholar 

  30. Schiffer AA, Denollet J, Widdershoven JW, Hendriks EH, Smith OR (2007) Failure to consult for symptoms of heart failure in patients with a type-D personality. Heart 93:814–818

    Article  PubMed Central  PubMed  Google Scholar 

  31. Warnes CA, Liberthson R, Danielson GK, Dore A, Harris L, Hoffman JIE, Somerville J, Williams RG, Webb GD (2001) Task force 1: the changing profile of congenital heart disease in adult life. J Am Coll Cardiol 37:1170–1175

    Article  PubMed  Google Scholar 

  32. Costa PT, McCrae RR (1992) Revised NEO Personality Inventory (NEO-PI-R) and NEO Five-Factor Inventory (NEO-FFI) professional manual. Psychological Assessment Resources, Odessa

    Google Scholar 

  33. Claessens P, Moons P, Dierckx B, Cannaerts N, Budts W, Gewillig M (2005) What does it mean to live with a congenital heart disease? A qualitative study on the lived experiences of adult patients. Eur J Cardiovasc Nurs 4:3–10

    Article  PubMed  Google Scholar 

  34. Rigby BT, Huebner ES (2005) Do causal attributions mediate the relationship between personality characteristics and life satisfaction in adolescence? Psychol Sch 42:91–99

    Article  Google Scholar 

  35. Rassart J, Luyckx K, Apers S, Goossens E, Moons P (2012) Identity dynamics and peer relationship quality in adolescents with a chronic disease: the sample case of congenital heart disease. J Dev Behav Pediatr 33:625–632

    Article  PubMed  Google Scholar 

  36. Seiffge-Krenke I (2001) Diabetic adolescents and their families: stress, coping, and adaptation. Cambridge University Press, Cambridge, UK

    Book  Google Scholar 

  37. Shiffer AA, Denollet J, Widdershoven JW, Hendriks EH, Smith ORF (2007) Failure to consult for symptoms of heart failure in patients with a type-D personality. Heart 93:814–818

    Article  Google Scholar 

  38. Pereira DB, Antoni MH, Danielson A, Simon T, Efantis-Potter J, O’Sullivan MJ (2004) Inhibited interpersonal coping style predicts poorer adherence to scheduled clinic visits in human immunodeficiency virus infected women at risk for cervical cancer. Ann Behav Med 28:195–202

    Article  PubMed  Google Scholar 

  39. Yu XN, Chen ZS, Zhang JX, Liu XH (2011) Coping mediates the association between Type D personality and perceived health in Chinese patients with coronary heart disease. Int J Behav Med 18:277–284

    Article  PubMed Central  PubMed  Google Scholar 

  40. Williams L, Wingate A (2012) Type D personality, physical symptoms and subjective stress: the mediating effects of coping and social support. Psychol Health 27:1075–7085

    Article  PubMed  Google Scholar 

  41. Caspi A, Roberts BW, Shiner RL (2005) Personality development: stability and change. Annu Rev Psychol 56:453–484

    Article  PubMed  Google Scholar 

  42. Larsen RJ (1992) Neuroticism and selective encoding and recall of symptoms: evidence from a combined concurrent-retrospective study. J Pers Soc Psychol 62:480–488

    Article  PubMed  Google Scholar 

  43. Branje SJ, van Lieshout CF, van Aken MA (2004) Relations between Big Five personality characteristics and perceived support in adolescents’ families. J Pers Soc Psychol 86:615–628

    Article  PubMed  Google Scholar 

  44. Moons P, Van Deyk K, Marquet K, Raes E, De Bleser L, Budts W, De Geest S (2006) Individual quality of life in adults with congenital heart disease: a paradigm shift. Eur Heart J 26:298–307

    Article  Google Scholar 

  45. Bogg T, Roberts BW (2004) Conscientiousness and health-related behaviors: a meta-analysis of the leading behavioral contributors to mortality. Psychol Bull 130:887–919

    Article  PubMed  Google Scholar 

  46. Skinner TC, Hampson SE, Fife-Schaw C (2002) Personality, personal model beliefs, and self-care in adolescents and young adults with type 1 diabetes. Health Psychol 21:61–70

    Article  PubMed  Google Scholar 

  47. Van Deyk K, Moons P, Gewillig M, Budts W (2004) Educational and behavioral issues in transitioning from pediatric cardiology to adult-centered health care. Nurs Clin North Am 39:755–768

    Article  PubMed  Google Scholar 

  48. Rassart J, Luyckx K, Klimstra T, Moons P (2012) The importance of studying personality in individuals with congenital heart disease. Eur J Cardiovasc Nurs 11:261–262

    Article  PubMed  Google Scholar 

  49. Goossens E, Stephani I, Hilderson D, Gewillig M, Budts W, Van Deyk K, Moons P (2011) Transfer of adolescents with congenital heart disease from pediatric cardiology to adult health care: an analysis of transfer destinations. J Am Coll Cardiol 57:2368–2374

    Article  PubMed  Google Scholar 

  50. Yeung E, Kay J, Roosevelt GE, Brandon M, Yetman AT (2008) Lapse of care as a predictor for morbidity in adults with congenital heart disease. Int J Cardiol 125:62–65

    Article  PubMed  Google Scholar 

  51. Chapman BP, Hampson S, Clarkin J (in press) Personality-informed interventions for healthy aging: conclusions from a National Institute on Aging workgroup. Dev Psychol 50:1426–1441

    Google Scholar 

  52. Matthews G, Saklofske DH, Costa PT, Deary IJ, Zeidner M (1998) Dimensional models of personality: a framework for systematic clinical assessment. Eur J Psychol Assess 14:36–49

    Article  Google Scholar 

  53. Hall JA (2011) Clinicians’ accuracy in perceiving patients: its relevance for clinical practice and a narrative review of methods and correlates. Patient Educ Couns 84:319–324

    Article  PubMed  Google Scholar 

  54. Tang TZ, DeRubeis RJ, Hollon SD, Amsterdam J, Shelton R, Schalet B (2009) Personality change during depression treatment: a placebo-controlled trial. Arch Gen Psychiatry 66:1322–1330

    Article  PubMed Central  PubMed  Google Scholar 

  55. Madigson J, Lejuez CW, Roberts BW (in press) Theory-driven intervention for changing personality: expectancy value theory, behavioral activation, and conscientiousness. Dev Psychol 50:1442–1450

    Google Scholar 

  56. Moons P, Pinxten S, Dedroog D, Van Deyk K, Gewillig M, Hilderson D, Budts W (2009) Expectations and experiences of adolescents with congenital heart disease on being transferred from pediatric cardiology to an adult congenital heart disease program. J Adolesc Health 44:316–322

    Article  PubMed  Google Scholar 

  57. Stinson J, Kohut SA, Spiegel L, White M, Gill N, Colbourne G, Sigurdson S, Duffy KW, Tucker L, Stringer E, Hazel B, Hochman J, Reiss J, Kaufman M (2014) A systematic review of transition readiness and transfer satisfaction measures for adolescents with chronic illness. Int J Adolesc Med Health 26:159–174

    Google Scholar 

  58. Hagger MS, Orbell S (2003) A meta-analytic review of the common-sense model of illness representations. Psychol Health 18:141–184

    Article  Google Scholar 

  59. Schoormans D, Mulder BJ, van Melle JP, Pieper PG, van Dijk AP, Sieswerda GT, Hulsbergen-Zwarts MS, Plokker TH, Brunninkhuis LG, Vliegen HW, Sprangers MA (2014) Illness perceptions of adults with congenital heart disease and their predictive value for quality of life two years later. Eur J Cardiovasc Nurs 13:86–94

    Google Scholar 

  60. Tackett JL (2006) Evaluating models of the personality-psychopathology relationship in children and adolescents. Clin Psychol Rev 26:584–599

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. School Psychology and Child and Adolescent Development, Department of Psychology, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium

    Jessica Rassart MSc & Koen Luyckx

  2. Centre for Health Services and Nursing Research, Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 blok d, 3000, Leuven, Belgium

    Philip Moons

Authors
  1. Jessica Rassart MSc
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  2. Koen Luyckx
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  3. Philip Moons
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Corresponding author

Correspondence to Jessica Rassart MSc .

Editor information

Editors and Affiliations

  1. Pediatric and Adult Congenital Heart Disease Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy

    Edward Callus

  2. Pediatric and Adult Congenital Heart Disease Center, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy

    Emilia Quadri

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Rassart, J., Luyckx, K., Moons, P. (2015). Adjusting to Congenital Heart Disease in Adolescence: The Role of Patients’ Personality and Self. In: Callus, E., Quadri, E. (eds) Clinical Psychology and Congenital Heart Disease. Springer, Milano. https://doi.org/10.1007/978-88-470-5699-2_4

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