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Journal Article•DOI•

A taxometric analysis of type-D personality.

Eamonn Ferguson1, Lynn Williams2, Rory C. O'Connor2, Siobhán Howard3, Brian M. Hughes3, Derek Johnston4, Julia L. Allan4, Daryl B. O'Connor5, Christopher Alan Lewis6, Madeleine Grealy7, Ronan E. O'Carroll2 •
University of Nottingham1, University of Stirling2, National University of Ireland, Galway3, University of Aberdeen4, University of Leeds5, Ulster University6, University of Strathclyde7
01 Jan 2009-Psychosomatic Medicine (Lippincott Williams & Wilkins)-Vol. 71, Iss: 9, pp 981-986
TL;DR: Testing the dimensionality of Type-D personality, using taxometric procedures, indicates that Type D is more accurately represented as a dimensional rather than categorical construct.
Abstract: Objective: To test the dimensionality of Type-D personality, using taxometric procedures, to assess if Type-D personality is taxonic or dimensional. Type-D personality is treated as a categorical variable and caseness has been shown to be a risk factor for poor prognosis in coronary heart disease. However, at present, there is no direct evidence to support the assumption that Type D is categorical and able to differentiate true cases from noncases. Methods: In total, 1012 healthy young adults from across the United Kingdom and Ireland completed the DS14, the standard index of Type D, and scores were submitted to two taxometric procedures MAMBAC and MAXCOV. Results: Graphical representations (comparing actual with simulated data) and fit indices indicated that Type D is more accurately represented as a dimensional rather than categorical construct. Conclusion: Type D is better represented as a dimensional construct. Implications for theory development and clinical practice with respect to Type D are examined as well as the wider use of taxometrics within psychosomatic medicine (e.g., to investigate if there are medically unexplained syndrome taxons, such as a Gulf War Syndrome taxon).

Summary (2 min read)

Jump to: [Introduction] – [Evidence for the Dimensionality or Taxonicity Type-D] – [Sample and Sampling] – [Prevalence of Type-D] – [Taxometric Analyses] – [Type-D and a Dimensional Construct in Research and Practice] – [Taxometrics and Psychosomatic Medicine: Functional Syndromes and Bio-] and [Conclusions]

Introduction

  • Published in Psychosomatic Medicine, Volume 71, Issue 9, pp. 981 - 986, by Lippincott, Williams & Wilkins / American Psychosomatic Society.
  • Whether Type-D is dimensional (i.e., distributed as a continuous variable, with individuals varying quantitatively from each other) or taxonic (i.e., individuals are differentiated into non-arbitrary groups or categories) has important clinical and theoretical implications [8].
  • While exact mechanisms may not be clear at present the underlying principle is that the existence of dimensional and taxonic models requires very different theoretical accounts.

Evidence for the Dimensionality or Taxonicity Type-D

  • Recently, psychometric work using item response theory (IRT) was interpreted as support for a categorical interpretation of Type-D using a cutoff score of 10 on each of the two sub-scales (NA and SI) of the DS14 [11].
  • While this evidence appears compelling, it does not demonstrate that Type-D is taxonic, just that there are between-group differences based on median splits.
  • Given the very different implications for theory, research and clinical practice afforded by dimensional and taxonic conceptualizations, a direct test of the dimensionality of Type D is urgently required [8].
  • Indeed in the case of Type-D the evidence shows that the prevalence of Type-D is significantly higher in clinical groups with cardiovascular disease compared to healthy controls [14].

Sample and Sampling

  • Second, of the valid indictors those with high item-total correlations are retained as they represent the most valid indicators of the construct [26].
  • With divisions represented on the x-axis and mean differences, covariance or eigenvalues on the y-axis, characteristic curves represent either a taxonic or dimensional solution.
  • MAXEIG is used when there are more than 3 indicators, this is an extension of MAXCOV, where the 1st eigenvalue is calculated across successive windows on the remaining output variables.
  • This means using a number of taxometric procedures to show consistency across Taxometrics of Type-D methods and showing the same results while successively increasing the number of cuts/windows [30, 32].

Prevalence of Type-D

  • As Type-D is hypothesized to be an independent risk factor for cardiovascular disease, this prevalence rate appears high and in fact highlights how the simple taxonic model can be somewhat problematic as a prognostic risk factor in a healthy population.
  • The indicator validities (expressed in standard units as Cohen’s d), item-total correlations and skew for each indicator are presented in Table 1.
  • The second factor represents finding social contact inhibiting and uncomfortable and the authors refer to this as a social discomfort factor.
  • Similarly mean nuisance covariance for the 3 indicators in the MAXCOV analyses for the taxon and complement at 50 windows was .23 and .26 respectively; at 150 windows they were .23 and .20 and for 200 windows they were .11 and .24 respectively.

Taxometric Analyses

  • The pattern of results reported here indicates clearly that Type-D is better represented as a dimensional rather than a categorical construct.
  • This finding has important theoretical and clinical implications for Type-D. Theoretical models should focus on additive multi-causal agents or risk factors [8].
  • More research is now needed to explore the additive nature of these different mechanisms.

Type-D and a Dimensional Construct in Research and Practice

  • Based on the above, theoretical models and clinical interventions should be examined using regression approaches with large unselected samples [8] which also have the advantage of increasing statistical power [33].
  • The remaining MAMBAC and MAXCOV curves are available form the 1st author on request.
  • It has been argued that it is appropriate to draw distinctions within a latent dimensional construct as long as these are systematic and empirically justifiable [8].
  • An inflection point expresses the association between the continuous dimensional construct and other relevant clinical data (e.g., bio-markers, prognostic clinical outcomes or treatment responses).
  • With respect to diagnosis it should also be noted that Type-D is a risk factor and not a clinical diagnosis in itself and should be Taxometrics of Type-D used in conjunction with other information.

Taxometrics and Psychosomatic Medicine: Functional Syndromes and Bio-

  • It has been strongly argued that taxometric approaches have implications for many fields beyond their current application mainly to investigating psychopathology (e.g., depression, personality disorder) [15].
  • Within the field of psychosomatic medicine these may be applied initially to the dimensionality of traits directly relevant to psychosomatic medicine.

Conclusions

  • The present taxometric analysis indicates that Type-D is better represented as a dimensional construct.
  • Denollet J, Pedersen SS, Vrints CJ, Conraads VM.
  • Usefulness of type D personality in predicting five year cardiac events above ad beyond current symptoms of stress in patients with coronary heart disease.
  • Detecting taxonicity with two quantitative indicators using means above and below a sliding cut (MAMBAC procedure), also known as Taxometric analysis I.

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Figures (2)

Content maybe subject to copyright    Report

Published in Psychosomatic Medicine, Volume 71, Issue 9, pp. 981 - 986, by
Lippincott, Williams & Wilkins / American Psychosomatic Society.
This is a non-final version of an article published in final form in Psychosomatic
Medicine, Volume 71, Issue 9, November/December 2009, pp. 981 - 986.
Available from: http://hdl.handle.net/1893/1906
Copyright © 2009 by the American Psychosomatic Society.
http://dx.doi.org/10.1097/PSY.0b013e3181bd888b
- 1 –
Taxometrics of Type-D
A Taxometric Analysis of Type-D Personality
Eamonn Ferguson
1
PhD, Lynn Williams
2
PhD, Rory C. O’Connor
2
PhD, Siobhán
Howard
3
PhD, Brian M. Hughes
3
PhD, Derek W. Johnston
4
PhD, Julia L. Allan
4
PhD,
Daryl B. O’Connor
5
PhD, Christopher A. Lewis
6
DPhil, Madeleine A. Grealy
7
PhD
and Ronan E. O’Carroll
2
PhD
1
School of Psychology, University of Nottingham, Nottingham, UK
2
Department of Psychology, University of Stirling, Stirling, UK
3
School of Psychology, National University of Ireland, Galway, Ireland
4
School of Psychology, University of Aberdeen, Aberdeen, UK
5
Institute of Psychological Sciences, University of Leeds, Leeds, UK
6
School of Psychology, University of Ulster at Magee College, Londonderry,
Northern Ireland
7
Department of Psychology, University of Strathclyde, Glasgow, UK
Correspondence: Eamonn Ferguson, Risk Analysis, Social Processes and Health
(RASPH) group, School of Psychology, University of Nottingham, Nottingham, NG7
2RD, UK. Tel: + 44 (0) 115 9515327. Fax: + 44 (0) 115 9515324. Email:
eamonn.ferguson@nottingham.ac.uk
Short Title: Taxometrics of Type-D
Word = 5, 092
Tables = 2
Figures = 1
Support: There was no financial support for this project
- 2 –
Taxometrics of Type-D
Abstract
Background: Type-D personality is treated as a categorical variable and caseness has
been shown to be a risk factor for poor prognosis in coronary heart disease. However,
at present there is no direct evidence to support the assumption that Type-D is
categorical and able to differentiate true cases from non-cases.
Methods: In total, 1012 healthy young adults from across the UK and Ireland
completed the DS14, the standard index of Type-D, and scores were submitted to two
taxometric procedures MAMBAC and MAXCOV.
Results: Graphical representations (comparing actual to simulated data) and fit
indices indicated that Type-D is more accurately represented as a dimensional rather
than categorical construct.
Conclusion: Type-D is better represented as a dimensional construct. Implications for
theory development and clinical practice with respect to Type-D are examined as well
as the wider use of taxometrics within psychosomatic medicine (e.g., to investigate if
there are medically unexplained syndrome taxons such as a Gulf War Syndrome
taxon).
Key Words: Type-D, Taxometric Analysis, Taxon, Dimensional, Functional
Syndromes
Acronyms: CHD = Coronary Heart Disease, IRT = item response theory, NA =
Negative Affectivity, SI = Social Inhibition, MAMBAC = mean above minus below a
cut, MAXCOV = Maximum Covariance, MAXEIG = maximum eigenvalue, L-
MODE = L-mode factor analysis, CCFI = curve comparison fit index, GCMT =
General Covariane Mixture Theorem, CFS = Chronic fatigue syndrome. IBS =
Irritable bowel syndrome, GWS = Gulf war syndrome.
- 3 –
Taxometrics of Type-D
The Type-D or ‘distressed’ personality is defined as the ‘…tendency to
experience negative emotions and to inhibit self-expression’ (p 970) [1]. Type D plays
an important role in contemporary research on the relationship between personality
characteristics and cardiovascular disease [1-5]. Coronary heart disease (CHD)
patients classified as Type-D cases have a significantly poorer prognosis [1, 4] leading
Type-D to be defined in the literature as a categorical risk factor in CHD. Whether or
not initially intended, this implies a qualitative difference between Type-D cases and
non-cases. Indeed, the researchers who originally developed the Type-D construct,
Denollet and colleagues have, in one paper, directly referred to it as a taxonomy [6],
but in other papers they have referred to it as a ‘tendency’. This notion of ‘tendency’
implies dimensionality and indeed others have described Type-D as consisting of ‘…
negative affectivity (NA) and social inhibition (SI) personality dimensions’ (p 235)
[7]. Whether Type-D is dimensional (i.e., distributed as a continuous variable, with
individuals varying quantitatively from each other) or taxonic (i.e., individuals are
differentiated into non-arbitrary groups or categories) has important clinical and
theoretical implications [8]. It has been argued that to explain dimensionality the
existence of multiple, additive causal factors that sum to produce quantitative
variation on the trait is the most plausible model [8]. This implies that clinicians and
researchers should utilize the full range of scores rather than the use of arbitrary
cutoffs [cf. 9] and the use of the full range of scores in research [cf. 10]
1
. By contrast,
for a categorical approach there is a need to explain the discontinuity between people.
This suggests a greater number of possibilities, including a single causal factor (e.g.,
genetic or threshold models) leading to a dichotomous outcomes or more complex
interacting systems such a environmental influences leading to developmental
1
While this should be generally true, a single cause is always a possibility.
- 4 –
Taxometrics of Type-D
bifurcation [8]. While exact mechanisms may not be clear at present the underlying
principle is that the existence of dimensional and taxonic models requires very
different theoretical accounts. Therefore, it is essential to test directly if Type-D is
taxonic or dimensional and this is the focus of this paper.
Evidence for the Dimensionality or Taxonicity Type-D
Recently, psychometric work using item response theory (IRT) was
interpreted as support for a categorical interpretation of Type-D using a cutoff score
of 10 on each of the two sub-scales (NA and SI) of the DS14 [11]. This interpretation
should be reconsidered. First, it has been argued that, mathematically, IRT methods
produce unidimensional factors and so lack the specificity necessary to determine
non-arbitrary cutoffs [12-13]. Second, this study only considered a single cutoff of 10
on each sub-scale. There is no way to know if this is the optimal cutoff for achieving
validity, or if a more reliable function may have been observed at other cutoffs. More
importantly, it should be noted that the original decision to define these cutoffs for
Type-D was based on the combination of cluster analysis and the use of median splits
rather than on theoretical considerations [4, 14].Cluster analysis is limited when it
comes to identifying taxons, as (1) it always produces sub-groups, and yet (2) there is
no way to establish the appropriate number of sub-groups [15]. Using median splits to
identify Type-D cases amounts essentially to using arbitrary cutoffs which others have
argued against as a basis for suggesting taxonicity [cf. 9].
The other type of evidence that could be offered to suggest that Type-D is
taxonic is based on the following argument: Using these cutoffs Type-D demonstrates
good prognostic outcomes. There is a large body of evidence showing that Type-D
cases differ from non-cases in terms of mortality [4], morbidity [1], biological
markers [16-18] physiological stress responses [19] and psychosocial factors [5, 20].
Citations
More filters
Journal Article•DOI•
Categories versus dimensions in personality and psychopathology: a quantitative review of taxometric research

[...]

Nick Haslam1, Elise Holland1, Peter Kuppens2•
University of Melbourne1, Katholieke Universiteit Leuven2
01 May 2012-Psychological Medicine
TL;DR: It is indicated that most latent variables of interest to psychiatrists and personality and clinical psychologists are dimensional, and that many influential taxonic findings of early taxometric research are likely to be spurious.
Abstract: Taxometric research methods were developed by Paul Meehl and colleagues to distinguish between categorical and dimensional models of latent variables. We have conducted a comprehensive review of published taxometric research that included 177 articles, 311 distinct findings and a combined sample of 533 377 participants. Multilevel logistic regression analyses have examined the methodological and substantive variables associated with taxonic (categorical) findings. Although 38.9% of findings were taxonic, these findings were much less frequent in more recent and methodologically stronger studies, and in those reporting comparative fit indices based on simulated comparison data. When these and other possible confounds were statistically controlled, the true prevalence of taxonic findings was estimated at 14%. The domains of normal personality, mood disorders, anxiety disorders, eating disorders, externalizing disorders, and personality disorders (PDs) other than schizotypal yielded little persuasive evidence of taxa. Promising but still not definitive evidence of psychological taxa was confined to the domains of schizotypy, substance use disorders and autism. This review indicates that most latent variables of interest to psychiatrists and personality and clinical psychologists are dimensional, and that many influential taxonic findings of early taxometric research are likely to be spurious.

474 citations

Journal Article•DOI•
A General Propensity to Psychological Distress Affects Cardiovascular Outcomes Evidence From Research on the Type D (Distressed) Personality Profile

[...]

Johan Denollet1, Angélique A. Schiffer, Viola Spek•
Tilburg University1
01 Sep 2010-Circulation-cardiovascular Quality and Outcomes
TL;DR: The authors provided a reliable estimate of the prognostic risk associated with Type D (distressed) personality, a general propensity to distress that is defined by high scores on the "negative affectivity" and "social inhibition" traits.
Abstract: Evidence Specific negative emotions have been related to adverse cardiac events, but a general propensity to psychological distress may also affect cardiovascular outcomes. In this summary article, we provide a reliable estimate of the prognostic risk associated with Type D (distressed) personality, a general propensity to distress that is defined by high scores on the “negative affectivity” and “social inhibition” traits. Quantitative analyses of prospective studies that included a total of 6121 patients with a cardiovascular condition indicated that Type D personality was associated with a more than 3-fold increased risk of adverse events (9 studies) and long-term psychological distress (11 studies). In addition, a narrative review of 29 studies showed that Type D personality and depression are distinct manifestations of psychological distress, with different and independent cardiovascular effects. There are also plausible biological and behavioral pathways that may explain this adverse effect of Type D personality. The findings reported in this summary article support the simultaneous use of specific and general measures of distress in cardiovascular research and practice. Depression, anxiety, anger, and posttraumatic stress are specific markers of distress that have been related to cardiac disorder,1,–,5 whereas broader markers of psychological distress have received substantially less attention in cardiovascular research.6 However, the general distress shared across these specific markers may predict the development of coronary heart disease1 and may also partly account for the association of depression and anxiety with myocardial infarction,3 poor cardiac prognosis,4 and autonomic cardiac dysregulation.7 Hence, the conceptual idea of psychological distress as a cardiovascular risk marker may be broadened to include a general propensity to distress. Many studies report on depression, anxiety, and cardiovascular outcomes.2,–,4 Although patients may go in and out of depressive and anxious episodes, there …

270 citations

Journal Article•DOI•
Association between type D personality and prognosis in patients with cardiovascular diseases: a systematic review and meta-analysis.

[...]

Gesine Grande1, Matthias Romppel1, Jürgen Barth2•
Leipzig University of Applied Sciences1, University of Bern2
12 Jan 2012-Annals of Behavioral Medicine
TL;DR: More recent method sound studies suggest that early type D studies had overestimated the prognostic relevance, and possible moderators of this association are suggested.
Abstract: Since 1995, the association of type D personality and mortality in patients with cardiovascular diseases has been increasingly investigated. The aim of this meta-analysis was to integrate conflicting results and to examine possible moderators of this association. Prospective studies assessing type D personality and hard endpoints were selected and pooled in meta-analyses. Cardiovascular diagnosis, type and quality of adjustment, and publication date were examined in moderator analyses. Twelve studies on patients with cardiovascular diseases (N = 5,341) were included. Pooled crude and adjusted effects demonstrated a significant association of type D personality and hard endpoints (odds ratio (OR) of 2.28 (95% CI [1.43–3.62]), adjusted hazard ratio (HR) of 2.24 (95% CI [1.37–3.66])). The OR decreased over time (OR 5.02 to OR 1.54). There was no association in congestive heart failure patients. More recent methodologically sound studies suggest that early type D studies had overestimated the prognostic relevance.

194 citations

Cites background from "A taxometric analysis of type-D per..."

  • ...Even for the type D measurement, a dimensional operationalization rather than a categorical structure is supported [59]....

    [...]

Journal Article•DOI•
Personality is of central concern to understand health: towards a theoretical model for health psychology

[...]

Eamonn Ferguson1•
University of Nottingham1
28 May 2013-Health Psychology Review
TL;DR: A theoretical framework to understand the links between personality and health drawing on current theorising in the biology, evolution, and neuroscience of personality is developed and argued that health psychology needs to move from its traditional focus on the individual level to engage group and organisational levels.
Abstract: This paper sets out the case that personality traits are central to health psychology. To achieve this, three aims need to be addressed. First, it is necessary to show that personality influences a broad range of health outcomes and mechanisms. Second, the simple descriptive account of Aim 1 is not sufficient, and a theoretical specification needs to be developed to explain the personality-health link and allow for future hypothesis generation. Third, once Aims 1 and 2 are met, it is necessary to demonstrate the clinical utility of personality. In this review I make the case that all three Aims are met. I develop a theoretical framework to understand the links between personality and health drawing on current theorising in the biology, evolution, and neuroscience of personality. I identify traits (i.e., alexithymia, Type D, hypochondriasis, and empathy) that are of particular concern to health psychology and set these within evolutionary cost-benefit analysis. The literature is reviewed within a three-level hierarchical model (individual, group, and organisational) and it is argued that health psychology needs to move from its traditional focus on the individual level to engage group and organisational levels.

173 citations

Journal Article•DOI•
Psychological processes and repeat suicidal behavior: a four-year prospective study.

[...]

Rory C. O'Connor1, Roger Smyth, Eamonn Ferguson2, Caoimhe Ryan3, J. Mark G. Williams4 •
University of Glasgow1, University of Nottingham2, University of St Andrews3, University of Oxford4
15 Jul 2013-Journal of Consulting and Clinical Psychology
TL;DR: Individually sensitive suicide risk processes like entrapment could usefully be targeted in treatment interventions to reduce the risk of repeat suicidal behavior in those who have been previously hospitalized after a suicide attempt.
Abstract: Objective: Although suicidal behavior is a major public health concern, understanding of individually sensitive suicide risk mechanisms is limited. In this study, the authors investigated, for the first time, the utility of defeat and entrapment in predicting repeat suicidal behavior in a sample of suicide attempters. Method: Seventy patients hospitalized after a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, defeat, and entrapment) while in hospital. Four years later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. Results: Over 4 years, 24.6% of linked participants were readmitted to hospital after a suicidal attempt. In univariate logistic regression analyses, defeat and entrapment as well as depression, hopelessness, past suicide attempts, and suicidal ideation all predicted suicidal behavior over this interval. However, in the multivariate analysis, entrapment and past frequency of suicide attempts were the only significant predictors of suicidal behavior. Conclusions: This longitudinal study supports the utility of a new theoretical model in the prediction of suicidal behavior. Individually sensitive suicide risk processes like entrapment could usefully be targeted in treatment interventions to reduce the risk of repeat suicidal behavior in those who have been previously hospitalized after a suicide attempt.

161 citations

Cites background from "A taxometric analysis of type-D per..."

  • ...…show the potential clinical applications of including entrapment as a key predictor of repeat suicide attempts; however, much more work is needed to show that these scales are indeed taxonic and that the cutoffs vary meaningfully with external criteria (see Ferguson, 2009; Ferguson et al., 2009)....

    [...]

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Journal Article•DOI•
DS14 : Standard assessment of negative affectivity, social inhibition, and Type D personality

[...]

Johan Denollet1•
Tilburg University1
01 Jan 2005-Psychosomatic Medicine
TL;DR: The DS14 is a brief, psychometrically sound measure of negative affectivity and social inhibition that could readily be incorporated in epidemiologic and clinical research.
Abstract: OBJECTIVE Type D personality-a joint tendency toward negative affectivity (NA) and social inhibition (SI)-is related to poor cardiac prognosis, but there is no standard for assessing Type D. This study reports on the Type D Scale-14 (DS14) as a standard measure of NA, SI, and Type D. METHODS The study included 3813 participants (2508 from the general population, 573 cardiac patients, 732 hypertension patients). They all filled out the DS14, containing 7-item NA and SI subscales; 275 subjects also completed the NEO-FFI, and 121 patients filled out the DS14 twice. RESULTS Factor analysis of the DS14 yielded 2 dominant traits; all of the NA and SI items loaded between 0.62 to 0.82 on their corresponding factor (N = 3678). The NA scale covered dysphoria, worry, and irritability; the SI scale covered discomfort in social interactions, reticence, and lack of social poise. The NA and SI scales were internally consistent (alpha = 0.88/0.86; N = 3678), stable over a 3-month period (test-retest r = 0.72/0.82) and not dependent on mood and health status (N = 121). NA correlated positively with neuroticism (r = 0.68); SI correlated negatively with extraversion (r = -0.59/-0.65). Scale-level factor analysis confirmed the construct validity of the DS14 against the NEO-FFI. Using a cutoff of 10 (NA > or =10 and SI > or =10), 1027 subjects (28%) were classified as Type D, 21% in the general population versus 28% in coronary heart disease and 53% in hypertension (p < or = .001). Age, sex, and Type D (odds ratio, 3.98; 95% confidence interval, 3.2-4.6; p <.0001) were independently associated with cardiovascular morbidity. CONCLUSION The DS14 is a brief, psychometrically sound measure of negative affectivity and social inhibition that could readily be incorporated in epidemiologic and clinical research.

1,323 citations

Journal Article•DOI•
Plate tectonics in the classification of personality disorder: shifting to a dimensional model.

[...]

Thomas A. Widiger1, Timothy J. Trull2•
University of Kentucky1, University of Missouri2
01 Feb 2007-American Psychologist
TL;DR: It may be time to consider a shift to a dimensional classification of personality disorder that would help address the failures of the existing diagnostic categories as well as contribute to an integration of the psychiatric diagnostic manual with psychology's research on general personality structure.
Abstract: The diagnostic categories of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders were developed in the spirit of a traditional medical model that considers mental disorders to be qualitatively distinct conditions (see, e.g., American Psychiatric Association, 2000). Work is now beginning on the fifth edition of this influential diagnostic manual. It is perhaps time to consider a fundamental shift in how psychopathology is conceptualized and diagnosed. More specifically, it may be time to consider a shift to a dimensional classification of personality disorder that would help address the failures of the existing diagnostic categories as well as contribute to an integration of the psychiatric diagnostic manual with psychology's research on general personality structure.

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Paul E. Meehl
01 Apr 1995-American Psychologist
TL;DR: Two taxometric procedures, MAMBAC and MAXCOV-HITMAX, provide independent tests of the taxonic conjecture and satisfactorily accurate estimates of theTaxon base rate, the latent means, and the valid and false-positive rates achievable by various cuts.
Abstract: Classification in psychopathology is a problem in applied mathematics; it answers the empirical question "Is the latent structure of these phenotypic indicator correlations taxonic (categories) or nontaxonic (dimensions, factors)?" It is not a matter of convention or preference. Two taxometric procedures, MAMBAC and MAXCOV-HITMAX, provide independent tests of the taxonic conjecture and satisfactorily accurate estimates of the taxon base rate, the latent means, and the valid and false-positive rates achievable by various cuts. The method requires no gold standard criterion, applying crude fallible diagnostic "criteria" only in the phase of discovery to identify plausible candidate indicators. Confidence in the inference to taxonic structure and numerical accuracy of latent values is provided by multiple consistency tests, hence the term coherent cut kinetics for the general approach. Further revision of diagnostic systems should be based on taxometric analysis rather than on committee decisions based on clinical impressions and nontaxometric research.

636 citations

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Frequently Asked Questions (10)
Q1. What have the authors contributed in "A taxometric analysis of type-d personality" ?

Denollet et al. this paper showed that Type-D personality is a predictor of long-term mortality in patients with coronary heart disease. 

Future theorizing and research examining the links between Type-D and cardiovascular disease should consider dimensional approaches in order to move this area of inquiry forward. 

The basic principle of Meehl’s taxomeric technique istermed ‘coherent cut kinetics’ where indictor variables are split into input and output variables. 

The idea that Type-D is a dimensional construct comes from the finding that anumber of individual differences theoretically and empirically related to the subcomponents of Type-D – worry, depression, anxiety – [14, 22-23] are dimensional [8]. 

Within the putative taxon and complement (using the recommended cutoffpoint of ≥ 10 on both NA and SI) the nuisance covariance for NA and SI for the taxon is .30 and for the complement it is -.09. 

the question addressed herein is about the latent-dimensional structure of Type D: if the construct is a general personality trait then its latent structure should be stable across populations. 

psychometric work using item response theory (IRT) wasinterpreted as support for a categorical interpretation of Type-D using a cutoff score of 10 on each of the two sub-scales (NA and SI) of the DS14 [11]. 

Similarly mean nuisance covariance for the 3 indicators in the MAXCOV analyses for the taxon and complement at 50 windows was .23 and .26 respectively; at 150 windows they were .23 and .20 and for 200 windows they were .11 and .24 respectively. 

Given the dimensional nature of Type-D these potential synergistic effects of Type-D should be tested using both additive and multiplicative regression terms [see 18]. 

Using median splits to identify Type-D cases amounts essentially to using arbitrary cutoffs which others have argued against as a basis for suggesting taxonicity [cf. 9].The other type of evidence that could be offered to suggest that Type-D istaxonic is based on the following argument: Using these cutoffs Type-D demonstrates good prognostic outcomes.